No abstract

Background: Coronary artery calcifications comprise one of the most significant factors interfering with the diagnostic accuracy of Multi-Slice Computed Tomography (MSCT). Despite this fact, measurement of Coronary Artery Calcification (CAC) score using Agatston method is a useful noninvasive test for expecting rare but serious potentially lifethreatening Percutaneous Coronary Intervention (PCI) complications, our aim to highlight the role of MSCT in coronary disease severity and CAC score as a predictor tool to determine PCI associated complications. Methods: A prospective study was carried out in the period from January 2022 to May 2022, conducted at the radiology and cardiology departments of Zagzig University Hospitals, and enrolled 60 patients with 78 significant stenotic calcified coronary lesions diagnosed by conventional coronary angiography and MSCT coronary angiography with total, target vessel and significant lesion CAC scores calculation using the Agatston method prior to percutaneous coronary intervention (PCI). Results: Our patients were divided into a lower CAC score cases (CAC score, ≤300, n=12 cases/ 12 lesions) and a higher CAC case (CAC score, >300, n=48 cases/ 66 lesions). The highest vessel CAC score mean is of LAD 100.1± 61.98 followed by RCA then LCX and lastly LM, with only three cases of higher CAC score group developed dissection during PCI. with significant difference between successful and complicated PCI regarding the total, target vessel and significant lesion CAC scores with P value < 0.02 Conclusion: Using MSCT to measure CCS prior to intervention can anticipate PCI problems and improve PCI outcomes.

Digital mammography (DM) is the cornerstone of breast cancer detection. Digital breast tomosynthesis (DBT) is an advanced imaging technique used for diagnosing and screening breast lesions, particularly in dense breasts. This study aimed to evaluate the impact of combining DBT with DM on the BI-RADS categorization of equivocal breast lesions. We prospectively evaluated 148 females with equivocal BI-RADS breast lesions (BI-RADS 0, 3, and 4) with DM. All patients underwent DBT. Two experienced radiologists analyzed the lesions. They then assigned a BI-RADS category for each lesion according to the BI-RADS 2013 lexicon, using DM, DBT, and integrated DM and DBT. We compared the results based on major radiological characteristics, BI-RADS classification, and diagnostic accuracy, using the histopathological examination of the lesions as a reference standard. The total number of lesions was 178 on DBT and 159 on DM. Nineteen lesions were discovered using DBT and were missed by DM. The final diagnoses of 178 lesions were malignant (41.6%) and benign (58.4%). Compared to DM, DBT produced 34.8% downgrading and 32% upgrading of breast lesions. Compared with DM, DBT decreased the number of BI-RADS 4 and 3. All the upgraded BI-RADS 4 lesions were confirmed to be malignant. The combination of DM and DBT improves the diagnostic accuracy of BI-RADS for evaluating and characterizing mammographic equivocal breast lesions and allows for proper BI-RADS categorization.

There has been a notable increase in rhino-orbito-cerebral mucormycosis (ROCM) post-coronavirus disease 2019 (COVID-19), which is an invasive fungal infection with a fatal outcome. Magnetic resonance imaging (MRI) is a valuable tool for early diagnosis of ROCM and assists in the proper management of these cases. This study aimed to describe the characteristic MRI findings of ROCM in post-COVID-19 patients to help in the early diagnosis and management of these patients. This retrospective descriptive study was conducted at a single hospital and included 52 patients with COVID-19 and a histopathologically proven ROCM infection who were referred for an MRI of the paranasal sinuses (PNS) due to sino-orbital manifestations. Two radiologists reviewed all the MR images in consensus. The diagnosis was confirmed by histopathological examination. The maxillary sinus was the most commonly affected PNS (96.2%). In most patients (57.7%), multiple sinuses were involved with the black turbinate sign on postcontrast images. Extrasinus was evident in 43 patients with orbital involvement. The pterygopalatine fossa was involved in four patients. Three patients had cavernous sinus extension, two had pachymeningeal enhancement, and one had epidural collection. The alveolar margin was affected in two patients, and five patients had an extension to the cheek. The awareness of radiologists by the characteristic MRI features of ROCM in post-COVID-19 patients helps in early detection, early proper management, and prevention of morbid complications.

Imaging plays an essential role in the evaluation of patients after cranial surgery. Postoperative infection and hemorrhage are common complications after cranial surgeries. Life-threatening complications (like tension and paradoxical herniation) must be identified rapidly at imaging to secure a favorable prognosis. This cross-sectional study included 250 patients who underwent neurosurgical operations and were imaged for the developed postoperative complications using Computed Tomography(CT), Magnetic Resonance Imaging(MRI) with and without contrast. We reviewed the common normal and abnormal findings in post-operative neurosurgical patients. The expected postoperative CT and MRI appearances of these procedures are discussed, followed by complications. These include hemorrhage, tension , wound/soft tissue infection, bone flap infection and abscesses. Complications specifically related to include herniation, external brain , paradoxical herniation, and syndrome. In our study165 male; 58 % and 85 female; 42 % were included; age range (6months-69 years), mean age 34.7 ± 2.9 years. 130 patients underwent , infection (23%) was the most dominant complication followed by cranial hemorrhage (19 %). So to conclude;radiologist must know how to recognize postoperative complications and differentiate them from expected normal findings because an early and accurate diagnosis is important for proper postoperative care. tomography is fast, cost effective, and easily accessible for first-line imaging. Magnetic resonance imaging has higher sensitivity for detecting postoperative infection and ischemia.