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مشاهدات مفراس تلوين الاوعية الدموية ذي 46 مقطع لمرضى نزف ماتحت العنكبوتية == Sixty - Four Multi Slice Computed Tomographic Angiography Findings in Early Non - Traumatic Subarachnoid Hemorrhage

Author name: باسمة كاظم عبود
Supervisor name: مظفر بالي مهدي | عبد اللطيف علي اصغر
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Spontaneous SAH is sub type of hemorrhagic stroke with extremely poor prognosis. It’s a medical emergency and can lead to death or severe disability - even when recognized and treated at an early stage .CTA is frequently become the initial step in detecting intracranial aneurysms and planning therapeutic interventions.Objectives : To study the findings and the underlying causes of non traumatic SAH in CTAPatients and methods : This descriptive study was done on 62 patients with non traumatic SAH who underwent CTA in Baghdad Teaching Hospital in medical city - Baghdad from August 2012 - august 2013 with patients with highly clinical suspicion of SAH or those who were diagnosed by native CT or MRI, the sample of study was consist of 37 males and 25 females , age of patients ranged from 1 - 70 years .all patients examined by CTA using 64 MDCT.Results : From 62 patients in our study ,10 patients have negative finding ,38 have aneurysm,7 have AVM , 5have cavernoma and 2 patients have venous angioma, the aneurysms were 81.6 % saccular. 18.4% fusiform shape and mostly located supra tentorially 89.5% , 10.5% infratentorially single in384.2% more than one 15.8%, and the most frequent types of AVM were parenchymal 71.4%, from which the size 3 - 6 cm most frequent 60% , while Dural AVM 28.6% from which size 3cm most frequent size 66.6% and no cases reported with mixed types.Conclusion : CTA can provide rapid , minimally invasive evaluation of broad spectrum of cerebrovascular disorders and CTA adequate for detecting aneurysms in symptomatic SAH patients especially when conjoinded with native CT, also CTA is helpful in intervention planning and post - intervention evaluation.

نتائج التصوير بالرنين المغناطيسي لمرضى التنكس العظمي لمفصل الركبة بين السكان ممن لديهم نتائج سالبة بالتصوير بالاشعة السينية == MRI FINDINGS IN OSTEOARTHRITIC KNEE JOINT IN PATIENTS WITH NEGATIVE X - RAY FINDINGS IN IRAQI POPULATION

Author name: عوف عبد الرحيم حسين
Supervisor name: ليث احمد خلف
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: نبذة : مرض التنكس العظمي هو مرض المفاصل الاكثر شيوعا ويصيب في بدايته انسجة المفاصل قبل العظام التقدم في تكنولوجيا الرنين المغناطيسي ساعد كثيرا في الكشف المبكر عن الاصابة المبكرة بمرض التنكس الهدف من الدراسة : لتقييم نتائج التصوير بالرنين المغناطيسي لمرضى التنكس العظمي لمفصل الركبة بين السكان ممن لديهم نتائج الاشعة السينية السالبةالمرضى وطرق البحث : هذه الدراسة عبارة عن دراسة متابعة مستقبلية اجريت في العيادة الاستشارية للمفاصل في مستشفى بغداد التعليمي في مدينة بغداد الطبية على عينة من 50 مريضا يشتبه في اصابتهم بمرض التنكس العظمي لمفصل الركبة ز تم جمع المرضى الذين يعانون من نتائج الاشعة السينية السلبية واعطاء تاريخ بعد 1 - 3 اسابيع من قبل الباحث من اجل التصوير بالرنين المغناطيسيالنتائج : كان التصوير بالرنين المغناطيسي للمرضى ممن لديهم نتائج سلبية للاشعة السينية لالتهاب مفصل الركبة مؤثرا بنسبة 50%منهم وكانت النتائج الرئيسية هي ووذمة نخاع العظم 36%من المرضى الذين لديهم نتائج موجبة بالرنين المغناطيسي وبصورة رئيسية اللقمة الوحشية (16%) , ارتشاح مقصل الركبة الزليلي (68%),معتدل بشكل عام (88,2%) واقل شيوعا (متوسط)(11,8), تمزق القرن الخلفي للقرن الهلالي الانسي (48%),تمزق القرن الخلفي للقرن الهلالي الجنبي (16%), التمزق الجزئي للرباط الصليبي الامامي (52%),التمزق الجزئي للرباط الصليبي الخلفي (4%), وكيس بيكر (4%)وكانت نتائج التصوير بالرنين المغناطيسي مرتبطة بشكل كبير بزيادة العمر والجنس الانثوي والوظائف البدنية الشاقة وزيادة الوزن الاستنتاجات : ان التصوير بالرنين المغناطيسي هو طريقة تشخيص دقيقة وموثوقة لتشخيص وتصنيف تنكس العظم لمفصل الركبة | Background : OA is the most common disease of knee joint causes tissue destruction .Advanced technology of MRI help in early detection of OA Aim of study : to assess the MRI findings in OA of knee joint among population with negative x - ray findings.Patients and methods this study is cross - sectional study conducted in rheumatology consultation clinic in Baghdad Teaching Hospital in Baghdad medical city on sample of 50 patients suspected to have OA Results : the MRI of the patients with negative x - ray findings for knee OA was positive for 50% of them and the main findings were synovial joint effusion (68%) commonly mild (88.2%) and less common moderate (11.8%),Anterior cruciate ligament partial tear(52%),posterior horn of medial meniscal tear(48%),bone marrow edema in (36%) of patients with positive MRI, mainly of lateral condyle(16%),posterior horn of lateral meniscal tear (16%), Baker cyst(4%),and posterior cruciate ligament partial tear (4%). The MRI findings were significantly related to increase age ,female gender ,hard physical occupation and increase weight. Conclusion : The MRI is accurate and reliable diagnostic method for diagnosis and categorization of knee joint OA Keyword : A ,MRI ,negative x - ray

