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Article
The significance of incidental breast findings on routine computed tomography of the chest
اهمية المشاهدات العرضية للثدي في مفراس الصدر المعتاد

Authors: Mohammed Al-Hilli محمد الحلي --- Abdullateef A. Mustafa عبد اللطيف علي اصغر --- Hiba M. Abdul Wahid هبة محمد عبد الواحد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2016 Volume: 58 Issue: 3 Pages: 221-228
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: with the dramatic increase in the use of chest computed tomography (CT) for diagnostic or screening purposes, incidental breast lesions faced more frequently; while most of these incidental breast findings are benign; nevertheless, breast cancer be existing.Objectives: to determine the imaging characteristic of incidentally detected breast lesions in routine chest computed tomography and to review the outcome of further assessment of these abnormalities.Patients and methods: a prospective study performed on (33 patients) during the period from October 2014 to November 2015 in AL Shaheed Ghazi Al Hariri hospital, Baghdad teaching hospital, and Radiology Institute at Medical city complex, Baghdad. All patients were female and their ages ranging from (18-74) years. Then breast lesions found incidentally at CT scan identified and their CT features analyzed and include number of lesions, size, location, shape, margin characteristics, and density of the lesion and associated calcification. Most of these patients with incidental breast findings were followed up by performing breast ultrasound (US) and/or mammography in oncology teaching hospital (according to their age) and according to breast imaging and reporting data system (BIRADS); BIRAD- IV and V lesions followed by cytopathological examination and final results were recorded.Results: during the study period, a total of 39 incidental breast lesions were identified on chest CT scan among those 33 patients because some patients had multiple lesions. The mean age of patients for malignant lesions was (53±6.1 years) and for benign lesions was (43.21±0.8years). 25.6%, of incidental, breast lesions found to be malignant and 74.4% found to be benign. Malignant incidental breast lesions tend to have an irregular shape, ill-defined margin and have soft tissue attenuation.Conclusion: Although CT scan is not the primary procedure for the breast imaging, but it can show a significant complementary role in the evaluation of the breast with ultrasound and mammography. A careful review of the breast and accurate characterization of incidental breast lesions (IBL) would highlight the radiological reports, it would achieve appropriate management for the patients, and this would improve survival. Although some of the findings of benign and malignant breast lesions on CT scan do overlap to some degree, we can conclude that an irregular shape and ill-defined margin are important features that go with malignant breast lesions.Key words: incidental, breast, computed tomography.

خلفية البحث: مع الزيادة المطردة في استعمال المفراس الحلزوني للصدر للاغراض التشخيصية,فإن حالات الثدي العرضية بدت تتضح كثيرا. مع ان اغلب حالات الثدي العرضية هي حميدة ,مع ذلك فإن اورام الثدي الخبيثة توجد فعلا.اهداف البحث: لتحديد الخصائص التصويرية لحالات الثدي المكتشفة عرضيا في فحوصات المفراس الحلزوني المعتادة للصدر ,لتقييم اهميتها ولتدقيق النتائج للتقييم الاضافي لهذه الحالات.المرضى وطرائق العمل: دراسة تفقدية استباقية اجريت على 33 مريضة خلال الفترة من تشرين الاول 2014 الى تشرين الثاني 2015 في مستشفى الشهيد غازي الحريري ,مستشفى بغداد التعليمي ومعهد الاشعة. كل المرضى كانوا نساء واعمارهم تتراوح ما بين 18 الى 74 سنة . ومن ثم حالات الثدي المرضية المكتشفة عرضيا في فحوصات مفراس الصدر يتم تحديدها و تحليل ميزاتها في المفراس وتتضمن:عدد الاضرار, موقعا, الحجم ,الشكل, صفات الحافة ,الكثافة و وجود التكلسات. اغلب المرضى ذوو حالات الثدي العرضية تتم متابعتهم بعمل سونار الثدي تحت اشراف طبيب متخصص في الاشعة او ارسالهم لعمل السونار او فحص الثدي بالاشعة (الماموكرام) و( ذلك حسب اعمارهم) في مستشفى الاورام التعليمي لزيادة توصيف وتصنيف هذه الحالات باستعمال نظام البايراد. اذا كانت هناك حالات مشكوك بها في فحص سونار الثدي او اشعة الثدي , تتم الدراسة الخلوية او النسيجية للحالات وتوثيق النتائج.النتائج: خلال فترة الدراسة، 39 حالة ثدي عرضية كمجموع اجمالي تم تحديدها في فحوصات المفراس الحلزوني للصدر بين 33مريضة لان بعض المريضات لديها حالات متعددة . معدل عمر المريضات ذات الحالات الخبيثة كان 53±6.1 سنة و لذات الحالات الحميدة كان 43.21±0.8 سنة .في هذه الدراسة 25.6% من حالات الثدي العرضية وجدت خبيثة و 74.4% وجدت حميدة .حالات الثدي العرضية الخبيثة تميل ان تكون غير منتظمة الشكل وذات حافة غير دقيقة ولديها كثافة النسيج الرخو. الاستنتاجات: مع ان فحص المفراس الحلزوني ليس الطريقة الاولية لتصوير الثدي , لكن يمكن ان يلعب دور مهم في تقييم حالات الثدي مع سونار واشعة الثدي. التفحص الحذر للثدي و التوصيف الدقيق لحالات الثدي العرضية تنير تقرير الاشعة وتحقق علاجا مناسبا للمرضى وتحسن بقائهم. مع ان بعض نتائج حالات الثدي العرضية الخبيثة والحميدة تتشابك لدرجة, يمكننا ان نستنتج انه الشكل غير المنتظم والحافة غير الدقيقة هي ميزات مهمة تتماشى مع حالات الثدي الخبيثة . مع ذلك اغلب حالات الثدي العرضية في فحص المفراس الحلزوني يجب احالتها للتقييم الاضافي للوصول للتشخيص النهائي.مفتاح الكلمات: عرضي، ثدي، مفراس


