Incidental findings of cervical magnetic resonance imaging: A retrospective reinterpretation of a large adult population.

Background: Magnetic resonance imaging (MRI) of the cervical spine is one of the routine MRI scans of the cervical region in investigating spinal disc pathologies, spinal stenosis, and the detection of spinal lesions, which are the major parameters to be evaluated in this examination. Purpose: The authors of this study are focused on a different aspect of cervical MRI, revealing the incidences and reporting rates of extraspinal incidental findings. Methods: A total of 1000 patients (324 males, 676 females, mean age 47 ± 14) who had undergone an MRI of the cervical spine were enrolled in this study. The magnetic resonance (MR) images of these patients were re-interpreted with respect to the incidental extraspinal imaging findings. The incidence and reporting rate of each incidental finding encountered during the evaluation were presented in percentages. Results: 726 patients in this study had at least one incidental lesion. The results of this study revealed that the most common incidental lesions encountered during the reinterpretation of cervical MRI were nasopharyngeal mucosal thickening (n = 442) and thyroid hypertrophy (n = 231). The total reporting rate of incidental findings was 5.29%. Conclusion: There are many data to be reported and evaluated by MR imaging of the cervical spine, not only the main parameters of MRI scanning in the routine daily practice of radiologists. All our colleagues should be aware and careful of these incidental findings, which may be the initial medical data of the patients' diagnoses, or to avoid undesirable medicolegal problems.

Normative measurements of orbital structures on magnetic resonance images; a cross-sectional study with mini review of the literature.

PURPOSE: Awareness of normative values of extra orbital structures would provide useful information to interpret the radiological images better and use them for diagnostic purposes. This study aimed to reveal the average values of major extraocular structures measured on magnetic resonance images. METHODS: In this retrospective cross-sectional study, magnetic resonance (MR) images of 256 orbits of 128 patients were re-interpreted regarding the measurements of major orbital structures. Extraocular muscles, superior ophthalmic vein, and optic nerve-sheath complex were measured on orbital MR images of these patients. The data distributions were presented by box-plot analyses for each parameter, and the measurement results were analyzed regarding gender and age groups. RESULTS: Lateral rectus muscle thickness (LR), inferior rectus muscle thickness (IR), globe position (GP), and interzygomatic line (IZL) values were higher in the male group than in the female group (p values were < 0.001, 0.003, 0.020, and < 0.001 respectively). LR, the thickness of the superior group muscles (SUP GR), IR, superior oblique muscle thickness (SOBL), and the thickness of optic nerve-sheath complex (ON) values indicated a significant relationship between age groups. There was a significant, positive, and low-level correlation between age and LR, SUP GR, and IR values (p values were < 0.001, 0.001, and < 0.001, respectively). CONCLUSION: This study provides quantitative data on normative values of orbital structures with gender and age group comparisons. Clinicians or surgeons can easily use the measured values to gather diagnostic information from the orbital region.

Association between the most superior point of patella-entrance of femoral trochlea distance ratio (SP-ET index) and chondromalacia patella: an investigation via magnetic resonance imaging.

Purpose: In this study, the effect of the most superior point of patella-entrance of femoral trochlea distance ratio (SP-ET index) on chondromalacia patella (CP) was investigated with 2 reviewers. Material and methods: A total of 348 knees of 308 patients were analysed retrospectively with magnetic resonance imaging (MRI). Patients with or without CP constituted the study and the control groups in this cross-sectional investigation. Two reviewers interpreted the dataset regarding the SP-ET index. This ratio was calculated as the distance between the most superior point of patella and the entrance of femoral trochlea (ß) divided by the patellar articular surface length (α). The relationship between the SP-ET index and CP was presented using independent samples T-tests, and the intraclass correlation coefficient (ICC) was calculated to reveal the interobserver differences. Results: There was excellent agreement between the reviewers regarding α, ß, and SP-ET values (ICC was 0.971, 0.964, and 0.943, respectively). Higher SP-ET values were obtained for patients with CP, in comparison with patients without any chondral lesion (p < 0.001). A significant, positive, and moderate level of correlation was revealed between SP-ET measurements and CP grades for the total study population. Conclusions: SP-ET index showed high interobserver agreement and indicated a significant difference between patients with and without CP. Both reviewers' results indicated positive and significant correlation between the measured SP-ET values and different grades of CP for females, males, and the total study population.

