Emad S. Tarawneh

Pseudoaneurysm of the breast after blunt trauma: Successful treatment with ultrasound‐guided compression

We present a case of breast pseudoaneurysm following a blunt trauma in a 58‐year‐old woman. Few cases of breast pseudoaneurysm have been reported in the literature, and most of these are related to previous interventional procedures. Pseudoaneurysm was suspected on real‐time sonography and confirmed with color Doppler and spectral wave analysis, which revealed a characteristic to‐and‐fro pattern. Unlike previously reported cases, treatmentwith ultrasound‐guided compression was successful.

Standardization of quantitative single photon emission computed tomography in control individuals and in patients with condylar hyperplasia.

ObjectivesThe aim of the study was to evaluate the diagnostic accuracy of various single photon emission computed tomography (SPECT) quantitative methods in patients with condylar hyperplasia (CH) and to investigate whether normal condylar activity changes with age. Patients and methodsWe analyzed the SPECT images of 33 patients with CH and those of 16 control individuals. Regions of interest (ROIs) were drawn on whole condyle, or fixed-size ROIs were drawn on both condyles and the clivus on the slice with higher activity [a two-dimensional (2D) approach] and on the summation of five adjacent transaxial slices [a three-dimensional (3D) approach]. A percentage difference between both condyles of above 10% or a cutoff value of 1.44 or 1.88 for abnormal condyle/clivus ratio was considered abnormal. ResultsSeventeen patients with active CH, 16 with inactive CH, and 16 control individuals were evaluated. The highest sensitivity and highest specificity were observed for the whole-condyle approach (88 and 87%, respectively), followed by the percentage 2D maximum condyle/total (82.4 and 81.3%, respectively). The condyle/clivus ratio yielded low sensitivity for both 2D and 3D approaches. No effect of age on condylar activity was demonstrated. No statistically significant difference in condyle/clivus ratio was evident between patients with active and those with inactive CH. ConclusionUse of 2D maximum fixed-size ROI and percentual difference in condylar activity offers optimal diagnostic accuracy in patients with CH and should be encouraged in future studies. The condyle/clivus ratio offers suboptimal results and cannot, therefore, be recommended. No effect of age on normal condylar activity was demonstrated.

Ultrasonographic assessment of splenic volume and its correlation with body parameters in a Jordanian population

Objectives: To estimate normal linear dimensions and volume of spleen in Jordanians using ultrasonography, and to correlate splenic volume with age and body parameters: height, weight, body surface area (BSA), and body mass index (BMI). Methods: A prospective pilot study was conducted on 205 volunteers (115 males and 90 females) not known to have any conditions likely to be associated with splenomegaly. The study was performed at the Radiology Department, Jordanian University Hospital, Amman, Jordan, between December 2013 and August 2014. All linear dimensions of spleen were measured, and splenic volume (index) was calculated using the standard prolate ellipsoid formula (length × width × depth × 0.523). The splenic volume was then analyzed with age and body parameters using the Pearson’s correlation coefficient. Results: The mean (± SD) splenic dimensions were 10.72±1.37 cm in length, 7.40±1.52 cm in width, 4.40±1.47 cm in depth, and 184.15±79.56 cm3 in volume. Men had larger spleens than women (p<0.0001). Age had no significant effect on spleen volume (r=0.11, p=0.12). There was a significant moderate positive correlation (p<0.0001), using Pearson’s correlation coefficient, between the spleen volume, and other parameters (height, weight, BSA, and BMI), with correlation coefficients exceeding 0.3. Conclusion: A local reference of spleen dimensions was established with a different range of values reported previously.

Mesenchymal stem cells and conditioned media in the treatment of multiple sclerosis patients: Clinical, ophthalmological and radiological assessments of safety and efficacy

This open‐label prospective phase I/IIa clinical study used autologous bone marrow‐derived mesenchymal stromal cells (BM‐MSCs) followed by mesenchymal stromal cells conditioned media (MSC‐CM) for the first time to treat multiple sclerosis (MS) patients. The primary goal was to assess the safety and feasibility and the secondary was efficacy. The correlation between the MSC‐CM content and treatment outcome was investigated.

