Pub Date : 2024-06-28DOI: 10.1186/s43055-024-01300-4
Jehad Fataftah, Raed Tayyem, Salem Al-Dwairy, Abdel Rahman Al Manasra, Aqleh Ibrahim, Randa Al Ryalat, Mallak Alwreikat, Hebatuallah Al-Shraah, Razan Alharbi, Banan Alharbi
Ionizing radiation has become increasingly utilized in medical practice. Consequently, healthcare workers must be aware of radiation hazards and apply the necessary countermeasures to reduce occupational exposure. This study assessed the awareness of radiation hazards and knowledge of radiation protection measures among radiologists and non-radiologists. These findings may improve the application of various safety measures during medical interventions involving radiation. We conducted a cross-sectional questionnaire-based study among 200 medical personnel, including consultant surgeons, physicians, radiologists, nurses, and radiographers, across five hospitals in Jordan between November 2022 and February 2023. The questionnaire collected data on demographic characteristics, awareness of radiation hazards, and knowledge of radioprotective techniques. Overall, the knowledge of radiation protection and awareness of radiation hazards among the participants were poor (51.55% and 37.17%, respectively). No significant difference was detected between the medical disciplines in terms of the level of knowledge of radiation protection; however, radiographers were significantly more aware of radiation hazards. According to our findings, medical personnel generally have poor awareness of radiation hazards and radiation protection protocols. However, this understanding can be enhanced through periodic in-service training and regular monitoring of occupational radiation exposure by health professionals.
{"title":"Awareness of radiation hazards and knowledge of radioprotective measures among radiologists and non-radiology staff: a cross-sectional survey","authors":"Jehad Fataftah, Raed Tayyem, Salem Al-Dwairy, Abdel Rahman Al Manasra, Aqleh Ibrahim, Randa Al Ryalat, Mallak Alwreikat, Hebatuallah Al-Shraah, Razan Alharbi, Banan Alharbi","doi":"10.1186/s43055-024-01300-4","DOIUrl":"https://doi.org/10.1186/s43055-024-01300-4","url":null,"abstract":"Ionizing radiation has become increasingly utilized in medical practice. Consequently, healthcare workers must be aware of radiation hazards and apply the necessary countermeasures to reduce occupational exposure. This study assessed the awareness of radiation hazards and knowledge of radiation protection measures among radiologists and non-radiologists. These findings may improve the application of various safety measures during medical interventions involving radiation. We conducted a cross-sectional questionnaire-based study among 200 medical personnel, including consultant surgeons, physicians, radiologists, nurses, and radiographers, across five hospitals in Jordan between November 2022 and February 2023. The questionnaire collected data on demographic characteristics, awareness of radiation hazards, and knowledge of radioprotective techniques. Overall, the knowledge of radiation protection and awareness of radiation hazards among the participants were poor (51.55% and 37.17%, respectively). No significant difference was detected between the medical disciplines in terms of the level of knowledge of radiation protection; however, radiographers were significantly more aware of radiation hazards. According to our findings, medical personnel generally have poor awareness of radiation hazards and radiation protection protocols. However, this understanding can be enhanced through periodic in-service training and regular monitoring of occupational radiation exposure by health professionals.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"4 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141501076","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}
Clinical diagnosis of the masses of the oropharynx and the oral cavity is usually straightforward; however, deep extension of lesions should be assessed by imaging. Thirty patients with suspected masses in oral cavity and oropharynx were enrolled in the present study. Contrast-enhanced CT and MRI were used for imaging of all patients, and superficial ultrasound was used as screening (whether the mass was accessible to ultrasound or not). The aim of this study was to evaluate clinical impact of combined imaging modalities for assessment of intraoral and oropharyngeal masses. There was a statistically significant difference between CT and MRI regarding the detected tumor size, lymph node and adjacent structures. CT had a sensitivity of 77.78% and specificity of 75% in the detection of malignancy. A low apparent diffusion coefficient can detect malignancy with 61.11% sensitivity and 91.67% specificity. The radiographic diagnosis of the oral cavity presents a complex challenge. According to the unique presentation of each patient, combined CT and MRI imaging will enhance the identification and characterization of lesions in the oral cavity and oropharynx. There is a secondary, limited role for ultrasonography.
