Accuracy Of Ultrasonography In Detection Research Articles

Diagnostic Accuracy of Ultrasonography for Detection of Intussusception in Children; a Systematic Review and Meta-Analysis.

The diagnosis of intussusception can be challenging in children due to the fact that the findings of clinical evaluations are nonspecific and most of the patients present with unclear history. Therefore, in this systematic review and meta-analysis, we aimed to investigate the diagnostic accuracy of ultrasonography for detection of intussusception and also compare the efficacy of point-of-care ultrasound (POCUS) with radiologist-performed ultrasound (RADUS). Two independent reviewers systematically searched different online electronic databases including MEDLINE, Scopus, Web of Science, Google Scholar, Embase, and Cochrane from inception to December 1, 2022 to identify published papers reporting accuracy of ultrasonography for diagnosis of intussusception. The quality assessment of the included studies was investigated using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool. A total of 1446 records were retrieved in the initial search of databases. After screening the titles, a total of 344 studies were retrieved for the detailed assessment of full-text. Finally, 37 studies were included in qualitative and quantitative analysis. The pooled sensitivity and specificity of ultrasonography for diagnosis of intussusception were 0.96 (95% CI: 0.95-0.97) and 0.97 (95% CI: 0.97-0.98), respectively. The pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 24.57 (95% CI: 8.26-73.03) and 0.05 (95% CI: 0.04-0.08), respectively. The area under the hierarchical summary receiver operating characteristic (HSROC) curve was 0.989. Mete-regression showed that there is no significant difference between diagnostic performance of POCUS and RADUS (p = 0.06 and rDOR (diagnostic odds ratio) = 4.38 (95% CI: 0.92-20.89)). This meta-analysis shows that ultrasonography has excellent sensitivity, specificity, and accuracy for diagnosis of intussusception in pediatric patients. Moreover, we found that diagnostic performance of POCUS is similar to that of RADUS for diagnosis of intussusception.

Comparative Study of Diagnostic Accuracy of Ultrasonography Vs Histopathology in patients Undergoing Hysterectomy due to Uterine Pathologies

Background: Accurate diagnosis of uterine pathologies has become a core part when referring patients for hysterectomy. A variety of modalities can be used for the diagnosis of uterine abnormalities. Aims: To evaluate the accuracy of ultrasound in diagnosing various uterine pathologies and to compare histopathological findings with ultrasonographical findings. Methods: A cross-sectional study was conducted on 80 females who met the inclusion criteria at Department of Gynaecology, University of Lahore Teaching Hospitalover a period of 9 months from November 2020 to August 2021. The study was started after the approval of ethical committee at the University of Lahore. All the patients were enrolled in this study after signing the informed consent form. Patients preop ultra-sonographic findings and post-operative histopathology reports of the hysterectomy was analyzed and sensitivity, specificity and diagnostic accuracy of ultrasonography for uterine pathologies was calculated. Results: Majority of the patients were in 40’s age group. Most common sonographical indication for hysterectomy was fibroids, followed byadenomyosis and endometrial hyperplasia. The overall sensitivity, specificity and diagnostic accuracy values for ultrasonography in the diagnosis of uterine abnormality was satisfactory. The diagnostic accuracy of ultrasonography in detection of uterine fibroids and adenomyosis was 96.25% and 98.75%. Conclusion: Histo-pathological analysis correlates well with the pre-operative sonographical diagnosis. The diagnostic accuracy of ultrasound in detecting intrauterine pathology urges us to utilize ultrasonography as a first-line investigation in gynaecological patients. It is a valuable adjunctive to histopatholoogy with high accuracy for identification and characterization of uterine pathologies. Keywords: Ultrasound, Menorrhagia, Fibroids, Adenomyosis, Endometrial hyperplasia.

