Transabdominal ultrasonography in staging of wilms tumor

Objective: To determine the sensitivity and specificity of transabdominal ultrasonography [US] in staging of Wilms tumor, taking transabdominal contrast enhanced computed tomography [CT] of abdomen as gold standard. Study Design: Cross sectional/validation study. Place and Duration of Study: Radiology department, Children Hospital, Pakistan Institute of Medical Sciences, Islamabad, from Apr 2006 to Mar 2007

Material and Methods: Thirty patients presenting with Wilms tumor underwent transabdominal ultrasound and CT abdomen with contrast for staging. All of them were evaluated for age, gender, presenting complaints, signs and symptoms. As patients were children so consent was taken from their parents. X-ray chest of all of the patients was done to exclude pulmonary metastasis

Results: For stage-I: Ultrasound correctly staged 10 out of 15 cases of stage-I [66.6%] and over staged 5 out of 15 cases of stage-I [33.3%]. For stage-II: Ultrasound correctly staged 2 out of 8 cases of stage-II [25%] and incorrectly staged 6 out of 8 cases of stage-II [75%]. For stage-III: Ultrasound correctly staged 4 out of 7 cases of stage-III [57%] and incorrectly staged 3 out of 7 cases of stage-III [43%]

Conclusion: In children, ultrasound abdomen plays a vital role in cases of renal tumors for differential diagnosis, staging, monitoring of therapy and surgical planning. Diagnostic information obtained from CT and ultrasound examinations are complementary in many instances, however, computed tomography [CT] has been shown to be superior to ultrasound [US] in this regard

Determination of mean fetal transcerebellar diameter as a predictive biometric parameter in third trimester of pregnancy in correlation with fetal gestational age

Objective: To determine mean transcerebellar diameter [TCD] in third trimester of pregnancy on ultrasound as a predictive biometric parameter of gestational age

Study Design: Cross-sectional study

Place and Duration of Study: Department of Radiology Combined Military Hospital, Lahore, from Feb to Aug 2013

Material and Methods: A total of 100 pregnant women in their third trimester were included in this study. TCD was measured on ultrasound, by identifying the cerebellum in the posterior cranial fossa and measuring it in from outer edge to outer edge

Results: Mean age of the patients was 26.80 +/- 2.71 years. Mean gestational age was 33.18+/- 2.42 weeks. In present study mean TCD was 36.47 +/- 4.30 cm. After applying ANOVA test on parity, gestational age and maternal age it revealed that gestational age and TCD [mm] had significant relation [p<0.001]

Conclusion: In the normally developing fetus, the TCD increases in a linear fashion with advancing gestational age. The data of this study suggest fetal TCD on ultrasound is a reliable predictive biometric parameter of gestational age

Segmental spinal dysgenesis

We report a rare case of segmental spinal dysgenesis in a nine months old boy. The boy was born with flaccid paraplegia and lower limb deformities. Radiological workup revealed severe vertebral and spinal cord anomalies resulting into kyphosis and neurological deficits leading to grave disability and morbidity. The aim of reporting this case is to highlight the role of magnetic resonance imaging in the diagnosis of extent of spinal abnormalities for surgical correction.

Isolated cardiac hydatid cyst

Hydatid cyst disease is common in our part of the world. Cardiac hydatid cyst is its rare manifestation. We report this case of 48-year male having isolated cardiac hydatid cyst, incidentally found on computed tomography. This patient presented in medical OPD of Combined Military Hospital, Lahore with one month history of mild retrosternal discomfort. His general physical and systemic examinations as well as ECG were unremarkable. Chest X-ray showed an enlarged cardiac shadow with mildly irregular left heart border. Contrast enhanced CTscan of the chest showed a large well defined multiloculated non-enhancing cystic lesion with multiple daughter cysts involving wall of left ventricle and overlying pericardium. Serology for echinococcus confirmed the diagnosis of hydatid cyst. Patient was offered the surgical treatment but he opted for medical treatment only. Albendezol was prescribed. His follow-up echocardiography after one month showed no significant decrease in size of the cyst

Assessment of occult cervical lymph node metastasis in primary squamous cell carcinoma of the head and neck by computed tomography

To determine the frequency of occult [node negative] cervical lymph node metastasis in primary head and neck squamous cell carcinoma, using contrast enhanced computed tomography [CT]. Cross sectional descriptive study. Study was conducted in Department of Radiology, Combined Military Hospital Rawalpindi. Duration of the study was 06 months i.e. from 19[th] February 2011 to 19[th] August 2011. A total of 141 cases, fulfilling the inclusion criteria, reporting to the radiology department, were included in the study after seeking written informed consent. All patients underwent contrast enhanced CT scan of the neck from base of skull to root of neck using Asteion Whole Body X-ray CT Scanner [Model TSX-021A]. Images were evaluated for the presence or absence of cervical lymph node metastasis according to the cervical lymph node metastatic criteria at each level of the neck. Of the 141 patients with clinically no head and neck squamous cell carcinoma, 45.4% were found to have lymph node metastases. Frequency of occult metastases in squamous cell carcinoma of oral cavity was 47.6%, oropharynx 23.5%, larynx 33.3% md hypopharynx 78.6%. In clinically node negative neck the risk of lymph node metastases is significantly high in patients of head and neck squamous cell carcinoma in our population AU patients presenting with node negative neck should undergo CT scans for early detection of occult metastasis

Role of grey scalie ultrasound in benign and malignant breast lesions

To evaluate the sensitivity and specificity of ultrasound in diagnosis of benign and malignant disease in correlation with histopathological findings. A comparative study. Diagnostic Radiology Department of PNS Shifa, Karachi, from January 2000 to July 2002. Adult female patients presenting with breast lump were included. Grey-scale ultrasound was done with high frequency probe. Findings were compared with histopathology. The sensitivity and specificity was determined. Eightyfive female patients with positive clinical findings were differentiated into benign [n=45, 52.9%], intermediate [n=15, 17.6%] and malignant [n=25, 29.4%], by ultrasound examination. Only one [2.2%] benign lesion was found malignant on histopathology, 8 [32%] cases of malignant group were benign on histopathology. The sensitivity of ultrasound for malignant lesion was 95.24% and specificity was 68.75% for a benign lesion. Our results were compatible with international studies. Ultrasound of breast is very useful in evaluating breast lumps. This modality is, however, not a good screening tool. When combined with clinical evaluation and mammographic studies, a subset of patients can be identified which do not require biopsy. This will not only save the cost but will also alley the anxiety of patients