ABSTRACT
Background: To evaluate the value of diffusion weighted magnetic resonance imaging [DWMRI] in detection and T- staging of bladder carcinoma and correlation with histopathological staging
Patients and Methods: An analytic prospective study was conducted at the MRI units of Al-yarmook teaching hospital in the period from January of 2015 to December 2015, 42patients [36 male and 6 female] presented with hematuria [40 patients] and 2 patients presented with pelvic pain were enrolled prospectively, they underwent conventional magnetic imaging [MRI] and diffusion weighted MRI using 3 tesla MR units [Achieva; Philips medical systems, the Netherlands]. Diffusion weighted images were obtained using a single shot echo planar imaging sequence EPI with b value 0,500 sec/mm [2]. ADC value map was reconstructed and mean ADC value were measured in 42 patients .and histological examination was done to all patients
Results: Correlation between standard MR staging of bladder carcinoma and histopathological results revealed that 17 patients [40%] had the same T -staging while 17 patients [40%] over staged. DWI and ADC values were able to declare the cause of overstating by discrimination between tumoral tissue and peritumoral inflammation. Statistically significant difference is found between ADC value of bladder tumor and those of urine
Conclusion: Diffusion weighted MR imaging at 3 tesla is new and good imaging modalities for detection and staging of bladder carcinoma, without using contrast media, so can used in patient with renal impairment or contrast media allergy
ABSTRACT
Background: Atypical vertebral hemangioma and metastatic spinal lesions share many MRI signal intensity and appearance in common, thats why differentiation between them is crucial. For two decades, diffusion-weighted imaging [DWI] has been applied to the evaluation of intracranial diseases, but DWI technical advancement make it possible to apply for assessment of extra cranial sites, including vertebral column
Objective: The goal of our study is to assess the value of diffusion weighted MRI imaging in differentiating vertebral atypical hemangiomas from metastatic lesions
Patients and Methods: A prospective cross-sectional study was employed at AL-Imammain AL-Khadymain Medical city in Baghdad health directorate, [43] patients with total [65] vertebral lesions grouped into three groups Group [A] 10 patients [23.2%] with total [15] lesions of vertebral typical hemangiomas, Group [B] 13 patients [30.3%] with total [ 13] lesions of vertebral atypical hemangiomas and Group [C] 20 patients [46.5%] with total [ 37] lesions of spinal vertebral metastases. MRI was done for all patients [including T1, T2, T1 fat suppression with IV contrast administration [when needed] and DWI]. Complementary non contrast CT was also done
Results: Total study sample were [43] patients with total [65] lesions, with [29/43] females and [14/43] males with male to female ratio of [1:2], their age range from [28-75 years] and their mean age was [54.2 +/- 10.1 years]. Atypical hemangioma and malignant lesions were generally low signal in T1 and high or intermediate signal in T2 WI. Restricted diffusion and low ADC values were seen in atypical hemangioma compared with metastasis with mean ADC value were [1.426 +/- 0.231.6x10[-3] mm[2]/s and 0.6182 +/- 0.137x10[-3] mm[2]/s respectively]. Complementary CT confirmed the lytic or sclerotic nature of malignant lesions while in haemangiomas, it showed their characteristic striated [polka dot] appearance
Conclusion: Diffusion weighted Magnetic Resonance Imaging is a valuable tool in differentiation of atypical hemangioma and metastasis of spine with high sensitivity and specificity with the aid of ADC values calculated from the maps obtained by DWI
ABSTRACT
Background: About 2-3% of the population experiences an attack of acute ureteric colic during their lifetime, and 67%-95% caused by ureteric calculi. Magnetic Resonance Imaging [MRI] can rapidly demonstrate both the presence and the level of ureteric obstruction]
Objective: To study the diagnostic accuracy of MRI [alone and in combination with plain abdominal radiograph] in detecting acute ureteric calculus obstruction compared to unenhanced Computed Tomography [CT]
Patients and Methods: A cross sectional comparative study was conducted on a total of 48 patients suspected to have acute ureteric calculus obstruction, at the radiology department in AL-Imamain AL-Kadhemain Medical city, during the period from March to November 2015. Patients underwent MRU then unenhanced abdominal CT, and plain abdominal radiograph. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of MRU findings were obtained in comparison to CT findings regarding ureteric dilatation and its level, stone detection and perirenal fluid and fat stranding
Results: Of the 48 patients imaged with both CT and MRU, 4 of them showed no evidence of obstruction on any imaging modality, and 44 of them had a final diagnosis of acute calculus ureteric obstruction. Regarding the detection of ureteric dilatation in MRU, in comparison to CT, the sensitivity = 100%, specificity = 80%, the positive predictive value [97.72%], the negative predicative value [100%], and overall accuracy [97.9%]. The detection of ureteric stone by MRU [when combined with plain abdominal radiograph] in comparison to CT, the sensitivity = 95.45%, specificity = 100%, the positive predictive value [100%], the negative predicative value [66.66%], and over all accuracy [95.8%]. The detection of peri-renal fluid by MRU in comparison to CT, the sensitivity = 96.66%, specificity = 72.22%, positive predictive value [85.29%], the negative predicative value [92.85%], and overall accuracy [87.5%]
Conclusion: MRI when combined with plain abdominal radiograph was nearly as accurate as unenhanced spiral CT in acute calculus ureteric obstruction. Also the MRI was more sensitive than unenhanced CT in detecting the secondary signs of upper urinary tract obstruction, as perirenal fluid