Radiology Commons^™

Accreditation Of Healthcare Facilities: A Friend Or Foe?, Maseeh Uz Zaman, Nosheen Fatima

Department of Radiology

No abstract provided.

The Specificity And Sensitivity Of Ultrasonography In The Diagnosis Of Acute Right Lower Quadrant Pain In Women Of Child Bearing Age, Shumaila Arooj, Arfanul Haq, Zafar Amin

Department of Radiology

Abstract

OBJECTIVE:

To assess the sensitivity and specificity of ultrasonography in differentiating causes of acute right lower quadrant pain in women of child-bearing age by taking surgical outcome as the gold standard.

METHODS:

The descriptive analytical study was conducted at PNS Shifa Hospital, Karachi, from July to December 2008, and comprised female patients of child-bearing age who presented with acute right lower quadrant pain and underwent surgery after ultrasonography. SPSS 10 was used for statistical analysis.

RESULTS:

Of the 75 patients, 54(72%) patients were symptomatically and sonographically positive to have either acutely inflamed non-compressible appendix or focal fluid collection in …

Targeted Ultrasound Of An Indeterminate Breast Lesion On Mammography: When Does It Influence Management?, Saba Sohail, Imrana Masroor, Shaista Afzal

Department of Radiology

Objective: To determine the change over mammographic diagnosis, BI-RADS category and management following targeted ultrasound of an indeterminate lesion seen on mammography and associated factors, if any.
Study design: Descriptive, analytical study.
Place and duration of study: Radiology Department, The Aga Khan University Hospital and Clifton Medical Services, Karachi, from April 2010 to May 2011.
Methodology: Patients referred for targeted breast ultrasound following X-ray mammography were selected regardless of age. Targeted Ultrasound (TUS) was defined as a limited ultrasound of a specific lesion or breast part as indicated by the referring source. Comparison was made between the post mammography and …

Fortifying The External Peer Review: An Editorial Perspective, Saba Sohail

Department of Radiology

No abstract provided.

Diagnostic Performance Of Breast Mri In The Evaluation Of Contralateral Breast In Patients With Diagnosed Breast Cancer, Shaista Afzal Saeed, Imrana Masroor, Madiha Beg, Romana Idress

Department of Radiology

AIMS: The purpose of our study was to evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in the evaluation of contralateral breast in patients with diagnosed breast cancer. A secondary objective was to determine accuracy of breast MRI in diagnosing multi-focal and multicentric lesions in the ipsilateral breast.MATERIALS AND Methods: Using a non-probability convenience sampling technique, patients with histopathologically diagnosed breast cancer with MRI of breast performed to exclude additional lesions were included. MRI findings were correlated with histopathology. In addition, follow-up imaging with mammography and ultrasound was also assessed for establishing stability of negative findings and for …

Management Of Radioactive Spills In Nuclear Medicine; Teaching And Assessing With Objectively Structured Assessment Of Technical Skills, Riffat Parveen Hussain

Department of Radiology

Routine work in nuclear medicine requires the careful elution of radioactivity and its subsequent, storage and handling. Though all effort is maintained to prevent any "spill" of this radioactivity, accidents are bound to happen. The response to this spill is a methodically worked out a plan that is written and adopted as a "standard operating procedure." This protocol is taught to all involved in the area of working as a mock drill/apprenticeship model. No formal evaluation of learning is in place except for the mock drills. The objectively structured assessment of technical skills (OSATS) is a variation on the Objective …

Comparison Of Microcoils And Polyvinyl Alcohol Particles In Selective Microcatheter Angioembolization Of Non Variceal Acute Gastrointestinal Hemorrhage, Tanveer-Ul-Haq, Muhammad Idris, Basit Salam, Waseem Akhtar, Yasir Jamil

Department of Radiology

Objectives: To compare the efficacy of polyvinyl alcohol (PVA) particles with microcoils in angiembolisation of non variceal acute gastrointestinal haemorrhage.Methods: This is a retrospective cross-sectional study of patients who underwent transcatheter angioembolization from January, 1995 to December, 2013 at Aga Khan University Hospital, Karachi. Patients were divided into two groups on basis of use of either microcoils or PVA particles and compared in terms of technical success, clinical success, re-bleeding and ischemic complication rates. Chi (chi(2)) square and Fisher's exact tests were applied and a P-value of less than 0.05 was considered statistically significant.Results: Fifty seven patients underwent angioembolization. Microcoil …

