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1.
Ahmed A. Baz Ahmed M. Gad Mohamed R. Waly 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):125-132
Chronic plantar fasciitis (PF) is, by far, considered one of the commonest causes of foot complaints; constituting up to 15% of the foot symptoms that needs medical care in adult and active subjects.
Purpose
Is to confirm the clinical diagnosis of plantar fasciitis by ultrasound and to depict the effect of ultrasound guided injection of PRP in such cases.Methods
The study was conducted on 44 patients with chronic plantar fasciitis not responding to conservative treatment, they were diagnosed and were treated by ultrasound guided PRP injection then followed-up after 4 months by both clinical and ultrasound examinations.Results
By ultrasound mild improvement in plantar fascia thickness from 6.04 mm (mean of pre injection) to 4.93 mm (mean of 4 months post last injection). By VAS, significant improvement from 8.14 (mean of pre injection) to 2.59 (mean of 4 months post injection). By Roles and Maudsley score, significant improvement from 81.8% of patients who were acceptable and 18.2% were poor (pre injection) to 59.1% became excellent, 31.8% good, 4.5% acceptable and 4.5%poor (4 months post injection).Conclusion
Ultrasound is a confirmatory diagnostic tool of PF and PRP ultrasound guided injection is recommended after failure of conservative treatment. 相似文献2.
Role of Ultrasound Guided Platelet-Rich Plasma (PRP) Injection in Treatment of Lateral Epicondylitis
Enass M. Khattab Mohamad H. Abowarda 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(2):403-413
Background
Lateral epicondylitis is referred to a degenerative disorder that affects the common extensor tendon (CET) where it attaches to the lateral epicondyle of the humerus. Nowadays, one of minimally invasive interventions is platelet-rich plasma (PRP) injection that had been explored in some controlled clinical studies to show its effectiveness in treating lateral epicondylitis through inducing inflammation rather than suppressing it.Objectives
The aim of our study was to investigate the effectiveness of ultrasound guided platelet-rich plasma (PRP) injection in treating chronic lateral epicondylitis in addition to identifying the potential sonographic morphological changes in the common extensor tendon (CET) after PRP injection.Results
Statistical analysis showed high significant improvement in all ultrasound findings of common extensor tendon (CET) including echotexture, thickness, cross section, partial tear and calcification in majority of patients.Conclusion
We concluded that US-guided platelet-rich plasma (PRP) injection for treatment of lateral epicondylitis was a safe, minimally invasive and effective procedure in improving the sonographic and pathological changes of common extensor tendon (CET). 相似文献3.
Mohamed H. Shaaban Raafat M. Reyad Hossam Z. Ghobrial Rania H. Hashem 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(1):71-75
Objective
To assess the efficacy and safety of fluoroscopic–guided versus ultrasound (US)-guided techniques for pulsed radiofrequency (RF) therapy of stellate ganglion for refractory neuropathic pain syndromes.Methods
40 patients with severe chronic neuropathic pain syndromes, Visual Analogue Scale (VAS) score?>?7, with poor response to medical treatment were randomly integrated into 2 groups: Group (F): (20 patients) in whom pulsed R.F. therapy is done under fluoroscopy, group (U): (20 patients) in whom pulsed R.F. therapy is done under US guidance.Results
The current study revealed that there is significant reduction of VAS, and of the medical treatment consumption after the block as compared with pre block values, there is no statistically significant difference between the guidance techniques of RF treatment in pain relief. However, the procedure time was significantly lower in U group.Conclusion
Pulsed R.F. blockade of the stellate ganglion in patients with refractory neuropathic pain syndromes can be done safely and efficiently under the guidance of either ultrasound or fluoroscopy. Both radiological techniques provide similar satisfactory guidance without significant complications. 相似文献4.
Mohammad Fouad Abdel-Baki Allam Mostafa Mohamed Mostafa Elian Ahmad Fouad Abdel-Baki Allam 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):394-399
The wrist joint is a complex joint containing several intrinsic and extrinsic ligaments that contribute to carpal stability. There is increased incidence of ligamentous/capsular injury following trauma.
