Detection Of Lymphadenopathy Research Articles

Role of Ultrasonography in the Diagnosis of Wilms' Tumour.

Background. Wilms’ tumour or nephroblastoma is the most common renal malignancy encountered in the paediatric population. Imaging findings are of great importance to the surgeon, the oncologist and the radiologist in the diagnosis and the staging and surveillance of this tumour. Material and Methods. This study was carried out as a 10-year retrospective study of patients who were diagnosed with Wilms’ tumour. Results. The study included 12 boys and 11 girls. Ultrasound and computed tomography were performed in all cases. Ultrasonography was found to be superior to the CT examination when approximating the antero-posterior and transverse diameters; the computer-tomographic examination is cited as superior for estimating the invasion of nephroblastomas. Conclusions: Ultrasound has been shown to be effective in detecting the rupture of the renal capsule, tumour calcifications and invasion of the renal vein, pelvis and ureter. However, ultrasound cannot replace CT in the detection of lymphadenopathy and the invasion of adjacent organs.

COMPARISON OF ENDOSCOPIC ULTRASOUND AND COMPUTED TOMOGRAPHY FOR EVALUATION OF PANCREATIC MASS LESIONS ASSUMING HISTOPATHOLOGY AS GOLD STANDARD

Background-Diagnostic imaging is an important tool to evaluate pancreatic neoplasms. Accurate detection and staging are essential for ensuring appropriate selection of patients who will benefit from surgery and for preventing unnecessary surgeries in patients with unresectable disease. Ultrasound (US), multidetector computed tomography (MDCT) with multiplanar reconstruction and magnetic resonance imaging (MRI) can help to do a correct diagnosis.
 Methods- Hospital based cross-sectional and quantitative study. Patients with suspected pancreatic mass lesions referred to Department of Radiodiagnosis and Modern Imaging and to Department of Gastroenterology for MDCT and EUS respectively.
 Results- EUS sensitivity was 98.00%, specificity was 75.00% and by CT scan sensitivity was 93.00%, specificity was 88.00% for mass detection. EUS sensitivity was 88.00%, specificity was 72.00% and of CT scan sensitivity was 76.00%, specificity was 100.00% in detection of vascular involvement. EUS sensitivity was 86.00%, specificity was 74.00% and by CT scan sensitivity was 92.00%, specificity was 100.00% for detection of lymphadenopathy.
 Conclusion- In conclusion, our results showed that CT with pancreas protocoland EUS correlate moderatelywell in terms of mass detection, masssize, vascular involvement and lymphadenopathy.
 Keywords: CT, EUS, Pancreatic lesion.

Диагностически значимые отличия асептической и септической нестабильности компонентов эндопротеза при артропластике крупных суставов

The purpose of the work is to analyze the results of laboratory, microbiological and instrumental studies to search for screening criteria for the difference between aseptic and septic instability of endoprosthesis components after knee and hip joint arthroplasty. The materials contained 146 cases of revision arthroplasty of the knee and hip joints, performed under the conditions of Federal State Budgetary Institution Federal Center of Traumatology, Orthopedics and endoprosthesis replacement of Ministry of Health of the Russian Federation (Cheboksary) for a 3-year period, including cases of aseptic instability - 69, septic instability - 77. By methods for laboratory diagnosis were used to evaluate the blood levels of leukocytes, stab neutrophils, ESR, C - reactive protein (CRP), presepsin, procalcitonin, D-dimer, interleukin-6. Using ultrasound (ultrasonic) examination of the periprosthetic zone, the presence of fluid, granulation tissue in the joint cavity, altered lymph nodes was determined. Before the operation, the level of cytosis and cellular composition were determined in the synovial fluid; tissue bioptates, removed components of implants (after ULTRASONIC treatment) with sowing on the microflora were studied intraoperatively. Intraoperative tissue biopsies were used to make smears-prints on the glass, with gram staining, estimating the number of leukocytes and neutrophils in the field of vision. Results. Determination of indicators of ESR, presepsin and interleukin-6, the level of which goes beyond the generally recognized normal values in the presence of infection, can be recommended as a screening test in the diagnosis of the infectious nature of instability of the components of the endoprosthesis of large joints. The second stage of differential diagnosis of septic and aseptic instability can be the detection of lymphadenopathy. The third (final) stage of determining the infectious nature of instability is an invasive technique to determine the level of cytosis with the calculation of neutrophils in the synovial fluid.