Article
Diagnostic accuracy of panoramic maxillary sinus projection in patients with maxillary bone fractures according to CT scan findings

Author: Ali S. Al-Haddad
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2016 Volume: 9 Issue: 2 Pages: 2479-2482
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Diagnostic imaging has been of recent and unique importance in substantiating the clinically suspected existence of the midface fracture and it is essential to be aware of the various procedures available to help initially in establishing an accurate diagnosis. The aim of the study is to evaluate the diagnostic accuracy of panoramic maxillary sinus projection according to computed tomographical findings in patients with maxillary bone fractures to be used as an emergency radiographic diagnostic aid.Subjects, material and methods: Thirty patients with a midfacial trauma and twenty patients suspected to having midfacial fractures. All subjects were examined radiographically using panoramic maxillary sinus imaging system to evaluate the maxillary bone and recorded as either “positive” or “negative” according to the positive computed tomographical maxillary bone fracture findings.Results: Panoramic maxillary sinus projection was 87.5% sensitive in detecting maxillary bone fractures line with 96% accuracy and it can establish the diagnosis of any maxillary bone fracture with 100% confidence in any clinical setting.Conclusion: If panoramic maxillary sinus imaging is performed as the first imaging modality in case of suspected midfacial fractures by an experienced investigator, the visualization of fracture line can avoid conventional imaging, so that only an indicated computed tomography scan can be added.


Article
Validity of Hounsfield Units in Skyview Cone Beam Computed Tomography to detect bone densities at different jaw sites during implant insertion

Author: Dr. Amal R.S. Mohammed, B.D.S., H.D.D., M.Sc. Rad. د. امل رؤوف
Journal: MUSTANSIRIA DENTAL JOURNAL مجلة المستنصرية لطب الاسنان ISSN: 18138500 Year: 2016 Volume: 13 Issue: 1 Pages: 105-111
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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AbstractBackground: The purpose of this study was to evaluate the bone densities byHounsfield Unit at jaw sites in sky view cone beam computed tomography andto compare these values to the optimal bone densities proposed in the literature.Materials and Methods: Thirty-six patients, 15 males and 21 females were assessed;CT data for different jaw sections and regions were compared using (t-test).Results: The means of bone density in all regions are higher in male than female. Themean bone density in the anterior mandible is higher ; the mean bone densitiesin the four jaw regions decreased in the following order in female or male orgeneral ( anterior mandible > anterior maxilla > posterior mandible > posteriormaxilla ) .Conclusion: The bone densities assessed by HU fell into the range of optimal bonedensities proposed in the literature.