Examination of ethmoidal roof regarding Keros and Yenigun classifications in a Turkish population: a computerized tomography study.

PURPOSE: Understanding ethmoid roof morphology is crucial to prevent complications in endoscopic sinus surgery. This study aimed to evaluate the morphological properties of the ethmoidal roof regarding gender and age differences using Keros and Yenigun classifications on high-resolution computed tomography images. METHODS: We retrospectively analyzed 891 high-resolution computed tomography paranasal sinus study images and measured the depth of the cribriform plate in coronal sections and the anterior-posterior length in axial planes. The study retrospectively examined CT images of paranasal sinuses of patients living in the eastern Anatolian region of Turkey. RESULTS: In both Keros and Yenigun Classifications, the most common class was type 2, and the least common class was type 3. According to Keros et al.'s method, no significant difference was observed between men and women (p = 0.698). However, according to Yenigun et al., the average values of women in terms of the anterior-posterior distance of the ethmoid roof were significantly higher than men (p = 0.001). When examined according to age, a very low, negative correlation was revealed regarding Keros and Yenigun classifications (p = 0.047 and p < 0.001 retrospectively). According to Keros and Yenigun's classification, there was no significant difference between the left and right sides (p = 0.488 and p = 0.919, respectively). CONCLUSION: The morphological properties of the ethmoidal roof have importance to be considered for preoperative planning. Studying larger patient groups and meta-analyses that gather various research results about this subject might help better understand the ethmoidal roof morphology among populations.

Using the Blackburne-Peel index to measure the patellar height on magnetic resonance images.

To reveal the normal values of patellar height measurements using the Blackburne-Peel index on magnetic resonance (MR) images and to show the gender and age differences regarding this measurement technique. This retrospective cross-sectional study investigated 148 knee MR images, and those images were re-evaluated to find out the normal values of patellar height using the Blackburne-Peel index (BPI). An adapted measurement technique of this index was applied to MR images. The study group was analyzed regarding the sex and age differences, correlation with age was investigated, and all descriptive data were presented. Independent Samples T-test, Kruskal-Wallis variance analysis, and Spearman's Rho correlation test was applied to calculate the results. The mean value was 0.80 ± 0.09 for the total of patients. The measurements regarding the height of the inferior edge of the patella articular surface and the length of the patella articular surface indicated a significant difference between females and males (p < 0.001 for both measurements). The descriptive data obtained from this study revealed the mean values of the whole study group, different sexes, and age groups separately. Additional studies are needed for adapting BPI on MR images and verifying the normal values of the population.

Does the use of computed tomography scenogram alone enable diagnosis in cases of bowel obstruction?

