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2. Regarding our 2018 paper titled 'Magnetic resonance imaging of the pediatric mediastinum': reply to Mirjalili et al.
- Author
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Bardo DME, Biyyam DR, Patel MC, Wong K, van Tassel D, and Robison RK
- Subjects
- Child, Humans, Magnetic Resonance Imaging, Mediastinum
- Published
- 2020
- Full Text
- View/download PDF
3. MRI-based brain age prediction model for children under 3 years old using deep residual network.
- Author
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Hu L, Wan Q, Huang L, Tang J, Huang S, Chen X, Bai X, Kong L, Deng J, Liang H, Liu G, Liu H, and Lu L
- Subjects
- Adult, Humans, Child, Preschool, Infant, Newborn, Infant, Neuroimaging, Brain diagnostic imaging, Aging, Magnetic Resonance Imaging, Autistic Disorder
- Abstract
Early identification and intervention of abnormal brain development individual subjects are of great significance, especially during the earliest and most active stage of brain development in children aged under 3. Neuroimage-based brain's biological age has been associated with health, ability, and remaining life. However, the existing brain age prediction models based on neuroimage are predominantly adult-oriented. Here, we collected 658 T1-weighted MRI scans from 0 to 3 years old healthy controls and developed an accurate brain age prediction model for young children using deep learning techniques with high accuracy in capturing age-related changes. The performance of the deep learning-based model is comparable to that of the SVR-based model, showcasing remarkable precision and yielding a noteworthy correlation of 91% between the predicted brain age and the chronological age. Our results demonstrate the accuracy of convolutional neural network (CNN) brain-predicted age using raw T1-weighted MRI data with minimum preprocessing necessary. We also applied our model to children with low birth weight, premature delivery history, autism, and ADHD, and discovered that the brain age was delayed in children with extremely low birth weight (less than 1000 g) while ADHD may cause accelerated aging of the brain. Our child-specific brain age prediction model can be a valuable quantitative tool to detect abnormal brain development and can be helpful in the early identification and intervention of age-related brain disorders., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2023
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- View/download PDF
4. Diagnostic magnetic resonance imaging characteristics of congenital mesoblastic nephroma: a retrospective multi-center International Society of Pediatric Oncology-Renal Tumor Study Group (SIOP-RTSG) radiology panel study.
- Author
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van der Beek JN, Schenk JP, Morosi C, Watson TA, Coma A, Graf N, Chowdhury T, Ramírez-Villar GL, Spreafico F, Welter N, Dzhuma K, van Tinteren H, de Krijger RR, van den Heuvel-Eibrink MM, and Littooij AS
- Subjects
- Humans, Retrospective Studies, Infant, Male, Female, Infant, Newborn, Diagnosis, Differential, Nephroma, Mesoblastic diagnostic imaging, Kidney Neoplasms diagnostic imaging, Magnetic Resonance Imaging methods
- Abstract
Background: Congenital mesoblastic nephroma is the most common solid renal tumor in neonates. Therefore, patients <3 months of age are advised to undergo upfront nephrectomy, whereas invasive procedures at diagnosis in patients ≥3 months of age are discouraged by the International Society of Pediatric Oncology-Renal Tumor Study Group (SIOP-RTSG). Nevertheless, discriminating congenital mesoblastic nephroma, especially from the more common Wilms tumor, solely based on imaging remains difficult. Recently, magnetic resonance imaging (MRI) has become the preferred modality. Studies focusing on MRI characteristics of congenital mesoblastic nephroma are limited., Objective: This study aims to identify diagnostic MRI characteristics of congenital mesoblastic nephroma in the largest series of patients to date., Materials and Methods: In this retrospective multicenter study, five SIOP-RTSG national review radiologists identified 52 diagnostic MRIs of histologically proven congenital mesoblastic nephromas. MRI was performed following SIOP-RTSG protocols, while radiologists assessed their national cases using a validated case report form., Results: Patients (24/52 classic, 11/52 cellular, and 15/52 mixed type congenital mesoblastic nephroma, 2/52 unknown) had a median age of 1 month (range 1 day-3 months). Classic type congenital mesoblastic nephroma appeared homogeneous with a lack of hemorrhage, necrosis and/or cysts, showing a concentric ring sign in 14 (58.3%) patients. Cellular and mixed type congenital mesoblastic nephroma appeared more heterogeneous and were larger (311.6 and 174.2 cm
3 , respectively, versus 41.0 cm3 for the classic type (P<0.001)). All cases were predominantly T2-weighted isointense and T1-weighted hypointense, and mean overall apparent diffusion coefficient values ranged from 1.05-1.10×10-3 mm2 /s., Conclusion: This retrospective international collaborative study showed classic type congenital mesoblastic nephroma predominantly presented as a homogeneous T2-weighted isointense mass with a typical concentric ring sign, whereas the cellular type appeared more heterogeneous. Future studies may use identified MRI characteristic of congenital mesoblastic nephroma for validation and for exploring the discriminative non-invasive value of MRI, especially from Wilms tumor., (© 2024. The Author(s).)- Published
- 2024
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5. How we do it: Cardiac implantable devices are not a contraindication to MRI: time for a paradigm shift.
- Author
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De Leon-Benedetti LS, Ramirez-Suarez KI, Otero HJ, Rapp JB, Biko DM, Smith C, Serai SD, Janson C, Shah M, Englehardt G, Fogel M, and White AM
- Subjects
- Humans, Child, Contraindications, Procedure, Patient Safety, Magnetic Resonance Imaging methods, Pacemaker, Artificial, Heart Defects, Congenital diagnostic imaging, Defibrillators, Implantable
- Abstract
Magnetic resonance imaging (MRI) is now an indispensable diagnostic tool in medicine due to its outstanding contrast resolution and absence of radiation exposure, enabling detailed tissue characterization and three-dimensional anatomical representation. This is especially important when evaluating individuals with congenital heart disease (CHD) who frequently require cardiac implantable electrical devices (CIEDs). While MRI safety issues have previously limited its use in patients with CIEDs, new advances have called these limitations into question. However, difficulties persist in the pediatric population due to the continued lack of specific safety data both related to imaging young children and the specific CIED devices they often require. This paper discusses MRI safety considerations related to imaging patients with CIEDs, investigates pediatric-specific problems, and describes thorough methods for safe MRI access, highlighting the significance of specialized institutional guidelines., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2024
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6. Deep learning-based high-accuracy detection for lumbar and cervical degenerative disease on T2-weighted MR images.
- Author
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Yi W, Zhao J, Tang W, Yin H, Yu L, Wang Y, and Tian W
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- Humans, Retrospective Studies, Magnetic Resonance Imaging methods, Deep Learning
- Abstract
Purpose: To develop and validate a deep learning (DL) model for detecting lumbar degenerative disease in both sagittal and axial views of T2-weighted MRI and evaluate its generalized performance in detecting cervical degenerative disease., Methods: T2-weighted MRI scans of 804 patients with symptoms of lumbar degenerative disease were retrospectively collected from three hospitals. The training dataset (n = 456) and internal validation dataset (n = 134) were randomly selected from the center I. Two external validation datasets comprising 100 and 114 patients were from center II and center III, respectively. A DL model based on 3D ResNet18 and transformer architecture was proposed to detect lumbar degenerative disease. In addition, a cervical MR image dataset comprising 200 patients from an independent hospital was used to evaluate the generalized performance of the DL model. The diagnostic performance was assessed by the free-response receiver operating characteristic (fROC) curve and precision-recall (PR) curve. Precision, recall, and F1-score were used to measure the DL model., Results: A total of 2497 three-dimension retrogression annotations were labeled for training (n = 1157) and multicenter validation (n = 1340). The DL model showed excellent detection efficiency in the internal validation dataset, with F1-score achieving 0.971 and 0.903 on the sagittal and axial MR images, respectively. Good performance was also observed in the external validation dataset I (F1-score, 0.768 on sagittal MR images and 0.837 on axial MR images) and external validation dataset II (F1-score, 0.787 on sagittal MR images and 0.770 on axial MR images). Furthermore, the robustness of the DL model was demonstrated via transfer learning and generalized performance evaluation on the external cervical dataset, with the F1-score yielding 0.931 and 0.919 on the sagittal and axial MR images, respectively., Conclusion: The proposed DL model can automatically detect lumbar and cervical degenerative disease on T2-weighted MR images with good performance, robustness, and feasibility in clinical practice., (© 2023. The Author(s).)
- Published
- 2023
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7. Functional individual variability development of the neonatal brain.
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Gao W, Huang Z, Ou W, Tang X, Lv W, and Nie J
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- Brain Mapping, Gyrus Cinguli, Humans, Infant, Newborn, Parietal Lobe, Brain diagnostic imaging, Magnetic Resonance Imaging methods
- Abstract
Individual variability in cognition and behavior results from the differences in brain structure and function that have already emerged before birth. However, little is known about individual variability in brain functional architecture at local level in neonates which is of great significance to explore owing to largely undeveloped long-range functional connectivity and segregated functions in early brain development. To address this, resting-state fMRI data of 163 neonates ranged from 32 to 45 postconceptional weeks (PCW) were used in this study, and various functional features including functional parcellation similarity, local brain activity and local functional connectivity were used to characterize individual functional variability. We observed significantly higher local functional individual variability in superior parietal, sensorimotor, and visual cortex, and lower variability in the frontal, insula and cingulate cortex relative to other regions within each hemisphere. The mean local functional individual variability significantly increased with age, and the age effect was found larger in brain regions such as the occipital, temporal, prefrontal and parietal cortex. Our findings promote the understanding of brain plasticity and regional differential maturation in the early stage., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2022
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8. [Comments on the paper by J. Groh et al. Anesthesia for magnetic resonance tomography].
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Petricek W, Fitzal S, and Tonczar L
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- Humans, Anesthesia, Magnetic Resonance Imaging
- Published
- 1989
9. Pediatric magnetic resonance imaging: faster is better.
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Gallo-Bernal S, Bedoya MA, Gee MS, and Jaimes C
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- Humans, Child, Child, Preschool, Motion, Artifacts, Magnetic Resonance Spectroscopy, Magnetic Resonance Imaging methods, Anesthesia, General
- Abstract
Magnetic resonance imaging (MRI) has emerged as the preferred imaging modality for evaluating a wide range of pediatric medical conditions. Nevertheless, the long acquisition times associated with this technique can limit its widespread use in young children, resulting in motion-degraded or non-diagnostic studies. As a result, sedation or general anesthesia is often necessary to obtain diagnostic images, which has implications for the safety profile of MRI, the cost of the exam and the radiology department's clinical workflow. Over the last decade, several techniques have been developed to increase the speed of MRI, including parallel imaging, single-shot acquisition, controlled aliasing techniques, compressed sensing and artificial-intelligence-based reconstructions. These are advantageous because shorter examinations decrease the need for sedation and the severity of motion artifacts, increase scanner throughput, and improve system efficiency. In this review we discuss a framework for image acceleration in children that includes the synergistic use of state-of-the-art MRI hardware and optimized pulse sequences. The discussion is framed within the context of pediatric radiology and incorporates the authors' experience in deploying these techniques in routine clinical practice., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2023
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10. Practical Aspects of NMR-Based Metabolomics.
