Background: Patients with lymphoproliferative diseases frequently develop non-Hodgkin lymphoma or Hodgkin disease outside of the lymph nodes, a condition known as extra-nodal lymphoma.Non-Hodgkin lymphomas and Hodgkin disease are best imaged anatomically using Multi Detector Computed Tomography (MDCT).Aim and Objectives: To evaluate the possible MDCT imaging findings in patients with pelviabdominal extra-nodal lymphoma before and after therapy.Patients and methods: This quasi-experimental study involved 18 cases, whose ages ranged from 18 to 81 years (10 males and 8 females), with extra-nodal lymphoma of the abdominal and pelvic organs.The study was conducted at the Radiology Department, Suez Canal University, and Mansoura Oncology Hospital, with an assessment of therapy response by MDCT scan.Results: The spleen was found to have the highest number of diseases among the pelvic and solid organs, followed by the liver and the uterus.Regarding the GIT affection, in descending order, the stomach, intestine, and esophagus were affected.MDCT scan showed diffuse intestinal wall thickening with luminal dilation of intestinal loops.The majority of cases were found to be non-Hodgkin lymphoma (83.3%), with diffuse large B cell lymphoma being the most prevalent subtype (15 individuals).Hodgkin lymphoma was found in 3 patients (16.6%) with mixed cellularity.Conclusion: MDCT is the most preferred and widely used imaging modality to evaluate lymphomatous involvement in extra-nodal sites.It provides details about the nature and extension of the lesion.Also, it can be used to guide needle biopsy into a suspicious area.
Background: Due to the common problems after pelvic-abdominal procedures, the post-operative abdomen is tough.Hence, every radiologist must be extremely accurate in identifying these problems in order to rapidly identify potentially life-threatening situations and initiate necessary care immediately.Aim: To the early diagnosis and for adequate treatment planning through using the Multi-Detector Computed Tomography (MDCT) in the diagnosis of post-operative pelvi-abdominal surgical complications.Patients and Methods: This was a descriptive cross-sectional study carried out on 50 adult patients who were referred to the surgery clinic of Ismailia Suez Canal University and Ismailia General Hospitals suspected to have post pelvi-abdominal surgical complications.MDCT was done to all patients and the findings were interpreted by two specialty-certified radiologists.Results: Our results showed that the most common pre-surgical diagnosis was malignancy and recurrence in 38 patients (76%).Our study showed that recurrent malignancy was the most frequent findings, and 60% of the patients were managed conservatively.Conclusion: Computed tomography (CT) was used as gold standard tool in the evaluation of all patients included in this study as it is presently the workhorse to assess post-operative problems, with the exception of MRI for probable recurrence of rectal cancer or inflammatory bowel disease.
Background & Objectives: Unanticipated difficult intubation constitutes 1.5 – 8.5% of all intubations. Despite the use of different tools and scores to predict difficult intubation, we are still lacking one with high specificity and sensitivity. The aim of this work was to evaluate a novel method for preoperative assessment of airway using ultrasonography for measuring four distances: - Distance from hard palate to epiglottis - Distance from hard palate to vocal cords - Distance from vocal cords to hyoid bone - Distance from vocal cords to epiglottis, and their correlation with intubation difficulty score (IDS). Materials & Methods: 50 adult patients undergoing general anesthesia with endotracheal intubation who consented to the study during the year 2014 were included. All of them preoperative airway assessment: thyromental distance and Mallampati score, followed by ultrasound examination of the airway in the classic sniffing position. The following distances were measured ultrasonographically: Direct laryngoscopy and endo tracheal intubation was