Pub Date : 2024-09-05DOI: 10.1186/s43055-024-01312-0
Govardhana Das Joel, Bhavya Basetti, Balaji Varaprasad Mallula
Herlyn–Werner–Wunderlich syndrome also known as OHVIRA syndrome is a rare complex congenital developmental anomaly characterized by the triad of uterine didelphys, obstructed hemivagina causing hematometrocolpos and ipsilateral renal anomaly. Here we report a case of a 14-year-old girl who presented with acute onset lower abdominal pain. Ultrasound and magnetic resonance imaging showed uterus didelphys, hematometrocolpos, obstructed hemivagina and right renal agenesis. Patient underwent hematocolpos drainage. OHVIRA syndrome is an uncommon congenital anomaly. Imaging plays a major role in diagnosis. Surgery is the treatment of choice to resect the septum and relieve the obstruction. An early correct diagnosis is the goal to relieve the symptoms and prevent complications, caused by retrograde menstruation which may result in endometriosis and, also, preserve sexual and conception abilities.
{"title":"A rare case report of urogenital anomaly in a teenage girl: Herlyn–Werner–Wunderlich syndrome/OHVIRA syndrome (Obstructed Hemivagina and Ipsilateral Renal Anomaly)","authors":"Govardhana Das Joel, Bhavya Basetti, Balaji Varaprasad Mallula","doi":"10.1186/s43055-024-01312-0","DOIUrl":"https://doi.org/10.1186/s43055-024-01312-0","url":null,"abstract":"Herlyn–Werner–Wunderlich syndrome also known as OHVIRA syndrome is a rare complex congenital developmental anomaly characterized by the triad of uterine didelphys, obstructed hemivagina causing hematometrocolpos and ipsilateral renal anomaly. Here we report a case of a 14-year-old girl who presented with acute onset lower abdominal pain. Ultrasound and magnetic resonance imaging showed uterus didelphys, hematometrocolpos, obstructed hemivagina and right renal agenesis. Patient underwent hematocolpos drainage. OHVIRA syndrome is an uncommon congenital anomaly. Imaging plays a major role in diagnosis. Surgery is the treatment of choice to resect the septum and relieve the obstruction. An early correct diagnosis is the goal to relieve the symptoms and prevent complications, caused by retrograde menstruation which may result in endometriosis and, also, preserve sexual and conception abilities.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"26 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142203527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-03DOI: 10.1186/s43055-024-01349-1
Porkodi Dharmalingam, Devimeenal Jagannathan
Contrast-enhanced mammography (CEM) is a recently developed, cost-effective imaging technique that offers both anatomical and functional breast imaging. Lesion conspicuity, a newly introduced lexicon in the ACR BIRADS supplementary atlas on CEM (2022), lacks sufficient data to correlate with malignancy likelihood. The feasibility of assessing contrast kinetics with CEM remains uncertain, and there is a scarcity of available data. Our research aims to address these gaps. Two radiologists, blinded to pathological reports, independently evaluated 504 CEM enhanced breast lesions with histopathology reports, out of which 176 were benign and 328 were malignant. Subjective qualitative assessment of lesion conspicuity and contrast kinetics was done for each enhancing lesion. The lesion conspicuity was classified as low, moderate, or high. The kinetic behavior of each lesion was categorized into either persistent, plateau, or washout. The distribution of lesion conspicuity among benign and malignant lesions, respectively, was as follows: for low conspicuity, 74.4% versus 25.6%; for moderate conspicuity, 30.6% versus 69.4%; and for high conspicuity, 8.4% versus 91.6%. Regarding contrast kinetics and their distribution between benign and malignant lesions, persistent kinetics was detected in 95.6% compared to 4.4%, plateau kinetics in 43.4% versus 56.6%, and washout kinetics in 3.5% versus 96.5%. Statistically significant differences in distribution between benign and malignant lesions were observed for both lexicons (P < 0.001). The inter-observer agreement for lesion conspicuity (kappa = 0.97) and contrast kinetics (kappa = 0.92) was deemed excellent. The addition of lesion conspicuity and contrast kinetics as lexicons in CEM could enhance its diagnostic accuracy.
