The role of MRI in the diagnosis of endometriosis

AbstractAimThe aim of this study is to evaluate the accuracy of the magnetic resonance imaging in diagnosis of endometriosis especially in non-apparent types as tubal and cul de sac endometriosis.Patients and methodsMRI obtained between January 2007 and June 2009 for 34 premenopausal women complaining of dysmenorrhea, menorrhagia and infertility and the diagnosis of endometriosis were included in the differential diagnosis. T1 weighted fat saturated and T2 weighted images were done for every patient, we evaluated the MR images for the presence of T1 bright signal suggesting endometriosis. Transvaginal US was performed in two perpendicular planes for the detection of focal areas with ill defined borders or abnormal echo texture. Suspicious cases which become negative by laparoscopy were excluded from the study.ResultsMRI diagnosed endometriosis in the uterus in 18 patients, ovarian endometriosis in 13 patients, tubal in two patients, and cul de sac in one patient.ConclusionIt is concluded that MRI is superior in the diagnosis of endometriosis than transvaginal ultrasound

MRI imaging of posterior reversible encephalopathy syndrome associated with pregnancy

Purpose: Our purpose is to characterize MRI, and diffusion-weighted imaging (DWI) findings in pregnant patients who were identified clinically to have PRES. We study the conversion of reversible vasogenic edema to irreversible cytotoxic edema and predict the progression to infarction. Patients and methods: Twenty two pregnant females, aged between 20 and 46 years with gestational age between 20 and 40 weeks of gestation and with neurological manifestations had undergone conventional MRI, diffusion weighted image study, and ADC map. Results: Lesions were mainly affecting the parieto-occipital regions, symmetrical or slightly asymmetrical distribution of the lesions in both cerebral hemispheres was found in most cases. The MRI findings in all the twenty two patients were: abnormal low SI in T1 WI, abnormal high SI on T2 and FLAIR WI. In DWI, hyperintensity with hyperintensity in ADC map was seen in 15 patients, hyperintensity with hypointensity in ADC map in 4 patients, normotensive in DWI with hyperintensity in ADC map in 3 patients. Conclusion: The diagnosis of PRES has important therapeutic and prognostic value. The use of diffusion-weighted imaging and ADC maps allows an earlier and clearer differentiation of cytotoxic and vasogenic edema, which can predict the development of infarction

The accuracy of MDCT for staging of Wilms’ tumor

Aim of work: To evaluate the accuracy of multidetector computed tomography (MDCT) in staging of Wilms’ tumor. Patients and methods: This prospective study was performed on 32 children (age range 4–8 years), having renal mass lesion, were studied with multidetector computed tomography (MDCT). Axial and multiplanar imaging were evaluated. All tumors were staged according to NWTS-4 classification. MDCT diagnosis was compared with surgical and pathohistological data. Results: All the cases were staged according to the fourth trial of the National Wilms’ tumor Studies (NWTS-4). The 32 cases were found to have 36 tumors (4 cases were bilateral masses), 4 tumors were diagnosed as stage I, 9 tumors were diagnosed as stage II, 7 tumors as stage III, 8 tumors stage IV and 8 tumors were stage V. Conclusion: In conclusion, MDCT represents a reliable diagnostic method for evaluating Wilms’ tumor and it is accurate and sensitive in diagnosing stages I, IV and V, but is not as accurate in the diagnosis of stages II and III and has poor correlation with histopathological data

Diagnostic performance of sonoelastographic Tsukuba score and strain ratio in evaluation of breast masses

The aim of this prospective study was to evaluate the diagnostic performance of the use of strain index ratio by sonoelastography to differentiate between benign and malignant breast lesions. Patients & Methods: This prospective study including 40 females, complaining of breast masses which were suspicious to be malignant on clinical examination. All patients were submitted to B-mode Ultrasound and sonoelastography. Biopsy as a gold standard and pathological study were done for all breast lesions. Results: US examination of every mass was done and categorized according to BI-RADS categories according to ACR2013, according to US lexicon. Sonoelastography examination with Lesions classification was performed on the basis of a 5-point scoring method proposed by Tsukuba elasticity score. Then measurements of strain ratio were done. Statistical analysis of combination of the three methods was sensitivity of 96.7%, specificity of 100% when we use cut off value of 3–4 in elastography score and ≤3 cut off value of strain ratio. Conclusion: The combined use of strain ratio with Tsukuba score and BI-RADS categorization increased the diagnostic performance in differentiation between benign and malignant breast lesions. Keywords: Elastography, Breast masses, Strain ratio, Ultrasound, BI-RADS classification, Tsukuba scor