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Herregods N, Anisau A, Schiettecatte E, Vereecke E, Morbée L, Laloo F, Jaremko JL, Jans L. MRI in pediatric sacroiliitis, what radiologists should know. Pediatr Radiol 2023; 53:1576-1586. [PMID: 36856758 DOI: 10.1007/s00247-023-05602-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/21/2022] [Accepted: 01/11/2023] [Indexed: 03/02/2023]
Abstract
MRI is used for early detection of inflammation of sacroiliac joints as it shows active lesions of sacroiliitis long before radiographs show damage to the sacroiliac joints. Early diagnosis of arthritis allows early treatment of inflammation and can help delay disease progression and prevent irreversible damage. Also, early identification of axial involvement in juvenile spondyloarthropathy is crucial, as treatment options are different than for peripheral juvenile spondyloarthropathy. In general, standard sequences used in adults are also applied to children. However, interpreting MR images of pediatric sacroiliac joints is more challenging than in adults, because of normal physiological changes during skeletal maturation, which can simulate disease on MR images. Furthermore, classical definitions of sacroiliitis used in adults, for both active inflammatory and structural lesions, can be difficult to extrapolate to children. The development of reliable pediatric-specific definitions for sacroiliitis is still in active study. Understanding both normal and pathological signal changes in children is important to distinguish physiologic findings from disease and to make a correct diagnosis. In this review, the main imaging characteristics of sacroiliitis on MRI in children and its frequent pitfalls will be illustrated, while also citing some discussion points regarding the scan protocol.
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Affiliation(s)
- Nele Herregods
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | - Aliaksandr Anisau
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Eva Schiettecatte
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Elke Vereecke
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Lieve Morbée
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Frederiek Laloo
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Jacob L Jaremko
- Department of Radiology & Diagnostic Imaging, University of Alberta, 8440-112 Street, EdmontonAlberta, T6G 2B7, Canada
- Medical Imaging Consultants, Edmonton, AB, Canada
| | - Lennart Jans
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
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Jiang S, Wen Z, Ahn SS, Cai K, Paech D, Eberhart CG, Zhou J. Applications of chemical exchange saturation transfer magnetic resonance imaging in identifying genetic markers in gliomas. NMR IN BIOMEDICINE 2023; 36:e4731. [PMID: 35297117 PMCID: PMC10557022 DOI: 10.1002/nbm.4731] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 05/23/2023]
Abstract
Chemical exchange saturation transfer (CEST) imaging is an important molecular magnetic resonance imaging technique that can image numerous low-concentration biomolecules with water-exchangeable protons (such as cellular proteins) and tissue pH. CEST, or more specially amide proton transfer-weighted imaging, has been widely used for the detection, diagnosis, and response assessment of brain tumors, and its feasibility in identifying molecular markers in gliomas has also been explored in recent years. In this paper, after briefing on the basic principles and quantification methods of CEST imaging, we review its early applications in identifying isocitrate dehydrogenase mutation status, MGMT methylation status, 1p/19q deletion status, and H3K27M mutation status in gliomas. Finally, we discuss the limitations or weaknesses in these studies.
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Affiliation(s)
- Shanshan Jiang
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Kejia Cai
- Department of Radiology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Daniel Paech
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
- Clinic for Neuroradiology, University Hospital Bonn, Bonn, Germany
| | | | - Jinyuan Zhou
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
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3
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Jaju A, Li Y, Dahmoush H, Gottardo NG, Laughlin S, Mirsky D, Panigrahy A, Sabin ND, Shaw D, Storm PB, Poussaint TY, Patay Z, Bhatia A. Imaging of pediatric brain tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee/ASPNR White Paper. Pediatr Blood Cancer 2023; 70 Suppl 4:e30147. [PMID: 36519599 PMCID: PMC10466217 DOI: 10.1002/pbc.30147] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/16/2022]
Abstract
Tumors of the central nervous system are the most common solid malignancies in children and the most common cause of pediatric cancer-related mortality. Imaging plays a central role in diagnosis, staging, treatment planning, and response assessment of pediatric brain tumors. However, the substantial variability in brain tumor imaging protocols across institutions leads to variability in patient risk stratification and treatment decisions, and complicates comparisons of clinical trial results. This White Paper provides consensus-based imaging recommendations for evaluating pediatric patients with primary brain tumors. The proposed brain magnetic resonance imaging protocol recommendations balance advancements in imaging techniques with the practicality of deployment across most imaging centers.
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Affiliation(s)
- Alok Jaju
- Department of Medical Imaging, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Yi Li
- UCSF Department of Radiology and Biomedical Imaging, San Francisco, California, USA
| | - Hisham Dahmoush
- Department of Radiology, Lucile Packard Children's Hospital at Stanford, Palo Alto, California, USA
| | - Nicholas G Gottardo
- Department of Paediatric and Adolescent Oncology and Haematology, Perth Children's Hospital, Brain Tumour Research Programme, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Suzanne Laughlin
- Department of Diagnostic Imaging, The Hospital for Sick Children and Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - David Mirsky
- Department of Radiology, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Ashok Panigrahy
- Department of Radiology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Noah D Sabin
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Dennis Shaw
- Department of Radiology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Phillip B Storm
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Tina Young Poussaint
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Zoltan Patay
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Aashim Bhatia
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Verkuil F, Hemke R, van Gulik EC, Barendregt AM, Rashid ANS, Schonenberg-Meinema D, Dolman KM, Deurloo EE, van Dijke KF, Harder JMD, Kuijpers TW, van den Berg JM, Maas M. Double inversion recovery MRI versus contrast-enhanced MRI for evaluation of knee synovitis in juvenile idiopathic arthritis. Insights Imaging 2022; 13:167. [PMID: 36264355 PMCID: PMC9584003 DOI: 10.1186/s13244-022-01299-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Double inversion recovery (DIR) MRI has the potential to accentuate the synovium without using contrast agents, as it allows simultaneous signal suppression of fluid and fat. The purpose of this study was (1) to compare DIR MRI to conventional contrast-enhanced (CE) MRI for delineation of the synovium in the knee in children with juvenile idiopathic arthritis (JIA) and (2) to assess the agreement between DIR MRI and CE-MRI regarding maximal synovial thickness measurements. RESULTS In this prospective study, 26 children with JIA who consecutively underwent 3.0-T knee MRI between January 2018 and January 2021 were included (presence of knee arthritis: 13 [50%]; median age: 14 years [interquartile range [IQR]: 11-17]; 14 girls). Median confidence to depict the synovium (0-100 mm visual analogue scale; scored by 2 readers [consensus based]) was 88 (IQR: 79-97) for DIR MRI versus 100 (IQR: 100-100) for CE-MRI (p value = < .001). Maximal synovial thickness per child (millimeters; scored by 4 individual readers) on DIR MRI was greater (p value = < .001) in the children with knee arthritis (2.4 mm [IQR: 2.1-3.1]) than in those without knee arthritis (1.4 mm [IQR: 1.0-1.6]). Good inter-technique agreement for maximal synovial thickness per child was observed (rs = 0.93 [p value = < .001]; inter-reader reliability: ICC DIR MRI = 0.87 [p value = < .001], ICC CE-MRI = 0.90 [p value = < .001]). CONCLUSION DIR MRI adequately delineated the synovium in the knee of children with JIA and enabled synovial thickness measurement similar to that of CE-MRI. Our results demonstrate that DIR MRI should be considered as a child-friendly alternative to CE-MRI for evaluation of synovitis in children with (suspected) JIA.
