Reliability and Validity of Diagnosing Acetabular Labral Lesions with Magnetic Resonance Arthrography

Background: Arthroscopic surgery of the hip is being increasingly used to diagnose and treat various abnormalities, including acetabular labral tears. Magnetic resonance arthrography has been suggested as the imaging test of choice for the evaluation of the acetabular labrum. There is substantial variability in the previously reported accuracy of magnetic resonance arthrography for diagnosing labral lesions. Interobserver reliability has not been established previously. The purpose of this study was to establish the interobserver reliability and the validity of magnetic resonance arthrography for detecting lesions of the acetabular labrum in a retrospective case series. Methods: Two radiologists independently assessed the acetabular labrum on magnetic resonance arthrograms of ninety-five hips in ninety-three patients who underwent hip arthroscopy for a suspected acetabular labral lesion. Magnetic resonance arthrography findings were compared with the gold standard, which was defined as the assessment of the labrum during the hip arthroscopy. Results: At arthroscopy, ninety-one labral lesions were identified in the ninety-five hips. The interobserver reliability of detecting labral lesions with magnetic resonance arthrography was fair (kappa = 0.268). Magnetic resonance arthrography, as interpreted by observers A and B, showed a sensitivity of 86% and 86%, specificity of 75% and 50%, negative predictive value of 19% and 13%, and positive predictive value of 99% and 98%, respectively. Conclusions: Because of its limited reliability and the high prevalence of labral lesions, magnetic resonance arthrography provides a limited complementary benefit in the detection of labral lesions in patients with a high clinical suspicion of labral pathology. When there is a high clinical suspicion of a labral lesion, magnetic resonance arthrography has a poor negative predictive value and cannot be used to rule out a labral lesion. Physicians should critically consider whether the findings

Microinfarcts in the Deep Gray Matter on 7T MRI: Risk Factors, MRI Correlates, and Relation to Cognitive Functioning-The SMART-MR Study

BACKGROUND AND PURPOSE: The clinical relevance of cortical microinfarcts has recently been established; however, studies on microinfarcts in the deep gray matter are lacking. We examined the risk factors and MR imaging correlates of microinfarcts in the deep gray matter on 7T MR imaging and their relation to cognitive functioning. MATERIALS AND METHODS: Within the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) study, 213 patients (mean age, 68 [SD, 8] years) had a risk-factor assessment, 7T and 1.5T brain MR imaging, and a cognitive examination. Microinfarcts on 7T MR imaging were defined as lesions of,5 mm. Regression models were used to examine the age-adjusted associations among risk factors, MR imaging markers, and microinfarcts. Cognitive function was summarized as composite and domain-specific z scores. RESULTS: A total of 47 microinfarcts were found in 28 patients (13%), most commonly in the thalamus. Older age, history of stroke, hypertension, and intima-media thickness were associated with microinfarcts. On 1.5T MR imaging, cerebellar infarcts (relative risk ¼ 2.75; 95% CI, 1.4-5.33) and lacunes in the white (relative risk ¼ 3.28; 95% CI, 3.28-6.04) and deep gray matter (relative risk = 3.06; 95% CI, 1.75-5.35) were associated with microinfarcts, and on 7T MR imaging cortical microinfarcts (relative risk = 2.33; 95% CI, 1.32-4.13). Microinfarcts were also associated with poorer global cognitive functioning (mean difference in the global z score between patients with multiple microinfarcts versus none = -0.97; 95% CI, -1.66 to -0.28, P = .006) and across all cognitive domains. CONCLUSIONS: Microinfarcts in the deep gray matter on 7T MR imaging were associated with worse cognitive functioning and risk factors and MR imaging markers of small-vessel and large-vessel disease. Our findings suggest that microinfarcts in the deep gray matter may represent a novel imaging marker of vascular brain injury

Quantitative visualization of pectin distribution maps of peach fruits

Abstract Pectin content is an important quality index of fruits, as pectin content undergoes significant changes during the peach ripening process. The commonly used carbazole colorimetry method measures only the total content value of each kind of pectin for each pulp sample and cannot provide distribution maps of the pectin contents for the whole fruit pulp. This work used the hyperspectral imaging technique to quantitatively visualize the distribution maps of pectin contents inside peach pulp at the pixel level. The protopectin contents were well predicted, with the best residual predictive deviation of 2.264, whereas the predictions of the water-soluble pectin and the total pectin contents were not satisfied. On the basis of the best predictive model, the distribution maps of the protopectin contents were quantitatively visualized. A histogram of an example protopectin distribution revealed the existence of a wide range of protopectin contents in peach pulp. Our results show that hyperspectral imaging holds promise as a powerful alternative to the carbazole colorimetry method for measuring the spatial variations in the protopectin distribution inside peach pulp. The distribution maps could be used as a maturity indicator to understand and evaluate the ripening process of peach fruit in depth