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1.
Ahmed M. Abdrabou Mennatallah H. Shalaby 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):977-981
Purpose
To highlight the relationship between coraco-humeral distance and subscapularis tendon tear.Material and methods
Sixty-two shoulder MRI studies were examined. Twenty-two patients had partial or complete tear of subscapularis tendon and forty shoulder as a control group. Axial and oblique sagittal MR images were examined to measure the coraco-humeral distance followed by statistical analysis to correlate the distance with tendon tear.Results
A cut-off value of 8.25?mm for the coraco-humeral distance gave a sensitivity of 77.5% and specificity of 72.7% for subscapularis tendon tear.Conclusion
There is a well-known relationship between the coraco-humeral distance and the subscapularis tendon tear and its meticulous assessment in subjects with pain in the anterior shoulder region increases the diagnosis of subcoracoid impingement. 相似文献2.
Julien Pintat Alain Silvestre Guy Magalon Alain Pierre Gadeau Lionel Pesquer Anne Perozziello Alain Peuchant Charbel Mounayer Benjamin Dallaudière 《Journal of vascular and interventional radiology : JVIR》2017,28(12):1708-1713
Purpose
To assess the feasibility and safety of concomitant intra-articular (IA) knee injection of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) under fluoroscopic guidance to treat patellofemoral osteoarthritis (OA).Materials and Methods
This prospective study included 19 consecutive patients referred for fluoroscopically guided IA MSC and PRP injection for symptomatic patellofemoral chondropathy in which conservative treatment had failed. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and magnetic resonance (MR) data, including T2 mapping sequence, were prospectively collected before and 6 months after treatment. Clinical data without MR imaging were collected until 12 months after the procedure.Results
WOMAC scores were significantly lower after IA injection of MSCs and PRP at 6 months and during 12-months follow-up compared with baseline (mean score decreased from 34.3 to 14.2; P < .0018). Patients reported no complications. Concerning MR imaging follow-up, there were no significant differences in grade, surface, or T2 value of the chondral lesions (P > .375).Conclusions
IA injection of MSCs and PRP in early patellofemoral OA appears to allow functional improvement. 相似文献3.
Ahmed A. Baz Ahmed M. Gad Mohamed R. Waly 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):125-132
Chronic plantar fasciitis (PF) is, by far, considered one of the commonest causes of foot complaints; constituting up to 15% of the foot symptoms that needs medical care in adult and active subjects.
Purpose
Is to confirm the clinical diagnosis of plantar fasciitis by ultrasound and to depict the effect of ultrasound guided injection of PRP in such cases.Methods
The study was conducted on 44 patients with chronic plantar fasciitis not responding to conservative treatment, they were diagnosed and were treated by ultrasound guided PRP injection then followed-up after 4 months by both clinical and ultrasound examinations.Results
By ultrasound mild improvement in plantar fascia thickness from 6.04 mm (mean of pre injection) to 4.93 mm (mean of 4 months post last injection). By VAS, significant improvement from 8.14 (mean of pre injection) to 2.59 (mean of 4 months post injection). By Roles and Maudsley score, significant improvement from 81.8% of patients who were acceptable and 18.2% were poor (pre injection) to 59.1% became excellent, 31.8% good, 4.5% acceptable and 4.5%poor (4 months post injection).Conclusion
Ultrasound is a confirmatory diagnostic tool of PF and PRP ultrasound guided injection is recommended after failure of conservative treatment. 相似文献4.
Mennatallah Hatem Shalaby Sherin M. Sharara Mohammed H. Abdelbary 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):645-652
Background
The ankle is frequently injured in trauma, overuse syndrome and inflammatory processes. Different imaging modalities assess the ankle, including plain radiography, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography (US).Purpose
Our objective is to assess the role of high resolution US as a valuable tool in the depiction of causes of ankle joint pain.Patients and methods
The study included 28 patients presented with ankle pain ranging in age from 17 to 60 years. They were examined by US and findings were correlated with MRI.Results
US was capable to detect various lesions (synovitis, arthritis, plantar fasciitis, tendon and ligamentous lesions). It had a sensitivity of 95.4%, a specificity of 83.3% and an overall accuracy of 92.8%. US had a limited value in detection of avascular necrosis (AVN), bone marrow oedema and fractures.Conclusion
US can be used as a first step diagnostic tool in cases of ankle pain. MRI should be spared to cases with negative or equivocal US findings. 相似文献5.
