Reference for Normal Diameters of the Abdominal Aorta and Common Iliac Arteries in the Saudi Population.

The abdominal aorta is the largest artery in the abdomen. It then bifurcates giving the two common iliac arteries. Knowing the normal abdominal aorta diameter is a basis for diagnosing abdominal aortic aneurysms (AAAs) and subsequently developing an optimal management plan. In order to diagnose AAA, one must have a reference for the normal abdominal aortic diameter that represents the anatomical variation in the population being studied. The aim of this research is to establish normal abdominal aortic diameters in the Saudi population.

Shoulder impingement: various risk factors for supraspinatus tendon tear: A case group study.

ABSTRACT: A total of 680 cases of monolateral shoulder pain and functional impairment were included, and Chi-Squared tests was incorporated to test for possible associations.No relation between impingement syndrome and potential risk factors was found, such as presence of down slopping (P = .083), presence of ossification acromiale (P  = .102), presence of calcific tendinitis (P  = .144), types of acromion (I [P = .600], II [P = .536], III [P = .633] and IV [P = .832]) and grade of acromioclavicular degenerative changes (mild [P = .077], moderate [P = .111], and severe [P = .700]). However, a significant relationship was uncovered between impingement syndrome and risk factors such as gender (X2 = 7.004, df = 1, P = .08) (where females were more prone), history of shoulder dislocation (X2 = 19.440, df = 1, P = .001), presence of supraspinatus tendon tear or tendinopathy (X2 = 69.344, df = 1, P = .001) and supraspinatus complete tear (X2 = 13.593, df = 1, P = .001). A significant relationship was found between the type of supraspinatus pathology and factors such as gender (female more prone) (X2 = 34.719, df = 3, P = .01), presence of down slopping (X2 = 57.765, df = 3, P = .01), history of shoulder dislocation (X2 = 148.880, df = 3, P = .001), type III of the acromion (X2 = 12.979, df = 3, P = .005), presence of acromioclavicular generative changes mild (X2 = 76.408, df = 3, P = .001) and moderate (X2 = 29.697, df = 3, P = .001), and acromiohumeral distance of ≤3 mm (X2 = 18.915, df = 3, P = .001), 3.1 to 6 mm (X2 = 13.212, df = 3, P = .004), and 9.1-12 mm (X2 = 15.066, df = 3, P = .002). Overall, the Magnetic Resonance Imaging results yielded high sensitivity for detecting full-thickness supraspinatus tears.Considering the findings, this study may help radiologists understand the salient risk factors and identify which factors are mainly responsible for supraspinatus tendon tears and the respective grade of tear (articular partial, bursal partial, complete, or tendinopathy).

Magnetic resonance enterography and bowel ultrasonography in Saudi Arabian patients with Crohn's disease: A correlation study.

Background: Crohn's disease (CD) is a complex autoimmune disease that results in chronic inflammation of the gastrointestinal tract. CD activity is determined through clinical, laboratory, endoscopic, and radiological evaluations. Studies that examine the data of radiological modalities of evaluation are lacking, particularly in Saudi Arabia. This study compares magnetic resonance enterography (MRE) and ultrasonography (US) findings among patients diagnosed with CD, to uncover a possible correlation between these techniques. Methods: All patients were assessed for disease activity using MRE and US. Results: A total of 376 patients with CD were recruited. The mean age was 14.9 ± 4.3 years (range, 8-27 years), and males constituted 64% (n = 239) of the cohort. Overall, a strong positive correlation was found between US and MRE evaluations of disease activity (r = 0.83, P < 0.001). US activity correlated positively with MRE findings of enlarged lymph nodes (P < 0.001), bowel wall enhancement (P < 0.001), distal jejunal thickness (P < 0.001), and distal ileal thickness (P < 0.001). The mean difference in wall thickness was significant based on gender (P < 0.001), age in proximal jejunal thickness (P < 0.001), and distal ileal thickness (P = 0.011). Conclusions: MRE and US correlate significantly as imaging techniques for the assessment of CD activity.