performed 30 seconds after administration of fentanyl, propofol and rocuronium 0.6 mg/kg. Following intubation Mc Cormack and Lehane score as well as intubation difficulty score (IDS) are recorded. Results: Of the 50 patients who were enrolled in our study, there were four observed to be difficult intubation, IDS was > 5, all of them were Lehan class 3, three of the four were unanticipated, and one of them was anticipated by the standard airway examination (Malampati and Thyromental distance). The rest of the sample (46 patients) were easy intubation. FPO Conclusion: Measuring vocal cords to epiglottis distance ROC = 1.00 and hard palate to epiglottis distance ROC = 0.851 are highly correlated to, and carries a high sensitivity and specificity for; prediction of difficulty of intubation. References: 1. Steven L.: Definitions, Incidence, and Predictors of the Difficult Airway. In: Steven L.: Atlas of Airway Management: Techniques and Tools, 1st Edition, Lippincott Williams & Wilkins, USA, 2007; 39 2. Shiga T., Wajima Z., Inoue T., et al: Predicting Difficult Intubation in Apparently Normal Patients. Anesthesiology 2005; 103:429–37 Disclosure of Interest: None declared
Background: Most individuals inflicted with COVID-19 present with pneumonia.Chest computed tomography is such a promising and feasible technique of diagnosis.Aim: Evaluation of the diagnostic precision of chest CT in identification of COVID-19 related pneumonia and assessment of severity in relation with ABO blood grouping system.Patients and methods: This cross-sectional analytical research performed on 60 patients with symptoms suggestive of COVID-19 related pneumonia presented to Radiology Department in Al-Ahrar Teaching Hospital from August 2020 till February 2021.Results: As regard ABO system, it was group A in 24 patients (40%), group B in twenty individuals (33.3%), group AB in 6 individuals (10%) and group O in 10 individuals (16.7%).As regard Rh system, there were 21 Rh positive patients (35%) and 39 Rh negative patients (65%) in all studied patients.The most common symptom was cough in 42 patients (70%).Regarding the diagnostic performance of chest CT for COVID-19, 48 individuals (80%) were true positive, 10 individuals (16.7%) true negative, 1 patient (1.7%) false positive and 1 patient (1.7%) was false negative.Thus, chest CT had the sensitivity of 98%, specificity of 90.9%, PPV of 98%, NPV of 90.9% and precision of 96.7%. Conclusion:In the absence of negative nucleic acid test outcomes, clinical diagnosis of COVID-19 infection may be possible via CT characteristics.Clinical practice currently relies irreplaceably on CT for diagnosis, screening, and monitoring the efficacy of treatments, as it is exceptionally sensitive to COVID-19 lesions.
Balloon-assisted coiling (BAC) is acknowledged as an auxiliary method for the endovascular treatment of difficult wide-necked cerebral aneurysms (WNCAs). An intracranial stent may be necessary as a supportive scaffold when the anatomical conditions are unfavorable, as BAC alone may be inadequate to avoid coil protrusion into the parent artery. We aimed to evaluate the safety of the balloon-assisted rapid intermittent sequential coiling technique (BARISCT) and the effectiveness of BARISCT in reducing the risk of coil prolapse in the primary artery during the coiling of WNCA. From March 2021 to April 2023, a quasi-experimental investigation was conducted on more than 19 patients with WNCA who visited the Neurointervention Unit at Suez Canal University Hospital and fulfilled the inclusion criteria of WNCA, specifically defined by an unfavorable dome-to-neck ratio of less than 2 or a neck length exceeding 4 mm. BARISCT has proven to be a safe and successful tool for occluding ruptured and unruptured WNCA, with a full occlusion rate of roughly 73% with minimum sequelae and no major complications. BARISCT seems to be a method that is both safe and successful for the endovascular treatment of wide-neck intracranial aneurysms (WNCA), with no concern regarding the potential for an increase in the likelihood of complications.