Ayman F. Ahmed Ahmed Abdel Azeem Amr Eladawy Mohamed Abdeen 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):953-960
Background
The knee menisci are compound anatomical structures with important purposes within the knee. In the long term, meniscal losing results in high risk of developing degenerative osteoarthritis. MRI is an accurate and non-invasive diagnostic method for the knee injuries providing satisfactory guide for conservative treatment and guarding the patients from uncritical arthroscopy.Objective
This study aimed to detect the MRI accuracy in diagnosis of meniscal lesions compared to arthroscopy.Patients & methods
This study included 13 females and 17 males presented by pain, swelling, limitation of movement, in the duration from April 2015 to June 2016. All patients were subjected to MRI followed by arthroscopy.Results
The study revealed that specificity, sensitivity, NPV, PPV and accuracy, in MRI diagnosis of medial meniscal abnormal signals were 50%, 95.8%, 88.4%, 86.6%, and 90% respectively, whereas those for lateral meniscus signals were 84.6% 88.2%, 84.6%, 88.2% and 86.7% respectively.Conclusion
MRI of the knee will give the orthopedic surgeons ability to select suitable treatment and arthroscopic interference for their patients. MRI has high accuracy in meniscal tears diagnosis allowing accurate grading of them. 相似文献6.
Nesreen Mohey Tamir A. Hassan 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):1-6
Perianal fistula is a common disorder with high tendency to recur in spite of satisfactory surgery. Pelvic MRI is the preferable imaging modality for recognition and assessment of perianal fistulas.
Aim of the work
To evaluate the effectiveness of MRI in grading of primary perianal fistula and verification of its associated findings in correlation with surgical outcome.Subjects and methods
This prospective study included 30 patients with age range 14–44 years. Preoperative MR grading was correlated with surgical outcome.Results
The sensitivity, specificity, PPV, NPV and weighted Kappa of MR grading in correlation with surgery was 95.8%, 83.3%, 95.8%, 83.3% and 0.79 respectively with P value = 0.000Conclusion
MRI is a valuable modality for grading of primary perianal fistula and its complications. Accurate pre-operative grading may reduce the surgical complications and possibility of recurrence. 相似文献7.
Hala Yehia Yousef Haitham A. Dawood Nesreen Mohey 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):927-930
Aim of the work
To evaluate the role of diffusion weighted imaging (DWI) in the planning for CT guided biopsy of lung and mediastinal lesions.Subjects and methods
This cross sectional study included 23 patients with mean age was 42.7?years came with clinical and imaging suspicion of chest malignancy, referred for CT guided transthoracic biopsy. DWI and apparent diffusion coefficient (ADC) were evaluated for all patients to choose the area of maximum restriction.Results
The study showed that with DWI guidance; all the biopsy specimens were diagnostic and provide adequate material for analysis.Conclusion
DWI and measurement of ADC value has a very helpful role in the pre-procedural planning of transthoracic biopsies. 相似文献8.
Objectives
We assessed the implications of MR imaging with clinical history in lateral epicondylitis management by evaluating imaging and clinical features in patients with lateral epicondylitis treated conservatively or operatively.Methods
Sixty patients with lateral epicondylitis treated conservatively (n = 38) or operatively (n = 22) from 2011–2015 were included. MR imaging findings of common extensor tendon (CET), lateral collateral ligament (LCL) complex, muscle oedema, ulnar nerve and elbow joint were reviewed. Clinical data recorded were frequency, duration and intensity of pain, history of trauma and injection therapy, range of motion.Results
MRI-assessed CET and LCL complex abnormalities, muscle oedema, radiocapitellar joint widening, joint effusion/synovitis, pain frequency and intensity differed significantly between the two groups (p < .05) with increased severity in operative group. Persistent pain (OR 12.2, p < .01), CET abnormality on longitudinal plane (OR 7.5, p = .03 for grade 2; OR 22.4, p < .01 for grade 3) and muscle oedema (OR 6.7, p = .03) were major factors associated with operative treatment. Area under the ROC curve of predicted probabilities for combination of these factors was 0.83.Conclusion
MR imaging, combined with clinical assessment, could facilitate appropriate management planning for patients with lateral epicondylitis.Key Points
? MRI can reflect different disease severity between patients treated conservatively/operatively. ? CET abnormality, muscle oedema were major MRI findings with operative treatment. ? Patients in operative group were more likely to experience persistent pain. ? MRI plus clinical symptoms could facilitate appropriate management for lateral epicondylitis.9.