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Affiliation(s)
- Floris Verkuil
- Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. .,Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Robert Hemke
- grid.7177.60000000084992262Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - E. Charlotte van Gulik
- grid.7177.60000000084992262Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands ,grid.7177.60000000084992262Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Anouk M. Barendregt
- grid.7177.60000000084992262Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands ,grid.7177.60000000084992262Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Amara Nassar-Sheikh Rashid
- grid.7177.60000000084992262Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands ,grid.417773.10000 0004 0501 2983Department of Pediatrics, Zaans Medical Center, Koningin Julianaplein 58, 1502 DV Zaandam, The Netherlands
| | - Dieneke Schonenberg-Meinema
- grid.7177.60000000084992262Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Koert M. Dolman
- grid.440209.b0000 0004 0501 8269Department of Pediatrics; Location OLVG Oost, OLVG, Oosterpark 9, 1091 AC Amsterdam, The Netherlands ,grid.440209.b0000 0004 0501 8269Department of Pediatrics; Location OLVG West, OLVG, Jan Tooropstraat 164, 1061 AE Amsterdam, The Netherlands ,grid.418029.60000 0004 0624 3484Pediatric Rheumatology, Reade, Dr. Jan van Breemenstraat 2, 1056 AB Amsterdam, The Netherlands
| | - Eline E. Deurloo
- grid.7177.60000000084992262Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Kees F. van Dijke
- Department of Radiology and Nuclear Medicine, Noordwest Hospital Group Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands
| | - J. Michiel den Harder
- grid.7177.60000000084992262Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Taco W. Kuijpers
- grid.7177.60000000084992262Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - J. Merlijn van den Berg
- grid.7177.60000000084992262Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Mario Maas
- grid.7177.60000000084992262Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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Lin KM, Gadinsky NE, Klinger CE, Kleeblad LJ, Shea KG, Dyke JP, Helfet DL, Rodeo SA, Green DW, Lazaro LE. Vascularity of the early post-natal human distal femoral chondroepiphysis: Quantitative MRI analysis. J Child Orthop 2022; 16:152-158. [PMID: 35620125 PMCID: PMC9127880 DOI: 10.1177/18632521221084179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 02/07/2022] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Injury to or abnormality of developing distal femoral chondroepiphysis blood supply has been implicated in osteochondritis dissecans development. Progressive decrease in epiphyseal cartilage blood supply occurs in normal development; however, based on animal studies, it is hypothesized that there is greater decrease in regions more prone to osteochondritis dissecans lesions. We aimed to quantify differential regional perfusion of the immature distal femoral chondroepiphysis. We hypothesized there is decreased perfusion in the lateral aspect of the medial femoral condyle, the classic osteochondritis dissecans lesion location. METHODS Five fresh-frozen human cadaveric knees (0-6 months old) were utilized. The superficial femoral artery was cannulated proximally and contrast-enhanced magnetic resonance imaging performed using a previously reported protocol for quantifying osseous and soft tissue perfusion. Regions of interest were defined, and signal enhancement changes between pre- and post-contrast images, normalized to background muscle, were compared. RESULTS When comparing average normalized post-contrast signal enhancement of whole condyles, as well as distal, posterior, and inner (toward the notch) aspects of the medial and lateral condyles, no significant perfusion differences between condyles were found. In the medial condyle, no significant perfusion difference was found between the medial and lateral aspects. CONCLUSION We quantified immature distal femoral chondroepiphysis regional vascularity in the early post-natal knee. In specimens aged 0-6 months, no distinct watershed region was detected. Despite possible limitations, given small sample size, as well as resolution of magnetic resonance imaging and analysis, our results suggest the hypothesized vascular abnormality predisposing osteochondritis dissecans either does not occur universally or occurs after this developmental age.
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Affiliation(s)
- Kenneth M Lin
- Hospital for Special Surgery/New York Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Naomi E Gadinsky
- Hospital for Special Surgery/New York Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Craig E Klinger
- Hospital for Special Surgery/New York Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA,Orthopaedic Trauma Service, Hospital for Special Surgery, New York, NY, USA,Craig E Klinger, Orthopaedic Trauma Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
| | | | - Kevin G Shea
- Stanford University Medical Center, Stanford, CA, USA
| | - Jonathan P Dyke
- Citigroup Biomedical Imaging Center and Weill Cornell Medicine, New York, NY, USA
| | - David L Helfet
- Hospital for Special Surgery/New York Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Scott A Rodeo
- Hospital for Special Surgery/New York Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Daniel W Green
- Hospital for Special Surgery/New York Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Lionel E Lazaro
- Miami Orthopedic & Sports Medicine Institute, Baptist Health South Florida, Miami, FL, USA
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Kilian A, Aigner A, Simon M, Salchow DJ, Potratz C, Thomale UW, Hernáiz Driever P, Tietze A. Tumor load rather than contrast enhancement is associated with the visual function of children and adolescents with optic pathway glioma - a retrospective Magnetic Resonance Imaging study. J Neurooncol 2022; 156:589-597. [PMID: 34994964 PMCID: PMC8860805 DOI: 10.1007/s11060-021-03941-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/29/2021] [Indexed: 11/06/2022]
Abstract
Introduction Optic pathway gliomas are often asymptomatic tumors occurring in children with neurofibromatosis type 1 (NF1 + OPG) or sporadically (spOPG). Treatment is usually prompted by visual loss and/or tumor progression on MRI. The aim of this study was to investigate the relationship between visual acuity (VA), tumor growth, and contrast enhancement to provide more distinct indications for the administration of gadolinium-based contrast agents. Methods Tumor load was retrospectively measured and enhancement semi-quantitatively scored on 298 MRIs of 35 patients (63% NF1 + OPG). Spearman rank correlation between tumor load and enhancement was calculated and a linear mixed model used to examine the influence of tumor load and enhancement on corresponding VA tests (LogMAR). Results The optic nerve width in NF1 + OPGs was strongly associated with VA (regression coefficient 0.75; confidence interval 0.61—0.88), but weakly with enhancement (0.06; −0.04—0.15). In spOPGs, tumor volume and optic nerve width were more relevant (0.31; −0.19—0.81 and 0.39; 0.05—0.73) than enhancement (0.09; −0.09—0.27). Conclusions Tumor load measures may be more relevant for the surveillance of optic pathway gliomas than enhancement, given that VA is the relevant outcome parameter. Regular contrast administration should therefore be questioned in these patients. Supplementary Information The online version contains supplementary material available at 10.1007/s11060-021-03941-1.
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Affiliation(s)
- Anna Kilian
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Neuroradiology, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Annette Aigner
- Charité - Universitätsmedizin Berlin, Institute of Biometry and Clinical Epidemiology, Berlin, Germany
| | - Michèle Simon
- Charité - Universitätsmedizin Berlin, Department of Pediatric Oncology and Hematology, Berlin, Germany
| | - Daniel J Salchow
- Charité - Universitätsmedizin Berlin, Department of Ophthalmology, Berlin, Germany
| | - Cornelia Potratz
- Charité - Universitätsmedizin Berlin, Department of Pediatric Neurology, Berlin, Germany
| | - Ulrich-Wilhelm Thomale
- Charité - Universitätsmedizin Berlin, Department of Pediatric Neurosurgery, Berlin, Germany
| | - Pablo Hernáiz Driever
- Charité - Universitätsmedizin Berlin, Department of Pediatric Oncology and Hematology, Berlin, Germany.,German HIT-LOGGIC-Registry for Children and Adolescents With Low-Grade Glioma, Berlin, Germany
| | - Anna Tietze
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Neuroradiology, Augustenburger Platz 1, 13353, Berlin, Germany.
