Diagnostic Value Of Ultrasonography Research Articles

Diagnostic value of ultrasonography and magnetic resonance imaging in pregnant women at risk for placenta accreta

Objective: The purpose of this study was to evaluate whether ultrasonography and magnetic resonance imaging can detect placenta accreta reliably in at-risk patients.Patients and methods: Thirty-nine gravid women with abnormal placentation and previous uterine surgery were collected after meeting the inclusion criteria depending on gray scale sonographic findings which suggested placenta accreta. Ultrasonography (US) and resonance imaging (MRI) findings were classified as positive and negative according to presence or absence of imaging criteria of placenta accreta.Results: The surgical findings of our patients confirmed placenta accreta in 8/39 (20.5%) patients. According to gray scale and color Doppler US 11/39 (28.2%) patients were positive and 28/39 (71.8%) were negative for placenta accreta. According to MRI findings, 12/39 (30.7%) patients were positive for placenta accreta and 27/39 (69.3%) were negative. Sensitivity, specificity, positive predictive value, negative predictive value of US and MRI were 82.0%, 89.6%, 72.7%, 92.8% and 88.8%, 86.8%, 66.6%, 96.2%, respectively.Conclusion: US and MRI were useful in the diagnosis of placenta accreta with lacunae and an abnormal color Doppler imaging pattern are the most helpful findings. MRI is most clearly indicated when US findings are ambiguous or there is a posterior placenta.

Diagnostic Value of Ultrasonography in Patients Suspected Acute Appendicitis

Introduction: Appendectomy is one of the most frequently performed abdominal operations in surgical practice. Preoperative imaging has been demonstrated to improve diagnostic accuracy in appendicitis. Abdominal ultrasonography (US) is the most commonly and first-line imaging modality used for diagnosing acute appendicitis (AA).The aim of this study was to demonstrate the diagnostic value of abdominal ultrasonography for diagnosing acute appendicitis. Methods: In a retrospective study, we analyzed 200 consecutive patients with abdominal pain that undergoing appendectomy, from June 2009 to April 2012. Patient characteristics, preoperative ultrasonography (US) and laboratory assessment including WBC were collected. Final diagnosis of appendicitis was confirmed by histopathological examination. Results were compared with US. Results: Two hundred patients were admitted to this study that undergoing appendectomy. Mean age was 24 years (range: 1 to 91 years), and 57% were females. Patient White blood cell counts were found to be high in 78% while it was 86% for AA group and 64% for NA group (p < 0.05). One hundred sixty-six of these patients (83%) were diagnosed as acute appendicitis on pathology, and 34 (17%) were diagnosed differently. 157 of patients underwent US, eighty two of this patients diagnosed as acute appendicitis on US examinations and in 78 of them were also reported as acute appendicitis on histopathological examination. The sensitivity and specificity of abdominal US for diagnosing appendicitis were 70% and 90.2% respectively. Positive predictive value (PPV) was 93% and negative predictive value (NPV) was reported 62%. Conclusion: Ultrasonography has a high PPV and specificity, so as a diagnostic tool, positive US strongly suggests the diagnosis of AA. A low negative predictive value recommends that negative US is not sufficient to exclude the diagnosis of AA and patients could not be managed on an outpatient basis following a negative scan. Nepalese Journal of Radiology; Vol. 2; Issue 2; July-Dec. 2012; 13-19 DOI: http://dx.doi.org/10.3126/njr.v2i2.7680

Diagnostic Value of Ultrasound in Detection of Biliary Tract Complications After Liver Transplantation