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Wishart DS, Rout M, Lee BL, Berjanskii M, LeVatte M, and Lipfert M
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- Animals, Cattle, Reproducibility of Results, Magnetic Resonance Spectroscopy methods, Metabolomics methods, Magnetic Resonance Imaging
- Abstract
While NMR-based metabolomics is only about 20 years old, NMR has been a key part of metabolic and metabolism studies for >40 years. Historically, metabolic researchers used NMR because of its high level of reproducibility, superb instrument stability, facile sample preparation protocols, inherently quantitative character, non-destructive nature, and amenability to automation. In this chapter, we provide a short history of NMR-based metabolomics. We then provide a detailed description of some of the practical aspects of performing NMR-based metabolomics studies including sample preparation, pulse sequence selection, and spectral acquisition and processing. The two different approaches to metabolomics data analysis, targeted vs. untargeted, are briefly outlined. We also describe several software packages to help users process NMR spectra obtained via these two different approaches. We then give several examples of useful or interesting applications of NMR-based metabolomics, ranging from applications to drug toxicology, to identifying inborn errors of metabolism to analyzing the contents of biofluids from dairy cattle. Throughout this chapter, we will highlight the strengths and limitations of NMR-based metabolomics. Additionally, we will conclude with descriptions of recent advances in NMR hardware, methodology, and software and speculate about where NMR-based metabolomics is going in the next 5-10 years., (© 2022. The Author(s), under exclusive license to Springer Nature Switzerland AG.)
- Published
- 2023
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11. Abstracts Scientific Papers Honorary Lectures Categorical Courses Workshops State-of-the-Art Symposia
- Published
- 1999
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12. Arterial spin labeling for head and neck lesion assessment: technical adjustments and clinical applications.
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Martín-Noguerol T, Kirsch CFE, Montesinos P, and Luna A
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- Arteries, Humans, Perfusion, Spin Labels, Contrast Media, Magnetic Resonance Imaging
- Abstract
Purpose: Despite, currently, "state-of-the-art" magnetic resonance imaging (MRI) protocols for head and neck (H&N) lesion assessment incorporate perfusion sequences, these acquisitions require the intravenous injection of exogenous gadolinium-based contrast agents (GBCAs), which may have potential risks. Alternative techniques such as arterial spin labeling (ASL) can provide quantitative microvascular information similar to conventional perfusion sequences for H&N lesions evaluation, as a potential alternative without GBCA administration., Methods: We review the existing literature and analyze the latest evidence regarding ASL in H&N area highlighting the technical adjustments needed for a proper ASL acquisition in this challenging region for lesion characterization, treatment monitoring, and tumor recurrence detection., Results: ASL techniques, widely used for central nervous system lesions evaluation, can be also applied to the H&N region. Technical adjustments, especially regarding post-labeling delay, are mandatory to obtain robust and reproducible results. Several studies have demonstrated the feasibility of ASL in the H&N area including the orbits, skull base, paranasal sinuses, upper airway, salivary glands, and thyroid., Conclusion: ASL is a feasible technique for the assessment of H&N lesions without the need of GBCAs. This manuscript reviews ASL's physical basis, emphasizing the technical adjustments necessary for proper ASL acquisition in this unique and challenging anatomical region, and the main applications in evaluating H&N lesions., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2021
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13. Abstracts Scientific Papers Honorary Lectures Categorical Courses Workshops State-of-the-Art Symposia
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Transjugular Intrahepatic Portosystemic Shunt ,Spiral Compute Tomography ,Magnetic Resonance Imaging ,Takayasu Arteritis ,Article ,Magnetic Resonance Angiography - Published
- 2013
14. Educational paper
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van Rijn, Rick Robert and Sieswerda-Hoogendoorn, Tessa
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Diagnosis, Differential ,Fractures, Bone ,education ,Humans ,Pediatrics, Perinatology, and Child Health ,Review ,Child Abuse ,Radiology ,Child ,Radionuclide Imaging ,Tomography, X-Ray Computed ,Fractures ,Magnetic Resonance Imaging - Abstract
Fractures are reported to be the second most common findings in child abuse, after skin lesions such as bruises and contusions. This makes careful interpretation of childhood fractures in relation to the provided clinical history important. In this literature review, we address imaging techniques and the prevailing protocols as well as fractures, frequently seen in child abuse, and the differential diagnosis of these fractures. The use of a standardised protocol in radiological imaging is stressed, as adherence to the international guidelines has been consistently poor. As fractures are a relatively common finding in childhood and interpretation is sometimes difficult, involvement of a paediatric radiologist is important if not essential. Adherence to international guidelines necessitates review by experts and is therefore mandatory. As in all clinical differential diagnoses, liaison between paediatricians and paediatric radiologists in order to obtain additional clinical information or even better having joint review of radiological studies will improve diagnostic accuracy. It is fundamental to keep in mind that the diagnosis of child abuse can never be solely based on radiological imaging but always on a combination of clinical, investigative and social findings. The quality and interpretation, preferably by a paediatric radiologist, of radiographs is essential in reaching a correct diagnosis in cases of suspected child abuse.
- Published
- 2011
15. Sporadic inclusion body myositis: no specific cardiac involvement in cardiac magnetic resonance tomography.
- Author
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Rosenbohm A, Buckert D, Kassubek J, Rottbauer W, Ludolph AC, and Bernhardt P
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- Aged, Aged, 80 and over, Echocardiography, Female, Humans, Male, Middle Aged, Heart Diseases diagnostic imaging, Heart Diseases etiology, Magnetic Resonance Imaging, Myositis, Inclusion Body complications
- Abstract
Objective: To investigate cardiac involvement in patients with sporadic inclusion body myositis (IBM) by cardiac magnetic resonance tomography (CMR)., Methods: A case series of 20 patients with IBM underwent basic cardiac assessment and CMR including functional imaging, native and contrast-enhanced T1-weighted, and late gadolinium enhancement (LGE) imaging., Results: All IBM patients reported no cardiac symptoms. Echocardiography was normal in 16/17 IBM patients. In CMR, IBM patients had normal ejection fractions (mean LVEF 63 ± 7%) and ventricular mass. They had reduced left (mean 55 versus 88 ml) and right ventricular stroke volumes (mean 54 versus 86 ml) and increased early myocardial enhancement (pathological T1 Ratio in 44% versus 5%), as compared to age- and gender-matched controls. Since arterial hypertension was more often observed in IBM patients, hypertensive heart disease can also be causative for these changes. Late gadolinium enhancement did not differ statistically from healthy controls. There was no apparent association between elevated biomarkers, echocardiography and CMR., Conclusion: CMR revealed subtle changes in cardiac geometry and tissue characterization in IBM patients when compared to a gender- and age-matched control group. Findings in CMR indicated a higher extent of diffuse myocardial fibrosis as well as smaller left ventricular stroke volumes. These alterations may be due to a higher prevalence of arterial hypertension in the IBM cohort.
- Published
- 2020
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16. Measuring and reporting of vertebral endplate bone marrow lesions as seen on MRI (Modic changes): recommendations from the ISSLS Degenerative Spinal Phenotypes Group.
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Fields AJ, Battié MC, Herzog RJ, Jarvik JG, Krug R, Link TM, Lotz JC, O'Neill CW, and Sharma A
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- Humans, Low Back Pain etiology, Bone Marrow diagnostic imaging, Lumbar Vertebrae diagnostic imaging, Magnetic Resonance Imaging
- Abstract
Purpose: The positive association between low back pain and MRI evidence of vertebral endplate bone marrow lesions, often called Modic changes (MC), offers the exciting prospect of diagnosing a specific phenotype of chronic low back pain (LBP). However, imprecision in the reporting of MC has introduced substantial challenges, as variations in both imaging equipment and scanning parameters can impact conspicuity of MC. This review discusses key methodological factors that impact MC classification and recommends guidelines for more consistent MC reporting that will allow for better integration of research into this LBP phenotype., Methods: Non-systematic literature review., Results: The high diagnostic specificity of MC classification for a painful level contributes to the significant association observed between MC and LBP, whereas low and variable sensitivity underlies the between- and within-study variability in observed associations. Poor sensitivity may be owing to the presence of other pain generators, to the limited MRI resolution, and to the imperfect reliability of MC classification, which lowers diagnostic sensitivity and thus influences the association between MC and LBP. Importantly, magnetic field strength and pulse sequence parameters also impact detection of MC. Advances in pulse sequences may improve reliability and prove valuable for quantifying lesion severity., Conclusions: Comparison of MC data between studies can be problematic. Various methodological factors impact detection and classification of MC, and the lack of reporting guidelines hinders interpretation and comparison of findings. Thus, it is critical to adopt imaging and reporting standards that codify acceptable methodological criteria. These slides can be retrieved under Electronic Supplementary Material.
- Published
- 2019
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17. A systematic review of (semi-)automatic quality control of T1-weighted MRI scans.
- Author
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Hendriks J, Mutsaerts HJ, Joules R, Peña-Nogales Ó, Rodrigues PR, Wolz R, Burchell GL, Barkhof F, and Schrantee A
- Subjects
- Humans, Machine Learning, Algorithms, Quality Control, Image Processing, Computer-Assisted methods, Magnetic Resonance Imaging methods
- Abstract
Purpose: Artifacts in magnetic resonance imaging (MRI) scans degrade image quality and thus negatively affect the outcome measures of clinical and research scanning. Considering the time-consuming and subjective nature of visual quality control (QC), multiple (semi-)automatic QC algorithms have been developed. This systematic review presents an overview of the available (semi-)automatic QC algorithms and software packages designed for raw, structural T1-weighted (T1w) MRI datasets. The objective of this review was to identify the differences among these algorithms in terms of their features of interest, performance, and benchmarks., Methods: We queried PubMed, EMBASE (Ovid), and Web of Science databases on the fifth of January 2023, and cross-checked reference lists of retrieved papers. Bias assessment was performed using PROBAST (Prediction model Risk Of Bias ASsessment Tool)., Results: A total of 18 distinct algorithms were identified, demonstrating significant variations in methods, features, datasets, and benchmarks. The algorithms were categorized into rule-based, classical machine learning-based, and deep learning-based approaches. Numerous unique features were defined, which can be roughly divided into features capturing entropy, contrast, and normative measures., Conclusion: Due to dataset-specific optimization, it is challenging to draw broad conclusions about comparative performance. Additionally, large variations exist in the used datasets and benchmarks, further hindering direct algorithm comparison. The findings emphasize the need for standardization and comparative studies for advancing QC in MR imaging. Efforts should focus on identifying a dataset-independent measure as well as algorithm-independent methods for assessing the relative performance of different approaches., (© 2023. The Author(s).)