Ahmed Elsammak 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):1073-1081
Objectives
To assess the clinical utility of PET-CT in assessment of thoracic involvement in lymphoma patients prior to, during and after finishing treatment and comparing it to contrast enhanced CT (CECT).Patients and methods
PET-CT was performed for 30 patients with lymphoma. Thoracic nodal and extranodal involvement was assessed and compared to contrast enhanced CT.Results
Comparison of CECT and PET-CT in staging and assessment of treatment response reveals significant statistical difference (P?=?.0001 & .04 respectively). CECT shows sensitivity?=?83.3% and specificity?=?75% in evaluation of patients after finishing chemotherapy.Conclusion
PET-CT plays an important role in staging, detection of response to treatment and restaging of lymphoma after finishing chemotherapy. 相似文献10.
Adel Ali Ramadan Mohamed Samir Shaaban Alaa Magdy El-Sayed 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):1097-1104
Background
Urinary tract injuries occur in 3–10% of abdominal trauma. Early recognition and diagnosis of ruptured bladder is essential to lower this mortality rate. CT is the method of choice for the evaluation of patients with blunt or penetrating abdominal and/or pelvic trauma. Imaging in patients with suspected bladder injury with CT cystography may be performed using either an intravenous or retrograde technique.Aim of work
The aim was to evaluate the role of CT in diagnosing traumatic urinary bladder injuries.Materials and methods
The study was carried out on 32 patients with suspected traumatic urinary bladder injury. All patients were subjected to contrast-enhanced CT study and classified according to Sandler et al. classification of urinary bladder injuries.Results
All patients were classified according to the type of the encountered urinary bladder trauma. Type I injury was diagnosed in 3.1% of patients, type II in 18.8%, type III in 3.1%, type IVa in 12.5%, type IVb in 43.7% and type V in 18.8%. 21.8% of patients were managed conservatively, while 78.2% of patients underwent surgical repair.Conclusion
CECT well demonstrated traumatic urinary bladder injuries. 相似文献11.
Mennatallah Hatem Shalaby Khaled A. Ali Shehata 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):791-798
Background
Ninety percent of hepatic cancers are hepatocellular carcinomas (HCC) which have an unfavorable prognosis. HCC is a hypervascular tumor supplied mainly by the hepatic artery. It has a higher blood supply than the surrounding hepatic tissue due to neovascularization. Computed tomography with perfusion imaging (CTP) is a non invasive tool which quantifies the blood flow parameters of HCC and compares it to the surrounding tissue.Purpose
To prove that CTP is a valuable diagnostic tool in diagnosis of HCC and posttherapeutic assessment.Patients and methods
One hundred and twenty-six HCC patients with 150 focal lesions are enrolled this study. Perfusion parameters are quantified and results are compared to those of triphasic CT.Results
CTP detected 141 lesions with 94% sensitivity and 40% specificity with elevated arterial perfusion (AP) and perfusion index (PI) with low portal flow (PF). It missed 5 lesions because of their hypovascularity and 4 lesions following radiofrequency ablation (RFA) and trans arterial chemo embolization (TACE).Conclusion
CTP is a safe and specific imaging tool for diagnosis and assessment of therapeutic interventional procedures in HCC. 相似文献12.
Sherif El-Sayed Mahmoud Hegab Maged Mohamed El-Sayed Eissa Amr Aly Aly Abdel-Kerim Mohamed Said Abel Aziz 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):133-139
Purpose
This study was done targeting the role of streptokinase injected through pigtail catheter in treatment of pleural empyema in pediatric.Subjects and methods
15 patients were involved in this study of age ranged from 5 months to 15 years were subjected to STK injection once daily until the drainage don’t exceed 100 ml/day and managed by ultrasound guided insertion of pigtail catheter. Broad spectrum antibiotics were given to all patients, after that the antibiotics were adapted according to result of microbial culture because of failed chest tube drainage intrapleural STK is recommended.Results
13 cases show significant improvement, as the total amount of fluid before streptokinase injection was 5 cc in average and significantly rose to 220 cc after streptokinase instillation, while 2 cases do not response to this treatment.Conclusion
Imaging guided streptokinase injected through a pigtail catheter provides a powerful protocol for managing of complicated empyema in pediatrics. 相似文献13.
