Background The current COVID-19 pandemic has resulted in marked and rapid changes to the standing policies of radiology departments globally. The aim of this review article is to describe the various processes implemented by a radiology department in an educational institution in a resource limited country during the COVID-19 crisis, giving insights into the adopted strategies in other institutions in developed countries. Main body Our preparedness strategy was directed into five main domains: protection and wellness of radiology faculty and staff, radiological examinations and patients’ safety, education, research, and financial support. By implementing new strategies, we found that work reorganization through the use of home PACS provided safe and effective reporting service, low infection rate with zero mortality, and online lectures and theses defense were successful. Furthermore, governmental support and donations were helpful in facing financial challenges during the pandemic. A comprehensive literature review search for policies adopted by other radiology departments in the world was performed. The adopted strategies of various centers are generally similar to ours aiming for mitigating the spread of the virus, keeping good patients’ care, and maintaining the educational process. Few policy differences across institutions were found in the reporting strategy of COVID-19 pneumonia and according to the availability of resources. Conclusion Covid-19 pandemic has opened the door for changes in the radiology department policies with renewed focus on educational, clinical, and scientific strategies. Documentation of the dynamic modifications of everyday practices and lessons learned are important as a reference for preparedness for possible second surge or future crisis.
Background: phase contrast MR imaging is a rapid, simple and non-invasive technique which is sensitive to even small CSF flows, and can be used to evaluate CSF flow both qualitatively and quantitatively. Cine phase contrast MR images show CSF flow in a dynamic, more easily appreciable, and in a more pleasing manner, allowing the delineation of obstruction, if present, along the portions of CSF pathway where obstruction is common (foramen of Monro, acqueduct of Sylvius) Patients and Methods: the study includes 20 patients from the pediatric population with ventriculomegaly (diagnosed by a radiological report) referred from Ain Shams Pediatric Hospital, Neurosurgery department at Ain Sahms University, clinic, and outpatients. Control group of 20 pediatric patients of matched age group underwent CSF flow study to obtain normal reference values. These patients had no hydrocephalus and came to our institute to undergo MRI for other neurological causes. CSF flowmetry was added to their study after obtaining oral informed consent from their parents. Results: our study included 20 patients, 8 males and 12 females, with age range 2 months -12 years and average age 3.5 years old. All patients included were diagnosed with hydrocephalus by a previous radiological report. All patients underwent conventional MRI brain and CSF flowmetry. Patients were given diagnosis based on findings of conventional MR images, and were categorized into groups according to their underlying etiologies. 9 patients had aqueductal stenosis, 4 patients had atrophy, 2 patients had communicating hydrocephalus, 2 patients had Arnold Chiari malformation, 1 patient had Dandy-Walker variant, 1 patient had obstruction at foramen of Monro, and 1 had obstruction at foramen of Magendi. CSF flowmetry was added to evaluate the cause of hydrocephalus. Conclusion: phase contrast MR imaging is a rapid, simple and non-invasive technique which is sensitive to even small CSF flows, and can be used to evaluate CSF flow both qualitatively and quantitatively, and could be used in conjunction with conventional MRI in assessment of cases of hydrocephalus.
Background Ovarian cyst is a common gynecological problem.The great majority of ovarian cysts are asymptomatic functional (physiological) cysts with simple appearance and small size. Ultrasonography (US) is the imaging modality of choice in the evaluation of cystic ovarian lesions in adolescent females. Aim of the Work To document ovarian cyst frequency and characteristics in females at school age group between 10-15 years old to study the prevalence and characteristics of ovarian cysts among them. Patient and Methods Our study was done on 52 girls aged between 10-15 years old presented and referred to our Radio-diagnosis department at Mataria teaching hospital from different outpatient clinics for pelvic US examination in a period of six months from May 2018 to November 2018. Results In our study the mean age 12.87±1.79, while age of start of menstruation (menarche) ranged from 10-14 with mean value 11.94±0.88. Regarding their menstrual pattern, girls with regular menstruation were (65.6 %) while those with irregular menstruation were (34.4%). Ovarian cystic lesions were founded in 9 girls (17.3%) while 43girls (82.7%) have normal ovaries. Simple ovarian cyst was the most frequent lesion which was seen in 8 girls(15.4%) followed by hemorrhagic cyst in one girl (1.9%). Conclusion Cystic lesions of the ovary are a common gynecological finding. They are very common and mostly benign during adolescence. Many ovarian cysts are asymptomatic and found incidentally on routine pelvic examination.
Background Despite the high-frequency rate of cerebrospinal fluid shunt malfunction, radiological evaluation of CSF shunts has remained deficient, focusing mainly on demonstrating secondary signs of shunt failure rather than evaluating the shunt tube itself. We aimed to study the utility of different MR pulse sequences in evaluating the cranial and abdominal ends of CSF shunts in order to identify the potential cause of shunt failure and its impact on patient management. Results Twenty-five patients (18 males, 7 females, median age 2.5 years, IQR 0.75–15) were enrolled in the study, having 28 ventriculo-peritoneal shunts and single ventriculo-gallbladder shunt. The catheter lumen and fine intraventricular septae were only demonstrated in 3D-DRIVE sequences (p < 0.001). Except for three patients (having cranial end-related complications), all patients with cranial and/or abdominal end-related complications received surgery (p < 0.001, positive likelihood and negative likelihood ratios = 7.27, 0.3, respectively, sensitivity = 0.7 and specificity = 0.9). MRI findings (luminal occlusion, disconnection, CSF collection, or migration) were consistent with operative data. There is no significant difference between patients who underwent surgery and those with conservative management, or symptomatic and asymptomatic patients in terms of the prevalence of ventricular dilatation or white matter signal abnormality. The results of the abdomino-pelvic fat-suppressed T2-WI showed excellent agreement with ultrasound findings (Cohen’s Kappa 0.9). Quantitative PC could give insights into CSF dynamics, which depend on the site and cause of shunt malfunction. Conclusions MRI could be a one-stop destination for evaluating patients with suspected non-acute shunt malfunction. It was found to have clinical relevance in terms of accurately locating the exact site and possible cause of shunt-related complications.
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