tamir hassan | Zagazig University (original) (raw)

Papers by tamir hassan

Research paper thumbnail of Coronary CT angiography with iterative reconstruction in early triage of patients with acute chest pain

The Egyptian Journal of Radiology and Nuclear Medicine, 2013

Background: Patients who present to the emergency department (ED) complaining of acute chest pain... more Background: Patients who present to the emergency department (ED) complaining of acute chest pain are of clinical concern because a small percentage will have acute coronary syndrome (ACS). The American College of Cardiology (ACC) and the American Heart Association (AHA) recommend hospitalization for patients with a low-to-intermediate risk of ACS who have initial negative ECG and enzyme test results. A negative coronary CT angiography (CCTA) during the triage has a very high negative predictive value for ruling out ACS decreasing the length of hospital stay. Recent techniques e.g. ASiR in CCTA should be used to decrease the radiation dose as low as possible.

Research paper thumbnail of Value of combined real time sonoelastography and apparent diffusion coefficient value measurement in differentiation of enlarged neck lymph nodes

The Egyptian Journal of Radiology and Nuclear Medicine, 2014

Purpose: To evaluate the role of real-time sonoelastography (UE) and apparent diffusion coefficie... more Purpose: To evaluate the role of real-time sonoelastography (UE) and apparent diffusion coefficient (ADC) value measurement in differentiating benign versus malignant enlarged neck lymph nodes. Materials and methods: This study included 26 patients presented with 32 enlarged neck lymph nodes (LNs), underwent real-time UE and diffusion weighted MRI (DWI). ADC maps are generated from DWI and ADC values were calculated. Both UE and ADC findings were compared with histopathological results. Results: The LNs were 12 benign lymphadenopathy (37.5%, seen in 10 patients), 10 metastatic (31.25% seen in 8 patients) and 10 lymphoma (31.25%, seen in 8 patients) including 4 LNs with Hodgkin's lymphoma (HL, seen in 3 patients) and 6 LNs with non Hodgkin's lymphoma (NHL, seen in 5 patients). On UE 10 of the 12 benign LNs had pattern of 1-2 (83.3%) and 18 of 20 neoplastic LNs (90%) had pattern of 4-5. The mean ADC values of the benign, metastases and lymphoma groups were 1.52 ± 0.37, 0.90 ± 0.15 and 0.72 ± 0.12 · 10 À3 (mm 2 /s), respectively. Conclusion: Combined real-time UE and ADC value measurement are non invasive techniques useful for differentiation of enlarged neck lymph. The combination potentially could reduce unnecessary biopsy especially for elasticity pattern 1-2. Please cite this article in press as: Dawood HA et al., Value of combined real time sonoelastography and apparent diffusion coefficient value measurement in differentiation of enlarged neck lymph nodes, Egypt J Radiol Nucl Med (2014), http://dx.Please cite this article in press as: Dawood HA et al., Value of combined real time sonoelastography and apparent diffusion coefficient value measurement in differentiation of enlarged neck lymph nodes, Egypt J Radiol Nucl Med (2014), http://dx.

Research paper thumbnail of The MRI finding of the nerve root sedimentation sign: Its clinical validity and operative relativity for patients with lumbar spinal stenosis

