Vol 5, No 2 (2022)

Table of Contents

Open Access
Article
Article ID: 1750
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by Aura C. Puche, John Fredy Ochoa-Gómez, Yésika Alexandra Agudelo-Londoño, Jan Karlo Rodas-Marín, Carlos Andrés Tobón-Quintero
Imaging. Radiat. Res. 2022 , 5(2);    570 Views
Abstract The human brain has been described as a complex system. Its study by means of neurophysiological signals has revealed the presence of linear and nonlinear interactions. In this context, entropy metrics have been used to uncover brain behavior in the presence and absence of neurological disturbances. Entropy mapping is of great interest for the study of progressive neurodegenerative diseases such as Alzheimer’s disease. The aim of this study was to characterize the dynamics of brain oscillations in such disease by means of entropy and amplitude of low frequency oscillations from Bold signals of the default network and the executive control network in Alzheimer’s patients and healthy individuals, using a database extracted from the Open Access Imaging Studies series. The results revealed higher discriminative power of entropy by permutations compared to low-frequency fluctuation amplitude and fractional amplitude of low-frequency fluctuations. Increased entropy by permutations was obtained in regions of the default network and the executive control network in patients. The posterior cingulate cortex and the precuneus showed differential characteristics when assessing entropy by permutations in both groups. There were no findings when correlating metrics with clinical scales. The results demonstrated that entropy by permutations allows characterizing brain function in Alzheimer’s patients, and also reveals information about nonlinear interactions complementary to the characteristics obtained by calculating the amplitude of low frequency oscillations.
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Open Access
Article
Article ID: 1752
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by Iris-Katharina Penner, Achim Gass, Herbert Schreiber, Mike Peter Wattjes
Imaging. Radiat. Res. 2022 , 5(2);    523 Views
Abstract Background:  Multiple sclerosis is often a longitudinal disease continuum with an initial relapsing-remitting phase (RRMS) and later secondary progression (SPMS). Most currently approved therapies are not sufficiently effective in SPMS. Early detection of SPMS conversion is therefore critical for therapy selection. Important decision-making tools may include testing of partial cognitive performance and magnetic resonance imaging (MRI).  Aim of the work:  To demonstrate the importance of cognitive testing and MRI for the prediction and detection of SPMS conversion. Elaboration of strategies for follow-up and therapy management in practice, especially in outpatient care.  Material and methods:  Review based on an unsystematic literature search.  Results:  Standardized cognitive testing can be helpful for early SPMS diagnosis and facilitate progression assessment. Annual use of sensitive screening tests such as Symbol Digit Modalities Test (SDMT) and Brief Visual Memory Test-Revised (BVMT-R) or the Brief International Cognitive Assessment for MS (BICAMS) test battery is recommended. Persistent inflammatory activity on MRI in the first three years of disease and the presence of cortical lesions are predictive of SPMS conversion. Standardized MRI monitoring for features of progressive MS can support clinically and neurocognitively based suspicion of SPMS.  Discussion:  Interdisciplinary care of MS patients by clinically skilled neurologists, supported by neuropsychological testing and MRI, has a high value for SPMS prediction and diagnosis. The latter allows early conversion to appropriate therapies, as SPMS requires different interventions than RRMS. After drug switching, clinical, neuropsychological, and imaging vigilance allows stringent monitoring for neuroinflammatory and degenerative activity as well as treatment complications.
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Open Access
Article
Article ID: 1753
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by Felipe Aluja Jaramillo, Daniel Upegui Jiménez
Imaging. Radiat. Res. 2022 , 5(2);    481 Views
Abstract Colorectal cancer is the fourth leading cause of death worldwide and the fifth leading cause of cancer death in Colombia. Magnetic resonance imaging is the ideal modality for the evaluation of colorectal cancer, since it allows staging by determining invasion beyond the muscularis propria, extension towards adjacent organs, identification of patients who are candidates for chemotherapy or pre-surgical radiotherapy and planning of the surgical procedure. The key point is based on the differentiation between T2 and T3 stages through the use of sequences with high-resolution T2 information. In addition to this, it allows the assessment of the size and morphology of the lymph nodes, and considerably increases the specificity for the detection of lymph node involvement. MRI is a technique with high specificity and high reproducibility.
