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دور النقص الوريدي المخي النخاعي المزمن في مرض تصلب الاعصاب المتعدد بواسطة السونار الملون (الدوبلر) == The Role of chronic cerebrospinal venous insufficiency in Multiple sclerosis assessed by Doppler Ultrasound

اسم المؤلف: نغم عبد الزهرة الجصاني
اسم المشرف: حيدر كاظم حسون | حسن النفاخ
الموضوع العام: الطب
السنة: 2013
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: النجف
الصفحات الاولى:

تقييم الفحص بالرنين المغناطيسي والامواج فوق الصوتية بالمقارنة مع الفحص النسيجي لورم الرحم الليفي == Evaluation of Uterine Fibroid Using MRI & U/S with Histopathological Correlation

اسم المؤلف: زهراء هاشم محمود
اسم المشرف: ليث احمد طعمة
الموضوع العام: الطب
السنة: 2013
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Uterine fibroids, also known as leiomyomas, are the commonest uterine neoplasm's about 30% - 40% in the reproductive age , Although benign, they can be associated with significant morbidity and are the commonest indication for hysterectomy, they are often discovered incidentally when performing imaging for other reasons, usually first identified by USG which the cheapest, easiest, safe during pregnancy, they can be further characterized by MRI, they are usually easily recognizable, but degenerate fibroids can have unusual appearance, MRI is informative in excluding associated Adenomyosis. AimTo evaluate US &MRI sequences in patients with leiomyoma about detection, number, mapping, characterization &associated other lesions correlated with histopathological result after surgical treatment.Patients & methods A prospective study was done in the Radiological department of BAGHDAD teaching hospital from September 2012 through May 2013, about 65 females patients where imaged by MRI after physical examination & US, where 45 patients did operation myomectomy or hysterectomy.Resultsage of patients 19 - 69 years mean age 39.4y, The women presented with menorrhagia and a variety of symptomes,45 patients where followed up by hysterectomy & myomectomy which inter really in my study ,the remaining (20 patients) non operative treated medically and followed up by US, MRI detect more than US in 60 fibroids which not detected by US being MRI more sensitive 98%, specific93% &accurate 97% than US ,also MRI more specific (93.9%)&more accurate 97%in detecting single &multiple fibroids than us with low specificity (50%)&accuracy (63.9%), also MRI more sensitive in detecting smaller fibroid <1cm 95.2% compared with US sensitivity 15.5%, about mapping US was 89%agree with histopathology results while MRI was more agreement with histopathology 98%, about 7 patients from 45(15.6%) was found to have Adenomyosis with fibroids which all of them diagnosed by MRI, we depend on T2 sequence in detecting fibroids which show about 80%hypointense, MRI cannot differentiate between the type of degeneration which about 2/3 degenerated , 44%show contrast enhancement which is not important in detection and characterization , in most of cases fibroids are iso to hypointense in T1.Conclusion : Superior sensitivity and minimal measurement discrepancies suggest MR imaging superior to US in evaluation for uterine fibroid especially pre surgical study &to exclude other causes of large uterus & should be preferentially utilizedfor assessing fibroids .

مقارنة بين التصوير بالموجات فوق الصوتية والتصوير بالرنين المغناطيسي في وصف كتل ملحقات الرحم == Comparison of magnetic resonance imaging and Transvaginal ultrasound findings in evaluation of adnexal mass

