Cystic echinococcosis in the middle region of the Nile Delta, Egypt: Clinical and radiological characteristics

Background: Cystic echinococcosis (CE) is a parasitic disease characterized by cystic lesions mainly in the liver. The diagnosis relies on clinical, laboratory, and radiological examination. Aim: To explore the clinical, radiological, and biological features of patients with CE in the middle region of the Nile Delta, Egypt. Patients and methods: From March 2012 to February 2014, this study was conducted on 45 patients, aged 20–65 years. Patients were subjected to clinical, laboratory, and radiological assessment using conventional X-ray chest, ultrasound and multi-detector CT of the abdomen and chest. Results: This study identified the epidemiological, clinical, laboratory, and radiological characteristics of patients with CE in the middle Delta region, Egypt. The CT may display the same findings as US in diagnosing and staging of most cases; however, CT is more superior to US in the evaluation of heavily calcified cysts, small inaccessible cysts, and pulmonary hydatid cysts. Conclusion: Biological markers seem neither sensitive nor specific, whereas the serological tests, preferably two different techniques, are useful. Ultrasound showed high accuracy rate, but CT, whenever possible, should be employed as it provides additional diagnostic value

The use of multi-detector computed tomography and ultrasonography for evaluation of pleural lesions

Background and objective: Multidetector CT (MDCT) and ultrasonography (US) are of increasing importance for assessment of many pulmonary disorders. Our aim was to evaluate their role in diagnosis of pleural diseases. Methods: Patients from Tanta University Hospital who were suspected to have pleural lesions (symptoms, signs and/or suggestive chest X-ray) during one year period were enrolled in the study. US and MDCT were done for all of them, then data were reported and analyzed. Results: Seventy-one patients were included, sixty of them had evident pleural lesions. Chest pain was the commonest presenting symptom. Malignancy represented 36.7% of pleural lesions, a percentage similar to lesions due to infection etiology. Free pleural effusions were the most common pleural lesions followed by pleural thickening. US was diagnostic in 72% of pleural lesions detectable by MDCT. Multiplanar reconstruction (MPR) images had an additional value than axial images in 39% of pleural lesions, mostly in cases of pleural thickening, free pleural effusion, pleural masses, encysted pleural effusions and pleural plaques. On the other hand, the MPR images had the same value as axial images in empyema and pneumothorax cases. Conclusion: MDCT is an important noninvasive imaging tool in accurate detection and characterization of pleural lesions with complementary MPR images that solve many diagnostic problems. Ultrasonography is a safer alternative but with less diagnostic value

Functional disability of occupational-related lumbar disc degeneration: Evaluation by magnetic resonance imaging with surgical correlation

Objectives: The objectives of our work were to determine disability and study MRI findings of occupational-related lumbar disc degeneration and also to show the relationship between MRI grading of nerve root compromise with surgical grading. Participants and methods: The study included 103 workers with lumbar disc prolapse. Nerve roots were assessed on MRI and during surgery for the degree of compromise. Oswestry Disability Index and Visual Analogue Scale were used for assessment of disability and pain intensity pre- and post-operative respectively. Results: The majority of workers was less than 40 years and suffered from moderate to severe disability. 73.8% had grade IV disc degeneration mostly at the level of L4/L5. Nerve root compromise was found in 86.4% of workers. 48% of nerve roots were deviated and 32% were compressed, with significant correlation between MR grading of nerve root compromise and surgical grading (r = 0.89, P < 0.0001). Conclusion: Disability of occupational-related lumbar disc degeneration is a grave health problem between construction workers. MR imaging is a reliable tool for grading nerve root compromise in disc degeneration. Nerve root compromise is a significant factor to explain pain than the morphologic extension of disc material outside the intervertebral space