{"title":"Imaging of oral cavity and oropharyngeal masses: clinico-radiologic correlation","authors":"Wafaa Mohamed Elbadawy, Mohamed Adel Eltomy, Mostafa Ibrahim Ammar, Ekhlas Abdelmonem Shaban","doi":"10.1186/s43055-024-01293-0","DOIUrl":"https://doi.org/10.1186/s43055-024-01293-0","url":null,"abstract":"Clinical diagnosis of the masses of the oropharynx and the oral cavity is usually straightforward; however, deep extension of lesions should be assessed by imaging. Thirty patients with suspected masses in oral cavity and oropharynx were enrolled in the present study. Contrast-enhanced CT and MRI were used for imaging of all patients, and superficial ultrasound was used as screening (whether the mass was accessible to ultrasound or not). The aim of this study was to evaluate clinical impact of combined imaging modalities for assessment of intraoral and oropharyngeal masses. There was a statistically significant difference between CT and MRI regarding the detected tumor size, lymph node and adjacent structures. CT had a sensitivity of 77.78% and specificity of 75% in the detection of malignancy. A low apparent diffusion coefficient can detect malignancy with 61.11% sensitivity and 91.67% specificity. The radiographic diagnosis of the oral cavity presents a complex challenge. According to the unique presentation of each patient, combined CT and MRI imaging will enhance the identification and characterization of lesions in the oral cavity and oropharynx. There is a secondary, limited role for ultrasonography.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"36 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141501077","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 : 2024-06-17DOI: 10.1186/s43055-024-01292-1
Neha Singh, Kishan Kumar Thakur, Deepak Kumar Singh, James Marak
Hypertrophic olivary degeneration (HOD) is a unique type of neuronal degeneration presenting as hypertrophy, in contrast to atrophy as seen in most cases. It presents with classical characteristic clinical features due to involvement of dentate-rubral-olivary pathway, also described as triangle of Guillain and Mollaret formed in midbrain, pons and cerebellum. It can be idiopathic or secondary to infarction, bleeding, tumours, trauma or demyelination. However, the mechanism is still unclear. Herein, we present a case of HOD that had developed after post-traumatic pontine and midbrain haemorrhagic contusion. A young male patient presented with progressively increasing tremors of both hands, inability to walk and multiple cranial nerve palsy. Magnetic resonance imaging demonstrated bilateral inferior olivary nucleus enlargement and signal changes seen as T2 and T2-FLAIR hyperintensities and non-enhancing T1 iso-intensities. Based on these features, diagnosis of HOD was made. Patient was kept on conservative management and his condition improved. Hypertrophic olivary degeneration is a unique neuronal degeneration with typical clinical manifestations and distinct imaging features. Proper and early recognition and multidisciplinary treatment approach can result in the best outcomes for the patient.
{"title":"Hypertrophic olivary degeneration following head injury: a case report","authors":"Neha Singh, Kishan Kumar Thakur, Deepak Kumar Singh, James Marak","doi":"10.1186/s43055-024-01292-1","DOIUrl":"https://doi.org/10.1186/s43055-024-01292-1","url":null,"abstract":"Hypertrophic olivary degeneration (HOD) is a unique type of neuronal degeneration presenting as hypertrophy, in contrast to atrophy as seen in most cases. It presents with classical characteristic clinical features due to involvement of dentate-rubral-olivary pathway, also described as triangle of Guillain and Mollaret formed in midbrain, pons and cerebellum. It can be idiopathic or secondary to infarction, bleeding, tumours, trauma or demyelination. However, the mechanism is still unclear. Herein, we present a case of HOD that had developed after post-traumatic pontine and midbrain haemorrhagic contusion. A young male patient presented with progressively increasing tremors of both hands, inability to walk and multiple cranial nerve palsy. Magnetic resonance imaging demonstrated bilateral inferior olivary nucleus enlargement and signal changes seen as T2 and T2-FLAIR hyperintensities and non-enhancing T1 iso-intensities. Based on these features, diagnosis of HOD was made. Patient was kept on conservative management and his condition improved. Hypertrophic olivary degeneration is a unique neuronal degeneration with typical clinical manifestations and distinct imaging features. Proper and early recognition and multidisciplinary treatment approach can result in the best outcomes for the patient.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"75 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141501135","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}
The importance of a diagnostic strategy combining coronary computed tomography angiography (CCTA) with fractional flow reserve derived from CCTA (FFRCT) for detecting myocardial ischemia is increasing. However, sensitivity and specificity alone may be insufficient to understand the efficiency characteristics of a diagnostic strategy combining CCTA and FFRCT (DSCCF). Our study aimed to evaluate the overall efficiency of DSCCF in detecting myocardial ischemia and compare it with other diagnostic strategies to determine whether evaluation by DSCCF is currently appropriate. This simulation study included 1000 patients with stable chest pain and suspected myocardial ischemia. Using a decision tree analysis, assuming a diagnostic strategy of adding FFRCT to CCTA-positive patients, we calculated the following efficiency parameters of DSCCF: (1) true positive (TP), false positive (FP), net false negative (FN), and net true negative (TN) test results; (2) net sensitivity; (3) net specificity; (4) positive predictive value; (5) negative predictive value; (6) post-test probability; (7) diagnostic accuracy; (8) diagnostic odds ratio; and (9) number needed to diagnose. We also calculated the efficiency parameters of other diagnostic strategies and compared them with those of DSCCF. In the basic setting, regarding efficiency parameters (1), the number of TPs, FPs, net FNs, and net TNs were 254, 69, 46, and 631, respectively. Efficiency parameters (2)–(9) were 0.85 (95% confidence interval [CI], 0.80–0.89), 0.90 (95% CI 0.88–0.92), 0.79 (95% CI 0.74–0.83), 0.93 (95% CI 0.91–0.95), 0.07 (95% CI 0.05–0.09), 0.89 (95% CI 0.86–0.90), 50.50 (95% CI 33.83–75.37), and 1.34 (95% CI 1.24–1.48), respectively. Compared with other diagnostic strategies, DSCCF had good efficiency parameters. Moreover, the sensitivity analysis did not reveal any evidence to contradict the findings in the basic setting. This study demonstrated the diagnostic ability characteristics of DSCCF by assessing various efficiency parameters. Compared with other diagnostic strategies, DSCCF had good efficiency. In terms of efficiency, evaluation using DSCCF for detecting myocardial ischemia appears to be appropriate.
