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Article
Hyperprolactinaemia: when MRI is indicated?

Author: Wasan I. Majeed
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2009 Volume: 8 Issue: 1 Pages: 59-64
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Design This prospective study was carried out at the magnetic resonance imaging (MRI) unit at the department of diagnostic imaging of Al-Kadhmiya Teaching Hospital over a period of 26 months. Objective: To establish a strategy for the use of MRI of the pituitary region in patients with hyperprolactinaemia based on the possibility of finding a pathology in the pituitary region as a cause of hyperprolactinaemia with respect to serum prolactin (PRL) as well as the analysis of serum PRL in relation to the size of adenoma in the pre & post medical treatment evaluation to determine the need for MRI in the follow up in patients with pituitary adenoma. Subjects & Methods We selected 69 women recently found to have clinical & biochemical evidence of hyperprolactinaemia with serum PRL exceeding the double the upper normal level of the control. MRI of the pituitary region & serum PRL were assessed at the initial presentation for all patients & after the institution of bromocriptine (BRC) treatment for 28 patients who were shown to have either micro or macroadenomas at the initial MRI. The diameter of the adenoma served as a predictor for its size & was considered for correlation with serum PRL level at the follow up period of 3 , 6 & 12 months of treatment. Results At the initial MRI, 27 patients had microadenomas (39.1%), 12 patients had macroadenomas (17.4%), 9 patients had empty sella turcica (13.1%), and 21 patients (30.4%) had no obvious abnormality in the pituitary region The analysis of individual serum PRL level to establish a cut-off point of serum PRL above which all cases were positive for a pathology in the pituitary region on MR imaging, revealed a cut-off value = 84.6 ng/ml. A strong correlation has been found between the size of adenoma and serum PRL level at the initial presentation as well as at the follow up assessment that revealed a parallel reduction in adenoma diameter & serum PRL level. Conclusion MRI of the pituitary region is justifiable in women with hyper-prolactinaemia when serum PRL level is approximately two & a half folds of the upper normal level where its likely to reveal an abnormality , but it should not be used routinely for the follow up of patients on treatment as the assessment of serum PRL level will suffice as a predictor of tumor shrinkage unless there is no response to medical treatment or the patient developed new symptoms that suggest increase in the size of the adenoma or involvement of the surrounding structures.


Article
Correlation between Clinical Features & MRI Findings in Patients with Internal Derangement of Temporomandibular Joint

Authors: Dr. Shahrazaad Sami Saeed B.D.S., M.Sc. ** د. شهرزاد سامي --- Dr. Lamia Al – Nakib B.D.S.,M.Sc. * د. لمياء النقيب
Journal: MUSTANSIRIA DENTAL JOURNAL مجلة المستنصرية لطب الاسنان ISSN: 18138500 Year: 2007 Volume: 4 Issue: 2 Pages: 131-135
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Temporomandibular joint disorder (TMD) is a collective term embracing a number of clinically distinct problem including myalagia, internal derangement, arthritic problem & disorders of mobility & growth.Aim of study: The aim of this study is to make correlation analysis between clinical signs of temporomandibular internal derangement and magnetic imaging for diagnosis of disk displacement with or without reduction and disk configuration.Material and method: Eighteen patients were examined according to Helkimo index which include impaired TMJ function, impaired range of movement, TMJ tenderness muscle tenderness &pain during mandibular movement.Results: The results showed significant correlation between Helkimo index and MRI findings, in that as the severity of index increased, there was an increase in progression of disk displacement, and when the index was mild 88.9% of the joints were with normal disk position, the posterior band of disk was on 12 o’clock position on top of condyle and about 11.1% had disk displacement with reduction, the disk return to normal position relative to condyle in open mouth position and no patient had disk displacement without reduction.Conclusion: There is significant correlation between clinical signs and MRI findings.

Keywords

Key words: MRI --- TMJ.


Article
Hyperprolactinaemia: when MRI is indicated?

