BACKGROUND & AIMS: :Thirty-five patients with definite multiple sclerosis (MS) were studied. They underwent neuropsychological testing and magnetic resonance imaging (MRI). The MRI findings at different brain areas levels were compared with the neuropsychological findings. A quantitative system was used to measure MRI-MS lesions. In this series, a positive correlation was established between memory and learning disturbances measured by Battery 144, and the lesions measured by MRI (total, hemispheric and, particularly, periventricular lesions). MRI can detect MS lesions, and this study shows that a correlation between MRI and neuropsychological findings is possible if quantitative methods are used to distinguish different MS involvement areas in relation to neuropsychological tasks. These findings suggest that hemispheric lesions in MS produce cognitive disturbances and MRI could be a useful tool in predicting memory and learning impairment.

背景与目标： : 研究了35例确诊的多发性硬化症 (MS) 患者。他们接受了神经心理学测试和磁共振成像 (MRI)。将不同脑区水平的MRI表现与神经心理学表现进行比较。定量系统用于测量MRI-MS病变。在该系列中，通过电池144测量的记忆和学习障碍与通过MRI测量的病变 (总，半球，特别是脑室周围病变) 之间建立了正相关。MRI可以检测MS病变，这项研究表明，如果使用定量方法区分与神经心理学任务有关的不同MS受累区域，则MRI与神经心理学发现之间的相关性是可能的。这些发现表明，MS的半球病变会产生认知障碍，MRI可能是预测记忆和学习障碍的有用工具。

BACKGROUND & AIMS: :Purpose of this study was to assess the additional value of first pass myocardial perfusion imaging during peak dose of dobutamine stress Cardiac-MR (CMR). Dobutamine Stress CMR was performed in 115 patients with an inconclusive diagnosis of myocardial ischemia on a 1.5 T system (Magnetom Avanto, Siemens Medical Systems). Three short-axis cine and grid series were acquired during rest and at increasing doses of dobutamine (maximum 40 microg/kg/min). On peak dose dobutamine followed immediately by a first pass myocardial perfusion imaging sequence. Images were graded according to the sixteen-segment model, on a four point scale. Ninety-seven patients showed no New (Induced) Wall Motion Abnormalities (NWMA). Perfusion imaging showed absence of perfusion deficits in 67 of these patients (69%). Perfusion deficits attributable to known previous myocardial infarction were found in 30 patients (31%). Eighteen patients had NWMA, indicative for myocardial ischemia, of which 14 (78%) could be confirmed by a corresponding perfusion deficit. Four patients (22%) with NWMA did not have perfusion deficits. In these four patients NWMA were caused by a Left Bundle Branch Block (LBBB). They were free from cardiac events during the follow-up period (median 13.5 months; range 6-20). Addition of first-pass myocardial perfusion imaging during peak-dose dobutamine stress CMR can help to decide whether a NWMA is caused by myocardial ischemia or is due to an (inducible) LBBB, hereby preventing a false positive wall motion interpretation.

背景与目标： : 这项研究的目的是评估多巴酚丁胺应激心脏MR (CMR) 峰值剂量期间首过心肌灌注成像的附加价值。多巴酚丁胺应激CMR在1.5 T系统 (Magnetom Avanto，Siemens Medical Systems) 上对115例未明确诊断为心肌缺血的患者进行。在休息期间和增加多巴酚丁胺的剂量 (最大40微克/千克/分钟) 获得了三个短轴电影和网格系列。在峰值剂量多巴酚丁胺之后立即进行首过心肌灌注成像序列。根据十六段模型对图像进行了四分制的分级。97名患者未显示新的 (诱发的) 壁运动异常 (NWMA)。灌注成像显示这些患者中有67例 (69%) 不存在灌注缺陷。在30例患者 (31%) 中发现了可归因于已知先前心肌梗塞的灌注缺陷。18例患者患有NWMA，指示心肌缺血，其中14例 (78% 例) 可以通过相应的灌注不足来确认。四名NWMA患者 (22%) 没有灌注缺陷。在这四名患者中，NWMA是由左束支传导阻滞 (LBBB) 引起的。在随访期间 (中位13.5个月; 范围6-20)，他们没有心脏事件。在峰值剂量多巴酚丁胺应激CMR期间增加首过心肌灌注成像可以帮助确定NWMA是由心肌缺血引起还是由 (可诱导的) LBBB引起，从而防止假阳性壁运动解释。