اسم المؤلف: اخلاص حميد علي
اسم المشرف: ليث احمد خلف
الموضوع العام: الطب
السنة: 2013
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: دراسة مقارنة مكونه من 45 حالة مرضية اجريت في مستشفى بغداد التعليمي في مجمع مدينة الطب خلال الفترة من اغسطس 2012 والى اغسطس لسنة 2013 وقد قورنت نتائج التصوير بالرنين المغناطيسي والتصوير بالموجات فوق الصوتية لوصف كتل ملحقات الرحمالنتائج : ان معظم ملحقات كتل الرحم كانت تابعة لحلات حميدة شائعة وقد شكل الكيس الوظيفي البسيط اعلى نسبة( 20%)ويتبعه كل من الكيس النزفي بنسبة( 17.7%) ومرض هجرة بطانة الرحم بنسبة ( 13.3%)على التوالي .كانت نتائج التصوير بالموجات فوق الصوتية من ناحية تحديد موقع الورم متوسطة التوافق مع التشخيص النهائي مقارنة بالرنين المغناطيسي كان التوافق جيد جدا مع التشخيص النهائي. كانت نتائج التصوير بالموجات فوق الصوتية لتحديد كون الكتل خبيثة او حميدة حساسة بنسبة(100 %) وكانت خصوصية بنسبة(52%) وكانت درجة الدقة (62%) مقارنة بنتائج التصوير بالرنين المغناطيسي كانت حساسة بنسبة(100 %) وكانت خصوصية بنسبة(91%) وكانت درجة الدقة (93%)الاستنتاجات : ان ملحقات كتل الرحم الغير محددة عند الفحص بالموجات فوق الصوتية الغير موكدة الموقع والصلبة والكيسية المعقدة ستستفيد من الفحص الاضافي بالرنين المغناطيسي والذي كان على درجة عالية من الدقة في تحديد منشا الكتلة وخصائصها. | Aim : To compare the findings of transvaginal ultrasound and pelvic magnetic resonance imaging in patients with adnexal mass.Patient and method : Comparative cross sectional study was conducted in radiological department of Bagdad Teaching Hospital in the medical city center in period from August 2012 to August 2013 ,forty five female patient was examined by magnetic resonance imaging after physical examination and trans vaginal ultrasound examination, and the result was correlated with histopathology in 29cases only.The aged from 18 - 70 years old ,the women present with variety of symptoms include irregular cycle , abdominal pain, dysmenhorria and menorrhagia . Results : forty five patients enrolled in this study,33 patients (73.3%) were in reproductive age and 12 (26.7%) were post menopause, benign condition more than malignant ,simple follicular cyst was the higher percent consist( 20% ),followed by hemorrhagic cyst (17.7% ),followed by endometrioma( 13.3%)Regarding the origin of mass magnetic resonance imaging had(k0.89) almost perfect agreement with final diagnosis whereas the transvaginal sonography had (k o.42) moderate agreement with final diagnosis.Regarding tissue characterization magnetic resonance imaging had ( k = 0.83) almost perfect agreement . magnetic resonance imaging had sensitivity of 100%, specificity of 91% for identifying malignant and benign lesion Whereas transvaginal sonography had sensitivity of 100%, specificity of 52% Conclusion : sonograpgically vague adnexal mass of uncertain origin and solid or complex content will be benefit from further evaluation by magnetic resonance imaging,which highly accurate for identifying the origin of the mass and characterization of its tissue content.

خزعة نخاع العظم مقارنة بالرنين المغناطيسي لنخاع العظم للورم السرطاني للعقد اللمفاوية في الفقرات القطنية == BONE MARROW BIOPSY VERSUS MRI IN LYMPHOMA OF LUMBAR SPINE

اسم المؤلف: زينب ثامر عبد الحسن
اسم المشرف: سلام محمد جوري | بسام فرنسيس متي
الموضوع العام: الطب
السنة: 2013
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: الخلفية : اصابة نخاع العظم هو نتيجة متكررة الحدوث في الورم السرطاني للعقد اللمفاوية ولتحديد درجة هذا المرض خزعة نخاع العظم من القمة الخلفية للعظم الحرقفي تنجز عادة لتقييم درجة الاشارة الغير طبيعية لتصوير الرنين المغناطيسي لنخاع العظم وقد ثبتت ايضا لتكون مؤشر لاصابة نخاع العظم .الهدف من الدراسة : لتقييم قابلية الرنين المغناطيسي لتوثيق تاثر واصابة نخاع العظم لمرضى الورم السرطاني للعقد اللمفاوية.الطريقة : نموذج دراستنا يتضمن 80 مريض بالغ محال الى قسم الاشعة في مستشفى بغداد التعليم ,العراق. مابين اب 2012 واب 2013 اللذين انطبقت عليهم المواصفات المشمولة وشخصوا كمصابين بالورم السرطان للعقد اللمفاوية واثبت ذلك بالفحص النسيجي لخزعة العقد اللمفاوية، كلا من خزعة نخاع العظم والرنين المغناطيسي اجريت لهم . النتائج : 48 من الذكور (60%) و32 من الاناث (40%) قد فحصوا ونسبة الذكر للانثى 1 : 1,5. في 78% من هؤلاء المرضى، خزعة نخاع العظم والرنين المغناطيسي كانتا متفقتان تماما. في مريض واحد فشل الفحص النسيجي في اثبات اصابة نخاع العظم بالرغم من الاشارة الغير طبيعية للرنين المغناطيسي المخمنة لاصابة نخاع العظم. في خمسة مرضى، الرنين المغناطيسي كان طبيعيا كاملة بالرغم من ان الخزعة اثبتت اصابة نخاع العظم وان معدل السلبية الخاطئة (5\16) والايجابية الكاذبة (1\62) كانت قليلة جدا . الخاتمة : في الورم السرطاني للعقد اللمفاوية، الخزعة السالبة لنخاع العظم مع النتيجة الموجبة للرنين المغناطيسي يجب ان لا تستثني اصابة نخاع العظم وتحتاج الى تقييم اكثر بواسطة خزعة نخاع العظم من كلا الجانبين ولذلك نحن نستنتج انه الرنين المغناطيسي لنخاع العظم هو شكلية حساسة غير متداخلة وممكن ان يكون ذو قيمة قويةفي ايجاد اصابة نخاع العظم بالورم السرطاني للعقد اللمفاويةاللذي من الممكن ان يستعمل كمساعد مفيد للطريقة المثالية لقياس الدرجة.التوصيات : الرنين المغناطيسي لكل الجسم، يوصى به ليساعد في تقييم اصابة نخاع العظم بالورم السرطاني للعقد اللمفاوية | Background : Bone marrow involvement is a frequent finding in lymphoma. For the staging of lymphoma, a bone marrow biopsy of the posterior iliac crest is routinely performed. An abnormal magnetic resonance imaging (MRI) signals of bone marrow was also reported to be indicative of bone marrow involvement.Aim of the study : To assess the ability of MRI to document bone marrow infiltration and involvement in patient with lymphoma.patients and Methods : Our study sample consisted of 80 adult patients referred to the radiology department in Baghdad teaching hospital, Iraq, between August 2012 to August 2013 who met the inclusion criteria were diagnosed as lymphoma and proved by histological examination of LN biopsy, both bone marrow biopsy and MRI were done for them.Results : 48 male (60%) and 32 female (40%) were examined, with male : female ratio was (1.5 : 1). With mean age was(52.25 ± 7.3)years. 67 patients of them have NHL and the remaining 13 patients have HD. Among 62 patients with MRI positive findings, 39 patients (63%) showed diffuse infiltration and 23 patients (37%) showed multifocal infiltration. In 78 % of patients bone marrow biopsy and MRI agreed completely. Only in one patient, histological sections of bone marrow biopsy failed to show any evidence of bone marrow involvement despite abnormal MRI signals suggestive of bone marrow involvement by lymphoma infiltration. In five patients, MRI was completely normal despite biopsy proven bone marrow infiltration .False negativity (5/16) and false positivity (1/64 ) rates were very low .Conclusion : In lymphoma, a negative bone marrow biopsy finding with positive MRI results should not exclude bone marrow involvement and needs further evaluation with bilateral bone marrow biopsy. Thus, we conclude that MRI of bone marrow is a fairly sensitive, non invasive modality and might be of potential value in detecting bone marrow infiltration in malignant lymphoid neoplasms which can be utilized as a useful adjunct to standard staging procedures. Recommendation : Total body MRI is recommended to help the assessment of bone marrow infiltration by lymphoma also bilateral biopsy is recommended in suspected cases that patients with positive MRI finding had negative biopsy results

