The Study of Different Presentations of Breast Lumps in Radiographic Imaging.

Introduction: Breast USG is an established and accurate tool for the primary evaluation of breast lumps and pathology. It also compliments X- ray mammography in further evaluation and characterization of breast masses and thus avoids surgeries in benign breast diseases and pathology. Method: For USG examination of the breast lumps, a linear-array transducer of 5-7 MHz frequency is required with a good resolution machine. Results: We present a pictorial essay on the role of USG in evaluation and characterization of various breast lumps and pathology. Conclusion: Breast sonography considerably improves the visualization and evaluation of lumps in mammographically radiodense breasts and helpful in the characterization of it, either as solid or cystic lesion. It also improves the specifi city of X-ray mammography when used as an adjunct to it. It is also helpful in guiding FNAC/biopsy from the breast masses.

Imaging in 100 patients of thoracic hydatid disease including unusual imaging appearances

To evaluate the chest radiography and CT scan characteristics of pulmonary hydatid disease [PHD]. One hundred patients [59 males and 41 females, age ranged from 9 to 80 years] with surgically proven pulmonary hydatid cysts were studied. We reviewed clinical and imaging findings including PA and LAT chest roentgenograms and conventional CT of the chest. Only 82 patients had CT scan in their files, but all had CXR. The radiological features [localization, diameter, architecture, density and other radiological signs and appearances] were determined. On CXR, 124 cysts were determined. In evaluation of 82 available CT scans, a total of 112 cysts were detected. No cysts was detected on 5 CT scans. No discrete cyst was detected on 10 CXRs: 4 patients. only consolidation; and 6 patients, only hydropneumothorax. The most frequent site of involvement was RLL [29.6%]. Fifteen hydatid cysts appeared as solid masses on CT. Fifty-seven cysts were ruptured cysts and 25 patients with ruptured cysts had hemoptysis [43.9%]. Thirty-eight percent of cysts had thin walls and 62% had thick walls. Sixty-four cysts were round in shape [55.7%]. Single cysts were seen in 63 patients while multiple cysts were seen in 37. Median CT density of the cysts was 24 Hounsfeild Units [HU] [-18 to 84]. There were 16 giant cysts [diameter >/= 10 cm] on CT. Mean maximum and minimum dimensions of cysts were 5 cm and 4 cm on CT and 6.8 cm and 5.7 cm on CXR, respectively. On CT and CXR, "water lily sign" was seen in 18 and 22 patients, 'air-fluid level" in 12 and 17 patients, and "crescent sign" in 11 and 5 of patients, respectively. Inverse crescent sign and calcification were not observed on CXRs, but each was reported on 4 CT scans. On CT' 90% of cysts were smooth, 74 cysts were uniloculated and 9 were multiloculated. Nineteen percent of cysts were infected. Other imaging findings included mediastinal shift, atelectasis, infiltration. pericystic lung reaction, chest wall involvement, and rib destruction. CXR is helpful with diagnosis of intact cysts but fails to define entire morphology of complicated cysts. CT imaging recognizes certain details not visible on radiography. In endemic regions like Iran, atypical imaging presentations of complicated pulmonary hydatid disease, such as solid masses, should be considered in differential diagnosis of pulmonary lesions

Over utilization of the accident-emergency and X-ray departments in AL- Ain hospital, United Arab Emirates

The extent of inappropriate utilisation of the Accident and Emergency Department [AED] and the X-ray Department in the Al-Ain Hospital, United Arab Emirates [UAE] was investigated by doing a prospective study using a standardised questionnaire to assess the utilization of the AED and X-ray departments between a period from 25th November 1993 to 3rd May1994. The survey was based on the systematic sampling procedure 1 in 3, in which every third patient is selected. Two thousand eight hundred and thirty six patients were available. Overall, about 406 cases [14.3%] were thought to be appropriate or serious enough to warrant attendance at the AED. Nationality and occupation did not have significant effect on the proportion of patients who attended the AED. There were very statistically significant differences in the numbers attending the AED with regards to age, and marital status. The most common conditions were respiratory [14.4%], and trauma, fractures and road traffic accidents a [13.2%], while the least common was poisoning [1.6%]. The study showed that 56.6% of X-rays requested were not for acceptable indications. A high proportion of the AED users were classified as non urgent cases and led to an "inappropriate" level of utilisation of the service