Background: The aim of this study was to investigate the diagnostic efficiency of magnetic resonance (MR) spectroscopy with diffusion-weighted imaging in the evaluation of the recurrent contrast-enhancing regions at the location of treated gliomas. Patients and Methods: In 49 patients who had new contrast-enhancing lesions at the vicinity of previously resected and irradiated high-grade gliomas, single-voxel MR spectroscopy and diffusion-weighted imaging were performed. Spectral data for N-acetylaspartate (NAA), creatine (Cr), choline (Cho), lipid (Lip), and lactate (Lac) were analyzed in combination with the apparent diffusion coefficient (ADC) in all patients. Diagnosis of these lesions was allocated by means of follow-up or histopathology. Results: The Cho/NAA and Cho/Cr ratios were significantly higher in recurrent tumor group than in radiation injury group (p < 0.001). The ADC values and ADC ratios (quotient of ADC of contrastenhancing lesion and matching structure in the contralateral hemisphere) were significantly higher in radiation injury regions than in recurrent tumor (p< 0.001). With MR spectroscopy, two variables (Cho/NAA and Cho/Cr ratios) were proved to differentiate recurrent glioma from radiation injury, and 81.5% of total patients were classified into correct groups. Using discriminant analysis for MR spectroscopy with diffusion-weighted imaging, three independent variables (Cho/NAA, Cho/Cr, and ADC ratio) could classify 91% of total patients into their correct groups. There was a significant difference between the diagnostic accuracy of the two discriminant analyses (Chi-square=4.15, p=0.042). Conclusion: MR spectroscopy combined with ADC ratio can enhance the ability to differentiate recurrent glioma from radiation injury.

Background: MR arthrography in the abduction and external rotation (ABER) position has been shown to increase the diagnostic rate of anterior labroligamentous complex tears. However, the diagnostic and discriminative value of MR arthrography in ABER position in the different categories of the anteroinferior labroligamentous lesions has not been fully revealed. Aim: To compare MR arthrography in the ABER position with the conventional MR arthrography regarding the detection rate and discrimination accuracy of several anteroinferior labroligamentous lesions with arthroscopy as the gold standard technique. Patients and Methods: We examined a total of 38 Patients with shoulder disorders and compared results of both conventional MR arthrography and MR arthrography in ABER position retrospectively. An anteroinferior labroligamentous lesion was supposed to exist when the anteroinferior labrum was absent, fraying, detached, displaced from the glenoid rim, or as the contrast material was seen within the labrum, or when the inferior glenohumeral ligament was avulsed or ruptured at the humeral or labral attachment. All patients underwent shoulder arthroscopy after MR examination. Results: MR arthrography in ABER position has significantly higher accuracy and diagnostic sensitivity than that of conventional MR arthrography for the detection of different subtypes of the anteroinferior labroligamentous lesions (p<0.05). Conclusion: According to our results, we suggest that ABER position imaging should be added when conventional MR arthrography is questionable or unremarkable in suspected anteroinferior labroligamentous complex injury.

Background: Shoulder arthrography is an accurate method that can help in diagnosing several diseases. When shoulder arthrography is done combined with magnetic resonance imaging (MRI), a more comprehensive assessment of the cartilaginous structures of the glenohumeral joint is performed. Objective: This study aims to compare the anterior with the posterior ultrasound-guided arthrography injection approaches in achieving optimal needle placement, ensuring the accuracy of shoulder arthrography injections. Subjects and Methods: A total of 38 individuals (suffering from shoulder dislocation) were enrolled, in the study. The efficacy of the technique was evaluated relative to the success or failure of contrast medium administration into the glenohumeral joint, and the number of attempts required to achieve that success. Results: The success rate among the anterior approach group was 84.2% versus 89.5% in the posterior approach group. The mean number of trials for the anterior and posterior approaches showed no statistically significant difference while the mean injected volume with the anterior approach was significantly lower than that of the posterior approach group (P-Value: 0.006). Conclusion:The posterior approach has a slight advantage over the anterior approach regarding the injected volume of the contrast medium. However, there were better results yet non-statistically significant regarding the anterior and posterior approaches accuracy, pain tolerance, and the number of trials.