ABSTRACT
Introduction Bone tumors are a common pathology of the musculoskeletal system being frequently encountered by clinicians. Radiological workup is a mainstay in the diagnostic workup of bone tumors. This study aimed to highlight the importance of plain radiography and MRI in the diagnosis of bone tumors keeping histopathology as a gold standard. It is a descriptive validation study conducted in the Radiology Department of Pakistan Institute of Medical Sciences Islamabad. Methodology The study included 92 patients with suspected bone lesions. After taking a complete history and receiving informed written consent. X-rays radiographs and magnetic resonance imaging were performed. X-ray radiograph and magnetic resonance imaging parameters were recorded and compared with the histopathology of lesions as a standard. Results The mean age of patients was 30.50 ± 8.95 years. Of 92 patients examined on X-ray, 51 (55.4%) had lytic lesions, 34 (37.0%) had sclerotic lesions, and seven (7.6 %) had mixed lesions. MRI revealed the location of the lesion. There were 25 (27.2%) bone lesions in diaphysis, 19 (20.7%) in metaphysis, nine (9.8%) at meta-diaphysis, and 32 (34.8 %) in the meta-epiphyseal region. These findings were later on confirmed with histopathological results. Conclusion MRI can differentiate soft-tissue components and periosteal reactions. An X-ray radiograph can provide information about bony matrix and calcifications within tumors. After analysis of imaging findings and histopathological results, it is concluded that these modalities can be used to diagnose bone tumors with high diagnostic accuracy.
ABSTRACT
Objective The goal of this research was to define the diagnostic precision of CT signs to distinguish malignant ascites from cirrhotic ascites. Ascitic fluid cytology was kept as the gold standard. Study design This research was a prospective cross-sectional study. Place and duration of the study Participants' recruitment started on July 15, 2021, and the whole study lasted about three months till October 15, 2021, at the Radiology Department of Pakistan Institute of Medical Sciences, Islamabad. Patients and methods A total of 80 patients were included in the research and divided into two groups grounded on the cirrhotic or malignant etiology of the ascites based on their fluid cytology. Ascites volume, relative spread between the lesser sac and greater peritoneal cavity, the wall thickness of gallbladder, density of ascites, parietal peritoneum thickness and degree of its enhancement, and presence of septa and loculations were some of the major CT signs studied. Results The average age of patients included in this study was 36.2 ± 6.67 years (range 29-49 years). Of the 80 patients, 50 (62.5 %) were men, and 30 (37.5 %) were women. CT signs associated with the malignant ascites reported in this study were fluid present in the lesser sac (p = 0.03), peritoneal thickening and degree of its enhancement (p = 0.05), increased ascites density (p= 0.001), and presence of septa and loculations (63.6 % of malignant ascites). However, gallbladder wall thickness did not show any variation between both groups. Conclusion We conclude that in the diagnosis of malignant ascites, CT scan imaging can play a vital role. This research approves and testifies the benefits of indirect signs such as the spread of ascites, increased density of ascites, thickening and enhancement of parietal peritoneum, and ascitic fluid complexity in pointing out malignancy as a cause of ascites.