دراسة مقارنة بين نتائج الدوبلر والاعراض السريرية في مرضى القدم السكري == CORRELATION STUDY OF TRIPLEX ULTRASOUND AND CLINICAL FINDINGS IN DIABETIC FOOT PATIENTS

اسم المؤلف: رمزي حلوان طعين
اسم المشرف: ليث احمد خلف | مؤيد عباس فاضل
الموضوع العام: الطب
السنة: 2013
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Diabetes mellitus is a common ailment in our community, diabetes affects about 10% of our population and the prevalence of diabetes varies form 5.3% to 16.2%. Diabetic foot disease is a common cause of admission in the surgical wards and sometimes the first presentation of this debilitating disease. Foot ulcers carry a 25% risk of major amputation. The diabetic foot disease classified according to Wagner’s Classification, and to manage it according to the standard protocols. The ultrasound scanning for lower limb arteries clearly show that it can provide information about the vascularity of the lower limb arteries. It is established as a valuable noninvasive method to investigate lower limb arteries. Objective : Evaluation of Doppler ultrasound finding in correlation with clinical finding (Wagner's classification ) of diabetic foot. Patient and method : A cross sectional study from August 2012 to August 2013, for 58 patients referring to ultrasound unit for triplex ultrasound examination of lower limbs at medical city complex in Baghdad. Patient were randomly selected and consisted of 21 female and 37 male. Age ranged between 40 and 75 year. Result : The mean age of patients was 57.9±7.8 years with predominance ofIIImale gender (63.8%) and type II DM(8602%). Mean duration of DM for selected patients in our study was 12.33±6.2 years. . In the present study approximately half of the diabetic patients were in fourth Wagner grades. Doppler USG revealed a pathological finding of lower limbs arteries in 89.7% of the patients. The most frequent site of occlusion was found in the dorsalis paedis artery (12.1%). There is a significant association of impaired blood flow diagnosed by Doppler USG and clinical deterioration of DM detected by Wagner's grade (p<0.001).The normal blood flow in all arteries of lower limbs had been found in 10.3% with Wagner's grade II, III and IV. Conclusion : There is correlation between clinical finding of diabetic foot (Wagner grade ) and Doppler finding (degree of stenosis) which mean when increase Wagner's grade, this is associated with increase degree of stenosis, therefor lower extremity artery triplex US is an excellent method, which can monitor the grade of Diabetic foot. The normal blood flow in all arteries of the lower limbs was 10.3% in spite of patient present with Wagner grade II, III and IV, these should be remembered during management of diabetic foot.