The Egyptian Journal of Radiology and Nuclear Medicine, 2014

Background: Lumbar spinal stenosis (LSS) is increasingly being recognised as a cause of disabling... more Background: Lumbar spinal stenosis (LSS) is increasingly being recognised as a cause of disabling low back and lower extremities pain in adult population. Advanced spinal imaging thought as confirmation tool for the diagnosis and as preoperative tool to delineate the extent and precise location of the pathology. Nerve roots normally sediment, due to gravity, to the dorsal part of the dural sac, which was known as negative sedimentation sign. If there is MRI finding of nerve roots in the ventral part of the dural sac the sedimentation sign is positive. Objectives: To evaluate the presence of the MRI finding of positive sedimentation sign in patients clinically suspected to have lumbar spinal stenosis and to follow up operated cases to identify the absence of the radiological signs in the operated cases. Material and methods: 70 patients clinically suspected to have lumbar spinal stenosis evaluated by MRI lumbosacral spine in supine position. A panel of two radiologists reviewed radiological data. MRI features were agreed by both radiologists in 48 patients. Out of these 48 patients; 25 were operated upon for central decompressive laminectomy, partial medial facetectomy and foraminotomy with instrumented fusion and fixation if indicated. Visual analogue score (VAS) collectively preoperative and postoperative was compared and the walking distance postoperative was reported and follow up MRI studies were done one year after the operation.

Research paper thumbnail of Value of mammography and combined grey scale ultrasound and ultrasound elastography in the differentiation of solid breast lesions

The Egyptian Journal of Radiology and Nuclear Medicine, 2014

Aim of the work: The aim of this work was to evaluate the value of ultrasound elastography (UE) i... more Aim of the work: The aim of this work was to evaluate the value of ultrasound elastography (UE) in differentiating benign versus malignant solid breast lesions discovered in mammography and compare it with grey scale ultrasound (US) and mammography. Methods: From May 2011 to May 2013, 114 solid lesions from 100 consecutive patients discovered during mammography were categorized into benign or malignant by mammography and US and further analyzed with UE. The diagnostic results of the cases were compared with histopathologic findings. Results: Of 114 lesions, 33 were histologically malignant, and 81 were benign. UE was the most specific (95.1%) of the 3 modalities. The accuracy (81.7%) of UE was equal to mammography and was higher than those of US (82.5% and 71.9%, respectively). A combination of UE and US had the best sensitivity (90.9%) and accuracy (93.8%). Conclusions: Ultrasound elastography is useful for breast lesion characterization and is an easier and cheaper method and more specific than mammography or US alone, but it is operator dependent. When combined with US, detection accuracy can be greatly improved and the combination potentially could reduce unnecessary biopsy.

Research paper thumbnail of Role of combined grey scale US and US tissue elastography in differentiating solid thyroid nodules

The Egyptian Journal of Radiology and Nuclear Medicine, 2013

Background: Ultrasonographic (US) examination is an accurate method for detecting thyroid nodules... more Background: Ultrasonographic (US) examination is an accurate method for detecting thyroid nodules, but its use in differentiating between benign and malignant thyroid nodules is relatively low. US elastography has been applied to study the hardness/elasticity of nodules to differentiate malignant from benign lesions thus deviating a significant group of patients from unnecessary FNAB. Objectives: The aim of the study is to evaluate the validity of combined grey scale US and tissue elastography in differentiating benign form malignant solid thyroid nodules. Methods: The study included 46 selected patients with solid thyroid nodules according to our inclusion and exclusion criteria. The patients underwent surgery for compressive symptoms or suspicion of malignancy on FNA cytology. US features and tissue elastography were scored according to the Rago criteria (1). Results: On US elastography: all the 31 cases with a final diagnosis of benign nodule had a score of 1-3, while 14 of 15 (94.1%) with a final diagnosis of carcinoma had a score of 4-5, with a sensitivity of 93.3%, a specificity of 100% and an accuracy of 97.8%. Combined US and elastography reveals that hypoechogenicity/score 4-5 was most predictive of malignancy with sensitivity 80% and specificity 100%; and accuracy 93.4%. Conclusions: US elastography seems to have great potential as a new tool for differentiating solid thyroid nodules and for recommending FNAC. Combined grey scale US features and US elastography added no significant value when compared with US elastography alone. Further prospective studies are needed.