Objective
The aim of this study was to assess the value of high resolution MDCT arthrography in detection of various ligamentous and capsular injuries of the wrist in post-traumatic writ pain.Patients and methods
From August 2016 to February 2017 Seventeen patients with posttraumatic wrist pain underwent MDCT arthrography primarily through radiocarpal injection and using high resolution study, all patients have negative MRI study of the wrist.Results
59% of cases had ligamentous/capsular tear. The most frequent was the capsular tears. Incomplete intrinsic ligament tears were observed, the dorsal scaphotrapezio-trapezoid ligament was the commonest to be affected. Class IA traumatic TFC tear was found in 12%. There was significant high positive correlation between the VAS score for wrist pain and the presence of ligamentous/capsular tear in absence of bone fracture.Conclusion
MDCT arthrography of the wrist is an excellent imaging method that can detect MRI occult ligamentous tear in unexplained post traumatic pain. 相似文献5.
Ahmed M. Abd El-Khalek Nehal Tharwat Mohammed El-Sayed Hatem Elalfy Tarek Besheer Khaled Farid Mohamed ElAgezy Wagdi Elkashef Ahmed Alhawarey Mahmoud El-Bendary Ali Hasan Elmokadem 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(3):797-803
Introduction
Percutaneous treatment of simple or hydatid liver cysts is widely used in clinical practice and ethanol is the commonest sclerosant used. Abdominal discomfort and pain commonly occurs after ethanol injection which increase with increased ethanol volume.Purpose
To evaluate the safety and efficacy of the combination of tetracycline and ethanol for percutaneous sclerotherapy of either symptomatic simple hepatic cysts or unilocular hepatic hydatid cysts.Patients and methods
A total of 34 adult patients with symptomatic simple cyst and 36 unilocular hydatid cysts underwent clinical, laboratory and radiological evaluations followed by diagnostic cyst aspiration. Each was divided into 2 arms. The first arm was treated by ethanol sclerotherapy and the second was treated by combined ethanol and tetracycline sclerotherapy.Results
Combined ethanol and tetracycline sclerotherapy was associated with fewer sessions than ethanol sclerotherapy (P?=?≤0.001) and higher rate of sustained cyst size reduction on follow up (P?=?≤0.001). Also second arm was associated with less pain than alcohol alone due to the beneficial effect of tetracycline. Conclusion: combined ethanol and tetracycline seems to be more effective, non expensive, more sustained action and more comfortable to our patients than single ethanol use. 相似文献6.
7.
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8.
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9.
Rehab Abdel Rahman El Bakry 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):529-535
Objectives
Comparison between digital mammography alone and with adding digital breast tomosynthesis in breast cancer screening.Patients & methods
143 females underwent digital mammography, digital breast tomosynthesis and breast ultrasound.Results
DBT+DM decreased recall rate by 38% in BI-RADS 0. From BI-RADS I till BI-RADS V DBT+DM showed more accuracy than DM. In BI-RADS IV DBT+DM decreased false positive results by 33%.Conclusion
Adding digital breast tomosynthesis to digital mammography improves the diagnostic accuracy in breast cancer screening. 相似文献10.
Ahmed M. Bassiouny 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):374-377
Objectives
To assess the efficacy of radiofrequency ablation of Morton's neuroma (MN) as a substitute to surgery, in patients not responding to conservative treatment.Methods
15 patients, who performed radiofrequency ablation (RFA) of Morton's neuroma between November 2015 and December 2016, were submitted to follow up to assess the response to therapy over a period of 6?months by assessment of pain relief through visual analogue scale (VAS) scale from 1 to 10 from least to severe pain.Results
All of the 15 patients suffered from intense pain during their normal daily activity prior to RF ablation, pretreatment VAS average was 7.Follow up of the patients was done after 1?week, 1?month, 3?months and 6?months.After RF ablation, pain disappeared in 9 cases (60%), 3 had mild pain (20%), 2 moderate pain (13.3%) and 1 with severe pain (6.6%) and proceeded to surgery. Complete resolution of pain was encountered in the patients with mild and moderate pain with conservative or second session of RFA.Conclusion
Radiofrequency ablation of Morton's neuroma, is an effective technique in treatment of symptomatic patient's after failure of conservative treatment and prior to surgical intervention. 相似文献11.
Ahmed A. Baz Talaat A. Hassan A.T. Atta Mohamed S. El kholy 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(3):776-781
Objective
Evaluating the role of MRI lymphangiography with the intracutaneous injection of gadolinium in the assessment of the lower extremity lymphatic vessels in primary lymphedema.Patients and methods
The study was conducted on 20 patients (had 26 affected extremities) with primary lymphedema. All were evaluated by MRI lymphangiography with the intracutaneous injection of gadolinium in the digital web spaces of the feet.Results
The patterns of the lymphatic pathways in the affected lower limbs were classified in this study into five patterns. Pattern (I) was seen in 53.84% (n?=?14), pattern (II) was seen in 26.92% (n?=?7), pattern (III) was seen in7.69% (n?=?2), pattern (IV) was seen in 3.84% (n?=?1) and pattern (V) was seen in 7.69% (n?=?2) of the affected extremities.Conclusions
MRI lymphangiography with the intracutaneous injection of gadolinium had the potentiality for being the main diagnostic modality in primary lymphedema patients especially those who are candidates for microsurgical reconstruction through providing better visualization of the precise lymphatic anatomy by a feasible, minimally invasive and safe technique. 相似文献12.
