Role of multidetector CT [MDCT] in preoperative resectability assessment of central cholangiocarcinoma

CT is an excellent imaging technique for evaluating the soft-tissue extent of hilar cholangiocarcinoma and the relation between the tumor and the hepatic vasculature. To assess the role of multidetector CT [MDCT] in preoperative resectability assessment of hilar cholangiocarcinoma. The study included 20 patients presenting with hilar cholangiocarcinoma. Informed consent signed by the patients. All patients subjected to proper history taking, clinical examination as well as routine laboratory investigations. Triphasic abdominal MDCT. Post-processing techniques including multi-planner reformation [MPR], maximum intensity projection [MIP] and minimum intensity projection [MinIP]. 11 patients with portal vein invasion, 10 patients with hepatic artery invasion. Four patients had type I obstruction; four patients, type II obstruction; two patients, type IIIa obstruction; four patients, type IIIb obstruction; and six patients, type IV obstruction. The tumors were considered resectable in 12 patients in the preoperative assessment. Multidetector CT provides important information on the preoperative assessment of central cholangiocarcinoma resectability and the extent of surgery

impact of sonography and Alvarado score on the clinical management of patients with acute appendicitis

Purpose: To determine whether diagnosis by graded compression ultrasonography improves clinical outcome for patients with suspected acute appendicitis. Material and A total of 180 patients suspected to have acute appendicitis were included in the study. 90 patients were randomized to the intervention group and were subjected to a diagnostic protocol incorporating ultrasonography and the Alvarado score. A control group included 90 patients in whom the standard clinical management was applied. The appendix was visualized at US in 69 of 83 patients [83%]. Sensitivity, specificity and accuracy of ultrasound in the diagnosis of acute appendicitis were measured at 92%, 90% and 91% respectively. Patients in the intervention group had a statistically significant lower number of both non-therapeutic operations and perforated appendix. There was no statistically significant difference in between groups in the total number of operations performed. Graded compression sonography is a powerful imaging tool that substantially improves diagnostic accuracy in patients with clinically equivocal appendicitis