Background
There is limited data in the literature regarding the role of nonarthrographic MRI for detecting biceps pulley (BP) lesions.
Purpose
To assess the accuracy of nonarthrographic MRI for ...detecting BP lesions, and to evaluate the diagnostic value of various MRI signs (superior glenohumeral ligament discontinuity/nonvisibility, long head of biceps (LHB) displacement sign or subluxation/dislocation, LHB tendinopathy, and supraspinatus and subscapularis tendon lesions) in detecting such lesions.
Study Type
Retrospective.
Population
84 patients (32 in BP‐lesion group and 52 in BP‐intact group‐as confirmed by arthroscopy).
Field Strength/Sequence
1.5‐T, T1‐weighted turbo spin echo (TSE), T2‐weighted TSE, and proton density‐weighted TSE spectral attenuated inversion recovery (SPAIR) sequences.
Assessment
Three radiologists independently reviewed all MRI data for the presence of BP lesions and various MRI signs. The MRI signs and final MRI diagnoses were tested for accuracy regarding detecting BP lesions using arthroscopy results as the reference standard. Furthermore, the inter‐reader agreement (IRA) between radiologists was determined.
Statistical Tests
Student's t‐tests, Chi‐squared, and Fisher's exact tests, and 4‐fold table test were used. The IRA was calculated using Kappa statistics. A P‐value <0.05 was considered statistically significant.
Results
The sensitivity, specificity, and accuracy of nonarthrographic MRI for detecting BP lesions were 65.6%–78.1%, 90.4%–92.3%, and 81%–86.9%, respectively. The highest accuracy was noticed for the LHB displacement sign (84.5%–86.9%), and the highest sensitivity was registered for the LHB tendinopathy sign (87.5%). Furthermore, the highest specificity was observed for the LHB displacement sign and LHB subluxation/dislocation sign (98.1%–100%). The IRA regarding final MRI diagnosis and MRI signs of BP lesions was good to very good (κ = 0.76–0.98).
Data Conclusion
Nonarthrographic shoulder MRI may show good diagnostic accuracy for detecting BP lesions. The LHB displacement sign could serve as the most accurate and specific sign for diagnosis of BP lesions.
Level of Evidence
3
Technical Efficacy
Stage 2
Background
The retropalatal and retroglossal spaces are the main affected areas in obstructive sleep apnea (OSA) and they are the main targeted regions during OSA surgeries. But the dimensions of ...these spaces are sparsely referred to in literature.
Aim
To measure the retropalatal and retroglossal spaces dimensions in an easily measured way on the radiological evaluation to put basic measurements for such areas in normal subjects by multislice computed tomography (MSCT) in adults.
Methods
MSCT scans of asymptomatic adults were done for all included subjects to obtain delicate anatomical details of the recess using coronal, axial, and sagittal reformatted capability. Each retropalatal and retroglossal space was revised in the CT to find and measure their dimensions
Results
Within included 100 subjects, the mean transversal diameter (width) of the retropalatal space was 16.7±3 mm axially and the mean anteroposterior diameter (depth) was 6.9±1.4 mm. At the retroglossal area, the mean transversal diameter (width) was 17.7±3.8 mm axially and the mean anteroposterior diameter (depth) was 10.1±1.95 mm.
Conclusion
The current work describes the measurements of the retroglossal and retroplatal spaces. It is recommended to add the retroglossal and retropalatal space dimensions to the preoperative CT checklist, particularly in OSA.
Background
The CT details of the dimensions of the posterior ethmoid sinus are not fully covered in the literature, so building up for a base for the CT measurements and description of that area is ...important. Preoperative details of the posterior ethmoid sinuses are mandatory before any approach or procedure involving this area
.
Objective
To determine the different dimensions, measurements, and grading of the posterior ethmoid sinus by computed tomography (CT) that were not previously published.
Methods
Two hundred paranasal CT scans (400 sides) were included in the study. Axial images were acquired with multiplanar reformats to obtain delicate details in coronal and sagittal planes for all subjects.
Results
Within 200 CTs (400 sides), the mean anteroposterior dimension of the posterior ethmoid was 13.62± 1.75 mm (range= 9.5–19.5), the mean posterior ethmoid transverse diameter was 12.15+1.6 mm (range= 8–16.2) and the mean posterior ethmoid height was 44.64±3.83 mm (range= 35.8–56) without reported significant differences between both sides in all posterior ethmoid dimensions. The mean width of the posterior ethmoid sinus and its height from the orbital roof and nasal floor was significantly more in males than in females. There was significantly lower fovea ethmoidalis in males than females as we go posterior.
Conclusion
This study improves surgeons’ awareness and orientation of posterior ethmoid sinus variations in the endoscopic sinus surgery and can be of help to residents in training.
Background
Retro
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maxillary recess of the sphenoid sinus is an area that is yet to have appropriate description in the literature and usually overlooked. The objective of the current study was to ...determine the incidence and detailed description of the retromaxillary recess of the sphenoid sinus by multi-slices computed tomography (MSCT) in adults. Paranasal MSCT scan of asymptomatic adults was done for all our subjects to obtain delicate anatomical details of the recess using coronal, axial, and sagittal reformatted capability. Each sphenoid sinus in the CT was revised to find and describe the retro-maxillary recess of the sphenoid sinus regarding its extensions and dimensions.
Results
This study included 100 adult subjects (200 sphenoid sinuses); retro-maxillary recess was detected in 16.5% (33 sides) of them using MSCT. They were distributed in 20 subjects (20% of all examined sphenoid sinuses). Sixty-five percent of reported recesses were bilateral. Range of antero-posterior diameter (depth) of the recess was 3.9 to 14 mm while its width range was 1.1 to 9 mm. The thickness of the bony septum between the recess and the maxillary sinus ranged from 0.2 to 3.2 mm.
