ABSTRACT
Background: Portal hypertension is a serious complication of liver cirrhosis. Doppler ultrasound assessment may be a non-invasive and cost-effective means of evaluating portal hemodynamics in patients with portal hypertension
Aims and objectives: To assess efficacy of Doppler ultrasound in detecting changes in hemodynamics of hepatic circulation after beta-blocker administration
Methodology: 11 patients with liver cirrhosis and portal hypertension were included. All underwent Doppler assessment of portal vein velocity [PVV], spleno-portal index [SPI], congestive index [CI], liver vascular index [LVI], dampening index [DI], hepatic artery velocity [HAV], splenic artery velocity [SAV], hepatic artery resistive index [HARI] and splenic artery resistive index [SARI]. They were started on beta-blocker carvedilol 6.25 mg once daily and recalled after two weeks for repeat assessment
Results: Out of 13 enrolled, 4 were lost to follow up and one stopped carvedilol. 8 remained. The changes in parameters were: PVV: reduction in 3 [37.5%], no change in 1 and increase in 4[50%] patients; SPI: reduction in 3 [37.5%] and increase in 5 [62.5%]; CI: reduction in 3 [37.5%], no change in 1 and increase in 4 [50%]; LVI: decrease in 3 [50%], no change in 1 and increase in 2; DI: decrease in 5 [62.5%] and increase in 3 [37.5%]; HAV: increase in 4 [50%], no change in 1 [12.5%] and decrease in 3 [37.5%]; SAV: decrease in 4 [50%] and increase in 4 [50%]; HARI: increase in 7 [87.5%] and decrease in 1 [12.5%]; SARI: reduction in 3 [37.5%] and increase in 3 [37.5%]. 3 patients achieved reduction in 5 [PVV, LVI, DI, SARI and SAV] parameters. DI had the largest number of patients with observable reduction and HARI with the largest number showing observable increase in measured parameters
Conclusion: Doppler ultrasound represents a cost effective means of assessing the hemodynamics of hepatic circulation and any associated changes due to diseases and drugs
ABSTRACT
Hepatocellular Carcinoma [HCC] responsible for a large proportion of cancer deaths worldwide? is frequently diagnosed after the development of clinical deterioration with poor survival. Triple phase CT scan enables good characterization and diagnosis even at an early stage and could improve survival
Objectives: to describe the frequency of [Heterogonous Mosaic] enhancement pattern of Hepatocellular carcinoma in cirrhotic patients on triple phase Multi Detector CT
Study Design: descriptive Case series. Material and Methods: Study was performed in Radiology Department of FPGMI / Shaikh Zayed Hospital Lahore from September 30 2008 to March 30 2009. Sixty cirrhotic patients with ultrasound and histopathological evidence of Hepatocellular cancer underwent Triple phase contrast enhanced CT
Results: in sixty patients, 110 lesions detected. Eighty one [73.6%] of these was heterogeneous in appearance, while 55.5% of these were hyper attenuating as well. Seventy five [61/81] percent heterogeneous lesions showed mosaic pattern of enhancement. Twenty nine lesions [26.4%] were homogenous and 89% of these were hyper attenuating
Conclusion: majority of the hepatocellular carcinoma lesions appear as heterogeneous and hyper attenuating. Mosaic internal contrast distribution is the leading pattern in these nodular lesions followed by ring enhancement
ABSTRACT
Objective: unexplained recurrent chest infections are a cause of failure to thrive in infants and young children. Repeated hospital admissions with respiratory symptoms are an extra economic burden on the health budget along with the morbidity. The aim of this study was to analyze the utility of Nuclear Medicine to screen children with clinically significant gastroesophageal reflux
Design and Place of Study: this study was descriptive case series and was conducted at Punjab Institute of Nuclear Medicine in collaboration with the department of pediatrics Allied Hospital Faisalabad
Patients and Methods: seventy clinically symptomatic patients underwent Gastroesophageal Reflux [GER] Scan with effective fasting of one to three hours. Four to thirty seven MBq of [99m]Tc labeled Colloid was diluted in milk for oral intake. Thirty minutes dynamic study with frame rate of 3 second per frame was acquired in either anterior or posterior projection. Both qualitative and quantitative analysis was done using cine review, time active curves [TAC] and percentage reflux index [%RI]. Patients with high grades of reflux were also reviewed after 08 weeks of conventional antireflux treatment
Results: sixty three percent of the patients [44/70] were declared as reflux positive of varying grades on GER scan. Most of the refluxing subjects [26/44] were in grade I/II category while [13/44] of the patient showed moderate degree reflux and only [2/44] of the patients fell into severe reflux category. Chest infection was the chief clinical presentation in each grade of reflux [57%]. Of all the refluxing individuals, [9/44] were having no refluxing spikes on TACs while when reflux index [%RI] were calculated [4/44] of the patients showed value below 4%. Eighty percent of selected patients [8/10] showed improvement with conventional antireflux treatment but complete improvement was evident only in [3/10] patients
Conclusion: GER scan is a non-invasive and effective way of screening clinically symptomatic babies for reflux of the gastric contents interfering with the respiratory tract. Quantitative assessment of improvement after conventional antireflux treatment offer cost-effective follows up of GERD