Diagnostic Accuracy of Ultrasonography for Detection of AT by Taking Surgical Findings as Gold Standard

Objective: To assess the diagnostic accuracy of ultrasonography for detection of Achilles tendinopathy by taking surgical findings as gold standard. Design of the Study: It was a descriptive cross-sectional study. Study Settings: This study was carried out at Department Of Diagnostic Radiology And Diagnostic Imaging Combined Military Hospital, Lahore from 23rd December 2017 to 22nd June 2018. Material and Methods: A total of 70 patients of age 20-70 years, of either gender presenting with severe pain and swelling in area of Achilles tendon were included. Patients with heel pain having concurrent heel ulcer, eczematous changes or calcaneal fractures, muscular dystrophy and previous surgery were excluded. All the patients were then underwent ultrasonography and findings were noted for presence or absence of Achilles tendinopathy. Each Ultrasonographic finding were compared with surgical findings. Results of the Study: Mean age was 41.24 ± 10.34 years. Out of these 70 patients, 46 (65.71%) were male and 24 (34.29%) were females with male to female ratio of 1.9:1. In USG positive patients, 40 (True Positive) had Achilles tendinopathy and 04 (False Positive) had no Achilles tendinopathy on surgical findings. Among, 26 USG negative patients, 03 (False Negative) had Achilles tendinopathy on surgical findings whereas 23 (True Negative) had no Achilles tendinopathy on surgical findings. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ultrasonography for detection of Achilles tendinopathy by taking surgical findings as gold standard was 93.02%, 85.19%, 90.91%, 88.46% and 90.0% respectively. Conclusion: This study concluded that diagnostic accuracy of ultrasonography for detection of Achilles tendinopathy is quite high. Keywords: Achilles tendinopathy, ultrasonography, sensitivity.

Diagnostic accuracy of ultrasound in detection of pregnancy associated breast cancer

Introduction: Some unique physiological changes occur in breast volume and water content during pregnancy which makes the radiological evaluation of the breast difficult. As a result, diagnosis of Pregnancy Associated Breast Cancer. is often delayed.
 Objective: To find out the diagnostic accuracy of ultrasonography in detection of pregnancy associated breast cancer taking histopathology as gold standard.
 Methodology: Present Cross-sectional study was carried out at INMOL Hospital, Lahore. Ultrasound of 200 women was performed. The patient was laid supine and then turned slightly in oblique position to scan the breast with high frequency linear probe (7.5-10 MHz). The contra-lateral breast and both axillae were also scanned in the same way. Findings were categorized on the basis of Breast Imaging Reporting and Data System (BI-RADS) assessment categories. Subsequently the breast tissue was sent to histopathology laboratory for tissue diagnosis. The pathologist was blinded of the results of ultrasonography.
 Results: Mean age was 34 ± 11.36 years. Twenty-eight percent patients were primi-para while 72% patients were multi-para. Diagnostic accuracy of ultrasonography taking histopathology as gold standard was analyzed and ultrasonography had sensitivity 84.78%, specificity 98.05%, positive predictive value 92.85%, negative predictive value 95.56% and diagnostic accuracy was 95%. Invasive ductal carcinoma was most commonly observed (P<0.001) malignant histopathology. On the other hand, significantly high (P = 0.033) number of benign lesions were Fibroadenomas.
 Conclusion: The high sensitivity and specificity along with easy availability, and non-invasive nature makes ultrasonography a very useful technique for the diagnosis of Pregnancy Associated Breast Cancer.

The accuracy of ultrasonography for detection of enlarged parathyroid glands in patients with different forms of hyperparathyroidism

