With the expanded role of screening breast ultrasonography and accumulating clinical experience, the American College of Radiology (ACR) has established the Breast Imaging Reporting and Data System (BI-RADS) ultrasonography lexicon to standardize terminology for description and management recommendations according to stratified risks. It has been established that probably benign (BI-RADS category 3) lesions having a malignancy rate of less than 2% require short-term imaging follow-up rather than immediate biopsy. The BI-RADS 4 category is assigned to suspicious lesions for which biopsy is recommended. Routine screening methods such as mammography and breast ultrasound are valuable methods for managing breast masses. Breast ultrasound is the preferable screening method as it provides high sensitivity for detecting breast cancer in women with dense breast tissue and can detect cancers not identified on mammography in asymptomatic women with dense breast tissue.In our study we included 46 patients with different breast lesions. All patients had a conventional B-mode ultrasound examination and were evaluated according to the BIRADS categories, then real time free-hand ultrasound elastography was performed in the same session and images were evaluated using both the Tsukuba elasticity score and the strain ratio method. Finally, the results were compared to the histopathologic results of those lesions. It was found that conventional B-mode ultrasound examination had a sensitivity of 72.73% and specificity of 83% While, elastography scoring alone turned out to have sensitivity of 65.5%, specificity of 83.4% using the Tsukuba score system. The additional of Strain ratio parameter for evaluating the elastography images showed the highest sensitivity 98.4% and specificity 85.68% at a best cutoff point of 3.47. So we have found that elastography is an easy procedure with high diagnostic performance which can be easily integrated with the B-mode ultrasound examination in the same session and improves its specificity. That has proven benefit in minimizing the number of unnecessary biopsies especially in the assessment of BIRADS 3 and 4 lesions

Background: Breast carcinoma is classified in keeping with its morphologic features. As regards the WHO classification, the histopathological kinds of the breast carcinoma; ductal carcinomas, lobular carcinomas, and uncommon kinds, these are associated with particular imaging features, primarily based on every kind. Additionally, predictive biologic markers along with estrogen, progesterone receptors, HER2 receptor status, and Ki-67 may be suitable to subclassify breast carcinoma into the intrinsic subtypes primarily based totally on gene expression profiling into: Luminal A, Luminal B, HER2+, and Triple Negative. Correlation among the imaging and the molecular subtypes has discovered an enormously circumscribed lesions with posterior acoustic enhancement without calcification inside the triple negative breast cancer subtype, microcalcifications are seen with the HER2+ subtype, but speculated lesions of irregular margin and posterior acoustic shadow with the luminal A and B subtypes, MRI is a longtime supplemental method to mammography and ultrasonography for the assessment of breast lesions. Diffusion-weighted MR imaging (DWI) has lately been incorporated into the breast MRI, moreover dynamic contrast enhanced MRI (DCE-MRI). Conclusion: Understanding medical collaboration of molecular subtypes and imaging features can assist the radiologist to help the clinician to adjust treatment consistent with the patient condition and tumor characteristics.

Objectives: Staging of pancreatic cancer including vascular staging by use of CT angiography with assessment of presence of direct invasion of surrounding structures or distant metastasis. Patients and Methods: In our study 50 patients with pancreatc cancer were examined with CT angiography to assessresectability and the presence or absence of vascular infiltration of 5 main peri-pancreatc vessels which are celiac artery (CA), superior mesenteric artery (SMA), common hepatic artery (CHA), superior mesenteric vein (SMV) and portal vein (PV). We assessed five vessels in fifty patientsi.e two hundred and fifty vessels as a whole. Results: Twenty four patients were pre-operatively judged to be resectable or requiring surgical bypass due to jaundice. The remaining 26 patients were judged to be irresectable from the start and referred for chemotherapy or radio-therapy. Conclusion:CT angiography proved to be an important tool in assessing intra abdominal malignancy specially the cancer of the pancreas which in most of cases is missed by abdominal ultrasonography.

Background: Hypoxic Ischemic Encephalopathy is defined as a heterogeneous, clinically defined syndrome characterized by disturbed neurologic function in the earliest days of life in a neonate. Proton MR spectroscopy could reveal brain ischemic injuries in asphyxiated neonates earlier than T1-or T2-weighted MR imaging. MR spectroscopy and MR imaging are very important for the diagnosis of hypoxic-ischemic injury. Patients and Methods: A cross-sectional study. From December 2018 to December 2019, 50 full-term neonates were admitted to Neonatal Care Unit (NCU) in Sohag University Hospital with signs of HIE and referred to the Radio Diagnosis Department for brain imaging. MR imaging studies were performed using an MRI system 1.5 tesla Achieva, Philips superconductive MRI system. Our MRI sequences 1. Axial T1WI. 2. Axial T2WI. 3. Axial FLAIR. 4. Axial DWI. 5. proton MR spectroscopy Results: The study included 50 neonates; 7 of them had normal MRI findings. The other 43 neonates showed different patterns of injury; 24 neonates showed a central pattern of injury,11 neonates show peripheral patterns of injury, While the other 8 neonates had shown both central and peripheral patterns of brain injury. Only 45 of the examined neonates show abnormal lactate peak. The sensitivity of MRS is 100%. However, the specificity is low 70 %, the overall accuracy is 60 %. Conclusion: MR spectroscopy is an accurate, sensitive, and non-invasive method for early detection of perinatal ischemic brain injuries.

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