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Article
Disorders of the Cerebellum In Children , MRI – Clinical Correlation

Authors: Ahlam Mohamad Abdulabbas --- Muna Abdul Ghani Zghair --- Raad Hifdhi Al-Khayat
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 1 Pages: 13-18
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:The recognition of cerebellar anomalies, with the advent of neuro-imaging, has greatly improved, it present a wide variety of clinical and radiological Imaging findings.OBJECTIVE: 1.To describe the spectrum of cerebellar anomalies by MRI .2. To correlate with clinical presentation.MATERIALS AND METHODS:Sixty six patients(22Females, 44 Males) with the diagnosis of some form of cerebellar malformations, were included in this study, in the Central Teaching Hospital of Pediatrics in Baghdad over 18 months from July 2103 through December 2104. They were arranged for complete clinical and neuro-radiological evaluation. Age ranging from over 1month --- 15 years.RESULTS:Twenty nine patients ( 43.9 % ) had vermian hypoplasia, ranging from mild to moderate , cerebellar hypoplasia( 19) patients ( 28.7 % ) ,combined anomalies in 16 patients (24.4%)and 2 patients (3 %) with cystic dilatation of the posterior fossa.The bulk of cases fall in the category of 1-- 5 years age group, with the major clinical presentation being motor and speech deficits, 28 ( 80 % ) and 27 (77.1 % ) patients respectively.CONCLUSION:Magnetic resonance imaging is the basic modality of choice, in the setting of cerebellar malformation, especially in the association of extreme variability of clinical presentation, and lack of easy availability of the required cytogenetic analysis


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
The Value of Diffusion Weighted Magnetic Resonance Imaging 3 Tesla in Detection and Staging of Bladder Carcinoma

Author: Raad H. Abed Tawfeeq*,Thaair A. Kameel Alkhuzaie**, Shameem Ali Hussein
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 3 Pages: 266-271
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACK GROUND:To evaluate the value of diffusion weighted magnetic resonance imaging (DWMRI) indetection and T- staging of bladder carcinoma and correlation with histopathological staging.PATIENTS AND METHODS:An analytic prospective study was conducted at the MRI units of Al-yarmook teaching hospitalin the period from January of 2015 to December 2015, 42patients (36male and 6 female)presented with hematuria (40 patients ) and 2 patients presented with pelvic pain were enrolledprospectively ,they underwent conventional magnetic imaging(MRI) and diffusion weightedMRI using 3 tesla MR units (Achieva ; Philips medical systems, the Netherlands).Diffusion weighted images were obtained using a single shot echo planar imaging sequence EPIwith b value 0,500sec/mm2.ADC value map was reconstructed and mean ADC value weremeasured in 42 patients .and histological examination was done to all patients.RESULTS:Correlation between standard MR staging of bladder carcinoma and histopathological resultsrevealed that 17 patients (40%) had the same T -staging while 17 patients(40%) over staged.DWI and ADC values were able to declare the cause of overstating by discrimination betweentumoral tissue and peritumoral inflammation. Statistically significant difference is found betweenADC value of bladder tumor and those of urine.CONCLUSION:Diffusion weighted MR imaging at 3 tesla is new and good imaging modalities for detection andstaging of bladder carcinoma, , without using contrast media, so can used in patient with renalimpairment or contrast media allergy


Article
Pre-Operative Shunt Vs Attack With Safety Burr Hole In Obstructive Hydrocephalus Complicating Medulloblastoma

Authors: Asr Faeq Abdulrasool Alattar --- Ali Abbas Hashim Almusawi
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 1 Pages: 32-40
Publisher: Babylon University جامعة بابل

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Abstract

A prospective study of 50 patients with obstructive hydrocephalus complicating medulloblastoma in posterior fossa (malignant tumors formed from primitive or poorly developed cells at a very early stage of life) with a histopatho-logically proved medulloblastoma. The patients had different age group and from different geographical regions in Iraq. The aim of this study was to clarify the best method for treating hydrocephalus associated with these tumors.And compare in outcome with patient treated with preoperative shunt and those with direct attack with safety burr hole or direct attack only and our results. In those patients that shunt operation was conducted before tumor resection there is improvement in their clinical condition before tumor resection leading to lax brain during operation.CSF diversion was recommend before tumor resection is recommended for most patients especially for those with midline solid tumors.

Keywords

ICP --- CSF --- CT-scan --- Computerized axial tomography --- MRI --- Burrhole.


Article
Pre-Operative Vs Post-Operative Shunt Procedure in Meningocele Repair

Authors: Ali Abbas Hashim Almusawi --- Asr Faeq Abdulrasool Alattar
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 1 Pages: 224 -229
Publisher: Babylon University جامعة بابل

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Abstract

A prospective study of 50 neonates with hydrocephalus and meningocele (one of the important congenital malformations involving defective development of spinal neural tube). This study to compare between patients with V-P shunt before repair of meningocele and those with repair first and the results shows that preoperative shunt procedure in patient with meningocele and hydrocephalus is very important aspect to prevent post-operative CSF leak and wound infection.