对比增强乳腺 X 射线摄影（CEM）是最近开发的一种经济有效的成像技术，可同时进行乳腺解剖和功能成像。病变显着性是 ACR BIRADS 关于 CEM 的补充图集（2022 年）中新引入的词汇，但缺乏足够的数据将其与恶性肿瘤的可能性联系起来。用 CEM 评估造影剂动力学的可行性仍不确定，可用数据也很稀缺。我们的研究旨在填补这些空白。两名放射科医生在病理报告盲区内，独立评估了 504 例 CEM 增强乳腺病变和组织病理学报告，其中 176 例为良性，328 例为恶性。他们对每个增强病灶的病变清晰度和造影剂动力学进行了主观定性评估。病灶的清晰度分为低、中、高三个等级。每个病灶的动力学表现分为持续、高原或消失。良性病变和恶性病变的病灶清晰度分布分别为：低清晰度，74.4% 对 25.6%；中度清晰度，30.6% 对 69.4%；高清晰度，8.4% 对 91.6%。关于造影剂动力学及其在良性病变和恶性病变之间的分布，95.6%的造影剂动力学检测到持续动力学，而 4.4%的造影剂动力学检测不到持续动力学；43.4%的造影剂动力学检测到高原动力学，而 56.6%的造影剂动力学检测不到高原动力学；3.5%的造影剂动力学检测到冲出动力学，而 96.5%的造影剂动力学检测不到冲出动力学。两种词典在良性病变和恶性病变之间的分布差异具有统计学意义（P < 0.001）。病灶清晰度（kappa = 0.97）和对比度动力学（kappa = 0.92）的观察者间一致性被认为非常好。在 CEM 中增加病灶明显性和对比度动力学词典可提高其诊断准确性。
{"title":"Lesion conspicuity and contrast kinetics as predictors to differentiate benign and malignant breast lesions in contrast-enhanced mammogram","authors":"Porkodi Dharmalingam, Devimeenal Jagannathan","doi":"10.1186/s43055-024-01349-1","DOIUrl":"https://doi.org/10.1186/s43055-024-01349-1","url":null,"abstract":"Contrast-enhanced mammography (CEM) is a recently developed, cost-effective imaging technique that offers both anatomical and functional breast imaging. Lesion conspicuity, a newly introduced lexicon in the ACR BIRADS supplementary atlas on CEM (2022), lacks sufficient data to correlate with malignancy likelihood. The feasibility of assessing contrast kinetics with CEM remains uncertain, and there is a scarcity of available data. Our research aims to address these gaps. Two radiologists, blinded to pathological reports, independently evaluated 504 CEM enhanced breast lesions with histopathology reports, out of which 176 were benign and 328 were malignant. Subjective qualitative assessment of lesion conspicuity and contrast kinetics was done for each enhancing lesion. The lesion conspicuity was classified as low, moderate, or high. The kinetic behavior of each lesion was categorized into either persistent, plateau, or washout. The distribution of lesion conspicuity among benign and malignant lesions, respectively, was as follows: for low conspicuity, 74.4% versus 25.6%; for moderate conspicuity, 30.6% versus 69.4%; and for high conspicuity, 8.4% versus 91.6%. Regarding contrast kinetics and their distribution between benign and malignant lesions, persistent kinetics was detected in 95.6% compared to 4.4%, plateau kinetics in 43.4% versus 56.6%, and washout kinetics in 3.5% versus 96.5%. Statistically significant differences in distribution between benign and malignant lesions were observed for both lexicons (P < 0.001). The inter-observer agreement for lesion conspicuity (kappa = 0.97) and contrast kinetics (kappa = 0.92) was deemed excellent. The addition of lesion conspicuity and contrast kinetics as lexicons in CEM could enhance its diagnostic accuracy.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"6 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142203532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-03DOI: 10.1186/s43055-024-01354-4
Gehad A. Saleh, Fatmaelzahraa Abdelfattah Denewar, Khadiga M. Ali, Marwa Saleh, Mahmoud Abdelwahab Ali, Ahmed Shehta, Manar Mansour
Hepatocellular carcinoma (HCC) is the most frequent primary liver tumor globally and a leading cause of mortality in cirrhotic patients. Our study aimed to estimate the diagnostic performance of triphasic CT and inter-observer reliability in the preoperative detection of microvascular invasion (MVI) in HCC. Two independent radiologists accomplished a retrospective analysis for 99 patients with HCC to assess the CT features for MVI in each lesion. Postoperative histopathology was considered the gold standard. Multivariate regression analysis revealed that incomplete or absent tumor capsules, presence of TTPV, and absence of hypodense halo were statistically significant independent predictors of MVI. There was excellent agreement among observers in evaluating peritumoral enhancement, identifying intratumoral arteries, hypodense halo, TTPV, and macrovascular invasion. Also, our results revealed moderate agreement in assessing the tumor margin and tumor capsule. Triphasic CT features of MVI are reliable imaging predictors that may be helpful for standard preoperative interpretation of HCC.
