[show abstract][hide abstract] ABSTRACT: Uterine artery embolization (UAE) is a minimally invasive procedure performed under fluoroscopy for the treatment of uterine fibroids and accompanied by radiation exposure.
To compare ovarian radiation doses during uterine artery embolization (UAE) in patients using conventional digital subtraction angiography (DSA) with those using digital flat-panel technology.
Thirty women who were candidates for UAE were randomly enrolled for one of the two angiographic systems. Ovarian doses were calculated according to in-vitro phantom study results using entrance and exit doses and were compared between the two groups.
The mean right entrance dose was 1586±1221 mGy in the conventional and 522.3±400.1 mGy in the flat panel group (P=0.005). These figures were 1470±1170 mGy and 456±396 mGy, respectively for the left side (P=0.006). The mean right exit dose was 18.8±12.3 for the conventional and 9.4±6.4 mGy for the flat panel group (P=0.013). These figures were 16.7±11.3 and 10.2±7.2 mGy, respectively for the left side (P=0.06). The mean right ovarian dose was 139.9±92 in the conventional and 23.6±16.2 mGy in the flat panel group (P<0.0001). These figures were 101.7±77.6 and 24.6±16.9 mGy, respectively for the left side (P=0.002).
Flat panel system can significantly reduce the ovarian radiation dose during UAE compared with conventional DSA.
Iranian Journal of Radiology 09/2013; 10(3):111-115. · 0.04 Impact Factor
[show abstract][hide abstract] ABSTRACT: Magnetic resonance imaging (MRI) is important in the early diagnosis of novel or relapsing multiple sclerosis (MS). In addition, the optimal MRI protocol plays an important role in detecting MS plaques.
To find the best time to detect MS plaques on MRI after Gadobutrol injection.
Sixty-two relapsing-remitting type MS patients, (56 women, 6 men) with the mean age of 31 ± 7 years were enrolled into this study. The patients underwent T1-weighted MRI scan without contrast agents. Subsequently, Gadobutrol was injected (0.1 mmol/kg) and MRI scanning was repeated after 30 s, 5, 10, 15, and 30 min of Gadobutrol injection. The size, signal intensity, and enhancement pattern were determined for each plaque by contrast-enhanced T1-weighted images.
Enhancing plaques were seen in 42 out of 62 patients. The mean number of enhancing plaques was 4 ± 8 plaques after 30 s of contrast injection. This figure increased to 7 ± 13 plaques after 15 min and 6 ± 10 plaques after 30 min. The signal intensity and size of plaques increased progressively, and the maximum signal intensity and plaque size were seen after 30 min (P < 0.001).
The maximum number of enhancing plaques in MS patients was detected 15 min after contrast agent administration and the size and signal intensity of the lesions also increased remarkably at this time.
[show abstract][hide abstract] ABSTRACT: The aim of this study is to report our experience about endovenous laser treatment (EVLT) for lower extremity varices in our centre which was followed by ultrasonography during the 6-month period.
During a 1-year period, 46 patients who were treated by EVLT with the 940-nm diode laser for venous insufficiency enrolled in the study. The diagnosis of greater saphenous vein (GSV) incompetence with reflux was made by clinical evaluation and duplex Doppler examinations. Clinical outcomes, complications and duplex ultrasound of the GSV were assessed within 1 week, 1 month, 3 months and 6 months, after the endovascular laser treatment.
The mean age of our patients was 44 ± 11 years (24-70), and among them, 23 (50%) were male. Improvement in visible varicosity was seen in 39 (84.8%) patients after 6 months (P value = 0.011). The baseline mean diameter of GSV was 4.9 ± 1.6 mm and it dropped to 3.5 ± 1.3 after 6 months (P < 0.0001). After 6 months, 95.7% of our patients were satisfied and recommended this procedure to others.
Endovascular laser ablation seems to be a safe and effective method for the treatment of lower limb varices.
