Introduction: Ophthalmic Ultrasound (USG) produces real time high resolution images of the eye and orbit. It can categorise, predict location and diagnose posterior segment pathology of the eye very well and is usually used in preoperative evaluation. However, the diagnostic accuracy, in terms of predicting probability of Posterior Segment Disease (PSD) post-USG, has usually not been studied, that too in Indian set-up. Hence, this study was conducted. Aim: To find out the prevalence and pattern of PSD among patients referred to radiology department using B-scan USG, and to find out the diagnostic accuracy of B-scan USG in such cases. Materials and Methods: The study was cross-sectional in nature conducted over a period of two years (2007-09) and conducted in the Department of Radiodiagnosis and Ophthalmology of a tertiary care centre of Eastern India. Patients were referred to the Radiology department for ruling out intraocular pathology using B-scan ophthalmic USG were included in the study, irrespective of any age and gender. Data were captured on an excel sheet and analysed using Stata 12.1. Prevalence and pattern of PSDs were established from the data while diagnostic accuracy was calculated in terms of sensitivity, specificity, predictive values and log Likelihood Ratios (LR). Accuracy of B-scan USG was also estimated and adjusted for verification bias. Results: The mean age of 84 study participants was 37.4±19.5 years, with maximum in between 41-50 years. Males predominated (72.6%). A 50% presented with low vision, and most commonly associated with cataract 45 cases (54%). Prevalence of posterior segment eye disorders was 13.1%. Adjusted sensitivity, adjusted specificity and Negative Predictive Values (NPV) were 100%. Positive Predictive Value (PPV) was 45.33%. Post-test probability was 46.6%, while after adjustment it was infinite. Adjusted accuracy was 100%. Conclusion: Prevalence of posterior segment eye disorders was 13.1% for cases referred to radiology department. The most common PSD that was found was retinal mass. Using B-scan USG for preoperative assessment and confirmation of diagnosis increases the probability of detecting presence or absence of posterior segment pathology. Absence of PSD using this is also very helpful in ruling out disease entirely. It also has a very high sensitivity and hence has a scope to be used even in rural health centres.
Background: Computed tomographic enterography (CTE) is a newer non-invasive modality having distinct advantages over conventional CT and capsule endoscopy. Objectives: This technique allows faster evaluation of small bowel diseases in the endoscopically inaccessible segments. Being an operator-independent procedure, CTE is widely available and allows a better depiction of extra enteric complications. The aim is to evaluate CTE features of various small bowel diseases and the role of 2% mannitol for adequate small bowel distension. Materials and methods: A cross-sectional study comprising 105 patients had presented with small bowel diseases. Patients in the age group of 10 to 85 years with complaints of fever, abdominal pain, nausea, vomiting, altered bowel habits, loss of appetite and loss of weight were included in this study. CTE images were analyzed to compare the diagnosis with the available histopathological and ultrasonography results. Results: Among the study population, the majority had presented CTE features such as symmetrical wall thickening (53.3%), peri-bowel inflammatory changes (61%), mucosal hyperenhancement (39%), and mural stratification, i.e., target sign (33.3%). The majority of diagnoses of CTE were ileocecal tuberculosis (11.5%), small bowel inflammation (7.6%), and Crohn’s disease (6.7%). Other conditions such as small bowel neoplastic masses, diverticula, ischemic bowel disease, bowel strictures, intussusception, and ulcerative colitis. Conclusion: CTE has the vital role of first-line modality in the work-up of suspected small intestinal diseases and helps evaluate disease activity before endoscopy, particularly in inaccessible segments. It allows a better depiction of extra enteric complications of the bowel.
Objective: The study's objective is to assess the technical and clinical results of the transjugular intrahepatic portosystemic shunt (TIPS) procedure carried out under additional transabdominal ultrasound guidance. Methods: We evaluated the radiation dosage for all TIPS performed with transabdominal ultrasound guidance for PV puncture over a four-year period (n=212, with 210 successfully completed and data available for 206); fluoroscopy time, dose area product (DAP), and skin dose were recorded. Results: The mean fluoroscopy time was 12 minutes and 9 seconds (SD, 14 minutes and 38 seconds), the mean DAP was 40.3 ± 73.1 Gy.cm2, and the mean skin dosage was 404.3 ± 464.8 mGy. Conclusion: Our findings show that ultrasound-guided PV puncture yields fluoroscopy times and radiation doses that are significantly lower than the sole published dose reference limits.
Introduction: Ophthalmic ultrasound (USG) produces real time high resolution images of the eye and orbit. It can categorize and predict the location of pathology in the posterior chamber of eye very well. It is useful even in pre-operative evaluation and diagnosing posterior segment eye disorders. However, the diagnostic accuracy has usually not being studied thoroughly, with special emphasis to its probability of predicting posterior-segment eye disorders using B-scan USG. Objectives: To find out the prevalence and pattern of posterior segment disorders using B-scan ultrasonography, and to find its diagnostic accuracy. Materials and Methods: The study was prospective in nature and conducted in the department of radiodiagnosis and ophthalmology of a tertiary care center of Eastern India. Patients referred to the radiology department for ruling out intra-ocular pathology using B-scan ophthalmic ultrasound were included in the study, irrespective of any age and gender. Data were captured on an excel sheet and analyzed using Stata 12.1 SE. Results: The mean age of 84 study participants was 37.4 ± 19.5 years, with maximum in between 40-50 years. Males were more (72.6%). 50% presented with low vision, and most commonly associated with cataract (45%). Prevalance of posterior segment eye disorders was 13.1%. Sensitivity and negative predictive values were 100%. Post-test probability was 95.5%. Accuracy was however very less (39.3%). Conclusion: Using B-scan ultrasonography for pre-operative assessment and confirmation of diagnosis increases the probability of detecting presence or absence of posterior segment pathology. Absence of posterior segment disorder using this is also very helpful in ruling out disease entirely. It also a very high sensitivity and hence can be used even in rural health centers.
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