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Article
Correlation between magnetic resonance imaging and intra-operative findings in disc herniation at lumbo-sacral region

Author: Correlation between magnetic resonance imaging and intra-operative findings in disc herniation at lumbo-sacral region
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2015 Volume: 11 Issue: 1 Pages: 25-27
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Prolapsed intervertebral disc is an important and common cause of low backache. MRI has now become universally accepted investigation for prolapsed intervertebral disc. We, however, regularly come across situations, when MRI shows diffuse disc bulges, even at multiple levels, which cannot be correlated clinically and when such cases are operated, no significant disc prolapse is found resulting in negative exploration.Objective: To evaluate the role of M.R.I. finding not only for diagnosis of disc herniation at lumbar region but also for localization the level of herniationMethods: A prospective study on seventy five symptomatic low backache and MRI confirmed prolapsed intervertebral disc patients at lumbo-sacral region were operated on, all of the cases required excision of disc through posterior approach in knee elbow position. The time between MRI taken and surgery was two weeks, from which the data were taken in a questioner forma which include name , age ,gender , occupation , chief complaint , duration, MRI findings and intra operative finding , from June 2011 to October 2013 at Al- Kindy teaching hospital .Results: In our study 75 patients were diagnosed by clinical examination and MRI finding to have disc herniation at lumbar region . The female more than male( 36 females , 12 males) and the ratio was 5-1, the accuracy of MRI against intra operative finding in deciding the provisional diagnosis as disc herniation was 68% .The commonest site was L4-5 disc herniation 43 patients (57.3 % ) , and L5-S1 prolapse is the next common disc herniation level 27 patient (36 % ) , L3-L4 disc herniation was two cases (2.7 %) and L4-L5 ,L5-S1 disc herniation was 3 cases (4% ).Conclusion: The most common level was L4-5 followed by L5S1.The MRI is more accurate in diagnosis of the lumbo-sacral disc herniation and its level in single one is more than multiple levels.Keywords: Disc herniation, MRI, Surgery, posterior approachAl


Article
A Comparison of Sagittal Sections of Short T1inversion Recovery and T2 Weighted Fast Spin Echo Magnetic Resonance Sequences for Detection of Multiple Sclerosis Spinal Cord Lesions

Author: Qusay Abed Fahad (MB ChB, FIBMS, DMRD), Ameer Shaker Hadi (MB CHB FIBMS, FICNS,MAAN, Shaymaa Fadhil Obaid (MB CHB DMRD)
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2016 Volume: 12 Issue: 2 Pages: 60-63
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Multiple sclerosis is a chronic autoimmune inflammatory demyelinating disease of the central nervous system of unknown etiology. Different techniques and magnetic resonance image sequences are widely used and compared to each other to improve the detection of multiple sclerosis lesions in the spinal cord.Objective: To evaluate the ability of MRI short tau inversion recovery sequences in improvementof multiple sclerosis spinal cord lesion detection when compared to T2 weighted image sequences.Type of the study: A retrospective study.Methods: this study conducted from 15thAugust 2013 to 30thJune 2014 at Baghdad teaching hospital. 22 clinically definite MS patients with clinical features suggestive of spinal cord involvement, patients were imaged with sagittal short tau inversion recovery sequences and sagittal T2 weighted.Results: The mean age of the patients was 32.5 ± 6.7years; female to male ratio was 2.7:1. The total number of spinal cord MS lesions was 44 of them 86.4% in the cervical spine, 68.2%of the lesions had less than one vertebra extension,79.6% of the lesions did not show changes in the spinal cord morphology. There was a significant upgrading in the lesions conspicuity at short tau inversion recovery sequence comparing to T2 weighted image, P<0.001. A significant difference had been found in artifact grading between both sequences; P<0.001.Conclusions: short tau inversion recovery magnetic resonance image sequences improve detection of MS spinal cord plaques compared with T2 weighted image and itincreasesthe conspicuity of the visualized T2weighted image lesions, but also it accentuates theartifacts more than T2weighted image.


