ABSTRACT
INTRODUCTION: Ultrasound is a widely utilized method of screening patients with chronic liver disease for hepatocellular carcinoma (HCC). However, the sensitivity of ultrasound for small tumours is limited. We have prospectively compared ultrasound screening with diffusion-weighted (DWI) MRI for detecting HCC. METHODS: Patients with chronic liver disease referred for ultrasound screening underwent a liver ultrasound and a liver MRI comprising free breathing DWI. Each test was independently read to determine the accuracy of each modality for detecting HCC. RESULTS: One hundred and ninety-two patients were recruited and HCC was diagnosed in six patients (3%); all of whom were detected at ultrasound screening, and five detected at MRI screening. Ultrasound had false-positive studies 20 times (10%) while DWI MRI had three false-positive examinations (2%) p≥0.05. The sensitivity, specificity, positive predictive value and negative predictive values for ultrasound are 100%, 90%, 23% and 100%, respectively, while for MRI are 83%, 98%, 63% and 99%. CONCLUSION: In patients with chronic liver disease undergoing surveillance for hepatocellular carcinoma, DWI MRI screening shows similar sensitivity to screening ultrasound but with a significantly lower false-positive rate.
Subject(s)
Carcinoma, Hepatocellular/diagnostic imaging , Diffusion Magnetic Resonance Imaging , Liver Neoplasms/diagnostic imaging , Ultrasonography , Adult , Aged , Aged, 80 and over , Chronic Disease , Female , Humans , Liver/diagnostic imaging , Male , Middle Aged , Prospective Studies , Reproducibility of Results , Sensitivity and Specificity , Young AdultSubject(s)
Community Health Nursing , Learning Disabilities/nursing , Nursing Staff , Patient Care Team , Humans , United KingdomABSTRACT
Intraventricular lesions of the central nervous system (CNS) can present a diagnostic challenge due to a range of differential diagnoses and radiological appearances. Both CT and MRI imaging findings, in combination with location and patient's age, can help limit the differentials. This pictorial essay presents the salient radiological features, location and demographics of the more common intraventricular lesions of the brain.
Subject(s)
Brain Neoplasms/diagnosis , Cerebral Ventricle Neoplasms/diagnosis , Diagnostic Errors/prevention & control , Magnetic Resonance Imaging/methods , Tomography, X-Ray Computed/methods , Adolescent , Adult , Diagnosis, Differential , Humans , Male , Middle Aged , Young AdultABSTRACT
Magnetic resonance imaging (MRI) is the modality of choice for the investigation of intramedullary lesions of the spinal cord. A wide variety of conditions may result in similar imaging findings on MRI, and it is essential that the reporting radiologist have a detailed understanding of spinal cord anatomy, the pertinent imaging features of specific intramedullary lesions and the typical clinical presentation of those conditions to aid clinicians to make a prompt diagnosis. This pictorial essay discusses the clinical features and MRI appearance of a number of intramedullary conditions, which can be broadly categorised as congenital, demyelinating, vascular, neoplastic or infectious, and highlights their differentiating features.
Subject(s)
Image Enhancement/methods , Magnetic Resonance Imaging/methods , Spinal Cord Diseases/pathology , Spinal Cord Injuries/pathology , Spinal Cord/abnormalities , Spinal Cord/pathology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle AgedABSTRACT
Female hirsutism is an embarrassing condition that threatens both a woman's perception of her femininity and her self-esteem. There are various causes of excessive facial hair in women, the most common being polycystic ovary syndrome. Periods of hormonal flux such as pregnancy and the menopause can exacerbate the condition.