Authors: Wasan I. Majeed --- Mohammed Abd Kadhim
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2008 Volume: 7 Issue: 2 Pages: 59-64
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Design: This prospective study was carried out at the magnetic resonance imaging (MRI) unit at the department of diagnostic imaging of Al-Kadhmiya Teaching Hospital over a period of 26 months. Objective: To establish a strategy for the use of MRI of the pituitary region in patients with hyperprolactinaemia based on the possibility of finding a pathology in the pituitary region as a cause of hyperprolactinaemia with respect to serum prolactin (PRL) as well as the analysis of serum PRL in relation to the size of adenoma in the pre & post medical treatment evaluation to determine the need for MRI in the follow up in patients with pituitary adenoma. Subjects & Methods: We selected 69 women recently found to have clinical & biochemical evidence of hyperprolactinaemia with serum PRL exceeding the double the upper normal level of the control. MRI of the pituitary region & serum PRL were assessed at the initial presentation for all patients & after the institution of bromocriptine (BRC) treatment for 28 patients who were shown to have either micro or macroadenomas at the initial MRI. The diameter of the adenoma served as a predictor for its size & was considered for correlation with serum PRL level at the follow up period of 3 , 6 & 12 months of treatment. Results: At the initial MRI, 27 patients had microadenomas (39.1%), 12 patients had macroadenomas (17.4%), 9 patients had empty sella turcica (13.1%), and 21 patients (30.4%) had no obvious abnormality in the pituitary region The analysis of individual serum PRL level to establish a cut-off point of serum PRL above which all cases were positive for a pathology in the pituitary region on MR imaging, revealed a cut-off value = 84.6 ng/ml. A strong correlation has been found between the size of adenoma and serum PRL level at the initial presentation as well as at the follow up assessment that revealed a parallel reduction in adenoma diameter & serum PRL level. Conclusion: MRI of the pituitary region is justifiable in women with hyper-prolactinaemia when serum PRL level is approximately two & a half folds of the upper normal level where its likely to reveal an abnormality , but it should not be used routinely for the follow up of patients on treatment as the assessment of serum PRL level will suffice as a predictor of tumor shrinkage unless there is no response to medical treatment or the patient developed new symptoms that suggest increase in the size of the adenoma or involvement of the surrounding structures.


Article
8.THE VALUE OF MAGNETIC RESONANCE IMAGING IN THE EVALUATION OF PERI-ANAL FISTULA

Authors: Ammar M. Jawad --- Mohammed A. kadhim محمد عبد كاظم --- Zainab K. Al-Jobouri --- Mohssin A.A. Hussain
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2018 Volume: 16 Issue: 2 Pages: 166-176
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: Perianal fistula accounts for 0.01% of general population and is frequently managed inadequately resulting in a significant morbidity. Magnetic resonance imaging (MRI) plays an essential role in the preoperative assessment of the disease, therefore improving post-operative surgical outcome.Objective: To study the role of MRI in the evaluation of perianal fistula and to show the value of using contrast enhanced MR study in the determination of the precise tract pathway, extensions and other associated pathologies.Methods: A cross sectional analytic study was conducted on a total of 32 patients with perianal fistulas in the MRI Department of Al-Imamein Al-Kadhimein Medical City, Baghdad, Iraq during the period from November 2015 to December 2016. Patients underwent MRI examination using axial and coronal T2 weighted images with and without fat suppression and T1 fat suppressed sequences before and after contrast administration. The type of fistula, location of the internal opening, associated abscesses and/or sinus tracts and horseshoe extension were evaluated using different MR sequences. Results: The most common type of fistula encountered was the inter-sphincteric type, which was seen in 21 patients (66%), of those patients 16 fistulas (50%) were grade I and 5 fistulas (16%) were grade II. Trans-sphincteric fistulas were seen in 9 patients (28%), 2 of them (6%) were grade III and 7 fistulas (22%) were grade IV. Two patients (6%) had extra-sphincteric type. T2 weighted TSE, T2 TSE with fat suppression and T1 weighted fat suppressed post contrast sequences all show significant correlation with surgical results (with p-value less than 0.05) and the highest significance was obtained by the post contrast sequence (p-value of 0.00001). The highest accuracy in the diagnosis of fistula in ano was with the use of T1 enhanced fat suppressed sequence (98.8%) followed by 87% for the T2 fat suppression sequence and only 57% for the T2 weighted TSE sequence.Conclusion: MRI is an essential, noninvasive tool in the preoperative assessment of perianal fistulous tracks, with the axial and coronal post contrast fat suppression T1 providing the highest accuracy and clinical significance with surgical data and therefore giving a highly promising decrement in the incidence of post-operative complications.Keywords: MRI, perianal fistulaCitation: Jawad AM, kadhim MA, Al-Jobouri ZK, Hussain MAA. The value of magnetic resonance imaging in the evaluation of peri-anal fistula. Iraqi JMS. 2018; 16(2): 166-176. doi: 10.22578/IJMS.16.2.8