Sahar Mahmoud Mansour Mariam Raafat 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):1131-1139
Objective
To assess the diagnostic accuracy of diffusion weighted imaging (DWI-MRI) being a non-contrast based MR sequence versus dynamic contrast enhanced MRI (DCE-MRI) in the preoperative loco-regional staging of the cervical carcinoma.Methodology
Fifty cases of proved cancer cervix prior staging subjected to dynamic post contrast technique: one pre-and six post contrast phases (40?s each). DWI was scanned using different b values and ADC values were measured.Results
DWI was the most accurate in staging operable cases (93.3%).Parametrial infiltration was overestimated in 3 cases versus 4 cases in DCE-MR. DWI showed 100% sensitivity, positive predictive value and accuracy in the assessment of locally advanced carcinomas. In metastatic lymph nodes, DCE-MR showed the least accuracy of 86%.Conclusion
DWI is helpful in discriminating local from locally advanced cervical carcinomas. DCE-MR can delineate cervical carcinomas confined to the uterus and exclude bladder/rectal invasion. 相似文献14.
Mohamed Aboul-fotouh E. Mourad Ahmed Fathy A. Al Gebaly Manal F. Abu Samra 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):563-568
Background
Patients with pulmonary embolism have high mortality and morbidity rate due to right heart failure and circulatory collapse leading to sudden death. Multi-detector computed tomography MDCT can efficiently evaluate the cardiovascular factors related to pulmonary embolism.Objectives
To evaluate the diagnostic accuracy of multi-detector computed tomography (MDCT) in differentiation of between sever and non-severe pulmonary embolism groups depending on the associated cardiovascular parameters and create a simple reporting system.Patients & methods
Prospective study contained 145 patients diagnosed clinically pulmonary embolism. All patients were examined by combined electrocardiographically gated computed tomography pulmonary angiography-computed tomography venography (ECG-CTPA-CTV) using certain imaging criteria in a systematic manner.Results
Our study revealed 95 and 55 non-severe and severe pulmonary embolism groups respectively. Many cardiovascular parameters related to pulmonary embolism shows significant p value and can differentiate between sever and non-severe pulmonary embolism patients include pulmonary artery diameter, intraventricular septum flattening, bowing, superior vena cava and Azygos vein diameters, right and left ventricular diameters.Conclusion
Multi-detector computed tomography (MDCT) can be valuable to assess the severity of pulmonary embolism using the related cardiovascular parameters and leading the management strategy aim for best outcome. 相似文献15.
Tamer W. Kassem 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):141-145
Objective
The aim of this study was to monitor the incidence of complicated inferior vena cava (IVC) anomalies and evaluate the role of Multidetector Computed Tomographic Venography (MDCTV) in diagnosis and assessment of associated venous collaterals, lower limb deep venous thrombosis (DVT) or varicose veins (VV).Patients and methods
During two years duration 100 patients with clinical history and complains suggesting of DVT or VV were prospectively evaluated after performance of MDCTV examination. The images obtained were interpreted and reconstructed using dedicated software and work stations. Results were correlated with Color Doppler Ultrasound (CDUS) findings.Results
Out of 100 cases, 9 cases (9%) were diagnosed to have complicated IVC anomalies while 91 cases (91%) had either well developed IVC or common anatomical variations. 6 cases (66.7%) had complicated IVC anomalies and 3 cases (33.3%) had associated complicated common iliac veins (CIV) anomalies. 8 cases (88.9%) had associated DVT and all cases (100%) had bilateral VV. 2 cases (22.2%) had associated varicocele and 1 case (11.1%) had associated KILT syndrome.Conclusion
MDCT venography examination has a major role in diagnosis of complicated IVC anomalies and detection of associated venous collaterals, lower limb DVT or VV. 相似文献16.
