[Comparative study between multi-detector Ct Angiography and digital subtraction Angiography in evaluation of Peripheral Arterial Occlusive Disease]

Objective: Evaluation of peripheral arterial occlusive disease with multidetector or multi-slice CT angiography [MDCTA] and comparison of the results with the results of digital subtraction angiography [DSA], a standard reference

Patients and Method: The written informed consent of the patients and ethics committee approval was obtained. The prospective study group consisted of 10 patients complaining of peripheral arterial disease. Using MDCT-A, the arterial tree of the lower extremity was evaluated for the presence of steno-occlusive lesions that might have led to luminal stenosis. The diagnostic accuracy of MDCTA was calculated and compared with that of DSA

Results: In the segment-based analysis, the sensitivity, specificity, and accuracy of MDCT angiography in determining significant stenoses were 100%, 99.3%, and 99.6.3%, respectively. The compatibility between MDCTA and DSA methods in grading stenosis was calculated as 0.896 [P < 0.007] and it was statistically significant

Conclusion: MDCT angiography is significantly compatible with DSA method in the evaluation of peripheral arterial diseases. It is a non-invasive method and can be an alternative to DSA

[Color duplex ultrasound-guided foam sclerotherapy: an approach in the of lower extremity management of patients with superficial varicosities]

Background: Duplex ultrasonography guided foam sclerotherapy is now considered as standard option in varicose vein treatment; it is conducted as an outpatient procedure, does not require general ansthesia and compared with surgery results in an earlier return to normal activities. However, for treatment several sessions may be required

Aim of Work: The objective of this study is to cribe the efficacy, results and safety of DCU foam sclerotherapy for treating superficial venous ase of the lower limbs

Patients and Methods: 80 patients [28 males, 52 females] who were diagnosed to have clinical and radiological evidence of lower extremities venous diseases in the department of Vascular Surgery AT Assiut University Hospital from March 2012 to May 2014 were included. Their ages ranged from 18 to 57 years. Local ethics committee approval and written informed consent were obtained. To be considered suitable for UGFS all patients treated with UGFS the foam was prepared by Tessari's method. Any residual veins treated with another session

Results: Eighty patients presenting with symptomatic varicose veins of superficial system. There were52 females [65%], and 28 males [35 %] with a mean age of 55.76 +/- 9.67. CEAP grades of patients were as follows; [60.0%] in C2, [10.0%] in C3, [21.25%] in C4 [2.5%] in C5 and [6.25%] in C6. The affected segments of the superficial system which were treated were ; [70.0%] great saphenous, [17.5%] small saphenous, [6.25%] were great saphenous vein and varies and [6.25%] small saphenous vein and varies. The numbers of sessions needed to eradicate the affected segment were one session in [70%], two sessions in [18.75%] and three in [11.25%].Minor complications encountered were skin discoloration in 30% of patients, superficial thrombophlebitis in 16% and an allergy to the foam sclerosant in 2.5%. After one year follow up by CDU [70%] had complete occlusion, [15%] had partial occlusion and [80%] of patients showed improvement of CEAP classification

Conclusions: UGFS is a safe and effective treatment as an alternative to surgical treatment for superficial system varicosities. One and infrequently two to three treatment sessions, to complete eradication of superficial reflux in virtually 100% of cases. It is considered as an outpatient procedure. Complications are few, and appear mostly self-limiting

MDCT with multiplanar reformation in evaluation of malignant ovarian tumors

Purpose: 10 evaluate the accuracy of multidetector CT [MDCT] with multiplanar reformation in defection and evaluation of malignant ovarian masses and to correlate the findings with histopathological results and surgery

Patient and methods: MDCT was performed to 48 patients with clinically and sonographically suspected malignant ovarian masses. All scans were performed on a 16 row CT scanner at the South Egypt Cancer Institute, Assiut University. The axial and reformatted images were evaluated for mass detection and the relationship to adjacent structures

Results: Surgical and histopathological examination demonstrated 45 malignant ovarian masses and 3 benign ovarian masses [which excluded from our results], MDCT detected 4 metastatic cases among the malignant masses, MDCT examination of the remaining 41cases shows 92.6% accuracy in detection of ovarian masses. The sensitivity and specificity of MDCT as regared, detection of peritoneal deposits was [91.6%. 100% respectively], LN involvement was [100%, 90.6% respectively], and pelvic organ infiltration was [44%, 9.4% respectively]. Also MDCT reported 85.4% accuracy in tumor staging

Conclusion: MDCT is a highly sensitive and specific diagnostic method in evaluation of malignant ovarian masses and successfully stage the tumor in consistent with surgery and histopathology

Role of multlidetector computed tomography in the diagnosis of small bowel neoplasms

Objective: to determine the role of Multidetector computed tomography [MDCT] in diagnosis of small bowel neoplasms

Methods: from September 2010 till March 2013, small bowel neoplasms evaluated by MDCT in 17 patients [14 males and 3 females]

Results: The small bowel neoplasms found and included in this study were lymphoma [12 patients], malignant gastrointestinal stromal stromal tumor [GIST] [3 patients], primary duodenal adenocarcinoma [1 patient] and jejunal metastasis [1 patient]

Conclusion: MDCT can he used as a front-line imaging modality for detection of small bowel neoplasms, regarding its ability, to show intraluminal, mural and extraintestinal lesions with their characteristic density and features to successfully differentiate between the different neoplasms and stage them