Role of multidetector computed tomography prostatic perfusion in diagnosis of prostate cancer

To evaluate the role of multidetector computed tomography prostatic perfusion in diagnosis of prostate cancer. From November 2007 to December 2009, 112 patients with suspected prostate cancer [with no previous histologic proof of prostate cancer] performed multidetector computed tomography prostatic perfusion followed by TRUS examination results were correlated with histopathological results from TRUS guided biopsy of the prostate were included in this thesis study. Our results are yielding multidetector computed tomography [functional ct "fct"] evaluation for detection of malignancy with sensitivity 90.54%, specificity 86.8%, positive predictive value 93.056%, negative predictive value 82.5%, accuracy 89.3% and pre-test probability = 64.3%. Multidetector computed tomography prostatic perfusion is a sensitive imaging modality the diagnosis of prostate cancer and should be routinely employed for raising the positive predictive value of prostatic biopsy

Dynamic magnetic resonance imaging in evulation of female pelvic organ prolapse

The aim of this study is to evaluate the role of dynamic MRI in diagnosis of pelvic organ prolapse [POP]. Forty-three female patients were included in this prospective observational study with age range from 25 to 70 year. They presented with POP and voiding dysfunction. They were evaluated by dynamic pelvic MRI at our institute. The MRI examination was done using superconducting magnet 1.5 tesla with surface body coil. The patient was positioned supine in the magnet. Then dynamic fast images were obtained using single shot T2 - weighted sequence in the sagittal plane in sequential images during voluntary strain. The images were analyzed by drawing the following lines: Pubo-coccygeal line [PCL]: as a reference line, H line and M line. Extent of POP by MRI was measured by the vertical distance from the PCL to the most inferior portion of the bladder base, cervix or vaginal vault and ano-rectal junction. A total of 43 female patients were included with mean age 42.8 +/- 9.8 years and mean parity of 5[range 0-10]. History of previous pelvic floor repair was reported in 8 patients and vaginal hysterectomy in 2 patients. Stress urinary incontinence was the most presenting symptom [69.8%] followed by constipation [60.5%] and heaviness in the pelvis [53.5%]. MRI depicted cystocele in 40 patients with a mean urinary bladder base descent below PCL by 2.80 +/- 1.9cm. Uterine-cervical descent was detected by MRI in 31 patients with mean descent below PCL 1.99 +/- 1.8cm as well as vaginal vault prolapse in 2 patients with descent of vaginal vault below PCL by 1cm. MRI depicted Excessive ano-rectal descent in 40 patients with mean 4.04 +/- 1.2cm, anterior rectocele in 43 patients and enterocele in 21 patients. All patients have pelvic floor relaxation with mean H line [7.31 +/- 1.03cm] and mean M line [4.42 +/- 1.47cm]. Multi-compartment organ prolapse was found in all patients. MRI is a new non-invasive imaging modality for evaluation of POP with encouraging results especially in those with multi-compartment prolapse