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Article
Ultrasonography for Detecting Ureteric Calculi with Non Enhanced CT as a Reference Standard (Prospective Study )

Author: Kassim A. Hadi Taj-Aldean
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2010 Volume: 7 Issue: 1-2 Pages: 165-173
Publisher: Babylon University جامعة بابل

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Abstract

Objective: To prospective study determine the sensitivity and specificity of ultrasonography (US) for detecting ureteric calculi and to establish the accuracy of US for determining the site ,size and number of calculi in ureter . Patients and Methods: Between June 2008 and December 2009, 100 consecutive patients (age range, 16-65 years; 60 male, 40 female) seen on our emergency department with ureteric colic suspected to have ureteric stone by clinical examination ,underwent US evaluation included a careful search for ureteral calculi. Presence of calculi ,site of calculi and obstruction and incidental diagnoses were recorded .then patients undergo CT on same day or second day for compare the result. All CT studies evaluated the ureter for presence of calculi .US and computed tomography (CT) examinations were compared for the presence of ureteric calculi (site in ureter and size ). The sensitivity of US was determined for presence of calculi in ureter findings were compared with computed tomography . The size of calculi in longest axis were compared on US and CT images . Results: US depicted 20 calculi identified at CT ,yielding sensitivity 20% and specificity 100 %,there was no substantial difference for detecting calculi in left or right ureter ,the specificity of the ultrasound examination was 100 %, but the sensitivity was 20 % except for the lower ureteric calculi (sensitivity 28%). US find 6 calculi in upper ureter from 26 calculi (sensitivity 23 %) ,while 2 calculi from 30 in middle ureter (sensitivity 6 %) ,and 12 calculi from 42 calculi in lower ureter (sensitivity 28 % ) identified at CT, Conclusion: US is of limited value for detecting ureteric calculi specially in middle ureter

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Article
The validity of ultrasonography (US) and magnetic resonance imaging (MRI) in characterizing adnexal masses( prospective study )

Author: Kassim A. Hadi Taj-Aldean
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2012 Volume: 8 Issue: 14 Pages: 205-220
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

To determine whether ultrasonography and MRI images on the basis of their morphologic features and enhancement patterns. could help accurately distinguish benign adnexal masses from malignant . Between January 2009and December 2011, prospectively studied 80 women (mean age 30 years, range 17 to 70 years) with clinically suspected adnexal masses. A single experienced sonographer performed transabdominal and transvaginal greyscale spectral and colour Doppler examinations. MRI was carried out on a 1.5T system using T1, T2 and fat-suppressed T1-weighted sequences before and after intravenous injection of gadolinium. The adnexal lesions were examined for several features including size, shape, character (solid–cystic), signal intensity, and enhancement. Secondary signs such as ascites, peritoneal disease, and lymphadenopathy were noted. We compared the imaging features with the surgical and pathologic findings. All MR imaging features were categorized as benign or malignant without knowledge of clinical details, according to the imaging features which were compared with the surgical and pathological findings. . Sixty four (80%) cases of benign and 16(20%) cases of malignant on histopathology .Mean age (30 year ),size of mass range from 1-14 cm .Both MRI and US correctly diagnosed 11 cases with malignant and false negative diagnosis 1 case with malignant lesion , MRI correctly diagnosed 4 cases with malignant lesions, which on US were thought to be benign ., both MRI and US correctly diagnosed 45 cases with benign lesions . MRI correctly diagnosed 18cases with benign lesion(s), which on US were thought to be malignant. For characterizing lesions as malignant, the sensitivity of MRI were 93.75 %, and of US were 68.75 % , the US features were suggestive of malignancy (large masses and solid-cystic lesions with nodules). MRI is more sensitive than US for differentiation benign and malignant adnexal masses.