- Published
- 2024
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18. ProbaStem, a pipeline towards the first high-resolution probabilistic atlas of the whole human brainstem.
- Author
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Mohammadi MS, Planty-Bonjour A, Poupon F, Uszynski I, Poupon C, Destrieux C, and Andersson F
- Subjects
- Humans, Gray Matter, Histological Techniques, Magnetic Resonance Imaging, Brain Stem diagnostic imaging
- Abstract
The brainstem plays an essential role in many vital functions, such as autonomic control, consciousness and sleep, motricity, somatic afferent function, and cognition. Its involvement in several neurological diseases and the definition of brainstem targets for deep brain stimulation (DBS) explain the need for brainstem atlases describing its structural organization and connectivity from several modalities, from histology to ultrahigh field ex vivo MRI. Nonetheless, these atlases are often limited to a subpart of the brainstem or only include a single subject, the brainstem variability being considered low. This paper proposes a pipeline to create a high-resolution multisubject probabilistic atlas of the whole human brainstem based on four ultrahigh field ex vivo MRI datasets. The variability of the brainstem structures appears higher than usually considered, both for the volume and position of the central gray matter structures of the brainstem. This justifies the creation of atlases that capture the anatomical variability across subjects. The one we present here only included four specimens, but can easily be incremented due to its highly flexible design., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2024
- Full Text
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19. The primacy of multiparametric MRI in men with suspected prostate cancer
- Author
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Geert Villeirs, Vibeke Løgager, Jonathan Richenberg, Olivier Rouvière, Valeria Panebianco, Ivo G. Schoots, and Radiology & Nuclear Medicine
- Subjects
Image-Guided Biopsy ,Male ,medicine.medical_specialty ,Biopsy ,Disease ,Prostatic Neoplasms/pathology ,Multiparametric Magnetic Resonance Imaging/methods ,Triage/methods ,Risk Assessment ,030218 nuclear medicine & medical imaging ,Management of prostate cancer ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Magnetic resonance imaging ,SDG 3 - Good Health and Well-being ,Prostate ,medicine ,Humans ,biopsy ,magnetic resonance imaging ,observer variation ,prostate cancer ,risk assessment ,Radiology, Nuclear Medicine and imaging ,Multiparametric Magnetic Resonance Imaging ,Risk Assessment/methods ,Neuroradiology ,Aged ,Observer Variation ,medicine.diagnostic_test ,business.industry ,Prostatic Neoplasms ,Urogenital ,General Medicine ,Middle Aged ,Prostate-Specific Antigen ,medicine.disease ,Biopsy/methods ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Position paper ,Radiology ,Triage ,business ,Risk assessment - Abstract
Background Multiparametric MRI (mpMRI) became recognised in investigating those with suspected prostate cancer between 2010 and 2012; in the USA, the preventative task force moratorium on PSA screening was a strong catalyst. In a few short years, it has been adopted into daily urological and oncological practice. The pace of clinical uptake, born along by countless papers proclaiming high accuracy in detecting clinically significant prostate cancer, has sparked much debate about the timing of mpMRI within the traditional biopsy-driven clinical pathways. There are strongly held opposing views on using mpMRI as a triage test regarding the need for biopsy and/or guiding the biopsy pattern. Objective To review the evidence base and present a position paper on the role of mpMRI in the diagnosis and management of prostate cancer. Methods A subgroup of experts from the ESUR Prostate MRI Working Group conducted literature review and face to face and electronic exchanges to draw up a position statement. Results This paper considers diagnostic strategies for clinically significant prostate cancer; current national and international guidance; the impact of pre-biopsy mpMRI in detection of clinically significant and clinically insignificant neoplasms; the impact of pre-biopsy mpMRI on biopsy strategies and targeting; the notion of mpMRI within a wider risk evaluation on a patient by patient basis; the problems that beset mpMRI including inter-observer variability. Conclusions The paper concludes with a set of suggestions for using mpMRI to influence who to biopsy and who not to biopsy at diagnosis. Key Points • Adopt mpMRI as the first, and primary, investigation in the workup of men with suspected prostate cancer. • PI-RADS assessment categories 1 and 2 have a high negative predictive value in excluding significant disease, and systematic biopsy may be postponed, especially in men with low-risk of disease following additional risk stratification. • PI-RADS assessment category lesions 4 and 5 should be targeted; PI-RADS assessment category lesion 3 may be biopsied as a target, as part of systematic biopsies or may be observed depending on risk stratification. Electronic supplementary material The online version of this article (10.1007/s00330-019-06166-z) contains supplementary material, which is available to authorized users.
- Published
- 2019
20. Paperless Protocoling of CT and MRI Requests at an Outpatient Imaging Center
- Author
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David A. Dierolf, Matthew J. Bassignani, Steven Lee, and David L. Roberts
- Subjects
medicine.medical_specialty ,Outpatient Clinics, Hospital ,Radiology workflow ,media_common.quotation_subject ,Population ,education ,Information Storage and Retrieval ,Tertiary care ,Article ,Workflow ,Reading (process) ,Outpatients ,medicine ,Electronic Health Records ,Humans ,Radiology, Nuclear Medicine and imaging ,Medical physics ,media_common ,Protocol (science) ,education.field_of_study ,Radiological and Ultrasound Technology ,Radiology Department, Hospital ,business.industry ,Time Management ,Paper based ,Magnetic Resonance Imaging ,Computer Science Applications ,Radiology Information Systems ,Radiology ,business ,Tomography, X-Ray Computed ,Program Evaluation - Abstract
We created our imaging center (IC) to move outpatient imaging from our busy inpatient imaging suite off-site to a location that is more inviting to ambulatory patients. Nevertheless, patients scanned at our IC still represent the depth and breadth of illness complexity seen with our tertiary care population. Thus, we protocol exams on an individualized basis to ensure that the referring clinician’s question is fully answered by the exam performed. Previously, paper based protocoling was a laborious process for all those involved where the IC business office would fax the requests to various reading rooms for protocoling by the subspecialist radiologists who are 3 miles away at the main hospital. Once protocoled, reading room coordinators would fax back the protocoled request to the IC technical area in preparation for the next day’s scheduled exams. At any breakdown in this process (e.g., lost paperwork), patient exams were delayed and clinicians and patients became upset. To improve this process, we developed a paper free process whereby protocoling is accomplished through scanning of exam requests into our PACS. Using the common worklist functionality found in most PACS, we created “protocoling worklists” that contain these scanned documents. Radiologists protocol these studies in the PACS worklist (with the added benefit of having all imaging and report data available), and subsequently, the technologists can see and act on the protocols they find in PACS. This process has significantly decreased interruptions in our busy reading rooms and decreased rework of IC staff.
- Published
- 2008
21. Oligodendroglial neoplasms with ganglioglioma-like maturation: a diagnostic pitfall
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Arie Perry, Gregory N. Fuller, Stephanie S. Burton, Marc K. Rosenblum, Eileen H. Bigio, Meena Gujrati, Cheryl A. Palmer, Christopher A. Robinson, and Lothar Resch
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Oligoastrocytoma ,Neuronal ,Oligodendroglioma ,Clinical Neurology ,Biology ,Ganglioglioma ,Pathology and Forensic Medicine ,symbols.namesake ,Cellular and Molecular Neuroscience ,FISH ,Neurofilament Proteins ,Eosinophilic ,Glial Fibrillary Acidic Protein ,medicine ,Humans ,Anaplasia ,In Situ Hybridization, Fluorescence ,Retrospective Studies ,Original Paper ,Brain Neoplasms ,Middle Aged ,medicine.disease ,Immunohistochemistry ,Magnetic Resonance Imaging ,Ganglion ,medicine.anatomical_structure ,Chromosomes, Human, Pair 1 ,Nissl body ,symbols ,Female ,Neurology (clinical) ,medicine.symptom ,Differential diagnosis ,Chromosome Deletion ,Chromosomes, Human, Pair 19 - Abstract
Although oligodendroglial neoplasms are traditionally considered purely glial, increasing evidence suggests that they are capable of neuronal or neurocytic differentiation. Nevertheless, ganglioglioma-like foci (GGLF) have not been previously described. Herein, we report seven examples where the primary differential diagnosis was a ganglioglioma with an oligodendroglial component. These five male and two female patients ranged in age from 29 to 63 (median 44) years at initial presentation and neuroimaging features were those of diffuse gliomas in general. At presentation, the glial component was oligodendroglioma in six and oligoastrocytoma in one; one was low-grade and six were anaplastic. A sharp demarcation from adjacent GGLF was common, although some intermingling was always present. The GGLF included enlarged dysmorphic and occasionally binucleate ganglion cells, Nissl substance, expression of neuronal antigens, GFAP-positive astrocytic elements, and low Ki-67 labeling indices. In contrast to classic ganglioglioma, however, cases lacked eosinophilic granular bodies and CD34-positive tumor cells. Scattered bizarre astrocytes were also common and one case had focal neurocytic differentiation. By FISH analysis, five cases showed 1p/19q codeletion. In the four cases with deletions and ample dysmorphic ganglion cells for analysis, the deletions were found in both components. At last follow-up, two patients suffered recurrences, one developed radiation necrosis mimicking recurrence, and one died of disease 7.5 years after initial surgery. We conclude that GGLF represents yet another form of neuronal differentiation in oligodendroglial neoplasms. Recognition of this pattern will prevent a misdiagnosis of ganglioglioma with its potential for under-treatment.
