Multiparametric MRI with MR elastography findings in patients with sinusoidal obstruction syndrome after oxaliplatin-based chemotherapy.

OBJECTIVE: To evaluate the magnetic resonance elastography (MRE)-derived liver stiffness measurement (LSM), T1 and T2 relaxation times, and hepatobiliary phase images in patients, who developed sinusoidal obstruction syndrome (SOS) after oxaliplatin-based chemotherapy. METHODS: Thirty-four patients (M/F:22/12) who underwent liver MRI-MRE and received oxaliplatin for colorectal, gastric, and pancreas cancer were included in the study. SOS was diagnosed by Gd-EOB-DTPA-enhanced MRI in 18 patients. MRE-LSM and T1-T2 maps were evaluated. Patients with SOS were grouped according to the amount of reticular hypointensity on the hepatobiliary phase images. RESULTS: The mean MRE-LSM in the patients with SOS was 3.14 ± 0.45 kPa, and the control group was 2.6 ± 0.5 kPa (p = 0.01). The mean-corrected T1 (cT1) relaxation time was 1181 ± 151 ms in the SOS group and 1032 ± 129 ms in the control group (p = 0.005). The mean T2 relaxation time was 50.29 ± 3.6 ms in the SOS group and 44 ± 3.9 ms in the control group (p = 0.01). Parenchymal stiffness values were 2.8 ± 0.22 kPa, 3 ± 0.33 kPa, and 3.65 ± 0.28 kPa in patients with mild, moderate, and advanced SOS findings, respectively (p = 0.002). Although cT1 and T2 relaxation times increased with increasing SOS severity, no statistical significance was found. CONCLUSIONS: We observed increased MRE-LSM in patients with SOS after chemotherapy compared to control group. T1 and T2 relaxation times were also useful in diagnosing SOS but were found inadequate in determining SOS severity. MRE is effective in diagnosing SOS and determining SOS severity in patients who cannot receive contrast agents, and it may be useful in the follow-up evaluation of these patients.

Magnetic resonance imaging findings of invasive breast cancer in different histological grades and different histopathological types.

BACKGROUND: The aim of this study was to evaluate the magnetic resonance imaging (MRI) findings of invasive breast cancer in different histopathological types (invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC) and mixed ductal-lobular carcinoma (MDLC)) and different histological grades. METHODS: A retrospective review was made of 1256 patients who underwent breast MRI at our hospital between January 2015 and December 2018. A total of 152 lesions (27 ILC, 102 IDC, 23 MDLC and 20 grade 1, 83 grade 2 and 49 grade 3) were included in the study. All the lesions were evaluated according to size, shape, margin, dynamic curve, ADC value and T2 signal intensity ratio (SIR). RESULTS: Most of the lesions tended to show type 2 and type 3 dynamic curve, type 1 dynamic curve was more commonly seen in ILC and grade 1 groups. IDC showed higher T2 SIR than the other types and grade 3 showed higher T2 SIR than other grades (p< 0,05) There was no statistically significant difference between the groups according to morphological features and mean ADC values (p > 0,05). CONCLUSION: T2 SIR and dynamic curve can help the radiologists predict histopathological findings while morphological features and ADC values were not helpful in distinguishing histological types and grades.

Role of femoral artery ultrasound imaging in cardiovascular event risk prediction in a primary prevention cohort at a medium-term follow-up.

BACKGROUND: Cardiovascular (CV) disease prevention guidelines have addressed how imaging may influence CV risk determined by established risk score systems in primary prevention. Nevertheless, data are lacking regarding the use of femoral artery ultrasonography for CV risk modification. Herein, we hypothesized that femoral artery plaque and its characteristics, as well as femoral intima-media thickness (fIMT) measurements, may predict major adverse cardiovascular events (MACE). METHODS: Subjects free from documented CV disease who were scheduled for coronary computed tomographic angiography at our institution from September 2016-June 2017 were included. IMT measurements and plaque assessment were performed at femoral and carotid arteries. Coronary artery calcium score (CACS) was recorded. Patients were followed-up for MACE. RESULTS: A total of 215 subjects (mean age: 54.85 years, 47.91% male) were eligible. Median number of CV risk factors was 3. Median 10-year atherosclerotic CV disease risk based on Pooled Cohort Equation (PCE) equation was 6.3%. At a median follow-up of 24 months, 9 subjects (4.19%) had MACE. Patients who experienced MACE at follow-up were older (p=0.047), more of male gender (p=0.015), had higher serum creatinine levels despite being within reference limits (p=0.031) and PCE equation risk score (p=0.011). In patients who experienced MACE at follow-up, distal (p=0.027), bifurcation (p=0.007), and proximal carotid IMT (p=0.030) and fIMT (p=0.015) were increased. Surface irregularities and ulceration in femoral artery plaques were more common (p=0.001) and CACS was higher (p<0.001). When adjusted for other subclinical atherosclerosis imaging markers, femoral artery plaque surface irregularities and ulceration and only coronary calcification (without concomitant carotid or femoral atherosclerosis) were found to be independent predictors of MACE at follow-up (both p=0.004). CONCLUSIONS: Our data emphasize that baseline ultrasonographic assessment of the femoral arteries to define plaque characteristics may provide prognostic information for predicting MACE in a primary prevention cohort.