BackgroundBiliary complications are significant source of morbidity after liver transplantation (LT). Cholangiography is the gold standard for diagnosis and specification of biliary complications.ObjectivesDetailed analyses of ultrasound (US) as a safe imaging method in this regard are still lacking. Therefore we analyzed systematically the diagnostic value of US in these patients.Patients and MethodsRetrospectively, 128 liver graft recipients and their clinical data were analyzed. All patients had a standardized US examination. The findings of US were compared to cholangiographic results in 42 patients. Following statistical analyses were performed: descriptive statistics, sensitivity, specificity, positive and negative predictive values (PPV, NPV).Results42 patients had 54 different biliary complications (Anastomotic stenosis (AS) n = 33, ischemic type biliary lesions (ITBL) n = 18 and leakage n = 3). US detected n = 22/42 (52%) patients with biliary complications. The sensitivity, specificity, PPV and NPV of US were: 61%, 100%, 100%, 79% (95CI, 36-86%) for ITBL and 24%, 100, 100%, 31% (95CI, 9-46 %) for AS, respectively.ConclusionsUS examination had no false positive rate. Therefore, it may be helpful as a first screening modality. But for the direct diagnosis of the biliary complication US is not sensitive enough.

Diagnostic value of abdominal ultrasonography in patients with blunt abdominal trauma

Background:Various investigative modalities are used to detect intra-abdominal injury requiring surgical intervention. Ultrasonography (US) is a cheap, readily available, safe and non-invasive investigation used in the evaluation of patients with blunt abdominal trauma. Patients are subjected to no added risk of radiation.Aims:The aim of this study was to evaluate the diagnostic value of US in patients with blunt abdominal trauma.Materials and Methods:Patients who had US for blunt abdominal trauma were prospectively evaluated from 1 January 2006 to 31 December 2007. A total of 57 patients were included is this study. US results in each patient were classified as true positive (TP), false positive (FP), false negative (FN) or true negative (TN) by comparing with findings at either diagnostic peritoneal lavage or surgery. Sensitivity, specificity, positive and negative predictive values (NPV) and diagnostic accuracy of US in detecting free fluid and in detecting the visceral parenchymal injury were calculated using two by two tables. The Epi Info statistical software version 3.4.1 was used for data analysis.Results:By scanning to detect free fluid, TPs were 46, FPs three, FNs two and TNs six. Sensitivity, specificity, positive and NPV and the diagnostic accuracy were 96%, 67%, 94%, 75% and 91% respectively. By scanning to detect the parenchymal injury, TPs were 24, FPs 15, FNs 10 and TNs 8. Sensitivity, specificity, positive and NPV and diagnostic accuracy were 71%, 35%, 62%, 44% and 56% respectively.Conclusion:US has a high diagnostic value in the screening of patients with blunt abdominal trauma. Scanning for the presence of free fluid yields better results than scanning for the visceral parenchymal injury.

Diagnostic Value of Ultrasonography in Pediatric Chest Diseases

Diagnostic Value of Ultrasonography in Pediatric Chest Diseases

The Diagnostic Value of Ultrasonography in Korean Carpal Tunnel Syndrome Patients

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. In most cases of CTS, characteristic clinical findings alone may be sufficient for diagnosis. Although the electrodiagnostic tests (EDT) have been reported to be high sensitivity and specificity, other studies noted a substantial false-positive and false-negative rate of 1020%. Since 1992, Buchberger et al. has been the first to quantify changes in CTS using ultrasonography (USG), many studies demonstrated a consistent and significantly increased median nerve cross-sectional area (CSA) in patients with CTS. The most frequently used criterion for USG study is at the level of carpal tunnel inlet, where the median nerve is identified most easily. However, the normal range and pathologic threshold of median nerve CSA vary widely between laboratories. The pathologic thresholds are ranging from 9 to 14 mm. The object of our study is to establish the clinical efficacy of USG in patients with CTS through reestablish the normal range and pathologic threshold of median nerve CSA at the level of carpal tunnel inlet in prospectively recruited patients with and without CTS; and also to correlate ultrasonographic measurements with electrophysiological measurements of CTS severity.