Evaluation Of Common Risk Factors For Breast Carcinoma In Females: A Hospital Based Study In Karachi, Pakistan, Saira Naz, Imrana Masroor, Waseem Mirza, Sehrish Abrar, Shaista Afzal Saeed, Zafar Sajjad

Department of Radiology

Background: Breast malignancies are one of the leading causes of deaths in females worldwide. There are a number of risk factors associated with breast cancer but in Karachi Pakistan there are insufficient data available.
Materials and methods: A case control study was conducted on females in age group between 30-80 years. This study was accomplished by retrospective data collection in Aga Khan University Hospital Karachi, Pakistan. A total of 108 females with primary malignancy of breast were included along with 108 matched controls. Relationship of various factors with disease was studied using logistic regression to calculate odds ratios with 95 …

Evaluation Of Common Risk Factors For Breast Carcinoma In Females: A Hospital Based Study In Karachi, Pakistan, Saira Naz Sufian, Imrana Masroor, Waseem Mirza, Sehrish Butt, Shaista Afzal, Zafar Sajjad

Department of Radiology

Background: Breast malignancies are one of the leading causes of deaths in females worldwide. There are a number of risk factors associated with breast cancer but in Karachi Pakistan there are insufficient data available.
Materials and methods: A case control study was conducted on females in age group between 30-80 years. This study was accomplished by retrospective data collection in Aga Khan University Hospital Karachi, Pakistan. A total of 108 females with primary malignancy of breast were included along with 108 matched controls. Relationship of various factors with disease was studied using logistic regression to calculate odds ratios with 95 …

Fibrodysplasia Ossificans Progressiva Misdiagnosed As Cervical Exostosis, Muhammad Awais, Abdul Rehman, Noor Ul-Ain Baloch

Department of Radiology

No abstract provided.

Pseudo-Thyroid Lobe: A Diagnostic Conundrum Caused By Ossified Anterior Longitudinal Ligament On Bone Scan, Maseeh Uz Zaman, Nosheen Fatima, Zafar Sajjad, Unaiza Zaman, Areeba Zaman, Rabia Tahseen

Department of Radiology

Radionuclide bone imaging is one of the most commonly performed nuclear medicine procedure around the world and characterized by its high sensitivity and relatively low specificity. False positive findings on a bone scan are very common; however, dense uptake over unilateral ossified anterior longitudinal ligament appearing as single thyroid lobe on a bone scan has not been described in the literature.

Comparison Between Greulich-Pyle And Girdany-Golden Methods For Estimating Skeletal Age Of Children In Pakistan, Muhammad Awais, Naila Nadeem, Yousuf Husen, Abdul Rehman, Madiha Beg, Yasir Jamil Khattak

Department of Radiology

Objective: To compare Greulich-Pyle (GP) and Girdany-Golden (GG) methods for estimation of Skeletal Age (SA) in children referred to a tertiary care hospital in Karachi, Pakistan.STUDY Design: Cross-sectional study.PLACE AND DURATION OF STUDY: Department of Radiology, The Aga Khan University Hospital, Karachi, Pakistan, from July 2010 to June 2012.METHODOLOGY: Children up to the age of 18 years, who had undergone X-ray for the evaluation of trauma were included. Each X-ray was interpreted using both methods by two consultant paediatric radiologists having at least 10 years experience, who were blinded to the actual Chronologic Age (CA) of children.Results: A total of …

Magnetic Resonance Spectroscopy Of Enhancing Cerebral Lesions: Analysis Of 78 Histopathology Proven Cases, Muhammad Shahbaz Alam, Humera Ahsan, Zafar Sajjad, Madiha Beg, Umer Bhatti, Ather Enam, Mohammad Wasay

Department of Radiology

Objectives: To investigate the efficacy of magnetic resonance spectroscopy in differentiating various types of neoplastic and non-neoplastic enhancing cerebral lesions.
Methods: The prospective study was conducted from January 2007 to December 2009 at the Department of Radiology, Aga Khan University Hospital, Karachi. All patients with enhancing brain lesions on magnetic resonance imaging who underwent magnetic resonance spectroscopy and a biopsy with histopathological analysis were included in study. The lesions were categorised into neoplastic and non-neoplastic lesions on the basis of spectroscopy findings. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of magnetic resonance spectroscopy were calculated. …

Of Predatory Publishers And Spurious Impact Factors, Saba Sohail

Department of Radiology

No abstract provided.

