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Abstract Background Hepatic arterial anatomy is important in performing many surgical and endovascular procedures. Familiarity with variations in the hepatic arterial anatomy is essential to achieving adequate embolization. In some patients, in addition to anatomic variations of the hepatic arteries, different extrahepatic collateral arteries may provide partial or total vascular supply to hepatocellular carcinoma (HCC), which makes transcatheter arterial chemoembolization (TACE) technically challenging. We aim to evaluate the different feeding vessels of HCC using multi-detector computed tomography angiography (MDCTA) as a pre-procedural step before planning suitable management. Results One hundred patients with 150 focal HCC lesions were involved in our study. The anatomy of the blood supply and the morphological characteristics of HCC, including the size, location, and history of previous hepatitis, were quantitatively assessed and statistically analysed. The number of patients who had classic hepatic arterial supply for the HCC lesions in our study was 54 (54%). The number of patients with additional extrahepatic supply is 26, while the number of patients with anatomical vascular variants is 20. Among these 26 patients with extrahepatic (parasitic) blood supply, six patients were supplied by the right inferior phrenic artery, four patients were supplied by the right internal mammary artery, and two patients were supplied by each other type of extrahepatic feeder, which are the left inferior phrenic artery, left internal mammary artery, left gastric artery, cystic artery, right lumbar artery, direct branch from the aorta, omental arteries, right renal artery, and LHA from the LGA. Twelve of the 20 patients with anatomical vascular variants had replaced RHA from the SMA; four patients had replaced LHA from the LGA; two patients had replaced RHA from the GDA; and two patients had replaced CHA from the SMA. Only 50 cases of CT findings were correlated with the data from the interventional procedures of these patients. Conclusions Because of the differences in HCC blood supply between typical, parasitic, and anatomical vascular variants, MDCTA has significant clinical significance prior to TACE and any interventional procedure.

Abstract Background The high incidence of non-cardiac congenital anomalies in high-risk pregnancies is a major worldwide health problem. Congenital deformities represent 20–25% of perinatal deaths. The best non-invasive screening method for diagnosing congenital abnormalities is ultrasound. Four-dimensional ultrasound added additional diagnostic value to two-dimensional ultrasound in evaluating fetal prenatal conditions. Our study's goal was to compare the roles of two-dimensional and four-dimensional ultrasound in the diagnosis of non-cardiac fetal congenital anomalies in high-risk pregnancies. Results Out of the 100 pregnant women who underwent examinations, all had high-risk pregnancies and were expected to give birth to babies with deformities, a total of 25 cases (or 25%) of fetal abnormalities were found. The two-dimensional ultrasound diagnosis's accuracy sensitivity, and specificity were 84%, 76%, and 86.67%, respectively, while they were 87%, 80%, and 89.33%, respectively, for four-dimensional ultrasound. The accuracy, sensitivity, and specificity of two-dimensional ultrasound combined with four-dimensional ultrasound were significantly higher (94%, 88%, and 96%, respectively) than those of two-dimensional ultrasound or four-dimensional ultrasound alone. This study also analyzed the risk factors leading to fetal malformations. The results showed that consanguinity, increased maternal age, past history or family history of congenital anomalies, history of medication during pregnancy, and maternal diabetes were major risk factors statistically significant for congenital anomalies. Conclusion The diagnosis rate of fetal abnormalities can be significantly increased by combining two-dimensional ultrasound with four-dimensional ultrasound. Avoiding risk factors that raise the likelihood of fetal abnormalities should take priority for pregnant women with high risk factors. To lower the incidence of fetal abnormalities, prenatal screening and diagnosis should be standardized.

Abstract Background Whole-body diffusion-weighted magnetic resonance is being developed as a tool for assessing tumor spread. Patients with known primary tumors require meticulous evaluation to assess metastasis for better staging; we attempted to detect bony metastasis without radiation exposure. Our study's goal was to use whole-body diffusion-weighted imaging with background body signal suppression (WB-DWBIS) to evaluate bony metastasis in confirmed patients who have primary tumors. Results Our study included 90 patients with known primary cancer, 10 patients were excluded as they had no bony metastasis, from 80 patients: 36 (45.0%) having one site of metastasis, 36 (45%) having two sites of metastasis, and 8 (10.0%) having three sites of metastasis. 56 (70.0%) of the metastasis sites were bony metastasis, and 76 were mixed both bony and non-bony, including 32(40.0%) lung, 16 (20.0%) liver, and 28 (35%) lymph nodes. Sensitivity of bone scanning in detecting metastasis was as follows: 95.1% sensitivity and 92.0% accuracy, while that of whole-body diffusion-weighted image with background signals suppression was 94.8% sensitivity and 91.7% accuracy, WB-DWBIS inter-observer agreement in the detection of bony metastatic deposits in cancer patients was good (0.7 45, agreement = 93.2%). Conclusions Using WB-DWBIS images, bone lesion identification and characterization (site and number) were improved, producing outcomes similar to bone scanning without the use of ionizing radiation.

