OBJECTIVE: To evaluate the retrospective accuracy of the Vesical Imaging-Reporting and Data System (VI-RADS) in detecting muscle invasion in bladder cancer. MATERIALS AND METHODS: We investigated patients who underwent pelvic magnetic resonance imaging and were submitted to transurethral resection of a bladder tumor between 2015 and 2018. Thirty cases were reviewed by radiologists blinded to the final clinical stage. The VI-RADS score was applied and compared with the histopathological findings in the surgical specimen. RESULTS: Of the 30 patients with suspicious bladder lesions, 5 (16.6%) had benign histopathological findings, 17 (56.6%) had non-muscle-invasive bladder cancer, and 8 (26.6%) had muscle-invasive bladder cancer. The optimal criterion to detect muscle-invasive bladder cancer was a final VI-RADS score > 3, for which the sensitivity and specificity were 100% (95% CI: 56.0-100%) and 90.9% (95% CI: 69.3-98.4%), respectively. CONCLUSION: The VI-RADS appears to estimate correctly the degree of muscle invasion in suspicious bladder lesions. However, prospective studies evaluating larger samples are needed in order to validate the method.

Keywords: Urinary bladder neoplasms; Data systems; Magnetic resonance imaging/methods; Diffusion magnetic resonance imaging/methods; Muscle, smooth/diagnostic imaging; Neoplasm invasiveness.

OBJECTIVE: To evaluate the effect of acromial inferolateral tilt on subacromial impingement syndrome. MATERIALS AND METHODS: The acromial inferolateral tilt was retrospectively quantified by two researchers on 346 shoulder magnetic resonance images using the glenoacromial (between the inferior proximal acromial surface and the glenoidal face) and acromioclavicular (between the axis of the proximal acromion and distal clavicle) angles. RESULTS: The glenoacromial angle was associated with subacromial impingement syndrome (p < 0.001) and complete supraspinatus tendon rupture (p < 0.001), and the acromioclavicular angle was associated with partial or complete supraspinatus tendon rupture (p = 0.003). The area under the receiver operating characteristic curve (AUC), best cut-off angle, and odds ratio (OR) of the glenoacromial angle for impingement syndrome were 0.579 (95% confidence interval [CI]: 0.508–0.649; p = 0.032), 72°, and 2.1 (95% CI: 1.136–4.053), respectively. For complete supraspinatus tendon rupture, the AUC, best cut-off angle, and OR of the glenoacromial angle were 0.731 (95% CI: 0.626–0.837; p = 0.001), 69°, and 8.496 (95% CI: 2.883–28.33), respectively. For partial or complete supraspinatus tendon rupture, the AUC, best cut-off angle and OR of the acromioclavicular angle were 0.617 (95% CI: 0.539–0.694; p = 0.002), 17°, and 3.288 (95% CI: 1.886–5.768), respectively. Interobserver agreement found for the glenoacromial and acromioclavicular angles were 0.737 (95% CI: 0.676–0.787; p < 0.001) and 0.507 (95% CI: 0.391–0.601; p = 0.001), respectively. CONCLUSION: Inferolateral acromial tilt may have some impact on subacromial impingement syndrome; however, the best quantification method identified (glenoacromial angle) showed a moderate interobserver agreement and a fair performance to assess the risk of complete supraspinatus tendon rupture.

Keywords: Shoulder impingement syndrome; Inferolateral acromial tilt; Magnetic resonance imaging.