MANAGEMENT OF DEFECTS IN LONG BONES BY SEGMENTAL BONE TRANSPORT

Faculty Medicine Year: 2005
Type of Publication: Theses Pages: 210
Authors:
BibID 10328732
Keywords : BONES    
Abstract:
Management of bone defects had been represented one of the most difficult challenges in orthopaedic practices. Bone grafts with different types and techniques remained for long time the gold standard for treatment of bone gaps. The use of Ilizarov principles of distraction osteogenesis offered orthopedic surgeons a new option in dealing with such problems.In the current study, a group of 50 patients (40 male and 10 females) with bone defects ( 38 tibial , 10 femoral and 2 ulna ) had been managed using the Ilizarov technique of distraction osteogenesis. The study included defects of variable origin as regards the causative pathological condition such as open injuries, bone resection during the course of treatment of chronic bone infections, bone tumors and congenital defects.In this thesis we used 2 techniques which were bone transport and shortening distraction techniques; the former technique depended on sliding a healthy segment after corticotomy to close the gap at a rate of 5.0 to 1 mm / day. This technique was used in 25 cases when the possibility of acute shortening was difficult as very bad skin, kinking of the vessels and long defects in which shortening was impossible.Acute shortening or partial shortening and lengthening were used in 25 cases when the situation was reasonable for shortening as small defect and more healthy skin and patency of vessels in spite of kinking. It has the advantage of long contact of the docking site which allowed healing during the course of lengthening with short period of treatment.In this work complete excision of the pathological segment was mandatory to avoid non union and persistence of infection in infected non united cases, recurrence of tumor in cases with neoplasm and non union in pathological segment of congenital pseudoarthrosis tibia.In this thesis we evaluated the results according to the system described by Paley et al, 1989 into bony and functional results. Bone results were determined according to four criteria which were union, infection, deformity and limb length discrepancyBone graft was performed in 11 cases, one with application of the frame and 9 cases after reaching the docking site with removal of intervening soft tissue and freshening the bone surfaces and insertion of cancellous bone graft to fasten the process of bone union and one case for augmentation of the regenerated bone.Infection had been eradicated in 29 cases out of 31 cases of infection associated with the problem of debridement without the fear of bone shortening as previously considered and the increase of blood supply in the limb with corticotomy and this was noticed in cases of bone graft in which the bone ends appeared vascular and with minimal or no sclerosis.Bone deformity was associated with the problem of bone defect in 7 cases which were treated simultaneously by fractional lengthening with hinges at the CORA site to overcome this combined problem.This work had achieved excellent bony result in 33 cases, good result in 14 cases fair result in 2 cases and poor result in are case.The functional results of this work were determined according to 5 criteria which were noteworthy limping, joint stiffness, reflex sympathetic dystrophy, persistence of pain and inactivity. Noteworthy limping was persent in 28 cases of this work due to either single or combined problem of shortening, stiffness, arthrodesis, axial deviation and non union.Joint stiffness developed in 12 joint in 11 patients due to long time of joint immobilization, lack of physiotherapy during the course of treatment and untolerated pain during frame application with frequent fear of joint mobilization to avoid occurrence of pain .Pain was characteristic symptom during the course of treatment in all of the patients but with variable degree of severity from mild tolerated pain to severe pain which prevent the normal activity and causing insomnia in some patient and may develop to psychic depression in some patients, but all of them were managed with assurance, treatment of the cause as pin tract infection, lose of wire tension, decreasing the rate of distraction in some cases and the use of analgesics in severe cases. Pain alone was not a cause of set removal in any case.All the patients attained some degree of activity during the course of treatment but all of them regained their previous activity except in 3 cases due to nonunion, amputation and polytrauma which required further treatment after set removal. The overall functional results were excellent in 17 cases (34%), good in 27 cases (54%), fair in 3 cases (6%) and poor in 3 cases (6%).The complication rate of this work was remarkably frequent due to long standing procedure and the difficulty of the cases. The total number of these complications was 169 in 50 patients.These complications had been evaluated according to the system described by Paley et al 1990 into problems which were curable during the course of treatment; obstacles which needed surgical intervention during set application and true complication which persisted after set