Radiology Department Of Hospital Research Articles

Incidence of post ERCP biliary Ascariasis diagnosed on ultrasound

Ascaris lumbricoides are familiar with the roundworm that causes biliary infections in humans. Nevertheless, ascariasis is primarily found in the jejunum and transferred in numerous body parts with the intake of Ascaris lumbricoides present in food and water. These study methods were implemented at the Saidu Teaching Hospital Radiology department from December 2021 to January 2023. This study includes the participants suffering from biliary ascariasis admitted or visited Saidu Teaching hospital in that time frame. Clinical assessment of the participants was done based on the appearance of signs and symptoms present in them. The participant's laboratory test was done to determine the level of basic body parameters, after that ultrasonography was used to diagnose the presence and appearance of worms. Endoscopic retrograde cholangiopancreatography (ERCP) was used to extract worm from biliary channels, and the incidence of post-ERCP biliary ascariasis was accessed with ultrasonography. This study's results show the presence of numerous types of worms in biliary channels of patients. Also, the level of body parameters, for instance, neutrophil, hemoglobin, and others were compared at the time of admission, and at the time of discharge from the hospital. Furthermore, the incidence of post-ERCP biliary ascariasis was reported as 4% in females, and 1% in males respectively.

Elastofibroma Dorsi Detected Incidentally on Chest Computed Tomography: The Prevalence and Reporting Rate in Radiology Reports.

Background Elastofibroma dorsi (ED) is an uncommon benign connective-tissue tumor, usually seen in the subscapular region of women after the fifth decade. The study aimed to determine the prevalence, radiological characteristics, and the rates of mentionin the initial radiology reports of ED incidentally detected by chest computed tomography (CT) imaging in a large population. Methodology This study was conducted at Hitit University, Erol Olçok Training and Research Hospital Radiology Department in Çorum, Turkey. A total of 3,299 patients (1,554 females, 1,745 males)who underwent non-contrast chest CT for various reasons were included in this retrospective study. The presence, side, thickness, and density of ED were investigated in these patients. Differences in gender and laterality were assessed statistically. It was also reviewed whether it was stated in the initial radiology report or not. Results ED was detected in 79 (2.4%) of 3,299 patients, in 60 (75.9%) females and 19 (24.1%) males with a median age of 57.5 years (range, 18-99 years). The risk of ED presence was determined to be 3.65-fold in females than in males. In the cases determined with ED, the median age was 75 years (range, 53-96 years), and ED was not determined in any patient aged <50 years. A statistically significant correlation was determined between age and the presence of ED (p < 0.001). No statistically significant correlation was found between age and ED thickness or density (p = 0.602, p = 0.233, respectively). It was noted that none of the patients were diagnosed in the first radiological report. Conclusions ED can be easily overlooked on cross-sectional examinations because of the similar appearance and density to adjacent structures. Knowledge of the characteristic radiological features of these lesions and increased awareness of radiologists will make early diagnosis possible in asymptomatic cases.

Comparison Between Diagnostic Accuracy of MR Cerebral Perfusion and Histopathology for Diagnosing Low and HighGrade Gliomas

Background: Gliomas represent the most prevalent type of primary brain tumor and are associated with a significant mortality rate. The utilization of MR cerebral perfusion proves effective in distinguishing between low-grade and high-grade gliomas, surpassing the capabilities of routine MRI. This distinction allows for the timely initiation of surgical intervention. We aimed to document the diagnostic accuracy of MR cerebral perfusion against the gold standard of lab-based histopathology. Methods: We conducted this cross-sectional validation study over a duration of six months in the outpatient radiology department of a major public sector hospital of Rawalpindi, Pakistan. All patients had MR cerebral perfusion Scan of brain in order to differentiate low grade and high grade glioma. Quantitative rCBV analysis was carried out adopting a threshold value of 3, above this value the lesion was considered at a high grade. The results were written on specially designed proforma. Results: A total 230 patients were included in the study with mean age of 50.68+16.36 and there were 135 (58.7%) male and 95 (41.3%) were female. There were 122 (53.0%) patients presented with low grade glioma and 108 (47.0%) patients presented with high grade glioma. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of MR cerebral perfusion to differentiate between low grade and high grade gliomas was 85.71%, 70.97%, 88.89%, 64.71% and 81.74% respectively. Conclusion: This study concludes that the MR perfusion reliably identifies higher-grade features in a tumor that otherwise may not appear on standard MRI scan.

