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1.
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2.
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3.
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4.
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5.
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6.
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7.
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8.
Purpose
We aimed to assess potential role of strain sonoelastography in diagnosing focal testicular lesions.Patient & methods
21 patients with 23 focal testicular lesions were subjected to sonoelastography. Compression was performed manually by the transducer upon the testis and monitored on the compression graph on the machine. Diagnosis was reached either by surgical resection, or follow-up.Result
23 focal testicular lesions were included. 10 lesions were in the right and 9 in the left, and 2 lesions are bilateral. Cases included 7 focal orchitis (30.5%), two hematomas (8.7%), 7 scar tissue (30.5%), 4 seminomas (17.4%), one choriocrcinoma (4.3%), one epidermoid cyst (4.3%), and one hydatid cyst (4.3%). On strain Sonoelastography; all four seminomas and 7 scars were of low strain, also the epidermoid cyst and the two hematomas were hard, while the 7 cases of focal orchitis showed high strain. The cases of choriocarcinoma and the hydatid cyst showed mixed strain patterns. Statistical analyses showed a sensitivity of 100% in identifying neoplastic lesions, with a specificity of 40%, a negative predictive value of 100%, and a positive predictive value of 37.5%.Conclusion
Strain Sonoelastography is useful adjunct method to differentiate benign from malignant focal testicular lesions. 相似文献9.
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10.
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11.
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.
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15.
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16.
Mohammad Fouad Abdel Baki Allam Mohamed Ahmed Ibrahiem Ahmad Fouad Abdel Baki Allam 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):201-206
Objective
The aim of this study was to assess the efficacy of quantitative MRI parameters using 1.5 T magnet in evaluation of MN in CTS.Patients and methods
From August 2015 and July 2016. Twenty patients diagnosed as having CTS and other ten healthy volunteers, underwent a quantitative MRI examination of the wrist with T2 SPAIR and DWI sequences. A computation of SIR, ADC values at different levels and ADC ratio was made.Results
There was significant increase in SIR in CTS patients at DRUJ and pisiform. SIR at pisiform was significantly correlated with operative documentation of bulbous nerve swelling. There was increase in mean ADC value of MN in CTS when moving from proximal to distal locations, in contrast to normal subjects. SIR and ADC value were specific especially when measured at the pisiform. Cutoff values of 1 for ADC ratio showed high Specificity, and Overall accuracy.Conclusion
Quantitative 1.5 T MRI is an accurate diagnostic tool in CTS. The increase in MN ADC value from proximal to distal with an ADC ratio cutoff value of 1 is highly accurate in diagnosing CTS. 相似文献17.
Youssriah Yahia Sabri Khaled Mahmoud Kamel Mona Ahmed Fouad Hafez Sara Mohamed Saleh Saleh Nasef 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):947-952
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18.
Ahmed H. Afifi Hany L. Abdel Shafy Adel A. Ramadan Mohamed A. Ataa Samir N. Assad 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):271-284
Purpose
To evaluate role of quantitative assessment of chemical shift MR imaging and chemical shift subtraction technique in differentiating adenomatous from non-adenomatous adrenal lesions with comparison of accuracy level of each technique.Materials and methods
A prospective study was carried out from 4-2014 to 5-2016 using 1.5T MRI. In-phase/opposed phase MRI sequences were applied for 52 patients having 58 adrenal lesions, 18 were hyper functioning and 40 were non-functioning. Lesions signal changes between in- and opposed phase sequences and post processing was done to calculate different quantitative chemical shift parameters using spleen, paraspinal muscle, and liver as a reference tissues. Additionally subtraction chemical shift MR technique on selected 16 cases was applied.Results
Signal intensity index and the two formulas of adrenal to spleen ratio were more accurate than other quantitative chemical shift MRI parameters in discrimination between adenomatous and nonadenomatous adrenal lesions with selected cutoff value 23.4% for the signal intensity index, 0.72 and ?27.82% for adrenal to spleen ratio% using the old and new formulas respectively. Chemical shift subtraction technique expressed significant difference between adenomas and non-adenomatous adrenal lesions where adenomas had ratio of 108.87 or more, and the non-adenomatous lesions had ratio of 47.74 or less with selected cutoff value 173.0475.Conclusion
The signal intensity index and adrenal to spleen ratio are the most reliable quantitative chemical shift MRI methods in differentiation of adrenal adenomas from other non-adenomatous adrenal solid lesions. Chemical shift subtraction MRI is a recent technique that gives highly confident discrimination between two categories of pathology without using of any reference organ. 相似文献19.
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20.
Mohamed Ali El Adalany Amal Abdel Sattar Sakarana Sherif Abdel Fattah 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):961-969