Research paper thumbnail of Multislice CT imaging of gastrointestinal stromal tumors (GISTs)

The Egyptian Journal of Radiology and Nuclear Medicine, 2011

Objective: The purpose of this study is to investigate the anatomical and pathological features o... more Objective: The purpose of this study is to investigate the anatomical and pathological features of the gastrointestinal stromal tumors. Patients and methods: in the period between 2008 and 2010 multislice CT images of 32 patients affected by GIST were analyzed, the scanning was obtained before and after contrast medium injection also the bowel distension was obtained by the diluted gastrografin. Images were evaluated for presence, site and origin of the tumor as well as growth pattern relative to the bowel wall density, relationship with adjacent structures and presence or absence of lymph nodes and metastases. Results: Thirty two patients with gists were identified (17 men and 15 women; mean age, 55.6 years). The primary tumor was located in the stomach in 14 cases, in the small intestine in 10 cases, in the ceacum and rectum in 5 and 3 cases, respectively. Mean primary tumor size was 14.3 cm (range from 2 to 18 cm). Tumors were typically with regular margins (12/32 cases, 37.5%), lobular (4/32 cases, 12.5%) while (16/32 cases, 50%) were irregular. Central fluid attenuation was seen in (15/32 cases, 49%).

Research paper thumbnail of Epidemiological characteristics and survival studies of rhabdomyosarcoma in East egypt: a five-year multicenter study

ISRN oncology, 2012

Background. Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children, it represe... more Background. Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children, it represents 5-8% of childhood malignancies. Aim of the Work. To evaluate the epidemiological characteristics and treatment outcome in two pediatric oncology centers. Patients and Method. A retrospective analysis was performed on 41 medical records of children with RMS during 6 years period. Results. The median age of patients was 6 years with 80.4% below 10 years. Head and neck was the most common primary site. Embryonal RMS was the most frequent histopathologic subtype. Stage IV was the most frequent stage. According to IRS postsurgical grouping classification, group 4 was the most frequent group. There was a significant relationship between histopathologic subtypes of tumor and metastasis, primary site of tumor and histopathologic subtype, age, metastasis, IRS presurgical stage and IRS postsurgical group and outcome. The overall survival rate was 56.9% ± 8.4 and the failure free survival rate ...

Research paper thumbnail of Coronary CT angiography with iterative reconstruction in early triage of patients with acute chest pain

The Egyptian Journal of Radiology and Nuclear Medicine, 2013

Background: Patients who present to the emergency department (ED) complaining of acute chest pain... more Background: Patients who present to the emergency department (ED) complaining of acute chest pain are of clinical concern because a small percentage will have acute coronary syndrome (ACS). The American College of Cardiology (ACC) and the American Heart Association (AHA) recommend hospitalization for patients with a low-to-intermediate risk of ACS who have initial negative ECG and enzyme test results. A negative coronary CT angiography (CCTA) during the triage has a very high negative predictive value for ruling out ACS decreasing the length of hospital stay. Recent techniques e.g. ASiR in CCTA should be used to decrease the radiation dose as low as possible.

Research paper thumbnail of Value of combined real time sonoelastography and apparent diffusion coefficient value measurement in differentiation of enlarged neck lymph nodes

