The usefulness of endometrial thickness, morphology and vasculature by 2D Doppler ultrasound in prediction of pregnancy in IVF/ICSI cycles

Objective: The aim of this study was to assess the predictive value of endometrial thickness, morphology and vasculature using two-dimensional (2D) Doppler ultrasound on the IVF/ICSI cycle outcome. Subjects and methods: Endometrial thickness, morphology and subendometrial blood flow were assessed using transvaginal ultrasound on the day of hCG in 100 patients undergoing IVF/ICSI treatment in the period between June 2013 and January 2015. Statistical analysis was done. Results: There was no difference in the demographic features or details of ovarian stimulation between pregnant and non-pregnant women. Overall, 40 patients conceived; 23 (57.5%) of them had blood flow in zone III and 15 (37.5%) in zone II. All patients achieved pregnancy had endometrial thickness >8 mm. Using the ROC curve, the cutoff endometrial thickness for non-achieving pregnancy was 7 mm with a sensitivity and specificity of 100%. There was no significant difference in Doppler indices between pregnant and non-pregnant women. Conclusion: When the endometrial thickness is <8 mm, and if there are non-triple endometrial line and non-favorable blood flow zone on day of hCG in IVF/ICSI cycles, pregnancy is unlikely and embryo transfer should be canceled with freezing of all embryos for future transfer to increase the success rate

Multi-detector computed tomography (MDCT) imaging of cardiovascular effects of pulmonary embolism: What the radiologists need to know

Background: Patients with pulmonary embolism have high mortality and morbidity rate due to right heart failure and circulatory collapse leading to sudden death. Multi-detector computed tomography MDCT can efficiently evaluate the cardiovascular factors related to pulmonary embolism. Objectives: To evaluate the diagnostic accuracy of multi-detector computed tomography (MDCT) in differentiation of between sever and non-severe pulmonary embolism groups depending on the associated cardiovascular parameters and create a simple reporting system. Patients & methods: Prospective study contained 145 patients diagnosed clinically pulmonary embolism. All patients were examined by combined electrocardiographically gated computed tomography pulmonary angiography-computed tomography venography (ECG-CTPA-CTV) using certain imaging criteria in a systematic manner. Results: Our study revealed 95 and 55 non-severe and severe pulmonary embolism groups respectively. Many cardiovascular parameters related to pulmonary embolism shows significant p value and can differentiate between sever and non-severe pulmonary embolism patients include pulmonary artery diameter, intraventricular septum flattening, bowing, superior vena cava and Azygos vein diameters, right and left ventricular diameters. Conclusion: Multi-detector computed tomography (MDCT) can be valuable to assess the severity of pulmonary embolism using the related cardiovascular parameters and leading the management strategy aim for best outcome. Keywords: Pulmonary embolism, MDCT, Cardiovascular, Computed tomography venograph

Accuracy of CESM versus conventional mammography and ultrasound in evaluation of BI-RADS 3 and 4 breast lesions with pathological correlation

Aim: Assess accuracy of contrast enhanced spectral mammography (CESM) versus conventional mammography and ultrasound in evaluation of BI-RADS 3 and 4 breast lesions with pathological correlation. Patients and methods: Thirty female patients with 35 breast lesions diagnosed by conventional imaging as BI-RADS 3 and 4, presented to Womenâs Imaging Unit of Radiology Department between January and December 2015, age ranged from 23 to 70 years. All patients underwent conventional mammography and ultrasound then CESM. Results: Patients divided into two groups, benign and malignant lesions group according to histological analysis. Mammography results that malignant lesions detected in 18/35 (51.4%) while benign lesions 17/35 (48.6%). Ultrasound revealed 27/35 (77.1%) lesions were malignant and 8/35 (22.9%) lesions benign. But CESM, revealed 25/35 (71.4%) lesions were malignant & 10/35 (28.6%) lesions benign. Among 7 patients with multifocal/ multi-centric histologically proven malignant lesions, all detected by CESM 7/7 cases (100%) versus 2/7 cases (28.6%) and 6/7 cases (85.7%) detected by mammography and ultrasound respectively. Based on, CESM had 95.2% sensitivity and 82.9% diagnostic accuracy. Conclusion: CESM has better diagnostic accuracy than mammography alone and mammography plus ultrasound. CESM has 82.9% diagnostic accuracy in comparison to 51.4% for mammography and 77.1% for ultrasound. Keywords: Breast lesions, CESM, BI-RADS lexico