atoosa adibi

Mammograms often reveal breast microcalcifications, necessitating invasive procedures to ascertain whether they are cancerous or benign.

Although many microcalcifications are linked to noncancerous conditions, this study sought to investigate the efficacy of a computer-aided detection (CAD) system using breast MRI in distinguishing between benign and malignant breast anomalies.

This cross-sectional study included forty patients with mammographically suspicious microcalcifications who underwent stereotactically-guided biopsies at our institution over two years. Prior to the biopsy, these patients received a breast MRI within eight weeks. Surgical interventions were carried out for cases identified as malignant or of uncertain malignant potential. The study aimed to determine diagnostic benchmarks by comparing the breast imaging reporting and database system (BI-RADS) category assignments from initial mammography screenings and breast MRI reports to the pathology findings.

Histopathology reports showed that of the total cases, 23 were benign, and 17 were malignant. Breast MRI exhibited a sensitivity of 88.8%, specificity of 54.5%, a positive predictive value of 58.5%, and a negative predictive value of 94.1%. Further analysis using CAD demonstrated sensitivity, specificity, positive predictive value, and negative predictive value of 100%, 50.0%, 59.0%, and 100%, respectively.

Utilizing breast MRI with the support of CAD, radiologists could significantly enhance their capability to differentiate between benign and malignant mammographic microcalcifications. This innovative diagnostic approach has the potential to decrease the necessity for unnecessary breast biopsies.

Premature delivery is called delivery before 37 weeks. It is estimated thatevery year, about 15 million babies are born with preterm delivery worldwide, which is approximatelyequal to 11% of the total number of deliveries. In this study, a number of pregnant women with 11-14weeks of pregnancy were evaluated in order to evaluate the value of cervical length at the end of the firsttrimester of pregnancy in predicting preterm delivery.

In this cohort study, 156 asymptomatic pregnant women with a gestational ageof 11-14 weeks were randomly selected and evaluated. Cervical length was measured by transvaginalultrasound using a standard method. Cervical length and gestational age at delivery were recorded in acomputer database along with demographic information, clinical history, and pregnancy information.

The mean length of the cervix in women with preterm delivery was 31.32±6.71 mm and inwomen with term delivery was 38.96±5.80 mm. Data analysis showed that shorter cervical length wassignificantly associated with preterm delivery. With a threshold of 34.5 mm, the length of the cervix from3rd month to 6th month could predict preterm delivery with a sensitivity of 76% and a specificity of 81%.

Measuring cervical length with transvaginal ultrasound in the second trimester can predictpreterm delivery.

Low back pain (LBP) is the most common musculoskeletal disorder and an important cause of disability. Although imaging techniques have been developed for LBP treatment, they have not been successful to improve its prognosis. Although MRI is necessary for diagnosing some diseases, their economic burden on the health system is high. It is challenging to set appropriate guidelines for the correct use of imaging methods in developing countries due to limited capacity and resources. This study aims to investigate the frequency of the positive results of lumbosacral MRI in non-traumatic patients aged >18 years with LBP.

This retrospective descriptive-analytical study was conducted from August 2016 to September 2017. The inclusion criteria were: having non-traumatic LBP, age >18 years, completeness file of medical records file, and having knowledge of the specialty of the referring physician. The MRI findings and demographic information including age and gender were collected from the imaging information system of Al-Zahra Hospital in Isfahan, Iran.MRI findings including disc herniation, spinal canal stenosis, spondylosis and spondylolisthesis were considered as the positive result. We also called the patients and asked about their need for medical or surgical intervention. The frequency of positive lumbosacral MRI results were estimated based on the specialty of the referring physician and the results were then compared between different groups. To confirm the validity and reliability of the data collection tool, all MRI images were performed with one single imaging protocol and the reports were made by the same radiologist.The final collected data were entered into SPSS software, version. All quantitative data were reported as Mean±SD and the qualitative data were reported using frequency and percentage. Chi-squared test, independent t-test and one-way analysis of variances (ANOVA) were used to determine if there was a significant difference in the frequency of positive MRI findings among the different groups based on the specialty of the referring physician. P<0.05 was statistically significant.

