共查询到20条相似文献，搜索用时 15 毫秒
1.
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2.
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3.
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4.
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5.
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6.
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7.
Wael Hamza Kamr Amir Monier El-Tantawy Manar Moustafa Osama Ahmed Abd-Elsalam 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):215-223
Acute disseminated encephalomyelitis (ADEM) is an inflammatory disease affecting the central nervous system (CNS) with multiple and variable neurological signs.
Aim of the study
To assess the diagnostic value of MR Diffusion in diagnosis of ADEM and its outcome predilection.Patients and method
A prospective study included 35 patients conducted for accurate history taking and meticulous clinical examination, radiological imaging including CT in 23 cases, contrast enhanced MRI and MR Diffusion for all cases. Further CSF laboratory investigations were done for all cases. All patients were followed up after I month from the first presentation, after 6 months, 12 months and after 18 months with repeated MRI examination.Results
Thirty-five patients were included in our study over a period of 3 years; 9 patients with no abnormality in diffusion WI, 10 patients with T2 shine through effect and 16 patients with restricted diffusion. On follow up, patients with no abnormal diffusion or T2 shine through effect respond to medication and shows complete recovery within 6 months. While the other 16 patients with initial restricted diffusion, 7 of them showed recovery within 6 months and other 9 patients showed other attacks and complete recovery on long run follow up till 18 months.Conclusion
MR Diffusion provides a great help in detection of the brain tissue changes in ADEM in addition to the predilection of the course and outcome of the disease. 相似文献8.
Amr F. Mourad Hosam El-din G. Mohammad Mona M. Sayed Mohamed A. Ragae 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):661-669
Objective
To evaluate the additional diagnostic value of diffusion and perfusion MRI in the differentiation of glioblastoma multiforme (GBM) and solitary brain metastasis.Patients and methods
This retrospective study included 24 patients with histologically proven brain tumors who underwent conventional MRI with analysis of diffusion (DWI) and perfusion (PWI) MRI findings of each tumor. The Apparent Diffusion Coefficient (ADC) values were calculated in the minimum (ADC-MIN), mean (ADC-MEAN), and maximum (ADC-MAX) in all the tumors and the peritumoral regions. The PWI data was expressed as maximum regional cerebral blood volume (rCBV) of the tumors and peritumoral regions.Results
After adding diffusion and perfusion to conventional MRI findings, we found that the accuracy of differentiation between glioblastoma multiforme (GBM) and solitary metastasis increased from 70% to 90%.There is a significant difference in DWI signal intensity between GBM and metastatic tumors (P < 0.05). The ADC values of GBM were lower than that of metastatic tumors. On perfusion MRI, the maximum rCBV of the peritumoral region (rCBVP) of GBM was higher than that of brain metastases (P < 0.001).Conclusion
The addition of diffusion and perfusion to the MRI protocol increases the accuracy of differentiation between GBM and solitary brain metastasis and should be considered routinely. 相似文献9.
H.M. Etman A. Mokhtar M.I. Abd-Elhamid M.T. Ahmed T. El-Diasty 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):153-160
Objective
To study image quality of MRI scanner using the American College of Radiology (ACR) phantom.Material and methods
Image quality of 1.5 T MRI scanner was tested using ACR phantom. A standard head coil with standard restraints was used to fix the phantom head position. The phantom included seven modules for measuring MRI scanner image quality. MRI images for each module were analyzed.Results
For the Geometric accuracy test the inside length of the phantom was 146 mm and the inside diameter was 189.4 mm. For the High-contrast spatial resolution, individual small bright spots on the image were three pairs of hole arrays and were distinguishable. For the slice thickness test, the top signal ramp length was 54.4 mm and bottom signal ramp length was 54.8 mm so the slice thickness was 5.46 mm. For the slice position accuracy, the bar length differences of intensity uniformity a value, called percent integral uniformity (PIU), was 96.15%. For the percent-signal ghosting, ghosting ratio was 0.0002. For the low contrast object detectability, the sum of numbers of complete spokes scored was 30 spokes.Conclusions
Image quality tests were very important in acceptance of any MRI scanner after installation and during maintenance. Using ACR phantom, these tests approve that the image parameters are acceptable. 相似文献10.
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11.