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Open Access
Article
Article ID: 1754
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by Lílian Santuza Santos Porto, Wilson Campos Tavares Júnior, Dário Alves da Silva Costa, Cristina Costa Duarte Lanna, Adriana Maria Kakehasi
Imaging. Radiat. Res. 2022 , 5(2);    422 Views
Abstract Introduction:  the presence of anti-CCP is an important prognostic tool for rheumatoid arthritis (RA), but its relationship with the activity of the disease and functional capacity is still being investigated. Objectives:  to study the relationship between anti-CCP and the indices of disease activity, functional capacity and structural damage, by means of conventional radiography (CR) and magnetic resonance imaging (MRI), in stabilized RA. Methods:  cross-sectional study of RA patients with one to 10 years of disease. The participants were subjected to clinical evaluation with anti-CCP screening. Disease activity was assessed by means of the Clinical Disease Activity Index (CDAI) and functional capacity by means of the Health Assessment Questionnaire (HAQ). CR was analyzed by the Sharp van der Heijde index (SmvH) and MRI by the Rheumatoid Arthritis Magnetic Resonance Image Scoring System (RAMRIS). Results:  56 patients were evaluated, with median (IIq) of 55 (47.5–60.0) years, 50 (89.3%) were female among whom 37 (66.1%) were positive for anti-CCP. The median (IIq) of CDAI, HAQ, SmvH and RAMRIS were 14.75 (5.42–24.97), 1.06 (0.28–1.75), 2 (0–8) and 15 (7–35), respectively. There was no association between anti-CCP and CDAI, HAQ, SmvH and RAMRIS. Conclusion:  our results did not establish the association of anti-CCP with the severity of the disease. So far, we cannot corroborate the anti-CCP as a prognostic tool in RA established.
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Open Access
Article
Article ID: 1755
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by Andrés Alejandro Kohan, Mariana Cecilia Kucharczyk, Natalia T. Posadas, Noelia N. Napoli, Santiago Jose Gil, Nora Angélica Fuentes, Ricardo Daniel García-Mónaco, Carolina Rosa Beatriz Chacón
Imaging. Radiat. Res. 2022 , 5(2);    506 Views
Abstract Objective:  to determine the diagnostic performance of magnetic resonance hysterosalpingography (HSG-MRI), using laparoscopy as the reference method.  Materials and methods:  22 patients were included. All underwent HSG-MRI with a 1.5 Tesla resonator and then laparoscopy with chromotubation. Two radiologists examined the MRIs, determining tubal patency by consensus. Descriptive and diagnostic performance analyses were performed.  Results:  HSG-MRI had a success rate of 91%. Study duration was 49 ± 15 minutes, volume injected 26 ± 16 cm 3  and pain scale 30 ± 19 out of 100. Sensitivity and specificity of HSG-MRI were 100% for global and left Cotte test, and 25% and 93.3% for right Cotte test, respectively. There were 2 minor complications and no major complications.  Discussion:  our initial results demonstrated high sensitivity and specificity. Although other studies analyzed the ability of HSG-MRI to assess tubal patency with good results, the use of a flawed reference standard left room for reasonable doubt, preventing a recommendation based on solid evidence. However, when comparing our results with those published, we observed a high degree of concordance insofar as the positive effusion is correctly diagnosed with a specificity of 100% or with a percentage close to this figure.
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Open Access
Article
Article ID: 1756
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by Laís Uyeda Aivazoglou, Orlando Rondan Zotti, Marcelo de Medeiros Pinheiro, Moacir Ribeiro de Castro Junior, Andrea Puchnick, Artur da Rocha Corrêa Fernandes, Eloy de Ávila Fernandes
Imaging. Radiat. Res. 2022 , 5(2);    452 Views
Abstract Objective:  To evaluate the imaging features of spondyloarthritis on magnetic resonance imaging (MRI) of the sacroiliac (SI) joints in terms of topography (in thirds) and affected margin, since this aspect is rarely addressed in the literature.  Methods:  Cross-sectional study with MRI (1.5 T) evaluation of the SI in 16 patients with diagnosis of axial spondyloarthritis regarding the presence of acute (subchondral bone edema, enthesitis, synovitis and capsulitis) and chronic changes (erosions, subchondral bone sclerosis, bone bridging and fatty replacement), performed by two radiologists, blinded to clinical data. MRI findings were correlated with clinical data including age, disease duration, medications, HLA-B27, BASDAI, ASDAS-VHS and ASDAS-PCR, BASMI, BASFI, and mSASSS. Results:  Bone edema pattern and erosions showed predominance in the upper third of SI ( p  = 0.050, p  = 0.0014, respectively). There was a correlation between the time of disease and structural changes by affected third ( p  = 0.028-0.037), as well as the presence of bone bridges with BASMI ( p  = 0.028) and mSASSS ( p  = 0.014). Patients with osteitis of the lower third had higher ASDAS values (ESRV: p  = 0.011 and CRP: p  = 0.017).  Conclusion:  Chronic inflammatory changes and the pattern of bone edema predominated in the upper third of the SI, but there was also concomitant involvement of the middle or lower thirds of the joint. The localization of involvement in the upper third of the SI was insufficient to differentiate between degeneration and inflammation.
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Open Access
Article
Article ID: 1757
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by Blanka Pophof, Gunnar Brix
Imaging. Radiat. Res. 2022 , 5(2);    570 Views
Abstract Problem:  in recent years, new studies have been published on biological effects of strong static magnetic fields and on thermal effects of high-frequency electromagnetic fields as used in magnetic resonance imaging (MRI). Many of these studies have not yet been incorporated into current safety recommendations.  Method:  scientific publications from 2010 onwards on the biological effects of static and electromagnetic fields of MRI were searched and evaluated.  Results:  new studies confirm older work that has already described effects of static magnetic fields on sensory organs and the central nervous system accompanied by sensory perception. A new result is the direct effect of Lorentz forces on ionic currents in the semicircular canals of the vestibular organ. Recent studies on thermal effects of radiofrequency fields focused on the development of anatomically realistic body models and more accurate simulation of exposure scenarios.  Recommendation for practice:  strong static magnetic fields can cause unpleasant perceptions, especially dizziness. In addition, they can impair the performance of the medical personnel and thus potentially endanger patient safety. As a precaution, medical personnel should move slowly in the field gradient. High-frequency electromagnetic fields cause tissues and organs to heat up in patients. This must be taken into account in particular for patients with impaired thermoregulation as well as for pregnant women and newborns; exposure in these cases must be kept as low as possible.
