ABSTRACT
Objective: To determine diagnostic accuracy of gray-scale and colour doppler ultrasonography in diagnosing malignant thyroid nodules
Study Design: Validation study
Place and Duration of Study: Radiology department Combined Military Hospital [CMH] and Military Hospital [MH] Rawalpindi from July 2007 to July 2008
Subjects and Methods: Fifty cases of solitary/multinodular goitre with clinical suspicion of malignancy were included in the study by non-probability purposive sampling. Gray-scale and colour doppler ultrasonography of neck/thyroid gland was done and results were compared with histo-pathological findings from Armed Forces Institute of Pathology [AFIP] and Army Medical College keeping histopathology as gold standard
Results: In 50 patients, 10 cases found to have ultrasound findings suspicious of malignancy. Out of these 10 cases, 6 cases confirmed as malignant on histopathology. In 40 patients with benign ultrasound findings, one had malignancy on histo-pathological examination. Out of these 7 patients with confirmed malignancy, four had papillary carcinoma; two had follicular carcinomas and one anaplastic carcinoma. Diagnostic parameters calculated and found to be: sensitivity 85.7%; specificity 90.6%; PPV 60%; NPP 97.5% and accuracy of 90%
Conclusion: Gray-scale and colour doppler ultrasonography is a good technique in diagnosing malignant thyroid nodules. Entirely solid nodule with no cystic element having spiculated margins, micro-calcifications and central flow are helpful sonographic findings pointing towards malignancy. Associated cervical lymphadenopathy with calcification or degeneration is a significant finding favouring malignancy
ABSTRACT
Magnetic Resonance Imaging [MRI] is frequently advised to evaluate clinically suspected cases of meniscal injuries in our setup. The objective was to determine the diagnostic accuracy of MRI in meniscal injuries of knee joint and its effectiveness in selection of patients for arthroscopy. A Cross-sectional comparative study was conducted at Radiology Department Military Hospital [MH] Rawalpindi in collaboration with Orthopaedic Department Combined Military Hospital [CMH] Rawalpindi from 31 Jan 2007 to 1 Aug 2007. Fifty-seven patients with clinical suspicion of meniscal injuries were subjected to MRI. Arthroscopy was done only in 34 patients while 23 were excluded on the basis of MRI findings. MRI findings were compared with arthroscopic findings. Medial and lateral menisci were considered separately in each case. Among 57 patients only 30 showed significant tear on MRI. Arthroscopy was done in these cases. Arthroscopy was considered on clinical grounds only in 4 patients who did not show significant tear on MRI. MRI showed Medial Meniscus [MM] injury in 23 patients and Lateral Meniscus [LM] injury in 10 patients. Arthroscopy confirmed MM injury in 17 patients and LM injury in 7 patients. MRI missed two MM and one LM injuries. This showed that MRI has sensitivity of 89.4% and specificity of 62% in diagnosing injuries of MM, while sensitivity of 87% and specificity of 88% in diagnosing injuries of LM. Diagnostic accuracy of MRI in MM and LM injuries was 76.4% and 88.2% respectively. MRI is accurate in diagnosing meniscal injuries of knee joint and is effective in selection of patients for arthroscopy