- Published
- 2010
22. Fetal magnetic resonance imaging at 3 Tesla - the European experience.
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Colleran GC, Kyncl M, Garel C, and Cassart M
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- Child, Female, Fetus diagnostic imaging, Humans, Motion, Pregnancy, Signal-To-Noise Ratio, Artifacts, Magnetic Resonance Imaging methods
- Abstract
Background: The Fetal Imaging Taskforce was established in 2018 by the European Society of Paediatric Radiology. The first survey on European practice of fetal imaging published in 2020 revealed that 30% of fetal magnetic resonance imaging (MRI) is performed at 3 tesla (T). The purpose of this second survey was to identify the impact of 3-T fetal MRI with an emphasis on image quality, diagnostic yield, and technical challenges and artifacts at higher field strengths., Objective: To describe the prenatal imaging practice at 3-T MRI units in various centres in Europe and to prepare recommendations on behalf of the Fetal Imaging Taskforce., Materials and Methods: A survey was sent to all members performing 3-T fetal MRI. Questions included practitioner experience, magnet brand, protocols, counselling, artifacts and benefits of imaging at higher field strengths., Results: Twenty-seven centres replied and reported improved spatial resolution and improved signal-to-noise ratio when performing fetal MRI at 3 T. Shading and banding artifacts and susceptibility to motion artifacts were common problems identified by practitioners at the higher field strength. For all neurological indications, practitioners reported a benefit of imaging at 3 T, most marked for posterior fossa evaluation and parenchymal lesions., Conclusion: The use of 3-T magnets in fetal MRI has improved the availability and quality of advanced imaging sequences and allowed for better anatomical evaluation. There remain significant challenges to minimize the impact of artifacts on image quality. This paper includes guidelines for clinical practice and imaging at 3 T., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2022
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23. Basics of magnetic resonance imaging and quantitative parameters T1, T2, T2*, T1rho and diffusion-weighted imaging.
- Author
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Serai SD
- Subjects
- Child, Humans, Diffusion Magnetic Resonance Imaging, Magnetic Resonance Imaging
- Abstract
Magnetic resonance imaging is widely available and accepted as the imaging method of choice for many pediatric body imaging applications. Traditionally, it has been used in a qualitative way, where the images are reported non-numerically by radiologists. But now MRI machines have built-in post-processing software connected to the scanner and the database of MR images. This setting enables and encourages simple quantitative analysis of MR images. In this paper, the author reviews the fundamentals of MRI and discusses the most common quantitative MRI techniques for body imaging: T1, T2, T2*, T1rho and diffusion-weighted imaging (DWI). For each quantitative imaging method, this article reviews the technique, its measurement mechanism, and selected clinical applications to body imaging., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2022
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24. Magnetic resonance imaging of the pediatric mediastinum: updates, tips and tricks.
- Author
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Thacker PG
- Subjects
- Artifacts, Child, Humans, Motion, Thorax, Magnetic Resonance Imaging, Mediastinum diagnostic imaging
- Abstract
Magnetic resonance imaging (MRI) of the pediatric mediastinum is challenging for the practicing radiologist. Many confounding factors add to the complexity of pediatric mediastinal MRI including small patient size, broad spectrum of mediastinal pathologies, motion artifacts and the need for sedation in a significant portion of children. However, with special attention to motion-reduction techniques and knowledge of pediatric-specific considerations, pediatric radiologists can help to provide accurate and timely diagnosis and also prevent multimodality imaging where MRI might be all that is needed. The purpose of this paper was present a practical review of pediatric mediastinal MRI with particular emphasis on diseases where MRI is the primary imaging modality of choice. Additionally, the author addresses those mediastinal processes for which MRI serves as a secondary problem-solving imaging tool., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2022
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25. Quantitative renal magnetic resonance imaging: magnetic resonance urography.
- Author
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Grattan-Smith JD, Chow J, Kurugol S, and Jones RA
- Subjects
- Child, Humans, Kidney Pelvis, Magnetic Resonance Spectroscopy, Urography, Kidney diagnostic imaging, Kidney physiology, Magnetic Resonance Imaging
- Abstract
The goal of functional renal imaging is to identify and quantitate irreversible renal damage and nephron loss, as well as potentially reversible hemodynamic changes. MR urography has evolved into a comprehensive evaluation of the urinary tract that combines anatomical imaging with functional evaluation in a single test without ionizing radiation. Quantitative functional MR imaging is based on dynamic contrast-enhanced MR acquisitions that provide progressive, visible enhancement of the renal parenchyma and urinary tract. The signal changes related to perfusion, concentration and excretion of the contrast agent can be evaluated using both quantitative and qualitative measures. Functional evaluation with MR has continued to improve as a result of significant technical advances allowing for faster image acquisition as well as the development of new tracer kinetic models of renal function. The most common indications for MR urography in children are the evaluation of congenital anomalies of the kidney and urinary tract including hydronephrosis and renal malformations, and the identification of ectopic ureters in children with incontinence. In this paper, we review the underlying acquisition schemes and techniques used to generate quantitative functional parameters including the differential renal function (DRF), asymmetry index, mean transit time (MTT), signal intensity versus time curves as well as the calculation of individual kidney glomerular filtration rate (GFR). Visual inspection and semi-quantitative assessment using the renal transit time (RTT) and calyceal transit times (CTT) are fundamental to accurate diagnosis and are used as a basis for the interpretation of the quantitative data. The importance of visual assessment of the images cannot be overstated when analyzing the quantitative measures of renal function., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2022
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26. The anterior talo-fibular ligament reconstruction in surgical treatment of chronic lateral ankle instability
- Author
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Handl M, Vojtech Havlas, and Tomáš Trč
- Subjects
Adult ,Joint Instability ,Male ,medicine.medical_specialty ,Lateral ankle ,Adolescent ,Physical examination ,Instability ,Young Adult ,medicine ,Anterior talo fibular ligament ,Humans ,Orthopedics and Sports Medicine ,Ankle Injuries ,Prospective Studies ,Young adult ,Prospective cohort study ,Original Paper ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Recovery of Function ,Middle Aged ,Plastic Surgery Procedures ,Magnetic Resonance Imaging ,Surgery ,Orthopedic surgery ,Chronic Disease ,Female ,business ,Lateral Ligament, Ankle ,Ankle Joint - Abstract
Chronic lateral ankle instability causes significant problems in physical activity and accelerates development of osteoarthritic changes. The results of treatment for chronic ankle instability are often meets controversial. A surgical reconstruction of ATFL as described in this paper was performed during the period 1997–2005 on 47 patients (26 male, 21 female), with a mean age of 29.3 years. The average follow-up period was 46.2 months. All patients had clinical examination, X-ray and MRI. The mean values of the Good score improved from an average 3.32 prior to surgery to 1.19 one year after the operation. Paired t-tests showed improvements of great significance (p
- Published
- 2010
27. Stress fractures of the base of the metatarsal bones in young trainee ballet dancers
- Author
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Dario Perugia, Omar De Bartolomeo, Walter Albisetti, L. Tagliabue, Giorgio Maria Calori, and Emanuela Camerucci
- Subjects
Male ,medicine.medical_specialty ,injuries/radiography ,Adolescent ,Fractures, Stress ,Ballet ,diagnosis ,Cumulative Trauma Disorders ,Magnetic Field Therapy ,Classical ballet ,Physical examination ,Tarsal Joints ,physiopathology/radiography ,doppler ,methods ,High-Energy Shock Waves ,stress ,Young Adult ,Lithotripsy ,medicine ,Humans ,Orthopedics and Sports Medicine ,Dancing ,Metatarsal Bones ,injuries ,Original Paper ,Stress fractures ,medicine.diagnostic_test ,business.industry ,ultrasonography ,fractures ,medicine.disease ,pulsed ,Magnetic Resonance Imaging ,Radiography ,Early Diagnosis ,Treatment Outcome ,diagnosis/therapy ,Minor trauma ,Ultrasonography, Doppler, Pulsed ,therapeutic use ,Orthopedic surgery ,Physical therapy ,Surgery ,adolescent ,cumulative trauma disorders ,dancing ,early diagnosis ,female ,high-energy shock waves ,humans ,lithotripsy ,magnetic field therapy ,magnetic resonance imaging ,male ,metatarsal bones ,tarsal joints ,treatment outcome ,young adult ,Female ,Ballet dancer ,Metatarsal bones ,business - Abstract
Classical ballet is an art form requiring extraordinary physical activity, characterised by rigorous training. These can lead to many overuse injuries arising from repetitive minor trauma. The purpose of this paper is to report our experience in the diagnosis and treatment of stress fractures at the base of the second and third metatarsal bones in young ballet dancers. We considered 150 trainee ballet dancers from the Ballet Schools of "Teatro Alla Scala" of Milan from 2005 to 2007. Nineteen of them presented with stress fractures of the base of the metatarsal bones. We treated 18 dancers with external shockwave therapy (ESWT) and one with pulsed electromagnetic fields (EMF) and low-intensity ultrasound (US); all patients were recommended rest. In all cases good results were obtained. The best approach to metatarsal stress fractures is to diagnose them early through clinical examination and then through X-ray and MRI. ESWT gave good results, with a relatively short time of rest from the patients’ activities and a return to dancing without pain.
- Published
- 2009
28. Technical and clinical validation of commercial automated volumetric MRI tools for dementia diagnosis-a systematic review.
- Author
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Pemberton HG, Zaki LAM, Goodkin O, Das RK, Steketee RME, Barkhof F, and Vernooij MW
- Subjects
- Humans, Dementia diagnostic imaging, Magnetic Resonance Imaging
- Abstract
Developments in neuroradiological MRI analysis offer promise in enhancing objectivity and consistency in dementia diagnosis through the use of quantitative volumetric reporting tools (QReports). Translation into clinical settings should follow a structured framework of development, including technical and clinical validation steps. However, published technical and clinical validation of the available commercial/proprietary tools is not always easy to find and pathways for successful integration into the clinical workflow are varied. The quantitative neuroradiology initiative (QNI) framework highlights six necessary steps for the development, validation and integration of quantitative tools in the clinic. In this paper, we reviewed the published evidence regarding regulatory-approved QReports for use in the memory clinic and to what extent this evidence fulfils the steps of the QNI framework. We summarize unbiased technical details of available products in order to increase the transparency of evidence and present the range of reporting tools on the market. Our intention is to assist neuroradiologists in making informed decisions regarding the adoption of these methods in the clinic. For the 17 products identified, 11 companies have published some form of technical validation on their methods, but only 4 have published clinical validation of their QReports in a dementia population. Upon systematically reviewing the published evidence for regulatory-approved QReports in dementia, we concluded that there is a significant evidence gap in the literature regarding clinical validation, workflow integration and in-use evaluation of these tools in dementia MRI diagnosis., (© 2021. The Author(s).)