Background/Aim. Ultrasonography is a cheap, easily available and convenient method for diagnosis. The aims of this study were: to determine the utility of ultrasonography for preoperative identification and localization of enlarged parathyroid glands (PTG) in patients with different forms of hyperparathyroidism (HPT); to examine the frequency of PTG detection in patients previously non-suspected for HPT but having symptoms relevant to the disease; to determine sensitivity and positive predictive value (PPV) of ultrasonography for identification of PTG in HPT and to compare obtained results with those obtained by scintigraphy. Methods. This investigation was designed as a retrospective?prospective study. The total number of patients undergoing ultrasonography prior to surgery was 179 and the number of those subjected to scintigraphy, mostly by the 201Tl/99mTc method, was 112. The patients (52 male, 128 female) were divided into the following four groups: group A ? patients with primary (p)HPT (n = 78); group B ? patients with secondary (s)HPT (n = 47); group C ? patients with tertiary (t)HPT (n = 13); group D ? patients with unrecognized (u)HPT, but with anamnestic data implying the disease (n = 42). High resolution ultrasonography was performed by a single experienced observer. Diagnosis of HPT was based on characteristic clinical and biochemical parameters. Final proof of HPT diagnosis was surgery followed by histopathological examination. Results. Ultrasonography detected enlarged PTG in 93.85% of total patients, whereas scintigraphy uncovered 75.89% of positive cases (p < 0.05). The total number of positive PTG detected by ultrasonography was 211 vs 225 detected by surgery (sensitivity ? 95.9%; PPV ? 99.4%). Histopathology confirmed the predominance of adenoma in the A and D groups in comparison with the B group of patients having PTG hyperplasia. The group C was characterized by the presence of adenomas in hyperplastic PTG. The mean size of PTG measured by ultrasonography was 17.59 ? 8.0 mm (n = 164) vs 18.36 ? 8.54 mm (n = 179) measured after surgery. Ultrasonography proved itself as an accurate technique in all HPT groups, regarding its high sensitivity (range 93.6?100%) and PPV (95.6?100%). In contrast, scintigraphy was shown to be less reliable, especially in the sPTH group (sensitivity: 51.7%; PPV: 78.4%). Conclusion. Ultrasonography is more sensitive and accurate method for pre-operative localization of PTG in comparison with 201Tl/99mTc scintigraphy. It can be also efficiently used for detection of PTG and diagnosis of HPT in patients previously not suspected for this disease.

ACCURACY OF PRENATAL DETECTION OF CONGENITAL HEART ANOMALIES USING ULTRASONOGRAPHY: A SYSTEMATIC REVIEW

Ultrasound examinations in the second trimester for detection of congenital malformations are now part of pregnancy care in most developed countries. Major heart defects can be diagnosed before birth by sonographic assessment of the four-chamber view. This review is aimed to evaluate the evidence published on the accuracy of prenatal detection of congenital cardiac anomalies using ultrasonography. A web-based search was conducted in MEDLINE database and eligible studies were identified and then screened against inclusion criteria such as detection of congenital heart anomalies and reporting of ultrasonography accuracy. The full texts were retrieved for eligible studies and secondary in-depth screening were conducted for the study against inclusion criteria. Data were extracted from our studies regarding study’s characteristics, type of heart anomalies and level of accuracy. The data were synthesized and discussed with qualitative approach. The electronic search resulted in 145 eligible studies. After screening of titles and abstracts of these articles, irrelevant and duplicated studies were excluded and finally full-texts of 13 articles were retrieved. Overall sample size was ranged between 31 to 4172 with gestational age ranged between 11 weeks to 41 weeks. Overall accuracy of ultrasonography in the prenatal detection of heart anomalies was ranged between 81% to 98.4%. Ultrasonography has fair to high accuracy in prenatal detection of heart anomalies. The variation depends on factors such as technology, experience of the operator, and type of the anomaly. The findings of the included studies showed an acceptable accuracy of ultrasonography in detection of heart anomalies either in high or low risk groups

The Accuracy of Ultrasonography in Detection of Ulnar Collateral Ligament of Thumb Injuries; a Cross-Sectional Study

The Accuracy of Ultrasonography in Detection of Ulnar Collateral Ligament of Thumb Injuries; a Cross-Sectional Study

Concordance of US and MRI for diagnosis of ligamentous and tendinous injuries around the ankle

PurposeTo estimate the accuracy of ultrasonography in detection of tendinous and ligamentous injuries around the ankle in comparison to MRI. Materials and methods60 patients referred with unilateral painful ankles are subjected to ankle ultrasonography and the results are compared with ankle MRI between December 2015 and September 2016. Results132 pathologies including 62 tendon lesions, 46 ligamentous lesions, 10 bursitis and 14 joint effusion were diagnosed by MRI. Ultrasonography detected 59 tendinous lesions (missed 3 partial tears) with allover accuracy of 96%, 41 ligamentous lesions (missed 1 stretching lesion, 2 partial tears and 1complete tear) with allover accuracy of 94.3%, all bursal lesions detected and 2 cases with joint effusion were missed by ultrasonography. ConclusionUltrasonography is an accurate and sensitive modality in detecting tendinous and ligamentous lesions around the ankle and represent with MRI complementary tool for diagnosis and can be used alone is some conditions

The Accuracy of Ultrasonography in Detection of Ulnar Collateral Ligament of Thumb Injuries; a Cross-Sectional Study.

