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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
Sun Mar 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
The effectiveness of the organization in the philosophy of the most prominent theoreticianAdministrative thought
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بناء على ما تقدم يتضح ان القطاع العام والقطاع الخاص ليسا موقفا ايدولوجيا انتقائيا، وانما هو انبثاق من العمود الفقري للصيرورة الرأسمالية القائمة على تقديس الملكية الخاصة، وان الادوار التي يمكن ان يلعباها ليسا منعزلين عن الحركة العامة للاقتصاد في كليته، وليس هما ابنا السياسات الاقتصادية، والبناء الفوقي بقدر ماهما نتاج الحركة الموضوعية وصيرورة التطور الاجتماعي معبرا عنها في تطور علاقات الانتاج وقوى الانتا

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Publication Date
Thu Aug 21 2025
Journal Name
Journal Of Babylon Center For Humanities Studies
Reflection of Zionism in the literature of the Jews of Iraq ... Read in the novel &quot;The Dove Flyer&quot; by Elie Amir
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The upbringing of Yehuda Amichai and the conditions he lived in had a great influence on his deep sense of pain, which made him think of death and suicide. Especially after the Nazis came to power in Germany, and his emigration with his family. Amichai searched for love throughout his life, and his failure was one of the most important factors affecting his psyche, which is A deep influence that made him live in harsh and painful pains that broke him, and prevented her from achieving his ambitions in life.Dramatic texts are characterized by repetition in writing and presentation. It is a textual discourse that has two advantages, first, that it can be read as a literary text like all other literary texts, and second, that it can be consider

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Publication Date
Sun Dec 20 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of the reserve requirement ratio in the activity of the bank credit: Applied Research in a sample of Iraqi private banks
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The research topic (The Impact of the Compulsory Reserve on the Banks Credit-an applied  research on    a sample of Iraqi banks), was chosen on basis of the Iraqi  private Banks attempts to increase their credit activities in hope to gain more profits.This coincided with  the CBI aim to back the private banking market.It is thus apparent why the CBI issued its regulation to those banks to increase their capitals up  to IDB250. On the other hand,the CBI acted as an obstacle in the way of increasing the private banks of their capitals,that is by implementing the quantitive  monetary tool  so called the compulsory reserve.This is why we intended to overlook at this contradictional  problome

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of Educational And Psychological Researches
Reality and constraints of the use of computers in public schools in the governorate of Ma'an From the standpoint of teachers
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 This study aims to recognize the process of using computer in    publicschools in Ma`an governorate in terms of hardware, capabilities, and teachers usage. It also aims to identify the most important obstacles those schools face from a teachers perspective.

            The study sample consists of (150) teachers from different disciplines. The researcher prepared two questionnaires related to the research pivotal, then presented to a group of arbitrators to be used in this final form. The data was analyzed statistically and the study concluded that there is a shortage in the computer services provided to teachers, and there is a w

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Publication Date
Wed Jun 30 2021
Journal Name
Modern Sport
The impact of the question network strategy in accordance with mental capacity in the strength of cognitive control in the subject of teaching methods of sports education for undergraduate students
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The study aimed at identifying the mental capacity of the research sample and classifying them for the purposes of the study, preparing the scale of cognitive control of the subject of teaching methods of sports education, preparing educational units by establishing the question network for the subject of the teaching methods of sports education, and adopting the experimental method by experimental design workers (2×2) for the two groups The limits of the research community are represented by third-stage students of the Department of Physical Education and Sports Science in the morning study of the College of Knowledge, the Community University, which continues in the regular working hours of the year (2019-2020) adult Their number

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Publication Date
Wed Oct 05 2016
Journal Name
Al-academy
The Employment of Brainstorming in developing the idea of design of Fine Arts Institute Students in Designing the Technical Advertisement
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Brainstorming is considered as one of the manners that develop learners' mental abilities. Besides, it can help learners get a lot of ideas and thoughts. And by following applied steps to answer the problem concerned, the researcher carried out this practical study aimed at:Developing the ideas of design of third year students/Institute of Fine Arts/Evening Studies- Baghdad/First Rusafa by employing Brainstorming mechanism to develop the ideas of design of institute students in designing the technical advertisement and to achieve the authenticity of the goal of the research, Department of Plastic Arts/Institute of Fine Arts/Evening Studies/Baghdad-First Rusafa was chosen as a case study for the research. It embraced (20) students who rep

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Publication Date
Thu Aug 21 2025
Journal Name
Journal Of Physical Education
Platform proposal impact in the development of some special physical abilities in the level of achievement of ran (1500) meters of the young players in athletics.
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Publication Date
Sun Dec 31 2023
Journal Name
College Of Islamic Sciences
Variation in general formulas in the strength of its foundation and the reasons for the discrepancy
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A legal discourse in the Qur’an and Sunnah is almost devoid of the use of one of the general formulas, and due to its frequent rotation in the tongue of the legislator, the formulas may overlap their members in apparently contradictory provisions, which makes the individual from the general members appear to the beholder to be covered by two contradictory provisions, and this research came to present what might happen to him The legal text interpreter of weighting between the two opposing texts is the strength of the generality that is established by the generality formula, so the two strongest formulas in the inclusion of its members outweigh the weaker of them and precede them, and the research decided that the formulas vary

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Publication Date
Thu Aug 21 2025
Journal Name
Al-anbar University Journal Of Law And Political Sciences
The reasons for the fall of sanctions in the decisions and customs provisions in Iraqi law
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Publication Date
Fri Dec 31 2021
Journal Name
Political Sciences Journal
The application of smart power in the regional power struggle in the Middle East after 2011
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Receipt date:12/7/2020 accepted date:24/1/2021 Publication date:31/12/2021

 Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

The constant characteristic of international relations is the constant change due to political, economic and military developments in addition to technology, and this in turn has led to many transformations in the concept of power, its uses, and the elements that form power and its distribution, and according to those variables, the concept of power has shifted from hard to soft, up to smart powe

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