Background: low birth weight (LBW) is one of the major determinants of perinatal survival, infant morbidity, and mortality as well as the risk of developmental disabilities and illnesses in future.WHO estimates that 25 million LBW babies are born annually worldwide and 95% occur in developing countries.In Egypt, as in many other developing countries, most infant and childhood mortality has been also due to diarrhea, acute respiratory infections, other infectious diseases such as meningitis, neonatal infections and vaccine preventable diseases.These conditions are more critical among LBW children since they are more at risk of premature birth, fetal defects, neonatal complications, deficient immune system and greater exposure to infections.Global nutrition targets set at the World Health Assembly in 2012 include an ambitious 30% reduction in LBW prevalence between 2012 and 2025.Aim of the study: To estimate percentage and risk factors of LBW among population in Mallawy city, Minia, Egypt.Research methodology: This study is prospective cohort study among pregnant females in 3 rd trimester, included 346 participants, recruited from two health centers in Mallawy city.Face to face interview questionnaire was used in data collection.Results: LBW cases consisted 32.4% of all participants.By logistic regression analysis twin pregnancy, hypertension and preterm labor (PTB) were associated with the highest probability to LBW, with AOR= 3.88, 3.43 and 3.30 respectively.Conclusion: working status, passive smoking, short interpregnancy intervals, twin pregnancy, PTB, hypertension, and vaginal bleeding during pregnancy found to be risk factors for LBW.Recommendations: Increase the community awareness of risk factors of the problem.More research on larger populations is necessary for risk assessment and long term consequences of LBW.
To evaluate the effectiveness of transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treatment of malignant hepatic focal lesions versus use of either TACE or RFA alone. The study included 57 patients; 53 with hepatocellular carcinoma (HCC), 3 with hepatic metastases, and one case with cholangiocarcinoma. They were divided into three groups according to the technique of treatment: the first group (25 patients) was treated by RF alone, the second group (17 patients) was treated by TACE alone and the third group (15 patients) was treated by combined RFA and TACE. In cases treated with RF only there was good response in 20% of hypervascular tumors and 28% of hypovascular tumors. In cases treated with TACE there was 47.06% good response in hypervascular tumors and 11.76% in hypovascular tumors. While in combined use of TACE and RF there was 60% good response in hypervascular tumors, and 26.66% in hypovascular tumors. Combined interventional therapies are superior to any single therapy in treatment of either hypervascular or hypovascular hepatic malignant tumors.
Abstract Background Ovarian tumors are one of the prevalent gynecological tumors. They are the fifth commonest tumor in women. The therapeutic strategy depends on whether the tumor is benign, borderline or malignant. They always cause nonspecific symptoms at early stages and diagnosed at advanced stages. We tried to test and compare the sensitivity and accuracy of diffusion-weighted imaging (DWI) and MR perfusion in the diagnosis of ovarian tumors among fifty patients with ovarian masses who collected after meeting the inclusion criteria depending on grayscale sonographic findings after the approval of the ethical committee of our institution. The sensitivity and accuracy of the techniques were compared. Results The surgical and pathological reports of our patients proved a non-tumorous lesion in three patients. They also proved benign ovarian tumors in 18/47 (38.3%) patients, borderline tumors in 4/47 (8.5%) patients and malignant ovarian tumors in 25/47 (53.2%) patients. According to conventional MRI, ovarian tumors could be diagnosed with sensitivity 92%, specificity 61.11%, PPV 76.7%, NPV 84.6% and accuracy 79.1%. DWI and MR perfusion showed the same results where they showed sensitivity 98%, specificity 83%, PPV 90%, NPV 98% and accuracy 93% with ADC cut-off value 1 × 10− 3 mm 2 /s. Conclusion Diffusion-weighted imaging and MR perfusion are useful in the diagnosis of ovarian tumors with approximately the same sensitivity and positive impact on operative management.