تاثير العلاج الشعاعي لمرضى سرطان الثدي على المنسوب القذفي لعضلة القلب

Author name: زينب محمد دخيل علي
Supervisor name: خضير جاسم صبيح الرواق
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: ان سرطان الثدي في الوقت الحالي يعتبر من اكثر انواع السرطانات شيوعا واصابة للنساء حول العالم وكذلك يعتبر السبب الرئيسي للموت للمراه بسبب السرطان حول العالم .في العراق يعتبر سرطان الثدي من اكثر انواع السرطانات انتشارا بين النساء , حيث تصل نسبة الحصائيات لسنه 2011 الى 18,96% , وان احد اهم الخطوات في علاجه هو العلاج بالاشعاع .الغرض من الدراسهتسليط الضوء على تاثير العلاج الشعاعي لسرطان الثدي في المنسوب القذفي لعضلة القلب .المرضى وطرق البحثان هذه الدراسه هي دراسه جدوليه منظوريه وان المعلومات الخاصه بمرضى سرطان الثدي وفحوصات القلب قد تم جمعها من مستشفى الاورام التعليمي منذ بداية شهر شباط/2016 ولغاية شهر كانون الثاني/2017.النتائجان هذه الدراسه التي تضمنت (50) مريضا جميعهم من النساء اللاتي تتراوح اعمارهم مابين 32 - 70 سنه , وقد اظهرت نتائجها وجود تاثر للمنسوب القذفي لعضل القلب بعد اربعة اشهر من العلادج الشعاعي مقارنة بنسبته ماقبل العلاج.حيث انه تم ملاحظة ان المريضات اللاتي يعانين من سرطان الثدي الايسر واللاتي قد استلمن جرعة من العلاج الشعاعي بمقدرا4260 سينتي غرايو لديهن النسبه الاعلى في التغير وبمعدل وسط حسابي مقداره 66% قبل العلاج و65,5% مابعد العلاج .و كذلك لاحظنا ان المريضات اللاتي استلمن جرعه شعاعيه مقدارها 5000 سينتي غراي سواء للثدي الايمن او الايسر , كان لديهن نسبة تغيير بمعدا حسابي للثدي الايمن ومقداره 66,3% قبل العلاج الشعاعي الى 64,3 % بعد العلاج الشعاعي , اما بالنسبه للثدي الايسر فكانت النسبه بمقدار 66,8% قبل العلاج الشعاعي الى 65,2% بعده . الاستنتاجاتان المرضات اللاتي يعانين من سرطان الثدي واللاتي عولجن بالعلاج الشعاعي ثلاثي الابعاد الموحد سواء كان لنسيج الثدي او لجدار القفص الصدري , وبعد المتابعه لفحوصات القلب التي تمت , قد لوحظ ان هناك تغيرا في المنسوب القذفي لعضلة القلب وخصوصا بين الثدي الايمن والثدي الايسر وكذلك بين مقدار الجرعه الشعاعيه المستلمه والسبب على الاغلب في الاشعاع المتطاير الواصل للشرايين المحيطه بالقلب اثناء العلاج | Breast cancer now represents the most common female malignancy in both developing and developed world, and is the primary cause of death in woman globally. In Iraq breast cancer constitute 18.96 % of all other types of cancers up to 2011. One of the main steps in the management of early breast cancer is radiotherapy.Aim of studyTo shade the light on the radiation therapy effect on the ejection fraction of the heart in breast cancer patients.Patients and methodsThis is a prospective observational study that was conducted in Radiotherapy and nuclear medicine center of the oncology teaching hospital/medical city complex using Echo cardiograph for following up the patients. Data recruitment included patients received Adjuvent 3D conformal radiotherapy as a whole breast irradiation or as a chest wall irradiation from August/2016 to January/2017 and followed with Echo study four months later until January/2017.ResultsIn our registry 50 patients were recorded; patient’s age was between 32 and 70 years old female gender. We found that there was a significant effect of radiation on the ejection fraction percentage of pre radiotherapy and post radiotherapy of both radiotherapy doses (P - value=0.001).2We noticed that patients with left sided breast whom received 4260 centigray had the highest significant result of a mean difference of pre - radiation =66%, and post radiotherapy =65.5 %.Also we noticed that patients whom had received 5000 centigray of either left or right sided breast cancer, have substantial difference between pre - radiotherapy of 66.3% and 66.8% to 64.3% and65.2% for right and left side respectively.ConclusionIn patients with breast cancer treated with adjuvant 3D conformal radiotherapy as a whole breast irradiation or as a chest wall irradiation, an evaluation for the cardiac ejection fraction after four months of completing their radiotherapy, to either right sided or left sided breast, there was a marked difference in the ejection fraction size between the left sided treated BC and right sided BC, and between different doses mainly due to scattered and transmitted irradiation to the coronary arteries.

