Azza A. Gad

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Differentiation between Recurrent Glioma and Radiation Injury by Magnetic Resonance Spectroscopy Combined with Diffusion-Weighted Imaging

Suez Canal University Medical Journal (2011)

Wael Nemattalla Laila El Kady Tarek H. Khalil Azza A. Gad Khaled Mohamed

Background: The aim of this study was to investigate the diagnostic efficiency of magnetic resonance (MR) spectroscopy with diffusion-weighted imaging in the evaluation of the recurrent contrast-enhancing regions at the location of treated gliomas.Patients and Methods: In 49 patients who had new contrast-enhancing lesions at the vicinity of previously resected and irradiated high-grade gliomas, single-voxel MR spectroscopy and diffusion-weighted imaging were performed.Spectral data for N-acetylaspartate (NAA), creatine (Cr), choline (Cho), lipid (Lip), and lactate (Lac) were analyzed in combination with the apparent diffusion coefficient (ADC) in all patients.Diagnosis of these lesions was allocated by means of follow-up or histopathology.Results: The Cho/NAA and Cho/Cr ratios were significantly higher in recurrent tumor group than in radiation injury group (p < 0.001).The ADC values and ADC ratios (quotient of ADC of contrastenhancing lesion and matching structure in the contralateral hemisphere) were significantly higher in radiation injury regions than in recurrent tumor (p< 0.001).With MR spectroscopy, two variables (Cho/NAA and Cho/Cr ratios) were proved to differentiate recurrent glioma from radiation injury, and 81.5% of total patients were classified into correct groups.Using discriminant analysis for MR spectroscopy with diffusion-weighted imaging, three independent variables (Cho/NAA, Cho/Cr, and ADC ratio) could classify 91% of total patients into their correct groups.There was a significant difference between the diagnostic accuracy of the two discriminant analyses (Chi-square=4.15,p=0.042).Conclusion: MR spectroscopy combined with ADC ratio can enhance the ability to differentiate recurrent glioma from radiation injury.

10.21608/scumj.2011.57475

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Transperineal ultrasound of fetal head progression in prolonged labor: women’s acceptance and ability to predict the mode of delivery

The Egyptian Journal of Radiology and Nuclear Medicine (2020)

Sara Ateya Solaiman Khaled A. Atwa Azza A. Gad Mohammad al-Shatouri

Abstract Background Digital transvaginal examination of fetal head progression is subjective evaluation with many limitations. Using ultrasound (US) in the assessment of labor progression in prolonged labor is the current trend to predict the mode of delivery. The study intends to evaluate the women’s acceptance to the transperineal ultrasound (TPUS) compared with digital transvaginal examination, and its ability to predict the mode of delivery in prolonged labor. We included 28 pregnant ladies in a prolonged active phase of first or second stages of labor and followed them till delivery. TPUS was used to measure the fetal head–perineum distance (FHPD) and the angle of fetal head descent. Results Of the 28 participants, 53.5% of them delivered vaginally and 46.5% by Cesarean section (CS). All pregnant ladies described the TPUS as more convenient and less painful than digital vaginal examination. Cervical dilatation was negatively correlated with FHPD, and positively correlated with angle of fetal head descent. Both FHPD and angle of fetal head descent had a strong significant negative correlation. Using a cutoff value of 115° for the angle of fetal head descent, the positive predictive value (PPV) of vaginal delivery was 87%; using a cutoff value of 4.2 cm for FHPD, the PPV for vaginal delivery was 85%. Conclusion TPUS is more convenient, more accepted, and less painful than digital vaginal examination. Angle of head descent and FHPD are reliable predictors of the mode of delivery in prolonged labor.

Fetal head

Cut-off

10.1186/s43055-020-00215-0

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Citations (8)

Correction: Magnetic resonance imaging correlation with molecular and epigenetic markers in assessment of breast cancer

The Egyptian Journal of Radiology and Nuclear Medicine (2024)

Aya S. El-Rawy Hoda Y. Abdallah Marwa Suliman Mohamed R. Habba Azza A. Gad

10.1186/s43055-024-01376-y

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Brain volumetric and white matter structural connectivity alterations in autistic children: case–control study

The Egyptian Journal of Radiology and Nuclear Medicine (2023)

