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Shalabi, Adel
Publications (10 of 18) Show all publications
Samir, A., Gharraf, H. S., Baess, A. I., Sweed, R. A., Matrawy, K., Geijer, M., . . . Tarek, Y. (2022). Splenomegaly versus pathological lung volume during COVID-19 infection with or without cytokine storm; a linear regression analysis using CT volumetry. EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE, 53(1), Article ID 117.
Open this publication in new window or tab >>Splenomegaly versus pathological lung volume during COVID-19 infection with or without cytokine storm; a linear regression analysis using CT volumetry
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2022 (English)In: EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE, ISSN 2090-4762, Vol. 53, no 1, article id 117Article in journal (Refereed) Published
Abstract [en]

Background: Due to the paucity of scientific evidence, it is unclear among pulmonologists and physicians in critical care units if and when splenomegaly in novel coronavirus disease (2019) (COVID-19) patients is worrisome. This study aims to evaluate the significance of splenic volume during COVID-19 infection with or without cytokine storm and correlates splenic volume to the volume of pathological lung changes through linear regression analysis.

Results: A retrospective study collected 509 polymerase chain reaction proved COVID-19 patients (399 males, 110 females; mean age 48 years, age range 24-78 years) between June and November 2021, without a history of splenic pathology. A control group of age and sex-matched 509 healthy subjects was used and analyzed according to the splenic volume. Five consulting radiologists evaluated initial and follow-up computed tomography (CT) examinations using lung CT volumetry and splenic volume calculation in consensus. Three consulting pulmonologists correlated the severity of clinical and laboratory findings, including oxygen requirements and interleukin-6 (IL-6) levels. The T test results for comparison between the COVID-19 patients and the healthy subjects control group regarding the splenic volume were significant (Tvalue was - 4.731452 and p value was 0.00002). There was no significant correlation between the severity of the disease and normal-sized spleen (26% of patients, p= 0.916) or splenomegaly (24% of patients, p= 0.579). On the other hand, all patients with a small spleen or progressive splenomegaly during serial follow-up imaging had clinically severe disease with a statistically significant correlation (p= 0.017 and 0.003, respectively). Ninety-seven percent of patients with clinically mild disease and splenomegaly had 0-20% lung involvement (CT-severity score 1) while all patients with clinically severe disease and splenomegaly had 27-73% lung involvement (CT-severity score 2 and 3) (r = 0.305, p = 0.030).

Conclusions: Splenomegaly is a non-specific sign that may be found during mild and severe COVID-19 infection, it was not statistically correlated with the clinical severity and a weak positive relationship was found between the splenic size and the CT-severity score of the pathological lung volume. On the other hand, the presence of splenic atrophy or progressive splenomegaly was correlated with severe COVID-19 presentation and "cytokine storm". Therefore, the splenic volume changes should not be overlooked in COVID-19 serial CT examinations, particularly in severe or critically ill patients with cytokine storms.

Place, publisher, year, edition, pages
Springer NatureSpringer Nature, 2022
Keywords
COVID, Splenomegaly, Cytokine
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-475596 (URN)10.1186/s43055-022-00793-1 (DOI)000798030100002 ()
Available from: 2022-06-09 Created: 2022-06-09 Last updated: 2024-01-15Bibliographically approved
Söderman, T., Werner, S., Wretling, M.-L., Hänni, M., Mikkelsen, C., Sundin, A. & Shalabi, A. (2021). Knee function 30 years after ACL reconstruction: a case series of 60 patients.. Acta Orthopaedica, 92(6), 716-721
Open this publication in new window or tab >>Knee function 30 years after ACL reconstruction: a case series of 60 patients.
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2021 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 92, no 6, p. 716-721Article in journal (Refereed) Published
Abstract [en]

