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MRI of liver hemangioma. The axial T2-weighted image a shows a giant hemangioma in hepatic segment 6 (arrows) with central cystic change contrasting with the less hyperintense periphery. Fat-suppressed T1-weighted postcontrast arterial phase (b), portal phase (c), and delayed (d) images demonstrate the classic clumped, discontinuous, and centripetally progressive hemangioma enhancement pattern that clinches the diagnosis
Source publication
MRI has transformed from the theoretical, investigative realm to mainstream clinical medicine over the past four decades and has become a core component of the diagnostic toolbox in the practice of gastroenterology (GI). Its success is attributable to exquisite contrast and the ability to isolate specific proton species through the use of different...
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Background
While MR enterography allows detection of inflammatory bowel disease (IBD), the findings continue to be of limited use in guiding treatment—medication vs. surgery.
Purpose
To test the feasibility of MR elastography of the gut in healthy volunteers and IBD patients.
Study Type
Prospective pilot.
Population
Forty subjects (healthy volun...
Citations
... When managing brain lesions and other tumors, MRI is commonly used. We may predict anatomical details and locate anomalies using MRI. is method is better than computed tomography at detecting changes in tissue or structures, and it can also detect a size of a tumor [7]. Manual brain tumor detection is a tough task. ...
A brain tumor is an abnormal enlargement of cells if not properly diagnosed. Early detection of a brain tumor is critical for clinical practice and survival rates. Brain tumors arise in a variety of shapes, sizes, and features, with variable treatment options. Manual detection of tumors is difficult, time-consuming, and error-prone. Therefore, a significant requirement for computerized diagnostics systems for accurate brain tumor detection is present. In this research, deep features are extracted from the inceptionv3 model, in which score vector is acquired from softmax and supplied to the quantum variational classifier (QVR) for discrimination between glioma, meningioma, no tumor, and pituitary tumor. The classified tumor images have been passed to the proposed Seg-network where the actual infected region is segmented to analyze the tumor severity level. The outcomes of the reported research have been evaluated on three benchmark datasets such as Kaggle, 2020-BRATS, and local collected images. The model achieved greater than 90% detection scores to prove the proposed model's effectiveness.
... and 0.961 (95% CI: 0.948-0.971) (27)(28)(29). The diagnostic performance and accuracy of MRI were similar to that of GI-RADS. ...
Background:
Adnexal masses, mostly benign, are common in the female genital system. However, adnexal masses are the leading cause of death among women with gynecologic cancer. Ultrasound is a common imaging method for diagnosing adnexal masses. Gynecologic Imaging Reporting and Data System (GI-RADS) is a useful diagnostic tool based on objective ultrasound features to diagnose the malignancy of the female genital system. Therefore, we conducted a meta-analysis to evaluate the ability of GI-RADS to differentiate adnexal masses.
Methods:
Published articles were searched in PubMed, Medline, and Embase from 1990 to February 2020. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio, and area under the curve (AUC) were estimated via the extracted data from the selected studies.
Results:
Ten studies and 2,474 patients were included in this meta-analysis. The pooled sensitivity of selected studies was 0.95 [95% confidence intervals (CI): 0.94-0.97], and the pooled specificity was 0.86 (95% CI: 0.84-0.88). The pooled NLR and PLR were 0.06 (95% CI: 0.04-0.10), and 8.30 (95% CI: 4.93-13.97), respectively. Moreover, the pooled diagnostic odds ratio for GI-RADS was 174.59 (95% CI: 76.70-397.42), and the AUC was 0.9806.
Conclusions:
This research indicates that GI-RADS might be a valuable tool to distinguish malignancies from adnexal masses.
... improved the diagnostic performance but also tended to show higher sensitivity in the detection of distant metastasis, which resulted in better diagnostic performance in determining overall resectability by providing higher specificity. PET/MRI has the combined advantages of PET and MRI [25][26][27][28][29][30]; high soft-tissue contrast and information of cellularity from DWI could attribute the superior results of PET/MRI regarding hepatic metastases [15], while PET imaging is effective and sensitive in extahepatic malignancies, including metastases to lymph nodes [31] and bones [32]. Furthermore, CT plus PET/MRI has the advantage of less radiation exposure compared with CT plus MRI plus PET/CT, which is commonly performed in patients with biliary tract cancer [25,33]. ...
Objective:
To evaluate the value of 18F-fluorodeoxyglucose PET/MRI added to contrast-enhanced CT (CECT) in initial staging, assessment of resectability, and postoperative follow-up of biliary tract cancer.
Materials and methods:
This retrospective study included 100 patients (initial workup [n = 65] and postoperative follow-up [n = 35]) who had undergone PET/MRI and CECT for bile duct or gallbladder lesions between January 2013 and March 2020. Two radiologists independently reviewed the CECT imaging set and CECT plus PET/MRI set to determine the likelihood of malignancy, local and overall resectability, and distant metastasis in the initial workup group, and local recurrence and distant metastasis in the follow-up group. Diagnostic performances of the two imaging sets were compared using clinical-surgical-pathologic findings as standards of reference.
