فهرست مطالب

  • Volume:7 Issue: 4, 2011
  • تاریخ انتشار: 1389/12/12
  • تعداد عناوین: 9
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  • Sh. Akhlaghpoor, A. Aziz Ahari Page 211
    Background/
    Objective
    The major concern about the invasive prenatal diagnostic tests is the frequency of procedure induced pregnancy loss. Chorionic Villus Sampling (CVS) is the invasive test of choice in the first trimester after the 10th gestational week. Our experience suggests marked chorioamniotic separation is an uncommon finding after the 10th gestational week. This study assesses the rate of marked membrane separation in a 10 to 14-week gestational period and its effect on post CVS fetal loss.Patients and
    Methods
    Forty-one patients (5.2%) were selected among 782 patients as cases with marked membrane separation (mean maternal age, 26.9 years). CVS procedures were performed with a 20-gauge Chiba needle attached to a 20-ml syringe under ultrasound guidance. Follow-up was performed by phone call and clinical visits until 24 weeks of gestation. For the control group, the follow-up was performed for only 2 weeks. Early fetal loss in the first two weeks of post procedural period, and late fetal loss from 2 weeks after procedure till the 24th gestational week were considered as CVS complications.
    Results
    We detected 2.4% early fetal losses after the procedure. Fourteen cases voluntarily underwent therapeutic abortion due to beta-thalassemia or hemophilia. One fetus with microcephaly was spontaneously aborted in the 21st gestational week. Twenty-five neonates were delivered alive at term and one prematurely at the 32nd week. Marked membrane separation had no significant effect on early post CVS fetal loss rate.
    Conclusion
    The procedure does not have a major impact on the early post CVS fetal loss in patients with marked membrane separation.
  • M. Kalantari, N. Mostaghel, M. Khoshnood Shariati, Z. Amiri, S. Piri, A. Ghazal Page 215
    Background/
    Objective
    In order to predict the time of labor in patients with preterm premature rupture of membrane (PPROM), different factors have been studied resulting in different detection rates. Recently, sonographic measurement of myometrial thickness (MT) has been introduced and studied as an applicable and noninvasive method in predicting the length of latency interval (LI) of labor (the period from PPROM to start of labor). The objective of our study was to determine the correlation between MT and LI in pregnant women with PPROM led to oligohydramnios.Patients and
    Methods
    This was a cross-sectional study on 24 cases with PPROM. The sonographic measurement of myometrial thickness and the latency interval of patients with PPROM without labor pain were recorded. Gestational age was between 26-34 weeks and amniotic fluid index (AFI) was less than 5 percentile. The data were analyzed using SPSS software.
    Results
    The mean±SD maternal age was 29.2±1.2 years. The AFI in all women was less than 5% percentile of normal fluid for that gestational age. The mean±SD of gestational age was 29.1±2.2 weeks. The mean±SD of MT was 6.5±1.5 mm interiorly, 7.9±4.2 mm fundal, 6.6±1.7 mm in the lower segment and 7.8±2.2 mm laterally. The mean LT was 545±4.7 hours.
    Conclusion
    Our study showed that there is no significant correlation between MT and LI in pregnant women with PPROM and reduced AFI.
  • M. Niknejadi, F. Ahmadi, H. Haghighi Page 221
    In this case report, we present a dizygotic twin pregnancy with two different major anomalies one of which was a fetus with multiple congenital anomalies consisting of alobar holoprosencephaly, cleft lip and palate, enlarged echogenic kidneys and clubfoot. The other fetus with early asymmetrical growth restriction and sandal gap sign suggesting Down syndrome which was confirmed after birth.
  • L. Bahreini, E. Fatemizadeh, M. Guity Page 225
    Background/
    Objective
    To discriminate between malignant and benign breast lesions; conventionally, the first series of Breast Subtraction Dynamic Contrast-Enhanced Magnetic Resonance Imaging (BS DCE-MRI) images are used for quantitative analysis. In this study, we investigated whether using all series of these images could provide us with more diagnostic information.Patients and
    Methods
    This study included 60 histopathologically proven lesions. The steps of this study were as follows: selecting the regions of interest (ROI), segmentation using Gradient Vector Flow (GVF) snake for the first time, defining new feature sets, using artificial neural network (ANN) for optimal feature set selection, evaluation using receiver operating characteristic (ROC) analysis.
    Results
    The results showed GVF snake method correctly segmented 95.3% of breast lesion borders at the overlap threshold of 0.4. The first classifier which used the optimal feature set extracted only from the first series of BS DCE-MRI images achieved an area under the curve (AUC) of 0.82, specificity of 60% at sensitivity of 81%. The second classifier which used the same optimal feature set but was extracted from all five series of these images achieved an AUC of 0.90, specificity of 79% at sensitivity of 81%.