Automated Detection of Lymphadenopathy in Neck Resulting from Oral SCC on 3D CT Imaging

Background/Objectives: Detection of lymphadenopathy is challenging issue in medical field. Squamous Cell Carcinoma (SCC) can lead to a certain type of lymphadenopathy which is different from all other pathological factors. Nowadays detection of these cases is done by expert radiologists, Computing Tomography (CT), and sonography and etc., challenges in detection of this type of lymphadenopathy in neck is mainly due to neck anatomy which similar objects are close to each other. Methods/Statistical Analysis: In this paper, was presented a method to detect this type of the lymphadenopathy in neck by 3 dimensional (3D) image processing techniques and Computer-Aided Diagnosis (CAD) systems. This method consists of four steps. The first is preprocessing, the second is thresholding and morphological operation, the third is feature extraction and the last is classification. By using this method, detection of lymphadenopathy will be done more accurate and less time consuming. Findings: This method is done in 18 neck CT data sets, consisting of lymphadenopathy by SCC cells. The sensitivity of using this method is 94%. Applications/Improvements: The goal is to introduce a sensitive, accurate and generalizable method with the least false positive.

The impact of coinfection with human immunodeficiency virus and pulmonary tuberculosis on the success of bronchial artery embolisation

Pulmonary tuberculosis (PTB) is often associated with human immunodeficiency virus (HIV) in South Africa. Bronchial artery embolisation (BAE) is a specialised, expensive and risky procedure. The aim of this study was to investigate the impact of coinfection with HIV and PTB on the success of BAE. A retrospective cross-sectional study of sequential BAE procedures during 2006 and 2007 was performed. Rates of procedural and clinical outcome, reasons for failures and the impact of cluster of differentiation cell type 4 (CD4) level on failure were investigated. Patients were included if they presented with massive or life-threatening haemoptysis with a diagnosis of previous or active PTB and their HIV status was known, for the first two attempts at BAE only. The study population consisted of 74 patients who were HIV positive and 33 who were HIV negative. Statistically, procedural success did not imply a clinically successful outcome, and HIV status and CD4 level did not correlate significantly with procedural success. Statistically, no technical reason had an impact on the success of the procedure when correlated with HIV status. The detection of lymphadenopathy was noted in 19.1% of patients who were HIV positive and in 42.4% of patients who were HIV negative, and was the only feature of significance. Coinfection with HIV does not have an impact on the success of BAE in patients with active PTB or with the sequelae of PTB who present with massive or life-threatening haemoptysis. Technical success does not imply clinical success, regardless of HIV status. Improvement in technique locally may improve outcome. PTB coinfection with HIV should not affect the decision to consider BAE.

Nephrolithiasis as primary symptom in sarcoidosis

A 30-year-old black woman presented with a 1-year history of repeated episodes of worsening weight loss and fatigue. Physical examination showed no skin lesions and a chest roentgenogram was normal. Workup showed no obvious cause of recurrent renal stones. Finally, the detection of lymphadenopathy led to the diagnosis of extrapulmonary sarcoidosis. Up to 4% of all cases of sarcoidosis may present with urolithiasis only. Renal stones may be more common in severe cases of sarcoidosis, which affect blacks most frequently. Although not generally recommended for diagnostic purposes in sarcoidosis, in this case determination of the angiotensin-converting enzyme level was helpful in making the correct diagnosis. It is important that physicians are aware of the possibility that sarcoidosis may present as urolithiasis, even in the presence of a negative chest roentgenogram.

