Background: The size of Hamstring autograft of less than 8.0 mm in ACL re-construction is one of the key factors that may contribute to the failure of the graft. In this study, we are going to assess the correlation o...Background: The size of Hamstring autograft of less than 8.0 mm in ACL re-construction is one of the key factors that may contribute to the failure of the graft. In this study, we are going to assess the correlation of pre-operative MRI measurement of Hamstring tendons with the intra-operative ACL graft. Thus, it may help surgeons to anticipate the needs for graft augmentation should the final graft size be smaller than expected. Methods: We retrospectively re-viewed 41 cases of ACL reconstructions in which MRI were done pre-operatively, in Hospital Pakar Sultanah Fatimah (HPSF), Muar between January 2019 until December 2022. MRI measurements of Hamstring tendon (semitendinosus: ST, and gracilis) were done by a radiologist, and the in-tra-operative notes were reviewed for the final graft size. Pearson’s correlation coefficients were calculated to determine the relationship between graft size and tendon cross-sectional area. The intraclass correlation (ICC) by using two-way mixed model with type consistency, the reliability based on average measure was 0.41 (95% CI: ?0.10, 0.69). A p-value < 0.05 was considered sig-nificant. Results: Of 105 patients with primary ACL reconstruction done be-tween January 2019 to December 2022, only 41 patients were included in this study. There was fair correlation (p = 0.048) between pre-operative MRI measurement and the graft diameter intra-operatively. The mean of 17.0 mm of combined diameter of ST and gracilis tendon in MRI may results in graft diameter of 8.3 mm. There was also positive correlation between patients’ height and the intra-operative graft size. Conclusion: These results showed good correlation between pre-operative MRI measurement of Hamstring ten-don size with the intra-operative graft size, hence it is a reliable tool to predict the Hamstring autograft size in ACL reconstruction.展开更多
Objectives: MRI is the most sensitive modality for local staging of breast cancer. Herceptin receptor over-expression is seen in 15% - 30% of breast tumours, and is associated with increased aggression, poorer prognos...Objectives: MRI is the most sensitive modality for local staging of breast cancer. Herceptin receptor over-expression is seen in 15% - 30% of breast tumours, and is associated with increased aggression, poorer prognosis, higher grade at diagnosis and increased lymphatic dissemination. This study aimed at evaluating the role of MRI in Herceptin receptor positive vs negative tumours. Methods: 193 pre-operative MRIs were performed in 2021 for staging of 162 Her-2 negative and 37 Her-2 positive tumours. Recall rates and further biopsies (ipsilateral/contralateral) were assessed in both groups, and MRI largest size was compared to pathological size of invasive cancer and DCIS. Results: 36.4% of Her-2 negative tumours were recalled;further ipsilateral malignancy was identified in 13.6%. Contralateral malignancy was identified in 1.2%. 29.7% of Her-2 positive tumours were recalled;further ipsilateral malignancy was identified in 16.2%. No contralateral malignancy was seen in Her-2 positive tumours. The OR of Her-2 positive tumours having ipsilateral foci of malignancy on MRI is 0.83 (CI 0.3, 2.2). Pathological size concordance with MRI size was seen in 70.3% of Her-2 negative, and 48.6% of Her-2 positive tumours. Discordance in both groups was due to MRI size overestimation (70.8% of Her-2 negative discordance;89.4% of Her-2 positive discordance). Conclusions: Pre-operative MRI did not detect significant increased additional foci in Her-2 positive tumours. Significant concordance with pathological size was not seen in both groups;MRI overestimation was the most frequent cause for discordance in both groups. Advances in Knowledge: This study compares MRI features of Her-2 positive and Her-2 negative tumours. It demonstrates that there is no significant increased multifocality or multicentricity of Her-2 positive tumours, but MRI over-estimates size in 30% of Her-2 negative and 51% of Her-2 positive cancers.展开更多
文摘Background: The size of Hamstring autograft of less than 8.0 mm in ACL re-construction is one of the key factors that may contribute to the failure of the graft. In this study, we are going to assess the correlation of pre-operative MRI measurement of Hamstring tendons with the intra-operative ACL graft. Thus, it may help surgeons to anticipate the needs for graft augmentation should the final graft size be smaller than expected. Methods: We retrospectively re-viewed 41 cases of ACL reconstructions in which MRI were done pre-operatively, in Hospital Pakar Sultanah Fatimah (HPSF), Muar between January 2019 until December 2022. MRI measurements of Hamstring tendon (semitendinosus: ST, and gracilis) were done by a radiologist, and the in-tra-operative notes were reviewed for the final graft size. Pearson’s correlation coefficients were calculated to determine the relationship between graft size and tendon cross-sectional area. The intraclass correlation (ICC) by using two-way mixed model with type consistency, the reliability based on average measure was 0.41 (95% CI: ?0.10, 0.69). A p-value < 0.05 was considered sig-nificant. Results: Of 105 patients with primary ACL reconstruction done be-tween January 2019 to December 2022, only 41 patients were included in this study. There was fair correlation (p = 0.048) between pre-operative MRI measurement and the graft diameter intra-operatively. The mean of 17.0 mm of combined diameter of ST and gracilis tendon in MRI may results in graft diameter of 8.3 mm. There was also positive correlation between patients’ height and the intra-operative graft size. Conclusion: These results showed good correlation between pre-operative MRI measurement of Hamstring ten-don size with the intra-operative graft size, hence it is a reliable tool to predict the Hamstring autograft size in ACL reconstruction.
文摘Objectives: MRI is the most sensitive modality for local staging of breast cancer. Herceptin receptor over-expression is seen in 15% - 30% of breast tumours, and is associated with increased aggression, poorer prognosis, higher grade at diagnosis and increased lymphatic dissemination. This study aimed at evaluating the role of MRI in Herceptin receptor positive vs negative tumours. Methods: 193 pre-operative MRIs were performed in 2021 for staging of 162 Her-2 negative and 37 Her-2 positive tumours. Recall rates and further biopsies (ipsilateral/contralateral) were assessed in both groups, and MRI largest size was compared to pathological size of invasive cancer and DCIS. Results: 36.4% of Her-2 negative tumours were recalled;further ipsilateral malignancy was identified in 13.6%. Contralateral malignancy was identified in 1.2%. 29.7% of Her-2 positive tumours were recalled;further ipsilateral malignancy was identified in 16.2%. No contralateral malignancy was seen in Her-2 positive tumours. The OR of Her-2 positive tumours having ipsilateral foci of malignancy on MRI is 0.83 (CI 0.3, 2.2). Pathological size concordance with MRI size was seen in 70.3% of Her-2 negative, and 48.6% of Her-2 positive tumours. Discordance in both groups was due to MRI size overestimation (70.8% of Her-2 negative discordance;89.4% of Her-2 positive discordance). Conclusions: Pre-operative MRI did not detect significant increased additional foci in Her-2 positive tumours. Significant concordance with pathological size was not seen in both groups;MRI overestimation was the most frequent cause for discordance in both groups. Advances in Knowledge: This study compares MRI features of Her-2 positive and Her-2 negative tumours. It demonstrates that there is no significant increased multifocality or multicentricity of Her-2 positive tumours, but MRI over-estimates size in 30% of Her-2 negative and 51% of Her-2 positive cancers.