اجريت دراسة مقطعيه لثمانين مريضا للفترة من كانون الثاني 2009-كانون الاول 2011 يشتبه بإصابتهم بتكتل الحوض الجنبي ,تم فحصهم بالسونار لتشخيص كون التكتل كيسي أم صلب وحجم الكيس , تم اجراء الرنين المعناطيسي لحالات التكتل الصلبوالكيسي قبل العملية ,حيث اعتبرت المعاير الاتيه اساس في التميز كون التكتل حميد أم خبيث (نوعية ودرجة اخذ التكتل الصلب للصبغه ,فابليته على تكوين الاوعيه الدمويه ,وقياس درجة التكلس )اظهرت هذه الدراسه ان التكتل الذي يحتوي على الخراج بعد اجراء الرنين المغناطيسي له يمكن تشخيصه بان له قابليه على اخذ الجدار فقط للصبغه بينما الورم الخبيث له قابليه مختلفة لأخذ ألصبغه بالاضافه إلى ذالك ,الورم الخبيث له قابليه عاليه على تكوين الاوعيه الدمويه ,بينما الورم الحميد له درجه متوسطه على اخذ ألصبغه نستنتج من هذه الدراسه هناك بعض الفحوصات ودرجة اخذ الورم التكتلي للصبغه بامكانها أن تميز كون التكتل حميد او خبيث .

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Article
The Assessment of Sonography in Distinguishing Benign from Malignant Solid Breast Mass, Can It Be Improved?

Authors: Kassim A. Hadi Taj-Aldean --- Kadhim Ch. Hasan
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2009 Volume: 6 Issue: 2 Pages: 300-308
Publisher: Babylon University جامعة بابل

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Abstract

Objective: To determine whether sonography could help accurately distinguish benign solid breast masses from malignant ones and whether its role can be improved . Patients and Methods: Between November 2007 and January 2009 , 243 female patients with breast lesions diagnosed by their managing surgeons, were sonographically assessed .Those who had solid lesions were selected for a prospective study through comparison with the histopathological finding of the open biopsies taken from the lesions . US features that most reliably characterize masses as benign or malignant had been strictly applied for diagnosing these cases. Sonographic classifications were compared with histopathological reports of the biopsies . The sensitivity, specificity, and negative and positive predictive values of the sonography were calculated. Results: Sonographically, 108(44%) cases were classified as benign and 135(56%) were malignant . 12 (11%) lesions classified as benign sonographically, were found to be malignant histopathologically. 33 (24%) lesion classified as malignant were found to be benign histopathologically. Thus, the classification scheme had a negative predictive value of 89% and positive predictive value 75%. Conclusion: Sonography can be used to identify most benign solid lesions for follow up through imaging. Making use of FNA cytology and True-cut needle biopsy, in addition to including mammography will eliminate son graphic mishaps.

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Article
The Sensitivity of Renal Color Doppler Sonography In Differentiating Obstructive and Nonobstructive Urinary Calculi In Patients With Acute Renal Colic Prospective Study

Authors: Kassim A. Hadi Taj-Aldean --- hasanain Ahmed Al bayati
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2015 Volume: 23 Issue: 2 Pages: 843-852
Publisher: Babylon University جامعة بابل

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Abstract

objective: The purpose of this study was to determine the sensitivity of renal color Doppler sonography in differentiating obstructive and nonobstructive urinary calculi in patients with acute renal colic and to compare findings with nonenhanced helical computed tomography (CT)PATIENTS AND METHODS Between January 2009 and May 2012. Eighty five patients referred to the emergency department of Hilla teaching hospital with acute renal colic underwent nonenhanced CT and renal resistive index (RI) measurement with color pulsed Doppler sonography within 8 to 10 hours of the onset of the symptoms. Computed tomographic evaluation was based on the detection of urolithiasis and the presence of obstruction. The mean RI of each kidney and the difference between the mean RI of both kidneys were calculated and compared with CT findings.RESULTS: Tomography revealed obstruction in 43 patients and nonobstucted in 42 patients . Mean RI values for the obstructive and nonobstructive groups were 0.64 and 0.63, respectively. The differences in the mean RI for the patients with and without obstruction were statistically insignificant (P = .73). No significant relationship was found between the RI values, calculus location, and degree of obstruction.. CONCLUSION: No significant relationship was found between the RI and obstruction, obstruction degree, or location. The use of this modality will be time-consuming and ineffective in routine practice.The RI is not sensitive for detection of obstruction in patients with acute renal colic

