Faculty of Medicine

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Author: search.filters.author.Kostova, MashaHas files: No

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    THE ROLE OF T2W PULSE SEQUENCE AND DIFFUSION WITH ITS NUMERICAL ADC MAP IN PROSTATE CANCER DIAGNOSIS
    (Macedonian Association of Anatomists and Morphologists, 2023)
    Kostova, Masha
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    In patients with increased PSA (prostate-specific antigen), the next diagnostics tool is transrectal ultrasound-guided biopsy-TRUS. Multiparametric magnetic resonance imaging (mp MRI) as non invasive diagnostic tool is used as a triage test to avoid biopsy, as well as to improve the diagnostics. In our study we want to prove the clinical meaning of T2W pulse sequence and diffusion as a part of mp MRI in prostate malignant lesions detection and their distinction from the benign lesions. This cohort prospective study included 100 patients with increased levels of PSA from 4 ng/ml to 76 ng/ml. The MRI equipment used was Siemens Essenza1,5T with body coil. The results from the T2W pulse sequence and diffusion are correlated with the values of diffusion and ADC map, in which the suspected zones are marked on a template. Patients undergo biopsy depending on the PIRADS (prostate-imaging and reporting data system) classification. The MRI results and the pathohistological findings are then compared. Clinically significant cancer is considered to be a cancer with a Gleason score 6, diameter > 6mm. The values of diffusion with its numerical ADC map are considerably lower for malignant nodules compared to benign ones. Hyposignal of T2W pulse sequence is characterized with score 2 and 3 in benign changes, and 4 and 5 in malignant changes using the PI RADS score system for differentiation. T2W pulse sequence combined with diffusion is a powerful tool for non-invasive differentiation of benign prostatic hyperplastic nodule and prostatitis from a malignant nodule.
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    Clinical Effectiveness of Single Lumbar Periradicular Infiltration in Patients with Sciatica
    (Walter de Gruyter GmbH, 2023-07-01)
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    Kostova, Masha
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    Ristikj-Stomnaroska, Daniela
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    Stoshevska, Tatjana Deleva
    Periradicular therapy (PRT) is a minimally invasive radiological procedurein patients with chronic lumbar pain.The aim of the study is to identify clinical and radiological predictive factors for treatment success after a single PRT treatment in patients with sciatica.The study includes a prospective follow-up of 166 patients treated with PRT. The pain intensity is determined according to the VAS scale and the degree of improvement is presented as excellent (over 75%), good (50-70%), moderate (25-49%), and weak (less than 25%). The follow up of the treated patients was done at 2 weeks, 3 and 6 months. In patients with pain duration up to 3 months, the improvement was excellent in n=32 (58.18%) after 2 weeks, after 3 months n=41 (74.55%) and after 6 months n=41 (74.55%). This stands in contrast to patients with pain over 1 year. The percentage of improvement after 6 months, post-intervention, was highest in patients without nerve root compression (86.25±19.2),and the highest improvement after 6 months was in patients with localization of pain at the L4-L5 level (69.69±29.7), the greatest improvement after six months was in patients with extraforaminal hernia (62.82±34.3), and the lowest in patients with central stenosis (40.21±30.7).Our study results suggest that the shorter a pain duration, low-grade root compression, injection level and type of herniation area predictor the more favourable response patients have to transforaminal epidural steroid injection in patients with sciatica.