Article
Radiological Assessment of Mandibular Retromolar Canal (MRMC) Using CBCT-Radiographs in a Sample of Iraqi Patients

Authors: Jamal Abid Mohammed جمال عبد محمد --- Zainab H. Al-Ghurabi زينب الغرابي
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2016 Volume: 28 Issue: 3 Pages: 99-103
Publisher: Baghdad University جامعة بغداد

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Background: Because of its clinical and surgical importance and lack of precise information about this rare andimportant anatomical landmark, this study was designed to detect the presence, configurations and length ofMandibular Retromolar Canal (MRMC) with aid of CBCT visualization.Materials and methods: In this retrospective study the data was obtained from Specialist Health Center in AL-Saddercity in Baghdad for (100) patients with 200 inferior dental canal, all of them referred to CBCT scan (Kodak 9500,French origin). The scanning was done with tube voltage 90 kVp, tube current with 10mA and exposure time was 10s., the field of view was measured with 5cm x 3.7cmwith 0.03mm voxel sizeResults: In the present study the prevalence of MRMC was 12% , 2 patients have ( two ) bilateral MRMC and 10patients have a unilateral canal, there was asignificant difference between two sides (left and right), the right sidewas 64.29% and left 35.71%, regarding to gender also there was a significant difference , female 33.3% and male66.7%. In this study there were three types of MRMC and there was a significant difference between them, the meanlength (hight) was 11.78 mm and mean horizontaldistance from canal to distal surface of the second molar was 18.5mm.Conclusions: MRMC also detectedin this study within the global percentage and configurations and should betaken with consideration in oral surgical procedures and radiological interpretations.


Article
Sex Variations by Linear Measurements of Palatal Bones and Skull Base Using 3D Reconstructed Computed Tomographic Scan among Iraqi Sample

Authors: Noora A. Abdul Ameer نورا عبد الامير --- Ahlam A. Fatah احلام فتاح
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2016 Volume: 28 Issue: 4 Pages: 82-88
Publisher: Baghdad University جامعة بغداد

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Background: The skull base and the hard palate contain many anatomical features that make them rich in information which are useful in sex differentiation; in addition to that they have the ability to resist the hardest environmental conditions that support them in making sex differentiation. Three dimensional computed tomographic techniques has important role in differentiation between sex since it offers images with very accurate data and details of all anatomical structures with high resolution. This study was made to study sex variations among Iraqi sample by craniometric linear measurements of the hard palate and the skull base using 3D reconstructed Computed Tomographic scan.Materials and methods: This study composed of 100 Iraqi subjects (50 male and 50 female) aged between 20-59 years. The sample collected from patients attending Al-Shaheed Ghazi hospital in Baghdad city to for spiral CT scanner. The craniometrical linear measurements of the hard palate and the skull base in this study were including: Maxillo-Alveolar Breadth, Maxillo-Alveolar Length, the distance between incisive foramen and greater palatine foramen (right and left), the distance between the incisor foramen and B point (the median point located at the anterior area of the magnum foramen), the distance between the incisor foramen and the anterior root of the mastoid notch on both sides (right and left), Maxillo-Alveolar Index and size of Palate. All these measurements were done by (mm) unit.Results: The statistical analysis of linear measurements of the hard palate and the skull base showed that the mean values of all measurements were significantly higher in males than females except for Maxillo-Alveolar Index was not significant and also showed that the size of the palate was the best indicator for sex variation and making the diagnosis of male with accuracy 93.3%. The age had none significant effect on these measurements.Conclusion: Three dimensional Computed Tomographic scanners is the best diagnostic tool for sex variation by the craniometrical linear measurements for the anatomical landmarks points of the hard palate and the skull base


Article
An Assessment of Sagittal Condylar Position of TMJ Dysfunction in Centric Occlusion by Using Cone Beam Computed Tomography

Authors: Lamia H. Al-Nakib لمياء حامد النقيب --- Ako Omer Abdullah --- Saeed A.Abd Al-Kareem --- Sangar Hamid Ali
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2016 Volume: 28 Issue: 2 Pages: 58-62
Publisher: Baghdad University جامعة بغداد

