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Article
Correlation between Coronary Calcium Score and Severity of Coronary Artery Disease in Coronary CT-Angiography

Authors: Karim O Al –Naffi --- Zaid Ahmed Al Mahdy
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 2 Pages: 1856-1864
Publisher: Kerbala University جامعة كربلاء

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Abstract

ackground: The presence of calcification in the epicardial coronary arteries indicates that the patient has coronary atherosclerosis, CT scan is a reliable noninvasive investigation to detect the degree of coronary calcification.Aim: to study correlation between the degree of coronary calcification and severity of coronary artery stenosis by CT-angiographyPatient and method: one hundred and seventy-five patient ,119(68%) are male and56 (32%) are females. mean age is 55.52for males &55.30 for females, who was referred to the Iraqi Medical center in Karbala for CCTA between october2009- Nov.2013. They have either clinical diagnosis of CAD or chest pain suggestive of CAD. They were studied using CT-64 slices, initially by smart score to assess their calcium level using Agatston score, then contrast given to complete the examination, all coronary arteries were studied for any stenosis. The result was analyzed using SPSS 19.Results & Discussion: There is statistically significant positive correlation (P value less than 0.005) between the degree of CAC score and the degree of vascular obstruction, also with the number of diseased vessel. It also revealed that 12.9%. of symptomatic patients with negative calcium score may have obstructive lesion although of fewer vessel & of mild obstructive lesionConclusion: in symptomatic patient CAC score reflect the severity of CAD especially if it is of high degree but in the absence of calcification it does not exclude presence of diseased vessel.Keyword: coronary artery disease, coronary calcium, coronary CT-AngiographyAbbreviations: CAD: coronary artery disease. CAC: coronary artery calcium, CCTA: Coronary Computed Tomography Angiography


Article
CT angiographic determination of most frequent anatomic variations of coronary arteries in Erbil population

Authors: Zana Mustafa Mahmood --- Nasih Mohsin Ahmed --- Nali Abdulkader Maaruf
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2019 Volume: 23 Issue: 1 Pages: 19-27
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Computed tomography angiography is one of the best methods for knowing the detailed anatomy of coronary arteries and can successfully detect any variation of coronary arteries. Anatomic variations of coronary arteries have not been studied among Erbil population which is mostly inhabited by Kurds. This study was conducted to compare the incidence of the anatomic variations of coronary arteries in Erbil population with international standards.Methods: Variations of coronary arteries were retrospectively studied by using computed tomography angiography of 412 cases (214 males 198 females) with mean age 51.5 ± 13.5 years (mean ± SD) who underwent this procedure on suspicion of coronary artery disease. The main indication was chest pain in patients with low to intermediate probability of ischemic heart disease. The present study was carried out in the Department of Radiology, Surgical Specialty Hospital/Cardiac Center in Erbil city. Results: The right coronary artery was dominant in 86.4% of cases, while the left main coronary artery was dominant in 10.92% of cases. Co-dominance was observed in 2.67% of cases, and Double Ostia of right aortic sinus was observed in 25% of cases. Long left main coronary artery was observed in 10.68 % of cases. Myocardial bridging was observed in 7.04% of cases. Other variations were also observed, and their prevalence was recorded.Conclusion: Variations of coronary arteries among Erbil population were recorded and were near to the international standards.


Article
Sixty-four multi-slice cerebral CT angiographic findings in early non-traumatic subarachnoid hemorrhage
مشاهدات التصوير الطبقي الوعائي (64 شريحة) في حالات النزف تحت العنكبوتية المبكرة غير الرضية