Keywords

MRI --- perianal fistula


Article
Analytical Study of Medical Image Combination Techniques

Authors: Heba Kh. Abbas --- Anwar H. Mahdy --- Ali A. Al Zuky --- Sally F. Ahmad
Journal: Iraqi Journal of Science المجلة العراقية للعلوم ISSN: 00672904/23121637 Year: 2018 Volume: 59 Issue: 3B Pages: 1538-1547
Publisher: Baghdad University جامعة بغداد

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Abstract

Image combination is a technique that fuses two or more medical images taken with different conditions or imaging devices into a single image contain complete information. In this study relied on mathematical, statistical and spatial techniques, to fuse MRI images that captured horizontal and vertical times (T1, T2), and applied a method of supervised classification based on the minimum distance before and after combination process, then examine the quality of the resulting image based on the statistical standards resulting from the analysis of edge analysis, showing the results to identify the best techniques adopted in combination process, determine the exact details in each class and between classes.

Keywords

combination --- MRI --- contrast


Article
MRI ASSESSMENT OF CLINICALLY SUSPECTED MENISCAL TEARS
تقييم التمزق الغضروفي بواسطه الرنين المغناطيسي

Authors: SALEEM KHADIR MUSALAH سليم خدر مصلح --- HASIBA MUAHMED SHUKRI حسيبة محمد شكري
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2017 Volume: 11 Issue: 1 Pages: 32-37
Publisher: University of Dohuk جامعة دهوك

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Abstract

Background: Magnetic resonance imaging (MRI) is the tool commonly used in the diagnosis of meniscal tears. It has been suggested that, for clinically suspected meniscal tears, the adoption of routine MRI before therapeutic arthroscopy will reduce the number and cost of unnecessary invasive procedures.The aim of this study was to document MRI yield in knee injuries clinically suspected as possible meniscal tears in Duhok city Subject and Methods: This cross sectional study was conducted during the period from June to December 2014. A consecutive sampling procedure was used to enroll eighty cases of Knee injuries presenting with clinical features of meniscal tears. All patients underwent MRI examination by 1.5 Tesla machine.Results: The mean age of the patients was 33.5 years. The number of males was 58 (72.5%) with mean age 29.55 years while females constituted 22 (27.5%) with mean age 44years.The results revealed that 64 patients (80%) were affected by tear in the medial meniscus compared to 16 patients (20%) in the lateral meniscus .Isolated anterior horn tear was significantly more common in the lateral meniscus(12.5%) than in the medial meniscus (1.25%) while isolated posterior horn tear was more common in the medial meniscus (66.25%) than the lateral meniscus (7.5%)Conclusions: Meniscal tears were more common in males (~ 3/4th of cases) who presented at a younger age. Medial meniscal tears were four times as common as those affecting the lateral meniscus.

