Micro-structural Auditory Pathway Changes in Patients with Sensorineural Hearing Loss with or without Tinnitus, could diffusion tensor imaging be valuable?

Background: Advanced magnetic resonance imaging (MRI) technique called diffusion tensor imaging (DTI) can assess tissue microstructure. It's challenging to identify sensorineural hearing loss (SNHL) cause suing CT or MRI without significant gross disruption. Objectives: to assess microstructural integrity of auditory neural pathway SNHL patients with or without tinnitus by DTI. Patients and methods: This prospective, case-control study included 55 subjects in three groups: 30 healthy volunteers in control group (GI), 12 patients in bilateral SNHL without tinnitus group (GII), and 13 patients in bilateral SNHL with tinnitus group (GIII) were MRI-assessed using 1.5 Tesla GE machine. Ordinary one-way ANOVA test was used to compare groups with normal distributions, Kroskal Wallis test: compares groups with abnormally distributed data; post-hoc test: determines significance between pairs. Results: ANOVA test revealed statistically significant difference at Lateral lemniscus(LL), Inferior colliculus(IC), medial geniculate body (MGB), auditory radiation(AR), Superior temporal gyrus(STG), Hippocampus, amygdala, Superior longitudinal fasciculus(SLF), genu and splenium of corpus callosum (CC) with P value ≤0.05. Post-hoc test: group II had lower FA comparing to group I at LL, MGB, IC, AR, STG, genu and splenium of CC. In group III the forementioned regions were affected besides hippocampus and amygdala. Group III had statistically significant lower FA values compared to group II at LL, IC, MGB, hippocampus, amygdala, SLF, genu and splenium of CC. Conclusion: Using DTI to assess microstructural integrity of auditory pathway, SNHL is associated with white matter microstructure affection as proved by the current study, and presence of tinnitus is associated with limbic system affection

Early predictors of neonatal intraventricular hemorrhage

Objective: Current study aimed toward the early prediction of neonatal intraventricular hemorrhage (IVH) for better management and prognosis. Methods: This prospective study was conducted on forty neonates at the Neonatal Intensive Care Unit of Pediatrics and Medical Biochemistry department (Tanta University, Egypt) from July 2016 to June 2017. Cord blood erythropoietin and venous blood Activin A were assayed within the first hour of life. Neonates were divided into 2 groups: Group 1 (with IVH) included twenty neonates who developed IVH proved by transcranial ultrasonography (u/s) and Group 2 (without IVH) included twenty neonates who were admitted to the NICU but did not develop IVH, also proved by transcranial u/s. Data were analyzed using Chi Square and t-test. Results: Group 1 had a significantly higher cord blood erythropoietin concentration than group 2 (46.75±27.98 mIU/mL vs. 18.82±8.91 mIU/mL), respectively (p<0.05). Group 1 had a significantly higher venous blood Activin A concentration than group 2 (3.18±2 ng/L vs. 0.42±0.25 ng/L) with (p<0.05). Conclusion: Cord blood erythropoietin and venous blood Activin A were presumed to be used as early predictors of IVH in neonates with early treatment and better prognosi

Apparent diffusion coefficient and Magnetic resonance spectroscopy in grading of malignant brain neoplasms

Aim: This work aims to study the role of combined apparent diffusion coefficient (ADC) and Magnetic resonance spectroscopy (MRS) in grading malignant brain neoplasms. Methods: A prospective study included 40 patients who were evaluated by standard contrast enhanced MRI, diffusion weighted imaging and multivoxel spectroscopy. Results: Statistically significant difference was found between tumoral ADC values in low grade versus high grade tumors and metastasis and also between the peritumoral ADC values in metastasis versus low and high grade tumors. Statistically significant difference is noticed between tumoral Cho/Cr ratio values in low grade versus high grade tumors and metastasis, and also peritumoral Cho/Cr ratio values in low grade and metastasis versus high grade tumors. Statistically significant difference between tumoral Cho/NAA ratio in low grade versus high grade tumors and metastasis and lastly between peritumoral Cho/NAA ratio in low grade and metastasis versus high grade tumors was found. Lipid and lactate peaks were found frequently in high grade tumors and metastasis. Conclusion: The combination of calculated ADC values and MR spectroscopy is useful in grading of malignant brain tumors and were more useful together than each on its own

Relationship of lumbosacral spine morphometrics and lumber disc degenerative disease in young adults using magnetic resonance imaging

Objectives: To evaluate the relationship between lumbosacral morphological parameters and intervertebral disc degenerative disease. Material and methods: A retrospective study of MRI lumbosacral studies of low backache patients included 152 patients (92 females and 60 males). Patients were evaluated for the presence of disc herniation or degeneration. Angles of lumbar lordosis, sacral table, and sacral kyphosis were measured. Results: Normal population included 51 patients (30 males and 21 females) and showed no statistically significant difference between male and female. 101 patients had degenerated disc and/or disc herniation. There was no statistically significant difference between normal population and patients with disc pathology as regards lumber lordosis angle (p > 0.05) while a statistically significant difference was observed as regards both sacral kyphosis angle and sacral table angle. Patients with disc pathology showed; moderate negative correlation between lumber lordosis angle and sacral table angle (p = 0.001), strong negative correlation between lumber lordosis angle and sacral kyphosis angle (p = 0.000) and no correlation between sacral table angle and sacral kyphosis angle (p > 0.05). Conclusion: The risk of developing disc degeneration and herniation increases with increasing sacral table angles and decreasing sacral kyphosis angle