Of 335 participants, 145(43.3%) were male and 190(56.7%) were female. Their mean age was 43.9±15.4 years. Among the referring physicians, 139(41.5%) were neurosurgeons, 114(34%) were orthopedists, 61(18.2%) were neurologists, and 21(6.3%) were physical medicine specialists. It was reported that 291(87.1%) of patients had no spinal canal stenosis, while 43(12.9%) had this pathology. More than 95% of patients had no any spinal deformity and spondylolisthesis, while 52.2% had spondylosis. Moreover, 201 cases (60%) had no disc herniation; among the reminding cases, 104(31%) had disc protrusion, 27(8.1%) had disc extrusion, and 3(0.9%) had disc sequestration.The MRI results of 335 patients based on the specialty of the referring physician are shown in Table 1. There was no significant difference among different specialties in the frequency of positive MRI results (P>0.05).Since the number of the physical medicine specialists was low and could affect the significance of the result for this group, data analysis was conducted one more time after removing this group. Based on the results, spinal canal stenosis was observed in 40 patients, of which 62.5% were related to neurosurgery group, 22.5% for orthopedics group, and 15% for neurology group. The difference was statistically significant (P=0.044). Regarding other positive MRI findings, no statistically significant difference was observed among different specialties of physicians. Table 2 shows the frequency of LBP managements (surgical and non-surgical) based on the specialty of the referring physician. Regarding the relationship between the LBP management in patients and the specialty of the referring physician, the correlation coefficient was obtained 0.227 which was statistically significant (P=0.032).

There is no significant difference in frequency of positive lumbosacral MRI results in patients with LBP based on the specialty of the referring physician.

CA125 is the most used tumor marker for ovarian cancer monitoring and diagnosis. This study aimed to evaluate the capacity to predict malignancy in women with adnexal tumors using CA125 measurement and ultrasound criteria before the pathological examination.

This observational diagnostic study was conducted on 300 patients with obvious diagnosis of adnexal mass consists of ovarian masses, fallopian tubes, and masses within the broad ligament referring to Alzahra and Beheshti Hospitals from 2018 to 2019. Ultrasound examinations were done before surgery and malignancy risk was investigated by the ADNEX criterion. Sensitivity, specificity, positive and negative likelihood ratio (likelihood ratio [LR]+ and LR−), and area under the curve (AUC) were calculated.

From 284 patients, 260 masses were categorized in benign, 18 were in borderline, and 18 masses were malignant. The mean age of patients with malignant tumors was significantly higher than the others (P = 0.01). Differences in the level of CA‑125 were not statistically significant (P = 0.78). Furthermore, the proportion of ascites in the malignant group (16.3%) was significantly higher than the others (P = 0.003). The AUC in ADNEX model (cutoff ≥9%) for differentiation of benign and malignant tumors was 0.75 (95% confidence interval [CI]: 0.69–0.80) with a sensitivity of 0.63 (95% CI: 0.41–0.81) and a specificity of 0.80 (95% CI: 0.74–0.84). Receiver operating characteristic analysis for CA‑125 revealed that this variable is not capable for discrimination between benign and malignant tumors as the AUCs of the aforementioned variable were 0.60, 0.60, and 0.52 for the whole patients, premenopause, and postmenopause categories.

CA‑125 marker, along with other ultrasound findings, can be more accurate in identifying the malignancy of the adnexa tumor

The Isfahan Thyroid Cohort Study (ITCS) is one of the few population-based epidemiological studies in Iran that investigates the prevalence and incidence of thyroid disorders including hypothyroidism, hyperthyroidism, goiter, nodule, and iodine status.

This cohort is located in Isfahan, Iran. The first phase was initiated in 2006 with 2523 participants (1275 males, 1248 females). The participants were selected using multi-stage cluster sampling from the general residents of Isfahan, Iran. The study had two phases (2006 and 2011) and its third stage is planned for 2020–2021.

The prevalence of thyroid function states was euthyroid (89.3%, 95% CI: 88%–90%), overt hypothyroidism (2.8%, 95% CI: 2%‒3%), subclinical hypothyroidism (5.8%, 95% CI: 4%–6%), overt hyperthyroidism (0.8%, 95% CI: 0.4%‒1%), and subclinical hyperthyroidism (0.99%, 95% CI: 0.6%–1%). Hypothyroidism and hyperthyroidism were significantly associated with goiter. The incidence of thyroid dysfunction was reported as follows: overt hypothyroidism (2.7, 95% CI: 1.6–3.7), subclinical hypothyroidism (20.6, 95% CI: 18–23), overt hyperthyroidism (1.9, 95% CI: 1–2.7) and subclinical hyperthyroidism (2.7, 95% CI: 1.6–3.7) per 1000 (person-year).

We assessed the prevalence and incidence of thyroid disorders in Isfahan in the first and second phase, respectively. We are conducting the third phase of the ITCS in order to study the associations between thyroid peroxidase antibody (TPOAb) level and environmental factors such as infection.

Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive method to detect pancreaticobiliary strictures. In this study, we aimed to evaluate the diagnostic performance of MRCP and detect sensitive and specific radiologic features in distinguishing malignant and benign pathologies.

In this study, 50 patients with biliary obstruction and a confirmed diagnosis using histopathology were included. The pathologies were evaluated using MRCP which were categorized into malignant and benign strictures. The etiology of strictures was detected using histopathology and endoscopic retrograde cholangiopancreatography. The diagnostic performance of MRCP was calculated using SPSS software. P < 0.05 was considered statistically significant.

Of 50 patients, 23 patients (46%) had malignant strictures based on MRCP and histopathology. The sensitivity and specificity of MRCP to detect malignancy were 95.7% and 96.3%, respectively. The most sensitive MRCP features to detect malignancy were upstream biliary duct dilation, abrupt tapering, and the presence of a solid mass with sensitivity 100%, 95.7%, and 78.2%, respectively. The malignancy rate was significantly higher in the strictures with length >11.5 mm or wall thickness >2.75 mm (P < 0.05).

MRCP is a sensitive method to differentiate malignant lesions from benign pathologies. A long and thick stricture with the presence of a solid mass, upstream biliary duct dilation, and abrupt tapering is highly suggestive of malignancy

Novel coronavirus disease of 2019 (COVID‑19) is the current pandemic causing massive morbidity and mortality worldwide. The gold standard diagnostic method in use is reverse transcription–polymerase chain reaction (RT‑PCR) which cannot be solely relied upon. Computed tomography (CT) scan is a method currently used for diagnosis of lung disease and can play a substantial role if proved helpful in COVID‑19 diagnosis. We conducted this study to evaluate the diagnostic value of CT scan compared to RT‑PCR in the diagnosis of COVID‑19.

We recruited 291 hospitalized patients suspicious of COVID‑19 according to typical clinical findings during February–March 2020. The patients underwent CT‑scan and RT‑PCR procedures on the day of hospital admission. CT scans were reported by two radiologists as typical, indeterminate, negative, and atypical. Statistical indices were calculated twice: once considering “typical” and “indeterminate” categories as positive and the other time counting “typical” results as positive.

The CT reports were classified as typical (64.95%), indeterminate (10.31%), atypical (11%), and negative (13.75%). Considering “typical” and “intermediate” as positive, sensitivity and specificity were 85.3% and 38.8%, respectively, and using the second assumption, the mentioned indices were 75.9% and 50.4%, respectively.

According to our study, CT results do not create enough diagnostic benefit and could result in incorrect confidence if negative. Since widely available, CT integration in the clinical process may be helpful in screening of suspected patients in epidemics. Yet, suspected patients should be isolated till confirmed by (multiple) PCRs.

This study aimed at investigating the effects of speech intervention on Non-Oral Cleft Speech Characteristics (NCSCs), intelligibility, and Quality of Life (QoL), as well as the relationship between speech variables and QOL-related variables in intensive speech therapy among children with cleft palate.

This single-group pre-test and post-test clinical trial study was performed on 12 Persian-speaking children with cleft palate and NCSCs aged 3-7 years. For this purpose, we used 30 sessions of speech therapy and the Persian version of the Pediatric Quality of Life Inventory (PPedsQL). The pre-test and post-test assessments included perceptual assessment using the CAPS-A and QoL assessment using the Parent Proxy of the Persian version of the PPedsQL. The Wilcoxon’s test was applied to analyze group differences in the NCSCs, the intelligibility of speech, the total score of PPedsQL, physical, emotional, social, and school functions before and after providing the speech therapy.

The obtained results indicated that the frequency of NCSCs, the intelligibility of speech, the total score of PPedsQL, and its subscales significantly improved after the intervention (P<0.001). However, physical function presented no significant change after intensive treatment (P= 0.15). Additionally, the frequency of NCSCs had a significant negative c with a total score of PPedsQL and subscales. The intelligibility of speech was significantly and positively related to the total score of PPedsQL and its subscales.

This study demonstrated that intensive speech therapy was an effective approach in improving the intelligibility of speech and QoL in children with cleft palates. moreover, this study revealed that speech variables were significantly related to QoL variables.

This study was performed to determine the sensitivity and specificity of ultrasound in the diagnosis of traumatic ankle injury in comparison with magnetic resonance imaging (MRI).

