Mohamed Yousef

Role of CT scan and Ultrasound Imaging in Characterization of Common Liver Diseases

The purpose of this work was to evaluate the detection and characterization of common liver diseases using CT scan versus ultrasound imaging. Between January 2013 and January 2014, a prospective study was conducted and included fifty patients (28 males and 22 females) with a mean age of 49 years (age range from 15 to 91 years) suffering from liver diseases underwent gray scale sonography , helical CT. This study was done in Buraydah K.S.A in the King Fahad Specialist And Suleiman Alhabib hospitals using ultrasound and CT scan C.T&Ultrasound scan was performed on 50 patientswho presented with history symptoms and signs of focal liver lesions(40 with Pain , 24with Fever , 24 with Tend and 12 with Jaundice,and the most affected group their age more than 60 years Figure(1).Out of these 50 cases, according to CT findings 10 were malignant (hepatocellular carcinoma) , Liver Abscess(5.1%), Fattey liver(27.1%), Haemangioma(8.5%), liver Cyst(16.95), Cirrhosis(13.6%), Others(11.9%). On sonography lesions were diagnosed as 7 were malignant (hepatocellular carcinoma) , Liver Abscess(5.2%), Fattey liver(36.1% ), Haemangioma(6.9%), liver Cyst(13.8%), Cirrhosis(8.6%), Others(17.2%) ,54% of patients affected in both lobes . Imaging plays a significant role in the detection, characterization and treatment of hepatic lesions. Knowledge of the imaging features seen with hepatic diseases can assist in early diagnosis and timely initiation of appropriate therapy. This study presents the imaging appearances of hepatic lesions, emphasizing specific features that may contribute to the diagnosis. sonography and CT have significantly improved the diagnostic efficacy in liver lesions. INTRODUCTION Chronic liver disease (CLD) is a significant cause of morbidity and mortality in developed nations. It is commonly caused by viral hepatitis and alcohol abuse with significant contributions from metabolic disorders[1]. Accurate diagnostic testing for CLD to identify asymptomatic patients in a high risk population has become more important due to recent advances in management and treatment options that provide better patient outcomes if the diagnosis of fibrosis or cirrhosis can be made before cirrhosis becomes clinically apparent[2]. In some cases, liver fibrosis has been demonstrated to be reversible[3], a phenomenon that was previously not considered possible. The standard method for determining, staging and grading CLD is liver biopsy[4]. The invasiveness of this method, and its associated morbidity and mortality has led to the emergence of less invasive methods which include medical imaging techniques (computed tomography, magnetic resonance imaging and ultrasound), serum markers (both direct and indirect markers of fibrosis) and transient elastography[2]. All of these techniques have the potential to reduce the number of biopsies performed in a high risk population. Ultrasound can identify the manifestations of CLD such as liver fibrosis and cirrhosis which are characterized by the presence of vascularized fibrotic septa and regenerating nodules[1,5-7]. Ultrasound is an attractive diagnostic tool because it is readily available, inexpensive, well tolerated and is already extensively used in the diagnostic work-up of patients with CLD. The diagnostic accuracy of ultrasound needs to be established to inform clinicians of its role in patients at high risk of CLD. Liver diseases have become one of the most important causes of morbidity and mortality in the world so that the evaluation of the patient with liver disease has become more complex and advanced in recent years. [8] The role of diagnostic imaging in liver diseases has gained increasing importance over the past decades. Whereas 30 years ago the thorough history taking, clinical judgment, and laboratory analysis were the most important and often only tools to establish a diagnosis. Nowadays a multitude of imaging methods provide complementary information [9] The main indication for investigation of the liver by imaging are diagnosis exclusion of tumor primary and secondary, cysts, diffuse disease and inflammatory lesions. Other indications are the investigation of hepatomegaly and portal hypertension.[10] The technique available include simple x-ray, ultrasound, computed tomography, isotopes scanning and MRI. Most ultrasonography (US) imaging consists of real-time, gray-scale, B-mode display, with the reflected signal amplitude displayed as a variation in brightness. This technique is referred to as gray-scale US or simply as US to distinguish it from Doppler US.[11] The transducer is most often in contact with a patient’s skin (conventional US), although it can be placed in body cavities (endoluminal US) either directly or endoscopically (endoscopic US or endosonography).[12] Chronic hepatitis B (CHB) and C (CHC) are major causes of chronic hepatitis.[13] Chronic carriers of the hepatitis B virus (HBV) are currently estimated to number of 350 million worldwide.[14] Chronic carriers of hepatitis C virus (HCV) are estimated to number approximately 170 million people.[15] Chronic hepatitis can progress to compensated liver cirrhosis. Compensated liver cirrhosis may then progress to liver failure and hepatocellular carcinoma with attendant complications, such as hepatic encephalopathy and varix bleeding. Therefore, early detection of liver cirrhosis in patients with chronic hepatitis has become an important clinical issue for physicians. [16,17]

The Role of Time to Half-Maximum Activity Clearance of Technetium-99m-Mercaptoacetyltriglycine in the Assessment of Obstructive Uropathy

Objective: We aimed to evaluate the utility of the quantitative time to half-maximum (T½) value in the detection of obstructive (Ob\HyN) and non-obstructive hydronephrosis (Non-Ob\HyN) using 99mTc-MAG3.

Correlation of Thyroid Hormone Levels with Radioactive 99m TcThyroid Uptakes

Objective: This study aimed to study the relationship between thyroid function test and thyroid uptake using 99m Tc and to determine of the normal range of the thyroid uptake in Sudanese as well as the possibility of replacing the TFT test by thyroid uptake. Methods: Out of the 77 patients (6.2%)males and (93.5%) females who referred to the department of nuclear medicine at radio isotope center Khartoum (RICK) for thyroid function test and thyroid scan in the period fromMay to Aug 2009, were included in this study.Simple sensitive RIA wasused for the measurement of thyroid related hormones (T4, T3and TSH), and thyroid uptake value in the gamma camera (mediso). Results: The results showed that mean±SD values for T3, T4, TSH and thyroid uptake were 5.6±3.6, 79.8±6.5, 6.7±0.8 and 6.3±2.4 respectively. The normal range for thyroid uptake in this study was ranged from 5.78 to 6.12% at 20 min after injected with a dose of 3mCi 99mTc. As well as the results showed that there is strong and significant correlation at p = 0.05 between the thyroid uptake versus T3 and T4. Whereas in low uptake the correlation coefficient r = 0.87 and 0.81 for T4 and T3 respectively, and in elevated group r = 0.94 for T4 and 0.96 for T3. While in the normal uptake group r = 0.99 and 0.88 for T4 and T3 respectively. This study concluded that there was relationship between thyroid uptake and the level of the thyroid related hormones The percentage of thyroid uptake was ranging between 1.2 and 8.0 Conclusion: There were possibilities of using thyroid uptake only as a diagnostic tool for thyroid activity

Evaluated of Testicular Tumors using Doppler Sonography

This study aimed to determine the gray scale and color Doppler sonographic features of the most common and some of the least common scrotal lesions. Between October 2012 to May 2013, 100 patients the age range of new born to 85 years old the mean 30.95, with scrotal symptoms, who underwent scrotal ultrasonography (US), were retrospectively reviewed. The clinical presentation, outcome, and US results were analyzed. The presentation symptoms including scrotal pain, painless scrotal mass or swelling, and trauma. Sonographic features that were reviewed included the size and echogenicity of the tumors, presence of cystic areas or calcifications,and distribution pattern of detectable blood flow on color or power Doppler