BACKGROUND: Ileus is a pathological condition of the abdomen that presents as a medical emergency. It is characterized by potential complications such as perforation and ischemia, which can lead to significant morbidity and mortality if not promptly addressed. The successful management of ileus relies heavily on the timely and precise identification of the condition. While conventional radiography (CR) is commonly used as the primary diagnostic tool, its accuracy in identifying obstructions ranges from 46% to 80%. Furthermore, the diagnostic accuracy of identifying the location and etiology of intestinal obstruction by CR is limited, therefore making computed tomography (CT) the ideal imaging modality in this regard. AIM: To determine the presence of acute bowel obstruction (BO) on abdominal CT scenogram images and the accuracy of determining its possible location, taking into account the experience of the observers. METHODS: A retrospective screening was conducted on an ensemble of 46 individuals who presented to the emergency department between January 2021 and January 2022 with severe abdominal pain and were subsequently monitored for suspected ileus. The abdominal CT scans of these patients were assessed by three radiologists with varying levels of experience (1, 3, and 10 years) at different intervals (1 mo apart). The evaluation focused on determining the presence or absence of BO, as well as identifying the potential location of the obstruction (small bowel or large bowel). The study employed Kappa statistics to assess inter-observer variances, while the McNamer test was used to evaluate obstruction and segmentation discrepancies between observations. A significance level of P < 0.05 was determined to indicate statistical significance. RESULTS: Out of the total sample size of 46 patients, 15 individuals (32.6%) were identified as female, while the remaining 31 individuals (67.4%) were identified as male. The ultimate diagnosis of 42 instances (91.3%) indicated ileus resulting from mechanical obstruction (MO). Among these patients, 14 (33%) experienced obstruction in the large bowel (LB), while 28 (66%) experienced obstruction in the small bowel (SB). The initial evaluation yielded sensitivity rates of 76.19%, 83.31%, and 83.33%, and diagnostic accuracy rates of 69.56%, 76.08%, and 80.43% for the detection of BO among the three observers. The initial study revealed that the average sensitivity of three observers in detecting the presence of ileus caused by MO was 80.94%, while the diagnostic accuracy was 75.35%. Based on the first evaluation, the senior observer demonstrated the highest sensitivity (85.71%), negative predictive value (92.60%), and diagnostic accuracy (80.43%) when accurately estimating the thick and thin segmentation, as per the final diagnosis. There was no statistically significant disparity observed in the sensitivities pertaining to the identification of ileus during the second assessment, as well as the precise determination of the segment level inside the LB or SB, when comparing the second and third observers. Nevertheless, although there was no statistically significant alteration in the detection rate of ileus by the first observer, there was a notable rise in the accuracy rate of segment estimating (73.91%). The senior assessor had a higher level of accuracy in assessing the existence of ileus and segmentation compared to the other evaluators in both evaluations. CONCLUSION: The findings of our study indicate that the sensitivity and accuracy rates of abdominal CT scenogram scans in diagnosing acute MOs are similar to or greater than those of CR. Additionally, the study revealed that radiologists with more experience demonstrated a higher likelihood of accurately predicting the existence and potential localization of MO compared to their less experienced counterparts.

The Comparison between Herniated and Non-Herniated Disc Levels Regarding Intervertebral Disc Space Height and Disc Degeneration, A Magnetic Resonance Study.

PURPOSE: The main purpose of this study was to evaluate the intervertebral disc height and intervertebral disc degeneration between the normal group and the group with disc herniation at the level of the L4-L5 intervertebral disc by MRI using the Pfirrmann grading system. MATERIALS AND METHODS: 385 patients were included in this study. MRI images were reevaluated and intervertebral disc heights were measured from the anterior, middle and posterior segments. Researchers divided disc pathologies into two groups. In the non-herniated group; normal or bulging ones; in the herniated group, they included those with protrusion or extrusion. RESULTS: 385 lumbar MRI examinations meeting the study criteria were included in study. There were 56.9% (219/385) females and 43.1% (166/385) males in the study. For the whole patients in the study group, the intervertebral disc height values at the L4-5 level were measured as 12.34 mm, 11.58 mm, and 7.60 mm in the anterior, middle, and posterior localizations, respectively. CONCLUSIONS: At the L4-5 level, the height of the disc distances in the herniated group was lower than in the normal group. The Pfirrman score was found to be higher in the herniated group in terms of disc degeneration compared to the normal group.

Association between the subcutaneous fat thickness of the knee and chondromalacia patella: a magnetic resonance imaging-based study.

OBJECTIVE: Subcutaneous fat tissue thickness (SFTT) is a representative marker of obesity. This study was performed to determine the relationship between SFTT and chondromalacia patella (CP) through routine 1.5-Tesla magnetic resonance imaging (MRI) of the knee. METHODS: In this retrospective cross-sectional study, 440 knee MRI scans were re-examined and divided into those with and without CP. A 1.5-Tesla MRI machine with a standard knee coil was used. Prepatellar SFTT (PSFTT) and medial SFTT (MSFTT) were measured on each MRI scan. PSFTT and MSFTT were compared between patients with and without CP. RESULTS: Both the PSFTT and MSFTT values were significantly higher in patients with than without CP. Women had significantly higher PSFTT and MSFTT values than men. A statistically significant correlation was found between the PSFTT and MSFTT values and the CP grades. CONCLUSIONS: The results of this study indicate an association between SFTT and CP. A positive correlation was also found between SFTT and CP severity.

Correlation of Diffusion weighted MR Imaging and ADC values of hepatic metastasis of Gastrointestinal Stromal and Gastroenteropancreatic Neuroendocrine Tumors.