Journal of Medical Imaging and Radiation Oncology 02/2013; 57(1):15-20. · 0.98 Impact Factor
[show abstract][hide abstract] ABSTRACT: To evaluate the accuracy of magnetic resonance imaging (MRI) in bladder cancer staging as well as differentiating superficial from invasive tumors and organ-confined from non-organ-confined tumors.
A total number of 108 bladder tumors in 86 patients (86% men and 14% women) were evaluated by 1.5 Tesla MRI machine. The tumor stages that were determined by MRI study were compared with pathology results after resection of the tumor.
The most common stage determined by both MRI and pathology was T2a. Considering stages in details, the kappa agreement coefficient between MRI and pathology was 0.8 (P < .0001). Combining groups a and b in each stage, the kappa agreement coefficient between MRI and pathology was 0.87 (P < .0001). Considering stages in details, we had 22 (20.3%) mismatches in staging between MRI and pathology; 10 (45.5%) were underestimation and 12 (54.5%) were overestimation. Combining groups a and b in each stage, we had 14 (13%) mismatch cases; 6 (46.2%) were underestimation and 8 (53.8%) were overestimation. The detection rate of MRI was 0% in stage Ta, 80% in stage T1, 88.1% in stage T2, 81.2% in stage T3, and 100% in stage T4. The sensitivity and specificity of MRI in differentiating superficial from deep tumors were 0.98 and 0.82, respectively. The sensitivity and specificity of MRI in differentiating organ-confined from non-organ-confined tumors were 0.93 and 0.94, respectively.
Magnetic resonance imaging is a reliable modality for determining the stage of bladder tumors with high accuracy, and could show the depth of invasion and extension of tumor that is useful for treatment planning.
[show abstract][hide abstract] ABSTRACT: The imaging of hepatocellular carcinoma (HCC) is challenging and plays a crucial role in the diagnosis and staging of the disease. A variety of imaging modalities, such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and nuclear medicine are currently used in evaluating patients with HCC. Although the best option for the treatment of these cases is hepatic resection or transplantation, only 20% of HCCs are surgically treatable. In those patients who are not eligible for surgical treatment, interventional therapies such as transcatheter arterial chemoembolization (TACE), percutaneous ethanol injection (PEI), radio-frequency ablation (RFA), percutaneous microwave coagulation therapy (PMC), laser ablation or cryoablation, and acetic acid injection are indicated. In this paper, we aimed to review the evidence regarding imaging modalities and therapeutic interventions of HCC.
Iranian Journal of Radiology 11/2012; 9(4):167-77. · 0.04 Impact Factor
[show abstract][hide abstract] ABSTRACT: Non-echo-planar imaging (EPI) MRI has been recently introduced to improve the detection of small-sized cholesteatoma and decrease different artefacts occurring in the EPI-diffusion-weighted (DW) technique. This technique is also time saving in comparison to delayed post-contrast imaging. We prospectively assessed the diagnostic accuracy of MRI including delayed post-contrast standard MRI, EPI and non-EPI-DW sequences in the detection of middle ear cholesteatoma.
We evaluated 35 patients suspected of having cholesteatoma who underwent MRI including delayed post-contrast MRI, EPI and non-EPI-DW sequences prior to their planned surgery, and the MR findings were compared with surgical findings. Two experienced radiologists reported the images. Sensitivity, specificity and predictive values of MRI were estimated.
We detected 26 cases of cholesteatoma at surgery. Sensitivity and specificity of delayed post-contrast MRI, EPI DW and non-EPI DW were 73.1 and 77.8%, 61.5 and 88.9%, and 96.2 and 100%, respectively, as interpreted by the first radiologist. Sensitivity and specificity of delayed post-contrast MRI, EPI-DW sequence and non-EPI-DW sequence were 84.6 and 88.9%, 50 and 88.9%, and 92.3 and 100%, respectively, as interpreted by the second radiologist.
