Utility of doppler study of the arterial system of the upper limb prior to radial artery harvesting in coronary bypass candidates

Preoperative evaluation of the arterial system of the non-dominant upper limb in RA harvesting candidates to estimate the compliance of the ulnar artery to receive the entire flow from the brachial artery for better case selection to avoid post-operative ischaemic complications in the used upper limb. Doppler and/or Power Doppler examination were performed prior to surgery to evaluate the arterial system of the non-dominant upper limbs of 32 patients admitted as candidates for radial artery harvesting for coronary bypass surgery. The state of radial artery removal was imitated by RAC at the wrist. The PSV, EDV and RI were estimated under basal conditions and during RAC. The readings were collected, tabulated and compared to previous reports and accordingly some of the candidates were excluded from RA harvesting owing to significant expectations of upper limb ischaemic manifestations following RA removal. Doppler and/or power Doppler is a very useful preoperative screening test for better selection of candidates for RA harvesting for coronary bypass surgery to avoid post-operative upper limb ischaemic manifestations following RA removal

Intracranial Vascular abnormalities: value of conventional MR angiography

Forty-eight patients with a variety of intracranial vascular abnormalities were studied by conventional MR angiography. It proved to gave an important role in the diagnosis of 12 cases of vessel thrombosis, 15 aneurysms, 10 arteriovenous malformations, 3 cases of idiopathic sinus thrombosis, 7 cases of neoplasms adjacent to venous sinuses and a case of megadolichobasilar artery. The MR findings were correlated with clinical, CT and conventional angiography findings when available. This study highlights some of features of the intracranial circulation that make conventional MR angiography valuable in the demonstration of vascular disease

Value of MRI in assessment of suprarenal masses

Fifteen patients with variable adrenal pathology were studied by magnetic resonance imaging [MRI]. They included six adenomas [three non-functioning and three hyperfunctioning presented as Cushing and Conn syndromes], two pheochromocytomas, four metastases, a case of carcinoma, a case of hyperplasia and a case of histoplasmosis. SE, short TR sequences provided best anatomic images, especially for initial screening of the adrenal area preferably in combination with thin sections. SE, long TR long TE sequences were useful for tissue characterization of adrenal masses and for differentiation of non- hyperfunctioning adenomas from other adrenal masses, including high intensity metastases and pheochromocytomas. Enhancement with Gd- DTPa further increased the specificity of MRI. This study assessed the ability of MRI to demonstrate abnormal adrenal glands with determination of the MRI features of various adrenal mass lesions

diagnostic value of MR imaging in the evaluation of carpal tunnel syndrome

Magnetic resonance [MR] imaging of the wrists was performed in fourteen patients who were suspected to have carpal tunnel syndrome [CTS]. The most predominant MR abnormalities were that related to the median nerve [seven cases] and of such nerve abnormalities, the most frequent sign was the swelling being segmental at the proximal part of the carpal tunnel in two cases and diffuse in three cases. In three cases, altered signal intensity of the median nerve was noted. These findings seemed to represent edematous changes of the median nerve due to compression and/or neuritis. Bowing of the flexor retinaculum was seen in three cases. Swelling of the tendon sheath was demonstrated in five cases and hemangiomas in another two cases. Surgical correlation was obtained in four wrists. Based on this study, MR imaging proved to be capable of demonstrating characteristic pathological changes of the median nerve in CTS regardless of the cause and in some cases it could detect the underlying cause, thus helping in the treatment planning

Transvaginal sonographic evaluation of ectopic pregnancy

Effectiveness of transvaginal sonography for identification of ectopic pregnancy was studied in 43 pregnant women. Forty patients had tubal, two cornual and one ovarian ectopic pregnancies. The most common sonographic finding was a sac-like adnexal ring which was seen in 27 of the women. This finding was strongly associated with an intact Fallopian tube. In 16 of the women, an adnexal mass with a complex texture was found. Out of these 16 women, 13 had a tubal hematoma and 3 had a ruptured tube. Transvaginal sonography also enabled detection of hemoperitoneum in 38 patients. The results of transvaginal sonography were compared with pregnancy test and surgical findings. This study suggested that the status of an ectopic pregnancy could be predicted reliably on the basis of transvaginal sonographic findings

Computerized tomography of the pericardium

46 patients with various pericardial diseases were studied by computed tomography [CT] and the results were compared with that of chest radiography and echocardiography. CT readily did not identify the normal pericardium only but was of great value in the diagnosis of pericardial effusions [29 cases], thickened pericardium [4 cases], pericardial calcifications [12 cases] and one case of pericardial cyst. CT was important in the evaluation of constrictive pericarditis and in differentiating restrictive from constractive cardiomyopathy. CT also allowed for simultaneous proper demonstration of adjacent lungs and mediastinum for possible associated pathological conditions