Publications by authors named "Hadeel Eid"

3 Publications

  • Page 1 of 1

Eight-Year Experience With 3-T Intraoperative MRI Integration in Focal Pediatric Epilepsy Surgery: Impact on Extent of Resection, Residual Volumes, and Seizure Outcomes.

AJR Am J Roentgenol 2020 06 24;214(6):1343-1351. Epub 2020 Mar 24.

Department of Diagnostic Imaging, Montreal Children's Hospital, McGill University, 1001 Decarie Blvd, Rm B02.7005, Montreal, QC H4A 3J1, Canada.

The purpose of this study was to investigate the influence of 3-T intraoperative MRI (ioMRI) on the extent of resection of pediatric focal epileptogenic lesions, residual lesion volumes, and postoperative seizure outcomes. All surgical procedures for focal epilepsy from 2003 to 2017 were retrospectively reviewed. Patients were divided into two groups: those who underwent ioMRI and those who did not. Each group was subdivided into two subcategories according to preoperative MRI visualization of the lesion: those with well-defined and those with poorly defined lesions. The volumes of preoperative lesions and postoperative residual lesions were delineated. Outcome data and patient characteristics were reviewed. The results were compared between the two groups and the two subcategories. Eighty patients were included: 45 in the ioMRI group (24 with well-defined lesions, 21 with poorly defined lesions) and 35 in the non-ioMRI group (18 with well-defined lesions, 17 with poorly defined lesions). The well-defined lesions included tumors and vascular lesions. The poorly defined lesions included malformations of cortical development, hippocampal sclerosis, and tuberous sclerosis. The mean follow-up duration was 5.1 ± 3.3 years. The rate of gross total resection was not significantly different between the ioMRI and non-ioMRI groups ( 0.46). However, ioMRI findings facilitated further resection during surgery, increasing gross total resection by an additional 11.1%. The ioMRI group had a significant reduction in percentage of residual volume ( < 0.001). Outcome data suggested that ioMRI is protective against poor Engel score ( = 0.048). Although ioMRI prolonged the mean operative time by 1.2 hours ( = 0.002), the additional time was not associated with additional complications. Integration of ioMRI into focal epilepsy surgery was associated with smaller residual lesions and was protective against poor Engel score. It prolonged the operative time but without increasing the number of complications.
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June 2020

Neurofibromatosis Type 1: Description of a Novel Diagnostic Scoring System in Pediatric Optic Nerve Glioma.

AJR Am J Roentgenol 2019 04 11;212(4):892-898. Epub 2019 Feb 11.

1 Department of Medical Imaging, Montreal Children's Hospital, McGill University, 1001 Decarie Blvd, Rm B02.7005, Montreal, QC H4A 3J1, Canada.

Objective: Neurofibromatosis type 1 (NF1) is a multisystemic genetic disease in which patients develop benign tumors including optic nerve gliomas (ONG). Optic nerve thickening and tortuosity are radiologic markers of tumors but can also be present in children with NF1 who do not have gliomas, thus complicating screening and diagnosis. We undertook this study to retrospectively determine quantitative and qualitative diagnostic criteria using MRI of the orbits for ONG in children with NF1.

Materials And Methods: MR images of the orbits obtained from 2003 to 2016 for children with and without NF1 were reviewed. Optic nerves were divided into three groups: NF1 with glioma (n = 71 nerves), NF1 without glioma (n = 151 nerves), and healthy control subjects (n = 66 nerves). The diameter of each nerve was measured at multiple locations. Two radiologists assessed tortuosity using validated criteria, and subarachnoid dilatation was quantified. Last, a composite score using both optic nerve diameter and tortuosity was proposed.

Results: The mean diameter of the optic nerve was significantly larger in patients with NF1 with glioma compared with those with NF1 without glioma and with control subjects at all locations. Maximal nerve diameter greater than 2 SD above the mean maximal diameter for control nerves was considered abnormally enlarged. The tortuosity parameters were all significantly associated with ONG compared with absence of ONG in NF1. A scoring system derived from these data were highly reliable in differentiating ONG from absence of ONG in NF1.

Conclusion: The radiologic diagnosis of ONG in patients with NF1 is challenging. The scoring systems we describe provide a framework for simple radiologic criteria for ONG in these patients.
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April 2019

Is the renal pyramidal thickness a good predictor for pyeloplasty in postnatal hydronephrosis?

J Pediatr Urol 2018 06 20;14(3):277.e1-277.e6. Epub 2018 Mar 20.

Department of Pediatric Surgery, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.

Objectives: We evaluated the feasibility and value of renal pyramidal thickness (PT) as a predictor of pyeloplasty in high-grade postnatal hydronephrosis.

Patients And Methods: We retrospectively reviewed the charts of patients who presented with postnatal hydronephrosis from 2008 to 2013. Included cases had grade 3 or 4 hydronephrosis. We included only units diagnosed as ureteropelvic junction obstruction. Gender, laterality, hydronephrosis side, renogram data, and follow-up data were recorded. Two investigators reviewed all patients' ultrasounds images. We measured PT and pelvic anteroposterior diameter (APD) in the last ultrasound before surgery. For those managed conservatively, measurements were obtained from the ultrasound with worst hydronephrosis. PT was measured in supine position in the middle third of the sagittal plane (Figure). We assessed the reliability of PT measurement using the intraclass correlation coefficient (ICC). Univariate and multivariate analyses were used to correlate the collected parameters to pyeloplasty incidence. Receiver operating characteristic curve was used to evaluate the cutoff value of PT that predicts pyeloplasty.

Results: The total included cases were 155 patients (165 units). One hundred and fourteen units had grade 3 hydronephrosis and 51 units had grade 4 hydronephrosis. Fifty-two cases (55 units) underwent pyeloplasty. The median follow-up period was 37.6 months. PT measurement was reliable (ICC = 0.94). Univariate analysis revealed that SFU grading, APD, PT, T1/2, and MAG-3 curves were associated with surgery. Multivariate analysis showed that PT was a single independent predictor for pyeloplasty. PT ≤ 3 mm had 98.1% sensitivity and 89.7% specificity in predicting pyeloplasty.

Discussion: PT is the first portion of renal parenchyma that is affected in high-grade hydronephrosis. Moreover, it changes little over the first 9 years of life. PT measurement in hydronephrosis was not previously evaluated. We found that PT was easily measured in most kidneys with high negative predictive value. The PT value as an indicator for pyeloplasty should undergo extensive assessment by other institutions with different protocols.

Conclusion: Being a slowly growing part of the parenchyma, PT can be a good measurable parameter to predict pyeloplasty. Measurement of PT in hydronephrosis is reliable. PT ≤ 3 mm can predict pyeloplasty with 98.1% sensitivity and 89.7% specificity.
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June 2018