Analysis of The Value of Multi-Slice Spiral CT and Magnetic Resonance Imaging in The Diagnosis of Carpal Joint Injury

Objective:To analyze the value of multi-slice spiral computed tomography(CT)and magnetic resonance imaging(MRI)in the diagnosis of carpal joint injury.Methods:A total of 130 patients with suspected wrist injuries admitted to the Department of Orthopedics of our hospital from January 2023 to January 2024 were selected and randomly divided into a single group(n=65)and a joint group(n=65).The single group was diagnosed using multi-slice spiral CT,and the joint group was diagnosed using multi-slice spiral CT and magnetic resonance imaging,with pathological diagnosis as the gold standard.The diagnostic results of both groups were compared to the gold standard,and the diagnostic energy efficiency of both groups was compared.Results:The diagnostic results of the single group compared with the gold standard were significant(P<0.05).The diagnostic results of the joint group compared with the gold standard were not significant(P>0.05).The sensitivity and accuracy of diagnosis in the joint group were significantly higher than that in the single group(P<0.05).The specificity of diagnosis in the joint group was higher as compared to that in the single group(P>0.05).Conclusion:The combination of multi-slice spiral CT and MRI was highly accurate in diagnosing wrist injuries,and the misdiagnosis rate and leakage rate were relatively low.Hence,this diagnostic program is recommended to be popularized.

Optimized cardiac magnetic resonance imaging inversion recovery sequence for metal artifact reduction and accurate myocardial scar assessment in patients with cardiac implantable electronic devices

Late gadolinium enhancement(LGE) cardiovascular magnetic resonance(CMR) is the gold standard for imaging myocardial viability.An important application of LGE CMR is the assessment of the location and extent of the myocardial scar in patients with ventricular tachycardia(VT), which allows for more accurate identification of the ablation targets.However, a large percentage of patients with VT have cardiac implantable electronic devices(CIEDs), which is a relative contraindication for cardiac magnetic resonance imaging due to safety and image artifact concerns.Previous studies showed that these patients can be safely scanned on 1.5 T scanners provided that an adequate imaging protocol is adopted.Nevertheless, imaging patients with a CIED result in metal artifacts due to the strong frequency off-resonance effects near the device; therefore, the spins in the surrounding myocardium are not completely inverted, and thus give rise to hyperintensity artifacts.These artifacts obscure the myocardial scar tissue and limit the ability to study the correlation between the myocardial scar structure and the electro-anatomical map during catheter ablation.In this study, we developed a modified inversion recovery technique to alleviate the CIED-induced metal artifacts and improve the diagnostic image quality of LGE images in patients with CIEDs without increasing scan time or requiring additional hardware.The developed technique was tested in phantom experiments and in vivo scans, which showed its capability for suppressing the hyperintensity artifacts without compromising myocardium nulling in the resulting LGE images.

Cardiac functional magnetic resonance imaging at 7T:Image quality optimization and ultra-high field capabilities

BACKGROUND 7T cardiac magnetic resonance imaging(MRI)introduces several advantages,as well as some limitations,compared to lower-field imaging.The capabilities of ultra-high field(UHF)MRI have not been fully exploited in cardiac functional imaging.AIM To optimize 7T cardiac MRI functional imaging without the need for conducting B1 shimming or subject-specific tuning,which improves scan efficiency.In this study,we provide results from phantom and in vivo scans using a multi-channel transceiver modular coil.METHODS We investigated the effects of adding a dielectric pad at different locations next to the imaged region of interest on improving image quality in subjects with different body habitus.We also investigated the effects of adjusting the imaging flip angle in cine and tagging sequences on improving image quality,B1 field homogeneity,signal-to-noise ratio(SNR),blood-myocardium contrast-to-noise ratio(CNR),and tagging persistence throughout the cardiac cycle.RESULTS The results showed the capability of achieving improved image quality with high spatial resolution(0.75 mm×0.75 mm×2 mm),high temporal resolution(20 ms),and increased tagging persistence(for up to 1200 ms cardiac cycle duration)at 7T cardiac MRI after adjusting scan set-up and imaging parameters.Adjusting the imaging flip angle was essential for achieving optimal SNR and myocardium-toblood CNR.Placing a dielectric pad at the anterior left position of the chest resulted in improved B1 homogeneity compared to other positions,especially in subjects with small chest size.CONCLUSION Improved regional and global cardiac functional imaging can be achieved at 7T MRI through simple scan set-up adjustment and imaging parameter optimization,which would allow for more streamlined and efficient UHF cardiac MRI.

