T.B and pyogenic neck infection: different patterns in CT examination

The aim of this work was to illustrate the different CT patterns of neck infections. This study included 28 patients with suspected neck infection were referred to the Radiodiagnosis Department. They were subjected to history taking, clinical examination and multislices computed tomography [CT] evaluation with contrast. 28 patients were included in this study, 19 males and 9 females, their age ranged from 2-73 years. The different affected neck spaces were as follows: 12 peritonsillar, 7 submandibular, 7 parapharyngeal, 4 retropharyngeal, 2 sublingual, 4anterior cervical, 1 posterior cervical, and 1 parotid space. Lymph nodal abnormalities were identified in 9 patients. Nine patients with chest involvement as mediastinal extension in 6 patients, lung parenchymal lesions 2, one with mediastinal lymph nodes. CT is sufficient in detection of the extension of various neck infections. CT chest in the same sitting with CT neck may add information about the extension of the disease or can give a due to the diagnosis

Role of transcranial color doppler in cerebrovascular lesions

We evaluated the role of transcranial color Doppler sonography in diagnosis of cerebrovascular lesions. This study was conducted on 40 subjects, 15 were normal healthy volunteers as control and 25 were patients with clinical and radiological diagnosis of cerebrovascular lesions. All subjects underwent sonographic examination of the brain parenchyma and major intracranial cerebral arteries namely anterior, middle and posterior cerebral arteries via temporal acoustic window with a 2.8-MHz transducer. Major intracranial arteries were examined bilaterally by color flow imaging, and angle-corrected blood flow velocities were determined with integrated pulse wave [PW] Doppler. This study was conducted on 40 subjects, [22 males and 18 females], 15 were normal healthy volunteers as control and 25 were patients with clinical and radiological diagnosis of cerebrovascular lesions. There were ten cases of failed study, five from the control group and five from patients group. The remaining subjects with good acoustic temporal bone window were thirty, twenty from the patients group and ten from the control group. There were twenty patients with cerebrovascular lesions radiologically diagnosed as seven ischemic stroke, four hemorrhage stroke, one brain tumor, five intracerberal aneurysms, and three intracerebral arteriovenous malformations [AVM]. In stroke patients, four patients with intracerebral hematoma [ICH] and three with ischaemic stroke showed no changes in transcranial color coded sonography [TCCS], while four patients with ischemic stroke showed dynamic changes in the ipsilateral middle cerebral artery manifested as increased flow in one patient, creased flow in 2 patients and occluded Ml segment in one patient. The case with decreased flow, showed evidence of cross flow from the contralateral side through the anterior communicating artery [ACoA] shown as reversal in color and direction of flow in the ipsilateral middle cerebral artery [MCA] due to complete occlusion in the ipsilateral internal carotid artery seen in carotid Doppler sonography. The case with CT diagnosis as brain tumor was diagnosed by transcranial color coded sonography [TCCS] as intracranial space occupying mass lesion. the five patients with angiographically proven as intracerebral aneurysms, transcranial color coded sonography [TCCS] revealed only three cases through the temporal bone with mean diameter more than 5 mm. two small aneurysms less than 5 mm were missed. One of the three patients with angiographically proven intracrebral AVM was missed by transcranial color coded sonography [TCCS]. Transcranial Color sonography also revealed hemodynamic changes in the feeder arteries as increased. Peak systolic [PS] and end diastolic [ED] velocities, while the resistive index [RI] and pulsatility index [PI] were decreased. Transcranial color-coded sonography [TCCS] combines non-invasive imaging of intracranial vessels and parenchymal structures at a high spatial resolution in different intracranial vascular lesions

role of magnetic resonance sialography in assessment of duct system in salivary glands diseases

We evaluated in this study the diagnostic accuracy of MR Sialography in assessment of duct system in salivary gland diseases. This study was conducted on twenty patients. Magnetic Resonance imaging of the major salivary glands using conventional T1 and T2 weighted sequences, with addition of a heavily T2 weighted RARE [Rapid Acquisition with Relaxation Enhancement] MR sialography sequence was performed for all patients supplemented by conventional sialography and plain x-ray examination of the salivary glands. This study included twenty patients of different ages of both sexes, their ages were ranging from 4-80 years, complaining of pain and swelling at the regions of the salivary glands There were six neoplastic lesions, six inflammatory lesions, six sialolithiasis with and without associated sialadenitis, and two cases of non-neoplastic non-inflammatory lesions [sialosis]. Heavily T2-weighted MR sialographic imaging was able to delineate ductal anatomy and pathological changes as dilatation and displacement of the duct system of the examined major salivary glands in all cases. Combining such sialographic sequence with conventional MR sequences [T1 W and T2 W images] promise to be an ideal apprehensive imaging modality for evaluation of major salivary glands diseases

Direct percutaneous embolization of renal pseudoaneurysm

To describe and evaluate a novel method of direct ultrasound [US] guided percutaneous embolization of renal pseudoaneurysm. Elevn patients with severe hematuria were included in this study during the period from February 2005 to February 2006. They included five patients with penetrating renal trauma, two patients post-renal biopsy and four patients after percutaneous nephrolithotripsy. Diagnostic duplex US of the pseudoaneurysm was performed. The size of the pseudoaneurysm and its neck were determined. A solution of Gelfoam particles was prepared in sterile saline solution and under US guidance, the tip of the needle was inserted into the aneurysm and slowly Gelfoam particles solution was injected. During the injection of Gelfoam, the pseudoaneurysm initially filled with an echo genic thrombus, decreasing thereby the color flow detected by US. The needle was removed when no flow in the pseudoaneurysm was detectable. The patient was kept for 30 minutes in the department and then discharged home. Follow up by color Doppler US every 2 to 4 weeks. In 10 patients bleeding was effectively controlled with direct embolization in a single session and did not need any further intervention, while one patient needed endovascular embolization due to recurrent severe hematuria after 24 hours. The amount of the injected Gelfoamn particles [1-2 mm diameter] was from 1 to 3 ml, according to the size of the pseudoaneurysm. No complication was observed secondary to embolization procedure. Re-bleeding did not occur in any patient during their follow-up period that ranged from 3-12 months. Direct ultrasound guided percutaneous embolization of renal pseudoanureysm is a new method for treating renal pseudoaneurysm. It avoids the side effects of contrast media, hazards of irradiation and complications of angiographic catheterization. Moreover, it saves the patient the risk of surgical interference to control bleeding by partial or total nephrectomy specially in patients with solitary kidney. it has been proved to be a rapid, effective, feasible, tissue preserving, and likely to reduce morbidity and mortality. Therefore, it is recommended to be a first line of treatment of actively bleeding renal pseudoaneurysms