Role of MRI in characterization of occult breast lesions in high risk population

To evaluate the diagnostic validity of breast MRI in discriminating benign from malignant lesions in women with occult breast lesions who are at a high risk of developing breast cancer, with histopathologic findings and/or follow up used as the reference standard. Contrast-enhanced bilateral breast MRI was performed on 100 women at high risk of developing breast cancer with indeterminate imaging findings by mammography and/or ultrasonography. Lesions detected by MRI that could represent potential malignancies in both breasts were evaluated. Morphologic assessment and kinetic analysis [contrast enhancement and time/intensity curves] were performed on each lesion using dedicated postprocessing and display software. Functional MR tools were used in about 60% of cases to help in the differential diagnosis between malignant and benign of suspicious lesions detected at conventional MRI. Among 100 patients included in the study12% of the patients were finally diagnosed as free of any pathology, 56% had benign findings, while 31% of the patients were malignant. [24 IDC, 4 Invasive Lobular Carcinoma, 1 Medullary carcinoma, 1 Mucinous carcinoma and 1 DCIS.] The sensitivity, specificity, positive and negative predictive values of CE-MRI, were 100%, 93%, 86%, and 100% respectively. Overall accuracy of MRI breast was 95%. Breast MRI is highly effective in detection and characterization of occult breast lesions in high risk population, with excellent sensitivity and high specificity. Development of functional MRI tools contributed to the improving validity of this modality

Role of MDCT in detection of ventricular dysfunction and pulmonary obstruction index in patients with acute pulmonary embolism

To retrospectively quantity right ventricular dysfunction [RVD] and the pulmonary artery obstruction index in MDCT on the basis of various criteria proposed in the literature and to assess the predictive value of these CT parameters for mortality it has been compared to the echocardiographic assessments. In a retrospective study we reviewed 80 patients where there primary clinical and laboratory diagosis are suggestive of Pulmonary embolism [in Erfan and Baghdo hospital], 20 patient were negative on CT Study while 60 patient were positive [25 men, 35 women; mean age +/- standard deviation 50 years +/- 16] with proved PE, by dectection of the extent of RVD by quantifying the ratio of the right ventricle to left ventricle short-axis diameters [RV/LV] and tile pulmonary artery to ascending aorta diameters, the shape of the interventricular septum, and the extent of obstruction to the pulmonary artery circulation on MDCT. Regression analysts was used to correlate these parameters with the echocardiography and patient outcome. CT signs of RVD [RV/LV ratio, >1.0] were seen in 35 patients [58.3%] in the follow-up, 5 patients died of PE. Both the obstruction index and RV/LV ratio were shown to be significant risk factors for mortality [p=.01 and .03, respectively]. No relationship was found for the ratio of the pulmonary artery to ascending aorta diameters [p= .99] or for the shape of the interventricular septum [p= .30]. The positive predictive value for PE-related mortality with an RV/LV ratio greater than 1.0 was 10.1%. The negative predictive value for an uneventful outcome with an RV/LV ratio of 1.0 or less was 100%. There was a 14 -fold increased risk of dying of PE for patients with an obstruction index of 40% or higher. The Measurement of RVD and pulmonary vascular obstruction index evaluated with MDCT CT at baseline, help predict the prognosis during follow-up

Comparison of continuous inflow occlusion, intermittent inflow occlusion and ischemic preconditionning: an experimental study on murine liver

The present study was carried out on 40 white female rats classified into four groups, 10 rats in each group. In the first group, a continuous vascular inflow occlusion for 30 minutes was carried out using microvascular clamps. In the second group, a continuous vascular inflow occlusion for 60 minutes was carried out. In the third group, intermittent vascular inflow occlusion for 60 minutes was carried out [15 minutes clamping and 5 minutes reperfusion for 3 successive cycles]. In the fourth group, ischemic preconditioning was carried out [10 minutes clamping and 15 minutes reperfusion, followed by continuous clamping for 60 minutes]. In all groups, these different ischemic protocols were followed by two-hour reperfusion. The ischemia-reperfusion injurious effects were assessed in the liver specimens using light microscopy as well as electron microscopy. Apoptosis, as a marker of ischemia-reperfusion injury, was evaluated in the liver specimens stained with specific TUNEL staining. The continuous inflow occlusion for 60 minutes is associated with a highly significant degree of hepatic parenchymal damage compared with the other groups