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To compare biliary stricture severity on magnetic resonance cholangiopancreatography (MRCP), magnetic resonance elastography (MRE), and vibration-controlled transient elastography (VCTE) liver stiffness (LS) for evaluation of risk stratification and prognostication in primary sclerosing cholangitis (PSC). Eighty-seven patients (31–61 years; 34 female/53 male) prospectively underwent biochemical testing, VCTE, MRCP, and MRE between January 2014 and July 2016. Correlation between the MRCP grading of PSC based on biliary stricture severity, LS on MRE and VCTE, and the Mayo Risk Score as well as the Amsterdam Oxford Prognostic Index (AOPI) were evaluated and compared. Stricture severity was classified according to previous classification systems based on ERCP. Spearman’s correlation and Kruskal-Wallis tests were performed. MRE-LS and intrahepatic stricture severity combined demonstrated higher discriminatory ability among risk categories based on Mayo Risk Score (AUROC = 0.8). MRE-LS alone demonstrated excellent discriminatory ability among risk categories based on AOPI using cutoffs of 1 and 2.7 and was superior to intrahepatic stricture severity (AUROC = 0.9, AUROC = 0.6–0.7). There was a weak correlation between intrahepatic stricture severity and MRE-LS (rho = 0.3; p = 0.011). VCTE-LS values were not correlated with stricture severity and were noncontributory to differentiate patients across risk groups. Intrahepatic stricture severity alone was a poor discriminator of advanced liver fibrosis on MRE (AUROC = 0.7); however, combining intra- and extrahepatic stricture severity and controlling for cholestasis and disease duration improved results (AUROC = 0.9). This study demonstrates a significant discriminatory ability of LS values on MRE to distinguish between early to moderate and advanced liver fibrosis. LS values on MRE may add value to risk prognostication and further studies including clinical outcomes are needed. • Risk stratification was excellent for liver stiffness measurements on MRE and poor for VCTE and biliary stricture severity. • Risk stratification was further improved when liver stiffness measured on MRE was combined with intrahepatic and extrahepatic stricture severity and indicators of cholestasis were controlled for. • Liver stiffness measurements on MRE correlated with prognostic scores better than measurements performed on VCTE.

Fractures of the cervical spine are a medical emergency and may lead to permanent paralysis and even death. Accurate diagnosis in patients with suspected fractures by computed tomography (CT) is critical to patient management. In this paper, we propose a deep convolutional neural network (DCNN) with a bidirectional long-short term memory (BLSTM) layer for the automated detection of cervical spine fractures in CT axial images. We used an annotated dataset of 3,666 CT scans (729 positive and 2,937 negative cases) to train and validate the model. The validation results show a classification accuracy of 70.92% and 79.18% on the balanced (104 positive and 104 negative cases) and imbalanced (104 positive and 419 negative cases) test datasets, respectively., This paper is accepted for presentation at the IEEE International Symposium on Biomedical Imaging (ISBI) 2021

The objective of this article is to review the normal anatomy and posttraumatic findings of the Chopart joint complex. Key imaging features of the normal ligaments and patterns of ligamentous and osseous injuries are discussed.Traumatic midtarsal injuries, particularly midtarsal sprain, are often overlooked clinically and on imaging but are relatively common and typically are associated with inversion ankle injuries. Radiologists should be familiar with Chopart joint anatomy and the imaging features of midtarsal injuries because early diagnosis may help optimize clinical management.

The shoulder joint is the most unstable articulation in the entire human body. While this certainly introduces vulnerability to injury, it also confers the advantage of broad range of motion. There are many elements that work in combination to offset the inherent instability of the glenohumeral joint, but the glenoid labrum is perhaps related most often. Broadly, clinical unidirectional instability can be subdivided into anterior and posterior instability, which usually raise concern for anteroinferior and posteroinferior labral lesions, respectively. In the special case of superior labral damage, potential dislocation is blocked by structures that include the acromion; hence, while damage elsewhere commonly manifests as clinical instability, damage to the superior labrum is often described by the term microinstability. In this particular case, one of the radiologist's main concerns should be classic superior labral anteroposterior lesions. The glenoid labrum is also subject to a wide range of normal variants that can mimic labral tears. Knowledge of these variants is central to interpreting an imaging study of the labrum because misdiagnosis of labral variants as tears can lead to superfluous surgical procedures and decreased shoulder mobility. This article reviews labral anatomy and normal labral variants, describes their imaging features, and discusses how to discriminate normal variants from labral tears. Specific labral pathologic lesions are described per labral quadrant (anteroinferior, posteroinferior, and superior), and imaging features are described in detail. Online supplemental material is available for this article. ©RSNA, 2016.