结合冠状动脉计算机断层扫描血管造影（CCTA）和由 CCTA 导出的分数血流储备（FFRCT）的诊断策略在检测心肌缺血方面的重要性与日俱增。然而，仅凭敏感性和特异性可能不足以了解结合 CCTA 和 FFRCT（DSCCF）的诊断策略的效率特征。我们的研究旨在评估 DSCCF 在检测心肌缺血方面的整体效率，并将其与其他诊断策略进行比较，以确定 DSCCF 评估目前是否合适。这项模拟研究包括 1000 名患有稳定型胸痛并疑似心肌缺血的患者。通过决策树分析，假设诊断策略是在 CCTA 阳性患者中增加 FFRCT，我们计算了 DSCCF 的以下效率参数：(1) 真阳性 (TP)、假阳性 (FP)、净假阴性 (FN) 和净真阴性 (TN) 检测结果；(2) 净灵敏度；(3) 净特异性；(4) 阳性预测值；(5) 阴性预测值；(6) 检测后概率；(7) 诊断准确性；(8) 诊断几率；(9) 诊断所需人数。我们还计算了其他诊断策略的效率参数，并与 DSCCF 的效率参数进行了比较。在基本设置中，关于效率参数（1），TPs、FPs、净 FNs 和净 TNs 的数量分别为 254、69、46 和 631。效率参数（2）-（9）分别为 0.85（95% 置信区间 [CI]，0.80-0.89）、0.90（95% CI 0.88-0.92）、0.79（95% CI 0.74-0.83）、0.93（95% CI 0.91-0.95）、0.07（95% CI 0.05-0.09）、0.89（95% CI 0.86-0.90）、50.50（95% CI 33.83-75.37）和 1.34（95% CI 1.24-1.48）。与其他诊断策略相比，DSCCF具有良好的效率参数。此外，敏感性分析也没有发现任何与基本设置中的结果相矛盾的证据。本研究通过评估各种效率参数，展示了 DSCCF 的诊断能力特征。与其他诊断策略相比，DSCCF 具有良好的效率。就效率而言，使用 DSCCF 检测心肌缺血的评估似乎是合适的。
{"title":"Efficiency assessment of a two-stage diagnostic strategy combining CT angiography and fractional flow reserve derived from coronary CT angiography for the detection of myocardial ischemia: a simulation study","authors":"Kunihiro Iwata, Akira Yanagisawa, Katsuhiko Ogasawara","doi":"10.1186/s43055-024-01281-4","DOIUrl":"https://doi.org/10.1186/s43055-024-01281-4","url":null,"abstract":"The importance of a diagnostic strategy combining coronary computed tomography angiography (CCTA) with fractional flow reserve derived from CCTA (FFRCT) for detecting myocardial ischemia is increasing. However, sensitivity and specificity alone may be insufficient to understand the efficiency characteristics of a diagnostic strategy combining CCTA and FFRCT (DSCCF). Our study aimed to evaluate the overall efficiency of DSCCF in detecting myocardial ischemia and compare it with other diagnostic strategies to determine whether evaluation by DSCCF is currently appropriate. This simulation study included 1000 patients with stable chest pain and suspected myocardial ischemia. Using a decision tree analysis, assuming a diagnostic strategy of adding FFRCT to CCTA-positive patients, we calculated the following efficiency parameters of DSCCF: (1) true positive (TP), false positive (FP), net false negative (FN), and net true negative (TN) test results; (2) net sensitivity; (3) net specificity; (4) positive predictive value; (5) negative predictive value; (6) post-test probability; (7) diagnostic accuracy; (8) diagnostic odds ratio; and (9) number needed to diagnose. We also calculated the efficiency parameters of other diagnostic strategies and compared them with those of DSCCF. In the basic setting, regarding efficiency parameters (1), the number of TPs, FPs, net FNs, and net TNs were 254, 69, 46, and 631, respectively. Efficiency parameters (2)–(9) were 0.85 (95% confidence interval [CI], 0.80–0.89), 0.90 (95% CI 0.88–0.92), 0.79 (95% CI 0.74–0.83), 0.93 (95% CI 0.91–0.95), 0.07 (95% CI 0.05–0.09), 0.89 (95% CI 0.86–0.90), 50.50 (95% CI 33.83–75.37), and 1.34 (95% CI 1.24–1.48), respectively. Compared with other diagnostic strategies, DSCCF had good efficiency parameters. Moreover, the sensitivity analysis did not reveal any evidence to contradict the findings in the basic setting. This study demonstrated the diagnostic ability characteristics of DSCCF by assessing various efficiency parameters. Compared with other diagnostic strategies, DSCCF had good efficiency. In terms of efficiency, evaluation using DSCCF for detecting myocardial ischemia appears to be appropriate.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141501134","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}
B-Lynch braided compression sutures are applied as a lifesaving procedure to control atonic post-partum hemorrhage if the patient is not responding to uterotonics and other conservative methods. These sutures are applied to avoid hysterectomy so as to preserve fertility. However, if not applied properly, these can lead to a rare but serious complication of uterine necrosis secondary to uterine ischemia and sepsis. The patient then ends up in hysterectomy defeating the sole purpose of maintaining fertility for which the sutures were applied at the first place. Here we describe a case of primipara who had caesarian section complicated by post-partum hemorrhage which was managed with modified B-Lynch compression sutures for achieving hemostasis. The patient presented three weeks post-procedure with signs and symptoms of inflammation and sepsis. The MR imaging revealed features of uterine necrosis. The patient underwent hysterectomy unwillingly as no other option was left to save her life. A detailed MR imaging of this case has been described given the scarcity of MR features of uterine necrosis following compressive sutures in medical literature. The case is reported to make the clinicians aware of the possibility of such a dreaded complication following compressive sutures for post-partum hemorrhage and to emphasize on early and timely follow-up of such patients so that uterus could be salvaged.
