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Background: Atherosclerotic cardiovascular diseases are the leading cause of death worldwide (30% of the mortalities).Coronary atherosclerotic plaques are classified into stable and unstable. Unstable plaques increase the risk of acute coronary syndrome and early detection will help prevention. Evaluation of plaque vulnerability is done best by invasive intravascular ultrasound and so, this study aims to evaluate the possible use of non invacive CT for plaque characterization.Aim of the work: Determine the role of multidetector CT in the assessment of plaque composition and configuration. This will improve risk stratification thus, decreasing the incidence of sudden death.Patients and methods: This study included 46 patients with coronary atherosclerotic plaques. The most expansive or solitary lesion was selected for each patient.Results: Forty-six atherosclerotic plaques were evaluated by multi-slice coronary CT; 30 patients were unstable clinically and 16were stable. Dyslipidemia was found in 40 patients while diabetes was found in 22 patients. 69.6% of the lesions were found in the proximal LAD. Most of unstable patients showed mixed plaques and soft plaques. In a stable group, most of the plaques were calcified. As for the attenuation pattern 18/46 of the plaque with heterogeneous attenuation were in the unstable clinical group. 28/46 of the plaques with homogenous attenuation were stable. Regarding the Napkin ring sign it was positive in 18/46 of the plaques and the 18 patients on follow up were found to be unstable.All patients with spotty calcification proved to be unstable clinically.Remodeling index, low hounse field unit and plaque burden were higher in the unstable group.. No association between stability and degree of stenosis.Conclusion: A strong correlation between plaque characteristics and clinical presentation: Multislice coronary CT angiography detect high-risk plaque criteria.

Background Reperfusion therapy in patients with acute myocardial infarction (AMI) can salvage the myocardium; however, successful restoration of the coronary artery patency is not always associated with adequate perfusion at the level of microvasculature, known as the no-reflow or microvascular occlusion (MVO). The primary objective of our prospective study was to assess, by cardiac magnetic resonance (CMR), the prognostic value of MVO size, and its impact on left ventricular (LV) remodeling in cases of reperfused AMI. Thirty-three patients with AMI underwent cardiac MRI at 1.5-T scanner within 7 days (baseline) and 3 months (follow-up) after reperfusion. Patients with MVO were included where early gadolinium enhancement (EGE), late gadolinium enhancement (LGE), and cine sequences were acquired. The impact of MVO size on LV ejection fraction (EF%) and LV volumes was quantitively analyzed. Results There was a significant inverse correlation between the MVO size % of the LV mass (LVM) and the EF% values measured at follow-up with a P value of 0.000, while a significant positive correlation was encountered between the MVO% of LVM and both indexed end-systolic volume (ESVI) and indexed end-diastolic volume (EDVI) values measured at follow-up with P values of 0.438 and 0.389, respectively. MVO size was found to be a significant factor affecting the patient’s outcome (P = 0.000) where MVO size of > 10% of the total LVM can be a predictor of a worse outcome and reduced EF% at follow-up. Conclusion The prognostic value of MVO could be statistically determined with a cut off value to predict a possible good outcome using CMR.

Liver cirrhosis and hepatocellular carcinoma (HCC) constitute one of the major causes of morbidity, mortality, and high health care costs worldwide. Multiple treatment options are available for HCC depending on the clinical status of the patient, size and location of the tumor, and available techniques and expertise. Locoregional treatment options are multiple. The most challenging part is how to assess the treatment response by different imaging modalities, but our scope will be assessing the response to locoregional therapy for HCC by MRI. This will be addressed by conventional MR methods using LI-RADS v2018 and by functional MR using diffusion-weighted imaging, perfusion, and highlighting the value of the novel intravoxel incoherent motion (IVIM).

Purpose: To emphasis the role of MSCT utilizing the remodeling index in assessment of positive coronary remodeling which was associated with plaque rupture and vulnerability. Methods and material: Studied group included 35 patients with positive coronary remodeling. One lesion per patient was assessed, either a solitary lesion or the most significant one. All patients were subjected to history taking and radiological evaluation using a contrast-enhanced 64 MSCT then post processed. Assessment of the plaque causing positive remodeling regarding the site, number (single, kissing, or multiple), relative composition and predominant type in H.U. was performed. Specific measurements at the reference and remodeling segment were taken. Calculation of remodeling index was done. Two comparative groups were made between subjects with remodeling index (RI)

Purpose: To investigate the accuracy of 64-row MDCT to analyze and quantify coronary arterial plaques in patients presented with acute coronary syndrome (ACS). Patients and methods: Between April 2010 and December 2013, 50 patients presented with acute cardiac chest pain were categorized into 2 groups according to their diagnosis based on clinical evaluation, ECG findings and cardiac biomarkers; group A including patients with ACS and group B including patients with stable angina (SA). Both groups underwent 64-row multidetector CT (MDCT) coronary arterial imaging. For each plaque, stenosis percentage was evaluated and the plaque was quantified using software (Sureplaque®) based on the density (HU) and percentage of its individual components including lipid, soft tissue, and calcium density. Results: Of the 50 patients; 24 and 26 were grouped into groups A & B respectively. The mean value of stenosis percent of the proximal & middle coronary segments of group A patients = 77.2% ± 10.2% - 90.5% ± 58.4% and 79.5% ± 9.1% - 85.25% ± 11% respectively, while in group B = 54.1% ± 12.1% - 65.2% ± 18.4% & 53.3% ± 1.5% - 68.6% ± 11.7% respectively (p=0.00-0.001). Quantification showed a mean value of lipid content percentage of group A = 15.4% ± 0.8% - 47.7 % ± 19.2 %, while in group B = 7.2% ± 5.5% - 10.3% ± 8.2% (p=0.008–0.001). The mean value of soft tissue content percentage in group A = 15.4% ± 0.8% - 47.7 % ± 19.2 %, while in group B = 7.2% ±5.5% - 10.3% ± 8.2%. The calcification content percentage in group A = 18% ± 8.7% - 35.1 % ± 16 %, while in group B = 66.4% ± 13.8% - 76.7% ± 16.5%. Conclusion: 64-row MDCT angiographic quantification software provides a good basis for the future attempts of proper risk stratification of patients with coronary artery disease especially those liable for developing ACS.

