Radiologia Brasileirahttps://www.scielo.br/journal/rb/feed/2024-03-01T20:17:16.927000ZVol. 56 No. 6 - 2023WerkzeugAre we ready to stratify BI-RADS 4 MRI lesions?10.1590/0100-3984.2023.56.6e12024-03-01T20:17:16.927000Z2020-08-09T06:48:58.242000ZOliveira, Tatiane Mendes Gonçalves de
<em>Oliveira, Tatiane Mendes Gonçalves De</em>;
<br/><br/>
Advancing prognostic assessment in primary sclerosing cholangitis: insights from abdominal magnetic resonance imaging and magnetic resonance cholangiopancreatography with Anali scores10.1590/0100-3984.2023.56.6e22024-03-01T20:17:16.927000Z2020-08-09T06:48:58.242000ZMello, Renato Jose Kist deSchuch, Alice
<em>Mello, Renato Jose Kist De</em>;
<em>Schuch, Alice</em>;
<br/><br/>
Computed tomography: an efficient, opportunistic method for assessing body composition and predicting adverse outcomes in cancer patients10.1590/0100-3984.2023.56.6e3-en2024-03-01T20:17:16.927000Z2020-08-09T06:48:58.242000ZLiguori, Adriano de Araújo LimaFayh, Ana Paula Trussardi
<em>Liguori, Adriano De Araújo Lima</em>;
<em>Fayh, Ana Paula Trussardi</em>;
<br/><br/>
Exploring the relationship between patellofemoral instability and bone morphology: discoveries and challenges10.1590/0100-3984.2023.56.6e4-en2024-03-01T20:17:16.927000Z2020-08-09T06:48:58.242000ZAihara, André Yui
<em>Aihara, André Yui</em>;
<br/><br/>
Are we ready to stratify BI-RADS 4 lesions observed on magnetic resonance imaging? A real-world noninferiority/equivalence analysis10.1590/0100-3984.2023.00872024-03-01T20:17:16.927000Z2020-08-09T06:48:58.242000ZAlmeida, João Ricardo Maltez deBitencourt, Almir Galvão VieiraGomes, André BoechatChagas, Gabriela LemosBarros, Thomas Pitangueira
<em>Almeida, João Ricardo Maltez De</em>;
<em>Bitencourt, Almir Galvão Vieira</em>;
<em>Gomes, André Boechat</em>;
<em>Chagas, Gabriela Lemos</em>;
<em>Barros, Thomas Pitangueira</em>;
<br/><br/>
Abstract Objective: To demonstrate that positive predictive values (PPVs) for suspicious (category 4) magnetic resonance imaging (MRI) findings that have been stratified are equivalent to those stipulated in the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) for mammography and ultrasound. Materials and Methods: This retrospective analysis of electronic medical records generated between January 4, 2016 and December 29, 2021 provided 365 patients in which 419 suspicious (BI-RADS category 4) findings were subcategorized as BI-RADS 4A, 4B or 4C. Malignant and nonmalignant outcomes were determined by pathologic analyses, follow-up, or both. For each subcategory, the level 2 PPV (PPV2) was calculated and tested for equivalence/noninferiority against the established benchmarks. Results: Of the 419 findings evaluated, 168 (40.1%) were categorized as malignant and 251 (59.9%) were categorized as nonmalignant. The PPV2 for subcategory 4A was 14.2% (95% CI: 9.3–20.4%), whereas it was 41.2% (95% CI: 32.8–49.9%) for subcategory 4B and 77.2% (95% CI: 68.4–84.5%) for subcategory 4C. Multivariate analysis showed a significantly different cancer yield for each subcategory (p < 0.001). Conclusion: We found that stratification of suspicious findings by MRI criteria is feasible, and malignancy probabilities for sub-categories 4B and 4C are equivalent to the values established for the other imaging methods in the BI-RADS. Nevertheless, low suspicion (4A) findings might show slightly higher malignancy rates.Prognostic role of magnetic resonance imaging of the abdomen with intravenous contrast and magnetic resonance cholangiopancreatography in primary sclerosing cholangitis10.1590/0100-3984.2023.00412024-03-01T20:17:16.927000Z2020-08-09T06:48:58.242000ZGrove, Roy LópezVespa, FlorênciaAineseder, MartinaVillamil, AlejandraSpina, Juan Carlos
<em>Grove, Roy López</em>;
<em>Vespa, Florência</em>;
<em>Aineseder, Martina</em>;
<em>Villamil, Alejandra</em>;
<em>Spina, Juan Carlos</em>;
<br/><br/>
Abstract Objective: To evaluate the usefulness of Anali scores, determined by magnetic resonance imaging, for predicting the prognosis of primary sclerosing cholangitis (PSC) and to analyze interobserver variability, as well as to assess the impact of periportal edema and heterogeneous signal intensity on diffusion-weighted imaging of the liver. Materials and Methods: This was a retrospective cohort study of 29 patients with PSC and baseline magnetic resonance imaging. Anali scores, without gadolinium (0-5 points) and with gadolinium (0-2 points), were calculated by two radiologists. Clinical end-points included liver transplantation, cirrhotic decompensation, and death. We calculated intraclass correlation coefficients (ICCs) for interobserver agreement