{"title":"MR imaging features of uterine necrosis following modified B-Lynch sutures: a case report","authors":"Shruti Thakur, Anupam Jhobta, Mukesh Surya, Ashwani Tomar","doi":"10.1186/s43055-024-01282-3","DOIUrl":"https://doi.org/10.1186/s43055-024-01282-3","url":null,"abstract":"B-Lynch braided compression sutures are applied as a lifesaving procedure to control atonic post-partum hemorrhage if the patient is not responding to uterotonics and other conservative methods. These sutures are applied to avoid hysterectomy so as to preserve fertility. However, if not applied properly, these can lead to a rare but serious complication of uterine necrosis secondary to uterine ischemia and sepsis. The patient then ends up in hysterectomy defeating the sole purpose of maintaining fertility for which the sutures were applied at the first place. Here we describe a case of primipara who had caesarian section complicated by post-partum hemorrhage which was managed with modified B-Lynch compression sutures for achieving hemostasis. The patient presented three weeks post-procedure with signs and symptoms of inflammation and sepsis. The MR imaging revealed features of uterine necrosis. The patient underwent hysterectomy unwillingly as no other option was left to save her life. A detailed MR imaging of this case has been described given the scarcity of MR features of uterine necrosis following compressive sutures in medical literature. The case is reported to make the clinicians aware of the possibility of such a dreaded complication following compressive sutures for post-partum hemorrhage and to emphasize on early and timely follow-up of such patients so that uterus could be salvaged.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"48 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141254568","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 : 2024-06-03DOI: 10.1186/s43055-024-01261-8
Ghada S. Ibrahim, Emad H. AbdelDayem, Sherif N. Abbas, Wesam E. El Mozy, Ahmed S. Ibrahim
Cardiovascular magnetic resonance-feature tracking (CMR-FT) is a novel quantitative objective noninvasive technique in the assessment of myocardial deformation. The purpose of that study was to assess the capability of the CMR-FT in the detection of myocardial ischemia and viability. We investigated 30 patients (n = 480 myocardial segments), with known or suspected coronary artery disease (CAD). Dobutamine stress cardiovascular magnetic resonance (DS-CMR) and late gadolinium enhancement (LGE) were used to identify the viable non-ischemic, ischemic, and non-viable myocardial segments. Cine images at rest were used to calculate the segmental radial (Err), circumferential (Ecc), and longitudinal (Ell) strain parameters by manual contouring of endocardial and epicardial borders using Segment Software. Of the 480 myocardial segments and based on the DS-CMR and LGE results, 338 segments were defined as viable non-ischemic (remote), 101 segments were viable ischemic, and 41 segments were non-viable. Rest segmental Ecc, Err, and Ell values were significantly impaired in the non-viable (mean ± SD = − 3.94 ± 4.99%, 11.81 ± 12.55%, and − 7.50 ± 6.96%, respectively) compared to both viable groups, p < 0.001. Ecc and Err significantly differentiated between the non-ischemic and ischemic groups (mean ± SD = − 19.14 ± 7.20% vs − 13.18 ± 8.57% and 44.03 ± 19.56% vs 32.79 ± 17.91% respectively), p < 0.001. However, Ell showed no statistical significance between them (mean ± SD = − 16.44 ± 8.78% vs − 16.12 ± 10.00%, p = 0.945). CMR-FT can differentiate between viable and non-viable as well as ischemic and non-ischemic myocardial segments. So, such a noninvasive technique has a promising additional objective diagnostic role in conjunction with CMR in ischemia and viability assessment or even may replace stress and LGE studies in the future.
