Diffusion tensor magnetic resonance imaging in assessment of prognostic

Purpose: The purpose of this study was to assess the utility of diffusion tensor MR imaging as a prognostic imaging technique to detect the clinical outcome in patients presenting with cerebrovascular stroke. Subjects and methods: The study was conducted on 50 cases presenting with different types of stroke between May 2012 and November 2013. We assessed our patients according to the size of stroke, NIHSS score, degree of reduction of FA and pattern of WM tract affection. Patients presenting with acute ischemic stroke were followed up clinically after 3 months for residual neurological deficits. Results: We found good association between tractography findings and clinical score at admission as well as the clinical recovery on the follow-up after 3 months. Patients with disruption of white matter tracts had residual deficits on follow-up, whereas patients with displaced and preserved tracts had near complete neurological recovery. Conclusion: DTI can visualize the changes in the integrity and orientation of the white matter tracts that are affected by cerebrovascular lesions which cannot be detected by conventional MRI. By MR tractography, we can detect the pattern of white matter tract affection that offers a potential tool for correlating the clinical outcome with the imaging findings

Role of MRI in the assessment of treatment response after radiofrequency and microwave ablation therapy for hepatocellular carcinoma

Purpose: The purpose of this study was to assess the role of dynamic contrast enhanced and diffusion MR imaging in the detection of tumor viability after radiofrequency and microwave ablation therapy of hepatocellular carcinoma. Subjects and methods: The study was done on 50 patients with HCC underwent radiofrequency or microwave ablation. Patients were classified into resolved group if there’s no MRI evidence of tumor viability at the ablated lesion and unresolved group if there’s evidence of tumor viability. Results: In the early 1 month post-ablation period, heterogenous signal of the ablation zone in the precontrast T1 and T2 images was noted that gradually become more homogenous in the 3–12 months follow-up. Ill defined persistent perilesional enhancement is considered as a benign finding that was present in 100% of patients imaged within the 1st month and persists only in 5% after 9–12 months. The mean ADC value of the malignant lesions was 0.91 ± 0.09 × 10−3 mm2/s, while the mean ADC value of the benign post-ablation parenchymal changes was 1.29 ± 0.12 × 10−3 mm2/s with a cutoff value of 1.05 × 10−3 mm2/s. Conclusion: MRI provides a powerful tool in the assessment of treatment response after RFA and MWA of hepatocellular carcinoma