Background Corpus callosum agenesis (CCA) is a midline congenital anomaly. Routine prenatal 2D ultrasonography (2D US) can suggest CCA. A definitive diagnosis and identification of more subtle associated neurological or non-neurological abnormalities are difficult to be detected by prenatal 2D US; therefore, a further study by fetal magnetic resonance imaging (MRI) is needed. This study highlights the role and evaluates the diagnostic value of fetal MRI in the diagnosis of CCA and identifying the associated anomalies, which is a prognostic of the postnatal developmental outcome. Results Out of 27 fetuses that were suspected to have CCA on prenatal US, fetal MRI diagnosed 25/27 fetuses (92.5%) with CCA, while the last 2/27 (7.5%) were ruled out; being false positive (FP) on prenatal US, they had normal corpus callosum (CC). Cases diagnosed as CCA were either complete 77.7% (n = 21) or partial agenesis 14.8% (n = 4). They were classified as followed: Only 5/25 (18.5%) had isolated CCA, while the majority 20/25 (74%) of CCA were complex form associated with other anomalies (most of them 14 cases (70%) associated with other neurological anomalies, while 4 cases (20%) associated with other non-neurological anomalies, and last 2 cases (10%) were having both anomalies). The diagnostic performance of fetal MRI in diagnosis of CCA was as follows: sensitivity 100%, specificity 67%, positive predictive value (PPV) 96%, negative predictive value (NPV) 100%, and accuracy 96.3%. The sensitivity of the detection of associated neurological abnormalities was 100% by fetal MRI for 75% by 2D US. Conclusion The prevalence of the complex CCA is higher than the isolated form. Fetal MRI is a valuable adjunctive complementary imaging to prenatal 2D US with high diagnostic performance in the diagnosis of fetuses with CCA. It confirms the diagnosis, assesses the extent of agenesis, and detects coexisting anomalies, which is a prognostic of the postnatal developmental outcome.

New corona virus disease COVID-19 is a pandemic outbreak viral infection that is highly contagious. The disease can affect any age groups. Majority of patients show mild or no symptoms. Immunocompromised patients and patients with co-morbidities are more vulnerable to have more aggressive affection with higher rate of complications. Thus, cancer patients carry a higher risk of infection. Diseased patient can transmit infection throughout the disease course starting from the incubation period to clinical recovery. All healthcare workers contacting COVID-19-positive patients are at great risk of infection, especially the anesthesiologists who can be exposed to high viral load during airway manipulation. In the National Cancer Institute of Egypt, we apply a protocol to prioritize cases where elective cancer surgeries that would not affect patient prognosis and outcome are postponed during the early phase and peak of the pandemic till reaching a plateau. However, emergency and urgent surgeries that can compromise cancer patient’s life and prognosis take place after the proper assessment of the patient’s condition. Aim This review aims to spot the management of cancer patients undergoing surgery during the COVID-19 pandemic in the National Cancer Institute, Egypt.

Background: Acute necrotizing encephalopathy of children (ANEC) is a rare fulminant type of acute encephalopathy that mainly occurs in children with a characteristic clinico-radiological pattern. It is commonly preceded by viral infections. The condition carries a poor prognosis with high morbidity and mortality rates. We highlight the relationship between diagnostic multi-parametric magnetic resonance imaging (MRI) findings and correlate them with the clinical outcome of children with ANEC by enrollment of MRI scoring. Results: The thalami were involved in all 30 patients, brain stem in 80%, basal ganglia (13.3%), cerebral white matter (WM) in 73%, and cerebellar WM in 33%. Hemorrhage was present in 86.7% patients, edema 80%, and necrosis in 13.3%. We found that the patients having the highest MRI scores were in the poor outcome category; whereas the patients with lower MR score (1 or 2) had better outcomes. Statistically positive correlation (r= 0.1198) was found between the multi-parametric MR score and the outcome category. Conclusion: An extended multi-parametric MRI should be performed in ANEC, allowing early detection and scoring of the disease for better prognosis. There is a positive correlation between the clinical outcome and the MR scoring.