Image reject analysis and rejection causes in digital radiography at a university hospital through estimates of patient doses.

The introduction of digital radiography has improved image acquisition. However, rejection of images remains a matter of concern. Reject analysis is part of the quality assurance program in radiology and helps identify potential errors or lack of training. A retrospective study was conducted at the radiology department of a university hospital. The reject rate was calculated both using the number of examinations, $r_n$, and the dose-area product, $r_d$. A reject rate $r_n$ of 3.3% for paediatric units and 4.5% for adults was found. The corresponding values of rd were 4.4 and 8.4%, respectively. The main rejection cause was patient motion, being 50.2% of rejected examinations in adults and 63.7% in children. The contribution of exposure errors was minor, as expected in digital radiography units. A discrepancy between reject rates $r_n$ and $r_d$ was observed, suggesting dosimetric quantities could be considered in reject analysis for further assessment of patient radiation burden.

Audit of adequacy of the ultrasound reports in the patients of obstructive jaundice presented to tertiary care hospital radiology department

Audit of adequacy of the ultrasound reports in the patients of obstructive jaundice presented to tertiary care hospital radiology department

Direct hydrogen peroxide MRI fistulography versus indirect (intravenous) MRI fistulography in patients with perianal fistula

BackgroundPerianal fistula is a rather common disease; its symptoms range from mild to severe, impairing anal continence; accurate preoperative evaluation avoids recurrence following surgical procedures.Aim of workOur study examined the diagnostic accuracy of magnetic resonance imaging with direct percutaneous instillation of hydrogen peroxide mixed with gadolinium (direct fistulography) in comparison to intravenous gadolinium contrast-enhanced study (indirect fistulography).MethodsThis prospective study was conducted on patients referred to Airforce hospital radiology department and were diagnosed with perianal fistula, Direct and indirect MR fistulography were performed using a 1.5T MRI scanner. The type of fistulae, internal openings, secondary branches, and abscesses were compared to surgical findings.ResultsOur study included 35 male patients. Both direct and indirect methods detected primary tracts with 97.1% sensitivity and accuracy rates of 91.9% and 89.2%, respectively. The direct method was superior in detecting secondary branches and internal openings with accuracy rates of 97.37% and 93.3%, respectively, compared to 86.8% and 86.6% for the indirect method, while the indirect method was superior in detecting abscess collections with 100% accuracy rate compared to 89.2% accuracy rate for the direct method. None of the patients reported fever or bleeding after the procedure.ConclusionsBoth direct and indirect fistulography showed comparable abilities in detecting primary fistulous tracts. However, the direct fistulography was superior in detecting internal openings and secondary tracts particularly in chronic cases, whereas indirect Fistulography was superior in detecting abscess collections. Incorporating both methods into our routine could thus improve the efficacy of surgical procedures.

Inadvertent Discovery of Gerstmann's Syndrome During a Skull MRI and Its Anatomical Basis: A Case Report