The non-EPI MRI technique is a more accurate method in detecting middle ear cholesteatoma in comparison to other conventional sequences.
Journal of Medical Imaging and Radiation Oncology 08/2012; 56(4):398-408. · 0.98 Impact Factor
[show abstract][hide abstract] ABSTRACT: Following failure of systemic chemotherapy, transarterial chemoembolization (TACE) is an available method to control unresectable liver metastases from colorectal carcinoma (CRC). The aim of present study was to evaluate the efficacy of chemoembolization for inoperable metastatic liver lesions from CRC. Forty-five CRC patients with liver metastases resistant to systemic chemotherapy were enrolled in our study. For each patient, three session of TACE were conducted with 45 days interval. A combination of mitomycin, doxorubicin, and lipiodol were used for TACE. A tri-phasic computed tomography scan and biochemical laboratory tests were performed for all patients at baseline and 30 days after each TACE. Image analysis included measurement of lesion diameters as well as contrast enhancement. Eleven patients deceased before completing three session and the final analyses were performed on the remaining 34 patients. Evaluation of a total 93 lesions in all patients after chemoembolization sessions revealed a 25.88% reduction in anteroposterior (AP) diameter, 33.92% transverse (T) diameter, and 42.22% in product of APxT diameter of lesions (P<0.001 for all instances). CT scan showed a total disappearance of 33% of lesions and evident reduction in contrast enhancement in 16% of them. There were no changes in contrast enhancement in 51% of lesions. Evaluation of single largest lesion in each patient revealed 57.32% reduction in AP diameter, 59.66% in T diameter, and 62.17% in product of APxT diameters (P<0.001 for all diameters). TACE offers a viable option for CRC patients with unresectable liver metastases by significantly reducing lesion size and contrast enhancement.
[show abstract][hide abstract] ABSTRACT: BACKGROUND: Infection after transrectal ultrasound (TRUS) guided biopsy of the prostate is a major and potentially life-threatening problem. Using antibiotic premedication can not completely eliminate infection after biopsy. OBJECTIVES: We performed this study to determine the value of using povidone-iodine in prevention of post biopsy infection. PATIENTS AND METHODS: Totally, 280 patients who were referred for TRUS guided biopsy of the prostate were divided randomly into two equal groups. The case group received an intrarectal mixture of povidone-iodine and lidocaine gel before performing biopsy, while the control group received only lidocaine gel. Patients were followed up for 30 days for possible signs of infection including fever, chills and dysuria. RESULTS: The mean age in the case group was 68.7 ± 7 years and 68.1 ± 7 years in the control group (P = 0.78). Overall, there were signs and symptoms of infection in 78 patients (27.9%), of which 27 (19.3%) were in the case group, while 51 (36.4%) were in the control group (P = 0.001, OR = 2.4, 95% CI = 1.4-4.1). CONCLUSION: Simple use of widely available povidone-iodine for cleaning the rectum before TRUS guided prostate biopsy can reduce the infection rate.
Iranian Journal of Radiology 06/2012; 9(2):67-70. · 0.04 Impact Factor
[show abstract][hide abstract] ABSTRACT: As part of an institutionally approved research protocol, patients with cerebral berry aneurysm were enrolled in a clinical trial designed to evaluate the safety of the new moldable liquid embolic agent Neucrylate AN.
Twelve patients with aneurysms judged to be suboptimal for treatment by standard endovascular or surgical approaches were treated with Neucrylate AN. The agent was injected during temporary balloon occlusion at the neck of the aneurysm. The immediate angiographic percentage of aneurysm occlusion and periprocedural adverse events were assessed for each patient. Six-month follow-up angiographic studies were obtained for nine of the 12 patients.
Ten of the 12 aneurysms treated (83%) were large to giant (>1.0 cm in diameter), nine (75%) were wide-necked (dome/neck ratio <2.0) and three (25%) were dissecting aneurysms. There were four (33%) periprocedural neurological events. Immediate aneurysm occlusion of >90% was obtained in nine of the 12 cases (75%). There were five recurrences (55.5%) at 6 months.
