Volumetric study of the olfactory bulb in patients with chronic rhinonasal sinusitis using MRI

AbstractObjectiveOlfaction plays an important role in human daily life. The olfactory bulb size is dependent on stimulation. Smell loss is one of the main symptoms in chronic rhinonasal sinusitis. MRI has been indicated to evaluate the size of the olfactory bulb in such patients.The aim of this study was to assess the volumetric changes of the olfactory bulb in patients with sinonasal polyposis before and after treatment using MRI.Patients and methodsFifteen control subjects and 30 patients were included in the study, 24 of them patients underwent endoscopic sinus surgery. Volumetric analysis of their olfactory bulb volume was done using MRI and specialized software.ResultsIt was found that the olfactory bulb volume was significantly smaller in patients (19.98±5.88mm3) when compared to control mean (39.6±13.8mm3) and there was a significant increase in the olfactory bulb volumes in patients who underwent surgery 6months postoperatively (24.79±5.11mm3).ConclusionsMRI with volumetric analysis is a useful tool in assessment of the olfactory bulb volume in patients with olfactory loss and appears to be of help in assessment of the degree of recovery in patients after sinus surgery

Contrast enhanced MRI and Diffusion Weighted Imaging (DWI) in the evaluation of renal cell carcinoma and differentiation of its subtypes

Objective: The prognosis of different histologic subtypes of RCC varies and affects management. Patients with chromophobe or papillary RCC have better prognosis than those with clear cell RCC. The aim of our work was to study the utility of DCE and DWI in the preoperative prediction of renal cell carcinoma subtypes, using histopathology as a gold standard method of diagnosis. Patients and methods: Thirty five patients with 38 renal masses were included in the study. All had DCE MRI studies with DWI sequences, CER and ADC values calculation for normal and diseased renal tissues. Results: The Mean ADC value of normal renal parenchyma was significantly higher than RCC. The CER and ADC values for Clear cell RCC were higher than Papillary and Chromophobe RCC. No statistically significant difference was found between the CER & ADC values for Papillary and Chromophobe RCC. CER & ADC values of clear RCC were higher than non clear RCC. Conclusions: DCE MRI in addition to DWI & ADC appears as a very helpful imaging tool in the differentiation between clear cell and non-clear cell RCCs

Postoperative ultrasonography changes of the pylorus in infants with hypertrophic pyloric stenosis

Infantile hypertrophic pyloric stenosis (IHPS) is a common condition affecting infants. Ramstedt pyloromyotomy procedure remains the standard of surgical treatment of IHPS till today. Postoperative ultrasonography of the pylorus is indicated in patients with persistent vomiting after pyloromyotomy to assess pyloric morphology, gastric emptying and excludes other associated conditions or complications that may present with this clinical picture. Aim of the work: To assess the short term morphological and dynamic changes of the pyloric muscle following pyloromyotomy in patients with HPS. Subjects and methods: Forty infants who were admitted to the pediatric surgery unit at Tanta university hospitals had a preoperative ultrasound (US) examination for assessment of the pylorus for HPS. Follow up postoperative US was performed on the 3rd day, after 1 week and 1 month by the same radiologist. Results: All the patients showed pyloric measurements that exceeded the agreed upon criteria for diagnosis of HPS. On the postoperative scans the pyloric muscle measurements were recorded and compared to preoperative ones. Conclusion: Postoperative US of the pylorus, with emphasis on the pyloric behavior, is a key tool in assessment of the postoperative changes of the pylorus for patient with surgically treated HPS

Assessment of vascular invasion in pancreatic carcinoma by MDCT

Background: Pancreatic cancer is one of the aggressive cancers with poor resectability and survival rates. The relationship to adjacent vessels must be assessed before deciding the choice of treatment. Aim: Assessment of the MDCT signs of arterial and venous invasion in pancreatic carcinoma. Subjects and methods: Total of 179 of the major peripancreatic vessels (CA; CHA; SMA; PV; SMV) in 47 patients who underwent surgery for pancreatic cancer after MDCT were assessed at surgery and compared with CT findings. Statistical analysis of the findings was done using Chi square test. Results: 115 vessels were not invaded at surgery, while the remaining 64 vessels were invaded (22 arteries and 42 veins). There was over all statistically significant difference between arterial and venous invasion regarding stenosis, occlusion, infiltration and circumferential involvement of the vessel wall. Conclusion: Assessment of vascular invasion is crucial in the evaluation of resectability for pancreatic cancer. MDCT is an accurate diagnostic tool for peripancreatic vascular invasion in cancer pancreas

