scholarly journals Role of Perfusion CT Differentiating Hemangiomas from Malignant Hepatic Lesions

2014 ◽  
Vol 4 ◽  
pp. 10 ◽  
Author(s):  
Jagjeet Singh ◽  
Sanjiv Sharma ◽  
Neeti Aggarwal ◽  
R G Sood ◽  
Shikha Sood ◽  
...  
Keyword(s):  
Predictive Value ◽  
Multidetector Ct ◽  
Ct Perfusion ◽  
Mean Transit Time ◽  
Liver Parenchyma ◽  
Study Data ◽  
Perfusion Ct ◽  
Hepatic Malignancy ◽  
Hepatic Lesions

Objective: The purpose of the study was to determine the role of computed tomography (CT) perfusion in differentiating hemangiomas from malignant hepatic lesions. Materials and Methods: This study was approved by the institutional review board. All the patients provided informed consent. CT perfusion was performed with 64 multidetector CT (MDCT) scanner on 45 patients including 27 cases of metastasis, 9 cases of hepatocellular carcinoma (HCC), and 9 cases of hemangiomas. A 14 cm span of the liver was covered during the perfusion study. Data was analyzed to calculate blood flow (BF), blood volume (BV), permeability surface area product (PS), mean transit time (MTT), hepatic arterial fraction (HAF), and induced residue fraction time of onset (IRFTO). CT perfusion parameters at the periphery of lesions and background liver parenchyma were compared. Results: Significant changes were observed in the perfusion parameters at the periphery of different lesions. Of all the perfusion parameters BF, HAF, and IRFTO showed most significant changes. In our study we found: BF of more than 400 ml/100 g/min at the periphery of the hemangiomas showed sensitivity of 88.9%, specificity of 83.3%, positive predictive value (PPV) of 57.1%, and negative predictive value (NPV) of 96.7% in differentiating hemangiomas from hepatic malignancy; HAF of more than 60% at the periphery of hemangiomas showed sensitivity of 77.8%, specificity of 86.1%, PPV of 58.3% and NPV of 93.9% in differentiating hemangiomas from hepatic malignancy; IRFTO of more than 3 s at the periphery of hemangiomas showed sensitivity of 77.8%, specificity of 86.1%, PPV of 58.3%, and NPV of 93.9% in differentiating hemangiomas from hepatic malignancy. Conclusion: Perfusion CT is a helpful tool in differentiating hemangiomas from hepatic malignancy by its ability to determine changes in perfusion parameters of the lesions.

scholarly journals The role of rebound tenderness in acute appendicitis and appendicular perforation

2017 ◽  
Vol 4 (2) ◽  
pp. 725
Author(s):  
Yashwant R. Lamture ◽  
Varsha P. Gajbhiye
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Study Data ◽  
Rebound Tenderness ◽  
Important Sign ◽  
Male Patients ◽  
Rule Out

Background: Acute appendicitis is the most common surgical emergency. Inspite of sophisticated new investigations mainstay of diagnosis depends on clinical sign and symptoms, rebound tenderness is very important sign with controversial views regarding it in available literature. Hence this study was undertaken to prove its efficacy of it related to rule out appendicular perforations.Methods: This study was conducted in 418 patients with 186 female and 251 male. Patients were of acute appendicitis operated for appendicectomy were included in the study. Data analysis was done by data statistic software.Results: The sensitivity and specificity of rebound tenderness to diagnose acute appendicitis is 65% and 73.6% respectively whereas the sensitivity and specificity of rebound tenderness to diagnose appendicular perforation was 94% and23.3% respectively with positive predictive value is 5 and negative predictive value is 99.Conclusions: Hence it indicates that rebound tenderness is very important to rule out complications like perforation or peritonitis and to support diagnosis of acute appendicitis. It has minimal significance to diagnose perforation of appendix as positive predictive value is less.

