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Reduction of the Body Weight-adapted Volume of Contrast Material by Increasing the Injection Rate in 320-detector Row Coronary CT Angiography
Wencai Yang,
Zhaohui Xian,
Feifeng Qiu,
Nengwei Wang,
Sihua Liang,
Lin Qiu
Issue:
Volume 8, Issue 4, December 2020
Pages:
65-71
Received:
24 August 2020
Accepted:
6 October 2020
Published:
16 October 2020
Abstract: Background: 320-detector row dynamic volume computed tomography (CT) scanner was widely applied in coronary CT angiography (CCTA)，which made it possible to reduce the volume of contrast material (CM) used. Some studies have reported the feasibility of reducing the CM in 320-detector row CCTA using a weight-adapted injection protocol. However, it hasn't been studied to investigate what was the significance of increasing the injection rate with a lower volume of CM. Objective: To investigate the feasibility of reducing the body weight-adapted volume of CM by increasing the injection rate in 320-detector row CCTA. Methods: A total of 116 patients who underwent 320-detector row CCTA were divided into three groups. Group A received 0.7 ml/kg of CM (350 mg I/ml) at an injection rate of 5.0 ml/s (n = 40); group B received 0.6 ml/kg of CM at 5.5 ml/s (n = 39); group C received 0.5 ml/kg of CM at 6.0 ml/s (n = 37). A 30-ml 0.9% saline chaser was administered after the CM. Enhancement values of the cardiovascular territories and coronary arteries were measured and compared. Image quality was also evaluated and compared among the three groups. Result: Enhancement values of the proximal coronary arterial segments for group C were significantly lower than those for groups A and B (all, P < 0.05), whereas there were no significant differences between groups A and B (all, P > 0.05). Similar statistical results were found in the proportion of proximal coronary arterial segments with enhancement values ≥ 300 HU, image quality ratings and the proportion of the main of coronary arterial segments with image quality scores ≥ 3 on both per-vessel and per-patient analyses. Conclusion: At least 0.6 ml/kg with 350 mg I/ml of CM at 5.5 ml/s injection rate was required to achieve sufficient and credible evaluation of the coronary artery in 320-detector row CCTA.
Abstract: Background: 320-detector row dynamic volume computed tomography (CT) scanner was widely applied in coronary CT angiography (CCTA)，which made it possible to reduce the volume of contrast material (CM) used. Some studies have reported the feasibility of reducing the CM in 320-detector row CCTA using a weight-adapted injection protocol. However, it ha...
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Evaluation of Fetal Echocardiography as Antenatal Diagnostic Tool in Detection of Congenital Heart Diseases
Lamees Mohamed Ghith,
Rania Essam-El-Dein Mohamed Ali,
Emad Mohamed Mashaly,
Alshaimaa Zakarya Elshahawy
Issue:
Volume 8, Issue 4, December 2020
Pages:
72-83
Received:
25 September 2020
Accepted:
10 October 2020
Published:
30 October 2020
Abstract: Congenital heart diseases (CHDs) are one of the most common fetal malformations; the aim of the present study was to assess the role of fetal echocardiography in diagnosis of CHDs. The prenatal diagnosis of CHDs has been shown to have a significant effect on prenatal and postnatal management and outcomes. The current prospective study included 80pregnant women; detailed fetal echocardiography was performed according to International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) guidelines [1]. In this study the range of gestational age was between 20 – 35 weeks, (57.5%) were males and (42.5%) were females, 48 CHDs (60%) were detected in the low risk group and 32 (40%) were found in the high risk group, we found the most frequent risk factors for CHDs was positive parental consanguinity in (18 cases), multiple risk factors were found in (14 cases), there was insignificant correlation between mother age, fetal age and presence of risk factors. Our results showed that 20% of cases had associated ECAs, while 80% of cases had no associated ECAs. The most frequent CHDs encountered in our study was isolated VSDs (10%). Complete agreement was found in (85%) of cases between prenatal and postnatal echo findings. It is concluded that due to the high frequency of CHDs within the low risk pregnant females, we suggest that basic fetal echocardiography should be done for all pregnant women regardless the presence of risk factors.
Abstract: Congenital heart diseases (CHDs) are one of the most common fetal malformations; the aim of the present study was to assess the role of fetal echocardiography in diagnosis of CHDs. The prenatal diagnosis of CHDs has been shown to have a significant effect on prenatal and postnatal management and outcomes. The current prospective study included 80pr...
