Acta radiologica open最新文献_第8页

Pseudohemothorax induced by residual contrast medium mimicking aortic dissection rupture 残余造影剂诱发假性血胸，模拟主动脉夹层破裂

Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Acta radiologica open

Pub Date : 2022-04-01 DOI: 10.1177/20584601221097468

K. Okamura, R. Yoshida, T. Yoshizako, H. Kitagaki

Hemothorax is an urgent condition, and its accurate diagnosis and the identification of the cause are important. Herein, we report a case of a 74-year-old man with end-stage renal disease who was presented with high-concentration pleural effusion owing to residual contrast medium. The case required differentiation from hemothorax owing to an aortic dissection and its rupture. In patients with end-stage renal disease, noncontrast-enhanced computed tomography after contrast-enhanced computed tomography may result in high-concentration pleural effusion owing to the existence of residual contrast medium. This realization is important to determine whether high-concentration pleural effusion symptoms reflect an urgent hemothorax case possibly related to an imminent rupture of an aortic aneurysm or intrathoracic penetration of aortic dissection, and whether invasive procedures, such as thoracentesis, ought to be avoided.

血胸是一种紧急情况，其准确诊断和病因鉴定至关重要。在此，我们报告了一例74岁的终末期肾病患者，他因残留造影剂而出现高浓度胸腔积液。由于主动脉夹层及其破裂，该病例需要与血胸鉴别。在终末期肾病患者中，由于残留造影剂的存在，在增强计算机断层扫描后进行非增强计算机断层摄影可能会导致高浓度胸腔积液。这一认识对于确定高浓度胸腔积液症状是否反映了可能与主动脉瘤即将破裂或主动脉夹层胸腔内穿透有关的紧急血胸病例，以及是否应避免胸腔穿刺等侵入性手术至关重要。

引用次数: 0

Bi-parametric MRI/TRUS fusion targeted repeat biopsy after systematic 10-12 core TRUS-guided biopsy reveals more significant prostate cancer especially in anteriorly located tumors. 系统性10-12核TRUS引导活检后的双参数MRI/TRUS融合靶向重复活检显示更显著的前列腺癌症，尤其是位于前方的肿瘤

IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Acta radiologica open

Pub Date : 2022-03-31 eCollection Date: 2022-03-01 DOI: 10.1177/20584601221085520

Michael Häggman, Pär Dahlman, Mats Ahlberg, Per Liss, Rafaele Cantera Ahlman, Anca Dragomir, Sam Ladjevardi

Background: MRI and fusion guided biopsy have an increased role in the diagnosis of prostate cancer.

Purpose: To demonstrate the possible advantages with Bi-parametric MRI fusion-guided repeat biopsy over systematic 10-12-core biopsy for the diagnosis of prostate cancer.

Material and methods: Four hundred and twenty-three consecutive men, with previous systematic 10-12-core TRUS-guided biopsy, and with suspicion of, or diagnosis of, low-risk prostate cancer underwent fusion-guided prostate biopsy between February 2015 and February 2017. The material was retrospectively assessed. In 220 cases no previous cancer was diagnosed, and in 203 cases confirmatory fusion guided biopsy was performed prior to active monitoring. MRI was classified according to PI-RADS. Systematic biopsy was compared to fusion guided biopsy for the detection of cancer, and PI-RADS was compared to the Gleason score.

Results: Fusion guided biopsy detected significantly more cancers than systematic (p < .001). Gleason scores were higher in the fusion biopsy group (p < .001). Anterior tumors were present in 54% of patients. Fusion biopsy from these lesions showed cancer in 53% with previously negative biopsy in systematic biopsies and 66% of them were upgraded from low risk to intermediate or high-risk cancers.

Conclusion: These results show superior detection rate and grading of bi-parametric MRI/TRUS fusion targeted repeat biopsy over systematic 10-12 core biopsies. Fusion guided biopsy detects more significant cancers despite using fewer cores. The risk group was changed for many patients initially selected for active surveillance due to upgrading of tumors. Bi-parametric MRI shows promising results in detecting anterior tumors in patients with suspected prostate cancer.

