"Ring-shaped" meniscus and accompanying intermeniscal bridge meniscus: a rare combined variant resembling a bucket-handle tear.

Many anatomical variations have been described in the menisci, especially in the lateral meniscus. Among these, discoid meniscus is the most common variation. Others are described in the literature as double-layered meniscus, accessory meniscus, ring-shaped meniscus, and hypoplastic meniscus. Also, combined variations associated with ring-shaped meniscus have been described, and they can be confused with fragmented complex tears and cause unnecessary surgery. Increasing awareness of the imaging features of these accompanying combined variations may aid in the recognition and differentiation of this entity from meniscus tears. We report the case of a ring-shaped meniscus and accompanying intermeniscal bridge meniscus, which has not been described before in the literature, highlighting the MRI and arthroscopic imaging findings of it.

Educating the next generation of radiologists: a comparative report of ChatGPT and e-learning resources

Rapid technological advances have transformed medical education, particularly in radiology, which depends on advanced imaging and visual data. Traditional electronic learning (e-learning) platforms have long served as a cornerstone in radiology education, offering rich visual content, interactive sessions, and peer-reviewed materials. They excel in teaching intricate concepts and techniques that necessitate visual aids, such as image interpretation and procedural demonstrations. However, Chat Generative Pre-Trained Transformer (ChatGPT), an artificial intelligence (AI)-powered language model, has made its mark in radiology education. It can generate learning assessments, create lesson plans, act as a round-the-clock virtual tutor, enhance critical thinking, translate materials for broader accessibility, summarize vast amounts of information, and provide real-time feedback for any subject, including radiology. Concerns have arisen regarding ChatGPT's data accuracy, currency, and potential biases, especially in specialized fields such as radiology. However, the quality, accessibility, and currency of e-learning content can also be imperfect. To enhance the educational journey for radiology residents, the integration of ChatGPT with expert-curated e-learning resources is imperative for ensuring accuracy and reliability and addressing ethical concerns. While AI is unlikely to entirely supplant traditional radiology study methods, the synergistic combination of AI with traditional e-learning can create a holistic educational experience.

Synergizing photon-counting CT with deep learning: potential enhancements in medical imaging.

This review article highlights the potential of integrating photon-counting computed tomography (CT) and deep learning algorithms in medical imaging to enhance diagnostic accuracy, improve image quality, and reduce radiation exposure. The use of photon-counting CT provides superior image quality, reduced radiation dose, and material decomposition capabilities, while deep learning algorithms excel in automating image analysis and improving diagnostic accuracy. The integration of these technologies can lead to enhanced material decomposition and classification, spectral image analysis, predictive modeling for individualized medicine, workflow optimization, and radiation dose management. However, data requirements, computational resources, and regulatory and ethical concerns remain challenges that need to be addressed to fully realize the potential of this technology. The fusion of photon-counting CT and deep learning algorithms is poised to revolutionize medical imaging and transform patient care.

Improving radiology workflow using ChatGPT and artificial intelligence.

Artificial Intelligence is a branch of computer science that aims to create intelligent machines capable of performing tasks that typically require human intelligence. One of the branches of artificial intelligence is natural language processing, which is dedicated to studying the interaction between computers and human language. ChatGPT is a sophisticated natural language processing tool that can understand and respond to complex questions and commands in natural language. Radiology is a vital aspect of modern medicine that involves the use of imaging technologies to diagnose and treat medical conditions artificial intelligence, including ChatGPT, can be integrated into radiology workflows to improve efficiency, accuracy, and patient care. ChatGPT can streamline various radiology workflow steps, including patient registration, scheduling, patient check-in, image acquisition, interpretation, and reporting. While ChatGPT has the potential to transform radiology workflows, there are limitations to the technology that must be addressed, such as the potential for bias in artificial intelligence algorithms and ethical concerns. As technology continues to advance, ChatGPT is likely to become an increasingly important tool in the field of radiology, and in healthcare more broadly.

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.

A Case of Alveolar Echinococcosis Presenting as Cerebral and Spinal Intradural Metastases.

Alveolar echinococcosis is a chronic and serious, even lethal, parasitic infection caused by the helminth Echinococcus multilocularis. The involvement of Central Nervous System is reported to be 1-3% in literature. Brain involvement is considered a sign of the terminal phase of alveolar echinococcosis. We here in reported a 67-year-old female who had liver alveolar hydatid disease with brain and spinal intradural metastases.

The role of coronary CT angiography in diagnosis of patent foramen ovale.

PURPOSE: We aimed to examine the incidence of patent foramen ovale (PFO) and atrial septal aneurysms (ASA) in the Turkish population using coronary computed tomography angiography (CTA); assess the feasibility of coronary CTA for PFO diagnosis by conducting a comparison with transthoracic echocardiography (TTE); and determine the diagnostic role and characteristics of the interatrial tunnel, free flap valve (FFV), and shunts. METHODS: The present study was conducted retrospectively and included a sample of 782 patients. Coronary CTA results for all patients were evaluated for the following parameters: the presence of PFO, the degree of contrast jet (if present due to PFO), ASA existence, free flap valve (FFV) length, and PFO tunnel diameters (1 and 2). Coronary CTA and TTE results for PFO detection were also compared for 19 patients who underwent both procedures. RESULTS: PFO was present in 118 patients (15%). In 19 patients who underwent both CTA and TTE, the shunt was present in 15 patients on TTE compared with nine patients on CTA. The sensitivity and specificity of CTA for shunt existence were 53% (8/15) and 75% (3/4), respectively. FFV was observed on CTA in 118 patients (15%). No significant relationship was observed between shunt existence and FFV length (P = 0.148), or between shunt existence and tunnel diameter-1 (P = 0.638) or diameter-2 (P = 0.058). ASAs were present in 16 patients (2%), while accompanying PFO was present in three patients (2.4%). CONCLUSION: Coronary CTA constitutes a more practical and efficient alternative to TTE for PFO diagnosis. Further, it allows the clear visualization of anatomical details of the interatrial tunnel, shunts, and associated abnormalities and detects ASAs.

Ivy Sign in Moyamoya Disease.

Moyamoya disease is an idiopathic disease characterized by the progressive stenosis and collateral development of the distal internal carotid arteries. In this disease, several collateral vascular structures develop following stenosis and occlusion. The ivy sign is a characteristic Magnetic rezonance imaging (MRI) finding frequently encountered in patients with moyamoya. It can be observed both in post contrast T1-weighted images and Fluid attenuated inversion recovery (FLAIR) images. While this sign manifests in the form of contrasting on the cortical surfaces due to the formation of leptomeningeal collateral development and increased numbers of pial vascular webs on post contrast images, in FLAIR images it originates from the slow arterial flow in the leptomeningeal collateral vascular structures. In this case, we presented the Digital subtraction angiography (DSA) signs of moyamoya disease and "ivy sign" in MRI and its development mechanism in a 16 years old female patient.

Non-invasive evaluation of liver fibrosis by acoustic radiation force impulse and aminotransferase:platelet ratio index in chronic hepatitis C.

In a previous issue of the World Journal of Gastroenterology, we have read the article by Li et al with great interest. We would like to thank the authors for their comprehensive contribution. However, it is our wish to make minor criticism over the present study from the perspective of methodology.