Background: Spinal dysraphism (SD) is a spectrum of congenital disorders. MRI is the gold standard technique for diagnosis of SD. Spinal ultrasonography (USG) can be used as a screening tool for SD in infants. The purpose of our study is to assess the diagnostic value of spinal USG in the diagnosis of spinal dysraphism in pediatrics compared to MRI as a gold standard technique. Our prospective, cross-sectional study involved 45 infants and children with suspected spinal dysraphism. All patients were subjected to supervision of their medical history, full neurological examination, spinal ultrasonography and anatomical spine assessment by conventional MRI examination including sagittal and axial T1W & T2W, sagittal & coronal STIR imaging. Comparison of spinal USG with MRI findings was done. Results: There is excellent overall agreement between MRI and ultrasound diagnosis in the evaluation of spinal cord morphology and bony elements in patients aged ≤ 2 years old (κ = 0.96 and 0.98) respectively, and fair overall agreement between MRI and ultrasound diagnosis (κ = 0.58) in patients aged > 2 years old. The accuracy of spinal USG in diagnosis of spinal dysraphism in patients aged ≤ 2 years old was as the following: specificity (94.5-100%), sensitivity (84.3100%), PPV (86.7-100%) and NPV (85.7-100%), as compared to MRI. Conclusion: Spinal ultrasound can be used as a first-line screening investigation for SD; patients with USG abnormalities proceed to MRI. Spinal ultrasound is of no worthy value after the age of bone ossification, and MRI is the best modality of diagnosis in older pediatrics.

Background: Osteoporosis is a worldwide health problem and a common cause of bone fractures; the most common type of osteoporosis is post-menopausal type. MRI has a role in the diagnosis of osteoporosis and can be used as a screening tool, so the purpose of our study was to define a quantitative MRI-based score (M-score) for the detection of lumbar spine osteoporosis and to evaluate the correlation between lumbar spine signal intensity measured by MRI and BMD (bone mineral density) in post-menopausal women. Our case-control study involved 100 cases (50 old post-menopausal females as a case group and 50 healthy females as a control group of matched age). Both groups were subjected to history taking, dual-energy X-ray absorptiometry (DEXA), and conventional lumbar MRI. DEXA was performed for the lumbar spine and all scores (T-score, Z-score, BMD) were calculated. Lumbar MRI was performed (sagittal T1WI and T2WI) from L1-L4 levels. SNR L1-L4 and M-score were calculated from T1W images. Results: All DEXA scores were significantly lower in post-menopausal females compared to the control group (P < 0.0001). Meanwhile, SNR L1-L4 and M-score were significantly higher among cases than controls (P < 0.0001). The diagnostic threshold of SNR L1-L4 and M-score for distinguishing osteoporotic from non-osteoporotic females was 104.5 for SNR L1-L4 with a sensitivity of 94%, specificity 60%, positive predictive values (PPV) 31%, and negative predictive values (NPV) 98%, and 3.5 for M-score with a sensitivity of 93.

Background The purpose of our study was to assess diagnostic performance and comparison of strain and shear wave ultrasound elastography for differentiation of benign and malignant breast lesions compared to histopathological diagnosis as a reference standard. Our single center study involved 100 female patients with 132 solid breast masses. All patients underwent supervision of medical history, clinical examination, conventional B-mode ultrasound which was evaluated according to the BIRADS (Breast Imaging Reporting and Data System), and strain and shear wave ultrasound elastography. Strain ratio for strain elastography, mean elasticity value, and stiff ratio for shear wave elastography were calculated. All breast lesions were biopsied. Comparison of the elastography results with the histopathological diagnoses was done. Results There was no statistically significant difference as regard the AUCs for calculated values of strain and shear wave ultrasound elastography (strain ratio, 0.916; mean elasticity, 0.884; and stiff ratio, 0.872; P > 0.05). The AUCs for the combined use of B-mode US and elastography techniques were improved as the following: B-mode + strain, 0.920; B-mode + shear wave 0.952 with a significant P value < 0.001. Higher diagnostic accuracy was noted with the combination of strain and shear wave elastography than each single elastographic modality (P = 0.02). Conclusions Ultrasound elastography of breast masses is a non-invasive procedure with high sensitivity. Strain and shear wave elastography had almost similar diagnostic performance and displayed higher diagnostic performance if combined with B-mode ultrasound which helps in decreasing the number of unneeded breast biopsies.

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Background: Liver biopsy has been the main method for diagnosis, but it is an invasive method, with many complications, so a non-invasive method is needed to assess the severity of liver cirrhosis. Aim of Study:To assess the severity of liver cirrhosis by measurement of hepatic blood flow using triphasic CT. Patients and Methods:Our case control, single centre study involved 30 patients with chronic diffuse parenchymatous liver disease (which were further divided into Child-Pugh A, B, and C subgroups) and 30 healthy volunteers. All cases underwent supervision of their medical history, clinical examination, liver function tests, and triphasic CT scan. Measurement of contrast enhancement fraction (CEF) as a parameter of hepatic blood flow was calculated using triphasic CT, assessment of ROI (region of interest) in HU for the hepatic parenchyma in both arterial and venous phases were done. The contrast enhancement (CEF) was obtained by dividing the contrast concentration in the hepatic arterial phase by that in the portal venous phase using ROI measurement in HU. CEF values and the ROI measurements from the study and control groups were compared.Results: The differences in the ROI measurements were statistically significant between the subgroups with multiple comparisons, except between the control and the Child-Pugh (A) group. The ROI measurement in the portal phase was higher than that measured in the hepatic arterial phase in both the study and control groups. There was a decrease in ROI measurement in both the arterial and portal phases with increase of the Child-Pugh grade; more evident in the portal phase. The value of CEF in the control group was 0.74. The CEF values increased with increasing Child-Pugh grades in the study group. There were noticeable differences for CEF between Child-Pugh A and B groups, Child-Pugh A and C groups and Child-Pugh B and C groups. The CEF increased as liver function (Child-Pugh grade) deteriorated in the study group.Conclusion: Measurement of hepatic blood flow and CEF by using triphasic CT can be used to evaluate the liver hemodynamics and severity of liver cirrhosis.