bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of MRI in Detecting and Characterizing Small Hepatic Focal Lesions
Authors: Maarouf Rania Ali , Ali Ali Haggag , Onsy Mahmoud Abdelatif 
Published: October 2021

Abstract

Background
Despite the recent advances in liver imaging, the detection and characterization of small hepatic focal lesions is still a real challenge. Particularly in cancer patients where the characterization of a small HFL as thus the precise tumor staging is critical for optimal treatment planning.

Aim of the Work
To explore the effectiveness, and hence the clinical utility, of MRI detection and characterization of small focal hepatic lesions either only discovered on MRI or as a further work up of CT/US-indeterminate lesions.

Patients and Methods
We reviewed our database for individuals who underwent liver MR imaging between March 2018 and March 2019 for the evaluation of small hepatic lesions that were discovered for the first time or had been previously visualized on routinely performed CT and had been considered indeterminate.

Results
The present study included 44 patients of which 26 were males (59.1%) and 18 were females (40.9%). The age range of the study group was 19 to 77 years. The mean age for Malignant lesions was 51 years. The right lobe of liver was involved in 23 cases (52.3%), left lobe in 5 cases (11.4%) and both lobes in 16 cases (36.4%). There were 30 (68.18%) benign, 13 (29.54%) malignant lesions and 1 (2.3%) indeterminate, hemangiomas were predominant in benign lesions whereas hepatocellular carcinomas were predominant in malignant lesions. N'TRI could characterize 92% cases.

Conclusion
The diagnostic process of small hepatic focal lesions, either detection or characterization or both, continues to represent a challenge. Contrast-enhanced MR can accurately detect and characterize majority of small hepatic focal lesions.
How Can an Updated 320 Multi Detector Computed Tomography Low Dose Protocol Help in Assessment of Coronary Heart Disease
Authors: Ibrahim Ahmed Samir , Abd-Eldayem Asst. Emad Hamed , Osman Mostafa Mohammed 
Published: October 2021

Abstract

Background
Coronary artery disease (CAD) is the single most common cause of death in the developed world, responsible for about I in every 5 deaths. The morbidity, mortality, and socioeconomic importance of this disease make timely accurate diagnosis and cost-effective management of CAD of the utmost importance. The recent years showed an overall increase in the use of CT for imaging of the heart and coronary arteries, coronary CT angiography is a rapidly growing technique that offers distinct advantages over traditional imaging techniques. However, because of rapid growth of this technique, radiation dose safety has been placed under the spotlight. Integration of dosesaving techniques will go a long way in maintaining diagnostic image quality and improving patient safety.

Objectives
The purpose of our study is the assessment of coronary artery disease by 320 MDCT and its capabilities of maintaining the quality of images and dose reduction improving patient safety.

Patients and Methods
This study was performed at New Cairo Police Hospital (Radiology department) and at Center in East Cairo, From October 2018 to October 2019, a total of 39 patients who had referred for CTCA for suspicion of coronary artery disease enrolled in our prospective study.

Results
In this study we used MDCT 64 with retrospective ECG-gating in 25.6% of patients (10 patients) and MDCT 320 with Retrospective ECG-gating was used in 25.6% (10 patients) and with Prospective ECG-gating in 48.8% (19 patients).we compared the radiation dose between prospective ECG-gating and retrospective ECG-gating acquisition techniques among all study population by the effective dose (ED) which is calculated from the DLP of the coronary scan. The effective radiation dose (ED) median was significantly lower in the prospective ECG-gating technique (7 msv) in comparison to retrospective ECG-gating technique (23 msv). We also compared the difference in radiation dose between MDCT 320 and 64 using retrospective ECG gating acquisition technique, the median (ED) was significantly lower in the 320 MI)CT technique (20 msv) in comparison to 64 MDCT (26 msv). The last comparison was the difference Of radiation dose between patients who underwent through MDCT 320 using two different techniques (prospective and retrospective), the median effective dose was lower in the prospective ECG-gating technique (7 msv) in comparison to retrospective ECG-gating technique (20 msv) this difference is also of high statistical significant value.

