Specificity Of Ultrasonography Research Articles

Clinical evaluation of the shape of the suprascapular notch--an ultrasonographic and computed tomography comparative study: Application to shoulder pain syndromes.

The most common site of suprascapular nerve compression and injury is the suprascapular notch. The aim of this study was to assess the sensitivity and specificity of sonography in determining the type of suprascapular notch (SSN). Thirty randomized patients (60 upper extremities) underwent USG examination of the shoulder area. The results were further compared with three-dimensional reconstructions of the scapulae obtained through CT examination to place the SSNs within a fivefold classification. For identification of type I, the sensitivity was 73.3% and the specificity 97.8%. For identification of type III, the values was 96.9% and 85.7%, respectively. Type II was not found in USG examination. Discrimination between type IV and V was not possible. The mean distance between the line connecting the edges of the SSN and the skin was 38 mm in right-handed patients and 34 mm in ambidextrous subjects. Ultrasonographic examination of the SSN is characterized by high specificity for type I, and high sensitivity for type III SSN. Discrimination between type IV and V of the SSN is not recommended based on sonographic evaluation.

Correlation between Clinical, Sonographic and Pathologic Findings of Patients Undergoing Appendectom

Introduction: Acute appendicitis is the most common cause of acute abdomen and is considered as a surgical emergency. Approximately, 10% of patients with acute appendicitis and delayed diagnosis can face many complications. This study was designed to examine the correlation between ultrasound and pathological findings in patients with appendicitis and aimed to determine the diagnostic levels of ultrasound in these patients. Methods: This study is a retrospective study conducted on 500 patients with clinical symptoms suggestive of appendicitis in 2010-2012 in the Ayatollah Kashani hospital. These patients have undergone appendectomy. Having collected clinical and ultrasound data and compared them with pathological results, the data were analyzed. Results: In this study, 56.3% of patients were male and 43.7% of them were female. The mean age of the study population was 24.8±14.1 years. In this study, the sensitivity of ultrasonography in the diagnosis of acute appendicitis was 83% and its specificity was 56%. The positive predictive value of ultrasound in this study was 89.2% and the negative predictive value was 42.6%. Conclusion: Based on these results and by comparing with those of other studies, the sensitivity and specificity of ultrasonography in the center is acceptable and is at the similar level to other centers. Besides, the accuracy of ultrasound in the negative cases is much more than the positive ones. Keywords: Appendicitis, Sonography, Pathology, Sensitivity, Specificity

A Set of Shear Wave Elastography Quantitative Parameters Combined with Ultrasound BI-RADS to Assess Benign and Malignant Breast Lesions

The goal of this study was to determine whether a combination of shear wave elastography (SWE) quantitative parameters could improve the accuracy of ultrasonography in the differentiation of benign and malignant breast lesions. Two hundred seventy-nine breast lesions in 251 women were evaluated with ultrasonography and SWE; pathologic results of all lesions were available. Each lesion was classified according to the Breast Imaging Reporting and Data System (BI-RADS) for ultrasound. SWE quantitative parameters, including maximum elastic value (Emax), mean elastic value (Emean), standard deviation (SD) and ratio of Emean of the lesion to Emean of the surrounding parenchyma (Eratio), were recorded. A receiver operating characteristic curve was used to determine their cutoff values. When any of the four parameters was equal to or higher than the cutoff value, the set of SWE parameters was counted as positive. When both BI-RADS and the set were positive, lesions were evaluated as positive for malignancy. We compared the performance of this combination with use of BI-RADS, Emax, Emean, SD or Eratio alone and also with the combination of BI-RADS and Emax for benign/malignant differentiation. The combination of Emax, Emean, SD, or Eratio with BI-RADS had a sensitivity, specificity, positive predictive value, negative predictive value, accuracy and Youden index of 0.967, 0.912, 0.908, 0.969, 0.938 and 0.879, respectively. The accuracy was the highest (p < 0.01) without loss of sensitivity. Combining a set of SWE quantitative parameters (Emax, Emean, SD and Eratio) could improve the accuracy of ultrasonography in differentiation of benign from malignant breast lesions, without loss of sensitivity.