    Conclusion
    The result of GVF snake segmentation showed that it could make an accurate segmentation in the borders of breast lesions. According to this study, using all five series of BS DCE-MRI images could provide us with more diagnostic information about the breast lesion and could improve the performance of breast lesion classifiers in comparison with using the first series alone
  • A. Alizadeh, S. A. Roudbari, A. Heidarzadeh, M. Kouhsari Page 235
    Background/
    Objective
    Magnetic resonance imaging (MRI) is a noninvasive and valuable method in the diagnosis of Multiple Sclerosis (MS). Compared with other modalities, the sensitivity of MRI for detection of the lesion increases using magnetization transfer (MT) and delayed imaging. Our aim was to compare the two methods in detecting MS lesions.Patients and
    Methods
    In this double-blind clinical trial, twenty-one patients with the definite diagnosis of MS referred to Poursina Hospital, Rasht were included. Two radiologists evaluated all the images. First, images without contrast were conducted, then 0.1 mmol/kg contrast material (Dotarem, single dose) was injected and after 30 minutes, T1W and MT images were obtained.Seventy-two hours later, T1W images were obtained immediately after injection of 0.2 mmol/kg contrast material (double dose). The data were analyzed using Fisher's and McNemar tests by SPSS for Windows.
    Results
    Delayed magnetization transfer showed 44 enhanced lesions using MT (69.84%) and 29 lesions using T1 (46.03%). In addition, the number of enhanced lesions in the delayed method were significantly more than those in the immediate method (p value=0.003).
    Conclusion
    The use of single dose in combination with MT and delayed images after 20-30 minutes enables us to detect more enhanced lesions.
  • H. Ghanaati, M. Motevalli, Z. Keyhanidoost, H. Eslamiyeh, A. H. Jalali Page 241
    The authors reported a patient with unilateral blindness of the left eye after trauma. Apart from paralysis of the 4th cranial nerve and mild optic nerve edema, there was no structural problem during the ophthalmologic examination. Brain CT scan, CT angiography and MRI demonstrated aneurysm in the left pericavernous region. The patient underwent angiography for coiling of the aneurysm, which detected large carotid cavernous fistula (CCF) mainly draining into the petrous sinus. Therapeutic embolization was performed with balloon and the CCF vanished completely. The most important points of this case are the blindness without exophthalmia as the only presentation of CCF which has not been reported as the only symptom and failure of CT-angiography and MRI evaluation for the diagnosis of CCF.
  • D. Goodarzi Pour, E. Rajaee, B. Golestan Page 245
    Background/
    Objective
    Exploring the association between magnetic resonance imaging (MRI), temporomandibular joint (TMJ) scanography and clinical manifestations of joint pain and sounds in patients with temporomandibular (TM) disorder.Patients and
    Methods
    This study included 62 TM joints with internal derangement. Sagittal scanography and MRI of these TMJs were obtained and reported blindly by the consensus of two radiologists.
    Results
    No significant association was observed between clinical ands canographic findings with MRI. The abnormal range of motion had significant relationship with pain (P=0.017) and sound (P=0.046). There was a strong association between sound and condylar flattening (P=0.007).
    Conclusion
    It was demonstrated that joint pain and sounds were predictors of the abnormal range of motion in TMJ scanography. Sound could be heard more often in patients with condylar flattening, and TMJ scanographic findings as well as joint pain and sounds had limited value in the diagnosis of disk position or effusion.
  • H. Ghanaati, M. Mohammadzadeh, M. A. Mohammadzadeh, H. Heidari Page 255
    The pseudo-aneurysms of thoracic aorta are rare and a life-threatening complication of aortic surgery and blunt chest trauma. This article demonstrates a case report of a traumatic aortic arch dissection and formation of a false aneurysm after blunt chest trauma in Iran. A 23-year-old man was referred complaining of chest pain and exertional cough. He had a history of chest and abdominal trauma five months ago after a car accident, resulting in acceleration-deceleration injury. The trauma resulted in an extensive injury on the left side of the chest and abdomen associated with multiple rib fractures, hemopneumothorax and splenic rupture. Splenectomy and left chest tube drainage was performed. The patient was admitted for 15 days. Finally, he recovered to normal and was discharged in satisfactory condition. However, his chest pain and cough restarted and its severity gradually increased. In chest x-ray, a left upper mediastinal masswas detected, which was later confirmed by 64 multi-slice chest CT scan as a false aortic arch aneurysm and aortic dissection. It seems endovascular stent-graft technique for the treatment of thoracic aorta aneurysm may present a good treatment choice with a low risk and less invasive approach.