Conclusion
Prospective ECG-Gated CT coronary angiography protocol impressively reduces effective radiation doses in comparison to retrospective ECG-gated technique on 320 MDCT and is still sensitive for diagnosing significant coronary stenosis for patients with suspected CAD. Retrospective Coronary CT angiography can be performed with 320-MDCT with less radiation doses compared to 64-MDCT.
PET/CT in the Staging of Non-Small Cell Lung Cancer
Authors: Ghoneim Nada Mohammed Farid Hassan , Elia Remon Zaher , Sheha Aliaa Sayed 
Published: October 2021

Abstract

Background
NSCLC accounts for about 80% of all lung cancers. The current criteria for its staging is based on the TNM system that determines treatment options and predicts survival rate in patients.

Objective
To evaluate the diagnostic accuracy of 18F-FDG PET/CT in staging of NSCLC patients

Methods
A prospective study, conducted at Ain Shams University hospitals on pathologically proven patients of NSCLC, the patients were investigated using CT and PET/CT in the period between October 2018 till end of June 2019.

Results
A total of 40 patients were evaluated with the age ranging from 37 to 77 years old, whether the mean was 55.63 years (SD ± 10.29). There were 31 male cases and 9 female cases. When we compared CECT against PET-CT for staging, PET-CT helped upstage disease in 10 of 40 patients (25%) and downstage in 3 of 40 patients (7.5%).

Conclusion
PET/CT is a useful imaging tool in initial staging of the newely diagnosed patients with NSCLC. It is better thаn СT alone for detection of malignant lesions for accurate staging. It can change the strategy of treatment according to its findings
Role of diffusion weighted MRI imaging in characterization of hepatic focal lesions in cirrhotic patients in comparison to dynamic cross sectional imaging
Authors: Ibrahim Nouran G , Kamel Faten M. M , Maarouf Rania A , Abdulhafiz Essam M 
Published: October 2021

Abstract

Aim of work
The aim of the study is to show the feasibility of diffusion weighted (DWI) MRI with calculation of the apparent diffusion coefficient in characterization of hepatic focal lesions as well as differentiating benign from malignant lesions in cirrhotic patients.

Patients and Methods
The study included 35 patients (25 males and 10 females) by cross sectional study and convenient sampling at the Demerdash hospital, inclusion criteria: patients diagnosed by hepatic focal lesions on top of post-viral induced cirrhosis, detected by ultrasound, triphasic CT or dynamic MRI imaging. All patients to be included in the study underwent characterization of hepatic focal lesions to differentiate benign from malignant lesions using a combination of characteristic imaging criteria, including contrast enhancement patterns on MRI. Sequences used were T2 weighted imaging, T2 Spectral Attenuated Inversion Recovery (SPAIR), and diffusion weighted imaging sequences with estimation of the ADC map and calculation of the ADC values.

Results
Our study was carried on a total of 35 patients including 25 males and 10 female patients having a mean age of 59 ± 10.2 years (58.1 ± 11 and 61.2 ± 8 years for the male and female patients respectively). DWI and ADC showed statistically significant difference among the benign and malignant focal lesions in terms of their diffusion restriction criteria ( P &lt; 0.0001), with a sensitivity, specificity, positive and negative predictive values of 100% (95% CI = 89.5 – 100%), 92.3% (95% CI = 79.6 – 97.3%), 91.6% (95% CI = 78.1 – 97.1%) and 100% (95% CI = 90.3 – 100%), as well as a likelihood ratio of 13. On comparing the ADC values of the focal lesions for the benign and malignant focal lesions, the malignant lesions showed statistically significant lower means as compared to the benign lesions (malignant = 1.08 ± 0.28 x 10-3 mm2/s, benign =2.0 ± 0 x 10-3 mm2/s, P &lt; 0.0001). ROC curve analysis of the ADC values of the benign and malignant focal lesions was highly significant (P &lt; 0.0001), with an area under curve of 0.9745 (97.45% overall accuracy), giving an ADC cut-off value of (&lt; 0.98 x 10-3 mm2/s) for malignant lesions with 97.2% sensitivity (95% CI = 85.83% - 99.86%), 97.2% specificity (95% CI = 85.83% - 99.86%) and a likelihood ratio of 35.

