Background: Doppler ultrasound in second and third trimesters is non invasive method to assess fetal wellbeing and monitoring fetoplacental unit. Normal umbilical artery Doppler indices reference values have been established in Western countries but there is paucity of studies conducted in Pakistan regarding normal umbilical artery Doppler indices reference values. Objective: To evaluate the Doppler indices in the umbilical arteries of healthy pregnant women from 18-40 wks gestation. Material and Methods: A cross sectional study was conducted in Radiology department of Hayatabad Medical Complex from July 2018 to Dec 2018.Total 260 normal singleton pregnancies with gestational age ranging from 18--40 weeks were included. Doppler parameters; Resistive Index (RI), Pulsatility Index (PI) and the systolic to diastolic ratio(S/D) were recorded. Results: The normal umbilical artery Doppler indices at different gestational ages in healthy pregnant women were analyzed. Percentile values were calculated for these indices. Median values for the pulsatility index were 1.23 at 18-20 wks which reduced to 0.86 at 39-40 wks, for the resistivity index median values were 0.70 at 18-20 wks and 0.52 at 39-40 wks. Systolic/diastolic ratio was 4.16 at 18-20 wks and 2.21 at 39-40 wks. Conclusion: In normal healthy pregnancies, doppler ultrasound should be used to evaluate the degree of feto-placental blood flow in order to detect the risk of pregnancy complications. Our study results can form a baseline for Doppler indices in second and third trimester which can further help in abnormal values in high risk patients.
OBJECTIVES The objective of this study was to investigate the role of ultrasound in the detection of early pregnancies presenting with placental molar changes. METHODOLOGY This retrospective study was carried out at Radiology department of Hayatabad Medical Complex, Peshawar, between Aug 2020 and July 2021. All cases suspected of molar changes were evaluated from 10-14 weeks of gestation. The patient were referred to our department because of fetal abnormality, maternal disease or age and family or previous pregnancy history or were identified from an ongoing ultrasound screening study for aneuploidy by measurement of fetal nuchal translucency thickness. Transabdominal or transvaginal sonography was used to examine the fetus and placenta. RESULTS Total 85 patients of molar pregnancies were enrolled in the study. Age ranged between 20-45 years with a mean age of 32.5 years. There were 60(70.6%) complete moles (CM) and 25(27.4%) partial moles (PM) were suspected on ultrasound. In case of complete mole coexisting with a normal singleton or twin pregnancy, the molar placenta was clearly separated from the normal placenta, whereas with partial moles the molar structures were dispersed inside the placental mass. CONCLUSION Ultrasound detection of molar pregnancy remains a diagnostic challenge. Data suggest that there has been an increase in both the predictive value and the sensitivity of ultrasound over time; however, the diagnostic criteria remain ill defined. Prior to managing a miscarriage, being aware of the possibility of molar pregnancy will guide treatment and allow for adequate follow-up.
OBJECTIVESTo assess the usefulness of Tri-phasic computed tomography in the evaluation of hepatocellular carcinoma in cirrhotic patients.METHODOLOGYThis cross-sectional study was carried out in the Radiology and Imaging Department of Hayatabad Medical Complex Peshawar from October 2020 to September 2021 (01 year). Tri-phasic CT was done in all patients. Patients with suspected hepatocellular carcinoma diagnosed by clinical and ultrasonography and having high serum α-fetoprotein levels were enrolled in the study.RESULTSMalignant cases on tri-phasic CT were 120(82.8%) while benign cases were 25 (17.2%) Fig -I. In malignant tumor cases, 99(82.5%) patients had hepatocellular carcinoma (HCC), 13(10.8%) had metastases and 8(6.7%) had dysplastic nodule respectively. In benign tumour cases, 15(60%) had regenerative nodules, 6(24%) had hepatic adenoma and 4 (16%) had haemangioma. Tri -phasic CT as a tool in the diagnosis of hepatocellular carcinoma in cirrhotic patients showed a sensitivity of 96.8%, specificity of 79.7%, the accuracy of 95%, positive predictive values of 96.2% and negative predictive values of 88.1%.CONCLUSIONTri-Phasic CT can be an ideal diagnostic tool for detecting as well as characterizing hepatocellular carcinoma in cirrhotic patients.
Background: New-onset seizure can be potential life threatening condition. It raises the suspicion of intracranial abnormality or a primary epilepsy .These are mostly diagnosed and differentiated clinically, however diagnostic imaging has important role in evaluating the cause of seizure . Previously studies done on neuroimaging in seizures have mostly focused on assessment of seizures in children or adults in acute emergency however this study focused on new onset seizures in adults .Magnetic Resonance Imaging (MRI) is readily available in tertiary care hospitals these days and is important diagnostic modality for evaluating the causes of new-onset seizure in adults. Aims and Objectives: The purpose of this study was to discuss the magnetic resonance imaging finding in adult patients presenting with new-onset seizure and if the MRI established the cause for the patient's new onset seizure Methods: This was prospective cross sectional study done in 330 adult patients above age of 18 year who presented with new-onset seizures from May 2020 to April 2021. These patients were referred to Radiology department Hayatabad Medical Complex to evaluate intracranial abnormality and to find out the cause of seizure. MRI brain was performed on 1.5T machine and images were independently reviewed by two consultant Radiologists. The findings were summarized and categorized into a study database. Results: In our study 330 adults presenting with new onset seizures underwent MRI within 48 hours of seizure . The mean age was 47 yrs . MRI determined the cause of new-onset seizure in 139 (42.1%) patients while 191(57.9%) studies were normal.. The most common findings were encephalomalacia with gliosis related to previous trauma ,chronic infarcts and surgery ( 38.1%),primary/metastatic brain tumour (24.4%), infectious encephalitis and meningitis(15.8 %), venous sinus thrombosis (8.6%), while and PRESS(7.2%) and vascular malformation(5.7%) were less common findings, . Patients with focal seizures had a higher proportion of potentially epileptogenic lesions (64.7%) compared with those with seizures of generalized onset (10.8%) or uncertain type (24.6%) Conclusion: This study emphasizes the importance of magnetic resonanace imaging in adults presenting with acute seizures and its usefulness in determining the epileptogenic lesions and helps in planning the treatment strategy. Keywords: Seizures, Magnetic resonance imaging, Intracranial abnormality.
Background: Radiology reporting in today's era has a very important role in diagnosis and management of patient so it is very important to rule out the causes and ways to improve reporting time and its quality. Delays in performing radiology scans or interpreting them can prolong the time until a proper treatment decision can be made, leading to increased costs and potential compromises in patient care.Objective: To find out reasons for delay in radiological reporting and to find out how to reduce them and improve reporting standards.Materials and Methods: This study was an observational descriptive study and it involved data collected from all patients whose CT scan or MRI was performed for random problems in HMC. There scans were followed till they were reported and handed over to patients or patient's attendants. Questionnaires were given to five consultants of radiology department to know about causes of delay.Results: In this observational study we found that delay in reporting was multifactorial. Approximately 11,600 CT scans and MRI scans were performed in the period between 1st July to 31st December 2018. Approximately 2070 (17.8%) reports were delayed more than 72 hours while 82.1% scan were reported in time within 72 hours. In our study the most important cause of delayed reporting was incomplete history (34.8%), while other causes were inappropriate technique (21.5%), radiologist overburden (29.7%) while in 14% patients the cause of delayed reporting was lack of communication between radiologist and clinician.Key Words: Computed tomography, Magnetic resonance imaging, Reporting.
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