A rare neurological disorder in which an individual is unable to perform tasks related to language, spatial recognition,mathematics, and cognition is known as Gerstmann's syndrome(GS). Gerstmann hypothesised that the four symptoms thatmakeup Gerstmann's syndrome are caused by a shared cognitive problem (Grundstörung). Gerstmann asserted that it is a bodyschema disorder that only affects the hand and fingers. Since then, the existence of a Grundstörung has been disputed. The studyproposed a shared psychoneurological element, but it should be connected to changes in mental pictures rather than the bodilyschema. The significant facts appear to be the common simultaneous impairment of writing, computation, and bodily awarenessafter left parietal lesion, beyond the diagnostic label of "pure" and "non-pure" Gerstamann's syndrome instances. Some functionaldomains can be linked to patients' symptoms despite being heterogeneous. A 65-year-old male was brought to the hospital witha history of injury to the head and complaints of confusion, speech difficulty, inability to perform simple calculations, severeheadache, and drowsiness. The patient was sent to the radiology department of Sree Balaji Medical College and Hospital,Chennai, for a Magnetic Resonance Imaging of Skull (MRI). The MRI study revealed chronic ischemic changes in periventricularand subcortical white matter in the parietal lobes. Certain ischemic changes were also observed in the frontal lobe, suggestingage-related changes and Gerstmann's syndrome. By cutting off various portions of the inferior parietal cortex, a lesion affectingsubcortical and subangular bundles of fibers affects many circuits with distinct roles. Therefore, the deficits seen in the patientare best explained by this anatomical explanation.

Lessons learned: audit of the record-keeping quality of a tertiary hospital’s mammography service

Breast cancer is the most common cancer worldwide. In diagnostic centers offering mammography, periodic audit of medical archived procedures is an important component of a quality assurance program; this ensures optimal follow-up of positive cases and establishment of measures to combat any deficiencies. The study aimed to audit the record-keeping of the mammography service in a tertiary institution, with a view to improving its efficiency. A retrospective audit of request forms, questionnaires, mammograms, and reports of 1,098 women who had mammography at the radiology department of a public tertiary hospital between 2011 and 2018. An internal audit of records evaluated the completeness of clinical information on the request forms, questionnaires, accuracy of diagnosis, and state of stored mammographic films, years later. Microsoft Excel and SPSS version 23 were used for the analysis of descriptive and inferential statistics, respectively. Two hundred and thirty (21%) and 791 (72%) women had screening and diagnostic mammography, respectively; their ages ranged from 31 to 85 years. Indication of study was not stated on 73 (7%) request forms and 281 (26%) request forms were improperly filled. There were 52 (4.7%) women not clerked with the questionnaire, while 158 (14%) had no clinical breast examination prior to imaging. One hundred and thirty (12%) mammograms were damaged, while 2 were missing and not reviewed. Our study revealed a significant lapse in quality of our mammography record archival system. Evidence obtained helped institute necessary measures in place for digitization and quality control of mammography services.

Radiographic assessment of sacral hiatus anatomy with backache.

To determine hiatal variations in cases of backache and controls on radiographs and association of age groups with hiatal parameters in patients with backache versus normal individuals. This case control study on 178 patients (89 cases and 89 controls), aged from 18-65 years, selected by non-probability convenience sampling was conducted at Radiology Department of PNS Shifa Hospital, Karachi over six months.The sacral hiatus was identified on lumbosacral spine radiographs. Both metric and non-metric parameters of hiatus with respect to sacral vertebra were noted and compared between the groups. Inverted "U" was the most common type observed in cases with base of hiatus at S5 level. Comparison of hiatal shape among different age groups showed inverted "U" and inverted "V" types among all age groups. Hiatal anteroposterior diameter and width were greatest in 36-45-year age group, and it was longest in 46-55-year age group. Determination of relationship between sacral hiatal parameters and incidence of low back pain showed positive association of inverted "U" and "M" shapes with back pain. Increased risk of back pain was observed with high apex (first sacral vertebra (S1)). Strong positive correlation was determined with inverted "U" and "M" shapes, and level of apex at S1 with low backache.

