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Biomedical subjects

Diane Bergin

Publications and source records attributed to Diane Bergin.

9 recordsLinked to original sources

Postoperative imaging of the ankle and foot.

This article describes the relevant surgical detail and MR imaging appearance of common operations performed in the foot and ankle. To evaluate postsurgical patients critically, it is important to understand the primary clinical diagnosis, surgical treatment undergone, the interval since surgery, and patients' current clinical symptoms. Radiography is the most common imaging modality for evaluation of the postoperative ankle and foot. MR imaging may be useful for evaluating the soft tissues and osseous structures in the postsurgical foot and ankle.

Ankle Injuries↗

Abnormalities on MRI of the subscapularis tendon in the presence of a full-thickness supraspinatus tendon tear.

OBJECTIVE: Our objective was to determine the association between size and chronicity of full-thickness supraspinatus tendon tears with subscapularis tendon abnormalities on MRI. MATERIALS AND METHODS: One hundred forty-two MRI examinations with full-thickness supraspinatus tendon tears were categorized on the basis of the supraspinatus muscle (SS): normal muscle (SS(normal)), suggesting a recent or small tear; reduced muscle bulk without fatty atrophy (SS(volume loss)); and those with fatty atrophy, suggesting a large or chronic tear (SS(fatty atrophy)). Subscapularis tendon abnormalities, the subcoracoid interval, and subcortical bone marrow edema in the lesser tuberosity and coracoid process were recorded. RESULTS: The mean size of supraspinatus tendon tears in the SS(normal) (n = 45) group was 8.5 mm, 16.6 mm in SS(volume loss) (n = 53), and 29 mm in the SS(fatty atrophy) group (n = 44). Subscapularis tendon abnormality was identified in 22% of SS(normal) patients, 61% of SS(volume loss), and 86% of the SS(fatty atrophy) group (p < 0.001). There was moderate correlation between chronicity of supraspinatus tendon tears and subscapularis tendon abnormality (r = 0.47; p < 0.0001), with no correlation between the subcoracoid interval and abnormalities of the subscapularis tendon. There was moderate correlation between chronicity of supraspinatus tendon tears and bone marrow changes in the lesser tuberosity (r = 0.44; p < 0.0001). CONCLUSION: Subscapularis tendon abnormality is related to chronicity of supraspinatus tendon tears. Bone marrow edema in the lesser tuberosity with a subscapularis tendon abnormality suggests increased stress at the subscapularis tendon insertion with chronicity of full-thickness supraspinatus tendon tears. Lack of correlation with the subcoracoid interval indicates that anterior instability may be a more important contributing factor to subscapularis tendon abnormalities than static subcoracoid impingement in the setting of a full-thickness supraspinatus tendon tear.

Adult↗

Adenomyosis:common and uncommon manifestations on sonography and magnetic resonance imaging.

OBJECTIVE: The purpose of this presentation is to show the imaging findings of the common and uncommon variants of adenomyosis as seen on sonography and magnetic resonance imaging (MRI). METHODS: A 3-year database search was performed to identify women who had pelvic sonography and pelvic MRI within a 6-month interval. Images of these cases were retrospectively reviewed. RESULTS: Eighty women were identified. Adenomyosis was diagnosed on MRI, which was used as the reference standard, in 45 of these women. The correct diagnosis was made on sonography in 73% of the cases. CONCLUSIONS: Awareness of the spectrum of imaging features of adenomyosis is important to use sonography effectively for diagnosing this entity and to help avoid misdiagnosis.

Adult↗

Lunate chondromalacia: evaluation of routine MRI sequences.

OBJECTIVE: Chondromalacia is a commonly encountered abnormality at arthroscopy and may be responsible for significant clinical symptoms and disability. In the wrist, the most common location for chondromalacia is the lunate bone. Consequently, we sought to study the accuracy of clinical MRI in the assessment of lunate articular cartilage. MATERIALS AND METHODS: MR images of 34 patients who underwent arthroscopy and had an MRI examination within 1 month of surgery were evaluated by two reviewers for the presence and location of lunate cartilage defects and subchondral edema. RESULTS: Lunate cartilage defects were seen on MRI in 10 of the 13 patients with chondromalacia, but these defects were also incorrectly noted in three of 21 of patients without chondromalacia. The visible locations for cartilage defects were the ulnar aspect of the proximal lunate bone (n = 3), radial aspect of the proximal lunate bone (n = 4), ulnar aspect of the distal lunate bone (n = 2), and radial aspect of the distal lunate bone (n = 1). Subchondral marrow edema was observed in six of the 10 patients with chondromalacia seen on MRI; in all six patients, the edema was seen in the same quadrant as the cartilage defect. Marrow edema was detected in one patient without chondromalacia. CONCLUSION: We conclude that lunate chondromalacia can be accurately assessed using routine MRI sequences, although there are occasional false-positive interpretations.

Adolescent↗

Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation.