Effects of Weight Loss on Pericardial Fat and Left Ventricular Mass Assessed with Cardiac Magnetic Resonance Imaging in Morbid Obesity

Background: Obesity is a risk factor for cardiovascular disease and mortality. Significant weight loss has beneficial effects on left ventricular structure, in particular on regression of left ventricular hypertrophy (LVH). We therefore evaluated the consequences of significant weight loss on left ventricular morphology, hemodynamics and pericardial fat. Methods: We performed volumetric cardiac magnetic resonance (CMR) imaging before and after significant weight loss due to laparoscopic adjustable gastric banding (LAGB). CMR was used to measure cardiac mass, volume and function, as well as to quantify pericardial fat. Results: Eleven patients (age 40.5 ± 10 yrs, body mass index 42.5 ± 3.9 kg/m2) underwent CMR imaging before and a median 15.4 months after gastric banding. The BMI declined by 9.3 ± 3.3 kg/m2 (p Discussion: Significant weight loss in obesity is accompanied by a marked regression of LVH, with no apparent change in cardiac volume or function. The local effect of a diminished amount of pericardiac fat tissue may be more important than absolute weight loss with respect to the regression of LVH in obesity.

Correlation between myocardial infarction activity assessed by cardiac magnetic resonance imaging and the evolution of cardiac function after PCI

Objective:To investigate the correlation of cardiac magnetic resonance imaging(MRI)in the assessment of myocardial activity in patients with myocardial infarction and the outcome of cardiac function after PCI.Methods:30 patients with myocardial infarction(MI)who had complete clinical and imaging data from July 2016 to December 2018 after PCI were analyzed retrospectively.MR and echocardiogram were performed before and 6 months after PCI,and the parameters related to left ventricular function were measured by post-processing software of MRI workstation.The left ventricular transmural degree of CMR late gadolinium enhancement was compared with the left ventricular wall motion degree of 6-month echocardiography as a standard to judge the viable myocardium.Result:There were 193 left ventricular segmental abnormalities in 30 cases,including 121 viable myocardium and 72 non viable myocardium in CMR-LGE before operation.Six months after PCI,echocardiography showed that 125 of 193 abnormal segments of left ventricle detected by CMR-LGE before PCI were viable myocardium and 68 were non viable myocaridium.The sensitivity and specificity of CMR-LGE to determinate of viable myocardium were 92.0%and 91.1%respectively.The larger the non-viable myocardial area of the left ventricular wall,the worse the recovery of wall motion ability,and there was a negative correlation between them(r=0.416,P<0.05).The first-pass perfusion time in CMR-LEG region was significantly longer than that in normal myocardial region(4.85(+)1.51)s and(3.79(+)1.73)s,respectively.The difference was statistically significant(t=5.191,P<0.05).Conclusion:MRI can evaluate the myocardial activity of myocardial infarction,reflect the range of viable myocardium,and provide imaging basis for clinical treatment and prognosis.