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7
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MRI in Pregnancy and Precision Medicine: A Review from Literature. J Pers Med 2021; 12:jpm12010009. [PMID: 35055324 PMCID: PMC8778056 DOI: 10.3390/jpm12010009] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/11/2021] [Accepted: 12/15/2021] [Indexed: 12/29/2022] Open
Abstract
Magnetic resonance imaging (MRI) offers excellent spatial and contrast resolution for evaluating a wide variety of pathologies, without exposing patients to ionizing radiations. Additionally, MRI offers reproducible diagnostic imaging results that are not operator-dependent, a major advantage over ultrasound. MRI is commonly used in pregnant women to evaluate, most frequently, acute abdominal and pelvic pain or placental abnormalities, as well as neurological or fetal abnormalities, infections, or neoplasms. However, to date, our knowledge about MRI safety during pregnancy, especially about the administration of gadolinium-based contrast agents, which are able to cross the placental barrier, is still limited, raising concerns about possible negative effects on both the mother and the health of the fetus. Contrast agents that are unable to cross the placenta in a way that is safe for the fetus are desirable. In recent years, some preclinical studies, carried out in rodent models, have evaluated the role of long circulating liposomal nanoparticle-based blood-pool gadolinium contrast agents that do not penetrate the placental barrier due to their size and therefore do not expose the fetus to the contrast agent during pregnancy, preserving it from any hypothetical risks. Hence, we performed a literature review focusing on contrast and non-contrast MRI use during pregnancy.
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8
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Park SY, Lee NY, Jung MH, Lim GY. Dedicated sellar magnetic resonance imaging protocols without contrast enhancement in girls with central precocious puberty: prevalence of pathologic lesions and clinical correlation. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 65:758-767. [PMID: 34762782 PMCID: PMC10065397 DOI: 10.20945/2359-3997000000412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Contrast-enhanced brain magnetic resonance imaging (MRI) is routinely performed in children with central precocious puberty (CPP). We evaluated the value of a dedicated sellar MRI protocol without contrast enhancement in girls with CPP. METHODS This study included 261 girls diagnosed with CPP. We performed sellar MRI scanning without gadolinium enhancement of the hypothalamic-pituitary area (HPA) at the pituitary level, including additional T2-weighted imaging of whole-brain scans to check for other lesions. We evaluated the prevalence of intracranial lesions via this MR protocol. In addition,the correlation between the clinical parameters and morphology of the pituitary gland on the images was assessed. RESULTS Intracranial lesions were detected in 17 (6.5%) of the 261 girls. Of the 17 girls with abnormalities, 16 (94.1%) had findings in brain areas other than the HPA. The weight, height, Tanner stage of patients were significantly (p < 0.05) higher in the group with greater pituitary height. Patient weight and height, Tanner stage of breast development, and luteinizing hormone (LH) levels were significantly (p < 0.05) greater in those with a higher pituitary grade as determined on sellar MRI. CONCLUSION A dedicated unenhanced sellar MRI protocol provides valuable information on brain lesions and pituitary morphology. We found a significantly low prevalence of brain lesions among girls with CPP. Analysis of the height or shape of the pituitary gland on sellar MRI revealed significant correlations with the weight, height, Tanner stage, and LH levels of the patients.
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Michali-Stolarska M, Tukiendorf A, Zacharzewska-Gondek A, Jacków-Nowicka J, Chrzanowska J, Trybek G, Bladowska J. MRI Protocol for Pituitary Assessment in Children with Growth or Puberty Disorders-Is Gadolinium Contrast Administration Actually Needed? J Clin Med 2021; 10:jcm10194598. [PMID: 34640616 PMCID: PMC8509364 DOI: 10.3390/jcm10194598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to assess the diagnostic value of non-contrast pituitary MRI in children with growth or puberty disorders (GPDs) and to determine the criteria indicating the necessity to perform post-contrast examination. A retrospective study included re-analysis of 567 contrast-enhanced pituitary MRIs of children treated in a tertiary reference center. Two sets of sequences were created from each MRI examination: Set 1, including common sequences without contrast administration, and Set 2, which included common pre- and post-contrast sequences (conventional MRI examination). The differences in the visibility of pituitary lesions between pairs of sets were statistically analyzed. The overall frequency of Rathke’s cleft cysts was 11.6%, ectopic posterior pituitary 3.5%, and microadenomas 0.9%. Lesions visible without contrast administration accounted for 85% of cases. Lesions not visible before and diagnosed only after contrast injection accounted for only 0.18% of all patients. Statistical analysis showed the advantage of the antero-posterior (AP) pituitary dimension over the other criteria in determining the appropriateness of using contrast in pituitary MRIs. The AP dimension was the most significant factor in logistic regression analysis: OR = 2.23, 95% CI, 1.35–3.71, p-value = 0.002, and in ROC analysis: AUC: 72.9% with a cut-off value of 7.5 mm, with sensitivity/specificity rates of 69.2%/73.5%. In most cases, the use of gadolinium-based contrast agent (GBCA) in pituitary MRI in children with GPD is unnecessary. The advantages of GBCA omission include shortening the time of MRI examination and of general anesthesia; saving time for other examinations, thus increasing the availability of MRI for waiting children; and acceleration in their further clinical management.
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Affiliation(s)
- Marta Michali-Stolarska
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, 50-367 Wroclaw, Poland; (M.M.-S.); (J.J.-N.); (J.B.)
| | - Andrzej Tukiendorf
- Department of Public Health, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Anna Zacharzewska-Gondek
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, 50-367 Wroclaw, Poland; (M.M.-S.); (J.J.-N.); (J.B.)
- Correspondence: ; Tel.: +48-(71)-733-1668; Fax: +48-(71)-734-1669
| | - Jagoda Jacków-Nowicka
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, 50-367 Wroclaw, Poland; (M.M.-S.); (J.J.-N.); (J.B.)
| | - Joanna Chrzanowska
- Department of Developmental Endocrinology and Diabetology, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Grzegorz Trybek
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland;
| | - Joanna Bladowska
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, 50-367 Wroclaw, Poland; (M.M.-S.); (J.J.-N.); (J.B.)
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10
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Chaturvedi A. Pediatric skeletal diffusion-weighted magnetic resonance imaging: part 1 - technical considerations and optimization strategies. Pediatr Radiol 2021; 51:1562-1574. [PMID: 33792751 DOI: 10.1007/s00247-021-04975-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/12/2020] [Accepted: 01/15/2021] [Indexed: 12/28/2022]
Abstract
Diffusion-weighted MRI, or DWI, is a fast, quantitative technique that is easily integrated into a morphological MR acquisition. The ability of DWI to aid in detecting multifocal skeletal pathology and in characterizing tissue cellularity to a level beyond that possible with other techniques makes it a niche component of multiparametric MR imaging of the skeleton. Besides its role in disease detection and establishing cellularity and character of osseous lesions, DWI continues to be examined as a surrogate biomarker for therapeutic response of several childhood bone tumors. There is increasing interest in harnessing DWI as a potential substitute to alternative modes of imaging evaluation that involve radiation or administration of intravenous contrast agent or radiopharmaceuticals, for example in early detection and diagnosis of capital femoral epiphyseal ischemia in cases of Legg-Calvé-Perthes disease, or diagnosis and staging of lymphoma. The expected evolution of skeletal diffusivity characteristics with maturation and the unique disease processes that affect the pediatric skeleton necessitate a pediatric-specific discussion. In this article, the author examines the developmentally appropriate normal appearances, technique, artifacts and pitfalls of pediatric skeletal DWI.