The Role of Musculoskeletal USG as Diagonostic Tool of CTS

2014 ◽  
Vol 25 (2) ◽  
pp. 44-49
Author(s):  
P Das ◽  
R Pramanik ◽  
M Kataruka ◽  
RN Haldar ◽  
S Samanta ◽  
...  
Keyword(s):  
Diagnostic Tool ◽  
Predictive Value ◽  
Low Cost ◽  
Large Population ◽  
Study Data ◽  
Cross Sectional ◽  
Non Invasive ◽  
Invasive Test ◽  
Kappa Value

Abstract Introduction Over the years NCS has been used to diagnose and monitor the patients with CTS though USG has several advantages as diagnostic tool. This study has been done to find out the diagnostic accuracy of USG in CTS and to compare the efficacy of USG with standard NCS in CTS. Prospective cross-sectional analytical study was conducted at Dept. of PM&R, IPGME&R, Kolkata from 1st March, 2012 to 31st August 2012 (6 months). Patient with clinical diagnosis of CTS of age >18 year of both sexes were included in this study and on the other hand patient with previous wrist surgery /injury, wrist deformity, diabetes mellitus, anatomical variants of median nerve on ultrasound were excluded from the study. Methodology After getting institutional ethical committee clearance, all patients who fulfil the above criteria were included in the study and further diagnostic conformation done by the standard diagnostic criteria of NCS. The same group of patients have been also screened by ultrasonography (USG). Results At the end of the study, data analysis showed that sensitivity and specificity were 92.3 and 70.0% respectively. Predictive value of +test, predictive value of -test were 88.9 and 77.8% respectively. Kappa value was 0.64 (between 0.5 and 0.7). It signifies that there is good correlation between NCS and USG as diagnostic tool of CTS. The comparison of the numerical values of median latency, amplitude and CSA USG within the groups with the help of ANOVA followed by Tukey's test showed that there was good correlation between latency and amplitude in mild, moderate, severe and profound CTS but unfortunately it was not correlated with the CSA measured by USG. Conclusion USG can be used for screening large population of patients as it is simple, easily available, non-invasive test and has relatively low cost and useful in evaluating and excluding local causes of nerve compression.

scholarly journals Role of FNAC in Hepatic lesions: Risk of track metastases

2015 ◽  
Vol 04 (01) ◽  
pp. 035-037 ◽  
Author(s):  
Challa Vasu Reddy ◽  
Y. G. Basavana Goud ◽  
R. Poornima ◽  
Vijayalakshmi Deshmane ◽  
B. A. Madhusudhana ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Value ◽  
Metastatic Breast ◽  
Needle Aspiration ◽  
Primary Hepatocellular Carcinoma ◽  
Advanced Malignancy ◽  
Needle Aspiration Cytology ◽  
Hepatic Lesions ◽  
Sensitivity Specificity

Abstract Background: Liver is one of the most common site of metastases in patients with malignancy and the evaluation of space occupying lesions (SOL) of liver in patients with malignancy is important. Its important to differentiate benign from malignant to take necessary decisions. Materials and Methods: We have performed a retrospective analysis of liver SOLs for which fine needle aspiration cytology (FNAC) was done in the year 2011. Risks and benefits associated with FNAC were evaluated. Results: We analyzed 755 patients who underwent FNAC of which 524 patients had secondary metastases to liver, 148 patients had primary hepatocellular carcinoma, 14 cases were benign neoplasms and 53 were nonneoplastic conditions. Histological correlation with FNAC was available in 112 patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 93%, 90.9%, 98.9%, 58.8%, and 92.8%, respectively. Though there were no incidence of bleeding, two patients developed track metastases following FNAC. One was a case of Hepatocellular carcinoma and the other a case of metastatic breast cancer. Conclusion: FNAC was very much useful in our setup where most of the patients could not afford for Computer tomography (CT) scan and was useful in counseling them especially in patients with advanced malignancy where no active cancer directed therapy is required.