Timely diagnosis and treatment of traumatic injury to ulnar collateral ligament (UCL) of thumb is of special importance for preserving the full function of the hand. Therefore, the present study has been designed with the aim of evaluating the accuracy of ultrasonography in detection of these injuries. The present diagnostic accuracy study was performed on trauma patients over 15 years old who had clinical evidence of injury to UCL of thumb and were admitted to the emergency department. All patients were evaluated regarding injury to the mentioned ligament via ultrasonography and MRI and finally, the accuracy of ultrasonography in this regard was measured considering MRI as the reference test. 20 individuals with the mean age of 38.60 ± 13.45 (16 - 64) years were evaluated (60% male). Based on ultrasonography and MRI findings 7 (35%) individuals and 7 (35%), respectively had complete ligament rupture (kappa: 0.560 (95% CI: 0.179 - 0.942)). Sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratio of ultrasonography in detecting injuries of the mentioned ligament were 71.42 (30.25 - 94.88), 84.61 (53.66 - 97.28), 71.42 (30.25 - 94.88), 84.61 (53.66 - 97.28), 2.5 (0.71 - 8.82), and 0.18 (0.04 - 0.67), respectively. Based on the findings of the present study, performance of ultrasonography by a radiologist in the emergency department has 80% accuracy in detecting traumatic injuries of UCL of the thumb.

The Accuracy of Emergency Physicians in Ultrasonographic Screening of Acute Appendicitis; a Cross Sectional Study.

Diagnostic values reported for ultrasonographic screening of acute appendicitis vary widely and are dependent on the operator's skill, patient's gender, weight, etc. The present study aimed to evaluate the effect of operator skill on the diagnostic accuracy of ultrasonography in detection of appendicitis by comparing the results of ultrasonography done by radiologists and emergency physicians. This prospective diagnostic accuracy was carried out on patients suspected to acute appendicitis presenting to EDs of 2 hospitals. After the initial clinical examinations, all the patients underwent ultrasonography for appendicitis by emergency physician and radiologist, respectively. The final diagnosis of appendicitis was based on either pathology report or 48-hour follow-up. Screening performance characteristics of appendix ultrasonography by emergency physician and radiologist were compared using STATA 11.0 software. 108 patients with the mean age of 23.91 ± 7.46 years were studied (61.1% male). Appendicitis was confirmed for 37 (34.26%) cases. Cohen's kappa coefficient between ultrasonography by the radiologist and emergency physician in diagnosis of acute appendicitis was 0.51 (95% CI: 0.35 - 0.76). Area under the ROC curve of ultrasonography in appendicitis diagnosis was 0.78 (95% CI: 0.69 - 0.86) for emergency physician and 0.88 (95% CI: 0.81 - 0.94) for radiologist (p = 0.052). Sensitivity and specificity of ultrasonography by radiologist and emergency physician in appendicitis diagnosis were 83.87% (95% CI: 67.32 - 93.23), 91.5% (95% CI: 81.89 - 96.52), 72.97% (95% CI: 55.61 - 85.63), and 83.10% (95% CI: 71.94 - 90.59), respectively. Findings of the present study showed that the diagnostic accuracy of ultrasonography carried out by radiologist (89%) is a little better compared to that of emergency physician (80%) in diagnosis of appendicitis, but none are excellent.

Ability of Ultrasonography in Detection of Different Extremity Bone Fractures; a Case Series Study.

Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture. After initial assessment, ultrasonography of suspected bones was performed by a trained emergency medicine resident and prevalence of true positive and false negative findings were calculated compared to plain radiology. 108 patients with the mean age of 44.6 ± 20.4 years were studied (67.6% male). Analysis was done on 158 sites of fracture, which were confirmed with plain radiography. 91 (57.6%) cases were suspected to have upper extremity fracture(s) and 67 (42.4%) to have lower ones. The most frequent site of injuries were forearm (36.7%) in upper limbs and leg (27.8%) in lower limbs. Prevalence of true positive and false negative cases for fractures detected by ultrasonography were 59 (64.8%) and 32 (35.52%) for upper and 49 (73.1%) and 18 (26.9%) for lower extremities, respectively. In addition, prevalence of true positive and false negative detected cases for intra-articular fractures were 24 (48%) and 26 (52%), respectively. The present study shows the moderate sensitivity (68.3%) of ultrasonography in detection of different extremity bone fractures. Ultrasonography showed the best sensitivity in detection of femur (100%) and humerus (76.2%) fractures, respectively. It had low sensitivity in detection of in intra-articular fractures.

Screening Characteristics of Ultrasonography in Detection of Ankle Fractures.

Ankle fracture is one of the most common joint fractures. X-ray and physical examination are its main methods of diagnosis. Recently, ultrasonography (US) is considered as a simple and non-invasive method of fracture diagnosis. This study evaluated the diagnostic accuracy of US in detection of ankle fracture in comparison to plain radiography. In this diagnostic accuracy study, which was done in emergency departments of Imam Hossein and Shohadaye Tajrish hospitals, Tehran, Iran, during 2014, 141 patients with suspected diagnosis of distal leg or ankle fracture were examined by US and radiography (gold standard), independently. Screening performance characteristics of US in detection of distal leg fractures were calculated using SPSS version 21. 141 patients with the mean age of 34 ± 11.52 years (range: 15 - 50) were evaluated (75.9% male). Radiography confirmed ankle fracture in 102 (72.3%) patients. There was a significant correlation between the results of US and radiography [Agreement: 95%; kappa: 0.88 (95% CI: 0.80-0.97); P < 0.001]. The screening performance characteristics of US in detection ankle fracture were as follows: sensitivity 98.9% (95% CI: 93.5% - 99.9%), specificity 86.4% (95% CI: 71.9%-94.3%), PPV 94.1% (95% CI: 87.1% - 97.6%), NPV 97.4% (95% CI: 84.9% - 99.8%), PLR 16 (95% CI: 7.3 - 34.8), and NLR 0.02 (95% CI: 0.003 - 0.182). The area under the ROC curve of US in this regard was 95.8 (95% CI: 91.9 ± 99.7). According to the results of this study, we can use US as an accurate and non-invasive method with high sensitivity and specificity in diagnosis of malleolus fractures. However, the inherent limitations of US such as operator dependency should be considered in this regard.

Direct ultrasound methods

Early confirmation of incorrect endotracheal tube (ETT) placement is of vital importance when performing emergency airway management. No ideal confirmation technique has been proposed under all circumstances. Recently, ultrasonography was suggested as a useful tool for confirmation of correct positioning of the ETT. The aim of this study is to assess the diagnostic accuracy of ultrasonography for detection of proper ETT placement. This prospective study was carried out in the emergency department from February to October 2012. The ultrasonography was performed by a trained senior resident in two phases: (a) as the intubation was being performed (dynamic phase) and (b) after the intubation had been completed (static phase). A linear probe was placed transversely over the cricothyroid membrane during the intubation process (dynamic phase) and on the anterior neck just superior to the suprasternal notch in the static method. Operating characteristics were calculated for both dynamic and static determination of ETT placement. Sixty patients were enrolled in each study group. The sensitivity, specificity, positive predictive value, and negative predictive value of the dynamic technique for determining correct endotracheal intubation were 98.1% [95% confidence interval (CI), 88.8-99.9%], 100% (95% CI, 51.6-100%), 100% (95% CI, 91.5-100%), and 85.7% (95% CI, 42-99.2%), respectively. Using the static technique, all testing characteristics listed previously were 100%. In this study, we found acceptable sensitivity, specificity, positive predictive value, and negative predictive value for prediction of tracheal ETT placement with the use of dynamic and static ultrasonography.

