Bi-parametric MRI of the Diaphragm Using Dynamic and Static Images: The Initial Experience.

BACKGROUND: With recent technological advances, magnetic resonance imaging (MRI) has offered new sequences that can evaluate the real-time motion of anatomic structures. This study aims to evaluate the interobserver agreement in the diagnosis of diaphragmatic dysfunctions using bi-parametric MRI, in which dynamic sequences for diaphragm movement and static sequences for soft tissue resolution are used together to provide a visualization of the diaphragm. METHODOLOGY: Twenty-nine cases that underwent a bi-parametric magnetic resonance examination which includes coronal T2 single-shot turbo spin echo and the coronal SENSE single-shot balanced turbo field echo real-time sequences were retrospectively evaluated. The images of the patients were assessed by two independent observers. Cohen's kappa coefficient was calculated to evaluate the interobserver agreement. RESULTS: The mean age of the patients was 44.86 ± 17.57, ranging from 18 to 80 years. The kappa value was calculated as 0.889, indicating a strong agreement between the interobservers. CONCLUSIONS: Our experience suggests that bi-parametric MRI is a promising tool in the evaluation of diaphragmatic abnormalities.

Assessment of the relationship between smoking and meniscal injury.

Objective: To determine whether being a smoker and the years of smoking correlate with the presence and degree of meniscal injury. Materials and Methods: Individuals who underwent magnetic resonance imaging of the knee were divided into two groups: smokers and nonsmokers. For each smoker, the total smoking history was calculated by multiplying the daily consumption (packs/day) by the years of smoking, and the result is expressed as pack-years. In the evaluation of meniscal injury, the grade of injury was recorded. The thickness of the subcutaneous adipose tissue, as an indicator of obesity, was measured at the medial knee on axial plane images. The relationships that smoking and obesity had with meniscal injury were analyzed statistically. Results: A total of 156 individuals were included in the study. The smoker group consisted of 48 individuals (30.8%), and the nonsmoker group consisted of 108 (69.2%). The meniscus was normal in one (2.1%) of the smokers and in 32 (29.6%) of the nonsmokers (p < 0.0001). The median subcutaneous adipose tissue thickness was 23 mm and 24 mm in the smokers and nonsmokers, respectively (p = 0.900). A moderate but statistically significant correlation was observed between packs/day and injury grade, as well as between pack-years and injury grade (r = 0.462, p = 0.001 and r = 0.523, p = 0.001, respectively). Smoking and age significantly increased the risk of meniscal injury, by 31.221 times (p = 0.001) and 1.076 times (p < 0.001), respectively. Conclusion: Our findings indicate that current smoking and smoking history correlate significantly with meniscal injury grade.

Objetivo: Determinar a correlação do tabagismo e do tempo de tabagismo com a presença e o grau de lesão do menisco. Materiais e Métodos: Foram incluídos pacientes submetidos a ressonância magnética do joelho e divididos em dois grupos: fumantes e não fumantes. O consumo total de cigarros dos pacientes foi calculado multiplicando-se a quantidade diária de cigarros (maços/dia) pelo tempo de tabagismo (anos). O grau mais alto de lesão foi registrado na avaliação da lesão meniscal. A espessura do tecido adiposo subcutâneo foi medida com base em imagem do joelho em plano axial, como indicador de obesidade. A relação entre tabagismo, obesidade e lesão meniscal foi analisada estatisticamente. Resultados: Foram incluídos no estudo 156 indivíduos. O grupo de fumantes consistiu de 48 (30,8%) indivíduos e o grupo de não fumantes, de 108 (69,2%) indivíduos. O menisco estava normal em um (2,1%) fumante e em 32 (29,6%) não fumantes (p < 0,0001). A espessura média do tecido adiposo subcutâneo em fumantes foi 23 mm e nos não fumantes foi 24 mm, com valor de p = 0,900. Foi observada correlação moderada e estatisticamente significante entre o grau de lesão por pacote/dia (r = 0,462, p = 0,001) e o grau de lesão por pacote × ano (r = 0,523, p = 0,001). O tabagismo e a idade afetaram significativamente o risco de lesão do menisco (31,221 vezes, p = 0,001 e 1,076 vez, p < 0,001, respectivamente). Conclusão: Foi encontrada correlação significativa entre tabagismo/dia e grau de lesão do menisco e pacote de tabagismo × ano e grau de lesão do menisco.

Extraprostatic extension in multiparametric MRI; Is presurgical detection possible?

INTRODUCTION: Extraprostatic extension (EPE) is one of the important factors affecting the prognosis of prostate cancer (PCa). Therefore, preoperative evaluation of the presence of EPE is essential in multiparametric magnetic resonance imaging (mpMRI) examination. However, for the evaluation of mpMRI, objective criteria are needed to detect EPE, especially microscopic EPE. AIM: To evaluate the efficacy of 1.5T MRI using lesion length (LL) and tumor-capsule contact length (TCL) in detecting EPE in PCa. METHODS: A total of 110 patients who underwent radical prostatectomy due to PCa were enrolled. Preoperative MR images were evaluated retrospectively by two independent observers who did not know the histopathological results. The observers evaluated LL and TCL. The radiological findings, including lesion location, were verified using histopathological mapping. RESULTS: Multiparametric MRI examination of the prostate demonstrated low sensitivity (Observer 1; 40.4% and Observer 2; 40.4%) but high specificity (Observer 1; 96.6% and Observer 2; 84.5%), with significant differences for detecting EPE (Observer 1, P < 0.0001; Observer 2, P = 0.003). The increased PI-RADS score correlated positively with the increased EPE rate (P < 0.0001 for both observers). The mean LL and TCL values were statistically significantly higher in patients with EPE than in patients without EPE. The TCL was a significant parameter for EPE, with high sensitivity and low for both observers. For both observes the cutoff value of LL for EPE was 14.5 mm, and the cutoff value of TCL for EPE was 9.5 mm. Histopathological LL value (28 ± 12,3 mm) was higher than radiological LLs (Observer 1; 22,14 ± 10,15 mm and Observer 2; 19,06 ± 8,61). CONCLUSION: The results revealed that 1.5T MRI demonstrated low sensitivity and high specificity in detecting EPE. The LL and TCL may be indirectly beneficial in detecting EPE. Considering the radiological underestimation of LL may be helpful before PCa surgery.