“PERFUSION CT IN PREDICTING THE DEVELOPMENT OF PANCREATIC NECROSIS IN EARLY STAGE OF SEVERE ACUTE PANCREATITIS”

2021 ◽  
pp. 27-31
Author(s):  
Sayan Bhoumik ◽  
Alpana Manchanda ◽  
jyoti Kumar ◽  
Pawanindra Lal ◽  
Sushanto Neogi
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Perfusion Defect ◽  
Pancreatic Necrosis ◽  
Ct Perfusion ◽  
Early Stage ◽  
Perfusion Ct ◽  
Iodinated Contrast

PURPOSE: To evaluate the role of perfusion CT (PCT) scan in predicting the development of pancreatic necrosis (PN) in early stage of severe acute pancreatitis (SAP). MATERIALS AND METHODS: A total of 20 adult patients with a clinical diagnosis of SAP presenting within 72 hours of onset of symptoms with a positive SIRS criteria were included in the study. All the patients underwent PCT on a 128 slice MDCT scannerusing 40 ml of non-ionic iodinated contrast followed by post processing using vendor provided CT perfusion software whereby perfusion parameters were calculated. Perfusion defect (PD) was dened as pancreatic BF and/or BV qualitatively less than hepatic BF and/or BV respectively on the color coded maps. A follow up CECT abdomen was done after 2 weeks as a 'gold standard' to assess whether PN developed in the corresponding region of PD. RESULTS: 8 out of 20 patients developed perfusion defect (PD) on the PCT, of which 6 patients developed PN on the follow up scan. Patients who did not show any PD on the PCT (12 out of 20) did not develop necrosis on the follow up CECT. The sensitivity, specicity, PPV, NPV and accuracy of PCT in predicting necrosis was 100%, 85.71%, 75%, 100% and 90% respectively. The cut off values of pancreatic BF and BV in predicting the development of PN were 34.87 ml/100ml/min and 11.70ml/100ml respectively based on the ROC curve. CONCLUSION: PCT is a useful technique that can predict development of PN in the early stage of SAP so that early aggressive management can be initiated.

scholarly journals Diagnostic accuracy of perfusion-CT using Peak Enhancement Intensity (PEI) in detecting high grade pancreatic ductal adenocarcinoma keeping histopathology as gold standard.

2019 ◽  
Vol 26 (11) ◽  
pp. 1829-1834
Author(s):  
Abdul Raouf ◽  
Adeela Abid Bukhari ◽  
Natasha Arshad ◽  
Muhammad Ahsan
Keyword(s):  
Diagnostic Accuracy ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Predictive Value ◽  
Gold Standard ◽  
Ct Perfusion ◽  
Perfusion Ct ◽  
Ductal Adenocarcinoma ◽  
Correct Identification ◽  
High Grade ◽  
Ct Guided

Pancreatic ductal carcinoma is the most common primary malignancy of the pancreas and is associated with a very poor prognosis, being worldwide one of the leading cause of cancer related death. The pre-operative correct identification of this group of patients is very important to minimize unnecessary resections but remains difficult owing to the post-operative assessment of some factors such as tumor resection margins and grading. Perfusion CT (P-CT) is a new imaging technique able to provide qualitative and quantitative information on perfusion parameters of tissues, which have been demonstrated to be correlated with histological markers of angiogenesis. Objectives: To estimate the diagnostic accuracy of CT perfusion using PEI in detecting high grade pancreatic ductal adenocarcinoma keeping histopathology as gold standard. Study Design: Cross sectional study. Setting: Radiology department of Allied Hospital Faisalabad. Period: 6 months after approval from June, 2016 to Nov, 2016. Material and Methods: Permission for research was sought from hospital ethical committee. Patients were collected from OPD & indoor of Radiology and surgical department of Allied Hospital Faisalabad. Confounding variables were controlled by restriction (by excluding the subjects with history of metastatic disease or chemotherapy). CT-Perfusion examination was performed with the patient in supine position on a 128 slice Optima Multi detector CT scanner. Image guided (CT guided) biopsy was done on all patients and specimen was sent to the hospital pathology lab and histopathology was done by senior pathologist, who kept blinded to perfusion-CT analysis. Results: In this study, out of 100 cases, the diagnostic accuracy of CT perfusion using PEI in detecting high grade pancreatic ductal adenocarcinoma keeping histopathology as gold standard was recorded as 90.59%, 91.49%, 92.31%, 89.58% and 91% for sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate. Conclusion: We concluded that diagnostic accuracy of CT perfusion using PEI is higher in detection of high grade pancreatic ductal adenocarcinoma keeping histopathology as gold standard. 

