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1.
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2.
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3.
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4.
Mennatallah Hatem Shalaby Khaled A. Ali Shehata Mohamed Amr Farouk 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):183-188
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5.
Mohamed Saeid Abdelgawad Mohamed Ihab Samy Reda Nermeen Abd El-Monsef Abd El-Maaboud 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(2):431-437
Our goal of this research is to assess the value of MR fiber tractography in assessment of inflammatory process and neoplasms of the cervical cord.
Patients
We included 40 patients diagnosed as inflammatory diseases and neoplasm of the cervical cord in our research. 17 patients with pathologically proved cervical cord neoplasms, including three patients with anaplastic astrocytoma, five patients with cellular ependymoma, two patients with anaplastic ependymoma, two patients with fibrillary astrocytoma, one glioblastoma multiforme (GBM), one with cervicomedullary glioma, two with metastasis and one hemangioblastoma. The remaining 23 patients were finally diagnosed as inflammatory processes of the cervical cord, through clinical examination, laboratory results and serial follow up. The latter category include ten patients with myelitis, eight with multiple sclerosis, three patients with post irradiation myelitis and two patients with neuromyelitis optica.Methods
MRI sequences including T2W (sagittal and axial), pre and post contrast T1 (Sagittal and axial) and diffusion tensor MR fiber tractography.Results
All the 17 patients with neoplasm of the cervical cord show more or less displacement of the cervical tract fibers, ten without fibers disruption and seven with fibers disruption. In all patients with inflammatory processes (23 patients) of the cervical cord no fibers displacement identified, but different grades of fibers disruption or sparse fibers.Conclusion
MR fibers tractography is a very promising tool in assessment of inflammatory processes and neoplasms of the cervical cord. 相似文献6.
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7.
Youssriah Yahia Sabri Marian Fayek Farid Kolta Mostafa Ahmed Khairy 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):569-580
Background
Diffusion-weighted imaging is a fundamental tool integrated in MR protocols useful in differentiating benign from malignant mediastinal masses, assessing mediastinal lymphadenopathy and investigating central bronchogenic carcinoma. This method is an excellent alternative to CT or PET/CT in the investigation of mediastinal masses. Current applications of diffusion MRI in malignancies include monitoring the treatment response and detecting recurrent cancer.Aim of the work
This study aims to assess the value of using MRI diffusion in differentiating benign and malignant mediastinal masses, differentiating central masses from post obstructive collapse and differentiating lymphoma versus sarcoidosis.Patients and methods
This study included 30 patients; 16 males and 14 females in the period from June 2013 to July 2014. The mean age was 49.3 ± 16.85 (range: 22–82 years).Cases were referred for MRI assessment and were approved by the ethical committee in our department.The complaints varied between dyspnea, chest pain, cough, hemoptysis, fatigue and loss of weight. A superconducting 1.5 T MRI machine with a four-channel body phased-array coil was used for the examination. Biopsy and histopathological assessment was done after that.Results
MRI examination with diffusion imaging was able to differentiate between benign and malignant mediastinal and hilar lesion confirmed by the biopsy and histopathology.Conclusion
MRI with diffusion weighted images can detect and stage lung cancer, differentiate benign from malignant mediastinal masses and differentiate lymphoma from sarcoidosis in mediastinal/hilar lymphadenopathy. 相似文献8.
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9.
Ahmed Ebraheem Ebeed Marwa Abd El-hamied Romeih Medhat Mohamed Refat Mohamed Hamdy Yossef 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):807-815
Purpose
To assess the role of dynamic contrast- enhanced and diffusion-weighted (DWI) MRI in the evaluation of the response of hepatocellular carcinoma (HCC) after chemoembolization.Patient & method
30 patients having 40 HCC lesions underwent transcatheter arterial chemoembolization (TACE). Ages ranged between 41 and 76?years. All examinations were performed using Philips 1.5 Tesla MRI (Achieva). Precontrast T1, T2, Dynamic contrast enhanced and respiratory triggered DWI MR images with (b?=?50, 400, 800?mm/s). DWI MRI images and Contrast-enhanced MRI images after TACE are assessed to evaluate post treatment response. DWI was used to create ADC maps and ADC values were calculated looking for a cut off value using the ROC curve.Results
Dynamic MRI had a sensitivity of 94.1%, a specificity of 95.6%, PPV value of 94.1%, NPV of 95.6% and an overall agreement of 95% compared to 82%, 73.9%, 70%, 85% and 77.5% respectively of DWI MRI. The difference between the malignant residual and well ablated groups' ADC variables was statistically significant P value 0.009.Conclusion
Dynamic and diffusion MRI complete each other in assessment of HCC response to therapy, especially in those who cannot properly hold their breath that cause degradation of the dynamic MR quality. 相似文献10.