Retrorectal tumors in adults:Magnetic resonance imaging findings

AIM:To retrospectively evaluate the magnetic resonance imaging (MRI) features of adult retrorectal tumors and compare with histopathologic findings.METHODS:MRI features of 21 patients with preoperative suspicion of retrorectal tumors were analyzed based on the histopathological and clinical data.RESULTS:Fourteen benign cystic lesions appeared hypointense on T1-weighted images,and hyperintense on T2-weighted images with regular peripheral rim.Epidermoid or dermoid cysts were unilocular,and tailgut cysts were multilocular.Presence of intracystic intermediate signal intensity was observed in one case of tailgut cyst with a component of adenocarcinoma.Six solid tumors were malignant lesions and showed heterogeneous intensity on MRI.Mucinous adenocarcinomas showed high signal intensity on T2-weighted and mesh-like enhancing areas on fat-suppressed T2-weighted images.There was a fistula between the mass and anus with an internal opening in mucinous adenocarcinomas arising from anal fistula.Gastrointestinal stromal tumors displayed low signal intensity on T1-weighted images,and intermediate to high signal intensity on T2-weighted images.Central necrosis could be seen as a high signal on T2-weighted images.CONCLUSION:MRI is a helpful technique to define the extent of the retrorectal tumor and its relationship to the surrounding structures,and also to demonstrate possible complications so as to choose the best surgical approach.

Impact of cardiac magnet resonance imaging on management of ventricular septal rupture after acute myocardial infarction

A 74-year-old man was admitted to the cardiac catheterization laboratory with acute myocardial infarction. After successful angioplasty and stent implantation into the right coronary artery, he developed cardiogenic shock the following day. Echocardiography showed ventricular septal rupture. Cardiac magnet resonance imaging (MRI) was performed on the critically ill patient and provided detailed information on size and localization of the ruptured septum by the use of fast MRI sequences. Moreover, the MRI revealed that the ventricular septal rupture was within the myocardial infarction area, which was substantially larger than the rupture. As the patient's condition worsened, he was intubated and had intra-aortic balloon pump implanted, and extracorporeal membrane oxygenation was initiated. During the following days, the patient's situation improved, and surgical correction of the ventricular septal defect could successfully be performed. To the best of our knowledge, this case report is the first description of postinfarction ventricular septal rupture by the use of cardiac MRI in an intensive care patient with cardiogenic shock and subsequent successful surgical repair.

Investigation of cardiomyopathy using cardiac magnetic resonance imaging part 1:Common phenotypes

Cardiac magnetic resonance imaging(CMRI) has emerged as a useful tertiary imaging tool in the investigation of patients suspected of many different types of cardiomyopathies,CMRI sequences are now of a sufficiently robust quality to enable high spatial and temporal resolution image acquisition.This has led to CMRI becoming an effective non-invasive imaging gold standard for many cardiomyopathies.In this 2-part review,we outline the typical sequences used to image cardiomyopathy,and present the imaging spectrum of cardiomyopathy.Part 1 focuses on the current classification of cardiomyopathy,basic CMRI sequences used in evaluating cardiomyopathy and the imaging spectrum of common phenotypes.

Long term evolution of magnetic resonance imaging characteristics in a case of atypical left lateral wall hypertrophic cardiomyopathy

We are reporting a long-time magnetic resonance imaging(MRI) follow-up in a rare case of cardiac left lateral wall hypertrophy. Hypertrophic cardiomyopathy(HCM) is the most common genetic cardiovascular disorder and a significant cause of sudden cardiac death. Cardiac magnetic resonance(CMR) imaging can be a valuable tool for assessment of detailed information on size,localization,and tissue characteristics of hypertrophied myocardium. However,there is still little knowledge of long-term evolution of HCM as visualized by magnetic resonance imaging. Recently,our group reported a case of left lateral wall HCM as a rare variant of the more common forms,such as septal HCM,or apical HCM. As we now retrieved an old cardiac MRI acquired in this patient more than 20 years ago,we are able to provide the thrilling experience of an ultra-long MRI followup presentation in this rare case of left lateral wall hypertrophy. Furthermore,this case outlines the tremendous improvements in imaging quality within the last two decades of CMR imaging.

