MDCT contrast enhancement patterns of HCC

Hepatocellular Carcinoma [HCC] responsible for a large proportion of cancer deaths worldwide? is frequently diagnosed after the development of clinical deterioration with poor survival. Triple phase CT scan enables good characterization and diagnosis even at an early stage and could improve survival

Objectives: to describe the frequency of [Heterogonous Mosaic] enhancement pattern of Hepatocellular carcinoma in cirrhotic patients on triple phase Multi Detector CT

Study Design: descriptive Case series. Material and Methods: Study was performed in Radiology Department of FPGMI / Shaikh Zayed Hospital Lahore from September 30 2008 to March 30 2009. Sixty cirrhotic patients with ultrasound and histopathological evidence of Hepatocellular cancer underwent Triple phase contrast enhanced CT

Results: in sixty patients, 110 lesions detected. Eighty one [73.6%] of these was heterogeneous in appearance, while 55.5% of these were hyper attenuating as well. Seventy five [61/81] percent heterogeneous lesions showed mosaic pattern of enhancement. Twenty nine lesions [26.4%] were homogenous and 89% of these were hyper attenuating

Conclusion: majority of the hepatocellular carcinoma lesions appear as heterogeneous and hyper attenuating. Mosaic internal contrast distribution is the leading pattern in these nodular lesions followed by ring enhancement

Analysis of 210 cases of radiologically guided FNAC of intraabdominal masses

Two hundred and ten cases of intraabdominal masses were aspirated under ultrasound and CT scan guidance. These aspirates were done by senior radiology staff at Sheikh Zayed Postgraduate Medical Institute Lahore. The smears and cell blocks were studied by consultant pathologists and final diagnosis was obtained. Seven cases were considered as inadequate, these were excluded from study. The remaining 203 cases included in the study consisted of 147 cases of liver masses,29 cases of nodal masses ,16 cases of retroperitoneal masses, 10 cases of GIT masses and one case of ovarian mass. Most of the malignant aspirates were from liver followed by nodal masses and retroperitoneal masses. The diagnostic yield was 97.4% and diagnostic yield of malignancy was 69.9%. In liver masses. HCC was the commonest lesion found followed by lesions from GIT metastatic to liver. In nodal masses, NHL was the commonest malignancy found. We successfully aspirated retroperitoneal masses and diagnosed these lesions cytologically with cl inical correlation. The accuracy rate for diagnosing GIT lesions was 100%. Thus radiologically guided FNAC is simple, quick accurate and essentially risk free procedure for diagnosis of intraabdominal masses

Spectrum of intrathoracic lesions by guided fine needle aspiration cytology [FNAC]

This study was done to evaluate the spectrum of various intrathoracic lesions by radiologically guided fine needle aspiration cytology FNAC was performed on 62 patients [48 males and 14 females] at Shaikh Zayed Hospital, Lahore under ultrasound and CT scan guidance. The cytologic diagnoses were classified as primary lung lesions and mediastinal lesions. Four major groups were made; Non Diagnostic, Benign or negative for malignancy, inflammatory lesions and malignant lesions. Diagnostic yield was 95.1%. Thirty cases [48.4%] were malignant, 19 cases [30.7%] belonged to inflammatory group, 10 cases [16.7%] were diagnosed as benign or negative for malignant cells, and 3 cases [4.9%] were non-diagnostic due to F inadequate aspirate inspite of repeated aspirations. Malignant lung lesions comprised of 9 cases [31.1%] 1 small cell carcinoma, 2 cases [6.9%] broadly categorized as non-small cell carcinoma, 7 cases [24.1%] of squamous cell carcinoma, 5 cases [17.2] of metastatic adenocarcinoma, 4 cases [13.8] of undifferentiated carcinoma and a single case each of mesothelioma and of malignant round cell tumor [3.4%]. Out of mediastinal lesions there was only one case of malignancy that was malignant round cell tumour of child hood. Nineteen out of total 62 cases were of inflammatory group. Out of which 10 cases [52.6%] had, chronic granulomatous inflammation, and nine cases [47.4%] were of abscesses. Tuberculosis was found 1 in 6 cases and the remaining 4 cases were suggestive of tuberculosis. Majority of lung lesions were encountered in 6`h decade of life. As the method is simple, rapid, and cost effective, it can be easily practiced in any centre, where specialized radiologists and pathologists are available. It reduces the patient`s stay in hospital and thus the cost of treatment is markedly reduced