اجريت دراسة مقطعيه لخمسة وثمانين مريضا مصابين بالم الكلية الحاد يشتبه بإصابتهم بحصاة الكلية ,تم فحصهم بالسونار لتشخيص كون الحصاة بالكلية او الحالب كون هناللك انسداد بالكية او لا ثم تم فحصهم بالسونار الملون وتم أخذ حساسية السونار الملون , تم اجراء المفراس الحلزوني لجميع الحالات ,المفراس الحلزوني وجد ان هناللك 43 مريض مصابين بانسداد الكليه و42 مريض غير مصابين بانسداد الكلية،تم مقارنة الفرق باحساسية السونار الملون بين انسداد الكلية وعدم انسداد الكلية ، نستنتج من هذه الدراسه ان السونار الملون غير مفيد في فحص الم الكليه الحاد


Article
Solid renal masses: use of spiral Computed tomography for Differentiation between benign and malignant lesions

Authors: Emad H.Mahmood --- Kassim A. Hadi Taj-Aldean قاسم امير هادي
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2009 Volume: 5 Issue: 7 Pages: 150-162
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

objective: To determine whether CT images on the basis of their morphologic features and enhancement patterns. could help accurately distinguish benign renal masses from malignant . patients and Methods : Between April 2006 and February 2009, 80 consecutive patients (age range, 1–65 years; 50 male, 30 female) suspected to have renal mass by physical examination ,underwent ultrasound examination to evaluate the mass ,whether cystic or solid. Only patients with solid renal mass documented with US were included in the study then preoperative renal CT. All CT studies evaluated the mass about the pattern and degree of enhancement, lesion contour, presence of neovascularity, and calcifications . Results: Of the 80 renal masses (median size, 3.4 cm; range, 1.1–20.0 cm) included in this study, 30 (37 %) were benign and 50 (63 %) were malignant. of benign 14 (47%)patients have abscess and 16(54 %) have angiomyolipoma , while malignant tumor classified as clear cell renal cell carcinomas (RCCs) 28 (56 %) , papillary lesions 16 (32 %) and 6 (12 %) Wilm's tumors. abscess most commonly classified as hypodense with peripheral enhancement while Clear cell RCC most commonly manifested with a mixed enhancement pattern of both hypervascular soft-tissue components and low-attenuation areas that corresponded to necrotic or cystic changes ,whereas the homogeneous and peripheral enhancing patterns were more predictive of less aggressive papillary . Clear cell RCCs tended to be hypervascular and angiomyolipomas tended to enhance moderately, and papillary lesions were mostly hypovascular. Conclusion: Certain imaging features and the degree of enhancement may be helpful in differentiation of renal masses .

اجريت دراسة مقطعيه لثمانين مريضا يشتبه بإصابتهم بتكتل بالكلية ,تم فحصهم بالسونار لتشخيص كون التكتل كيسي أم صلب , تم اجراء المفراس الحلزوني لحالات التكتل الصلب قبل العملية ,حيث اعتبرت المعاير الاتيه اساس في التميز كون التكتل حميد أم خبيث (نوعية ودرجة اخذ التكتل الصلب للصبغه ,فابليته على تكوين الاوعيه الدمويه ,وقياس درجة التكلس ).اظهرت هذه الدراسه ان التكتل الذي يحتوي على الخراج بعد اجراء المفراس الحلزوني له يمكن تشخيصه بان له قابليه على اخذ الجدار فقط للصبغه بينما الورم الخبيث له قابليه مختلفة لأخذ ألصبغه بالاضافه إلى ذالك ,الورم الخبيث له قابليه عاليه على تكوين الاوعيه الدمويه ,بينما الورم الحميد له درجه متوسطه على اخذ الصبغه .نستنتج من هذه الدراسه هناك بعض الفحوصات ودرجة اخذ الورم التكتلي الكلوي للصبغه بامكانها أن تميز كون التكتل الكلوي حميد او خبيث .

