Abnormal Uterine bleeding (AUB) is one of the frequent complaints of female patients of all ages.AUB is present in 33% of women referred to gynecologists and this increases to 69% in peri-menopausal and postmenopausal women. About 10 % of postmenopausal bleeding results from endometrial cancer and imaging is the mainstay for its identification. Imaging plays a vital role in differentiating structural lesions like endometrial carcinomas, myomas and polyps which require surgical management from functional disorders requiring medical management. Transvaginal Ultrasonography (TVUS) is the first line imaging modality for AUB after selecting the patients with inconclusive pelvic ultrasonographic results. Hysterosonography (HSG) also plays a pivotal role. Objectives:To compares between TVUS and HSG in the detection and identification of intrauterine lesions in patients with abnormal uterine bleeding, and comparing the sensitivity and specificity of the respective methods in the detection of such lesions. Methods: Thisstudy was conducted in Department ofRadiology, Mayo Hospital Lahore. Fifty women presented with history of abnormal uterine bleeding were included in this study. Pregnancy was ruled out by transabdominal scan. Transvaginal ultrasound and hysterosonography were performed in all the patients. All the data were coded and analyzed using SPSS version 20. Results:Out of 50 patients, 10 patients had intramyometrial fibroid, 11 had submucosal fibroid, endometrial polyp was found in 17 patients and 2 patients had thickened endometrium (thickness > 8mm). The sensitivity and specificity of TVUS was found to be 83.2% and 82.7% respectively whereas HSG showed sensitivity and specificity of 95.4% and 91.5% respectively. In the detection of the submucosal fibroid and endometrial polyp, HSG showed highest sensitivity and specificity as compared totransvaginal ultrasound. Conclusion:Both the TVUS and HSG have comparable sensitivity and specificity in the detection of endometrial disease in patients presented with abnormal uterine bleeding however HSG is more sensitive in the detection of polyps.
Purpose of the Study: The estimation of the degree of hepatic fibrosis is important for diagnostic and therapeutic management of patients with chronic liver disease, in particular those associated with hepatic viral infections. In cirrhosis portal blood inflow, hepatic resistance and portal venous pressure increase. Doppler sonography is non-invasive diagnostic modality based on hemodynamic parameters. Hemodynamic changes might have developed even in cases with normal findings on B mode sonography. Therefore, assessment of these alterations has importance for early diagnosis and for close follow-up of previously dia-
Objective: The current gold standard for the diagnosis of ureteric stones in patients with a stent in situ is ureteroscopy but this study is planned to determine the positive predictive value of computerized tomography (CT) scan among such patients. Methods: This study involved patients who had ureteral stent in situ and were referred for re-evaluation of residual stones after extracorporeal shock wave lithotripsy. These patients underwent CT-scan for detection of ureteric stone. Later on, ureteroscopy was performed and ureteric stone was confirmed on direct visualization. Results: The mean age of the patients was 32.2±8.9 years. Male to female ratio of 1.7:1. CT scan shows a stone in 252 patients (70.2%) out of which 165 (46.0%) were confirmed on ureteroscopy. This yielded a sensitivity of 88.7 %, specificity of 49.7 %, positive predictive value of 65.5%, negative predictive value of 80.4% and diagnostic accuracy of 69.9% of CT for detecting ureteric calculi in patients with ureteric stents (p value < 0.0001). Conclusion: CT scan owing to its limited diagnostic accuracy cannot replace ureteroscopy for detection of ureteric stones in patients with ureteric stents.
Purpose of the study: The purpose of study was to interrelate CT findings of depressed skull fracture with clinical findings. Study design: This was exploratory study. Place of study: The study was conducted at Mayo Hospital Lahore and Lahore General Hospital. Duration of study: From March 9, 2004 to October 2004. Sample size: Fifty patients irrespective of their age and sex were included. Patients selection: Only the newly admitted patients in the above mentioned hospitals were included in the study. Previously diagnosed depressed skull fracture or the patients having associated facial abdominal and thoracic injuries were excluded. Methodology: Patients having depressed skull fracture were clinically evaluated and thereafter subjected to 4th generation spiral CT scan at the radiology Department of the above mentionedhospitals. Both bone and brain window were taken for various intracranial structures. Results: Analysis of the data for association between the variables of clinical and CT findings revealed that patients with conscious level, with DSF and having mild head injury were less associated with scalp injury (p=0.1156) which is statistically insignificant. DSF with moderate and severe head injury had more probability of scalp injuries. Scalp laceration seen with DSF had association with scalp injury (p<0.001). Conclusion: It is a key for clinician and neurosurgeon to use GCS score in congestion with the CT findings for early management of DSF.
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