OBJECTIVE: The purpose of our study was to describe the MR appearance and coexistence of anterior cruciate ligament ganglia with mucoid degeneration and to address the clinical significance of these entities. MATERIALS AND METHODS: A database search of 4221 knee MRI examinations over 2 years revealed 90 examinations with reported anterior cruciate ligament ganglion or mucoid degeneration. Imaging criteria for ligament ganglion included fluid signal in the ligament disproportionate to joint fluid showing mass effect on intact ligament bundles. The size, location, complexity, and degree of lobulation of ganglia were recorded. Criteria for mucoid degeneration included ligament bundles poorly seen on T1-weighted and proton density-weighted images but with both bundles seen as intact on T2-weighted images. Intraosseous cysts at the ligament attachments and presence of joint effusion were noted. Clinical assessment of ligament instability was recorded when available. RESULTS: Of 74 examinations that met imaging criteria, 56 (76%) had discrete intraligamentous ganglia, 18 (24%) had mucoid degeneration, and 26 (35%) had features of both. Ganglia were located in the proximal ligament in 16 examinations (22%) and the distal ligament in 10 (14%) and involved the entire ligament in 30 (40%). Ganglia ranged in maximum diameter from 20 to 73 mm (mean, 31 mm). Complexity of ganglia was mild (41%), moderate (39.2%), or marked (19.8%). Intraosseous cysts were noted proximally in 48 examinations (65%) and distally in 20 (27%). Of 52 patients with accessible records, 48 had no clinical evidence of instability. Twelve patients who underwent arthroscopy had an intact anterior cruciate ligament at that time. CONCLUSION: Anterior cruciate ligament ganglia and mucoid degeneration commonly coexist on MRI and are typically not associated with ligament instability.

Adult↗

Functional magnetic resonance cholangiography (fMRC) of the gallbladder and biliary tree with contrast-enhanced magnetic resonance cholangiography.

PURPOSE: To determine the diagnostic performance of functional magnetic resonance cholangiography (fMRC) for the evaluation of anatomic and functional biliary disorders. MATERIALS AND METHODS: At 1.5 T, 39 MR examinations with conventional MRC and mangafodipir trisodium-enhanced fMRC were retrospectively reviewed by three observers who recorded anatomic (duct dilation, stricture, filling defects) and functional (cholecystitis, obstruction) abnormalities in three modes: MRC alone, fMRC alone, and MRC and fMRC images together (combined-MRC). Performance was determined by comparing findings with each mode to findings of invasive cholangiography (IC) and surgery. RESULTS: Among 75 biliary segments (correlated with IC), the sensitivity/specificity for diagnosing dilation (N = 41) with MRC was 95%/97%; with fMRC, 90%/100%; with combined-MRC, 100%/97%. For stricture (N = 7), the sensitivity/specificity of MRC was 86%/98%; of fMRC, 43%/100%; of combined-MRC, 86%/100%. For filling defects (N = 9), the sensitivity/specificity of MRC was 91%/98%; of fMRC, 82%/100%; of combined-MRC, 91%/100%. For diagnosing obstruction (N = 9), the sensitivity/specificity of MRC, fMRC, and combined-MRC were 89%/100%, 100%/100%, and 100%/100%, respectively. For surgically proven cholecystitis (N = 13), positive predictive values for diagnosing acute/chronic cholecystitis for MRC were 33%/40%; for fMRC, 100%/50%; for combined-MRC, 100%/50%. CONCLUSION: Although single-shot fast spin echo (SSFSE)-MRC is valuable, the addition of fMRC increased diagnostic performance for functional biliary disorders.

Biliary Tract↗

Simple pancreatic cysts: CT and endosonographic appearances.

OBJECTIVE. This report describes the CT and endoscopic sonographic appearance of simple pancreatic cysts in three adults. CONCLUSION. Simple pancreatic cysts are typically an incidental finding in adults who have no history of pancreatic disease. The imaging characteristics of simple pancreatic cysts on CT and endosonography are similar to those of benign cysts.

Adult↗

Atraumatic medial collateral ligament oedema in medial compartment knee osteoarthritis.

OBJECTIVE: To describe and determine the prevalence of atraumatic medial collateral oedema identified in patients with medial compartment osteoarthritis. DESIGN AND PATIENTS: Sixty patients, 30 patients with medial compartment knee osteoarthritis (Kellgren and Lawrence grade 2 to 4) and 30 age-matched patients with atraumatic knee pain without osteoarthritis, referred for MR imaging over a 2 year period were included in the study. In each case, severity of osteoarthritis was recorded on radiographs and correlated with the presence or absence of medial collateral ligament oedema at MR imaging. RESULTS: Medial collateral oedema was identified in 27 of the 30 patients with osteoarthritis, of whom 14 had grade 1 oedema and 13 had grade 2 oedema compared with the presence of medial collateral ligament oedema (grade 1) in only two of the 30 control patients without osteoarthritis ( P<<0.0001). CONCLUSION: Medial collateral oedema is common in patients with osteoarthritis in the absence of trauma. When identified, medial collateral ligament oedema should be considered to be a feature of osteoarthritis and should not be incorrectly attributed to an acute traumatic injury.

Edema↗