Implementation of artificial intelligence models in magnetic resonance imaging with focus on diagnosis of rheumatoid arthritis and axial spondyloarthritis: narrative review.

Early diagnosis in rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) is essential to initiate timely interventions, such as medication and lifestyle changes, preventing irreversible joint damage, reducing symptoms, and improving long-term outcomes for patients. Since magnetic resonance imaging (MRI) of the wrist and hand, in case of RA and MRI of the sacroiliac joints (SIJ) in case of axSpA can identify inflammation before it is clinically discernible, this modality may be crucial for early diagnosis. Artificial intelligence (AI) techniques, together with machine learning (ML) and deep learning (DL) have quickly evolved in the medical field, having an important role in improving diagnosis, prognosis, in evaluating the effectiveness of treatment and monitoring the activity of rheumatic diseases through MRI. The improvements of AI techniques in the last years regarding imaging interpretation have demonstrated that a computer-based analysis can equal and even exceed the human eye. The studies in the field of AI have investigated how specific algorithms could distinguish between tissues, diagnose rheumatic pathology and grade different signs of early inflammation, all of them being crucial for tracking disease activity. The aim of this paper is to highlight the implementation of AI models in MRI with focus on diagnosis of RA and axSpA through a literature review.

The Herlyn-Werner-Wunderlich triad (OHVIRA syndrome) with good pregnancy outcome - two cases and literature review.

The Herlyn-Werner-Wunderlich syndrome (HWWS) is a complex congenital malformation, originally described as a triad of symptoms: didelphys uterus, low genital obstruction and unilateral renal anomaly. The term OHVIRA is an acronym (obstructed hemivagina/hemicervix with ipsilateral renal anomaly) and refers to the same syndrome. It gained acceptance in recent years, due to reports of cases having a non-didelphys uterus (normal, septated or having other abnormalities). In the following, we report two cases with good pregnancy outcome and we provide a short discussion on published literature. We highlight differences and complications in these two cases, confirming the extreme variability of anatomic structures involved in the syndrome. Though rare, the condition allows successful pregnancies. We describe the sixth case of didelphys uterus with unique (anatomically normal) vagina and unilateral isolated hemicervix hypoplasia∕atresia. Imaging has a paramount importance in the diagnosis of HWWS∕OHVIRA, with magnetic resonance (MR) usually superseding the ultrasound (US) method, and providing other viscera details. US, MR and laparoscopy∕laparotomy complement each other, and for describing the anatomy of the obstruction a thorough clinical examination is required. The clinical course of the pathology is not standard and the management must be tailored, but term∕near-term pregnancies resulting in healthy newborns are possible in HWWS. We advocate an appropriate maternal and fetal prenatal care and long-term follow-up.