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- 2021
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29. Role of the mechanical axis of lower limb and body weight in the horizontal tear and root ligament tear of the posterior horn of the medial meniscus
- Author
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Soo-Min Cha, Jung-Mo Hwang, Yong-Bum Joo, and Young Mo Kim
- Subjects
Cartilage, Articular ,Male ,medicine.medical_specialty ,Knee Joint ,Radiography ,Genu varum ,Knee Injuries ,Menisci, Tibial ,Body Mass Index ,Talus ,Weight-Bearing ,Arthroscopy ,Risk Factors ,Statistical significance ,Genu Varum ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Retrospective Studies ,Orthodontics ,Rupture ,Original Paper ,Leg ,medicine.diagnostic_test ,Tibia ,business.industry ,Body Weight ,Femur Head ,Anatomy ,Middle Aged ,musculoskeletal system ,Magnetic Resonance Imaging ,Tibial Meniscus Injuries ,medicine.anatomical_structure ,Orthopedic surgery ,Ligament ,Surgery ,Female ,Stress, Mechanical ,medicine.symptom ,business ,Medial meniscus - Abstract
To compare and analyse the relationship between horizontal tear and root ligament tear of the posterior horn of the medial meniscus (PHMM) and the degree of varus in the axis of lower limb and body weight. One hundred and nineteen patients underwent surgical treatment as they were diagnosed with medial meniscus tear in our hospital from May 2006 to December 2009. Of these, 19 cases (group 1), underwent partial meniscectomy as they were confirmed to solely have horizontal tear of the PHMM on arthroscopic examination and 27 cases (group 2), underwent subtotal meniscectomy as they were confirmed to solely have root ligament tear of the PHMM on arthroscopic examination, were chosen for retrospective study. Standing radiographs were taken of every case prior to arthroscopic surgery to measure varus angle. Also, we checked body mass index (BMI) of two groups. The difference of varus angle and BMI between two groups were statistically verified using the Levene’s test, paired t-test. Group 1 showed mean value of varus angle of 2.30 ± 0.54, and BMI of 25.32 ± 3.23. Group 2 showed mean value of varus angle of 5.64 ± 0.54, and BMI of 25.67 ± 3.12. The degree of varus of group 2 was statistically significantly higher than group 1 (p = 0.002). Comparison between the BMI of two groups showed no statistical significance (p = 0.053). Through a comparative study of sole horizontal tear and root ligament tear of the PHMM, the authors have found that sole root ligament tear of the PHMM is more relative to the genu varum than sole horizontal tear of the PHMM. However, body weight was statistically irrelevant to the incidence of the two lesions.
- Published
- 2012
30. Muscular atrophy of the lower leg in unilateral post traumatic osteoarthritis of the ankle joint
- Author
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Christina Steiger, Martin Wiewiorski, Kai Dopke, and Victor Valderrabano
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Osteoarthritis ,Cohort Studies ,Arthroplasty, Replacement, Ankle ,Atrophy ,Physical medicine and rehabilitation ,medicine ,Health Status Indicators ,Humans ,Orthopedics and Sports Medicine ,Ankle Injuries ,Range of Motion, Articular ,Muscle, Skeletal ,Aged ,Pain Measurement ,Original Paper ,Leg ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Arthroplasty ,Magnetic Resonance Imaging ,Muscle atrophy ,Surgery ,Muscular Atrophy ,medicine.anatomical_structure ,Adipose Tissue ,Orthopedic surgery ,Female ,Ankle ,medicine.symptom ,Range of motion ,business ,Ankle Joint - Abstract
Purpose: Muscle atrophy is a commonly encountered problem in osteoarthritis (OA). The aim of this study was to estimate the amount of muscle atrophy and fatty degeneration of the lower leg muscles related to ankle OA by magnetic resonance imaging (MRI). Methods: Twenty-one patients with unilateral ankle OA were included in this cohort study. Calf circumference of the affected and healthy lower leg was documented. The degree of OA was classified in conventional radiographs. The cross-sectional areas and fatty degeneration of the muscles of the lower leg were measured in bilateral MRI. Results: We found a significantly reduced calf circumference of the affected vs. healthy leg (p = 0.016). MRI showed a significantly lower cross-sectional area of the entire lower leg musculature in OA (p = 0.013). Sub-analysis of muscle groups revealed that only the M. soleus had a significant cross-sectional area decrease (p
- Published
- 2012
31. Spondylodiscitis in patients under haemodyalisis
- Author
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Ana Maria Cervan, Alfonso del Arco, Juan de Dios Colmenero, Enrique Guerado, and Francisco Villanueva
- Subjects
Spondylodiscitis ,Adult ,Male ,medicine.medical_specialty ,Discitis ,Comorbidity ,X ray computed ,Renal Dialysis ,medicine ,Humans ,Orthopedics and Sports Medicine ,In patient ,Aged ,Retrospective Studies ,Aged, 80 and over ,Original Paper ,business.industry ,Retrospective cohort study ,Length of Stay ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,Multicenter study ,Orthopedic surgery ,Kidney Failure, Chronic ,Female ,business ,Tomography, X-Ray Computed - Abstract
The purpose of this study was to reach conclusions about the diagnosis and treatment of a series of patients with spondylodiscitis under haemodialysis treatment.We collected and studied 23 patients included in a prospective database from two neighbouring hospitals. Descriptive statistical analysis was performed.The diagnosis was frequently made very late and early negative cultures were not uncommon; magnetic resonance images allowed for an early diagnosis with accurate anatomical information. Empirical antibiotic treatment with prompt surgery produced good results in patients under risk of, or having neurological problems. Surgical approaches did not differ from pyogenic or tuberculous spondylodiscitis. Age in our series was not a predictive issue.Whenever a patient under haemodialysis has symptoms of spinal disease, particularly back pain with fever, they should undergo an MRI. If diagnosis of spondylodiscitis is made prompt empirical antibiotherapy should be instituted. Blood cultures should be performed and tissue samples taken for cultures; however, culture outcome must not delay therapy. Early surgical decompression leads to good results.
- Published
- 2011
32. One-Stage Anterolateral Surgical Treatment for Lumbosacral Segment Tuberculosis
- Author
-
Wei Hu, Jie-fu Song, Bin Chen, Zisheng Ai, and Zhi-zhen Jing
- Subjects
Adult ,Male ,medicine.medical_specialty ,Sacrum ,Tuberculosis ,medicine.medical_treatment ,Lumbar vertebrae ,Blood Sedimentation ,Ilium ,Fixation (surgical) ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Orthopedic Procedures ,Pain Measurement ,Original Paper ,Bone Transplantation ,Lumbar Vertebrae ,business.industry ,One stage ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,medicine.anatomical_structure ,Spinal Fusion ,Debridement ,Spinal fusion ,Orthopedic surgery ,Female ,Tuberculosis, Spinal ,business ,Lumbosacral joint - Abstract
The purpose of this study was to evaluate clinical outcomes following one-stage anterior radical debridement, interbody fusion, and sacral rod fixation for the treatment of lumbosacral segment tuberculosis.From March 2004 to November 2008, 11 patients diagnosed with spinal tuberculosis received antituberculosis medications for two to three weeks before anterior radical debridement, autologous iliac bone grafting, and internal sacral rod fixation. Surgery was performed when the toxic symptoms of tuberculosis were controlled and erythrocyte sedimentation rates (ESR) decreased to 37.2 ± 9.6 mm/h (25-54 mm/h). Lumbosacral angle, visual analogue scale (VAS) pain, ESR, and neurological performance were assessed before and after surgery.All surgical procedures were performed successfully without intra or postoperative complication. There were no instances of spinal tuberculosis recurrence. Patients were followed-up for a mean of 19.6 months. The mean lumbosacral angle was significantly increased from the mean preoperative angle (12.9 ± 5.0°) both postoperatively (21.5 ± 6.1°) and at final follow-up (20.1 ± 5.2°) (both P0.001). The mean VAS scores and ESR were significantly decreased from preoperative levels (7.3 ± 1.2 and 37.2 ± 9.6 mm/h, respectively) both postoperatively (1.5 ± 0.5 at month six and 10.4 ± 4.5 mm/h at month three, respectively) and at final follow-up (0.6 ± 0.5 and 10.5 ± 2.3 mm/h, respectively) (all P0.001). Bone fusion occurred in all patients at a mean of nine months (range six to 12 months) after surgery. Three patients who had impaired neurological performance before surgery had normal neurological performance after surgery.Our findings suggest that anterior radical debridement, interbody fusion, and sacral rod fixation can be an effective treatment option for lumbosacral segment tuberculosis.
- Published
- 2011
33. Comparison between the antero-posterior and anterior approaches for treating L5-S1 vertebral tuberculosis
- Author
-
Qingyi He and Jianzhong Xu
- Subjects
musculoskeletal diseases ,Adult ,Male ,medicine.medical_specialty ,Sacrum ,Tuberculosis ,Adolescent ,Treatment outcome ,Young Adult ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Orthopedic Procedures ,Plate fixation ,Aged ,Retrospective Studies ,Original Paper ,Lumbar Vertebrae ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Spinal surgery ,Surgery ,Spinal Fusion ,Treatment Outcome ,Debridement ,Orthopedic surgery ,Female ,Anterior approach ,Tuberculosis, Spinal ,business - Abstract
Both the antero-posterior and anterior approaches have been used for treating L5-S1 vertebral tuberculosis. However, no studies have compared the efficacy of the two methods in treating the disease.The antero-posterior (AP group, 14 cases) and anterior (A group, 13 cases) approaches were performed on L5-S1 vertebral tuberculosis cases who were followed up for average of 25 months. Clinical and radiographic data were obtained from and compared between groups.Average operative time, blood loss and pre-operative, post-operative and last follow-up of lumbo-sacral angles for groups AP and A were 497 min vs 190 min, 980 ml vs 410 ml, 22.3° vs 20.6°, 29.8° vs 25.7° and 28.3° vs 23.6°, respectively. Averaged visual analogue scale (VAS) scores in groups AP and A, respectively, were 6.5 vs 6.0 points before surgery and 3.0 vs 2.8 points after surgery. Mean ODI scores were 60.2 vs 63.0 points before and 30.0 vs 28.5 points after the operation for groups AP and A, respectively. Six cases in the AP group and five in the A group who exhibited neurological symptoms recovered to American Spinal Injury Association (ASIA) grade E. The average hospitalisations of groups AP and A lasted for 21 and 15 days, respectively. Bony fusion was achieved in both groups, with an average fusion time of five and four months, respectively.Both the antero-posterior and anterior approaches can effectively heal L5-S1 vertebral tuberculosis, but the average surgical time, blood loss and hospital stay following the anterior approach are prominently less than those following the antero-posterior approach.