Enhancement of Anemia Detection by Correlating Computed Tomography Findings of Abdominal Aorta and Inferior Vena Cava With Laboratory Investigations.

Anemia affects approximately a quarter of the global population, and improved detection may reduce the associated morbidity and mortality. This study investigated correlations between the results of laboratory hematological determinations of hemoglobin levels and attenuation values measured in the lumina of the abdominal aorta and inferior vena cava (IVC) via unenhanced computed tomography (CT) with the aim of expanding diagnostic options for anemia. The data of 423 patients who underwent abdominal unenhanced CT examinations and laboratory examinations at a tertiary hospital were retrospectively evaluated. CT data were collected using a standard abdominal protocol without contrast. The 151 patients who met the inclusion criteria were categorized by hemoglobin values as follows: <8 (severe anemia), 8-10.9 (moderate anemia), 10.9-12 (mild anemia in females), 10.9-13 (mild anemia in males), and >13 g/dL (non-anemic). The mean CT attenuation values in the aorta and IVC were 37.7 and 36.1 Hounsfield units (HU), respectively. A regression analysis performed to evaluate the correlation and predictability of hemoglobin-based aortic and IVC density yielded a coefficient of determination, R2: 0.42 (F ratio: 149.23, p < 0.0001). The highest contribution in the dependent variable (hemoglobin) was reported to IVC density, showing a significant positive correlation between hemoglobin and IVC density. Our study results demonstrate significant correlations between the densities of the aorta, IVC, and hemoglobin value. Accordingly, radiologists and clinicians can use these readily available values to facilitate diagnosis and patient care.

Magnetic resonance imaging in the management of Crohn's disease: a systematic review and meta-analysis.

OBJECTIVES: Crohn's disease (CD) is a condition that can occur in any part of the gastrointestinal tract, although usually forms in the colon and terminal ileum. Magnetic resonance imaging (MRI) has become a beneficial modality in the evaluation of small bowel activity. This study reports on a systematic review and meta-analysis of magnetic resonance enterography for the prediction of CD activity and evaluation of outcomes and possible complications. METHODS: Following the PRISMA guidelines, a total of 25 low-risk studies on established CD were selected, based on a QUADAS-II score of ≥ 9. RESULTS: A sensitivity of 90% was revealed in a pooled analysis of the 19 studies, with heterogeneity of χ2 = 81.83 and I2 of 80.3%. Also, a specificity of 89% was calculated, with heterogeneity of χ2 = 65.12 and I2 of 70.0%. CONCLUSION: It was concluded that MRI provides an effective alternative to CT enterography in the detection of small bowel activity in CD patients under supervision of radiologist for assessment of disease activity and its complications. Its advantages include the avoidance of radiation exposure and good diagnostic accuracy.

Reviewing the relationship between machines and radiology: the application of artificial intelligence.

BACKGROUND: The scope and productivity of artificial intelligence applications in health science and medicine, particularly in medical imaging, are rapidly progressing, with relatively recent developments in big data and deep learning and increasingly powerful computer algorithms. Accordingly, there are a number of opportunities and challenges for the radiological community. PURPOSE: To provide review on the challenges and barriers experienced in diagnostic radiology on the basis of the key clinical applications of machine learning techniques. MATERIAL AND METHODS: Studies published in 2010-2019 were selected that report on the efficacy of machine learning models. A single contingency table was selected for each study to report the highest accuracy of radiology professionals and machine learning algorithms, and a meta-analysis of studies was conducted based on contingency tables. RESULTS: The specificity for all the deep learning models ranged from 39% to 100%, whereas sensitivity ranged from 85% to 100%. The pooled sensitivity and specificity were 89% and 85% for the deep learning algorithms for detecting abnormalities compared to 75% and 91% for radiology experts, respectively. The pooled specificity and sensitivity for comparison between radiology professionals and deep learning algorithms were 91% and 81% for deep learning models and 85% and 73% for radiology professionals (p < 0.000), respectively. The pooled sensitivity detection was 82% for health-care professionals and 83% for deep learning algorithms (p < 0.005). CONCLUSION: Radiomic information extracted through machine learning programs form images that may not be discernible through visual examination, thus may improve the prognostic and diagnostic value of data sets.

