Background Glioma is the most common intracranial primary tumor of central nervous system (CNS) and accounts for about 70% of primary adult malignant brain tumors. The optimum therapeutic treatment and prognosis evaluation largely depends on the tumor pathological grades. Objective To evaluate the role of susceptibility weighted imaging (SWI) in grading of cerebral gliomas. The magnetic resonance imaging (MRI) results were compared and correlated to the pathology results to evaluate its role. The pathological grading of the glioma was done according to WHO 2007 classification system. Patients and Methods This was a retrospective study that included 35 adult patients, (11females & 24 males), their ages ranging from 18 years to 73 years. They were pathologically proven glioma patients ranging from grade I to grade IV. All the patients were referred from neurosurgeon to our radiology center (private center). This study was carried out during the period between January 2017 and November 2018. Results In our study, there were a strong positive correlation between both conventional imaging and pathological grading and between pathological and SWI grading. Using SWI sequence in grading of glioma will be very beneficial in patients with contraindication to contrast. Conclusion SWI using 3T MR system may provide quite useful information for preoperative glioma grading. There seems to be a strong positive correlation between pathological grading and SWI grading system for glioma. The main disadvantage for SWI is the extra time added to the usual time of routine MRI protocol used in cases of intra cranial space occupying lesions (SOL).
Background: Detection of residual, recurrent, or second primary malignancies in head and neck cancers treated patients can be challenging. Soft tissue changes and anatomical disfigurement seen after surgery, radiotherapy, and chemotherapy can distort the anatomy of the head and neck and make post treatment imaging reporting very complex. Aim of work:To evaluate the performance of the Neck imaging, and reporting data system template recently created by the American College of Radiology (ACR) Committee in the prediction of local and regional disease recurrence or persistence of head and neck squamous cell carcinoma after treatment by using CE MRI/ CT, and PET-CT in inconclusive cases.Patients and Methods: 116 scans for 55patients with head and neck squamous cell cancerswere included after finishing their treatment, reporting done using the ACR NI-RADS reporting template and lexicon and NI-RADS category was assigned to each scan, the accuracy of this categorization was done by correlation with our gold standard: tissue pathological examination and/ or three months interval follow up scan.Results: Out of the 116 scans included in our study, we had 232 targets for primary tumour sites and lymph nodes, the overall tumour recurrence have occurred in 53 targets out of the total of 232, with a total tumour recurrence rate of 22.8%, the recurrence rates for each NI-RADS category for the primary tumour site were: 3.9% (2/51) for 17.6% (3/17) for NI-RADS 2a category, 18.2% (4/22) for NI-RADS 2b category , and 76.9% (20/26) for NI-RADS 3 category. Regarding the lymph nodes, the recurrence rates for the different NI-RADS categories were: 3.8% (3/80) for NI-RADS 1 category, 7.1% (1/14) for NI-RADS 2 category, and 81.8% (18/22) for NI-RADS 3 category. The recurrence rates for combined NI-RADS categories for both the primary tumour site and lymph nodes were (Table 7): 3.8% (5/131) for NI-RADS 1 category, 19.6% (10/51) for NI-RADS 2 category, and 76.2% (38/48) for NI-RADS 3 category. Conclusion:The performance of the ACR NI-RADS reporting system and its linked management recommendations is excellent, with statistically significant discrimination in between the different NI-RADS categories for either the primary tumour site, lymph nodes and for both combined. The use of NI-RADS can help to direct the management plans towards more proper options.
Background Recovery of upper extremity (UE) motor function after stroke is variable from one to another due to heterogeneity of stroke pathology. Structural and biochemical magnetic resonance imaging of the primary motor cortex (M1) have been used to document reorganization of neural activity after stroke. Objective To assess cortical biochemical and structural causes of delayed recovery of UE motor function impairment in chronic subcortical ischemic stroke patients. Methodology A cross-sectional study with fifty patients were enrolled: thirty patients with chronic (> 6 months) subcortical ischemic stroke suffering from persistent UE motor function impairment (not improved group) and twenty patients with chronic subcortical ischemic stroke and improved UE motor function (improved group). We recruited a group of (16) age-matched healthy subjects. Single voxel proton magnetic resonance spectroscopy (1H-MRS) was performed to measure n-acetylaspartate (NAA) and glutamate+glutamine (Glx) ratios relative to creatine (Cr) in the precentral gyrus which represent M1of hand area in both ipsilesional and contralesional hemispheres. Brain magnetic resonance imaging (MRI) to measure precentral gyral thickness is representing the M1of hand area. UE motor function assessment is using the Fugl Meyer Assessment (FMA-UE) Scale. Results The current study found that ipslesional cortical thickness was significantly lower than contralesional cortical thickness among all stroke patients. Our study found that ipsilesional NAA/Cr ratio was lower than contralesional NAA/Cr among stroke patients. UE and hand motor function by FMA-UE showed highly statistically significant correlation with ipsilesional cortical thickness and ipsilesional NAA/Cr ratio, more powerful with NAA/Cr ratio. Conclusion We concluded that persistent motor impairment in individuals with chronic subcortical stroke may be at least in part related to ipsilesional structural and biochemical changes in motor areas remote from infarction in form of decreased cortical thickness and NAA/Cr ratio which had the strongest relationship with that impairment.
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