{"title":"Dobutamine stress cardiac magnetic resonance-feature tracking in assessment of myocardial ischemia and viability","authors":"Ghada S. Ibrahim, Emad H. AbdelDayem, Sherif N. Abbas, Wesam E. El Mozy, Ahmed S. Ibrahim","doi":"10.1186/s43055-024-01261-8","DOIUrl":"https://doi.org/10.1186/s43055-024-01261-8","url":null,"abstract":"Cardiovascular magnetic resonance-feature tracking (CMR-FT) is a novel quantitative objective noninvasive technique in the assessment of myocardial deformation. The purpose of that study was to assess the capability of the CMR-FT in the detection of myocardial ischemia and viability. We investigated 30 patients (n = 480 myocardial segments), with known or suspected coronary artery disease (CAD). Dobutamine stress cardiovascular magnetic resonance (DS-CMR) and late gadolinium enhancement (LGE) were used to identify the viable non-ischemic, ischemic, and non-viable myocardial segments. Cine images at rest were used to calculate the segmental radial (Err), circumferential (Ecc), and longitudinal (Ell) strain parameters by manual contouring of endocardial and epicardial borders using Segment Software. Of the 480 myocardial segments and based on the DS-CMR and LGE results, 338 segments were defined as viable non-ischemic (remote), 101 segments were viable ischemic, and 41 segments were non-viable. Rest segmental Ecc, Err, and Ell values were significantly impaired in the non-viable (mean ± SD = − 3.94 ± 4.99%, 11.81 ± 12.55%, and − 7.50 ± 6.96%, respectively) compared to both viable groups, p < 0.001. Ecc and Err significantly differentiated between the non-ischemic and ischemic groups (mean ± SD = − 19.14 ± 7.20% vs − 13.18 ± 8.57% and 44.03 ± 19.56% vs 32.79 ± 17.91% respectively), p < 0.001. However, Ell showed no statistical significance between them (mean ± SD = − 16.44 ± 8.78% vs − 16.12 ± 10.00%, p = 0.945). CMR-FT can differentiate between viable and non-viable as well as ischemic and non-ischemic myocardial segments. So, such a noninvasive technique has a promising additional objective diagnostic role in conjunction with CMR in ischemia and viability assessment or even may replace stress and LGE studies in the future.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"21 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141254610","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 : 2024-06-03DOI: 10.1186/s43055-024-01284-1
Abeer Gamal Lotfy, Nora Nabil Abdou, Ahmed Mohamed Monib, Rasha S. Hussein
PET/CT is currently the gold standard for lung cancer staging, and it is also used to identify distant and nodal metastases. High-resolution MRI can also be used to diagnose and provide morphological details about lung cancer. Standardized uptake value ‘SUV’ calculated from PET/CT gives information about tumor behavior where the SUV reflects metabolic tumor activity. Apparent diffusion coefficient ‘ADC’ calculated from DW-MRI is a quantitative imaging marker aiming to assess tumor cellularity which reflects tumor behavior. The study aimed to correlate ADC assessed by DW-MRI and metabolic activity determined by SUV max in PET/CT in local and nodal staging of newly diagnosed NSCLC. Our study involved twenty-one patients who were pathologically proven to be NSCLC, 19 males (90.5%) and 2 females (9.5%), with a median age of 61 years (ranging from 37 to 84 years). Among all NSCLC primary mass lesions, we observed a statistically significant inverse correlation between SUV max achieved from PET/CT and ADC max, ADC mean, and ADC min calculated from DW-MR (r = − 0.509 and p = 0.019, r = − 0.472 and p = 0.031 and r = − 0.434 and p = 0.049 for correlation between SUV max of PET/CT and ADC max, ADC mean and ADC min of DW-MR, respectively). Additionally, we observed another statistically significant inverse correlation between SUV max achieved from PET/CT and ADC max, ADC mean, and ADC min calculated from DW-MR in NSCLC mediastinal lymph nodes (r = − 0.699 and p = 0.011, r = − 0.58 and p = 0.048 and r = − 0.629 and p = 0.028 for correlation between SUV max of PET/CT and ADC max, ADC mean and ADC min of DW-MR, respectively). ADC values calculated from DW-MRI might act as a new prognostic tool owing to its significant inverse correlation with SUV max achieved from PET/CT in NSCLC primary mass lesions as well as mediastinal lymph nodes.