AimThe aim of this study was to evaluate the effect of temporomandibular joint bony ankylosis and surgical sequelae of gap arthroplasty on middle ear volume (MEV).Patients and methodsSixteen Egyptian individuals were selected and divided into two equal groups. The first group (group I) included eigh

Purpose: To emphasis the role of cardiac magnetic resonance compared to echocardiog- raphy in evaluating patients with ischemic cardiomyopathy to accurately assess global and regional Left ventricular function which is essential for prognosis and for evaluating therapeutic responses. Methods and materials: The studied group included 37 patients already diagnosed as having ische- mic cardiomyopathy. All patients were subjected to full history taking and radiological evaluation using a 1.5-T MR system and echocardiography. Comparison was made between echocardiography and cardiac magnetic resonance regarding segmental wall motion by using the 17-segment model of the American Heart Association. Agreement regarding segmental wall motion was assessed by using Cohen's Kappa statistics. Also ejection fraction measurement by both modalities was com- pared. Detection of transmural extent of myocardial scar was also performed. Results: Poor agreement between cardiac magnetic resonance and echocardiography regarding seg- mental wall motion with Cohen's Kappa is 0.195, P value of

Patients with pulmonary hypertension and suspected right ventricular (RV) dysfunction often have dyspnea at rest, making reliable assessment of RV function using traditional breath-holding methods difficult to perform. Using single-heartbeat fast strain encoding (Fast-SENC) imaging, peak systolic RV circumferential and longitudinal strains were measured in 11 healthy volunteers and 11 pulmonary hypertension patients. Fast-SENC RV longitudinal strain and circumferential strain measurements were compared to conventional SENC and MR tagging, respectively. Fast-SENC circumferential and longitudinal RV shortening correlated closely with SENC measurements (r = 0.86, r = 0.90, P < 0.001 for all). Circumferential strain, by conventional tagging, showed moderate correlation with Fast-SENC in pulmonary hypertension patients only (r = 0.5, P = 0.003). A nonuniform pattern of RV circumferential shortening was depicted in both groups. Peak systolic circumferential strain was significantly reduced at the basal RV in pulmonary hypertension patients (−18.06 ± 3.3 versus −21.9 ± 1.9, P < 0.01) compared to normal individuals, while peak systolic longitudinal strain was significantly reduced at all levels (P < 0.01 for all). Fast-SENC is a feasible and reliable technique for rapid quantification of RV regional function in a single-heartbeat acquisition. Information derived from Fast-SENC allows characterization of RV regional function in normal individuals and in pulmonary hypertension patients. Magn Reson Med, 2010. © 2010 Wiley-Liss, Inc.

Patients with pulmonary hypertension and suspected right ventricular (RV) dysfunction often have dyspnea at rest, making reliable assessment of RV function using traditional breath-holding methods difficult to perform. Using single-heartbeat fast strain encoding (Fast-SENC) imaging, peak systolic RV circumferential and longitudinal strains were measured in 11 healthy volunteers and 11 pulmonary hypertension patients. Fast-SENC RV longitudinal strain and circumferential strain measurements were compared to conventional SENC and MR tagging, respectively. Fast-SENC circumferential and longitudinal RV shortening correlated closely with SENC measurements (r = 0.86, r = 0.90, P0.001 for all). Circumferential strain, by conventional tagging, showed moderate correlation with Fast-SENC in pulmonary hypertension patients only (r = 0.5, P = 0.003). A nonuniform pattern of RV circumferential shortening was depicted in both groups. Peak systolic circumferential strain was significantly reduced at the basal RV in pulmonary hypertension patients (-18.06 +/- 3.3 versus -21.9 +/- 1.9, P0.01) compared to normal individuals, while peak systolic longitudinal strain was significantly reduced at all levels (P0.01 for all). Fast-SENC is a feasible and reliable technique for rapid quantification of RV regional function in a single-heartbeat acquisition. Information derived from Fast-SENC allows characterization of RV regional function in normal individuals and in pulmonary hypertension patients.

Objective: The aims of the study were the evaluation of peripheral arterial occlusive disease with multidetector or multi-slice CT angiography (MDCTA) and comparison of the results with the results of digital subtraction angiography (DSA), a standard reference. Patients and method: The written informed consent of the patients and ethics committee approval were obtained. The prospective study group consisted of 10 patients complaining of peripheral arterial disease. Using MDCT-A, the arterial tree of the lower extremity was evaluated for the presence of steno-occlusive lesions that might have led to luminal stenosis. The diagnostic accuracy of MDCTA was calculated and compared with that of DSA. Results: In the segment-based analysis, the sensitivity, specificity, and accuracy of MDCT angiography in determining significant stenoses were 100%, 99.3%, and 99.6.3%, respectively. The compatibility between MDCTA and DSA methods in grading stenosis was calculated as 0.896 (P