Preventing post-contrast acute kidney injury and hypersensitivity reactions: UK national audit

To audit UK radiology departmental protocols related to the prevention of Iodine-based contrast media (ICM) adverse drug reactions (ADRs) and to assess their compliance with the Royal College of Radiologists (RCR) endorsed Royal Australian and New Zealand College of Radiologists' 2018 Iodinated Contrast Guidelines. Questionnaires were sent to all UK acute National Health Service (NHS) providers treating adult patients with an audit lead registered with the RCR (162 providers encompassing 211 hospital radiology departments). The questionnaire included three main sections: renal function screening, renal protection regimens, and hypersensitivity reactions prevention and follow-up. Data collection was conducted between April and July 2022. Sixty-one per cent (129/211) of departments responded, representing 67% of eligible providers. An independent imaging services provider supplied one additional set of data (n=130 overall). Of the responding departments, for post-contrast acute kidney injury (PC-AKI), 41% and 56% had the recommended risk assessment for inpatients and outpatients, respectively. Renal function testing was often over-utilised, and their results were applied improperly. Sixty-eight per cent of departments used the advised threshold for considering renal protection. For hypersensitivity reactions, 9% of departments had the correct risk assessment. Thirty-six per cent of departments had the correct risk mitigation protocol for identified high-risk patients. The documentation and follow-up for hypersensitivity reactions were similarly inadequate. Local protocols on preventing ICM ADRs were largely non-compliant with RCR guidelines. Departments need to update their protocols in line with current evidence to avoid iatrogenic morbidity or unnecessary tests and over-precaution.

Evaluation of Cancer Risk Induced by Radiation Exposure from Normal Head CT Scans

Purpose: Radiology examinations are growing significantly every year. Analysis of the CT scan reports can highlight defects and is a good way to develop safety in healthcare. This study aimed to evaluate the rate of normal head Computed Tomography (CT) scans at a hospital radiology department in Shahroud and estimate the cancer risk associated with these normal CT scans.&#x0D; Materials and Methods: In total, the data of 400 patients referred to the emergency radiology center of Imam Hossein hospital in Shahroud from November 23 to December 10, 2021, were collected. CT scan reports were categorized into three groups according to the interpretation of the radiologist. The BEIR VII model was used to estimate the radiation cancer risk.&#x0D; Results: Among the 400 patients, 248 (62%) were males and the average age of the patients was 49.05 ± 22.60 years. CT scans in 270 (67.5%) cases were reported normal. The average age of the patients with normal, and abnormal CT scans were 41.86 ± 20.27, and 63.03 ± 20.27 years, respectively and the difference was significant (p-value &lt;0.001). The average effective dose was obtained 1.72±0.09, 1.31±0.11, and 0.87±0.09 mSv for different age groups of 1-5, 5-10, &gt;10-year-old. The average risks of all solid cancers were 7.82 cases per 100,000 patients, while the average risk of leukemia was 0.71 cases per 100,000 patients.&#x0D; Conclusion: A large percentage of CT examinations are normal in our country which leads to many public health issues in the future years. Therefore, efforts should be made to establish predictor clinical factors to reduce unnecessary radiology examinations.

STATUS OF TONGUE COATING AND PERCEIVED HALITOSIS AMONG THE PATIENTS SEEKING ORAL TREATMENT

Background: Tongue coating is accountable for various oral and systemic diseases. It is the prime cause of intraoral halitosis. Oral cleaning has primarily been focused on tooth cleaning, leaving the tongue neglected. Studies on tongue coating status have not been conducted in Nepal. Therefore, this study aimed to assess the tongue coating status and perceived halitosis among the patients seeking oral treatment in a tertiary care centre of Lalitpur, Nepal. Methods: A cross-sectional study was conducted among 392 randomly selected patients above 18 years of age attending the Oral Medicine and Radiology department of KIST Medical College and Teaching Hospital. Demographic details, tooth brushing, tongue cleaning, and tobacco consumption habits and self perception of halitosis were recorded. Amount of tongue coating and plaque was assessed using Winkel tongue coating index and Silness and Loe plaque index respectively. Results: The mean value of tongue coating was 5.06±3.35. Tongue cleaning was performed by 240(61.2%) participants and daily tongue cleaning was practiced by 142(36.2%) participants. Prevalence of oral malodor was 65.8%(n=258). Twenty three (5.9%) participants suffered from halitosis on a regular basis. Tongue coating was related with gender (p=.03) and tongue cleaning frequency (p=0.02). No relationship was observed between tongue coating and perceived halitosis. Conclusions: Mean value of tongue coating was lower but higher percentage of people suffered from halitosis. Halitosis reduction and other health benefits can be motivating factors for people to clean their tongue. Oral health professionals should raise the awareness of tongue cleaning among general population.