Higher Event Rate In Patients With Known Cad Despite A Normal Myocardial Perfusion Scan, Maseeh Uz Zaman, Nosheen Fatima

Department of Radiology

Abstract

OBJECTIVE:

The negative predictive value of a normal single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is very high. However, prognostic implication of a normal SPECT MPI in patients with known coronary artery disease (CAD) is not clear. Objective of this study was to evaluate the cardiac event rate in patients with known CAD who had a normal stress SPECT MPI.

METHODS:

This prospective study accrued 428 consecutive patients with a history of CAD [revascularization or previous myocardial infarction (MI)] who had a normal stress (dynamic exercise or dipyridamole intervention) and rest Tc-99m-MIBI SPECT MPI. These patients were …

Correlations Of Skin Fold Thickness And Validation Of Prediction Equations Using Dexa As The Gold Standard For Estimation Of Body Fat Composition In Pakistani Children., Zainab Hussain, Tazeen H. Jafar, Maseeh Uz Zaman, Riffat Parveen Hussain

Department of Radiology

OBJECTIVE:

To determine the correlation between dual energy X-ray absorptiometry (DEXA) and skin fold thickness (SKF) equations for estimation of body fat (BF) composition in secondary school children and validation of prediction equations by Slaughter, Goran and Dezenberg.

DESIGN:

Cross sectional analytical study.

SETTING:

Joint Commission for International Accredited (JCIA) tertiary care hospital of Karachi, Pakistan from January 2010 to May 2010.

PARTICIPANTS:

The study was approved by the Hospital's ethical review committee. Written and verbal consents were obtained from principals of two schools and parents of 99 children (mean age of 14±1.89 years; min-max 9-19 years; 54 men and …

5-Fu Induced Acute Toxic Leukoencephalopathy: Early Recognition And Reversibility On Dwi-Mri, Shayan Sirat Maheen Anwar,, Fatima Mubarak, Zafar Sajjad, Muhammad Azeemuddin

Department of Radiology

Acute toxic leukoencephalopathy (ATL) is a rare adverse effect of 5-Fluorouracil (5-FU) chemotherapeutic agent. It is imperative for the radiologist to confidently identify the white matter changes caused by this agent in case of toxicity. This will help in early detection and appropriate management of patient, as the condition is reversible both clinically and on imaging. We report a case of a 29 years old gentleman, known case of carcinoma of esophagus who suffered from acute toxic leukoencephalopathy secondary to leukotoxic therapeutic agent 5-FU, and illustrate the reversible imaging findings of this condition on withdrawal of the inciting agent.

18fdg Synthesis And Supply: A Journey From Existing Centralized To Future Decentralized Models, Maseeh Uz Zaman, Nosheen Fatima, Zafar Sajjad, Unaiza Zaman, Rabia Tahseen, Areeba Zaman

Department of Radiology

Positron emission tomography (PET) as the functional component of current hybrid imaging (like PET/ CT or PET/MRI) seems to dominate the horizon of medical imaging in coming decades. 18Flourodeoxyglucose (18FDG) is the most commonly used probe in oncology and also in cardiology and neurology around the globe. However, the major capital cost and exorbitant running expenditure of low to medium energy cyclotrons (about 20 MeV) and radiochemistry units are the seminal reasons of low number of cyclotrons but mushroom growth pattern of PET scanners. This fact and longer half-life of 18F (110 minutes) have paved the path of a centralized …

Mdct Of Small Bowel Obstruction: How Reliable Are Oblique Reformatted Images In Localizing Point Of Transition?, Wasim Memon, Yasir Jamil Khattak, Tariq Alam, Luca Maria Sconfienza, Muhammad Awais, Shayan Sirat Maheen Anwar

Department of Radiology

The goal of this study is to prospectively assess the additional value of oblique reformatted images for localizing POT, having surgery as a reference standard. Materials and Methods. 102 consecutive patients with suspected small bowel obstruction (SBO) underwent 64-slice multidetector row CT (MDCT) using surgical findings as reference standard. Two independent GI radiologists reviewed the CT scans to localize the exact POT by evaluating axial images (data set A) followed by axial, coronal, and oblique MPR images. CT findings were compared to surgical findings in terms of diagnostic performance. McNemar's test was used to detect any statistical difference in POT …

Assessment Of Apparent Diffusion Coefficient Values As Predictor Of Aggressiveness In Peripheral Zone Prostate Cancer: Comparison With Gleason Score, Shayan Sirat Maheen Anwar, Zahid Anwar Khan, Rana Shoaib Hamid, Fahd Haroon, Raza Sayani, Madiha Beg, Yasir Jamil Khattak