BACKGROUND & AIMS: STUDY OBJECTIVES:Population-based studies have demonstrated associations between sleep-disordered breathing (SDB), hypertension, and cardiovascular disease; few large-scale studies have examined associations of SDB with objective measures of cerebrovascular disease. This study tested the significance of associations of SDB with evidence of brain injury or ischemia determined by cerebral magnetic resonance imaging (MRI) studies. DESIGN:Cross-sectional and longitudinal analyses in a nested sample of Cardiovascular Health Study participants in the Sleep Heart Health Study. PARTICIPANTS:The 843 individuals (mean age 77, SD 4.3 years, 58% women) who had MRI studies as part of the Cardiovascular Health Study before and after polysomnography obtained as part of the Sleep Heart Health Study. MEASUREMENTS:A 12-channel polysomnogram was used to derive indexes of sleep-disordered breathing. Repeated MRI measurements provided indexes of infarct (presence and size) and white matter disease. Logistic regression analyses were used to model MRI changes of infarct-like lesions and white matter disease as a function of age, baseline white matter grade, and indexes of central and obstructive sleep-disordered breathing. RESULTS:Individuals who showed progression in white matter disease compared to those who did not were significantly more likely to show a Cheyne-Stokes respiration pattern and to have an increased number of central but not obstructive apneas. CONCLUSIONS:An association between change in white matter grade and measures of central sleep apnea was demonstrated that was consistent with a causal pathway in which central sleep apnea contributes to the progression of white matter disease; alternatively, central sleep apnea may be a marker of subclinical cerebrovascular or cardiovascular disease.

背景与目标：

BACKGROUND & AIMS: :Functional Magnetic Resonance Imaging (fMRI) represents a powerful tool with which to examine brain functioning and development in typically developing pediatric groups as well as children and adolescents with clinical disorders. However, fMRI data can be highly susceptible to misinterpretation due to the effects of excessive levels of noise, often related to head motion. Imaging children, especially with developmental disorders, requires extra considerations related to hyperactivity, anxiety and the ability to perform and maintain attention to the fMRI paradigm. We discuss a number of methods that can be employed to minimize noise, in particular movement-related noise. To this end we focus on strategies prior to, during and following the data acquisition phase employed primarily within our own laboratory. We discuss the impact of factors such as experimental design, screening of potential participants and pre-scan training on head motion in our adolescents with developmental disorders and typical development. We make some suggestions that may minimize noise during data acquisition itself and finally we briefly discuss some current processing techniques that may help to identify and remove noise in the data. Many advances have been made in the field of pediatric imaging, particularly with regard to research involving children with developmental disorders. Mindfulness of issues such as those discussed here will ensure continued progress and greater consistency across studies.

背景与目标： : 功能磁共振成像 (fMRI) 是一种强大的工具，可用于检查典型发展中的儿科人群以及患有临床疾病的儿童和青少年的大脑功能和发育。但是，由于通常与头部运动有关的过多噪声水平的影响，fMRI数据很容易受到误解。对儿童进行成像，尤其是患有发育障碍的儿童，需要额外考虑与多动，焦虑以及执行和保持对fMRI范例的关注有关的能力。我们讨论了许多可用于最小化噪声 (尤其是与运动相关的噪声) 的方法。为此，我们专注于主要在我们自己的实验室中使用的数据采集阶段之前，期间和之后的策略。我们讨论了诸如实验设计，潜在参与者的筛查以及扫描前训练等因素对患有发育障碍和典型发育的青少年的头部运动的影响。我们提出了一些建议，可以最大程度地减少数据采集过程中的噪声，最后，我们简要讨论了一些当前的处理技术，这些技术可能有助于识别和消除数据中的噪声。在儿科成像领域已经取得了许多进展，特别是在涉及发育障碍儿童的研究方面。对诸如此处讨论的问题的正念将确保研究的持续进展和更大的一致性。