Interobserver variability in the detection of mediastinal and hilar lymph nodes on CT in children with suspected pulmonary tuberculosis

The presence of mediastinal or hilar adenopathy is critical for the diagnosis of pulmonary TB. Interobserver variability in the detection of lymphadenopathy on CT in children affects the usefulness of CT as a gold standard. To determine the interobserver variability for the detection of hilar and mediastinal adenopathy on CT in children. One hundred children with clinically suspected pulmonary TB were prospectively recruited for CT scanning of the chest. Four observers reviewed the scans independently for the presence of lymphadenopathy at predetermined sites. Overall Kappa statistic was determined for each recognised site of mediastinal and hilar lymphadenopathy. Kappa statistics showed that observers only agreed moderately in their detection of lymphadenopathy. The site of best agreement was the right hilum, followed by the subcarinal, right paratracheal and precarinal locations. Observers differed most at the anterior mediastinum and left hilum. The best Kappa statistic was for the overall presence of lymphadenopathy taking all sites into account. Imaging techniques that are considered the gold standard for particular diseases must be validated pathologically, and if this is not possible, interobserver variability should be evaluated. CT is considered the gold standard for detecting lymphadenopathy, but we have shown only moderate agreement between readers. Readers had difficulty in distinguishing lymphadenopathy from normal thymus and were unable to distinguish normal from pathological nodes without a predetermined size threshold for abnormality. The right hilum and the sites around the carina are the most reliable for the reported presence of lymphadenopathy.

Staging of Malignant Lymphoma with Three-Station black-Blood Fast Short-Inversion Time Inversion Recovery (STIR)

The purpose of this study was to assess the usefulness of three-station black-blood fast short-inversion time inversion recovery (STIR) imaging in detecting and staging malignant lymphoma. Seventeen patients with malignant lymphoma were examined with a 1.5T imager. The findings and stagings determined with three-station black-blood fast STIR imaging were compared with reference standards (e.g., computed tomography [CT] findings and clinical stagings). Three-station black-blood fast STIR imaging provided a fat-suppressed T2-weighted imaging contrast with fewer flow artifacts and revealed nodal involvement as well as bone marrow and spleen involvement to an extent comparable with CT. Especially notable was the excellent specificity (94%) of this imaging technique. Regarding disease staging, significant agreement was observed between clinical staging (k=0.60) and staging as evaluated by three-station black-blood fast STIR, although the detection of lymphadenopathy in the thorax was relatively poor. The average time required for this imaging was approximately 30 min. Three-station black-blood fast STIR MR imaging may be useful as a staging tool for malignant lymphoma because this imaging technique reveals lymphoma lesions, which determine the staging, without radiation exposure or the use of contrast agents.

Ability of Primary Care Physicians to Recognize Physical Findings Associated With HIV Infection

To assess the ability of primary care physicians to identify physical findings associated with human immunodeficiency virus (HIV) infection. Standardized patient examination. A total of 134 general internists and family practitioners were randomly selected after stratifying by year of medical school graduation, specialty, and experience caring for patients with HIV infection. Recognition of physical findings of Kaposi's sarcoma, oral hairy leukoplakia, and diffuse lymphadenopathy. Despite being directed by presenting histories to sites of prominent physical abnormalities, only 23 (25.8%) of 89 physicians evaluating a patient with Kaposi's sarcoma and 22 (22.7%) of 97 physicians evaluating a patient with oral hairy leukoplakia detected and correctly diagnosed the abnormalities. Twenty-three (17%) of 133 physicians detected diffuse lymphadenopathy in a patient complaining of fatigue, fever, and arthralgias. Physicians with the most experience treating patients with HIV infection more frequently identified oral hairy leukoplakia, but HIV experience did not influence identification of Kaposi's sarcoma or detection of lymphadenopathy. There were no differences between general internists and family practitioners or among physicians by year of medical school graduation in identifying the three physical findings associated with HIV infection. Primary care physicians may frequently miss important physical findings related to HIV infection during patient examinations.

Comparison of Transrectal Ultrasound and Magnetic Resonance Imaging in the Staging of Prostate Cancer

A group of 32 patients with a histological diagnosis of prostate cancer underwent transrectal ultrasound (TRUS) and magnetic resonance imaging (MRI) to stage the disease. TRUS was more sensitive in the detection of tumour and in the detection of direct extracapsular spread. MRI was more sensitive in the detection of tumour involvement of the seminal vesicles and bladder base. MRI allowed the detection of lymphadenopathy and bone metastases in the lumbosacral spine and pelvis. During MRI the short tau inversion recovery (STIR) sequence was found to be particularly useful for the detection of tumour spread. TRUS and MRI are complementary investigations and for the accurate staging of prostatic malignancy both investigations should be used.