BACKGROUND: DWI and ADC-mapping was performed to analyze hepatic metastasis of GIST, GEP-NET. OBJECTIVE: The objective of this study is to present hepatic metastasis of GIST and GEP-NET with Diffusion weighted MR imaging(DWI) and the Apparent diffusion coefficients (ADC) values of masses. METHOD: 18 GIST patients and 8 GEP-NET patients were examined retrospectively. 11 males and 6 females were present in GIST group, 7 males to 5 females were involved in GEP-NET group. 18 primary GIST and 10 hepatic metastasis of GIST, 8 original GEP-NET and 19 hepatic metastasis of GEP-NET; total 55 GIST and GEP-NET masses were analysed by ADC mapping. MR images were acquired by 1,5 T MR units (32 mT/min gradient strength- Achieva; Philips Healthcare, Best, Netherlands and 32 channel GE Signa GE-Wisconsin-USA); by using a 4-8 channel standard phased-array torso XL coil, all images were evaluated by an Abdominal MRI experienced radiologist. DWI was performed in the transverse plane by using spin-echo-planar imaging sequence. RESULT: No statistical differences were observed between GIST and GEP-NET patients according to age and gender variations. No significant statistical differences were observed according to the diameters and ADC values of GIST and GEP-NET patients. A significant statistical difference was observed between GIST and GEP-NET groups in terms of size of liver metastasis which was significantly higher in GIST patients. All three groups (GIST_Hep. MET, GEP-NET_Liver_Met and normal) were statistically differed according to ADC values. With the ROC curve analysis: Hepatic metastasis of GIST(n=10) and normal liver (n:47) had cut-off value for ADC: 0.925 under AUC: 0.939 with regard to ADC values and regarded 89.4 % Sensitivity, 100% Specificity, 100% PPV and 66.7% PPV. ROC curve of GEP NET_ Hepatic metastasis (n=19) group and normal liver (n:47) group presented cut-off value for ADC: 0.860 under AUC: 0.967 correlated to ADC values with 93.6 % sensitivity, 89.5% specificity, 95.7% PPV and 85% PPV. CONCLUSION: High cellular tumors resulted from liver metastasis of GIST and GEP-NET's, and a positive correlation was observed between ADC values and cellularity/differentiation ratios of metastatic masses.

Percutaneous management in hepatic alveolar echinococcosis: A sum of single center experiences and a brief overview of the literature.

BACKGROUND: Hepatic alveolar echinococcosis (HAE) is a serious zoonotic infection that affects humans. It may have a tumor-like appearance at times. Percutaneous treatment of HAE patients is extremely relaxing for them. HAE is a significant human zoonotic infection caused by the fox tapeworm Echinococcus Multilocularis larvae. It possesses the characteristics of an invasive tumor-like lesion due to its infiltrative growth pattern and protracted incubation period. The disease is endemic over central Europe, Asia, and North America. AIM: To characterize HAE patients who were treated percutaneously, their outcomes, and the major technical features of percutaneous treatment in HAE. METHODS: Patients who were treated with percutaneous cyst drainage and/or percutaneous biliary drainage were included in the study. Uncorrected abnormal coagulation values and solid or non-infected HAE with minor necrotic change were excluded. RESULTS: Thirty-two patients underwent percutaneous cyst drainage, two patients underwent percutaneous biliary drainage, and four patients underwent percutaneous biliary drainage alone. Interventional radiology is utilized to drain echinococcal necrosis and abscesses within/without the liver, as well as diseased and clogged bile ducts. CONCLUSION: Percutaneous drainage of cyst contents and/or biliary channels using a minimally invasive technique is a very beneficial. Percutaneous cyst drainage with albendazole therapy improves quality of life in patients who are unable to undergo surgery, even when the mass resolves with long-term treatment.

Infarcts and ischemia in the abdomen: an imaging perspective with an emphasis on cross-sectional imaging findings.

