Objective: To evaluate the value of MDCT Angiography in imaging the arterial tree of the lower limbs in peripheral vascular disease. Background: Peripheral arterial disease (PAD) is defined as any pathologic process causing obstruction to blood flow in the arteries, exclusive of the coronary and cerebral vascular beds. Conventional angiography is associated with 1-2% rate of complications and requires highly skilled physician to perform it. Non-invasive imaging modalities include duplex ultrasonography, magnetic resonance angiography (MRA), and multi-detector computed tomography angiography (MDCTA). Methods: This study includes 30 patients of variable ages, complaining from peripheral arterial disease manifestations referred to the radiology department of Menoufia University hospital. All patients underwent multi-detector row CT angiography of the lower limbs arteries. The findings were then analyzed and retrospectively compared with the surgical outcome in cases of operative intervention or Color Doppler correlation. Results: 120 lesions were detected in which 12 lesions (10%) were noted at the aortoiliac vessels, 33 lesions (27.5%) were noted at the femoropopliteal vessels in and 75 lesions (62.5%) were noted at the infrapopliteal vessels. No statistically significant difference between Doppler and CT angiography regarding all the anatomic segments of the arterial tree. Conclusion: Multi-detector CT angiography has demonstrated its efficacy as a promising new, fast, accurate, safe and a minimallyinvasive imaging modality in cases of trauma with suspected arterial injuries and in cases of peripheral vascular diseases for diagnosis, grading and for preoperative evaluation. It can also replace color Doppler ultrasonography in many cases.
Background Determination of the hormonal receptor (HR) status, HER2neu expression, and the molecular subtype has valuable diagnostic, therapeutic, and prognostic implications for breast cancer as breast cancer stratification during the last two decades has become dependent upon the underlying biology. The aim of this study is to assess the correlation between imaging features of breast cancer and the HR status, HER2neu expression, and the molecular subtype. Sixty breast cancer patients underwent breast ultrasound, mammography, and MRI evaluation. Pathological evaluation using immunohistochemistry and FISH was used to detect the HR status, HER2/neu expression, and the molecular subtype. Those findings were then correlated with the radiologic data. Results HR-positive tumors were associated with posterior acoustic shadowing (34/44, 77.3%; p = 0.004). Hormonal-negative tumors presenting as masses were more likely circumscribed on US and MRI compared to hormonal positive mass tumors (6/14, 42.9% vs 3/36, 7.7%; p = 0.003 on US and 6/13, 46.3% vs 3/36, 8.3%; P = 0.007 on MRI) and had malignant DCE kinetics with washout curves compared to the hormonal positive group (10/16, 62.5% vs 4/44, 9.1%; P < 0.001). HER2neu-positive tumors were significantly associated with calcifications and multifocality on mammography compared to HER2neu-negative group (9/13, 69% vs 12/34, 25.5%; P = 0.007) and (7/13, 53% vs 3/47, 6%; P < 0.001). TNBC and HER2neu-enriched were associated with washout kinetic curve pattern (57.1% and 66.7%, respectively). TNBCs were associated with circumscribed margins on US and MRI (6/9, 66.7%; P < 0.001). Conclusion Microcalcifications, margins, posterior acoustic features, and malignant washout kinetics strongly correlate with the hormonal receptor status, HER2neu status, and molecular subtype of breast cancer. These findings may suggest the molecular subtype of breast cancer and further expand the role of imaging.
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