removal according to this system. We had 109 problems including pin tract infection pin or wire site skin ulcer, reflex sympathetic dystrophy, delayed union and premature consolidation.We faced 14 obstacles including premature consolidation, delayed union, delayed maturation of regenerate and axial deviation of transported segment.The true complications of this work were 46 which included shortening, axial deviation, joint contracture; residual infection, non union, chronic edema and refracture either of the docking site or the regenerate of these true complications 15 were considered minor and 31 were considered major.The most frequent complications were pin tract infection, joint contracture, refracture and chronic edema.In this work union was achieved in 49 (98%) out of 50 patients with control of infection in 29 (93.5%) out of 31 patients. The final leg length discrepancy was achieved in all cases except in 7 cases (14%) due to many causes as old age, amputation of the other limb, long defect which require multiple stages and persistence of deformity. The bone defect averaged 7.3 cm (2-20 cm) the mean duration of treatment was 10.2 months, regeneration of distraction gap was achieved in all the cases (100%). Bone graft was performed in 11 cases, either during application of the frame or at the docking site with poor signs of union and at the site of regenerate in wear regenerate.In this work both ring and monolateral fixators were used. Circular fixators was preferred in long defects which required trifocal lengthening, epiphyseal and metaphyseal defects with small fragment not accessible for monolateral clamps and associated deformity which require gradual correction during the process of bone lengthening.Monolateral fixators had good tolerability and more simple in application than ring fixators but were less versatile in multiple problems associated with bone defect as deformity and the need for by pass the near-by joint which require very big expensive frames and easily managed by the ring fixator.In this work no age limitation has been encountered although the rate of complication were remarkably high in older age group and the need of bone graft was not needed in young patients except in one case.The pathology of the defect had a great importance in determining the procedure of treatment. Cases of trauma required either debridement in cases of devitalized or infected fractures, cases of non union required resection of the bone ends and sclerosed bone till fresh bleeding bone ends reached, bone tumors required radical removal with safety margin including the near-by joint with subsequent arthrodesis and congenital deformities required correction of the associated deformity with the problem of bone defectThe healing index was markedly variable in this work ranging from 0.6 to 4 with a mean index of 1.6 depending on many factors like age, sex , pathology of the defect (infection, nonunion, tumors and congenital ),the site of defect (tibial ,femoral or upper limb ) ,the magnitude of distraction gap ,the operative technique (bone transport or acute shortening distraction) and the presence of deformity with the defect .Finally distraction osteogenesis technique had become established and proved to be effective measure in managing a highly complex problems of orthopaedic surgery; the complication rate in spite of being high but the highly difficult problems deserve for acceptance of such complications as the final results are usually promising and encouraging. Also improvement of learning curve adds for the better application and better results and finally the less rate of complication.The use of Ilizarov method of distraction osteogenesis has represented a relatively new but promising option for the management of skeletal bone defects. The technique could be utilized for the management of bone defects of different causes.The use of external fixators in the management of bone defects has the advantages of filling the bone gap with mature .normal bone, lack of donor site morbidity, lower incidence of deep infections, and lower incidence of fatigue failures.In addition the technique avoids the need for internal fixation, minimizes operative time and operative exposure. Blood transfusion is almost always unnecessary.The great versatility of the fixator devices especially ring devices offers the chance for simultaneous correction of other associated pathological conditions that are commonly encountered with skeletal bone defects such as skeletal deformities and limb length discrepancy.However patient selection is of utmost importance for achieving satisfactory results with this technique, regarding the patient’s mentality, site and length of the defect, age of the patient, and the estimated time required to close the defect and to achieve bone union. Also the original pathology of the condition is to be considered. Viability of both ends of the bone fragments is mandatory for successful bone transport, local vascularity at the docking site and the soft tissue condition are important factors that affect bone union at the docking site.Due to the previously mentioned factors, selection of the patients depends on many factors in addition to the available experience of