The Egyptian Journal of Radiology and Nuclear Medicine, 2014

Purpose: To evaluate the role of real-time sonoelastography (UE) and apparent diffusion coefficie... more Purpose: To evaluate the role of real-time sonoelastography (UE) and apparent diffusion coefficient (ADC) value measurement in differentiating benign versus malignant enlarged neck lymph nodes. Materials and methods: This study included 26 patients presented with 32 enlarged neck lymph nodes (LNs), underwent real-time UE and diffusion weighted MRI (DWI). ADC maps are generated from DWI and ADC values were calculated. Both UE and ADC findings were compared with histopathological results. Results: The LNs were 12 benign lymphadenopathy (37.5%, seen in 10 patients), 10 metastatic (31.25% seen in 8 patients) and 10 lymphoma (31.25%, seen in 8 patients) including 4 LNs with Hodgkin's lymphoma (HL, seen in 3 patients) and 6 LNs with non Hodgkin's lymphoma (NHL, seen in 5 patients). On UE 10 of the 12 benign LNs had pattern of 1-2 (83.3%) and 18 of 20 neoplastic LNs (90%) had pattern of 4-5. The mean ADC values of the benign, metastases and lymphoma groups were 1.52 ± 0.37, 0.90 ± 0.15 and 0.72 ± 0.12 · 10 À3 (mm 2 /s), respectively. Conclusion: Combined real-time UE and ADC value measurement are non invasive techniques useful for differentiation of enlarged neck lymph. The combination potentially could reduce unnecessary biopsy especially for elasticity pattern 1-2. Please cite this article in press as: Dawood HA et al., Value of combined real time sonoelastography and apparent diffusion coefficient value measurement in differentiation of enlarged neck lymph nodes, Egypt J Radiol Nucl Med (2014), http://dx.Please cite this article in press as: Dawood HA et al., Value of combined real time sonoelastography and apparent diffusion coefficient value measurement in differentiation of enlarged neck lymph nodes, Egypt J Radiol Nucl Med (2014), http://dx.

Research paper thumbnail of The MRI finding of the nerve root sedimentation sign: Its clinical validity and operative relativity for patients with lumbar spinal stenosis

The Egyptian Journal of Radiology and Nuclear Medicine, 2014

Background: Lumbar spinal stenosis (LSS) is increasingly being recognised as a cause of disabling... more Background: Lumbar spinal stenosis (LSS) is increasingly being recognised as a cause of disabling low back and lower extremities pain in adult population. Advanced spinal imaging thought as confirmation tool for the diagnosis and as preoperative tool to delineate the extent and precise location of the pathology. Nerve roots normally sediment, due to gravity, to the dorsal part of the dural sac, which was known as negative sedimentation sign. If there is MRI finding of nerve roots in the ventral part of the dural sac the sedimentation sign is positive. Objectives: To evaluate the presence of the MRI finding of positive sedimentation sign in patients clinically suspected to have lumbar spinal stenosis and to follow up operated cases to identify the absence of the radiological signs in the operated cases. Material and methods: 70 patients clinically suspected to have lumbar spinal stenosis evaluated by MRI lumbosacral spine in supine position. A panel of two radiologists reviewed radiological data. MRI features were agreed by both radiologists in 48 patients. Out of these 48 patients; 25 were operated upon for central decompressive laminectomy, partial medial facetectomy and foraminotomy with instrumented fusion and fixation if indicated. Visual analogue score (VAS) collectively preoperative and postoperative was compared and the walking distance postoperative was reported and follow up MRI studies were done one year after the operation.

Research paper thumbnail of Value of mammography and combined grey scale ultrasound and ultrasound elastography in the differentiation of solid breast lesions

The Egyptian Journal of Radiology and Nuclear Medicine, 2014

Aim of the work: The aim of this work was to evaluate the value of ultrasound elastography (UE) i... more Aim of the work: The aim of this work was to evaluate the value of ultrasound elastography (UE) in differentiating benign versus malignant solid breast lesions discovered in mammography and compare it with grey scale ultrasound (US) and mammography. Methods: From May 2011 to May 2013, 114 solid lesions from 100 consecutive patients discovered during mammography were categorized into benign or malignant by mammography and US and further analyzed with UE. The diagnostic results of the cases were compared with histopathologic findings. Results: Of 114 lesions, 33 were histologically malignant, and 81 were benign. UE was the most specific (95.1%) of the 3 modalities. The accuracy (81.7%) of UE was equal to mammography and was higher than those of US (82.5% and 71.9%, respectively). A combination of UE and US had the best sensitivity (90.9%) and accuracy (93.8%). Conclusions: Ultrasound elastography is useful for breast lesion characterization and is an easier and cheaper method and more specific than mammography or US alone, but it is operator dependent. When combined with US, detection accuracy can be greatly improved and the combination potentially could reduce unnecessary biopsy.