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Affiliation(s)
- Apeksha Chaturvedi
- Division of Pediatric Radiology, Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY, 14642, USA.
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11
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de Sonnaville WFC, Speksnijder CM, Zuithoff NPA, Verkouteren DRC, Wulffraat NW, Steenks MH, Rosenberg AJWP. Mandibular range of motion in children with juvenile idiopathic arthritis with and without clinically established temporomandibular joint involvement and in healthy children; a cross-sectional study. Pediatr Rheumatol Online J 2021; 19:106. [PMID: 34217306 PMCID: PMC8254997 DOI: 10.1186/s12969-021-00583-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/08/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Recognition of temporomandibular joint (TMJ) involvement in children with juvenile idiopathic arthritis (JIA) has gained increasing attention in the past decade. The clinical assessment of mandibular range of motion characteristics is part of the recommended variables to detect TMJ involvement in children with JIA. The aim of this study was to explore explanatory variables for mandibular range of motion outcomes in children with JIA, with and without clinically established TMJ involvement, and in healthy children. METHODS This cross-sectional study included children with JIA and healthy children of age 6-18 years. Mandibular range of motion variables included active and passive maximum interincisal opening (AMIO and PMIO), protrusion, laterotrusion, dental midline shift in AMIO and in protrusion. Additionally, the TMJ screening protocol and palpation pain were assessed. Adjusted linear regression analyses of AMIO, PMIO, protrusion, and laterotrusion were performed to evaluate the explanatory factors. Two adjusted models were constructed: model 1 to compare children with JIA and healthy children, and model 2 to compare children with JIA with and without TMJ involvement. RESULTS A total of 298 children with JIA and 169 healthy children were included. Length was an explanatory variable for the mandibular range of motion excursions. Each centimeter increase in length increased AMIO (0.14 mm), PMIO (0.14 mm), and protrusion (0.02 mm). Male gender increased AMIO by 1.35 mm. Having JIA negatively influenced AMIO (3.57 mm), PMIO (3.71 mm), and protrusion (1.03 mm) compared with healthy children, while the discrepancy between left and right laterotrusion raised 0.68 mm. Children with JIA and TMJ involvement had a 8.27 mm lower AMIO, 7.68 mm lower PMIO and 0.96 mm higher discrepancy in left and right laterotrusion compared to healthy children. CONCLUSION All mandibular range of motion items were restricted in children with JIA compared with healthy children. In children with JIA and TMJ involvement, AMIO, PMIO and the discrepancy between left and right laterotrusion were impaired more severely. The limitation in protrusion and laterotrusion was hardly clinically relevant. Overall, AMIO is the mandibular range of motion variable with the highest restriction (in millimeters) in children with JIA and clinically established TMJ involvement compared to healthy children.
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Affiliation(s)
- Willemijn F. C. de Sonnaville
- grid.5477.10000000120346234Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, PO Box 85500, The Netherlands
| | - Caroline M. Speksnijder
- grid.5477.10000000120346234Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, PO Box 85500, The Netherlands
| | - Nicolaas P. A. Zuithoff
- grid.7692.a0000000090126352Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Daan R. C. Verkouteren
- grid.5477.10000000120346234Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, PO Box 85500, The Netherlands
| | - Nico W. Wulffraat
- grid.5477.10000000120346234Department of Pediatric Rheumatology and Immunology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Michel H. Steenks
- grid.5477.10000000120346234Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, PO Box 85500, The Netherlands
| | - Antoine J. W. P. Rosenberg
- grid.5477.10000000120346234Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, PO Box 85500, The Netherlands
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Semyachkina-Glushkovskaya O, Mamedova A, Vinnik V, Klimova M, Saranceva E, Ageev V, Yu T, Zhu D, Penzel T, Kurths J. Brain Mechanisms of COVID-19-Sleep Disorders. Int J Mol Sci 2021; 22:6917. [PMID: 34203143 PMCID: PMC8268116 DOI: 10.3390/ijms22136917] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 02/06/2023] Open
Abstract
2020 and 2021 have been unprecedented years due to the rapid spread of the modified severe acute respiratory syndrome coronavirus around the world. The coronavirus disease 2019 (COVID-19) causes atypical infiltrated pneumonia with many neurological symptoms, and major sleep changes. The exposure of people to stress, such as social confinement and changes in daily routines, is accompanied by various sleep disturbances, known as 'coronasomnia' phenomenon. Sleep disorders induce neuroinflammation, which promotes the blood-brain barrier (BBB) disruption and entry of antigens and inflammatory factors into the brain. Here, we review findings and trends in sleep research in 2020-2021, demonstrating how COVID-19 and sleep disorders can induce BBB leakage via neuroinflammation, which might contribute to the 'coronasomnia' phenomenon. The new studies suggest that the control of sleep hygiene and quality should be incorporated into the rehabilitation of COVID-19 patients. We also discuss perspective strategies for the prevention of COVID-19-related BBB disorders. We demonstrate that sleep might be a novel biomarker of BBB leakage, and the analysis of sleep EEG patterns can be a breakthrough non-invasive technology for diagnosis of the COVID-19-caused BBB disruption.
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Affiliation(s)
- Oxana Semyachkina-Glushkovskaya
- Institute of Physics, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany;
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
| | - Aysel Mamedova
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
| | - Valeria Vinnik
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
| | - Maria Klimova
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
| | - Elena Saranceva
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
| | - Vasily Ageev
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
| | - Tingting Yu
- Wuhan National Laboratory for Optoelectronics, Britton Chance Center for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan 430074, China; (T.Y.); (D.Z.)
- MoE Key Laboratory for Biomedical Photonics, Collaborative Innovation Center for Biomedical Engineering, School of Engineering Sciences, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Dan Zhu
- Wuhan National Laboratory for Optoelectronics, Britton Chance Center for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan 430074, China; (T.Y.); (D.Z.)
- MoE Key Laboratory for Biomedical Photonics, Collaborative Innovation Center for Biomedical Engineering, School of Engineering Sciences, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Thomas Penzel
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
- Sleep Medicine Center, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Jürgen Kurths
- Institute of Physics, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany;
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
- Potsdam Institute for Climate Impact Research, Telegrafenberg A31, 14473 Potsdam, Germany
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Dietrich CF, Augustiniene R, Batko T, Cantisani V, Cekuolis A, Deganello A, Dong Y, Franke D, Harkanyi Z, Humphries PD, Jędrzejczyk M, Jüngert J, Kinkel H, Koller O, Kosiak W, Kunze C, Ljutikov A, Madzik J, Mentzel HJ, Piskunowicz M, Rafailidis V, Schreiber-Dietrich D, Sellars ME, Stenzel M, Taut H, Yusuf GT, Sidhu PS. European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB): An Update on the Pediatric CEUS Registry on Behalf of the "EFSUMB Pediatric CEUS Registry Working Group". ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2021; 42:270-277. [PMID: 33690876 DOI: 10.1055/a-1345-3626] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The European Federation of Ultrasound in Medicine and Biology (EFSUMB) created the "EFSUMB Pediatric Registry" (EFSUMB EPR) with the purpose of collecting data regarding the intravenous application of pediatric contrast-enhanced ultrasound (CEUS). The primary aim was to document the current clinical practice and usefulness of the technique and secondarily to assess CEUS safety in children. We issue the preliminary results of this database and examine the overall practice of CEUS in children in Europe.