Laila A. O. Shehata Omneya Ibrahim Tarek H. El-Kammash Azza A. Gad

Abstract Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder that includes a large heterogeneous constellation of disorders with overlapping symptoms and clinical features. The diagnosis is based mainly on clinical symptoms meeting DSM-5 criteria with no radiologic or laboratory diagnostic investigations available yet. The specific neuropathologic aberrations occurring in ASD are still under investigation. This study aimed at providing a preliminary database for better understanding of the neuropathologic aspects of ASD, regarding both macrostructure and microstructure of the brain using magnetic resonance imaging. This case–control study included total of 40 children, 20 cases (diagnosed with ASD) and 20 control (Typically Developing Children, TDC) aged 2–18 years. 3D-T1 and Diffusion Tensor Images (DTI) were acquired. 3D-T1 images were uploaded to Volbrain and brain segmentation was done using Volbrain 2.0 pipeline. DTI data were analyzed using FSL where Tract-Based Spatial Statistics analysis was carried out and mean fractional anisotropy values obtained. Independent samples t test was used to compare means of both groups. Results ASD group displayed statistically significant larger intracranial cavity, brain, white matter, grey matter and cerebrospinal fluid volumes ( p < 0.001 for all except CSF volume p = 0.01) with the white matter occupying higher percentage of intracranial volume in ASD compared to TDC group ( p < 0.001). The cortical thickness showed statistically significant larger volume in entorhinal cortex in ASD group compared to TDC group at both sides ( p < 0.001 at right side, p = 0.003 at left side). Widespread statistically significant ( p < 0.001) higher mean FA value was observed at multiple white matter tracts. Conclusion These findings suggest that the main pathology of ASD is within the white matter. It also supports the hypothesis that autistic brain undergoes period of precocious growth in early years of life. Further studies with age and clinical severity stratification are needed to investigate temporal changes and severity related macrostructure and microstructure changes in autistic brains.

Grey matter

10.1186/s43055-023-00985-3

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Citations (6)

Systematic approach by computed tomography and magnetic resonance imaging in cochlear implantation candidates in Suez Canal University Hospital

The Egyptian Journal of Radiology and Nuclear Medicine (2017)

Aya S. Al-Rawy Mohammad al-Shatouri Mohammed El Tabbakh Azza A. Gad

To create a systematic approach using computed tomography (CT) and magnetic resonance imaging (MRI) findings to facilitate identifying the etiology of hearing loss, evaluating the anatomy for surgery, and predicting complications. Twenty nine pediatric patients with congenital or acquired sensory-neural hearing loss (SNHL) requiring cochlear implant (CI) were included. They underwent combined CT, 3D DRIVE MRI axial plane and axial T2WIs for the whole brain. The inner ear, cochlear nerve development, temporal bone anatomy, operative window, normal variants and causes of central hearing loss were assessed. CT showed that 100% of the patients are suitable for CI while MRI showed that 96.5% of studied patients are suitable. The examined ears were categorized into 4 groups according the candidacy for operation; 86.2% were suitable for CI, 5.1% were suitable for CI but with expected poor response, 1.7% of examined ears were suitable for CI with modification of surgical procedure and 6.8% were not suitable for CI. In Suez Canal area, the combined CT/MRI approach categorized the majority of patients with SNHL (96.6%) as good candidates for CI.

Cochlear Implantation

Cochlear nerve

10.1016/j.ejrnm.2017.08.005

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Citations (5)

Molecular and Epigenetic Markers Correlation with Ultrasound Features of Breast Cancer

Suez Canal University Medical Journal (2023)

Aya S. El-Rawy Hoda Y. Abdallah Mohamed Soliman Mohammed R. Habba Azza A. Gad

10.21608/scumj.2023.309145

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Comparison between the diagnostic utility of three-dimensional fluid attenuated inversion recovery (3D FLAIR) and three dimensional double inversion recovery (3D DIR) magnetic resonance sequences in the assessment of overall load of multiple sclerosis lesions in the brain

The Egyptian Journal of Radiology and Nuclear Medicine (2024)