背景MRI和融合引导活检在诊断癌症中的作用越来越大。目的证明在诊断癌症时，双参数MRI融合引导重复活检优于系统10–12核活检的可能优势。材料和方法在2015年2月至2017年2月期间，连续423名男性，之前有系统的10-12核心TRUS引导活检，怀疑或诊断为低风险前列腺癌症，接受了融合引导前列腺活检。对材料进行了回顾性评估。在220例病例中，没有诊断出以前的癌症，在203例病例中在积极监测之前进行了验证性融合引导活检。MRI根据PI-RADS进行分类。将系统活组织检查与融合引导活组织检查进行比较，以检测癌症，并将PI-RADS与Gleason评分进行比较。结果融合引导活检发现的癌症明显多于系统性（p＜0.001）。融合活检组的Gleason评分更高（p＜.001）。54%的患者存在前部肿瘤。这些病变的融合活组织检查显示，53%的患者患有癌症，之前系统活组织检查呈阴性，66%的患者从低风险癌症升级为中风险或高风险癌症。结论这些结果表明，与系统的10-12核心活检相比，双参数MRI/TRUS融合靶向重复活检的检出率和分级更高。尽管使用较少的核心，但融合引导的活检可以检测到更显著的癌症。由于肿瘤升级，许多最初选择进行主动监测的患者的风险组发生了变化。双参数MRI在检测疑似前列腺癌症患者的前部肿瘤方面显示出有希望的结果。

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引用次数: 0

Effectiveness of radiofrequency ablation versus transarterial chemoembolization for recurrent hepatocellular carcinoma: A meta-analysis 射频消融与经动脉化疗栓塞治疗复发性肝癌的有效性:一项荟萃分析

Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Acta radiologica open

Pub Date : 2022-03-01 DOI: 10.1177/20584601221085514

Haoxian Gou, Sheng Liu, Gang Zhu, Yisheng Peng, Xinkai Li, Xiao-li Yang, K. He

Background Both transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) are effective methods for the treatment of recurrent hepatocellular carcinoma (RHCC). Thus far, it is unclear which method is more satisfactory in short- and long-term survival benefits. Purpose To compare the overall survival (OS) and complications of TACE and RFA used for the management of RHCC. Material and Methods A literature search was carried out using PubMed, the Cochrane Library and, Embase databases, and Google Scholar, keywords including “RHCC,” “TACEC,” and “RFA” with a cutoff date of 30 April 2021. Used Review Manager software was to calculate short- and long-term OS. The clinical outcomes are major complications and complete response (CR). Results Finally, nine clinical trials met the research standard, including 1326 subjects, of which 518 received RFA and 808 received TACE. The analysis showed that patients who underwent RFA had significantly higher 1-, 3-, and 5-year OS (OR1-year = 1.92, 95% confidence interval (CI) = 1.27–2.91, p = .002; OR3-year = 1.64, 95% CI = 1.30–2.08, p <.0001; OR5-year = 3.22, 95% CI = 1.34–7.72, p=.009). Besides, the patients who chose RFA had an obvious higher rate of CR than those receiving TACE (OR = 33.75, 95% CI = 1.73–658.24, p = .002). However, the major complications were consistency between these two groups. Conclusion Our study discovered that RFA had greater CR and incidence in both the short-term and long-term OS than TACE. In addition, obvious difference was not found in major complications in these two methods.

