Background Diffusion-tensor imaging (DTI) is a magnetic resonance imaging (MRI) technique that depicts the integrity of white matter (WM) tracts. This study was conducted to assess the utility of DTI tractography as an imaging technique in assessment of brain gliomas and planning of the surgical corridor. Results Twenty adult patients with brain gliomas were included. Neurological examination and conventional MRI and DTI scans were performed before and after surgery. Low-grade and high-grade tumors were found in 30% and 70% of patients, respectively. Preoperative DTI demonstrated five patterns of WM tract involvement: non-affected (10%), displaced (75%), edematous (55%), infiltrated (60%), and disrupted (20%). The obtained DTI scans were used for preoperative planning of the surgical corridor and extent of resection to achieve the maximum resection while preserving the WM tracts. Total resection was achieved in 40%, while 60% underwent subtotal resection. Postoperative neurological examination showed deterioration of cognitive function, motor power, and vision in 15%, 10%, and 5% of patients, respectively. Headache persisted in 15%, while motor power improved in 35% of patients. High-grade tumors were significantly associated with higher percentage of subtotal resection (p=0.018) and pattern IV (p=0.018). There was a significant association between the preoperative pattern of WM tract involvement and the postoperative DTI changes (p<0.001). Conclusion DTI enables assessment of displaced and infiltrated WM tracts in the vicinity of brain tumors. Preoperative planning of tumor resection and surgical corridor should include DTI scan to achieve the balance between maximum resection of tumor and maximal preservation of function.

Background Repaired tetralogy of Fallot patients develops postoperative complications that are in need for follow-up and re-intervention in some circumstances. CMR myocardial feature tracking is a novel method that allows quantification of bi-atrial and bi-ventricular mechanics of deformation. So our aim is to assess the added value of cardiac magnetic resonance imaging and its advanced feature tracking analysis in evaluation of repaired tetralogy of Fallot patients. Results CMR was done with feature tracking post-processing analysis for 56 patients with repaired tetralogy of Fallot and 56 healthy volunteers. The commonest postoperative complications in patients with repaired tetralogy of Fallot are in the following order: pulmonary regurgitation with subsequent right ventricular dilatation and tricuspid regurgitation followed by pulmonary stenosis, right ventricular dysfunction, right ventricular outflow tract dilatation, left ventricular dysfunction, aortic and mitral regurgitation and residual ventricular septal defect. All right ventricular volumes were found to be significantly increased compared to those of the healthy volunteers (p value < 0.001) also left ventricular end-diastolic and end-systolic volumes indexed were found to be increased in those patients compared to healthy volunteers (p value < 0.001). Right and left ventricular function were significantly lower in those patients compared to controls. Bi-ventricular CMR-FT indices and right atrial global longitudinal strain were found to be significantly lower in patients with repaired tetralogy of Fallot compared to controls. Right atrium global longitudinal strain was found to be significantly correlated with right ventricular global longitudinal strain and did not correlate with right ventricular ejection fraction and end-diastolic volume indexed; p value < 0.001, 0.109 and 0.565, respectively. Right ventricular global circumferential strain was found to be significantly increased in patients with right ventricular outflow tract obstruction compared to those without obstruction (− 16.26 ± 4.27% vs. − 12.2 ± 3.78%, respectively). Pulmonary regurgitant volume indexed was found to be significantly related to right ventricle longitudinal strain (p value 0.027). Conclusion Biventricular volumetric measures are increased in patients with repaired tetralogy of Fallot compared to controls; however, feature tracking parameters for both ventricles and right atrium are lower in those patients compared to controls.

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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Introduction: mediastinal masses include a broad spectrum of histopathological and radiological entities. Although imaging modalities aid at narrowing the purposed differential diagnosis, accurate categorization is not always possible. Objective: to assess the efficacy as well as safety of percutaneous ultrasound guided biopsy modality in the proper diagnosis of anterior mediastinal lesions.Materials and methods: Forty patients presented with anterior mediastinal masses were enrolled in this study. Each patient was subjected to CT chest with contrast, US guided biopsy from the anterior mediastinal lesions and obtained specimens underwent histopathological examination. Then, patients were observed for possible post-procedural complications. Results: 97.5% of the included cases were symptomatic; with dyspnea [representing 62.5%] was the most frequent complaint among our cases, followed by cough and fever representing 50% and 37%, respectively. The most frequent lesions were lymphoma (40%) followed by metastatic carcinoma (25%) and thymoma (15%). Two cases showed inconclusive results (failure rate 5%).Conclusions: Combined clinico-radiological data can narrow the differential diagnosis of anterior mediastinal masses; yet histopathological examination remains the mainstay of the precise diagnosis. Percutaneous US guided biopsy is claimed to be a useful, minimally invasive cost-effective tool for proper sampling, with minimal complications and low failure rate.