Current Issue : October - December Volume : 2020 Issue Number : 4 Articles : 6 Articles
Degenerative disc disease is the most common cause of low back pain. Intervertebral\ndisc abnormalities are commonly evaluated by magnetic resonance\nimaging (MRI), and Pfirrmannâ??s system involves the use of T2-weighted images\n(T2WI) to classify disc degeneration. However, as this classification is\nbased on visual evaluation, it is not possible to quantify degeneration using\nthis method. The present study was performed to establish an MRI-based intervertebral\ndisc classification system using diffusional kurtosis imaging\n(DKI), to quantify intervertebral disc water content according to the Pfirrmann\nclassification. Sagittal mean diffusional kurtosis (MK) mapping was\nperformed for the L3/4, L4/5, and L5/S1 intervertebral discs in 32 patients (15\nfemale, 17 male; age range, 24 - 82 years; mean age, 57.7 years). The degree of\ndisc degeneration was assessed in the midsagittal section on T2WI according\nto the Pfirrmann classification (grade I - V). The relationships between MK\nvalues, which are correlated with intervertebral disc composition changes,\nand grade of degeneration determined using the Pfirrmann classification\nwere analyzed. The MK values tended to decrease with increasing grade of\ndegeneration, and differed significantly between grades I and IV, but not between\ngrade IV and V...................
Objective: To date, few studies have compared the diagnostic performance\nand visibility of microcalcifications obtained using digital breast tomosynthesis\n(DBT) with those obtained from full-field digital mammography\n(FFDM). The visualization and characterization of microcalcifications with\nDBT remain controversial. The purpose of this study was to compare the\nvisibility of microcalcifications and determine whether DBT exhibits a\ndiagnostic advantage for visualizing microcalcifications over FFDM. Methods:\nWe retrospectively reviewed 120 cases including DBT and FFDM\nimaging (60 histologically verified as breast cancers and 60 as benign microcalcifications\nor normal). DBT images with a wide scan-angle of.....................
Stroke represents the 2nd cause of mortality and 1st cause of physical disability in the adult population. In Senegal, it represents 30% of hospitalization and 2/3 of the mortality in the department of neurology in the capital city, Dakar. Objective: To specify the types of stroke and to evaluate diagnostic delays in Senegalâ??s regional hospitals. Materials and Methods: This was a retrospective, cross-sectional, descriptive, multicentric study for 4 years (from 2014 to 2017) including any patient presenting a clinical suspicion with a CT scan confirmation of stroke in one of the 9 regional hospitals in Senegal with a recruitment period of 6 months per hospital. CT scans were performed with a 16 slices machine in 6 hospitals, 4 slices in 2 hospitals and 2 slices in 1 hospital. We studied the types and location of strokes, the associated signs and the time from stroke onset to admission and the time from admission to CT scan. Results: 655 patients were retained including 322 men and 333 women for an M/F ratio of 0.96. The average age was 63 years (range: 7 years, 112 years). High blood pressure was noted in 59.2% of patients and diabetes in 10.7% of patients. Strokes were ischemic in 76% of cases involving the middle cerebral artery in 73% of cases and hemorrhagic in 24%, of which 80.7% were deep localized. A mass effect was noted in 7.5% of cases, an engagement in 6.9% of cases and ventricular hemorrhage in 2.7% of cases. The delay between the onset of the deficit and admission was less than 6 hours in 10.6% of patients. The time between the onset of stroke and admission to hospital was specified in 416 patients (63.5%) of the study population, it was less than 6 hours in 10.6% of patients, between 6 hours and 24 hours for 29.3% and more than 24 hours for 60.1%. Between admission and the CT scan, the time was precise in 459 patients (70%), it was less than 6 hours in 37.9%, between 6 hours and 24 hours in 43.6 % and more than 24 hours in 18.5%. Conclusion: CT is central to the diagnosis of stroke in rural areas. However, there is a significant delay in diagnosis and management....
