Purpose This study was designed to evaluate the role of multiparametric magnetic resonance imaging (MRI) for differentiation of parotid gland neoplasms. Methods Prospective study was conducted upon 52 consecutive patients (30 men, 22 women; aged 24–78 years; mean, 51 years) with parotid tumours that underwent multiparametric MRI using combined static MRI, dynamic contrast enhanced (DCE) MRI, and diffusion-weighted imaging (DWI). The static MRI parameter, time signal intensity curves (TIC) derived from DCE-MRI, and apparent diffusion coefficient (ADC) values of parotid tumours were correlated with histopathological findings. Results Static MRI revealed a significant difference between both benign and malignant lesions in regards to margin definition ( P < .001) and T2 hypointensity ( P < .013), with a diagnostic accuracy 95% and 78.33% respectively. Study of the TIC type on DCE-MRI revealed statistically significant difference between benign and malignant lesions ( P < .001) and diagnostic accuracy 96.55%. There was no statistically significant difference ( P = .181) between the ADC values of benign and malignant lesions. ROC curve analysis revealed that by using ADC cut-off value of 1 × 10−3 mm2/s had accuracy of 84.62% respectively for differentiating Warthin from malignant tumours that could be modified to higher value (94.28%) by excluding lymphoma from malignant lesions. By using cutoff value of 1.3 × 10−3 mm2/s to differentiate pleomorphic adenoma from malignancy, ROC curve analysis had high accuracy of 97.06%. Conclusion Multiparametric MRI can be used for differentiation of malignant from benign parotid tumours and characterization of some benign parotid tumours.

IntroductionTo explore whether chest X-ray severity scoring (CX-SS) could be reliable to assess the severity of pulmonary parenchymal disease in COVID-19 patients.Material and methodsThe study consisted of 325 patients whose COVID-19 was confirmed by RT-PCR test and who underwent chest X-ray and computed tomography (CT) studies to assess parenchymal disease severity. Only 195 cases included in the final analysis after exclusion of cases with previous chest disease and cases having more than 24 hours interval between their X-ray and CT chest studies. Both chest X-ray and CT severity scores (CT-SS) were recorded by 2 experienced radiologists and were compared to the clinical severity. Interobserver agreement was assessed for CX-SS and CT-SS.ResultsIn relation to the clinical severity, the sensitivity of the CX-SS for diagnosis of moderate to severe parenchymal disease was high (90.4% and 100%) and low for mild cases (66.2%), while the specificity was high for mild to moderate parenchymal disease (100%) compared to severe cases (86.7%). The sensitivity, specificity, and diagnostic accuracy of the CT-SS were higher than CX-SS. Pearson correlation coefficient demonstrated a strong positive correlation between CX-SS and CT-SS (rs = 0.88, p < 0.001). The inter-observer agreement for CX-SS was good (k = 0.79, p = 0.001), and it was excellent for CT-SS (k = 0.85, p = 0.001).ConclusionsCX-SS is reliable to assess the severity of COVID-19 pulmonary parenchymal disease, especially in moderate and severe cases, with the tendency of overestimation of severe cases.

We conclude that WB-MDCT has an impact on treatment planning and prognosis in patients with multiple myeloma, as it has high rate of detecting cortical and medullary bone lesions, spinal fracture and extraosseous lesions. This information may alter treatment planning in multiple myeloma due to disease upstaging and detection of spine fracture and extraosseous spinal lesions.

In the morphometry of the patella, there are several naturally occurring variations. Few studies have focused on these anatomical differences among the Egyptian population. The present work aimed to evaluate age and gender variations in different morphometric patellar measurements using magnetic resonance imaging (MRI) in the Egyptian population. Nine patellar parameters were measured on 200 individuals "100 males and 100 females", aged from 20 to 70 years old using knee joint MRI obtained retrospectively from the picture archiving and communication system (PACS) of Radiology Department, Mansoura University. The mean values revealed statistically significant differences across gender for 5 out of 9 patellar measurements and 4 out of 9 across age, denoting sex and age differentiation in patellar morphology among the Egyptian population. Patellar height (PH), width (PW), thickness (PT), lateral facet width (PLFW), and facet thickness (PFT) showed statistically significant sexual dimorphism (p≤ 0.05) in all age groups. On the other hand, patellar angle (PA) showed the highest statistically significant difference (p ≤ 0.001) for age estimation in all age groups. PH, PW, and PLFW showed a statistically significant negative correlation with age. Moreover, patellar measurements showed high accuracy rates for sex determination among the Egyptian population (84.3-93.6%) in different age groups. Morphometric patellar measurements obtained by non-invasive MRI examination were shown to be useful for sex determination and age prediction in the Egyptian population.

Background: Liver diseases have been known to be a major health problem principally because of their world-wide distribution. Focal liver disease is a common diagnostic problem referred to radiologists for evaluation owing to its nonspecific clinical presentation and marked interobserver variation on clinical examination. Aim of Study:The purpose of this study is to evaluate the role of diffusion tensor imaging in characterization of hepatic focal lesions and its value in post-treatment response.Patients and Methods: This prospective study included 30 patients previously diagnosed to have hepatic focal lesions (HFLs) by their characteristic triphasic computed tomography (CT), dynamic magnetic resonance imaging (MRI) features and/or biopsy. The study included 43 lesions in 30 patients (16 benign lesions, 23 malignant lesions, and 4 treated malignant lesions). MRI with diffusion tensor imaging (DTI) was performed for all patients. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were evaluated for all lesions.Results: There was a statistically significant difference in ADC values between the benign and malignant lesions (p<0.001) and between the treated malignant and untreated malignant lesions (p=0.002). There was a statistically significant difference in FA values between the benign and malignant lesions (p<0.001) and between the treated malignant and untreated malignant lesions ( p=0.004). The best cut-off ADC value to differentiate between benign and malignant lesions respectively was >1.42x 10 -3 mm 2 /s with 95.7% sensitivity and 82.8% specificity. The best cut-off ADC value to differentiate between treated malignant and malignant lesions respectively was >1.65x 10 -3 mm 2 /s with 97.8% sensitivity and 95.7% specificity. The best cut-off FA value to differentiate between malignant and benign lesions respectively was >0.29 with 95% sensitivity and 70% specificity. The best cut-off FA value to differentiate between treated malignant and untreated malignant lesions respectively was <0.297 with 100% sensitivity and 69.2% specificity. Conclusion: Diffusion tensor imaging is an evolvingtechnique that can be used to characterize different hepatic focal lesions either benign or malignant with significant