مقارنة المقاطع السهمية لسلسلتي الرنين المغناطيسي : استرداد الانقلاب قصير T1 وT2 الموزونة ذوات صدى الانفتال السريع في الكشف عن افات الحبل الشوكي الناجمة عن تصلب الاعصاب المتعدد == A Comparison of Sagittal Sections of Short T1inversion Recovery and T2 Weighted Fast Spin Echo Magnetic Resonance Sequences for Detection of Multiple Sclerosis Spinal Cord Lesions

Author name: شيماء فاضل عبيد
Supervisor name: امير شاكر هادي
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Multiple sclerosis (MS) is a chronic autoimmune inflammatory demyelinating disease of the CNS of unknown etiology. Age of onset is 20 - 50 years in 50 - 60% of cases, with female propensity. MRI of the spinal cord is thought reliable for investigation lesions. Different techniques and MRI sequences are widely used and compared to each other to improve the detection of MS lesions in the spinal cord. Objective : To evaluate the ability of MRI STIR sequences in improvement of MS spinal cord lesion detection when compared to T2 WI sequences.Patients and Methods : A cross sectional study conducted during the period from 15th of August 2013 to 30th of June 2014. A total of 22 MS patients who had clinically definite MS with clinical features suggestive of spinal cord involvement, and had no contraindication for MRI examination were included. Spinal cord lesions which had artifacts significantly reduce the reading confidence of the images or those which did not show the typical characteristics of MS spinal cord plaques and lesions due to spondyloticmyelopathy were excluded. Patients were imaged with unified MRI protocol for all patients and two MRI sequences were used in imaging; sagittal STIR sequences and sagittal T2 weighted. All images were read by the same radiologist. The study protocol was approved by the ethical committee and the data of the patients were kept confidentially.Results : The mean age of the patients was 32.5 ± 6.7 (range : 23 - 45) years and 54.5% of the patients aged 30 - 39 years. Females were the dominant and represented 72.7% with a female to male ratio of 2.7 : 1. The total number of spinal cord MS lesions was 44,of them 86.4% in the cervical spine, 68.2% of the lesions had less than one vertebra extension,79.6% of the lesions did not associated with changes in the spinal cord morphology. There was a significant upgrading in the lesions conspicuity at STIR sequence comparingto T2 WI, P<0.001. A significant difference had been found in artifact grading between both sequences; P<0.001.Conclusions and Recommendations : STIR MRI sequence improves detection of MS spinal cord plaques compared with T2 WI and it increases the conspicuity of the visualized T2 WI lesions, but also it accentuates the artifacts more than T2WI. The STIR sequence should be included in the standard spinal cord MR imaging protocols and should be obtained routinely with T2 WI. Further studies are suggested.

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

Author name: رمزي حلوان طعين
Supervisor name: ليث احمد خلف | مؤيد عباس فاضل
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: 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.

دور فحص المرونة النسيجية للخصيتين لمرضى العقم والدوالي == The role of Testicular Elastography in patients with varicocele and infertility

Author name: بشارعبد الرزاق مولان
Supervisor name: سعد داخل فرحان | سلام محمد جوري
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: To assess the value of Real - time Elastography (RTE) in evaluation of the effect of varicocele on the elasticity of the testicular interstitium and ability to predict the effect of varicocele on the sperm motility.Methods : In total of 73 candidate. 50 patient with varicocele and 23 control normal volunteer were examined by ultrasound B mode gray scale, color Doppler and elastography . Elasticity images of the testicles were assigned the color - coded score of Itoh , according to the distribution of strain induced by light compression. RTE findings were analyzed and compare the result of affected patient with normal volunteer.Results : Most of the testicles of the varicocele patient showed elevated elastography ratio as compared with the same side of normal volunteer, also there was positive correlation between the varicocele grade and the elasto ratio. When I compared the percentage of active motile sperm with elasto ratio I found negative correlation.Conclusions : RTE is non - invasive, bed side test, useful technique in assessing the changes which happen in the interstitium of the affected testicles with varicocele and in the prediction of the active motile sperm status.This is relevant in clinical practice allowing expectant management according to elasto ratio in selected cases.(as the testicular elasto ratio will predict the outcome of varicocele operation in at the point of sperm quality improvement).