- Published
- 2011
34. Arthroscopic repair for combined Bankart and superior labral anterior posterior lesions: a comparative study between primary and recurrent anterior dislocation in the shoulder
- Author
-
Doo-Sup Kim, Chang-Ho Yi, and Yeu-Seung Yoon
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Visual analogue scale ,Lesion ,Arthroscopy ,Young Adult ,Recurrence ,Tendon Injuries ,medicine ,Humans ,Orthopedics and Sports Medicine ,Range of Motion, Articular ,Original Paper ,medicine.diagnostic_test ,business.industry ,Shoulder Joint ,Shoulder Dislocation ,Anterior shoulder ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,Bankart lesion ,medicine.anatomical_structure ,Orthopedic surgery ,Shoulder joint ,Female ,medicine.symptom ,Shoulder Injuries ,Range of motion ,business - Abstract
The purpose of this study was to compare clinical outcomes between a primary dislocation group (group P) and a recurrent dislocation group (group R) with combined lesion of Bankart and type II SLAP lesions (type V SLAP lesion) and to evaluate incidence of type V SLAP lesion. In addition, the authors evaluated clinical outcomes of these patients by dividing two groups according to the sequence for Bankart and SLAP lesion suture. From May 2000 to May 2005, 310 patients who gave informed consent, underwent the diagnostic arthroscopy and magnetic resonance arthrography (MRA). One hundred and ten patients met the following criteria: (1) post-traumatic primary or recurrent anterior shoulder instability, (2) a normal contralateral shoulder, (3) a type V SLAP lesion, and (4) minimum follow-up of two years. Group P included 42 patients, and group R, 68 patients. Among all patients, 58 patients who had Bankart lesions sutured first were included in group B, and 52 who had their SLAP lesions sutured beforehand, group S. Visual analogue scale, range of motion, Rowe and Constant score were used to compare results between group P and group R, also group B and group S. The incidence rates of type V SLAP lesion were 42.8% in group P and 32.0% in group R. The overall treatment results in our study were good. Even if the difference between the two groups was statistically insignificant, group P showed greater recovery of range of motion than group R in external rotation. No significant difference was found between the two different operative methods according to suture sequence. The incidence rates of type V SLAP lesion were 42.8% in the primary dislocation group and 32.0% in the recurrent dislocation group. The overall treatment results in our study were good. Although there was no statistical significance in surgical time between the two groups, when both SLAP and Bankart lesions are present, the Bankart lesion must be sutured first to reduce surgical time.
- Published
- 2011
35. Developmental changes of the central sulcus morphology in young children.
- Author
-
Gajawelli N, Deoni SCL, Ramsy N, Dean DC 3rd, O'Muircheartaigh J, Nelson MD, Lepore N, and Coulon O
- Subjects
- Brain diagnostic imaging, Brain Mapping, Child, Child, Preschool, Humans, Neuroanatomy, Cerebral Cortex, Magnetic Resonance Imaging
- Abstract
The human brain grows rapidly in early childhood, reaching 95% of its final volume by age 6. Understanding brain growth in childhood is important both to answer neuroscience questions about anatomical changes in development, and as a comparison metric for neurological disorders. Metrics for neuroanatomical development including cortical measures pertaining to the sulci can be instrumental in early diagnosis, monitoring, and intervention for neurological diseases. In this paper, we examine the development of the central sulcus in children aged 12-60 months from structural magnetic resonance images. The central sulcus is one of the earliest sulci to develop at the fetal stage and is implicated in diseases such as Attention Deficit Hyperactive Disorder and Williams syndrome. We investigate the relationship between the changes in the depth of the central sulcus with respect to age. In our results, we observed a pattern of depth present early on, that had been previously observed in adults. Results also reveal the presence of a rightward depth asymmetry at 12 months of age at a location related to orofacial movements. That asymmetry disappears gradually, mostly between 12 and 24 months, and we suggest that it is related to the development of language skills.
- Published
- 2021
- Full Text
- View/download PDF
36. Surgical treatment of thoracic outlet syndrome in young adults: single centre experience with minimum three-year follow-up
- Author
-
Giuseppe M. Peretti, Roberto Chiesa, Gianfranco Fraschini, Celeste Scotti, Simonetta Gerevini, Pietro Ciampi, Francesco De Cobelli, Ciampi, P, Scotti, C, Gerevini, S, DE COBELLI, Francesco, Chiesa, Roberto, Fraschini, G, and Peretti G., M.
- Subjects
Thoracic outlet ,Adult ,Male ,medicine.medical_specialty ,Decompression ,First rib resection ,Young Adult ,Postoperative Complications ,Surveys and Questionnaires ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Orthopedics and Sports Medicine ,Thoracic outlet syndrome ,Retrospective Studies ,Original Paper ,business.industry ,Middle Aged ,medicine.disease ,Decompression, Surgical ,Clavicle ,Magnetic Resonance Imaging ,Surgery ,Radiography ,Venous thrombosis ,Thoracic Outlet Syndrome ,medicine.anatomical_structure ,Treatment Outcome ,Patient Satisfaction ,Orthopedic surgery ,Cervical Vertebrae ,Female ,business ,Cervical vertebrae ,Follow-Up Studies - Abstract
"Thoracic outlet syndrome is an often misdiagnosed syndrome which consists of a neurovascular compression at the upper thoracic outlet. The clinical presentation can be variable, ranging from mild symptoms to venous thrombosis and muscle atrophy. Many aetiologies, both congenital and acquired, related either to bony or soft tissue anomalies, have been associated with this syndrome. As a consequence, the diagnosis is often challenging and sometimes it can be obtained only with surgical exploration. Additionally, no specific clinical test is considered diagnostic of thoracic outlet syndrome. However, the recent advances in imaging techniques together with a careful clinical evaluation give the surgeon the chance to recognize the constricting anatomy before surgery in many cases. No standard surgical procedure has been identified; however, in literature the largest series have been treated with transaxillary first rib resection. Here we report our experience in the surgical treatment of this syndrome with a minimum follow-up of three years. Our approach consists of performing a supraclavicular decompression without routine first rib resection. This allows for identifying and removing the constricting anatomy in most cases, with satisfactory results in 96.9% of patients and a low complication rate."
- Published
- 2010
37. Visualization of transcoronary ablation of septal hypertrophy in patients with hypertrophic obstructive cardiomyopathy: a comparison between cardiac MRI, invasive measurements and echocardiography
- Author
-
Lars S. Maier, Christian Sohns, Jan D. Schmitto, Claudius Jacobshagen, Björn Raab, Silvia Obenauer, and Samuel Sossalla
- Subjects
Male ,medicine.medical_specialty ,genetic structures ,medicine.medical_treatment ,HOCM ,Catheter ablation ,030204 cardiovascular system & hematology ,TASH ,CMR ,Cardiac imaging ,Obstructive cardiomyopathy ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Septal hypertrophy ,Heart Septum ,medicine ,Humans ,cardiovascular diseases ,Aged ,Ultrasonography ,Cardiac catheterization ,Original Paper ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,General Medicine ,Cardiomyopathy, Hypertrophic ,Middle Aged ,Ablation ,Magnetic Resonance Imaging ,Heart septum ,Treatment Outcome ,Catheter Ablation ,cardiovascular system ,Cardiology ,Feasibility Studies ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Medicine & Public Health - Abstract
Objective Hypertrophic obstructive cardiomyopathy (HOCM) is treated by surgical myectomy or transcoronary ablation of septal hypertrophy (TASH). The aim of this study was to visualize the feasibility, success and short-term results of TASH on the basis of cardiac MRI (CMR) in comparison with cardiac catheterization and echocardiography. Methods In this in vivo study, nine patients with HOCM were treated with TASH. Patients were evaluated by transthoracic echocardiography, invasive cardiac angiography and CMR. Follow-up examinations were carried out after 1, 3 and 12 months. MR imaging was performed on a 1.5-T scanner. All images were processed using the semiautomatic Argus software and were evaluated by an attending thoracic radiologist and cardiologist. Results The echocardiographic pressure gradient (at rest) was 69.3 ± 15.3 mmHg before and 22.1 ± 5.7 mmHg after TASH (P
- Published
- 2010
38. Outcomes after Excision of Pigmented Villonodular Synovitis of the Knee
- Author
-
Edward Y. Cheng and Vivek Sharma
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Sports medicine ,genetic structures ,Adolescent ,Knee Joint ,medicine.medical_treatment ,Salvage therapy ,Synovectomy ,Synovitis, Pigmented Villonodular ,Risk Assessment ,Statistics, Nonparametric ,Cohort Studies ,Arthroscopy ,Young Adult ,Synovitis ,medicine ,Secondary Prevention ,Humans ,Orthopedics and Sports Medicine ,Orthopedic Procedures ,Child ,Symposium: Selected Papers Presented at the 2008 Meeting of the Musculoskeletal Tumor Society ,Aged ,Probability ,Retrospective Studies ,Salvage Therapy ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,Treatment Outcome ,Pigmented villonodular synovitis ,Orthopedic surgery ,Female ,business ,Tomography, X-Ray Computed ,Follow-Up Studies - Abstract
Pigmented villonodular synovitis (PVNS) has a high but variable recurrence rate. Prior studies do not compare recurrence-free survival (RFS) for various surgical approaches or salvage surgery for relapse. We therefore determined: (1) RFS after excision; (2) RFS after salvage surgery for relapse; (3) factors associated with relapse. We retrospectively reviewed the medical records of 49 patients with previously untreated PVNS of the knee (12 localized, 37 diffuse) who were treated with synovectomy from 1991 to 2008; there were 22 males and 27 females, with mean age of 35.2 years (range, 10–73). Minimum followup was 1 year (mean, 6.2 years; range, 1–13). Twenty-one patients had a relapse. The RFS for index surgery was 75% and 53%; and for salvage surgery was 71% and 52% at 2 and 5 years respectively. The RFS was 95% for open versus 62% for arthroscopic synovectomy at 2 years, 71% and 41% at 5 years. The RFS was 91% for localized and 70% for diffuse PVNS at 2 years, 73% and 48% at 5 years. Diffuse disease (RR = 4.49) and arthroscopic synovectomy (RR = 3.30) were associated with relapse. Recurrence was frequent after synovectomy. Reexcision can salvage relapses as successfully as excision for primary disease; however, morbidity was associated with additional surgeries. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
- Published
- 2009
39. Lesion size changes in osteonecrosis of the femoral head: a long-term prospective study using MRI
- Author
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Nian Fei Zhang, Liming Cheng, Bai Liang Wang, Wei Sun, Zhao Hui Liu, Feng Chao Zhao, and Zi Rong Li
- Subjects
Male ,medicine.medical_specialty ,Bone Regeneration ,Lesion volume ,Severe Acute Respiratory Syndrome ,Lesion ,Femoral head ,Young Adult ,Adrenal Cortex Hormones ,Femur Head Necrosis ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Bone regeneration ,Prospective cohort study ,Mri scan ,Original Paper ,Hyperbaric Oxygenation ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Middle Aged ,Magnetic Resonance Imaging ,body regions ,medicine.anatomical_structure ,Orthopedic surgery ,Surgery ,Female ,Radiology ,medicine.symptom ,business ,Follow-Up Studies - Abstract
Osteonecrosis of the femoral head (ONFH) is one of the intractable diseases. It is controversial whether the lesion size assessed by magnetic resonance imaging (MRI) can change over time without any operative treatment. In this study, we used MRI to observe the lesion size changes of ONFH induced by corticosteroid administration in severe acute respiratory syndrome (SARS) patients. The study included 51 SARS patients (84 hips) with early-stage ONFH who did not receive any operative treatment and were diagnosed by MRI. All of the patients underwent MRI follow-ups. Each patient was evaluated on the basis of the lesion volume on MRI at every follow-up for further comparisons. At the first MRI scan, the mean lesion volume was 10.12 +/- 8.05 cm(3) (range: 0.39-41.62 cm(3)). At the mid-term follow-up (2.5 years), the mean lesion volume was 7.82 +/- 7.59 cm(3) (range: 0.11-39.65 cm(3)). At the final follow-up (five years), complete regression of the lesion was observed in six hips, and the mean lesion volume was 5.67 +/- 6.58 cm(3) (range: 0.00-31.47 cm(3)). Overall, the lesion volume was reduced by15% in 80 hips, and only four hips with relatively larger lesion volumes showed no apparent reductions. The reduction in lesion size of ONFH observed on MRI is a slow, discontinuous and time-dependent process.