Cryptorchidism and the value of ultrasonography.

The aim of this study was to evaluate the usefulness and accuracy of ultrasonography in investigating cryptorchidism. Case notes were reviewed of all children with cryptorchidism who had undergone ultrasonography for their testes between February and October 2010. Preoperative ultrasonography findings for presence or absence and position of testes were noted and compared with the operative findings. The sensitivity and specificity of ultrasonography were calculated. A total of 50 testes in 42 boys were examined by ultrasonography preoperatively during the study period. The median age was 6 years. All had single B-mode greyscale ultrasonography using greyscale and Doppler imaging. Of the 50 testes, 42 were visualised intracanalicularly or in the superficial inguinal pouch, 2 were intra-abdominal and 6 could not be detected. However, on examination under anaesthesia, 37 out of the 50 testes were palpable in the groin and 13 were impalpable. Two out of the remaining thirteen were found to be atrophic on diagnostic laparoscopy. The sensitivity and specificity of ultrasonography in determining the presence of testes was 85% and 25% respectively. Ultrasonography has low sensitivity and specificity in determining the presence of testes and localisation of their position. When performing an examination under anaesthesia and using a laparoscopic technique, ultrasonography is not recommended in cases of cryptorchidism.

Correlation of dental pulp stones, carotid artery and renal calcifications using digital panoramic radiography and ultrasonography.

Background:The human tissues continuously undergo modification as deposition of calcium (CA) salts either in an organized or disorganized pattern. The latter pattern usually occurs in the soft tissues such as in arteries, brain, kidneys, lungs, and dental pulp. The purpose of this study is to evaluate the presence of pulp calcification and carotid artery calcification (CDC) as a marker for renal calcification and altered serum biomarkers such as serum CA, phosphorus (P), and alkaline phosphatase (ALP).Materials and Methods:Digital panoramic radiographs of 50 patients with the presence of pulp stones and suspected CAC were subjected to carotid artery and renal ultrasonography (USG) examination for the presence of vascular calcification and also to evaluate the alterations in serum CA, P, and ALP levels. Data were analyzed statistically using Chi-square test.Results:Panoramic radiographs of 50 patients showed 88.28% of teeth with the presence of pulp stones stones and 91% carotid arteries with calcification. The sensitivity of panoramic radiograph was greater than that of USG (93.67%), but the specificity of USG was more than the panoramic radiograph (44.44%) in detecting CAC. The prevalence rate of renal calcification on USG was 92%. The statistical difference between the patients with or without alteration in serum Ca levels was not significant (χ2 = 0.581 and P = 0.446). On comparison of serum P and ALP, the difference was found to be statistically significant.Conclusion:Presence of pulp stones and CAC's on panoramic radiograph have remarkably proved to establish the chances of renal artery calcification associated with alterations in serum CA levels.

The role of ultrasonography in predicting vesicoureteral reflux.

To evaluate the accuracy of renal and bladder ultrasonography (RBU) in predicting vesicoureteral reflux (VUR) in infants and children. A total of 134 children who had VUR demonstrated on voiding cystourethrography (VCU) and also had RBU within 1 month of the VCU were included in the study, which took place between January 2005 and December 2012. VUR and hydronephrosis were graded with standard methods on VCU and RBU, respectively. Using VCU findings of reflux as the gold standard, diagnostic accuracy measures were performed for hydronephrosis and ureteral visualization on RBU, including sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Reflux grade was significantly associated with the degree of hydronephrosis (P = .0032). The sensitivity, negative predictive value, and accuracy of ultrasonography in predicting reflux was significantly higher for grade IV+ or grade V reflux compared with lower reflux grades. Also, the specificity of ultrasonography in predicting reflux was constant and at high level across all reflux grades, suggesting that ultrasonography is a good diagnostic screening tool. Normal RBU is rare with grade IV-V reflux, and moderate to severe hydronephrosis is rare with reflux grades <IV. RBU is a valid screening test for the selection of patients with a first urinary tract infection who should undergo VCU. Diagnosis of grade IV and V reflux will be delayed in very few cases, using a definition of abnormal RBU to include all degrees of hydronephrosis (Society for Fetal Urology classification).