Moustafa Abdel Kader Hosny Sayed Abdel Ghani Zienab Moustafa Saad Nilly Helmy Abdalla Eman Abdel Razek 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):825-837
Aim
To assess the role of DW-MRI and ADC value in evaluation of hepatic focal lesions in cirrhotic patients compared to triphasic CT and dynamic MRI.Patients and methods
164 cirrhotic patients with hepatic focal lesions were subjected to full clinical examination and laboratory evaluations. DW-MRI with ADC value measurement was done for all patients in addition to triphasic CT and dynamic MRI. The radiological diagnosis was correlated to pathological results in all patients.Results
164 included cirrhotic patients (312 lesions), their mean age (57.7 ± 3.2). 206 lesions were diagnosed pathologically as malignant; hepatocellular carcinoma was the most common (83%), metastasis (32%) and cholangiocarcinoma (1.5%). 106 lesions were diagnosed pathologically as benign; hemangioma was the most common (61.3%), cirrhotic regeneration nodules (32.1%) and cysts (6.6%). The mean ADC values for malignant lesions were lower than those for benign lesions with significant P-value (0.007) and cutoff value 1.2 × 10?3 mm2/sec. DWI-MRI was more accurate in the assessment of HFLs (96.1% sensitivity, 98.1% specificity and 96.8% accuracy) than triphasic CT and dynamic MRI.Conclusion
DW-MRI with ADC value can be used in the assessment of HFLs in cirrhotic patients with comparable results to dynamic MRI and more accurate than the use of triphasic CT. 相似文献12.
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13.
Rania E. Mohamed Ashraf A. Aboelsafa 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(2):439-449
Background
Major depressive disorder (MDD) is one of the most commonly encountered psychiatric disorders in daily medical practice. Severity of depression may relate to thalamic neurochemical metabolic changes. Proton magnetic resonance spectroscopy (1H-MRS) can give an idea about the mechanisms that possibly underlie MDD and the response to therapy.Aim of the work
To detect the possible neurochemical metabolic changes that may occur in both thalami of patients with MDD by multivoxel 1H-MRS of the brain.Materials and methods
Forty-three drug-naïve patients with MDD and 15 age- and sex-matched normal controls were subjected to brain imaging with multivoxel 1.5 T 1H-MRS for measuring the NAA/Cho, NAA/Cr, Cho/Cr, mI/NAA and mI/Cr ratios in the thalamus bilaterally. The severity of depression was assessed by the Hamilton Depression Rating Scale (HDRS).Results
Patients with MDD showed a significant decrease in the NAA/Cr and NAA/Cho ratios in both thalami compared to normal controls (P < 0.05). Also, the severity of depression was significantly associated with decreased thalamic NAA/Cr and NAA/Cho ratios.Conclusion
The multi-voxel 1H-MRS can provide an insight to the neurochemical metabolic changes occurring in both thalami in patients with MDD. Increased severity of depression is significantly related to these thalamic neurochemical changes. 相似文献14.
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15.
Ahmed Elsammak S.M Shehata Mona Abulezz Ghada Gouhar 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):751-759
Objectives
To assess the role of DW-MRI and ADC values in distinguishing benign from malignant endometrial disorders.Patients and methods
Pelvic ultrasound, conventional MRI, DW-MRI and histopathologic examinations were done for 42 female patients with abnormal vaginal bleeding. Mean ADC values of endometrial lesions were calculated and compared.Results
Endometrial malignancies showed significant low ADC values (0.82 + 1.09 × 10?3 mm2/s) compared to benign lesions (1.44 + 0.15 × 10?3 mm2/s) (p: 0.000). Using 1.19 × 10?3 mm2/s as cut-off value for distinguishing malignant from benign lesions achieved 88.9% sensitivity and 100% specificity.Conclusion
DW-MRI is useful in distinguishing malignant from benign endometrial lesions and tumor staging as well. 相似文献16.