Infarcts and ischemia of abdominal organs may present with acute abdominal pain, and early diagnosis is crucial to prevent morbidity and mortality. Unfortunately, some of these patients present in poor clinical conditions to the emergency department, and imaging specialists are crucial for optimal outcomes. Although the radiological diagnosis of abdominal infarcts is often straightforward, it is vital to use the appropriate imaging modalities and correct imaging techniques for their detection. Additionally, some non-infarct-related abdominal pathologies may mimic infarcts, cause diagnostic confusion, and result in delayed diagnosis or misdiagnosis. In this article, we aimed to outline the general imaging approach, present cross-sectional imaging findings of infarcts and ischemia in several abdominal organs, including but not limited to, liver, spleen, kidneys, adrenals, omentum, and intestinal segments with relevant vascular anatomy, discuss possible differential diagnoses and emphasize important clinical/radiological clues that may assist radiologists in the diagnostic process.

Incidental findings on prostate MRI: a close look at the field of view in this anatomical region.

Magnetic resonance imaging (MRI) has been widely used as an advanced imaging modality to detect prostate cancer and indicate suspicious areas to guide biopsy procedures. The increasing number of prostate examinations with MRI has provided an opportunity to detect incidental lesions, and some might be very significant to elucidate patient symptoms or occult neoplastic process in the early stages. These incidental lesions might be located in the prostate gland, adjacent tissues, or organs around the prostate gland or out of the genitourinary system. The field of view of prostate MRI includes not only the prostate gland but also other critical pelvic organs in this specific anatomical region. Some of these incidental lesions might cause the same symptoms as prostate cancer and might explain the symptoms of the patient, and some might indicate early cancer stages located outside the prostate. Reporting these lesions might be life-saving by initiating early disease treatment. Awareness of the predicted locations of congenital anomalies would also be beneficial for the radiologists to mention these incidental findings.

Imaging findings of two patients with isolated infarction of the splenium during COVID-19.

Coronavirus disease 2019 (COVID-19) is caused by the virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the literature, this virus has been associated with coagulation dysfunction and arterial thromboembolism. In clinical practice, corpus callosum infarcts are very rare, and the incidence of isolated splenium infarct is very low. Here, two cases of isolated splenium infarct after COVID-19 are reported with clinical and imaging findings. These findings are thought to be useful in daily practice for our colleagues. In addition, differential diagnoses of this entity will also be discussed in this case report.

Evaluation of Circle of Willis variants using magnetic resonance angiography.

The Circle of Willis (COW) is an important collateral pathway to protect the persistence of cerebral blood perfusion. This study aims to investigate the morphological variants of this significant vascular structure with a large study population. 867 patients who had undergone MR angiography (MRA) evaluation were enrolled in this study. The MRA images of these patients obtained by the three-dimensional time-of-flight technique were re-interpreted to measure the vessel diameters of all components of the COW and classify the COW variations. In addition, correlations of the vessel calibers and the integrity of the COW with gender and age groups were presented. There was female dominance in the study population, and the mean age was 48. Type A was the most common variation in anterior (75.78%) and posterior (53.98%) circulation. Types G and H were the other common variation in the anterior circulation, and types E and D were the second and third common variations in the posterior COW, respectively. Smaller calibration for both ICAs, both P1s and BA were observed in females compared with the male group. Diameters of the BA, and both P1 segments were lower, and the left PCom diameter was significantly higher in the patients with a complete circle. There was a significant sex and age difference regarding the distribution of the complete, partially complete, and incomplete circle groups. The significant differences in the vessel calibers of specific components of the COW for complete, partial, and incomplete circulations revealed by this study should be explained with further research. In addition, meta-analyses with other studies in the literature might be a guide to understanding the morphological alterations of the COW and their relationships with a complete and non-complete circle.

The Role of Diffusion Weighted MR Imaging in the Diagnosis of Tendon Injuries of the Ankle and Foot.