Summary and conclusion
DWI MRI and the calculation of the ADC are great non invasive possible tools to detect and characterize hepatic focal lesions as well as to differentiate benign from malignant lesions in cirrhotic patients especially in patients with renal impairment and allergy to contrast media also to avoid unnecessary biopsies.
The Updated Role of Ultrasound in the Assessment of Knee Osteoarthritis
Authors: Alaam Khalid Esmat , Rahman Hazem Ibrahim Abd El , Ahmed Nouran Saieed 
Published: October 2021

Abstract

Background
Osteoarthritis (OA) of the knee is the most common form of knee arthritis and a leading cause of chronic disability.

Objective
The aim of the current study is to reassess the utility of the updated ultrasound in the patients with knee osteoarthritis and outline its clinical application.

Patients and Methods
The studied group included 36 patient 23females and 13 males with their ages ranged between 39 and 58 years (average age 44 years). The patients were referred to US examination fulfilling the ACR clinical criteria for knee OA after orthopedic and /or rheumatologist consultation. The study was performed in Radiodiagnosis department Ain Shams University Hospitals (20 patients ) and at one private center (16 patients).

Results
There was a discrepancy between the results obtained by clinical examination and those demonstrated by ultrasonography. Clinical examination detected 22 (61.1%) of our cases. Prevalence of US findings in our cases were femoral articular degeneration in 28 (77.7%) patients, Tibiofemoral osteophytes were seen in 26 patients (72.2%), knee effusion in 22 patients (61.1%),meniscal extrusion in 22 patients (61.1%) meniscal degeneration in 17 patients (47.2%) and synovial hypertrophy in 15patients (41.6%). Baker’s cysts were demonstrated in 14patients (38.8%) while pes anserine syndrome was demonstrated in 4 cases. Meniscal degeneration and meniscal extrusion were correlated significantly with femoral cartilage degeneration (P&lt;.001). Although knee effusion did not correlate with advanced knee effusion did significantly (P &gt; 0.05). Baker's cysts is statistically related to the presence and severity of mensical changes and also related to the degree of femoral articular cartilage degeneration.

Conclusion
US is a valuable technique that can assess soft tissue structures within the knee and their involvement in the osteoarthritic process .US enables in guiding and monitoring therapy through detection of knee structural damage.
Utility of PET/CT for therapy response assessment in non-Hodgkin's lymphoma
Authors: Abdel-Aziz Sally Mahmoud Abdel-Aziz , BadrElden Safaa Kamal Mohamed , Salama Asmaa Magdy Mohamed 
Published: October 2021

Abstract

Aim of the study
to evaluate the role of PET/CT in initial diagnosis and staging of lymphoma, and to determine the predictive value of 18F-FDG PET by monitoring the early response and final response after completion of chemotherapy in patients with non-Hodgkin's lymphoma.

Patient and Methods
our prospective study included 25 patients with pathologically confirmed nonHodgkin Lymphoma diffuse large B cell lymphoma selected from Department of Radiology at Ain Shams University Hospital from January 2019 to March 2020. The patients included in this study performed the followings: Initial PET/CT for staging, interim PET/CT and end of the treatment PET/CT. We performed low dose non enhanced CT scan first, then a whole body PET study followed by diagnostic enhanced whole body CT scan. The whole study took approximately 20-30 minutes.

Results
PET/CT has greater sensitivity 100% and specificity 68.8% than CT alone for detecting sites of nodal and extra-nodal involvement and for assessment of therapeutic response in non-Hodgkin lymphoma.

Conclusion
PET / CT is an accurate method for evaluating tumor viability in the post-therapy setting of Non-Hodgkin lymphomas. PET / CT has a significant advantage for the diagnosis of diffusely infiltrating organs without mass lesions or contrast enhancement compared to contrast enhanced CT.
Current Applications of Susceptibility Weighted Images in Pediatric Neurological Diseases
Authors: Abdelwahab Sarah Mohamed Mahmoud , Abdelazem Yasser , Khater Nivan Hany 
Published: October 2021

Abstract

Background
SWI provides information and helps in the differential diagnosis of different pediatric neurological diseases as it accentuates the paramagnetic properties of intravascular hemoglobin in the brain, and is sensitive for other extravascular blood products such as de-oxy-hemoglobin, hemosiderin, calcifications and air.

