Purpose:To analyze the diffusion and perfusion parameters of central gland (CG) prostate cancer, stromal hyperplasia (SH), and glandular hyperplasia (GH) and to determine the role of these parameters in the differentiation of CG cancer from benign CG hyperplasia. Materials and Methods:In this institutional review board-approved (with waiver of informed consent), HIPAA-compliant study, 38 foci of carcinoma, 38 SH nodules, and 38 GH nodules in the CG were analyzed in 49 patients (26 with CG carcinoma) who underwent preoperative endorectal magnetic resonance (MR) imaging and radical prostatectomy. All carcinomas and hyperplastic foci on MR images were localized on the basis of histopathologic correlation. The apparent diffusion coeffi cient (ADC), the contrast agent transfer rate between blood and tissue (K trans ), and extravascular extracellular fractional volume values for all carcinoma, SH, and GH foci were calculated. The mean, standard deviation, 95% confi dence interval (CI), and range of each parameter were calculated. Receiver operating characteristic (ROC) and multivariate logistic regression analyses were performed for differentiation of CG cancer from SH and GH foci. Results:The average ADCs ( 3 10 2 3 mm 2 /sec) were 1.05 (95% CI: 0.97, 1.11), 1.27 (95% CI: 1.20, 1.33), and 1.73 (95% CI: 1.64, 1.83), respectively, in CG carcinoma, SH foci, and GH foci and differed signifi cantly, yielding areas under the ROC curve (AUCs) of 0.99 and 0.78, respectively, for differentiation of carcinoma from GH and SH. Perfusion parameters were similar in CG carcinomas and SH foci, with K trans yielding the greatest AUCs (0.75 and 0.58, respectively). Adding K trans to ADC in ROC analysis to differentiate CG carcinoma from SH increased sensitivity from 38% to 57% at 90% specifi city without noticeably increasing the AUC (0.79). Conclusion:ADCs differ signifi cantly between CG carcinoma, SH, and GH, and the use of them can improve the differentiation of CG cancer from SH and GH. Combining K trans with ADC can potentially improve the detection of CG cancer.

There is a moderate correlation between ADC values and Gleason score and between k(ep) and microvessel density of prostate cancer. Although the strength of the correlations is insufficient for immediate diagnostic utility, these results warrant further investigation on the potential of multiparametric MRI to facilitate noninvasive assessment of prostate cancer aggressiveness and angiogenesis.

Purpose: To determine relative diagnostic value of MR diffusion and perfusion parameters in detection of active small bowel inflammation in patients with Crohn's disease (CD). Materials and Methods:We reviewed 18 patients with active CD of terminal ileum (TI) who underwent MR enterography (MRE; including dynamic contrast enhanced MRI and diffusion-weighted MRI). Conventional MRI findings of TI were recorded. Regions of interest were drawn over TI and normal ileum to calculate apparent diffusion coefficient (ADC), the volume transfer constant (K trans ) and the contrast media distribution volume (v e ). Receiver operating characteristic analysis was used to determine their diagnostic performance.Results: Among conventional MR findings, mural thickening and increased enhancement were present in all actively inflamed small bowel. K Conclusion: Dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) provide quantitative measures of small bowel inflammation that can differentiate actively inflamed small bowel segments from normal small bowel in CD. DWI provides better sensitivity compared with DCE-MRI and combination of ADC and K trans parameters for analysis can potentially improve specificity.

The aim of this study was to investigate and compare the therapeutic effect of three different combinations in the conservative treatment of carpal tunnel syndrome (CTS) by means of clinical and electrophysiological studies. The combinations included tendon- and nerve-gliding exercises in combination with splinting, ultrasound treatment in combination with splinting and the combination of ultrasound, splinting, tendon- and nerve-gliding exercises. A total 28 female patients (56 wrists) with clinical and electrophysiologic evidence of bilateral CTS were studied. In all patient groups, the treatment combinations were significantly effective immediately and 8 weeks after the treatment. The results of the long-term patient satisfaction questionnaire revealed that symptomatic improvement is more prominent in the group treated with splinting, exercise and ultrasound therapy combination. Our results suggest that a combination of splinting, exercise and ultrasound therapy is a preferable and an efficacious conservative type of treatment in CTS.

No abstract

The present study shows that ADC measurements have the potential to quantitatively differentiate between normal and cancerous tissues of the uterine zones. We propose adding DWI as an adjunct sequence in the MR protocol for the assessment of uterine lesions.

The aim of this study was to retrospectively measure and compare pancreatic apparent diffusion coefficient (ADC) in patients with acute pancreatitis (AP) with aged matched controls who underwent diffusion weighted imaging (DWI). The institutional review board approved this retrospective Health Insurance Portability and Accountability Act compliant study with a waiver for informed consent. Pancreatic ADC values from 27 patients with a clinical diagnosis of AP and 38 normal age-matched controls evaluated with DWI (b = 0 and 800 mm(2)/s) were retrospectively and independently measured by two radiologists. The ADCs were compared between the groups and between each of the pancreatic segments in the normal group. Inter-observer reliability was calculated and receiver operating characteristic analysis was used to determine the sensitivity and specificity of DW imaging in the diagnosis of acute pancreatitis. P < 0.05 was considered statistically significant. The ICC for inter-observer reliability was 0.98 in the control and 0.97 in the AP group. The mean pancreatic ADC in the AP group (1.32 × 10(-3) mm(2)/s ± 0.13) was significantly lower than in the normal group (1.77 × 10(-3) mm(2)/s ± 0.32). There was no significant difference in mean ADCs between each of the pancreatic segments in the controls. A threshold ADC value of 1.62 × 10-3 mm(2)/s yielded a sensitivity of 93% and specificity of 87% for detecting acute pancreatitis for b values of 0 and 800 s/mm(2). Pancreatic ADCs are significantly lower in patients with AP than normal controls.

No abstract