Value of magnetic resonance cholangiography in detection of extent of hilar cholangiocarcinoma

To determine the extent of hilar cholangiocarcinoma, using different magnetic resonance [MR] spin-echoes. A total of 87 patients, who presented with painless jaundice, comprised the subjects of the present study. All patients were prospectively examined with MR cholangiography after endoscopic retrograde cholangiography, percutaneous trans-hepatic cholangiography, ultrasound and CT. Only 18 patients [4 men and 14 women] had established the diagnosis of hilar cholangiocarcinoma. MR angiography was performed to provide a non-invasive angiographic picture for the hepatic artery and portal vein. MR cholangiography examinations allowed for visualization of the intrahepatic and extrahepatic bile ducts of all patients. It was able to delineate any hilar stricture, the proximal extent of the disease and the distal duct in all patients. The MR cholangiographic findings of 6 patients [33.3%] detected the tumor and its extension, similar to that of the direct cholangiograms. In the rest of patients with cholangiographic correlation [12 patients, 66.7%], MR cholangiography detected the mass and the exact extension in 8 patients [44.4%], while the mass was detected in 2 patients by CT and in one patient by ultrasound. As the proximal extent of tumor and stricture were clearly seen by MR cholangiographic findings, this resulted in change of the therapy plan in 8 patients [44.4%] regarding their resectability or interventional stenting. MR and MR cholangiography are rapid, reliable and non-invasive diagnostic modality in the diagnosis of hilar cholangiocarcinoma. Since MR cholangiography provides a wealth of relevant information, it should be used routinely for the diagnosis and staging of hilar cholangiocarcinoma

Role of MRI in improving diagnosis of breast tumors

To assess the role that can be played by MRI to minimize the number of false positive cases of breast tumors that commonly occur with mammography. This study included 200 consecutive patients aged 40 years or more, who were referred to the Department of Radiology for suspicion of a breast lump. Mammography then magnetic resonance imaging [MRI] was performed for each patient. A patient with a positive finding in any of these two modalities underwent histopathological diagnosis. Sensitivity and specificity were calculated for each imaging modality and that for MRI of mammography positive patients. Most common benign lesion were fibroadenoma [11%] and radial scars [5.9%], while the most common malignant tumors were invasive ductal carcinoma [37.3%] and ductal carcinoma in situ [21.2%]. Prevalence of breast tumors among participants increased with their age. Prevalence of breast tumors among nulliparous participants was significantly higher than that among parous participants [88.6% Vs. 72.5%, respectively, p = 0.01]. The prevalence of breast tumors was significantly higher among those with positive family history of breast cancer [93.2%] than those with negative family history [70.6%], p = 0.003. Mammography provided a higher sensitivity than that provided by MRI [97.5% Vs. 90.7%, respectively], but a lower specificity [48.6% Vs. 94.3%, respectively], which has been fully improved by the application of MRI on cases who were positive by mammography [100%].The application of MRI for cases with positive mammographic findings can be a cost-effective procedure that greatly limits false positives, increases specificity and spares unnecessary invasive interventions. To conduct a community-based study to assess the role and cost-effectiveness of MRI in screening for breast cancer among females aged over 40 years, applying MRI on all those with mammographic findings