Ultrasonographic Diagnosis of Suspected Hemopneumothorax in Trauma Patients

Background:Bleeding and trapped air in the pleural space are called hemothorax and pneumothorax, respectively. In cases where there are delays in diagnosis and treatment, the mortality rates due to hemopneumothorax can be significant. Hemopneumothorax is characterized by decreased lung sounds or chest percussion and subcutaneous emphysema. Diagnosis of pneumothorax and hemothorax can be achieved by portable chest X-ray (CXR), computed tomography (CT) scan, or ultrasonography. Portable CXR and CT-scans have their individual drawbacks. CXR creates a high percentage of false negative results, and a CT-scan is time consuming and less cost-effective; in addition, both modalities expose patients to radiation. Therefore, the introduction of ultrasonography as an easily available and highly accurate diagnostic modality has particular importance.Objectives:The aim of this study was to evaluate the sensitivity and specificity of ultrasonography in the diagnosis of pneumothorax and hemothorax in comparison with the other two methods, namely portable CXR and CT-scan.Patients and Methods:Patients (163) with multiple trauma who were suspected of having chest injuries, and who had indications for a chest CT-scan according to ATLS algorithms, were included in the study. All patients underwent portable CXR, CT-scan, and ultrasonography.Results:In total, 163 patients were included in this study; 29 patients had a pneumothorax, 24 patients had a hemothorax, and 23 patients had a hemopneumothorax confirmed. The study revealed that ultrasonography had a sensitivity of 96.15%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 98%, in the diagnosis of pneumothorax. The sensitivity for ultrasonography in the diagnosis of a hemothorax was 82.97%, with a specificity of 98.05%, a positive predictive value of 90%, and a negative predictive value of 92.66%. Portable CXR for pneumothorax detection had a sensitivity of 34.61%, a specificity of 97.95%, a positive predictive value of 90%, and a negative predictive value of 73.84%. In the detection of hemothorax, CXR had a sensitivity of 25.53%, a specificity of 95.14%, a positive predictive value of 70.58%, and a negative predictive value of 73.68%.Conclusions:Ultrasonography sensitivity and specificity for diagnosis of hemopneumothorax was high. The sensitivity of portable CXR was low despite its high specificity for the detection of hemothorax and pneumothorax.

Screening for asymptomatic carotid artery stenosis: a systematic review and meta-analysis for the U.S. Preventive Services Task Force.

Approximately 10% of ischemic strokes are caused by carotid artery stenosis (CAS). Estimated prevalence of asymptomatic CAS is 1%. To evaluate evidence on screening and treating asymptomatic adults for CAS. MEDLINE, the Cochrane Library, EMBASE, and trial registries through September 2013; MEDLINE through March 2014 for trials. Good- or fair-quality trials of screening, carotid endarterectomy (CEA), or stenting compared with medical therapy or of intensification of medical therapy; systematic reviews; multi-institution studies reporting harms; and externally validated risk-stratification tools. Dual extraction and quality assessment. No trials compared screening with no screening or stenting with medical therapy or assessed intensification of medical therapy, and no externally validated, reliable risk-stratification tools were found. Given the specificity of ultrasonography (range, 88% to 94% for CAS ≥ 50% to ≥ 70%), its use in low-prevalence populations would yield many false-positive results. Absolute reduction of nonperioperative strokes was 5.5% (95% CI, 3.9% to 7.0%; 3 trials; 5223 participants) over approximately 5 years for CEA compared with medical therapy. The 30-day rates of stroke or death after CEA in trials and cohort studies were 2.4% (CI, 1.7% to 3.1%; 6 trials; 3435 participants) and 3.3% (CI, 2.7% to 3.9%; 7 studies; 17474 participants), respectively. Other harms of interventions included myocardial infarction, nerve injury, and hematoma. Trials may have overestimated benefits and used highly selected surgeons. Medical therapy used in trials was outdated, and stroke rates have declined in recent decades. Harms may have been underreported. Current evidence does not establish incremental overall benefit of CEA, stenting, or intensification of medical therapy. Potential for overall benefit is limited by low prevalence and harms. Agency for Healthcare Research and Quality.

