Background: In the developing world the leading cause of seizures and epilepsy is neurocysticercosis caused by the larvae of Taenia solium . Neurocysticercosis is diagnosed by Computed Tomography (CT), Magnetic Resonance Imaging (MRI) or by serological tests on serum or cerebro spinal fluid. We evaluated the role of conventional MRI and serum anti bodies to cysticercal vasicular fluid antigen in patients with seizures diagnosed as neurocysticercosis by CT. Methods: Plain and gadolinium-enhanced MRI of brain in 51 patients, and ELISA to detect IgG antibodies in the serum to cysticercal vesicular fluid antigen in 44 patients, were performed. Results: The lesions observed were predominantly Single enhancing CT lesions (SECTL) in 36(70.5%) of the 51 patients studied; they were confined to the brain parenchyma in 50(98%) of the patients. There was no statistically significant difference in the number of lesions detected by CT or MRI in the brain parenchyma. IgG antibodies to cysticercal antigen could be detected in 11(24.8%) of the 44 patients tested by ELISA.
Conclusion:In the patient population studied, MRI did not contribute much in the diagnosis of neurocysticercosis over CT in terms of number of lesions detected. Serology was found to be useful in the diagnosis of neurocysticercosis in only about a quarter of patients diagnosed by imaging modalities.
Objective: To evaluate the diagnostic accuracy of high resolution CT (HrCT) for confirmatory evaluation of patients having active pulmonary TB (PTB) taking Acid-fast bacillus (AFB) culture reporting as standard parameter. Methods: In this cross-sectional (validation) analysis we included 200 patients having chest X-rays and clinical evidence of active TB and sputum smear (SS) –ve results. These patients were recruited from March-2019 to December-2019. Data of patients regarding baseline hematology investigations, sputum smear findings, and presenting symptoms was obtained. Sputum samples were obtained again for each patients, and sent for AFB culture reporting. The HrCT was performed in the radiology unit using a 64 slices CT machine. Results: The mean age of included patients was 53.61 ± 11.96 years. There 81 (40.5%) female and 119 (59.5%) male patients. The proportion of true positive (TP) cases was 79 (39.5%), true negative cases was 96 (48.0%), false positive (FP) cases 11 (5.5%) and false negative (FN) was 14 (7.0%). The HrCT was found to have sensitivity of 84.9%, specificity 89.7%, PPV 87.8% and NPV 87.3%. Conclusion: HrCT is a reliable imaging method for accurately diagnosis the active Pul. TB with a good sensitivity and specificity. In our view, HrCT can be used as a firstline imaging evaluation test for diagnosing pul. TB in suspected patients. Keywords: Pulmonary TB, Microbial culture, high resolution CT.Objective: To evaluate the diagnostic accuracy of high resolution CT (HrCT) for confirmatory evaluation of patients having active pulmonary TB (PTB) taking Acid-fast bacillus (AFB) culture reporting as standard parameter. Methods: In this cross-sectional (validation) analysis we included 200 patients having chest X-rays and clinical evidence of active TB and sputum smear (SS) –ve results. These patients were recruited from March-2019 to December-2019. Data of patients regarding baseline hematology investigations, sputum smear findings, and presenting symptoms was obtained. Sputum samples were obtained again for each patients, and sent for AFB culture reporting. The HrCT was performed in the radiology unit using a 64 slices CT machine. Results: The mean age of included patients was 53.61 ± 11.96 years. There 81 (40.5%) female and 119 (59.5%) male patients. The proportion of true positive (TP) cases was 79 (39.5%), true negative cases was 96 (48.0%), false positive (FP) cases 11 (5.5%) and false negative (FN) was 14 (7.0%). The HrCT was found to have sensitivity of 84.9%, specificity 89.7%, PPV 87.8% and NPV 87.3%. Conclusion: HrCT is a reliable imaging method for accurately diagnosis the active Pul. TB with a good sensitivity and specificity. In our view, HrCT can be used as a firstline imaging evaluation test for diagnosing pul. TB in suspected patients. Keywords: Pulmonary TB, Microbial culture, high resolution CT.
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