No abstract

Congenital pulmonary arteries anomalies included a wide-ranged spectrum of pathology that is usually associated with other congenital heart diseases. These anomalies can be classified into several major categories, which show considerable overlap among those categories. The aim of this study is to evaluate the role of multi-slice computed tomography (MSCT) angiography in assessment of pulmonary arteries anomalies. This study included 76 patients (42 males and 34 females) with male to female ratio 55.2% to 44.7%. The age of the patients ranged from 4 days to 15 years. The studied cases for pulmonary arteries anomalies were subclassified to anomalies of the caliber, origin and development (conotruncal anomalies). We compared MSCT findings with the data collected by cardiac catheterization and/or operation in 38 patients. 320-MSCT diagnosed cases of pulmonary arterial anomalies with 99% sensitivity, 99.8% specificity, 99% PPV, 99.8% NPV and 93.4% accuracy. This study concluded that MSCT is a non-invasive imaging modality that has a significant value in the evaluation of the congenital pulmonary arteries anomalies and its associated extracardiac anomalies in pediatric patients as well as assessment of post-operative complications. It is superior to ECHO in evaluating the pulmonary artery anomalies specially the pulmonary artery branches which are obscured by aerated lung. Also, there is good outcome of the cases owing to early and accurate diagnosis of the cases and post-operative follow up.

Background: During COVID-19 world-wide pandemic, there are increasing needs to evaluate pulmonary changes at follow up chest Computed Tomography (CT) scans and to explore the risk factors for out coming fibrotic like sequel in the lung of the patients who recovered from severe COVID-19, the incidence of chronic manifestations in patients with novel coronavirus (COVID-19) are now declared to increase the clinician`s orientation of this issue and to limit long-lasting chronic pulmonary affection. Objectives: The main intended objectives of this study to evaluate the expected post-COVID-19 intermediate -long term pulmonary sequels, namely fibrosis, as a chronic morbidity. Patients and methods: An observational single center study on 100 subjects were confirmed having COVID-19 by clinical and/or laboratory findings. After applying the exclusion criteria, study included 72 participants who were exposed to full clinical history taken (was available in their files) then two series of CT chest with 3 month apart between them; the data were collected during the period from March 2022 to December 2022 Results: In this retrospective single center cross sectional study, and in view of participant's clinical presentation; our initial and 3 months follow up Computed Tomography scan findings in 72 patients, who were divided into 2 groups according to the CT Severity score (CT-SS) at time of presentation; into Group 1 and Group 2, were recorded; 39 were male (54.2%) and 33 were female (45.8%) with clinically proven COVID-19. Mean age was (44.8 ± 16.7). At 1 st CT series; evidence of Ground glass patches (GGP) which considered main radiological findings were seen in 45 patients (90 %) in Group 1, while it was seen in 22 patients (100%) in Group 2. At CT follow up exam; CT abnormalities had resolved in (65.3 %) while Post Covid pulmonary fibrosis was observed in 25 patients (34.7 %) distributed as follow 10 patients from group 1 (40 %) and 15 patients from group 2 (60 %) . Conclusion: On follow up CT chest scans; various pulmonary changes in post COVID-19 patients are recorded. However, Post-COVID-19 pulmonary fibrosis remains one of the most worrying pulmonary complications as it causes permanent lung damage, so prediction of potential high-risk patients; giving special attention to risk factors as exposure to mechanical ventilation& general as well as local comorbidities; may help in applying early medical treatment strategies such as antifibrotic drugs, thus reducing disease morbidity and mortality rates.

Background Neonatal respiratory distress syndrome (RDS) is a leading cause of neonatal respiratory failure and neonatal mortality. It is frequent in preterm infants, because deficient surfactant needed to keep the airways (alveoli) open to assist infants breathe after birth. Nonetheless, it was also seen in full-term pregnancies. Noninvasive approaches for predicting the development of neonatal respiratory distress (RD) in preterm newborns include comparing the prenatal clinical outcome with the pulmonary artery resistance index (PA-RI) and fetal lung capacity as assessed by the virtual organ computer-aided analysis (VOCAL). Our study aimed to estimate optimal cutoff values and compare measurements of fetal pulmonary artery resistance index (PA-RI) and fetal lung volume (LV) assessed by VOCAL as noninvasive measures to predict neonatal RD development in preterm pregnancies to show which is more accurate. Results Out of the examined 147 women who delivered 147 living newborns, 59 of newborn (40.1%) developed neonatal RD. PA-RI has a higher value in 45 (76.27%), while fetal lung volume (FLV) was significantly lower in 43 (72.88%) of neonates who developed RD. Combining both measurements of PA-RI and FLV could predict all cases of RDS 59 (100%). Thirty of RDS neonates had mechanical ventilation and died (50.85%). Cutoff values of PA-RI ≥ 0.75 with 76.27% sensitivity, 82.95% specificity and 81.5% accuracy, whereas a cutoff of FLV ≤ 28 cm3 with sensitivity of 72.88%, specificity of 65.91% and accuracy of 74.8%, for prediction of RDS. Combining both cutoffs generated a more accurate detection 100%, specificity of 65.91% and 66.3% positive predictive value (PPV) and 100% negative predictive value (NPV) and 83% accuracy. Conclusions Both PA-RI and FLV are promising noninvasive tools which help in predicting RD fetuses with high sensitivity and specificity. PA-RI is more accurate than FLV cm3 in prediction of neonatal RDS. Combining these parameters increases the predictive value.

Background The SYNTAX score (SS) was created to aid the Heart Team in assessing the severity and extent of coronary artery disease (CAD) in patients with multi-vessel disease, hence helping in the decision between percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG). SS is an important tool that assesses the angiographic complexity of the CAD based on Invasive coronary angiography (ICA). The study aims to evaluate the role of coronary Multi-Slice Computed Tomography (MSCT) angiography in the assessment of CAD on the basis of SS. Results Our study involved 60 patients with a male to female ratio 78.4% to 21.6%. The mean age of the patients was 57 years. Then, we applicate SYNTAX score II (SS-II) by incorporating a combination of SS-I and clinical variables. MSCT findings were compared with the data collected by cardiac catheterization. SYNTAX scores produced from coronary CT-angiography (CCTA) and those derived from ICA are concordant (P = 0.001). Direct correlation and significant relationship between SS-II for PCI and the mortality rate with the CT-derived SS-I. There was an inverse relationship between the CT-derived SS-I and SS-II for CABG. There was an inverse relationship between the CT-derived-SS with CABG mortality rate. Conclusions MSCT is a noninvasive imaging modality that has a significant value and high diagnostic accuracy compared to ICA in the evaluation of the complexity of CAD using SS and can be applied in clinical practice to determine the most convenient treatment procedure and predict long-term prognosis.