الخلفية والأهداف: التصوير بالرنين المغناطيسي (MRI) هو الوسيلة التي عادة ما تستخدم في تشخيص اصابات الغضروف الهلالي لمفصل الركبة. وقد أشارت الدراسات إلى أناعتماد التصوير الروتيني بالرنين المغناطيسي قبلا لتنظير العلاجي في حالات الاصابات المحتملة سريريا سوف يقلل من عدد وتكلفة الإجراءات المجتاحة لاعضاء الجسم. كان الغرض من هذه الدراسة هو توثيق نتائج التصوير بالرنين المغناطيسي في إصابات الركبة و التي يشتبه فيها سريريا تضرر الغضروف الهلالي لدى عينة من المرضى في مدينة دهوك. طرق البحث: أجريت هذه الدراسة المقطعية خلال الفترة من حزيران الى كانون الاول 2014. تم استخدام اسلوب الاعتيان المتعاقب لضم ثمانين حالة من إصابات الركبة ممن لديهم ملامح سريرية لاصابة الغضروف الهلالي. اخضع جميع المرضى لفحص التصوير بالرنين المغناطيسي (1.5 Tesla) . النتائج: اظهرت النتائج بانمتوسط عمرالمرضى 33.5 سنة. وكان عدد الذكور 58 (72.5 %) بمتوسط عمر 29.55 سنة، في حين شكلت الإناث 22 (27.5%) بمتوسط عمر44 سنة. كما كشفت أن 64 مريضا (80%) تضرر لديهم الغضروف الهلالي الأنسي مقارنة مع 16 مريضا (20%) تضرر لديهم الغضروف الهلالي الوحشي. كذلك اظهرت النتائج بان تمزق القرن الأمامي للغضروف كان أكثر شيوعا في الغضروف الوحشي (12.5%) من الغضروف الأنسي (1.25%) بينما كان تمزق القرن الخلفي أكثر شيوعا في الغضروف الأنسي (66.2%) من الغضروف الجانبي (7.5%).الاستنتاجات: كانت اصابات الغضروف الهلالي أكثر شيوعا في الذكور (~ 3/4 من الحالات) وحدثت في اعمار اصغر مما هي لدى الاناث كما ان اصابات الغضروف الهلالي الانسي اكثر شيوعا باربعة اضعاف من نضيراتها في الغضروف الهلالي الجانبي.


Article
The Effects of Magnetic Resonance Imaging (MRI) On Tensile Strength and Indentation Hardness of Acrylic Resin Denture Base Materials

Authors: Ahmed I. Al-Khyeet --- Ammar Kh. Al-Noori --- Amer A. Taqa
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2015 Volume: 15 Issue: 27 Pages: 399-404
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: This study aims to evaluate the effect of (MRI) on physical, and mechanical properties of acrylic resin denture base materials. Materials and Methods: one hundred and ten samples were the total no. of samples, samples were divided into two groups each group contain two fifty five, the 1st sample group pink and 2nd groups clear heat cured acrylic resin, then the two groups is divided into four sub-groups, follow that the samples were exposed to magnetic resonance image at three different peri-ods of time (5, 15, 30) minutes within control group respectively and samples tested for indentation hardness, tensile strength. Results: the results obtained to show that there was a change in the physical properties “heat cured” acrylic resin weather it is “Pink” or “Clear” after exposure to (MRI) and this change happened at different levels and variable degree, also it has shown that there was a slight tendency to change order of a arrangement of atoms within each molecules with no well and clear evidence of altering of the main material itself, at least at circumstances of experiment. Conclusion: Exposure to (MRI) at different periods of time lead to altering of physical properties and at different levels of significant.


Article
MRI finding versus arthroscopic finding regarding ACL injury

Journal: Muthanna Medical Journal مجلة المثنى الطبية ISSN: 2226146x Year: 2015 Volume: 2 Issue: 1 Pages: 10-14
Publisher: Al-Muthanna University جامعة المثنى

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Abstract

Abstract 25 patients, 20 male patients and 5 female patients with knee joint injury, all of them with single knee joint injury. 25 knee joints are examined during this study, all patients are perform MRI in different centers send with report of the MRI from expert radiologist. They perform arthroscopy in Al Sadder medical city from January 2013 – October 2014. The aim of this study is to confirmed or unconfirmed ACL injury after clinical examination and MRI which they perform to them either in our center or other centers. The majority of ACL injuries 70% occur while playing agility sports, and the most often reported sports are football. About 70% of ACL injuries are sustained through noncontact mechanisms, while the remaining 30% result from direct contact. The aim of this study is to assess the diagnostic value and compare the accuracy (sensitivity and specificity) of MRI to arthroscopic finding regarding the ACL injury.