دوبلر الشريان السباتي للمرضى المرشحيه لعملياث تبديل الشراييه التاجية == Doppler of Carotid Artery Assessment in Evaluation of Patients indicated for Coronary Artery Bypass Graft

Author name: فرج عبد الخالق زكي
Supervisor name: ليث احمد خلف | علي محسن حسن
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Atherosclerosis is a generalized disease, mainly manifested in all vascular trees. An association between carotid artery stenosis and coronary artery disease has been well established. Carotid artery stenosis is an important etiologic factor for cerebrovascular accidents, is associated with coronary artery disease .Methods;A prospective study of 86 patients, who were scheduled for CABG, was done at radiology department, Medical city Baghdad,Gazzi Al - Harirri hospital from Nov.2016 to July 2017. The majority were males, (73) and (13) were Females.All patients , after a clinical history was taken by the cardiac surgery team, they underwent a physical examinations ,and investigations ; chest x - ray , ECG , blood was taken for fasting blood suger and cholesterol study , Doppler ultrasonography for bilateral carotid arteries were performed by aspescailized radiologist for carotid artery atherosclerosis Results; The majority of the patients were above 50 years of age, 73 patients (84.45%) and only 15% were below the age of 50 years. Male affected by carotid artery atherosclerosis, (76.7%) more than females above the age of 50 years, while below the age of 50 years females (46.7%) more affected than males (9.58%). Risk factors were significantly correlated with both carotid and coronary artery stenosis like age, sex, smoking hypertension, cholesterol and diabetes mellitus.Doppler Ultrasonography was performed to screen the presence of carotid artery stenosis. Carotid artery atherosclerosis was present in 66 patients, (76.7%).Ten patients ( 15.1%) with one coronary artery disease , 17 (25.75%) with two coronary artery disease , and 39 patients ( 59.09%) with three coronary artery disease.The location of atherosclerosis is mostly in ICA, (53%), of which 15% in the bulb, in the CCA (32%) .Conclusions; Our finding indicated significant associations between carotid artery atherosclerosis and coronary artery disease.there is strong association between increase in intma media thickness of carotid arteries and the presence of coronary artery disease.

دقة فحص رنين قنوات الصفراء بالمقارنه مع ناظور قنوات الصفراء في تقييم انسداد قنوات الصفراء == ACCURACY OF MRCP VERSUS ERCP IN THEEVALUATION OF BILIARY OBSTRUCTION

Author name: ايمان سامي سوادي العطية
Supervisor name: ليث احمد خلف
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine - Department Of Diagnostic Scans
Language: English
University location: Baghdad
First pages:
Abstract: ان انسداد قنوات الصفراء من الحالات المتكرر مشاهدتها في قسمي الجراحه والباطنيه وان تشخيصها يحتاج الى الكثير من الفحوصات المختبريه والشعاعيه للتمكن من معالجتها واصبح فحص الرنين المغناطيسي من الفحوصات الاساسيه لغرض التشخيص الدقيق لاسباب الانسداد لتسهيل العلاج وفي بحثنا هذا اجريت مقارنه لنتائج فحص قنوات الصفراء بالرنين مع نتائج الفحص الناظوري الارتجاعي لللقنوات الصفرايه والبنكرياسيه باعتباره المعيار الذهبي لقد تم اجراء هذه الدراسه خلال الفتره من شهر كانون الاول لسنة 2015 لغاية شهر ايلول 2016 واجريت على 50 مريض اجري لهم فحص رنين قنوات الصفراء بعد الشك بوجود انسداد قنوات الصفراء بالاعتماد على نتائج فحص السونار او ارتفاع نسبة الماده الصفراء في الدم بعد ذالك اجريت لهم عمليه فحص القنوات الصفراء بالناظورالهدف من الدراسه : لغرض اثبات مدى دقة فحص الرنين المغناطيسي في تشخيص وجود انسداد في القنوات الصفراويه فقد تم فحص المرضى من قبل استشاري الامراض الباطنيه تخصص دقيق في امراض الجهاز الهضمي واحيلوا لفحص الرنين المغناطيسي في قسم الاشعه في مستشفى بغداد التعليمي او في معهد الاشعه وتمت مراجعه الفحص من قبل اخصائي الاشعه وتحدد سبب الانسداد اعتمادا على نتائج الرنين المغناطيسي بعد ذالك اجريت لهم عملية ناظور القنوات الصفراويه في الطابق السادس في مستشفى بغداد التعليمي او في مستشفى امراض الجهاز الهضمي والكبد من قبل استشاري امراض الجهاز الهضمي ثم تمت مقارنة النتائج لكلا الفحصين وقد تم التوصل ال مايلي : ان فحص الرنين المغناطيسي ذو كفاءه تصل الى ( 97.6بالمائه) مقارنة بنتائج الناظور لذلك يمكن استغلاله للتشيخص بحساسيه وكفاءه عاليه وابقاء الناظور للحالات التي يتوقع احتياج تداخل كسحب الحصى من القنوات الصفراويه او اخذ خزعه للفحص النسيجي او لوضع عباره خاصه في حالات التضيق او تلك التي لا يمكن فيها سحب الحصى | Biliary obstruction is one of the common problems in both medical and surgical departments and its diagnosis needs many investigations and radiological in order to reach the correct giagonsis to arrange for possible treatment Aim of the study : To assess the accuracy of MRCP versus ERCP in the evaluation of biliary obstruction as the ERCP is a gold standard and to asses the validity of row data and MIP sequences for evaluation of the final results of MRCP study. Materials and method : During the period from December 2015 to September 2016, 50 patients with initial diagnosis of biliary obstruction based on ultrasound, and or clinical and biochemical evidence of cholestatic jaundice, were examined in the radiology department in medical city hospitals with MRCP to evaluate the cause and site of obstruction followed by ERCP done within few days.Results : By comparing the MRCP and ERCP findings in identifying the cause of obstruction reveals that .The sensitivity, specificity and accuracy of MRCP versus ERCP was found to be 97.6%, 66% and 92% respectively the major cause of biliary obstruction ound to be intraluminal CBD stone , luminal stricture and ampullary tumors are other causes of obstruction, according to the site 0f obstruction , distal obstruction found to be more common than mid or proximal. Conclusion : MRCP was found to be of high diagnostic accuracy in diagnosing biliary obstructionAnd ERCP should be reserved for therapeutic intervention since it was found that the sensitivity and specificity of MRCP were high and it can precisely define the site and cause of obstruction when compared to ERCP