Background and purpose - Until now, there have been no studies beyond 30 years after anterior cruciate ligament (ACL) reconstruction. We report knee function a mean 31 years after ACL reconstruction.Patients and methods - This cohort comprised a case series of 60 patients with a mean follow-up of 31 years (28-33) after ACL reconstruction. Patients were evaluated with the International Knee Documentation Committee (IKDC) objective assessment, Knee injury Osteoarthritis Outcome Score (KOOS), Tegner Activity Scale, radiography, and MRI.Results - 30 patients showed an intact ACL graft and 30 a ruptured or missing ACL graft. 40 patients had osteoarthritis in the tibiofemoral compartment and 24 patients in the patellofemoral compartment. Patients with intact ACL grafts scored higher than those with ruptured or missing ACL grafts when it comes to KOOS Sport/Rec. The Hodges Lehmann estimated median difference between groups was 15 (95% CI 0-35). The KOOS scores were lower in the group with ruptured or missing ACL grafts when compared with a healthy-knee reference group of males in terms of Pain, mean difference -8 (CI -15 to -1), Symptoms, mean difference -18 (CI -27 to -9), and Sport/Rec, mean difference -21 (CI -34 to -8). In the group with intact ACL grafts, the KOOS score was lower than a healthy-knee reference group of males in terms of Symptoms, mean difference -12 (CI -21 to -3). Scores for all subgroups of KOOS were higher in patients without osteoarthritis. The IKDC overall clinical assessment outcome was worse in patients with a ruptured or missing ACL graft. The Hodges Lehmann estimated median difference between groups was 1 (CI 0-1).Interpretation - Patients with an intact ACL graft reported higher sports activity and recreation, as measured with KOOS, than patients with a ruptured or missing ACL graft. Patients with severe osteoarthritis reported lower sports activity and recreation, as measured with KOOS.

Place, publisher, year, edition, pages
Taylor & FrancisMedical Journals Sweden AB, 2021
National Category
Orthopaedics
Identifiers
urn:nbn:se:uu:diva-456063 (URN)10.1080/17453674.2021.1959709 (DOI)000678408400001 ()34319200 (PubMedID)
Available from: 2021-10-14 Created: 2021-10-14 Last updated: 2024-01-15Bibliographically approved
Liegnell, R., Wessman, F., Shalabi, A. & Harringe, M. (2021). Validity of ultrasonography-derived predictions for estimating skeletal muscle volume: a systematic literature review. BMC Medical Imaging, 21(1), Article ID 106.
Open this publication in new window or tab >>Validity of ultrasonography-derived predictions for estimating skeletal muscle volume: a systematic literature review
2021 (English)In: BMC Medical Imaging, ISSN 1471-2342, E-ISSN 1471-2342, Vol. 21, no 1, article id 106Article, review/survey (Refereed) Published
Abstract [en]

Background

The amount of muscle volume (MV) varies between individuals and is important for health, well-being and performance. Therefore, the monitoring of MV using different imaging modalities is important. Magnetic resonance imaging (MRI) is considered the gold standard, but is not always easily accessible, and the examinations are expensive. Ultrasonography (US) is a much less expensive imaging method widely used to measure changes in muscle thickness (MT). Whether MT may translate into MV needs further investigation.

Purpose

The aim of this review is to clarify whether US-derived equations based on MT predict MV based on MRI.

Methods

A systematic literature review was conducted according to the PRISMA statement, searching the electronic databases PubMed, CINAHL and Web of Science, for currently published equations to estimate MV with US.

Results

The literature search resulted in 363 citations. Twelve articles met the eligibility criteria. Ten articles scored eight out of eleven on QUADAS and two scored nine. Thirty-six prediction equations were identified. R values ranged between 0.53 and 0.961 and the standard error of the estimate (SEE) ranged between 6 and 12% for healthy adult populations, and up to 25.6% for children with cerebral palsy. Eight studies evaluated the results with a Bland–Altman plot and found no systematic errors. The overall strength and quality of the evidence was rated “low quality” as defined by the GRADE system.

Conclusions

The validity of US-derived equations based on MT is specific to the populations from which it is developed. The agreement with MV based on MRI is moderate with the SEE ranging between 6 and 12% in healthy adult populations. Suggestions for future research include investigations as to whether testing positions or increasing the number of measuring sites could improve the validity for prediction equations.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2021
Keywords
Bland-Altman analysis, Magnetic resonance imaging, Muscle thickness, Muscle volume, Prediction equation, Ultrasonography
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-453381 (URN)10.1186/s12880-021-00638-9 (DOI)000670267400001 ()34229618 (PubMedID)
Available from: 2021-09-17 Created: 2021-09-17 Last updated: 2024-01-15Bibliographically approved
Söderman, T., Wretling, M.-L., Hänni, M., Mikkelsen, C., Johnson, R. J., Werner, S., . . . Shalabi, A. (2020). Higher frequency of osteoarthritis in patients with ACL graft rupture than in those with intact ACL grafts 30 years after reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy, 28(7), 2139-2146
Open this publication in new window or tab >>Higher frequency of osteoarthritis in patients with ACL graft rupture than in those with intact ACL grafts 30 years after reconstruction
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2020 (English)In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 28, no 7, p. 2139-2146Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The aim was to assess the results of anterior cruciate ligament (ACL) reconstruction regarding graft failure, knee laxity, and osteoarthritis (OA) from a longterm perspective. It was hypothesized that intact ACL graft reduces the risk for increased OA development.

