Magnetic resonance cholangiopancreaticography with esomeprazole: comparison between single and double oral dose

The aim of this study was to compare patient's Magnetic Resonance Cholangiopancreaticography [MRCP] control images with the same patient's images after taking 40mg or 80mg Esomeprazole, and to define the medication role in improving visualization quality of images. Seventy patients attending gastroenterology clinic at Jordan University Hospital during the period first of January 2007 till the end of December 2007 were in a consecutive manner control images, then either 40 mgs or 80 mgs Esomeprazole was given and images re-obtained compared with control images for each patient. Improvement of Contrast effect on stomach and duodenum in Esomeprazole single dose group was 72.5% and in double dose group was 78.5%, while image effect of pancreatic duct was the same for single dose Esomeprazole and double dose [60%], and their statistical results were in concordance with no considerable difference, and the image effect of the biliary tree didn't show any significant difference between imaging and statistical results in both groups. Esomeprazole improves images and gives superior quality of Magnetic Resonance Cholangiopancreaticography especially the contrast effect of duodenum and stomach and image effect of pancreaticobiliary ducts. But images obtained from patients given a double dose showed no significant difference to those patients given a single dose except some advantage is seen in favor of double dose group in improving intrahepatic duct images

[De Quervain's tenosynovitis imaging: ultrasonography versus magnetic resonance imaging]

To determine the diagnostic efficiency of ultrasonography [U/S] and magnetic resonance imaging [MRI] in detecting de Quervain's tenosynovitis. Forty wrists of 29 symptomatic patients [21 females and 8 males] were selected during a 12 months period. Patients with suggestive clinical de Quervain's tenosynovitis underwent both wrist ultrasonography and magnetic resonance imaging, to determine changes in the first dorsal compartment thickness in both genders. T1-weighted images were obtained in axial, sagittal and coronal planes. Whereas, T2-weighted gradient echo images and T2-weighted fat saturation images were performed in axial and coronal planes. Cohen Kappa was used for statistical analysis. The ultrasonographic results among all diseased wrists showed 100% tendon thickening, 97.5% peritendinous edema, 72.5% decreased tendon mobility and 70% septation. The magnetic resonance imaging results showed 95% tendon thickening, 85% peritendinous edema, 62.5% increased tendon signal, 60% septation, 55% subcutaneous edema, and 45% synovial thickening among the whole group. All values demonstrated differences among genders and more prominent in females.The prime reliable finding is in respect to superiority of ultrasound in all comparable criteria which was confirmed by statistical results. Ultrasonography is considered the favorite technique to validate the clinical diagnosis. It gives special accuracy and high diagnostic capability even in early stages. Magnetic resonance imaging could be significant in doubtful clinical diagnoses not confirmed by ultrasonography. In addition, magnetic resonance imaging has advanced capability to detect other soft tissue and bone marrow abnormalities

Clinico-radiological correlates of achalasia

To study the clinical and radiographic characteristics of achalasia in a cohort Jordanian patients and to investigate the presence of any clinico-radiological relationships. Thirty-five cases of recently diagnosed untreated achalasia patients were studied at Jordan University Hospital, Amman, Jordan during the period of January 1999 to December 2002. Measurements of maximum esophageal and gastroesophageal [GE] junction diameters, as radiographic features, were obtained from films. The clinical features included age; gender; nature; frequency and duration of typical and atypical symptoms; total number of symptoms; calculated typical symptoms score; and diagnostic delay. Pearson correlation coefficients were calculated between radiographic and clinical features, and among the radiographic features themselves. Using Spearman's correlation coefficients, the later analysis was repeated for patients with diagnostic delay of 2 years or less and patients with more than 2 years. All results were evaluated based on the 0.05 level of significance. There were 35 consecutive achalasia patients enrolled in this study [20 females and 15 males] with a mean age of 42.3 +/- 15.6 years and diagnostic delay of 29 +/- 26 months. On average, each patient has presented 2 typical symptoms and 2 atypical symptoms. The mean typical symptoms score was almost 3 out of the full score of 6. The mean GE junction diameter was 2.4 mms and maximum esophageal diameter was 29 mms. Maximum esophageal diameter was significantly correlated with the number of typical, atypical and total symptoms as well as with the typical symptom score and diagnostic delay. Negative correlation was found between GE junction diameter and maximum esophageal diameter; but only statistically significant for patients with diagnostic delay of more than 2 years. Statistically significant relationship exists between maximum esophageal diameter and all clinical variables. Negative correlation exists between maximum esophageal diameter and GE junction diameter; however, only significant for patients with a diagnostic delay more than 2 years. The possibility of achalasia is high in patients with longer diagnostic delay who demonstrate negative relationship between maximum esophageal diameter and GE junction diameter