| 1. |
- Hardie, Claire, et al.
(författare)
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Diagnostic accuracy of magnetic resonance imaging for nerve injury in obstetric brachial plexus injury : protocol for systematic review and meta-analysis
- 2022
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Ingår i: Systematic Reviews. - : BioMed Central. - 2046-4053. ; 11:1
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Forskningsöversikt (refereegranskat)abstract
- Background: Early and accurate clinical diagnosis of the extent of obstetric brachial plexus injury (OBPI) is challenging. The current gold standard for delineating the nerve injury is surgical exploration, and synchronous reconstruction is performed if indicated. Magnetic resonance imaging (MRI) is a non-invasive method of assessing the anatomy and severity of nerve injury in OBPI but the diagnostic accuracy is unclear. The primary objective of this review is to determine the diagnostic accuracy of MRI in comparison to surgical brachial plexus exploration for detecting root avulsion in children under 5 with OBPI. The secondary objectives are to determine its’ diagnostic accuracy for detecting nerve abnormality and detecting pseudomeningocele(s) in this group.Methods: This review will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA).We will include studies reporting the accuracy of MRI (index test) compared to surgical exploration (reference standard) in detecting any of the three target conditions (root avulsion, any nerve abnormality and pseudomeningocele) in children under five with OBPI. Case reports and studies where the number of true positives, false positives, true negatives and false negatives cannot be derived will be excluded. We plan to search PubMed, Embase and CENTRAL for relevant studies from database inception to 15 June 2022. We will also search grey literature (medRxiv, bioRxiv and Google Scholar) and perform forward and backward citation chasing. Screening and full-text assessment of eligibility will be conducted by two independent reviewers, who will then both extract the relevant data. The QUADAS-2 tool will be used to assess methodological quality and risk of bias of included studies by two reviewers independently. The following test characteristics for the target conditions will be extracted: true positives, false positives, true negatives and false negatives. Estimates of sensitivity and specificity with 95% confidence intervals will be shown in forest plots for each study. If appropriate, summary sensitivities and specificities for target conditions will be obtained via meta-analyses using a bivariate model.Discussion: This study will aim to clarify the diagnostic accuracy of MRI for detecting nerve injury in OBPI and define its clinical role. Systematic review registration: PROSPERO CRD42021267629.
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| 2. |
- Lasič, Samo, et al.
(författare)
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Stay on the Beat With Tensor-Valued Encoding: Time-Dependent Diffusion and Cell Size Estimation in ex vivo Heart
- 2022
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Ingår i: Frontiers in Physics. - : Frontiers Media SA. - 2296-424X. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Diffusion encoding with free gradient waveforms can provide increased microstructural specificity in heterogeneous tissues compared to conventional encoding approaches. This is achieved by considering specific aspects of encoding, such as b-tensor shape, sensitivity to bulk motion and to time-dependent diffusion (TDD). In tensor-valued encoding, different b-tensor shapes are used, such as in linear tensor encoding (LTE) or spherical tensor encoding (STE). STE can be employed for estimation of mean diffusivity (MD) or in combination with LTE to probe average microscopic anisotropy unconfounded by orientation dispersion. While tensor-valued encoding has been successfully applied in the brain and other organs, its potential and limitations have not yet been fully explored in cardiac applications. To avoid artefacts due to motion, which are particularly challenging in cardiac imaging, arbitrary b-tensors can be designed with motion compensation, i.e. gradient moment nulling, while also nulling the adverse effects of concomitant gradients. Encoding waveforms with varying degrees of motion compensation may however have significantly different sensitivities to TDD. This effect can be prominent in tissues with relatively large cell sizes such as in the heart and can be used advantageously to provide further tissue information. To account for TDD in tensor-valued encoding, the interplay between asynchronous gradients simultaneously applied along different directions needs to be considered. As the first step toward in vivo cardiac applications, our overarching goal was to explore the feasibility of acceleration compensated tensor-valued encoding on preclinical and clinical scanners ex vivo. We have demonstrated strong and predictable variation of MD due to TDD in mouse and pig hearts using a wide range of LTE and STE with progressively increasing degrees of motion compensation. Our preliminary data from acceleration compensated STE and LTE at high b-values, attainable on the preclinical scanner, indicate that TDD needs to be considered in experiments with varying b-tensor shapes. We have presented a novel theoretical framework, which enables cell size estimation, helps to elucidate limitations and provides a basis for further optimizations of experiments probing both mean diffusivity and microscopic anisotropy in the heart.
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