METHODS: The cohort comprised 60 patients with a median follow-up 31 (range 28-33) years after ACL reconstruction. They were evaluated with magnetic resonance imaging, radiography, KT-1000 arthrometer and the pivot shift test.

RESULTS: Out of the 60 patients, 30 (50%) showed an intact ACL graft and 30 (50%) a ruptured or absent ACL graft. Patients with ruptured ACL grafts had more medial tibiofemoral compartment OA than those with an intact ACL graft (p = 0.0003). OA was asymmetric in patients with ruptured ACL grafts with more OA in the medial than in the lateral tibiofemoral compartment (p = 0.013) and the patellofemoral compartment (p = 0.002). The distribution of OA between compartments was similar in patients with an intact ACL graft. KT-1000 values of anterior knee laxity were higher in patients with ruptured compared to those with intact ACL grafts (p = 0.012). Side-to-side comparisons of anterior knee laxity showed higher KT-1000 values in patients with ruptured ACL graft (p = 0.0003) and similar results in those with intact graft (p = 0.09). The pivot shift grade was higher in the group with a ruptured ACL graft (p < 0.0001).

CONCLUSIONS: Median 31 (range 28-33) years after ACL reconstruction, 50% of the patients showed an intact ACL graft and no side-to-side difference regarding anterior knee laxity. Patients with ruptured ACL grafts had more OA of the medial tibiofemoral compartment than those with intact ACL grafts.

LEVEL OF EVIDENCE: Retrospective cohort study, Level III.

Keywords
ACL reconstruction, Knee laxity, Long-term evaluation, Magnetic resonance imaging, Osteoarthritis
National Category
Surgery Orthopaedics
Identifiers
urn:nbn:se:uu:diva-397545 (URN)10.1007/s00167-019-05726-6 (DOI)000493257800001 ()31664487 (PubMedID)
Available from: 2019-11-21 Created: 2019-11-21 Last updated: 2022-01-20Bibliographically approved
Eriksson, T., Maguire, G. Q., Noz, M. E., Zeleznik, M. P., Olivecrona, H., Shalabi, A. & Hänni, M. (2019). Are low-dose CT scans a satisfactory substitute for stereoradiographs for migration studies?: A preclinical test of low-dose CT scanning protocols and their application in a pilot patient. Acta Radiologica, 60(12), 1643-1652
Open this publication in new window or tab >>Are low-dose CT scans a satisfactory substitute for stereoradiographs for migration studies?: A preclinical test of low-dose CT scanning protocols and their application in a pilot patient
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2019 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 60, no 12, p. 1643-1652Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Computed tomography (CT) has the potential to acquire the data needed for migration studies of orthopedic joint implants of patients who have had tantalum beads implanted at the time of joint replacement surgery. This can be accomplished with the same precision as radiostereometric analysis (RSA). Switching to CT would increase availability without the need for the specific facilities required for RSA. However, higher effective dose is a concern.

PURPOSE: To investigate if migration measurements can be done with CT with an accuracy and effective dose comparable to that of conventional RSA.

MATERIAL AND METHODS: Fourteen scanning protocols were tested in a hip phantom that incorporated tantalum beads and an uncemented femoral stem. The protocols were graded for clinical practice according to the three parameters of image quality, effective dose, and robustness of numerical data. After grading, the two protocols that graded best overall were applied to a pilot patient.

RESULTS: All protocols produced scans in which the numerical data were sufficient for a migration analysis at least as precise as would be expected using RSA. A protocol with an effective dose of 0.70 mSv was shown to be applicable in a pilot patient.

CONCLUSION: Low-dose CT scans with an effective dose comparable to a set of routine plain radiographs can be used for precise migration measurements.