Efficiency of hysteroscopic visualization of bubaline uterus

Abattoir derived buffalo genitalia (n=98) were evaluated for uterine pathology employing palpable, ultrasonographic and hysteroscopic visualization. A high proportion (45.92%) of genitalia evidenced uterine pathology including endometritis (14.29%), pyometra (7.14%), hemorrhages in the endometrium (14.29%) and mucometra (6.12%). The sensitivity and specificity of hysteroscopy was 100% for endometritis and hemorrhages whereas for same conditions ultrasonography and palpation had low sensitivity and specificity. For pyometra and mucometra the sensitivity and specificity of ultrasonography and hysteroscopy was similar. It was concluded that for the diagnosis of minor pathological changes in the uterus such as endometritis and hemorrhages which can hamper fertility hysteroscopy is more efficient technique.

Evaluation of the breeding soundness of male camels (Camelus dromedarius) via clinical examination, semen analysis, ultrasonography and testicular biopsy: a summary of 80 clinical cases.

Male camel infertility is a heterogeneous disorder. A variety of factors may adversely affect sperm production and function and impair fertility. This study was designed to evaluate the sensitivity and specificity of ultrasonography and testicular biopsy in the evaluation of the breeding soundness of male dromedaries compared with results obtained by clinical examination and semen analysis. Eighty-four male dromedary camels (5-15years old) were used in this study during the rutting season (November-May). Four sexually mature male camels were used as controls. These animals were apparently healthy and had histories of normal fertility. Eighty infertile male camels were subjected to an algorithmic approach based on information collected during careful examinations of the camels' breeding histories, clinical examinations, testicular evaluations, testicular ultrasonographies, the results of the semen analyses and testicular biopsies to diagnose the camels' infertilities. The differences in the semen parameters between the control and infertile male camels were highly significant (p<0.01). Regarding the diagnoses of male camel infertility, the results of testicular ultrasonographies and biopsies were compared with those from the semen analyses, and the accuracies of these tests were 92.5% and 90%, respectively. Additionally, the results of the testicular ultrasonographies were matched with those of the testicular biopsies of the infertile animals, and this comparison resulted in 85% accuracy. Testicular biopsy is a promising method that, along with a carefully performed history, clinical examination, an appropriate testicular ultrasonography procedure and semen analysis, can afford veterinarians the opportunity for more precise diagnosis and treatment of many dromedary infertility disorders.

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.

Reliability of Ocular Ultrasonography Findings for Pre-surgical Evaluation in Various Vitreo-retinal Disorders

Objective: To find the reliability of ocular ultrasonography (USG) for pre-surgical evaluation in various vitreo-retinal conditions. Method: In a retrospective study, a chart review of patients who underwent preoperative USG for various vitreoretinal conditions was done. We correlated findings of preoperative USG with intraoperative findings. Results: 131 of 130 patients were included. Various ocular pathologies included trauma, diabetic vitreous hemorrhage, endophthalmitis, and other causes of vitreous hemorrhage. We found overall sensitivity and specificity of 92.31% and 98.31% for identification of rhegmatogenous retinal detachment, and 96.2% and 100% for posterior vitreous detachment, respectively, whereas it was 100% for vitreous hemorrhage, preretinal bleed, and vitreous exudates. In eyes with trauma, sensitivity and specificity of USG for identifying the status of retina was least (90.9% and 97.7%). Conclusion: Our study highlighted that the reliability of USG findings was least in cases of trauma, hence requiring special care while reporting.