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Affiliation(s)
- Christoph F Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
- Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Germany
- Johann Wolfgang Goethe University Hospital, Frankfurt/Main, Germany
| | - Rasa Augustiniene
- Department of Radiology, Children's Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos, Lithuania
| | - Tomasz Batko
- Department of Pediatric, Haematology and Oncology, Medical University of Gdansk, Poland
| | - Vito Cantisani
- Radiological, Oncological and Anatomy-Pathological Sciences University Sapienza of Rome, Italy
| | - Andrius Cekuolis
- Department of Radiology, Children's Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos, Lithuania
| | - Annamaria Deganello
- Department of Radiology, King's College London, King's College Hospital, United Kingdom of Great Britain and Northern Ireland
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Doris Franke
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Zoltan Harkanyi
- Department of Radiology, Heim Pal National Pediatric Institute, Budapest, Hungary
| | - Paul D Humphries
- Great Ormond Street Hospital for Children and University College London NHS Foundation Trusts
| | - Maciej Jędrzejczyk
- Ultrasound Diagnostic Department, Faculty of Medical Sciences, Medical University of Warsaw, Poland
| | - Jörg Jüngert
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Horst Kinkel
- Krankenhaus Düren, Klinik für Gastroenterologie, Hepatologie, Diabetologie und Intensivmedizin, Düren, Germany
| | - Orsolya Koller
- Department of Radiology, Heim Pal National Pediatric Institute, Budapest, Hungary
| | - Wojciech Kosiak
- Ultrasound and Biopsy Diagnostics Lab at the Clinic of Pediatrics, Haematology and Oncology, Medical University of Gdansk, Poland
| | - Christian Kunze
- Clinic and Policlinic of Radiology, University Medical Center Halle (Saale), Germany
| | - Anoushka Ljutikov
- Department of Diagnostic Imaging, Barts Health NHS Trust, The Royal London Hospital, London, United Kingdom
| | - Jaroslaw Madzik
- Institute of Mother and Child, Department of Diagnostic Imaging, Warsaw, Poland
| | - Hans-Joachim Mentzel
- Section of Pediatric Radiology, Institute of Diagnostic and Interventional Radiology. University Hospital Jena, Germany
| | | | - Vasileios Rafailidis
- Department of Radiology, King's College London, King's College Hospital, United Kingdom of Great Britain and Northern Ireland
| | - Dagmar Schreiber-Dietrich
- Localinomed, Bern Switzerland
- Department of Pediatric Medicine, Caritas-Krankenhaus Bad Mergentheim, Germany
| | - Maria E Sellars
- Department of Radiology, King's College London, King's College Hospital, United Kingdom of Great Britain and Northern Ireland
| | - Martin Stenzel
- Kliniken der Stadt Köln gGmbH, Kinderradiologie, Köln, Germany
| | - Heike Taut
- Children's Hospital, Universitätsklinikum Dresden, Technische Universität Dresden, Dresden, Germany
| | - Gibran T Yusuf
- Department of Radiology, King's College London, King's College Hospital, United Kingdom of Great Britain and Northern Ireland
| | - Paul S Sidhu
- Department of Radiology, King's College London, King's College Hospital, United Kingdom of Great Britain and Northern Ireland
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de Sonnaville WFC, Speksnijder CM, Zuithoff NPA, Verkouteren DRC, Wulffraat NW, Steenks MH, Rosenberg AJWP. Maximum bite force in children with juvenile idiopathic arthritis with and without clinical established temporomandibular joint involvement and in healthy children: a cross-sectional study. J Oral Rehabil 2021; 48:774-784. [PMID: 33780558 PMCID: PMC8251949 DOI: 10.1111/joor.13172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/27/2021] [Indexed: 12/14/2022]
Abstract
Background In children with juvenile idiopathic arthritis (JIA), the temporomandibular joint (TMJ) can be involved, resulting in dysfunction of the masticatory system. Bite force is one of the variables that reflects the function of the masticatory system. The aim of this study was to compare maximum bite force in children with JIA, with and without TMJ involvement and with healthy children. Methods Children with JIA and healthy children between the ages 6 and 18 were included in this cross‐sectional study. The clinical examination consisted of measuring the anterior maximum voluntary bite force (AMVBF), assessment of the TMJ screening protocol items and TMJ, masseter and temporal muscle palpation pain. Unadjusted linear regression analyses were performed to evaluate the explanatory factors for AMVBF. Two adjusted models were constructed with corrections for age and gender differences: model 1 to compare children with JIA and healthy children and model 2 to compare children with JIA with and without TMJ involvement. Results In this cross‐sectional study, 298 children with JIA and 169 healthy children participated. AMVBF was 24 Newton (N) lower in children with JIA, when compared with healthy children (95%CI: −35.5–−12.4, p = .000). When children with JIA also had clinically established TMJ involvement, AMVBF was reduced 42 N (component JIA:−16.78, 95% CI −28.96–−4.59, p = .007 and component TMJ involvement:−25.36, 95% CI −40.08–−10.63, p = .001). Age and male gender increased AMVBF. Conclusion Children with JIA had a reduction in the AMVBF compared with healthy children. In children with JIA and clinically established TMJ involvement, AMVBF was more reduced.
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Affiliation(s)
- Willemijn F C de Sonnaville
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Caroline M Speksnijder
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Nicolaas P A Zuithoff
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Daan R C Verkouteren
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Nico W Wulffraat
- Department of Pediatric Rheumatology and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Michel H Steenks
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Antoine J W P Rosenberg
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Gadinsky NE, Lin KM, Klinger CE, Dyke JP, Kleeblad LJ, Shea KG, Helfet DL, Rodeo SA, Green DW, Lazaro LE. Quantitative assessment of the vascularity of the skeletally immature patella: a cadaveric study using MRI. J Child Orthop 2021; 15:157-165. [PMID: 34040662 PMCID: PMC8138784 DOI: 10.1302/1863-2548.15.200261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE While predominant blood supply to the adult patella enters inferomedially, little is known about skeletally immature patellar perfusion. Improved knowledge of immature patella vascularity can further understanding of osteochondritis dissecans, dorsal defects of the patella and bipartite patella, and help ensure safe surgical approaches. We hypothesized that the immature patella would exhibit more uniform blood flow. The study purpose was to quantify immature patella regional perfusion in comparison with adults. METHODS Ten cadaveric knees were utilized (five immature, five mature). The superficial femoral artery was cannulated proximally. Signal enhancement increases were compared from pre- to post-contrast MRI to assess relative arterial contributions to patella regions (quadrants, anterior/posterior, superior/inferior, medial/lateral, and outer/inner). RESULTS Quantitative-MRI analysis revealed similar distribution of enhancement between the immature and mature patella. The inferior pole exhibited significantly higher arterial contribution versus superior pole in both immature and mature groups (p = 0.009; both groups), while the inferomedial quadrant had the highest arterial contribution of all quadrants in both groups. The superolateral quadrant demonstrated the lowest arterial contribution in the immature group and second lowest in the adult group. The patella outer periphery had significantly greater arterial contribution than the inner central region in both immature (p = 0.009) and mature (p = 0.009) groups. CONCLUSION Distribution of arterial contributions between the immature and mature patella was similar. Our results highlight the importance of inferior and inferomedial blood supply in both immature and mature patellas. These findings have implications for paediatric and adult patients; surgical damage to inferior patellar vessels should be avoided to prevent associated complications.