PET/CT 是目前肺癌分期的金标准，也可用于确定远处转移和结节转移。高分辨率核磁共振成像也可用于诊断肺癌并提供肺癌的形态细节。PET/CT 计算出的标准化摄取值 "SUV "可提供有关肿瘤行为的信息，其中 SUV 反映了肿瘤的代谢活动。DW-MRI 计算出的表观弥散系数 "ADC "是一种定量成像标记，旨在评估反映肿瘤行为的肿瘤细胞性。本研究旨在将 DW-MRI 评估的 ADC 与 PET/CT 最大 SUV 测定的代谢活动相关联，用于新诊断 NSCLC 的局部和结节分期。我们的研究涉及 21 例经病理证实为 NSCLC 的患者，其中男性 19 例（占 90.5%），女性 2 例（占 9.5%），中位年龄为 61 岁（从 37 岁到 84 岁不等）。在所有 NSCLC 原发性肿块病变中，我们观察到 PET/CT 的最大 SUV 值与 DW-MR 计算的最大 ADC 值、平均 ADC 值和最小 ADC 值之间存在统计学意义上的显著负相关（PET/CT 的最大 SUV 值与 DW-MR 的最大 ADC 值、平均 ADC 值和最小 ADC 值之间的相关性分别为 r = - 0.509 和 p = 0.019、r = - 0.472 和 p = 0.031 以及 r = - 0.434 和 p = 0.049）。此外，我们还观察到 PET/CT 的最大 SUV 值与 DW-MR 计算出的 NSCLC 纵隔淋巴结的最大 ADC 值、平均 ADC 值和最小 ADC 值之间存在另一种具有统计学意义的反相关性（PET/CT 的最大 SUV 值与 DW-MR 的最大 ADC 值、平均 ADC 值和最小 ADC 值之间的相关性分别为 r = - 0.699 和 p = 0.011，r = - 0.58 和 p = 0.048，r = - 0.629 和 p = 0.028）。在NSCLC原发肿块病灶和纵隔淋巴结中，DW-MRI计算出的ADC值与PET/CT计算出的最大SUV值呈显著的负相关，因此DW-MRI可作为一种新的预后工具。
{"title":"Correlation between chest DW-MRI and 18F-FDG PET/CT in newly diagnosed non-small cell lung cancer (NSCLC)","authors":"Abeer Gamal Lotfy, Nora Nabil Abdou, Ahmed Mohamed Monib, Rasha S. Hussein","doi":"10.1186/s43055-024-01284-1","DOIUrl":"https://doi.org/10.1186/s43055-024-01284-1","url":null,"abstract":"PET/CT is currently the gold standard for lung cancer staging, and it is also used to identify distant and nodal metastases. High-resolution MRI can also be used to diagnose and provide morphological details about lung cancer. Standardized uptake value ‘SUV’ calculated from PET/CT gives information about tumor behavior where the SUV reflects metabolic tumor activity. Apparent diffusion coefficient ‘ADC’ calculated from DW-MRI is a quantitative imaging marker aiming to assess tumor cellularity which reflects tumor behavior. The study aimed to correlate ADC assessed by DW-MRI and metabolic activity determined by SUV max in PET/CT in local and nodal staging of newly diagnosed NSCLC. Our study involved twenty-one patients who were pathologically proven to be NSCLC, 19 males (90.5%) and 2 females (9.5%), with a median age of 61 years (ranging from 37 to 84 years). Among all NSCLC primary mass lesions, we observed a statistically significant inverse correlation between SUV max achieved from PET/CT and ADC max, ADC mean, and ADC min calculated from DW-MR (r = − 0.509 and p = 0.019, r = − 0.472 and p = 0.031 and r = − 0.434 and p = 0.049 for correlation between SUV max of PET/CT and ADC max, ADC mean and ADC min of DW-MR, respectively). Additionally, we observed another statistically significant inverse correlation between SUV max achieved from PET/CT and ADC max, ADC mean, and ADC min calculated from DW-MR in NSCLC mediastinal lymph nodes (r = − 0.699 and p = 0.011, r = − 0.58 and p = 0.048 and r = − 0.629 and p = 0.028 for correlation between SUV max of PET/CT and ADC max, ADC mean and ADC min of DW-MR, respectively). ADC values calculated from DW-MRI might act as a new prognostic tool owing to its significant inverse correlation with SUV max achieved from PET/CT in NSCLC primary mass lesions as well as mediastinal lymph nodes.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"43 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141254386","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 : 2024-05-31DOI: 10.1186/s43055-024-01268-1
Shariq Ahmad Shah, Bheru Dan Charan, Sushant Agarwal, Sumanta Das, Pankaj Kumar Singh, Leve Joseph Devaranjan Sebastian, Ajay Garg
Primary intracranial Ewing’s sarcoma (ES) is a type of primitive neuroectodermal tumour and is a rare malignant tumour in children and adolescents. The imaging features of ES overlap with other central nervous system embryonal tumours, making it difficult to pinpoint a specific diagnosis. We aim to explore the clinical, neuroimaging and differential diagnoses of this entity. We describe a 6-month-old infant who presented with complaints of enlarging the head size and poor feeding. Imaging revealed a contrast-enhancing large solid-cystic mass lesion with internal calcification, focal bone erosion and haemorrhage in the posterior fossa. Histopathological examinations, immunohistochemistry, and molecular analysis confirmed ES. The confirmative diagnosis of primary intracranial ES requires histological examination, immunohistochemical analysis, and genetic detection, along with radiological findings. Surgical excision followed by combined radiotherapy and chemotherapy is the treatment of choice.