This preliminary clinical series shows that it is feasible to achieve a high percentage of immediate aneurysm occlusion with limited patient morbidity and mortality in the setting of morphologically challenging aneurysms. These preliminary data support larger trials assessing the safety and efficacy of this agent.
Journal of neurointerventional surgery 01/2012; 4(1):58-61. · 1.38 Impact Factor
[show abstract][hide abstract] ABSTRACT: Magnetic resonance imaging (MRI) is the standard method for observing brain plaques and contrast material injection is necessary for demonstrating the active plaque.This study compared the rate of enhancement of plaques with Gadovist and Magnevist in relapse phase of MS.
In this double blind study, after neurological examination of 62 patients in the attack phase of MS, two consecutive MRIs were performed with Gadovist and Magnevist with 48 hours interval. The two contrast materials were injected in first and second imaging randomly and the reporting radiologist was blind about the contrast material.
With both contrast materials, the probability of enhancement of supratentorial plaques was higher than the infratentorial ones. The probability of observing a symptomatic infratentorial enhanced plaque was higher than the supratentorial region and when the symptoms were due to supratentorial lesions, the corresponding enhanced plaque was more probable. It was detected that the number of enhanced plaques was the highest if the imaging was performed in the second week after the relapse, although there was no statistically significant difference when the imaging was done within the first month after the beginning of the symptoms.
It seems that both Magnevist and Gadovist could be used as the contrast material to detect enhancing plaques in relapse phase of multiple sclerosis.
Iranian journal of neurology. 01/2012; 11(2):42-6.
[show abstract][hide abstract] ABSTRACT: Fiberoptic bronchoscopy (FB) is the best modality for evaluation of tracheobronchial endoluminal lesions. Virtual bronchoscopy (VB) with the aid of computed tomography (CT) makes it possible to reconstruct endoscopic-like visualization of major airways. Sulfur mustard (SM) used during the Iraq-Iran war affects respiratory tracts and can lead to tracheobronchial stenosis.
To compare VB with FB in SM-exposed patients suspected for airway stenosis.
Thirty-one patients were evaluated with CT and bronchoscopic studies about 15 years after chemical attacks. The median age of patients was 40 years. Spiral CT scans were obtained and data were transferred to a workstation to generate VB images of major airways. Less than one week after CT scan, FB was performed.
For the tracheal pathologies seen in FB, the sensitivity, specificity, and accuracy of VB was 90.9%, 95%, and 93.5% for tracheal stenosis, 40%, 96.2%, and 87.1% for vocal cord problems, 100%, 100%, and 100% for postoperative changes, and 100%, 96.7%, and 96.8% for intratracheal nodule. The inflammation of mucosal surface could not be assessed by VB. The bronchial pathologies seen in FB included eight cases of stenosis, and one case of nodule. Sensitivity, specificity, and accuracy of VB for detection of bronchial stenosis was 62.5%, 97.8% and 92.6%, respectively. Overall sensitivity, specificity and accuracy of VB in detecting tracheobronchial stenosis were 78.9%, 97.0%, and 92.9%, respectively.
Our study indicates that VB is an accurate method for evaluating stenoses, endoluminal nodules, and poststenotic areas within the tracheobronchial tree of SM-exposed victims. This complementary method could be helpful in revealing hidden post-stenotic lesions and also better depict the long tracheal strictures and their actual length.
