ABSTRACT
With the advent of endoprothetic replacement and sophisticated oncologieal treatment, the detailed imaging of all musculoskeletal tumours has become a matter of major importance. This short review has highlighted the success or the newer diagnostic techniques and the dramatic recent developments in MRI. Fourteen cases with known or clinically strongly suspected to have skeletal neoplastic lesion were enrolled in the study and all underwent MRI examination with various image sequences. Images were reviewed retrospectively and suggested diagnosis was correlated with that or pathological diagnosis. MRI proved to provides a more reliable assessment of marrow involvement in primary bone tumours such as osteosarcoma and Ewing sarcoma. Fat suppression techniques may be of practical value in the evaluation of soft tissue oedaema and soft tissue involvement. Involvement of neurovascular tissue can he established. The presence of sharply defined boundaries and homogenous internal structures favour a lesion being benign whilst irregularity of the margins and heterogenous internal structure suggest malignancy. The absence of known biological hazards, the high level of tissue differentiation and spatial resolution and the ability to image multiple planes have enabled MRI to become the dominant force in imaging of skeletal neoplasms
ABSTRACT
This study was designed' to evaluate the relationship between oocyte granularity and fertilization rate, further embryonic development and the outcome of ICSI. The study included 986 oocytes retrieved from 92 patients undergoing ICSI treatment that was assessed for oocyte cytoplasm morphology as either normal oocytes with clear cytoplasm and homogeneous fine granularity, granular oocytes that showed dark cytoplasm with granularity either homogeneous affecting the whole cytoplasm [Generalized] or concentrated as a dark mass in the central portion of the oocyte with a clear peripheral ring [Localized] or having cytoplasmic inclusions: then, the embryo quality was graded after 16-18, 48 and 60 hours; into grade I [embryos without fragmentation], grade II [embryos with <20% of the volume of the embryo fragmented] and grade III [embryos with enucleate fragments present in 20-50% of the volume of the embryo]. There were 348 [35.3%] oocytes with normal cytoplasm [Group A], 308 [31.2%] oocyte had generalized granularity [Group B], 21 4 [21.7%] with localized dense central granularity, [Group C] and 116 [11.8%] with cytoplasmic inclusions [Group D]. Fertilization rate, determined after 16-1 8 hours, was 69% [n=240] in group A, 64% [n=197] in group B, 60% [n=128] in group C and 65 [56%] in group D. Cleavage rate determined at 48 hours after ICSI was 60%, 52%, 43% and 32% in the four groups, respectively. Cytoplasmic fragmentation, evaluated 60 hours after ICSI, was reported in 0-10% of group -4, 10-20% of group B, 15-25% in-group C and >25% in group D. Good quality embryo was detected in 40% in-group A oocytes, 25% in group 8, 10% in group C and <10% in group D oocytes. There was a significant difference in cleavage rate of fertilized oocytes categorized according to cytoplasmic granularity, [F=4.34, p=0.0375] with a significant increase of percentage of cytoplasmic fragmentation in oocytes with dense granularity, compared to oocytes with $ne granularity, [F=100.96, p=0.0000] and a significant difference in percentage of good quality embryos between fertilized oocytes categorized according to cytoplasmic granularity, [F=7.469, p=0.0275]. It could be concluded that although oocyte granularity does not significantly affect fertilize ability in ICSI procedure; it affects embryo cleavage rate and embryo fragmentation significantly and hence the predictability of the outcome of ICSI procedure reflected as the percentage of good quality embryo