Department of Radiology

Purpose. To determine association between apparent diffusion coefficient value on diffusion-weighted imaging and Gleason score in patients with prostate cancer. Methods. This retrospective case series was conducted at Radiology Department of Aga Khan University between June 2009 and June 2011. 28 patients with biopsy-proven prostate cancer were included who underwent ultrasound guided sextant prostate biopsy and MRI. MRI images were analyzed on diagnostic console and regions of interest were drawn. Data were entered and analyzed on SPSS 20.0. ADC values were compared with Gleason score using one-way ANOVA test. Results. In 28 patients, 168 quadrants were biopsied and 106 quadrants …

Knowledge, Attitudes And Practices Of Parents Regarding Antibiotic Use In Children, Saad Siddiqui, Mubeen Sultan Cheema, Romana Ayub, Noreen Shah, Ameer Hamza, Sheraz Hussain, Muhammad Hamza Khan, Syed Musa Raza

Department of Radiology

Background: Emerging resistance to antimicrobial chemotherapy is becoming a challenge for medicine in recent times. Un-prescribed use of antibiotics is a major contributor to development of this problem. In Pakistan access to antibiotics remains unchecked and hence results in it are over use. The aim of this study was to assess knowledge of parents regarding use of antibiotics, its associated problems, their source of information and their expectations from Paediatricians for prescription of anti-biotics.Methods: This is a questionnaire based cross sectional study conducted in Hayatabad town, District Peshawar. Parents who were consenting, had children aged between 0-16 years, and were …

Accuracy Of Magnetic Resonance Imaging In Pretreatment Lymph Node Assessment For Gynecological Malignancies, Saira Naz Sufian, Imrana Masroor, Waseem Mirza, Zainab Hussain, Saima Hafeez, Zafar Sajjad

Department of Radiology

Objective: To determine the accuracy of magnetic resonance imaging (MRI) in detection of metastasis in pelvic and para-aortic lymph nodes from different gynecological malignancies.MATERIALS AND Methods: This retrospective cross sectional analytic study was conducted at the Department of Diagnostic Radiology, Aga Khan University Hospital Karachi Pakistan from January 2011 to December 2012. A sample of 48 women, age range between 20-79 years, fulfilling inclusion criteria were included. All patients had histopathologically proven gynecological malignancies in the cervix, endometrium or ovary and presented for a pretreatment MRI to our radiology department.Results: MRI was 100% sensitive and had a 100% positive predictive …

Endovascular Embolisation Of Visceral Artery Pseudoaneurysms, Yasir Jamil Khattak, Tariq Alam, Rana Hamid Shoaib, Raza Sayani, Tanveer-Ul Haq, Muhammad Awais

Department of Radiology

Objective. To evaluate the technical success, safety, and outcome of endovascular embolization procedure in management of visceral artery pseudoaneurysms. Materials and Methods. 46 patients were treated for 53 visceral pseudoaneurysms at our institution. Preliminary diagnostic workup in all cases was performed by contrast enhanced abdominal CT scan and/or duplex ultrasound. In all patients, embolization was performed as per the standard departmental protocol. For data collection, medical records and radiology reports of all patients were retrospectively reviewed. Technical success, safety, and outcome of the procedure were analyzed. Results. Out of 46 patients, 13 were females and 33 were males. Mean patient …

Diagnostic Accuracy Of Ultrasonography In Differentiating Benign And Malignant Thyroid Nodules Using Fine Needle Aspiration Cytology As The Reference Standard, Tariq Alam, Yasir Jamil Khattak, Madiha Beg, Abdul Raouf, Muhammad Azeemuddin, Asif Alam Khan

Department of Radiology

Background: In Pakistan thyroid cancer is responsible for 1.2% cases of all malignant tumors. Ultrasonography (US) is helpful in detecting cancerous thyroid nodules on basis of different features like echogenicity, margins, microcalcifications, size, shape and abnormal neck lymph nodes. We therefore aimed to calculate diagnostic accuracy of ultrasound in detection of carcinoma in thyroid nodules taking fine needle aspiration cytology as the reference standard.MATERIALS AND Methods: A cross-sectional analytical study was designed to prospectively collect data from December 2010 till December 2012 from the Department of Radiology in Aga Khan University Hospital, Karachi, Pakistan. A total of 100 patients of …

Pancreatic Lymphangioma, Shaista Afzal, Imrana Masroor, Gulnaz Shafqat

Department of Radiology

Lymphangioma develops as a consequence of lymphatic malformation and blockage of lymphatic flow. Pancreatic lymphangioma is a rare benign tumour which can grow reasonably large prior to manifestation of symptoms. On imaging, it appears as a complex multiseptated cystic mass. However, this appearance is not diagnostic and overlaps with cystic pancreatic neoplasm. We present a case of pancreatic lymphangioma incidentally discovered in an elderly lady who was managed conservatively since surgery could not be performed as the patient was high risk for surgery. Imaging findings along with follow-up of the case and review of literature is presented.