{"title":"Inter-observer reliability and predictive values of triphasic computed tomography for microvascular invasion in hepatocellular carcinoma","authors":"Gehad A. Saleh, Fatmaelzahraa Abdelfattah Denewar, Khadiga M. Ali, Marwa Saleh, Mahmoud Abdelwahab Ali, Ahmed Shehta, Manar Mansour","doi":"10.1186/s43055-024-01354-4","DOIUrl":"https://doi.org/10.1186/s43055-024-01354-4","url":null,"abstract":"Hepatocellular carcinoma (HCC) is the most frequent primary liver tumor globally and a leading cause of mortality in cirrhotic patients. Our study aimed to estimate the diagnostic performance of triphasic CT and inter-observer reliability in the preoperative detection of microvascular invasion (MVI) in HCC. Two independent radiologists accomplished a retrospective analysis for 99 patients with HCC to assess the CT features for MVI in each lesion. Postoperative histopathology was considered the gold standard. Multivariate regression analysis revealed that incomplete or absent tumor capsules, presence of TTPV, and absence of hypodense halo were statistically significant independent predictors of MVI. There was excellent agreement among observers in evaluating peritumoral enhancement, identifying intratumoral arteries, hypodense halo, TTPV, and macrovascular invasion. Also, our results revealed moderate agreement in assessing the tumor margin and tumor capsule. Triphasic CT features of MVI are reliable imaging predictors that may be helpful for standard preoperative interpretation of HCC.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"24 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142203340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-02DOI: 10.1186/s43055-024-01345-5
Beshoy Samuel Megalaa, Ahmed Fathy Abd El Ghany, Waleed Mohamed Hetta, Nourhan Mohammed Hossam El Din
The most prevalent cause of peripheral nerve entrapment is carpal tunnel syndrome, which is characterized by compression of the median nerve at the wrist as a result of nearby or localized microvascular interference as well as structural alterations to the median nerve or adjacent tissues. However, no special information regarding the median nerve or its surroundings is provided by clinical examination or electrophysiological testing. The purpose of this study is to evaluate the effectiveness of magnetic resonance neurography (MRN) and ultrasound in identifying changes and abnormalities of the median nerve in carpal tunnel syndrome. The twenty-five patients in this study ranged in age from 27 to 63 years old, with a mean age of 47. There were 18 female patients and seven male patients. All patients were sent to the radiology department from the orthopedics, neurology, outpatient clinic, and neurology department, at Ain Shams Hospital, Faculty of Medicine, Ain Shams University. All of the patients had clinically manifested pain along the median nerve distribution, each of the sixteen patients had hand paresthesia, and four had thenar muscle atrophy. In the current study, Ultrasound exhibits low negative predictive value of 67% and specificity of 67%, but high positive predictive value of 95%, sensitivity of 95%, and overall accuracy of 92%. On the other hand, (MRN) exhibits a low negative predictive value of 60% and a high specificity of 75% in the diagnosis of nerve entrapment, but it also displays a high positive predictive value of 95%, sensitivity of 90%, and overall accuracy of 88%. Regarding the assessment of the recurrence cause and post-surgical evaluation is more reliable by Magnetic Resonance Neurography examination. Magnetic resonance neurography and high-resolution ultrasonography can be utilized to diagnose patients with median nerve entrapment and patients who cannot be diagnosed electrophysiologically. MRN is a more accurate method for detecting the exact location of nerve entrapment and evaluating nerve recovery after surgical intervention than nerve conduction studies and electromyography. Additionally, MRN can be used to identify causes that were not previously recognized based on physical examination and electrophysiological tests.