The diagnostic value of ultrasound for the residual gallbladder

Objective To explore the diagnostic value of ultrasonography for the residual gallbladder after cholecystectomy.Methods Application of the ultrasound diagnostic apparatus in cholecystectomy patients was to be screened to find the residual gallbladder.Results Ultrasound resuts showed 18 cases of residual gallbladder,which combined stones in 12 cases(66.7％ ),polyps in 1 case(5.6％ ) ;Atrophic cholecystitis,acute cholecystitis,postoperative residual gallbladder probability were high,accounting for 83.0％.Conclusion Ultrasound for the preoperative prevention and postoperative diagnosis of the residual gallbladder has better value,and the cholecystectomy patients should be routinely review the ultrasound. Key words: Cholecystectomy; Residual gallbladder

Mammography and ultrasonography evaluation of unexpected focal 18F-FDG uptakes in breast on PET/CT

Unexpected focal 18F-FDG breast uptakes are occasionally identified on PET/CT due to its increased use for cancer staging and follow-up. The need for their characterization has been suggested. To retrospectively evaluate the diagnostic value of ultrasonography (US) in distinguishing benign from malignant lesions for unexpected focal 18F-FDG uptakes in breast on PET/CT scans. Between April 2004 and January 2010, 27 focal 18F-FDG breast uptakes in 27 patients (age range 33-62 years; mean age 46 years) among 5214 patients who had undergone PET/CT scans were retrospectively analyzed. The American College of Radiology (ACR) Breast Imaging-Reporting and Data System (BI-RADS) final assessment categories of the US and the maximum standardized uptake values (SUVs) of the lesions were compared between the benign and malignant lesions. Of the 27 lesions, 15 (56%) lesions were malignant. The rate of malignancy, according to the final assessment category on the US, was 0% (0 of 6) for category 3, 60% for category 4 (9 of 15), and 100% (6 of 6) for category 5 (P = 0.001). The US evaluation revealed a sensitivity of 100% (15 of 15) and a specificity of 50% (6 of 12). The average maximum SUV of the malignant lesions was greater than that of the benign lesions (4.12 ± 1.94 vs. 1.94 ± 0.82; P = 0.001). US evaluation of unexpected focal 18F-FDG uptakes on PET/CT scans can accurately distinguish benign lesions from malignant lesions.

Diagnostic value of ultrasonography in evaluation and management of acute abdominal conditions in the paediatric age group

The aims of this study have been elaborated below: (1) to enumerate the common causes of acute abdominal emergencies by ultrasonography in paediatric patients; (2) to establish the diagnostic efficacy of ultrasonography in evaluation of acute abdominal conditions in children and to illustrate the associated ultrasonographic findings; (3) and, to discuss the role of ultrasonography in guiding the mode of intervention in these cases. This prospective study of ultrasonographic examination in 146 paediatric patients presenting with acute onset abdominal pain at the emergency/paediatric outpatient department section of Jawaharlal Nehru Medical College & Hospital, Aligarh, between June 2006 and December 2007, using 3.75 MHz and 8 MHz transducers of the ADARA (Siemens) machine. Common causes of acute abdominal emergencies in pediatric patients as noted on ultrasonography included nonspecific pain (28%), abdominal abscess (21%), acute appendicitis (7%) and intussusception (7%). Ultrasonography was diagnostic in 45.2% cases and supportive in 12.3% of the cases. As for as the final outcome, ultrasonography prevented surgery in almost 20% cases and laparotomy was avoided in 7% of the patients as ultrasound guided interventions in the form of abscess aspiration were carried out. Ultrasonography evaluation of children with acute abdominal pain, helps in making significant changes in the management plan of the patients, and also reveals various clinically unsuspected diseases.