scholarly journals Role Of Multidetector CT in Evaluation of Benign Focal Liver Lesions in a Tertiary Care Centre in North India

2020 ◽  
Vol 8 ◽  
Author(s):  
Tarun Narang ◽  
Shweta ◽  
Chiranjeev Gathwal ◽  
Shailley
Keyword(s):  
Multidetector Ct ◽  
Imaging Modality ◽  
Tertiary Care ◽  
North India ◽  
Radiology Department ◽  
Focal Liver Lesions ◽  
Benign Lesions ◽  
Simple Cyst ◽  
Hepatic Lesions

Introduction: Introduction of Multi Detector computed Tomography has been a huge leap in the CT technology. MDCT has a high diagnostic accuracy, sensitivity and specificity in the evaluation of focal and diffuse lesions of liver. The present study aimed to study the role of MDCT as a diagnostic modality for the benign lesions of liver. Material and methods: A prospective study of the role of MDCT in detecting and characterizing neoplastic hepatic lesions was conducted in the period in radiology department of RMCH, Bareilly. Thirty patients, with hepatic benign lesions, were selected. Diagnosis was confirmed by surgery and histopathology, follow up imaging and other non-radiological investigations. Results: Thirty patients were finally included as they were found to have benign lesions. Mean age of the patients was 49.8 years. 37% patients aged between 41 and 50 years while 17% patients were elderly. 63% were females. 63% patients had alcohol abuse while 60% were smokers. The most common presenting complaint was pain abdomen (n=15) followed by abdominal discomfort (n=13). Total of 29 lesions were identified on MDCT. The most common lesions were hemangioma (n=15)  followed by simple cyst (n=5). Conclusion: MDCT is “The Imaging Modality of choice” in characterizing benign hepatic lesions.

scholarly journals Dynamic CT perfusion for acute cerebral ischemia: increasing anatomical coverage with the “toggling table” technique

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 342-342
Author(s):  
Heidi C Roberts ◽  
William P Dillon ◽  
Jack W Tsao ◽  
Nancy J Fischbein ◽  
Wade S Smith
Keyword(s):  
Acute Stroke ◽  
Ct Perfusion ◽  
Mean Transit Time ◽  
Perfusion Ct ◽  
Dynamic Ct ◽  
Tissue Ischemia ◽  
Time To Peak ◽  
Acute Cerebral Ischemia ◽  
Perfusion Scan ◽  
Perfusion Assessment

P17 Computed tomography (CT) has experienced a revival for perfusion assessment in acute stroke. However, so far it is limited by its small anatomical coverage. We studied a toggling table approach to (multislice) dynamic perfusion CT for extended coverage in patients with suspected acute MCA ischemia. In 20 patients with suspected acute MCA ischemia, a dynamic CT perfusion scan was performed on a multidetector scanner. To increase anatomical coverage, 2 distinct “toggling” table positions (each consisting of two 1cm slices) were chosen to represent the MCA territory and scanned in an alternating fashion during the bolus injection of 40mL contrast agent. Dynamic images were evaluated on a ROI and pixel-by-pixel basis, estimating peak density change, time to peak (TTP), integral (rCBV), mean transit time (MTT), and flow (rCBF). Acutely acquired CT perfusion data were compared with follow-up CT or MR (perfusion and diffusion) images. With the toggling table approach, temporal resolution is reduced to approximately 5 secs. Four imaging slices at two distinct locations can be obtained, covering the MCA territory. In 15 patients, perfusion CT revealed focal abnormalities in at least one slice, most commonly on MTT maps. In 14 of these 15 patients, the area of perfusion abnormality was a good predictor of the ultimate infarct. A single table location approach would have underestimated or missed the involved tissue in most cases. In 5 of the 20 patients, perfusion maps failed to delineate any abnormality: in 4 cases, MRI confirmed the absence of ischemia, in 1 case, CT failed to reveal a small ischemic injury visible on diffusion MRI. Addition of the dynamic CT perfusion scan adds less than 5 minutes to a CT stroke protocol and can be coupled with CTA studies to image the cervical and cerebral vasculature in acute stroke. The dynamic CT perfusion technique is a practical and useful tool for the emergency assessment of acute stroke patients. By employing the toggling table approach, perfusion information can be obtained over an extended anatomic area and thus reveal the presence and the extent of presumed tissue ischemia.