This cross‑sectional study was performed on 31 patients with soft‑tissue injury or fracture, referring to the MRI imaging center of Alzahra and Kashani Hospitals in Isfahan from October 2018 to March 2019. After an MRI, an ultrasound of the affected ankle was performed for all patients. Sonography and MRI were performed by two radiologists who were blinded to the results of each other’s reports. The sensitivity, specificity, positive predictive value, and negative predictive value of sonography were determined.

In this study, 31 patients with ankle trauma were studied. The mean age of the patients was 30.73 ± 10.15 years; 32.3% were male and 67.7% were female. The sensitivity of ultrasound relative to MRI to detect damage to the anterior talofibular ligament (ATFL), posterior talofibular ligament (PTFL), and calcaneofibular ligament (CFL) was 66.67%, 50%, and 100%, respectively, and the corresponding specificity was 92.86%, 93.10%, and 93.10%, respectively. According to Kappa test, the agreement between ultrasound and MRI methods for detecting injury to ATFL (κ = 0.51), PTFL (κ = 0.35), and CFL (κ= 0.63) was statistically significant (P < 0.05).

Ultrasound is an appropriate modality for the diagnosis of injuries to CFL and ATFL and has shown acceptable results for PTFL. It could be used as an alternative in cases where access to MRI is not available.

Intraductal papillary mucinous neoplasm of the biliary tract (B‑IPMN) is an intraductal growing mucin producing tumor that is precursor of cholangiocarcinoma. Dilation of both upstream and downstream biliary ducts is the radiological key feature that is respectively caused by intraductal obstructive growth and massive mucin production. Although B‑IPMN is rare, if the radiologist is familiar with its manifestation, can lead to early diagnosis when surgical resection can be curative. Here, we report a long standing pathologically proved case of B‑IPMN with emphasis on radiological manifestation during a long time of 13 years across different imaging modalities.

The results of the former study confirmed the accuracy of magnetic resonance imaging (MRI) in determining the origin and content of ovarian masses. The present study aimed to evaluate the diagnostic value of MRI in differentiating benign and malignant ovarian masses in women.

This was a cross-sectional study. All candidates for surgery to remove ovarian masses were selected to participate in this study. They underwent MRI with gadolinium before the surgery. MRI images were reviewed by an experienced radiologist who was aware of the ovarian mass found in pelvic ultrasonography (US). A thick-enhancing wall, mural nodules, septations, and internal enhancement within the mass were reviewed by the radiologist. Mass specimens were examined in the laboratory by an experienced pathologist to determine malignancy or benignancy of the masses. Pathological findings were compared with MRI results.

there was no significant difference between MRI findings and pathology denoted by benign and malignant (P = 0.06), but results showed a significant difference between US and pathology (P = 0.002). In MRI findings related to a thick-enhancing wall (P = 0.18), internal enhancement (P = 0.18), and pelvic fluid (P = 1.00), no significant difference was seen in benign or malignant masses. However, in findings related to septation, all cases had malignant reports (P = 0.006), and in mural nodule, 80% had malignant reports (P = 0.006). CA-125 blood level in patients with benign masses (1.72 ± 0.97) was significantly less than patients with malignant masses (3.20 ± 0.83) (P < 0.001).

We showed that MRI has better results in diagnosing adnexal masses and their characteristics compared to simple ultrasound imaging based on pathological studies.

Although laparoscopic cholecystectomy (LC) is the gold standard approach for gallbladder diseases, this sometimes may face difficulties and require conversion to open surgery. The preoperative ultrasonographic study may provide information about the probability of difficult LC, but the data in this term are uncertain. We assessed the value of preoperative ultrasonographic findings for the prediction of LC’s difficulty.

The current prospective clinical trial was conducted on 150 patients who were candidates for LC due to symptomatic gallstone. All of the patients underwent ultrasonography study preoperatively, and then, LC was performed. The surgeon completed a checklist regarding the easy or difficult surgical criteria. Finally, the values of ultrasonographic findings for the prediction of LC difficulty were evaluated.

Among the 150 included patients, 80 had easy LC and 70 had difficult LC. Statistically significant differences were found between the two groups of easy and difficult LC regarding gallbladder wall thickness (P = 0.008), stone impaction (P = 0.009), and gallbladder flow (P = 0.04). The area under the curve (standard error [SE]) for the thickness of the gallbladder wall, flow in the gallbladder wall, and stone impaction was 0.598 ± 0.048, 0.543 ± 0.047, and 0.554 ± 0.047, respectively (P < 0.05). The highest specificity was for gallbladder wall flow (100%). Binary logistic regression showed that stone impaction had predictive value for determining difficult LC (odds ratio = 3.10; 95% confidence interval: 1.03–9.30; P = 0.04).

