Background: Bruxism is a common parafunctional activity that may alter the structural and mechanical properties of the masseter muscle. Shear wave elastography (SWE) provides a noninvasive and objective method for evaluating muscle stiffness. Despite increasing interest in SWE, its diagnostic value in bruxism has not been fully established. Methods: This comparative study included 2 groups: a bruxism group and a healthy control group. Bruxism was diagnosed in accordance with the diagnostic criteria for temporomandibular disorders (DC/TMD) by a dentist with 20 years of clinical experience. The control group comprised volunteers without bruxism, confirmed using the same diagnostic criteria. All participants underwent B-mode ultrasonography (US) in the supine position with their heads tilted to the opposite side at rest. US was used to assess the length and thickness of the masseter muscles, while SWE was used to measure muscle stiffness, reported in kilopascals (kPa). Results: Masseter muscle length was significantly shorter and SWE values were significantly higher in patients with bruxism compared to controls ( P < .05). A cutoff SWE value of 13.55 kPa was identified, yielding a sensitivity of 86.0% and specificity of 87.5% for the diagnosis of bruxism. The sample size in this study was larger than in previous SWE-based bruxism studies, enhancing the reliability of these findings. Conclusion: SWE demonstrates high diagnostic performance in identifying bruxism and may serve as a valuable objective tool in clinical practice. A threshold of 13.55 kPa can aid in distinguishing affected individuals with high sensitivity and specificity.

Objective: The purpose of the study is to compare the diagnostic efficacy of Susceptibility Weighted Imaging (SWI) to conventional Magnetic Resonance Imaging (MRI) in preoperative evaluation of endometriosis patients. Material and Methods: Between April 2022 and January 2023, patients with a histopathological diagnosis of endometrioma or endometriosis after laparoscopy were included in the study. A total of 18 patients with 30 endometrioma/endometriosis lesions were evaluated. SWI were evaluated for endometriosis foci detected in conventional MRI. Susceptibility artifacts detected in SWI but not in the conventional MRI were also noted. Results: There was no statistically significant difference between the diagnostic efficacies of SWI; T1 weighted imaging (WI) and T2 WI. While all of them had statistically significant diagnostic efficacy compared to the T2 dark spot sign. When the lesions were separated as ovarian endometrioma and deep pelvic endometriosis foci, no statistically significant difference was found between the diagnostic efficacies of the SWI sequence, while a statistically significant difference was found for the diagnostic efficacy of the T1 WI hyperintensity (p=1.000 and p=0.032, respectively). Conclusion: The diagnostic sensitivity of the SWI sequence in the diagnosis of endometrioma is similar to the fat-suppressed T1- WI hyperintensity and T2-WI hypointensity combination accepted as diagnostic criteria. The diagnostic superiority of the SWI sequence over the fat suppressed T1-WI sequence was shown in the detection of deep pelvic endometriosis foci. It was concluded that adding the SWI sequence to routine abdominal sequences and evaluating them with conventional MRI would increase the diagnostic efficacy for endometriosis.

Background: Differentiating ovarian endometriomas from hemorrhagic cysts matters because their management differs. Purpose: To evaluate whether a multiparametric magnetic resonance imaging (MRI) approach improves differentiation of endometriomas from hemorrhagic cysts over conventional subjective assessment. Material and Methods: In total, 83 hemorrhagic cystic ovarian lesions (45 endometriomas, 38 hemorrhagic cysts) on 1.5-T pelvic MRI were retrospectively evaluated by two independent blinded radiologists (with 20 and 7 years of experience in abdominopelvic and gynecological MRI) for quantitative T1 and T2 signal intensities (quantitative shading), intralesional and perilesional apparent diffusion coefficient (ADC), lesion size, and the T2 shading and dark-spot signs. ROC analysis, logistic regression, and inter-/intra-observer agreement were assessed, and models were compared with the DeLong test. Results: Endometriomas were larger (55.0 vs. 40.7 mm; P = 0.007), had lower intralesional ADC (1.054 vs. 1.563 ×10 ⁻³ mm ² /s; P = 0.002), and a greater T1–T2 signal difference ( P < 0.001), which had the highest single-parameter accuracy (AUC = 0.799). There was no statistically significant difference in the T2 shadowing sign between the groups (91.1% vs. 81.6%; P = 0.342). The T2 dark-spot sign was specific (100%) but insensitive (24.4%). Perilesional ADC did not differ ( P = 0.112) and showed poor inter-observer agreement (ICC = 0.064). A multiparametric model (quantitative shading, intralesional ADC, lesion size) outperformed conventional MRI (AUC = 0.894 vs. 0.670; DeLong P < 0.001), increasing sensitivity from 24.4% to 88.9% at comparable specificity. Conclusion: A multiparametric model combining quantitative shading, intralesional ADC and lesion size significantly improved differentiation over conventional MRI, whereas perilesional ADC showed no diagnostic utility at 1.5 T.