Ultrasound and doppler in assessment of cervical lymphadenopathy

Tuberculous lymphadenitis and metastatic cervical nodes are common in Asians and are often indistinguishable clinically. Because their treatment depends on prompt diagnosis, we undertook this study to evaluate if ultrasound, colored, pulsed and power Doppler sonography could distinguish the pathologic abnormalities including tuberculous, metastatic, reactive and lymphomatous lymphadenopathy. Analytic, case control study. Ultrasound and Doppler examinations of reactive, tuberculous, lymphomatous and metastatic nodes were done and open biopsy or FNAC considered as a gold standard. Intranodal distribution of vessels and the intranodal vascular resistance were compared among these four groups. All examinations were performed by the same sinologist to eliminate interobserver variation. Intrandodal vascular distribution in tuerculous nodes was varied and simulated both benign and malignant disease. Avascularity of nodes and displacement of hilar vascularity were frequent in tuberculous nodes, Capsular pattern of vascularity is seen in malignant lymphadenopathy. Metastatic nodes [resistive index "RI, 0.92"] had a higher vascular reistance than did tuberculous nodes [RI, 0.69 +/- 0.07] and lymphomatous nodes [RI, 0.67 +/- 0.05]. Tuberculous nodes had a relatively similar vascular resistance as found in reactive nodes [RI, 069 +/- 0.1]. Sonograhic coupled with Doppler examinations can help in differential diagnosis of cervical lymphadenopathy, however, final diagnosis by biopsy still needed in some cases of atypical criteria which have relatively high false +ve and false -ve results

Colonic wall thickening in cirrhotic patients CT findings and clinical significance

The purpose of this study was to determine the spectrum of colonic wall changes in patients with cirrhosis and to assess its clinical significance by CT. 80 patients clinically diagnosed as liver cirrhosis underwent triphasic CT study of the liver. They were evaluated for the degree and extent of colonic involvement. Other features of cirrhosis including portal hypertension, ascites and splenomegaly were also recorded. Colonic wall thickening >6mm was seen in the 41% [33/80] of the patients. The ascending colon and ceacum were involved in 17 cases. The ascending and transverse colon were involved in 11 cases while the ascending, transverse and descending colon were involved in 5 cases. Portosystemic collaterals were present in 33 cases of colonic wall thickening. Splenomegaly, was present in all the examined cases. Ascites was present in 20 cases, all of them has colonic wall thickening. Colonic wall thickening was limited predominantly to the right colon which could be explained due to portal hypertension and can be used as one of the indicators of poor prognosis in cirrhotic patients. CT can be used as one of the indicators of poor prognosis in patients of liver cirrhosis