Intra-substance meniscal changes and their clinical significance: a meta-analysis.

The degeneration of radial tie fibres of the central meniscal layer, and thinning of its lamellar layer results in increased intensity signals on magnetic resonance imaging, making it difficult to differentiate from true meniscal tear. This study aimed to assess the rate of encountered MRI grades 1 and 2 intrasubstance meniscal changes, and to set guidelines to report these changes based on predicted clinical outcome. A systematic review approach was employed using search engines, libraries, and databases (Google Scholar, ERIC, PubMed, and Medline) to search for scholarly sources on meniscal lesions and their significance in MRI published between 1 January 2000 and 30 June 2019. It retrieved 2750 abstracts, out of which 2738 were excluded and 13 studies meeting inclusion criteria were meta-analysed. It found an association between intrasubstances meniscal changes and outcomes. It resulted that intrasubstance meniscal changes were preservable through the protective functioning of the meniscus. Other than weight gain, no other significant risk factor of developing true meniscal tears later in life was found. It is important to examine intrasubstance meniscal change when patients suffer from mechanical meniscal symptoms especially in old age.

Impact of high-fidelity transvaginal ultrasound simulation for radiology on residents' performance and satisfaction.

RATIONALE AND OBJECTIVES: Because of the intimate and uncomfortable nature of transvaginal ultrasound, training residents to perform this type of examination is a difficult task. As a consequence, residents may receive inadequate training that leads to a lack of the skills and confidence needed to perform this examination. The aim of the study was to assess the effectiveness of using simulation sessions to teach residents how to perform transvaginal ultrasound, enabling them to diagnose obstetric and gynecologic emergencies and helping them survive on-calls alone while keeping their patients safe. MATERIALS AND METHODS: We used an experimental study design to compare the confidence levels of 20 senior residents who received clinical training only to those of 25 junior residents who were enrolled in a simulation-based teaching session. We also compared the junior residents' levels of performance and confidence using transvaginal ultrasound before and after the sessions. RESULTS: The performance of transvaginal ultrasound by the junior residents and their confidence levels significantly improved after they attended the simulation sessions. They had higher levels of confidence than the senior residents who did not attend the session. It was also observed that the number of nondiagnostic transvaginal ultrasounds performed by the on-call resident that needed to be repeated the next day had significantly dropped. CONCLUSIONS: Simulation-based teaching sessions are an effective method of education, which improve trainees' skills and confidence levels and improve patient safety.

Impact of adopting a newly developed blueprinting method and relating it to item analysis on students' performance.

BACKGROUND: In order to achieve validity of assessment results in the basic imaging module, an integrated assessment practice was introduced. The purpose of this article is to evaluate the impact of utilizing the created exam blueprint and relating its results to item analysis on students' achievement of the learning objectives as reflected in their overall performance scores and satisfaction. METHODS: A simple blueprint method was created by the authors. Cross-sectional study was performed on two groups of students: one did not utilize blueprinting while the other did. Data were retrieved from the results of two questionnaires evaluating the students' satisfaction of the course and of their perception of ILO; students' scores; and from item analysis results. The adopted assessment practice was evaluated using the modified and expanded version of Kirkpatrick's model. RESULTS: Group B results outperformed group A reflected as statistically higher students' scores, satisfaction, perceived and actual achievement of the assessed learning outcomes, and higher psychometric indices of the exams. CONCLUSION: The method adopted by using the newly developed blueprinting method and relating it to item analysis results has positive impact on the validity and reliability of students' performance results and their satisfaction in relation to intended learning outcomes.