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

Author name: افيل نديم كاظم
Supervisor name: خضير جاسم صبيح الرواق
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: 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

Author name: ميثاق محي عبد الله
Supervisor name: عبد اللطيف علي اصغر | محمد ضياء احمد
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: 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.

العلاقة بين النتائج السريرية ونتائج التصوير بالرنين المغناطيسي في عينة من المرضى العراقيين الذين لديهم تدلي القرص بين الفقرات القطنية == Correlation Between Clinical Finding And Magnetic Resonance Imaging In a sample of Iraqi patients with Lumbar Disc Prolapse

Author name: نورس نوري كعيد
Supervisor name: خضير زغير معيوف البدري | ليث احمد خلف
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine - Department Of General Surgery
Language: English
University location: Baghdad
First pages:
Abstract: Lumbar disc prolapse is one of the common causes of low back pain seen in the working population. There are contradictory reports regarding the clinical significance of various magnetic resonance imaging (MRI) findings observed in these patients.Objective : To find out the correlation of clinical features and magnetic resonance imaging (MRI) findings in determining the level of lumbar disc herniation.Patients and Methods : This study was conducted in department of radiology Baghdad teaching hospital from15thaugust 2013 to 15th august 2014 , the total number of patients with prolapse intervertebral disc was 100, the clinical level of disc herniation was determined depending on clinical findings (dermatomal distribution, pin - prick test , SLR Test , knee reflex And Ankle reflex ) and correlated with MRI findings (direction and location of disc herniation and nerve root compression).For both data entry and data analysis Statistical package for social science version 18 (SPSS18) was used. P - value of < 0.05 considered significant.11AbstractResults : Total 100 patients were studied during the12 months period. Out of 100 patient (52%) were male while (48%)were female. Age range was from 17 - 70 years, mean age was 38.9 ±11.4 .Maximum patients were in the age group range from17 - 34 (37%) followed by 35 - 45 years (33%).The duration of symptoms was ranging from 2 months to 2 years. The duration of symptoms was less than 1 year in 57% of patients and while 43% in 1 - 2 years group. The average duration in female patients was 1.1 years and in male patients was 11.23 monthon MRI the commonest nerve compression grade was grade 1 (contact) , when we comparing clinical test grade with nerve compression grade it was found that clinical test grade show very strong association with nerve compression grade .on MRI most disc herniation direction was posterolateral (61%)and (39%)central direction , when we test if there is association between the direction of disc herniation and whether there is nerve root compression we found strong relationship with p - value equal 0.003 .The level of disc herniation was determined on clinical basis as well as on MRI. These findings were compared and correlated for single level disc like L4 - L5 and L5 - S1 and for multiple levels. We found out the sensitivity, specificity and predictive values of clinical features and applied chi square test.In case of L4 - L5 level disc herniation, the sensitivity of all clinical features was 70.5% and positive predictive value was 80%, while the specificity was12Abstract62.5% and negative predictive value was 50%. The chi square value was significant with P value of 0.001.In case of L5 - S1 level disc herniation, the sensitivity and specificity of clinical features as a whole were 71.7% and 62% respectively. The positive predictive value was 55% and negative predictive value was 77.5% with significant chi square test of P value of 0.001.In case of L4 - L5 &L5 - S1 levels disc herniations the sensitivity and specificity of clinical features as a whole were 43% and 91.05% respectively. The positive predictive value and negative predictive value were 27% and 95.5% respectively with significant chi square test of P value of 0.028.Conclusion : This study shows that the lower lumbar discs are affected more than other disc site. In addition, there are strong association between nerve compression grade with severity of symptoms and signs so as the grade increase so also symptoms and signs increase.Also we found strong relationship between the direction of herniation and nerve root compression, so the posterolateral herniation direction compress root more often than central one .Finally, the clinical features should be correlated with MRI findings in determining the level of disc herniation. There is excellent correlation between the clinical features and MRI findings in case of single and multiple level disc herniation, when it is lying posterolaterally at L4 - L5 level or L5 - S1 level.