背景经动脉化疗栓塞（TACE）和射频消融（RFA）是治疗复发性肝细胞癌（RHCC）的有效方法。到目前为止，尚不清楚哪种方法在短期和长期生存效益方面更令人满意。目的比较TACE和RFA治疗RHCC的总生存率（OS）和并发症。材料和方法使用PubMed、Cochrane Library和Embase数据库以及Google Scholar进行文献检索，关键词包括“RHCC”、“TACEC”和“RFA”，截止日期为2021年4月30日。使用Review Manager软件计算短期和长期OS。临床结果为主要并发症和完全缓解（CR）。结果9项临床试验符合研究标准，包括1326例受试者，其中518例接受RFA，808例接受TACE。分析显示，接受RFA的患者具有显著更高的1年、3年和5年OS（OR1年=1.92，95%置信区间（CI）=1.27-2.91，p=0.002；OR3年=1.64，95%CI=1.30-2.08，p<.0001；OR5年=3.22，95%CI=1.34-7.72，p=0.009）。此外，选择RFA的患者的CR率明显高于接受TACE的患者（OR=33.75，95%CI=1.73-658.24，p=0.002）。然而，主要并发症是这两组之间的一致性。结论RFA在短期和长期OS中的CR和发生率均高于TACE。此外，两种方法在主要并发症方面没有发现明显差异。

{"title":"Effectiveness of radiofrequency ablation versus transarterial chemoembolization for recurrent hepatocellular carcinoma: A meta-analysis","authors":"Haoxian Gou, Sheng Liu, Gang Zhu, Yisheng Peng, Xinkai Li, Xiao-li Yang, K. He","doi":"10.1177/20584601221085514","DOIUrl":"https://doi.org/10.1177/20584601221085514","url":null,"abstract":"Background Both transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) are effective methods for the treatment of recurrent hepatocellular carcinoma (RHCC). Thus far, it is unclear which method is more satisfactory in short- and long-term survival benefits. Purpose To compare the overall survival (OS) and complications of TACE and RFA used for the management of RHCC. Material and Methods A literature search was carried out using PubMed, the Cochrane Library and, Embase databases, and Google Scholar, keywords including “RHCC,” “TACEC,” and “RFA” with a cutoff date of 30 April 2021. Used Review Manager software was to calculate short- and long-term OS. The clinical outcomes are major complications and complete response (CR). Results Finally, nine clinical trials met the research standard, including 1326 subjects, of which 518 received RFA and 808 received TACE. The analysis showed that patients who underwent RFA had significantly higher 1-, 3-, and 5-year OS (OR1-year = 1.92, 95% confidence interval (CI) = 1.27–2.91, p = .002; OR3-year = 1.64, 95% CI = 1.30–2.08, p <.0001; OR5-year = 3.22, 95% CI = 1.34–7.72, p=.009). Besides, the patients who chose RFA had an obvious higher rate of CR than those receiving TACE (OR = 33.75, 95% CI = 1.73–658.24, p = .002). However, the major complications were consistency between these two groups. Conclusion Our study discovered that RFA had greater CR and incidence in both the short-term and long-term OS than TACE. In addition, obvious difference was not found in major complications in these two methods.","PeriodicalId":72063,"journal":{"name":"Acta radiologica open","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42220934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Sensitivity of DECT in ACL tears. A prospective study with arthroscopy as reference method DECT对ACL撕裂的敏感性。关节镜作为参考方法的前瞻性研究

Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Acta radiologica open

Pub Date : 2022-03-01 DOI: 10.1177/20584601221075799

Ann-Sofi Björkman, H. Gauffin, A. Persson, S. Koskinen

Background CT is often used for fracture evaluation following knee trauma and to diagnose ACL injuries would also be valuable. Purpose To investigate the diagnostic accuracy of dual energy CT (DECT) for detection of ACL tears in acute and subacute knee injuries. Material and Methods Patients with suspected ACL injury were imaged with DECT and MRI. Clinically blinded DECT images were independently read twice by two radiologists. ACL was classified as normal or abnormal. Arthroscopy served as reference method. Sensitivity and positive predictive value (PPV) were calculated, and diagnostic performance between DECT and MRI was assessed. Results 48 patients (26 M, 22 F, mean age 23 years, range 15–37 years) were imaged with a mean of 25 days following trauma. Of these, 21 patients underwent arthroscopy with a mean of 195 days after trauma. Arthroscopy revealed 19 ACL tears and 2 ACLs with no tear. The combined sensitivity was 76.3% (95% CI 66.8–85.9) and 86.8 (95% CI 71.9–95.6) for DECT and MRI, respectively. There was no statistically significant difference between these two methods (p = .223). The positive predictive value (PPV) was 93.5 (95% CI 84.3–98.2) and 91.7 (95% CI 77.5–98.3) for DECT and MRI, respectively. Conclusion DECT has lower sensitivity to detect an ACL rupture than MRI, but the difference is not statistically significant. The PPV is high in both methods.