Wandering Meckel's Diverticulum On 99m Technetium-Pertechnetate Scintigraphy: A Diagnostic Dilemma?, Maseeh Uz Zaman, Nosheen Fatima, Unaiza Zaman, Zafar Sajjad

Department of Radiology

Meckel's diverticulum (MD) is the most common gastrointestinal anomaly with heterotopic mucosa in 60% of cases. 99m technetium-pertechnetate scintigraphy is a sensitive tool for detection of MD containing heterotopic gastric mucosa. It is usually located in the right lower quadrant or umbilical region and less frequently in other quadrants. A mobile or wandering MD is a rare clinical presentation and may pose a diagnostic dilemma. However, presence of temporal correlation with gastric activity and compactness of focus during wandering period could make this riddle easy.

Outcome Of Radiologically Placed Tunneled Haemodialysis Catheters, Raza Sayani, Muhammad Anwar, Tanveer-Ul-Haq, Nauman Al-Qamari, Muhammad Asif Bilal

Department of Radiology

Objective: To study the outcome of radiologically placed double lumen tunneled haemodialysis catheters for the management of renal failure.STUDY Design: Case series.PLACE AND DURATION OF STUDY: Interventional Suite of Radiology Department at the Aga Khan University Hospital, Karachi, from April 2010 to June 2011.METHODOLOGY: All consecutive patients who were referred to the department of radiology by the nephrologists for double lumen tunneled haemodialysis catheter (Permacath) placement during the study period were included. Patients with septicemia, those for whom follow-up was not available, those coming for catheter exchange or who died due to a noncatheter related condition were excluded. A radio-opaque, …

Hirayama Disease, A Rare Cause Of Posture Related Cord Compression: A Case Report From Radiological Perspective, Shumaila Arooj, Fatima Mubarak, Muhammad Azeemuddin, Zafar Sajjad, Wasey Jilani

Department of Radiology

Hirayama Disease is a disease of young adults lying in the age group between twenty to thirty years. It is an extremely uncommon disorder. Its other synonyms are juvenile muscular atrophy of the distal upper extremity (JMADUE) or monomelic amyotrophy (MMA). A previously healthy 25-year-old man presented with gradually increasing weakness in both hands for the past few years. There was neither history of trauma nor family history of neuromuscular disease. MRI was advised. Routine cervical sagittal MR images (Non-flexion or extension) revealed cord flattening and atrophy at C5 to C7 levels.There was evidence of syrinx. Flexion MRI was performed …

An Unsuspected Bleeding Meckel's Diverticulum In An Adult Detected On Mesenteric Angiography, Muhammad Ali, Raza Sayani, Muhammad Azeemuddin, Tanveer-Ul-Haq, Rizwan Khan

Department of Radiology

Meckel's diverticulum is usually asymptomatic and found in almost 2% of the population. Haemorrhage from a Meckel's diverticulum is common in children but rare in adults. Here we report a case of 20 years old male with recurrent gastrointestinal bleeding. Meckel's diverticulum was diagnosed due to abnormal vascularity on mesenteric angiography and embolization was performed. Diagnosis was correlated with other radiological imaging and later elective resection was performed. This case is reported to emphasize the potential role of mesenteric angiography in the detection and management of bleeding Meckel's diverticulum and correlation with other radiological imaging.

Indigenously Developed Close Delivery System For Oral Iodine-131 Therapy: Nominal Cost But Phenomenal Protection., Imran A Shah

Department of Radiology

Abstract

BACKGROUND:

Administration of radiopharmaceuticals through intravenous and oral routes is the major source of radiation exposure to nuclear medicine (NM) technologists. Adopting new strategies to minimize radiation exposure is an important step toward safe practice in nuclear pharmacy.

MATERIALS AND METHODS:

We have indigenously developed a relatively close delivery system for oral administration of radioiodine-131 ((131)I) to minimize radiation exposure to the technologists.

RESULTS:

The efficacy of this indigenously developed close system was assessed upon 23 patients who were given (131)I therapies for benign (13 patients) and malignant thyroid disorders (10 patients). There was 64 ± 6% (P < 0.05) reduction in exposure rate using indigenously developed delivery system.

CONCLUSION: …

---

Go to article