المقارنة بين المفراس الحلزوني باستخدام الصبغة والمشاهدات الجراحية في تشخيص اورام البنكرياس == Correlation of computed tomography angiographic findings and surgical findings in patients with pancreatic tumour

Author name: سندس صباح عبد الله
Supervisor name: مظفر بالي مهدي
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: الخلفية : سرطان البنكرياس هو ورم قاتل يظهر كسرطان منتشر او موضعيا محليا في كثير من المرضى. وتشير التقديرات الى ان حوالي 20٪ - 25٪ فقط من المرضى لديهم سرطان يحتمل ان يكون قابل للرفع. ورم البنكرياس هو السبب الرابع الاكثر شيوعا للوفاة من السرطان في الولايات المتحدة. معدل البقاء على قيد الحياة ل 5 سنوات اقل من 5٪. حوالي 60٪ من الاورام تقع في راس البنكرياس، 15٪ في الجسم، 5٪ في الذيل، في حين ان 20٪ منتشرة داخل البنكرياسالهدف من الدراسة : لتقييم قابلية فحص الاشعة المقطعية بتصوير الاوعية بتحديد ورم البنكرياس القابل للرفع جراحياالمرضى والطريقة : دراسة مقطعية اجريت في مستشفى الجهاز الهظمي والكبد التعليمي في مجمع مدينة الطب للفترة من 1 يناير 2017 وحتى نهاية يوليو 2017. تم تسجيل 43 مريضا في الدراسة الحالية (29 من الذكور و14 من الاناث) مع نسبة الذكور الى الاناث من (2 : 1). كان متوسط الفئة العمرية 66.4 ± 9.3 سنواتالنتائج. اكثر الاماكن شيوعا لاورام البنكرياس هو منطقة راس البنكرياس 29 (67.4٪)، 33 (76.7٪) من المرضى الذين يعانون من ورم البنكرياس لديهم ورم لا يمكن ان يرفع بالجراحة، وكانت نتائج صحة فحص الاشعة المقطعية بتصوير الاوعية فيما يتعلق بالجراحة كالاتي : حساسية الفحص (70.0٪)، خصوصية الفحص (91.0٪)، القيمة التنبؤية الموجبة (70.0٪)، القيمة التنبؤية السالبة (91.0٪) والدقة (86٪).الاستنتاج والتوصية : فحص الاشعة المقطعية بتصوير الاوعية هو اداة فعالة قبل الجراحة لتقييم قابلية رفع الورم مع دقة جيدة لقابلية عموما في اورام البنكرياس. يجب ان يستخدم فحص الاشعة المقطعية بتصوير الاوعية على نطاق واسع في المرضى الذين يعانون من ورم البنكرياس لتقييم ما قبل الجراحة. | Background : Pancreatic cancer is a lethal tumor presenting as a locally advanced or metastatic cancer in many patients. It is estimated that only about 20% - 25% of patients have a potentially resectable cancer. Pancreatic tumour is the fourth most common cause of death from cancer in the United States. The survival rate at 5 years is less than 5%. About 60% of tumors are located in the head of the pancreas, 15% in the body, 5% in the tail, while 20% are diffuse within the pancreas. Aim of the study : To assess the resectibility of pancreatic tumor by using CTA preoperatively. Patients and method : A cross sectional study carried out in Gastro - intestinal and hepatology teaching hospital in Baghdad Medical city for period from 1st of Jan, 2017 to end of Jul. 2017, on 43 patients (29 were male and 14 were female) with male to female ratio of (2 : 1). the mean age group was 66.4±9.3 years.Results : Most common site of the pancreatic tumors were involving the pancreatic head and uncinate process 29(67.4%), 33 (76.7%) of the patients with pancreatic tumor have unresectable tumor, and the most common site of unresctability was the head of pancreas 23(70%) the validity results of CTA regarding to the surgery were sensitivity (70.0%), specificity (91.0%), +ve predictive value (70.0%), - ve predictive value (91.0%) and accuracy (86%).Conclusion and recommendation : CTA is an effective preoperatively tool for assessing resectability with good accuracy for overall resectability in pancreatic tumors. CTA must be used widely in patients with pancreatic tumor for pre - operative assessment.

