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All Journal Indian Journal of Forensic Medicine & Toxicology
Hussein Hasan Nsaif
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Public Health

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Role of Magnetic Resonance Imaging Techniques and Protocols in Diagnosis and Staging of the Urinary Bladder Carcinoma in Comparison with Histopathological Findings Raad owaid jassim; Haider Qasim Hamood; Hussein Hasan Nsaif
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 3 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i3.15671

Abstract

Background: Bladder cancer is the second most common type of cancer of the urinary system in the world, after prostate cancer. Thus, we use a combination of the best imaging technology in the diagnosis and treatment of bladder cancer, because of its accuracy in local staging and grading .Aim of The Study: To determine the accuracy and effectivity of MRI in early detection and diagnosis of bladder carcinoma by using different protocols and to Compare the sensitivity of MRI in staging of urinary bladder carcinoma with histopathological findings.Patients and Method: : A prospective case control study was conducted in an oncology teaching hospital /the complex of Baghdad medical city. This study involved 41 suspected patient (35male &6 female). The participants ranged from (31–83 years) throughout the period of from September 2020 to January 2021.Patients who were referred for examination and diagnosis due to pelvic pain and hematuria, or who had been suspected of having bladder cancer by ultrasound were included in the study and were evaluated by the MRI performed with an MRI scanner (1.5 Tesla ,Siemens).Results: : the study included 41 patients with bladder cancer, mean age was 64.8 years ranging from (31-83 years), about 31.7% was in 61 – 70 years, and about 24.4 was in 71–80 years, 85.4% were males, and 97.6% were smokers.82.9% with chronic renal disease( UTI ),56.1% with heterogeneous enhancement & 39% with homogenous enhancement ,4.9% non-enhanced. 38 patients with symptom of hematuria, the lesion location according to the its site in the bladder wall was 34.1% in the lateral wall,24.4% in the posterior wall. The stages of T-primary tumor in MRI common protocols was(Tis=12% ,Tia=10% ,T1=17% ,T2=18% ,T3=28% ,T4=15% ) .the accuracy and sensitivity for early stages (Tis,Ta,T1.&T2) in conventional MRI protocols)T1WI,T2WI) was Inconclusive in the diagnosis of bladder carcinoma accuracy ranging (44% – 57%) & sensitivity ranging (50% – 75%),while in both advance MRI modalities) DCE &DWI) had specificity for diagnosing stage bladder CA with DWI offering slightly higher sensitivity (SN) , negative predictive values (NPV ), positive predictive value (PPV) , and accuracy (SN: 100% vs. 100%, SP: 50% for DCE &100% for DWI, accuracy: 97.6% vs 100%, PPV: 97.5% vs. 100%, and NPV: 100% vs.100%).
Technical Accuracy and Efficiency of Magnetic Resonance Imaging in Evaluation of Uterine Masses in Comparison with Ultrasound Hind Moafak Abd-Aljabbar; Haider Qasim Hamood; Hussein Hasan Nsaif
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 3 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i3.15672

Abstract

Aim of the Study: comparing accuracy, sensitivity and specificity of the magnetic resonance imaging and ultrasound in differentiating and characterizing of uterine masses.Patients and Method: A prospectively studied has been conducted on 41 female patients with suspected uterine masses. They were subjected to ultrasound and magnetic resonance imaging (MRI) examination. Comparison has been performed between modalities to detect and characterize all masses. Statistical parameters that include the specificity, sensitivity, accuracy and positive and negative predictive value have been estimated for the two modalities in all of the uterine masses.Results: Among 41 female patients, majority were diagnosed as leiomyoma 28 (68%), cervical cancer 1 (2%), adenomyosis 7 (17%), endometrial polyp 2 (5%), endometrial carcinoma 2 (5%) and normal 1 patient (2%). Totally 3 (i.e. 7%) patients have been found malignant while 37 (i.e. 93%) have been found benign. For detection of myometrial mass (leiomyoma), the sensitivity between the ultrasound and MRI is 100%, accuracy was (ultrasound: 92% and MRI: 100%). In the classification of myometrial mass (i.e. leiomyoma) site, sensitivity between the ultrasound and MRI has been 21% and 92% respectively and specificity was (ultrasound: 0 and MRI: 100%). All intramural and subserosal lesions are seen in MRI. For picking up degeneration within the leiomyoma MRI are more useful. There have been considerable differences in the diagnosis of the adenomyosis by the MRI in comparison with ultrasound with sensitivity was (MRI: 100% and ultrasound: 71%), and specificity for both was 100%, whereas accuracy was 75% for ultrasound and 100% for MRI. In the detection of the endometrial carcinoma, the MRI has achieved 100% sensitivity and 50% specificity whereas ultrasound had zero sensitivity and specificity was 50%. Among two cases of endometrial polyp, one patient is diagnosed correctly by ultrasound & MRI, the sensitivity for both was 50% and accuracy was (ultrasound: 50% and MRI: 75%). MRI and ultrasound was correctly diagnosis of one patient with cervical cancer with sensitivity and accuracy 100%.
Co-Authors Haider Qasim Hamood Hind Moafak Abd-Aljabbar Raad owaid jassim