BACKGROUND & AIMS: :Group data analysis in brainstem neuroimaging is predicated on accurate co-registration of anatomy. As the brainstem is comprised of many functionally heterogeneous nuclei densely situated adjacent to one another, relatively small errors in co-registration can manifest in increased variance or decreased sensitivity (or significance) in detecting activations. We have devised a 2-stage automated, reference mask guided registration technique (Automated Brainstem Co-registration, or ABC) for improved brainstem co-registration. Our approach utilized a brainstem mask dataset to weight an automated co-registration cost function. Our method was validated through measurement of RMS error at 12 manually defined landmarks. These landmarks were also used as guides for a secondary manual co-registration option, intended for outlier individuals that may not adequately co-register with our automated method. Our methodology was tested on 10 healthy human subjects and compared to traditional co-registration techniques (Talairach transform and automated affine transform to the MNI-152 template). We found that ABC had a significantly lower mean RMS error (1.22 +/- 0.39 mm) than Talairach transform (2.88 +/- 1.22 mm, mu +/- sigma) and the global affine (3.26 +/- 0.81 mm) method. Improved accuracy was also found for our manual-landmark-guided option (1.51 +/- 0.43 mm). Visualizing individual brainstem borders demonstrated more consistent and uniform overlap for ABC compared to traditional global co-registration techniques. Improved robustness (lower susceptibility to outliers) was demonstrated with ABC through lower inter-subject RMS error variance compared with traditional co-registration methods. The use of easily available and validated tools (AFNI and FSL) for this method should ease adoption by other investigators interested in brainstem data group analysis.

背景与目标： : 脑干神经影像学中的组数据分析基于解剖结构的准确共配准。由于脑干由彼此密集相邻的许多功能异质核组成，因此在共同配准中相对较小的误差可能表现为检测激活的方差增加或敏感性降低 (或显着性)。我们设计了一种2阶段自动参考面罩引导的注册技术 (自动脑干共同注册或ABC)，以改善脑干共同注册。我们的方法利用脑干掩模数据集对自动共同注册成本函数进行加权。我们的方法通过测量12个手动定义的地标上的均方根误差进行了验证。这些地标也被用作辅助手动共同注册选项的指南，该选项适用于可能无法与我们的自动方法充分共同注册的离群值个人。我们的方法在10名健康人类受试者上进行了测试，并与传统的共配准技术 (Talairach变换和自动仿射变换到MNI-152模板) 进行了比较。我们发现ABC的平均均方根误差 (1.22 +/-0.39毫米) 明显低于Talairach变换 (2.88 +/-1.22毫米，mu +/- sigma) 和全局仿射 (3.26 +/-0.81毫米) 方法。我们的手动地标引导选项 (1.51 +/-0.43毫米) 也提高了准确性。与传统的全球共配准技术相比，可视化单个脑干边界显示出ABC更加一致和统一的重叠。与传统的共配准方法相比，ABC通过较低的受试者间均方根误差方差证明了更高的鲁棒性 (对异常值的敏感性较低)。对于这种方法，使用易于获得和验证的工具 (AFNI和FSL) 应该可以简化对脑干数据组分析感兴趣的其他研究人员的采用。

BACKGROUND & AIMS: :Quantitative measurement of mechanical properties of biologic tissues may have several applications for diagnosis or biomechanic modeling in sports medicine, traumatology, or computer-guided surgery. The magnetic resonance imaging (MRI) methods previously tested for these applications all required synchronization between MRI acquisition pulses and the mechanical stimulation. A new unsynchronized method operating with no prior knowledge of intensity, direction, and frequency of the mechanical waves is proposed. A specifically modified SPAMM (SPAtial Modulation of Magnetization) sequence has been used, operating on a 0.2-T MRI system. The experimental results obtained on test objects fit well with theoretical calculations. The new proposed method is very fast (a less than 5-second acquisition time) for routine clinical use.