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Sex Determination from the Morphometry of the Foramen Magnum in Benin: Potential Forensic Identification Tool
Yekpe Ahouansou Patricia,
Savi de Tove Kofi-Mensa,
Bigot Cep,
Adjadohoun Sbmg,
Savi de Tove Jean-Louis,
Adjovi Boris,
Biaou Olivier,
Boco Vicentia
Issue:
Volume 8, Issue 4, December 2020
Pages:
84-88
Received:
6 October 2020
Accepted:
21 October 2020
Published:
30 October 2020
Abstract: Background: previous studies had concluded that studying the measurements of the foramen magnum could enable sex determination with good reliability for forensic identification issue. The reliability of identification methods based on foramen magnum measurements are related to natives populations. Objective: he objective of this study was to assess the value of the measurements’ use of the foramen magnum in the identification of the sex with a view to exploitation in forensic medicine at the local level. Methods: The antero-posterior and latero-lateral diameters as well as the area of the foramen magnum were measured and calculated on a series of 200 cranial scans (114 men and 84 women). The distribution of measurements was compared by sex. The collected data was subjected to binary logistic regression analysis. Results: The values of the measurements of the foramen magnum of the men are significantly higher than those of the women. Binary logistic regression performed from anteroposterior diameter or areas correctly predicted gender in 64 to 66% of cases. When the regression is based on the latero-lateral diameter alone, 56.8% of individuals are well classified. Conclusion: Sexual dimorphism is pronounced at the level of FM morphometry. Measurements of the foramen magnum can be used to identify sex in a forensic context in Benin. However, its use should preferably be done as a confirmatory test or in situations where the occipital bone is the only structure of the skull that is complete.
Abstract: Background: previous studies had concluded that studying the measurements of the foramen magnum could enable sex determination with good reliability for forensic identification issue. The reliability of identification methods based on foramen magnum measurements are related to natives populations. Objective: he objective of this study was to assess...
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MRI Features of Temporalis Muscle Flap Versus Dermis-fat Graft After TMJ Discectomy
Fatma Wageeh Attya,
Moustafa Mohamed El-Sayed Taha,
Ahmed Mohamed Salah,
Mahmoud El-Shamy,
Mohammed Abd El-Mageed Katamesh,
Mohamed Galal Gamal El-Deen Beheiri
Issue:
Volume 8, Issue 4, December 2020
Pages:
89-92
Received:
2 October 2020
Accepted:
2 November 2020
Published:
11 November 2020
Abstract: The aim of this study was to radiologically evaluate dermis-fat graft and temporalis muscle flap as replacements after TMJ discectomy. Patients and methods: fourteen female patients were categorized into two equal groups (seven patients on each group,) group (A) and group (B). Group A underwent TMJ discectomy followed by interpositional muscle flap. Group B underwent TMJ discectomy followed by interpositional dermis-fat graft. Pre-operative MRI (T1, T2 and proton density) were obtained in addition to 3 months and 12 months post-operative MRI for comparison and follow up of the graft. Results: Temporalis muscle flaps were diagnosed in all group (A) patients (12 joints). The dermis-fat graft was detected within the operated joints or surrounding the condyle in three patients of group B while mostly resorbed in the other four patients after one year follow up. Conclusion: Discectomy and dermis-fat graft appears to be a successful surgical option regarding to the clinical parameters. However, summed degenerative changes depending on surgical operation should be retained. Temporalis muscle flap still the gold standard after TMJ menesictomy.
Abstract: The aim of this study was to radiologically evaluate dermis-fat graft and temporalis muscle flap as replacements after TMJ discectomy. Patients and methods: fourteen female patients were categorized into two equal groups (seven patients on each group,) group (A) and group (B). Group A underwent TMJ discectomy followed by interpositional muscle flap...
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Fibroscan and FIB-4 Assessment Versus Lymphocyte / Monocyte Ratio as Predictors of Post-Hepatectomy Liver Failure in HCV Egyptian Patients with Hepatocellular Carcinoma
Mona Nasef,
Lobna Abo Ali,
Mohammed Hablus,
Hossam Eldeen Soliman,
Nehad Hawash,
Nadia Elwan
Issue:
Volume 8, Issue 4, December 2020
Pages:
93-101
Received:
20 October 2020
Accepted:
10 November 2020
Published:
24 November 2020
Abstract: Background: Post-hepatectomy liver failure (PHLF) is the most leading cause of mortality in patients diagnosed with hepatocellular carcinoma (HCC) and undergoing resection of the affected part of the liver. Objectives: This research aimed to determine the value of the lymphocyte to monocyte ratio (LMR), fibrosis score 4 (FIB-4) and liver stiffness measurements (LSM) using Fibroscan as pre-operative predictors of PHLF in Egyptian patients with post- hepatitis C virus (HCV) liver cirrhosis and HCC. Methods: In this prospective cohort study definition of PHLF was done according to the “50-50 criteria”. Multivariate analysis was done to identify PHLF independent predictors. The predictive accuracy of the pre-operative LMR, FIB-4 and LSM with Fibroscan were evaluated by receiver operating characteristic (ROC) curve. Results: Enrollment of fifty Egyptian patients was done. 14 patients (28%) experienced PHLF. The presence of oesophageal varices, serum AST, serum albumin, LMR, FIB-4 score, and LSM (P<0.05) were independent pre-operative predictors for PHLF. According to ROC curve analysis, LMR yielded the best accuracy for predicting PHLF at cutoff <3.33 [AUC = 0.940; sensitivity = 93.65%; specificity = 94.44%; positive predictive value = 86.67%; negative predictive value = 97.14%]. FIB-4 score and LSM had lower AUC (0.886 and 0.875) respectively. Conclusion: The pre-operative LMR has a higher predictive ability for PHLF in patients with HCV-related HCC undergoing hepatectomy compared with FIB-4 score and LSM using Fibroscan.