Article
Case report Leigh Syndrome: Report of a Rare Case with Late Onset Presentation

Author: Qays A. Hassan*
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2018 Volume: 14 Issue: 1 Pages: 87-89
Publisher: Baghdad University جامعة بغداد

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Abstract

Leigh's syndrome, or sub acute necrotizing encephalomyelopathy, is a rare inherited neurometabolic disease of infancy and early childhood with variable course and prognosis. Rarely, it occurs in juveniles and adults. The diagnosis is difficult and still remains to challenge the clinicians on the basis of history; hence the role of imaging is very essential. It is the neuroimaging, chiefly the Magnetic Resonance Imaging showing characteristic symmetrical necrotic lesions in the basal ganglia and/or brain stem that leads to the diagnosis. Late-onset varieties are rare and only few cases were reported all over the world. Here, I report a case of late onset (juvenile) Leigh syndrome presenting with an acute polyneuropathy. Neuroimaging confirmed it to be a case of Leigh syndrome.

Keywords

Leigh syndrome --- MRI --- Children --- Case report.


Article
Secondary skull tumors: Prevalence, MRI findings as a diagnostic tool, and treatment

Author: Dr. Bassam Mahmood Flamerz (M.B.Ch.B , F.I.C.M.S)
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2016 Volume: 12 Issue: 1 Pages: 68-73
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Skull secondary tumors are malignant bone tumors which are increasing in incidence.Objective: The objectives of this study were to present clinical features , asses the outcome of patients with secondary skull tumors ,characterize the MRI features, locations, and extent of secondary skull tumors to determine the frequency of the symptomatic disease.Type of the study: This is a prospective study.Methods: This is a prospective study from February 2000 to February 2008. The patients were selected from five neurosurgical centers and one oncology hospital in Baghdad/Iraq. The inclusion criteria were MRI study of the head(either as an initial radiological study or following head CT scan when secondary brain tumor is suspected , visible or palpabable skull mass is noted ) that revealed either calvarial or skull base metastases were included in this study.Results: During the period of the study 175 patients were included according the inclusion criteria. Primary sites were breast cancer (54.85%), lung cancer (14.28%), prostate cancer (6.28%), malignant lymphoma (5.14%), and others (19.42%). The mean time from primary diagnosis to skull metastasis diagnosis was 71 months for cases of breast cancer, 26 months for prostate cancer, 9 months for lung cancer, and 4 months for malignant lymphoma. Calvarial circumscribed intraosseous metastases were found most frequently (25.7%). The patients were mainly asymptomatic. However, some patients suffered from local pain or cranial nerve palsies that harmed their quality of life. Treatment, mainly for symptomatic cases, was by local or whole-skull irradiation.Conclusion: Secondary skull tumors are not rare, and most are calvarial circumscribed intraosseous tumors. MRI contribute to understanding their type, location, and multiplicity, and their relationship to the brain, cranial nerves, and dural sinuses. Radiation therapy improved the quality of life (QOL) of patients with neurological symptoms.


Article
Extraction of Brain Tumor in Coronal MRI Sliced Images by Implementing Active Contour and Different Segmentation Techniques
إستخلاص أورام الدماغ من شرائح صور الرنين المغناطيسي ذات الاتجاه الامامي بواسطة المنحني النشط وتقنيات تجزئة مختلفة

Author: Rabab Saadoon Abdoon رباب سعدون عبدون
Journal: Journal of Kufa - physics مجلة الكوفة للفيزياء ISSN: 20775830 Year: 2016 Volume: 8 Issue: 2 Pages: 45-51
Publisher: University of Kufa جامعة الكوفة

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Abstract

Many segmentation methods were proposed to process medical images for diagnosis purposes. In this work, two stages were achieved to extract tumor region of three MRI sliced brain images of coronal orientation. Active contour algorithm was implemented as first step to extract brain matter of T2W_FLAIR modality MRI images for the first time to avoid interference of tumor gray values with skull. The second stage involved implementing four segmentation techniques to extract tumor regions. First technique was utilizing contrast adjustment process after presenting analysis study of this operation to select an adequate gray level range to be stretched. Second method is an adaptive technique, which is contour based method, to isolate and extract tumor regions. The third and fourth methods were K-Means and FCM. The surface and relative surface area of the extracted tumor regions were calculated. The results of extracting brain matter proved high quality performance of active contour algorithm with its adaptive initialization element. The adequate gray level range that deduced from the proposed analysis of contrast adjusting process is [0.6 0.7]. In addition, the results of the proposed contour based technique present good isolation and extraction of tumor regions. The four implemented techniques are adequate to extract tumor regions correctly without overlapping with skull as declared from the results. This work was implemented by utilizing the facilities of Mat lab programing system.