{"title":"Role of ultrasound and magnetic resonance neurography in the detection of median nerve abnormalities in carpal tunnel syndrome","authors":"Beshoy Samuel Megalaa, Ahmed Fathy Abd El Ghany, Waleed Mohamed Hetta, Nourhan Mohammed Hossam El Din","doi":"10.1186/s43055-024-01345-5","DOIUrl":"https://doi.org/10.1186/s43055-024-01345-5","url":null,"abstract":"The most prevalent cause of peripheral nerve entrapment is carpal tunnel syndrome, which is characterized by compression of the median nerve at the wrist as a result of nearby or localized microvascular interference as well as structural alterations to the median nerve or adjacent tissues. However, no special information regarding the median nerve or its surroundings is provided by clinical examination or electrophysiological testing. The purpose of this study is to evaluate the effectiveness of magnetic resonance neurography (MRN) and ultrasound in identifying changes and abnormalities of the median nerve in carpal tunnel syndrome. The twenty-five patients in this study ranged in age from 27 to 63 years old, with a mean age of 47. There were 18 female patients and seven male patients. All patients were sent to the radiology department from the orthopedics, neurology, outpatient clinic, and neurology department, at Ain Shams Hospital, Faculty of Medicine, Ain Shams University. All of the patients had clinically manifested pain along the median nerve distribution, each of the sixteen patients had hand paresthesia, and four had thenar muscle atrophy. In the current study, Ultrasound exhibits low negative predictive value of 67% and specificity of 67%, but high positive predictive value of 95%, sensitivity of 95%, and overall accuracy of 92%. On the other hand, (MRN) exhibits a low negative predictive value of 60% and a high specificity of 75% in the diagnosis of nerve entrapment, but it also displays a high positive predictive value of 95%, sensitivity of 90%, and overall accuracy of 88%. Regarding the assessment of the recurrence cause and post-surgical evaluation is more reliable by Magnetic Resonance Neurography examination. Magnetic resonance neurography and high-resolution ultrasonography can be utilized to diagnose patients with median nerve entrapment and patients who cannot be diagnosed electrophysiologically. MRN is a more accurate method for detecting the exact location of nerve entrapment and evaluating nerve recovery after surgical intervention than nerve conduction studies and electromyography. Additionally, MRN can be used to identify causes that were not previously recognized based on physical examination and electrophysiological tests.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"8 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142203531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-02DOI: 10.1186/s43055-024-01335-7
Somaia Mohammed Ali Mahfouz, Fatma Salah eldin Mohamed, Nivine Abdel Moneium Chalabi, Hazem Ibrahim Abdel-Rahman
The most prevalent persistent parenchymatous liver alterations in healthy individuals are thought to be hepatic steatosis. The liver biopsy is the most crucial procedure for the identification and measurement of hepatic steatosis. By identifying the liver attenuation index (LAI) at CT image with fibroscan controlled attenuation parameter (CAP), hepatic steatosis can be evaluated without the risk of liver resection. Using liver biopsy histological analysis as a reference standard, to examine the precision of the CT liver attenuation index (LAI) and fibroscan controlled attenuation parameter (CAP) for quantitative evaluation of macrovesicular steatosis in living related liver donors. In this cross-sectional study, comparing the CT liver attenuation index & fibroscan controlled attenuation parameter with liver biopsy result for the detection of the steatosis in subject's candidate for liver living donors, 50 subjects were conducted at Ain Shams Specialized Hospital and other private hospitals over about 2 years. Our study reported that liver attenuation index of 9 is the cutoff value in post-contrast CT images with sensitivity 100% and specificity 80% that make it a very good method to exclude donor to have steatosis ≥ 15%, which mean that if donor had LAI index < 9, we can safely do proceed do liver biopsy. Our study reported that CAP measurement had an AUROC OF 0.780, for detecting steatosis ≥ 15%, with sensitivity is only 60% with specificity as CT LAI of 80%, our results consider low compared to other studies, that could be due to small number of donors in our study with steatosis ≥ 15% (five cases from 50 donors) unlike the other studies. When used to estimate the amount of liver fat in liver donors, the examined CAP and CT indices worked equally. But according to multivariate analysis, the only factor strongly linked with hepatic steatosis in a living donors was the CT LAI index. We contend that the combination of CT LS attenuation index and CAP allows for the detection of the degree of hepatic steatosis and can be used as an option to liver biopsy, reserving liver biopsy for those with positive steatosis donors.