背景CT通常用于膝关节创伤后的骨折评估，诊断ACL损伤也很有价值。目的探讨双能CT（DECT）对急性和亚急性膝关节损伤前交叉韧带撕裂的诊断准确性。材料与方法对疑似ACL损伤的患者进行DECT和MRI检查。临床盲法DECT图像由两名放射科医生独立读取两次。ACL分为正常或异常。关节镜检查作为参考方法。计算敏感性和阳性预测值（PPV），并评估DECT和MRI之间的诊断性能。结果48名患者（26M，22F，平均年龄23岁，范围15-37岁）在创伤后平均25天内进行了成像。其中，21名患者在创伤后平均195天接受了关节镜检查。关节镜检查显示19个ACL撕裂，2个ACL无撕裂。DECT和MRI的综合灵敏度分别为76.3%（95%CI 66.8-85.9）和86.8（95%CI 71.9-95.6）。这两种方法之间没有统计学上的显著差异（p=.223）。DECT和MRI的阳性预测值（PPV）分别为93.5（95%CI 84.3–98.2）和91.7（95%CI 77.5–98.3）。结论DECT检测ACL断裂的敏感性低于MRI，但差异无统计学意义。两种方法的PPV都很高。

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引用次数: 0

Inverted intercostal hernia of elastofibroma dorsi mimicking well-differentiated liposarcoma in the chest wall 与胸壁高分化脂肪肉瘤相似的背弹性纤维瘤的内翻性肋间疝

Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Acta radiologica open

Pub Date : 2022-03-01 DOI: 10.1177/20584601221080514

R. Yoshida, T. Yoshizako, K. Okamura, Shinji Ando, Megumi Nakamura, N. Ishikawa, H. Kitagaki

Elastofibroma dorsi is a well-known benign chest wall tumor. Herein, we present a case in which an elastofibroma protruded into the thoracic cavity, leading to inverted intercostal hernia. Imaging revealed a soft tissue mass containing fat, typical of elastofibroma dorsi; however, precise diagnosis was difficult owing to the location of this mass that protruded into the thoracic cavity. Liposarcoma had to be ruled out because it was a growing fat-containing mass. Considering that the tumor moved while the patient was undergoing computed tomography-guided biopsy in the prone position, a diagnosis of inverted intercostal hernia of elastofibroma dorsi was made. We report this case with a review of current literature.

背部弹力纤维瘤是一种众所周知的良性胸壁肿瘤。在此，我们报告一例弹性纤维瘤突入胸腔，导致肋间倒疝。影像显示一个含有脂肪的软组织肿块，典型的背部弹性纤维瘤；然而，由于这个突出到胸腔的肿块的位置，精确诊断是困难的。必须排除脂肪瘤，因为它是一个生长中的含脂肪肿块。考虑到肿瘤在患者俯卧位接受计算机断层扫描引导的活检时发生了移动，诊断为背部弹性纤维瘤倒肋间疝。我们通过对现有文献的回顾来报道这一案例。

引用次数: 1

Do the variations in ROI placement technique have influence for prostate ADC measurements? ROI放置技术的变化对前列腺ADC测量有影响吗?

Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Acta radiologica open

Pub Date : 2022-03-01 DOI: 10.1177/20584601221086500

Yoshiko Ueno, T. Tamada, K. Sofue, Y. Urase, N. Hinata, M. Fujisawa, Takamichi Murakami

Background Prostate apparent diffusion coefficient (ADC) values calculated from diffusion-weighted imaging have been used for evaluating prostate cancer (PCa) aggressiveness. However, the way of measuring ADC values has varied depending on the study. Purpose To investigate inter- and intra-reader variability and diagnostic performance of three kinds of shaped 2D regions of interests (ROIs) for tumor ADC measurements in PCa. Material and Methods Seventy-four patients with PCa undergoing 3-T MRI before surgery were included. Histologic findings from radical prostatectomy specimens were reviewed to define each patient’s dominant tumor. Three readers independently measured the tumor ADCs using three different ROI methods: freehand, large-circle, and small-circles ROIs. Readers repeated measurements after 3 weeks. Bland-Altman analysis was performed to evaluate the inter- and intra-reader variability. Receiver Operating Characteristic analysis was used for assessment of tumor aggressiveness for PCa. Results For intra-reader and inter-reader variability, the mean coefficient of repeatability for freehand ROIs, large-circle ROIs, and small-circles ROIs were as follows: 13.7%, 12.4%, and 11.5%; 9.4%, 9.7%, and 9.5%. For differentiating Gleason score (GS) = 3 + 3 from GS ≥ 3 + 4 tumors, the area under the curves were 0.90 for freehand ROIs, 0.89 for large-circle ROIs, and 0.94 small-circles ROIs (p = 0.31). Conclusion The variations in ROI method did not have a major influence on intra-reader or inter-reader reproducibility or diagnostic performance for prostate ADC measurements.

背景通过扩散加权成像计算的前列腺表观扩散系数（ADC）值已用于评估前列腺癌症（PCa）的侵袭性。然而，测量ADC值的方式因研究而异。目的研究三种形状的二维感兴趣区域（ROI）在前列腺癌中用于肿瘤ADC测量的读卡器间和读卡器内变异性和诊断性能。材料与方法74例前列腺癌患者术前接受3-T MRI检查。对根治性前列腺切除术标本的组织学检查结果进行回顾，以确定每位患者的主要肿瘤。三位读者使用三种不同的ROI方法独立测量肿瘤ADC：徒手、大圆和小圆ROI。读者在3周后重复测量。Bland-Altman分析用于评估读者之间和读者内部的变异性。受试者操作特征分析用于评估前列腺癌的肿瘤侵袭性。结果对于读者内部和读者之间的变异性，徒手ROI、大圆ROI和小圆ROI的平均重复系数分别为：13.7%、12.4%和11.5%；9.4%、9.7%和9.5%。对于区分Gleason评分（GS）=3+3和GS≥3+4的肿瘤，徒手ROI的曲线下面积为0.90，大圆ROI为0.89，小圆ROI为0.94（p=0.31）。结论ROI方法的变化对前列腺ADC测量的阅读器内或阅读器间再现性或诊断性能没有重大影响。

{"title":"Do the variations in ROI placement technique have influence for prostate ADC measurements?","authors":"Yoshiko Ueno, T. Tamada, K. Sofue, Y. Urase, N. Hinata, M. Fujisawa, Takamichi Murakami","doi":"10.1177/20584601221086500","DOIUrl":"https://doi.org/10.1177/20584601221086500","url":null,"abstract":"Background Prostate apparent diffusion coefficient (ADC) values calculated from diffusion-weighted imaging have been used for evaluating prostate cancer (PCa) aggressiveness. However, the way of measuring ADC values has varied depending on the study. Purpose To investigate inter- and intra-reader variability and diagnostic performance of three kinds of shaped 2D regions of interests (ROIs) for tumor ADC measurements in PCa. Material and Methods Seventy-four patients with PCa undergoing 3-T MRI before surgery were included. Histologic findings from radical prostatectomy specimens were reviewed to define each patient’s dominant tumor. Three readers independently measured the tumor ADCs using three different ROI methods: freehand, large-circle, and small-circles ROIs. Readers repeated measurements after 3 weeks. Bland-Altman analysis was performed to evaluate the inter- and intra-reader variability. Receiver Operating Characteristic analysis was used for assessment of tumor aggressiveness for PCa. Results For intra-reader and inter-reader variability, the mean coefficient of repeatability for freehand ROIs, large-circle ROIs, and small-circles ROIs were as follows: 13.7%, 12.4%, and 11.5%; 9.4%, 9.7%, and 9.5%. For differentiating Gleason score (GS) = 3 + 3 from GS ≥ 3 + 4 tumors, the area under the curves were 0.90 for freehand ROIs, 0.89 for large-circle ROIs, and 0.94 small-circles ROIs (p = 0.31). Conclusion The variations in ROI method did not have a major influence on intra-reader or inter-reader reproducibility or diagnostic performance for prostate ADC measurements.","PeriodicalId":72063,"journal":{"name":"Acta radiologica open","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44799516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

