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Article
10.Large Intraarticular Ganglion in Knee Joint: A case report

Authors: Ali E. Dagher علي اسكندر داغر --- Falah K. Hasan فلاح كاظم حسن
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2019 Volume: 17 Issue: 2 Pages: 161-165
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Ganglion is defined a cystic lesion composed of myxoid matrix having jelly like consistency and is lined by pseudomembrane. Large ganglionic cyst in Hoffa Pad is quite uncommon and only few are mentioned in literatures.A 25-year old female presented with history of gradually worsening anterior knee pain and swelling for 10 months duration, she was disabled due to repeated attacks of knee pain. Magnetic resonance imaging (MRI) shows large intra-articular multilocular cyst. The decision was to do open excision of the cyst in order to decrease the recurrence rate. Histopathological finding shows multi-lobulated cysts with glassy fibrous wall and clear jelly like consistency, which confirm diagnosis. Postoperative period was uneventful and she was doing well during follow up after four months.Large ganglionic cyst developed in Hoffa fat pad of the knee should be considered in deferential diagnosis of intraarticular mass causing pain around the knee. The decision was open excision depending on MRI finding to avoid incomplete resection and prevent recurrence.Keywords:Knee, Ganglion Cyst, Hoffa Fat Pad, MRICitation:Dagher AE, Hasan FK. Large Intraarticular Ganglion in Knee Joint: A case report. Iraqi JMS. 2019; 17(2): 161-165. doi: 10.22578/IJMS.17.2.10

Keywords

Knee --- Ganglion Cyst --- Hoffa Fat Pad --- MRI


Article
Correlation of Optic Nerve Sheath Diameter and Optic Sheath to Optic Nerve Diameter Ratio with Lumbar puncture opening Pressure in Pseudotumor Cerebri Syndrome

Author: Saif Hasan Ali , Noor Abbas Hummadi Fayadh , Hasan A. Al-Hamadani
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2019 Volume: 18 Issue: 2 Pages: 133-140
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: In cases of Pseudotumor Cerebri Syndrome, increased intracranial pressure is transmitted to the subarachnoid space surrounding the optic nerve, causing increase in the optic nerve sheath diameter and Optic nerve sheath to optic nerve diameter ratio. Magnetic Resonance Imaging is the image of choice in Pseudotumor Cerebri Syndrome and it can be used to measure precisely the diameter of optic nerve and its surrounding sheath.OBJECTIVE: To evaluate the diagnostic value of optic nerve sheath diameter, Optic nerve sheath to optic nerve diameter ratio, and their correlation with lumbar puncture opening pressure in Pseudotumor Cerebri Syndrome PATIENTS AND METHODS: In a prospective blinded correlational diagnostic yield study, a 3 tesla Magnetic Resonance Imaging data of 34 patients with Pseudotumor Cerebri Syndrome, and 34 normal control were collected and analyzed, optic nerve sheath diameter and optic nerve diameter were measured in an axis perpendicular to the optic nerve, 3 mm behind the globe.RESULTS: Both optic nerve sheath diameter and Optic nerve sheath to optic nerve diameter ratio were found to be significantly larger in patient's group compared to control. Lumbar puncture opening pressure in patient was measured and found to be correlated significantly with both optic nerve sheath diameter and optic nerve sheath to optic nerve diameter (r 0.79-p 0.000, r 0.45-p 0.007 respectively). The optic nerve sheath diameter in patients were 5.75 ±0.6 mm, cut-off value for diagnoses of Pseudotumor Cerebri Syndrome was 4.9 mm with a sensitivity of 91% and specificity of 88%. The cut-off value of optic nerve sheath to optic nerve diameter ratio was 2.39 with a sensitivity of 100% and specificity of 97%.CONCLUSION: Magnetic Resonance Imaging -determined (optic nerve sheath diameter & optic nerve sheath to optic nerve diameter ratio) have excellent diagnostic value in Pseudotumor Cerebri Syndrome, and they were correlated significantly with LP opening pressure.KEYWORDS: MRI, Optic nerve, Pseudotumor Cerebri Syndrome


Article
Role of ADC Value in Differentiation of Malignant and Benign Hepatic Lesion

Authors: Choman Sabah Omer --- Kawa A. Mahmood --- Rezheen Jamal Rashid
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2019 Volume: 12 Issue: 2 Pages: 2174-2183
Publisher: Kerbala University جامعة كربلاء

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Abstract

Background: Apparent diffusion coefficient ADC value used in this research for differentiation of the malignant and benign hepatic lesions, which has an impact on the management of these lesions by surgery or conservatively. Aim: To analyze the role of diffusion weighted imaging (DWI) with the apparent diffusion coefficient (ADC) values in the differentiation of malignant from benign hepatic lesions.Materials and methods: this is a prospective cross-sectional study 80 patients with 118 focal hepatic lesions contributed. MRI with DWI examination was carried out for all patients. After DWI examination, an ADC map was created and ADC values were measured for 118 focal hepatic lesions.Results: out of 118 hepatic lesions, 62 were benign and 56 were malignant. Benign lesions comprised 30 hemangiomas and 21 simple cysts, 6 focal nodular hyperplasia (FNH), 4 abscesses and 1 adenoma. Malignant lesions comprised 47 metastases, 6 hepatocellular carcinomas (HCC), 2 fibrolamellar hepatocellular carcinomas and 1 case intra hepatic cholangiocarcinoma. The highest ADC values were measured for cysts. The mean ADC value of benign lesions was 2.27 ± 0.7 x 10ˉ³mm²/sec, whereas malignant lesions had a mean ADC value of 0.85 ± 0.18 × 10ˉ³mm²/sec. The mean ADC value of benign lesions was significantly higher than that of malignant lesions (P < 0.001).Conclusion: DWI and quantitative measurement of ADC values shows promising result in characterization of benign and malignant hepatic lesions, with other MRI sequences of dynamic contrast study. Especially, when contrast is contraindicated.

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