Equipment downtime in the radiology departments of three teaching hospitals in Ghana

IntroductionRadiology equipment requires routine maintenance to prevent equipment breakdown. Equipment breakdown can lead to adverse patient outcomes and lost revenue to hospitals. In Ghana, there is a mismatch between the available radiology equipment and requests which may result in frequent breakdown. Several studies have been conducted to investigate equipment downtime across radiology departments. However, there is none for Ghana. This study therefore investigated the downtimes of radiology equipment across three hospitals in Ghana. MethodThe study covered the period January–December 2020. An inventory sheet was used to collect data on equipment specifications, frequency of breakdown, downtimes, average daily patient throughput, the average cost of common examinations, the availability of post-installation training and maintenance contracts/agreements. ResultsThe study reviewed 32 items of radiology equipment. Radiology equipment across the hospitals broke down frequently and downtimes were very high. Radiographers/radiologists across the hospitals were provided with poor/inadequate post-installation training, and maintenance contracts/agreements were unavailable. The radiology equipment downtimes resulted in significant lost revenue of GH₵ 16,279,803 (US$ 1,968,537). ConclusionRadiology equipment across the hospitals broke down frequently and downtimes were lengthy leading to significant lost revenue for the hospitals. Post-installation trainings were poor/inadequate, spanning a few hours. Also, maintenance contracts/agreements were non-existent across the three hospitals. A nationwide study is needed to determine equipment downtimes and lost revenue across all radiology departments in Ghanaian hospitals, to better inform policy-making. Implications for practiceThis study may help hospital managers and other stakeholders involved in policy formulation and strategic planning, put measures in place to minimise radiology equipment breakdown in Ghana. The study may also help optimise radiology services and enable radiology departments to render uninterrupted clinical services to patients in Ghana.

Frequency of Breast Ultrasound Findings in patients presenting with Mastalgia

Aim: To determine the frequency of different Mastalgia findings on breast ultrasound. Methodology: This was a prospective, cross-sectional study, conducted at Radiology department of Shalamar Hospital, Lahore from 1st September 2021 to 29 February 2022. This study includes all patients having breast pain with at least one month of duration presenting to OPD or breast clinic of Shalamar Hospital. All patients were referred breast ultrasound after taking history and examination. The results of their breast ultrasound were recorded on Performa. Results: A total of 95 female patients of age above 18 years were included. Mean age of patients, was 35.4 ±10.7years. Mean duration of breast pain was 4.27±3.9 months. The ultrasound findings which showed benign pathologies include, Benign lesion 10(10.5%), Fibroadenoma 13(13.7 %), Simple cyst 8(8.4%), and Duct ectasia 7(7.4%). Abscess in the breast also diagnosed in 5(5.3%) patient. 52 (54.7%) females had normal breast ultrasound from which 37(71.2%) were with cyclic pain and 15(28.8%) were with non cyclic pain. Conclusion: Females presenting with complaint of breast pain have different ultrasound findings. In the majority of patient, there was no abnormality found (normal ultrasound). Ultrasound helps to determine the cause of breast pain so that in case of any disease, specific treatment or further investigation advised and normal report provides reassurance to the patients by reducing fear and anxiety. Key words: Breast ultrasound, Mastalgia, breast pain

The application value of deep learning image reconstruction on improving image quality and evaluating the Qanadli embolism index of dual low-dose CT pulmonary angiography