Diffusion weighted MRI in chronic viral hepatitis C: Correlation between apparent diffusion coefficient values and histopathological scores

Aim of the work: To assess the utility of hepatic ADC of diffusion weighted MRI in the diagnosis of liver fibrosis in chronic hepatitis C patients and to evaluate its relationship with both the stage of liver fibrosis and grade of necro-inflammation. Subjects and methods: Forty patients with chronic viral hepatitis C and 30 healthy control group were examined by 1.5 T MRI scanner using DWI at b-values of 100, 400 and 800 s/mm2. The mean ADC values of both patients and the control group were correlated to biopsy findings and graded according to METAVIR scoring system. Results: The mean ADC values of the liver at all b-values were statistically significantly lower in the study group than those of the control group. A strong negative correlation was found between the mean ADC value and the stage of fibrosis. No significant correlation was found between the mean ADC value and the grade of necroinflammation. Conclusion: The ADC value of diffusion weighted MRI can be used to distinguish between liver parenchyma of patients with chronic viral hepatitis C and healthy subjects and it is useful for estimation of the stage of liver fibrosis but not valuable in estimation of the grade of necro-inflammation

Role of transperineal ultrasound measurements in women with prolonged second stage of labor as predictors of the mode of delivery

Aim of the work: To assess the clinical significance of transperineal ultrasound measurements, the angle of progression and the head progression distance in prediction of the mode of delivery in women with prolonged second stage of labor. Subjects and methods: 60 women with a live singleton fetus at full term who presented with prolonged second stage of labor were enrolled in our study. Transperineal ultrasound was used for determination of both angle of progression and head progression distance. We statistically analyzed the relationship between the ultrasound measurements and the different modes of delivery. Results: 32 women had spontaneous vaginal delivery, 13 women had assisted vaginal delivery using vacuum extraction and the remaining 15 women had a cesarean section. A statistically significant difference was found between the angle of progression and the mode of delivery, however there was no statistically significant difference between head progressive distance and different modes of delivery. The angle of head progression correlated with the mode of delivery using logistic regression analysis with a probability of 85.5% for an angle of 120°. Conclusion: Angle of progression measured by transperineal ultrasound, is an easy, simple, reliable, and noninvasive method for prediction of mode of delivery in women with prolonged second stage of labor rather than head progression distance

Magnetic resonance imaging of anorectal malformations

Anorectal malformation (ARM) occurs in approximately 1 in 5000 newborns and is frequently accompanied by anomalies of the genitalia, gynecologic system, urinary tract, spine, and skeletal system. Diagnostic imaging plays a central role in ARM evaluation. Because of the lack of ionizing radiation, excellent intrinsic contrast resolution, multiplanar imaging capabilities, technical advances in hardware, and innovative imaging protocols, magnetic resonance (MR) imaging is increasingly important in assessment of ARM patients in utero, postnatally before definitive surgical correction, and in the postoperative period. This article discusses the role of MR imaging in evaluating ARM patients. © 2013 Elsevier Inc

Postoperative pelvic MRI of anorectal malformations

OBJECTIVE. Patients operated on for anorectal malformations can experience technical complications related to the initial corrective surgery. Many of these complications may necessitate reoperation. Pelvic MRI is part of the evaluation to assess the position of the pulledthrough bowel, the sphincter muscles, and the critical area of the posterior urethra. This article reviews the various pelvic MRI findings in these patients. CONCLUSION. Pelvic MRI is a valuable tool in the assessment of postoperative anorectal malformations that may necessitate additional surgery. © American Roentgen Ray Society