ABSTRACT
Background: Magnetic resonance enterography [MRE] has become the modality of choice in assessment of patients with Crohn's disease [CD]
We aimed to present our experience on 300 patients with CD who underwent MRE during the first 30 months after setting up MRE for the first time in a referral center in Iran
Methods: Patients with a definite diagnosis of CD based on either ileocolonoscopy or histopathological studies were included in the final report and categorized into four phenotypes of inactive, active, stricturing, and penetrating disease
Results: This was a case series study on 300 patients with known CD out of 594 referred subjects. The most prevalent phenotype was inactive observed in 162 [54.0%] patients followed by stricturing in 44 [14.7%], active in 40 [13.3%], penetrating in 27[9%], and active on chronic in 27 [9%] cases. The number of referred patients increased from 51 cases in the first 6 months to 165 in the last 6 months
Conclusion: This study presents the first report on the application of MRE in Iran as superb modality for management of CD. The growing number of referred patients indicates that MRE has been successful in addressing the most critical concerns of clinicians on determining the dominant disease phenotype
ABSTRACT
Bilateral neck exploration is the gold standard for parathyroid adenoma localization in primary hyperparathyroidism. But surgeons do not have adequate experience for accurate surgical exploration and new methods are developed for surgery like unilateral exploration and minimally invasive surgery, thus, preoperative localization could reduces time and stress in surgical performance. 80 patients with documented primary hyperparathyroidism and with raised serum calcium and parathyroid hormone [PTH] were selected. The results of ultrasonographic localization for each patient were compared with findings of surgery and 99m technetium sestamibi scintigraphy. Also variables such as preoperative serum calcium, PTH level and adenoma weight were compared between patients who had localized and nonlocalized adenoma with ultrasonography or Sestamibi scan. The data was compared with student's t-test. In a prospective diagnostic tests' accuracy, 80 patients with primary hyperparathyroidism were enrolled. Ultrasonography images detected enlarged parathyroid glands in 61 of 80 patients [76.3%] with sensitivity of 83.5% and positive predictive value [PPV] of 89.7%. Sestamibi scintigraphy detected adenoma in 63 patients [78.8%] with sensitivity of 85% and PPV of 91.3%. There was no significant deference between ultrasonography and scintigraphy in localization of adenomas. Both ultrasonography and scintigraphy used for determining localization, and they located 73 adenomas [91.3%] with sensitivity of 97.3% and PPV of 93.5%. Ultrasonography as an accurate method for localization of enlarged parathyroid glands in primary hyperparathyroidism, is comparable in overall utility with sestamibi scintigraphy. This study suggests a strategy for initial testing with one method, followed by the alternate imaging test if the first test happen to be negative
ABSTRACT
A young man presented with a large liver mass and positive hepatitis B virus markers. This 18-year-old male has developed ascites, jaundice, high serum alpha fetoprotein [AFP] level, liver mass and portal hypertension, without fever or calcification in the mass. All favored the diagnosis of rapidly, progressive hepatocellular carcinoma, however proven hepatoblastoma in liver biopsy. Hepatoblastoma usually manifests prior to the third year of life, but can rarely be seen in older children or adults. Although HCC rarely can be presented in young patients with HBV infection, but in patients without cirrhosis hepato-blastoma should be considered as the first possible diagnosis