ABSTRACT
OBJECTIVE: The goal of this study was to assess the added value of dynamic contrast-enhanced (DCE) imaging in detecting locally radio-recurrent prostate cancer using multiparametric magnetic resonance imaging (mpMRI) at 3Tesla (T). MATERIALS AND METHODS: We retrospectively analyzed 45 patients with rising prostate-specific antigen level after prostate radiotherapy who underwent mpMRI [T2-weighted (T2w), diffusion-weighted (Dw) and DCE imaging] at 3T before prostate biopsy. Four readers assigned a 5-level Likert score of cancer likelihood in 8 prostate sectors (6 sextants, 2 seminal vesicles) on T2w+Dw and T2w+Dw+DCE images. Biopsy results were used as the standard of reference. RESULTS: T2w+Dw and T2w+Dw+DCE imaging had similar areas under the receiver operating characteristic curves on per-sector (0.87-0.89 vs. 0.87-0.89; P=0.19-0.78) and per-lobe (0.82-0.94 vs. 0.80-0.91; P=0.21-0.84) analysis. Using a Likert score≥2/5 for diagnosis threshold, T2w+Dw+DCE imaging showed non-significantly higher sensitivities on per-sector (0.56-0.72 vs. 0.52-0.73, P=0.34-0.69) and per-lobe (0.80-0.90 vs. 0.73-0.88; P=0.63-0.99) analysis. It also showed non-significantly lower specificities on per-sector (0.74-0.89 vs. 0.82-0.89; P=0.09-0.99) and per-lobe (0.48-0.81 vs. 0.61-0.84; P=0.10-0.99) analysis. Weighted kappa values were respectively 0.57-0.70 and 0.55-0.66 for T2w+Dw and T2w+Dw+DCE imaging at the sector level, and 0.66-0.83 and 0.58-0.85 at the lobe level. CONCLUSION: The use of DCE MR imaging tends to increase sensitivity and decrease specificity for all readers, but the differences are not significant.
Subject(s)
Contrast Media , Magnetic Resonance Imaging , Neoplasm Recurrence, Local/diagnostic imaging , Prostatic Neoplasms/diagnostic imaging , Aged , Humans , Magnetic Resonance Imaging/methods , Male , Retrospective StudiesSubject(s)
Brucella melitensis , Brucellosis/diagnostic imaging , Brucellosis/pathology , Liver Abscess/diagnostic imaging , Liver Abscess/pathology , Brucellosis/complications , Calcinosis/complications , Calcinosis/diagnostic imaging , Calcinosis/pathology , Humans , Liver Abscess/complications , Liver Diseases/complications , Liver Diseases/diagnostic imaging , Liver Diseases/pathology , Male , Middle Aged , NecrosisSubject(s)
Aneurysm/diagnosis , Vena Cava, Inferior/pathology , Abdominal Pain/etiology , Aneurysm/diagnostic imaging , Aneurysm/pathology , Humans , Magnetic Resonance Angiography , Male , Middle Aged , Ultrasonography, Doppler, Color , Ultrasonography, Doppler, Duplex , Vena Cava, Inferior/diagnostic imagingSubject(s)
Abdominal Pain/diagnosis , Burkitt Lymphoma/diagnosis , Ileal Diseases/diagnosis , Intussusception/diagnosis , Abdominal Pain/etiology , Abdominal Pain/surgery , Adult , Burkitt Lymphoma/complications , Burkitt Lymphoma/surgery , Diagnosis, Differential , Humans , Ileal Diseases/complications , Ileal Diseases/surgery , Intussusception/complications , Intussusception/surgery , MaleSubject(s)
Endometrial Stromal Tumors/diagnosis , Endosonography , Magnetic Resonance Imaging , Rare Diseases , Ultrasonography, Doppler , Adult , Diagnosis, Differential , Endometrial Stromal Tumors/pathology , Endometrial Stromal Tumors/surgery , Endometrium/pathology , Female , Humans , HysterectomySubject(s)
Hernia, Abdominal/diagnostic imaging , Hernia, Abdominal/surgery , Ileum , Intestinal Obstruction/diagnostic imaging , Intestinal Obstruction/surgery , Omentum , Tomography, X-Ray Computed , Aged , Diagnosis, Differential , Digestive System Surgical Procedures , Female , Hernia, Abdominal/complications , Humans , Intestinal Obstruction/etiology , Rare Diseases , Reproducibility of Results , Sensitivity and Specificity , Treatment OutcomeABSTRACT
The superior mesenteric artery (SMA) syndrome is an atypical cause of high intestinal obstruction in adults. Formerly considered controversial, this syndrome has now been recognized as a real clinical entity which results from extrinsic compression of the third portion of the duodenum by reduction of the angle formed between the SMA and the aorta, usually favoured by rapid and dramatic weight loss. We report a case observed in a 25-year-old female. The abdominal scan provided the diagnosis. Laparoscopic duodenojejunostomy provided cure after failure of initial conservative treatment.
Subject(s)
Intestinal Obstruction/etiology , Superior Mesenteric Artery Syndrome/diagnosis , Adult , Contrast Media , Duodenostomy , Female , Humans , Jejunostomy , Laparoscopy , Superior Mesenteric Artery Syndrome/surgery , Tomography, X-Ray Computed , Vomiting , Weight LossSubject(s)
Abdomen, Acute/etiology , Infarction/complications , Omentum/blood supply , Female , Humans , Middle AgedSubject(s)
Chlamydia Infections/complications , Chlamydia trachomatis , Pelvic Inflammatory Disease/diagnostic imaging , Pelvic Inflammatory Disease/microbiology , Peritoneal Diseases/diagnostic imaging , Peritoneal Diseases/microbiology , Tomography, X-Ray Computed , Contrast Media , Female , Humans , Syndrome , Tomography, X-Ray Computed/methods , Young AdultABSTRACT
This is a new case of Susac syndrome in a 27-year-old woman with polymorphic neurological disorders, her brain MRI showed multifocal hyperintense signals on T2-weighted images with possible effects on the corpus callosum. However, visualization of an occlusion in the retinal arterial branch of the right eye and hypoacusia on the right side allowed confirmation of the diagnosis. In this case report, we describe the imaging aspects of Susac syndrome and demonstrate that brain MRI allows the syndrome to be diagnosed at an early stage.
