ABSTRACT
Objective: To determine the positivity of CT angiography in visualization of poorly visualized left anterior descending artery [LAD] on conventional angiography for decision of its surgical revascularization. Study Design: Descriptive study. Place and Duration of Study: Department of Cardiac Surgery, Faisalabad Institute of Cardiology, Faisalabad, from July 2014 to March 2015
Methodology: This study involved 55 patients who had non-graftable LAD on conventional coronary angiography [CCA]. All patients underwent computed tomography angiography [CTA]. Patients having graftable LAD on CTA then underwent coronary artery bypass grafting [CABG]. Peroperatively, the characteristics of LAD such as diameter, calcification and graftability were also recorded
Results: The mean age of the patients was 52.76 +/-8.52 years. There were 45 [81.8%] male and 10 [18.2%] female patients. Out of 55 patients, CTA revealed graftable LAD in 33 [60%] cases while LAD was non-graftable in 22 [40%] cases. Out of 33 patients having graftable LAD, 26 [78.79%] patients underwent CABG; whereas, remaining 7 [21.21%] patients had different reasons like other associated diseases and refusal from surgery. Among those who underwent surgery, LAD was graftable in all the patients [100%] peroperatively. Peroperatively 11 [42.3%] patients had mild calcification followed by severe calcification in 9 [34.6%] and moderate calcification in 6 [23.1%] cases. Fifteen [57.7%] patients had LAD caliber >1.5 mm while 11 [42.3%] patients had LAD caliber between 1.25 - 1.5 mm preoperatively
Conclusion: Positivity of the CT angiography for poorly visualized LAD on conventional angiography was 60% in the present study
ABSTRACT
Objective: To determine the positivity of CT angiography in visualization of poorly visualized left anterior descending artery [LAD] on conventional angiography for decision of its surgical revascularization
Study Design: Descriptive study
Place and Duration of Study: Department of Cardiac Surgery, Faisalabad Institute of Cardiology, Faisalabad, from July 2014 to March 2015
Methodology: This study involved 55 patients who had non-graftable LAD on conventional coronary angiography [CCA].All patients underwent computed tomography angiography [CTA]. Patients having graftable LAD on CTA then underwent coronary artery bypass grafting [CABG]. Peroperatively, the characteristics of LAD such as diameter, calcification and graftability were also recorded
Results: The mean age of the patients was 52.76 +/-8.52 years. There were 45 [81.8%] male and 10 [18.2%] female patients. Out of 55 patients, CTA revealed graftable LAD in 33 [60%] cases while LAD was non-graftable in 22 [40%] cases. Out of 33 patients having graftable LAD, 26 [78.79%] patients underwent CABG; whereas, remaining 7 [21.21%] patients had different reasons like other associated diseases and refusal from surgery. Among those who underwent surgery, LAD was graftable in all the patients [100%] peroperatively. Peroperatively 11 [42.3%] patients had mild calcification followed by severe calcification in 9 [34.6%] and moderate calcification in 6 [23.1%] cases. Fifteen [57.7%] patients had LAD caliber >1.5 mm while 11 [42.3%] patients had LAD caliber between 1.25 - 1.5 mm peroperatively
Conclusion: Positivity of the CT angiography for poorly visualized LAD on conventional angiography was 60% in the present study
ABSTRACT
Objective: To determine the diagnostic accuracy of modified CT severity index in assessing the severe acute pancreatitis keeping APACHE II as gold standard
Study Design: Cross-sectional [validation] study
Place and Duration of Study: Department of Radiology, Allied Hospital, Faisalabad, from February to August 2014
Methodology: A total of 120 patients of either gender aged 20-60 years with epigastric pain radiating to back and having sonographic findings [decreased or heterogeneous pancreatic echogenicity, pancreatic enlargement, peripancreatic fluid collection], supportive of acute pancreatitis were taken. CT with intravenous contrast was performed on 128-slice scanner within 24 hours of presentation. Slice thickness was 3 mm in region of pancreas. Modified CT severity index was calculated. Score above 5 was graded as severe pancreatitis. APACHE II score of >11 considered as gold standard was also calculated within 24 hours of admission
Results: Mean age of the patients was 39.03 +/- 8.71 years. Most of the patients were females 73 [60.8%]. Out of 120 patients, 43 [35.83%] patients had severe acute pancreatitis. Sensitivity, specificity, positive predictive value and negative predictive value of modified CT severity index in assessing the severe acute pancreatitis were 100%, 87%, 81.13% and 100%, respectively. The diagnostic accuracy was yielded as 91.67% considered APACHE II as gold standard
Conclusion: Modified CT severity index had high diagnostic accuracy in assessment of severe acute pancreatitis and can be used reliably in early prediction of complications of severe acute pancreatitis
