Significance of sonographic characterization and fnac of small size thyroid nodules

The purpose of this study is to determine the accuracy of various ultrasound characteristics of small size thyroid nodules in the predication of malignancy and the usefulness of ultrasound guided FNAC of these nodules. Experimental / analytic study. This study was carried out at Radiology Department Services Hospital, Lahore from October 2011 to September 2012. This study was conducted on 70 patients, in whom 76 thyroid nodules 4mm to 10mm in size were biopsied. Diagnostic ultrasound was performed with high frequency linear probe for the evaluation of following ultrasound characteristics, internal structure, echogenicity, margins, posterior acoustic shadowing, height to width ratio, halo around the nodules, calcifications and vascular flow on Doppler scan. Each character was correlated with the results of FNAC to determine the accuracy of the feature in the prediction of malignancy. Out of 76 FNACs of 4mm to 10mm size thyroid nodules 8 [10.5%] biopsies did not yield significant cytological specimen. Another 8 [10.5%] specimen were classified as indeterminate so no further analysis was done. The rate of malignancy among nodules on final diagnosis was 20%. The most accurate sonographic features associated with malignancy were posterior acoustic shadowing [88.3%], taller than wider [83%], Halo around the nodule [80%] and calcification [70%]. Small size thyroid nodules are associated with significant risk of malignancy. Certain sonographic characteristics can be used to measure the risk of malignancy. FNAC of these nodules can be safely and accurately performed with high diagnostic rate

Diagnostic accuracy of magnetic resonance imaging in detection of acoustic neuroma

Acoustic neurojna is the most frequent benign tumour at cerebellopontine angle. It accou-ntsfor 8 - 10% of all primary intracranial tumours and 80% of Cerebellopontine angle tumours.[2] Meningioma constitutes 5 - 10% of Cerebellopontine angle tumors, with rare tumours constituting only a small percentage out of which epidennoid cyst is the most frequent. This study was performed to determine the diagnostic accuracy of magnetic resonance imaging in the detection of acoustic neuroma that is taking histopathology a gold standard. It is a cross sectional study conducted in the Department of Diagnostic Radiology, Lahore General Hospital, Lahore from 14-07-2012 to 14-07-2013. The study comprised of 55 patients with clinical suspicion of acoustic neuroma. Magnetic resonance imaging on a 1.5-T Philips whole body magnetic resonance system was performed. The cases were operated and histopathological results were recorded. The results of magnetic resonance imaging and histopathology were compared taking histopathology as gold standard. Out of 55 patients, 43 patients [78.2%] had acoustic neuroma on magnetic resonance imaging. After comparison of results of magnetic resonance imaging with histopathology, the sensitivity, specificity, positive piedictive value, negative predictive value and diagnostic accuracy of magnetic resonance imaging were 97.7%, 91.7%, 97-7%, 91-7% and 96.4% respectively. Magnetic resonance imaging is a highly accurate, non-invasive, safe and convenient imaging modality for the evaluation of acoustic neuroma and is valuable for guiding surgical biopsies thereby decreasing unnecessary intervention. It allows detection of small tumors which is very useful in tumor characterization and plays an integral role m early detection, planning management and estimating patient's prognosis