A 54-year-old male patient presented to the outpatient department of neurology with complaints of tingling and numbness of hands since two months. Neurological examination revealed reduced power and decreased proprioception and vibration sense of hands. Laboratory investigations done showed normal Hb-13.7g/dl (normal range, 13.5-17.5 g/dl).Other routine blood, urine parameters were within normal limits. MRI of cervical spine was advised and performed which showed symmetric T2W hyperintense signals in dorsal columns of cervical spinal cord from C2 to C5 RefeRences
BACKGROUND Clinical diagnosis of a scrotal swelling is not straightforward. It is often difficult to decide whether a palpable scrotal m ass is intratesticular or extratesticular. Moreover, the clinical examination may over look significant pathology and physical signs elicited may be improperly interpreted. The sonogram with high frequency linear transducer and colour Doppler is invaluable in evaluating scrotum and its contents. Sonography is simple to perform, rapid, non-invasive, relatively inexpensive, easily reproducible, widely available and does not expose the gonads to radiation. Aim and Objective-To evaluate various scrotal pathologies using ultrasonography and to describe the role of high resolution ultrasound and colour Doppler in their diagnosis.
The diagnosis of malignant lymphadenopathy is crucial for therapeutic planning in patients with suspected malignant neoplasm and for pretreatment staging in patients with primary malignant tumors of the head and neck. In patients with proven head and neck carcinomas, the presence of a unilateral metastatic node reduces the 5-year survival rate by 50%, whereas the presence of bilateral metastatic nodes reduces the 5-year survival rate to 25%. [1-3] The histologic variations observed in lymph nodes in patients with nodal diseases are used to describe the morphologic changes in lymph nodes shown by gray-scale sonography. [4] High-resolution ultrasound is a useful imaging tool for the assessment of cervical lymph nodes because of its high image resolution and high sensitivity (98%) and specificity (95%) when combined with fine-needle aspiration cytology (FNAC). [5-7] Moreover, ultrasound is noninvasive and easily available. Therefore, it is suitable for both monitoring Background: Cervical lymphadenopathy is a commonly encountered clinical problem. Patients either present with palpable neck masses or with malignancy of the head and neck where the preoperative detection of the involved nodes is essential. Ultrasound and color/power Doppler are used to localize the node and evaluate their multiplicity, size, shape (roundness index), hilum status, margin, calcification, necrosis (>3 mm), and perilymphnodal edema. Color and power Doppler is used to know the pattern of vascularity and doppler indices [resistive index (RI) and pulsatility index (PI)]. Aims and Objective: To determine the role of ultrasound and color/power Doppler in the differentiatiation of benign and malignant nodes and in tapering the differential diagnosis. Materials and Methods: Eighty lymph nodes were evaluated with ultrasound and color Doppler and correlated later with histopathology reports over a period of 18 months (May 2013 to November 2014) referred to Department of Radiology at Katuri Medical College and Hospital. Roundness index (<2), ill-defined margins, absence of hilum, peripheral/mixed vascularity, RI > 0.8 ,and PI > 1.5 were the criteria taken to diagnose the malignant involvement of the lymph node. Results: Of the 80 lymph nodes examined, 22 are proved to be malignant on histopathology examination. Features such as roundness index, absence of hilum, and vascular pattern demonstrated sensitivities of 91%, 86%, and 86% and positive predictive values (PPVs) of 71%, 73%, and 86%, respectively. Among these features, pattern of vascularity and Doppler indices showed high PPV. Conclusions: Ultrasound and color Doppler findings of roundness index, absence of hilum, vascular pattern, and impedance values revealed good PPV, sensitivity, specificity, and accuracy reaching 90% in differentiating benign from malignant lymph nodes.
Introduction: Breast Imaging, Reporting and Data System (BI-RADS) is an effective tool for management of patients with breast pathologies. While the BI-RADS 1 (negative) and BI- RADS 2 (benign) categories patients are advised for routine mammography screening. BI-RADS 4 (suspicious abnormality) and BI-RADS 5 (highly suggestive of malignancy) categories patients are recommended for tissue diagnosis, BI-RADS 3 category patients are managed with follow-up examinations. But upto 2% of BI-RADS 3 lesions are proved to be malignant on follow-up examinations and tissue diagnosis. Aim: To evaluate the efficacy of spectral Doppler indices in predicting malignancy in BI-RADS 3 category breast lesions. Materials and Methods: A prospective cohort study was conducted in the Department of Radiology, Katuri Medical College, Guntur, Andra Pradesh, India from July 2019 to February 2021. Study was conducted on 292 BI-RADS 3 lesions from 257 patients to evaluate the efficacy of spectral Doppler indices in differentiating malignant BI-RADS 3 lesions from benign ones. All the breast masses were evaluated with spectral doppler and the resistive and pulsatility indices were compared with histopathology findings of the suspicious lesions detected in follow-up examinations. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) 2017 version 25, and the quantitative data was expressed in mean and standard deviation. Results: The patients recruited in the study were in age range of 27-80 years, and the mean age of the patients was 46±15 years (mean±SD). Follow-up examinations and tissue diagnosis of suspicious lesions revealed 8 out of 292 BI-RADS breast masses to be malignant. On spectral Doppler analysis, high resistivity and pulsatility indices are predictive of malignancy. A resistive index of more than 0.6 as a sign of malignancy proved to have a sensitivity of 87.5% and specificity of 85.5% and more than 0.8 as a sign of malignancy has a sensitivity of 25% and specificity of 95%. A pulsatility index of more than 0.9 as a sign of malignancy has a sensitivity of 87.5% and specificity of 87% and more than 1.6 as a sign of malignancy has a sensitivity of 37.5% and specificity of 96%. Conclusion: Spectral doppler is reliable in the prediction of malignancy of BI-RADS 3 breast masses.
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