背景与目标： : 生物组织机械性能的定量测量可能在运动医学，创伤学或计算机指导手术中的诊断或生物力学建模中有多种应用。先前针对这些应用测试的磁共振成像 (MRI) 方法都需要MRI采集脉冲与机械刺激之间的同步。提出了一种新的非同步方法，该方法无需事先了解机械波的强度，方向和频率。已使用特定修改的SPAMM (磁化的空间调制) 序列，在0.2-T MRI系统上运行。在测试对象上获得的实验结果与理论计算非常吻合。新提出的方法对于常规临床使用非常快 (不到5秒的采集时间)。

BACKGROUND & AIMS: :Myocardial viability imaging by contrast-enhanced MRI has supported the broad acceptance of cardiac MRI as a valuable clinical tool in cardiology over the last few years. The late enhancement (delayed enhancement, late gadolinium enhancement) technique has emerged as an easy-to-perform and robust method for identifying and quantifying myocardial scars. In the condition of acute myocardial infarction, MRI offers important prognostic information regarding anticipated left ventricular changes ("remodeling") and future cardiac events. In coronary artery disease patients with chronic infarction, the extent of late enhancement reliably predicts the outcome of global and regional left ventricular function after revascularization. In particular, CAD patients with severely impaired left ventricular function benefit from preoperative viability imaging before bypass surgery. The present paper describes the definitions and physiology of viable and non-viable myocardium as well as the pathophysiologic basis of late enhancement. The process from the correct setting of imaging protocols via the interpretation of late enhancement images to the stating of the correct diagnosis and estimation of viability is followed. The background of the successful development of the late enhancement method towards the new reference standard in myocardial viability imaging is described.

背景与目标： : 在过去的几年中，通过对比增强MRI进行的心肌生存力成像支持了心脏MRI作为心脏病学中有价值的临床工具的广泛接受。晚期增强 (延迟增强，晚期g增强) 技术已成为识别和量化心肌疤痕的一种易于执行且可靠的方法。在急性心肌梗塞的情况下，MRI提供了有关预期左心室变化 (“重塑”) 和未来心脏事件的重要预后信息。在患有慢性梗塞的冠状动脉疾病患者中，晚期增强的程度可靠地预测了血运重建后整体和局部左心室功能的结果。特别是，左心室功能严重受损的CAD患者可在搭桥手术前从术前生存能力成像中受益。本文介绍了存活和非存活心肌的定义和生理学以及晚期增强的病理生理基础。遵循从正确设置成像协议到解释后期增强图像到正确诊断和估计生存能力的过程。描述了成功开发用于心肌活力成像新参考标准的后期增强方法的背景。

BACKGROUND & AIMS: BACKGROUND:Most dialysis patients receiving erythropoesis-stimulating agents (ESA) also receive parenteral iron supplementation. There are few data on the risk of hemosiderosis in this setting. METHODS:We prospectively measured liver iron concentration by means of T1 and T2* contrast magnetic resonance imaging (MRI) without gadolinium, in a cohort of 119 fit hemodialysis patients receiving both parenteral iron and ESA, in keeping with current guidelines. RESULTS:Mild to severe hepatic iron overload was observed in 100 patients (84%; confidence interval, [CI] 76%-90%), of whom 36% (CI, 27%-46%) had severe hepatic iron overload (liver iron concentration >201 μmol/g of dry weight). In the cross-sectional study, infused iron, hepcidin, and C-reactive protein values correlated with hepatic iron stores in both univariate analysis (P<.05, Spearman test) and binary logistic regression (P <.05). In 11 patients who were monitored closely during parenteral iron therapy, the iron dose infused per month correlated strongly with both the overall increase and the monthly increase in liver iron concentration (respectively, rho=0.66, P=.0306 and rho=0.85, P=0.0015, Spearman test). In the 33 patients with iron overload, iron stores fell significantly after iron withdrawal or after a major reduction in the iron dose (first MRI: 220 μmol/g (range: 60-340); last MRI: 50 μmol/g (range: 5-210); P <.0001, Wilcoxon's paired test). CONCLUSIONS:Most hemodialysis patients receiving ESA and intravenous iron supplementation have hepatic iron overload on MRI. These findings call for a revision of guidelines on iron therapy in this setting, especially regarding the amount of iron infused and noninvasive methods for monitoring iron stores.