Diagnostic Accuracy of Ultrasound in Detection of Traumatic Lens Dislocation.

Traumatic eye injuries (TEI) involved about 3% of cases referred to the emergency departments of developing countries. Lens dislocation is one of the critical cases of ophthalmic emergencies. The present study was aimed to evaluate the diagnostic accuracy of ultrasonography in detection of traumatic lens dislocation. In this cross-sectional study the findings of ultrasonography and orbital computed tomography (OCT) of head and face trauma patients, referred to Imam Reza hospital, Tabriz, Iran, from July 2013 to June 2014, have been compared. The sensitivity, specificity, positive and negative likelihood ratio, positive and negative predictive value, and accuracy of ultrasonography were calculated. Cohen's kappa coefficient was presented to assess the agreement of ultrasonography with OCT findings. One hundred thirty patients with the mean age of 35.4±18.0 were evaluated (75.4% male). Sensitivity and specificity of ultrasonography were 84.6% (95% Cl: 53.7-97.3) and 98.3% (95% Cl: 93.3- 99.7), respectively. In addition, positive and negative likelihood ratio were calculated 49.5 (95% Cl: 12.3-199.4) and 0.15 (95% Cl: 0.04- 0.56), respectively. Cohen's kappa coefficient of 0.83 (95% Cl: 0.66-1.0; p<0.0001) was representative of excellent agreement of these two tests. The finding of this project was representative of 84.6% sensitivity, 98.3% specificity, and 96.9% accuracy of ultrasonography in detection of traumatic lens dislocation. It seems that in cases, which OCT is not possible, ultrasonography, could be an acceptable option to assess traumatic eye injuries.

Sickle Cell Disease in Children: Accuracy of Imaging Transcranial Doppler Ultrasonography in Detection of Intracranial Arterial Stenosis

This study aimed to determine the accuracy of imaging transcranial Doppler sonography in detection of intracranial arterial stenosis in children with sickle cell disease using three-dimensional MR angiography as a reference standard. Sixty-one children (mean age 102±39 months, 30 males), who had no history of overt stroke, and were classified as at lowest risk of stroke by mean flow velocity criterion <170 cm/s, underwent conventional and imaging transcranial Doppler ultrasonographic examinations. We employed the area under the receiver operating characteristic curve (AUC) to determine the accuracy of flow velocity measurements obtained with imaging ultrasonography with and without correction for the angle of insonation as well as with conventional ultrasonography. We also established the most efficacious velocity thresholds for detection of the stenosis. We found ten intracranial stenoses in six patients on MR angiography, but we calculated AUC only for detection of stenosis (n=6) of the left intracranial internal carotid artery. The accuracy of flow velocity with angle correction was lower than the accuracy of velocity without angle correction (AUC=0.73, 95% CI, 0.53-0.93 versus AUC=0.87, 95% CI, 0.74-1.00; p=0.017). The accuracy of flow velocity obtained with conventional ultrasonography (AUC=0.82, 95% CI, 0.67-0.97) was not different from the accuracy of flow velocities obtained with imaging ultrasonography. We found that the threshold of 165 cm/s of mean velocity without angle correction is associated with highest efficiency for imaging (92%) and conventional ultrasonography (90%). Velocity measurements without angle-correction provide good accuracy in detection of stenosis of the terminal internal carotid artery, whereas angle-corrected velocities have lower accuracy.

Is Fluid Ingestion Really Necessary During Ultrasonography for Detecting Ureteral Stones?

