role of diffusion weighted MR imaging in assessment of hepatocellular carcinoma after radiofrequency ablation

Background: hepatocellular carcinoma [HCC] is the most common primary liver malignancy. Surgical resection and local ablative therapies represent the most frequent first lines therapies adopted when liver transplantation cannot be offered

Aim of the work: this study aimed to evaluate the feasibility of DWI and the corresponding ADC values to detect tumor response after radiofrequency ablation for hepatocellular carcinoma

Patients and methods: MR examinations were done for 20 HCC patients post-RFA. Pre and post gadolinium enhanced images as well as DW sequences were performed. ADC values of ablation zones and liver parenchyma were assessed. ADC values of ablation zones and adjacent signal alterations identified in DWI were analyzed

Results: residual or recurrent lesions were detected in 4 patients [20%]. The mean ADC value of ablated zones differed significantly from that of normal liver parenchyma. The corresponding ADC values were significantly lower in patients with residual lesion than in patients without residual lesion

Conclusion: it can be concluded that DWI is a feasible follow-up tool for post ablation liver contributing indetection of residual lesion

Value of transvaginal ultrasonography in the diagnosis of endometrium abnormalities in patients treated with tamoxifen

This study was conducted to investigate the value of endovaginal ultrasound in the assessment of tamoxifen associated changes of the endometrium in patients with breast cancer and to correlate sonographic and pathologic findings to symptoms and duration of tamoxifen therapy. Medical records and sonograms of 80 post-menopausal women treated for cancer breast with adjuvant tamoxifen therapy were reviewed retrospectively. Endometrial thickness was recorded as a single layer thickness and considered abnormal when greater than 2.5 mm for post-menopausal women. Sonographic endometrial thickness was correlated to histologic findings, symptoms and duration of tamoxifen therapy. Fifty seven of 80 post-menopausal women had single layer endometria1 thickness of 2.5 mm or greater measured by TVS and 55 of 57 had endometrial biopsies or dilatation and curettage. Biopsies detected 24 cases of abnormal endometrial including endometrial carcinoma [2], breast carcinoma metastatic to the endometrium [one], endometrial polyps [13], tuba1 metaplasia [3] and benign endometrial hyperplasia [5]. Using a single- layer endometrial thickness greater than 2.5 mm by TVS, 21 of 24 women with abnormal endometrial were detected. Women with abnormal pathologic findings had a significantly thicker mean single layer endometrial thickness than those with normal findings [7 mm versus 4 mm]. Twelve women had post-menopausal bleeding all of whom had a single layer endometrial thickness greater than 2.5 mm on TVS

Gastric emptying by ultrasonography

Ultrasound examination for the stomach is a non-aggressive and easy technique validated versus scintigraphy. It has been used to assess gastric motility and emptying. The adoption of the [Fluid filled stomach technique] helped a lot to overcome certain difficulties which prevent good gastric imaging namely the presence of air inside the stomach which attenuates the transmission of the U.S. waves. We studied simultaneously the rate of gastric emptying in 10 healthy controls and in 10 patients with non-ulcer dyspepsia [Chronic Upper Gastrointestinal Symptoms Without Organic lesion] after ingestion of 500 cc. freshly tap water, and 500 cc of liquid mixed meal. We found with the liquid mixed meal, that patient with non-ulcer dyspepsia had a significant delay in gastric emptying