Abstract Background Few studies tried to detect the risk of developing COVID-19 (corona virus disease 2019) between different groups of workers. Health care workers are more likely to have severe form of COVID infection. The objective of our study is to compare the severity scoring system of COVID infection between medical and non-medical personnel by CT (computed tomography). This study started from 1 May, 2020, to 30 December, 2021. CT study of the chest for 1200 infected patients with COVID-19 (600 were medical stuff and 600 persons of non-medical staff) was done in five health quarantine centres in Egypt. CT findings were reviewed in relation to the severity of symptoms. The results of the two groups were compared to each other. Results CT findings were more frequent and more severe in the medical staff group, including that the number of consolidative patches mixed with areas of ground glass attenuation in medical staff group was (37.2%) versus non-medical staff group was (22.2%), with p-value (*0.001), diffuse lobar involvement was in (150 severe cases) in medical staff group versus in 67 severe cases of non-medical staff group and had significant difference (p value *0.005), fibrosis (p value *0.002) and more opportunity to get severe form of infection increased in medical personnel rather than control group (p value *0.001) which may be due to limited health care facilities in protection against infection especially in developing countries and more contact during work time with infected persons and high viral load. Conclusion The current study results show that severity score is higher in the medical personnel than non-medial personnel.

Abstract Background Management of brachial plexopathy requires proper localization of the site and nature of nerve injury. Nerve conduction studies and electrophysiological studies (ED) are crucial when diagnosing brachial neuropathy but these do not determine the actual site of the lesion. Conventional MRI has been used to evaluate the brachial plexus. Still, it carried the disadvantage of the inability to provide multi-planar images that depict the entire length of the neural plexus .It might be difficult to differentiate the brachial plexus nerves from adjacent vascular structures. Magnetic resonance neurography (MRN) is an innovative imaging technique for direct imaging of the spinal nerves. Our study aims to detect the additive role of MRN in the diagnosis of brachial plexopathy over ED. Forty cases of clinically suspected and proved by clinical examination and ED—traumatic (N = 30) and non-traumatic (N = 10)—were included in our study. We compared MRN finding with results of clinical examination and ED. Results MRN findings showed that the root was involved in 80% of cases, trunks in 70% of cases affecting the middle trunk in 40% of cases, the middle and posterior cord in 25%, lateral cord in 50%, and terminal branches on 10% of cases. Ten percent of cases were normal according to MRN, and 90% had abnormal findings in the form of preganglionic nerve root avulsion in 30% of cases, mild perineural edema surrounding C6/7 nerve roots in 20%, lower brachial trunk high signal in 10%, complicated with pseudo meningocele in 20%, and with increased shoulder muscle T2 signal intensity with muscle atrophy in 10%. There were minimal differences between clinical examination finding and MRN findings, with very good agreement between electromyography and nerve conduction (p value < 0.05, with sensitivity and specificity values of 94.44% and 100%, respectively). Conclusion MRN is important in differentiating different types of nerve injuries, nerve root avulsion, and nerve edema, playing an important role in differentiating the site of nerve injury, both preganglionic or postganglionic and planning for treatment of the cause of nerve injury, either medical or surgical.

Abstract Background T2 relaxometry is a highly sensitive technique used to assess morphological changes in the cartilage prior to anatomical changes; it provides the quantification of the disparate components of cartilage such as water, proteoglycans, and collagen. This study aims to assess T2 values of glenohumeral joint cartilage using 1.5 T magnetic resonance imaging (MRI) and comparing T2 relaxation time values between two groups—the control group and the group of patients with osteoarthritis (OA). The study was conducted among 35 OA patients (27 females and eight males; median age, 60 years; age range, 43–69 years). This group was divided into primary OA (n = 15) and secondary OA (n = 20). The control group had 30 patients (25 females and five males; median age, 46 years; age range, 30–56 years). All patients were assessed using plain radiography to determine the grade of osteoarthritis followed by a multi-echo spin pulse sequence (T2 mapping) of the coronal plane. Three areas were considered to evaluate the cartilage-humeral zone, glenoid zone, and central zones by manually drawing the region of interest (ROI). The values were compared statistically by using Mann-Whitney U tests. Results Median T2 values differed significantly between the control group (43.4 ms [interquartile ranges, 41.54-45.33 ms]) and the OA patients for grades I (59.2 ms [interquartile ranges, 57.54-63.33 ms]), II (64.7 ms [interquartile ranges, 62.54-67.39 ms]), and III (61.9 ms, [interquartile ranges, 57.54-64.53 ms]). Mean T2 values were significantly higher in the different zones when comparing the OA patients whatever the cause primary or secondary (p value < 0.05) with the control group; no significant difference was noticed between the primary and secondary OA (p value > 0.05). Conclusion T2 relaxometry is a reliable, quantitative method for the assessment of the glenohumeral cartilage for significant differences in T2 values between the control group and the OA patients.

