ABSTRACT
Aim: The aim of this study was to investigate the diagnostic accuracy of high resolution ultrasonography for the assessment of painful ankle joint as compared with the clinical findings. Material and Methods: A prospective study was conducted on 136 patients having history of ankle pain and referred to the Department of Radiodiagnosis and Imaging for ultrasonography. Statistical analysis: Comparison of ultrasonography findings and clinical findings was done using McNemar Test. Results: 136 patients with 218 pathologies of the ankle joint were analyzed. Of these, 178 pathologies were clinically suspected, but 206 were diagnosed with ultrasonography. This difference was statistically significant (p value = 0.000). Conclusion: Ultrasonography is an excellent tool for evaluating patients with ankle pain, especially in cases of lateral ligament pathologies, tendinous pathologies, joint effusion, and miscellaneous pathologies. It can be used as the primary imaging investigation because it allows a rapid, dynamic, and cost-effective examination of the ankle joint. However, ultrasonography has limitations when using it to evaluate a suspected posterior talofibular ligament injury, marrow abnormalities, and deep seated pathologies, for which MRI should be incorporated for a diagnosis.Aim: The aim of this study was to investigate the diagnostic accuracy of high resolution ultrasonography for the assessment of painful ankle joint as compared with the clinical findings. Material and Methods: A prospective study was conducted on 136 patients having history of ankle pain and referred to the Department of Radiodiagnosis and Imaging for ultrasonography. Statistical analysis: Comparison of ultrasonography findings and clinical findings was done using McNemar Test. Results: 136 patients with 218 pathologies of the ankle joint were analyzed. Of these, 178 pathologies were clinically suspected, but 206 were diagnosed with ultrasonography. This difference was statistically significant (p value = 0.000). Conclusion: Ultrasonography is an excellent tool for evaluating patients with ankle pain, especially in cases of lateral ligament pathologies, tendinous pathologies, joint effusion, and miscellaneous pathologies. It can be used as the primary imaging investigation because it allows a rapid, dynamic, and cost-effective examination of the ankle joint. However, ultrasonography has limitations when using it to evaluate a suspected posterior talofibular ligament injury, marrow abnormalities, and deep seated pathologies, for which MRI should be incorporated for a diagnosis.
ABSTRACT
BACKGROUND: The study aimed to evaluate of the role of high-resolution ultrasound and magnetic resonance imaging in patients with shoulder pain. MATERIAL/METHODS: This prospective study included 50 patients referred for ultrasound and MRI because of shoulder pain. All patients were examined clinically, followed by radiography of the affected shoulder. High-resolution ultrasound examination of the involved shoulder was performed together with an examination of the contralateral normal shoulder, followed by MRI of the symptomatic shoulder in all 50 patients. RESULTS: In the present study, the majority of patients were in age group 56-65 years, 56% were males and 44% were females (of a total of 50 patients). A total of 40 patients were diagnosed as having rotator cuff tears on ultrasound (USG) and MRI. USG showed complete-thickness tears in 25 patients and partial-thickness tears in 15 patients. MRI detected 28 complete- and 12 partial-thickness tears of the rotator cuff. In the diagnosis of rotator cuff tears, the strength of agreement between ultrasound and magnetic resonance imaging was good (kappa coefficient=0.79). CONCLUSIONS: Ultrasonography of the shoulder shows promising results in the diagnosis of rotator cuff tears and in differentiating partial from complete tears. A wide availability, cost effectiveness and better tolerability of ultrasonography make it a modality of first choice for evaluating rotator cuff tears.
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BACKGROUND: Aim of the present study was to evaluate the role of MRI in staging of malignant lesions of the oral cavity and to correlate MRI findings with clinical/surgical and anatomical-pathological findings, wherever possible. MATERIAL/METHODS: The study included 50 patients who presented with malignant lesions of the oral cavity and were referred to radiology departments for MRI. All patients included were subjected to a detailed physical examination following which MRI was carried out on Philips Gyroscan Achieva 1.5 Tesla unit. RESULTS: In the study, the highest number of patients were found to have tongue malignancy (82%) followed by buccal mucosa and gingivobuccal sulcus malignancy (18%). The highest number of patients was in the age group of 51-60 years (32%). The incidence was higher in males (96%). There was moderate agreement (k=0.537) for T stage between the clinical and MRI staging assessments. The agreement for N stage between clinical and MRI staging assessments was fair (k=0.328). The final diagnosis was made by histopathology in 22 patients. The agreement for T stage was good/substantial (k=0.790) and for N stage was moderate (k=0.458) between MRI and histopathology staging assessments. CONCLUSIONS: MRI provides satisfactory accuracy for preoperative estimation of tumor thickness and predicting occult cervical nodal metastasis. MRI is the preferred modality in evaluation and staging of oral cavity malignancy which helps a clinician for planning of treatment.