Although a significant difference was observed between two groups in terms of impacted stone, flow in the gallbladder wall, and thickness of the gallbladder wall, only stone impaction had predictive value for determining difficult LC.

Fatty liver disease is a common hepatic disorder that remains undiagnosed due to the high number of asymptomatic patients and lack of a proper noninvasive diagnostic tool. Liver biopsy, the gold standard of liver steatosis diagnosis, is an invasive method that can be replaced by fibroscan. Fibroscan can detect liver steatosis with high sensitivity and specificity, but it is not accessible around the world. In this study, we compared ultrasonography (US) as a cheap and accessible device with fibroscan method in detecting patients with liver steatosis.

We enrolled 77 patients in this study. US and fibroscan were done in each patient at a single day. Liver steatosis stages were recorded using US and fibroscan. The diagnostic performance of US was calculated, using fibroscan as the reference method.

The sensitivity and specificity of US in detecting fatty liver disease using fibroscan as a standard method were 73% and 69%, respectively.

Based on sensitivity and specificity achieved from US, this study suggests that ultrasound is a suitable method for detecting patients with liver steatosis obviating liver biopsy and fibroscan.

The advent of multi-slice computed tomography (CT) technology has provided a new promising tool for non-invasive assessment of the coronary arteries. However, as the prognostic outcome of patients with normal or non-significant finding on computed tomography coronary angiography (CTCA) is not well-known, this study was aimed to determine the prognostic value of CTCA in patients with either normal or non-significant CTCA findings.|

This retrospective cohort study was performed on patients who were referred for CTCA to the hospital. 527 patients with known or suspected coronary artery disease (CAD), who had undergone CTCA within one year were enrolled. Among them, data of 465 patients who had normal (no stenosis, n=362) or non-significant CTCA findings (stenosis <50% of luminal narrowing, n=103) were analyzed and prevalence of cardiac risk factors and major adverse cardiac events (MACE) were compared between these groups. In addition, a correlation between these factors and the number of involved coronary arteries was also determined.

After a mean follow-up duration of 13.11±4.63 months, all cases were alive except for three patients who died by non-cardiac events. Prevalence of MACE was 0% and 3% in normal CTCA group and non-significant groups, respectively. There was no correlation found between the number of involved coronary arteries and the prevalence of MACE (P = 0.57).

A normal CTCA could be associated with extremely low risk of MACE over the first year after the initial imaging, whereas non-significant obstruction in coronary arteries may be associated with a slightly higher risk of MACE.

Considering the increasing incidence rate of ovarian cancer in worldwide and the utility of Gynecologic Imaging Reporting and Data System (GI‑RADS) in diagnosing malignant adnexal lesions such as ovarian cancer, we aimed to evaluate the diagnostic performance of this reporting system in differentiating between malignant and benign adnexal lesions. In this cross‑sectional study, women with suspected adnexal lesions were enrolled. For differentiating of malignant adnexal lesions, Grade II and III of GI‑RADS system were classified as low risk for malignancy and Grades IV and V as high risk. Results of histopathologic diagnosis were compared with the results of the mentioned GI‑RADS system classification, and the diagnosed accuracy of the system was determined. Patients who did not have histopathologic diagnosis were followed up. In this study, 197 women with suspected adnexal lesions were evaluated. Frequency of GI‑RADS II, III, IV, and V were 34.5% (69 cases), 38.0% (76 cases), 19.5% (39 cases), and 6.5% (13 cases), respectively. According to the low‑ and high‑risk classification of GI‑RADS, 72.5% were classified as GI‑RADS II and III and 26% as GI‑RADS IV and V, respectively. Definitive histopathologic diagnosis was reported for 158 cases. Histopathologic evaluation indicated that 12 (7.6%) of the masses were malignant and 146 (92.6%) were benign. Comparing with the histopathologic diagnosis, the GI‑RADS system sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio (LR), and negative LR were 91.6%, 80.82%, 28.2%, 99.1%, 4.77, and 0.10, respectively. The accuracy of the scoring system was 81.64%. Our findings indicated that using GI‑RADS, we could quantify the risk of malignancy by such a structured as well as simple reporting system so that the system could be useful for clinicians for performing an appropriate clinical management.