Enass M. Khattab Ayman F. Ahmed Abd El Motaleb Mohamed Ayman M. Ismail Mona M. Amer 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):1027-1034
Objective
Conventional MRI does not provide sufficient information to differentiate post-radiotherapy necrosis from brain tumor recurrence, recent studies have investigated the use of more advanced imaging modalities that are able to differentiate between the two entities.Aim of the study
To assess the usefulness of combined apparent diffusion coefficient (ADC) value and single voxel spectroscopy (SVS) in the differentiation between recurrent brain gliomas and post-radiotherapy necrosis.Methods
Twenty-two patients with suspected tumor recurrence after surgical resection and radiotherapy treatment were included in our study. MRI with contrast, diffusion weighted MRI with ADC value and MR spectroscopy were done to all patients.Results
ADC values were ≤1.150?×?10?3?mm2/sec for recurrent high grade gliomas, >1.150–≤1.370?×?10?3?mm2/sec for recurrent low grade gliomas and >1.370?×?10?3?mm2/sec for post radiation necrosis. NAA/Cr ratio could significantly differentiate between recurrent gliomas and post radiation necrosis (p value?=?.019), also Cho/Cr was significant p value?=?.006. Also NAA/Cr and Cho/Cr were statistically significant in differentiating recurrent high grade from low grade gliomas (p value?<?.001).Conclusion
Combination of calculated ADC value and MR spectroscopy added more information and increase the accuracy of conventional MR imaging in the differentiation of patients with suspected recurrent brain glioma from post-radiotherapy necrosis. 相似文献11.
Mennatallah Hatem Shalaby Shady Samir Ahmed Deif 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):639-643
Objective
To compare the accuracy of 2D and 3D CT measurements of femoral anteversion angle, in pediatric patients with developmental hip dysplasia.Materials and methods
Twenty patients (20 hips) with unilateral non syndromic DDH were studies. CT scans were performed using a 16 slice CT scanner to measure the femoral anteversion angle (FAVA) using 2D & 3D techniques. Findings were correlated with the intra operative measurements.Results
There was a significant difference between 2D & 3D methods. Results of clinical assessment were comparable to results of 3D CT assessment which range from 30 to 50° with a mean of 37.5°. Mean percent difference between 3D and intra operative measurement of FAVA was significantly lower than the corresponding value between 2D and intraoperative measurement of FAVA.Conclusion
3D is more accurate than 2D in measuring the degree of FAVA in DDH patients. It is easily applied and rapid and doesn't require sophisticated software. 相似文献12.
Tamir A. Hassan Nesreen Mohey Hala Yehia 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):1009-1017
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13.
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14.
Mohamad H. Abowarda Hossam M. Abdel-Rahman Mahmoud M. Taha 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):207-213
Aim
To evaluate the role of using a single shot spin echoplanar DW sequence (SSSEP-DWI) compared to conventional MRI and contrast enhanced T1WI in differentiation between vertebral osteoporotic fractures and malignant compression fractures. The sensitivity and specificity of (SSSEP-DWI) will also be calculated.Patients and methods
Sixty-eight acute vertebral compression fractures in 41 patients were imaged using conventional MRI, fat suppressed contrast enhanced T1WI and DW sequence on a 1.5 T MR machine. Quantitative assessment of the abnormal signal intensity was done by measuring apparent diffusion coefficients (ADCs). Also, the areas of abnormal signal intensity were compared to adjacent normal marrow.Results
We had 38 benign fractures, and 30 malignant fractures. Post contrast enhancement showed sensitivity of 92% and specificity of 70% for malignant compression fractures. The hyperintense signal on DWI has 89% PPV for malignancy, while the sensitivity and specificity were 86% and 91% respectively. The mean ADC for malignant fractures was significantly lower than those of osteoporotic fractures (p = 0.0002).Conclusions
SSSEP-DWI is a reliable adjunct parameter that supports conventional MRI in differentiating benign and malignant vertebral fractures. 相似文献15.
