The aim of this study was to determine apparent diffusion coefficients (ADCs) of focal liver lesions on the basis of a respiratory triggered diffusion-weighted single-shot echo-planar MR imaging sequence (DW-SS-EPI) and to evaluate whether ADC measurements can be used to characterize lesions. One hundred and two patients with focal liver lesions [11 hepatocellular carcinomas (HCC), 82 metastases, 4 focal nodular hyperplasias (FNH), 56 hemangiomas and 51 cysts; mean size, 16.6 mm; range 5-92 mm] were examined on a 1.5-T system using respiratory triggered DW-SS-EPI (b-values: 50, 300, 600 s/mm2). Results were correlated with histopathologic data and follow-up imaging. The ADCs of different lesion types were compared, and lesion discrimination using optimal thresholds for ADCs was evaluated. Mean ADCs (x10(-3)mm2/s) were 1.24 and 1.04 for normal and cirrhotic liver parenchyma and 1.05, 1.22, 1.40, 1.92 and 3.02 for HCCs, metastases, FNHs, hemangiomas and cysts, respectively. Mean ADCs differed significantly for all lesion types except for comparison of metastases with HCCs and FNHs. Overall, 88% of lesions were correctly classified as benign or malignant using a threshold value of 1.63 x 10(-3)mm2/s. Measurements of the ADCs of focal liver lesions on the basis of a respiratory triggered DW-SS-EPI sequence may constitute a useful supplementary method for lesion characterization.
Whole-body bone marrow MRI as used in this study is an effective method for evaluating the entire skeletal system in patients with suspected metastatic disease.
MR arthrography is accurate in enabling classification of acute and chronic anteroinferior labroligamentous injuries, although correct interpretation of Perthes lesions remains difficult.
We assessed the diagnostic performance of magnetic resonance (MR) arthrography in the diagnosis of articular-sided partial-thickness and full-thickness rotator cuff tears in a large symptomatic population. MR arthrograms obtained in 275 patients including a study group of 139 patients with rotator cuff tears proved by arthroscopy and a control group of 136 patients with arthroscopically intact rotator cuff tendons were reviewed in random order. MR imaging was performed on a 1.0 T system (Magnetom Expert, Siemens). MR arthrograms were analyzed by two radiologists in consensus for articular-sided partial-thickness and full-thickness tears of the supraspinatus, infraspinatus, and subscapularis tendons. At arthroscopy, 197 rotator cuff tears were diagnosed, including 105 partial-thickness (93 supraspinatus, nine infraspinatus, three subscapularis) and 92 full-thickness (43 supraspinatus, 20 infraspinatus, 29 subscapularis) tendon tears. For full-thickness tears, sensitivity, specificity, and accuracy were 96%, 99%, and 98%, respectively, and for partial tears 80%, 97%, and 95%, respectively. False negative and positive assessments in the diagnosis of articular-sided partial-thickness tears were predominantly [78% (35/45)] observed with small articular-sided (Ellman grade1) tendon tears. MR arthrography is highly accurate in the diagnosis of full-thickness rotator cuff tears and is accurate in the diagnosis of articular-sided partial-thickness tears. Limitations in the diagnosis of partial-thickness tears are mainly restricted to small articular-sided tears (Ellman grade 1) due to difficulties in differentiation between fiber tearing, tendinitis, synovitic changes, and superficial fraying at tendon margins.
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