ABSTRACT
Background: According to numerous studies the positive predictive value for biopsy can be improved by proper complete diagnostic work up in which sonography is also included. Developments in imaging technique with high resolution ultrasonography has helped us to distinguish between benign and malignant masses. This study has been carried out for the ultrasonological characterization of palpable breast masses and to categorize them as benign and malignant and to correlate these benign and malignant breast masses with tissue diagnosis. Methods: Our study was a prospective analysis. The study included 150 patients with age range between 22–75 years (mean age, 40 years) and with a history of palpable breast masses. Data for our study was collected from the patients referred to Department of Radio diagnosis at Academy of medical sciences, Pariyaram, Kannur for the period of two years. A structured, pre-prepared case proforma (CP) was used to enter the clinical history, physical examination findings, investigations-sonography and histopathology findings. Initially sonography was performed with GE Voluson 730 expert scanner with 7.5-10 MHz linear array transducer and data was obtained of only solid masses. Then tissue diagnosis was obtained in all 150 cases. Later the tissue diagnosis results were correlated with sonological findings by statistical analysis. Results: The US features most predictive of a benign tissue diagnosis were oval or round shape, circumscribed margins, and width-to–AP dimension ratio greater than 1.4. The features most predictive of a malignant tissue diagnosis were spiculated or microlobulated margins, irregular shape, ill-defined margins, and width-to–AP dimension ratio of 1.4 or less. Some features like the effects of masses on posterior echo intensity were not reliable in differentiating between benign and malignant lesions. Some features like echogenicity showed excellent correlation with a benign or malignant tissue diagnosis were too infrequent to be generally applicable. Conclusions: In our study we performed the prospective analysis of the sonomammography findings in correlation with tissue diagnosis. The US features in our study most predictive of a benign tissue diagnosis were oval or round shape, circumscribed margins, presence of edge refraction, and width-to–AP dimension ratio greater than 1.4. The features most predictive of a malignant tissue diagnosis were spiculated or microlobulated margins, irregular shape, ill-defined margins, and width-to–AP dimension ratio of 1.4 or less. The results of our study were encouraging in that we were able to identify the most applicable US features for differentiating benign from malignant solid masses. These features have the potential to help decrease the number of biopsies performed for benign solid masses
ABSTRACT
Background: Cerebrovascular accident is one of the leading causes of death and disability throughout the world. It is the third most common cause of death after heart disease and cancer in India. Early diagnosis can improve the morbidity and mortality rates, as more advanced therapies are currently being instituted. Computed tomography imaging having wider availability, being cost effective and less time consuming, plays the role of first-line imaging modality. Many studies have been done all over the world to demonstrate the usefulness of computed tomography in management of cerebrovascular accident. Our study is aimed to establish the role of computed tomography in clinically suspected cases of cerebrovascular accident. The purpose of this study is to document the presence or absence of hemorrhage or infarcts, to find the location and reasonably assess the blood vessels involved and to spot the incidence of negative cases of clinically suspected stroke. Methods: A prospective study of 250 cases admitted to Academy of medical sciences, Pariyaram, Kannur with the clinical diagnosis of acute stroke were taken up for the study. Results: Out of 250 patients clinically suspected of CVA submitted for CT scan study of the brain. 150 patients i.e., 60% had infarcts. 70 patients i.e., 28% had haemorrhage,5 patients i.e., 2% had S.D.H.,5 patients i.e., 2% had C.V.T., 5 patients i.e., 2% had tumor and 15 patients i.e.,6% had normal scans. Infarcts formed the major group of the CVA cases i.e., 60%, involving most commonly the R.M.C.A. territory in patients i.e., 33.34%. Hemorrhage formed the second major group of the CVA cases i.e., 28.5%, involving most commonly the R.M.C.A. territory in patients i.e., 28.5%. Conclusions: The study showed that there is a preponderance of ischemic over hemorrhagic CVA. There is also a male preponderance in the occurrence of both hemorrhagic and ischemic CVA. C.T. Scanning is the “Gold Standard” technique for the diagnosis of acute stroke. And management of stroke depends upon “accurate diagnosis”. Hence, CT scan should be ideally done in all cases.