Showing 4 results for Diagnostic Imaging
Mohadese Zademir, Narjes Sargolzaie, Amirhossein Nourolah ,
Volume 78, Issue 4 (7-2020)
Abstract
Background: The empty sella syndrome (ESS) is a neurological or pathologic finding in which sella turcica is devoid of pituitary tissue and the subarachnoid space extends into sella turcica, which is either primary or secondary as well as partial and complete. The widespread use of CT scans and MRIs today has made the ESS a common finding in imaging. The aim of this study was to evaluate the prevalence of the empty sella syndrome.
Methods: This is a retrospective descriptive-analytic study in which all patients referred to Imam Ali Hospital (Zahedan) for electromagnetic brain imaging (n=1856) were recruited by cross-sectional sampling during the first 6 months from 21 March 2018 to 23 September 2018. Inclusion criteria included the absence of another known problem in the central nervous system and the absence of concurrent underlying disease. The data gathering tool was a questionnaire consisting of demographic and related variable to empty sella disorder.
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Results: The results of this study showed that the prevalence of empty sella was 8.2% with a mean age of 37.02±12.51 years. 66.4% of the patients were female. The prevalence of primary empty sella was 78.9% with a mean age of 34.51±11.26 years. 71.7% of the patients had partial empty sella. There was a significant difference between the mean age and sex of patients with empty sella and non-empty sella subjects (P=0.008) and (P<0.0001). There was a statistically significant difference between the mean age of affected patients with type of empty sella (P<0.0001). There was no statistically significant difference between mean age of patients with empty sella and severity of empty sella (P=0.056). There was no significant difference between the frequency of empty sella type and the severity with gender (P=0.224) and (P=0.091).
Conclusion: The findings of this study indicated that the overall prevalence of empty sella in the referring patients was relatively low. Most of them were females with primary type and minor severity.
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Nasim Vahidfar, Mahdieh Parvizi, Marzyehsadat Peyman, Hana Safar, Saeed Farzenehfar , Mehrshad Abbasi,
Volume 80, Issue 2 (5-2022)
Abstract
Background: Labeled leucocytes could be used for localization of infection foci after surgeries or in inflammatory diseases including inflammatory bowel diseases. Extraction of leucocytes needs 10% Hetastarch which is not available in Iran. We provide a method employing multiple centrifuges to extract and label leucocytes with Tc-HMPAO.
Methods: The study was conducted from April to June 2018 in the Nuclear Medicine Unit of Valiasr Hospital. Leucocytes were extracted from a 60 ml blood sample anticoagulated with Acid-citrate-dextrose through four-step centrifugation as below: 1-whole blood was centrifuged at 1k cycle per minute (CPM) for eight minutes to precipitate red blood cells (RBC). Supernatant including RBC free plasma, WBC, and platelet was extracted for the next step. 2-WBC was precipitated at 1.8k CPM for five minutes and platelet-rich plasma (PRP) as supernatant. 3- PRP was centrifuged at 3k for five minutes and cell-free plasma (CFP) was extracted as supernatant, and 4- precipitate WBS at step two was washed with saline and centrifuged at 0.5k CPM to achieve washed WBC. Then the leucocytes were labeled with 40 mCi Tc-HMPAO through 15 minute incubation at 37-38 degrees centigrade. The extra free pertechnetate was eliminated using two additional centrifugation steps as follows: 1-0.5k CPM for five minutes to dispense free pertechnetate, and 2-0.5 for five minutes to achieve high radiochemical purity labeled WBC. Finally, the labeled WBC was re-suspended in CFP and reinjected to the patient. Imaging at 2-4 hours was done. The pathology and imaging of labeled WBC distribution are reported
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Results: No RBC was detected in microscopy. The majority of the leucocytes were lymphocytes with rare accompanying platelets. The radiolabeling efficiency of the procedure was higher than 40%. The viability test indicated more than 80% of viable cells. The radiochemical purity of the final product was more than 95%. Two to four hours after injection, low background images were acquired. The liver and spleen were target organs with low-grade urinary, thyroid, and GI activity.
Conclusion: Employing multi-stage centrifugation, Tc-HMPAO labeled leucocyte scan could be efficiently performed.