اورام الدماغ الثانوية المنتشرة ضمن الاورام السرطانية الصلبة == Secondary brain metastasis in solid tumors

اسم المؤلف: افيل نديم كاظم
اسم المشرف: خضير جاسم صبيح الرواق
الموضوع العام: الطب
السنة: 2013
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Title : Secondary brain metastasis in solid tumors.Background : Brain metastases are among the most feared complications of cancer because they often cause profound neurologic symptoms that severely impair the quality of life. They represent a common complication, occurring in 10 - 30% of cancer patients. The prevalence of brain metastases in cancer patients has been rising over the past three decades.Aims of the study : To investigate the distributions of secondary Brain metastases and their percentage of frequency among common solid tumors and to correlate the strength of the relationship with different prognostic criteria that are obtained from common primary diseases which ended up with secondary brain metastases in Al - Amal hospital for radiation oncology and nuclear medicine .Patients and methods : Clinical data of 40 patients with brain metastatic cancers were collected and analyzed for the relationship between survival time and age, gender, primary diseases, quantity of brain metastatic foci, their position, extra cranial lesions, and therapeutic regimens used before brain metastasis detection.Results : The average female to male ratio was 3.4 : 1, with highest frequency were among patients in the 4th and 5th decades, females with breast cancer showed the highest frequency to develop brain metastases. Highest frequency was seen at 1 - 5 years after diagnosis of the primary disease. Majority of patients were treated with surgery and chemotherapy showed a high frequency for brain metastases.Conclusion : Female gender 30 - 50 years age having breast cancer, between 1 - 5 years after the diagnosis of the primary disease are at high risk for secondary brain metastases.Keywords : Secondary brain tumor, brain metastases, cerebral cancer treatment, brain neoplasm, metastasis

مصاحبة الاختلافات التشريحية للجيوب الانفية مع امراض الجيوب الانفية في المفراس الحلزوني متعدد المقاطع == Co - existence of anatomical variations of paranasal sinuses and sinonasal abnormalities on multislice computed tomography

اسم المؤلف: ميثاق محي عبد الله
اسم المشرف: عبد اللطيف علي اصغر | محمد ضياء احمد
الموضوع العام: الطب
السنة: 2013
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Background : Certain anatomic variations ( as concha bullosa and nasal septal deviation) are common in general population and are often predispose the patients to inflammatory diseases because they may obstruct the infundibulum or any part of the osteomeatal complex resulting in interference of air flow or mucociliary clearance. Computed tomography is the imaging modality of choice since the advent of functional endoscopic sinus surgery. It is now mandatory and a medicolegal requirement to evaluate the paranasal sinuses as this provide a road map with excellent details regarding anatomy, anatomical variants with type and extension of the pathology.Objectives : to identify the incidence of different types of paranasal sinus variants and their coexistence with sinonasal abnormalities by using multislice computed tomography.Patients and methods : This is a cross sectional study was done on 87 patients referred for computed tomography scan of the paranasal sinuses in Al - shaheed Ghazi Al.Hariri Teaching Hospital in medical city - Baghdad, from January 2013 to June 2013, patients were clinically suspected to have sinonasal diseases. The sample of this study was consist of 52 males and 35 females. The age of patients ranged from 12 - 60 years. All patients were examined by computed tomography scan of paranasal sinus protocol in axial sections with coronal reformat.Results : From 87 patients in our study, 76 patients were have diseased sinuses, we reported 5 mucosal abnormalities; mucosal thickening, opacification, air fluid level, mucosal polyp and cyst. The most commonly involved sinus was the maxillary (62 patients) followed by anterior ethmoid, and the commonest abnormality was mucosal thickening. Types of variations were seen in this study; nasal septal deviation(52.4%), concha bullosa(49%), enlarged ethmoidal bullae (15.9%), large Aggar nasi (15.9%), Haller cells(19.1%), bent uncinate process(11.4%),Onodi cells(11.4%), paradoxical middle turbinate(9.1%), maxillary sinus hypoplasia(7.9%), pneumatized crista galli(6.8%), and both pneumatized nasal septum and asymmetrical ethmoid roof were of (3.4%). the total number of patients having anatomical variants but with no associated sinonasal mucosal abnormalities were (17.1%), while (82.9%) of patients were associated with sinonasal abnormalities.Conclusion : by using multislice computed tomography we find correlation between certain anatomical variations and specific inflammatory sinonasal mucosal abnormalities due to defect in the drainage of the sinus secretions and secondary infection. Also there was another group of variants which may lead to intraoperative complications if surgery indicated.