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

Value of diffusion-weighted MRI in evaluation of solid hepatic focal lesions in patients with renal insufficiency

Objectives: To evaluate the diagnostic accuracy of diffusion weighted MRI in diagnosis of solid hepatic focal lesions in patients with impaired renal functions. Patients and methods: This prospective study included (30) patients with impaired renal function and had solid hepatic focal lesions based on ultrasound examination. All patients subjected to diffusion MRI examination and ADC measurement, and the data obtained were compared with histopathological results of malignant lesions and previously reported appearance of benign lesions. Results: There were 57 solid focal lesions in the included 30 patients. The mean ADC value of hemangiomas was 2.03 × 10−3, lipoma was 0.1 × 10−3, HCC was 1.06 × 10−3 and for metastases was 1.2 × 10−3. Benign lesions have significant higher ADC values than malignant ones (p = 0.003), and in malignant lesions the primary hepatic carcinomas had lower ADC values compared to metastatic lesions which had no significant value. Using a cutoff value of 1.6 × 10−3 for the ADC to differentiate between benign and malignant lesions the AUC was 90% with Sensitivity, Specificity, PPV, NPV and accuracy of 92%, 80%, 98%, 50% and 91% respectively. Conclusion: DW-MRI and ADC value measurements are effective in characterizing solid focal hepatic lesions without contrast injection in patients with renal impairment

ADC value as a predictor for myelin loss/Preservation in MS plaques with different enhancement pattern in correlation with disease activity

Background: MS plaques display different pattern of enhancement with variable clinical course. The purpose is to assess the role of ADC value as a predictive for MS histologic changes with different enhancing pattern and its correlation with disease activity. Patients and methods: This prospective study included 28 chronic MS patients with 75 lesions, subjected for magnetic resonance imaging and ADC value measurement of the plaques and normally appearing white matter (NAWM) to be correlated with that of normal white matter (NWM) in 20 healthy controls. Results: T1-Hypointense and confluent lesions had statistical significant higher mean ADC value relative to the isointense and discrete lesions. Statistical significance difference was detected between mean ADC value of homogeneously enhancing lesions (HELs) and ring enhancing lesions (RELs) and between HELs and non-enhancing lesions (NELs), but no difference between NELs and RELs. Statistical significance difference was detected between ADC of NAWM relative to NWM of healthy controls. Conclusion: ADC value predicts histological changes in MS lesions. Pattern of enhancement doesn't correlate with neurologic deficits but ADC value is more valuable in assessing the disease activity