Authors: Basima Kadhim باسمة كاظم --- Abdullateef Aliasghar عبداللطيف علي اصغر مصطفى --- Mudhaffar B. Mahdi مظفر بالي مهدي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2014 Volume: 56 Issue: 2 Pages: 151-156
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: spontaneous subarachnoid hemorrhage (SAH) is subtype of hemorrhagic stroke with extremely poor prognosis. It’s a medical emergency and can lead to death or severe disability even when recognized and treated at an early stage. Computed tomographic angiography (CTA) is frequently become the initial step in detecting intracranial aneurysms and planning therapeutic interventions.Objectives: to analyze the findings of non traumatic SAH in cerebral CTA and characterization of the underlying causes, emphasizing the importance of CTA as a new advent investigation in Iraq. Patients and methods: This cross sectional study performed on 62 patients with non-traumatic SAH who underwent CTA in Baghdad Teaching Hospital at medical city-Baghdad from August 2012–August 2013 of patients with highly clinical suspicion of SAH or those who were diagnosed by native computed tomography (CT) or magnetic resonance imaging (MRI), the sample of the study was consist of 37 males and 25 females, age of patients ranged from 1-70 years; all patients examined by CTA using 64 multi-slice CT.Results: From 62 patients in our study, 10 patients have negative finding, 38 have aneurysm, 7 have AVM, 5 have cavernoma and 2 patients have venous angioma. 81.6 % of the aneurysms were saccular and 18.4% were fusiform in shape and mostly (89.5%) supratentorial in location and 10.5% infratentorially, which is single in 84.2% and more than one in 15.8% of patients. The most frequent types of arteriovenous malformation (AVM) were parenchymal (71.4%), from which the size 3-6 cm was most frequent (60%), while the Dural AVM identified in 28.6% of patients; from which, the size 3 cm most frequent size (66.6%) and no cases reported with mixed types.Conclusion: CTA can provide rapid, minimally-invasive evaluation of broad spectrum of cerebrovascular disorders and CTA adequate for detecting aneurysms in symptomatic SAH patients especially when conjoined with native CT, also CTA is helpful in intervention planning.Key words: subarachnoid hemorrhage, aneurysm, CT angiography

خلفية البحث: النزف تحت العنكبوتية هو نوع فرعي من السكتة الدماغية النزفية ونسبة التكهن فيه سيئة للغاية وتضم 1-7% من جميع السكتات الدماغية. أنها حالة طبية طارئة ويمكن أن تؤدي إلى الموت او الإعاقة الشديدة ، وحتى عندما تشخص ويتم علاجها في مرحلة مبكرة. المفراس متعدد الطبقات يصبح في كثير من الأحيان الخطوة الأولى في الكشف عن تمدد الأوعية الدموية داخل الجمجمة والتخطيط للتداخلات العلاجية.الأهداف: دراسة نتائج النزف تحت العنكبوتية غير المؤلمة في المفراس الحلزوني متعدد الطبقات وتقييمه ودراسة صفات الأسباب للنزف تحت العنكبوتية للمفراس متعدد الطبقات.المرضى والطرائق: تم إجراء هذه الدراسة المقطعية على 62 مريضا مع النزف تحت العنكبوتية غير المؤلمة الذين خضعوا لفحص في المفراس الحلزوني بدون صبغة والمفراس متعدد الطبقات في مستشفى بغداد التعليمي في مدينة الطب ببغداد من الفترة من آب 2012 إلى آب 2013 مع المرضى الذين يشتبه سريريا أن يكونوا مصابين بالنزف تحت العنكبوتية. كانت عينة الدراسة تتكون من 37 من الذكور و25 من الإناث وعمر المرضى يتراوح بين 1-70 سنة. جميع المرضى تم فحصهم بالمفراس الحلزوني للدماغ بدون صبغة تم تحويلهم للفحص بالمفراس متعدد الطبقات.النتائج: تبين من 62 مريضا في دراستنا: 38 من المرضى لديهم تمدد الأوعية و 10 لديهم نتائج سلبية ، و7 لديهم تشوه شرياني وريدي ، و5 ليدهم ورم كهفي ، واثنان لديهم ورم وعائي وريدي، ولوحظ أن 80.6 % من المرضى المصابين بتمدد الأوعية الدموية لديهم شكل التمدد كيسي و 18% لديهم شكل التمدد مغزلي. ويقع معظم التمدد أعلى الخيمة بنسبة 89.5 % مقابل 10,5% في أسفل الخيمة و 84,2% كان أحادي بالمقابل 6% كان متعدد وكان النوع أكثر شيوعا من أنواع التشوه الشرياني الوريدي هو ( متني) 71,4 % وكان حجمها 3-6 سم هو الحجم الأكثر شيوعا 60% في حين الجافية شكلت 28,6% وكان الحجم هو 3 سم بنسبة 66,3% ولا توجد حالات اكتشفت من النوع المختلط. الاستنتاجات: المفراس الحلزوني متعدد الطبقات يمكن أن يقدم تقييم سريع لكثير من الاضطرابات الدماغية ويساعد في اكتشاف التمدد الحاصل في الأوعية الدموية للمريض الذي يعاني من النزف تحت العنكبوتية ويساعد في صنع القرار في طرق المعالجة. مفتاح الكلمات: النزف تخت العنكبوتية ، تمدد الأوعية الدموية، التصوير الطبقي الوعائي.


