Accuracy of multidetector computed tomography coronary angiography in the diagnosis of coronary artery disease

The standard of reference diagnosis of CAD is the conventional coronary angiography. However its invasive nature necessitates a new non-invasive imaging modality. MSCT coronary, angiography is a new development non-invasive technique in the diagnosis of coronary disease. The aim of this study is to investigate the accuracy of 64-slice CT coronary angiography for assessing coronary artery disease in comparison with conventional coronary angiography. The study included 45 patients out of 50 patients with suspected coronary, artery disease underwent both MSCT coronary angiography and conventional coronary angiography. The total sensitivity and specificity of MSCT coronary, angiography were 99% and 94.5% respectively and the overall accuracy was 95.5%. The negative predictive value was 97.5% while the positive predictive value was 83.5%. Non-invasive CT angiography of the coronary arteries can diagnose and exclude hemodynamically significant coronary stenoses with high accuracy

Role of [201]TI-[99m]TC.HIDA subtraction liver scan in detection and specification of focal hepatic lesions

Focal hepatic lesion is a common problem accidentally discovered on imaging studies as abdominal ultrasonography, computed tomography and magnetic resonance imaging that must be characterized. The aim of this prospective study is to verify, the efficacy of [201]Tl-[99m]Tc.HIDA subtraction scan in detection and specification of such lesions. Seventy five patients, divided into two groups according to their definitive diagnosis, were the subject of the this work. Group 1: included 41 patients with benign focal hepatic lesions. Group 2 : included 34 patients with malignant focal hepatic lesions. All cases were diagnosed by sonography and /or tissue biopsy through true-cut needle biopsy. All of them were subjected to [201]Tl-[99m]Tc.HIDA subtraction liver scan that was interpreted both qualitatively and quantitatively. Correct diagnosis was achieved in about 80.5% and 82.4% of group 1 and 2 cases respectively using abdominal ultrasonography whereas [201]Tl-[99m]Tc.HIDA subtraction scan achieved correct diagnosis in 100% of group 2 patients. All malignant lesions appeared hot, whereas benign lesions showed no abnormality in subtraction images respectively. Moreover, [201]Tl-[99m]Tc.HIDA subtraction quantitative analysis failed to discriminate between primary and secondary hepatic focal lesions or different histopathological types or grades [P > 0.05]. [201]Tl-[99m]Tc-HIDA subtraction scan is recommended in any patient with hepatic focal lesion suspected sonographically being non-invasive, simple, easy and efficient method that can differentiate between benign and malignant focal hepatic lesions

Initial [99m]Tc thyroidal kinetics in thyrotoxicosis: patterns and usefulness in differential diagnosis of toxic nodular goiter

This prospective study included 74 untreated hyperthyroid patients as well as 25 age- matched healthy controls aiming at assessment of initial Tc 99m thyroidal kinetics' patterns in different types of thyrotoxicosis, its usefulness in differential diagnosis of toxic nodular goiter, mainly discrimination between its immune and non-immune variants, compared to CDFS and to find-out which of the parameters evaluated was the best in such issue. Patients were selected and divided into four groups according to their definitive diagnosis based on clinical laboratory data, sonography and Tc 99m static thyroid scan. Group I: included 23 patients with Graves ' disease, group 2 : included 26 patients with toxic nodular goiter, group 3: included 10 patients with single toxic adenoma, group 4-.included 15 patients with thyroiditis. All patients,except group 4 patients, had statistically significant higher FI values compared to control subjects [p<0.05]. Moreover, group 1 and 4 patients [cases with immune thyrotoxicosis] showed statistically significant higher PI values compared to other groups [non-immune thyrotoxic patients] as well as control group [p<0.05].Group 1 and group 4 patients showed almost similar PI values [p>0.05]. Also, group 2 and 3 showed almost similar PI and FI values [p >0.05]. Retrospective analysis of PI and FI values of group 2 patients [toxic nodular goiter] revealed different behaviour of their PI values. Cases with immune variants of toxic nodular goiter had higher PI values than non-immune variants [p< 0.0001] despite their almost similar FI values and hormonal levels. Regarding the sensitivity and specificity, PI showed statistically significant higher values than those of CDFS in differentiating immune from non-immune variants of toxic nodular goiters [p<0.002 and <0.0003 respectively]. our results suggest that initial Tc 99m thyroidal kinetics done as a part of the routinely done static thyroid scan is an objective, non-invasive simple methods that can be useful in discrimination between immune and non-immune variants of toxic nodular goiter with better sensitivity and specificity than CDFS

Biliary dilatation: differentiation of benign from malignant causes-value of adding axial T2 W1 to single shot-breath hold MR cholangiopancreatography

MRCP is a rapidly developing technique with progressively increased role in the assessment of jaundiced patients. This study included 42 patients presenting with biliary obstruction. The study tried to asses the reliability of single shot breath hold MRCP technique and the superadded value of complementary conventional axial T2 WI. Such axial images confirmed the MRCP diagnosis in 28 cases [66.7%] and increased the diagnostic accuracy of MRCP in 11 cases [26.2%]. Furthermore, they extended the information to extrabiliary structures in all the malignant 17 cases providing staging criteria that would influence management planning. The study concluded that conventional axial T2 WI should be considered indispensable in any MRCP study

MRI approach and findings in sport injuries and overuse syndromes involving of the elbow

MRI approach and findings in sport injuries and overuse syndromes involving of the elbowABSTTwenty-seven patients presenting with painful elbow attributed to acute or repetitive microtrauma were examined by MRI. The multiplanar capability and variable sensitivity of different MR pulse sequences clearly demonstrated radiographically occult osteochondral injuries as well as the wide spectrum of periarticular ligamentous, muscular tendinous and neuropathic injuries. Because positioning and scan planning are not straight forward as they are with other joints, the study tried to propose to the optimal imaging protocol providing a tailored approach for each entity as suspected by the mechanism of injury, clinical presentation and examination findings in order to limit the examination time and reduce the patient discomfort