Randa Osama Kaddah Mohsen Elsayed Khalil 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):169-178
Objective
To detect the value of MR Arthrography over MRI in evaluation of labral and chondral lesions in all types of FAI, and to correlate the findings with arthroscopy as a gold standard.Patients and methods
50 patients including 33 males and 17 females, age ranges from 19 to 54 years old (mean age 39 ± 5.5), underwent MRI and MR Arthrography of the hip joint followed by arthroscopy correlation. Images were evaluated for labral abnormalities, cartilage and osseous abnormalities associated in FAI. α angle. Acetabular lateral edge angle and degree of focal retroversion were measured.Results
Cam type detected in 20, Mixed type in 28, pincer type in 2, MRI detected 28 labral injury, 51 cartilage affection in 33 cases, MR Arthrography detected 38 labral injury, fraying of the L/C zone in 23 cases, 53 cartilage affection in 33 cases, cam type ch.ch by large α angle, anterosuperior femoral cartilage lesion and osseous bump formation; mixed type include the previous cam findings with a deep acetabulum and posteroinferior cartilage lesions. Anterosuperior labral (AS) tears are more common than postersuperior (PS).Conclusion
Hip MR Arthrography is a faithful evaluation modality for diagnosing the acetabular labral tears, and cartilage abnormalities associated with different types of FAI. 相似文献16.
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17.
Dalia M. Fahmy Mohamed G. Dawoud 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):553-562
Aim of the study
The aim of this study was to explore the role of the DWI in assessment of peri-anal fistula and whether it can replace post contrast study.Patients and methods
MRI examinations was done for 35 patients. Images were reviewed for the presence and number of visible fistulas, internal openings, secondary extension, horse shoe and abscess. Apparent diffusion coefficient (ADC) measurement of suspected fistula tracks and abscess cavities was done to assess activity. Comparison between TIRM, DWI and post-contrast T1-weighted fat saturated sequences was done. Surgical findings were the reference standard.Results
Contrast enhanced images were superior to DWI in detection of primary fistula and internal opening while they were equivalent in detection of secondary extensions and abscess. There was no significant difference in overall accuracy of detection of perianal fistula and its complications between combined (DWI and TIRM images) and post contrast images. There was significant difference between ADC values of active and inactive fistulae and between abscess and inflammatory reaction.Conclusion
Combined DWI and TIRM is equivalent to post contrast images in detection of primary and complicated fistula. DWI is useful in differentiation between abscess and inflammatory reaction, and assessment of disease activity. 相似文献18.
Alsiagy A. Salama Reda A. Alarabawy Mohammed M. Dawoud Hanaa A. Zayed Ahmed Soliman Ahmed El-Tantawy 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):189-199
Objectives
The objectives of our work were to determine disability and study MRI findings of occupational-related lumbar disc degeneration and also to show the relationship between MRI grading of nerve root compromise with surgical grading.Participants and methods
The study included 103 workers with lumbar disc prolapse. Nerve roots were assessed on MRI and during surgery for the degree of compromise. Oswestry Disability Index and Visual Analogue Scale were used for assessment of disability and pain intensity pre- and post-operative respectively.Results
The majority of workers was less than 40 years and suffered from moderate to severe disability. 73.8% had grade IV disc degeneration mostly at the level of L4/L5. Nerve root compromise was found in 86.4% of workers. 48% of nerve roots were deviated and 32% were compressed, with significant correlation between MR grading of nerve root compromise and surgical grading (r = 0.89, P < 0.0001).Conclusion
Disability of occupational-related lumbar disc degeneration is a grave health problem between construction workers. MR imaging is a reliable tool for grading nerve root compromise in disc degeneration. Nerve root compromise is a significant factor to explain pain than the morphologic extension of disc material outside the intervertebral space. 相似文献19.
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20.
Reham Farghaly Iman Zaki Iman Gouda Mohamed Abdelfatah Ahmed El Ghoneimy Magdy El Sherbiny Ranin Soliman Manal Zamzam 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(2):461-465
Histologic response to neoadjuvant chemotherapy is an essential prognostic criterion in osteosarcoma. Non-invasive assessment of the effect of neoadjuvant chemotherapy influences the timing and method of definitive surgery.