背景与目标：

BACKGROUND & AIMS: :The usefulness of PET/MRI in head and neck malignancy has not been fully elucidated. The purpose of our study was to evaluate the diagnostic accuracy and confidence of PET/MRI in comparison with PET or MRI alone. This study included 73 consecutive patients who underwent [18F] FDG PET/MRI in head and neck under the suspicion of malignancy. A neuroradiologist and a nuclear medicine specialist reviewed MRI and PET images, respectively and independently, followed by a consensus review of PET/MRI one month later. For 134 lesions, accuracy and confidence were compared among PET, MRI, and PET/MRI. For lesion base, PET/MRI had a sensitivity of 85.7%, a specificity of 89.1%, a PPV of 89.6%, a negative predictive value of 85.1%, and an accuracy of 87.3%. AUCs of PET/MRI per lesion (0.926) and per patient (0.934) for diagnosing malignancy were higher than PET (0.847 and 0.747, respectively) or MRI (0.836 and 0.798, respectively) alone (P < 0.05). More than 80% of the cases (111/134) showed diagnostic concordance between PET and MRI. PPV of PET/MRI was higher in malignant concordant cases (93.2%, 55/59) than in discordant cases (62.5%, 5/8) (p = 0.040). Confident scoring rate in malignant concordant cases was higher on PET/MRI (96.6%, 57/59) than on MRI (76.3%, 45/59) (p = 0.003). In conclusion, compared with PET or MRI alone, PET/MRI presents better diagnostic performance in accuracy and confidence for diagnosis of malignancy. PET/MRI is useful in patients with head and neck cancer.

背景与目标： : PET/MRI在头颈部恶性肿瘤中的作用尚未完全阐明。我们研究的目的是评估PET/MRI与单独的PET或MRI相比的诊断准确性和置信度。这项研究包括连续73例在怀疑恶性肿瘤的情况下在头颈部接受 [18F] FDG PET/MRI检查的患者。神经放射学家和核医学专家分别独立检查了MRI和PET图像，然后在一个月后对PET/MRI进行了共识检查。对于134病变，比较了PET，MRI和PET/MRI之间的准确性和置信度。对于病变基础，PET/MRI具有85.7% 的敏感性，89.1% 的特异性，89.6% 的PPV，85.1% 的阴性预测值和87.3% 的准确性。每个病变 (0.926) 和每个患者 (0.934) 诊断恶性肿瘤的PET/MRI auc高于单独的PET (分别为0.847和0.747) 或MRI (分别为0.836和0.798) (p  <  0.05)。超过80% 的病例 (111/134) 显示PET和MRI之间的诊断一致性。恶性一致病例 (93.2% 、55/59) 的PET/MRI PPV高于不一致病例 (62.5% 、5/8) (p   =   0.040)。PET/MRI (96.6%，57/59) 对恶性肿瘤的自信评分率高于MRI (76.3%，45/59) (p   =   0.003)。总之，与单独的PET或MRI相比，PET/MRI在诊断恶性肿瘤的准确性和置信度方面具有更好的诊断性能。PET/MRI对头颈癌患者有用。

