Background T2 mapping and DWI are newly quantitated method for disk degeneration assessment; they were used in the determination of an early stage of intervertebral disk degeneration. T2 mapping was quantitatively sensitive for detecting the early stage and aging-related changes in intervertebral disk degeneration. Furthermore, T2 mapping and apparent diffusion coefficient values (ADC) in lumbar intervertebral disks indirectly correlated with the Pfirrmann grades in IVDD and age-related disk degeneration. The aim of this study is to evaluate the sensitivity of T2 mapping and apparent diffusion coefficient in the determination of an early stage of intervertebral disk degeneration. Results T2 relaxometry values were found to decrease with the increased disk degeneration except in grade V where it was found to be increased again. There was a negative correlation between T2 values and semi-quantitative grading (Pfirrmann Grading) of disk degeneration and T2 values were significantly different when comparing grade I to V. A T2 value of nucleus pulposus (NP) was more sensitive than annulus fibrosus (AF) and entire of the disk. ADC values were found to decrease with the increased degree of disk degeneration; there was a weakly significant negative correlation between age and T2 mapping values, ADC values of nucleus pulposus, and entire of disk. Conclusion T2 mapping was significantly different when comparing grade I to V while ADC value had a significant weak negative correlation with age, so T2 mapping and to a little extent ADC can be used for quantitative analysis of early disk generation seeking for early diagnosis and better management.
Background: Pre-operative diagnosis of ovarian represents diagnostic challenge as it affects the lines of treatment and patient's prognosis. Previous studies studied the role of the Diffusion Weighted Imaging (DWI) in discrimination between benign and malignant ovarian masses with controversial results. Aim of Study: The aim of this study was to evaluate the role of qualitative and quantitative Diffusion Weighted Imaging (DWI) in the discrimination between benign and malignant ovarian tumors. Material and Methods: The study included 82 patients. All patients underwent MRI with a 1.5T unit. Conventional MRI both pre and post contrast. Before administration of the contrast, the DWI sequence, single shot echo planar sequence in the axial plane was done for all patients. Analysis of the MRI findings, the signal intensity on DWI and the ADC value for solid and cystic components was done for all lesions. Results: For conventional MRI, the overall sensitivity, specificity, PPV, NPV and accuracy of MRI was 85.71%, 85.71%, 87.80%, 83.33% and 85.71% respectively. Hyperintense signal on DWI of the solid component was observed in 17/18 (94.4%) of malignant tumors. The restricted diffusion in the solid components had a sensitivity of 94.44%, specificity 85.71%, PPV 94.44% and NPV of 85.71% with overall accuracy of 92.% in prediction of malignancy. Using 1.2 X 10-3 mm 2 /sec) as a cut off value between benign an malignant lesion had sensitivity 88.89%, specificity 85.71% and accuracy 88% in differentiation between benign and malignant masses. Conclusion: Diffusion weighted imaging especially the qualitative component have high diagnostic accuracy in differentiation between benign and malignant ovarian masses and should be integrated into the pelvic MRI.
Background The diagnosis of peritoneal carcinomatosis is challenging and can be difficult to detect with imaging, especially the detection of small-sized peritoneal lesions. The presence of peritoneal neoplastic spread alters tumour staging and is one of the most significant prognostic indicators in several malignancies, and the purpose of this study was to highlight the diagnostic value of PET/CT in detection of peritoneal carcinomatosis in patients with malignant neoplastic disease. Results PET/CT has 76.2% sensitivity, 88.9% specificity, 94.1% PPV, 61.5% NPV and 80% accuracy in detection of peritoneal carcinomatosis. Different patterns of FDG uptake of peritoneal carcinomatosis were found such as focal nodular uptake, diffuse abdominal uptake and liver surface focal or diffuse uptake. From all these different patterns, focal nodular uptake was the most frequent pattern. The best cut-off value of SUVmax was 5 for diagnosis. Conclusions The study affirms the significant role of PET/CT in the diagnosis of peritoneal carcinomatosis and its important value in the staging, management and follow-up of patients with secondary peritoneal malignancies, especially in case of unavailable or inappropriate peritoneal biopsy. Therefore, PET/CT could help reduce the number of laparotomies and a better selection of patients who are candidates for adjuvant chemotherapy.
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