Role of static fluid MR urography in detecting post urinary diversion complications

Aim of work: The aim of the study was to assess the diagnostic performance of static MR urography in detection of post cystectomy complications & the ability of static fluid MR urography in visualization of urinary tract segments.Material & methods: We prospectively reviewed 21 MR urograms with urinary diversion. The most common surgical procedures included Ileal conduit & Ileocecal neobladder diversion.Material & methods: Magnetic resonance urography examinations were performed with 1.5-T MR scanners. T2 weighted (static fluid) MR urography techniques were done, in addition to conventional T1- and T2-weighted axial and coronal sequences. Urinary tract was divided in different parts: pelvicalyceal systems, upper, mid and lower ureteric segments & the reservoir or conduit Imaging features of the urinary collecting systems were evaluated for their visualization and complications detection.Results: T2-weighted MR urography could demonstrate 95% of urinary tract segments & together with conventional MR sequences all urinary tract segments can be visualized. Urinary diversion related complications were encountered included in 15 patients (71.4%) & no urological complications were seen in 6 patients (28.6%).Conclusion: Comprehensive T2-weighted MR urography is an effective imaging method for the visualization of the urinary system and detection of early and late postoperative complications in patients with urinary diversion.Keywords: MR urography, Urinary diversion, Cancer bladde

Diffusion tensor imaging in trigeminal neuralgia: beyond the normal morphology

Abstract Background Trigeminal neuralgia (TN) is an electric-like recurrent pain of a sudden onset and is localized to the area supplied by the trigeminal nerve, and the patients are usually free in between the attacks. It’s one of the most common causes of facial pain and is commonly induced by mechanical irritation, and there’s strong evidence suggesting an insult at the trigeminal nerve root which is usually caused by a neurovascular compression. The aim of the study was to evaluate the role of diffusion tensor imaging (DTI) in the detection of microstructural changes of normal appearing trigeminal nerve in patients with trigeminal neuralgia and the correlation between DTI parameters and pain severity. Results Thirty one cases were included in the study (16 patients with TN and 15 healthy controls) underwent MRI with diffusion tensor imaging. The fractional anisotropy (FA) values of the trigeminal nerves were recorded and then comparison between the affected and unaffected sides in TN patients and healthy controls was done, also the degree of FA reduction was correlated with the pain severity in TN groups. The mean FA value of the affected trigeminal nerves was 0.43 ± 0.083, while that of the unaffected sides was 0.56 ± 0.058. The mean FA value of the trigeminal nerves in the healthy controls was 0.54 ± 0.057. A significant statistical differences was found between affected and unaffected sides (P < 0.00001) and between the affected sides and healthy controls (P < 0.0003), while no statistically significant difference was detected between the unaffected side and the healthy controls. A strong negative correlation was found between the pain score and the degree of FA reduction (P < 0.001). Conclusions Diffusion tensor imaging is a functional MRI technique which can detect the microstructural changes in the normal appearing trigeminal nerves in patients with trigeminal neuralgia with a strong negative correlation between the severity of pain and the degree of FA reduction of the affected trigeminal nerve

Value of 18-F-FDG PET/CT in assessment of patients with fever of unknown origin

Aim: To evaluate the value of 18F-FDG (positron emission tomography) PET/CT in assessment patients with fever of unknown origin (FUO) and to compare the findings with the results of the other investigations. Patients and methods: This is perspective study in which 27 patients having FUO underwent 18F-FDG-PET/CT examination, using combined PET/CT with contrast enhanced CT. PET/CT findings were compared with the results of biopsies, immunology, or microbiology around the examination period & for the following 3 month duration, during which patients with negative PET/CT findings were followed also. Results: The cause of FUO was explained according to the PET/CT findings and the other investigations in 27 patients: 6 patients with infections, 2 patients with autoimmune inflammation, 3 patients with solid malignancies, 2 patients with sarcoidosis, 6 patients with vasculitis, 5 patients with lymphoproliferative disease & 3 patients with negative findings. PET/CT findings matched the clinical diagnosis in 23 patients, 4 patients showed negative PET/CT findings (2 patients as true negative & the other 2 patients as false negative that were fatherly diagnosed as lymphoma). The examination sensitivity 95%, specificity 67%. Conclusion: 18F-FDG PET/CT can be a useful tool for scanning the whole body to suggest the FUO cause

Role of static fluid MR urography in detecting post urinary diversion complications

Aim of work: The aim of the study was to assess the diagnostic performance of static MR urography in detection of post cystectomy complications & the ability of static fluid MR urography in visualization of urinary tract segments. Material & methods: We prospectively reviewed 21 MR urograms with urinary diversion. The most common surgical procedures included Ileal conduit & Ileocecal neobladder diversion.Magnetic resonance urography examinations were performed with 1.5-T MR scanners. T2 weighted (static fluid) MR urography techniques were done, in addition to conventional T1- and T2-weighted axial and coronal sequences. Urinary tract was divided in different parts: pelvicalyceal systems, upper, mid and lower ureteric segments & the reservoir or conduit Imaging features of the urinary collecting systems were evaluated for their visualization and complications detection. Results: T2-weighted MR urography could demonstrate 95% of urinary tract segments & together with conventional MR sequences all urinary tract segments can be visualized. Urinary diversion related complications were encountered included in 15 patients (71.4%) & no urological complications were seen in 6 patients (28.6%). Conclusion: Comprehensive T2-weighted MR urography is an effective imaging method for the visualization of the urinary system and detection of early and late postoperative complications in patients with urinary diversion. Keywords: MR urography, Urinary diversion, Cancer bladde