Accurate Segmentation of Breast Tumors in Ultrasound Images Using a Custom-Made Active Contour Model and Signal-to-Noise Ratio Variations

Outlining tumors in ultrasound B-mode images is an important process in many diagnostic procedures, but manual tumor segmentation is usually a time-consuming and challenging task. This paper presents a custom-made active contour model that is specifically designed for segmenting tumors in ultrasound images. The algorithm starts by drawing a circular contour around a manually selected point inside the tumor. The vertices of the circular contour are iteratively moved from the interior of the tumor to the tumor boundary. The motion of the vertices is controlled using an ultrasound-based statistical parameter, called the envelope signal-to-noise ratio (SNR), that is sensitive to variations in tissue anatomy. The proposed algorithm has been used to outline breast tumors in 10 ultrasound B-mode images. When compared to tumor outlines delineated by a human expert, the outlines obtained using the proposed algorithm achieved sensitivity values as high as 96.98%. The proposed algorithm provides a simple and accurate method for tumor segmentation in ultrasound images.

An adult ureterocele complicated by a large stone: A case report

Highlights • Ureterocele is a rare condition. One of its presentation is the presence of a stone, usually a solitary stone, inside the ureterocele.• Ureteroceles represent a clinical challenge in term of diagnosis and management due to their variable presentations and types.• Our patient ureterocele was complicated by a large calculus so we decided to proceed with endoscopic resection of the ureterocele along with stone removal.

Leydig cell tumor in grey zone: A case report

Highlights • Leydig cell tumor is a testicular tumor with a low incidence accounting for 1–3% of testicular neoplasms.• Only about 10% of them show malignant behavior in the form of metastatic disease.• When diagnosed and treated early, long-term favorable outcomes are seen even with its potential metastatic behavior.

Double Inferior Vena Cava Detected by CT Venography and Confirmed by Magnetic Resonance Venography: Embryogenesis and Literature Review

En el Departamento de Radiologia del Hospital de la Universidad de Jordania, Amman, Jordania, se llevo a cabo un estudio prospectivo entre el mes de julio de 2001 al mes de julio del 2015. Durante ese periodo se descubrieron cinco casos de vena cava inferior doble (VCID) en una cohorte de 7722 pacientes (3861 hombres y mujeres 3861, de 49,5 ± 16,9 anos, con un rango de edad de 16-78 anos). Los casos fueron diagnosticados por medio de venografia por tomografia computada espiral con contraste (TCV) y confirmados por medio de venografia por estudio tridimensional turbo. La mayoria de los pacientes (3166, 41 %) fueron remitidos para estadificacion y seguimiento de tumores malignos. Se presentaron complicaciones postoperatorias en 1777 pacientes (23 %), dolor abdominal no especificado en 1467 (19 %), evaluacion preoperatoria en 849 (11 %) y traumatismo en 463 pacientes (6 %). La venografia por resonancia magnetica (RMV) mostro una mayor sensibilidad, precision diagnostica, y resultando no invasiva para la evaluacion de la vena cava inferior (VCI). RMV es una modalidad mas util, no invasiva para la evaluacion de la VCI. VCID es una anomalia frecuente, encontrandose en nuestro estudio una incidencia de 0,064 %. Ademas se realizo una revision de la literatura, la embriogenesis, y la importancia de esta anomalia. Tambien, se proporcionaron cifras de muestras de los casos relevantes.

Cerebral Cavernoamas : Radiological Prevalence and Clinical Features in a 10 Year Retrospective Study in a Teaching Hospital = الأورام الوعائية الكهفية الدماغية : دراسة انتشار شعاعية مع المظاهر السريرية : دراسة استعادية لفترة عشر سنوات في مستشفى تعليمي

Objectives: Cerebral cavernous angiomas remain one of the most negotiable and controversial topics in neurological and neurosurgical practice. It can present with symptoms or can be found incidentally. The aim of this study is to evaluate the prevalence, clinical presentation, treatment options and outcome of patients with cerebral cavernoma. Materials and Methods: Brain MRI for (14372) patients done in our university teaching hospital during 10 -year period from 2001 to 2011 were reviewed, 33 cases of cerebral cavernoma were found. The medical charts of these patients were reviewed and analyzed for their clinical presentation, treatment options and outcome. Results: We identified 33 cases of cavernoma with a mean age of 33.3±16.8 years. There were18 females and 15 males. Four cases were excluded from analysis (but included in prevalence calculation) due to unavailability of clinical data. In the 29 other cases there were 35 cavernomas. The radiologic prevalence of cavernomas in this population was 0.23%. Most cavernomas were found in the supratentorial regions mostly found in the frontal lobes. The most common presenting symptoms were seizures in males and headache in females. Conclusion: The radiologic prevalence of cerebral cavernomas was less than previous series, while clinical presentation was the same. Performing MRI at higher resolution and field strength with more sensitive sequences may lead to the detection of subtle or small brain abnormalities that would not have been detected previously.