BACKGROUND & AIMS: BACKGROUND:Magnetic resonance imaging (MRI) has unique advantages for guiding interventions, but the narrow space is a major challenge. This study evaluates the feasibility of a remote-controlled hydrostatic actuator system for MRI-guided targeted needle placement. METHODS:The effects of the hydrostatic actuator system on MR image quality were evaluated. Using a reference step-and-shoot method (SS) and the proposed actuator-assisted method (AA), two operators performed MRI-guided needle placement in targets (n = 12) in a motion phantom. RESULTS:The hydrostatic actuator system exhibited negligible impact on MR image quality. In dynamic targets, AA was significantly more accurate and precise than SS, with mean ± SD needle-to-target error of 1.8 ± 1.0 mm (operator 1) and 1.3 ± 0.5 mm (operator 2). AA reduced the insertion time by 50% to 80% and total procedure time by 25%, compared to SS. CONCLUSIONS:The proposed hydrostatic actuator system may improve accuracy and reduce procedure time for MRI-guided targeted needle placement during motion.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:To investigate the association of spinal inflammation on MRI in patients with various clinical, functional and radiological outcomes in patients with axial spondyloarthritis (SpA). METHODS:Three hundred and ninety-seven participants with axial SpA and back pain were recruited from 10 rheumatology centres. Clinical, biochemical and radiological parameters were collected and participants underwent MRI of the spine. MRI features including inflammatory lesions of facet joints and costovertebral joints, corner inflammatory lesions, and spondylitis were assessed. BASFI, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Global Index, BASMI and modified Stoke Ankylosing Spondylitis Spinal Score were measured. Multivariate linear regression models were used to determine the associations between MRI parameters and various clinical, functional and radiological outcomes. RESULTS:BASMI and BASFI correlated well with inflammatory features in spinal MRI. Multivariate analysis showed that lumbar facet joint inflammation was independently associated with BASMI (regression coefficient (β) = 0.12, P < 0.001), lumbar spinal flexion (β = 0.13, P = 0.00), lateral spinal flexion (β = 0.09, P = 0.04), tragus-to-wall distance (β = 0.16, P < 0.001) and BASFI (β = 0.14, P = 0.01). Costovertebral joint inflammation was also associated with BASMI (β = 0.08, P = 0.05). CONCLUSION:Inflammatory lesions of facet and costovertebral joints in MRI are associated with restriction in spinal mobility and functional impairment. These important yet commonly overlooked lesions should be reviewed in clinical practice in patients with SpA.

背景与目标：

BACKGROUND & AIMS: PURPOSE:The aim of this review was to identify published studies in the literature relating to ictal induced MRI change and to identify certain common themes, practical points for clinicians and areas for future research. METHODS:We identified 96 articles that satisfied our inclusion criteria yielding 575 cases. All articles were analysed; number of subjects, spectrum of MRI and EEG change, aetiology, and follow-up (both clinical and imaging) were noted. RESULTS:The most frequent imaging changes were restricted diffusion, T2-hyperintensity and reduced ADC values. The mesial temporal structures and neocortex were most commonly affected locations though subcortical structures like the thalamus and pulvinar were also described. Practical clinical points included; the development of PLEDS concordant with ictal imaging change was associated with worse clinical prognosis, patients with seizures due to symptomatic aetiology may be more likely to develop ictal related imaging change and follow up is vitally important to ensure that ictal related oedema is not misidentified as a mass lesion or conversely that a mass lesion is not misidentified as ictal related change. CONCLUSION:Qualitative MRI studies have provided clinicians with useful in-vivo insights into the dynamic ictal neuronal environment. Changes are not only localised to the ictal focus but can be remote and irreversible. Small patient numbers varying study design and high numbers of symptomatic seizures makes comparison between studies problematic. Also there is possible microstructural quantitative MRI changes that are missed on qualitative MRI. There is a need for prospective quantitative MRI studies in patients with epilepsy peri-icatlly with a uniform period of follow up and comparison to control data.