TMJ contrast enhancement in CBCT images using a new algorithm. 一种新的CBCT图像TMJ对比度增强算法。

Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Acta radiologica open

Pub Date : 2022-02-17 eCollection Date: 2022-01-01 DOI: 10.1177/20584601221074565

María Florinda Otero, Pablo García Tahoces, Antonio Mera, Jorge Mira

Magnetic resonance imaging (MRI) is considered the gold standard to reliably diagnose inflammation in the temporomandibular joint (TMJ) of patients with juvenile idiopathic arthritis (JIA). However, even MRI imaging is dependent on the familiarity of the radiologist with the normal appearance of the TMJ; therefore, new approaches are needed. Our purpose here is to improve imaging quality of cone beam computed tomography (CBCT) as a tool to help in the diagnosis of JIA in the TMJ. We have designed and applied a filter (the Stacking Enhancement Filter) over a stock of CBCT images from the TMJs of two patients with JIA. We then made a visual comparison of the results with archival images from MRI of the same patients, to show that the filter substantially improves the visual quality of the image. The work on the image contrast and the increase of the difference of appearance between tissues of different densities (all the anatomical structures that are present within the joint) leads to an improvement of the resulting images of the TMJ without the use of a chemical contrast agent. We conclude that CBCT could be used as a filter tool for the analysis of the TMJs affected by arthritis. Our image processing technique yields images that possible improve the range of use of CBCT.

磁共振成像(MRI)被认为是可靠诊断幼年特发性关节炎(JIA)患者颞下颌关节(TMJ)炎症的金标准。然而，即使是MRI成像也依赖于放射科医生对TMJ正常外观的熟悉程度;因此，需要新的方法。我们的目的是提高锥形束计算机断层扫描(CBCT)的成像质量，以帮助诊断颞下颌关节的JIA。我们设计并应用了一个滤波器(堆叠增强滤波器)，对来自两名JIA患者tmj的CBCT图像进行处理。然后，我们将结果与同一患者的核磁共振成像档案图像进行了视觉比较，以表明过滤器大大提高了图像的视觉质量。在图像对比度和不同密度的组织(关节内存在的所有解剖结构)之间外观差异的增加方面的工作导致在不使用化学造影剂的情况下改善TMJ的最终图像。我们认为CBCT可以作为一种过滤工具来分析受关节炎影响的颞下颌关节。我们的图像处理技术产生的图像可能会提高CBCT的使用范围。

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引用次数: 1

MRI interobserver reliability in rectal tumor angulation 直肠肿瘤角度的MRI观察者间可靠性

Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Acta radiologica open

Pub Date : 2022-02-01 DOI: 10.1177/20584601221081292

M. Pedersen, P. Otto, H. Precht, S. Rafaelsen

Background When rectal tumors are examined using magnetic resonance imaging (MRI) the perpendicular angulation of the axial T2-weighted image to the tumor axis is essential for a correct measure of the shortest distance between tumor and mesorectal facia. Purpose The purpose of this study was to determine the interobserver variability in rectal tumor angulation between a radiologist and a radiographer. Material and Methods Two observers performed the angulation independently. All MRI examinations were performed using an MRI 1.5 Tesla unit. A Bland–Altman plot was used to assess the interobserver variance and Intraclass correlation coefficient (ICC) statistic was used to assess the interobserver reliability. Results MRI was performed in 55 patients with rectal cancer during a one-year period (25 (45.5%) women and 30 (54.5%) men). The median age was 71 years (range 46–87 years). The rectal tumor mean length was 3.9 cm. The interobserver reliability was good (ICC = 0.83, 95% confidence interval 0.72–0.90). Conclusion Radiographers receiving training will be able to perform MRI rectal tumor angulation.