Background: Characterization of an ovarian lesion is a diagnostic challenge. A correct preoperative assessment is of great importance so as to arrange adequate therapeutic procedures. The aim of the current study is to evaluate the diagnostic performance of functional MRI in differentiation between malignant, borderline, and benign ovarian masses. Results: This study included 56 adnexal lesions. Bilateral synchronous ovarian lesions are detected in 16 cases. Postoperative histologically proved to be benign in 17 (30%), borderline (low potential malignancy) in 12 (22%), and malignant in 27 (48%). The overall diagnostic performance of conventional MRI in the diagnosis of adenexal lesion was a sensitivity of 74%, specificity of 47%, positive predictive value (PPV) of 76%, negative predictive value (NPV) of 44%, and an accuracy of 66%. Functional pelvic MRI examination showed an increase in overall diagnostic performance compared to conventional values with the highest sensitivity of 90% and NPV of 67% using DWI, and the highest specificity of 88%, PPV of 94%, and an accuracy of 82% using DCE MRI. Conclusion: Functional MRI in conjugation with conventional MRI plays a key role in the ovarian lesion detection, characterization, and staging. Functional MRI is currently being evaluated as possible predictive and prognostic biomarkers in ovarian lesions.

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Background Childhood obesity is related to multiple serious health problems and an enhanced risk of premature onset of diseases. The relation of skeletal maturation to obesity is undetermined. The study aims to evaluate skeletal maturation in children and adolescents with obesity, to correlate it with their anthropometric data, body fat content, BMI, fat mass and pubertal stage. Results Our study shows that obese children and adolescents have accelerated skeletal maturation compared to control normal-weight healthy subjects (mean skeletal age difference of 0.123 ± 0.67 years versus − 0.175 ± 0.32 years). Also, there were significant positive correlations between bone age and BMI (r = 0.435, P value 0.00). Conclusion The mean skeletal age difference was more in the obese group as compared to the control group and suggesting accelerated skeletal development in the obese group. It is important to assess skeletal maturity in growing patients to determine the best timing for orthopedic and orthodontic treatment around the growth spurt.

Background Cystic fibrosis (CF) is a multisystem disorder. Gastrointestinal tract (GIT) involvement presently requires medical attention, and this improves the survival rate of patients with CF. GIT imaging has an essential role in the early detection of GIT affection. This study aimed to quantify the abdominal symptoms and their relationship to clinical findings, abdominal ultrasound scoring system, and laboratory parameters, correlating GIT manifestation with ultrasound diagnostic findings. Methods This was a cross-sectional study that included 60 patients diagnosed with CF based on clinical manifestations and confirmed by a positive sweat chloride test ≥ 60 mmol/L and/or genetic analysis (CFTR gene mutation; a copy from each parent) in the CF clinic in the Children’s Hospital, in a period of 12 months. Results Recurrent abdominal pain (RAP) was the most common GIT manifestation, followed by abdominal distension and steatorrhea. Ultrasonography (US) showed that the most frequent findings were pancreatic lipomatosis in 16 patients (26.7%), the next common finding was heterogeneous coarse hepatic parenchyma in 14 patients (23.3%), while the least finding was the thickened bowel walls in 2 patients (3.3%). Abdominal US scoring revealed that the highest burden of GIT symptoms was clearly associated with pancreatic lipomatosis and liver steatosis with the highest score (6/7) (p = 0.048), while bowel wall thickness (BWT) had the lowest score (3/7) (Table 4). Conclusion This study reveals that abdominal US is a non-invasive investigation that helps in the early detection of GIT involvement in CF. RAP is a common GIT manifestation and may reflect a major pathology. Moreover, a significant relationship was detected between RAP and pancreatic cystosis and lipomatosis. Therefore, the study also highlights the importance of US as a routine non-invasive follow-up tool for patients with CF and suggests close monitoring of patients with CF by abdominal US performed every 6 to 12 months.

Background Pediatric chronic lung disease (CLD) refers to a range of distinct clinical and pathological disorders that affect children. High-resolution CT (HRCT) is critical for detecting and characterizing parenchymal abnormalities as well as determining their nature and distribution. Although magnetic resonance imaging (MRI) shows promising results, however, due to its poor spatial resolution and signal-to-noise ratio, imaging of the lung parenchyma remains a challenge. As a result, in addition to the initial CT, a follow-up MRI is required. The goal of this paper is to highlight the main imaging features of children with CLD and to evaluate the efficacy of MRI lungs in the diagnosis and monitoring of pediatric CLD. Results There was a strong positive correlation between CT and MRI, with a significant P-value. Findings of HRCT and MRI showed a qualitative agreement of 78% complete agreement. MRI helped primary diagnosis in 54% of cases compared to CT in 91% of cases. Conclusion MRI lungs are an equivalent technique to HRCT in assessing pediatric CLD; using the modified Helbich–Bhalla score, a strong correlation is obvious between both in the overall assessment. MRI is beneficial for case surveillance rather than primary diagnosis.