Objective: To evaluate the role of MRI in differentiation of benign from malignant breast lesions using dynamic contrast enhanced MRI (DCE-MRI) and diffusion weighted MRI (DW-MRI).Patients and methods: The study included 33 female patients with clinically suspicious breast lesions detected by mammography and/or breast ultrasound. Cases were referred from general surgery departments in Tanta university hospital. The patients underwent full history taking and clinical examination, full field digital mammography and US, for those patients cases diagnosed on sonomammography as BI-RADS 3 & 4 were selected for MRI examination. Results: Quantitative analysis of DWI was done for the 33 breast lesions and their ADC values are recorded at 3 different b-values (250, 600, and 1000). Seventeen lesions showed facilitated diffusion, proved to be benign and 10 lesions showed restricted diffusion, 9 lesions of them proved to be malignant and one proved to be benign. There are 6 lesions showed mixed restricted and facilitated diffusion proved to be malignant. Conclusion: DWI improves the diagnostic ability of the DCE-MRI of the breast. It is a better method for detecting breast lesions than either T 1 -or T 2 -weighted imaging, but it is better to be performed in conjunction with contrast enhanced MRI.

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The prevalence of coronary artery anomalies (CAAs) is reported to be 0.3% to 2% of the general population.Asymptomatic CAAs are more common and have a better prognosis. Nevertheless, some of these anomalies are linked with symptoms such as syncope, chest pain, and sudden cardiac death. The aim of the study was to determine the prevalence and describe the coronary congenital anomalies and their variations using coronary CT angiography. MD (320) CT angiography was used to prospectively examine 630 patients with either myocardial ischemic symptoms or suspected coronary anomalies by echocardiography or invasive coronary angiography. Contrast injection with ultra-thin cardiac scanning were then carried out. Images were analyzed with multiplanar reformations (MPR), curved multiplanar reformations (cMPR), maximum intensity projections (MIP) & volume rendering techniques (VR). Coronary artery anomalies were found in 217/630 patients (34.44% incidence), 69 (10.95%) anomalies were of vessel origin with good agreement between CTA and ICA results (K= 0.630), 140 (22.22%) were of vessel course and intrinsic vessel anomalies with moderate agreement between CTA and ICA results (K= 0.448), and 8 (1.27%) were of vessel termination with very good agreement between CTA and ICA results (K= 1.000). from this study we conclude that the prevalence of coronary anomalies is substantially higher with coronary CTA than with invasive coronary angiography and ECG gated multidetector coronary CT angiography allows accurate anatomical assessment of coronary artery anomalies.

Background: For comprehensive internal architecture identification of ovarian tumors, DCE-MRI is advised. An imaging technique known as diffusion weighted (DW) assists in differentiating between benign and malignant lesions. The purpose of this study was to assess the effectiveness of DCE-MRI and diffusion-weighted MRI in characterizing ovarian cancers and distinguishing malignant from benign tumors. Methods: This retrospective study was carried out on 40 patients aged from 21 to 63 years old presented by ovarian masses based on clinical examinations and on US study. All patients were subjected to full history taking, laboratory investigations including pregnancy tests, complete blood counts and some tumour markers, pelvi-abdominal ultrasound and MRI. Results: MRI have a sensitivity of 53.85%, a specificity of 92.59%, positive predictive value (PPV) of 77.78%, negative predictive value (NPV) of 80.65% and accuracy of 80% compared to pathology of the studied patient. DCE has a sensitivity of 67.15%, a specificity of 100%, PPV of 100%, NPV of 79.4% and accuracy of 82.5%. compared to pathology of the studied patient. DWI score at a cut-off point (≤1.1) predicted patients with malignant ovarian tumours, with 97% accuracy, sensitivity of 88.89% and specificity of 100% (p < 0.001). There was a high statistical significance between findings on DWI-MRI, DCE-MRI, and pathological types (P <0.001 for benign versus malignant lesions). Higher magnetic resonance elastography (MRE) was seen with malignant ovarian lesions (MRE < 85% suspected malignancy). Conclusions: Conventional MR images are the mainstays for assessment of patients with adnexal lesions. The addition of DWI and DCE-MR imaging enhances the specificity of MRI, boosting the radiologist's confidence in picture interpretation and ultimately affecting the patients’ prognosis.

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