Ovarian torsion: Case–control study comparing the sensitivity and specificity of ultrasonography and computed tomography for diagnosis in the emergency department

ObjectiveEvaluate the sensitivity and specificity of pelvic ultrasound (US) and abdominopelvic computed tomography (CT) for the identification of ovarian torsion in women presenting to the emergency department with acute lower abdominal or pelvic pain. Materials and methodsThis is a retrospective study of 20 cases of ovarian torsion and 20 control patients, all of whom had both US and CT performed in the emergency department. Two radiologists who were blinded to clinical data interpreted all studies as (1) demonstrating an abnormal ovary or not, and (2) suggestive of torsion or not. Sensitivity, specificity and interobserver variation were calculated for each imaging modality. ResultsPelvic US was interpreted as demonstrating an abnormal ovary in 90.0% of ovarian torsion cases by reader 1, and in 100.0% by reader 2, whereas CT was interpreted as revealing an abnormal ovary in 100.0% of torsion cases by both readers. Pelvic US for ovarian torsion was 80.0% sensitive (95% CI, 58.4–91.9%) and 95.0% specific (95% CI, 76.4–99.1%) for reader 1, while 80.0% sensitive (95% CI, 58.4–91.9%) and 85.0% specific (95% CI, 64.0–95.0%) for reader 2. Interobserver agreement for pelvic US was fair (Kappa=0.60). Abdominopelvic CT for ovarian torsion was 100.0% sensitive (95% CI, 83.9–100.0%) and 85.0% specific (95% CI, 64.0–94.5%) for reader 1, while 90.0% sensitive (95% CI, 69.9–97.2%) and 90.0% specific (95% CI, 69.9–97.2%) for reader 2. Interobserver agreement was excellent (Kappa=0.85). ConclusionThe diagnostic performance of CT is not shown to be significantly different from that of US in identifying ovarian torsion in this study. These results suggest that when CT demonstrates findings of ovarian torsion, the performance of another imaging exam (i.e. US) that delays therapy is unlikely to improve preoperative diagnostic yield.

A comparative study on the diagnostic utility of ultrasonography with conventional radiography and computed tomography scan in detection of zygomatic arch and mandibular fractures.

Objectives:The objective of the following study is to evaluate the usefulness of ultrasonography (USG) in comparison with conventional radiography and computed tomography (CT) scan in the diagnosis of zygomatic arch and mandibular fractures.Materials and Methods:A total of 40 patients with suspected fracture of the zygomatic arch and/or mandibular fractures were included in the study. Two groups (one for zygomatic arch fractures and the other for mandibular fractures) of 20 patients each were designed for the study. Ultrasonographic examinations were performed using small linear probe (LA435, Siemens Acuson Antares) with 10 MHz frequency. Data from CT and conventional radiography were compared with that of USG.Results:Sensitivity and specificity of USG in assessing zygomatic arch fractures were 100% and 100%, respectively; and that of mandibular fractures were 94.74% and 100%, respectively. Overall sensitivity, specificity, positive predictive value, and negative predictive value of USG against CT in diagnosing zygomatic arch and mandibular fractures were found out to be 97.4%, 100%, 100%, and 66.7%, respectively.Conclusion:USG is a very reliable tool in detection of fractures involving zygomatic arch and mandible. It can be used for screening of suspected fractures of zygomatic arch and mandible to avoid unnecessary radiation exposure from conventional radiography and CT scans.

