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Article
Ultrasound strain Elastography of Normal Breast Tissue in Correlation with Mammographic Breast Density

Authors: Wasan Ismail Al-Saadi --- Suha Hussain Hayyawi --- Noor Kadhum Neema --- Huda Fawzi Salih
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2016 Volume: 15 Issue: 3 Pages: 45-51
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Strain elastography is relatively new ultrasound technique that assess elasticity of the tissue .This technique utilize the relative strain of the tissue of interest to generate color coded image and to measure the strain ratio. It has been extensively investigated and introduced as a promising technique for characterization of breast masses. Aim of study:To assess the relative strain of fat and glandular tissue as well as the strain ratio in relation to different mammographic breast density categories and with respect to the depth of tissue Subjects and Methods: A total of 162 women with normal breast imaging were included and categorized according to the American College of Radiologists (ACR) mammographic breast density categories (A, B , C , D). Elastography examination was performed for a single normal breast and the relative strain of the fatty tissue and glandular tissue at most superficial location as well as at 1-2 cm in depth were recorded . In addition the fat:glandular strain ratio was estimated. The elastographic variables were assessed with each other and with respect to breast density & the tissue depth Results:The subjects were subdivided according to ACR density system. It has been found that the mean relative strain of fat was higher in category A (0.30) in comparison with the other categories with statistically significant difference , however the relative strain of the glandular tissue was rather comparable between category A (0.25), category B (0.24) and category C (0.22) with statistically significant difference with category D(0.20) .The strain ratio was significantly different in category B (1.10) and category C (1.05) in comparison with category A (1.22).Comparing the relative strain in different depth revealed rather similar results where relative strain of fat in ( 1- 2 cm ) below Ref show significant difference in category B(0.21) and category C(0.20) in comparison with category A (0.29) as category group D is extremely dense so no fat tissue below ROI could be measured. Similarly the relative strain of glandular tissue in 1-2 cm below ROI show significant difference between category A (0.23) and category B (0.22) with category C and D (0.19 for both). Conclusion:The fat tissue elasticity is rather different in different breast density categories with higher elasticity of the fat in category A breast density (fatty breasts) as compared to other breast density categories .The glandular tissue strain is rather more comparable in the breasts in category B, C, and D and thus it may more convenient to use the glandular tissue as a reference tissue when assessing the relative elasticity of breast masses. Moreover , the depth of the measurement of the tissue elasticity has a significant influence on the quantitative assessment of the elastographic image


Article
Role of Diffusion-Weighted MR Imaging in Characterization of Posterior Fossa Tumors

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Abstract

Background: Conventional MR imaging is essential for diagnosis and evaluation of the posterior fossa tumors Objectives: To assess the value of diffusion weighted imaging and apparent diffusion coefficient in making distinction between different histological types of posterior fossa tumors. Type of the study: Cross-sectional study.Methods: Brain MRI and DWI assessed 19 patients (12 female and 7 male) with MRI diagnosis of posterior fossa tumors. absolute ADC values of contrast -enhancing solid tumor region and ADC ratio of solid tumor to ADC of normal -appearing deep White matter were compared with histological diagnosis postoperatively .The mean ADC value and ratio were determined by using a 2-tailed T test


Article
Value of Ultrasonography in Acute Appendicitis in Patients with Modified Alvarado Scoring System Score of 5 & 6

Authors: Ziad Ghanem Mohammed --- Mohammed Jawad Mohammed Al- Najjar --- Huda Ali Al-Hussaini --- Haider Abdulhussain --- et al.
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 277 -283
Publisher: Babylon University جامعة بابل

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Abstract

Acute appendicitis is one of the most common and challenging surgical emergencies. Ultrasound [US] is widely available , highly accurate imaging modality in patients suspected to have acute appendicitis, this study was done to assess the value of US in evaluation of suspected acute appendicitis patients with Alvarado Scoring System [MASS] of 5 & 6 . In this prospective study a total of (100) patients with clinically suspected acute appendicitis and with Alvarado score between 5 &6 underwent US examination of the abdomen The accuracy of ultrasonography in the diagnosis of appendicitis was compared with clinical diagnosis, laparotomy findings and histopathological examination reports.. The patients were divided into two groups: group A included those for whom surgery was done & the final diagnosis was established depending on the surgical finding &/or histopathology results & this group comprised (65) patients . Group B comprises patients who did not underwent surgery ,these patients were followed up until their improvement & discharge from the hospital & this group included (35) patients. The overall specificity of ultrasound was 88% and the sensitivity was 89% in the diagnosis of acute appendicitis in patients with MASS of 5 & 6 .US is a valuable tool in diagnosing acute appendicitis in patients with MASS (5 & 6). When the clinical sign and symptoms are combined with US, the diagnostic accuracy is significantly high.


Article
Predictors of poor first trimester outcome in asymptomatic women : the value of embryonic heart rate , mid sac diameter / yolk sac ratio & mid sac diameter / crown rump length

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Abstract

Background: Ultrasound provides a powerful tool for assessing early pregnancy and detecting pregnancy failure at first trimester and promoting rapid effective management. Several criteria have been established to predict the pregnancy outcome particularly in symptomatic women . Aim: To evaluate asymptomatic women at the first trimester of pregnancy , to assess the efficacy of certain ratios as mid sac diameter (MSD) / yolk sac ratio & crown rump length (CRL)/mid sac diameter (as indicator of early first trimester oligohydramnios) in predicting poor 1st trimester outcome Type of the study: A cross-sectional study.Patients & Methods: A sixty three asymptomatic women were enrolled in this prospective study . Transvaginal sonography was performed for confirmation of pregnancy viability & exclusion of multiple pregnancies 6-8 weeks of gestation & follow up ultrasound repeated at the beginning of second trimester to confirm the continuation of pregnancy and viability of fetus. Several parameters assessed and tested against each others as embryonic heart rate , the size and morphologic criteria of gestational sac , yolk sac and the crown rump length Results: The women were classified into two groups: group A are those with successful outcome at the first trimester and group B are those with poor outcome of the 1st trimester . Decrease embryonic heart rate below 100 beat per minute and low mid sac diameter/ yolk sac size ratio of < 1.9 , were found to be significant predictors of poor outcome however mid sac diameter/crown rump length ratio was not found to have a similar significance Conclusion: In addition to the classical parameters assessed by trans-vaginal ultrasound, other important parameters need to be routinely applied as the embryonic heart rate that predict poor outcome when less than 100 bpm . In addition to the ratio of mid sac diameter to the yolk sac diameter which , if less than 1.9 , may point to abnormal first trimester fate.

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