Abstract: Background: Post-hepatectomy liver failure (PHLF) is the most leading cause of mortality in patients diagnosed with hepatocellular carcinoma (HCC) and undergoing resection of the affected part of the liver. Objectives: This research aimed to determine the value of the lymphocyte to monocyte ratio (LMR), fibrosis score 4 (FIB-4) and liver stiffness ...
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Adherence to MRI Protocol Consensus Guidelines in Multiple Sclerosis Patients at Taif Hospitals
Issue:
Volume 8, Issue 4, December 2020
Pages:
102-105
Received:
7 November 2020
Accepted:
17 November 2020
Published:
24 November 2020
Abstract: Background: multiple sclerosis (MS) is a chronic inflammatory disease that affects the central nervous system (CNS). Its diagnosis is characterized by foci of demyelination, disseminated over time and anatomical space, both clinically and radiologically. Consensus guidelines for the diagnosis of MS have been established to identify the proper sequences and imaging technique. Objective: this study aims to investigate the adherence of Taif hospitals to these consensus guidelines. Method: data were collected from the radiology departments of 3 main hospitals in Taif (King Abdul-Aziz Specialist Hospital, King Faisal Medical Complex, and Al-Hada Hospital for Armed Forces). The standard magnetic resonance imaging (MRI) protocol for MS in each hospital was reviewed using the picture archiving and communication system (PACS). The comparisons were based on the strength of the magnetic field, slice thickness, slice orientation, coverage, and the MR core sequences used. Results: each Taif hospital has its own protocol, which differ from consensus guidelines. The main difference is the hospitals’ lack of 3D sequences. Another difference is the lack of inversion recovery prepared T1 sequences. Finally, for follow-up patients, no contrast administration exists in Taif hospitals. Conclusion: this study shows some major differences in the MS protocols among Taif hospitals. This is probably due to poor awareness of the guidelines in the radiology community. Neuroradiologists at Taif hospitals should ensure the recommended protocol is followed.
Abstract: Background: multiple sclerosis (MS) is a chronic inflammatory disease that affects the central nervous system (CNS). Its diagnosis is characterized by foci of demyelination, disseminated over time and anatomical space, both clinically and radiologically. Consensus guidelines for the diagnosis of MS have been established to identify the proper seque...
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Static Renal Scintigraphy in Diagnosis of Pediatric Renal Pyelonephritis
Asmaa Hamdy Mohamed Dkhail,
Samah Ahmed Ibrahim Radwan,
Hossam Mostafa Gad,
Hanan Mohamed Saleh El-Ahwal
Issue:
Volume 8, Issue 4, December 2020
Pages:
106-113
Received:
23 November 2020
Accepted:
4 December 2020
Published:
11 December 2020
Abstract: Imaging of children who had symptoms and signs of pyelonephritis is aimed to diagnosis of renal injury and identification of risk factors for pyelonephritis that might be uncovered during imaging includes vesico- ureteric reflux (VUR). The purpose of this study was to determine the role of static renal scintigraphy in diagnosis of pediatric renal pyelonephritis and the value of single photon emission computed tomography (SPECT) in diagnosis. This study was carried out on 50 patients in Radiology Department at Mansoura Urology and Nephrology center and Radiology department at Tanta university hospitals. High grade vesicoureteric reflux "VUR" (grade IV & V) was detected in 70% of the cases. 42.8% of the cases had vesicoureteric reflux in both kidneys, 42.8% of the cases had VUR only on the left side and 14.2% of the cases had VUR on the right side. A statistical significance was found between grades of pyelonephritis and grades of vescio-ureteric reflux, so there was a strong association between high grade VUR and renal pyelonephritis. It was found that no significant difference was found as regard to the number of abnormal segments detected by static renal scintigraphy and SPECT imaging. Static renal scintigraphy is considered the gold standard for diagnosis of children with pyelonephritis and detection the risk of renal scarring due to recurrent infection. SPECT offers no statistically significant diagnostic advantage over static images for detection of cortical defects.
