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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
The role of diffusion–weighted MRI in the evaluation of non-palpable undescended testis

Author: Raad H. Abed Al-Kayat
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2013 Volume: 12 Issue: 2 Pages: 1-6
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Cryptorchidism is the absence of one or both testes in the scrotum and is generally synonymous with undescended testis, in 20% of these cases undescended testis is clinically nonpalpable, we employed diffusion weighted imaging (DWI), as well as conventional magnetic resonance imaging (MRI) to increase sensitivity of diagnosis of the non-palpable testis. Objective: To evaluate role of diffusion weighted MRI in the detection of non-palpable undescended testes. Patients and Methods: twenty boys with unilateral undescended testis underwent preoperative abdominal and pelvic MRI to identify the location of the testis. MRI included free-breathing Diffusion-weighted imaging (DWI) with b values of 300 and 600 s/mm2, T1 and T2-weighted sequence, and T2-weighted fat-suppressed sequence, after surgical operation, two observer groups reviewed the preoperative images, starting with DW images alone, then the conventional MR images alone and after that the conventional-MR and the DW images together. Sensitivity, in the identification of nonpalpable undescended testis was calculated for DWI, conventional MRI, and the combination of DWI and conventional MRI. Results: The combination of DWI and conventional MRI was the most sensitive for detection of non-palpable undescended testis. The two observers detected 12 testes with this technique. Sensitivity 92.3 % for two observers, and. With DWI alone, observer 1 located 11 testes, and observer 2, located 12 testes (sensitivity 84.6% and 92.3%) respectively, by using conventional MRI alone, both observers located 10 testes (sensitivity, 76.9%). The sensitivity for locating testis was superior with the combination of DWI and conventional MRI for both observers. Conclusion: Use of DWI with a high b value gives information that complements conventional MRI findings, improving identification and location of non-palpable undescended testes. We recommend the use of DWI in addition to conventional MRI to increase the preoperative sensitivity of identifying and locating non-palpable testes.


Article
3-Tesla vs. 1.5-Tesla Magnetic Resonance Imaging in the Detection of Ischemic Deep White Matter Lesions

Author: Mohammed abd kadhim*, Mustafa Saleh Mutar Al-Sukainy**, MayadaFathel Hameed***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 3 Pages: 235-241
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Deep white matter ischemia (DWMI) is bilateral patchy or diffuse pattern of ischemia and demyelination in the deep white matter region of the brain. WM lesions (WMLs) increase in frequency with age and are associated with lower cognitive performance. Reported prevalence ranges from 5% to 90%, depending on study design, study population, and rating scales. Although the main pathophysiology is still under investigation, they are attributed to degenerative changes of long penetrating arteries and it has been postulated that chronic vascular diseases of the arteries and arterioles supplying these regions can play a role in the process. Deep white matter ischemia is imaged by using T2 weighted (T2W) sequences in addition to FLAIR sequences. Coronal section is used to enable precise sampling of WMLsOBJECTIVE: To assess 3T MRI vs. 1.5 MRI in evaluating the extent of DWMI.PATIENTS AND METHODS: A cross sectional study was conducted at the MRI unit of the Department of Radiology in Al-Imamain Al-Kadhimain Medical City in Baghdad. Data collection was obtained during the period starting on October 2015– June 2016. The study included 87 patients with the diagnosis of DWMI based on previous MRI data. Patients with initial MRI findings that show no evidence of DWMI as well as patients presented with trauma, migraine, epilepsy, tumor, TB and cerebral venous thrombosis were excluded. Each patient was examined by using 3T MRI, followed by a 1.5 T MRI two days later. The patient images were evaluated for 1.number of lesions, 2.size, 3.volume and 4.intensity of a selected prominent lesion.RESULTS: Of the 87 patients, 51 were male and 36 female. Their mean age was 59.48 ± 10.83 years. In all lobes there is a statistical significance (P < 0.0001) between 3T and 1.5T i.e. 3T platform was able to show a greater number of lesions in comparison with the 1.5T platform. It was seen with high statistic significance (P <0.0001) that one the 3T images, mean intensities, sizes, and volumes were higher across the board. The average additional number of lesions shown by 3T over 1.5T was 9.52 lesions with a standard deviation of 6.50. CONCLUSION: Three tesla MRI is significantly superior than1.5 tesla MRI in the number of detected lesions, determining size of a lesion, detecting lesion volume and intensity ز


Article
Role of ADC Value in Differentiation of Malignant and Benign Hepatic Lesion

Authors: Choman Sabah Omer --- Kawa A. Mahmood --- Rezheen Jamal Rashid
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2019 Volume: 12 Issue: 2 Pages: 2174-2183
Publisher: Kerbala University جامعة كربلاء

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Abstract

Background: Apparent diffusion coefficient ADC value used in this research for differentiation of the malignant and benign hepatic lesions, which has an impact on the management of these lesions by surgery or conservatively. Aim: To analyze the role of diffusion weighted imaging (DWI) with the apparent diffusion coefficient (ADC) values in the differentiation of malignant from benign hepatic lesions.Materials and methods: this is a prospective cross-sectional study 80 patients with 118 focal hepatic lesions contributed. MRI with DWI examination was carried out for all patients. After DWI examination, an ADC map was created and ADC values were measured for 118 focal hepatic lesions.Results: out of 118 hepatic lesions, 62 were benign and 56 were malignant. Benign lesions comprised 30 hemangiomas and 21 simple cysts, 6 focal nodular hyperplasia (FNH), 4 abscesses and 1 adenoma. Malignant lesions comprised 47 metastases, 6 hepatocellular carcinomas (HCC), 2 fibrolamellar hepatocellular carcinomas and 1 case intra hepatic cholangiocarcinoma. The highest ADC values were measured for cysts. The mean ADC value of benign lesions was 2.27 ± 0.7 x 10ˉ³mm²/sec, whereas malignant lesions had a mean ADC value of 0.85 ± 0.18 × 10ˉ³mm²/sec. The mean ADC value of benign lesions was significantly higher than that of malignant lesions (P < 0.001).Conclusion: DWI and quantitative measurement of ADC values shows promising result in characterization of benign and malignant hepatic lesions, with other MRI sequences of dynamic contrast study. Especially, when contrast is contraindicated.

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