Abstract Background Differentiation between malignant and benign masses is essential for treatment planning and helps in improving the prognosis of malignant tumors; the aim of this work is to determine the role of diffusion-weighted magnetic resonance imaging (DW-MRI) and the apparent diffusion coefficient (ADC) in the differentiation between benign and malignant solid head and neck masses by comparing diagnostic performance of low b values (0.50 and 400 s/mm2) versus high b values (800 and 1000 s/mm2) and comparing the result with histopathological finding. Results The study included 60 patients (34 male and 26 female) with solid head and neck masses > 1 cm who referred to radiodiagnosis department for MRI evaluation. Multiple b values were used 50, 400, 800, and 1000 s/mm2 (at least 2 b values). DWI and ADC value of all 60 patients were acquired. Mean ADC values of both malignant and benign masses were statistically measured and compared, and cut off value was determined. Solid head and neck masses in our study DWI with the use of high b value 800 and 1000 s/mm2 were of higher significance (P value 0.001*). There was a significant difference in the mean ADC value between benign and malignant masses (P

Abstract Background T2 mapping and DWI are newly quantitated method for disk degeneration assessment; they were used in the determination of an early stage of intervertebral disk degeneration. T2 mapping was quantitatively sensitive for detecting the early stage and aging-related changes in intervertebral disk degeneration. Furthermore, T2 mapping and apparent diffusion coefficient values (ADC) in lumbar intervertebral disks indirectly correlated with the Pfirrmann grades in IVDD and age-related disk degeneration. The aim of this study is to evaluate the sensitivity of T2 mapping and apparent diffusion coefficient in the determination of an early stage of intervertebral disk degeneration. Results T2 relaxometry values were found to decrease with the increased disk degeneration except in grade V where it was found to be increased again. There was a negative correlation between T2 values and semi-quantitative grading (Pfirrmann Grading) of disk degeneration and T2 values were significantly different when comparing grade I to V. A T2 value of nucleus pulposus (NP) was more sensitive than annulus fibrosus (AF) and entire of the disk. ADC values were found to decrease with the increased degree of disk degeneration; there was a weakly significant negative correlation between age and T2 mapping values, ADC values of nucleus pulposus, and entire of disk. Conclusion T2 mapping was significantly different when comparing grade I to V while ADC value had a significant weak negative correlation with age, so T2 mapping and to a little extent ADC can be used for quantitative analysis of early disk generation seeking for early diagnosis and better management.

Abstract Background Diagnosis of a small hepatic focal lesion (≤ 2 cm) in a cirrhotic liver by MRI depending on its characteristic signal intensities at different sequences, contrast enhancement, and diffusion-weighted image (DWI). Liver nodules were divided into malignant or benign according to the combination of different imaging features such as contrast uptake pattern, presence of fat, necrosis, diffusion pattern, and ADC value. We study about hepatic nodules which are difficult to diagnose using triphasic CT study due to a small size which make a characteristic pattern of enhancement of these focal lesions confusing and inadequate. Triphasic MRI and DWI increase the accuracy of the diagnosis of small nodule ≤ 2 cm and help in better treatment and intervention. The purpose of the study is to clarify the role of triphasic MRI and diffusion in differentiating a small hepatic nodule less than 2 cm in cirrhotic liver. Results Out of 60 patients with 124 hepatic nodules, MRI findings revealed 40 cases with malignant nodules (66.7%), 12 cases with premalignant nodules (20%), and 8 cases with benign nodules (hemangioma) (13.3%). Conclusion Combined triphasic MRI and diffusion WI increase the accuracy of the diagnosis of small hepatic focal lesions in the cirrhotic liver which may be difficult to diagnose by other imaging modalities, and help in early management and intervention.