Usefulness of hemodynamically distribution of intranodal vessels in differentiating metastatic neck lymph nodes - value of color doppler and spectral wave sonogram

Objective: To evaluate the diagnostic assessment of enlarged lymph nodes, based on its perfusion pattern by taking tissue diagnosis as gold standard

Study Design: Analytical study

Place and Duration of Study: Departments of Radiology and Pathology, PIMS Hospital, Islamabad, from February to May 2016

Methodology: Color sonography of patients with clinically, palpable cervical lymph nodes were carried by senior trainee under the supervision of senior radiologist. Ultrasound guided tissue diagnosis was obtained in all suspected malignant cases. Histopathology was taken as the gold standard for determining accuracy

Results: Accuracy, sensitivity and specificity, positive and negative predictive values of color Doppler ultrasound in detecting malignant cervical lymphadenopathy was found to be 88.46%, 86.05%, 79.31% and 92.50%, respectively with diagnostic accuracy of 86.95%, when intranodal vascular pattern on color Doppler imaging was analyzed. Using spectral wave indexes, the same values were 92.31%, 90.70%, 85.71%, 95.12%, respectively with overall diagnostic accuracy of 91.30%

Conclusion: Color Doppler sonography is much sensitive borderline than grey scale findings alone. Furthermore, lymph nodes appearing in the detection of malignant nodes on grey scale images can be reliably diagnosed on Doppler scan

Bedside ultrasonography: a useful tool for traumatic pneumothorax

Objective: To compare the diagnostic accuracy of bedside ultrasound and supine chest radiography for the diagnosis of traumatic pneumothorax

Study Design: Analytical study

Place and Duration of Study: PIMS and PAEC General Hospital, Islamabad, from November 2014 to August 2015

Methodology: Patients coming to emergency departments of the study centres, who had sustained chest injuries, were inducted. Their portable bedside ultrasound and supine chest radiographs were taken for assessing pneumothorax and subsequently CT chest was done for confirmation as gold standard

Results: Based on CT findings, sensitivity for ultrasonography and chest radiography was found to be 83.33% and 54.76%, respectively and specificity of 100% for both modalities

Conclusion: Ultrasound can be used as a useful and suitable adjunct to CT in trauma patients as it is easily available, non-invasive, bedside, easily examined with no radiation risk