RESUMEN
AIM: To evaluate the diagnostic accuracy of whole-body (WB) magnetic resonance imaging (MRI) utilising three-dimensional (3D) short tau inversion recovery (STIR) and T1-weighted in/opposed-phase MRI in the detection of neuroblastoma bone marrow metastasis compared to 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET)/computed tomography (CT). MATERIALS AND METHODS: A prospective study of 20 consecutive histopathologically proven neuroblastoma patients enrolled in this study from January 2021 to August 2022. WB MRI and FDG-PET/CT were performed for all cases. Bone marrow biopsy served as the standard of reference. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy were calculated. In addition, lesion-by-lesion analysis was performed and the number of bone marrow metastatic lesions in different body segments using both imaging methods was recorded and compared. RESULTS: WB MRI correctly identified true positives and true negatives in all cases with a sensitivity and specificity of 100%. In contrast, FDG-PET/CT showed two false-negative cases that resulted in a sensitivity, specificity, PPV, NPV, and accuracy of 86.7%, 100%, 100%, 71.4%, and 92%, respectively. In the lesion-by-lesion analysis, WB MRI detected more (24.3%) bone marrow metastatic lesions than FDG-PET/CT. CONCLUSION: Whole-body MRI can reliably identify neuroblastoma bone marrow infiltration, and could be an alternative to PET/CT in that regard.
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Neoplasias de la Médula Ósea , Neoplasias Óseas , Neuroblastoma , Humanos , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Médula Ósea/diagnóstico por imagen , Médula Ósea/patología , Fluorodesoxiglucosa F18 , Estudios Prospectivos , Imagen por Resonancia Magnética/métodos , Neoplasias Óseas/secundario , Sensibilidad y Especificidad , Imagen de Cuerpo Entero/métodos , Biopsia , Neuroblastoma/diagnóstico por imagen , Neuroblastoma/patología , Estándares de Referencia , Neoplasias de la Médula Ósea/diagnóstico por imagen , Tomografía de Emisión de PositronesRESUMEN
BACKGROUND: Vascular rings are congenital vascular anomalies of the aortic arch complex which cause compression of the trachea and/or oesophagus. A variety of investigations may lead to diagnosis of these anomalies, including bronchoscopy and computed tomography. During the latter, image acquisition and processing use the multi-detector row technique and new reconstruction algorithms, producing high-resolution images which can be visualised as complex, three-dimensional renditions. OBJECTIVE: This study aimed to assess and compare the roles of bronchoscopy and multi-detector row computed tomography in the diagnosis of congenital vascular ring. PATIENTS AND METHODS: We included infants and children below the age of 16 years who presented with congenital vascular ring. All patients underwent rigid bronchoscopy under general anaesthesia, with spontaneous respiration. All computed tomography scans were obtained using a 16 multi-detector row computed tomography system, followed by data reconstruction on a three-dimensional workstation. RESULTS: Ten patients with congenital vascular ring were identified (six boys and four girls). Fifty per cent of cases presented within the first year of life. Double aortic arch was the most common anomaly (40 per cent). Bronchoscopy detected external tracheal compression in nine cases (90 per cent). Associated airway lesions were detected endoscopically in three cases. In contrast, multi-detector row computed tomography detected the vascular ring in all cases, with accurate detection of the compressing vessel; however, it did not detect any associated airway lesions. CONCLUSION: Bronchoscopy and radiological evaluation are essential for the diagnosis and pre-operative evaluation of congenital vascular ring. Multi-detector row computed tomography can provide more information about the nature of the disease, and can facilitate better communication between clinicians, compared with conventional computed tomography.