ABSTRACT
Objective: To determine the diagnostic accuracy of perfusion computed tomography [PCT] in the grading of cerebral glioma
Study Design: Cross-sectional analytical study
Place and Duration of Study: Department of Radiology, Allied Hospital, Faisalabad, from January to June 2014
Methodology: All the patients with untreated glioma had an initial non-contrast head CT and then PCT using 128 multidetector CT scanner. Perfusion maps of permeability surface [PS] and cerebral blood volume [CBV] were generated and measured. As control, a second volume of interest was placed in the contralateral healthy cortex. PCT parameters were compared with World Health Organization [WHO] glioma grades
Results: Fifty patients of 30 - 70 years of age of both genders [mean 45.13 +/- 5.54], 31 [62%] males and 19 [38%] females were studied
These patients were classified as low-grade glioma group [22 patients] and high-grade glioma group [28 patients]. PS showed the sensitivity of 95.45%, specificity of 92.86% and diagnostic accuracy of 94% in differentiating the low-grade and high-grade glioma by using a cut-off value of 3.6 ml/100 g/minute. By using a cut-off value of CBV of 2.08 [ml/100 g] among low-grade and high-grade glioma group, CBV showed the sensitivity of 77.3%, specificity of 89.3%, and diagnostic accuracy of 84%
Conclusion: The derived parameters [PS and CBV] correlate well with tumor histopathology, differentiating low-grade from high-grade gliomas. PS showed better accuracy for glioma grading
ABSTRACT
Objectives: to evaluate the role of Diffusion-Weighted Imaging [DWI] in differentiating the various causes of enlarged neck lymph nodes
Design: prospective study
Setting: Department of Radiology Allied Hospital, Faisalabad
Period: from July 2013 to December 2013
Patients and Method: thirty four consecutive patients who presented with clinical suspicion of malignant cervical nodes were included in the study, 19 males [55.9%] and 15 females [44.1%]. Their age ranged from 45 to 70 years, mean age 56.62 +/-7.54 years referred to the radiology department of Allied hospital Faisalabad, complaining of neck swelling, ultrasound showed cervical nodes and all the patients underwent both MRI [T1W, T2W, DWI, ADC] and histopathological examination
Results: according to histopathological analysis we divided the examined patients with lymph nodes [n= 34] into 2 categories: malignant lymph nodes 70.6% [n=24] benign lymph nodes 29.4% [n=10]. DWI and ADC [apparent diffusion coefficient] values revealed 26 malignant lesions [76.5%], 8 benign [23.5%]. The accuracy of the DWMRI was 88.23%. A significant difference between benign and malignant cervical nodes on DWI and on ADC maps is reported. The results obtained were 23 true positive, 3 false positive, 7 true negative and 1 false negative case was identified, yielding a sensitivity of 96%, specificity of 70%, NPV= 87.5% and PPV= 88.5%. The difference between the mean ADC values between benign and malignant lesions was statistically significant [P<0.0001]
Conclusion: diffusion-weighted imaging is a valuable tool in the differentiation of benign and malignant lymph nodes
ABSTRACT
Objective: To determine the frequency of metastasis detection with diffusion-weighted whole-body imaging with background body signal suppression
Study Design: A Cross sectional study
Place and Duration of Study: The study was conducted at Punjab Medical College and Allied hospital Radiology and Oncology departments, Faisalabad from January 14, 2010 to May 28, 2012
Patients and Methods: A total number of 86 patients of all ages and both sexes with histopathological diagnosis of carcinoma presenting to the outdoor department and admitted in oncology department of Punjab Medical college and Affiliated hospital were selected. Whole-body MRI was performed using a 1.5-Tesla system [Intera Release 9; Philips, Best, The Netherlands] with a Mobi-Trak moving tabletop and b value of 1000. Both the T1 weighted and the STIR images at each station were reconstructed. On MRI, a lesion of high signal intensity on DWIBS, a lesion of high signal intensity on STIR images and low signal intensity on T1 weighted images was considered to be a suspected metastasis
Results: Out of 86 patients, 70 [81.4%] had metastasis. Osseous metastasis was detected in 13 [18.6%] patients however in 57 [81.4%] patients, both osseous and extra osseous metastasis were detected. Liver metastasis was detected in 47 [82.5%] patients out of 57 patients with extra osseous metastasis. Adrenal metastasis was found in 12 [21.1%] patients, brain in 13 [22.8%] patients, lung in 19 [33.3%] patients, renal in 6[10.5%] patients and peritoneal dissemination was seen in 5 [8.8%] patients. Nodal metastasis was detected in 57 patients and maximum number of 19 lymph nodes were detected
Conclusion: DWIBS MRI is helpful in the early diagnosis of metastasis