Nearly two-third of the patients with type 2 diabetes have degrees of fatty liver; this may induce some side effects in them. This study aimed to find effect of salsalate on treatment of steatohepatitis and correlation of fatty liver with metabolic syndrome in the setting of impaired glucose metabolism.

In a double-blind randomized trial within two distinct groups, i.e., recently diagnosed diabetics and prediabetic cases allocated in two arms of the intervention to receive 3 g salsalate or placebo. All cases underwent glucose and lipid level studies and liver ultrasound study.

Out of 46 patients with diabetes, 34 (74%) had fatty liver in ultrasound; this ratio was 75% in 113 prediabetic cases. Relative frequency of fatty liver stages did not differ between diabetics and prediabetics. Within diabetics, mean aspartate aminotransferase (AST) level of fatty liver cases (23 ± 7 IU/dl) was higher than others (18 ± 3 IU/dl) (P < 0.05). Changes in transaminase levels following intervention did not significantly differ, comparing drug and placebo arms in two subgroups.

According to the findings, if diabetes could be assumed as the logical consequence of prediabetic state, it seems that fatty liver did develop before this preliminary status. In this study, salsalate could not change biochemical markers of fatty liver significantly.

Considering that ethnicity and gestational age (GA) could a?ect the value of nuchal fold thickness (NFT) in mid?trimester, we aimed to determine the reference intervals of NFT values for each gestational week from 16 to 24 weeks of pregnancy among a group of Iranian pregnant women. In this cross?sectional study, medical fles of pregnant women who underwent fetal anomaly scanning at 16–24 weeks of gestation were reviewed and the following data were extracted: GA, value of NFT, value of nuchal translucency (NT) in their previous ultrasound study, if available, and head circumference (HC). Te 5th, 25th, 50th, 75th, and 95th percentiles of NFT for each gestational week were determined. Te association between NFT and HC, GA, and NT were also determined. Medical fles of 882 pregnant women were studied. Te expected 95th percentile value of NFT between 16th and 24th weeks of gestation ranged from 4 mm to 5.9 mm. Te mean (standard deviation) of NFT increased with GA from 2.67 (0.90) mm at 16th weeks to 4.69 (0.71) mm at 24th weeks. Tere was a signifcant positive association between NFT and GA (? = 1.11, P < 0.001), HC (? = 0.21, P < 0.001), and NT (? = 0.351, P < 0.001). Te fndings of this study revealed that before the 20th week of gestation, the appropriate cuto? value of NFT is 5 mm, and for 21st to 24th weeks, the proper cuto? is 6 mm. However, for providing more conclusive results, further studies with larger sample size and considering the impact of other in?uencing variables are recommended.

To prevent complications during surgical procedures, having knowledge about the anatomical variation of renal arteries in different races is important. This study aimed to determine the frequency of anatomical polymorphism of renal artery in Isfahan City, Iran.
Throughout a cross-sectional study on 129 patients referring to Alzahra hospital for kidney or abdominal multislice computed tomography angiography with multiple detector computed tomography (MDCT) in years 2015-2016, the arterial properties of kidneys on both sides were examined. The number of arteries was evaluated in terms of their laterality, location of the vasculation in kidney tissue, the number of accessory kidney arteries, and the patient's gender.
Findings: At least one additional artery was found in 15.5% of the right kidneys, and 17.1% of the left kidneys. Besides, the diameter of the accessory renal artery to the left in 14.3% of cases was the same as the major artery size, and in 85.7% smaller than the main artery; while all the right arteries (100%) were smaller than the main artery. There was no significant difference between the number of main and accessory renal arteries on the right or left sides between men and women. There was no significant difference between the number of main and secondary arteries between the two left and right sides.
Renal artery has anatomical variations and should be further investigated to prevent surgical complications. We recommend that a study with larger sample size be designed to compare anatomical variations between left and right accessory renal arteries in the Iranian population.

Breast cancer is among the most common cancers in the world. Ultrasound evaluations of breast have come into attention as an alternative route. Ultrasound features of benign lesions such as fi broadenoma can be overlapping with those in a malignant tumor. Here, we assessed the reports of breast ultrasound in patients with pathologic diagnosis of fi broadenoma.

We conducted a cross-sectional study and enrolled female patients with confi rmed histologic diagnosis of fi broadenoma. Ultrasound studies were performed on the participants to see which sonographic patterns are more frequent in such lesions.

