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1.

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.

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   

3.

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   

4.

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   

5.

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   

6.

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   

7.

Objective

This work aimed for using multislice computed tomography (MSCT) to map the bronchial tree and assess the exact site, direction, airway findings and bronchial measurements to guide trans-bronchial lung biopsy from an inaccessible lung lesion.

Patients and methods

This study was carried on 26 patients. It was conducted in the Radiology Department, in collaboration with Chest Department, in the period from January 2015 to April 2016. All patients were subjected to Virtual Bronchographic (VB) examination and Trans-Bronchial lung biopsy (in selected cases guided by the VB results).

Results

In this study, MSCT-VB maps guided the fiber-optic bronchoscopy in 30 bronchial lesions in 26 patients to the proper sampling site for different lung lesions with success rate 100% and CT maps were done, reaching 3rd to 7th order bronchial generation with mean distance from central bronchi was 21.3?mm and mean target bronchial diameter was 1.9?mm. Right sided lesions encountered in 57.7% and left sided lesions in 42.3% with the most common segmental affection was the right upper lobe in 36.7% of bronchial lesions and the apico-posterior subsegment of left upper lobe in 23.3% of lesions, then planning according to the site of the lesion in relation to the bronchial tree in the VB was done. Histopathological assessment was done with 61.5% neoplastic lesions and 38.5% inflammatory lesions.

Conclusion

Multiplanar reconstruction images together with virtual bronchographic images were accurate in the detection of lesion’s site, depiction of degree of narrowing, and distal visualization of airways. This CT map should be used to guide bronchoscopy or to direct trans-bronchial needle biopsy to guarantee positive histopathological results.  相似文献   

8.

Objective

To investigate the therapeutic response of radiofrequency ablation for treatment of hepatocellular carcinoma and the consequence of portal hypertension on the survival final results.

Patients & methods

168 patients with portal hypertension undergo radiofrequency ablation in the act of treatment of HCC (≤5?cm). Therapeutic response and prognostic outcomes were then analyzed. Overall survival was assessed using Kaplan-Meier method and multivariate analysis was achieved using the Cox regression model.

Results

Primary and secondary complete ablation of HCC was obtained in 86.3% & 100% of patients respectively. Complication occurred in 13.6% of patients, and thrombocytopenia and prolonged prothrombin time were independent risk factors of complication. Overall survival after the follow-up period of about 25?months was 74.4%. Two elements based on multivariate analysis had been recognized as prognostic factors for poor survival: Thrombocytopenia (HR?=?1.008, P?=?.004), and left lobe location of the tumor (HR?=?0.392, P?≤?.03).

Conclusion

This current study has shown that most cirrhotic patients with portal hypertension can tolerate RF ablation of HCC. The improved patient selection in terms of simple parameters such as platelet count, and prothrombin concentration, we will improve the outcome of RF ablation.  相似文献   

9.

Introduction

Radiographic findings of the shoulder joint have been reported in patients with rotator cuff tear, greater tuberosity changes are among the most reported.The aim of this work is to assess the greater tuberosity sclerosis as a radiographic sign of rotator cuff tear and its relation to the tear size.

Patients and methods

This study was conducted from July 2009 until May 2013 in a retrospective fashion and included 425 patients, 250 females (58.8%) and 175 males (41.2%).

Results

Sclerosis was detected in 398 cases out of 425 patients (93.6%). Of those, 360 (90%) were found to have a tear of the rotator cuff documented on M.R.I. Also greater tuberosity sclerosis being more prominent with large-sized tears. One hundred (23.5%) patients had been operated arthroscopically and a tear documented intraoperatively (Table 2).

Conclusion

Greater tuberosity sclerosis has both high sensitivity and positive predictive value for rotator cuff tear. Also greater tuberosity sclerosis is found more with large-sized rotator cuff tears.  相似文献   

10.

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   

11.

The aim of the study

Is to compare the role of minimum intensity projection (MinIP) images with that of volumetric high resolution computed tomography (HRCT) images in the diagnosis of interstitial lung diseases (ILD).

Patients and methods

180 patients (149 females and 31 males) were included in this prospective study that took place over a duration of two and half years. All patients underwent HRCT and MinIP images. The positive findings were compared recording which technique was better and if MinIP adds a value in reaching an accurate diagnosis.

Results

MinIP images showed better visualization of traction bronchiectasis, ground glass opacities and mosaic attenuation pattern, as well as, the cystic lung changes seen in LAM. While MinIP did not add a significant value in thick-walled cystic changes e.g.: honeycombing.

Conclusion

MinIP is one of the multiplanar techniques of HRCT that proved throughout our study to be an informative complementary tool increasing the observer confidence and agreement regarding some findings as compared with HRCT alone.  相似文献   

12.

Background

Magnetic resonance (MR) provides detailed information for the depiction of shoulder lesions. It allows a unique anatomical and tissue characterization providing a detailed evaluation of the rotator cuff (RC) and the surrounding bones.

Purpose

Our objective is to assess the diagnostic accuracy of MR in depiction of lesions encountered in shoulder impingement and rotator cuff (RC) degenerative lesions compared to shoulder arthroscopy.

Patients and methods

This study included 28 patients with shoulder impingement for which conventional MR was done followed by arthroscopy. The results of MR were compared to the results of surgical repair.

Results

MR was highly accurate in the diagnosis of full-thickness (FT) tears of the RC, showing 100% accuracy, 100% sensitivity, and 100% specificity. MR was capable of comprehensive evaluation of FT tears. MR had a high accuracy (96%) in the diagnosis of partial-thickness (PT) RC tears. It showed 100% specificity and 100% positive predictive value (PPV) with no false positive cases. MR revealed high specificity (100%) in the diagnosis of biceps abnormalities. It identified all the 20 negative cases that were confirmed surgically.