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Open Access
Review
Article ID: 1751
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by Andreas Hötker, Olivio F. Donati
Imaging. Radiat. Res. 2022 , 5(2);    543 Views
Abstract Clinical/methodological problem: The identification of clinically significant prostate carcinomas while avoiding overdiagnosis of low-malignant tumors is a challenge in routine clinical practice.  Standard radiologic procedures: Multiparametric magnetic resonance imaging (MRI) of the prostate acquired and interpreted according to PI-RADS (Prostate Imaging Reporting and Data System Guidelines) is accepted as a clinical standard among urologists and radiologists.  Methodological innovations: The PI-RADS guidelines have been newly updated to version 2.1 and, in addition to more precise technical requirements, include individual changes in lesion assessment.  Performance: The PI-RADS guidelines have become crucial in the standardization of multiparametric MRI of the prostate and provide templates for structured reporting, facilitating communication with the referring physician.  Evaluation: The guidelines, now updated to version 2.1, represent a refinement of the widely used version 2.0. Many aspects of reporting have been clarified, but some previously known limitations remain and require further improvement of the guidelines in future versions.
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Open Access
Review
Article ID: 1758
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by Frédéric Lecouvet, Bruno Vande Berg, Jacques Malghem, Baudouin Maldague, Augustin Ferrant, Jean-Louis Michauxu
Imaging. Radiat. Res. 2022 , 5(2);    418 Views
Abstract Multiple myeloma (MM) is a hematologic cancer characterized by clonal proliferation of plasma cells within the bone marrow. It is the most serious form of plasma cell dyscrasias, whose complications—hypercalcemia, renal failure, anemia, and lytic bone lesions—are severe and justify the therapeutic management. Imaging of bone lesions is a cardinal element in the diagnosis, staging, study of response to therapy, and prognostic evaluation of patients with MM. Historically, the skeletal radiographic workup (SRW), covering the entire axial skeleton, has been used to detect bone lesions. Over time, new imaging techniques that are more powerful than SRW have been evaluated. Low-dose and whole-body computed tomography (CT) supplants SRW for the detection of bone involvement, but is of limited value in assessing therapeutic response. Bone marrow MRI, initially studying the axial pelvic-spinal skeleton and more recently the whole body, is an attractive alternative. Beyond its non-irradiating character, its sensitivity for the detection of marrow damage, its capacity to evaluate the therapeutic response and its prognostic value has been demonstrated. This well-established technique has been incorporated into disease staging systems by many health systems and scientific authorities. Along with positron emission tomography (PET)-18 fluorodeoxyglucose CT, it constitutes the current imaging of choice for MM. This article illustrates the progress of the MRI technique over the past three decades and situates its role in the management of patients with MM.
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Open Access
Review
Article ID: 1759
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by Anne-Marie Kusch, Abell Sovero Gaspar
Imaging. Radiat. Res. 2022 , 5(2);    453 Views
Abstract The temporomandibular joint (TMJ) is considered a bicondylar diarthrosis type joint. Imaging evaluation is a fundamental part of its assessment, which should include both bony and soft tissue characteristics and the relationship between them. Magnetic resonance imaging (MRI) represents the gold standard for the study of soft tissues; however, up to now, its main application continues to be the visualization of the articular disc. For this reason, the present article aimed to point out the information available in the literature regarding the visualization of the joint capsule in MRI and to evaluate it as an independent structure.
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Open Access
Review
Article ID: 1760
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by Sandro Alexander Lévano Loayza, Abell Temistocles Sovero Gaspar
Imaging. Radiat. Res. 2022 , 5(2);    516 Views
Abstract A systemic and synthetic review of the anatomy of the temporomandibular joint in magnetic resonance imaging was developed for its evaluation. The temporomandibular joint is an anatomical structure composed of bones, muscles, ligaments and an articular disc that allows important physiological movements, such as mandibular opening, closing, protrusion, retrusion and lateralization. Magnetic resonance imaging is an imaging technique that does not use ionizing radiation and is more specific for the evaluation and interpretation of soft tissues, due to its high resolution, so it has an important role in the diagnosis of various maxillofacial pathologies, which is why the dentist should have knowledge of the structures and functions of the temporomandibular joint through magnetic resonance imaging. The review demonstrates the importance of magnetic resonance imaging in the study of the anatomy of the temporomandibular joint, in addition to mentioning the advantages provided by this imaging technique such as its good detail of the soft tissues in its different sequences and the non-use of ionizing radiation to obtain its images.
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