In 92 patients with 40.4 ± 9.2 years of age, all participants were classifi ed as stage 4 on Breast Imaging-Reporting and Data System scale. The mean ± standard deviation of size for the lesions was 167.4 ± 101.4 mm2. Upper outer quadrants in the breasts had the most number of lesions. Almost lesions were round with only 2.2% were oval. When assessed for the margin defi nition, 57.8% were circumscribed. Noncircumscribed masses were reported in 21.7%. About 91.3% of cases were hypoechoic in the ultrasound evaluation. Lobulated masses were in 28.3% of the cases. 8.7% of the masses were spongy whereas 9.8% and 2.2% of them had calcifi cation and heterogenic appearance, respectively.

The most frequent features include a hypoechoic mass with a circumscribed border; however, complex presentations that overlap malignant masses are also detectable including noncircumscribed margin, lobulation, presence of a posterior shadow, heterogenicity, and micro calcifi cation.

This study aimed to determine the prevalence of nonalcoholic fatty liver disease (NAFLD) and its related risk factors among the general population of Isfahan city located in the central part of Iran.

In this cross-sectional study, the prevalence of NAFLD among 483 general adult populations was determined using ultrasonography. Anthropometric and biochemical variables were compared in groups with and without NAFLD and their predictive value for occurrence of NAFLD was investigated also.

Prevalence of NAFLD was 39.3%. Frequency of focal fatty infi ltration (FFI), Grade I, Grade II, and Grade III of NAFLD was 9.5%, 21.1%, 7.2%, 1.4%, respectively. Prevalence of different types of NAFLD and FFI, was not different between female and male participants (P = 0.238). Ordinal regression was determined that all of the studied variables have signifi cant predictive value for NAFLD (P < 0.001, γ = 0.615). Spearman correlation indicated that there was a signifi cant relationship between NAFLD and BMI (r = 0.37, P < 0.001), age (r = 0.15, P = 0.001), FBS (r = 0.20, P < 0.001), cholesterol (r = 0.19, P < 0.001), triglyceride (r = 0.20, P < 0.001), LDL (r = 0.16, P < 0.001), AST (r = 0.17, P < 0.001), and ALT (r = 0.31, P < 0.001).

Considering the high prevalence of NAFLD specially its lower grades among Isfahani adult general population and their association with studied variables, it seems that interventional studies which target-related mentioned risk factors could reduce the overall occurrence of NAFLD.

Identification of osteoporosis in women in order to prevent its related morbidity and mortality is considered a priority. Routine mammography is performed on all menopausal women as a screening tool. Determination of the relation between breast arterial calcification (BAC) on mammography and the bone density of this high‑risk population could help us to determine those with osteoporosis. The aim of this study was to investigate the mentioned probable relation between BAC and osteoporosis.

In this cross‑sectional study, menopausal women referred for annual screening mammography were enrolled. According to the results of mammography, they were classified into two groups: menopausal women with and without calcification of breast arteries. The selected women were referred for bone mineral density (BMD) evaluation by dual‑energy x‑ray absorptiometry (DXA). The results of BMD were compared between the two studied groups.

In this study, BMD was measured in 43 and 45 menopausal women with and without BAC, respectively. After age adjustment the difference between BMD measurements were not statistically significantly different (P > 0.05). There was a significant negative correlation between age and lumbar (P = 0.002, r = ‑0.42) and hip bone (P = 0.000, r = ‑0.67) density in menopausal women with BAC.

The results of the current study indicated that there was no significant relationship between BAC and BMD in our studied population, but it seems that increasing age has an important role in both developing BAC and reducing BMD. For obtaining more conclusive results, further studies with larger sample sizes and considering the severity of BAC is recommended

Considering that establishment of reference value of nuchal translucency (NT)-related to the crown rump length (CRL) during the first trimester will be helpful for determining an appropriate cutoff level for screening of increased NT thickness-related abnormalities, we determined the NT thickness and investigated its relation with different chromosomal and nonchromosomal abnormalities among a large sample size of pregnant Iranian women. In this analytic cross-sectional study, pregnant women who were in their first trimester were enrolled at their antenatal visit. Using an abdominal ultrasonography, the fetal NT thickness of the studied population was measured. Those with increased NT thickness were determined. The reference value of NT thickness (5th, 25th, 50th, 75th, and 95th percentiles) within each 5-mm range of CRL and during the 11th, 12th, and 13th gestational weeks were determined. The presences of the different chromosomal and nonchromosomal abnormalities were compared in women with different percentiles of NT thickness who underwent amniocentesis and those who did not. 1,614 pregnant women were evaluated. The mean NT thickness was 1.30 ± 0.54 mm. Increased NT thickness >2 mm and >95th percentile according to their gestational age (GA) was detected in 89 (5.5%) and 58 (3.6%) pregnant women. The reference 95th percentile value range for NT was 1.8-2.35 and increased NT thickness according to our obtained values was associated significantly with chromosomal abnormalities. The obtained reference range in our studied population was different from that reported for other ethnic groups and it is suggested that using this values are more favorable for screening of chromosomal abnormalities during the first trimester of pregnancy than the recommended single cutoff value.

