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1.
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2.
Mohamed Ali El Adalany Amal Abdel Sattar Sakarana Sherif Abdel Fattah 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):961-969
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3.
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.
Deb Kumar Boruah Rajanikant R. Yadav Kangkana Mahanta Antony Augustine Manoj Gogoi Lithingo Lotha 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):1187-1196
Objective
Vaginal or uterine outlet obstruction leads to hematocolpos or hematometra. Detection of the etiology of this entity is important to guide adequate surgical management and thereby avoid complications and to preserve fertility. The aim of this study was to evaluate obstructing vaginal malformations in adolescent girls presenting with hematocolpos or hematometra with MR imaging.Materials and methods
A hospital based prospective study was conducted in a tertiary care centre from September 2015 to October 2016. The study included 17 adolescent females who were evaluated with MRI.Result
Of 17 adolescent female with vaginal or uterine outflow obstructive anomalies with hematocolpos or hematometra, where 6 patients (35.3%) had HWWS, 6 patients (35.3%) had imperforate hymen, 2 patients (11.8%) had transverse vaginal septum, 1 patient each (5.9%) had cervico-vaginal atresia, unicornuate uterus and communicating rudimentary Uterine horn. MRI revealed hematocolpos in 15 patients (88.2%), hematometra in 13 patients (76.5%), endometriotic ovarian cysts in 6 patients (35.3%) and hematosalpnix in 3 patients (17.6%).Conclusion
Early radiological diagnosis of the cause of vaginal or uterine outflow obstruction is important to guide adequate surgical management which if undertaken promptly helps to avoid complications due to reflux from vaginal or uterine outflow obstruction. 相似文献6.
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7.
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8.
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9.
Kunwarpal Singh C.L. Thukral Kamlesh Gupta 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):653-660
Background
Characterization of tendo-ligamentous pathologies of wrist remains problematic, despite advances in imaging. By using clinical history and imaging appearance, one can determine the diagnosis. USG is used as first imaging modality whereas MRI aids in making a specific diagnosis of few of the lesions.Aims
To investigate the etiological spectrum of tendo-ligamentous pathologies of wrist on USG & MRI with statistical correlation.Patients and methods
80 patients (male/female = 46/34) with complaint of swelling or pain in wrist were included and underwent USG and MRI of both the wrists.Results
The spectrum included ganglion cysts, vascular malformations, tenosynovitis, tendinopathy, ligament tears and fibrosis. The analysis was done using kappa coefficient and spearman's rho correlation coefficient. The strength of agreement between USG and MRI for the diagnosis of ganglion cysts, vascular malformations, tenosynovitis and tendinopathy was found to be very good.Conclusion
USG provides detailed depiction of superficial structures, is less expensive, and allows dynamic examinations of the wrist. It should be the first choice of investigation for majority of the cystic, tendinous, vascular, and fibrotic pathologies of the wrist. However, less promising results were observed for ligamentous pathologies on USG in our study. 相似文献10.
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11.
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12.
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13.
Mohamed I. Yousef Medhat M. Refaat Mohamed H. Faheem 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):817-824
Aim
To evaluate accuracy of DWI in evaluating HCC response to DEB TACE and compare the results with DCE MRI.Material and methods
42 patients with 59 lesions underwent precontrast abdominal MRI, DWI, ADC map with ADC value measurement and DCE MRI. The qualitative DWI and ADC values were correlated to the DCE MR findings.Results
Comparing the qualitative DWI findings to DCE MRI, showed sensitivity of 83.9%, specificity of 64.3%, positive predictive value of 72.2%, and negative predictive value of 78.3% and overall accuracy of 74.5%. The measured ADC values showed significant difference (P value <0.05) between the ADC values measured in the active tumoral areas and necrotic areas with no significant difference between areas of active tumoral enhancement in the different groups. ROC analysis for ADC values showed area under curve 0.7 and maximum combined sensitivity and specificity of 79% and 69.6% respectively at cutoff ADC value of 1.395?mm2/sec.Conclusion
DWI is useful highly sensitive technique in evaluation of HCC response to DEB TACE, yet it has low specificity related to high number of false positive results preventing using it solely. Also, DWIs is a reliable method in differentiation between active tumor residue/recurrence and benign perilesional enhancement. 相似文献14.
Aya S. Al-Rawy Mohammad al-Shatouri Mohammed El Tabbakh Azza A. Gad 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):877-884
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15.
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16.
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17.
Susan A. Ali Mohamed G. Mansour 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):251-256
Purpose
The goal of the study was to highlight the added value of combined DWI and conventional MRI in detecting clinically nonpalpable undescended testes.Patients and methods
Prospective study included 60 males referred for MRI evaluation of clinically diagnosed 66 nonpalpable undescended testes. MRI studies were performed using 1.5-T MRI machine and included axial and coronal spin-echo T1WIs, axial T2WIs, axial and coronal fat suppressed spin-echo T2WIs, and axial DWIs using three sets of b value (50, 400, and 800 s/mm2). All images were transferred to an independent workstation and evaluated by two radiologists for the presence or absence and location of the undescended testes. The findings were compared to laparoscopy results, and then, sensitivity, specificity, and accuracy were calculated for both conventional and combined (DWI and conventional) MRI.Results
According to laparoscopic findings, sensitivity, specificity and accuracy of conventional MRI were 73.91%, 100%, and 80% and 69.57%, 100%, and 76.67% for radiologists 1 and 2 respectively, and of combined MRI were 86.9%, 100%, and 90% and 82.61%, 100%, and 86.67% for radiologists 1 and 2 respectively.Conclusion
Adding DWIs to conventional MRI improves the sensitivity and accuracy of detecting clinically nonpalpable undescended testes. 相似文献18.
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.
Aim
This study evaluated the use of Dynamic Contrast Enhanced-MRI (DCE-MRI) in preoperative estimation of residual viable tumor present in Osteosarcoma following chemotherapy.Patients and methods
We conducted a prospective study from July 2011 till April 2013 on 50 pediatric patients with a mean age of 12.8 years diagnosed as Highgrade osteosarcoma in long bones at the Children Cancer Hospital Egypt.Conventional and dynamic MRI performed before definitive surgery was compared with histopathology assessment of necrosis. For DCE-MRI, 3 regions of interest (ROIs) were chosen and the signal intensity was plotted against time. Signal intensity values and curve pattern were compared to percent of necrosis of the corresponding areas on the resected specimens.Results
DCE-MRI showed sensitivity of 92.5% and specificity of 96% with positive predictive value of 92% and negative predictive value of 96%. Negative correlation was found between signal intensity values and percent of necrosis.Conclusions
DCE-MRI can be used preoperatively as a sensitive, specific, and non-invasive method for detection of viability and necrosis within osteosarcoma. 相似文献19.
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20.
Nadia F. El Ameen Mohamed F. Amin Ahmed kotb 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):999-1004