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Affiliation(s)
- Naomi E. Gadinsky
- Hospital for Special Surgery/New York Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Kenneth M. Lin
- Hospital for Special Surgery/New York Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Craig E. Klinger
- Hospital for Special Surgery/New York Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Jonathan P. Dyke
- Citigroup Biomedical Imaging Center and Weill Cornell Medicine, New York, NY, USA
| | | | - Kevin G. Shea
- Stanford University Medical Center, Stanford, CA, USA
| | - David L Helfet
- Hospital for Special Surgery/New York Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA,Correspondence should be sent to David L. Helfet, MD, Orthopaedic Trauma Service, Hospital for Special Surgery. E-mail:
| | - Scott A. Rodeo
- Hospital for Special Surgery/New York Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Daniel W. Green
- Hospital for Special Surgery/New York Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Lionel E. Lazaro
- Miami Orthopedic and Sports Medicine Institute, Baptist Health South Florida, Miami, FL, USA
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Barendregt AM, Mazzoli V, van Gulik EC, Schonenberg-Meinema D, Nassar-Sheikh Rashid A, Nusman CM, Dolman KM, van den Berg JM, Kuijpers TW, Nederveen AJ, Maas M, Hemke R. Juvenile Idiopathic Arthritis: Diffusion-weighted MRI in the Assessment of Arthritis in the Knee. Radiology 2020; 295:373-380. [PMID: 32154774 DOI: 10.1148/radiol.2020191685] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Diffusion-weighted imaging (DWI) can depict the inflamed synovial membrane in arthritis. Purpose To study the diagnostic accuracy of DWI for the detection of arthritis compared with the clinical reference standard and to compare DWI to contrast material-enhanced MRI for the detection of synovial inflammation. Materials and Methods In this institutional review board-approved prospective study, 45 participants with juvenile idiopathic arthritis (JIA) or suspected of having JIA (seven boys, 38 girls; median age, 14 years [interquartile range, 12-16 years]) were included between December 2015 and December 2018. Study participants underwent pre- and postcontrast 3.0-T MRI of the knee with an additional DWI sequence. For the clinical reference standard, a multidisciplinary team determined the presence or absence of arthritis on the basis of clinical, laboratory, and imaging findings (excluding DWI). Two data sets were scored by two radiologists blinded to all clinical data; data set 1 contained pre- and postcontrast sequences (contrast-enhanced MRI), and data set 2 contained precontrast and DWI sequences (DWI). Diagnostic accuracy was determined by comparing the scores of the DWI data set to those of the clinical reference standard. Second, DWI was compared with contrast-enhanced MRI regarding detection of synovial inflammation. Results Sensitivity for detection of arthritis for DWI was 93% (13 of the 14 participants with arthritis were correctly classified with DWI; 95% confidence interval [CI]: 64%, 100%) and specificity was 81% (25 of 31 participants without arthritis were correctly classified with DWI; 95% CI: 62%, 92%). Scores for synovial inflammation at DWI and contrast-enhanced MRI agreed in 37 of 45 participants (82%), resulting in a sensitivity of 92% (12 of 13 participants; 95% CI: 62%, 100%) and specificity of 78% (25 of 32 participants; 95% CI: 60%, 90%) with DWI when contrast-enhanced MRI was considered the reference standard. Conclusion Diffusion-weighted imaging (DWI) was accurate in detecting arthritis in pediatric participants with juvenile idiopathic arthritis (JIA) or suspected of having JIA and showed agreement with contrast-enhanced MRI. The results indicate that DWI could replace contrast-enhanced MRI for imaging of synovial inflammation in this patient group. © RSNA, 2020 Online supplemental material is available for this article.
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Affiliation(s)
- Anouk M Barendregt
- From the Department of Radiology and Nuclear Medicine (A.M.B., E.C.v.G., A.J.N., M.M., R.H.), Department of Pediatric Immunology, Rheumatology and Infectious Disease (A.M.B., E.C.v.G., D.S.M., A.N.S.a.R., J.M.v.d.B., T.W.K.), and Department of Pediatrics (C.M.N.), Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Lucas Center for Imaging, Stanford University, Stanford, Calif (V.M.); Department of Pediatric Rheumatology, Reade, Amsterdam, the Netherlands (K.M.D.); and Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (K.M.D.)
| | - Valentina Mazzoli
- From the Department of Radiology and Nuclear Medicine (A.M.B., E.C.v.G., A.J.N., M.M., R.H.), Department of Pediatric Immunology, Rheumatology and Infectious Disease (A.M.B., E.C.v.G., D.S.M., A.N.S.a.R., J.M.v.d.B., T.W.K.), and Department of Pediatrics (C.M.N.), Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Lucas Center for Imaging, Stanford University, Stanford, Calif (V.M.); Department of Pediatric Rheumatology, Reade, Amsterdam, the Netherlands (K.M.D.); and Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (K.M.D.)
| | - E Charlotte van Gulik
- From the Department of Radiology and Nuclear Medicine (A.M.B., E.C.v.G., A.J.N., M.M., R.H.), Department of Pediatric Immunology, Rheumatology and Infectious Disease (A.M.B., E.C.v.G., D.S.M., A.N.S.a.R., J.M.v.d.B., T.W.K.), and Department of Pediatrics (C.M.N.), Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Lucas Center for Imaging, Stanford University, Stanford, Calif (V.M.); Department of Pediatric Rheumatology, Reade, Amsterdam, the Netherlands (K.M.D.); and Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (K.M.D.)
| | - Dieneke Schonenberg-Meinema
- From the Department of Radiology and Nuclear Medicine (A.M.B., E.C.v.G., A.J.N., M.M., R.H.), Department of Pediatric Immunology, Rheumatology and Infectious Disease (A.M.B., E.C.v.G., D.S.M., A.N.S.a.R., J.M.v.d.B., T.W.K.), and Department of Pediatrics (C.M.N.), Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Lucas Center for Imaging, Stanford University, Stanford, Calif (V.M.); Department of Pediatric Rheumatology, Reade, Amsterdam, the Netherlands (K.M.D.); and Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (K.M.D.)
| | - Amara Nassar-Sheikh Rashid
- From the Department of Radiology and Nuclear Medicine (A.M.B., E.C.v.G., A.J.N., M.M., R.H.), Department of Pediatric Immunology, Rheumatology and Infectious Disease (A.M.B., E.C.v.G., D.S.M., A.N.S.a.R., J.M.v.d.B., T.W.K.), and Department of Pediatrics (C.M.N.), Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Lucas Center for Imaging, Stanford University, Stanford, Calif (V.M.); Department of Pediatric Rheumatology, Reade, Amsterdam, the Netherlands (K.M.D.); and Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (K.M.D.)
| | - Charlotte M Nusman
- From the Department of Radiology and Nuclear Medicine (A.M.B., E.C.v.G., A.J.N., M.M., R.H.), Department of Pediatric Immunology, Rheumatology and Infectious Disease (A.M.B., E.C.v.G., D.S.M., A.N.S.a.R., J.M.v.d.B., T.W.K.), and Department of Pediatrics (C.M.N.), Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Lucas Center for Imaging, Stanford University, Stanford, Calif (V.M.); Department of Pediatric Rheumatology, Reade, Amsterdam, the Netherlands (K.M.D.); and Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (K.M.D.)
| | - Koert M Dolman
- From the Department of Radiology and Nuclear Medicine (A.M.B., E.C.v.G., A.J.N., M.M., R.H.), Department of Pediatric Immunology, Rheumatology and Infectious Disease (A.M.B., E.C.v.G., D.S.M., A.N.S.a.R., J.M.v.d.B., T.W.K.), and Department of Pediatrics (C.M.N.), Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Lucas Center for Imaging, Stanford University, Stanford, Calif (V.M.); Department of Pediatric Rheumatology, Reade, Amsterdam, the Netherlands (K.M.D.); and Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (K.M.D.)