Objective: To test and compare the sensitivity and accuracy of diffusion weighted imaging (DWI) and MR perfusion in women having ovarian tumors. Patients and Method: Fifty women with ovarian masses were collected after meeting the inclusion criteria depending on gray scale sonographic findings which suggested the presence of ovarian masses. Conventional MRI, Diffusion weighted imaging (DWI) and MR perfusion (MRP) were done for all patient cohort after the approval of ethical committee of our institution. The sensitivity and accuracy of the techniques were compared. Results : The surgical and pathological reports of our patients proved non tumorous lesion in three patients. They proved benign ovarian tumors in 18/47 (38.3%) patients, borderline tumors in 4/47 (8.5%) patients and malignant ovarian tumors in 25/47 (53.2%) patients. According to conventional MRI ovarian tumors could be diagnosed with sensitivity 92%, specificity 61.11%, PPV 76.7%, NPV 84.6% and accuracy 79.1%. DWI and MR perfusion showed the same results where they showed sensitivity 98%, specificity 83%, PPV 90%, NPV 98% and accuracy 93% with ADC cut off value 1x10-3mm2 /sec. Conclusion : Diffusion weighted imaging and MR perfusion are useful in diagnosis of ovarian tumors with approximately the same sensitivity and positive impact on the operative management.
Abstract Introduction Diffusion weighted magnetic resonance imaging (DW MRI) is an imaging technique showing molecular diffusion. Cell size, density and integrity influence the signal intensity seen on diffusion-weighted images. This technique is a helpful complementary tool to distinguish tumoral from non tumoral tissue. The aim of this prospective study is to define the diagnostic accuracy of DWI to differentiate benign from malignant cervical lymph nodes. Patients and methods Twenty six patients who presented with 32 nodes were included in this study, 9 males (35.6%) and 17 females (65.4%). Their age ranged from: 6 to 76 years, mean age 45 ± 18.8 years referred to the radiology department of NCI, complaining of neck swelling, ultrasound showed cervical nodes. Results According to histopathological analysis we divided the examined lymph nodes (n = 32) into 2 categories: malignant lymph nodes 75% (n = 24) benign lymph nodes 25% (n = 8). DWI and ADC (apparent diffusion coefficient) values revealed 27 malignant lesions (84%), 5 benign (16%). The accuracy of the DWMRI was 89%. A significant difference between benign and malignant cervical nodes on DWI and on ADC maps is reported. The results obtained were 24 true positive, 3 false positive, 5 true negative. No false negative cases were identified, yielding a sensitivity of 100%, specificity of 62.5%, NPV = 100% and PPV = 89%. The difference between the mean ADC values between benign and malignant lesions was statistically significant (P Conclusion MR diffusion imaging could be an important supportive tool in differentiation between benign and malignant lymph nodes, can to a lesser extent differentiate between the types of malignant lymphadenopathy and can be used as an indicator for improvement and recurrence post chemo and radiotherapy.
Poster: ECR 2014 / C-1327 / Accuracy of diffusion weighted MRI in diagnosing cervical lymphadenopathy correlated with pathology results by: A. E. H. ElDeib, O. M. M. N. Nada, A. R. S. Semesim, Y. S. E. H. Habib ; Cairo/EG
Abstract Background Invasive lobular carcinoma is the second most prevalent histological subtype of breast cancer after invasive duct carcinoma, with a reported increased incidence in the last two decades. It often presents with challenging imaging characteristics that lower the sensitivity of mammography in their detection and delineation of their extent. Moreover, an increased risk of having synchronous lesions in the same or opposite breast was reported in cases with invasive lobular carcinoma. This obviates the need for other imaging modalities, specifically contrast-enhanced imaging modalities, to improve early detection as well as allow precise determination of the extent of the disease. Our aim in this study was to compare the diagnostic performance of contrast-enhanced digital mammography and dynamic contrast-enhanced magnetic resonance imaging (MRI) in the local staging of invasive lobular carcinoma regarding the size, extensions, multiplicity and bilaterality. Methods This study included 46 female patients with pathologically proven invasive lobular carcinoma. They underwent full-field digital mammography with a complementary ultrasound examination, contrast-enhanced digital mammography, and dynamic contrast-enhanced MRI. The findings encountered by the three imaging modalities were evaluated independently, and the results were compared with final histopathology. Results In the current study, dynamic contrast-enhanced MRI study was the most sensitive modality in the detection of the index lesion, synchronous ipsilateral and contralateral lesions and achieved a sensitivity of 100% in each analysis as compared to contrast-enhanced digital mammography, which achieved a sensitivity of 97.8%, 85.7% and 80%, respectively. Regarding the assessment of the lesion extent to the surroundings, there was a tendency to overestimation by MRI examination. Conclusions Although dynamic contrast-enhanced MRI is the most sensitive imaging modality for detecting the index lesion, multiplicity and bilaterality, contrast-enhanced digital mammography achieved comparable overall accuracy. Regarding the locoregional staging of invasive lobular carcinoma, there was a tendency for relative overestimation by MRI examination.
