Assessment of Diffusion Tensor Imaging Parameters of Hepatic Parenchyma for Differentiation of Biliary Atresia from Alagille Syndrome

Abdel Razek Ahmed Abdel Khalek,Abdalla Ahmed,Elfar Reda,Ashmalla Germeen Albair,Ali Khadiga,Barakat Tarik 대한영상의학회 2020 Korean Journal of Radiology Vol.21 No.12

Objective: To assess diffusion tensor imaging (DTI) parameters of the hepatic parenchyma for the differentiation of biliary atresia (BA) from Alagille syndrome (ALGS). Materials and Methods: This study included 32 infants with BA and 12 infants with ALGS groups who had undergone DTI. Fractional anisotropy (FA) and mean diffusivity (MD) of the liver were calculated twice by two separate readers and hepatic tissue was biopsied. Statistical analyses were performed to determine the mean values of the two groups. The optimum cut-off values for DTI differentiation of BA and ALGS were calculated by receiver operating characteristic (ROC) analysis. Results: The mean hepatic MD of BA (1.56 ± 0.20 and 1.63 ± 0.2 x 10-3 mm2/s) was significantly lower than that of ALGS (1.84 ± 0.04 and 1.79 ± 0.03 x 10-3 mm2/s) for both readers (r = 0.8, p = 0.001). Hepatic MD values of 1.77 and 1.79 x 10-3 mm2/s as a threshold for differentiating BA from ALGS showed accuracies of 82 and 79% and area under the curves (AUCs) of 0.90 and 0.91 for both readers, respectively. The mean hepatic FA of BA (0.34 ± 0.04 and 0.36 ± 0.04) was significantly higher (p = 0.01, 0.02) than that of ALGS (0.30 ± 0.06 and 0.31 ± 0.05) for both readers (r = 0.80, p = 0.001). FA values of 0.30 and 0.28 as a threshold for differentiating BA from ALGS showed accuracies of 75% and 82% and AUCs of 0.69 and 0.68 for both readers, respectively. Conclusion: Hepatic DTI parameters are promising quantitative imaging parameters for the detection of hepatic parenchymal changes in BA and ALGS and may be an additional noninvasive imaging tool for the differentiation of BA from ALGS.

Combined accuracy of optic nerve sheath diameter, strain ratio, and shear wave elastography of the optic nerve in patients with idiopathic intracranial hypertension

Ahmed Abdel Khalek Abdel Razek,Nada Elsaid,Tamer Belal,Nihal Batouty,Ahmed Azab 대한초음파의학회 2022 ULTRASONOGRAPHY Vol.41 No.1

Purpose: This study assessed the combined accuracy of optic nerve sheath diameter (ONSD), strain ratio (SR), and shear wave elastography (SWE) of the optic nerve (ON) in patients with idiopathic intracranial hypertension (IIH). Methods: This prospective study was carried out on both ONs of 34 consecutive patients diagnosed with IIH and 16 age- and sex-matched healthy volunteers. All of the study participants were women. The ONSD, SR, and SWE of the ON were measured. The severity of papilledema of IIH patients was sub-classified into mild papilledema and moderate/severe papilledema. Results: The mean ONSD (5.6±1.1 mm), SR (0.7±0.1), and SWE (30.1±16.7 kPa) of the IIH patients were significantly different (P=0.001) from the ONSD (4.1±0.5 mm), SR (0.9±0.1), and SWE (8.2±3.4 kPa) of controls. The cutoff values of ONSD, SR, and SWE of the ON for differentiating IIH patients from controls were 5.45 mm, 0.8, and 10.3 kPa with areas under the curve (AUCs) of 0.91, 0.86, and 0.96 and accuracy values of 91%, 81%, and 93%, respectively. Combined SWE and ONSD and combined SWE, ONSD, and SR for differentiating IIH patients from controls revealed AUCs of 0.98 and 0.99 and accuracy values of 96% and 96%, respectively. ONSD, SR, and SWE showed significant differences between mild and moderate/ severe papilledema (P=0.001). Papilledema was correlated with SWE (r=0.8, P=0.001), ONSD (r=0.4, P=0.001), and SR (r=-0.4, P=0.001). Conclusion: The combination of ONSD, SR, and SWE may be helpful for diagnosing IIH, and a good indicator of the degree of papilledema. Purpose: This study assessed the combined accuracy of optic nerve sheath diameter (ONSD), strain ratio (SR), and shear wave elastography (SWE) of the optic nerve (ON) in patients with idiopathic intracranial hypertension (IIH).Methods: This prospective study was carried out on both ONs of 34 consecutive patients diagnosed with IIH and 16 age- and sex-matched healthy volunteers. All of the study participants were women. The ONSD, SR, and SWE of the ON were measured. The severity of papilledema of IIH patients was sub-classified into mild papilledema and moderate/severe papilledema.Results: The mean ONSD (5.6±1.1 mm), SR (0.7±0.1), and SWE (30.1±16.7 kPa) of the IIH patients were significantly different (P=0.001) from the ONSD (4.1±0.5 mm), SR (0.9±0.1), and SWE (8.2±3.4 kPa) of controls. The cutoff values of ONSD, SR, and SWE of the ON for differentiating IIH patients from controls were 5.45 mm, 0.8, and 10.3 kPa with areas under the curve (AUCs) of 0.91, 0.86, and 0.96 and accuracy values of 91%, 81%, and 93%, respectively. Combined SWE and ONSD and combined SWE, ONSD, and SR for differentiating IIH patients from controls revealed AUCs of 0.98 and 0.99 and accuracy values of 96% and 96%, respectively. ONSD, SR, and SWE showed significant differences between mild and moderate/severe papilledema (P=0.001). Papilledema was correlated with SWE (r=0.8, P=0.001), ONSD (r=0.4, P=0.001), and SR (r=-0.4, P=0.001).Conclusion: The combination of ONSD, SR, and SWE may be helpful for diagnosing IIH, and a good indicator of the degree of papilledema.