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BACKGROUND: High Resolution Computed Tomography (HRCT), a modification of routine CT, provides a direct visual window in the temporal bone providing minute structural details. Purpose of the present study was to evaluate the normal variations, pathological processes (infections and congenital anomalies) and their extent involving the temporal bone along with their complications on HRCT and to correlate these imaging findings surgically, wherever available. MATERIALS AND METHODS: The prospective study included 50 patients who were referred to the radiology department with clinically suspected temporal bone or ear pathologies. After detailed clinical examination, the patients were subjected to high resolution computed tomography (HRCT) examination. The imaging findings were correlated with the surgical findings wherever available. The surgical findings were considered as final. RESULTS: From a total of 50 cases, 83.33% had cholesteatoma. The surgical and radiological findings showed a high level of sensitivity (89.29%) in the identification of cholesteatoma. HRCT provides a good sensitivity of 80.65% in the identification of changes to the ossicular chain despite the presence of surrounding soft tissue. HRCT was highly informative in identification of erosion of lateral semicircular canal. In diagnosis of facial canal dehiscence HRCT had a low sensitivity of 33.33%. In the evaluation of any congenital abnormality of the ear HRCT proved to be beneficial in depicting the anatomical details. CONCLUSION: The clinical and radiological findings showed a high level sensitivity with intraoperative findings as regards to the presence of cholesteatoma, changes of the ossicular chain and erosion of the lateral semicircular canal. HRCT findings, in the treatment of any congenital abnormality of the ear were a good guide to the surgeon for planning and management.
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BACKGROUND: Preoperative evaluation in patients with colorectal carcinoma is essential for a correct therapeutic plan. Conventional colonoscopy has certain limitations including its inability to detect synchronous lesions in case of distal obstructive mass and inaccurate tumour localization. CT colonography combines cross sectional imaging with virtual colonoscopic images and offers a comprehensive preoperative evaluation in patients with colorectal carcinoma including detection of synchronous lesions with accurate segmental localization and loco regional staging. AIM: The objective was to determine the role of CT colonography in various colonic lesions and to correlate the findings with conventional colonoscopy and histopathological findings. SETTINGS AND DESIGN: This prospective study included 50 patients with clinical symptoms suspicious of colonic pathology. MATERIALS AND METHODS: All the patients underwent both CT colonography and conventional colonoscopy on the same day. CT colonography was performed in supine and prone position. Considering histopathological and/or surgical findings as gold standard, sensitivity and specificity of both the modalities were calculated. RESULTS: Conventional colonoscopy missed two synchronous lesions proximal to occlusive mass and one lesion proximal to the anastomotic site; all were detected with CT colonography. One carpet lesion in rectum and one case of mild ulcerative colitis were missed by CT colonography. Sensitivity and specificity for detection of colorectal cancer were 97.56% and 100%, resp. with PPV and NPV of 100% and 93.75%, for CT colonography and 92.68% and 100%, respectively with PPV and NPV of 100% and 83.3% for conventional colonoscopy. Sensitivity for correct detection of acute and chronic ulcerative colitis of CT colonography was 66.6 % and 100 %, resp. CONCLUSION: CT colonography has higher sensitivity than conventional colonoscopy for detection of colorectal carcinoma, including its ability to detect abnormalities proximal to obstructing lesion, accurate segmental localization of lesions and staging. However, some limitations of CT colonography were difficulty in detection of flat lesions and lack of information about hyperemia and superficial mucosal erosion, where conventional colonoscopy scored over CT colonography.
ABSTRACT
BACKGROUND: The expanding spectrum of therapeutic options for patients with surgical jaundice makes it necessary for the radiologist to precisely assess the etiology, location, level and extent of disease. AIM: To compare the diagnostic accuracy of Magnetic Resonance Cholangiopancreatography (MRCP) with Ultrasound and Computed Tomography (CT) in evaluation of patients with obstructive jaundice taking direct cholangiographies (ERCP and PTC), hystologic tests and anatomo-pathological findings after surgical intervention as gold standard. SETTINGS AND DESIGN: This prospective study included 50 patients who were referred to the radiology department with clinical features of biliary obstructive disease. MATERIALS AND METHODS: Initial ultrasonography (USG) evaluation was followed by Computed tomography (CT) and Magnetic Resonance Cholangiopancreatography (MRCP);however in cases of benign pathologies where USG findings were unequivocal Computed tomography (CT )was not done to avoid unnecessary radiation exposure. The results were read by radiologists blinded to other imaging findings. The characteristic Endoscopic Retrograde Cholangiopancreatography (ERCP) features/ histopathological diagnosis / surgical findings (as applicable) were considered as final. RESULTS: Diagnostic accuracy of MRCP (98%) in the diagnosis of benign and malignant diseases was relatively high (98% and 98%) as compared to CT (82.86% and 91.43% in benign and malignant respectively) and USG (88% and 88%). In the diagnosis of benign diseases MRCP was 100% sensitive compared to ultrasound (80.77%), which was more sensitive than CT scan (54.55%).In the diagnosis of malignant diseases, MRCP was more sensitive (95.83%) as compared to CT scan (91.67%), which was more sensitive than ultrasonography (79.17%). CONCLUSION: Ultrasound as a screening modality is useful to confirm or exclude biliary dilatation and to choose patients for MRCP examination. MRCP is an important non invasive imaging investigation in the pre operative evaluation of patients with obstructive jaundice.