{"title":"Predicting of hepatic steatosis in living liver donor via CT liver attenuation index (LAI) and fibroscan controlled attenuation parameter (CAP) correlation with biopsy result","authors":"Somaia Mohammed Ali Mahfouz, Fatma Salah eldin Mohamed, Nivine Abdel Moneium Chalabi, Hazem Ibrahim Abdel-Rahman","doi":"10.1186/s43055-024-01335-7","DOIUrl":"https://doi.org/10.1186/s43055-024-01335-7","url":null,"abstract":"The most prevalent persistent parenchymatous liver alterations in healthy individuals are thought to be hepatic steatosis. The liver biopsy is the most crucial procedure for the identification and measurement of hepatic steatosis. By identifying the liver attenuation index (LAI) at CT image with fibroscan controlled attenuation parameter (CAP), hepatic steatosis can be evaluated without the risk of liver resection. Using liver biopsy histological analysis as a reference standard, to examine the precision of the CT liver attenuation index (LAI) and fibroscan controlled attenuation parameter (CAP) for quantitative evaluation of macrovesicular steatosis in living related liver donors. In this cross-sectional study, comparing the CT liver attenuation index & fibroscan controlled attenuation parameter with liver biopsy result for the detection of the steatosis in subject's candidate for liver living donors, 50 subjects were conducted at Ain Shams Specialized Hospital and other private hospitals over about 2 years. Our study reported that liver attenuation index of 9 is the cutoff value in post-contrast CT images with sensitivity 100% and specificity 80% that make it a very good method to exclude donor to have steatosis ≥ 15%, which mean that if donor had LAI index < 9, we can safely do proceed do liver biopsy. Our study reported that CAP measurement had an AUROC OF 0.780, for detecting steatosis ≥ 15%, with sensitivity is only 60% with specificity as CT LAI of 80%, our results consider low compared to other studies, that could be due to small number of donors in our study with steatosis ≥ 15% (five cases from 50 donors) unlike the other studies. When used to estimate the amount of liver fat in liver donors, the examined CAP and CT indices worked equally. But according to multivariate analysis, the only factor strongly linked with hepatic steatosis in a living donors was the CT LAI index. We contend that the combination of CT LS attenuation index and CAP allows for the detection of the degree of hepatic steatosis and can be used as an option to liver biopsy, reserving liver biopsy for those with positive steatosis donors.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"2 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142203529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-02DOI: 10.1186/s43055-024-01347-3
Yousef Hisham Ahmed
Trauma is a major cause of death worldwide. Interventional radiology provides a set of minimally invasive and effective options that are being integrated as part of the multidisciplinary care plan offered to the trauma patient. However, there are still a lot of areas of development that need to be explored. This article reviews the current role of endovascular interventions in trauma setting, the latest efforts to find the optimum ways to use them and highlights areas of knowledge and gaps in the literature.
{"title":"Interventional radiology in trauma: current role and prospects","authors":"Yousef Hisham Ahmed","doi":"10.1186/s43055-024-01347-3","DOIUrl":"https://doi.org/10.1186/s43055-024-01347-3","url":null,"abstract":"Trauma is a major cause of death worldwide. Interventional radiology provides a set of minimally invasive and effective options that are being integrated as part of the multidisciplinary care plan offered to the trauma patient. However, there are still a lot of areas of development that need to be explored. This article reviews the current role of endovascular interventions in trauma setting, the latest efforts to find the optimum ways to use them and highlights areas of knowledge and gaps in the literature.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"65 1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142203530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-02DOI: 10.1186/s43055-024-01341-9
Maha Mourad Mohyeldin Elsaid, Basant Mohamed Raief Mosaad, Hend Galal Eldeen Mohamed Ali Hassan, Youssef Mohamed Mohamed Fahmy Amin, Ahmed Samir Ibrahim
Cardiovascular magnetic resonance (CMR) is considered the gold standard imaging modality for assessing myocardial infarction lesions, offering precise myocardial tissue characterization. Elevated transverse relaxation time (T2) serves as a specific indicator of increased myocardial water content, thus becoming a valuable index for myocardial edema. However, conventional T2-weighted CMR sequence exhibits several limitations, primarily providing qualitative information. In contrast, recently developed quantitative T2 mapping techniques overcome these limitations, enabling a more reliable assessment of myocardial edema. These techniques offer the advantage of diagnosing and monitoring myocardial injury without the necessity of contrast agents. Our study aims to add to a growing literature demonstrating the efficacy of quantitative T2 mapping technique to detect and quantify regions of myocardial edema post-myocardial infarction. Native T1 and T2 mapping accurately identified myocardial edema in all patients enrolled in the study. Notably, native T1 and T2 values exhibited a significant elevation in the infarcted myocardium compared to the remote myocardium (for T1: 1295.50 ± 87.65 vs. 1074.95 ± 92.86 ms, respectively; and for T2: 74.63 ± 6.51 vs. 52.53 ± 6.26 ms, respectively; p < 0.0001 for both). Microvascular obstruction was observed in 12 out of 20 patients, affecting one or more myocardial segments within the infarct areas. Among this subgroup, regions with a microvascular obstruction within the infarct zone displayed lower T1 and T2 values compared to areas of infarction without microvascular obstruction (for T1: 1115.05 ± 64.70 vs. 1295.50 ± 87.65 ms, respectively; and for T2: 53.65 ± 3.56 vs. 74.63 ± 6.51 ms, respectively; p < 0.0001 for both). Additionally, we provided reference values for myocardial T1 and T2 specific to our facility’s 1.5 Tesla CMR system, applicable to both infarct and remote myocardium. Parametric T1 and T2 mapping techniques can detect and quantify myocardial edema resulting from myocardial infarction. The presence of microvascular obstruction that results from revascularization injury affects both T1 and T2 values. This information can be used and has broad clinical implications for diagnosis and guiding or monitoring the treatment of myocardial infarction.