Keywords
Low-dose computed tomography, RSA, THA, hip prosthesis, prosthesis loosening, radiostereometric analysis, total hip arthroplasty
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-382958 (URN)10.1177/0284185119844166 (DOI)000479576700001 ()31042065 (PubMedID)
Available from: 2019-05-07 Created: 2019-05-07 Last updated: 2020-04-03Bibliographically approved
Eriksson, T., Berg, P., Olerud, C., Shalabi, A. & Hänni, M. (2019). Low-dose CT of postoperative pelvic fractures: a comparison with radiography. Acta Radiologica, 60(1), 85-91
Open this publication in new window or tab >>Low-dose CT of postoperative pelvic fractures: a comparison with radiography
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2019 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 60, no 1, p. 85-91Article in journal (Refereed) Published
Abstract [en]

Background Computed tomography (CT) is superior to conventional radiography (CR) for assessing internal fixation of pelvic fractures, but with a higher radiation exposure. Low-dose CT (LDCT) could possibly have a sufficient diagnostic accuracy but with a lower radiation dose. Purpose To compare postoperative diagnostic accuracy of LDCT and CR after open reduction and internal fixation of pelvic fracture. Material and Methods Twenty-one patients were examined with LDCT and CR 0-9 days after surgery. The examinations were reviewed by two musculoskeletal radiologists. Hardware, degree of fracture reduction, image quality, and reviewing time were assessed, and effective radiation dose was calculated. Inter-reader agreement was calculated. Results LDCT was significantly better than CR in determining whether hardware positioning was assessable ( P < 0.001). Acetabular congruence was assessable in all fractured patients with LDCT. In 12 of the 32 assessments with CR of patients with an acetabular fracture, joint congruence was not assessable due to overlapping hardware ( P = 0.001). Image quality was significantly higher for LDCT. Median time to review was 240 s for LDCT compared to 180 s for CR. Effective dose was 0.79 mSv for LDCT compared to 0.32 mSv for CR ( P < 0.001). Conclusion LDCT is more reliable than CR in assessing hardware position and fracture reduction. Joint congruency is sometimes not possible to assess with CR, due to overlapping hardware. The image quality is higher, but also the effective dose, with LDCT than with CR.

Keywords
CT, Low dose computed tomography, image quality, pelvic fracture, radiation dose, radiography
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-350775 (URN)10.1177/0284185118770919 (DOI)000453211800011 ()29665704 (PubMedID)
Available from: 2018-05-16 Created: 2018-05-16 Last updated: 2020-02-20Bibliographically approved
Geijer, M., Jureus, J., Hänni, M. & Shalabi, A. (2017). MR appearance of the temporal evolution and resolution of spontaneous osteonecrosis of the knee: a case report. Acta Radiologica Open, 6(2)
Open this publication in new window or tab >>MR appearance of the temporal evolution and resolution of spontaneous osteonecrosis of the knee: a case report
2017 (English)In: Acta Radiologica Open, E-ISSN 2058-4601, Vol. 6, no 2Article in journal (Refereed) Published
Abstract [en]

Spontaneous osteonecrosis of the knee (SONK) is a feared condition of unknown cause, in its classic form appearing in the medial femoral condyle in middle-aged or elderly subjects. Diagnosis with radiography is notoriously difficult with a long latency before typical changes appear. Magnetic resonance imaging (MRI) is regarded as a diagnostic tool with the possibility to give an earlier diagnosis with improved chances for treatment. However, also with MRI there may be an initial diagnostic blind spot before typical changes appear. Little is known about the temporal evolution of the MRI changes. In the current case report, a case of SONK is reported where serial imaging with MRI was performed, from initial symptoms to eventual resolution after almost three years.

Keywords
Osteonecrosis, knee, magnetic resonance imaging (MRI)
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-315975 (URN)10.1177/2058460116688719 (DOI)000394670100001 ()28203389 (PubMedID)
Available from: 2017-02-23 Created: 2017-02-23 Last updated: 2022-04-20Bibliographically approved
Sten, S., Lovén, C., Kjellström, A., Liden, K., Vretemark, M., Hongslo Vala, C., . . . Jakobsson, M. (2016). Erik den heliges skelett. Fornvännen, 111(1), 27-40
Open this publication in new window or tab >>Erik den heliges skelett
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2016 (English)In: Fornvännen, ISSN 0015-7813, E-ISSN 1404-9430, Vol. 111, no 1, p. 27-40Article in journal (Refereed) Published
Abstract [en]

Saint Erik was King of Sweden for a few years up to 1160, when he was killed. A skeleton attributed to him is kept in Uppsala Cathedral. It underwent scientific reappraisal in 2014. The analyses included computer tomography, Xray absorptiometry, isotope analysis and DNA sampling. Radiocarbon confirms the alleged age of the bones. They belong to a 35-40-year-old man in excellent physical shape. The many wounds that he received in connection with his death fit surprisingly well with the saint's legend, whose preserved version was written 130 years after the event.