原发性颅内尤文氏肉瘤（ES）是一种原始神经外胚层肿瘤，是儿童和青少年中罕见的恶性肿瘤。ES 的影像学特征与其他中枢神经系统胚胎性肿瘤重叠，因此很难确定具体的诊断。我们旨在探讨这种实体瘤的临床、神经影像学和鉴别诊断。我们描述了一名 6 个月大的婴儿，主诉头颅增大和喂养不良。影像学检查发现其后窝有一个对比度增强的巨大实性囊性肿块病变，内部钙化、局灶性骨侵蚀和出血。组织病理学检查、免疫组化和分子分析证实了 ES。原发性颅内 ES 的确诊需要组织学检查、免疫组化分析、基因检测以及放射学检查结果。手术切除后联合放疗和化疗是首选治疗方法。
{"title":"Posterior fossa primary intracranial extraosseous Ewing’s sarcoma: case report","authors":"Shariq Ahmad Shah, Bheru Dan Charan, Sushant Agarwal, Sumanta Das, Pankaj Kumar Singh, Leve Joseph Devaranjan Sebastian, Ajay Garg","doi":"10.1186/s43055-024-01268-1","DOIUrl":"https://doi.org/10.1186/s43055-024-01268-1","url":null,"abstract":"Primary intracranial Ewing’s sarcoma (ES) is a type of primitive neuroectodermal tumour and is a rare malignant tumour in children and adolescents. The imaging features of ES overlap with other central nervous system embryonal tumours, making it difficult to pinpoint a specific diagnosis. We aim to explore the clinical, neuroimaging and differential diagnoses of this entity. We describe a 6-month-old infant who presented with complaints of enlarging the head size and poor feeding. Imaging revealed a contrast-enhancing large solid-cystic mass lesion with internal calcification, focal bone erosion and haemorrhage in the posterior fossa. Histopathological examinations, immunohistochemistry, and molecular analysis confirmed ES. The confirmative diagnosis of primary intracranial ES requires histological examination, immunohistochemical analysis, and genetic detection, along with radiological findings. Surgical excision followed by combined radiotherapy and chemotherapy is the treatment of choice.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"63 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141197355","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 : 2024-05-28DOI: 10.1186/s43055-024-01276-1
Tasneem Osama Mohamed, Moustafa Abdel Kader, Yasser Mohamed Abdel Gawwad, Shaimaa Sh. El Sharkawy, Sara Mahmoud Ragaee
Breast cancer is a major cause of both morbidity and mortality. Therefore, it is essential to promptly identify breast cancer in order to implement a more cautious surgical approach for disease treatment. Breast ultrasonography examination has long been used as a supplementary technique to mammography to evaluate palpable or mammographically detectable breast masses. Presently, Breast MRI has become an essential instrument for the detection and analysis of breast cancer. Diffusion-weighted imaging (DWI) is MRI technique that quantifies the movement of water molecules within tissue. It can provide valuable information about the density, viscosity, integrity of membranes, and microstructure of tissues. This study included sixty patients with Equivocal/high BIRADS lesions, underwent Mammography and /or U/S, CEMRI with DWI. The aim of this study was to disclose MRDWI potency in depiction and assessment of different breast lesions unaccompanied by contrast-enhanced MRI with a view to avoid the high cost of the MRI contrast, lessen the number of needless biopsies and probably reclassify breast lesions of high BIRADS categories. This prospective study included 58 patients (with 60 breast lesions), who came with sono-mammography breast lesions of BIRADS lesions > 2, comparison between sono-mammographic BIRADS and MRI BIRADS was done, where 40 cases were downgraded by MRBIRADS. On paralleling MRDWI unescorted by contrast-enhanced MRI with sono-mammographic BIRADS, 36 cases were downgraded. Correlation between pathology of the biopsied lesions with sono-mammography, MR BIRADS and MRDWI was done as well. Sono–mammography shows 88.9% sensitivity and 61.9% specificity with accuracy of 77.7%. Combined CE –MRI and DWI shows 94% sensitivity and 97.6% specificity with accuracy of 96%. While DWI solely shows 88.9% sensitivity and 90.5% specificity with accuracy of 96%. The cutoff value of ADC for prediction of malignancy was 0.9 with 94% sensitivity, 87% specificity and 83.3 accuracy. CEMRI is un-debatably effective in depicting and discriminating indeterminate breast lesions chiefly when combined with DWI. Yet, with the high expense of the contrast and in the event of contrast contraindications or unavailability, DWI has proven to be a convenient substitute for CE-MRI aiding in rendering the breast lesion BIRADS downgraded with diminishing the unneeded biopsies.