Abstract: Imaging of children who had symptoms and signs of pyelonephritis is aimed to diagnosis of renal injury and identification of risk factors for pyelonephritis that might be uncovered during imaging includes vesico- ureteric reflux (VUR). The purpose of this study was to determine the role of static renal scintigraphy in diagnosis of pediatric renal p...
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Role of Ultrasound and Magnetic Resonance Imaging in Evaluation of Elbow Pain
Reham Samy Sheta,
Rasha Lotfy Younis,
Radwa Mostafa Elkhouly,
Atef Hammad Teama
Issue:
Volume 8, Issue 4, December 2020
Pages:
114-125
Received:
23 November 2020
Accepted:
4 December 2020
Published:
11 December 2020
Abstract: The elbow is a complex joint designed to withstand a wide range of dynamic exertional forces. There are multiple lesions causing pain at the elbow. The location and quality of elbow pain can generally localize the injury to one of the four anatomic regions: anterior, medial, lateral, or posterior elbow. The purpose of this study is to evaluate the role of ultrasound and magnetic resonance imaging in identifying elbow pain causes. Sixty patients (36male and 24 female) were enrolled in this study who are complaining from elbow pain and or any discomfort at elbow region. Tendinous elbow lesions (flexor and extensor tendon injury) were the most detectable lesions (50/172) (29.0%), followed by ligamentous lesions (medial and lateral collateral ligament injuries) (42/172) (24.41%), bony lesions (38/172) (22.09%), muscle lesions (24/172) (13.95%) and nerve lesions come last with (20/172) (11.76%). Ultrasound is a rapid cheap modality of choice regarding screening of elbow tendionous and ligamentous injury to lesser degree bony and neural lesions, MRI should be considered to assess precisely the extent of any injury in addition to the value of bone visualization & nerve evaluation. Magnetic resonance neurography is a potentially useful diagnostic tool in the evaluation of ulnar neuropathy at the elbow especially ulnar nerve.
Abstract: The elbow is a complex joint designed to withstand a wide range of dynamic exertional forces. There are multiple lesions causing pain at the elbow. The location and quality of elbow pain can generally localize the injury to one of the four anatomic regions: anterior, medial, lateral, or posterior elbow. The purpose of this study is to evaluate the ...
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Role of Cardiac Magnetic Resonance Imaging in Diagnosis of Myocardial Infarction
Ahmed Mohamed Abdel Hakam,
Hisham Mostafa Imam,
Hany Mohamed Abdel-Hakeem Seif,
Nisreen Adel Abbas
Issue:
Volume 8, Issue 4, December 2020
Pages:
126-137
Received:
27 January 2020
Accepted:
20 February 2020
Published:
28 December 2020
Abstract: Introduction: Cardiac Magnetic Resonance Imaging provides an accurate and reproducible modality for the assessment of global ventricular volumes and function, and valuable in establishing a diagnosis of chronic and acute MI and distinguishing this condition from non-ischemic cardiomyopathies. Aim: To evaluate the role of cardiac Magnetic Resonance Imaging technique in diagnosis of myocardial infarction, assessment of myocardial viability. Subject and Method: The study was conducted over a period of 3 years at Assiut University Hospital. Fifty-six patients were recruited. All patients were subjected to full history taking and radiological evaluation using a 1.5-T MR system and echocardiography. Agreement regarding segmental wall motion was assessed by using Cohen’s Kappa statistics. Also ejection fraction measurement by both modalities was compared using bland-Altman plots. Agreement between Magnetic Resonance Imaging and conventional coronary angiography in detection of diseased coronary arteries was examined using Cohen’s kappa coefficient (κ). Results: It was found that ejection fraction detected by Echo were overestimated relative to Magnetic Resonance Imaging with statistically significant difference (p=0.004). While LV diameters detected by echocardiography were underestimated relative to Magnetic Resonance Imaging. Good agreement between Magnetic Resonance Imaging and Echo regarding segmental wall motion. There was positive very high correlation between the two modalities in evaluation of LV Functionality indices. Conclusion: CMR is superior to echo in evaluating left ventricular functionality indices with echo underestimating these indices except the ejection fraction which is overestimated by Echo. Moreover, CMR is better in evaluating post MI complications and associated cardiac abnormalities.
Abstract: Introduction: Cardiac Magnetic Resonance Imaging provides an accurate and reproducible modality for the assessment of global ventricular volumes and function, and valuable in establishing a diagnosis of chronic and acute MI and distinguishing this condition from non-ischemic cardiomyopathies. Aim: To evaluate the role of cardiac Magnetic Resonance ...
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