Objectives
The purpose of this article is to present and discuss the susceptibility weighted imaging signal characteristics of the normal pediatric brain and those of a variety of pediatric brain pathologic abnormalities. We aimed to evaluate the influence of the SWI signal pattern in current pediatric neurological diseases we will make a comprehensive review and discuss the utility of SWI in pediatric neuroimaging in establishing the diagnosis, differential diagnosis, and also understanding the pathomechanism of various paediatric brain pathologies

Materials and Methods
This study was held in MRI imaging unit of radiology department of Ain Shams university hospital and included 34 patients pediatric age group with different neurological diseases focusing on stroke, haemorrhage, tumour, calcifications and vascular malformation.

Results
We included 34 pediatric patients with different neurological diseases that commonly seen in our department and in which 26 (76.5 % )of them gained more detailed information from SWI sequence than conventional sequences, we found that SWI shows better sensitivity 100 % compared to conventional sequences that were 79.4 % in other means SWI was clinically and statistically significant .

Conclusion
Its high susceptibility for blood products, iron depositions, and calcifications makes susceptibility-weighted imaging an important additional sequence for the diagnostic workup of pediatric brain pathologic abnormalities that should be routinely added in our department. Compared with conventional MRI sequences, susceptibility-weighted imaging may show lesions with better detail and higher sensitivity. Familiarity with the pediatric susceptibility-weighted imaging signal variance is essential to prevent misdiagnosis.
Role of contrast enhanced mammography in diagnosis of malignant breast lesion with histopathological correlation
Authors: Mohamed Shaimaa Khalil Abd El-Maged , Shebreya Naglaa Hussien , El-mahdy Manal Mohamed , Elmaati Amal Amin Abo , Nasr Merehan Ahmed 
Published: October 2021

Abstract

Background
Contrast-enhanced spectral mammography (CESM) is a relatively new tool in breast imaging, which combines the benefits of full field digital mammography (FFDM) with intravenous contrast utilization. FFDM alone is a two-dimensional modality in which summation of overlapping tissues accounts for false-negative and false-positive findings, resulting in increased recall rates and limited sensitivity of the examination, especially in the setting of heterogeneously dense or extremely dense breast tissue. CESM advantageously uses the concept of angiogenesis in tumors by allowing contrast agents to highlight the areas of blood vessel proliferation relative to the surrounding normal breast tissue (Bhimani et al, 2017).

Objectives
The purpose of this study is to assess the role of contrast-enhanced (CEM) mammography for detecting malignant lesions compared to histopathological results.

Methods
A cross sectional study including 35 patients suspecting breast mass clinically, concluded at Ain Shams University hospitals, Radiology Department, in the outpatient breast clinic, the patients were investigated using SenoBright spectral mammography device, the period between January 2018 till the end of b June 2019.

Results
In our study CESM had a sensitivity of 95.7 %, a specificity of 66.7 %, a positive predictive value of 84.6% (PPV), a negative predictive value of 88.9 % (NPV) and efficacy 85.7 %.

Conclusions
CESM has better diagnostic performance than the standard conventional imaging; mammography plus ultrasound and provides a valuable tool to evaluate equivocal and suspicious breast lesions and detect multifocal/multicenteric disease accurately.
The role of magnetic resonance imaging in the assessment of acromial morphology in association with rotator cuff tear
Authors: Abdelghany Ahmed Fathy , Osman Ahmed Mohamed , Hussein Taha Kamal 
Published: October 2021