{"title":"T2 mapping post acute myocardial infarction: a novel technique in assessing myocardial edema","authors":"Maha Mourad Mohyeldin Elsaid, Basant Mohamed Raief Mosaad, Hend Galal Eldeen Mohamed Ali Hassan, Youssef Mohamed Mohamed Fahmy Amin, Ahmed Samir Ibrahim","doi":"10.1186/s43055-024-01341-9","DOIUrl":"https://doi.org/10.1186/s43055-024-01341-9","url":null,"abstract":"Cardiovascular magnetic resonance (CMR) is considered the gold standard imaging modality for assessing myocardial infarction lesions, offering precise myocardial tissue characterization. Elevated transverse relaxation time (T2) serves as a specific indicator of increased myocardial water content, thus becoming a valuable index for myocardial edema. However, conventional T2-weighted CMR sequence exhibits several limitations, primarily providing qualitative information. In contrast, recently developed quantitative T2 mapping techniques overcome these limitations, enabling a more reliable assessment of myocardial edema. These techniques offer the advantage of diagnosing and monitoring myocardial injury without the necessity of contrast agents. Our study aims to add to a growing literature demonstrating the efficacy of quantitative T2 mapping technique to detect and quantify regions of myocardial edema post-myocardial infarction. Native T1 and T2 mapping accurately identified myocardial edema in all patients enrolled in the study. Notably, native T1 and T2 values exhibited a significant elevation in the infarcted myocardium compared to the remote myocardium (for T1: 1295.50 ± 87.65 vs. 1074.95 ± 92.86 ms, respectively; and for T2: 74.63 ± 6.51 vs. 52.53 ± 6.26 ms, respectively; p < 0.0001 for both). Microvascular obstruction was observed in 12 out of 20 patients, affecting one or more myocardial segments within the infarct areas. Among this subgroup, regions with a microvascular obstruction within the infarct zone displayed lower T1 and T2 values compared to areas of infarction without microvascular obstruction (for T1: 1115.05 ± 64.70 vs. 1295.50 ± 87.65 ms, respectively; and for T2: 53.65 ± 3.56 vs. 74.63 ± 6.51 ms, respectively; p < 0.0001 for both). Additionally, we provided reference values for myocardial T1 and T2 specific to our facility’s 1.5 Tesla CMR system, applicable to both infarct and remote myocardium. Parametric T1 and T2 mapping techniques can detect and quantify myocardial edema resulting from myocardial infarction. The presence of microvascular obstruction that results from revascularization injury affects both T1 and T2 values. This information can be used and has broad clinical implications for diagnosis and guiding or monitoring the treatment of myocardial infarction.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"78 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142203533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-30DOI: 10.1186/s43055-024-01343-7
Hany El-Assaly, Asmaa Abdel Baky Mohamed, Hesham Adel Abdel Fattah Mustafa
Crohn’s disease is a chronic disease that causes remitting and relapsing inflammatory episodes in the transmural part of the gastrointestinal system. It usually affects young people. The study sought to establish whether ultrasound can visualize important/useful diagnostic features and complications of the disease in the same way that MR enterography (MRE) can. The study is a prospective cohort of 133 patients of various disease stages (active and in remission) who had previously been seen by a gastroenterologist. All patients underwent abdominal and pelvic ultrasound examinations, with each of the five intestine segments checked independently for thickening and active inflammation. Complications of fistulas, abscesses, and stenosis were evaluated. Findings at MRE together with ileocolonoscopic results were deemed the standard reference. Ultrasound showed wall stenosis ranging from 5 to 12 mm, with a mean ± SD of 7.73 ± 2.30. A single loop was present in 69.2% of cases. The ileum was the most heavily involved loop portion (66.7%). In 72.9% of patients, stenosis and dilatation were present, whereas 69.7% showed active inflammation. Complications such as fistulas and abscess formation (21.2%) were identified. Ultrasound was found to be an effective tool for detecting stenosis and dilatation in the examined patients, with sensitivity of 84% and 87%, and specificity of 91% and 97%, respectively. A high accuracy of 90.9% was demonstrated for abscess formation. Ultrasound is a noninvasive method that is comparable to MRI for detecting damaged bowel segments and transmural complications such as bowel strictures, fistulas, and abscesses in Crohn’s disease patients. However, MR imaging is more comprehensive in providing detailed information about the disease's extent and activity.