the surgeon and other treatment options available.The complication rate depends upon the surgeon’s experience in addition to the length and site of the defect, the original pathology and the associated pathological conditions. With proper patient selection and rise of the learning curves of the surgeon, complication rates are expected to decline.Bone transport by distraction osteogenesis using dynamic external fixator is recommend as the treatment of choice in cases with, skeletal bone defects secondary to bone resection during the course of treatment of chronic bone infections and infected nonunion. Also in cases with traumatic bone loss associated with open injuries and when the soft tissue conditions do not allow the application of cortical bone grafts, particularly if external fixation was selected as the treatment option for the patient.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.This study was done during the period from June 2002 to December 2003 in Radiology Departments, Zagazig University Hospitals. The study included 30 patients, 19 males and 11 females, their ages ranged from 5 to 69 years.The patients were subjected to:1- Clinical examination.2- CT scanning.3- MRI4- Histopathological analysis.The lesions encountered in our study were classified into 22 malignant lesions and 8 of benign nature.The malignant lesions were further subdivided into tumors arised from the nasopharynx itself, they were squamous cell carcinoma in 12 patients, lymphoma in 8 patients, and malignant tumors extended to the nasopharynx in the form of chordoma and carcinoma of the maxillary sinus.Eight patients with benign lesions were included in our series, further subdivided into 6 cases arised from the nasopharynx, they were 3 cases of angiofibroma, 3 cases of adenoids, or direct extension from adjacent structures in two cases, one case of nasal angiofibroma and the other was pleomorphic adenoma of the deep part of the parotid gland.Both CT and MRI were done for all our patients, CT was effective in the determination of the lesion, extension, other close association, the bone destruction and abnormal calcifications inside the tumor, however CT failed to distinguish between the tumor itself and the surrounding soft tissue structures.MRI is a sensitive technique in good differentiation between the tumor itself and the surrounding structures, the extension and the obliteration of the surrounding spaces, MRI has also good advantages of determination of the intracranial extension.In conclusion:The Computed Tomography is effective in imaging of the nasopharyngeal lesions as if they are primarily arise from or as an extension from the parapharyngeal structures. It also provides a good details about the nature of the lesion, density, extension and other association and presence of calcifications or bone destruction, which is deficient in MR imaging.The advantages of MR imaging with its superior soft tissue contrast resolution, absence of bone hardening artifacts, and ability to image in multiplanner fashion has allowed to image the deep fascial structures as well as the distinction between the tumor and the surrounding soft tissue is easier than that of computed tomography.So both CT and MRI are well-established methods in diagnosing diseases of the nasopharynx and its surrounding.The recommended diagnostic strategy for mass lesions of the nasopharynx and surrounding structures is to use Gd-enhanced MRI as a primary study and contrast enhanced CT as a secondary study for the evaluation of fine bony details.Summary and conclusionThe aim of this study is to assess the accuracy of magnetic resonance imaging versus computed tomography in diagnosis of nasopharyngeal mass.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Recommendation- We recommend to estimate the Kt/v by UKM (Watson and Nomogram) at least every month:- Regular examination of A-V fistula every 4 – 6 weeks and do Color Doppler if needed.- Construction of A-V fistula in arm if no contra indication.- The recommended ideal intra-access blood flow rate need further study on a wider scale.Summary and ConclusionThis work has been done in the nephrology and dialysis unit, internal medicine department, Zagazig university hospitals.This study included a total number of 25 patients were divided according to site of A-V fistula into two groups;Group I: included 15 patients; 3 of them were females, 12 of them males. Group II: included 10 patients; 4 of them were females and 6 of them were males. Subdivided according to the duration of haemodialysis (dialytic age) into three groups; Group 1 included 5 patients all of them were males, Group 2 included 14 patients 5 of them were females, 9 of them were males, Group 3 included 6 patients 2 of them were females, and 4 of them were males.And also subdivided according to the age of patients into four groups; Group A included 7 patients: (3 of them were female, 4 of them were male) with age ranged 21 - 30 years. Group B included 5 patients (all of them were male), with age ranged 31- 40 years. Group C included 8 patients (1 of them was female, and 7 of them were males) with age ranged 41 - 50 years. Group D included 5 patients (3 of them were female and 2 of them were male) with age