The ankle is one of the most common sites of musculoskeletal injury. In a series of 1176 athletic injuries, 14% were found to be injuries of the ankle, and 85% of those were specifically sprains of ankle ligaments [1]. Although many ankle ligaments can be well assessed by an operator trained in ultrasound techniques, evaluation by magnetic resonance imaging (MRI) offers the advantages of a comprehensive and operator-independent examination [2]. In this article, a practical review of MRI of ankle ligaments is presented. The discussion is limited primarily to the ligaments surrounding the tibiotalar joint, particularly the inferior tibiofibular syndesmotic ligaments and the medial and lateral collateral ligaments (Table 1). Because of its close association with the deltoid ligament, the spring ligament is also included. Ligament names are represented by unambiguous abbreviations similar to those appearing in the literature [3e5]. For each ligament, normal anatomy, MRI appearance, and function will be addressed. Next, with regards to the injured ligament, basic mechanisms of injury will be reviewed, taking into consideration differing opinions in the literature that, in some cases, diverge from the classic teachings of Lauge and Hansen [3]. Because ligament injury usually manifests itself in similar ways, such as abnormal signal intensity (intrasubstance or periligamentous) or abnormal morphology (thickening, thinning, discontinuity, absence, irregularity, indistinctness, or heterotopic ossification) [2,4,6], additional imaging clues to injury that are ligamentspecific will be emphasized. Finally, because chronic injury

The midtarsal (Chopart) joint complex consists of the talonavicular and calcaneocuboid joints and their stabilizing ligaments. Detailed assessment of this complex at MRI can be challenging owing to frequent anatomic variation and the small size of the structures involved. Nevertheless, a wide spectrum of pathologic conditions affect the joint complex, and its imaging evaluation deserves more thorough consideration. This review focuses on MRI evaluation of normal ligamentous anatomy and common variations about the Chopart joint, presenting practical imaging tips and potential diagnostic pitfalls. Imaging findings across a spectrum of traumatic Chopart joint injuries are also reviewed, from midtarsal sprains to Chopart fracture-dislocations. Midtarsal sprains-commonly associated with ankle inversion injuries-are emphasized, along with their often predictable radiographic and MRI injury patterns. Online DICOM image stacks are available for this article. ©RSNA, 2018.

Magnetic resonance imaging (MRI) represents the preferred noninvasive imaging technique to diagnose meniscal pathology in the pre- and postoperative setting. Furthermore, characterization of meniscal tissue MR properties has been possible by the development of advanced MRI techniques. Suspected meniscal tears are a frequent indication for MRI and the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification system has been developed to facilitate accurate and uniform reporting of such meniscal tears. Partial meniscectomy and meniscal suture repair are among the commonly performed procedures and several signs have been described to detect postoperative recurrent tears on MRI. Other techniques that have proven useful for meniscal assessment are ultrasound (US) and computed tomography (CT) arthrography. In recent years, US is being increasingly used in the selective assessment of some meniscal pathology such as tears, parameniscal cysts and meniscal extrusion as it is a relatively inexpensive, accessible, and safe technique. CT arthrography has been advocated as an acceptable alternative in patients with contraindications for MRI, with comparable diagnostic performance.

Following a brief description of the normal anatomy and biomechanics of the midfoot, this article focuses on MR imaging features of common osseous, tendon, and ligament abnormalities that affect the midfoot. Discussion of the anatomy and pathology affecting the Chopart and Lisfranc joint complexes, both of which play important roles in linking the midfoot to the hindfoot and the forefoot respectively, is also included.

Ankle impingement syndromes encompass a broad spectrum of post-traumatic and chronic degenerative changes that present with pain on specific movements about the ankle joint. Both amateur and professional athletes are disproportionately affected by these conditions, and while conservative measures can potentially treat an impingement syndrome, definitive therapy is often alleviated surgically. Imaging (including conventional radiography, ultrasound, CT and MRI) plays an invaluable role in the diagnosis and pre-surgical work-up. An anatomically based classification system is useful in these syndromes, as the aetiology, sites of pathology and preferred treatment methods are similarly based on anatomic locations about the ankle. This review focuses on the anatomic locations, pathophysiology, imaging considerations and brief discussion of therapies for each of the major anatomic ankle impingement syndromes.

To implement high-resolution morphologic and quantitative magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) using ultrashort time-to-echo (UTE) techniques in cadavers and volunteers. This study was approved by the institutional review board. TMJs of cadavers and volunteers were imaged on a 3-T MR system. High-resolution morphologic and quantitative sequences using conventional and UTE techniques were performed in cadaveric TMJs. Morphologic and UTE quantitative sequences were performed in asymptomatic and symptomatic volunteers. Morphologic evaluation demonstrated the TMJ structures in open- and closed-mouth position. UTE techniques facilitated the visualization of the disc and fibrocartilage. Quantitative UTE MRI was successfully performed ex vivo and in vivo, reflecting the degree of degeneration. There was a difference in the mean UTE T2* values between asymptomatic and symptomatic volunteers. MRI evaluation of the TMJ using UTE techniques allows characterization of the internal structure and quantification of the MR properties of the disc. Quantitative UTE MRI can be performed in vivo with short scan times.