Background MR imaging plays a significant role in detection and characterization of different brain diseases. The role of the post-contrast T1-weighted image magnetic resonance imaging (T1W MRI) sequence has been widely established in previous studies and clinical practice. In this study, we aim to share our experience as regards the added value of contrast-enhanced fluid-attenuated inversion recovery (CE-FLAIR) sequence in the diagnosis of various intracranial pathological conditions and evaluate its usefulness in comparison with post-contrast T1W images. Results Based on the final radiological diagnosis, the total cases were subdivided into three categories, and the majority of our cases were tumors (81.2%), followed by multiple sclerosis (11.8%), and the least was central nervous system infection (7.1%). CE-FLAIR showed superior enhancement in 35 cases (50.7) and equal enhancement in 25 cases (36.3%). However, it showed less enhancement than post-contrast T1W images in 9 cases (13%). Excellent inter-observer agreement (97.65%) was noted. Regarding lesion conspicuity, good delineation was found in the majority of cases (64.7%), fair delineation in 12.9%, and no delineation in 22.4%. A statistically significant difference was found in signal intensity of lesion between pre- and post-contrast FLAIR sequences. Contrast to background ratio was statistically significant in CE FLAIR images in comparison to CE T1 images. Conclusion CE-FLAIR imaging should be used as a routine or adjunctive sequence to CE-T1WI to enhance early detection and increase the diagnostic confidence in MRI examination of different brain pathological conditions.

Background. Musculoskeletal pain is common in hemodialysis (HD) patients and may be related to articular or periarticular amyloid deposition. The shoulder is one of the most common afflicted joints, but not all causes of shoulder pain are detectable on radiography, and magnetic resonance imaging (MRI) is not always available. The aim of this study was to evaluate the validity of musculoskeletal ultrasound (MSUS) to properly detect shoulder disorders in HD patients by identifying US abnormalities in the shoulder and comparing them to those identified on MRI, with MRI serving as the gold standard test. Methods. This cross-sectional observational study was conducted on 28 HD patients (16 males and 12 females, mean age 46.89) with either unilateral or bilateral shoulder pain. Demographic data and clinical characteristics were recruited. All patients were subjected to clinical assessment, MSUS and MRI of both shoulders. Results. US abnormalities were prevalent in almost all patients. Supraspinatus tendinopathy was the most common abnormality in symptomatic shoulders (92.1%), followed by subacromial-subdeltoid (SASD) bursitis (65.8%), humoral erosions (57.9%), and acromioclavicular joint (ACJ) osteoarthritis (52.6%). MSUS shows high sensitivity and specificity when compared to MRI in all the studied shoulder pathologies except glenohumeral joint (GHJ) effusion (sensitivity, 33.3%) and infraspinatus tendinopathy (sensitivity, 58.3%). The percentage of agreement between MSUS and MRI in detecting biceps tenosynovitis was 82.14% (kappa, 0.64), subscapularis tendinopathy 83.93% (kappa, 0.654), supraspinatus tendinopathy 91.07% (kappa, 0.617), infraspinatus tendinopathy 82.14% (kappa, 0.470), SASD bursitis 80.36% (kappa, 0.569), humeral head erosions 82.14% (kappa, 0.635), GHJ effusion 82.14% (kappa, 0.352), and ACJ osteoarthritis 76.79% (kappa, 0.539). Conclusions. Shoulder problems are common in HD patients, even in people who do not have obvious shoulder complaints. MSUS is a valuable imaging technique that assists in the diagnosis of HD patients who report shoulder pain.

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Background MRI is the imaging modality of choice in detecting and evaluating spinal lesions. However, advanced techniques as diffusion and perfusion studies can help more in differentiation between neoplastic and non-neoplastic lesions. Our study aimed to detect the role of diffusion and T2* perfusion weighted imaging in characterization of different spinal lesions by measuring the relative cerebral blood volume (rCBV) and apparent diffusion coefficient value (ADC) of all lesions, comparing perfusion of lesion in relation to normal cord and detection of diffusion pattern of each lesion by observing its signal intensity at diffusion images and ADC map. Results Fifty patients were included in this study. Twenty-five patients were with non-neoplastic lesions and twenty-five patients were with neoplastic lesions. The cutoff value of rCBV was 1.2 in differentiation between neoplastic and non-neoplastic lesions with 92% sensitivity and 100% specificity. The cutoff value of ADC was 1 in differentiation between neoplastic and non-neoplastic lesions with 56% sensitivity and 80% specificity. Conclusions Diffusion and perfusion weighted images help in differentiation between neoplastic and non-neoplastic spinal lesions.

2018)[44] Long-term outcome of shockwave lithotripsy in the management of patients presenting with calcular acute urinary retention, Arab Journal of Urology, 16:sup1, S21-S21,