Results:
The diagnostic performance of CECT significantly improved after the addition of PET/MRI for liver metastasis (area under the receiver operating characteristic curve [Az]: 0.77 vs. 0.91 [p = 0.027] for reviewer 1; 0.76 vs. 0.92 [p = 0.021] for reviewer 2), lymph node metastasis (0.73 vs. 0.92 [p = 0.004]; 0.81 vs. 0.92 [p = 0.023]), and overall resectability (0.79 vs. 0.92 [p = 0.007]; 0.82 vs. 0.94 [p = 0.021]) in the initial workup group. In the follow-up group, the diagnostic performance of CECT plus PET/MRI was significantly higher than that of CECT imaging for local recurrence (0.81 vs. 1.00 [p = 0.029]; 0.82 vs. 0.94 [p = 0.045]).
Conclusion:
PET/MRI may add value to CECT in patients with biliary tract cancer both in the initial workup for staging and determination of overall resectability and in follow-up for local recurrence.
... Park's classification 4 is familiar to most colorectal surgeons; this anatomic classification describes perianal fistulas based on the relationship of the fistulous tract to the anal sphincter ( Figure 1). Magnetic resonance (MR) imaging plays a key role in detection and characterization of perianal fistulas and to delineate their extent, 8,9 that may be surgically occult or need drainage prior to medical (immunosuppressive) treatment. Saint James University Hospital classification is based on radiologic anatomy on MR imaging that describes fistulous tracts under five grades, including both primary tract and secondary extensions or side-branches and associated abscesses. ...
Background:
Crohn's disease (CD) is a serious cause of perianal disease and the incidence is increasing in Saudi Arabia. MR imaging may document specific features that may help to foresee Crohn's disease in patients making an initial presentation.
Objective:
Present MR imaging findings of perianal fistulas in patients making an initial presentation.
Design:
Retrospective, observational.
Setting:
Radiology clinic in in Dhahran.
Patients and methods:
All previously undiagnosed and untreated patients who presented for the first time to the outpatient clinics from September 2015-2018 with perianal fistulas were retrospectively evaluated. Previously diagnosed CD patients, post-surgical or intervention cases were excluded. Fistulas were categorized as low or high anal, simple or complex, and were graded per St. James University Hospital Classification. Imaging was interpreted by two experienced readers based on the Van Assche score.
Main outcome measures:
Fistula features on MR imaging and diagnosis of CD.
Sample size:
171 patients.
Results:
Of 171 patients, 139 (81.3%) were males with mean age of 37.2 (12.7) years; the 32 females had a mean age of 35.8 (10.6) years. Twenty-one patients (12.3%) had CD. Fourteen (40.4%) patients with complex fistulas had CD in comparison to only 5 (4.8%) simple fistula patients ( P=.0005). More than half of patients with complex and high anal fistulas had CD ( P=.0005). Females were more affected than males ( P=.0005).
Conclusion:
Complex or high anal fistula on MR imaging may be the initial presentation of CD and warrant further work up to establish the diagnosis.
Limitations:
Retrospective, small sample, single center, and short duration study.
Conflict of interest:
None.
... Pancreatic MR protocols employed in clinical practice are generally optimised for anatomical imaging 1 . High native T1 signal of normal pancreatic parenchyma, high T2 signal of the main pancreatic duct, pancreatic secretions and cystic pancreatic lesions, use of fat suppressed T2 weighted imaging for the assessment of regional inflammation, avid pancreatic parenchymal contrast enhancement (compared to low T1/hypoenhancement of pancreatic adenocarcinoma) and increased conspicuity of many pancreatic lesions on diffusion-weighted imaging (DWI) 2 have all rendered widespread use of pancreatic MRI in routine clinical pancreatico-biliary practice 3 . ...
MRI plays an important role in the clinical management of pancreatic disorders and interpretation is reliant on qualitative assessment of anatomy. Conventional sequences capturing pancreatic structure can however be adapted to yield quantitative measures which provide more diagnostic information, with a view to increasing diagnostic accuracy, improving patient stratification, providing robust non-invasive outcome measures for therapeutic trials and ultimately personalizing patient care.
In this review, we evaluate the use of established techniques such as secretin-enhanced MR cholangiopancreatography, diffusion-weighted imaging, T 1 , T 2 * and fat fraction mapping, but also more experimental methods such as MR elastography and arterial spin labelling, and their application to the assessment of diffuse pancreatic disease (including chronic, acute and autoimmune pancreatitis/IgG4 disease, metabolic disease and iron deposition disorders) and cystic/solid focal pancreatic masses. Finally, we explore some of the broader challenges to their implementation and future directions in this promising area.
... This is of great regulatory value. The future of MRI of the abdomen includes ultra-high-field (7 T and above) scanners [53] and developments in the design of open magnets that have the advantage of imaging volunteers in the sitting position [11,54]. Also, susceptibility differences and air-tissue interfaces can be responsible for generating artifacts, some of which may be difficult to remove though some could potentially be eliminated by using diamagnetic elements to improve the quality and reliability of the images and data acquired [55]. ...