The Diagnostic Value of Ultrasonography in Patients with Blunt Abdominal Trauma

Correspondence to/Yazisma Adresi: Yrd. Doc. Dr. Havva Sahin, Ankara Ataturk Training and Research Hospital, Bilkent Yolu No: 3, Bilkent 6510 Ankara, Turkey Phone: +90 312 291 25 00-3250 e.mail: havvasahin1973@yahoo.com 10.5152/jaem.2011.002 Havva Sahin1, Fatih Tanriverdi1, Neriman Defne Altintas2 1 Department of Emergency, Ankara Ataturk Training and Research Hospital, Ankara, Turkey 2 Department of Medical Intensive Care, Ankara Ataturk Training and Research Hospital, Ankara, Turkey

Ultrasonography findings and tumour quantification in patients with pseudomyxoma peritonei

Pseudomyxoma peritonei (PMP) is a disease with various clinical presentations and the diagnostic value of ultrasonography (US) is under investigated. The purpose of this study was to identify the most common US finding in PMP and to investigate US sensitivity, specificity, positive and negative predictive value in quantifying tumour burden in different abdomino-pelvic regions in PMP patients. Between February 2006 and December 2008, 54 patients were treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) due to PMP. The results from preoperative US examination with and without intravenously administrated contrast (SonoVue) were compared to surgical findings. The mean US peritoneal cancer index (PCI) was 6 (range 0-25) and the surgical PCI was 18 (range 3-27) p<0.0001. The histo-pathological subtypes did not influence the US findings. Ascites, bowel loops adhesions and omental cake were mostly visualised correctly by US. The sensitivity of US in quantification of tumour nodules was 91.5% (range 74-100%) and specificity was 33.8% (range 18-55%). The positive predictive value of US examination in PMP was 22% (range 11-44%) and the negative predictive value was 93% (range 77-100%). US can detect the most common PMP findings (ascites and omental cake). The sensitivity of US to quantify PMP tumour burden in different abdominio-pelvic region was relatively high, however, this imaging tool had low specificity.

FC7 Role of lymph-node ultrasonography (US) in the follow-up of melanoma patients to detect nodal recurrence after sentinel lymph node biopsy (SNLB): a prospective cohort study

Nodal recurrence occurs in ♯ 10% of pts after negative sentinel lymph node biopsy (SNLB), and best follow-up strategy after SNLB has not been established. We studied prospectively the diagnostic value of US, a technique that has been shown in pts without prior SNLB (but not after SNLB) to be more sensitive and specific than palpation to detect nodal recurrence after SNLB. Methods From 9/03 to 12/08, 1256 new melanoma pts from Paris university hospitals were entered prospectively into MelanCohort (33). SNLB procedures have been standardized among participating hospitals. Every clinical and paraclinical nodal examinations were recorded as normal, doubtful, or highly suggestive of recurrence. We analyzed follow-up records of all patients who had SNLB procedure until nodal recurrence or to the 1/11/09. Gold standard for nodal status was histology or uneventful follow-up. Results Follow-up visits were recorded for 80% of the 452 pts who had SNLB procedure (22% with nodal invasion). Average melanoma thickness was 2.7±2.7 mm; 34% were ulcerated. 61% of the pts had ≥1 nodal US during follow-up (mean 3.4±2.7/pt). Nodal recurrence occurred in 13% of the pts, synchronous of distant metastasis in 17% only. Using the criteria ‘highly suggestive of recurrence’, US detected nodal recurrence with 88% sensitivity, 96% specificity; and positive and negative likelihood ratio of 21, and 0.12, respectively. 23% of the pts with US had ≥1 doubtful US result, justifying a control (usually negative) within 1–2 m or cytology. The initial mode of discovery of nodal recurrence was the patient himself (17%), clinical (38%) or paraclinical (30%) exam, or not specified (15%). Pts followed with US had similar melanoma thickness, ulceration or SNLB invasion rate than those without US surveillance. Using a Cox model in pts with negative SNLB, overall survival was better for lower AJCC stages (P<0.0001) and marginally better when US was used during follow-up (P=0.1). Conclusion US detected 30% of nodal recurrences after SNLB. As surgery is indicated in most of these pts, this may translate into better pt survival. This study is not randomized. The impact of US on pt's anxiety was not analyzed.