لقد اقترح العديد من طرق التجزئة لمعالجة الصور الطبية لأغراض تشخيصية. في هذا العمل انجزت مرحلتين لغرض إستخلاص مناطق الورم لثلاث شرائح من صور الرنين المغناطيسي ذات الاتجاه الامامي. نفذت خوارزمية المنحني النشط كخطوة اولى لاستخلاص المادة الدماغية من صور الرنين المغناطيسي ذات النمط T2W_FLAIR للمرة الاولى لتجنب التداخل ما بين القيم الرمادية لمناطق الورم و الجمجمة والمرحلة الثانية تتضمن تنفيذ أربع تقنيات تجزئة لغرض استخلاص مناطق الورم. التقنية الاولى إستخدام عملية تعديل التباين بعد تقديم دراسة تحليلية لغرض الحصول على أنسب مدى مستويات رمادية لغرض توسيعها. والطريقة الثانية هي طريقة مطورة مستندة على المنحني المغلق لغرض عزل واستخلاص مناطق الورم. أما الطريقتان الثالثة والرابعة فهما متوسطات كي و متوسط سي المضبب. كما حسبت المساحة السطحية والمساحة السطحية النسبية لمناطق الورم المستخلصة. وقد بينت النتائج الأداء عالي الجودة لخوارزمية المنحني النشط بعنصر تشغيله المطور لعزل المادة الدماغية. إن مدى المستويات الرمادية المناسب الذي توصل إليه هو]0.6-0.7[. إضافة الى ذلك، إن نتائج تقنية المنحني المغلق المقترحة أظهرت عزل وإستخلاص جيدين لمناطق الورم. إن التقنيات الأربعة المطبقة كانت سديدة في إستخلاص مناطق الورم وبشكل صحيح من دون تراكب مع الجمجمة وكما كشفت النتائج عن ذلك. وقد تم تنفيذ هذا العمل بالاستفادة من تسهيلات النظام البرمجي الماتلاب.


Article
Role of MRI diffusion weighted imaging in differentiation between benign and malignant ovarian masses

Author: Mohammed Abd kadhim *, Lina Saad Jaafer **, Noor Abbas Hummadi Fayadh***, Mohssin Abd Ali Hussain****
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2017 Volume: 13 Issue: 2 Pages: 28-36
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Characterization of the ovarian masses preoperatively is important to inform the surgeon about the possible management strategies. MRI may be of great help in identifying malignant lesion before surgery. Diffusion Weighted Imaging (DWI) is a sensitive method for changes in proton of water mobility caused by pathological alteration of tissue cellularity, cellular membrane integrity, extracellular space perfusion, and fluid viscosity.Objective: to study the diagnostic accuracy of DWI in differentiation between benign and malignant ovarian masses.Type of the study:Cross-sectional study.Methods: this study included 53with complex ovarian mass or masses ,Diffusion Weighted Imaging was obtained to all these patient with correlation to the histopathological results; the Signal Intensity (SI) of the solid and cystic part of the lesions was evaluated on T2 and Diffusion Weighted Imaging ,with Apparent Diffusion Coefficient (ADC) values were also obtained . Results: 22 masses out of the total 53 were malignant and 31 were benign .On DWI the high SI intensity observed more frequently in the malignant lesions than the benign lesions (p value 0.0293) .There was significant difference between the mean ADC value of the malignant and benign ovarian lesions, with the mean ADC value for the benign lesions solid component =1.05 x10 -3, and the mean ADC value for the malignant lesions solid component =0.91 x10-3. The ROC study reveals that 0.926 x 10 -3 may be the optimal cutoff value with sensitivity 54.8 %, specificity 59.1%, NPV 48.15 %, PPV 63.39% , Accuracy 56.6%. With exclusion of the teratoma and endometriomas from statistical analysis the ROC reveals that 0.99 x10 -3 may be the optimal cut off value with sensitivity 76.9 % , specificity 77.3% , PPV 66.67% , NPP 85% and accuracy 77.14% Conclusions: Combined with conventional pelvic MRI, DWI is a helpful tool in differentiation between benign and malignant ovarian masses, with high signal intensity on DWI more frequently observed in the malignant than benign ovarian lesions.

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