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Background Nine-point risk scoring system for metastatic cervical lymph nodes has been developed to be incorporated into clinical practice for further management and better prognosis for head and neck squamous cell carcinoma (HNSCC). It is based on suspicious computed tomography (CT) scanning findings. This study aimed to assess the risk scoring system validity and reliability for diagnosing cervical lymph node metastasis from head and neck squamous cell carcinomas. Results The intra-class correlation (ICC) was utilized to assess the inter-observer agreement. We had 102 malignant lymph nodes and 60 benign lymph nodes based on histopathological results. Based on a lymph node (LN) based analysis regarding the LNs categorized as scores 4 to 9 for diagnosing metastatic cervical lymph nodes, the risk scoring system had a sensitivity, specificity, and an accuracy of 89.2 to 91.2%, 68.3 to 70%, and 82.1 to 83.3%, respectively, depending on the observer. The inter-reviewer agreement (IRA) for the total score was excellent (ICC = 0.936). The optimal cutoff value for diagnosing metastatic cervical lymph nodes was > score 3. Conclusions Based on imaging findings, a risk scoring system for diagnosing metastatic cervical lymph nodes from head and neck squamous cell carcinoma was validated. This risk scoring system is a valuable guide for better decision-making.

Background: Anatomic variations and abnormalities of coronary arteries could affect the blood supply of the heart, hemodynamic characteristics and could be a risk of atherosclerosis. Knowledge about the variations of coronary artery origin and its course provides a valuable guide to Cardiothoracic Surgeons and Physicians and be useful for choosing the appropriate devices for such variant anatomical structures. The aim of the study was to estimate the prevalence of coronary artery anomalies among patients with fail ed coronary artery catheterization using CCTA to prevent misdiagnosis and reduce mismanagement of such anomalies. Methods: One hundred MDCT coronary angiography examinations were done using a 128detectors (Philips Healthcare Ingenuity) scanner for patients who had previously failed coronary artery catheterization. Dedicated software and post processing techniques were used for precise evaluation and description of the coronary artery tree to be a road map for future interventional procedures. Results: Class A coronary artery anomalies were found in 53.2% of the detected anomalies (25 / 47 anomalies) in 20% of the included patients while class B coronary artery anomalies were recorded in 46.8% of the detected anomalies (22 / 47 anomalies) in 19% of the included patients. No cases showed class C anomalies in our cohort. Significant coronary artery disease (CAD) had no significant association with the presence of coronary artery anomalies. Conclusions: Detection of different coronary artery anomalies among patients with previous failed coronary artery catheterization can help the cardiologists for better planning for the interventional procedures and better patient outcome.

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