Objectives: To set age-specific normal reference values for brainstem, cerebellar vermis, and peduncles measurements and characterize values’ variations according to gender, age, and age by gender interaction. Methods: 565 normal brain magnetic resonance examinations with normal anatomy and signal intensity of the supra and infratentorial structures were categorized into six age groups (infant, child, adolescent, young adult, middle-age adult, and old aged adults). Patients with congenital malformations, gross pathology of the supra or infratentorial brain, brain volume loss, developmental delay, metabolic disorders, and neuropsychological disorders (n = 2.839) were excluded. On midsagittal T1-weighted and axial T2-weighted images specific linear diameters and ratios of the brainstem, cerebellar vermis, and peduncles were attained. Two observers assessed a random sample of 100 subjects to evaluate the inter- and intra observer reproducibility. Intraclass correlation coefficients (ICCs), means ± standard deviation (SD), one, and two-way analysis of variance tests were used in the statistical analysis. Results: Good to excellent inter- and intra observer measurements’ reproducibility were observed, except for the transverse diameter of the midbrain, the anteroposterior diameter of the medulla oblongata at the pontomedullary and cervicomedullary junctions, cerebellar vermis anteroposterior diameter, and thickness of the superior cerebellar peduncle. Age-specific mean values of the investigated measurements were established. A significant gender-related variation was recorded in the anteroposterior diameter of the basis pontis (p = 0.044), the anteroposterior diameter of the medulla oblongata at the cervicomedullary junction (p = 0.044), and cerebellar vermis height (p = 0.018). A significant age-related change was detected in all measurements except the tectal ratio. Age by gender interaction had a statistically significant effect on the tectal ratio, inferior, and middle cerebellar peduncles’ thickness (p = 0.001, 0.022, 0.028, respectively). Conclusion: This study provides age-specific normal mean values for various linear dimensions and ratios of the posterior fossa structures with documentation of measurements’ variability according to gender, age, and their interaction. Advances in knowledge: It provides a valuable reference in the clinical practice for easier differentiation between physiological and pathological conditions of the posterior fossa structures especially various neurodegenerative diseases and congenital anomalies.

Background Sino-nasal mucormycosis is an opportunistic, invasive fungal disease which has shown a rising trend in the setting of COVID-19. The objective of this study is to document and analyze demographic data, clinical presentation and MR imaging spectra for early detection and management of post-COVID-19 sino-nasal mucormycosis. Results Sixty-two cases of sino-nasal mucormycosis were enrolled in this study; their mean age was 50.65 ± 8.25 years, with significant female predominance. Nine patients (14.5%) had active COVID-19 and 53 (85.5%) were recent COVID-19 cases. Sixty patients have not received COVID-19 vaccine. The mean duration from the initial COVID-19 laboratory confirmation to the detection of sino-nasal mucormycosis was 25.7 +/− 4.6 days. Thirty-five patients (56.5%) were kept in the hospital for COVID management and 4 of them received intensive care unit (ICU) treatment. Twenty-seven patients (43.5%) were treated in home isolation. Corticosteroids were administered in 48 cases (77.4%). Twenty-nine patients (46.8%) had been given oxygen for an average time of 11.2 ± 4.15 days. Diabetes was found in 56 cases (90.3%). The most common clinical symptoms were headache, seen in 52 patients (83.87%). The ethmoid sinus was the most common paranasal sinus involved in our study, seen in 47 cases (75.81%). In 36 cases (58%), multiple sinuses were involved. MRI staging according to the extent of regional involvement. Stage 1 seen in 2 cases (3.23%), stage 2 in 13 cases (20.97%), stage 3 in 35 cases (56.45%) and stage 4 in 12 cases (19.35%). Conclusions MRI shows a spectrum of findings in sino-nasal mucormycosis. Imaging plays a major role in staging and assessing the extent of involvement and complications. In light of this, mortality and morbidity can be dramatically decreased with adequate evaluation and therapy.

Background: Triple Negative Breast Cancer (TNBC) has the worst prognosis of any subtype of the disease because of tumor heterogeneity and a chronic lack of other effective treatment lines. To improve the low survival rate, early identification is the key. Objective: Our study aimed to determine the accuracy of Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) in differentiating TNBC from other Non-Triple Negative Breast Cancer (NTNBC) subtypes using pathological examination as the gold standard. Subjects and procedures Retrospective study was conducted at the Radio-diagnosis, Oncology, and Surgery departments of Meet Ghamr Oncology center, enrolling 68 female patients with pathologically proven 83 malignant breast lesions of different immunochemistry subtypes, consisting of TNBC (22 patients/29 lesions) and NTNBC (46 patients /54 lesions). Every patient received both conventional and (DCE) MRI scans, which are compared to histopathological and immune-chemistry analyses. Results: TNBC and NTNBC subtypes groups differed significantly (p<0.05) in terms of the tumor's size, shape, Apparent Diffusion Coefficient (ADC) value, enhancement shape and distribution, and specific criteria like central necrosis and peritumoral high T2 Weighted Image (T2WI) signal. There was a highly significant difference (p<0.001) between the two groups in terms of (Patient age, histologic grade, tumor margin, lesion-high T2W signal, and enhancement pattern). Validity values for differentiating between TNBC and NTNBC using combined DCE-MRI and MRI-Specific criteria were (100%, 91.49%, 87.1%, and 100%) as opposed to (88.89%, 97.87%, 96%, and 93.9%) Conclusions: The results of our study demonstrated the possibility of MRI-based imaging criteria for more accurate prediction and differentiation of TNBC from other subtypes.

Background: Elbow pain is a growing problem particularly among overhead athletes. Understanding the involved lesion is sometimes challenging problem because of anatomical complexity. So, precise diagnosis is a key to appropriate treatment and successful return to normal daily activities.Objective: This study aimed to emphasize the MRI role in detecting the tendinous, ligamentous, osseous, muscular, nerve and synovial based lesions in patients with elbow pain Subjects and methods: Our current retrospective study enrolled 60 patients complaining from elbow pain or discomfort in the period from January 2022 to August 2022. They were recruited from Orthopedic Surgery Outpatient Clinic and Radiodiagnosis Department, Zagazig University Hospitals for MRI evaluation. All patients were correlated with arthroscopic data as a gold standard. Results: Out of 60 patients, tendinous elbow lesions (flexor and extensor tendon injury) were the most frequent lesions (54/168, 32.1%), followed by ligamentous lesions (medial and lateral collateral ligament injuries) (40/168, 23.8 %), bony lesions (38/168, 22.6 %), muscle lesions (24/168, 14.3%) and nerve lesions were the least frequent (16/168, 9.6%). No significant difference between arthroscopy and MRI in detection of elbow pathology, with p value = 0.923169. MRI had 100% sensitivity for osseous lesions and excellent sensitivity in the diagnosis of tendon lesions (94.74%) as well as ligament lesions (90.91%). Also, it had good sensitivity in nerve lesions (76.19%). finally, MRI was highly specific tool with excellent accuracy in detecting all elbow pathologies. Conclusion: MRI has to be considered non-invasive precise diagnostic tool of elbow pain causes.