Assessment of Triangular Fibro-cartilaginous Complex Injuries of The Wrist Using High Resolution Ultrasound versus Magnetic Resonance Imaging

Background: Triangular fibrocartilage complex (TFCC) may be assessed using ultrasound (US) because of its wide availability, mobility, low cost, and lack of radiation. When it comes to TFCC imaging, MRI is the gold standard, although US can provide a more detailed picture of the disease. Objective: Comparing and contrasting the use of ultrasound (US) and magnetic resonance imaging (MRI) in the detection of triangular fibrocartilaginous complex injuries of the wrist. Patients and Methods: The study was conducted at the Radiodiagnosis Department, Zagazig University Hospital, Egypt. Wrist discomfort or reduced wrist mobility was reported by 35 individuals with a mean age of 39 ± 13.18 years old. Both radiologists who performed the ultrasound and the MRI were blinded to each other's results in order to minimize bias. Results: 82.9 % of patients showed normal ulnar variance while 11.4 % of patients showed positive variance and 5.7% with negative variance. The ultrasound detected 18 positive cases with TFCC injury with a percentage of 51.4%. The MRI detected 24 positive cases with TFCC injury with a percentage of 68.6%. The ultrasound detected TFCC cases with a sensitivity of 75%, specificity 100%, PPV 100 and NPV 64.7. Conclusion: It is very suggested that tendons and inflammation of the wrist could be examined by ultrasonography. In recent investigations, it was shown that US had the ability to identify injuries in the TFCC and intrinsic ligament

The value of high-resolution MRI technique in patients with rectal carcinoma : pre-operative assessment of mesorectal fascia involvement, circumferential resection margin and local staging

Background: The purpose of the study was to identify the accuracy of high-resolution MRI in the pre-operative assessment of mesorectal fascia involvement, circumfrential resection margin (CRM) and local staging in patients with rectal carcinoma. Material and Methods: The study included 56 patients: 32 male and 24 female. All patients underwent high-resolution MRI and had confirmed histopathological diagnosis of rectal cancer located within 15 cm from the anal verge, followed by surgery. MRI findings were compared with pathological and surgical results. Results: The overall accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI-based T-staging were 92.8, 88.8%, 96.5%, 96%, and 90.3%, respectively. The accuracy, sensitivity, specificity, PPV, and NPV of MRI-based assessment of CRM were 94.6%, 84.6%, 97.6%, 91.4, and 94.6%, respectively. The accuracy, sensitivity, specificity, PPV, and NPV of MRI-based N-staging were 82.1%, 75%, 67.3%, 60%, and 86.1%, respectively. Conclusions: Preoperative high-resolution rectal MRI is accurate in predicting tumor stage and CRM involvement. MRI is a precise diagnostic tool to select patients who may benefit from neo-adjuvant therapy and to avoid overtreatment in those patients who can proceed directly to surgery

Advantage of adding diffusion weighted imaging to routine MRI examinations in the diagnostics of scrotal lesions

BACKGROUND: The purpose of the study is to identify the diagnostic value of adding diffusion weighted images (DWI) to routine MRI examinations of the scrotum. MATERIAL AND METHODS: The study included 100 testes of 50 patients with a unilateral testicular disease. Fifty normal contralateral testes were used as a control group. All patients underwent conventional MRI and DWI examinations of the scrotum. The results of MRI and DWI of the group of patients treated surgically were correlated with histopathological findings. The MRI and DWI results of non-surgical cases were correlated with the results of clinical, laboratory and other imaging studies. Comparison of the ADC value of normal and pathological tissues was carried out followed by a statistical analysis. RESULTS: There was a significant difference between ADC values of malignant testicular lesions and normal testicular tissues as well as benign testicular lesions (P=0.000). At a cut-off ADC value of £0.99, it had a sensitivity of 93.3%, specificity of 90%, positive predictive value of 87.5%, and negative predictive value of 94.7% in the characterization of intratesticular masses. CONCLUSIONS: Inclusion of DWI to routine MRI has a substantial value in improving diagnosis in patients with scrotal lesions and consequently can reduce unnecessary radical surgical procedures in these patients