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Background: Temporomandibular joint (TMJ) is a compound articulation formed from the articular surfaces of thetemporal bone and the mandibular condyle.CBCT imaging of TMJ is that it allows accurate measurements of thevolume and surface of the condyle. The aim of the study is to assess the sagittal position of mandibular condyle inpatients with temporomandibulardysfunction using Cone Beam Computed Tomography in centric occlusion.Materials and Methods: CBCT images for all patients were obtained in an upright position using New Tom GianoCBCT with different field of view (11 x 8), (11 x 5), and (8 x 8) and exposure factors was changed accordingly usingNNT version 5.1 software for sagittal reconstruction, anterior, superior and posterior joint spaces was measured.Results: There was a significant change in the anterior, posterior and superior joint spaces when compared to normalfunctioning TMJ. The sagittal position of the condyle in glenoid fossa could be affected by TMJ dysfunction and itwould be positioned centrally but slightly inferior to the normal position according to the results of this study. Therewas no significant difference in the sagittal condylar position in glenoid fossa between sexes. There was significantdifference in the value of anterior, posterior and superior TMJ spaces between right and left sides of the mandible inboth normal cases and TMJD.Conclusion: Sagittal section of Temporomandibular joint revealed that TMJ dysfunction affects the joint spaces insagittal plane. It means significant changes occur in the value of anterior, posterior and superior joint spaces whencompared to normal functioning TMJ


Article
Cone Beam Computed Tomography in an Evaluation and Diagnosis of Anatomical Variations and Pathological Lesions in Maxillary Sinus Prior to Maxillary Sinus Lift Surgery

Author: Zainab H. Al-Ghurabi زينب حسن الغرابي
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2016 Volume: 28 Issue: 1 Pages: 99-102
Publisher: Baghdad University جامعة بغداد

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Abstract: Thorough assessment of the maxillary sinus is very important. Recently 3-dimensional image with ConeBeam Computed Tomography (CBCT) is very dependable in Maxillary Sinus diagnosis. The aim of this study is to:shade light on the role of (CBCT) diagnosis of the maxillary sinus anatomical variation and pathological findingamong smokers and nonsmokers prior to maxillary sinus lift techniques.Materials and Method: In this study 60 males with age ranged between 20-50 years old, referred for (CBCT)assessment of maxillary sinus in the Specialist Health Center of Al-Sadder city. The scanning were performed usingKodak 9500 (CBCT), the KV was 90, mA10 and scanning time 10 s. Voxel size 0.3mm with( DICOM ) software on amultiplaner reconstruction window in which the axial, coronal and sagittal plane could be visualized in 0.3 mminterval, 40 were smokers and 20 nonsmokers, both sides were evaluated to assess the presence of septa, maxillarysinus membrane (Schneiderian membrane)thickening, complete opacification and adenoid polyp.Result:The maxillary for nonsmoker patients (20) patients were clean and have no any pathological or anatomicalchanges, among smoker patients, it was found that 7 (17.5%) of them had a clean maxillary sinus, 25 (62.5%)patient from smokers, the mucosal thickening was clear and measured more than 4 mm, 20 (80%) of them bilateralmaxillary sinus were involved and 5 (20%) of them have a unilateral thickening, 6 (15%) of the smoker patient havebilateral involved adenoid with max sinus, and 2(5%) of them have full opacification., no septa was found in thisstudy.Conclusion:Cone Beam Computed Tomography(CBCT)was themost useful technique to diagnose maxillarysinusbefore maxillary sinus augmentation, an evaluation ofCone Beam Computed Tomography(CBCT)scans beforeimplant surgery or sinus augmentation procedures has extreme clinical importance in evaluation of anatomicstructures, such as thickening of the Schneiderian membrane and presence of pathological lesion such as adenoidpolyp.


Article
Preoperative Passive Ureteral Dilatation Using J Stent in Patients with Ureteric Stone (Benefits and Drawbacks)

Author: Wadhah Adnan Al-Marzooq
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 4 Pages: 834 -838
Publisher: Babylon University جامعة بابل

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Abstract

More than 95% 0f ureteric stone are now managed by ureteroscopy or extracorporeal shockwave lithotripsy. Although preoperative double J stent insertion is frequently used, little is known about its indications and results.During the period from November 2013 to October 2014, 38 patients with mid and lower ureteric stone were included in our study. All patients underwent ureteroscopy and laser lithotripsy using semi rigid 9 French ureteroscopy and holmium YAG LASER. The patients divided in to 2 groups the first group (1)includes 18 patients who underwent single session ureteroscopy this group compared to group (2) which included 20 patients who underwent 2 sessions procedure (ureteroscopy 2 to 4 week after ipsilateral double J stent insertion).The tow group compared with regard to operative time, stone free rate, stone migration and ureteric injury. The operative time was significantly shorter in group 2 (p value 0.001), ureteric mucosal injury was lower in group 2 (p value <0.05), while stone migration was higher in group 2 (p value <0.05), other results were comparable between both group.The study concludes that preoperative passive ureteral dilatation has many benefits and drawbacks and is recommended in cases of: any difficulty in accessing the ureter; patients cannot tolerate long operative time and patients with single kidney to avoid ureteral trauma and possible stricture.