背景:当使用磁共振成像(MRI)检查直肠肿瘤时，轴向t2加权图像与肿瘤轴的垂直角度对于正确测量肿瘤与肠系膜表面之间的最短距离至关重要。目的本研究的目的是确定在放射科医生和放射技师之间观察直肠肿瘤成角的变异性。材料与方法两名观察员独立进行成角。所有MRI检查均使用MRI 1.5特斯拉设备进行。采用Bland-Altman图评估观察者间方差，采用class内相关系数(ICC)统计量评估观察者间信度。结果55例直肠癌患者1年内行MRI检查，其中女性25例(45.5%)，男性30例(54.5%)。中位年龄为71岁(46-87岁)。直肠肿瘤平均长度为3.9 cm。观察者间信度良好(ICC = 0.83, 95%置信区间0.72-0.90)。结论经过培训的放射技师能够进行MRI直肠肿瘤成角检查。

引用次数: 3

1H-MR spectroscopy in grading of cerebral glioma: A new view point, MRS image quality assessment 磁共振成像在脑胶质瘤分级中的应用:磁共振成像质量评价的新视角

Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Acta radiologica open

Pub Date : 2022-02-01 DOI: 10.1177/20584601221077068

Tahir M Shakir, Liang Fengli, Guo Chenguang, N. Chen, Ming Zhang, Mai Shaohui

Background Noninvasive preoperative prediction of histological grading is essential for clinical management of cerebral glioma. Purpose This study aimed to investigate the association between the image quality assessment of 1H magnetic resonance spectroscopy and accurate grading of glioma. Materials and Methods 98 glioma patients confirmed by pathology were retrospectively recruited in this single-center study. All patients underwent 1H-MRS examination at 3.0T before surgery. According to WHO standards, all cases were divided into two groups: low-grade glioma (grade I and II, 48 cases) and high-grade glioma (grades III and IV, 50 cases). The metabolite ratios in both grades were calculated before and after image quality assessment. The area under the receiver operating characteristic (ROC) curve was used to evaluate the capacity of each ratio in glioma grading. Results The Cho/Cr, Cho/NAA and NAA/Cr metabolite ratios had certain differences in each glioma group before and after MRS image quality assessment. In the low-grade glioma group, there was a dramatic difference in the Cho/Cr ratio before and after image quality assessment (p = 0.011). After MRS image quality assessment, the accuracy of glioma grading was significantly improved. The Cho/Cr ratio with 83.3% sensitivity and 93.7% specificity is the best index of glioma grading, with the optimal cutoff value of the Cho/Cr ratio being 3.72. Conclusion The image quality of MRS does affect the metabolite ratios and the results of glioma grading. MRS image quality assessment can observably improve the accuracy rate of glioma grading. The Cho/Cr ratio has the best diagnostic performance in differentiating high-grade from low-grade glioma.

