Radiological feature of hepatic cirrhosis hepatitis "c" in Pakistan our experience at department of radiology, services institute of medical sciences

Objects: to evaluate the accuracy of liver fibrosis stage by utilizing the techniques of advanced ultrasound performance in patients with chronic liver disease with Hepatitis C

Material and Method: this cross-sectional study was prospectively designed by including 101 consecutive patients with a diagnosis of chronic liver disease including liver cirrhosis between January and December 2010. The ultrasound score was determined from both hepatic lobes and the average scoring was calculated for liver edge, liver surface and liver parenchymal texture. A score of O was given when no abnormality was observed; score 1 for mild abnormality; score of 2 for moderate abnormality; and a score of 3 for severe abnormality. Scoring was given for a blunted edge and severe irregular surface or a highly coarse texture only when these characteristics were clearly confirmed by the low frequency probe

Results: out of 101 subjects, 63.4 % were male and 36.6 % were female with age range of.23-70 years [mean age 50.73 years SD+/- 10]. 17.8 % subjects were between age group 20-40 years, 67 .3 % between age group 41- 60 years and 14.9 % between 61 years and above. Mean duration of illness was 2.86 years [minimum 1 year and maximum 15 years]. Mean liver size was 12.261 with SD+ 2.7145. Mean portal vein size was 1.662 SD+ 2.3247. Mean spleen size was 71.71 SD+ 32.226. 62.4 % had splenomegaly, 66.3 % had ascites, 56.4 % had bruising and bleeding, 62.4% had varices. 20.8 % had sharp edge 48.5 % had mildly blunted edge and 30.7 % had blunt edge, '11.9% had smooth edge. 33.7% had mildly irregular edge, 39.6 % had irregular edge and 14.9 % had highly irregular edge. Regarding liver parenchymal structure 13.9 % had fine, 22.8 % had mildly coarse, 48.5 had coarse and 14.9 % had highly coarse liver parenchymal. structure.15.8 % of subjects had mild fibrosis [score 0-2], 55.4 % had moderate fibrosis [score 3-5], 28.7 % had severe fibrosis [score 6-8]

Conclusion: US scoring system is clinically useful for differentiating patients with minimal or no fibrosis from those with mild to severe fibrosis. This is also useful for prognostic information and determining the optimal therapeutic options during the follow-up of chronic liver disease

Predictive value of ultrasonography in the differential diagnostics of adult neck masses

Background: the role of radiologists is to differentiate between conditions using imaging modalities such as, ultrasound, Computerized Tomography and Magnetic Resonance Imaging. Where appropriate the radiologist will stage lesions for management purposes and aid in guiding aspiration and biopsy, Proper evaluation of the adult neck masses is important and ultrasonography plays a very important role in neck mass differential diagnosis

Objectives: to asses the predictive value of ultrasonography in differential diagnostics of adult neck masses and to find out the frequency of the different types of neck masses among adult patients presenting in a tertiary teaching hospital

Study Design: cross sectional study

Study Setting: study was conducted in radiology department of a tertiary care, teaching hospitals Jinnah hospital Lahore

Sample Selection: 73 subjects with defined neck masses not undergone diagnostic biopsy were recruited for the study

Results: 73 subjects were recruited for the study. The Sonographic consistency of neck masses shows 65.8% solid masses 15.1% cystic masses and 19.2% are mixed consistency. Comparison of diagnostic accuracy of ultrasonography with FNAC [Gold standard] revealed that the infective neck masses diagnostic accuracy is 27.4% on sonography as compared to 24.7% on FNAC. Cystic neck mass diagnostic accuracy was 19.2% on both FNAC as well as sonography. The diagnostic accuracy in benign neck masses showed 26.0% on FNAC and 37.0% on sonography. The diagnostic accuracy in neoplastic neck mass was 17.8% on FNAC and 9.6% on sonography. The metastatic neck mass 12.3% FNAC and 6.8% is sonography. The screening value of ultrasonography for infective neck mass the sensitivity is 90.0% , specificity is 96.2% , for cystic mass showed a 100% sensitivity, specificity, for benign neck masses showed a sensitivity 100% , for neoplastic neck mass depicted a sensitivity 53.8% , specificity

Conclusions: the study results suggest that Modem ultrasound is highly valuable, useful, and reliable in the differential diagnosis of tumors in the preauricular area, submandibular area, and cheek. It enables precise localization, measurements, and assessment of the structure of lesions. It may be the first and last imaging method needed to formulate the final diagnosis, or it may guide fine-needle aspiration biopsy. In many cases, ultrasound may also suggest the nature of the tumor. The accuracy of ultrasound in detecting neoplastic lesion, and metastatic lesions turned out quite lower than expected

CT findings of a giant retroperitoneal liposarcoma; our experience at services hospital, Lahore

Liposarcoma is the most common primary neoplasm of mesodermal origin derived from adipose tissue. It is a slow-growing tumor with a propensity to displace rather than invade adjacent structures. This article reports the CT findings of retroperitoneal liposarcoma in one patient. CT scan revealed a huge hypodense expansile mass lesion with multiple hyperdense septation inside it, giving a whorly appearance to the mass. The mass was having mainly fat [attenuation. The mass appeared to be extending from the under surface of right hemidiaphragm to the right iliac fossa. The mass displaced all the abdominal viscerae and major vessels to the left side of the abdominal cavity, origin being retroperitoneum with most probable epicenter in right renal fossa