- Published
- 2009
40. Magnetic Resonance Imaging Findings in Hematogenous Osteomyelitis of the Hip in Adults
- Author
-
Charalampos G. Zalavras, Thomas Learch, Nick Rigopoulos, John S. Lee, and Michael J. Patzakis
- Subjects
musculoskeletal diseases ,Adult ,Male ,medicine.medical_specialty ,Medullary cavity ,Comorbidity ,Femoral head ,medicine ,Humans ,Orthopedics and Sports Medicine ,Femur ,Retrospective Studies ,business.industry ,Osteomyelitis ,Soft tissue ,Acetabulum ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,medicine.anatomical_structure ,Orthopedic surgery ,Female ,Hip Joint ,Osteitis ,business ,Symposium: Papers Presented at the 2008 Meeting of the Musculoskeletal Infection Society - Abstract
Hematogenous hip infections are rare in adults and the extent of infection into the bone or adjacent soft tissues may be underestimated, leading to inadequate surgical debridement. Using MRI, we sought to determine the extent of bone involvement and the presence of adjacent soft tissue abscesses in adults with hip osteomyelitis. We reviewed the records and MRIs in 11 adult patients (12 hips) with hematogenous osteomyelitis of the femoral head in 12 hips. Ten of 11 patients had one or more comorbidities. All patients underwent surgical debridement and received antibiotic therapy for 6 weeks. MRI revealed osteomyelitis distal to the femoral head in seven of 12 hips with extension into the medullary canal in three of these seven. Femoral head erosions were present in 10 hips, acetabulum osteomyelitis in 11, and acetabular erosions in six hips. Infection extended into adjacent soft tissues in eight of 12 hips. MRI demonstrated that the infection may extend distal to the femoral head or into the adjacent soft tissues. MRI may be useful for preoperative planning so that all regions affected by the infection can be treated. Level of Evidence: Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
- Published
- 2009
41. Role of MRI in detecting early physeal changes due to acute osteoarticular infection around the knee joint: a pilot study
- Author
-
Mussa Wardak, S. S. Gill, Vishal Kumar, Raghav Saini, Namita Jha, Paramjeet Singh, Ramesh Kumar Sen, and Emal Wardak
- Subjects
musculoskeletal diseases ,Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,Knee Joint ,Pilot Projects ,Metaphysis ,medicine ,Deformity ,Humans ,Orthopedics and Sports Medicine ,Growth Plate ,Child ,Original Paper ,medicine.diagnostic_test ,business.industry ,Osteomyelitis ,Infant ,Magnetic resonance imaging ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,Radiography ,medicine.anatomical_structure ,Epiphysis ,Case-Control Studies ,Child, Preschool ,Orthopedic surgery ,Acute Disease ,Disease Progression ,Septic arthritis ,Female ,medicine.symptom ,business ,Follow-Up Studies - Abstract
Physeal changes of any aetiology in children are usually diagnosed once the deformity is clinically evident. Between January 2006 and June 2007, 15 children who suffered from acute osteoarticular infection around the knee joint were studied. They were called up for follow-up six months after the onset of infection. All patients were evaluated by clinical and roentgenographic examination before undergoing magnetic resonance imaging (MRI) study of both knees “with the unaffected knee serving as control”. Abnormal findings in the physis, metaphysis and/or epiphysis on MRI were observed in five children. This group of five children was compared with the other ten children for clinical presentation and course of disease. We believe that MRI is a useful tool in the evaluation of growth plate insult in the early period following acute osteoarticular infection, and we can diagnose and prevent the catastrophic complications of the same.
- Published
- 2008
42. Concomitant noncontiguous level (thoracic & lumbar) spinal stenosis
- Author
-
Hitesh N. Modi, Bharat R Dave, Ankur Nanda, and Ankur Gupta
- Subjects
musculoskeletal diseases ,Adult ,Male ,medicine.medical_specialty ,Time Factors ,Decompression ,Spinal stenosis ,Risk Assessment ,Severity of Illness Index ,Thoracic Vertebrae ,Cohort Studies ,Myelopathy ,Lumbar ,Spinal Stenosis ,medicine ,Humans ,Orthopedics and Sports Medicine ,Prospective Studies ,Myelography ,Aged ,Original Paper ,Lumbar Vertebrae ,medicine.diagnostic_test ,business.industry ,Nerve Compression Syndromes ,Lumbar spinal stenosis ,Recovery of Function ,Middle Aged ,medicine.disease ,Decompression, Surgical ,Magnetic Resonance Imaging ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Thoracic vertebrae ,Female ,medicine.symptom ,Claudication ,business ,Follow-Up Studies - Abstract
Presented here is a prospective study assessing the efficacy of decompression of concomitant noncontiguous level (thoracic & lumbar) stenosis in accordance with neurological findings, nerve root blocks, and myelographically proven disease. The objective was to determine the efficacy, clinical outcome, and functional recovery in patients undergoing simultaneous decompression. No previous study has focussed on the clinical outcome of such simultaneous decompression. Twenty-one patients with neurological claudication, progressive gait disturbance, upper motor neuron symptoms, and findings of myelopathy in both the lower extremities underwent simultaneous decompression and were assessed. The average follow-up was 32 months (range, 24–40 months). At the last examination,13 patients (82%) had excellent or good clinical results. Postoperative improvement correlated inversely with the duration of symptoms. The patients usually had satisfactory outcomes when the correct diagnosis was made and management was implemented. Functional recovery depends on early diagnosis and timely surgical intervention.
- Published
- 2008
43. Anterior corpectomy and fusion for severe ossification of posterior longitudinal ligament in the cervical spine
- Author
-
Haijun Tian, Zhimin He, Xinwei Wang, Xuhai Lu, Yu Chen, Deyu Chen, and Yong-fei Guo
- Subjects
Male ,medicine.medical_specialty ,China ,medicine.medical_treatment ,Ossification of Posterior Longitudinal Ligament ,Preoperative care ,Risk Assessment ,Severity of Illness Index ,Cohort Studies ,Postoperative Complications ,Preoperative Care ,medicine ,Posterior longitudinal ligament ,Humans ,Orthopedics and Sports Medicine ,Spinal canal ,Muscle Strength ,Corpectomy ,Range of Motion, Articular ,Aged ,Pain Measurement ,Probability ,Retrospective Studies ,Original Paper ,business.industry ,Ossification ,Patient Selection ,Recovery of Function ,Middle Aged ,Decompression, Surgical ,Magnetic Resonance Imaging ,Surgery ,medicine.anatomical_structure ,Spinal Fusion ,Treatment Outcome ,Spinal fusion ,Orthopedic surgery ,Cervical Vertebrae ,Female ,Radiology ,medicine.symptom ,business ,Tomography, X-Ray Computed ,Cervical vertebrae ,Follow-Up Studies - Abstract
Between May 2002 and October 2006, 19 patients (17 men and 2 women; average age 57.2; range 47–71 years) received anterior corpectomy and fusion for severe ossification of the posterior longitudinal ligament (OPLL) in our department. Preoperative radiological evaluation showed the narrowing by the OPLL exceeded 50% in all cases, and OPLL extended from one to three vertebrae. We followed-up all patients for 12–36 months (mean 18 months). The Japanese Orthopaedic Association (JOA) score before surgery was 9.3 ± 1.8 (range 5–12) which significantly increased to 14.2 ± 1.3 (range 11–16) points at the last follow-up (P
- Published
- 2008
44. Clinical, MRI, and arthroscopic correlation in meniscal and anterior cruciate ligament injuries
- Author
-
Faizal Rayan, Divyang D. Shukla, and Sachin Bhonsle
- Subjects
medicine.medical_specialty ,Knee Joint ,Anterior cruciate ligament ,Physical examination ,Knee Injuries ,Sensitivity and Specificity ,Arthroscopy ,Predictive Value of Tests ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Physical Examination ,Lateral meniscus ,Original Paper ,medicine.diagnostic_test ,business.industry ,Anterior Cruciate Ligament Injuries ,Magnetic resonance imaging ,musculoskeletal system ,Magnetic Resonance Imaging ,Tibial Meniscus Injuries ,medicine.anatomical_structure ,Predictive value of tests ,Orthopedic surgery ,Surgery ,Radiology ,business ,human activities - Abstract
The aim of this prospective study was to compare and correlate clinical, magnetic resonance imaging (MRI), and arthroscopic findings in cases of meniscal tear and anterior cruciate ligament (ACL) injuries. MRI scan results and clinical diagnosis are compared against the arthroscopic confirmation of the diagnosis. One hundred and thirty-one patients had suspected traumatic meniscal or anterior cruciate ligament (ACL) injury. Clinical examination had better sensitivity (0.86 vs. 0.76), specificity (0.73 vs. 0.52), predictive values, and diagnostic accuracy in comparison to MRI scan in diagnosis for medial meniscal tears. These parameters showed only marginal difference in lateral meniscal and anterior cruciate ligament injuries. We conclude that carefully performed clinical examination can give equal or better diagnosis of meniscal and ACL injuries in comparison to MRI scan. MRI may be used to rule out such injuries rather than to diagnose them.
