Misses and errors in upper extremity trauma radiographs.

OBJECTIVE: The article reviews a select group of traumatic upper extremity injuries that can be easily misinterpreted on radiographs. CONCLUSION: The awareness of these specific injuries and an understanding of their underlying pathophysiology and the role that radiographs can play in their evaluation will give the reader the best opportunity to make the important imaging findings and guide appropriate treatment.

Rotator Cuff Fatty Infiltration Are Coronal Images More Helpful for Characterization than Sagittal Images?

OBJECTIVE: To assess for a difference in the characteriza - tion of rotator cuff (RC) muscle fatty infiltration (FI) between the sagittal and coronal planes in the setting of a large or massive RC tear. MATERIALS AND METHODS: Retrospective review of pa - tients with MRIs demonstrating large or massive RC tears (study group-SG) and no tearing (control group-CG) was conducted. Sagittal T1W and coronal PD images of the supraspinatus and infraspinatus muscles from each patient were selected, separated, and placed in random order. Three MSK readers reviewed the images blindly and independently and qualified the FI based on the Goutallier classification. RESULTS: The SG included 15 men and 15 women (mean age: 65; range: 45 to 87 years); CG included 10 men and 10 women (mean age: 60; range 45 to 76 years). Statistically significant (SS) discrepancies in the assessment of the FI between the sagittal and coronal images occurred 62% in SG and 33% in CG, (p < 0.001). In SG, each reader demon - strated a SS tendency (p < 0.04) to assign a higher value to each muscle when grading the sagittal images compared to coronal images. In SG, 33% of the time (37% supraspinatus, 29% infraspinatus), there was a grade greater than or equal to 3 assigned on the sagittal images but less than 3 grade on corresponding coronal images. CONCLUSION: There was a statistically significant differ - ence in the characterization of RC FI between the sagittal and coronal planes in the setting of a large or massive tear, likely related to incomplete visualization of the musculature on sagittal imaging secondary to muscle and tendon retrac - tion and more complete visualization on coronal imaging. Awareness of this difference may allow for a more accurate characterization of the degree of fatty infiltration.

Current Clinical Applications and Future Potential of Diffusion Tensor Imaging in Traumatic Brain Injury.

In the setting of acute central nervous system (CNS) emergencies, computed tomography (CT) and conventional magnetic resonance imaging (MRI) play an important role in the identification of life-threatening intracranial injury. However, the full extent or even presence of brain damage frequently escapes detection by conventional CT and MRI. Advanced MRI techniques such as diffusion tensor imaging (DTI) are emerging as important adjuncts in the diagnosis of microstructural white matter injury in the acute and postacute brain-injured patient. Although DTI aids in detection of brain injury pathology, which has been repeatedly associated with typical adverse clinical outcomes, the evolution of acute changes and their long-term prognostic implications are less clear and the subject of much active research. A major aim of current research is to identify imaging-based biomarkers that can identify the subset of TBI patients who are at risk for adverse outcome and can therefore most benefit from ongoing care and rehabilitation as well as future therapeutic interventions.The aim of this study is to introduce the current methods used to obtain DTI in the clinical setting, describe a set of common interpretation strategies with their associated advantages and pitfalls, as well as illustrate the clinical utility of DTI through a set of specific patient scenarios. We conclude with a discussion of future potential for the management of TBI.

Retroperitoneal hemangioma demonstrated on blood pool scan.

Retroperitoneal hemangioma is a rare but clinically significant condition that can be challenging to diagnose and characterize on anatomical imaging alone. We present a case of an 80-year-old woman with diabetes and hypertension, who was found to have an abdominal mass diagnosed first on CT abdomen and pelvis in March 2011 and demonstrated to be stable on subsequent MRI study performed 16 months later in July 2012. The mass was later confirmed to be a hemangioma on a 99mTc-red cell study.

Magnetic resonance spectroscopic imaging of benign prostatic tissue: findings at 3.0 T compared to 1.5 T-initial experience.

In a retrospective study of 71 voxels of benign peripheral zone tissue from 3 men who underwent endorectal magnetic resonance (MR) spectroscopic imaging of the prostate at both 1.5 and 3 T, 21 voxels that appeared more malignant at 3 T to either of two readers demonstrated significantly higher levels of choline and polyamines at 3 T compared to 1.5 T using a Wilcoxon ranked-sum test; awareness of this selective amplification of these metabolic signals at high field strength may help avoid overdiagnosis of prostate cancer.