背景与目标：

BACKGROUND & AIMS: OBJECTIVES:To evaluate the performance of diffusion-weighted imaging (DWI) against the reference standard of gadolinium-enhanced T1-weighted imaging (Gd-T1-WI) in children. METHODS:Thirty-nine consecutive patients (mean age 5.7 years) with suspected acute pyelonephritis underwent magnetic resonance imaging (MRI) including DWI and (the reference standard) Gd-T1-WI. Each study was read in double-blinded fashion by two radiologists. Each kidney was graded as normal or abnormal. Sensitivity and specificity of DWI were computed. Agreement between sequences and interobserver reproducibility were calculated (Cohen κ statistic and the McNemar tests). RESULTS:Thirty-two kidneys (41 %) had hypo-enhancing areas on Gd-T1-W images. The sensitivity and specificity of DWI were 100 % (32/32) and 93.5 % (43/46). DWI demonstrated excellent agreement (κ = 0.92,) with Gd-T1-W, with no significant difference (P = 0.25) in detection of abnormal lesions. Interobserver reproducibility was excellent with DWI (κ = 0.79). CONCLUSION:DWI enabled similar detection of abnormal areas to Gd-T1-WI and may provide an injection-free means of evaluation of acute pyelonephritis. KEY POINTS:• Diffusion weighted magnetic resonance imaging (DWI) can confirm acute pyelonepritis. • DWI provided comparable results to gadolinium enhanced T1-W MRI in acute pyelonepritis. • Contrast medium injection could be avoided for diagnosing acute pyelonephritis by MRI. • MRI with T2-WI and DWI provide a fast and comprehensive diagnostic tool.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:The objective of this study was to assess the feasibility of T2 relaxation time measurements of the sacroiliac joints. SUBJECTS AND METHODS:The sacroiliac joints of 40 patients were imaged by 3-T MRI using an oblique axial multislice multiecho spin-echo T2-weighted sequence. Manual plotting and automatic subdivision of ROIs allowed us to obtain T2 values for up to 48 different areas per patient (posterior and anterior parts, sacral, intermediate, and iliac parts). Intraand interobserver reproducibility of T2 values were calculated after independent assessment by two musculoskeletal radiologists. RESULTS:A total of 1656 measurement sites could be analyzed. Mean (± SD) T2 values were 40.6 ± 6.7 ms and 41.2 ± 6.3 ms for observer 1 and 39.9 ± 6.6 ms for observer 2. The intraobserver intraclass correlation coefficient was 0.72 (95% CI, 0.70-0.74), and the interobserver intraclass correlation coefficient was 0.71 (95% CI, 0.68-0.72). CONCLUSION:Our study shows the feasibility of T2 relaxation time measurements at the sacroiliac joints.

背景与目标：

BACKGROUND & AIMS: OBJECTIVES:Analysing the influence of additional carcinoma in situ (CIS) and background parenchymal enhancement (BPE) in preoperative MRI on repeated surgeries in patients with invasive lobular carcinoma (ILC) of the breast. METHODS:Retrospective analysis of 106 patients (mean age 58.6±9.9years) with 108 ILC. Preoperative tumour size as assessed by MRI, mammography and sonography was recorded and compared to histopathology. In contrast-enhanced MRI, the degree of BPE was categorised by two readers. The influence of additionally detected CIS and BPE on the rate of repeated surgeries was analysed. RESULTS:Additional CIS was present in 45.4% of the cases (49/108). The degree of BPE was minimal or mild in 80% of the cases and moderate or marked in 20% of the cases. In 17 cases (15.7%) at least one repeated surgery was performed. In n=15 of these cases, repeated surgery was performed after BCT (n=9 re-excisions, n=6 conversions to mastectomy), in n=2 cases after initial mastectomy. The initial surgical procedure (p=0.008) and additional CIS (p=0.046) significantly influenced the rate of repeated surgeries, while tumour size, patient age and BPE did not (p=ns). CONCLUSIONS:Additional CIS was associated with a higher rate of repeated surgeries, whereas BPE had no influence.

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