Objective: To compare the image quality and Qanadli embolism index between deep learning image reconstruction (DLR) and adaptive statistical iterative reconstruction-veo (ASiR-V) in dual low-dose CT pulmonary angiography (CTPA) with low contrast agent dose and low radiation dose. Methods: Eighty-eight patients who underwent dual low-dose CTPA in the radiology department of the affiliated hospital of Xuzhou Medical University from October 2020 to March 2021 were retrospectively analyzed, including 44 males and 44 females, aged from 11 to 87 years (61±15 years). The CTPA examination were performed using 80 kV tube voltage and 20 ml contrast agent. The raw data were reconstructed using standard kernel DLR high level (DL-H) and ASiR-V reconstruction, respectively. The patients were divided into standard kernel DL-H group (n=88, 33 cases of positive embolism) and ASiR-V group (n=88, 36 cases of positive embolism). The CT value, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), subjective image quality score, Qanadli embolism index, positive rate and positive Qanadli embolism index were compared between the two groups. Results: There were no statistically significant differences in CT values of the main pulmonary artery, the right pulmonary artery and the left pulmonary artery between the standard kernel DL-H group and ASiR-V group [(405.8±111.7) vs (404.0±112.0) HU, (412.9±113.1) vs (411.5±112.2) HU, (418.1±119.9) vs (415.4±118.0) HU, respectively;all P>0.05)]. The image noise of the main pulmonary artery, the right pulmonary artery and the left pulmonary artery in the standard kernel DL-H group was significantly lower than the ASiR-V group(16.6±4.7 vs 28.1±4.8, 18.3±6.1 vs 29.8±4.9, 17.6±5.6 vs 28.4±4.7, respectively;all P<0.001). The SNR and CNR of the main pulmonary artery, the right pulmonary artery and the left pulmonary artery in the standard kernel DL-H group were significantly higher than the ASiR-V group(SNR: 25.5±7.1 vs 14.5±3.9, 23.9±7.2 vs 13.9±3.4, 24.9±7.4 vs 14.8±4.1, CNR: 21.6±6.6 vs 12.3±3.9, 20.2±6.7 vs 11.8±3.4, 21.2±6.9 vs 12.6±4.1, respectively;all P<0.001). The subjective image quality score of the standard kernel DL-H group was significantly higher than the ASiR-V group (4.6 vs 3.8, P<0.001). There were no significant difference in the Qanadli embolism index, positive rate and positive Qanadli embolism index between the two groups (all P>0.05). Conclusion: Compared with ASiR-V reconstruction algorithms group, standard kernel DL-H reconstruction algorithms can significantly improve the image quality of dual low-dose CTPA.

Assessment of image rejection in digital radiography.

X-ray imaging uses ionizing radiation to generate diagnostic images. However, unnecessary radiation exposure can pose potential risks, including an increased risk of malignancy. One factor contributing to unnecessary radiation exposure is the rejection and retaking of X-ray images, which can lead to higher patient and occupational radiation doses. This study aimed to assess digital radiography rejection rates, causes of recurrence, and the most commonly repeated types of examinations. A cross-sectional online-based survey was conducted in 2022, involving 62 randomly selected radiographers in the UAE. The survey was distributed to radiographers through the head of radiology departments in various hospitals. Hospitals agreed to participate in the survey without disclosing their name. The data collected was analyzed using Excel. The study showed that 71% of radiographers working in the UAE hold a bachelor's degree. The examinations most frequently repeated were related to anatomical areas, with the spine accounting for 37.7% and facial bone for 19.7% of cases. The factors influencing repetition were primarily related to positioning (48.4%) and artifacts (21%), with the motion being the main cause of artifacts, including voluntary and involuntary movements. This study concluded that the most prevalent cause of repeating and retaking images is positioning, followed by artifacts. Furthermore, night shifts and workload impact radiographer performance, increasing the likelihood of picture retakes. The average number of rejects and repeated images has been reduced as new generations and modern equipment have been introduced, which also helped decrease the numbers.