[show abstract][hide abstract] ABSTRACT: Antidepressant effects of magnetic resonance imaging (MRI) based stimulation have been reported in animal studies, but no human studies are available on subjects with major depressive disorder. Here, the efficacy of two diagnostic MRI protocols (echo-planar diffusion-weighted imaging (DWI) and T1-weighted imaging) was assessed in patients with major depressive disorder. In this double-blind randomized clinical trial, 51 patients with clinically proven major depressive disorder were randomly enrolled into three equal groups. All patients were receiving a selective serotonin reuptake inhibitor as the only antidepressant treatment. The first group received echo-planar DW stimulation (DWI group), the second group received T1-weighted stimulation (T1 group), and the third group experienced a similar condition without receiving any magnetic stimulation (sham group). The Hamilton rating scale for depression (HAMD24) and Beck depression inventory (BDI) were used to assess the effect of MR stimulation on depressive symptoms. In comparison to baseline, mean HAMD24 and BDI scores significantly (p < 0.001) decreased in the DWI (by 35% and 39%) and T1 (by 38% and 39%) groups 2 weeks after MR stimulation. In the sham group, reduction in HAMD24 (19%, p = 0.04) and BDI score (15%, p = 0.07) were lower than the MR stimulation groups. Two weeks after the MR experiments, changes in mean HAMD24 score and BDI score were significantly (p < 0.05) higher in subjects treated with MR stimulation (DWI or T1) vs. sham group. In conclusion, this study demonstrated the antidepressant effects of DWI and T1 MRI protocols. Our results may point to usefulness of MR stimulation for clinical use in patients with major depressive disorder.
Brain Imaging and Behavior 11/2011; 6(1):70-6. · 2.67 Impact Factor
[show abstract][hide abstract] ABSTRACT: BACKGROUND: Uterine fibroids are common benign tumors of the female pelvis. Uterine artery embolization (UAE) is an effective treatment of symptomatic uterine fibroids by shrinkage of the size of these tumors. Segmentation of the uterine region is essential for an accurate treatment strategy. OBJECTIVES: In this paper, we will introduce a new method for uterine segmentation in T1W and enhanced T1W magnetic resonance (MR) images in a group of fibroid patients candidated for UAE in order to make a reliable tool for uterine volumetry. PATIENTS AND METHODS: Uterine was initially segmented using Fuzzy C-Mean (FCM) method in T1W-enhanced images and some morphological operations were then applied to refine the initial segmentation. Finally redundant parts were removed by masking the segmented region in T1W-enhanced image over the registered T1W image and using histogram thresholding. This method was evaluated using a dataset with ten patients' images (sagittal, axial and coronal views). RESULTS: We compared manually segmented images with the output of our system and obtained a mean similarity of 80%, mean sensitivity of 75.32% and a mean specificity of 89.5%. The Pearson correlation coefficient between the areas measured by the manual method and the automated method was 0.99. CONCLUSIONS: The quantitative results illustrate good performance of this method. By uterine segmentation, fibroids in the uterine may be segmented and their properties may be analyzed.
Iranian Journal of Radiology 11/2011; 8(3):150-156. · 0.04 Impact Factor
[show abstract][hide abstract] ABSTRACT: To determine whether intraneural vascularity seen at color Doppler ultrasonography (US) can be used to diagnose carpal tunnel syndrome (CTS) and to evaluate an image processing method for quantifying the severity of CTS on the basis of this vascularity.
This study was approved by the university ethics review committee. One hundred one patients with clinical evidence of CTS and 55 healthy control subjects were enrolled. Electrodiagnostic testing (EDT) was performed in all participants, and the presence of intraneural vascularity was evaluated with color Doppler US. An image processing program was designed by using software to determine the sum of pixels in the intraneural vascular area on power Doppler US scans of the median nerve. The relationship between the number of pixels and the severity of the abnormality at EDT was determined.
The sensitivity (83%) and specificity (89%) of intraneural vascularity in the diagnosis of CTS were similar to those of EDT (81% and 84%, respectively). Intraneural vascularity was seen in 91.4% of patients with mild CTS and 100% of patients with moderate or severe CTS. In participants with positive intraneural vascularity, the sum of pixels in the intraneural vascular area was significantly higher in patients than in control subjects and paralleled the severity of the abnormality at EDT (P < .01).