Abstract Background The status of axillary nodes is a determining factor of management and prognosis for patients having a recent diagnosis of breast cancer. Axillary nodes are usually evaluated by ultrasonography (US) and biopsy, if indicated. Ultrasound-guided sampling and intraoperative or sentinel nodal sampling are available options, however, are invasive and hold risks of potential complications, calling for reliable, non-invasive axillary imaging. In the current prospective study, we assessed the performance of shear wave (SWE) and strain (SE) ultrasound elastography regarding preoperative axillary assessment. Sixty axillary nodes from 60 patients (age 28–65 years, mean 49.88 ± 7.61 SD) were included, all scoring BIRADS 4–5 on sonomammography. Results For US, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 100%, 66.67%, 84.78%, 100%, and 88.33%, respectively. Cortical thickness and vascularity were the most sensitive. For qualitative SWE, indices were 76.92%, 80.95%, 88.24%, 65.38% and 78.33%, respectively. Calculated cut-off for Emax was 59.3 and for Eratio was 4.56, giving statistical indices of 76.9%, 90.5%, 93.75%, 67.86%, and 81.67% for Emax and 76.9%, 100%, 100%, 70% and 85% respectively for Eratio. Both Emax and Eratio were greater for malignant (Emax 81.77 ± 1.904, Eratio 8.95 ± 5.69) than for benign nodes (Emax 37.59 ± 33.37, Eratio 2.5 ± 1.37) ( P values < 0.001). For qualitative SE, sensitivity and specificity were 92.31% and 57.14%, while PPV, NPV, and accuracy were 80% each ( P values < 0.001). The calculated cut-off value for SR was 3.85, giving indices of 87.2%, 76.2%, 76.19%, 87.18% and 83.33% respectively. Conclusion Adding elastography evaluation to conventional US positively impacts the specificity and accuracy of the preoperative axillary nodal status assessment in patients having newly diagnosed breast cancer.
Abstract Background As mammography has its known limitations in dense breast, additional imaging is usually needed. We aimed to evaluate the role of automated breast ultrasound in addition to tomosynthesis in detection and diagnosis of breast lesions in dense breasts. Seventy patients with dense breasts subjected to full-field digital mammography (FFDM) including digital breast tomosynthesis (DBT) and automated breast ultrasound (ABUS). Both studies were evaluated by two experienced radiologists to assess breast composition, mass characterization, asymmetry, calcification, axillary lymphadenopathy, extent of disease (EOD), skin thickening, retraction, architectural distortion, and BIRADS classification. All breast masses were interpreted as above described and then correlated with final pathological diagnosis. Results Study included 70 females presenting with different types of breast lesions. Eighty-two masses were detected: 53 benign ( n = 53/82), 29 malignant ( n = 29/82). Histopathology of the masses was reached by core biopsy ( n = 30), FNAC ( n = 14), and excisional biopsy ( n = 11). The rest of the masses ( n = 27/82) were confirmed by their characteristic sonographic appearances; 20 cases of multiple bilateral anechoic simple cysts, 7 typical fibroadenomas showed stationary course on follow-up. As regards the final BIRADS score given for both modalities, tomosynthesis showed accuracy of 93.1% in characterization of malignant masses with accuracy of 94.3% in benign masses, on the other hand automated ultrasound showed 100% accuracy in characterization of malignant masses with 98.1% accuracy in benign masses. Conclusion Adding ABUS to tomosynthesis has proven a valuable imaging tool for characterization of breast lesions in dense breasts both as screening and diagnostic tool. They proved to be more sensitive and specific than digital mammography alone in showing tissue overlap, tumor characterization, lesion margins, extent, and multiplicity of malignant lesions.
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