Focal liver lesions:Practical magnetic resonance imaging approach

With the widespread of cross-sectional imaging, a growth of incidentally detected focal liver lesions(FLL) has been observed. A reliable detection and characterization of FLL is critical for optimal patient management. Maximizing accuracy of imaging in the context of FLL is paramount in avoiding unnecessary biopsies, which may result in post-procedural complications. A tremendous development of new imaging techniques has taken place during these last years. Nowadays, Magnetic resonance imaging(MRI) plays a key role in management of liver lesions, using a radiation-free technique and a safe contrast agent profile. MRI plays a key role in the non-invasive correct characterization of FLL. MRI is capable of providing comprehensive and highly accurate diagnostic information, with the additional advantage of lack of harmful ionizing radiation. These properties make MRI the mainstay for the noninvasive evaluation of focal liver lesions. In this paper we review the state-of-the-art MRI liver protocol, briefly discussing different sequence types, the unique characteristics of imaging non-cooperative patients and discuss the role of hepatocyte-specific contrast agents. A review of the imaging features of the most common benign and malignant FLL is presented, supplemented by a schematic representation of a simplistic practical approach on MRI.

The Role of Clinical Cardiac Magnetic Resonance Imaging in China:Current Status and the Future

Cardiac magnetic resonance(CMR)imaging plays an important role in the diagnosis and management of cardiovascular diseases.The state-of-the-art CMR imaging has many advantages in cardiac imaging,including excellent spatial and temporal resolution,unrestricted imaging fi eld,no exposure to ionizing radiation,excellent tissue contrast,and unique myocardial tissue characterization.Clinical CMR imaging is used during the cardiovascular diagnostic workup in the United States and some European countries.Use of CMR imaging is emerging in hospitals in China and has a promising future.This review briefl y describes the real-world clinical application of CMR imaging in China and discuss obstacles for its future development.

Role of cardiac magnetic resonance imaging in the diagnosis and management of COVID-19 related myocarditis: Clinical and imaging considerations

There is a growing evidence of cardiovascular complications in coronavirusdisease 2019 (COVID-19) patients. As evidence accumulated of COVID-19 mediatedinflammatory effects on the myocardium, substantial attention has beendirected towards cardiovascular imaging modalities that facilitate this diagnosis.Cardiac magnetic resonance imaging (CMRI) is the gold standard for thedetection of structural and functional myocardial alterations and its role inidentifying patients with COVID-19 mediated cardiac injury is growing. Despiteits utility in the diagnosis of myocardial injury in this population, CMRI’s impacton patient management is still evolving. This review provides a framework for theuse of CMRI in diagnosis and management of COVID-19 patients from theperspective of a cardiologist. We review the role of CMRI in the management ofboth the acutely and remotely COVID-19 infected patient. We discuss patientselection for this imaging modality;T1, T2, and late gadolinium enhancementimaging techniques;and previously described CMRI findings in other cardiomyopathieswith potential implications in COVID-19 recovered patients.

Comparison of computed tomography and magnetic resonance imaging for the detection of mandibular condylar osteochondroma

Objective The purpose of this study was to compare computed tomography(CT) and magnetic resonance imaging(MRI) for the detection of mandibular condylar osteochondroma.Methods Preoperative CT and MRI of 33 patients with unilateral condylar osteochondroma were reviewed. The morphology, location, continuity with the parent bone, cartilage cap, perichondrium of tumors, and changes in soft and hard tissues adjacent to the lesions were investigated by two reviewers. Data were analyzed using Mc Nemar test. A P value < 0.05 was considered significant.Results Among the 33 condylar osteochondromas, 11 were of the diffuse type, 10 were of the sessile type, and 12 were of the pedunculated type. Continuity with the cortex and marrow of the host condyle was observed on both CT and MRI. Both modalities had identical detection rates of surface reconstruction of the temporal bone joint, condylar dislocation, and pseudarthrosis formation. However, MRI showed significantly higher detection rates of the cartilage cap and perichondrium than CT(P < 0.05). Furthermore, MRI showed ipsilateral and contralateral temporo-mandibular joint(TMJ) disc displacement in 4 cases and 6 cases, respectively, and ipsilateral and contralateral TMJ effusion in 20 cases and 14 cases, respectively.Conclusion CT can intuitively display the morphology and spatial location of condylar osteochondromas through three-dimensional reconstruction. MRI may be superior to CT in the detection of cartilage cap, perichondrium of the condylar osteochondroma, and changes in the TMJ and adjacent soft tissues.