Background and objectives: Our aim is to determine the diagnostic performance and utility of Diffusion Weighted MR Imaging (DWI) against the routine Magnetic Resonance Imaging (MRI) for the evaluation of patients with tendon injuries of the ankle and foot. Materials and Method: After institutional review board approval and informed consent taken from all the patients, ankle and foot MR imaging and DWI-Apparent Diffusion Coefficient (ADC) mapping were performed on the 81 injured tendons of 50 patients. All tendon injuries were named as Rupture (R), Partial tear (PT), and Tenosynovitis (T). Diagnostic interpretation was based on the MRI-DWI and ADC mapping, verified by either open surgery, diagnostic arthroscopy, or conservative procedures-splint application. Statistical analysis of this research was assessed by Fischer's exact test, variance analysis test between dependent groups, Receiver Operating Characteristics (ROC) curve, and Pearson chi square statistics. Results: MRI depicted all tendon injuries with 70% sensitivity and 100% specificity, and showed a significant statistical relationship to surgical and arthroscopic references with high agreement (p < 0.05, k: 0.609). DWI had 100% sensitivity and 83-90% specificity for the visualization of tendon injuries with certain agreement and a significant statistical relationship to the gold standard (p < 0.05, k: 0.890-0.899). For all those injured tendons, DWI had 100% sensitivity for the diagnosis of R, and 92-97% sensitivity corresponding to PT and T over routine ankle MR imaging. The specificity of DWI to MRI ranged from 75 to 44% for all the injured tendons. DWI had significant statistical superiority over MRI for the visualization of R, PT, and T of all tendons included in this research (p < 0.05). Conclusions: DWI is a good imaging modality for the visualization of ankles with tendon injuries, possibly further improving the sensitivity of the classical ankle and foot MRI, and supplying more beneficial and diagnostic information than routine MR imaging on the basis of R, PT, and T of tendons at the ankle and foot.

Relationship between Body Mass Index and Articular Injuries Accompanying Primary Anterior Cruciate Ligament Tear in Male Knees: A Retrospective Observational Study.

The objective of this study was to determine the effects of body mass index (BMI), as a modifiable risk factor, on meniscal, chondral, and ligamentous injuries, as well as on bone marrow edema accompanying anterior cruciate ligament (ACL) rupture. This retrospective observational study analyzed 84 male patients who underwent primary ACL reconstruction from 2015 to 2018. Magnetic resonance imaging was performed within 6 weeks of injury. Bone bruise, tendon, ligament, meniscal, and muscle injuries were evaluated. The surgery was performed within 3 months after the injury. Detailed arthroscopic findings (chondral, meniscal, and ligamentous injuries) were documented intraoperatively. The weight and height were used to quantify BMI (weight in kg/height in m2). Of the 84 male patients, 58 had associated articular injuries. The median age of the study population was 24 years (minimum: 17 years, maximum: 43 years) years. The mean BMI, height, and weight were 27.12 ± 0.78 kg/m2, 1.73 ± 0.01 m, and 81.17 ± 21.52 kg, respectively. The relationship between higher BMI and associated articular injuries (95% confidence interval [CI]) was statistically significant (p < 0.001). There was a statistically significant relationship between weight and associated articular injuries (p = 0.003). Height and age were not predictive factors. Higher BMI and weight were significant risk factors for associated articular injuries in the presence of ACL tear. Height was not found to be a predictive factor. Higher BMI was associated with increased risk of medial and/or lateral meniscus tears and bone bruising.

The Combined Effect of Body Mass Index and Tibial Slope Angles on Anterior Cruciate Ligament Injury Risk in Male Knees: A Case-Control Study.

INTRODUCTION: Tibial slope angles (TSAs) have been identified as potential risk factors of anterior cruciate ligament (ACL) injury in the literature. A higher body mass index (BMI) might increase the risk of ACL tear because of greater axial compressive force. The aim of this study was to determine the relationship of these factors and the combined effect of BMI and TSA in determination of risk potential for ACL injury. METHODS: The preoperative magnetic resonance (MR) images of 81 ACL-injured male knees and of 68 male individuals with no ACL injuries were evaluated by 2 radiologists to measure the TSA. The Mann-Whitney U-test was performed to indicate the significant difference in height, weight, and BMI values. The independent samples t-test was used to determine the differences between ACL-injured and non-injured groups regarding TSA values. Odds ratios were calculated by logistic regression tests, and receiver operating characteristics (ROC) curves revealed the area under the receiver operating characteristics curve (AUC) values to compare the relationships of these parameters with ACL injury. RESULTS: Body mass index, lateral tibial slope (LTS), and medial tibial slope (MTS) were predictive of ACL risk injury. Body mass index alone had the greatest effect among these parameters, and there were no statistically significant differences in coronal tibial slope values between the ACL-ruptured and control groups. The greatest AUC was observed for the combination of BMI, MTS, and LTS. CONCLUSIONS: Body mass index, LTS, and MTS angles were associated with ACL injury risk and BMI + MTS + LTS together revealed the greatest effect on ACL injury.