Haisam Atta Tarek M. Elsaba Hesham M. Hassan Moemen M. Hafez Hassan A. Aboellela Hisham Imam 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):733-739
Purpose
To compare the quantitative data of multiparametric prostatic MRI with Gleason scores of histopathological analysis.Materials and methods
One hundred twenty-two patients performed Multiparametric MRI of the prostate. Functional MRI quantitative data (including diffusion with mean ADC value and spectroscopic metabolic ratio) where the DWI is employing b 50, 400, 800, 1000 and 2000 sec/mm2 and multivoxel MR spectroscopy compared with of Gleason scores of histopathological results. Malignant cases are classified into three groups according to their Gleason score as group I with Gleason score ≤6, group II Gleason score 7, while Gleason score 8–10 stratified as Group III.Results
The histopathological analysis reveals 78 malignant cases and 44 benign Cases. The significant statistical difference between group I and the other two groups (p < 0.001) regarding the quantitative mean ADC value and metabolic spectroscopic ratio. No significant statistical difference between group II and III with p = 0.2 for mean ADC difference and p = 0.8 for the metabolic spectroscopic ratio with a weak negative correlation between ADCand Gleason score [rs = ?0.26] and significant positive correlation (p = 0.02) for MRSI metabolic ratio [rs = 0.2].Conclusion
The quantitative data of functional imaging of the prostate is reliable in evaluating prostatic cancer aggressiveness and proper construction of therapeutic plan. 相似文献17.
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18.
Mohammed M. Dawoud Khaled Abd Al Wahab Abo Dewan Shaimaa Ahmed Zaki Magdy Abd Al-Raoof Sabae 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):717-727
Aim and objectives
To evaluate the role of dual energy computed tomography in renal stones.Methodology
40 patients (18 male and 22 female) with renal stones were included, their age ranging from 24 to 65 years (mean age 33 years), all patients were scanned first with a standard low-dose renal stone CT, then Dual energy CT examinations were performed by using a single-source dual energy with fast switching between two kilovoltage setting using 80 kV and 140 kV focusing on the region of the stone.Results
Dual energy CT provide reliable distinction between uric acid, Ca oxalate and Cystine stones, it predicted chemical composition of the stones as 22 stones composed of calcium oxalate, 10 stones composed of cystine and 8 stones composed of uric acid. DECT failed to distinguish Ca oxalate from Ca phosphate in 4 stones also failed to identify the mixed composition stones in 3 stones comparing with result of crystallography after passage or extraction of the stone which misdiagnosed as ca oxalate stones.Conclusion
Dual-energy CT has been shown to be effective for characterizing chemical composition of the urinary stones and it will be replace helical non contrast CT as the standard imaging modality. 相似文献19.
Ahmed Hafez Afifi Tarek Abdel Samie Abdel Maksoud Khaled Ibrahim EL-noueam Mohamed A. Ataa Dina Mohamad Abdallah 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(2):493-507
Objectives
To evaluate role of multiparametric-MRI as comprehensive technique for determining local staging of UB cancer and predicting histological grading of lymphadenopathy.Materials and methods
Fifty patients diagnosed as cancer bladder prospectively included and mp-MRI data were interpreted. Multiparametric techniques included added role of high resolution T2 weighted images (HR T2WI), diffusion weighted MRI (DW-MRI) and dynamic contrast enhanced MRI (DCE-MRI). Accuracy of these techniques separately and in conjunction were evaluated using histopathological findings as reference gold standard. Diagnosis of bladder cancer was performed either clinically, through urine cytology or using other radiologic investigations including ultrasonography or computed tomography.Results
Histopathological confirmation for local T staging done in 40 patients (80%) using cystoscopy/biopsy or from transurethral resection of bladder tumors (TURT) and in 10 patients (20%) from radical cystectomy. Metastatic lymphadenopathy was histopatholgically proved after radical cystectomy in 5 patients (10%), of them 3 were stage N1 and 2 were stage N2. Diagnostic accuracy of mp-MRI (88%) was superior to DW-MRI (82%), DCE-MRI (74%) and high resolution T2W-MRI (52%) in differentiating non-muscle invasive from muscle invasive and in differentiating organ-confined from non organ-confined tumors respectively. The agreement between the mp-MRI and histopathological staging were greater than DW-MRI (κ = 0.679), DCE-MRI (κ = 0.566) and high resolution T2W-MRI (κ = 0.274). Over staging decreased from (48%) using high resolution T2W or (26%) using DCE-MRI, or (18%) using DW to (12%) using multiparametric-MRI. Low ADC values and time-intensity curve were compared with histological grades and showed significant correlation. Size criteria of the lymph nodes, their restriction and low ADC values in DW-MRI suggest their metastatic nature.Conclusion
Mp-MRI is comprehensive & effective tool for determining local T stages, and the histological grades of urinary bladder cancers. Also, it predicts nature & stages of local lymph nodes, exhibiting high diagnostic performance with excellent objectivity. 相似文献20.
Samira Saraya Lamia Adel Asmaa Mahmoud 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(2):547-552