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Parivash Parvasi, Zahra Fazelinejad, Fatemeh Mahdipour, Shahram Bagheri , Mohammad Momen Gharibvand ,
Volume 80, Issue 7 (10-2022)
Abstract
Background: Shear wave elastography (SWE) estimates the stiffness of a mass based on the velocity of shear wave propagation by sound waves. Due to higher cell density and angiogenesis, malignant masses have higher stiffness than benign ones.
Methods: The present study was a prospective study and was performed on patients who were referred to Ahvaz Golestan Hospital with breast mass during March 2020 to March 2021. Only patients with 4-5 BI-RAD were evaluated. Patients were graded based on ACR BI-RAD. All patients were subjected to ultrasound and selection of BI-RAD 4-5 patients for evaluation with SWE and sampling for pathology testing. In this study, in order to increase the maximum accuracy and take samples from the main location of the lesion, sampling was done by ultrasound-guided biopsy method. Tumor information was recorded by a specialist doctor after ultrasound and SWE. This information included tumor type, tumor size and grade, presence of metastasis, involvement of lymph nodes, average and maximum elasticity. SWE cutoffs were compared for mean and maximum elasticity to distinguish benign from malignant masses.
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Results: In this study, 115 patients were evaluated. 63.5% (73) of the patients had benign mass and 36.5% (42) had malignant ones. There was a significant relationship between tumor size and mean and maximum elasticity (P<0.001 The results showed that the diagnostic accuracy of SWE in identifying malignant masses compared to benign ones was 100%, so that the mean (16.61±8.03 kPa) and maximum (21.14±8.88 kPa) elasticity in benign masses were significantly lower than the mean (32.21±7.59 kPa) and maximum (91.62±8.84 kPa) elasticity of malignant masses (P<0.001). There was also a significant difference between the 4 BI-RAD subgroups, so that in BI-RAD 4a, the lowest mean and maximum elasticity were seen (P<0.001).
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Conclusion: The results showed that SWE parameters have sufficient diagnostic accuracy in diagnosing malignant breast masses. Therefore, the use of quantitative SWE parameters in conjunction with ultrasound and BI-RADS classification can avoid unnecessary biopsies.
Behzad Nazemroaya, Fatemeh Kazemi Goraji , Azim Honarmand, Mohammad Saleh Jafarpisheh ,
Volume 80, Issue 11 (2-2023)
Abstract
Background: Double lumen tube (DLT) is used in lung surgeries. Classically, the patient should undergo fiberoptic bronchoscopy (FOB) to confirm the location of the DLT and its proper function. However, the sensitivity of ultrasound and clinical methods in diagnosing the correct position of DLT has not yet been definitively determined. This study was designed to assess the accuracy of point-of-care ultrasound and auscultation versus Fiberoptic Bronchoscope in determining the position of the Double-Lumen Tube.
Methods: This cross-sectional study of diagnostic value measurement type was conducted on patients who were candidates for double lumen implantation. After induction of anesthesia, DLT with the appropriate size was implanted, and then the position of DLT was evaluated. In the first step, the lungs were examined by auscultation, then the ultrasound was performed, and two signs of lung pulse sign and lung sliding sign were examined as signs of normal lung and ventilated lung. FOB was performed by an anesthesiologist. At the end, by opening the chest after surgery, the surgeon's opinion about the quality of lung collapse was recorded.
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Results: In our study, the correct placement of the tube was correct in 37 cases and wrong in 3 cases, which were checked and corrected by FOB. Vital signs of the patients were stable before and during the operation. There were no problems with anesthesia during the surgery. Diagnostic sensitivity of lung auscultation clinical examination was 64.9% and chest ultrasound was 91.9%. The sensitivity of ultrasound compared to auscultation was not significant (P=0.242), but there was a clinically significant difference in the positive predictive value of the two, so that the positive predictive value of lung auscultation was 88.9% and lung ultrasound was 91.9%. In terms of surgeon satisfaction level, 22 cases (59.5%) had excellent satisfaction and 15 cases (40.5%) had moderate satisfaction. The sensitivity of ultrasound was not significant in comparison with the surgeon's satisfaction.
Conclusion: Ultrasound can be a good substitute for FOB. Although ultrasound cannot have all the functions of FOB, but having advantages such as lower cost, speed of operation, and non-invasiveness, makes it more practical than FOB.
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