Introduction We aimed to assess the accuracy of ultrasound elastography in detecting pediatric malignant cervical lymph nodes, and if this modality can obviate the need for surgical biopsies.
Material and Methods A prospective study from September 2017 to September 2020 included 64 children with persistent cervical lymphadenopathy. Patients were evaluated by meticulous history and physical assessment. B-mode ultrasound, color Doppler, and sonoelastography were conducted thereafter. Elastography scans were classified into five patterns, and patterns from 3 to 5 were considered as malignancies. All children underwent open biopsies followed by pathological examination. Results of tissue diagnosis were compared with patterns of elastography to determine its accuracy.
Results Twenty-eight patients (43.8%) had malignant nodes and the remaining 36 (56.2%) were due to benign causes. Elastography patterns of 1 and 2 were documented in 30 patients, and all of them were diagnosed as benign lesions. Patterns of 3 to 5 were demonstrated in 34 patients. Out of them, 28 were confirmed as malignancies, while 6 children were of benign nature (false positive). Ultrasound elastography achieved sensitivity and specificity of 100 and 85.7%, respectively, and an overall accuracy of 90.6% in the differentiation between malignant and benign entities. The overall accuracy of B-mode and color Doppler were 75 and 82.2%, respectively.
Conclusion Elastography is a useful tool that should be added to ultrasound modalities during the diagnosis of pediatric cervical lymphadenopathy. Surgical biopsy in eligible patients is imperative to commence proper therapy or to discharge the child. Despite favorable results of elastography, it cannot replace surgical biopsy or change its indications.
Purpose of the study: This study is aiming to evaluate the role of duplex ultrasonography in comparison with multidetector computed tomography angiography (MDCT) angiography in the assessment of lower limb ischemia. The context: The study group includes 54 patients with unilateral or bilateral chronic lower limb ischemic disease-who have come to the Department of Radiology at Aswan University Hospital for CT angiography-and Doppler ultrasonography (US) was done for comparison. Out of the 54 patients, 6 were asymptomatic (Fontain's stage 1), 16 had intermittent claudication when walking more than 200 m (Fontain's stage 2a), 10 had intermittent claudication when walking more than 200 m (Fontain's stage 2b), 10 had rest pain (Fontain's stage 3), and 12 had trophic changes, ulcers, or gangrene (Fontain's stage 4).
Results:The study involved 54 patients, 24 men (44.4%) and 30 women (55.6%). They were between 33 and 75.0 years with mean 59.56 years and standard deviation ± 10.3. Out of them, there were 4 patients who had aboveknee amputation of one leg. There were 34 patients who are chronic smokers 63.0%, 40 had diabetes 74.1%, 26 had hypertension 48.1%, and 4 are cardiac 7.4%. There was good reliability and agreement between CT and Doppler techniques with significant kappa agreement in all measurements. As regards the external iliac artery, we found that the kappa agreement was 0.87; common femoral artery, kappa agreement was 0.88; superficial femoral artery, kappa agreement was 0.82 at the upper third, 0.76 at the middle third, and 0.86 at the lower third; popliteal artery, kappa agreement was 0.87; peroneal artery, kappa agreement was 0.88; posterior tibial artery, kappa agreement was 0.93; and anterior tibial artery, kappa agreement was 0.88.Conclusion: Both MDCT angiography and duplex US have a good predictive value of chronic lower limb ischemia, but the combination of them has better diagnostic accuracy.
Background: Cancer rectum is one of the most common causes of cancer all over the world. Early diagnosis depends on presenting symptoms and screening followed by diagnostic studies; the most widely used are colonoscopy and barium enema. Recently, the MRI examination of the rectum has evolved as the standard technique in the assessment of cancer rectum having multiplanar capabilities and high tissue contrast imaging. Aim: The purpose of this study was to examine all patients with rectal tumors regardless of size, level within the rectum, or degree of stenosis. Methods: Sixty patients with primary rectal cancer were studied .the age range was 20 to 65 years with the mean age 40 years .Female to male ratio was three to two .The diagnosis of rectal carcinoma in these patients was established based on their symptomatology, clinical examination, proctoscopy and biopsy. The lesions were located 3-12 cm from the anal verge .patients were selected from outpatients clinic and department of surgery at the National Cancer Institute, Cairo University. Results: MRI was proved to have high accuracy in the assessment of the rectal wall infiltration and pelvic organ involvement which is about 97.9 %. And also has high accuracy in the assessment of perirectal and pelvic lymph nodes involvement which is about 94.6 % as compared to the post-operative pathological results. Conclusion: Preoperative MRI has a golden standard value in the establishment of the best treatment strategy.
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