To determine the positive predictive value of magnetic resonance spectroscopy in diagnosing malignant thyroid nodules by taking histopathology as a gold standard

Objective: To determine the positive predictive value of magnetic resonance spectroscopy in diagnosing malignant thyroid nodules by taking histopathology as a gold standard

Methodology: This descriptive cross-sectional study was undertaken at the department of Radiology, CMH Multan from October 2014 to March 2015. 77 patients with malignant thyroid nodules on ultrasonography between ages 30-70 years, of either gender were included. Patients with previous thyroid surgery, already biopsy proven malignant thyroid nodules and, those having contraindication to magnetic resonance spectroscopy [MRS] were excluded. All the patients then underwent MRS for choline peak and choline /creatine [Cho/Cr] ratio. Findings were correlated with histopathology

Results: Mean age of the patients was 46.53 +/- 9.15 years. Out of these 77 patients, 62 [80.52%] were female and 15 [19.48%] were males with female to male ratio of 4:1. MRS supported the diagnosis of malignant thyroid nodules in 60 patients. Histopathology confirmed malignant thyroid nodules in 49 [true positive] cases where as 11 [False Positive] had no malignant lesion on histopathology. Positive predictive value of magnetic resonance spectroscopy [MRS] in diagnosing malignant thyroid nodules was 81.67%

Conclusion: Magnetic resonance spectroscopy [MRS] is a non-invasive modality of choice with high positive predictive value in diagnosing malignant thyroid nodules. It has not only dramatically improved our ability of diagnosing thyroid lesions pre- operatively but also helps the surgeons for proper decision making

Bilateral renal lymphangiectasia with ascites and pleural effusion

A 42 year male patient with complaints of dull abdominal pain and hematuria for 01 year was referred by Nephrologist for abdominal ultrasound [USG]

USG demonstrated echogenic kidneys, perinephric and renal sinus cystic fluid collections bilaterally with minimal ascites and mild right sided pleural effusion. The USG findings were confirmed by computed tomography [CT] and magnetic resonance imaging [MRI] scan and were characteristic of renal lymphangiectasia. Awareness regarding renal lymphangiectasia will result in early diagnosis and management and decreased morbidity