Keywords

Kidney --- ureter --- and bladder --- KUB --- Computed tomography --- CT --- YAGlaser.


Article
Prevalence of CT Scan Findings in Patient with Traumatic Brain Injury with Respect to Glasgow Coma Scale

Author: Wasan Ismail Majeed Al-Saadi *, Ihssan Subhi Nema**, Yasir Mohammed Hamandi **, Hashim Hassan Abed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 3 Pages: 259-265
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Traumatic brain injury (TBI) contribute to a significant mortality and substantial morbidity. CT isessential for identifying lesions requiring urgent intervention & those that require observation andnon surgical management .OBJECTIVE:To assess the prevalence of CT findings with respect to the severity of TBI & to find out therelation between the age of the patient & the severity of TBI.PATIENTS AND METHODS:100 patients with TBI evaluated by brain CT. All age groups with Glasgow coma scale (GCS) ofless than 15 were included.The abnormal CT findings were evaluated & recorded. The findings werefurther correlated with the patient`s age & the GCS scoreRESULTS:Eighty percent of the cases had mild TBI, 6% had moderate TBI and 14% had severe TBI. Ninetythree percent had closed type of injury . Twenty four percent of the patients had normal CT scan ,all of them had mild TBI . The most common CT findings in mild TBI cases were subgalialhaematoma(SGH) & calvarial skull fracture, with minority of cases had cerebral contusion , fracturebase of skull , diffuse cerebral oedema & intracranial haemorrhage . Two third of patients withmoderate TBI had subarachnoid haemorrhage(SAH) & cerebral contusion, 50% had diffusecerebral oedema, calvarial skull fracture,& 1/3 had Subdural haematoma & fracture base of skull.More than half of patients with severe TBI had calvarial skull fracture, fracture base of skull,cerebral contusion, SAH, with lower prevalence of diffuse cerebral oedema,and intracranialhaemorrhage.CONCLUSION:The lower the GCS score, the more significant CT findings,predominantly fracture base of skull,subarachnoid haemorrhage and diffuse cerebral oedema.KEY WORDS: traumatic brain injury, computed tomography, glasgow coma scale.


Article
Anatomical Study of Mental Foramen Using Cone Beam Computed Tomography in Selected Adult Dentate Kurdistan Patients

Authors: Khoshee Salih Hameed Al-Mufty --- Ali Sultan Al-Refai --- Faris Muhammed Mahmood
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 3 Pages: 679 -690
Publisher: Babylon University جامعة بابل

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Mental foramen is a very important anatomical landmark in dentistry and knowledge about mental foramen is very important because it transfers the mental nerve and vessels. The aim of thisresearch was to study the morphology and morphometry of the mental foramen using cone beam computed tomography in dentate adult Kurdistan patients. Thirty nine cone beam computed tomography were studied to analyze the shape, position, distance, and diameter of mental foramen. It was found that the most common variation of mental foramen was oval shape, and situated in line between 1st and 2nd premolar, and apical to the apex of associated tooth,and these variations showeda nonsignificant differences with the gender and age. The mean distances from mental foramen to the alveolar crest in the right and left side was 13.37±2.41 and13.60±1.96 mm respectively, and the mean distances from mental foramen to the inferior mandibular borderin the right and left side was10.98±1.97 and10.82±1.95mm respectively. Statistical analysis showed no significant differences regarding the gender and side, but significant difference present regarding age group. The mesio-lateralmean distance in the right and left side was 3.87±0.85and 3.68 ±0.78 mm respectively. But the superior-inferior distance in the right and left side was 3.17 ±0.85 and3.25 ±1.00 mm respectively. Statistical analysis showed no significant relation present with the gender, age group, and side.Knowing the exact location of the mental foramens and its variations is very important andcan help toplan surgical procedures properly.

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