In this study, we aimed to investigate the ability of transvaginal Doppler ultrasonography in predicting in vitro fertilization (IVF) outcome in women undergoing this procedure. In this prospective observational study, 65 infertile women underwent IVF procedure in Isfahan, during 2013-2014, were studied. The pulsatility index (PI), resistive index (RI) and peak systolic velocity (PSV) of the uterine arteries and arcuate arteries were measured in all selected women using transvaginal color and pulsed Doppler measurements on the day of human chorionic gonadotrophin injection. The women followed up for the primary endpoint which was a successful pregnancy. The mean of PI, RI, and PSV were compared in groups of women who had successful IVF and not. The receiver operating characteristic (ROC) curve was used to determine the predictive value of studied indices. In this study, from 65 women, 32 (49.2%) and 33 (50.8%) have successful and unsuccessful IVF outcome, respectively. The mean of PI and RI of both uterine and arcuate arteries were significantly lower in pregnant women than non-pregnant ones (P < 0.001). The area under the ROC curve of PI (84.7%) and RI (84.4%) for uterine arteries was higher than other indices. The most accurate indices for predicting the outcome of IVF was RI of uterine arteries with an accuracy of 81.5%. The findings of this study indicated that PI and RI assessments of uterine arteries could be used as a routine non-invasive factor, before hCG stimulation, for predicting the outcome of IVF.

There is an inverse relation between the uterine cervical length during pregnancy and the frequency of preterm delivery. The purpose of this study was to construct a chart and evaluate the cervical length at 8 to 38 weeks of normal gestation in the center of Iran.

Uterine cervical length was measured on 930 asymptomatic pregnant women by abdominal ultrasonographic technique. For statistical evaluation, regression analysis and calculation of percentiles were performed.

Our data show a significant decrease in uterine cervical length with increasing gestational age. The mean uterine cervical length exhibits minimal changes from 10 to 24 weeks for most women in this study, although the shortening is more prominent at 33 to 38 weeks' gestation. The mean shortening of the uterine cervical length between the second and the ninth months was 14.82% (P < 0.05). Also, the cervical length means in trimesters 1, 2 and 3 were 39.30 ± 4.33, 38.28 ± 5.13 and 36.58 ± 4.58 mm, respectively. The third trimester showed a significant reduction (P < 0.05) in cervical length compared to the first and second trimesters (6.92% and 4.44%, respectively). New charts with the 5 th , 10 th , 50 th , 90 th , and 95 th percentile are presented.

Our study provides a new chart and reference values for normal uterine cervical length throughout gestation based on a large sample in the center of Iran. There was a progressive decrease in mean uterine cervical length with increasing gestational age in the population of this study. Our established charts for uterine cervical length throughout gestation might be more useful than a single cut-off value for more efficient prevention and management of preterm birth.

Computed tomography (CT) scan is one the most useful devices in chest imaging. CT scan can be used in mediastinal abnormality, lungs, and pleural evaluations. According to the high prevalence and different causes of pulmonary nodules, we designed this study to evaluate the prevalence and the types of pulmonary nodules in noncancerous patients who underwent chest multi-detector CT (MDCT) scan. This was a cross-sectional study which was in our hospital to evaluate the prevalence of pulmonary nodules in noncancerous patients who underwent MDCT. A checklist was used for data collection containing number, location, size, and shape of pulmonary nodules if present in CT scan, and we also included patient’s age and history of smoking. We analyzed the data with Statistical Program for Social Sciences software (version 18). In this study, 115 patients (40%) had a pulmonary nodule. The mean number of a total nodule in each patient was 0.8 ± 0.07. Mean number of intra-parenchymal, subpleural, and perivascular nodules were 0.34 ± 0., 0.31 ± 0.04, and 0.14 ± 0.02, respectively. The mean number of calcified nodules was 0.13 ± 0.02. There was no significant correlation between age and nodule characteristics (P > 0.05). The prevalence of pulmonary nodules was quite frequent in MDCT scan of noncancerous cases. So, it should not be overvalued in noncancerous cases.