No abstract

Vascular rings are unusual anomalies represent less than 1% of all cardiac anomalies, it is abnormal development of aortic arch complex leading to formation of a ring formed by vessels that encircle both the trachea and esophagus, echocardiography had limited acoustic window which leads to inadequate evaluation of great vessels, Multi-detector computed tomography (MDCT) is one of the most important non invasive diagnostic tool for detection the vascular ring anomalies. The Aim: To evaluate role of MDCT Scanning for diagnosis of congenital vascular rings anomalies compared to echocardiography. Methods: This is a prospective study of 21 children suspected to have vascular ring anomalies. All patients underwent chest radiography, echocardiography examinations and MDCT Scanning using a 128-row CT scanner with 3D reconstruction. Results: Twenty-one patients (11 male and 10 female), mean age (14 months) were diagnosed as vascular ring anomalies by MDCT then confirmed by surgical results MDCT diagnosed 14 patients with (double aortic arch), 4 patients (right sided aortic arch with aberrant left subclavian), 2 patients (left sided aortic arch with aberrant right subclavian artery) and one patient with pulmonary sling. MDCT also diagnosed seven patients with tracheobronchial stenosis. Echocardiography succeeded only in nine patients with DAA and failed in five and succeeded in diagnosis of two cases of (right aortic arch with aberrant left subclavian). Conclusion: MDCT is an excellent diagnostic tool for optimum detection of vascular ring anomalies and other extra cardiac lesions compared to echocardiography.

Background Diffusion tensor imaging (DTI) is a novel approach which uses extra gradients to quantify diffusion in several directions (at least six). The purpose of this research was to determine the role of diffusion tensor magnetic resonance imaging in breast lesion differentiation. Results Apparent diffusion coefficient (ADC) values were significantly lower in malignant than benign lesions, with a cut-off value of 1.21 × 10−3 mm2/s, this gives a sensitivity of 88.46%, specificity 87.50% and accuracy 86.7%. Values of fractional anisotropy (FA) were higher significantly in malignant compared to benign lesions with a 0.15 cut-off value, has a 95.83% sensitivity, 96.15% specificity, and 95.6%, accuracy. Values of RA were significantly higher in malignant (0.180 ± 0.068) compared to benign lesions, with 0.13 cut-off value. Sensitivity, specificity, and accuracy were, respectively, 91.69%, 92.31%, and 90.2%. Values of λ1 were significantly lower in malignant (1.4 ± 0.453 × 10−3 mm2/s) than in benign (2.19 ± 0.659 × 10−3 mm2/s) lesions with a cut-off value of 1.71 × 10−3 mm2/s. Sensitivity and specificity were, respectively, 95.83 and 96.15%. The combined evaluation by (dynamic contrast enhancement) Sensitivity improved to 100% with DCE and DTI readings, while specificity remained at 95.6%. Conclusions DTI breast imaging is a noninvasive procedure which demonstrated a high potential utility for cancer detection and serving as a standalone technique or in conjunction with DCE-MRI, the discriminating values of FA, λ1 and λ1–λ3 were high. Their measurements were strongly associated with identification breast malignancy and combined evaluation by DTI parameters and DCE-MRI DTI enhanced the sensitivity, lowered the rate of false-negatives, and completely improved the accuracy of breast lesions differential diagnosis.

Background A wide variety of congenital thoracic aortic variants and pathological anomalies could be assessed recently in diagnostic and interventional radiology. Multi-detector computed tomography (MDCT) is one of the most important non-invasive diagnostic tools for their detection. The aim of the study was to evaluate role of MDCT scanning for diagnosis of thoracic aortic anatomic variants and diseases in pediatric patients. Results Thirty patients (15 male and 15 female), mean age (8.49 ± 20.29 months) were diagnosed with different thoracic aortic anomalies by MDCT then confirmed by surgical results. MDCT was more sensitive than echocardiography in detection of hypo plastic arch, vascular rings, interrupted aortic arch anomalies, and aortic coarctation. Both MDCT and echocardiography showed 100% sensitivity in their detection of TGA, TOF, and PDA. MDCT detected 6 cases of right-sided aortic arch while echo missed 2 cases. Different aortic arch branching patterns and coronary origin were better demonstrated by MDCT. Conclusion 320-Multi-detector computed tomography is a reliable tool for optimal detection of thoracic aortic anomalies and preoperative planning.