role of multi-detector CT pulmonary angiography in the diagnosis of clinically suspected acute pulmonary embolism

Our purpose was to review the utility of multi-detector Computed Tomography pulmonary angiography in positive diagnosis of acute pulmonary embolism and prove the importance of negative CT findings for excluding the clinically suspected pulmonary embolism. Our study included 72 patients clinically suspected to have acute pulmonary embolism [clinical suspicious was based on physical examination, ECG findings and high plasma D-dimmer concentration]. Al/patients underwent MDCT pulmonary angiography within the 1st 48 hours of the attack. CT diagnosis of FE was positive in 36% of clinically suspected cases, indeterminate for FE in 6.9% and negative for FE in 56.9% of our cases. MDCT is an occurate non invasive imaging modality for the diagnosis of pulmonary emboli. The negative predictive values of normal CT study is high and appear to be reliable for excluding clinical suspected FE, so CT provide an important information for the final diagnosis and exclusion of FE in clinical suspected patient who has no pulmonary emboli

Helical CT in the investigation of non traumatic acute abdomen in pediatric and adolescent patients

To evaluate the diagnostic yield of helical CT as an initial diagnostic procedure in patients with non traumatic acute abdomen. The study included 112 consecutive patients who were presented with acute abdomen to the emergency department of Al Yammamah maternity and pediatric hospital in Riyadh, Saudia Arabia during one year period. All of the patients were subjected to complete clinical examination, routine laboratory investigations, abdomen ultrasonography and helical CT abdomen and pelvis. CT established the overall causes of acute abdomen in 92.8% of the patients and provided information leading to change of management in 8% of the patients. CT established the diagnosis of acute appendicitis in 95.5% of the cases and correctly detected alternative lesions that clinically mimics acute appendicitis. Cases of urolithiasis and intussusception were diagnosed with an accuracy of 100%

role of MRI in the diagnosis of acute osteomyelitis in the peripheral bones

The objective of the study was to review and to evaluate the value of different MRI sequences in the diagnosis of acute osteomyelitis. This study was performed on 35 patients, clinically suspected to have acute osteomyelitis. MRI showed evidences of acute osteomyelitis in 32 out of 35 patients included in this study. Two patients had septic arthritis and there was one case of Brodie's abscess. The primary MRI sign for the diagnosis of acute osteomyelitis was bone marrow signal intensity abnormalities this was best detected at T2 weighted spin echo images and with STIR images. Other MRI signs included bone cortical interruption, and associated soft tissue infection

role of transvaginal sonography and serum beta-hCG in monitoring for expectant management of ectopic pregnancies

Spontaneous resolution of ectopic pregnancy is a recognized phenomenon. Currently, declining quantitative beta-hCG levels is the only effective predictor for monitoring such phenomenon. The aim of this study was to identify the potential sonographic predictors of spontaneous resolution of ectopic pregnancy. The study included 148 patients with transvaginal sonographic diagnosis of ectopic pregnancies. Two quantitative beta-hCG levels measurements were performed for all patients within the first 48 hours of initial diagnosis. Patients with rising beta-hCG levels were considered for immediate surgery, while patients with declining beta-hCG levels were considered for expectant management based on the follow up results of beta-hCG levels and transvaginal sonography. We evaluated 4 ultrasonic parameters as predictors for the outcome of ectopic pregnancy, which were the size and vascularity of extrauterine mass the presence of gestational sac and free fluid at cul de sac. Our results showed that low vascularity, high resistive index of ectopic mass and lack of gestational sac were the most useful ultrasonic predictors of spontaneous resolution of ectopic pregnancies in patients with declining beta-hCG levels

CT brain in neonatal asphyxia

Neonatal birth asphyxia is a clinical problem associated with a high mortality or neurodevelopmental disability. To study the immediate CT brain changes in neonates with birth asphyxia and to correlate findings with prognostic outcome. The study included 32 neonates with proven birth asphyxia; all had low Apgar score below 4, and umbilical cord pH less than 7. Cranial US and brain CT were performed to all cases. Our imaging findings were correlated with prognostic outcome during a short follow-up period of 12-18 months. Abnormal CT brain changes at presentation were seen in 22 cases, included brain oedema in 12 cases, encephalomalacia in 8 cases, IVH in 3 cases and parenchymal hemorrhage in 4 cases, Normal CT was noted in 10 cases. Out of the 22 cases who had abnormal brain CT at presentation 6 have expired, and the remaining 16 showed neurodevelopmental disability at follow up. Out of the 10 cases who had normal brain CT at presentation 4 showed neurological abnormalities

Utrasonic evaluation of neonatal hip dysplasia

Ultrasound imaging of the neonatal hip [less than five months] is crucial for the early diagnosis and management of the developmental dysplasia of the hip [DDH] and for avoiding hip morbidity. The objective of this study was to evaluate and compare the different sonographic techniques adopted for the assessment of DDH and to verify the value of routine neonatal hip sonography. For the early detection of DDH, the study included 1200 hips [600 neonates], being examined by the routine standard and stress dynamic ultrasound hip techniques. The results of this study showed the importance of performing combined standard and dynamic hip sonography for all cases