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Article
The Utility of Apparent Diffusion Coefficient in Diagnosis of Acute Cholecystitis

Author: Musafir Atea Hashim
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2018 Volume: 15 Issue: 3 Pages: 214-217
Publisher: Babylon University جامعة بابل

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Abstract

investigations are usually not sufficient for accurate diagnosis. Moreover, imaging findings can overlap with that of many other gallbladderpathology especially chronic cholecystitis (CC). Therefore, there is a reasonable necessity for new diagnostic tools for AC. Objective: Thisstudy aimed to evaluate the efficiency of the apparent diffusion coefficient (ADC) as a diagnostic tool for AC and differentiating it from CC.Materials and Methods: During the period from April 2017 to March 2018, a total of 62 patients with suspected cholecystitis were enrolledin this prospective cross‑sectional study. Patients were subjected to diffusion‑weighted imaging, from which the ADC values were calculated.All patients were then undergone laparoscopic or open cholecystectomy, and the diagnosis of AC or CC was proven through histopathologicalexamination. Receiver operating characteristic analysis was used to find out the area under the curve (AUC), sensitivity, and specificity of ADCin the diagnosis of AC. Results: The average value of ADC from three regions of interests from patients with AC was 1.434 ± 0.31 × 10−3 mm2/s.On the other hand, the average ADC from CC was 2.032 ± 0.31 × 10‑3 mm2/s with significant difference (P = 0.013). The AUC was 0.803,95% confidence interval = 0.702–0.905, P < 0.001, with a sensitivity and a specificity of the test at 1.94 × 10−3 mm2/s cutoff value were0.70 and 0.73, respectively. Conclusions: These results indicate a good diagnostic value of ADC in discrimination between acute and CC.Further studies using contrast media are required for more accurate evaluation of ADC as a diagnostic tool for AC.


Article
The Validity of Diffusion–Weight MRI in Differentiation Cystic Brain Tumors From Brain Abscess

Author: Kassim AH. Taj-Aldean
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2017 Volume: 14 Issue: 1 Pages: 48-56
Publisher: Babylon University جامعة بابل

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Abstract

To determine the ability of diffusion–weight MRI images and ADC (apparent diffusion coefficient) to differentiation brain tumors from brain abscess which are difficult to distinguish on conventional MRI technique. From May 2015 to march 2017, prospectively studied 50 patients (age range 20 to 85years, mean age 55 years) with diagnosis clinically brain tumor or abscess. A conventional MRI was done on Philips MRI a 1.5T using T2, T1 and fat-suppressed technique and echo-planar spin-echo sequence diffusion weight and ADC is carried for all patients. All MR imaging features were categorized brain lesion as brain tumor or abscess , according to the features of imaging which were compared the result with histopathological findings. Fifty patients, 29 male and 21 female the diagnosis was confirmed with pathological findings which included Primary malignant cystic brain tumors 10(20%) Primary benign cystic brain tumor 13 (26%), Metastatic tumor16 (32%) and abscess11 (22%).the sensitivity for diagnosis abscess in DWI are 100%, for diagnosis primary malignant cystic tumor 60%, Primary benign cystic brain tumor 100% and the sensitivity of DWI foe diagnosis metastasis tumor 81%. Diffusion –weight MRI and ADC is good modality for differentiation cystic necrotic tumor from brain abscess.


Article
The Role of Diffusion-Weighted MRI and Apparent Diffusion Coefficient in the Evaluation of Early Renal Allograft Dysfunction

Author: Raad H. Abed Tawfeq*, Abdul Ameer A. Al-Mosawi**, Mustafa Rasool Hussein***, Luma Khudayer Mohammad****
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 1 Pages: 35-40
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: The most common complication of allografted kidney is renal allograft dysfunction which in some cases results in graft loss, the Diffusion Weighted-Magnetic Resonant Imaging (DW-MRI) and Apparent Diffusion Coefficient (ADC) value may provide a useful insight into the underlying pathology of renal allograft dysfunction.OBJECTIVE:To evaluate the utility and diagnostic performance of the DW-MRI and its ADC value in patients with early renal allograft dysfunction.PATIENTS AND METHODS: An analytic prospective study was conducted at MRI unit of Al Shaheed Ghazi Al Hariri Teaching Hospital from February 2015 to the end of November 2015, a total of 57 cases were included in this study, they divided in to two groups; control group: including 30 cases with stable or normal renal allograft function and patients group: including 27 cases with early renal allograft dysfunction. All study cases underwent DW-MRI with b value=1000 sec/mm2. The ADC was reconstructed and mean ADC values were correlated with histopathological biopsy results which is done for all patients group to determine the underlying etiology.RESULTS: The mean ADC values of the patients group (1.7±0.2) *10-3 mm2/s were significantly lower (p=0.001) compared with the mean ADC values in the control group (2.2±0.1) *10-3mm2/s. The cutoff ADC value between the control group and the patients group was (2.06*10-3 mm2/s). According to the morphological appearance in DWI and ADC map we can differentiate acute tubular necrosis (ATN) cases which expressed a heterogeneous appearance/mosaic pattern from acute renal allograft rejection cases and calcinurin inhibiter (CNI) nephrotoxicity cases where both expressed a homogenous morphological pattern.CONCLUSION: DW-MR and its ADC were valuable in the assessment of the underlying etiology of early renal allograft dysfunction and there was a Cutoff ADC value between stable or normal renal allograft function cases and early renal allograft dysfunction. .

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