ABSTRACT
Background: Accurate evaluation of extra cardiac and intra cardiac anomalies in congenital heart diseases [CHD] is vital for diagnosis and treatment. Trans-thoracic echocardiography [TTE] is the classical choice for children suspected to have CHD because TTE is safe, readily available and its capacity to perform Doppler flow studies therefore can measure hemodynamic parameters. Plus its ability to evaluate intra cardiac abnormalities like atrial septal defect and ventricular septal defect. Therefore, owing to its lower spatial resolution and limited acoustic window; it is not precise in evaluation of extra cardiac abnormalities
Aim of the Work: to evaluate the advantage of recent advances of ECG gated MDCT in diagnosis of congenital heart disease in pediatrics and assessment of associated extra cardiac abnormalities within the great vessels in comparison with echocardiography findings
Patients and Methods: The current study was carried out on 36 patients in Radio-diagnosis Department, Faculty of medicine, Ain Shams University and specialized private radiology centers. The patients were referred from pediatric hospital, cardiology clinic with their echocardiographic reports to radio-diagnosis department, cardiac imaging unit with a view to execute ECG- gated multi-slice CT of the heart and extra-cardiac great vessels
Results: In this study aortic anomalies represent the most common extra-cardiac anomalies accounting for 36.5% of our cases while comprising: Supravalvular aortic stenosis; 4.3%, Aortic CoA; 26.1%, arch anomalies with vascular rings; 52.2% and finally anomalous coronary arteries; 17.4%. By Using MDCT we were able to delineate eight cases of right aortic arch [RAA].Two of them with aberrant left subclavian artery [ALSCA] adding to two cases of left aortic arch with an aberrant right subclavian artery [ARSCA]. On the other hand ,TTE failed to identify 6 cases of RAA with a sensitivity 75%, specificity 100%, NPV 96.61% and one case of ALSCA with a sensitivity 50.0%, specificity 100%, NPV 98.41% .Regarding coronary anomalies , Cardiac CTA succeeded in characterization of origin and course of all coronary abnormalities encountered in our study encompassing 4 cases specifically anomalous LAD from right coronary sinus running a prepulmonic course anterior to RVOT , RCA from LAD and single coronary artery adding to LCX- RV coronary fistula. While TTE failed to depict two cases of the coronary anomalies with a sensitivity of 50%, specificity 100%, PPV 100% and NPV 96.83%
Conclusion: CTA can provide the confident detection and exclusion of extra- cardiac vascular abnormalities with superb anatomical description which was feasible with a sensitivity 98.41%, specificity 99.76%, PPV 96.88% and NPV 99.88%
ABSTRACT
Background: ovarian cancer is the second most common gynecological cancer and the fifth most common cancer in women. Proper management depends on proper preoperative assessment with the help of clinical examination, laboratory tests and different imaging modalities. Radiological evaluation includes ultrasonography [US], computed tomography [CT] and recently magnetic resonance imaging [MRI]. Diffusion weighted imaging [DWI] has been established as a useful functional imaging tool in neurologic applications for a number of years, but recent technical advances now allow its use in abdominal and pelvic applications
Purpose: it was to evaluate the role of diffusion weighted and perfusion weighted MRI imaging in the characterization of ovarian tumours and differentiation between benign and malignant tumours
Patients and Methods: this study was performed on 24 patients. All patients had US finding of solid or complex adnexal lesions
Results: DWI and dynamic MRI are significant promising tool factors for characterization of ovarian tumours and differentiation between benign and malignant lesions with high sensitivity, specificity. The sensitivity, specificity and accuracy of detection of the nature of the lesions. Have been increases after adding of DWI and DCE-MRI to the conventional imaging
Conclusion: Adding of DWI and DCE-MRI to the conventional MRI improves the sensitivity and specificity of diagnosis and allows confident diagnosis and differentiation between benign and malignant lesions