{"title":"Could ultrasound alone substitute MR imaging in evaluation of Crohn’s disease complications?","authors":"Hany El-Assaly, Asmaa Abdel Baky Mohamed, Hesham Adel Abdel Fattah Mustafa","doi":"10.1186/s43055-024-01343-7","DOIUrl":"https://doi.org/10.1186/s43055-024-01343-7","url":null,"abstract":"Crohn’s disease is a chronic disease that causes remitting and relapsing inflammatory episodes in the transmural part of the gastrointestinal system. It usually affects young people. The study sought to establish whether ultrasound can visualize important/useful diagnostic features and complications of the disease in the same way that MR enterography (MRE) can. The study is a prospective cohort of 133 patients of various disease stages (active and in remission) who had previously been seen by a gastroenterologist. All patients underwent abdominal and pelvic ultrasound examinations, with each of the five intestine segments checked independently for thickening and active inflammation. Complications of fistulas, abscesses, and stenosis were evaluated. Findings at MRE together with ileocolonoscopic results were deemed the standard reference. Ultrasound showed wall stenosis ranging from 5 to 12 mm, with a mean ± SD of 7.73 ± 2.30. A single loop was present in 69.2% of cases. The ileum was the most heavily involved loop portion (66.7%). In 72.9% of patients, stenosis and dilatation were present, whereas 69.7% showed active inflammation. Complications such as fistulas and abscess formation (21.2%) were identified. Ultrasound was found to be an effective tool for detecting stenosis and dilatation in the examined patients, with sensitivity of 84% and 87%, and specificity of 91% and 97%, respectively. A high accuracy of 90.9% was demonstrated for abscess formation. Ultrasound is a noninvasive method that is comparable to MRI for detecting damaged bowel segments and transmural complications such as bowel strictures, fistulas, and abscesses in Crohn’s disease patients. However, MR imaging is more comprehensive in providing detailed information about the disease's extent and activity.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142203338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.1186/s43055-024-01339-3
Hassan Mahmood, Avinash Deshwal, Aleena Khalid, Ethel Mc Manus
This study aims to identify trends, research gaps, leading journals, institutions, countries, and authors by examining the top 100 cited Yttrium-90 Radioembolization (Y90) research articles. The insights gained will assist funding and collaboration efforts in Y90 research. The team analyzed 981 articles from 36 peer-reviewed journals, gathering data on authors, publication year, journal, citations, affiliations, keywords, and references. Author affiliations were scrutinized to pinpoint institutions and countries. p values < 0.05 were deemed statistically significant. The most cited paper (703 citations) was authored by Salem et al. (2010), and the journal with the most publications (16) was Journal of Vascular and Interventional Radiology. There was no significant correlation between journal impact factor and citation metrics. A decreasing trend in the number of top 100 articles was observed since the peak period (2008–2013). Most papers were published in high-impact factor (IF > 3, n = 31/35) and SCImago Q1 journals (86/100), with Northwestern University, Clínica Universidad de Navarra, and Ludwig Maximilian University of Munich being the leading institutions. The most prolific authors were Salem, R., Lewandowski, R.J., and Mulcahy, M.F., with Salem, R. as the most influential. A statistically significant positive correlation between collaborative links and published articles was also discovered. The top 100 cited articles were primarily published in high-impact journals, and Northwestern University and the USA showed greater productivity and collaboration. These findings have crucial implications for researchers, policymakers, and institutions, aiding in the improvement of Y90 application and understanding in clinical practice.
