Approach of multi-slice computed tomography (MSCT) in assessment of transcatheter aortic valve implantation (TAVI)

Objectives: For better approach and optimum benefit from cardiac CT in pre-procedural assessment of the transcatheter aortic valve implantation (TAVI). Materials and methods: 120 patients underwent cardiac CT examination and echocardiography for preoperative assessment of the aortic root measurements and vascular root evaluation. Results: In coronal view, the mean diameter of the aortic annulus was 26.3 ± 2.3 mm while in single oblique sagittal view it was 23.9 ± 2.0 mm. Mean Agatston score of aortic calcifications was 786 ± 1324. The mean diameter of the aortic annulus by echocardiography was 22.1 ± 2.5 mm. Conclusion: Cardiac CT is considered a valuable approach for optimum positioning of the aortic valve in conjunction with echocardiography to avoid undesirable complications and reducing the mortality rate

Comparing T2 weighted images/diffusion weighted imaging and T2 weighted images/dynamic contrast enhanced MRI for endometrial carcinoma myometrial invasion

Objectives: To evaluate accuracy of combined T2 and diffusion weighted images (DWI) in comparison to combined T2WI and dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) for assessment of the depth of myometrial invasion. Methods: Sixty-two patients diagnosed pathologically as endometrial carcinoma underwent MRI pelvis examination. Technique of examination for each patient includes T1 (axial), T2 (axial, sagittal and oblique sagittal) weighted images. Diffusion weighted images were done with b values of 0 and 1000 s/mm2. Dynamic contrast enhanced-magnetic resonance imaging done after administration of 0.1 mmol/kg gadolinium at 2 ml/s. The pathological diagnosis used as a gold standard for comparison with imaging. Results: Diagnostic accuracy, sensitivity, specificity of combined T2/diffusion weighted images (DWI) were 92%, 90% and 95.6% while for combined T2/dynamic contrast enhancement (DCE) were 79%, 77% and 82.6% for myometrial invasion 50%. Conclusion: Combined T2WI-DWI has superior diagnostic accuracy compared to combined T2WI-DCE-MRI in assessment of depth of myometrial invasion in endometrial cancer. T2WI-DWI can eliminate contrast material injection especially for patients who cannot tolerate contrast administration

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

RANK/RANKL/OPG axis genes relation to cognitive impairment in children with transfusion-dependent thalassemia: a cross-sectional study

Abstract Background RANK/RANKL/OPG axis was implicated in many pathological conditions. The study aimed to assess the relationship between the studied RANK, RANKL, and OPG polymorphisms and alleles and cognitive impairment in children with transfusion-dependent thalassemia (TDT). Methods This study included 60 TDT children. Real-time PCR was done for: rs1805034, rs1245811, and rs75404003 polymorphisms for the RANK gene, rs9594782 and rs2277438 polymorphisms for the RANKL gene, and rs207318 polymorphism for the OPG gene. The intelligence quotient (IQ) was assessed using the Wechsler Intelligence Scale for Children-Third Edition. Results TDT children had a low average total IQ, verbal IQ, and borderline performance IQ. RANK rs1805034 (C > T) had a significant effect on total IQ (p = 0.03). Its TT polymorphism and the CT polymorphism of RANKL rs9494782 (C > T) had a significantly lower total IQ (p = 0.01 for both). The G allele of the RANKL rs2277438 (G > A) had a significantly lower total IQ (p = 0.02). RANK rs1805034 (C > T) and RANKL rs2277438 (G > A) significantly affected verbal IQ (p = 0.01 and 0.03). TT genotype of RANK rs1805034 (C > T) had significantly lower verbal IQ (p = 0.002). Furthermore, the GG genotype of RANKL rs2277438 (G > A) had a significantly lower verbal and performance IQ than the AA genotype (p = 0.04 and 0.01 respectively), and its G allele had a significantly lower performance IQ than the A allele (p = 0.02). Conclusion TDT children had low average total and verbal IQ while their performance IQ was borderline. The RANK/RANKL/OPG pathway affects cognition in TDT children, as some of the studied genes’ polymorphisms and alleles had significant effects on total, verbal, and performance IQ of the studied TDT children