Research paper thumbnail of Role of combined grey scale US and US tissue elastography in differentiating solid thyroid nodules

The Egyptian Journal of Radiology and Nuclear Medicine, 2013

Background: Ultrasonographic (US) examination is an accurate method for detecting thyroid nodules... more Background: Ultrasonographic (US) examination is an accurate method for detecting thyroid nodules, but its use in differentiating between benign and malignant thyroid nodules is relatively low. US elastography has been applied to study the hardness/elasticity of nodules to differentiate malignant from benign lesions thus deviating a significant group of patients from unnecessary FNAB. Objectives: The aim of the study is to evaluate the validity of combined grey scale US and tissue elastography in differentiating benign form malignant solid thyroid nodules. Methods: The study included 46 selected patients with solid thyroid nodules according to our inclusion and exclusion criteria. The patients underwent surgery for compressive symptoms or suspicion of malignancy on FNA cytology. US features and tissue elastography were scored according to the Rago criteria (1). Results: On US elastography: all the 31 cases with a final diagnosis of benign nodule had a score of 1-3, while 14 of 15 (94.1%) with a final diagnosis of carcinoma had a score of 4-5, with a sensitivity of 93.3%, a specificity of 100% and an accuracy of 97.8%. Combined US and elastography reveals that hypoechogenicity/score 4-5 was most predictive of malignancy with sensitivity 80% and specificity 100%; and accuracy 93.4%. Conclusions: US elastography seems to have great potential as a new tool for differentiating solid thyroid nodules and for recommending FNAC. Combined grey scale US features and US elastography added no significant value when compared with US elastography alone. Further prospective studies are needed.

Research paper thumbnail of Multislice CT imaging of gastrointestinal stromal tumors (GISTs)

The Egyptian Journal of Radiology and Nuclear Medicine, 2011

Objective: The purpose of this study is to investigate the anatomical and pathological features o... more Objective: The purpose of this study is to investigate the anatomical and pathological features of the gastrointestinal stromal tumors. Patients and methods: in the period between 2008 and 2010 multislice CT images of 32 patients affected by GIST were analyzed, the scanning was obtained before and after contrast medium injection also the bowel distension was obtained by the diluted gastrografin. Images were evaluated for presence, site and origin of the tumor as well as growth pattern relative to the bowel wall density, relationship with adjacent structures and presence or absence of lymph nodes and metastases. Results: Thirty two patients with gists were identified (17 men and 15 women; mean age, 55.6 years). The primary tumor was located in the stomach in 14 cases, in the small intestine in 10 cases, in the ceacum and rectum in 5 and 3 cases, respectively. Mean primary tumor size was 14.3 cm (range from 2 to 18 cm). Tumors were typically with regular margins (12/32 cases, 37.5%), lobular (4/32 cases, 12.5%) while (16/32 cases, 50%) were irregular. Central fluid attenuation was seen in (15/32 cases, 49%).

Research paper thumbnail of Epidemiological characteristics and survival studies of rhabdomyosarcoma in East egypt: a five-year multicenter study

ISRN oncology, 2012

Background. Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children, it represe... more Background. Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children, it represents 5-8% of childhood malignancies. Aim of the Work. To evaluate the epidemiological characteristics and treatment outcome in two pediatric oncology centers. Patients and Method. A retrospective analysis was performed on 41 medical records of children with RMS during 6 years period. Results. The median age of patients was 6 years with 80.4% below 10 years. Head and neck was the most common primary site. Embryonal RMS was the most frequent histopathologic subtype. Stage IV was the most frequent stage. According to IRS postsurgical grouping classification, group 4 was the most frequent group. There was a significant relationship between histopathologic subtypes of tumor and metastasis, primary site of tumor and histopathologic subtype, age, metastasis, IRS presurgical stage and IRS postsurgical group and outcome. The overall survival rate was 56.9% ± 8.4 and the failure free survival rate ...