| | - J Merlijn van den Berg
- From the Department of Radiology and Nuclear Medicine (A.M.B., E.C.v.G., A.J.N., M.M., R.H.), Department of Pediatric Immunology, Rheumatology and Infectious Disease (A.M.B., E.C.v.G., D.S.M., A.N.S.a.R., J.M.v.d.B., T.W.K.), and Department of Pediatrics (C.M.N.), Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Lucas Center for Imaging, Stanford University, Stanford, Calif (V.M.); Department of Pediatric Rheumatology, Reade, Amsterdam, the Netherlands (K.M.D.); and Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (K.M.D.)
| | - Taco W Kuijpers
- From the Department of Radiology and Nuclear Medicine (A.M.B., E.C.v.G., A.J.N., M.M., R.H.), Department of Pediatric Immunology, Rheumatology and Infectious Disease (A.M.B., E.C.v.G., D.S.M., A.N.S.a.R., J.M.v.d.B., T.W.K.), and Department of Pediatrics (C.M.N.), Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Lucas Center for Imaging, Stanford University, Stanford, Calif (V.M.); Department of Pediatric Rheumatology, Reade, Amsterdam, the Netherlands (K.M.D.); and Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (K.M.D.)
| | - Aart J Nederveen
- From the Department of Radiology and Nuclear Medicine (A.M.B., E.C.v.G., A.J.N., M.M., R.H.), Department of Pediatric Immunology, Rheumatology and Infectious Disease (A.M.B., E.C.v.G., D.S.M., A.N.S.a.R., J.M.v.d.B., T.W.K.), and Department of Pediatrics (C.M.N.), Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Lucas Center for Imaging, Stanford University, Stanford, Calif (V.M.); Department of Pediatric Rheumatology, Reade, Amsterdam, the Netherlands (K.M.D.); and Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (K.M.D.)
| | - Mario Maas
- From the Department of Radiology and Nuclear Medicine (A.M.B., E.C.v.G., A.J.N., M.M., R.H.), Department of Pediatric Immunology, Rheumatology and Infectious Disease (A.M.B., E.C.v.G., D.S.M., A.N.S.a.R., J.M.v.d.B., T.W.K.), and Department of Pediatrics (C.M.N.), Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Lucas Center for Imaging, Stanford University, Stanford, Calif (V.M.); Department of Pediatric Rheumatology, Reade, Amsterdam, the Netherlands (K.M.D.); and Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (K.M.D.)
| | - Robert Hemke
- From the Department of Radiology and Nuclear Medicine (A.M.B., E.C.v.G., A.J.N., M.M., R.H.), Department of Pediatric Immunology, Rheumatology and Infectious Disease (A.M.B., E.C.v.G., D.S.M., A.N.S.a.R., J.M.v.d.B., T.W.K.), and Department of Pediatrics (C.M.N.), Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology, Lucas Center for Imaging, Stanford University, Stanford, Calif (V.M.); Department of Pediatric Rheumatology, Reade, Amsterdam, the Netherlands (K.M.D.); and Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (K.M.D.)
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18
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Takanezawa Y, Nakamura R, Kusaka T, Ohshiro Y, Uraguchi S, Kiyono M. Significant contribution of autophagy in mitigating cytotoxicity of gadolinium ions. Biochem Biophys Res Commun 2020; 526:206-212. [PMID: 32201079 DOI: 10.1016/j.bbrc.2020.03.080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 03/13/2020] [Indexed: 12/11/2022]
Abstract
Gadolinium-based contrast agents (GBCAs) are widely used in clinical magnetic resonance imaging (MRI). Free gadolinium ions (Gd3+) released from GBCAs potentially increase the risk of GBCA-related toxicity. However, the cellular responses to Gd3+ and the underlying mechanisms responsible for protection against Gd3+ remain poorly understood. Recently, autophagy has been considered a cell survival mechanism against various toxic metals. Here, we investigated the relationship between Gd3+ and autophagy, as well as the effect of autophagy inhibition on the survival of cells exposed to Gd3+. We found that the increased expression of microtubule-associated protein 1 light chain 3 (LC3)-II, a marker protein of autophagy, in Gd3+-exposed human embryonic kidney 293 (HEK293) cells. Moreover, we found a greater accumulation of LC3-II after exposure to an autophagy inhibitor, chloroquine (CQ), combined with Gd3+ than that after exposure to CQ alone, suggesting that Gd3+ activated autophagy in HEK293 cells. Furthermore, we found that Gd3+ reduced cell viability, which was more pronounced after CQ treatment. Our findings indicated that autophagy exerted a cytoprotective effect against Gd3+ toxicity, suggesting a potential link between autophagy and GBCA-associated adverse events.
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Affiliation(s)
- Yasukazu Takanezawa
- Department of Public Health, School of Pharmacy, Kitasato University, Tokyo, Japan, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan
| | - Ryosuke Nakamura
- Department of Public Health, School of Pharmacy, Kitasato University, Tokyo, Japan, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan
| | - Tomoya Kusaka
- Department of Public Health, School of Pharmacy, Kitasato University, Tokyo, Japan, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan
| | - Yuka Ohshiro
- Department of Public Health, School of Pharmacy, Kitasato University, Tokyo, Japan, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan
| | - Shimpei Uraguchi
- Department of Public Health, School of Pharmacy, Kitasato University, Tokyo, Japan, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan
| | - Masako Kiyono
- Department of Public Health, School of Pharmacy, Kitasato University, Tokyo, Japan, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan.
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19
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Lum M, Tsiouris AJ. MRI safety considerations during pregnancy. Clin Imaging 2020; 62:69-75. [PMID: 32109683 DOI: 10.1016/j.clinimag.2020.02.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 02/11/2020] [Accepted: 02/18/2020] [Indexed: 12/12/2022]
Abstract
The use of magnetic resonance imaging (MRI) during pregnancy is on the rise due its ability to provide detailed cross-sectional anatomy without ionizing radiation. Despite the favorable radiation profile, theoretically concerns regarding the safety of MRI and gadolinium-based contrast agent (GBCA) administration have been raised. Currently there are no studies that have shown any attributable harms of MRI during any trimester of pregnancy although prospective and longitudinal studies are lacking. GBCA administration may be associated with a slightly higher rate of neonatal death, although this is based on a single, large cohort study. Understanding the available evidence regarding MRI safety during pregnancy in the context of current society guidelines will help the radiologist serve as a valuable resource to patients and referring providers.