Abstract

Background: The pathogenesis of rotator cuff tear (RCT) remains controversial. The acromion portion ofthe scapula and its morphology may be attributable for a variety of shoulder disorders such as RCT.
Patients and Methods: This was a retrospective study that included 40 patients divided into two groups; a group with RCT included 20 patients and a control group with no RCT included the other 20 patients. 19 were males and 21 females, their age 20-69 years old with a mean age of 45. Cases were selected from the PACS system of the Radiology department of Ain Shams University Hospital. Statistical data analysis was done using IBM SPSS software package version 20.0. (Armonk, NY: IBM Corp)
Results: The study revealed that Type Il acromion was encountered in most of the male patients (42.1%) and type Ill acromion was encountered in most of the female patients (42.9%) while type IV acromion was less frequently seen among males and females (5% & 0%) respectively. It also revealed that Type Ill is mostly encountered in RCT (50%); 58% of full-thickness tear and 37% of partial thickness tear. while type I is less frequently associated with a partial tear or full thickness tear (8%) for each.
Acromion type Ill was the commonest type of acromion found between the patients of the case group with a significant statistical difference found between the case and control groups
(P value: 0.006). However, type I acromion was the commonest acromion type found between the control group with also a significant statistical difference (P value: 0.011).
Conclusion: Type Ill acromion may be a risk factor leading to rotator cuff tear. This may help guide therapy in patients with shoulder pain and findings suggesting type Ill acromion shape

Keywords
acromion shapes, magnetic resonance imaging, rotator cuff tear
Visual Outcome Predictors After Surgical Excision Of Meningiomas Compressing The Optochiasmatic Complex
Authors: Ali Ali Kotb , Alsayed Ahmad , Hamdy Tarek , Abdulrahman Mohammed , Galaleldeen Mahmoud 
Published: October 2021

Abstract

Background
Meningioma arising from locations in the vicinity of optic nerve or chiasm may affect the visual function which sometimes the presentation of such tumors. Decompression of the optic nerve or chiasm can give a chance to the visual function to recover.

Methods
30 patients who had visual function affection and underwent meningioma excision are followed up for a period of one year with regular follow of their visual function periodically.

Results
In this study, females were more prevalent than males, 24 out of 30, age ranged from 24 to 72 years at the time of surgery, half the patients (15) presented with visual deterioration, the other patients presented with headache, seizure, proptosis or accidentally discovered. 22 patients improved concerning their visual function over time, 6 patients had stationary course and 2 patients deteriorated postoperatively.

Conclusion
Follow up of patients after surgical excision of meningioma compressing the anterior optic pathway showed gradual improvement in vision in follow up period up to one year, although the improvement in visual function showed a surge in early postoperative period, with continuous less steep improvement afterwards till the end of the observation period. Surgical excision of meningiomas compressing the anterior visual pathway give chance for recovery of visual function, more in younger patients, patients with shorter period of visual deterioration, patients with mild affection of the preoperative visual status. No statistically significant influence of tumor site, size, degree of excision and surgical approach on the postoperative visual outcome in this series.
Efficacy of Endoscopic Surgery Management of Craniopharyngiomas in Terms of Tumor Control and Postoperative Morbidity
Authors: El bahy KhaledM , Kabil Mohammed S , Elgayar Abdelrahman H , Beniamen Shady K 
Published: October 2021

Abstract

Background
Craniopharyngiomas represent a surgical challenge with resection via either a transcranial or a transnasal approach using microscopy or endoscopy. The selection criteria of the classic transsphenoidal route for the management of craniopharyngiomas were postulated &gt;30 years ago and still are valid today.

Aim of the Work
to systematically review the literature published discussing the endoscopic management of craniopharyngioma as regard tumor control, symptomatic relief and post-operative morbidity.

Materials and Methods
This systematic review and meta-analysis was performed in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analyses Of Observational Studies in Epidemiology (MOOSE) statements. PRISMA and MOOSE are reporting checklists for Authors, Editors, and Reviewers of Meta-analyses of interventional and observational studies. According to International committee of medical journal association (ICJME), reviewers must report their findings according to each of the items listed in those checklists.

Results and Conclusion
The extended EEA for suprasellarcraniopharyngiomas avoids brain retraction, permits early exposure of the lesion, provides good visualization of the pituitary gland and stalk and the main vascular structures, and minimizes manipulation of the optic apparatus. The endoscopic technique, both standard and extended approaches, can be considered as a possible surgical treatment for craniopharyngiomas in the modern neurosurgical techniques.