Clinical Effect of Magnetic Resonance Imaging and 64-slice Spiral CT in the Diagnosis of Ischemic Heart Disease Patients

Objective:To explore the clinical methods and clinical effects of applying magnetic resonance imaging(MRI)and 64・slice spiral computed tomography(CT)in the diagnosis of patients with ischemic heart disease.Methods:100 patients with ischemic heart disease were selected as the research objects.Selecting the patients from May 2020 to May 2021 as a sample,the patients were divided into two groups,and different diagnostic methods were used to compare the clinical diagnosis effects.Results:In terms of the diagnostic accuracy of the two groups of patients,the maximum value was 92.00%(experimental group)and the minimum value was 80.00%(control group).There was a big difference in data between the two groups,P<0.05,which was statistically significant.The patient9s(experimental group)diagnosis accuracy rate is highe Conclusion:In the process of research work for patients with ischemic heart disease,it is particularly important to diagnose the patients.The combined application of and 64-slice spiral CT can improve the clinical diagnosis efficiency and achieve significant results.

Cardiac Amyloidosis: The Role of Magnetic Resonance Imaging

Amyloidosis, an infiltrative disease characterized by deposition of high molecular weight insoluble protein has a low detection rate and poor prognosis with congestive heart failure being the most common cause of death. Although definitive diagnosis is based on endomyocardial biopsy, this is rarely performed due to procedural risk and sampling error. Traditional non-invasive imaging, such as transthoracic echocardiography (TTE) and electrocardiogram (ECG) lacks sensitivity detecting the disease in its early stages. This case report demonstrates the utility of cardiac Magnetic Resonance Imaging in addition to traditional imaging modalities in this often clinically challenging problem.

A Rare Case of Concordant Atrioventricular Connection to L-Looped Ventricles in Situs Solitus:4-Dimensional Magnetic Resonance Imaging and 3D Printing

An infant male presented with the rare anatomy consisting of situs solitus,concordant atrioventricular connections to L-looped ventricles,double outlet right ventricle(DORV),and hypoplastic aortic arch.6 months after neonatal aortic arch repair,the morphologic right ventricle function deteriorated,and surgical evaluation was undertaken to determine if either biventricular repair with a systemic morphologic left ventricle or right ventricular exclusion was possible.After initial echocardiography,magnetic resonance imaging(MRI)was used to create detailed axial and 4-dimensional(4D)images and 3-dimensional(3D)printed models.The detailed anatomy of this rare,complex case and its use in pre-surgical planning is presented.

Cardiac involvement in hydrocarbon inhalant toxicity--role of cardiac magnetic resonance imaging:A case report

BACKGROUND We report a patient who was diagnosed with toxic myopericarditis secondary to hydrocarbon abuse using cardiac magnetic resonance imaging(CMR).CASE SUMMARY A 25-year-old male presented to emergency department with chest pain for 3 d.Patient also reported sniffing hydrocarbon containing inhalant for the last 1 year.Labs showed elevated troponin and electrocardiography was suggestive of acute pericarditis.Echocardiogram showed left ventricular(LV)ejection fraction(EF)of 40%.Given patient’s troponin elevation and reduced EF,cardiac catheterization was performed which showed normal coronaries.CMR was performed for myocardial infarction with non-obstructive coronary arteries evaluation.CMR showed borderline LV function with edema in mid and apical LV suggestive of myocarditis.CONCLUSION CMR can be used to diagnose toxic myopericarditis secondary to hydrocarbon abuse.