تقييم قطر غلاف العصب البصري بالموجات فوق الصوتية عند ارتفاع ضغط الدماغ == Sonographic assessment of optic nerve sheath diameter in detection of raised intracranial pressure

Author name: نور عدي عبد الحميد
Supervisor name: خليل ابراهيم محسن
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: ارتفاع ضغط الدم داخل الجمجمة هو حالة خطيرة تتطلب حذرا في النهج والادارة، ويعتبرقياس قطر غمد العصب البصري بواسطة جهاز الموجات فوق الصوتية من خلال محجر العين هو علامة دالة موثوقة للكشف عن اثار ارتفاع ضغط الدماغ داخل الجمجمة .الاهداف من الدراسة : 1) اظهار دقة فحص الموجات فوق الصوتية من خلال محجر العين في الكشف عن ارتفاع ضغط السائل السحائي داخل الجمجمة .2) تقييم العلاقة بين قطر غلاف العصب البصري وارتفاع الضغط الدماغ والتحقق من استخدام عتبة القطر من 5 ملم تقاس بواسطة جهاز الامواج فوق الصوتية لغرض الكشف المبكر عن ارتفاع ضغط السائل السحائي داخل الجمجمةطريقة البحث : اجريت دراسة استطلاعية في مستشفى بغداد التعليمي / عيادة الاعصاب خلال الفترة من يونيو 2016 الى مايو 2017 والتي تم فيها جمع 40 شخص طبيعي و40 مريض من الذين يشكون من اعراض ارتفاع الضغط داخل الجمجمة ويعتقد ان لديهم تورم في القرص البصري من خلال فحصهم بمنظار العين .و لقد تم فحص المرضى عن طريق الموجات فوق الصوتية من خلال محجر العين لقياس قطرالعصب البصري ومن ثم يتم اخضاعهم لعملية سحب السائل السحائي من المنطقة الظهرية القطنية.النتائج : من خلال استخدام اختبار الارتباط بيرسون،وجدت علاقه قويه بين قطر غمد العصب البصري المفحوص بواسطه الموجات فوق الصوتيه وقياس البزل القطني. (????> 0.9) و(قيمة P <0.001) واظهرت الموجات فوق الصوتية قدره تحسسيه عالية (91.6% مع خصوصية(75%)ودقة عالية (90.0% ) في قياس قطر غمد العصب البصري مع اعتبار الحد الادنى لقياس قطر غمد العصب البصري 5 ملم والتي تم الحصول عليها من خلال فحص 40 شخص طبيعي. اظهرت الموجات فوق الصوتية الصفه الهلاليه وانتفاخ الجزء الامامي من العصب البصري بتحسس اقل من قطر غمد العصب البصري (61.1% و41.6% على التوالي) ولكن مع خصوصيه عالية جدا (100%). الاستنتاجات : تقييم العصب البصري بواسطة الموجات فوق الصوتية من خلال محجر العين دقيق للغاية ويؤدى بسهولة ويمكن استخدامه لغرض تشخيص ارتفاع ضغط الدماغ ,يمكن الاستفاده منه لغرض فحص المرضى الذين لايمكن اجراء سحب السائل السحائي من المنطقة الظهرية ممكنا بسبب عدم توفره او عدم تحمل حاله المريض اجراء الفحص ,مثل المرضى الراقدين بالعنايه المركزه او شعبه الطوارئ | Background : Raised intracranial pressure is a serious condition require careful approach and management, the measurement of the optic nerve sheath diameter by transorbital ultrasound is a reliable sonographic marker for detection of raised intracranial pressure.Aim of the study : 1 - To demonstrate the accuracy of transorbital ultrasound in detection of raised intracranial pressure.2 - To evaluate the association between ONSD and raised ICP and to validate the use of ONSD threshold of 5 mm measured by US in early detection of intracranial hypertension.Patients and method : A prospective study was carried in Baghdad teaching hospital / neurology clinic during a period from the June 2016 to May 2017 in which 40 controls and 40 patients complaining of symptoms of raised intracranial pressure and suggesting to have optic disc swelling by ophthalmoscope were included in this study. All the patients were examined by transorbital ultrasound to measure the optic nerve sheath diameter and then underwent lumbar puncture.Results : Pearson’s correlations test was used, demonstrating very high significant correlation between the ultrasonographic optic nerve sheath diameter and the measures of lumbar puncture (???? > 0.9) and (p value < 0.001) . Transorbital ultrasound yielded high sensitivity (91.6 %) with modest specificity (75.0 %) and high accuracy (90.0%) of optic nerve sheath diameter considering the cut off normal value of 5 mm obtained from 40 controls. Ultrasound also showing crescent sign and optic disc bulging with lower sensitivity than optic nerve sheath diameter (61.1 % and 41.6% respectively) but with very high specificity (100 %) .Conclusion : Optic nerve assessment by transorbital ultrasonography is highly accurate easily performed and non - invasive procedure for detection of raised ICP. Routine ONSD daily monitoring could be of help in Intensive Care Units and emergency room when invasive intracranial pressure monitoring is not available or contraindicated, in early recognition of intracranial hypertension

تطبيق تصنيف الاكياس المائية وفقا لصوتها في الامواج فوق الصوتية في الشعب العراقي == Application of Ultrasound Classification of Hepatic Hydatid Cyst in Iraqi Population

