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The Role of Strain Elastography in Evaluating Borderline Axillary Lymph nodes

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
Thu Mar 09 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
The Role of Some Cytokines and Trace Elements in Pregnant Women with Acute Toxoplasmosi

  The present study was conducted on sixty five pregnant women that infected with    acute toxoplasmosis, serum samples were tested for detection specific anti-Toxoplasma gondii IgM using the rapid Toxo IgG/IgM Chromatographic immune assay test cassette and ELISA, and fifty healthy married women (not pregnant)  as  was considered as control group.       The level of serum IL-6, IL-8, IL-12, TNF-α, TGF-β1, IP-10, MIP-1, MIG and ICAM were significantly increased (P <0.005) in pregnant patients infected with acute toxoplasmosis, while serum level of MCP-1(14.46 ± 1.38pg/ml) was not significantly increased when compared to controls(11.25 ± 0.24pg/ml)  , these levels can be used as i

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Publication Date
Sun Jul 03 2011
Journal Name
Journal Of Educational And Psychological Researches
Educational activities in the role of government nurseries and its relationship to some variables

The skill of management educational activities gradually grow with the experience, but they differ from personal skill educator to another, because each style nanny personally and the way to work. There educator and active movement and vitality that look like happiness and clear during the implementation of the activity, and the other runs educational activities quietly, efficiently and without emotion and clear (dry, 2001: p. 274). And the stage of childhood is one of the most important stages that are based upon the future life as a whole because the man also confirmed by the School of analysis psychological is the son of his childhood and the best example to us what the Holy Prophet Muhammad (peace be upon him): (Every child i

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Publication Date
Sun Jan 01 2023
Journal Name
Dental Hypotheses
Revolutionizing Systematic Reviews and Meta-analyses: The Role of Artificial Intelligence in Evidence Synthesis

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Publication Date
Sat Jul 09 2022
Journal Name
Optik
The role of Ag NPs in PVA electrospun NFs for ultra-high sensitivity photodetector

This work aimed to produce PVA and PVA/Ag nanofibers ultra-high sensitivity photodetector by electrospinning. The electrospinning process was used to successfully prepare PVA nanofibers and a PVA-Ag nanofiber composite. FE-SEM, XRD, UV, I-V characterizations are used to study the morphological, structural, optical, and electrical properties of the material. In contrast, the PVA-Ag nanofiber composite film displayed a cubic structure with favored orientation (200) that indicated the presence of Ag NPs in the PVA-Ag nanofibers film. While the optical energy gap for PVA was 3.96 eV, it was only 2.14 eV for PVA-Ag nanofibers composite film, making this composite sensitive to visible light, particularly green light at 550 nm with a 65% photosens

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The role of strategic Agility in organizational excellence In Ministry of Construction, Housing, Municipalities and Public Works

The aim of this research is to identify the role of strategic agility achieving organizational excellence in one of the formations of the Ministry of Municipalities (Dhi Qar Sewage Directorate), as important service organizations that have a key role in serving and developing the society which faced many administrative challenges and issues and as a result of the changes in the environment is continuing and accelerating, so the adoption of modern administrative concepts such as strategic Agility and knowledge of their role in achieving organizational excellence can help them in facing these changes and achieve what they aspire to. In order to achieve research objectives, two main hypotheses have been formulated. The first hypothe

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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Economics And Finance Studies
THE ROLE OF COSTING TECHNIQUES IN REDUCTION OF COST AND ACHIEVING COMPETITIVE ADVANTAGE IN IRAQI FINANCIAL INSTITUTIONS

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Publication Date
Sun Jul 31 2022
Journal Name
Iraqi Journal Of Science
The Role of Hormones and Toxoplasma gondii Infection to Change the Secondary Sex Ratio

     The secondary sex ratio (SSR) is affected by many factors, including the concentration of hormones and infection with some pathogens such as Toxoplasma gondii. This study aimed to evaluate the effect of hormone variability concentrations and toxoplasmosis infection on the secondary sex ratio. 150 pregnant women were selected, 60 infected with late toxoplasmosis (LT), 60 infected with early toxoplasmosis (ET) and 30 seronegative to toxoplasmosis. After tracking the birth outcomes of these women, we calculated SSR in each group. During the second and third trimesters of pregnancy, estrogen, testosterone, progesterone, TSH, T4 and T3 concentrations were measured. The results of the three groups were compared. The results s

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Social intelligence and its role in demonstration the Potential abilities for individuals

Abstract

          The following research is marked by "social intelligence and its role in demonstration the potential abilities for individuals." The discussion dealt with the concepts of contemporary is very important because of their significant role in influencing the work of the Organization, as adopted link between the concepts of social intelligence and the potential role of the first to show the second .The research hypotheses tested in three health institutions in the city of Mosul, the research community is represented (Al-Salam Hospital and General Hospital and the son of ether), while the sample were the leaders of these institutio

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Publication Date
Mon Oct 30 2023
Journal Name
Iraqi Journal Of Science
Adenosine Deaminase and Guanine Deaminase: The Potential Role in Diabetic Foot Ulcers

     The present study explored the possible role of adenosine deaminase and guanine deaminase in diabetic foot ulcers which is considered one of the main chronic complications of diabetes mellitus. Serum adenosine deaminase, guanine deaminase, and some biochemical parameters were investigated in 54 patients with diabetic foot ulcers and 40 healthy individuals. According to our findings, adenosine deaminase and guanine deaminase activities are much higher in diabetic foot ulcer patients than in healthy individuals. A strong positive correlation was found between adenosine deaminase and guanine deaminase activities. Adenosine deaminase and guanine deaminase had 100% sensitivity and specificity for diagnosing diabetic foot ulcers, and

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
International Auditing Standards and their role in rationalizing the auditor's personal judgment in Iraq"

The impact of the auditor's personal judgment starts from the beginning of the audit process to the formation of the final opinion and the issuance of the report, and because of the possibility of bias in the auditor's judgment for various reasons that may relate to the auditor himself or the circumstances surrounding it, which requires assessing the current reality of the auditor's personal judgments In the local environment and determining their determinations. To clarify the concept and determinants of the auditor's personal judgments when implementing the audit work, prepare the report and determine the role of the international auditing standards in rationalizing the auditor's personal judgment when conducti

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