Optimization of MRI Protocol for the Musculoskeletal System

Quality assessment of shoulder MRI according to practice parameters of American College of Radiology: A multi-center study in Jordan

Magnetic resonance imaging (MRI) is essential for assessing shoulder conditions. This study aimed to evaluate current shoulder MRI practices in Jordan, including technical parameter patterns, and determine if they adhere to the American College of Radiology (ACR) guidelines. The retrospective analysis included data from 48 eligible participants from 13 MRI centers in March 2021. Descriptive and correlation data analysis were performed using IBM SPSS statistics version_20 and Excel 2013. Most MRI centers (50%) were private outpatient clinics with closed MRI machines above 1 Tesla. Most participants (62.5%) were male, and shoulder pain (47.9%) was the main clinical indication. Most shoulder orientations (68.7%, 33/48) were right shoulders, and the coronal MRI planes (43%, 121/280) were the most common. The alignment percentage for the axial plane was 100%, but MRI artifacts of the shoulder were present in 8.2% of cases (23/280). Dark fluid T1-W coronal sequence was not conducted in 25% of the cases. The percentage of the field view (FOV) within ACR recommendations was 45% (126/281), and slice thickness parameters were 96% (269/281). The recommended pixel area for all sequences was 47.9% (134/280), encompassing all axial, sagittal oblique, and coronal planes. However, crucial parameters, such as FOV and slice thickness, were inadequate and did not meet the ACR guidelines, resulting in suboptimal image quality of shoulder MRI. To improve MRI image quality, it is recommended that MRI technologists receive ongoing education and training on appropriate MRI image parameters.

[Chest computed tomography findings in different phases of SARS-CoV-2 infection]

Objective

To compare the findings on chest computed tomography (CT) in patients with COVID-19 during different phases of the disease and to evaluate the reproducibility of a visual radiologic score for estimating the extent of lung involvement.

Methods

We retrospectively reviewed chest CT studies from 182 patients with RT-PCR findings positive for SARS-CoV-2. Patients were classified according to the time elapsed from the onset of symptoms, as follows: early (0-4 days), intermediate/progressive (5-9 days), or advanced (≥10 days). We analyzed the frequency of each radiologic finding, as well as the pattern, appearance, and predominant distribution of lung involvement. A visual tomographic score (range, 0-25) was used to estimate the extent of involvement in each lobe and in the total lung volume.

Results

The predominant CT finding was the ground-glass pattern (n=110; 60.4%), the most common distribution was peripheral (n = 116; 66.7%), and the most prevalent appearance was typical (n=112; 61.5%). The halo sign was seen most frequently in the early phase (25%), whereas ground-glass opacities were more common in the intermediate/progressive and advanced phases. The median severity score was 10 (IQR: 5-13), and the scores increased as the disease progressed. The interobserver agreement (kappa) was 0.92 for the appearance, 0.84 for the distribution, 0.70 for the predominant pattern, and 0.89 for the visual score.

Conclusion

The CT findings in patients with COVID-19 vary with the course of the infection. The proposed visual radiologic score is a simple, reproducible, and reliable tool for assessing lung involvement in COVID-19 pneumonia.