BackgroundConventional magnetic resonance imaging (MRI) is a highly valuable tool for full assessment of the extent of bilateral symmetrical diffuse inflammatory myopathy, owing to its high sensitivity in the detection of edema which correlates with, and sometimes precedes, clinical findings.PurposeTo evaluate the use of whole-body (WB)-MRI in characterization and full assessment of the extent and distribution of diffuse inflammatory myopathy.Material and MethodsA prospective study on 15 patients presenting with clinical evidence of inflammatory myopathy. It included 4 boys/men and 11 girls/women (age range, 6–44 years; mean age, 25.5 years). 1.5 T WB-MRI was performed and the distribution and extent of disease severity was assessed according to muscle edema on STIR images.ResultsFour cases of dermatomyositis showed lower limb disease predilection with edema in gluteal, thigh, and calf muscles. The same finding was seen in one case with recurrent polymyositis and three cases with overlap myositis with systemic lupus erythematosus (SLE). Bilateral upper and lower limb myositis was demonstrated in three cases of polymyositis and one case of overlap myositis with scleroderma. Bilateral edema involving all scanned muscle groups was detected in three cases of polymyositis with paraneoplastic syndrome, SLE, and severe active dermatomyositis (including the neck muscles).ConclusionWB-MRI is the diagnostic modality of choice for cases of inflammatory myopathy. It accurately detects the most severely affected muscles candidate for biopsy and provides a reliable baseline study for follow-up of disease progression as well as response to treatment.

The objective of this study was to investigate the variability of several different phase contrast (PC) magnetic resonance techniques and duplex Doppler imaging (DDI) for measuring portal flow rate (PFR) with different patterns of respiration before and after a standard meal. PFR was measured in nine normal volunteers in both fasting and postprandial states, using both 2D and cine PC MR techniques. Two-dimensional PC technique was performed with and without breath-hold (BH). Four different patterns of BH (relaxed maximal inspiration, expiration, Valsalva maneuver, and Müller or reversed Valsalva) were used. Cine PC technique was performed without BH. DDI measurement of PFR was done in the fasting state with relaxed inspiration. PFR measurements made by means of PC MR techniques varied, depending on BH method, and were systematically less than those obtained by DDI. PFR measured during inspiration was significantly less than that measured during expiration and other respiratory maneuvers (P < .03). PFR increased significantly after a meal for PC and Doppler measurements, with a range of mean increases of 24 to 74%. Two-dimensional PC MR imaging techniques yielded differing measurements of PFR, depending on whether they were done with or without BH, as well as on the pattern of BH. PC mean measures of PFR were consistently less than those of DDI. The physiologic inspiratory decreases and postprandial increases of the PFR were evident from 2D and cine PC MRI techniques, as well as with DDI.

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Background: The diagnosis of breast cancer requires sensitive and specific examinations to detect the lesion and avoid surgical intervention in benign lesions. Moreover, therapeutic planning requires accurate preoperative evaluation of tumor extent and detection of multicentric and multifocal lesions. Aim of Study:This study aimed to assess the diagnostic accuracy of CT and Isotope scan in detection of breast cancer and their metastatic lesions.Patients and Methods: This study included 38 female patients who were referred from Oncology Center of Mansoura University and Outpatient Surgery Clinic based on physical finding of palpable breast masses. All patients underwent clinical history and examination, Ultrasound and mammography, Contrast enhanced CT, Isotope scan and SPECT / CT fusion technique if available.Results: Contrast enhanced CT, mammography, and US are 100% specific for diagnosis of malignant mass but they differ in their sensitivity that was 88% for mammography, 97% for US and 100% for post-contrast CT. Comparison of the area under the ROC curve of the perfect post-contrast CT versus the two other modalities revealed that the difference was statistically significant when comparing it with mammography (p=0.0351) but it was not statistically significant when comparing it with US (p=0.2787).Conclusions: CT mammography proved high efficacy in detection of solitary primary and bilateral masses. It has the advantage of wide images scope to detect LNs as well as other skin and chest wall lesions. We indicated in our study to do bone scan and whole body CT for all patients of breast cancer as combination between them which proved highly sensitivity and specificity in detection of primary breast masses as well as metastatic lesions.

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