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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
Sat Jun 01 2024
Journal Name
Journal Of Scientific Development For Studies And Research
The Role of E-Learning in teaching the Arabic language to non- native speakers
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After the information revolution that occurred in the Western world, and the developments in all fields, especially in the field of education and e-learning, from an integrated system based on the effective employment of information and communication technology in the teaching and learning processes through an environment rich in computer and Internet applications, the community and the learner were able to access information sources and learning at any time and place, in a way that achieves mutual interaction between the elements of the system and the surrounding environment. After the occurrence of the phenomenon of Covid 19, it led to a major interruption in all educational systems that had never happened before, and the disrupt

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Publication Date
Tue Oct 23 2018
Journal Name
Journal Of Economics And Administrative Sciences
The role of the government accounting system in preparing performance reports for government units
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The purpose of this study is to assess the performance of government units (Iraqi hospitals) by trying to determine the possibility of the current governmental accounting system to provide information on the performance reports of government units. In order to improve the efficiency of hospital resources management, the services provided by the hospital should be subject to performance measurement and evaluation The importance of the health sector in the provision of services, in order to raise the efficiency of the performance of services provided by government units has reached the researcher a set of conclusions, the most important

  1. The financial reports produced by the accounting s

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Publication Date
Fri Jan 01 2016
Journal Name
Al–bahith Al–a'alami
Designing the Websites of the Iraqi Electronic Newspapers and its Role in Attracting Visitors
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The researcher seeks to know the extent of applying the concept of design by Iraqi electronic press sites to provide media product with the acceptance of their browsers and ensure their repeated visits to such sites in the framework of the guiding rules for laser browsing. The researcher uses analytical study on a sample of six Iraqi electronic newspaper sites to identify the general features of their design and the methods of distribution of the structural elements of the pages. The researcher also conducts a field study on a sample of the surfers of electronic newspaper sites to see the extent of their evaluation to their design and the degree of their satisfaction.

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Publication Date
Sun Dec 20 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the external audit in improving the performance of the services provided: Applied research in the municipal directorate in ALMuthanna
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The subject of improving the performance of services provided by government institutions of the important topics at the present time because of their direct contact at the service of citizens and the increased importance of these units as a result of the diversity of activities performed by the so governments of the countries and their people made sure to pay attention to the good use of those allocated to those sectors of resources and spending in the service prescribed and manage the highest level of efficiency and effectiveness and monitor the proper management of the money used in those sectors and evaluate their performance through the Supreme Audit Institutions so that they can play their role oversight and contribute to th

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Publication Date
Fri Oct 28 2022
Journal Name
Political Sciences Journal
The protest movements in Sudan and their role in the political and social transformation
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This study investigates the factors that led to the outbreak of protest movements in Sudan, since Sudan’s independence in 1956 until December 2018. The study aims to identify the role of protests in bringing about political and social transformations in Sudan, besides identifying the factors that help in the success or failure of the governments that resulted from those protests, with special emphasis on the challenges of the government of the 2018 revolution. The main results of the study reveal that the December 2018 protests are the largest in term of numbers, and witness huge participation of youth and women, and the slogans raised were national and comprehensive. However, the challenges that the transitional government is going th

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Publication Date
Sat Jun 14 2025
Journal Name
Imam Ja&#39;afar Al-sadiq University Journal Of Legal Studies
The role of fluctuations and crises in stock markets in activating market makers models
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Publication Date
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Nurses' Knowledge and Role in the Management of Thalassemic Patients in Sulaimania Thalassemia Center
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The aim of this study is to assess nurse's knowledge and role in the management of thalassemic patients in the Sulaimania Thalassemia Centre. Methodology: This study utilized a qualitative approach to explore nurses’ knowledge about thalassemia through semi structured group interviews. Questionnaire was synthesized through a comprehensive review of literature. Results: The results show that nurses in Kurdistan region of Iraq have a limited role in terms of decision making and there is lack of nursing documentation other than that of recording abnormal events, and a lack of knowledge about and engageme

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Publication Date
Wed May 13 2015
Journal Name
Elsevier Procedia Economics And Finance
The Role of FDI Inflows in Economic Growth in Malaysia (Time Series: 1975-2010)
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Recently, Malaysia has been recognized as one of the most popular destinations for Foreign Direct Investment (FDI) in Southeast Asia. But how do these FDI inflows affect Malaysia economy? This paper aims to identify the role of FDI inflows in Malaysia economic growth through a proposed endogenous growth model. Annual data covers from 1975 to 2010. Unit root test and Johansen Co-integration test are adopted to respectively verify the time series data is stable and the linear combination of the variables is stationary. Hierarchical Multiple Regressions (HMR) Analysis is then conducted to find out the momentum of the Malaysia economic growth including FDI inflows. The results show that the FDI inflows together with the human capital deve

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Publication Date
Sun Dec 01 2019
Journal Name
Iop Conference Series: Materials Science And Engineering
Place dependence as the physical environment role function in the place attachment
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Abstract<p>This research sheds light on the physical environment role in creating the place attachment, by discussing one of the important factors in the attachment creation, it is the concept place dependence, consisting of two important dimensions: the place quality and the place expectation; they contain a number of the supporter physical environment sub-indicators for place attachment. Eight physical indicators were reached; they were found to have a close relationship to the place attachment, including: the open and green spaces existence, land use diversity, diversity of housing types, dwelling / population density, accessibility, transport network development degree, transport multiple mo</p> ... Show More
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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Environmental awareness in the curriculum and its role in sustainable environmental planning
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                The goal of current research to the definition of environmental awareness in the curriculum and its role in sustainable environmental planning, was the research community official regular educational schools (kindergarten, primary, secondary) for the province of Baghdad - Iraq, the sample consisted search of (100) teacher and a teacher, and what research was descriptive analytical, researchers have selected the right tool for the research procedures (closed) questionnaire, distributed to the research sample, has been used by researchers appropriate statistical methods for procedures including: the weighted average extraction unit paragraph,

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