Article
5.VALUE OF MULTI-DETECTOR CT ANGIOGRAPHY IN CHRONIC ISCHEMIA OF LOWER LIMBS IN COMPARISON WITH THE DOPPLER ULTRASOUND

Authors: Mohammed A. Kadhim محمد عبد كاظم --- Yaser A. Eisa ياسر عامر عيسى --- Sawsan J. Mohammed سوسن جاسم محمد
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2018 Volume: 16 Issue: 2 Pages: 144-151
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: Peripheral arterial disease (PAD) is one of the most common cardiovascular diseases in developed countries and is an emerging problem in developing countries. Duplex ultrasonography (DUS) has been used as the initial imaging modality in mild symptomatic PAD. Multi-slice helical CT angiography of arteries of the thigh represents a reliable means for the detection of relevant stenoses in patients with peripheral occlusive artery disease.Objective: To assess value of multi-detector computed tomography angiography (MDCTA) and to compare it with DUS to diagnose chronic ischemia of lower limbs.Methods: A prospective comparative study was conducted on 30 patients with chronic lower limbs ischemia of both limbs during the period from September 2015 to September 2016 at the Department of Diagnostic Radiology of Al-Imamein Al-Kadhimein Medical City, Baghdad, Iraq. DUS was done for all the patients and then MDCTA was done.Results: Thirty patients (20 males and 10 females) with a mean age of 57.1 ± 8.5 (range: 33 –80) years were included in this study. MDCTA detects 69 lesions (41 occluded segments and 28 stenotic segments) and DUS detects 58 lesions (35 occluded segments and 43 stenotic segments). In MDCTA, 8 patients (26.7%) had lesion in only one arterial segment, 13 patients (43.3%) had two segment lesions, 3 patients (10%) had three segment lesions, 4 patients (13.3%) with four lesions and only two patients (6.7%) had lesions in five arterial segments. Regarding the findings of the DUS one segment lesion was detected in 13 patients (43.3%), two segment lesions in 11 (36.7%), three segment lesions in 2 (6.7%), four segment lesions in 3 (10.0%) and only five segment lesions in only one patient (3.3). Furthermore, the measure of agreement between both MDCTA and DUS in the number of lesions detected revealed a good agreement between both tests, (Kappa = 0.81) with a percent agreement of (86.6%).Conclusion: Multi-detector CT angiography is a fast, accurate, safe and a minimally-invasive imaging modality which may be used in cases of PAD for diagnosis, grading and for preoperative assessment of lower limb arterial disease.Keywords: Multi-detector CT Angiography, chronic ischemia of lower limbs, doppler ultrasoundCitation: Kadhim MA, Eisa YA, Mohammed SJ. Value of multi-detector CT angiography in chronic ischemia of lower limbs in comparison with the doppler ultrasound. Iraqi JMS. 2018; 16(2): 144-151. doi: 10.22578/IJMS.16.2.5

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