Reem Hassan Bassiouny Rasha Tolba Khattab 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(4):934-947
Purpose
To analyze the diagnostic value of multi-detector CT enterography (MDCTE) in identifying small bowel causes of acute non traumatic abdominal pain and in determining the extent of bowel lesion.Patients and methods
A total of 73 patients (42 males and 31 females aged from 12 to 85?years) who presented with acute non traumatic abdominal pain and were evaluated with computed tomography enterography (MDCTE) between August 2014 and July 2017 were enrolled in the study. The diagnostic value of MDCTE was analyzed by using the results of other imaging modalities, endoscopy, surgery, pathology and clinical follow-up as the reference standards.Results
MDCTE correctly made the diagnosis in 66 of 73 patients (true positive), 7 cases were missed by CTE findings (false negative cases) and one case of ileus was falsely diagnosed as small bowel obstruction with an overall sensitivity of 90%, specificity?=?93%, PPV?=?98%, NPV?=?71%. The diagnostic accuracy of each CT sign was calculated independently for each underlying etiology.Conclusion
The use of MDCTE may be of significant value in identifying the cause of acute abdominal pain of small bowel etiology, in determining disease activity in inflammatory causes and identifying the level and cause of obstruction in SBO. 相似文献13.
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14.
Susan Adil Ali Mohamed Gamal El-Din Mansour Omar Farouk Walid E. Mohammed 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(3):892-898
Purpose
to evaluate the role of three dimentional power doppler ultrasonography (3D PDUS) of the uteroplacental circulation in early pregnancy as a screening tool for prediction of preeclampsia.Patients and methods
50 pregnant women who came to do routine ultrasound scan between 11 and 13.6?weeks of pregnancy during the period from February 2016 to April 2016. Placental volume and vascularization indices were obtained, and vascular index (VI), flow index (FI), blood vessels and blood flow index (VFI) were calculated by three-dimensional Doppler histogram.Results
Of the included 50 pregnant women, 22% developed preeclampsia and 78% did not develop preeclampsia. The placental blood flow perfusion in patients with pre-eclampsia had a lower VI, FI and VFI compared to non preeclamptic women with highly significant statistical difference (P?<?0.001)Conclusion
3D PDUS can be used as an effective screening tool to predict preeclampsia in early pregnancy. 相似文献15.
Magdy Mohammed EL Rakhawy Nehad Mahmoud Fouda Nahed Abd El-Gaber EL Toukhy Amr Fathy Abo EL Ftouh Dina harb Mohamed Mahmoud 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(4):1145-1154
Back ground
In some patients suffering from chest pain, we must start by non-invasive coronary CT angiography (CCTA) to protect these patients from unnecessary invasive coronary catheter angiography (CCA).Objective
Value of CCTA as the first diagnostic imaging modality in patient suffering from chest pain.Patients and methods
A total number of 100 patients were included in this study with mean age of 53.51?±?11.6 years. Our patients were divided into two groups, group (A) included 60 patients underwent both CCTA and CCA and group (B) included 40 patients underwent CCTA only. Then Framingham Risk Score was applied for 68 cases (68%) after exclusion of cases with previous coronary artery intervention as CABG or stent (32 cases).Results
We were calculated a cutoff point of Framingham Risk Score at which p value <0.001, sensitivity 85.7%, specificity 51.5%, PPV 65.2%, NPV 77.3% and accuracy 69.1%, it was 7.5%. The diagnostic statistics of MDCT for CABG with sensitivity (100%) and specificity (100%).Conclusion
It is reasonable to start with CCTA in patients with Ferminghaim Risk Score less than 7.5%, filtering the patients to avoid unnecessary CCA. CCTA should be the first imaging modality in patients with CABG suffering from chest pain. 相似文献16.