Omar Hassanen Usama Ghieda Mohamed A. Eltomey 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):1117-1123
Objective
The prognosis of different histologic subtypes of RCC varies and affects management. Patients with chromophobe or papillary RCC have better prognosis than those with clear cell RCC. The aim of our work was to study the utility of DCE and DWI in the preoperative prediction of renal cell carcinoma subtypes, using histopathology as a gold standard method of diagnosis.Patients and methods
Thirty five patients with 38 renal masses were included in the study. All had DCE MRI studies with DWI sequences, CER and ADC values calculation for normal and diseased renal tissues.Results
The Mean ADC value of normal renal parenchyma was significantly higher than RCC. The CER and ADC values for Clear cell RCC were higher than Papillary and Chromophobe RCC. No statistically significant difference was found between the CER & ADC values for Papillary and Chromophobe RCC. CER & ADC values of clear RCC were higher than non clear RCC.Conclusions
DCE MRI in addition to DWI & ADC appears as a very helpful imaging tool in the differentiation between clear cell and non-clear cell RCCs. 相似文献17.
Mohamed M. Radwan Khaled M. Moghazi Nevine M.F. ElDeeb Mohamed E. Ibrahim Mohamed A. Sharaan Doaa M. Emara 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):771-778
Introduction
Cystic pancreatic lesions are currently discovered at higher rate, hence adequate characterization of these lesions by the radiologist is important in guiding management.Aim of the work
Was to identify the role of MRI in characterization of cystic pancreatic lesions.Patients and methods
Thirty patients with suspected cystic lesions of the pancreas were examined by MRI using 1.5?T machines including conventional MRI sequences, dynamic contrast enhanced imaging, DWI and IP/OP sequence.Results
The study included 30 patients (12 males and 18 females) with their age ranging from 16 to 88?years (mean age 55?years), MRI analysis of the cyst contents and communication with ductal system were used to characterize different cyst types, among these patients we found serous cystadenoma in five patients, mucinous cystadenoma in seven patients, mucinous cystadenocarcinoma in one patient, branch type Intraductal papillary mucinous neoplasms (IPMN) in seven patients, Mixed IPMN in two patients. Cystic neuroendocrine tumors (CNET) in three patients. Solid cystic pancreatic neoplasm (SPN) in two patients. Pseudocyst in one patient and walled off necrosis (WON) in two patients. Pathological assessment of the lesions was done whenever indicated.Conclusions
MRI with its superior soft tissue resolution is of value in characterization of different cystic pancreatic lesions helping to reach the correct diagnosis. 相似文献18.
Manar A. Bessar Hanan A. Hassan Wesam A. Mokhtar 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):971-975
Aim
The aim of this study is to evaluate the role of high resolution ultrasonography (HRUS) of the hip in premature neonates admitted to the neonatal intensive care unit (NICU) in diagnosis of septic hip arthritis.Patients and methods
This prospective study was done for twenty premature neonates having clinical and laboratory findings compatible with the diagnosis of acute septic arthritis. They were subjected to HRUS of the hip as well as US-guided aspiration and analysis of synovial fluid.Results
Hip ultrasonography showed synovial fluid containing echoes in twelve patients and was clear in six patients. Joint capsule was thickened in fourteen patients. Seventeen patients had sonographic features of septic arthritis. The sensitivity of HRUS was 93.8%, specificity 50%, positive predictive value 88.2%, negative predictive value 66.7% and the accuracy was 85%.Conclusion
HRUS is beneficial in early diagnosis of septic hip arthritis in premature neonates admitted to the NICU. It is an easy, available and rapid procedure. 相似文献19.
Tamer W. Kassem 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):621-626
Objective
The goal of this study was to highlight the role of follow up CT angiography examination in detection and classification of endoleaks and therefore deciding management plans after endovascular abdominal aortic aneurysm repair (EVAR).Patients and Methods
During one year duration 37 patients who have been operated were examined 1 and 6 months after EVAR as routine follow up. The images obtained were interpreted and reconstructed using dedicated software and work stations.Results
Out of 37 cases, 14 cases (37.8%) had positive endoleaks and 23 cases (62.2%) were free. Type I endoleak was diagnosed in 4 cases (10.8%) and type II endoleaks was diagnosed in 10 cases (27%) as 7 cases (18.9%) showed leak through lumbar arteries and 3 cases (8.1%) showed leak through the inferior mesenteric arteries.Conclusion
CT angiography can accurately detect and classify endoleaks and thus determine line of treatment. Endoleaks are often asymptomatic and may become evident intra operatively or many years after the operation, therefore lifelong imaging supervision is necessary. 相似文献20.
Ahmad Mohammad Ghandour Sherif El Ghazaly Tarek El Ghandour 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(2):425-429