Background
The thoracic segment represents the most common area fractured in the whole spine. Complete neurological deficits are commonly associated with thoracic injuries possibly due to a relatively small canal diameter as compared to the cervical or lumbar spine. Magnetic resonance is the gold standard of imaging, especially in patients suffering from neurological deficits as well as in soft tissue assessment mainly the disc, ligaments, and neural elements. The thoracolumbar injury classification and severity score system (TLICS) and the thoracolumbar AO Spine injury score (TLAOSIS), are two scoring systems designed to help surgeons in management plans of thoraco-lumbar injuries. The aim of our study is to compare these two main thoracolumbar injury classification systems in deciding the management strategies in thoraco-lumbar injuries. This study is a retrospective study that included 70 patients (42 males and 28 females) who suffered acute traumatic vertebral fractures. All patients underwent MRI including T1WI, T2W and STIR sequences. The MRI was viewed by two independent radiologists of 5- and 10-years’ experience and compared to surgical decisions.
Results
Out of 70 patients included in our study, the TL AOSIS matched treatment recommendation in 62 patients (88.6%), and the TLICS matched in 60 patients (85.7%). The TL AOSIS achieved sensitivity 95%, specificity 80%, while the TLICS achieved sensitivity 72.2%, specificity 100%.
Conclusion
Both TL AOSIS and TLICS have very close results in their reliability for guiding treatment strategy, yet TL AOSIS matched treatment recommendation more than TLICS, with sensitivity more than TLICS, while TLICS had more specificity.
Background: The COVID-19 pandemic caused a worldwide dramatic loss of human life. The second wave of coronavirus showed a very rapid spread. Objective: This study aimed to retrospectively analyze the laboratory findings and chest computed tomography (CT) features in patients with suspected coronavirus disease (COVID-19) pneumonia during the second wave. Patients and methods: From November 2020 to February 2021, a total of 295 patients were admitted to our hospital with suspected COVID-19 pneumonia. They underwent multiple laboratory tests including (s. ferritin, CBC) as well as non-contrast CT. Only 144 patients had PCR results available. The CT findings were reported as regards the presence of ground glassing, consolidation and pleural effusion. Results: 198 (67.1%) showed ground glassing and 36.9% (109 cases) had consolidation in their CT. These lesions were bilateral in 181 cases about 63.3% being single in in 71 cases (25.3 %). Pleural effusion was found in 202 cases (68.7%). Significant correlation was found between CRP, s. ferritin and d-dimer with presence of consolidation. Significant decreased neutrophil count and decreased DD among positive in comparison with negative ground glassing. PCR results were available in only 144 out of 295 patients (48.8%). It was positive in 100 out of 144 patients (69.4%) and negative in 44 patients (30.6%). Highly significant relation between COVID-19 Reporting and Data System (CO-RADS) categories & PCR among all studied cases. Conclusion: During the second wave, the CT findings were similar to wave one with PCR proved COVID-19 cases more frequent with higher CO-RADS and RSNA categories.
The aim of the study was to validate a multimodality cranial computed tomography (CCT) protocol for patients with acute stroke in the United Arab Emirates as a basic imaging procedure for a stroke unit. Therefore, a comparative study was conducted between two groups: retrospective, historical group 1 with early unenhanced CCT and prospective group 2 undergoing a multimodality CCT protocol. Follow-up unenhanced CCT>48 h served as gold standard in both groups. Group 1: Early unenhanced CCT of 50 patients were evaluated retrospectively, using Alberta Stroke Program Early CT Score, and compared with the definite infarction on follow-up CCT. Group 2: 50 patients underwent multimodality CCT (unenhanced CCT, perfusion studies: cerebral blood flow, cerebral blood volume, mean transit time and CT angiography)<8 h after clinical onset and follow-up studies. Modified National Institute of Health Stroke Scale was used clinically in both groups. Group 1 showed 38 men, 12 women, clinical onset 2-8 h before CCT and modified National Institute of Health Stroke Scale 0-28. Group 2 included 38 men, 12 women, onset 3-8 h before CCT, modified National Institute of Health Stroke Scale 0-28. Sensitivity was 58.3% in group 1 and 84.2% in group 2. Computed tomography angiography detected nine intracranial occlusions/stenoses. The higher sensitivity of the multimodality CCT protocol justifies its use as a basic diagnostic tool for the set-up of a first-stroke unit in the United Arab Emirates.
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