Color Doppler US can be used to accurately diagnose CTS. By processing the recorded power Doppler images and determining the number of pixels in the intraneural vascular area, the severity of CTS can be assessed. 2011 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11110150/-/DC1.
[show abstract][hide abstract] ABSTRACT: Evaluation of the efficacy of black tea as the negative oral contrast agent in MRCP.
MRCP was performed before and 5 and 15 min after tea consumption for 35 patients. Depiction of the gall bladder (GB), cystic duct (CD), proximal and distal parts of the common bile duct (CBD), intrahepatic ducts (IHD), ampulla of vater (AV), main pancreatic duct (MPD) and signal loss of stomach and three different segments of the duodenum were investigated according to VAS and Likert scores.
Twenty-one of the patients (60%) were female (mean age, 50.3 ± 19.2 years). Regarding visibility of different anatomical parts of the pancreatobiliary tree, the post procedure images were better visualized in the distal part of CBD, AV and MPD in Likert and VAS scoring (all P ≤ 0.001). Regarding obliteration of high signal in the stomach and three different parts of the duodenum, all post procedure images showed significant disappearance of high signal in Likert and VAS scoring systems (all Ps ≤ 0.001).
Black tea is a simple and safe negative oral contrast agent which reduces the signal intensity of gastrointestinal tract fluid and provides improved depiction of the MPD, the distal CBD and the ampulla during MRCP. Key Points •Tea is an effective negative oral contrast agent for gastrointestinal MRI •Ingestion of black tea improves conspicuity of the distal CBD in MRCP.
European Radiology 08/2011; 21(12):2551-7. · 3.55 Impact Factor
[show abstract][hide abstract] ABSTRACT: Interventional radiologists are physicians who specialize in minimally invasive targeted therapies, offering the most in-depth knowledge of the less invasive therapies that are available and diagnostic and clinical experience across all specialties. Interventional radiologists offer treatments for hepatobiliary diseases without significant side effects or damage to the adjacent normal tissue. We briefly introduce some of the interventional procedures in gastroenterology.
[show abstract][hide abstract] ABSTRACT: Aim. To determine the level of the conus medullaris-Tuffier's line, and conus medullaris-Tuffier's line distance using imaging and evaluate their relation to age and gender. Methods. We performed a cross-sectional study of 189 adult participants, who underwent MR imaging of lumbosacral spine. Each vertebra was divided into 3 equal segments (upper, middle, and lower), and intervertebral disc space was also assumed as one segment. All segments from T12 upper segment to L5S1 intervertebral disc were numbered consecutively. The position of conus medullaris and Tuffier's line was determined by the vertebral segment or intervertebral disc space at the same level. The patients were stratified into high/low conus medullaris position (cutpoint: L1 middle segment) and short/long conus-Tuffier's distance (cutpoint: 14 segments). Results. Women with low conus were significantly more than men, in patients older than 50 years old (72.7% in females versus 55.3% in males; P < .05), whereas there was not such a sexual dimorphism in patients younger than 50 years old. Similarly, short conus-Tuffier's distance was more frequent among women than men in patients older than 50 years old (59.7% in females versus 39.5% in males; P < .05), whereas there was not any gender difference in patients younger than 50 years old. Conus-Tuffier's distance was negatively correlated with age (r = -0.32, P < .001) in all studied population. Conclusion. Anatomical landmarks vary according to age and gender, with a lower end of conus medullaris in women, so clinicians should use more caution on the identification of the appropriate site for lumbar puncture, particularly in elderly women.
International Journal of Biomedical Imaging 01/2011; 2011:868632.