{"title":"Mapping the landscape of Y90 radioembolisation research: a citation analysis of the top 100 papers","authors":"Hassan Mahmood, Avinash Deshwal, Aleena Khalid, Ethel Mc Manus","doi":"10.1186/s43055-024-01339-3","DOIUrl":"https://doi.org/10.1186/s43055-024-01339-3","url":null,"abstract":"This study aims to identify trends, research gaps, leading journals, institutions, countries, and authors by examining the top 100 cited Yttrium-90 Radioembolization (Y90) research articles. The insights gained will assist funding and collaboration efforts in Y90 research. The team analyzed 981 articles from 36 peer-reviewed journals, gathering data on authors, publication year, journal, citations, affiliations, keywords, and references. Author affiliations were scrutinized to pinpoint institutions and countries. p values < 0.05 were deemed statistically significant. The most cited paper (703 citations) was authored by Salem et al. (2010), and the journal with the most publications (16) was Journal of Vascular and Interventional Radiology. There was no significant correlation between journal impact factor and citation metrics. A decreasing trend in the number of top 100 articles was observed since the peak period (2008–2013). Most papers were published in high-impact factor (IF > 3, n = 31/35) and SCImago Q1 journals (86/100), with Northwestern University, Clínica Universidad de Navarra, and Ludwig Maximilian University of Munich being the leading institutions. The most prolific authors were Salem, R., Lewandowski, R.J., and Mulcahy, M.F., with Salem, R. as the most influential. A statistically significant positive correlation between collaborative links and published articles was also discovered. The top 100 cited articles were primarily published in high-impact journals, and Northwestern University and the USA showed greater productivity and collaboration. These findings have crucial implications for researchers, policymakers, and institutions, aiding in the improvement of Y90 application and understanding in clinical practice.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"106 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142203337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.1186/s43055-024-01338-4
Matthew Rollins, Thaddeus Harbaugh, Mohamed Fawzi, Mohamed Hamed, Sami Alkasab, Mohamed Almekkawy, Islam Elhelf
Focused ultrasound has emerged as a non-invasive technology with potential for treating various medical conditions, particularly neurological diseases. This article aims to explore recent advancements in the utilization of focused ultrasound for treating neurological conditions. A comprehensive literature review was conducted to explore current clinical applications and investigational uses of focused ultrasound, aiming to provide an up-todate overview of the field's progress. By employing different combinations of intensity and frequency, focused ultrasound can induce diverse interactions with soft tissues, including tissue ablation, cavitation, and mechanical effects. High-intensity focused ultrasound is utilized for tissue ablation and has received FDA approval for treating medication-refractory essential tremor. Conversely, low-intensity focused ultrasound is employed for neuromodulation and opening the blood–brain barrier, facilitating enhanced drug delivery for treating brain tumors and other neurological conditions. This article reviews ongoing clinical trials investigating focused ultrasound's role in neurological condition treatment. Focused ultrasound holds significant promise for managing and treating various neurologic conditions. Whether employed for tissue ablation or transiently opening the blood–brain barrier to enhance drug delivery, numerous potential applications exist. Further research is necessary to evaluate its safe implementation and compare clinical outcomes with standard-of-care therapies.
聚焦超声已成为一种非侵入性技术，具有治疗各种疾病，尤其是神经系统疾病的潜力。本文旨在探讨利用聚焦超声治疗神经系统疾病的最新进展。文章通过全面的文献综述，探讨了聚焦超声目前的临床应用和研究用途，旨在提供该领域的最新进展概况。通过采用不同的强度和频率组合，聚焦超声可与软组织产生多种相互作用，包括组织消融、空化和机械效应。高强度聚焦超声可用于组织消融，并已获得 FDA 批准用于治疗药物难治性本质性震颤。相反，低强度聚焦超声则用于神经调控和打开血脑屏障，促进药物输送以治疗脑肿瘤和其他神经系统疾病。本文回顾了正在进行的研究聚焦超声在神经系统疾病治疗中作用的临床试验。聚焦超声在控制和治疗各种神经系统疾病方面大有可为。无论是用于组织消融，还是瞬时打开血脑屏障以加强药物输送，都有许多潜在的应用。有必要开展进一步研究，以评估其安全性，并将临床结果与标准疗法进行比较。
{"title":"Neurological applications of focused ultrasound: an introduction and update on clinical and research trends","authors":"Matthew Rollins, Thaddeus Harbaugh, Mohamed Fawzi, Mohamed Hamed, Sami Alkasab, Mohamed Almekkawy, Islam Elhelf","doi":"10.1186/s43055-024-01338-4","DOIUrl":"https://doi.org/10.1186/s43055-024-01338-4","url":null,"abstract":"Focused ultrasound has emerged as a non-invasive technology with potential for treating various medical conditions, particularly neurological diseases. This article aims to explore recent advancements in the utilization of focused ultrasound for treating neurological conditions. A comprehensive literature review was conducted to explore current clinical applications and investigational uses of focused ultrasound, aiming to provide an up-todate overview of the field's progress. By employing different combinations of intensity and frequency, focused ultrasound can induce diverse interactions with soft tissues, including tissue ablation, cavitation, and mechanical effects. High-intensity focused ultrasound is utilized for tissue ablation and has received FDA approval for treating medication-refractory essential tremor. Conversely, low-intensity focused ultrasound is employed for neuromodulation and opening the blood–brain barrier, facilitating enhanced drug delivery for treating brain tumors and other neurological conditions. This article reviews ongoing clinical trials investigating focused ultrasound's role in neurological condition treatment. Focused ultrasound holds significant promise for managing and treating various neurologic conditions. Whether employed for tissue ablation or transiently opening the blood–brain barrier to enhance drug delivery, numerous potential applications exist. Further research is necessary to evaluate its safe implementation and compare clinical outcomes with standard-of-care therapies.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"20 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142203345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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