- Published
- 2008
45. Osteochondritis dissecans
- Author
-
A J, Hall
- Subjects
Adult ,Male ,Original Paper ,Bone Transplantation ,Knee Joint ,Contraindications ,Magnetic Resonance Imaging ,Osteochondritis Dissecans ,Severity of Illness Index ,Internal Fixators ,Radiography ,Young Adult ,Treatment Outcome ,Humans ,Orthopedics and Sports Medicine ,Surgery ,Female ,Letter to the Editor ,Pain Measurement ,Retrospective Studies - Abstract
To assess of the value of conservative and operative treatment of osteochondritis dissecans of the knee, a multicenter study was performed. In 12 European countries, 798 cases of osteochondritis of the knee have been collected from 44 hospitals. Results were based on 452 patients with 509 affected knees with minimum follow-up was 1 year (mean follow-up, 3 years and 11 months) and sufficient data for evaluation: 61% were male patients; 39% female patients; 318 affected knees were found in juvenile patients; 191 affected knees were in adult or premature patients. The localization was the medial femoral condyle on the lateral side in 51 % (typical site) of patients. Various other sites were involved. Of the 509 affected knees, 154 were treated conservatively, 355 were treated surgically (many with multiple operations). For evaluation, the initial situation (at the time of the diagnosis) was favorable in 198 patients (no effusion, diameter of the lesion
- Published
- 2007
46. Stress fractures presenting as tumours: a retrospective analysis of 22 cases
- Author
-
Christof Birkenmaier, Volkmar Jansson, Andreas Fottner, H.R. Dürr, and Andrea Baur-Melnyk
- Subjects
Adult ,Diagnostic Imaging ,Male ,medicine.medical_specialty ,Adolescent ,Fractures, Stress ,Bone Neoplasms ,Risk Assessment ,Sensitivity and Specificity ,Cohort Studies ,Diagnosis, Differential ,Young Adult ,Medical imaging ,medicine ,Humans ,Orthopedics and Sports Medicine ,Femur ,Tibia ,Child ,Letter to the Editor ,Aged ,Retrospective Studies ,Aged, 80 and over ,Original Paper ,Stress fractures ,medicine.diagnostic_test ,business.industry ,Biopsy, Needle ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Orthopedic surgery ,Surgery ,Female ,Radiology ,Tomography ,Differential diagnosis ,business ,Tomography, X-Ray Computed - Abstract
Frequently, the imaging features of stress fractures may be misinterpreted as tumour-like lesions. The aim of this study was to analyse the quality of different examinations in detecting stress fractures mimicking tumour-like lesions in magnetic resonance imaging (MRI). We evaluated 22 cases which were referred to our department with the suspected diagnosis of bone tumours turning out to be stress fractures. Whenever the MRI did not lead to a diagnosis after a second review, computed tomography (CT) scans and, if still required, additional examinations were performed until the fracture was detected. A stress fracture was diagnosed in 15 cases after the additional CT scan, in five cases with the review of the MRI and in two cases with a combination of several examinations. Especially in stress fractures of the tibia and the femur, CT scanning was essential for making a diagnosis by detecting the fracture line. Bone scans and biopsies, in contrast, were not helpful in making a correct diagnosis.
- Published
- 2007
47. Arthroscopic treatment of symptomatic type D medial plica
- Author
-
Sercan Akpinar, Reha N. Tandogan, Mustafa Uysal, Mehmet Asik, Necip Cesur, and Feyyaz Ciftci
- Subjects
musculoskeletal diseases ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Knee Joint ,medicine.medical_treatment ,Synovectomy ,Knee Injuries ,Cohort Studies ,Arthroscopy ,Young Adult ,medicine ,Humans ,Orthopedics and Sports Medicine ,Original Paper ,medicine.diagnostic_test ,Medical treatment ,business.industry ,Synovial Membrane ,Magnetic resonance imaging ,Recovery of Function ,Partial resection ,Middle Aged ,musculoskeletal system ,Chondromalacia ,Surgery ,Orthopedic surgery ,Female ,business ,human activities - Abstract
We aimed to review the results of subtotal arthroscopic resection of symptomatic type D medial plica. We retrospectively evaluated 23 knees with symptomatic type D medial plica in 22 patients without other intra-articular pathology. All patients complained of chronic knee pain that had not been alleviated by medical treatment or physical therapy. In only three (13%) of the patients studied was the plica diagnosed pre-operatively with magnetic resonance imaging. The type D medial plicae in our series were classified as fenestrated (14 knees), torn (5 knees), or reduplicated (4 knees). Fibrotic changes in the plicae and degenerative changes on the medial femoral condyle were found in 16 knees Patellofemoral chondromalacia was present in three knees Arthroscopic partial resection was performed in all patients. Comparative Lysholm Knee Scale scores before and after surgery revealed a significant clinical improvement (pre-operative status, 67.19 +/- 8.05 vs. post-operative status, 90.57 +/- 9.80; P0.001). Type D medial plica should be considered as a possible cause of chronic knee pain. Arthroscopic partial resection of the plicae in symptomatic patients gives satisfactory results.
- Published
- 2007
48. Preservation of C7 spinous process does not influence the long-term outcome after laminoplasty for cervical spondylotic myelopathy
- Author
-
Toshinori Sakai, Hirofumi Kosaka, K. Higashino, Shinsuke Katoh, Koichi Sairyo, and Natsuo Yasui
- Subjects
Adult ,Male ,medicine.medical_specialty ,Visual analogue scale ,Radiography ,medicine.medical_treatment ,Spinal Cord Diseases ,Spinal Osteophytosis ,Myelopathy ,medicine ,Humans ,Orthopedics and Sports Medicine ,Orthopedic Procedures ,Aged ,Retrospective Studies ,Aged, 80 and over ,Original Paper ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Laminoplasty ,musculoskeletal system ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Orthopedic surgery ,Cervical Vertebrae ,Female ,business ,Cervical vertebrae - Abstract
Axial pain is one of the major complications after laminoplasty, and preservation of C7 spinous process during the procedure can reduce the axial pain. However, it has not been elucidated whether laminoplasty preserving the C7 spinous process can maintain neurological improvement for a long time. The purpose of our retrospective study was to investigate the long-term neurological outcome after open-door laminoplasty preserving the C7 spinous process for cervical spondylotic myelopathy (CSM). Clinical and radiological outcomes were analysed in 42 patients who underwent open-door laminoplasty preserving C7 spinous process and followed up for more than 5 years. Neurological function was evaluated by means of the Japanese Orthopaedic Association (JOA) scoring system for cervical myelopathy. Axial pain was assessed using a visual analog scale (VAS) at the last examination. Alignment and motion of the cervical spine were measured from radiographs, and magnetic resonance imaging (MRI) was used to evaluate postoperative compression at C7. The mean JOA score was 9.4 before surgery and 12.0 at the latest follow-up. The mean VAS score in 26 patients score was 9.7/100. No compression of the spinal cord was observed in any MRI at the latest follow-up. Preservation of the C7 spinous process does not influence the long-term outcome of CSM after laminoplasty. Although we did not have a comparative group, the procedure described here should be considered as the solution.
- Published
- 2006
49. Massive tears of the rotator cuff treated with a deltoid flap
- Author
-
Bernard Augereau, Thierry Dart, Moncef Bensaïda, Eric Vandenbussche, and Céline Mutschler
- Subjects
Male ,medicine.medical_specialty ,Surgical Flaps ,Rotator Cuff Injuries ,Rotator Cuff ,Patient satisfaction ,medicine ,Humans ,Orthopedics and Sports Medicine ,Rotator cuff ,Muscle, Skeletal ,Aged ,Retrospective Studies ,Original Paper ,Chi-Square Distribution ,medicine.diagnostic_test ,business.industry ,Rotator cuff injury ,Magnetic resonance imaging ,Middle Aged ,Amyotrophy ,medicine.disease ,musculoskeletal system ,Magnetic Resonance Imaging ,Tendon ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Orthopedic surgery ,Tears ,Female ,business - Abstract
We retrospectively reviewed the charts of 29 patients younger than 65 years at surgery treated with deltoid flap reconstruction for massive postero-superior rotator cuff tears. All tears involved supraspinatus and infraspinatus tendons and were associated with tendon stump retraction to the glenoid rim, a preservable long biceps tendon, and an intact subscapularis tendon. Mean follow-up was 10.5 years. Patient satisfaction rate was 89%. Mean global Constant score improved from 43 to 71.5 points, mean pain score from 6.3 to 13.2, mean anterior flexion from 100 to 157 degrees, and force in elevation from 2.3 to 3 kg. Two thirds of patients had no humeral head migration. Of the 18 patients whose flap was examined by magnetic resonance imaging, 15 had no tear and 12 had a flap signal of muscle intensity; mean flap thickness was 5 mm. Pre-operative factors associated with poorer outcomes were upwards humeral head migration with a subacromial space smaller than 6 mm, presence of glenohumeral osteoarthritis, and supraspinatus amyotrophy greater than 40%. Deltoid flap reconstruction is a valid option in this patient population.
- Published
- 2004
50. Core decompression in early stages of femoral head osteonecrosis – an MRI-controlled study
- Author
-
Nicolas Aigner, W. Schneider, V. Eberl, and Karl Knahr
- Subjects
musculoskeletal diseases ,Adult ,Male ,medicine.medical_specialty ,Bone disease ,Radiography ,Femoral head ,Femur Head Necrosis ,medicine ,Humans ,Orthopedics and Sports Medicine ,Core decompression ,Stage (cooking) ,Aged ,Original Paper ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Harris Hip Score ,Orthopedic surgery ,Female ,business - Abstract
We treated 45 hips with idiopathic necrosis of the femoral head stages I–III with core decompression. Average age of patients was 41 (27–68) years and average follow-up 68.9 (31–120) months. In 30 hip joints in stage I, 29 showed no radiographic progression and a complete remission of the changes consistent with necrosis on MRI at the last follow-up. In 27 patients the clinical result – based on the Harris Hip Score (HHS) assessment – was excellent (average HHS 91.9 points). Of nine hips in stage II, four had received a total hip arthroplasty, one had deteriorated to stage IV, and four were still classified as stage II (average HHS 95 points). Of six hips in stage III, three had received a total hip arthroplasty and three had deteriorated to stage IV (average HHS 73 points).
- Published
- 2002
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