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Background: Accurate assessment of stenosis site, degree, and length in post-intubation laryngotracheal stenosis patients is crucial for procedure selection and prognosis prediction. Despite being the preferred method, bronchoscopy has its drawbacks in severely ill patients, with potential complications and limitations in evaluating airway features beyond high-grade stenosis. Computed Tomography (CT) scans with multiplanar reconstructions are suggested as a safer and alternative diagnostic tool to overcome these limitations. The present work aims to compare the diagnostic performance of CT virtual bronchoscopy (VB) and multiplanar reformatting (MPR) with conventional bronchoscopy (CB) in post-intubation laryngotracheal stenosis patients. Methods: This prospective comparative study, enrolled 30 patients with post-intubation laryngotracheal stenosis from October 2020 to October 2022. All patients were subjected to detailed history taking, thorough clinical examination, endoscopic and radiological investigations. All patients went through CT examination, rigid bronchoscope and underwent tracheal resection anastomosis operation. The evaluated parameters were the length, diameter, and cranio-caudal extent of stenosis in all settings, and the results were compared. Results: No statistically significant differences between computed tomography virtual bronchoscopy and MPR with crico-tracheal resection operation results regarding length (p-value = 0.943), diameter (p-value = 0.939), and craniocaudal extent (p-value = 0.988). Regarding conventional bronchoscopy and crico-tracheal resection, a statistically significant difference in lumen diameter (p-value = 0.024) was noted. No significant difference in length (p-value = 0.943). No statistically significant difference (p-value = 0.951) as regards cranio-caudal extent. Conclusions: CT multiplanar reformatting and virtual bronchoscopy offer accurate, noninvasive assessment of laryngotracheal stenosis, surpassing conventional bronchoscopy. They prove beneficial for precise evaluation of lesion length and lumen diameter, especially beyond high-grade stenosis where conventional bronchoscopy faces limitations. These techniques serve as dependable alternatives for patients at risk for anesthesia, providing a safer diagnostic approach. [ABSTRACT FROM AUTHOR]

Background and Objectives: Breast cancer is a variable group of diseases with different genotypic and phenotypic subtypes. Identifying the breast cancer molecular subtype is important in directing the type of treatment. The aim of this work: Our study aimed to evaluate the role of multiparametric MRI in prediction of molecular subtypes of breast cancer. Patients and Methods: A retrospective study included 135 female patients with pathologically proven invasive ductal carcinoma (IDC). Clinicopathological findings, morphological features, and dynamic contrast enhanced MRI (DCE-MRI) features were evaluated and correlated with the breast cancer molecular subtypes based on Immunohistochemistry classification. Results: We found that the most common histological grade (61.5%) was grade I &II (low grade) of invasive ductal carcinoma (IDC). There were 110 (81.5%) masses and 25 (18.5%) non-mass lesions. The luminal A-like (Lum A-like) was the most common subtype seen in 57 (42.2%), then luminal B-like (Lum B-like) in 46 (34.1%), human epidermal growth factor receptor2 (HER2) positive in 14 (10.4%), and triple-negative (TN) was the least common subtype seen in 18 (13.3%) of the lesions. Irregular or Spiculated mass margins and irregular shape were significantly associated with Luminal A-like subtype (87.7%&80.7%) and Luminal B-like (85%&100%), respectively (P=0.002). Larger mass size, multifocality, and non-mass enhancement were reliably associated with HER2-enriched subtype (78.6%,50% & 50%) respectively. The mass with oval shape, circumscribed margin, intra-tumoral high signal intensity on T2WI, rim enhancement, and higher histological grade was highly significant detected in TN breast cancer (P<0.001). The edema pattern was not significantly related to any molecular subtype. Conclusions: Morphological features of breast cancer, intra-tumoral T2WI signal intensity, the pattern of enhancement determined by multiparametric MRI, as well as the histological grade of the tumor could be helpful to predict and differentiate breast cancer molecular subtypes and hormone receptors. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate magnetic resonance imaging (MRI) and 3-dimensional transperineal ultrasound (3D-TPUS) features of pelvic floor dysfunction (PFD) in symptomatic women in correlation with digital palpation and to define cut-offs for hiatal dimensions predictive of muscle dysfunction. Methods: This prospective study included 73 women with symptoms suggesting PFD. 3D-TPUS, MRI, and digital palpation of the levator ani muscle were performed in all patients. Levator hiatal antero-posterior (LHap) diameter and area (LH area) were measured at rest and at maximum muscle contraction. Results: The reduction in LHap diameter and LH area during contraction was significantly less in women with underactive pelvic floor muscle contraction (UpfmC) than in those who had normal pelvic floor muscle contraction by digital palpation (P<0.001). Statistically significant positive correlations (P<0.001) were found between the Modified Oxford Score and 3D-TPUS and MRI regarding the reduction in the LHap diameter (r=0.80 and r=0.82, respectively) and LH area (r=0.60 and r=0.70, respectively). A reduction in LHap of <6.5% on 3D-TPUS and <7.6% on MRI predicted UpfmC with sensitivities of 46.2% and 82.7%, respectively. A reduction in LH area of <3.4% on 3D-TPUS and <3.8% on MRI predicted UpfmC with sensitivities of 75.0% and 88.5%, respectively. MRI was more sensitive in detecting levator avulsion (63.4%) than 3D-TPUS (27.1%). Conclusion: MRI and 3D-TPUS had strong positive correlations with findings on palpation, and at certain cut-offs for hiatal dimensions, they can be used as complementary and objective tools to improve the accuracy of diagnosis and management planning of PFD. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the added value of diffusion-weighted imaging (DWI)/apparent diffusion coefficient (ADC) in the categorization of small hepatic observation (≤ 20 mm) detected in patients with chronic liver disease in reference to LI-RADS (liver imaging reporting and data system) classification system. Methods: We prospectively evaluated 165 patients with chronic liver disease with small hepatic observations (≤ 20 mm) which were previously categorized as LI-RADS grade 3–5 on dynamic contrast-enhanced CT (DCE-CT). All patients were submitted to a functional MRI including DCE and DWI. Using LI-RADS v2017, two radiologists independently evaluated the observations and assigned a LI-RADS category to each observation using DCE-MRI alone and combined DCE-MRI and DWI/ADC. In the combined technique, the radiologists assigned a LI-RADS category based on a modified LI-RADS criteria in which restricted diffusion on DWI was considered a major feature of HCC. We evaluated the inter-reader agreement with Kappa statistics and compared the diagnostic performance of the LI-RADS with two imaging techniques by Fisher's exact test using histopathology as the reference standard. Results: Combined technique in LI-RADS yielded better sensitivities (reader 1, 97% [65/67]; reader 2, 95.5% [64/67]) for HCC diagnosis than DCE-MRI alone (reader 1, 80.6% [54/67], p = 0.005; reader 2, 83.6% [56/67], p = 0.04). The specificities were insignificantly lower in combined technique (reader 1, 88.4% [107/121]; reader 2, 77.7% [94/121]) than in DCE-MRI alone (reader 1, 90.9% [110/121], p = 0.67; reader 2, 79.3% [96/121], p = 0.88). The inter-reader agreement of the LI-RADS scores between combined technique and DCE-MRI was good (κ = 0.765). Conclusion: The use of DWI/ADC as an additional major criterion, improved the sensitivity of LI-RADS in the diagnosis of HCC while keeping high specificity. [ABSTRACT FROM AUTHOR]