Background: Ovarian masses present a special diagnostic challenge when imaging findings cannot be categorized into benign or malignant pathology. Ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) are currently used to evaluate ovarian tumors. Functional imaging by means of diffusion weighted magnetic resonance imaging (DW-MRI) is now part of the standard imaging protocols for evaluation of the female pelvis. DW-MRI is important MR imaging technique which enable the radiologist to move from morphological to functional assessment of diseases of the female pelvis. Aim of the Study: The aim of the current study is to evaluate the diffusion-weighted MR imaging in prediction of the nature of suspicious ovarian masses which are detected previously by conventional ultrasound. Patients and Methods: MRI Unit, radiodiagnosis department, Ain Shams University hospital. The study is prospective, included thirty women who presented with suspicious adnexal masses on previous ultrasound examination and referred for further assessment and characterization by DW-MRI. Patients with contraindications to MRI (e.g. claustrophobia, cardiac prosthesis and metallic plates) are excluded. Results: The study included 30 women ranging in age between 24 and 61 years with mean age 43.22±11.15. Out of 30 cases, 12 had of benign ovarian tumors while 18 had malignant tumors. Conclusion: Thus, combination of DWI and conventional MRI implies using a completely noninvasive technique with no radiation exposure. It is cost effective (no additional cost to MRI examination), and easily added to the MR study protocols with no marked lengthening of examination time. It improves the specificity of MRI and thus increasing radiologist's confidence in image interpretation which will finally reflect on patient's outcome and prognosis.
Background: Patients with chronic hemolytic anemia like thalassemia need repeated blood transfusions which lead to iron overload. MRI has emerged for the noninvasive assessment of iron overload in various tissues. Aim of Study:The aim of this study is to assess the role of MRI in the evaluation of hepatic iron overload in multi transfused P-Thalassemic children and to correlate the results with serum ferritin levels. Patients and Methods:In 45 cases of multi-transfused child with thalassemia, Liver Iron Concentration (LIC) was measured by MRI T2* and compared to serum ferritin (traditional marker of iron overload).Results: There were a significant positive correlation between serum ferritin and LIC ( r=0.557 and p<0.01) when SF level below 4000ng/ml, and the correlation became very weak when serum ferritin above 4000ng/ml. Also, there were a significant negative correlation of LIC with T2* ( r=-0.999 and p<0.01) and a significant positive correlation with R2* (r=1.000 and p<0.01) and no significant correlation with age, sex, splenectomy and frequency of blood transfusion.Conclusion: MRI T2* provides accurate reproducible and non-invasive technique for assessing tissue iron concentration. Through the widespread application of this technique it should be possible to improve management of tissue iron overload allowing earlier chelation intensification.
Back ground: Congenital heart disease (CHDs) is the most common birth anomaly worldwide and it has a significantly increasing prevalence rate. Traditional evaluation for assessment depends on echocardiography (ECHO) and conventional angiography. Recent technological advances in computed tomography (CT), is increasingly used for noninvasive evaluation and proper diagnosis. Aim of work: To examine the validity of administering low exposure dose by MDCT with the aid of ECG gating technique and post processing 3D reconstruction in diagnosis and follow up of congenital heart disease in pediatrics. Patients & methods: This study was performed on 40 patients with age ranged from 3 days to 16 year old with suspicious or clinically /echocardiographically known to have congenital heart disease. The study was performed with MDCT machines (64 and 80 slices spiral CT)with ECG gating technique. The radiation dose was kept to minimum by reducing the kilo voltage to 80 kvp. All patients underwent Nonionic contrast agent injection. Results: we found that there is overall no significant difference between the low Kvp ECG gated MDCT and high Kvp MDCT in detecting congenital cardiac anomalies moreover , in our study we detected some anomalies which were not reported by high Kvp protocol in other studies. Conclusion: low Kvp ECG gated MDCT is superior to conventional method of CT scanning in assessment of congenital heart anomalies as it reaches to the same diagnosis with less radiation dose and hazards
Background 18-F-2-Deoxy-D-Glucose Positron Emission Tomography [FDG-PET], combined with multidetector helical Computed Tomography [PET/CT] has emerged as a one of the most important prognostic tools for lymphoma management. Previous studies have indicated that PET/CT is a convenient method for bone marrow assessment in patients with lymphoma. A blind Bone Marrow Biopsy [BMB] has been traditionally used as the golden standard in marrow evaluation despite its invasiveness. Objective is to compare the results of PET/CT with BMB regarding bone marrow infiltration [BMI] in patients with Hodgkin's Lymphoma [HL] and Non-Hodgkin's Lymphoma [NHL] and to characterize the visual bone marrow FDG uptake pattern by PET-CT Methods A cross sectional study including 27 cases of Lymphoma, conducted at Ain Shams University hospitals, the patients were investigated using PET-CT scan and BMB ,the period was between December 2018 till the end of May 2019. Results Our study included 27 histologically proved Lymphoma patients, 14 (51.9%) were males and 13 (48.1%) were females, with age ranging from 17 to 69 years (mean 45 years). Among the total cases, 17 (63%) patients had NHL, while 10 (37%) patients had HL. All the patients were evaluated at first by BMB (taken from the dorsal portion of the iliac crest) for initial staging, then the patients underwent PET/CT scan. The study revealed 12 patients (44.4%) had BMI detected by PET/CT imaging; however, only 7 patients (25.9%) were detected by BMB. BMB and 18F-FDG PET/CT scans were concordant for BMI detection in 22 patients (81.5%): positive concordance in 7 patients and negative in 15. Of the 5 discordant cases, four had a focal marrow intense FDG uptake detected by PET/CT and were upstaged as their BMB results were false-negative, one patient had intense diffuse marrow uptake by PET/CT while its BMB was negative (revealed only hyper cellularity with mild dysplasia). The sensitivity, specificity, PPV, and NPV of PET for identifying BMI was 100%, 75%, 58.3%, 100% respectively with a diagnostic accuracy 81.5% with a (p value < 0.05). Conclusion 18F-FDG PET-CT imaging is more sensitive than bone marrow biopsy for bone marrow infiltration detection in Hodgkin's Lymphoma and Non-Hodgkin's Lymphoma staging.
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