Role of cardiac magnetic resonance imaging in troponinemia syndromes

Cardiac magnetic resonance imaging(MRI)is an evolving technology,proving to be a highly accurate tool for quantitative assessment.Most recently,it has been increasingly used in the diagnostic and prognostic evaluation of conditions involving an elevation in troponin or troponinemia.Although an elevation in troponin is a nonspecific marker of myocardial tissue damage,it is a frequently ordered investigation leaving many patients without a specific diagnosis.Fortunately,the advent of newer cardiac MRI protocols can provide additional information.In this review,we discuss several conditions associated with an elevation in troponin such as myocardial infarction,myocarditis,Takotsubo cardiomyopathy,coronavirus disease 2019 related cardiac dysfunction and athlete’s heart syndrome.

DIFFERENTIATION BETWEEN MALIGNANT AND BENIGN OVARIAN TUMORS BY MAGNETIC RESONANCE IMAGING

Objective To determine the magnetic resonance （MR） imaging findings of an ovarian mass which are most predictive of malignancy and assess the value of intravenous gadolinium administration in the characterization of an ovarian mass. Methods Totally 74 consecutive patients with a clinically or sonographicaUy indeterminate adnexal mass underwent MR imaging, of whom 59 had subsequent surgical resection of 70 adnexal masses. These 59 patients formed the study population. MR imaging studies were prospectively and independently reviewed by a senior and a junior radiologist. The senior radiologist also reevaluated the studies in a blind fashion after a minimum 6 months interval. The sensitivity, specificity, positive predictive value, and negative predictive value of contrast-enhanced and unenhanced MR im- aging were evaluated Results The most predictive MR imaging findings for malignancy were presence of vegetations in a cystic lesinn and presence of necrosis in a solid lesion. The odds ratio was even higher when the ancillary finding of peritoneal metastasis or ascites was present. Contrast media contributed significantly to lesinn characterization. Total 70 ovarian masses were detected by contrast-enhanced MR imaging including 37 malignant ovarian masses and 33 benign ovarian masses with 87% （61/70）accuracy, 86% （32/37）sensitivity, 88% （29/33）specificity, 89% （32/36）positive predictive value, and 85% （29/34） negative predictive value, whereas 70 ovarian masses were detected by unenhanced MR imaging with 74% （52/70） accuracy, 73 % （27/37） sensitivity, 76 % （ 25/33 ） specificity, 77% （27/35） positive predictive value, and 71% （ 25/35 ） negative predictive value. There were significant differences in accuracy （ P 〈 0. 01 ）, sensitivity （ P 〈0. 01 ）, specificity （ P 〈0. 01 ） between contrast-enhanced and unenhanced MR imaging. Conclusion Contrast-enhanced MR imaging is highly accurate in detection and characterization of complex adnexal masses.

Cardiac involvement in disseminated diffuse large B-cell lymphoma,successful management with chemotherapy dose reduction guided by cardiac imaging: A case report and review of literature

BACKGROUND Secondary cardiac involvement by lymphoma has received limited attention in the medical literature, despite its grave prognosis. Although chemotherapy improves patients' survival, a subgroup of treated patients dies suddenly due to myocardial rupture following chemotherapy initiation. Reducing the initial chemotherapy dose with dose escalation to standard doses may be effective in minimizing this risk but the data are limited. We report on the successful management of a patient with disseminated diffuse large B-cell lymphoma(DLBCL) involving the heart using such approach.CASE SUMMARY An 18-year-old male presented to our hospital with six months history of progressive dyspnea, orthopnea and cough. On physical examination, the patient was found to have a plethoric and mildly edematous face, fixed elevation of the right internal jugular vein, suggestive of superior vena cava obstruction, and a pelvic mass. Investigations during admission including a thoracoabdominal computed tomography(CT) scan with CT guided biopsy of the pelvic mass,echocardiography and cardiac magnetic resonance imaging led to the diagnosis of disseminated DLBCL with cardiac involvement. The patients were successfully treated with chemotherapy dose reduction followed by dose escalation to standard doses, under the guidance of cardiac imaging. The patient completed chemotherapy and underwent a successful bone marrow transplant. He is currently in remission and has a normal left ventricular function.CONCLUSION Imaging-guided chemotherapy dosing may minimize the risk of myocardial rupture in cardiac lymphoma. Data are limited. Management should be individualized.