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1.
Egyptian Journal of Hospital Medicine [The]. 2018; 71 (7): 3655-3666
en Inglés | IMEMR | ID: emr-197412

RESUMEN

Background: Ultrasound scanning is noninvasive, usually painless procedure that used as the main adjuvant modality with mammography for depiction of the breast lesions nature. It is easy-to-use and less expensive than other imaging modalities. Besides lacking the exposure risk to ionizing radiation as in mammography, it also provides real-time imaging, and can easily detect lesions in women with dense breasts. Conventional ultrasound however is not free from limitation. It cannot replace annual mammography and careful clinical breast examination. Being an operator dependent, US needs experienced radiologists as well as good equipment to avoid misinterpretation of the lesions, and to decrease the number of false positive and false negative results


Aim of the Work: is to detect the impact of ultrasound elastography in diagnosis of solid breast lesions, and to evaluate its capability in differentiating benign form malignant lesions, with special focus on: A-Evaluation of sensitivity and specificity of sonoelastography, with cyto-histological diagnosis taken as the reference. B-Detection of the ability of sonoelastography to provide additional information on tissue elasticity in the event of equivocal mammographic and/or sonographic findings in order to guide the diagnostic workup towards biopsy or follow-up


Patients and methods: The present study is a prospective research work that included 39 patients with breast lesions where elastographic ultrasound was performed following screening or diagnostic mammography and breast ultrasound to evaluate its possible impact on accurate diagnosis and consequent guidance for management planning. This study was performed at a private center in the period from September 2017 to March 2018. The patients' age ranged between [24 - 72 years] with a mean of 48 years


Results: The elastography scores for different breast lesions was: Lesions that scored 1, 2, and 3 were considered benign [30/39 cases, 77 %], whereas lesions that scored 4 and 5 [9/39 cases, 23%] were considered malignant. After revising pathology results of the 30 cases diagnosed as benign by elastography scoring 26/30 [87%] were benign [true negative] by pathology and 4/30 [13%] were malignant by pathology [false negative]. After revising pathology results of the 9 cases diagnosed as malignant by elastography scoring 7/9 [82.8%] lesions confirmed to be malignant by pathology [true positive] and 2/9[17.2%] lesions were proved to be benign by pathology [false positive]. The calculated sensitivity of elastography score was 80%, specificity was 88.9%, PPV and NPV were 82.8% and 87% respectively, and the total accuracy was 85.3%


Conclusion: Sonoelastography is a simple, non-invasive diagnostic technique that provides information about the stiffness of a breast masses, thus completing the morphological assessment of B-mode ultrasound


Recommendations: Other studies are recommended to be performed on axillary lymph nodes, to evaluate the elastographic efficacy in differentiating between reactive and malignant pathologically enlarged axillary lymphadenopathy

2.
Egyptian Journal of Hospital Medicine [The]. 2018; 72 (4): 4339-4342
en Inglés | IMEMR | ID: emr-197461

RESUMEN

Background: The prevalence of Achilles tendon injuries is a common musculoskeletal disorder affecting the foot in athletic and non-athletic population. The Achilles tendon is the thickest and strongest tendon in the human body. It is the major plantar flexor of the foot and contributes to the maintenance of the upright position. MRI is an excellent imaging modality for suspected Achilles tendon lesions due to its accuracy, efficiency, multiplanar imaging capabilities and excellent soft tissue characterization


Objective: The aim of this study is to evaluate the role of MR imaging in clinically diagnosed Achilles tendon rupture and how MRI influences the management


Patients and Methods: This study was conducted at the radiology department, Faculty of medicine, Ain shams University. 20 patients with clinically diagnosed partial and full thickness tear of the Achilles tendon underwent MRI evaluation after four clinical tests


Results: The results of our study revealed many limitations in clinical tests that revealed defective details which were essentially significant for the way of management being operative or conservative


Conclusion: MRI is the method of choice and superior to clinical tests when evaluating Achilles tendon lesions, facilitating the choice of treatment being operative or non-operative, evaluating intra-tendinous changes in all types of AT tear and follow up during the healing period

3.
Egyptian Journal of Hospital Medicine [The]. 2018; 72 (2): 3914-3917
en Inglés | IMEMR | ID: emr-197512

RESUMEN

Background: Our study showed that ultrasound-guided, vacuum-assisted excision can play an efficient role in the diagnosis of benign breast lesions and is a safe and successful alternative treatment of fibroadenomas. Although the breast fibroadenoma is a common benign breast tumor, the treatment and follow-up of these lesions is still debatable. We suggest that UGVAB, which has a well-documented role in the diagnosis of breast lesions, may provide an option for the definitive treatment of breast fibroadenomas


Objective: The objective of our work was to evaluate ultrasound-guided, vacuum-assisted excision [UGVAE] as an alternative approach in the diagnosis of radiologically benign breast lesions


Patients and Methods: We prospectively evaluated breast lesions excised using VAB between April -October 2017 at Ain-Shams University /interventionl radiology unit at radiology department, which had a proven diagnosis of fibroadenoma. An informed consent form was obtained from each patient of a total of 25 cases ultrasound-guided VABB using biopsy system. All patients have been subjected to breast ultrasound examination


Results: Thirteen patients developed hematomas during UGVAE but none needed surgical intervention, while twelve patients pass with no significant hematomas, with 100% cure rate. None of the patients experienced significant enough pain to require the cessation of the procedure, although 22 [88%] patients reported mild pain and moderate pain [12%] during procedure. At the two week control, 3[12%] patients reported taking paracetamol for mild pain. In ten of them [40%] the pain was strong enough to interfere with sleep


Conclusion: Vacuum assisted Ultrasound-guided biopsy allows real-time imaging, could be performed without breast compression, and is the preferred method if the lesion is detectable with ultrasound

4.
Scientific Journal of Al-Azhar Medical Faculty [Girls] [The]. 2000; 21 (Supp. 1): 911-921
en Inglés | IMEMR | ID: emr-55647

RESUMEN

In this study, the concentrations of urinary deoxypyridinoline [Dpyd] [a bone degradation marker] and serum osteocalcin [a bone formation marker] were measured in 20 rheumatoid arthritis [RA] patients, 20 knee osteoarthritis [OA] patients and ten healthy controls. It aimed to quantify these bone specific markers and investigate their role in the assessment of disease activity and severity in RA and OA patients. The results revealed significantly higher levels of urinary Dpyd and serum osteocalcin in the rheumatoid and osteoarthritis patients than the controls. Also, there was a significant positive correlation between these bone markers and disease severity, but no correlation was found with the disease activity in RA patients. In the OA group, there was a significant positive correlation between levels of urinary Dpyd and age, disease duration and disease severity. In conclusion, urinary deoxypyridinoline was superior to serum osteocalcin as a useful biochemical marker for the assessment of disease severity in both rheumatoid and osteoarthritis patients


Asunto(s)
Humanos , Masculino , Femenino , Artritis Reumatoide/complicaciones , Osteoartritis de la Rodilla/diagnóstico , Osteocalcina/sangre , Sedimentación Sanguínea
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