Role of lymph-node ultrasonography (US) in the follow-up of melanoma patients to detect nodal recurrence after sentinel lymph node biopsy (SNLB): A prospective cohort study.

8576 Background: Nodal recurrence occurs in 10% of pts after negative sentinel lymph node biopsy (SNLB), and best follow-up strategy after SNLB has not been established. We studied prospectively the diagnostic value of US, a technique that has been shown in pts without SNLB to be more sensitive and specific than palpation, to detect nodal recurrence after SNLB. Methods: From 9/03 to 12/08, 1256 new melanoma pts from Paris university hospitals were entered prospectively into MelanCohort (33). SNLB procedures have been standardized among participating hospitals. Every clinical and paraclinical nodal examinations were recorded as normal, doubtful, or highly suggestive of recurrence. We analyzed follow-up records of all patients who had SNLB procedure until nodal recurrence or to 1/11/09. Gold standard for nodal status was histology or uneventful follow-up. Results: Follow-up visits were recorded for 80% of the 452 pts who had SNLB procedure (22% with nodal invasion). Average melanoma thickness was 2.7 ± 2.7 mm; 34% were ulcerated. 61% of the pts had ≥ 1 nodal US during follow-up (mean 3.4 ± 2.7/pt). Nodal recurrence occurred in 13% of the pts, synchronous of distant metastasis in 17% only. Using the criteria “highly suggestive of recurrence”, US detected nodal recurrence with 88% sensitivity, 96% specificity; and positive and negative likelihood ratio of 21, and 0.12, respectively. 23% of the pts with US had ≥ 1 doubtful US result, justifying a control (usually negative) within 1-2 m. or cytology. The initial mode of discovery of nodal recurrence was the patient himself (17%), clinical (38%) or paraclinical (30%) exam, or not specified (15%). Pts followed with US had similar melanoma thickness, ulceration or SNLB invasion rate than those without US surveillance. Using a Cox model in pts with negative SNLB, overall survival was better for lower AJCC stages (p < 0.0001) and marginally better when US was used during follow-up (p = 0.1). Conclusions: US detected 30% of nodal recurrences after SNLB. As surgery is indicated in most of these pts, US use may induce better pt survival. This study is not randomized. The impact of US on pt's anxiety was not analyzed. No significant financial relationships to disclose.

The Diagnostic Value of Ultrasonography in Patient with Complaint Related to Urinary System

The Diagnostic Value of Ultrasonography in Patient with Complaint Related to Urinary System

The Diagnostic Value of Ultrasonography in Patient with Complaint Related to Urinary System

The Diagnostic Value of Ultrasonography in Patient with Complaint Related to Urinary System

Diagnostic value of ultrasonography for detection of intestinal diseases

Diagnostic value of ultrasonography for detection of intestinal diseases

Sonographic diagnosis of peritoneal carcinomatosis from ovarian cancer

Objecttve To investigate the diagnostic value of ultrasound in evaluation of peritoneal carcinomatosis from ovarian cancer.Methods Twenty-seven patients with suspected ovarian cancer were preoperatively evaluated with abdominal and pelvic ultrasonograpy,the presence or abcence of peritoneal carcinomatosis were observed.Results All the cases were primary ovarian cancers confirmed by pathology.Among them,22 cases with peritoneal carcinomatosis.Of the 22 patients with peritoneal carcinomatosis,19were detected by ultrasound,the diagnostic rate of peritoneal carcinomatosis by ultrasoud was 86.4%.Sonographic appearances of peritoneal carcinomatosis included:Discrete,hypoechoic or isoechoic nodules on the surface of peritoneum(16 cases),thickened peritoneum demonstrated by gray-scale ultrasound(12 cases).Conclusions Ultrasonograpy has a high diagnostic rate for peritoneal carcinomatosis,sensitivity for peritoneal carcinomatosis are relevant to the size,location of the lesions,the presence or abcence of ascites,etc.Transvaginal sonography(TVS)is the good method for detecting pelvic peritoneal carcinomatosis. Key words: Ultrasonography; Ovarian neoplasms; Neoplasm seeding; Peritoneal neoplasms

