Role of ultrasound in dense breast tissue [Bi Rads breast density category 3-4] on mammogram

To assess the role of high resolution ultrasound to find breast masses undetectable on high quality mammography in women with radiologically dense breast tissue [BI RADS category 3-4] on mammogram. Analytical study. PNS Shifa hospital Karachi, from 1[st] October 2004 to 30[th] June 2005 Hundred women were enrolled into the study. All these patients had BI RADS breast density category 3 and BI RADS breast density category 4 on mammogram and they were negative. The age range of patients was 30-60 years with mean age of 45 years. Out of 100 patients, 78 were related with HRT group and 22 patients with breast abnormality group. On ultrasound 58 patients had normal ultrasound [45 from hormone replacement therapy-HRT group and 13 from breast abnormality group.] as well as negative mammogram; remaining 42 patients were abnormal on ultrasound [33 from HRT group and 9 from breast abnormality group]. Ultrasound can find unsuspected, mammographically occult masses especially in dense breast [[BI RADS category 3-4] on mammogram

Sonomammography for evaluation of solid breast masses in young patients

This study was carried out to evaluate the applicability of sonomammography as the primary radiological modality in young patients with breast masses. This study was carried out at Radiology Departments of PNS Shifa Karachi and CMH Rawalpindi from February 2002 to April 2005. Sonomammography of 56 young patients with breast lump was done. Lesions were characterised by using sonographic criteria as benign [n=49], malignant [n=2] and intermediate [n=5] masses. Results of this evaluation were assessed by fine needle aspiration cytology. No false positive result was noted in 49 benign lesions while only one intermediate mass turned out to be malignant. Sensitivity of sonomammography was more for benign 92% than malignant lesions 67%, and its specificity was high for malignant lesions 92.4%. Retrospective scanning was done for intermediate masses. This study proves the efficacy of ultrasound as a method of choice to evaluate breast masses in young patients avoiding the need of biopsy. This study also reflects that benign diseases dominate the disease spectrum in young patients

Role of ultrasound in predicting conversion from laparoscopic to open cholecystectomy, a surgeon's and radiologist's dilemma!

This prospective study was jointly conducted by the Department of Radiology and Surgical Ward-II, Dow Medical College and Civil Hospital, Karachi from August 2000 to June 2002: 100 patients were selected for this study and all were admitted with complaints of pain in right hypochondrium / epigastrium, dyspepsia, nausea, vomiting and complained of pain in right shoulder. Provisional diagnosis was made on history and clinical examination as cholecystitis. The ages were between 35 to 60 years. 78 patients were female and 22 patients were male. The aim of this study was to assess the role of pre-operative ultrasound findings with operative findings in patients undergoing laparoscopic cholecystectomy. The purpose was to get the proper diagnosis and provide detailed information to the surgeons before operation about the status of liver, Gall Bladder, C.B.D, Biliary Channels, and specially adhesions between the Gall Bladder and the surrounding structures like Omentun, Duodenum etc. In this way, the surgeon was informed about the findings before operation for successful laparoscopic cholecystectomy to avoid the complications of open surgery. Ultrasound is readily available, inexpensive and the modality of choice in the diagnosis of hepato-biliary disease. Out of 100 patients, 74 patients were selected for laparoscopic cholecystectomy [USG findings showed no adhesions]. While 65 patients successfully underwent laparoscopic cholecystectomy, 9 patiems were converted to open cholecystectomy due to unavoidable conditions like inseparable adhesions with surrounding structures [Omentum and Duodenum]. Out of the 26 patients selected for open cholecystectomy [USG showed adhesions] due to cholelithiasis and chronic cholecystitis associated with choledocholithiasis, 3 were found to be without adhesions