Keywords

CSF --- MRI --- OFC --- CT-scan --- U/S --- V-P shunt


Article
Salivary Cortisol Level Pre and Post MRI Scanning
مستوى هورمون الكورتيزول في اللعاب قبل وبعد إجراء فحص الرنين المغناطيسي

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Abstract

The measurement of salivary cortisol level has become a reliable method for studying the adrenal cortical function and it is response to different intrinsic and extrinsic factors such as medications and stressful factors. The aims of this study is to investigate if there is difference between sex and the effect of time of testing on salivary cortisol level, pre and post was scanning, data for cortisol, Salivary Flow Rate (SFR) and PH of saliva were analyzed. Non-stimulated salivary samples from 24 subjects (8 males, 16 females) pre and post scanning with Magnetic resonance imaging (MRI) was collected and the diurnal variation was taken into consideration for that all the pre and post scanning samples collected at the morning. Salivary cortisol was measured by ELISA technique, PH of saliva was measured by PH meter and salivary flow rate by specific equation. The results shows there was significant difference in the level of salivary cortisol, SFR and PH of saliva pre and post examination and there was positive correlation with regard to cortisol level and PH of saliva pre and post scanning, just the salivary flow rate showed negative correlation, in addition the results revealed significant difference with regards to the sex of the participant as well as positive correlation between salivary PH and SFR in pretest phase and positive correlation between salivary cortisol level, SFR in post scanning phase. From the results of this study we can conclude that the exposure to MRI scanning have an effect on Hypothalamic pituitary –adrenal axes and predispose to significant changes in cortisol level post scanning and this difference must be taken into consideration in concern to effect of raising the level of cortisone on other variables.

أصبح قياس مستوى الكورتيزول في اللعاب طريقة موثوق بها لدراسة وظيفة الغدة الكظرية ومدى تأثرها بمختلف العوامل الداخلية والخارجية مثل الأدوية والعوامل المجهدة. الهدف من هذه الدراسة هو قياس مستوى هورمون الكورتيزول في اللعاب قبل وبعد إجراء فحص الرنين المغناطيسي ومدى اختلاف مستوى الكورتيزول بين الجنسين.تم إختيار (24) شخصا (8 ذكور، 16 إناث) وتم قياس مستوى هورمون الكورتيزول وكمية اللعاب وقاعديته قبل وبعد المسح بواسطة الرنين المغناطيسي وقد أخذ بعين الاعتبار تباين مستوى الكورتيزول خلال اليوم، وأن جميع العينات قد أخذت صباحا وتم قياس المتغيرات تحت الدراسة. تم قياس هورمون الكورتيزول بواسطة تقنية الإيلايزا وقياس مستوى درجة الحموضة بواسطة جهاز قياس الحموضة كذلك تم حساب كمية إفراز اللعاب وفق معادلة خاصة. أظهرت الدراسة وجود فروق ذات دلالة إحصائية في مستوى الكورتيزول ومستوى إفراز اللعاب وتغير حموضة اللعاب قبل وبعد إجراء فحص الرنين المغناطيسي كذلك إختلاف نتائج قراءات العوامل تحت الدراسة بين الجنسين كما أظهرت النتائج وجود إرتباط ذو دلالة إحصائية إما إيجابية أو سلبية بين بعض هذه المتغيرات.من خلال النتائج نستنتج أن إجراء فحص الرنين المغناطيسي يؤثر بصورة محسوسة على مستوى الكورتيزول وبعض المتغيرات الأخرى ويجب أن يؤخذ هذا المتغير بنظر الاعتبار بما يخص تأثير إرتفاع مستوى هورمون الكورتيزول على عوامل أخرى.


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
The Role of Double Inversion Recovery Sequence in Detecting Gray Matter Lesions in patients with Multiple Sclerosis Using 3Tesla MRI