ranged 51 - 60 yearsMethods:All patients were subjected to the following:1- Thorough history and Full Clinical Examination.2- Thorough history and Clinical Examination of A-V fistula.3- Haemodialysis program.4- Blood pressure pre- and post dialysis was measured.5- Intradialytic body weight gain.6- Routine investigation (to verify the inclusion and the exclusion criteria of our subjects included:a- Complete blood picture.b- Total protein and serum albumin.c- Liver function test.d- Serum Creatinine blood urea level Pre and post dialysis.e- ECG and Echocardiogram.f- Fasting and post prandial blood sugar to exclude DM.g- Calcium (Ca), Phosphorus (P), Sodium (Na), and Potassium (K).Research investigations included:a- Color Wave Doppler Ultrasound for A-V fistula.b- Prescribed dose of Haemodialysis from Kt/v equation.Our result as following:- The mean Kt/v in female was highly significant higher than in male.- The intra access MBFV in male A-V fistula was significant higher than in female.- The intra access MBFV in arm A-V fistula was highly significant higher than in forearm A-V fistula.- The difference among Kt/v and intra access MBFV as regards the age of patients and duration of haemodialysis (dialytic age) was non-significant.- The difference between Kt/v and intra access MBFV in complicated and uncomplicated A-V fistulae was non-significant.- The difference between Kt/v and intra access MBFV in private and university hospitals constructed A-V fistulae was non-significant.- The mean values of Kt/v was highly significant higher in UKM (Watson and nomogram) than in Daugirdas II.UKM method for Kt/v estimation more specific and more sensitive than in Daugirdas II.Conclusions:From the previous results it could be concluded that:- The intra–access blood flow rate was highly significant higher in arm A-V fistula than in fore arm A-V fistula.- The intra–access blood flow rate was significantly higher in male than in female A-V fistula.- Kt/v in female was highly significant higher than in male.Healthy pregnant women without medical or obstetric complications and all laboratory investigations were normal.(II) Patients with severe pre-eclampsia:(III) Patients with Intra-uterine growth restriction:This group included pregnancies complicated with IUGR, but without any symptoms of pre-eclampsia or pre-existing hypertension.All patients were subjected to:I- History, general and obstetric examinations.II- Routine laboratory investigations.III- Ultrasonographic and Doppler studies included uterine artery Doppler velocimetry.IV- Histopathology of the placenta.All cases were evaluated for the assessment of:* Maternal complications.* Mode of delivery.* Perinatal outcome.The correlation between uterine artery Doppler indices and histopathologic changes of placentas was studied and the data obtained were collected, tabulated and statistically analyzed.The results of the present study showed:I- Uterine artery Doppler indices were significantly higher in PET and IUGR groups than control group.II- As regard to histopathological findings of placentas, minimal hypoxic damage (MHD) significantly more frequently found in the groups with pre-eclampsia and IUGR than in the group with uncomplicated pregnancy. The difference between the groups with pre-eclampsia and IUGR was also significant (P < 0.01).III- Infarcts (regardless of their number) were found significantly more common in pre-eclampsia group. There was no difference between the groups in the prevalence of solitary infracts, but multiple infracts were significantly more common in pre-eclampsia group than in IUGR group.IV- At increased UARI, histopathological findings of placentas showed that minimal hypoxic damage was significantly more frequent in the group of placentas with IUGR.V- In the presence of normal UARI, there was statistically no significant difference between the groups in the prevalence of minimal hypoxic damage.VI- The comparison of placental findings in the presence of increased and normal UARI regardless of the complication of pregnancy showed that minimal hypoxic damage and infracts were significantly more frequently seen in the placentas with increased UARI.VII- As regard perinatal outcome, the present study showed that the presence of abnormal uterine artery Doppler velocimetry was associated with significantly higher rate of preterm delivery.VIII- The presence of abnormal uterine artery Doppler velocimetry was associated with significantly higher rate of neonate in need of NICU admission,Conclusion1- The hypoxic changes occurred significantly more frequently in placentas From pregnancies complicated with pre-eclampsia and IUGR than in those From uncomplicated pregnancy.2- The presence of Abnormal Doppler velocimetry of the uterine arteries in pregnancies with fetal intrauterine growth restriction and pregnancies with severe pre eclampsia, may be in fact an important indicator of hypoxic or ischemic placental lesions.3- Because there are close relationship between IUGR, pre-eclampsia and impaired trophoblast invasion, the pregnancies with high uterine artery RI and persistent early diastolic notch, should be observed for fetal morbidity and mortality. 
   
     
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