背景无创的术前组织学分级预测对脑胶质瘤的临床治疗至关重要。目的本研究旨在探讨1H核磁共振波谱图像质量评估与胶质瘤准确分级之间的关系。材料与方法对98例经病理证实的胶质瘤患者进行回顾性研究。所有患者在术前3.0T进行1H-MRS检查。根据世界卫生组织标准，将所有病例分为两组：低级别神经胶质瘤（Ⅰ、Ⅱ级，48例）和高级别神经胶质癌（Ⅲ、Ⅳ级，50例）。在图像质量评估前后计算两个级别的代谢物比率。受试者工作特性（ROC）曲线下面积用于评估神经胶质瘤分级中每个比率的能力。结果MRS图像质量评价前后各组脑胶质瘤的Cho/Cr、Cho/NAA和NAA/Cr代谢产物比值存在一定差异。在低级别胶质瘤组中，图像质量评估前后的Cho/Cr比率有显著差异（p=0.011）。MRS图像质量评估后，胶质瘤分级的准确性显著提高。Cho/Cr比值灵敏度为83.3%，特异性为93.7%，是胶质瘤分级的最佳指标，Cho/Cr比的最佳截断值为3.72。结论MRS的图像质量影响代谢产物的比例和胶质瘤分级结果。MRS图像质量评估可以显著提高胶质瘤分级的准确率。Cho/Cr比值在区分高级别和低级别胶质瘤方面具有最佳的诊断性能。

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引用次数: 3

Subclinical involvement of the trunk muscles in idiopathic inflammatory myopathies 特发性炎性肌病中躯干肌肉的亚临床累及

Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Acta radiologica open

Pub Date : 2022-02-01 DOI: 10.1177/20584601221075796

N. Matsuda, Shunsuke Kobayashi, O. Hasegawa, K. Yoshida, H. Kubo, Y. Ugawa, K. Kanai

Background Whole-body magnetic resonance imaging (WB-MRI) is a useful tool for revealing the disease-specific distribution of affected muscles and clinically asymptomatic muscle involvements in idiopathic inflammatory myopathies (IIMs). Purpose To examine inflammatory changes in the systemic skeletal muscles, including the thoracoabdominal trunk, in IIMs using WB-MRI. Material and Methods We prospectively obtained WB-MRI axial images from 10 patients with IIMs, including antisynthetase syndrome (ASS), immune-mediated necrotizing myopathy (IMNM), sporadic inclusion body myositis, and myopathy associated with antimitochondrial antibody. We evaluated 108 systemic skeletal muscles in short-tau inversion recovery (STIR) images and rated changes in signal intensity using a semiquantitative scale. Correlations between STIR sum score, peak creatine kinase (CK) and muscle strength were examined. We also investigated the correlation between STIR sum score within the thoracoabdominal trunk and forced vital capacity. Results High STIR signal changes were frequently identified in asymptomatic and routinely unexamined muscles. Thoracoabdominal trunk muscles were frequently involved in ASS and IMNM. Peak CK was positively correlated with the STIR sum score (R2 = 0.62, p < .01). There was no significant correlation between the STIR sum score within the thoracoabdominal trunk and forced vital capacity. Conclusion WB-MRI can detect subclinical muscle inflammation in the systemic muscles including the trunk muscles. STIR sum score is positively correlated with serum peak CK level; therefore, it could be a biomarker of overall muscle inflammation.

背景:全身磁共振成像(WB-MRI)是揭示特发性炎症性肌病(IIMs)中受影响肌肉的疾病特异性分布和临床无症状肌肉受累的有用工具。目的应用WB-MRI检查IIMs患者全身骨骼肌(包括胸腹干)的炎症变化。材料与方法前瞻性获得10例IIMs患者的WB-MRI轴向图像，包括抗合成酶综合征(ASS)、免疫介导的坏死性肌病(IMNM)、散发性包涵体肌炎和抗线粒体抗体相关的肌病。我们在短tau反转恢复(STIR)图像中评估了108个全身骨骼肌，并使用半定量量表评估了信号强度的变化。检测STIR总分、肌酸激酶峰值(CK)与肌力的相关性。我们还研究了胸腹干STIR总分与强迫肺活量的相关性。结果在无症状和常规未检查的肌肉中经常发现高STIR信号改变。胸腹干肌常累及ASS和IMNM。CK峰值与STIR总分呈正相关(R2 = 0.62, p < 0.01)。胸腹干STIR总分与用力肺活量无显著相关性。结论WB-MRI可检测包括躯干肌肉在内的全身肌肉的亚临床肌肉炎症。STIR总分与血清CK峰值水平呈正相关;因此，它可能是整体肌肉炎症的生物标志物。

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引用次数: 2