scholarly journals Perfusion Computed Tomography Scan Imaging in Differentiation of Benign from Malignant Parotid Lesions

2019 ◽  
Vol 24 (02) ◽  
pp. e160-e169
Author(s):  
Masume Niazi ◽  
Maryam Mohammadzadeh ◽  
Kayvan Aghazadeh ◽  
Hashem Sharifian ◽  
Ebrahim Karimi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Parotid Gland ◽  
Malignant Tumors ◽  
Ct Perfusion ◽  
Mean Transit Time ◽  
Perfusion Ct ◽  
Perfusion Computed Tomography ◽  
Parotid Tumors ◽  
The Mean ◽  
Malignant Parotid Tumors

Abstract Introduction The most common site of salivary gland tumors is the parotid gland. Computed tomography (CT), magnetic resonance imaging (MRI), and sonography are imaging modalities to differentiate benign from malignant parotid tumors. Objective The aim of this study is the evaluation of the diagnostic value of perfusion CT for differentiating histological categorization of benign and malignant parotid tumors. Methods A total of 29 patients with parotid neoplasms were enrolled in this study. Mean age and all CT perfusion variables (gradient and permeability, blood flow [BF], blood volume [BV], mean transit time [MTT], permeability surface [PS], maximum intensity projection [MIP], time-density curve [TDC], and time to peak [TTP]) were compared among three groups (malignant tumors [MTs], Warthin's tumor [WT] and pleomorphic adenomas [PA]). Results The mean age of the patients was 55.9 ± 14.1 (26–77), and 15 of them were male (51.7%). Eleven lesions were PAs [37.9%], 8 lesions were WTs (27.6%0 and 10 lesions (34.5%) were MTs (6 acinic cell carcinomas [ACCs], 3 adenocystic carcinomas [AdCCs], and 1 mucoepidermoid carcinoma [MEC]). The mean age of the patients with WTs was 62 ± 7.5 years; 52 ± 14.2 for patients with Pas, and 55.2 ± 17.2 for those with MTs (p = 0.32). The mean MIP was 122.7 ± 12.2 in WT, while it was 80.5 ± 19.5 in PA, and 76.2 ± 27.1 in MTs (p < 0.001); The mean MIP for WT was higher than for PAs and MTs; the values of MTs and PAs were not statistically different. The average of BF, BV, and curve peak were higher in WTs in comparison with the other two groups, and curve time 2 and TTP were higher in PAs in comparison with MTs. Conclusion Based on this study, perfusion CT of the parotid gland and its parameters can distinguish between benign and malignant parotid masses.

Kebijakan Badan Narkotika Nasional Dalam Penanggulangan Narkoba Wilayah Perbatasan

2020 ◽  
Vol 3 (1) ◽  
pp. 20-31
Author(s):  
Novana Veronica Julenta Kareth ◽  
Reni Shintasari
Keyword(s):  
Central Government ◽  
Descriptive Analysis ◽  
Study Data ◽  
Eastern Region ◽  
Analysis Model ◽  
Literature Study ◽  
Qualitative Descriptive ◽  
Multi Stakeholder ◽  
Collection Methods

This paper aims to determine the policies implemented by the Papua National Narcotics Agency against drug trafficking. This article is a qualitative descriptive study. Data collection methods through interviews and literature study. Data analysis using descriptive analysis model. The results showed that the role of BNN Papua is very central in the eastern region and the Indonesian border. The policies that have been planned by BNN with multi-stakeholder have been implemented, but the new modes adopted by the international network vary. The drug subscription policy cannot be carried out by one institution only, it needs to be supported by other government agencies and the community. The need for a serious role for the regional and central government in both preventive efforts and subscription programs in synergy with the Papua Provincial BNN.

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