National Category
Archaeology History
Identifiers
urn:nbn:se:uu:diva-313305 (URN)000389738300004 ()
Note

English title in Web of Science: Saint Erik's skeleton.

Available from: 2017-01-18 Created: 2017-01-18 Last updated: 2021-02-10Bibliographically approved
Gärdin, A., Rasinski, P., Berglund, J., Shalabi, A., Schulte, H. & Brismar, T. B. (2016). T2 * relaxation time in Achilles tendinosis and controls and its correlation with clinical score. Journal of Magnetic Resonance Imaging, 43(6), 1417-1422
Open this publication in new window or tab >>T2 * relaxation time in Achilles tendinosis and controls and its correlation with clinical score
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2016 (English)In: Journal of Magnetic Resonance Imaging, ISSN 1053-1807, E-ISSN 1522-2586, Vol. 43, no 6, p. 1417-1422Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To investigate if the T2 * of Achilles tendons can discriminate between chronic Achilles tendinosis and healthy controls; to correlate with clinical score; to evaluate its short-term repeatability; and to estimate minimal detectable change.

MATERIALS AND METHODS: Twenty patients, with chronic mid-portion Achilles tendinosis, and 10 controls without history of Achilles tendon symptoms, were examined with a 3T MR scanner with a 3D flash ultrashort time to echo sequence with five different echo times. The sequence was run twice to test repeatability. The tendon border was delineated on axial slices at three different levels in the calculated T2 * maps. The clinical severity of Achilles tendinosis was measured by a VISA-A questionnaire.

RESULTS: There was a significant difference in mean T2 * between symptomatic and control tendons (P < 0.001). In patients with unilateral symptoms no significant difference in T2 * was found between symptomatic and contralateral asymptomatic tendons (P = 0.19). There was no significant correlation between clinical severity and T2 * (r = -0.28, P = 0.22). The short-term repeatability of T2 * showed a coefficient of variation of 18%, a least significant change of 50%, and the intraclass correlation coefficient had an average consistency of 0.99.

CONCLUSION: T2 * may help to differentiate between chronic Achilles tendinosis and healthy controls but was not associated with the clinical score. However, and notably, the reproducibility of the method was low and the number of patients was small.

National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-304643 (URN)10.1002/jmri.25104 (DOI)000380066600017 ()26605756 (PubMedID)
Available from: 2016-10-06 Created: 2016-10-06 Last updated: 2022-01-12Bibliographically approved
Söderman, T., Olerud, C., Shalabi, A., Alavi, K. & Sundin, A. (2015). Static and dynamic CT imaging of the cervical spine in patients with rheumatoid arthritis. Skeletal Radiology, 44(2), 241-248
Open this publication in new window or tab >>Static and dynamic CT imaging of the cervical spine in patients with rheumatoid arthritis
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2015 (English)In: Skeletal Radiology, ISSN 0364-2348, E-ISSN 1432-2161, Vol. 44, no 2, p. 241-248Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE:

To compare CR with CT (static and dynamic) to evaluate upper spine instability and to determine if CT in flexion adds value compared to MR imaging in neutral position to assess compression of the subarachnoid space and of the spinal cord.

MATERIALS AND METHODS:

Twenty-one consecutive patients with atlantoaxial subluxation due to rheumatoid arthritis planned for atlantoaxial fusion were included. CT and MRI were performed with the neck in the neutral position and CT also in flexion. CR in neutral position and flexion were obtained in all patients except for one subject who underwent examination in flexion and extension.

RESULTS:

CR and CT measurements of atlantoaxial subluxation correlated but were larger by CR than CT in flexion, however, the degree of vertical dislocation was similar with both techniques irrespective of the position of the neck. Cervical motion was larger at CR than at CT. The spinal cord compression was significantly worse at CT obtained in the flexed position as compared to MR imaging in the neutral position.

CONCLUSIONS:

Functional CR remains the primary imaging method but CT in the flexed position might be useful in the preoperative imaging work-up, as subarachnoid space involvement may be an indicator for the development of neurologic dysfunction.

National Category
Radiology, Nuclear Medicine and Medical Imaging Orthopaedics
Identifiers
urn:nbn:se:uu:diva-233725 (URN)10.1007/s00256-014-2000-9 (DOI)000346904500010 ()25227660 (PubMedID)
Available from: 2014-10-09 Created: 2014-10-09 Last updated: 2022-01-20Bibliographically approved
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