[show abstract][hide abstract] ABSTRACT: This paper describes the angiographic findings of spontaneous aneurysmal subarachnoid hemorrhage (SAH) patients, including frequency, anatomic location and multiplicity of cerebral aneurysms. We retrospectively reviewed the records of 796 SAH patients at our university affiliated hospital. After confirming SAH by lumbar puncture or CT scan, all patients underwent digital subtraction angiography to find the definite anatomic location. The male to Female ratio in SAH patients was 9:10. The mean (SD) age of all patients with SAH was 47.9±14.7 years. The mean (SD) age of men with SAH was 46.6 ±15.6 years and women with SAH was 49.3±13.5 years (P=0.015). 357 (44.8%) patients had aneurysms. The mean (SD) age of aneurysmal patients was 49.8±14.3 years. The mean (SD) age of men with aneurysm was 47.8 ±15.9 years and women with aneurysm was 51.3±12.9 years (P= 0.03). The male to female ratio in aneurysms was 0.72:1. The most common aneurysm location was in the anterior communicating artery (N=166, 39%). The second most common anatomic location was the middle cerebral artery bifurcation (66 left, 60 right). The total number of patients with single aneurysms was 303 (84.9%) while 54 (15.1%) patients had multiple aneurysms. Among these patients, 49 had two aneurysms, three had three aneurysms and two had four aneurysms. In all, 418 aneurysms were detected. Of 357 patients with aneurysms 150 (42%) had vasospasm during angiography. In conclusion, the most common aneurysm location was the anterior communicating artery and the rate of multiplicity was also higher in our patients.
[show abstract][hide abstract] ABSTRACT: Nowadays, there is a trend toward early diagnosis and treatment of rheumatoid arthritis (RA) especially in patients with early signs of bone erosion which can be detected by magnetic resonance imaging (MRI). The aim of following study is to compare the sensitivity and specificity of ultrasonography (US) and conventional radiography (CR) compared to MRI for early detection of bone erosion in RA patients. In 12 patients with RA diagnosis, 120 first to fifth metacarpophalangeal joints and 96 second to fifth proximal interphalangeal joints were examined. Non-contrast MRI, US and CR were performed for bone erosion evaluation. For further analysis, the patients were divided in two equal groups according to disease activity score (DAS28). The overall sensitivity and specificity of US compared to MRI in detecting bone erosion were 0.63 and 0.98, respectively with a considerable agreement (kappa = 0.68, p < 0.001). Sensitivity and specificity of CR compared to MRI in detecting bone erosion were 0.13 and 1.00, respectively (kappa = 0.20, p < 0.001). In patients with more active disease, the sensitivity and specificity were 0.67 and 0.99 (kappa = 0.74, p < 0.001) compared to 0.59 and 0.97 (kappa = 0.61, p < 0.001) for the rest of patients according to DAS28. Conclusively, these findings reveal an acceptable agreement between US and MRI for detection of bone erosion in patients with early RA but not CR. US might be considered as a valuable tool for early detection of bone erosion especially when MRI is not available or affordable. Besides, it seems the US could be more reliable when the disease is more active.
[show abstract][hide abstract] ABSTRACT: Over the centuries, opium has been the most frequent substance abused in the Middle East. There are many controversial aspects about the effects of opioids on the atherosclerosis process, which is still unclear.
All patients who were candidates for coronary artery bypass graft in Tehran Heart Center were registered and evaluated for risk factors such as diabetes mellitus, hypertension, smoking status and duration, opium abuse, involved coronary arteries and left main branch lesion > 50%, carotid stenosis > or = 70%.
A total of 1,339 patients were enrolled in the study, of whom 400 (29.9%) were female and the other 939 (70.1%) male. Female patients were omitted from analysis due to the low numbers of female opium addicts. Our study revealed that in the addicted population, the risk of diabetes and hypertension was lower than in the non-addicted group (p < 0.05 for each variable) and fasting blood sugar tended to be less in addicted ones, but the number of involved coronary arteries, left main stenosis > 50% and extent of carotid stenosis was not significantly different between the two groups.
Our investigations demonstrate that opium is not cardioprotective, as has been claimed by some previous studies, and does not even decelerate atherosclerosis of carotid arteries in opium-addicted patients, but more evidence is still needed to completely prove the case.