on the Anali scores, performed Kaplan-Meier survival analysis comparing event-free survival among the score strata, and calculated the areas under receiver operating characteristic curves to determine sensitivity and specificity. Results: Among the patients with a clinical event, the median Anali score was 4 (interquartile range [IQR], 2-5) without gadolinium and 2 (IQR, 1–2) with gadolinium, compared with 1 (IQR, 1.0–2.5) and 1 (IQR, 0.25–1.0), respectively, among those without a clinical event. The ICC was 0.79 (95% confidence interval: 0.57–0.91) for the Anali score with gadolinium and 0.99 (95% confidence interval: 0.98–0.99) for the Anali score without gadolinium. Periportal edema and heterogeneous signal intensity in the liver on diffusion-weighted imaging showed no statistical impact on clinical events (p = 0.65 and p = 0.5, respectively). Conclusion: Anali scores correlate with clinical events in PSC, with a high level of interobserver agreement.Magnetic resonance imaging findings in autoimmune hepatitis: how frequent and reproducible are they?10.1590/0100-3984.2023.00442024-03-01T20:17:16.927000Z2020-08-09T06:48:58.242000ZGomes, Natália Borges NunesTorres, Ulysses S.Silva, Gabriella Souza eMamone, Perla Oliveira SchulzFerraz, Maria Lucia Cardoso GomesD’ippolito, Giuseppe
<em>Gomes, Natália Borges Nunes</em>;
<em>Torres, Ulysses S.</em>;
<em>Silva, Gabriella Souza E</em>;
<em>Mamone, Perla Oliveira Schulz</em>;
<em>Ferraz, Maria Lucia Cardoso Gomes</em>;
<em>D’ippolito, Giuseppe</em>;
<br/><br/>
Abstract Objective: To determine the frequency and interobserver reproducibility of the magnetic resonance imaging (MRI) features considered diagnostic for autoimmune hepatitis. Materials and Methods: Two abdominal radiologists, blinded to pathology data, reviewed the MRI examinations of 20 patients with autoimmune hepatitis, looking for liver enhancement, lymphadenopathy, portal hypertension, and chronic liver disease. The pattern of liver fibrosis was categorized as reticular, confluent, or mixed. Interobserver agreement was assessed by calculating intraclass correlation coefficients and kappa statistics. Results: The most common abnormal finding on MRI was surface nodularity (in 85%), followed by liver fibrosis with a reticular pattern (in 80%)—categorized as mild (in 25.0%), moderate (in 43.8%), or severe (in 31.2%)—; heterogeneous liver enhancement (in 65%); splenomegaly (in 60%); caudate lobe enlargement (in 50%); and lymphadenopathy (in 40%). The interobserver agreement was almost perfect for surface nodularity (0.83), ascites (0.89), and liver volume (0.95), whereas it was just slight and fair for the degree of fibrosis and for heterogeneous liver enhancement (0.12 and 0.25, respectively). It was also slight and fair for expanded gallbladder fossa and enlarged preportal space (0.14 and 0.36, respectively), both of which are indicative of chronic liver disease. Conclusion: The interobserver agreement was satisfactory for surface nodularity (the most prevalent abnormal MRI finding), ascites, liver volume, and splenomegaly. Conversely, it was only slight or fair for common but less objective criteria.Impact of preoperative body composition in patients with renal cell carcinoma submitted to surgical treatment10.1590/0100-3984.2023.00532024-03-01T20:17:16.927000Z2020-08-09T06:48:58.242000ZCarniatto, Letícia NascimentoBitencourt, Almir Galvão VieiraMiola, Thais ManfrinatoAgnello, JéssicaXavier, Camila MachadoCosta, Walter Henriques da
<em>Carniatto, Letícia Nascimento</em>;
<em>Bitencourt, Almir Galvão Vieira</em>;
<em>Miola, Thais Manfrinato</em>;
<em>Agnello, Jéssica</em>;
<em>Xavier, Camila Machado</em>;
<em>Costa, Walter Henriques Da</em>;
<br/><br/>
Abstract Objective: To evaluate the impact of preoperative body composition in patients with renal cell carcinoma (RCC) undergoing surgical treatment. Materials and Methods: This was a retrospective study of 52 patients with RCC undergoing total or partial nephrectomy. Body composition assessment was performed using the body mass index, together with computed tomography analysis at the level of the third lumbar vertebra to measure the area of visceral adipose tissue, as well as the area and density of skeletal muscle mass. Results: Malnutrition, obesity and inadequate skeletal muscle gauge (SMG) were associated with higher hospital length of stay (p = 0.028, p = 0.02 and p = 0.012, respectively). Although the rates of postoperative symptoms and readmissions were low, survival was better among the patients with an adequate SMG than among those with an inadequate SMG (p = 0.003). Conclusion: Among patients with RCC undergoing surgical treatment, preoperative body composition does not seem to be associated with the rates of perioperative complications, although an inadequate SMG seems to be associated with worse overall survival.Medial condyle hypoplasia in adolescent and young adult patients with trochlear dysplasia: a retrospective study10.1590/0100-3984.2023.00512024-03-01T20:17:16.927000Z2020-08-09T06:48:58.242000ZJacob, SruthiMahalingam, Harshavardhan