Abstract #1412895: Comparison of Radiological Features of ATA and TIRAD System of Evaluating Thyroid Nodules - A Prospective Study in a Tertiary Care Hospital of Pakistan

The occurrence of thyroid carcinoma had ascended through recent years. Excessive detection of thyroid nodules due to intensified use of thyroid ultrasonography and also increased FNAB (fine- needle aspiration biopsy) procedures are believed to cause the surge in the diagnosis of incidental papillary thyroid carcinomas. There have been two guidelines most commonly used in both clinical practice and scientific area; American Thyroid Association (ATA-2015) guideline and ACR-TIRADS (American College of Radiology - Thyroid Imaging Reporting and Data System) guideline. These guidelines have been established based on sonographic topographies and aim to distinguish nodules according to their doubt of malignancy to give recommendations for FNAB or follow-up. This study aims to compare the radiological features of ATA and TIRADS system of evaluating thyroid nodules. This was a prospective study, enrolling 105 patients. The patients presenting to Radiology Department of the study hospital with neck swelling/nodules for Ultrasound Neck and Thyroid were requested to participate in study after providing the informed consent. The participants must be of 18 years of age or above, however the patients with a known diagnosis of thyroid cancer or having recurrence of prior thyroid cancer were excluded. Proforma was filled as per ATA & ACR TI-RADS classification system. A few patients were followed with FNAB and Histopathology reports. Of all the nodules, 30 (28.5%) were benign, whereas 75 (71.5%) were malignant. ATA guidelines showed improved diagnostic efficiency than ACR TI-RADS (P<0.01). ACR TI-RADS confirmed a higher specificity (P<0.05), whereas the ATA outline had a higher sensitivity (P<0.01). The ACR-TIRADS and ATA guidelines performed better in differentiating nodules >1 cm. Both systems revealed good diagnostic presentation, however, ATA guidelines resulted in a superior number of thyroid biopsies or FNABs. Therefore, we believed that ACR-TIRADS is a better system in this regard, it can help us ruling out unnecessary biopsies.

Patterns of Computed Tomography Urography Findings in a Tertiary Hospital in Rivers State: 2 Years Retrospective Study

Background: Computed tomography urography (CTU), is a radiological examination and has largely replaced traditional intravenous urography (IVU) as the gold standard in the imaging of the genitourinary tract, hence it is now used as a primary imaging technique to evaluate patients with diseases involving the urinary tract.&#x0D; Objective: The aim of this study is to ascertain and document the indications as well as possible findings on CTU carried out on various patients sent to the Radiology department of a tertiary hospital in our environment.&#x0D; Methods: A retrospective study and descriptive design was employed in this study. A total of 140 patient’s data was used. A P-value below 0.05 was considered statistically significant.&#x0D; Results: One-hundred and forty patients were studied over a 24months period. The commonest age range is 41 to 50 years and also with most abnormalities. It also showed that more males presented for CTU than females. The most frequent indication for CTU is flank pain (31.4%, n=44). The most common finding in this study is hydronephrosis (39.3%, n=55) and it showed significant association with age (P-value=0.036). Stone is the next common finding with the inferior pole (n=23, 48.9%) as the commonest site for stones. Few congenital anomalies were noted with kinked ureters (n=9, 50.0%) been the most common. Right sided renal cyst is more frequent that left (n=21, 44.7% vs n=20, 42.6%) and inferior pole is the most common location.&#x0D; Conclusion: CTU is the imaging modality of choice in evaluating the genitourinary system with the advantage of giving additional information about other abdominal structures. Flank pain is the most prevalent indication in this study. Hydronephrosis is the commonest finding with significant association with age.