Assessment of the anterolateral ligament of the knee by 1.5 T magnetic resonance imaging.

Objective This study was performed to evaluate the visibility of the knee's anterolateral ligament (ALL) by magnetic resonance (MR) imaging when evaluating injuries of the ALL in relation to injuries of the anterior cruciate ligament (ACL). Methods Two reviewers retrospectively analyzed MR images for the visibility and dimensions of the ALL and the relationship between ALL and ACL injuries. The intraclass correlation coefficient (ICC) and kappa analysis were used to assess interobserver reliability. The chi-square test was used to assess the relationship between ALL and ACL injuries. Results The entire ALL was viewed on 82% of all MR images. The ICC for ALL visualization ranged from moderate to perfect between the two readers. There was almost perfect agreement between the reviewers when evaluating ALL dimensions. The mean length ± standard error, median thickness, and mean width ± standard error of the ALL were 36.5 ± 0.6 mm, 2.5 mm, and 8.2 ± 0.2 mm, respectively. A statistically significant relationship was observed between ALL and ACL injuries. Conclusion The ALL was visible on most MR images, allowing ALL injuries to be noted during routine MR image interpretation. Radiologists should note concomitant ACL and ALL injuries as part of their assessments.

Analysis of the risk factors for anterior cruciate ligament injury: an investigation of structural tendencies.

OBJECTIVE: The aim of this study was to determine the most important anatomical risk factors for injury of the anterior cruciate ligament (ACL) of the knee. MATERIALS AND METHODS: After study approval by our institutional ethics committee, 3 radiologists reinterpreted the preoperative magnetic resonance (MR) images of 86 patients who had undergone surgery for ACL rupture. The measurements were compared with those for a control group comprising 109 patients with intact ACL who had undergone MR examinations for other reasons, such as meniscal injuries or Baker cyst ruptures. Interobserver differences were calculated after measurement of the notch width (NW), NW index (NWI), medial condyle width (MCW), lateral condyle width (LCW), MCW/LCW ratios, alpha (α) angle, NW angle, quadriceps angle (Q angle), posterior medial tibial slope (MTS), posterior lateral tibial slope, coronal tibial slope, and depth of medial tibial plateau for each group. The relationships between these parameters and ACL injury were studied by performing logistic regression and receiver operating characteristic curve analyses in comparison with those in the control group. RESULTS: We found that there were significant differences in the anatomical parameters of the NW, MCW, NWI, α angle, and MTS between the ACL injured and noninjured groups (p<0.05). There were also significant differences in the bicondylar width, α angle, Q angle, and MTS between the patients with ACL rupture because of noncontact injuries and the control group (p<0.05). The NWI and MTS had the highest predicted relative risk for both the male and female groups. CONCLUSION: We found that the NW, NWI, and MTS were the most important parameters in risk assessment of ACL injuries.

Diffusion weighted magnetic resonance imaging in the diagnosis of parotid masses. Preliminary results.

OBJECTIVE: To demonstrate the diagnostic potentials of MRI, diffusion weighted imaging (DWI), and apparent diffusion coefficient (ADC) mapping in the detection of parotid masses correlated to the histopathological results. Methods: Study design was retrospective. Fifteen patients with parotid gland masses were included as the study group and contralateral normal parotis glands of same patients were taken as the control group. Patients with bilateral parotid gland tumors were excluded, 7 right-sided and 8 left-sided parotid masses were included in the research. The study took place at the Department of Radiology, Ankara, Turkey, between May 2012 and September 2014. Results: Apparent diffusion coefficient measurements of 15 parotis tumors in 1000 and 750 sec/mm2 b-values with comparison to the contralateral normal gland  parenchyma were demonstrated. Neurofibromas was predicted as the highest, and lipomas as the lowest ADC values. Pleomorphic adenomas, Warthin's tumor, and normal parotid parenchyma indicate significant statistical differences from each other on the basis of mean ADC values (p less than 0.05). Conclusion: The DWI and ADC mapping of parotis gland could aid in the differential diagnosis  of benign and malignant masses.