Conclusion
Current work described in details the retromaxillary recess in CT and its nearby surrounding important structures in all directions. From our results, it is recommended to add the retromaxillary recess of the sphenoid sinus to the preoperative CT checklist particularly in revision cases.
Maxillary sinus ostium assessment: A CT study El-Anwar, Mohammad Waheed; Raafat, Ashraf; Almolla, Rania Mostafa ...
Egyptian journal of radiology and nuclear medicine,
December 2018, 2018-12-00, 2018-12-01, Letnik:
49, Številka:
4
Journal Article
Recenzirano
Odprti dostop
To assess the maxillary sinus ostium (MSO) dimension and measuring the distance to nearby anatomical structures in adults using multi-slice computed tomography (MSCT).
ParanasalCT scans of ...asymptomatic adults withoutparanasalsinuses or nasal pathologywere included. Axial CT with coronal reformatted imageswas donefor all subjects to get delicate details.
In 86 subjects (172 sides), the width of MSO ranged from 1 to 11 mm and distance from the MSO to the anterior maxillary wall (towardnasolacrimalduct) ranged from 7 to 25 mm. Whilethe distance fromMSO to the posterior maxillary wall (towardsphenopalatineartery) ranged from 2 to 18 mm. MSO was found above orbital floor level in 74%, at the orbital floor level in 12% and below this level in 13% of our cases. Distance from MSO to the floor of maxilla ranged from 15 to 40 mm (mean = 28.6 ± 6.7).
MSOwas detectedin the posterior third of medial maxillary wall in 47%,in middle third in 32% and the anterior third in only 21%.Anteroposteriordiameter of maxillary sinus ranged from 18 to 41 mm. Its horizontal diameter ranged from 10 to 35 mm and its height ranged from 15 to 45 mm. For all measurements of the maxillary sinus and MSO, the differences between right and left side were non-significant.
This work describes in details MSO measurements usingMSCTand measures the distance from the MSO to the beyond adjacent anatomical structures in the all directions.
Background
Middle turbinate (MT) is one of the important anatomical and physiological structures of the nasal cavity. After the widespread use of nasal endoscope and paranasal sinus computed ...tomography (CT), many MT variations have been described. This study aimed to determine the incidence of MT variations by computed tomography (CT) in asymptomatic adult, their relation to each other, and to deviated septum (DS).
Results
In the included 86 subjects (172 MTs), pneumatized MT was the most common MT variation followed by paradoxical MT (PMT). Septal deviation did not appear to affect occurrence of pneumatized or PMT. Fifty-nine percent of the reported bilateral PMT were associated with pneumatized MT, while 35.7% of unilateral PMT were associated with pneumatized MT with non-significant difference.
Conclusion
MT variations in adults are common mainly pneumatized MT then PMT with no apparent relation to septum deviation.
Specific components of the posterolateral corner that can be identified on MRI, albeit with some variability, are the biceps femoris tendon, the fibular collateral ligament, the popliteus ...musculotendinous complex including the popliteofibular ligament, the fabellofibular ligament, and the arcuate ligament. In general, these normally low-signal-intensity structures are defined as "sprain" when there is thickening and intermediate signal intensity within the structure on fat?suppressed fast spin-echo T2-weighted images and as torn when the structure is discontinuous with a visible gap. Some researchers support the use of a coronal oblique plane of imaging to improve visualization of some of the finer, obliquely oriented structures of the posterolateral corner, including the popliteofibular, arcuate, and fabellofibular ligaments, although this has not become routine. Recognition of bone marrow changes in thefibular head, including the so called “arcuate” fracture that may also be seen on radiographs is also helpful in diagnosing posterolateral corner injury. Being aware of the normal and abnormal MRI appearances of the structures of the posterolateral corner of the knee and of the patterns of injury often seen in patients with posterolateral corner rotatory instability will help radiologists suggest the diagnosis of posterolateral corner injury even when not clinically suspected. This diagnosis is especially important in the setting of combined injuries because unrecognized and unaddressed posterolateral corner injuries may contribute significantly to ACL and PCL graft failure.
Recently, a new MRI-based classification for evaluating tibial spine fractures (TSFs) was developed to aid in treating these injuries. Our objective was to assess the detection efficacy, ...classification accuracy, and reliability of this classification in detecting and grading TSFs, as well as its impact on treatment strategy, compared to the Meyers and McKeever (MM) classification.
A retrospective study included 68 patients with arthroscopically confirmed TSFs. All patients had plain radiography and conventional MRI of the affected knee before arthroscopy. Three experienced radiologists independently reviewed all plain radiographs and MRI data and graded each patient according to MM and MRI-based classifications. The detection efficacy, classification accuracy, and inter-rater agreement of both classifications were evaluated and compared, using arthroscopic findings as the gold standard.
The final analysis included 68 affected knees. Compared to the MM classification, the MRI-based classification produced 22.0% upgrade of TSFs and 11.8% downgrade of TSFs. According to the reviewers, the fracture classification accuracy of the MRI-based classification (91.2-95.6%) was significantly higher than that of the MM classification (73.5-76.5%, p = 0.002-0.01). The fracture detection rate of MRI-based classification (94.1-98.5%) was non-significantly higher than that of the MM classification (83.8-89.7%, p = 0.07-0.4). The soft tissue injury detection accuracy for MRI-based classification was 91.2-94.1%. The inter-rater reliability for grading TSFs was substantial for both the MM classification (κ = 0.69) and MRI-based classification (κ = 0.79).
MRI-based classification demonstrates greater accuracy and reliability compared to MM classification for detecting and grading TSFs and associated soft tissue injuries.
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