Ahmed Mohamed Wafaie Kareem Mohsen Moussa Eman Mahmoud Ebeid 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(1):190-195
Objectives
Our aim in this study was to evaluate the efficiency of combined positron emission tomography and computed tomography (PET/CT), in the detection of the primary tumor origin in patients with cancer of unknown primary (CUP).Methods
PET/CT were performed for 52 patients with CUP. These patients presented with metastatic lesions that were proven pathologically, and no primary site was detected by previous investigations.Results
The number of patients with true positive primary tumor sites was 29 (55.8%), 4 patients with false positive results (7.7%), 9 patients with true negative results (17.3%) and 10 patients with false negative results (19.2%). The sensitivity was 74.4%, specificity was 69.2% and accuracy was 73.1%. Our positive predictive value in this study was 87.9% and our negative predictive value for this study was 47.4%.Conclusions
This study showed an advantage of PET/CT in the detection of the site of the primary tumor in patients diagnosed with CUP. 相似文献17.
Rania E. Mohamed Mohamed A. Amin Hazem M. Omar 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):627-637
Aim of this study
To appraise the value of CT-guided celiac plexus neurolysis (CPN) as an effective method for alleviating intractable pain in patients with unresectable pancreatic cancer.Patients and methods
22 patients (their ages ranged between 45 and 73 years) with severe pain due to unresectable pancreatic cancer were subjected to CT-guided CPN by 25–30 mL of 97% ethanol via anterior approach and single puncture technique. The pain intensity scoring, both before and after the procedure, was done using the Visual Analogue Scale (VAS).Results
All patients showed a significant pain reduction after CPN (P < 0.001), with peak reduction in the first day after CPN. Also, the mean ranks of analgesic requirements showed significant reduction (P < 0.001) and this reduction in analgesic requirements was maintained up to 3 months after the CPN. Less than half of the study population (45.5%) had some post-procedural adverse events, which were minimal and transient.Conclusion
The CT-guided CPN via using anterior median approach and single puncture technique with injection of 25–30 mL of 97% of ethanol is an ideal palliative treatment for controlling severe pain caused by unresectable pancreatic cancer, with a significant reduction in the analgesic requirements. 相似文献18.
Amr Farouk Ibrahim Moustafa Eman Faker Kamal Maher M. Hassan Mona Sakr Mohammed Mohammed Mohammed Gomaa 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(1):259-264
Objective
To evaluate the additive value of Contrast Enhanced Spectral Mammography (CESM) in the preoperative assessment of malignant lesions in dense breast parenchyma regarding multiplicity.Material and methods
The study included 160 women having heterogeneous dense breast parenchyma (ACR c and d) with suspicious lesions identified on sono mammography examination. All patients performed contrast enhanced spectral mammography to confirm or exclude lesion multiplicity. The number of lesions was calculated in the contrast high energy subtraction images with the reference standard being histopathological analysis.Results
Adding CESM to sono-mammography the accuracy in identifying multiple malignant lesion increased from 81.8% accuracy of sono-mammography up to 100% accuracy after adding CESM.Conclusion
Contrast enhanced spectral mammogram showed an added value in the preoperative assessment of breast masses increasing the accuracy of detection of lesions and multiplicity (multifocality and multi-centricity). 相似文献19.
Sarah Mamdouh Osman Ikram Hamed Mahmoud Rafaat Mahfouz Riad Mohamed Hamed Shaaban 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(3):788-796
Aim of work
To study the efficacy of visceral neurolytic blocks in the abdominopelvic cancer when guided by ultrasound/CT.Patients and methods
50 patients were selected randomly and prospectively from the pain clinic in NCI suffering from moderate-severe visceral pain (visual analogue score?≥?4) due to advanced abdominal and pelvic malignancy. Patients were divided into celiac plexus block-CPB (n = 25), superior hypogastric block-SHPB (n = 12) and ganglion impar block-GIB (n = 8) groups according to site of pain and then randomly and almost equally divided into subgroups of U/S and CT. Recording of baseline and postprocedure/follow up of visual analogue score (VAS), morphine consumption which constitute the primary outcome as well as patient global impression of change (PGIC) which represents the secondary outcome/quality of life. Complications at anytime during follow up were documented.Results
There was significant (p < 0.001) reduction in post procedure VAS scores and morphine consumption after performing CPB and SHPB with satisfactory PGIC. Patients who performed GIB showed no significant change in pain scores or morphine consumption. There was a low complications rate with no major side effects.Conclusion
This study shows that guided sympathetic neurolytic blocks significantly reduce abdominal/pelvic cancer pain and analgesic consumption with no significant complications. 相似文献20.
Mohamed Saied Abdelgawad Rania A.M. Abouyoussef 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):299-303