Inter-observer agreement and accuracy of LI-RADS v2018 for differentiating tumor in vein from bland thrombus using gadoxetic acid-enhanced magnetic resonance imaging.

PURPOSE: To assess inter-observer agreement and accuracy of LI-RADS v2018 for differentiating tumor in vein (TIV) from bland thrombus on gadoxetic acid-enhanced magnetic resonance imaging (Gx-MRI). Secondarily, to determine whether a multi-feature model improves accuracy compared to LI-RADS. METHODS: We retrospectively identified consecutive patients at risk for hepatocellular carcinoma with venous occlusion(s) reported on Gx-MRI. Five radiologists independently classified each occlusion as TIV or bland thrombus using the LI-RADS TIV criterion (enhancing soft tissue in vein). They also evaluated imaging features suggestive of TIV or bland thrombus. Intra-class correlation coefficient (ICC) was calculated for individual features. A multi-feature model was developed based on consensus scores of features with > 5% consensus prevalence and > 0.40 ICC. Sensitivity and specificity of the LI-RADS criterion and of the cross-validated multi-feature model were compared. RESULTS: Ninety-eight patients with 103 venous occlusions (58 TIV, 45 bland thrombus) were included. The LI-RADS criterion provided 0.63 ICC and, depending on the reader, 0.62-0.93 sensitivity and 0.87-1.00 specificity. Five other features had > 5% consensus prevalence and > 0.40 ICC, including three LI-RADS suggestive features and two non-LI-RADS features. The optimal multi-feature model incorporated the LI-RADS criterion and one LI-RADS suggestive feature (occluded or obscured vein contiguous with malignant parenchymal mass). After cross-validation, the multi-feature model did not improve sensitivity or specificity compared to the LI-RADS criterion (P = 0.23 and 0.25, respectively). CONCLUSION: Using Gx-MRI, the LI-RADS criterion for TIV provides substantial inter-observer agreement, variable sensitivity, and high specificity for differentiating TIV from bland thrombus. A cross-validated multi-feature model did not improve diagnostic performance.

Measurement of Cerebrospinal Fluid Flow Dynamics Using Phase Contrast MR Imaging with Bilateral Jugular Vein Compression: A Feasibility Study in Healthy Volunteers.

We measured the changes in the cerebrospinal fluid (CSF) flow dynamics after compression of the bilateral jugular veins using phase contrast-magnetic resonance imaging (PC-MRI). PC-MRI was performed in 10 healthy male volunteers using a 3T clinical scanner with a two-dimensional gradient echo sequence. We successfully measured the changes in CSF flow velocity using PC-MRI with and without compression of the bilateral jugular veins. The relative velocity range decreased by about 30% when the bilateral jugular veins were compressed.

Basi-parallel anatomical scanning (BPAS)-MRI can improve discrimination of vertebral artery dissection from atherosclerosis and hypoplasia.

RATIONALE AND OBJECTIVES: The purpose of this study was to determine the effectiveness of combining basi-parallel anatomic scanning (BPAS)-magnetic resonance (MR) imaging findings with those of time-of-flight (TOF)-MR angiography (MRA) for differentiating vertebral artery dissection (VAD) from other causes of true artery narrowing such as atherosclerosis or an anatomical variation such as vertebral artery hypoplasia. MATERIALS AND METHODS: Fifteen cases of VAD, 15 of atherosclerotic narrowing, and 8 of hypoplastic vertebral arteries were retrospectively selected for this study. Conventional MR sequences (T1WI, T2WI, and T2*WI, fluid attenuation inversion recovery, TOF-MRA) and BPAS images were analyzed by two readers blinded to the patients' clinical data and history. Receiver operating characteristic analyses were performed to compare the diagnostic capability of conventional MR sequences with and without BPAS imaging in suspected VAD cases. RESULTS: The area under the curve increased significantly by combining BPAS imaging findings with those of conventional MRI (0.72 vs. 0.96 and 0.81 vs. 0.99; P = .0022 and P = .0068, respectively, for readers 1 and 2). In addition, the sensitivity was 100% (15/15) for both readers and significantly greater than that of conventional MRI (53.3% [8/15] for both readers, P = .0156); however, specificities were not significantly different (82.6% [19/23] vs. 82.6% [19/23] and 91.33% [21/23] vs. 95.7% [22/23]). The interobserver agreement also improved by adding BPAS imaging. CONCLUSIONS: Adding BPAS imaging to conventional MRI and MRA sequences can improve diagnostic capability and sensitivity in suspected VAD cases and be helpful in differentiating it from other causes of vertebral artery narrowing such as atherosclerosis or hypoplasia.

The effect of fluoridation and its discontinuation on fluoride profiles in the alveolar bone of rat.

We investigated the effect of fluoridation and its discontinuation on fluoride content in the alveolar portion of the mandible in rats. Drinking water with three different fluoride contents (0, 50, 100 ppmF) was given to rats for three different periods (4, 13 and 25 weeks). Fluoride concentrations were measured in the crest, the middle, and the apical parts of the alveolar bone and in the body of the mandible. Furthermore, after fluoridated drinking water was given to rats for 4 or 13 weeks, distilled water was given to them for 21 or 12 weeks respectively; and the effect of the discontinuation on fluoride profiles was investigated. Layer samples were analyzed by abrasive microsampling. Fluoride and phosphorus concentrations were determined by ion-specific electrode and colorimetric procedures, respectively. There was an increase in fluoride concentrations in the mandible in proportion to the fluoride content in the drinking water and the duration of fluoridation. After fluoridation was discontinued, fluoride concentrations in the surface layers of the mandible presented a decrease. Among the four different parts of the mandible, the upper part of the alveolar bone and the alveolar crest part presented the highest rates of reduction. The relative reduction rate of fluoride concentration was closely related to the duration of discontinuation. The alveolar crest was affected most by the discontinuation of fluoridation, presenting the greatest reduction.