Wrist Sonography Versus Electrophysiologic Studies in Diagnosis of Carpal Tunnel Syndrome

Objectives The carpal tunnel syndrome (CTS) is the most common entrapment neuropathy and is caused by the compression of median nerve at the wrist. Electrophysiologic studies are reliable diagnostic tests for CTS diagnosis. The objective of this study was to compare the diagnostic value of sonography and electrophysiologic studies in the diagnosis of CTS. Methods This cross-sectional study was conducted on 100 wrists of 50 consecutive patients referred to 22-Bahman Hospital with suspected diagnosis of CTS during 2007 to 2008. The patients suspicious for CTS were referred for electrophysiologic studies. Then immediately the patients underwent sonography of the median nerve. Results From the 100 wrists (50 patients) studied, CTS was diagnosed in 53 cases. Most of the cases were in females (91%) of them 90% were homemakers. The peak age distribution was in the range of 40 to 49 years. The chief complaint in all cases was pain and paresthesia. There was no predisposing factor for most cases; however, 6% were affected by diabetes, 6% by hypertriglyceridemia, and 2% by hypothyroidism. The Tinel test and Phalen test were positive in 31% and 33% of the cases, respectively, and 42% of the cases were positive for both or one of the Tinel and Phalen tests. Comparison of the ultrasonography and electrophysiologic findings showed a sensitivity of 90%, specificity of 74%, and accuracy of 83% for ultrasound in CTS diagnosis. Conclusions The study findings indicated an accuracy of 77% for clinical tests and 83% for sonography against electrophysiologic studies as the gold standard. Considering the acceptable sensitivity and specificity of ultrasonography, it can be recommended as a noninvasive method for diagnosis of CTS.

1212: Diagnostic Value of Ultrasonography for the Assessment of Nasal Fracture

1212: Diagnostic Value of Ultrasonography for the Assessment of Nasal Fracture

Diagnostic value of sonography, ultrasound-guided fine-needle aspiration cytology, and diffusion-weighted MRI in the characterization of cold thyroid nodules

Introduction The purpose of this prospective study was to assess the diagnostic value of different modalities for the characterization of cold thyroid nodules. Methods In 35 patients with cold nodules, thyroid carcinoma was suspected on scintigraphy. These patients were prospectively investigated with sonography, ultrasound-guided fine-needle aspiration (USgFNA), and quantitative diffusion-weighted imaging magnetic resonance imaging (DWI) (navigated echo-planar imaging; maximum b-value 800 s/mm 2) prior to surgery. The sonographic findings, USgFNA cytology, and the apparent diffusion coefficient (ADC) values of DWI were correlated with the postoperative histology of benign and malignant lesions. Statistical analysis was performed with the Kruskal-Wallis test and the Fisher's exact test. P < .05 denoted statistical significance. Results The accuracy of sonography and USgFNA was 64% and 68.8%, respectively. The sensitivity was 86.7% and 80%, respectively. Specificity was only 57.2% and 50%, respectively. The median ADC values for carcinoma and adenoma were 2.73 × 10 −3 mm 2/s and 1.93 × 10 −3 mm 2/s, respectively ( P < .001). There was no significant difference between the median ADC value for Hashimoto thyroiditis (3.46 × 10 −3 mm 2/s) and carcinoma. An ADC value of 2.25 × 10 −3 mm 2/s or higher was proven to be the cut-off value for differentiating between benign and malignant cold thyroid nodules, with an accuracy of 88%, a sensitivity of 85%, and a specificity of 100%. Conclusions These results show that quantitative DWI is a more reliable diagnostic method for differentiation between benign and malignant thyroid lesions than sonography or USgFNA. However, further studies including a larger study population are necessary to confirm our study results.