The signal intensity patterns of rotator cuff lesions at magnetic resonance (MR) imaging were evaluated in 80 patients who had surgical correlation and in 13 asymptomatic individuals (14 shoulders). Six cadaver shoulders were examined with MR, and histologic correlation was obtained in four. All studies were performed at 1.5 T with a flexible circular surface coil. The accuracy of MR imaging in detection of full-thickness cuff tears (31 patients) was 0.95 and of partial thickness tears (16 patients), 0.84. The most common and accurate pattern for full-thickness cuff tears (22 of 31 tears) was a region of intense signal seen on T2-weighted images. Less often the torn region consisted of an extremely degenerated and attenuated tendon with moderate signal intensity or was obscured by low-signal-intensity scar. The intense signal pattern on T2-weighted images was also accurate, although a less common finding (seven of 16 cases), in the diagnosis of partial tears. Tendinitis was recognized as focal or diffuse regions of increased signal intensity or a nonhomogeneous pattern of increased signal often associated with tendinous enlargement. In some patients, manifestations of subacromial-subdeltoid bursitis was present. Tendon degeneration was also manifested as regions of increased signal intensity. Some similarity and overlap of signal patterns of partial interstitial tears, tendinitis, and tendon degeneration are observed.
The prevalence of lumbosacral intervertebral disk bulge and herniation on sagittal magnetic resonance (MR) images was determined in 45 pregnant subjects and 41 asymptomatic nonpregnant women of childbearing age. MR technique differed for the pregnant and nonpregnant groups. Fifty-three percent of pregnant and 54% of nonpregnant women had an abnormal disk (bulge or herniation) at one or more levels (L3-4, L4-5, or L5-S1). The difference was not statistically significant. There was also no significant difference in the distribution of outcomes among the 45 pregnant subjects, 17 parous nonpregnant women, and 24 nulliparous women. The results suggest that lumbosacral disk bulges or herniations are common in women of childbearing age, whether pregnant or not, and that, contrary to an earlier report, pregnant women do not have an increased prevalence of disk abnormalities.
Magnetic resonance (MR) imaging of the wrist was performed in 35 patients with specific complaints of pain and soft-tissue swelling in the medial side of the wrist. Twenty of the 35 subsequently underwent surgery. In 14 of the patients who underwent surgery, a diagnosis of triangular fibrocartilage (TFC) tear was made at MR imaging; in 13 of the 14 the tear was confirmed by surgical findings. In the six patients with an MR diagnosis of an intact TFC, surgical findings confirmed the diagnosis. These patients were operated on for an abnormality in the vicinity of the TFC (avascular necrosis, ganglion cyst, xanthoma). On the basis of findings from the 20 patients with surgical correlation, the accuracy of MR imaging in the detection of TFC tears was 95%. MR imaging is a valuable noninvasive method in the study of pathologic conditions of the TFC.
Purpose: To compare two T1-weighted (T1W) fat-suppressed sequences for 3D breath-hold pre-and postcontrast fat-suppressed T1W imaging of the female pelvis at 3T.
Materials and Methods:Pelvic MRI scans of 16 female patients were retrospectively identified who were scanned with two 3D breath-hold sequences: 1) a fast spoiled gradient echo sequence with spectral inversion at lipids (SPE-CIAL) (called 3D FSPGR), and 2) a dual-echo two-point Dixon (DE Dixon) sequence. Contrast between soft tissue and fat, soft tissue and fluid, and fat and fluid was measured on pre-and postcontrast images. Additionally, two readers subjectively scored the images for degree and homogeneity of fat suppression plus presence and severity of artifacts.
Results:Contrast between muscle and myometrium to fat was improved with the Dixon technique (0.61 vs. 0.09 and 0.7 vs. 0.3, respectively, P Ͻ 0.001). Both readers agreed that fat suppression was stronger with the Dixon sequence (P Ͻ 0.001 and P ϭ 0.06). Artifacts were equivalent (P ϭ 0.53 and 0.65).
Conclusion:The 3D DE Dixon sequence achieved stronger fat suppression in the female pelvis when compared to a 3D FSPGR sequence with SPECIAL.
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