ABSTRACT
An analysis of one year experience with fine needle aspiration biopsies (FNAB) guided by computed tomography or ultrasound was conducted in a tertiary care reference center. We performed 66 procedures, two of them considered insufficient (97% technical success). The overall sensitivity was 90% and the specificity 100%. There were five false negative and no false positive results. The cytological diagnosis was confirmed with core biopsy of surgical specimen (available in 30 patients, 47%), discharge diagnosis and/or clinical evolution. Twenty seven patients had a positive FNAB for malignancy. The complication rate was 12%, all of them considered as minor complications which resolved with conservative management. There was a concordance between FNAB results and final diagnosis in 91.5% of the cases. Fine needle aspiration biopsy is a very useful diagnostic procedure if performed adequately.
Subject(s)
Biopsy, Needle/methods , Neoplasms/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy, Needle/adverse effects , Evaluation Studies as Topic , False Negative Reactions , Female , Humans , Male , Middle Aged , Neoplasms/diagnostic imaging , Neoplasms/surgery , Sensitivity and Specificity , Tomography, X-Ray Computed , UltrasonographyABSTRACT
To determine the sensitivity, specificity, and predictive values of the sonographic analysis of liver surface irregularities for the diagnosis of cirrhosis, the authors conducted a prospective and blinded study in 70 subjects with abnormal liver function tests. All patients included underwent liver biopsy within 15 days of the sonographic study. Twenty-three subjects with no signs or symptoms of liver disease were examined to assess the sonographic appearance of normal liver surface. Studies were performed with a small-parts probe, high-frequency transducer (7.5 MHz). Three basic patterns of liver surface were found: type I, normal; type II, focal abnormality; and type III, diffuse irregularity. Considering diffuse surface irregularity as an objective sonographic sign of cirrhosis, the study's sensitivity was 87.5%, specificity 81.5%, and positive and negative predictive values were 80% and 88.5%, respectively. Disease prevalence for cirrhosis was 45%. We conclude that sonographic analysis of the liver surface is a useful noninvasive test for the diagnosis of cirrhosis in the appropriate clinical setting.
Subject(s)
Liver Cirrhosis/diagnostic imaging , Adult , Aged , Aged, 80 and over , Double-Blind Method , Female , Humans , Liver/diagnostic imaging , Liver/pathology , Liver/physiopathology , Liver Cirrhosis/pathology , Liver Diseases/diagnostic imaging , Liver Diseases/pathology , Liver Diseases/physiopathology , Male , Middle Aged , Predictive Value of Tests , Prospective Studies , Sensitivity and Specificity , UltrasonographyABSTRACT
Six patients underwent image-guided percutaneous drainage of liver abscesses at the Instituto Nacional de la Nutricion (a tertiary care referral center in Mexico City) in a seven month period. These patients were closely followed in order to evaluate appropriate indications for percutaneous drainage as well as techniques, complications and clinical evolution. Our study group included five males and one female; their mean age was 44.4 years (28-63) and the mean hospitalization time 24.3 days (10-34). We found multiple liver abscesses in three patients, and solitary abscesses in three, two in the left lobe and one in the right lobe. Considering the largest diameter, mean abscess size was 13.7 cm. The most important clinical symptoms were: fever, abdominal pain and malaise, and the most significant laboratory abnormalities were anemia, hypoalbuminemia, leukocytosis and high alkaline phosphatase serum levels. Etiology could be determined in three cases, two were pyogenic abscesses and one amebic. Percutaneous drainage was successful in five out of our six patients (83.3%). Complications included one subcapsular hematoma, without hemodynamic consequences, and one patient with severe upper gastrointestinal tract hemorrhage who required surgery, but we could not entirely demonstrate that the bleeding episode was directly related to the percutaneous drainage.
Subject(s)
Drainage/methods , Liver Abscess/therapy , Adult , Drainage/adverse effects , Female , Humans , Liver Abscess/diagnostic imaging , Male , Middle Aged , Radiography , UltrasonographySubject(s)
Acquired Immunodeficiency Syndrome/diagnostic imaging , Brain/diagnostic imaging , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/pathology , Adult , Aged , Atrophy , Brain/pathology , Brain Diseases/diagnostic imaging , Brain Diseases/etiology , Cytomegalovirus Infections/diagnostic imaging , Cytomegalovirus Infections/etiology , Humans , Male , Middle Aged , Opportunistic Infections/diagnostic imaging , Opportunistic Infections/etiology , Tomography, X-Ray Computed , Toxoplasmosis/complications , Toxoplasmosis/diagnostic imagingABSTRACT
El ultrasonido representa en la actualidad el metodo idoneo para el estudio de la patologia vesicular y principalmente de la colecistolitiasis.El avance tecnologico ha permitido la incorporacion de nuevos instrumentos que permiten efectuar estudios con mayor facilidad, rapidez con un mayor acierto diagnostico. Se revisa la apariencia ultrosonica de la colecistolitiasis y padecimientos asociados principalmente la colecistitis aguda y complicaciones, lobo biliar y engrosamiento de la pared vesicular