Usefulness of ultrasonography in assessment of laryngeal carcinoma

To evaluate the usefulness of ultrasonography in assessing laryngeal cancer. 72 patients with laryngeal carcinoma proven by surgery and pathology were enrolled. The pre-therapeutic ultrasonography and CT images were retrospectively evaluated, including tumour detection, localisation and invasion of intra- and extralaryngeal structures. A comparative assessment was made between the detection rate, correspondence rate of localisation and sensitivity and specificity of ultrasonography and CT. The mobility of the larynx was observed on real-time ultrasonography and compared with laryngoscopy. The detection rate of ultrasonography [63 (87.5%)/72] was lower than that of CT [72 (100.0%)/72] (p=0.006). The primary foci were accurately located in 59 (93.7%) of 63 lesions using ultrasonography compared with 70 (97.2%) of 72 lesions using CT (p=0.392). In the evaluation of invasion, the sensitivity and specificity of ultrasonography were similar to that of CT in most of the intra- and extralaryngeal structures (p=0.059-1.000). A higher specificity was obtained during the assessment of the paraglottic space involvement when using ultrasonography than CT (94.9% vs 66.7%, p=0.001). For vocal cord fixation, no statistical difference was found between ultrasonography and laryngoscopy (p=0.223). Ultrasonography could be used as a valuable supplementary imaging method to CT and laryngoscopy in the assessment of laryngeal carcinoma, even in male adults with some calcifications of the thyroid cartilage. Our study demonstrates that ultrasonography, which has been used scarcely in the larynx, could supply useful information on the detection, localisation and intra- and extralaryngeal invasion of laryngeal carcinoma.

Comparison of Breast Cancer Screening Results in Korean Middle-Aged Women: A Hospital-based Prospective Cohort Study

ObjectivesThe aim of this hospital-based prospective study was to evaluate the diagnostic ability of breast cancer screening in Korean middle-aged women using age, ultrasonography, mammography, and magnification mammography, which are commonly used in most hospitals. MethodsA total of 21 patents were examined using ultrasonography, mammography, and magnification mammography, and their data were prospectively analyzed from August 2011 to March 2013. All patients were divided into benign and malignant groups and the screening results were classified using the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS). The final pathology report was used as the reference standard and the sensitivity and specificity of ultrasonography, mammography, and magnification mammography were evaluated using receiver-operating characteristics (ROC) analysis. ResultsThe analysis included 21 patients who underwent biopsy. Among them, three (14.3%) were positive and 18 (85.7%) negative for breast cancer. The average age was 50.5 years (range = 38–61 years). The sensitivity was the same for ultrasonography and magnification mammography and the specificity of magnification mammography was higher than that of ultrasonography. The highest area under the ROC curve (AUC) was observed in the combination of age and magnification mammography (1.000) and the decreasing order of AUC in others was magnification mammography (0.833), ultrasonography (0.787), mammography (0.667), and age (0.648). ConclusionsIn Korean women, the diagnostic accuracy of magnification mammography was better than that of ultrasonography and mammography. The combination of age and magnification mammography increased the sensitivity and diagnostic accuracy.

Diagnostic significance of ultrasonography in investigations of swellings of head and neck region – A clinico-imaging study

ObjectivesA study was conducted with an aim to evaluate the reliability, diagnostic efficacy of ultrasonography in head and neck swelling and familiarize with the clinical application of ultrasonography as an investigative modality for diagnosis of head and neck swellings. Methodology90 randomly selected volunteering patients with obvious head and neck swellings of both gender and any age group who reported to the Dept. of Oral Medicine and Radiology, A.B. Shetty Memorial Institute of Dental Sciences, Deralakatte were included in the study. After a clinical diagnosis, they were subjected to ultrasonographic investigation and a diagnosis was arrived at. These findings were compared with final diagnosis. The data obtained were statistically analysed using sensitivity and specificity tests. ResultsThe sensitivity and specificity of ultrasonography in inflammatory swellings was 96.5%. For cystic, swellings of muscular origin, lymph node swellings and malignant neoplasms it was 100%. In addition, for benign neoplasms it was 92.86%. ConclusionUltrasonography is a valuable and accurate diagnostic tool in diagnosis of head and neck swellings. Even though ultrasonographic pictures were consistent and are, reliable they should be used only as an added informative investigation tool in diagnosing benign neoplasms, malignant neoplasms and swellings of lymph node origin.