Conclusion

Conventional MR plays an adequate role in evaluation of different lesions encountered in shoulder impingement and RC degenerative disorders.  相似文献   

13.

Aim of the work

The aim of this study was to assess the utility of non-enhanced MRCP in reduction of biliary complications in LDLT donors and compare the results with IOC.

Patients and methods

A total of 54 potential donors with preoperative MRCP (45 males, 9 females, age range 22–51 years). A total of 50 donors underwent right lobe resection and had IOC for comparison. The MRCP and IOC reports were reviewed.The MRCP was performed on 1.5 T MR magnets. Specificity, sensitivity and accuracy were analyzed and compared with IOC findings.

Result

A total of 50 donors underwent MRCP and IOC.The findings were classified according to Yoshida et. al.’s study: 42.6% with type 1, 5.6% with type 2, 25.9% with type 3, 7.4% with type 4, and 18.5% with type 8. In comparison with MRCP findings with the golden standard IOC, the sensitivity, specificity and the diagnostic accuracy of MRCP were calculated:Sensitivity was of 88.2%), specificity was of 94.2% and accuracy was of 92%.

Conclusion

Biliary complications remain common in LDLT. MRCP has potential in preoperative biliary evaluation for LDLT donors to minimize the postoperative biliary complications.Further improvements of MRCP in LDLT are required to increase its quality and accuracy.  相似文献   

14.

Aim of the work

To evaluate the role of fast imaging employing steady-state acquisition (FIESTA) together with conventional MRI and MR myelography (MRM) sequences in evaluation of brachial plexus traumatic roots injury in adults in correlation with surgical outcome.

Subjects and methods

This prospective study included 20 patients (their mean age was 22.6?years). All patients came with initial clinical diagnosis of traumatic brachial plexus and positive electrodiagnostic tests. All underwent conventional MRI, FIESTA and MRM and the imaging findings were correlated with surgical outcome.

Results

Combined evaluation of the conventional MRI, FIESTA and MRM sequences yielded highest diagnostic sensitivity (95%) of pseudomeningocele and non-visualized nerve root detection which are the most important marks of brachial plexus root injury compared to conventional MRI combined with FIESTA (90%) and to conventional MRI combined with myelography (85%)

Conclusion

In traumatic brachial plexus root injury, it is vital to differentiate between pre- and postganglionic injuries. Combined conventional MRI/FIESTA/MRM depicted root injury has the highest sensitivity in detection of psuesdomeningiocele and non-visualized nerve root.  相似文献   

15.

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.

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   

17.

Objective

To detect the diagnostic efficiency of sono elastographic strain ratio in discriminating malignant from benign solid breast masses and compare it with the sono elastographic elasticity score method.

Patients and methods

This study included 120 histopathologically diagnosed solid breast masses from 120 females (mean age 38.2?years). Elastography score and strain ratio (SR) were performed for each mass. Receiver operating characteristic (ROC) curve was plotted for both methods.

Results

The benign lesions had significant lower SR (mean 2.12?±?1.72) than that of malignant lesions (mean 6.91?±?3.96). The AUC from ROC curve was 0.98 for elasticity score and 0.99 for SR. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the elasticity score in the diagnosis of solid breast masses were 100%, 88%, 83.3%, 100% and 92.5% respectively, and of the strain ratio were 93.3%, 97.3%, 95.5%, 96.1% and 95.8% respectively (when cutoff value 3.77 was used). There is no statistically significant difference found between both methods.

Conclusion

SR has high diagnostic performance in differentiating malignant from benign solid breast masses, however there is no statistically significant difference between SR and elasticity score.  相似文献   

18.

Objective

The aim of this work is to assess the role of MRI in the diagnosis of ACL graft failure and detection of complications that may follow ACL reconstruction.

Patients and methods

This study included 55 patients (50 male & 5 female) with age ranged from 18 to 60?years with a mean age of 32y. All patients underwent MRI using sagittal T1WI, T2WI, proton density WI, and axial T2 and coronal STIR images. MRI images were assessed by two radiologists who were blinded to each other. Arthroscopic knee examination was considered as a gold standard of reference.

Results

Observer one found that the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of MRI in the detection of ACL graft failure were 97.8%, 80%, 95.6%, 88.9 and 94.5% respectively. Observer two found that MRI has a sensitivity of 95.6%, specificity of 70%, PPV of 93.5%, NPV of 77.8% and accuracy of 90.9%.

Conclusion

MRI is considered as a reliable method for assessment of ACL graft failure and detection of complications following ACL reconstruction.  相似文献   

19.

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   

20.

Objectives

To create a systematic approach using computed tomography (CT) and magnetic resonance imaging (MRI) findings to facilitate identifying the etiology of hearing loss, evaluating the anatomy for surgery, and predicting complications.

Methods

Twenty nine pediatric patients with congenital or acquired sensory-neural hearing loss (SNHL) requiring cochlear implant (CI) were included. They underwent combined CT, 3D DRIVE MRI axial plane and axial T2WIs for the whole brain. The inner ear, cochlear nerve development, temporal bone anatomy, operative window, normal variants and causes of central hearing loss were assessed.

Results

CT showed that 100% of the patients are suitable for CI while MRI showed that 96.5% of studied patients are suitable. The examined ears were categorized into 4 groups according the candidacy for operation; 86.2% were suitable for CI, 5.1% were suitable for CI but with expected poor response, 1.7% of examined ears were suitable for CI with modification of surgical procedure and 6.8% were not suitable for CI.

Conclusion

In Suez Canal area, the combined CT/MRI approach categorized the majority of patients with SNHL (96.6%) as good candidates for CI.  相似文献   

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