<em>Jacob, Sruthi</em>;
<em>Mahalingam, Harshavardhan</em>;
<br/><br/>
Abstract Objective: To determine the association between medial femoral condyle hypoplasia and trochlear dysplasia by analyzing the knee magnetic resonance imaging scans of young patients with or without trochlear dysplasia. Materials and Methods: This was a retrospective analysis of magnetic resonance imaging scans of the knees of young individuals (16-35 years of age): 30 patients with trochlear dysplasia and 30 individuals with no signs of patellofemoral instability. The ratios between the depth, width, and height of the medial and lateral femoral condyles (dLC/dMC, wLC/wMC, and hLC/hMC, respectively) were calculated, as was the ratio between the width of the medial condyle and the total width of the femur (wMC/FW). All of the values were determined in consensus by two radiologists. Results: We evaluated 60 patients: 30 with trochlear dysplasia and 30 without. The mean dLC/dMC, wLC/wMC, and hLC/hMC ratios were higher in the patients than in the controls (p < 0.05), whereas the mean wMC/FW ratio was lower in the patients (p < 0.05). The optimal cutoff values, obtained by calculating the areas under the receiver operating characteristic curves, were 1.0465 for the dLC/dMC ratio (76% sensitivity and 63.3% specificity), 0.958 for the wLC/wMC ratio (80% sensitivity and 73.3% specificity), and 1.080 for the hLC/hMC ratio (93.3% sensitivity and 93.3% specificity). Conclusion: Our findings confirm our hypothesis that trochlear dysplasia is associated with medial condyle hypoplasia.Lumbar safety triangle: comparative study of coronal and coronal oblique planes in 3.0-T magnetic resonance imaging10.1590/0100-3984.2023.00222024-03-01T20:17:16.927000Z2020-08-09T06:48:58.242000ZDannebrock, Fernando AugustoZardo, Erasmo de AbreuZiegler, Marcus SofiaVialle, EmilianoSoder, Ricardo BernardiSchwanke, Carla Helena Augustin
<em>Dannebrock, Fernando Augusto</em>;
<em>Zardo, Erasmo De Abreu</em>;
<em>Ziegler, Marcus Sofia</em>;
<em>Vialle, Emiliano</em>;
<em>Soder, Ricardo Bernardi</em>;
<em>Schwanke, Carla Helena Augustin</em>;
<br/><br/>
Abstract Objective: To compare the measurements of the lumbar safety triangle (Kambin’s triangle) and the invasion of the dorsal root ganglion in the triangle in coronal and coronal oblique planes. Materials and Methods: A cross-sectional study, in which 210 3.0-T magnetic resonance images of L2-L5 were analyzed in coronal and coronal oblique planes. Exams with lumbar spine anomalies were excluded. Demographic (sex and age) and radiological variables were recorded by a single evaluator. Results: Most sample was female (57.1%), mean age 45.5 ± 13.3 (18–98 years). The measurements average, as well as the areas, gradually increased from L2 to L5. The dorsal root ganglion invaded the triangle in all images. The safety triangle average area was smaller in the coronal oblique plane than in the coronal plane. Of the seven dimensions of safety triangle obtained for each level of the lumbar spine, six were significantly smaller in the coronal oblique plane than in the coronal plane. The only dimension that showed no difference was the smallest ganglion dimension. Conclusion: The dimensions and areas investigated were smaller in coronal oblique plane, especially the area (difference > 1 mm). The analysis of the triangular zone in this plane becomes important in the preoperative assessment of minimally invasive procedures.Assessment of the relationship between smoking and meniscal injury10.1590/0100-3984.2023.00812024-03-01T20:17:16.927000Z2020-08-09T06:48:58.242000ZŞirik, MehmetYetkin, Duygu İmreİnan, İbrahim
<em>Şirik, Mehmet</em>;
<em>Yetkin, Duygu İmre</em>;
<em>İnan, İbrahim</em>;
<br/><br/>
Abstract 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.Magnetic resonance imaging of the urethra10.1590/0100-3984.2023.00842024-03-01T20:17:16.927000Z2020-08-09T06:48:58.242000ZFiedler, GustavoBittencourt, Leonardo KayatZhou, ChristopherCavalcanti, André GuilhermeGoldman, Suzan Menasce
<em>Fiedler, Gustavo</em>;
<em>Bittencourt, Leonardo Kayat</em>;
<em>Zhou, Christopher</em>;
<em>Cavalcanti, André Guilherme</em>;
<em>Goldman, Suzan Menasce</em>;
<br/><br/>