Objective:To determine the diagnostic accuracy of magnetic resonance imaging (MRI) in injuries related to anterior cruciate ligament and menisci and compare its effectiveness with that of arthroscopy.Methods:This retrospective cross-sectional study was conducted in the department of Radiology & Medical Imaging of Dallah Hospital, Riyadh, Kingdom of Saudi Arabia from September 2012 to March 2014. Fifty four patients (including 30 men and 24 women) with internal derangement of knee referred from the orthopedic consulting clinics underwent MR imaging followed by arthroscopic evaluation. The presence of meniscal and ligamentous abnormality on the imaging was documented by two trained radiologist. Findings were later compared with arthroscopic findings.Results:The sensitivity, specificity and accuracy of MR imaging for menisci and ACL injury were calculated: 100% sensitivity, 88.4% specificity, 90% positive predictive value, 100% negative predictive value, and 94.4% accuracy were noted for medial meniscal injury. Similarly, MR had sensitivity of 85.7%, specificity of 95%, positive predictive value of 85.7%, negative predictive value of 95%, and accuracy of 92.5% for lateral meniscal injuries. Likewise, anterior cruciate ligament had 91.6% sensitivity, 95.2% specificity, 84.6% positive predictive value, 97.5% negative predictive value, and 94.4% accuracy.Conclusion:MRI is extremely helpful in identifying meniscal and anterior cruciate ligaments tears. MR imaging has high negative predictive value making it better choice as screening tool compared to diagnostic arthroscopic evaluation in most patients with soft tissue trauma to knee.
Objective:To evaluate the diagnostic accuracy of multidetector 64-slice computed tomography (MDCT) in the diagnosis and differentiation of benign and malignant ovarian masses using histopathology and surgical findings as the gold standard.Material and methods:This study was conducted in Aga Khan University Hospital, Karachi, Pakistan. Data was reviewed retrospectively from 1 November 2008 to 12 December 2009. One hundred patients found to have ovarian masses on CT scan were included in the study. CT scan was performed in all these patients after administration of oral and IV contrast. Ovarian masses were classified as benign and malignant on scan findings. Imaging findings were compared with histopathologic results and surgical findings. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of MDCT were calculated.Results:MDCT was found to have 97% sensitivity, 91% specificity, and an accuracy of 96% in the differentiation of benign and malignant ovarian masses, while PPV and NPV were 97% and 91%, respectively.Conclusion:MDCT imaging offers a safe, accurate and noninvasive modality to differentiate between benign and malignant ovarian masses.
We report a case of spontaneous gastrosplenic fistula in a 57 year old female who presented to the emergency department with abdominal pain and weight loss. From the physical examination, she had a palpable abdominal mass. A CT scan was performed and showed a mass involving the proximal greater curve of the stomach, infiltrating the spleen and pancreas. There was a 12 mm defect in the cardia of the stomach with gas entering the large mass but there was no free gas in the abdomen. The defect was a gastrosplenic fistula. A gastroscopic biopsy confirmed the diagnosis of diffuse large B cell lymphoma. Surgical removal of the mass was not feasible; therefore she was treated with RCHOP chemotherapy, achieving complete remission.
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