High-frequency Induction Heating Sintering of Hydroxyapatite-(ZrO2+3%Mol Y2O3) Bioceramics

Khalil Khalil Abdel-razek,Kim Sug-Won 한국분말야금학회 2006 한국분말야금학회 학술대회논문집 Vol.2006 No.1

In this study, hydroxyapatite (HAp) and hydroxyapatite-yttria stabilized zirconia (HAp-3YSZ) with 20 vol. %- (ZrO2+3 %mol Y2O3) nanopowders were consolidated very rapidly to full density by High-frequency induction heat sintering (HFIHS). Effects of temperature and the addition of 3YSZ on the toughness, hardness and microstructure properties have been studied. 3YSZ second phase toughening HAp composites with higher toughness were successfully developed at relatively low temperatures through this technique. Compared with hardness and toughness obtained for pure HAp, the hardness and toughness for HAp-20vol. % 3YSZ were much higher.

Epidural Fibrosis after Lumbar Disc Surgery: Prevention and Outcome Evaluation

Mohamed M. Mohi Eldin,Naglaa M. Abdel Razek 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.3

Study Design: This is a prospective, randomized, controlled study designed and conducted over 10 years from 2002 to 2012. Purpose: The study aimed to monitor the effect of suction drains (SD) on the incidence of epidural fibrosis (EF) and to test, if the use of SD alone, SD with local steroids application, SD combined with fat grafts and local steroids application, or SD combined with fat grafts and without local steroids application, would improve outcome. Overview of Literature: EF contributes to significant unsatisfactory failed-back syndrome. Efforts have been tried to reduce postoperative EF, but none were ideal. Methods: Between September 2002 and 2012, 290 patients with symptomatic unilateral or bilateral, single-level lumbar disc herniation were included in the study. Two groups were included, with 165 patients in group I (intervention group) and 125 patients in group II (control group). Group I was subdivided into four subgroups: group Ia (SD alone), group Ib (SD+fat graft), group Ic (SD+local steroids), and group Id (SD+fat graft+local steroids). Results: The use of SD alone or combined with only fat grafts, fats grafts and local steroids application, or only local steroids application significantly improved patient outcome and significantly reduced EF as measured by magnetic resonance imaging (MRI). Conclusions: This study has clearly demonstrated the fact that the use of suction drainage alone or combined with only fat grafts, fats grafts and local steroids application, or only local steroids application significantly improved patient outcome with respect to pain relief and functional outcome and significantly reduced EF as measured by an MRI. A simple grading system of EF on MRI was described.

Synthesis and Densification of Nanostructured Bioceramics by High-Frequency Induction Heat Sintering

Kim Sug-Won,Khalil Khalil Abdel-razek 한국분말야금학회 2006 한국분말야금학회 학술대회논문집 Vol.2006 No.1

Nanostructured Alumina - 20 vol% 3YSZ composites powder were synthesized by wet-milling technique. The starting materials were a mixture of Alumina micro-powder and 3YSZ nano-powders. Nano-crystalline grains were obtained after 24 h milling time. The nano-structured powder compacts were then processed to full density at different temperatures by high-frequency induction heat sintering (HFIHS). Effects of temperature on the mechanical and microstructure properties have been studied. composites with higher mechanical properties and small grain size were successfully developed at relatively low temperatures through this technique.