{"title":"MR diffusion-weighted imaging precision in BIRADS downstaging","authors":"Tasneem Osama Mohamed, Moustafa Abdel Kader, Yasser Mohamed Abdel Gawwad, Shaimaa Sh. El Sharkawy, Sara Mahmoud Ragaee","doi":"10.1186/s43055-024-01276-1","DOIUrl":"https://doi.org/10.1186/s43055-024-01276-1","url":null,"abstract":"Breast cancer is a major cause of both morbidity and mortality. Therefore, it is essential to promptly identify breast cancer in order to implement a more cautious surgical approach for disease treatment. Breast ultrasonography examination has long been used as a supplementary technique to mammography to evaluate palpable or mammographically detectable breast masses. Presently, Breast MRI has become an essential instrument for the detection and analysis of breast cancer. Diffusion-weighted imaging (DWI) is MRI technique that quantifies the movement of water molecules within tissue. It can provide valuable information about the density, viscosity, integrity of membranes, and microstructure of tissues. This study included sixty patients with Equivocal/high BIRADS lesions, underwent Mammography and /or U/S, CEMRI with DWI. The aim of this study was to disclose MRDWI potency in depiction and assessment of different breast lesions unaccompanied by contrast-enhanced MRI with a view to avoid the high cost of the MRI contrast, lessen the number of needless biopsies and probably reclassify breast lesions of high BIRADS categories. This prospective study included 58 patients (with 60 breast lesions), who came with sono-mammography breast lesions of BIRADS lesions > 2, comparison between sono-mammographic BIRADS and MRI BIRADS was done, where 40 cases were downgraded by MRBIRADS. On paralleling MRDWI unescorted by contrast-enhanced MRI with sono-mammographic BIRADS, 36 cases were downgraded. Correlation between pathology of the biopsied lesions with sono-mammography, MR BIRADS and MRDWI was done as well. Sono–mammography shows 88.9% sensitivity and 61.9% specificity with accuracy of 77.7%. Combined CE –MRI and DWI shows 94% sensitivity and 97.6% specificity with accuracy of 96%. While DWI solely shows 88.9% sensitivity and 90.5% specificity with accuracy of 96%. The cutoff value of ADC for prediction of malignancy was 0.9 with 94% sensitivity, 87% specificity and 83.3 accuracy. CEMRI is un-debatably effective in depicting and discriminating indeterminate breast lesions chiefly when combined with DWI. Yet, with the high expense of the contrast and in the event of contrast contraindications or unavailability, DWI has proven to be a convenient substitute for CE-MRI aiding in rendering the breast lesion BIRADS downgraded with diminishing the unneeded biopsies.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"53 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141172963","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 : 2024-05-27DOI: 10.1186/s43055-024-01278-z
Nada Sayed Mahdy, Sahar Mohammed El-Gaafary, Khaled Hamdy Abdel Mageed, Khaled A. Ali Shehata, Maha Ahmed Sayed AbdelKarim, Essam Mohamed Abdulhafiz
Crohn’s disease is a chronic inflammatory bowel disease that can affect any part of the gut. Endoscopy is the gold standard for diagnosis, but it only assesses mucosal lesions. Magnetic resonance enterography (MRE) can assess disease presence and activity, but it has limitations such as motion sensitivity, long scan time, and high cost. Bowel sonography has been introduced as a non-invasive, practical, safe, and low-cost technique to assess disease activity and complications. In our study we aim to assess the comparability of ultrasound to MRE in evaluation of patients with Crohn’s disease, and its complications. Twenty-five patients with 38 Crohn’s disease affected segments were evaluated by bowel ultrasound (BUS) and MRI enterography (MRE), where BUS and MRE showed equivalent diagnostic performance for disease detection and localization (97.4%, 100%), for sensitivity and specificity of both modalities. Peri-mural fluid (89.5%, 94.4%) and mural stratification loss (100%, 100%) showed high sensitivity and specificity by BUS compared to MRE, while for assessment of mural vascularity, BUS showed high sensitivity and specificity for high grade vascularity (100%, 83.3%), but low sensitivity and high specificity for low and moderate vascularity (0%–62.5%, 81.8%) compared to MRE. Complications including fistulae and abscessed were all correctly identified in BUS compared to MRE. BUS showed comparable results to MRE for identification, localization, assessment of findings related to disease activity, and complications in cases of Crohn’s disease rendering it a viable alternative to MRE.
{"title":"Comparative study between ultrasound and MR enterography in evaluation of Crohn’s disease","authors":"Nada Sayed Mahdy, Sahar Mohammed El-Gaafary, Khaled Hamdy Abdel Mageed, Khaled A. Ali Shehata, Maha Ahmed Sayed AbdelKarim, Essam Mohamed Abdulhafiz","doi":"10.1186/s43055-024-01278-z","DOIUrl":"https://doi.org/10.1186/s43055-024-01278-z","url":null,"abstract":"Crohn’s disease is a chronic inflammatory bowel disease that can affect any part of the gut. Endoscopy is the gold standard for diagnosis, but it only assesses mucosal lesions. Magnetic resonance enterography (MRE) can assess disease presence and activity, but it has limitations such as motion sensitivity, long scan time, and high cost. Bowel sonography has been introduced as a non-invasive, practical, safe, and low-cost technique to assess disease activity and complications. In our study we aim to assess the comparability of ultrasound to MRE in evaluation of patients with Crohn’s disease, and its complications. Twenty-five patients with 38 Crohn’s disease affected segments were evaluated by bowel ultrasound (BUS) and MRI enterography (MRE), where BUS and MRE showed equivalent diagnostic performance for disease detection and localization (97.4%, 100%), for sensitivity and specificity of both modalities. Peri-mural fluid (89.5%, 94.4%) and mural stratification loss (100%, 100%) showed high sensitivity and specificity by BUS compared to MRE, while for assessment of mural vascularity, BUS showed high sensitivity and specificity for high grade vascularity (100%, 83.3%), but low sensitivity and high specificity for low and moderate vascularity (0%–62.5%, 81.8%) compared to MRE. Complications including fistulae and abscessed were all correctly identified in BUS compared to MRE. BUS showed comparable results to MRE for identification, localization, assessment of findings related to disease activity, and complications in cases of Crohn’s disease rendering it a viable alternative to MRE.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"34 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141172961","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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