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Aorta Torácica/anomalías , Broncoscopía/métodos , Tomografía Computarizada por Rayos X/métodos , Malformaciones Vasculares/diagnóstico , Anciano , Obstrucción de las Vías Aéreas/diagnóstico , Obstrucción de las Vías Aéreas/etiología , Algoritmos , Preescolar , Tos/etiología , Cianosis/etiología , Femenino , Humanos , Imagenología Tridimensional/métodos , Lactante , Masculino , Valor Predictivo de las Pruebas , Ruidos Respiratorios/fisiopatología , Arteria Subclavia/anomalías , Tráquea/patología , Malformaciones Vasculares/complicacionesRESUMEN
PURPOSE: The purpose of this work was to describe the MR appearance of tears of the subscapularis tendon and compare the usefulness of different imaging planes as well as note the association of subscapularis tears with other rotator cuff tears and biceps tendon dislocations. METHOD: MR studies at 1.5 T over an 8 year interval were retrospectively assessed for the presence of a rotator cuff tear and/or tear of the subscapularis tendon. Images that showed a subscapularis tear were reviewed for the presence of a visible tear separately on the axial, coronal, and sagittal images. The MR studies were also evaluated for associated tears of the supraspinatus, infraspinatus, and teres minor muscles as well as biceps tendon dislocation and the "naked humerus sign" on coronal images. Last, clinical records and surgical reports were reviewed. RESULTS: Forty-five (2%) of 2,167 rotator cuff tears involved the subscapularis; 27% were partial and 73% were complete tears. Tears were best seen in the sagittal oblique plane. Almost all subscapularis tears were an extension of typical rotator cuff tears: supraspinatus in 35 patients (79%), extending into infraspinatus tears in 25 (56%) and into teres minor tears in 2 patients (4%). Bicipital dislocations were seen in 22 patients (49%), and three complete tears of the biceps (7%) were noted as well. The naked humerus sign was demonstrated in 31 patients (69%). Surgical reports that confirmed the MR findings were available for 15 patients. CONCLUSION: About 2% of rotator cuff tears involve the subscapularis tendon. Most subscapularis tears are extensions of supraspinatus tears and frequently involve the biceps tendon.
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Imagen por Resonancia Magnética , Lesiones del Manguito de los Rotadores , Manguito de los Rotadores/patología , Traumatismos de los Tendones/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Imagen por Resonancia Magnética/instrumentación , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Hombro/patología , Traumatismos de los Tendones/patologíaRESUMEN
PURPOSE: To determine if there is an association between wrist ganglia and internal derangements of the wrist joint by reviewing magnetic resonance (MR) images. MATERIALS AND METHODS: Two observers retrospectively reviewed MR images of the wrist obtained in 625 patients at 1.5 T for the presence of ganglia and associated triangular fibrocartilage complex, scapholunate ligamentous, or lunotriquetral ligamentous tears that were within 3 mm of the ganglion. When available, surgery and/or pathology records were reviewed. RESULTS: There were 122 ganglia and 37 internal derangements. Of the 22 ulnar-sided ganglia, 10 (45%) demonstrated associated triangular fibrocartilage complex tears. Of the 97 radial-sided ganglia, 27 (28%) demonstrated ligamentous tears related to the site of the ganglion. The radial-sided tears involved the radial aspect of the triangular fibrocartilage complex in 12 ganglia; the scapholunate ligament, in isolation, in eight ganglia; and both the triangular fibrocartilage complex and the scapholunate ligament in six ganglia. Only one of the ganglia demonstrated an associated lunotriquetral ligamentous tear. Surgical findings confirmed the ligamentous tears in 25 patients. CONCLUSION: Wrist ganglia are associated, not infrequently, with internal derangements of the wrist.
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Imagen por Resonancia Magnética , Quiste Sinovial/etiología , Traumatismos de la Muñeca/complicaciones , Articulación de la Muñeca/patología , Muñeca/patología , Humanos , Estudios Retrospectivos , Quiste Sinovial/patología , Traumatismos de la Muñeca/diagnósticoRESUMEN
This article provides a clear understanding of the pathophysiology of sinonasal inflammatory diseases and the rationale behind endoscopic surgery. Normal anatomy and pertinent anatomic variants that should be included in the radiology report are described. The relative role of CT and MR imaging in evaluation of inflammatory and neoplastic lesions is emphasized.
