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The Role of Strain Elastography in Evaluating Borderline Axillary Lymph nodes
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Background: Axillary lymph node (ALN) enlargement with diffuse cortical thickening and conserved echogenic hilum may represent a diagnostic and therapeutic challenge. Sonographic strain elastography may help the characterization of borderline ALN. 

Aim: To evaluate the strain elastography of borderline ALN and to calculate a cutoff value of strain ratio (SR) that can identify suspicious ALN with the highest sensitivity and specificity to reduce unnecessary invasive procedures. 

Subjects and Methods: A prospective study included 45 patients who attended the Breast clinic in Oncology Teaching Hospital with borderline axillary lymphadenopathy (intact hilum and diffusely thickened cortex more than 3mm) who had normal ipsilateral breast, suspicious ipsilateral breast lesion, or who had ipsilateral mastectomy. B-mode sonography and elastography were performed for all participants. Four-point elasticity score (ES), and SR were obtained for the targeted lymph node followed by ultrasound-guided fine need aspirate (FNA) biopsy..

Results: Malignant ALN constituted 20% of the cohort. B mode measurements were not able to differentiate between cytologically confirmed benign and malignant ALN in terms of axis ratio (mean ± standard deviation, 0.46 ± 0.08 vs 0.50 ± 0.12) and cortical thickness (4.88 ± 1.93 vs 6.27 ± 2.46). The mean SR of all samples was 2.66 ± 2.25.  Metastatic ALN depicted significantly higher SR (P<0.0001), with 88.9% exhibiting ES score 3 and 4. None of the metastatic ALN had ES score 1. ROC curve was used to investigate the utility of SR as a diagnostic tool. The area under the curve (AUC) was 0.906 with a 95% CI of 0.814-0.997, P<0.001. SR cutoff of 2.1 was chosen with 100% sensitivity and 66.7% specificity.

Conclusion: High proportion of borderline ALNs are not malignant. Strain elasticity can improve the risk stratification of such cases and prevent unnecessary invasive procedures. We suggested an algorithm that could better tackle borderline ALN which will need further evaluation

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Publication Date
Fri Sep 27 2024
Journal Name
International Journal Of Pharmaceutical Investigation
Investigating the Effect of Mixed Hydrotropy Approach on Solubility Enhancement of Felodipine
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Publication Date
Mon Jan 01 2018
Journal Name
Ibn Al-haitham Journal For Pure And Applied Science
Investigation of the Structural, Optical and Electrical Properties of AgInSe2 Thin Films
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Publication Date
Tue Jan 01 2019
Journal Name
Aip Conference Proceedings
Study of the structural and optical properties of CuAlxIn1-xTe2 thin film
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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Engineering Science And Technology
Quantitative and qualitative assessment of groundwater: The case of Khanaqin alluvial (Iraq
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Publication Date
Mon Jan 01 2018
Journal Name
World Journal Of Dentistry
Factors affecting the Duration of Surgical Extraction of Impacted Mandibular Third Molars
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Aim The aim of this study is to evaluate the effect of demographic, clinical, and radiographic factors on the duration of surgical extraction of impacted lower third molars. Materials and methods This retrospective study included patients who underwent surgical removal of impacted lower third molars, and the investigated factors were demographic data including age and gender, radiographic data including the impacted tooth angulation and depth of impaction and ramus relation, and clinical data including the state of eruption of the impacted teeth. These factors were evaluated for association with the duration of surgery. Descriptive statistical analysis included percentages and mean ± standard deviation (SD). Student's t-test was used to co

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Publication Date
Sat Feb 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Use Pareto Chart to diagnose the level of quality of municipal services
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The aim of the study is to study the quality of services in a sample of the municipalities of Baghdad governorate and identify the deviations in their operations and provide solutions to address the causes of deviations. The research field aims at the same activity related to municipal services and their quality and analysis using some tools for continuous improvement to identify the authorities responsible for the delay and quality of services. In the future, the importance of research is shown by the use of these tools and their use and their application to the data of the directorates (sample of the study) to diagnose and treat problems, especially that they include statistical methods that are clear and easy to understand the

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Publication Date
Wed Aug 11 2021
Journal Name
Journal Of The College Of Languages
Pragmatic Analysis of the Translation of English Culture -specific Proverbs into Arabic
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Publication Date
Wed Jun 28 2023
Journal Name
Al–bahith Al–a'alami
The Impact of Iraqi Politicians' Use of Twitter on Public Political Awareness
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This research investigates the impact of Iraqi politicians' utilization of Twitter as an interactive media tool to communicate their positions and perspectives on political events. Twitter has become a significant platform for dialogue and interactive discussions. The survey method, specifically the descriptive approach, was employed to answer research questions and achieve objectives. A sample of 100 Iraqi Twitter users was selected, considering demographic variables such as gender, age, and educational background, during the period from September 15 to October 1, 2022.

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Publication Date
Tue Feb 12 2019
Journal Name
Iraqi Journal Of Physics
The effect of deformation parameter of heavy nuclei on level density parameter
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The possible effect of the collective motion in heavy nuclei has been investigated in the framework of Nilson model. This effect has been searched realistically by calculating the level density, which plays a significant role in the description of the reaction cross sections in the statistical nuclear theory. The nuclear level density parameter for some deformed radioisotopes of (even- even) target nuclei (Dy, W and Os) is calculated, by taking into consideration the collective motion for excitation modes for the observed nuclear spectra near the neutron binding energy. The method employed in the present work assumes equidistant spacing of the collective coupled state bands of the considered isotopes. The present calculated results for f

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Publication Date
Thu Apr 13 2017
Journal Name
Journal Of Multidisciplinary Engineering Science Studies (jmess)
The Effect Of Thickness On Some Physical Properties Of CdSe Thin Films
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