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Article
Conventional Sinus Radiography Compared with CT in the Diagnosis of Sinusitis: Prospective Study

Authors: Kassim A. Hadi Taj-Aldean --- Saffa Hussain al Turahy --- Saffa Sahib Naji Sultan
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2009 Volume: 6 Issue: 2 Pages: 398-407
Publisher: Babylon University جامعة بابل

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Abstract

Objective: To evaluate the value of plain film radiography in a prospective investigation of patients with clinical suspicion of sinusitis, in comparison with computed tomography findings . Methods: Between October 2007 and January 2009, 100 patients with signs and or symptoms of sinusitis and did not respond to classical treatment were selected , age range 5-30years; 60 male and 40 female; each patient underwent conventional X-ray and standard dose CT examinations during the same visit. The sensitivity and specificity of the plain film and computed tomography examination were calculated Results: The false negative results of plain x-ray was 30%in diagnosis of sinusitis ,the specificity of the plain film examination was 33%, but the sensitivity was 45% except for the maxillary sinus (sensitivity 80%). Thus, for maxillary sinusitis, plain film examination was reasonably accurate. A negative finding in the other sinuses could not be relied upon. While the false negative results of computed tomography was 2% for maxillary sinus and 5% for ethmoid sinus which was confirmed by endoscopy of sinus surgery, the sensitivity of computed tomography 96% in diagnosis of sinusitis of and specificity 90%. Conclusions: The sensitivity of plain film in the diagnosis of sinus disease, particularly of the ethmoidal and sphenoidal sinuses is low and shows limitation for use in directing endoscopic surgery, therefore should be replaced by coronal CT scan especially of the patients subjected as candidates for endoscopic sinus surgery to see middle meatal complex and this contents.

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Article
The role magnetic resonance imaging and myelogram in the cervical spondylitis radiculopathy (prospective study)
دور التصوير بالرنين المغناطيسي والكشف النخاعي في اعتلال الشعاع الفقاعي العنقي (دراسة مستقبلية)

Authors: Saffa Mohammed Altaee صفاء محمد الطائي --- Kassim A. Hadi Taj-Aldean قاسم امير هادي تاج الدين
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2016 Volume: 12 Issue: 22 Pages: 124-129
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

objective:The objective of this study was to prospectively evaluate the accuracy of MRI and myelogram for the demonstration of foramina nerve root impingement in cervical spondylitis radiculopathyPatients And MethodsBetween January 2012 and May 2014. Eighty five patients referred to the department of Hilla teaching hospital with. cervical spondylitis radiculopathy were imaged with conventional MM and with MR myelogram . The diagnostic accuracy of these imaging strategies for the demonstration of exit foraminal stenosis was calculated relative to a gold standard of the combination of conventional MRI and MR myelogramResults:Conventional MRI had a sensitivity of 88.9%, specificity of 99.1%, and diagnostic accuracy of 94.5% for the demonstration of exit foraniinal disease. MR myelography alone had a sensitivity of 84.4%, a specificity of 90.1%, and diagnostic accuracy of 88%.Conclusion:However, the addition of MR myelography increased the diagnostic yield of the MR examination for the detection of forantinal stenotic disease. MR myelography is a useful adjunct to conventional MN in the investigation of cervical spondylotic radiculopathy.

الهدف:كان الهدف من هذه الدراسة هو تقييم مستقبلي دقة التصوير بالرنين المغناطيسي والكشف النخاعي لإظهار اصطدام جذر العصب الثقبي في اعتلال الجفن عنق الرحممرضى وطرقبين يناير 2012 ومايو 2014. خمسة وثمانون مريضا أحيلوا إلى قسم مستشفى الحلة التعليمي مع. تم تصوير اعتلال الجفن الفقاري العنقي مع MM التقليدي ومع تصوير النخاع الشوكي. تم حساب الدقة التشخيصية لاستراتيجيات التصوير هذه لإظهار تضيق خروج الثقب بالنسبة إلى المعيار الذهبي للجمع بين التصوير بالرنين المغناطيسي التقليدية و MR النخاعيالنتائج:كان التصوير بالرنين المغناطيسي التقليدية حساسية 88.9 ٪ ، وخصوصية 99.1 ٪ ، ودقة التشخيص من 94.5 ٪ لمظاهرة خروج foraniinal المرض. كان لدى التصوير النخاعي بالرنين المغناطيسي حساسية 84.4 ٪ ، وخصوصية 90.1 ٪ ، ودقة تشخيص 88 ٪.خاتمة:ومع ذلك ، زادت إضافة تصوير النخاع الشوكي MR من العائد التشخيصي لفحص MR للكشف عن مرض التضيق الجبهي. يعد تصوير النخاع الشوكي MR أحد العناصر المساعدة المفيدة للـ MN التقليدي في التحقيق في الاعتلال الشعاعي الفقاري العنقي.

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