Clinical and Radiological Correlation of Spinal Tuberculosis

Objective: The aim of this study is to establish a comprehensive understanding of the clinical and radiological features of spinal tuberculosis, and to evaluate their correlation in order to enhance diagnostic accuracy, management strategies, and patient outcomes. Study Design: This was a retrospective, observational, cross-sectional study. Place of Study: The research was conducted at the Department of Neuro-Sugery, Darul -Sehat Hospital and Neurology and Radiology Department of Creek General Hospital, both tertiary care hospital of Karachi. Duration of Study: Data were collected over a period of two years from January 2021 to December 2022. Methodology: A total of 120 patients diagnosed with spinal tuberculosis were included in this retrospective, observational, cross-sectional study.. Demographic data, clinical presentations, laboratory findings, and radiological findings were collected and analyzed. The radiological features were assessed using X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) scans. Statistical analysis was performed to identify correlations between clinical and radiological findings and their associations with patient outcomes. Results: The mean age of patients was 46.3 years, with a slight male predominance. The most common clinical manifestations were back pain (89.3%), neurological deficits (57.3%), and constitutional symptoms (45.3%). The thoracic spine was predominantly affected (61.3%), followed by the lumbar (28%) and cervical regions (10.7%). Radiological findings demonstrated vertebral destruction (90.7%), disc space narrowing (83.3%), paravertebral abscesses (76%), and epidural involvement (58%). A strong correlation was observed between the severity of clinical manifestations and the extent of radiological abnormalities. Patients with extensive vertebral destruction and spinal cord compression showed significantly higher rates of neurological deficits. Conclusion: This study highlights the crucial role of clinical and radiological correlation in the diagnosis and management of spinal tuberculosis. Early recognition of the disease, prompt initiation of appropriate treatment, and regular monitoring of clinical and radiological progress can significantly improve patient outcomes and reduce long-term complications. Keywords: spinal tuberculosis, clinical features, radiological features, correlation, diagnosis, management, prognosis.

CROSS SECTIONAL STUDY OF CORRELATION BETWEEN HRCT SEVERITY SCORE AND SPIROMETRY INDICES IN DIFFUSE PARENCHYMAL LUNG DISEASES.

Objectives: Ÿ To grade the severity of Diffuse Parenchymal Lung Diseases by HRCT and Correlate the HRCT Severity with Spirometry indices. Ÿ To predict the performance of carbon monoxide diffusion capacity (DLCO) for associated HRCT ndings in the detection of diffuse parenchymal lung diseases. Conclusion And Results A Cross sectional study was conducted at radiology department of tertiary healthcare hospital in Central India for 2 years study period in patients suffering from diffuse lung disease. The results are summarised below: Ÿ The highest frequency of age was 50-60 years (36.7%) followed by 60-70 years age (33.3%) and 40-50 years age (13.3%). Mean age was 57.83 year. Ÿ Maximum patients were male (70%). Ÿ Maximum patients had breathlessness (86.7%), cough (76.7%) and chest pain (56.7%). Ÿ Only few patients had fever (20%), history of smoking (30%), h/o infection (13.3%) and systemic disease (16.7%) Ÿ Maximum patients had UIP (46.7%) followed by NSIP (23.3%) and RB ILD (13.3%). Ÿ Mean FVC was 66.13 l, mean FEV1 was 56.47 %, mean FEV1/FVC was 0.81% and mean DLCO was 49.67 mL/min/mm Hg. Ÿ Maximum patients had restrictive (76.7%) followed by normal (20%) and obstructive (3.3%). Ÿ Normal interpretation (6) was seen in DSIP (1), SCLERODERMA-ILD (2) and UIP (3). Obstructive interpretation (1) was seen only in RB ILD (1). Restrictive interpretation was seen higher in NSIP (7), RB ILD (3) and UIP (11). Comparison between interpretation and diagnosis was showed statistically signicant results. Ÿ Total score was higher in restrictive (30.87) followed by obstructive (20) and normal (19.5). Comparison between interpretation and total score was showed statistically signicant results. Ÿ Comparison between interpretation and spirometry prole (every parameter) showed statistically signicant results. Ÿ Higher total score was showed in POST COVID FIBROSIS NSIP (36), SARCOIDOSIS (32), NSIP (31) and UIP (29.86). Comparison between interpretation and total score was showed statistically signicant results. INFERENCE: The patients included in the study were distinguished patients with diffuse parenchymal lung diseases from those with normal lungs, correlated closely with both 2D analysis and visual quantitation. This study shows that cough, restrictive, FVC, DLCO have statistically signicant correlation with total HRCT score in patients with diffuse parenchymal lung diseases. FCV correlated the best with HRCT. DLCO also showed correlation with HRCT in patients with diffuse parenchymal lung diseases.