Possibilities and limits of modern metods of diagnosis of distant metastases locallyadvanced cervical cancer

A retrospective study of 245 cases of recurrent cervical cancer, in every third case was detected metastases in paraaortic lymph nodes. Given these results, a prospective study aimed at optimizing the staging of cervical cancer Ib1–IIIb stages. Analyzed 48 clinical cases of patients with locally - common forms of cervical cancer, which before the combined treatment paraaortic lymphadenectomy was performed through laparoscopy with subsequent histological examination of surgical specimens. At the preoperative stage, to identify distant metastasis in para-aortic lymph nodes, patients were examined by various methods of radiation diagnosis. The sensitivity of MRI was 75 %, specificity 79 %, sensitivity and specificity of ultrasonography – 75 % and 93 %, respectively. The positive predictive value of the test was 25 % MRI, ultrasound – 50 %. Performing paraaortic lymphadenectomy with the greatest possible to individualize treatment policy and, as a consequence, to improve the results of combined treatment of patients with locally-common forms of cervical cancer. The use of laparoscopic approach, given the short period of rehabilitation, has not led to the postponement of chemoradiotherapy.

Estimation of age by ultrasonography of radius and ulna

Background Age estimation is very important task for the forensic practitioner in criminal and civil cases. X-rays of different joint to see the ossification centers is routinely used, to assess the age and at the same patient exposes to radiation. On the other hand ultrasonography is scarcely used for this purpose and is radiation free. Keeping this in mind we undertook this study. Aims To compare the usefulness of ultrasonography and X-rays in estimation of age up to 18 years and to find the advantages and disadvantages of ultrasonography over X-rays in estimation of age. Methods 53 Children of the age, new born to the 18 years of both sexes, underwent X-rays and Ultrasonography of “distal end of radius and ulna, and proximal of end of radius”. X-rays was done in the anterior posterior view and, ultrasonography was done in sagittal and transverse view. Age was deduced separately by X-rays films and Ultrasonography. Observer was blind to the actual age of the subjects. Results We found, there was a “fair” degree of the agreement between X-rays and ultrasonography. Sensitivity and specificity of ultrasonography was 74.3% and 70% respectively. Both X-rays and ultrasonography showed excellent correlation. Conclusion We recommend ultrasonography can be used to estimate age without undue risk of radiations; however X-rays are still the conventional method for age estimation. By conducting more studies by ultrasonography on different ossification centers and on larger population, USG can be made a valid alternative of X-rays.

Sensitivity and Specificity of Ultrasonography in Predicting Etiology of Azoospermia

To determine the sensitivity and specificity of different ultrasound (US) modalities in predicting an obstructive vs a nonobstructive etiology of azoospermia. A total of 268 azoospermic men with available histopathologic slides were separated into obstructive (n = 104) and nonobstructive (n = 164) groups. Scrotal US studies, including color Doppler and transrectal US examinations, were performed in all patients and compared with the testicular biopsy results as the reference standard. We found that a decreased testicular volume and intra- and extratesticular varicocele were the most common abnormalities detected using scrotal US in those with nonobstructive azoospermia. In contrast, epididymitis, spermatocele, and duct ectasia were the most common findings in those with obstructive azoospermia. The sensitivity and specificity of scrotal US in detecting nonobstructive azoospermia was 75% and 72%, respectively, and for detecting obstructive azoospermia was 29.8% and 87%, respectively. Prostatic midline cysts, ejaculatory duct calcification, dilated seminal vesicle, and/or vassal ampullae were the most common abnormalities detected using transrectal US for obstructive azoospermia. The sensitivity and specificity of transrectal US in detecting obstructive etiology was 45% and 83%, respectively, and for functional etiology was 39% and 88%, respectively. Scrotal US was more sensitive in detecting functional azoospermia and more specific in detecting obstructive azoospermia. However, transrectal US was more sensitive in detecting obstructive azoospermia and more specific in detecting functional azoospermia. Both tests had greater specificity than sensitivity for obstructive azoospermia, indicating that US has the ability to exclude more than to diagnose cases of obstructive azoospermia. However, US is unlikely to completely replace testicular biopsy.