Oral solid drug formulation is the most common route for administration and it is vital to increase knowledge of the gastrointestinal physiological environment to understand dissolution and absorption processes and to develop reliable biorelevant in vitro tools. In particular, colon targeted drug formulations have raised the attention of pharmaceutical scientists because of the great potential of colonic drug delivery. However, the distal bowel is still a relatively understudied part of the gastrointestinal tract. Recently, magnetic resonance imaging (MRI) has been gaining an emerging role in studying the colon. This article provides a comprehensive; contemporary review of the literature on luminal MRI of the colonic environment of the last 15 years with specific focus on colon physiological dimensions; motility; chyme and fluids; transit and luminal flow. The work reviewed provides novel physiological insight that will have a profound impact on our understanding of the colonic environment for drug delivery and absorption and will ultimately help to raise the in vitro/in vivo relevance of computer simulations and bench models.
The gastrointestinal (GI) system is a large organ system responsible for regulating the digestive functions of the body. Different incidences of specific GI diseases between women and men suggest a possible role of sex hormones in the promotion or prevention of disease development. In order to manage specific GI symptoms and their related diseases, it is important to understand the mechanism by which a disease has developed and the role of sex and gender. Sex and gender differences are observed in liver disease, specifically liver lesions, gastrointestinal reflux disease, and inflammatory bowel disease. The aim of this chapter is to improve understanding of sex and gender differences in these specific diseases in order to help focus differential diagnosis and treatment.
OBJECTIVES: Ultrasound (US) elastography has been proposed for the non-invasive prediction of clinically relevant pancreatic fistula (CR-POPF) in patients undergoing pancreatic resection. We aimed to perform a systematic review with meta-analysis to assess the diagnostic value of US elastography in predicting CR-POPF.
METHODS: MEDLINE via PubMed, Ovid Embase, Scopus, and Cochrane Library databases, and abstracts of international conference proceedings were searched up to April 20, 2020. Studies assessing the performance of abdominal US elastography in predicting CR-POPF in patients undergoing pancreatic resection were included. The quality of the studies was assessed using Quality Assessment of Diagnostic Accuracy Studies.
RESULTS: Five studies, including 247 patients who underwent partial pancreatic resection of whom 72 patients experiencing CR-POPF, were selected. All studies performed US elastography in different pancreatic sites. The pooled mean strain value was lower in pancreatic segments of patients experiencing CR-POPF than in those without, with a pooled weighted mean difference of -0.187 (95% confidence intervals, -0.303 to -0.071; P = 0.002). There was low heterogeneity between studies (I = 7.6%), and all studies were at "high risk" or "unclear risk" of bias.
CONCLUSIONS: This study provides evidence that US elastography values are statistically significantly lower in patients experiencing CR-POPF.
They would be called the Bach, Beethoven, and Brahms of liver surgery—Henri Bismuth, Stig Bengmark, and Leslie Blumgart—virtuosos in the surgical symphony of liver diseases. Each would make contributions in liver resection which would thrust the field into the modern era. Bismuth with his concepts of multidisciplinary care, Bengmark with his efforts to unite the liver communities, and Leslie Blumgart, who would expand liver resection to numbers of patients once considered hopelessly incurable.
Background
The liver R2* value is widely used as a measure of liver iron but may be confounded by the presence of hepatic steatosis and other covariates.
Purpose
To identify the most influential covariates for liver R2* values in patients with nonalcoholic fatty liver disease (NAFLD).
Study Type
Retrospective analysis of prospectively acquired data.
Population
Baseline data from 204 subjects enrolled in NAFLD/NASH (nonalcoholic steatohepatitis) treatment trials.
Field Strength
1.5T and 3T; chemical‐shift encoded multiecho gradient echo.
Assessment
Correlation between liver proton density fat fraction and R2*; assessment for demographic, metabolic, laboratory, MRI‐derived, and histological covariates of liver R2*.
Statistical Tests
Pearson's and Spearman's correlations; univariate analysis; gradient boosting machines (GBM) multivariable machine‐learning method.
Results
Hepatic proton density fat fraction (PDFF) was the most strongly correlated covariate for R2* at both 1.5T (r = 0.652, P < 0.0001) and at 3T (r = 0.586, P < 0.0001). In the GBM analysis, hepatic PDFF was the most influential covariate for hepatic R2*, with relative influences (RIs) of 61.3% at 1.5T and 47.5% at 3T; less influential covariates had RIs of up to 11.5% at 1.5T and 16.7% at 3T. Nonhepatocellular iron was weakly associated with R2* at 3T only (RI 6.7%), and hepatocellular iron was not associated with R2* at either field strength.
Data Conclusion
Hepatic PDFF is the most influential covariate for R2* at both 1.5T and 3T; nonhepatocellular iron deposition is weakly associated with liver R2* at 3T only.
Level of Evidence: 4
Technical Efficacy: Stage 2
J. Magn. Reson. Imaging 2018.