Authors: Mohssin Abd Ali Hussain --- Behjet Abid Hani --- Mohammed Abid Kadhim
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 1 Pages: 19-27
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT :BACKGROUND: In the recent time, the sequence used to delineate gray matter lesions is Double Inversion Recovery (DIR), with the use of this sequence in high magnetic field (3 Tesla machine).OBJECTIVE: To detect and localize gray matter lesions in patients with established multiple sclerosis using DIR sequence in 3 Tesla MRI. Also to compare the detection rate of white matter lesions by the use of DIR versus Fluid Attenuation Inversion Recovery (FLAIR) sequence.PATIENTS AND METHODS: A prospective study included 54 patients with established diagnosis of multiple sclerosis of more than 3 years duration was conducted from April 2014 to January 2015. The study was done in the MRI units of Al-Yarmouk Teaching Hospital and Al-Imamian Al-Kadhimian Medical City. All patients were examined with the following MRI imaging sequences: T2WI axial, T2 FLAIR sagittal and coronal, T1 axial and sagittal, DIR axial and coronal. T1 Sagittal and axial were repeated after giving IV contrast and examined after 30 minutes postcontrast. Gray matter lesions were classified according to Peterson and Bo model. Statistical analysis conducted by using Excel 2013 version. RESULTS: Fifty four patients with established diagnosis of MS (43 patients with relapsing remitting MS and 11 patients with secondary progressive MS) were included. Of the 54 patients, 39 patients (72.2%) patients have positive gray matter lesion. The 39 patients with positive gray matter lesions are classified as follows: 26 patients (66.5%) had sub-pial lesions, 9 patients (23%) had leucocortical lesions, 3 patients (7.5%) showed entirely cortical lesions, and finally the whole cortex is involved in 1 patient only (2.5%). The insular cortex was the most commonly involved region seen in 14 patients (35.8%), followed by the thalamic lesions. Among the 39 patients with positive 9 patients (16.5%) had additional deep nuclei lesions. Total number of lesions detected by DIR (320 lesions) was largely greater than the total number of lesions detected by FLAIR (185 lesions). CONCLUSION: DIR is a sensitive sequence for detection of gray matter lesion, DIR is more sensitive than FLAIR in detection of white matter lesions and cortical gray matter lesions are more commonly encountered than deep nuclei lesions. K


Article
Adaptive Technique Depending on Region Growing and Soft Clustering to Detect Tumors in Different Modalities of MRI Brain Images

Author: Rabab Saadoon Abdoon
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2016 Volume: 24 Issue: 5 Pages: 1333-1342
Publisher: Babylon University جامعة بابل

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Abstract

Brain tumor is a very dangerous disease and life threatening, so early detection of the tumor is a vital task. Many techniques and algorithms are presented to enable doctors for fast and accurate diagnosis of tumors in MRI brain images. In this study, analytical study of Region Growing segmentation method with different threshold values ranged from 10 to 35, with steps of 5, is proposed. In addition, an adaptive technique is proposed, which is Region Growing based on the fuzzy clustering scheme to investigate the performance of this algorithm by implementing it on FCM clustered images. The adopted MRI images are of different modalities and different orientations to test the ability of the adaptive technique to segment different modalities of MRI images. The results showed that, utilizing different values of the threshold in proceeding of Region Growing algorithm produced different segmented images’ properties. When the fine details of the processed images and their objects are the goal, low values of threshold must be adopted, while when isolating of the hole tumor regions is the goal, high values of threshold must be adopted. In addition, the results of the adaptive technique showed that Region Growing segmentation improved its performance and it could separate the consists of the tumor regions. The elapsed time of implementation is clearly reduced.

تعتبر أورام الدماغ خطرة جدا ومهددة للحياة لذا فان الكشف المبكر عن الورم يعتبر مهمة حيوية. لقد تم عرض العديد من التقنيات والخوارزميات لغرض تمكين الأطباء من التشخيص السريع والدقيق للأورام في صور الرنين المغناطيسي للدماغ. في هذا العمل تم اقتراح دراسة تحليلية لطريقة التجزئة باستخدام إنماء المناطق باستخدام قيم مختلفة للعتبة تتدرج من 10 إلى 35 وبخطوات تساوي 5. إضافة لذلك فقد تم تقديم تقنية مطورة وهي استخدام طريقة إنماء المناطق المستندة على العنقدة المضببة لاختبار أداءها من خلال تنفيذ خوارزمية إنماء المناطق على الصور المقسمة باستخدام تقنية ألـ FCM علاوة على تنفيذها على صور الرنين المغناطيسية الأصلية الداخلة. إن الصور المتبناة في هذا العمل هي من أنماط مختلفة وباتجاهات مختلفة وذلك لاختبار مدى قابلية هذه التقنية المطورة لتقسيم الأنماط المختلفة من صور الرنين المغناطيسي. لقد بينت النتائج التي تم التوصل إليها من خلال هذه الدراسة إن استخدام قيم تعتيب مختلفة لخوارزمية إنماء المناطق قد أنتجت صور مقسمة مختلفة الخصائص, فعندما تكون التفاصيل الدقيقة للصورة ومكوناتها هو الهدف فيجب استخدام قيمة تعتيب منخفضة في حين إذا كان الهدف هو عزل منطقة الورم ككل فيجب تبني قيمة تعتيب عالية . إضافة إلى ذلك فان نتائج التقنية المطورة قد بينت إن أداء خوارزمية إنماء المناطق قد تحسن, إذ تمكنت من فصل مكونات الورم. كما وأن الزمن اللازم لتنفيذ الخوارزمية قد انخفض بشكل واضح.


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.

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