Nehal S. Saad Azza A. Gad Mahmoud M. Elzoghby Heba R. Ibrahim

Abstract Background Multiple sclerosis (MS) is a complex CNS demyelinating disease. Assessment of MS plaques in specific anatomic locations in the brain was challenging to detect by conventional MRI sequences. So, this study aimed to compare the diagnostic accuracy of 3D FLAIR (Fluid attenuation inversion recovery), or 3D DIR (Double inversion recovery) sequences to conventional 2D FLAIR and T2 sequences in detecting MS plaques in different anatomic sites, as well as counting the total lesion burden. Methods A comparative cross-sectional study enrolled 30 MS patients on the basis of McDonald’s criteria 2017. All participants underwent a brain MRI study including 3D FLAIR or 3D DIR sequences, conventional 2D FLAIR, and T2 sequences. Results No statistically significant difference between the 3D DIR and 3D FLAIR in total lesion (plaque) burden results; however, when each is compared to the conventional ones, both are superior. 3D FLAIR detected the most significant number of plaques in the periventricular region, followed by 2D FLAIR and T2W sequences, with 3D DIR being the least accurate in this region. Meanwhile, 3D DIR was the most precise and can detect a statistically significant number of cortical plaques compared to the 3D FLAIR and the conventional sequences. No statistically significant results on which sequence is best in regard to infratentorial plaque detection. Conclusion 3D FLAIR and 3D DIR were superior to 2D FLAIR and T2 sequences in detecting overall lesion burden in MS. Moreover, the 3D DIR sequence was the most precise in the detection of the cortical plaques.

Fluid-attenuated inversion recovery

10.1186/s43055-024-01327-7

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Adult Sex Identification Using Three-Dimensional Computed Tomography (3D-CT) of the Pelvis: A Study Among a Sample of the Egyptian Population

Arab Journal of Forensic Sciences and Forensic Medicine (2016)

Enas M. A. Mostafa Said K. M. Dessouki Rania Hashish Azza A. Gad Amany A. M. Khafagy

Sex identification of unknown human skeletal remains is of great importance in establishing identity and individuality. In adults, the hip bone is the most reliable sex indicator because of its sexual dimorphism. Each population should have its own specific standards of identification. The objective of this study is to develop a logistic regression formula for adult sex identification using threedimensional computed tomography (3D-CT) of the pelvis and to perform an assessment of its validity in sex determination among a sample of the Egyptian population in the Suez Canal region. 141 pelvic-abdominal CT images (free of any pelvic orthopaedic disorder) were included; they were reconstructed to produce 3D-CT pelvic images which were divided into a calibration group (47 male and 47 female) and a test group (47 CT images the sex of which was unknown to the observers). Twenty radiometric variables were measured for the calibration group. A logit response formula for sex prediction was developed and applied on the test group for sex prediction. The logit response formula for the test sample showed sensitivity, specificity, and an overall accuracy of 100%. The proposed method represents a quick and reliable metric method in establishing sex from a CT image of the pelvis bone.

Sample (material)

Identification

10.12816/0026460

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Citations (9)

Brain Volumetric and Cortical Thickness Changes in Autistic Children Using Magnetic Resonance Imaging: A Case-Control Study

Suez Canal University Medical Journal (2023)

Laila A. O. Shehata Omneya Ibrahim Tarek H. El-Kammash Azza A. Gad

10.21608/scumj.2023.304386

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Abbreviated MRI Protocols: Efficacy in Improving Acquisition and Interpretation Time in Breast Cancer

The Egyptian Journal of Hospital Medicine (2024)

Sara El Garwany Azza A. Gad Sahar Mansour Mohamed Al-Shatouri Taghreed I. Alshafeiy

Background: To be cost-effective, the abbreviated magnetic resonance imaging (MRI) protocols have to be proved to reduce examination and reading times, while being clinically effective.Objective: To investigate the efficacy of these protocols in enhancing the efficiency of exams and reducing interpretation time.The study reviews the rationale behind abbreviated protocols and why they are an essential evolving tool in breast screening programs.Patients and methods: This was a prospective randomized study.60 female patients were examined.They were presented to Kasr Al-Ainy Medical School Breast Unit for screening.Patients were stratified using a risk assessment model.Different risk categories were included.Results: Abbreviated MRI is proved to be a cost-effective method of screening for breast cancer.It has found to be faster to be performed compared with traditional mammogram, as given all the preparation required and proper position needed in mammograms, MRI would be a better modality.Average time for completing abbreviated MRI (AB-MRI) was 5.1 minutes, while mammograms took 10 min.Reading AB-MR took an average of 4.7 minutes, while traditional mammograms 5.7minutes.Regarding efficacy, when compared to traditional screening methods, AB-MR showed the following: 100% negative predictive value (NPV), 85.7% specificity, 50% positive predictive value (PPV), and 100% sensitivity in breast cancer.Conclusion: Abbreviated MRI was found to be an efficient method to identify breast cancer, with shorter imaging and reading times.

10.21608/ejhm.2024.342169

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