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Diagnóstico por Imagen , Enfermedades de los Senos Paranasales/diagnóstico , Senos Paranasales/anatomía & histología , Endoscopía , Humanos , Imagen por Resonancia Magnética , Depuración Mucociliar/fisiología , Enfermedades de los Senos Paranasales/fisiopatología , Enfermedades de los Senos Paranasales/cirugía , Neoplasias de los Senos Paranasales/diagnóstico , Senos Paranasales/fisiología , Senos Paranasales/cirugía , Sinusitis/diagnóstico , Sinusitis/fisiopatología , Sinusitis/cirugía , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: The aim of this study was to define the MR imaging criteria for normal and abnormal retrocalcaneal bursae. SUBJECTS AND METHODS: Fifty ankles in 25 asymptomatic volunteers and 30 ankles in patients with Achilles tendon disorders underwent MR imaging. Increased signal intensity consistent with fluid or synovium outlining the retrocalcaneal bursa was measured. RESULTS: Of 80 bursae, 77 (96%) had measurable fluid or synovial signal intensity revealed by MR imaging. Asymptomatic volunteers had average bursal dimensions of 1 mm in the anteroposterior dimension, 6 mm in the transverse dimension, and 3 mm in the craniocaudal dimension. Bursal dimensions greater than 1 mm, 11 mm, or 7 mm, respectively, were not seen in asymptomatic subjects but were seen in 16 (53%) of 30 ankles of patients with Achilles tendon disorders. CONCLUSION: On MR imaging, the asymptomatic retrocalcaneal bursa normally contains detectable high-signal-intensity fluid or synovium or both. A bursa larger than 1 mm anteroposteriorly, 11 mm transversely, or 7 mm craniocaudally is abnormal.
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Articulación del Tobillo/anatomía & histología , Bolsa Sinovial/anatomía & histología , Calcáneo/anatomía & histología , Imagen por Resonancia Magnética , Tendón Calcáneo/lesiones , Tendón Calcáneo/patología , Adulto , Anciano , Análisis de Varianza , Articulación del Tobillo/patología , Bolsa Sinovial/patología , Bursitis/diagnóstico , Bursitis/patología , Calcáneo/patología , Enfermedad Crónica , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Estudios Retrospectivos , Rotura , Líquido Sinovial , Tendinopatía/diagnóstico , Tendinopatía/patologíaRESUMEN
OBJECTIVE: To determine the frequency of lumbar intervertebral disc vacuum clefts demonstrating high signal intensity on T2-weighted magnetic resonance (MR) images. DESIGN AND PATIENTS: MR images of the lumbosacral spine of 100 patients with radiographic evidence of the lumbar intervertebral disc vacuum phenomenon were retrospectively studied for the signal pattern of the intervertebral disc vacuum clefts. RESULTS AND CONCLUSION: Twelve of the reviewed MR studies demonstrated high signal intensity of the vacuum clefts on long TR and TE sequences while the remaining 88 cases demonstrated the vacuum as signal void on both T1- and T2-weighted images. It is concluded that vacuum clefts not infrequently show high T2 signal intensity.
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Disco Intervertebral/patología , Vértebras Lumbares/patología , Imagen por Resonancia Magnética , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Enfermedades de la Columna Vertebral/diagnósticoRESUMEN
PURPOSE: Our goal was to define the utility of contrast-enhanced MRI in the diagnosis of occult muscle injuries on T2 and STIR sequences. METHOD: We retrospectively reviewed the pre- and postcontrast MR studies of four professional athletes with a clinical diagnosis of suspected muscle injuries. RESULTS: The four cases demonstrated muscle strain injuries not visualized on the conventional T2 and STIR sequences but visualized on the postcontrast MR studies as areas of localized enhancement. CONCLUSION: We recommend the intravenous administration of gadolinium in the setting of clinically suspected muscle injuries not visualized on T2 and STIR sequences.
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Traumatismos en Atletas/diagnóstico , Medios de Contraste , Imagen por Resonancia Magnética , Músculo Esquelético/lesiones , Adulto , Humanos , Masculino , Estudios RetrospectivosRESUMEN
PURPOSE: To demonstrate the signal characteristics of subcutaneous rheumatoid nodules in correlation to their histopathologic features. METHOD: The magnetic resonance imaging (MRI) features of biopsy proven subcutaneous rheumatoid nodules are described in five patients with rheumatoid arthritis established by classic criteria. RESULTS: Two morphologic appearances of rheumatoid nodules were observed on MRI: one predominantly cystic, with enhancing peripheral component; and a second type which is predominantly solid, with uniform enhancement following gadolinium injection. CONCLUSION: Subcutaneous rheumatoid nodules can appear by MR as solid, cystic, or a combination of both components. This closely correlates with their histopathologic evolution.