Ultrasonographic evaluation of ureteral stones is usually performed after fluid ingestion for filling the bladder to visualize the ureterovesical junction better. We hypothesized that water ingestion may decrease the imaging quality of ultrasonography for detecting ureter stones. In our prospective randomized study, the accuracy of ultrasonography for detecting ureteral stones performed with or without fluid intake were evaluated. The study population comprised 150 consecutive patients thought to have ureteral stones who underwent ultrasonography. Patients were divided into 2 groups. Group A patients ingested 500 mL of water to distend the bladder before ultrasonographic examination. Group B patients were restricted from drinking any water at least 4 hours before the procedure. Ultrasonography showed 35 (67.30%) of 52 stones in group A and 68 (93.15%) of 73 stones in group B. The difference of detection rates between the 2 groups was statistically significant (P < .001). The greatest improvement in detection rates was noted in the middle ureter stones. The evaluated sensitivity and specificity rates for group A were 67% and 82%, respectively, and those for group B were 93% and 94%. When the 2 methods were compared, total accuracy of ultrasonography increased from 71% in group A to 93% in group B. This prospective randomized study showed that the diagnostic accuracy of ultrasonography for detection of middle ureteral stones increased significantly when performed without any water ingestion before the procedure. We recommend that patients thought to have ureteral stones should be first examined without any fluid ingestion.

Accuracy of transvaginal ultrasonography for detection of hematosalpinx in ectopic pregnancy.

The transvaginal approach has significantly improved the accuracy of ultrasonography for the detection of ectopic pregnancy. However, there has been limited emphasis given to determining the sensitivity of ultrasonography when a hematosalpinx was used as a specific finding to identify an ectopic pregnancy. The sensitivity of transvaginal ultrasonography was evaluated for the detection of a hematosalpinx defined as an "echogenic homogeneous or inhomogeneous, rounded or elongated structure" in a group of patients with surgically proven ectopic pregnancy. Retrospectively, transvaginal ultrasonography showed a hematosalpinx in 16 out of 18 (88.8%) tubal pregnancies. In 6/6 (100%) patients with a ruptured tube and 10/12 (83.3%) patients with an unruptured tube, a hematosalpinx was detected sonographically. A gestational sac with a live embryo was seen in 26.3% of these patients. The significance of identifying a hematosalpinx, predictability of rupture and implication in the treatment of ectopic pregnancy are discussed.

Accuracy of ultrasonography in the detection of severe hepatic lipidosis in cats

Summary The accuracy of ultrasonography in detection of feline hepatic lipidosis was studied retrospectively. The following ultrasonographic criteria were associated positively with severe hepatic lipidosis: the liver hyperechoic, compared with falciform fat; the liver isoechoic or hyperechoic, compared with omental fat; poor visualization of intrahepatic vessel borders; and increased attenuation of sound by the liver. In a group of 36 cats with clinically apparent hepatobiliary disease and in which liver biopsy was done, liver hyperechoic, compared with falciform fat, was the best criterion for diagnosis of severe hepatic lipidosis with 91% sensitivity, 100% specificity, and 100% positive predictive value.

Diagnostic accuracy of ultrasonography in detection of blunt abdominal trauma and comparison of early and late ultrasonography 24 hours after trauma.

Objective:Despite the advantages of ultrasound scan, its use as a screening tool in blunt abdominal trauma is controversial. The aim of this study was to evaluate the diagnostic value of early and late ultrasound in patients with blunt abdominal trauma (BAT).Methods:In this study which was performed in a level I trauma center, firstly, 2418 patients with BAT had ultrasound (US) examination by two trauma expert radiologists. Results were compared with the best available gold standards such as laparotomy, CT, repeated ultrasound or clinical course follow-up. Then, 400 patients with BAT were examined by a trained residency student.Results:In the first phase, sensitivity, specificity, negative predictive value, positive predictive value and accuracy of ultrasound were 97%, 98.1%, 99.7%, 83% and 98% respectively. In the second phase, they were 97.3%, 97.2%, 97.7%, 96.8% and 97.3% for the early and 98.5%, 97.6%, 98.5%, 97.5% and 98% for the late ultrasound respectively.Conclusion:Results obtained from this study indicate that negative ultrasound findings associated with negative clinical observation virtually exclude abdominal injury, and confirmation by performing other tests is unnecessary. High sensitivity and negative predictive value is achieved if ultrasound is performed by expert trauma radiologist.