Author name: ايناس محمد سهيل العاني
Supervisor name: مظفر بالي مهدي
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Cystic Echinococcosis (CE) is an endemic disease in Iraq. Its classification is crucial for proper management. Aim of the study Applying ultrasound study in classifying hepatic hydatid cyst disease in Iraqi population, which is essential in treatment planning. Patient and method : A prospective study was conducted throughout the period from March 2017 to March 2018, in the Gastroenterology and Hepatology Teaching Hospital/ medical city/ Baghdad. A total 100 patients with a diagnosis of hydatid cyst by ultrasound were followed up after surgery and histopathology were proved hydatid cyst. Their age range was 10 - 79 years, female to male ratio 1.6 : 1.WHO - IWGE; WHO Informal Working Group Echinococcus classification), was used in this study.Results : Cystic Echinococcus class I was noticed in (35%), Cystic Echinococcus class II was noticed in (35%), Cystic Echinococcus class III was observed in (17%) , Cystic Echinococcus class IV was noticed in (7%) and Cystic Echinococcus class V was noticed in (6%).ConclusionCystic Echinococcus class I and Cystic Echi

دور التصو ر المقطعي عديم التباين منخفض الجرعة في توقع نجاح علاج تفتيت حصاة الكلية بالموجات الصادمة من خراج الجسم == Role of Low Dose Noncontrast Computed Tomography in Predicting the Success of Extracorporeal Shock Wave Lithotripsy Treatment of Renal Stone

Author name: احمد عباس محمد
Supervisor name: ليث احمد خلف | عادل حفظي حمودي
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Currently, extracorporeal shock wave lithotripsy (ESWL) is the most common mode of therapy for small renal stones. Many studies have attempted to correlate the radiographic findings of non - contrast computed tomography (NCCT) with ESWL success and prospective assessment of patients with renal calculi.Objective : To assess the role of low dose non - contrast computed tomography in predicting the success of extracorporeal shock wave lithotripsy for renal stone treatment.Patients and Methods : A prospective study was conducted at Al - Shaheed Ghazi Al - Hariri teaching hospital in Baghdad medical city during the period from the 15th of December 2013 to the 30th of July 2014. Fifty patients who met the inclusion criteria and agreed to participate in this study were recruited . Data collected using a pre constructed data collection form in which the demographics and clinical data were reported. Stone characteristics were based on the pre - treatment non - contrast CT scanning reviewed and reported by one urologist and one radiologist. Diagnosis of renal stone was made by a specialist urologist depending on the clinical features and proved by urinalysis , KUB, Ultrasound and the non - contrast CT images. The SSD was calculated by measuring the 90° distance from the center of the stone to the skin .Patients received one session of ESWL and followed up for two weeks. Successful treatment considered if there was complete clearance of the stone with no residual fragments (stone - free) or presence of gravels less than 4 mm . Those who failed received another session 2 week after the first one. Data wereXIIanalysed using the statistical package for social sciences (SPSS) version 21, and appropriate statistical tests were used to assess the significance which set at ≤ 0.05 to be significant.Results : The age of the studied group ranged (23 - 74) years with a mean of (41.5± 12.5) years. Only 20% of the patients aged 30 years or less. Male to female ratio was (2.3 : 1). After the 1st session , 40% of patients had successful treatment and they became stone free. After the second session, the overall response rate (successful ESWL) was (66%). Success of treatment was significantly affected by the initial stone size . patients with successful treatment had the lower stone area (96.4 ± 34.4 mm2) compared to (150.8 ± 81.2 mm2) in those with unsuccessful treatment , (P=0.016). Stone density showed an inverse correlation with the success rate, the mean stone density was the lower among those with successful treatment (640.3 ± 301.2) HU , (P<0.001). Multiple logistic regression showed that stone size and density were the most significant predictors for successful treatment. Patients characteristics (age and sex), site of the stone and SSD didn’t reach the statistical significance for prediction (P>0.05) .Conclusion : Non - contrast Computed Tomography (NCCT) is a noninvasive and useful for obtaining a lot of information about the patient and renal calculi and can predict the success of ESWL. Stone density and size were significant predictors of the outcome of ESWL . Lower stone density and size predicted by NCCT associated with higher success rate of ESWL.

ترافق كالسيوم الشريان الابهر البطني مع كالسيوم الشرايين التاجية ومرض الانسداد التاجي == Association Of Abdominal Aortic Calcium With Coronary Artery Calcium And Obstructive Coronary Artery Disease

Author name: حنان محمد علي الرماح
Supervisor name: حيدر قاسم الموسوي | فاضل غالي العمران
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Kufa - Faculty Of Medicine
Language: English
University location: Najaf
First pages:

بزل تجمعات السوائل العميقة تحت سيطرة المفراس والسونار == Image Guided Percutaneous Drainage Of Deep Collections

Author name: ليلى كاظم عبود
Supervisor name: محمد عبد الامير مهدي | حسن عبد الله العاقولي
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Kufa - Faculty Of Medicine
Language: English
University location: Najaf
First pages:

مقارنة حساسية السونار مقابل اشعة ( س) التقليدية في اكتشاف كسر العظم الانفي == Comparison Between The Sensitivity Of Ultrasound And Conventional X - Rays In Diagnosing Of Nasal Bone Fracture

Author name: رجاء عزيز جبار
Supervisor name: رائد حليم السعد | احمد عذاب الزبيدي
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Kufa - Faculty Of Medicine
Language: English
University location: Najaf
First pages:
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