Abstract Background Detection of ‘spontaneous’ portosystemic collateral veins (PSCV) serves as an important tool in diagnosing portal hypertension (PTHN) and predicting prognosis. Multidetector computed tomography (MDCT) imaging is noninvasive and allows accurate assessment of variceal site and size. So, this study was conducted to assess the role of MDCT in predicting, detecting and grading gastroesophageal varices in correlation with endoscopy in cirrhotic patients in relation to other portosystemic collaterals. Methods Analytical cross-sectional prospective study was conducted on 100 cirrhotic patients. All patients were subjected to history taking, upper gastrointestinal endoscopic assessment, and triphasic CT or contrast-enhanced CT assessment of abdomen and pelvis. Results Patients who had esophageal varices in MDCT show a statistically significant difference ( p = 0.016) with its endoscopic grading. There was good agreement between endoscopy and MDCT in diagnosing grade of esophageal varices as k = 0.882. The presence of ascites, splenic size, and esophageal vein diameter serve as clinically significant predictors of esophageal varices. Splenic size showed a significant difference according to endoscopic grades of EV (esophageal varices) as p = 0.031 as patients with no varices had splenic size of (15.9 ± 1.4) cm, patients with grade I had a mean splenic size of (15.2 ± 8.7) cm, patients with grade II had mean splenic size of (16.9 ± 1.8) cm and patients with grade III had mean splenic size of (18 ± 4.2) cm, while other veins diameters showed increase with advanced grades of EV but with statistically insignificant differences as p > 0.05. Conclusions Multidetector CT features of the presence of PSCVs, splenic size, and ascites are accurate predictors of PTHN in either EVs presence or absence. MDCT can be an excellent alternative for patients who are contraindicated for endoscopy. Moreover, it can be potential screening tool for early detection of esophageal varices in very early stage of chronic liver disease and in the early care of patient with varices. MDCT remains the most applicable noninvasive diagnostic tool for patients with portosystemic collaterals.
Abstract Background Worldwide, there are more than 550,000 new instances of head and neck cancer per year, with over 300,000 fatalities. Among the Middle Eastern nations, Egypt had one of the highest overall incidence rates of oral cavity and pharynx cancer (5.5/105). A consistent reporting form for head and neck cancer monitoring provides many crucial functions, including directing patient care with simply explained numerical scores for tumor recurrence suspicion levels. The Neck-Imaging Reporting and Data System (NI-RADS) assigns a numerical grade, from 0 to 4, where 0 represents incomplete, 1 represents no evidence of local recurrence (primary site) or adenopathy (neck), 2 represents low suspicion, 3 represents high suspicion, and 4 represents definite recurrence. Our aim was to improve the management outcome for patients liable to recurrence of head and neck cancers post-treatment with radio or chemotherapy using Neck-imaging Reporting and Data System (NI-RADS) after imaging with Fluro-Deoxy-Glucose-Positron Emission Tomography/Computed Tomography Scan (FDG-PET/CT Scan). Materials and methods The study setting was done at our institution and the type of study was combined prospective and retrospective study for 24 months from June 2020 to June 2022. The study population included 71 scans for 55 patients aged between 18 and 70 years, who had suffered from head and neck cancer and underwent treatment by chemotherapy or radiotherapy to follow up on their cases and determine recurrence or resolution of tumors. Results The results demonstrated the classification of tumor findings according to the degree of malignancy with 16.9% of scans were diagnosed as low pathological grade, 60.6% were diagnosed as intermediate pathological grade and 22.5% were diagnosed as high pathological grade. The initial tumor subsites in our study were as follow: the oral cavity with its different subsites represented the largest group constituting 11 cases (20%) of the total cases, and the larynx and vocal cords came next and constituted 10 cases (18.2%) of the total scans, nasopharynx constituted 9 cases (16.4%) of the cases . According to application of NI-RADS score, cases were classified as 17 cases NI-RADS (1), representing 30.1% of cases, 9 cases NI-RADS (2), representing 16.36% of cases, 18 cases NI-RADS (3), representing 32.7% of cases and 11 cases NI-RADS (4) representing 20% of cases. Percentage of recurrence in NI-RADS (1) was 1/17 representing 5.9%, in NI-RADS (2) was 2/9 representing 22.2%, in NI-RADS (3) was 12/18 representing 66.66%, in NI-RADS (4) was 10/11 representing 90.9% with total recurrence 25/55 cases representing 45.45%. Conclusions Neck-Imaging Reporting and Data System using FDG PET/CT Scan imaging for assessment of recurrence of head and neck tumors was a choice of relatively high sensitivity and specificity for improvement of significant results and guiding the clinician to the proper management strategy for the patients as well as organizing a strategy for follow-up of cases according to their score of NI-RADS.
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