Keywords

MRI --- ACL injury --- Radiologist


Article
Automatic Technique to Produce 3D Image for Brain Tumor Of MRI Images

Authors: S.M. Ali --- Loay Kadom Abood --- Rabab Saadoon Abdoon
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2014 Volume: 22 Issue: 7 Pages: 1896-1907
Publisher: Babylon University جامعة بابل

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Abstract

In this research, three-dimensional images of brain tumors have been constructed from a series of Magnetic Resonance Images (MRIs) for successive T1-weighted slices, using a simple automatic technology. The MRIs are pre-processed through bilateral filtering to reduce noise and retaining the edges between brain tissues. Spatial enhancement technique is adopted to transform image gray levels by highlighting the band density of the region of interest (tumor) and expanding them into full range. Sobel edge detection is used by morphological operations to extract the tumor area of the image of each slice. The contour of the tumor area in each segmented slice is used to create 3D of the tumor. The relative size of the tumor then measured depending on brain tissue after stripping the skull. The result showed that the adopted technique can efficiently detect and extract the brain tumor from the consecutive slices which can be used to produce 3-D image of the tumor and to identify the tumor's location inside the skull.

في هذا البحث، تم بناء صور ثلاثية الأبعاد لأورام المخ من سلسلة من صور الرنين المغناطيسي لشرائح T1 متعاقبة، وذلك باستخدام تكنولوجيا أوتوماتيكية بسيطة. تم معالجة صور الرنين المغناطيسي بعملية ثنائية للحد من الضوضاء والحفاظ على حواف بين أنسجة الدماغ. اعتمدت التقنية الإطار المكاني لتحويل مستويات الشدة في الصور من خلال تسليط الضوء على الفرق بين مستويات الشدة في منطقة الورم. استخدمت تقنية سوبيل للكشف عن الحافات وبعملية مورفولوجية لعزل منطقة الورم من الصورة لكل شريحة. تم استخدام مخطط الكفاف (المخطط الكونتوري) في منطقة الورم في كل شريحة لإنتاج صور ثلاثية الأبعاد للورم. تم قياس حجم الورم النسبي بعد تجريده من الأنسجة المحيطة و الجمجمة. أظهرت النتائج كفاءة التقنية المعتمدة في تحديد وعزل الورم في الدماغ من الشرائح المتتالية وإمكانية استخدامها لإنتاج صور ثلاثية الأبعاد لأورام المح وتحديد موقع الورم داخل الجمجمة.


Article
The Role of Ultrasound and Magnetic Resonance Imaging in the Diagnosis of Obstructive Jaundice

Author: Safa Al-Obaidi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 1 Pages: 7-17
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Evaluation of jaundiced patients should include proper history and examination, laboratory investigation and imaging investigations (non invasive like US, CT and MRI or invasive like ERCP and PTC).AIM OF STUDY:The aim of this prospective study is to evaluate the role of US and MRI-MRCP in patients with obstructive jaundice in clinical practice.METHODS:This is a prospective study performed on 80 patients (42 female and 38 male) with an average age of 53 years presented with obstructive jaundice for whom abdominal ultrasound (US) and magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) performed in the departments of radiology in Al-Kadhemiyyah teaching hospital and Specialized surgical hospital and Baghdad teaching hospital from October 2003 to October 2005. The final diagnosis was found by endoscopic retrograde cholangiopancreatography (ERCP) and or surgery and confirmed by histopathology.RESULTS:The most common cause of obstructive jaundice in our study was tumors (41.25%) followed by common bile duct stones (36.25%) then benign strictures (13.75%), hydatid cyst (6.25%) & finally choledochal cyst (2.5%). In this study, MRI-MRCP could differentiate surgical from medical jaundice in all cases, while US could differentiate surgical from medical jaundice in 91.25% of cases. MRI-MRCP correctly defines the level of obstruction in all cases (100%).While US correctly define the level of obstruction in only 86.2 % of the total cases. MRI-MRCP correctly suggests the most possible cause of obstruction in 96.25% of cases. While US correctly suggests the most possible cause in only 36.2 %.CONCLUSION:So that US, as a screening modality is useful to confirm or exclude biliary dilatation & to choose patients for MRCP examination. MRI-MRCP is a useful non-invasive and essential method in the preoperative evaluation of patients with obstructive jaundice. In addition MRI-MRCP was superior to US or ERCP in studying the extent & staging of malignant lesions

Keywords

Ultrasound --- MRI --- MRCP --- Obstructive jaundice.

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