Intralobar sequestration (ILS) is a complex lung lesion where part of a lower\nlobe lacks communication with the tracheobronchial tree and receives an aberrant\narterial blood supply from the systemic circulation. That systemic artery\nis usually large, originating from the thoracic aorta or the abdominal\naorta and its upper branches. We describe a case of ILS where a large systemic\nartery coming up from below the diaphragm is formed by the convergence of\nmany very small serpiginous arteries coming up from the area of the celiac\ntrunk and common hepatic artery: a kind of â??rete mirabileâ?. This peculiar\nmorphology was not described before....
Plain radiography usual method to detect degeneration in the\nsubtalar and talonavicluar joints. MRI is a better way to fully characterise\nnon-ossified structures, such as articular cartilage, marrow tissue and synovial\nfluid and therefore detect changes of arthritis. The motivation behind this\nstudy was to develop a quantitative way to score arthritic changes to the subtalar\nand talonavicular joints using MRI. The developed system will then be\nused as a research tool and in the close assessment and monitoring of patients\nwith hindfoot degenerative disease. Methods: The MRI scans of thirty consecutive\nsubjects with foot and ankle pain were retrospectively evaluated. Images\nwere interpreted independently by three musculoskeletal radiologists in\norder to determine intra-observer reliability as well as the inter-observer reliability\nof the score. Five features of osteoarthritis were scored in the Subtalar\njoint and the Talonavicular joint. These were cartilage morphology, subarticular\nmarrow, subarticular cyst, marginal osteophytes and synovitis. Results:\nFor the 30 MRI scans the mean score for the Subtalar joint ranged from 11.7\nto 14.4 and for the Talonavicular joint ranged from 3.7 to 5.6. The inter-\nobserver correlation for the Subtalar joint between the three readers\nranged between 0.53 and 0.83 for the individual features but overall was excellent\nat 0.76. For the Talonavicular joint the total correlation was good at\n0.67. The inter-observer ICC for the total score was 0.75 which showed excellent\nagreement between the three readers. The total intra-observer correlation\nwas excellent. Conclusions: The current work has shown excellent reliability\nfor the scoring system. It will be a useful tool to diagnose and monitor disease\nprogression of the Subtalar and Talonavicluar joints....
Background: Dynamic contrast-enhanced MR imaging (DCE-MR) is becoming\na widely accepted complementary method for diagnosing breast cancer\nand other cancers in adults. It is useful to predict tumor response to anticancer\ntherapy and monitor the tumor response to the therapy. This form of\nimaging techniques has not been adequately explored in pediatric oncology\npatients. Objective: To determine the potential role of dynamic contrastenhanced\nMR imaging (DCE-MR) in the diagnosis and treatment response\nmonitoring of childhood and young adult extra-cranial tumors in routine\nclinical setting. Methods: Children with suspected extra-cranial solid tumors,\nincluding newly diagnosed or follow-up cases of confirmed tumors, were recruited.\nDCE-MR was performed with intravenous injection of 0.1 mmol/kg\ncontrast. The enhancement time curves were plotted and the enhancement\npatterns were categorized into type 1, 2 and 3 curves. Enhancement curve\npatterns and maximal enhancement intensity were compared with types of\ntumor in newly diagnosed cases. The preoperative percentiles of inactive area\non the colour map were compared with the necrotic areas on histologic sections\nof the resected specimens in follow-up cases. Pearson Chi-square test\nand Unpaired two-sample t-test were used for statistical analysis. Results:\nThere were 36 patients, involving 28 malignant and 8 benign cases. There\nwere 14 type 3 curves, (all of them were malignant tumors), 6 type 2 curves\nand 16 type 1 curves. All the benign cases (n = 8) demonstrated type 1 curve\n(accuracy & negative predictive value = 100%). All the malignant cases after\ntreatment showed type 2 or 1 curve. For those cases with operation done afterwards,\nthe extent of tumor necrosis was correlated closely with pathology\nfindings (accuracy = 93.3%). Conclusion: Type 1 curve was a good predictor\nof benign lesion. DEC-MR may have a role to play in the monitoring of the\nprogress of treatment and extent of tumor necrosis...
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