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Affiliation(s)
- Mark Lum
- Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medical Center, 525 E 68th St, New York, NY 10065, United States of America.
| | - A John Tsiouris
- Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medical Center, 525 E 68th St, New York, NY 10065, United States of America
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20
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Papageorgiou I, Dvorak J, Cosma I, Pfeil A, Teichgraeber U, Malich A. Whole-body MRI: a powerful alternative to bone scan for bone marrow staging without radiation and gadolinium enhancer. Clin Transl Oncol 2019; 22:1321-1328. [PMID: 31858434 DOI: 10.1007/s12094-019-02257-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 12/02/2019] [Indexed: 01/13/2023]
Abstract
PURPOSE Whole-body magnetic resonance imaging (WB-MRI) is a radiation-free alternative to the 99mTc-HDP bone scan (BS) for the detection of bone metastasis. The major drawback is the long examination time and application of gadolinium enhancer. The aim of this study is to analyze (i) the performance of WB-MRI versus the BS and (ii) the diagnostic benefit of gadolinium (WB-MRI + Gd) compared to a non-enhanced protocol (NE WB-MRI). METHODS AND MATERIALS 1256 eligible WB-MRI scans were analyzed retrospectively with a single inclusion criterion, a clinical 12-month follow-up or a biopsy as ground truth. N = 285 patients received both a WB-MRI and a BS within 12 months. All the patients were imaged with a coronal T1w and a STIR, and n = 528 (42%) received an additional T1w-mDixon with gadoteridol (0.1 mmol Gd-DTPA/kg). RESULTS From 1256 eligible patients, n = 884 (70%) had breast cancer as a primary disease, n = 101(8%) prostate cancer, and n = 77(6%) lung cancer. The sensitivity (Se) and negative predictive value (NPV) of the WB-MRI was 98/99%, significantly higher compared to BS with 82/89%, P < 0.001 Mc Nemar's test. The specificity (Spe) and positive predictive value (PPV) of the WB-MRI and BS was 85/82% and 91/86%, respectively. The interobserver agreement between WB-MRI and BS was 71%, Cohen's kappa 0.42. Analysis of the added diagnostic value of gadolinium revealed Se/Spe/PPV/NPV of 98/93/92/98% for the NE WB-MRI and 99/93/85/100% for the WM-MRI + Gd, P > 0.05 binary logistic regression with Fischer's exact test. CONCLUSION WB-MRI exceeds the sensitivity of BS without compromising the specificity, even after omitting the gadolinium enhancer.
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Affiliation(s)
- I Papageorgiou
- Institute of Diagnostic and Interventional Radiology, University Hospital of Jena, Jena, Germany. .,Institute of Radiology, Suedharz Hospital Nordhausen, 39 Dr.-Robert-Koch Street, 99734, Nordhausen, Germany.
| | - J Dvorak
- Department of Nuclear Medicine, Suedharz Hospital Nordhausen, Nordhausen, Germany
| | - I Cosma
- Institute of Radiology, Suedharz Hospital Nordhausen, 39 Dr.-Robert-Koch Street, 99734, Nordhausen, Germany
| | - A Pfeil
- Department of Internal Medicine, University Hospital of Jena, Jena, Germany
| | - U Teichgraeber
- Institute of Diagnostic and Interventional Radiology, University Hospital of Jena, Jena, Germany
| | - A Malich
- Institute of Radiology, Suedharz Hospital Nordhausen, 39 Dr.-Robert-Koch Street, 99734, Nordhausen, Germany
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21
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Brandsma R, Verschuuren-Bemelmans CC, Amrom D, Barisic N, Baxter P, Bertini E, Blumkin L, Brankovic-Sreckovic V, Brouwer OF, Bürk K, Catsman-Berrevoets CE, Craiu D, de Coo IFM, Gburek J, Kennedy C, de Koning TJ, Kremer HPH, Kumar R, Macaya A, Micalizzi A, Mirabelli-Badenier M, Nemeth A, Nuovo S, Poll-The B, Lerman-Sagie T, Steinlin M, Synofzik M, Tijssen MAJ, Vasco G, Willemsen MAAP, Zanni G, Valente EM, Boltshauser E, Sival DA. A clinical diagnostic algorithm for early onset cerebellar ataxia. Eur J Paediatr Neurol 2019; 23:692-706. [PMID: 31481303 DOI: 10.1016/j.ejpn.2019.08.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/25/2019] [Accepted: 08/06/2019] [Indexed: 10/26/2022]
Abstract
Early onset cerebellar Ataxia (EOAc) comprises a large group of rare heterogeneous disorders. Determination of the underlying etiology can be difficult given the broad differential diagnosis and the complexity of the genotype-phenotype relationships. This may change the diagnostic work-up into a time-consuming, costly and not always rewarding task. In this overview, the Childhood Ataxia and Cerebellar Group of the European Pediatric Neurology Society (CACG-EPNS) presents a diagnostic algorithm for EOAc patients. In seven consecutive steps, the algorithm leads the clinician through the diagnostic process, including EOA identification, application of the Inventory of Non-Ataxic Signs (INAS), consideration of the family history, neuro-imaging, laboratory investigations, genetic testing by array CGH and Next Generation Sequencing (NGS). In children with EOAc, this algorithm is intended to contribute to the diagnostic process and to allow uniform data entry in EOAc databases.
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Affiliation(s)
- R Brandsma
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - C C Verschuuren-Bemelmans
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - D Amrom
- Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium; Neurology Unit, Kannerklinik Centre Hospitalier de Luxembourg, Luxembourg, Grand Duchy of Luxembourg
| | - N Barisic
- Department of Pediatrics, Clinical Medical Centre Zagreb, University of Zagreb Medical School, Croatia
| | - P Baxter
- Department of Paediatric Neurology, Sheffield Children's Hospital, UK
| | - E Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesu' Children's Research Hospital, Rome, Italy
| | - L Blumkin
- Pediatric Neurology Unit, Wolfson Medical Center, Holon and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - V Brankovic-Sreckovic
- Clinic for Child Neurology and Psychiatry, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - O F Brouwer
- Department of Paediatric Neurology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - K Bürk
- Paracelsus-Elena-Klinik Kassel, University of Marburg, Germany
| | - C E Catsman-Berrevoets
- Department of Pediatric Neurology, Erasmus University Hospital/Sophia Children's Hospital, Rotterdam, the Netherlands
| | - D Craiu
- Carol Davila University of Medicine Bucharest, Department of Clinical Neurosciences, Pediatric Neurology II Discipline, Alexandru Obregia Hospital, Bucharest, Romania
| | - I F M de Coo
- Department of Genetics and Cell Biology, University of Maastricht, Maastricht, the Netherlands
| | - J Gburek
- Centre for Paediatrics and Adolescent Medicine, Hannover Medical School, Hannover, Germany
| | - C Kennedy
- Clinical Neurosciences, Faculty of Medicine, University of Southampton, UK
| | - T J de Koning
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Paediatric Neurology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - H P H Kremer
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - R Kumar
- Department of Pediatric Neurology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - A Macaya
- Grup de Recerca en Neurologia Pediàtrica, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Secció de Neurologia Pediàtrica, Hospital Universitari Vall d'Hebron, 08002, Barcelona, Spain
| | - A Micalizzi
- Laboratory of Medical Genetics, Bambino Gesu Children's Hospital, Rome, Italy
| | - M Mirabelli-Badenier
- DINOGMI Department-University of Genoa/Unit of Child Neuropsychiatry, G. Gaslini Institute, Genoa, Italy
| | - A Nemeth
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - S Nuovo
- Neurogenetics Unit, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - B Poll-The
- Department of Pediatric Neurology, Emma Children's Hospital, Academic Medical Centre (AMC), University of Amsterdam, the Netherlands
| | - T Lerman-Sagie
- Pediatric Neurology Unit, Wolfson Medical Center, Holon and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - M Steinlin
- Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - M Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - M A J Tijssen
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - G Vasco
- Division of Neurorehabilitation, Bambino Gesu' Children's Research Hospital, Rome, Italy
| | - M A A P Willemsen
- Department of Pediatric Neurology, Radboud University Medical Center/Amalia Children's Hospital, Nijmegen, the Netherlands
| | - G Zanni
- Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesu' Children's Research Hospital, Rome, Italy
| | - E M Valente
- Neurogenetics Unit, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - E Boltshauser
- Department of Pediatric Neurology, University Children's Hospital, Zürich, Switzerland
| | - D A Sival
- Department of Paediatric Neurology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
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