Sixty-four-slice MDCT is highly accurate in diagnosing the point of transition of small bowel obstruction with an accuracy of 92%. It can be used as a localizing tool before surgery for small bowel obstruction.

ObjectivesTo evaluate (1) whether or not the addition of computer-assisted diagnosis (CAD) to 64-slice multidetector computed tomography (CT) can be used as a screening tool for detection of pulmonary nodules in routine CT chest examinations and (2) whether or not to advocate the incorporation of CAD as a screening tool into our daily practice.Materials and methodsA retrospective cross-sectional analysis of 109 consecutive patients who had all undergone routine contrast-enhanced CT chest examinations for indications other than lung cancer at the Radiology Department of Aga Khan University Hospital, Karachi, between November 2010 and January 2011. All examinations were evaluated in terms of the detection of pulmonary nodules by a consultant radiologist and CAD (ImageChecker CT Algorithm R2 Technology) software. The ability of CAD software to detect pulmonary nodules was evaluated against the reference standard. In addition, a chest radiologist also calculated the number of pulmonary nodules. The sensitivity and specificity of the CAD software were calculated against the reference standard by using a 2 × 2 table. The Mann–Whitney U test was applied to compare the performances of CAD and the radiologist.ResultsCAD detected 610 pulmonary nodules while the radiologist detected only 113. The reference standard declared 198 pulmonary nodules to be true nodules. CAD detected 95% of all true nodules (189/198), whereas the radiologist detected only 57% (113/198). In the detection of true pulmonary nodules, CAD had 98% sensitivity compared with the radiologist who had 57% sensitivity; the statistical difference between their performances had a P value <0.001.ConclusionConsidering the high sensitivity of CAD to detect nearly all true pulmonary nodules, we advocate its application as a screening tool in all CT chest examinations for the early detection of pulmonary nodules and lung carcinoma.

Intussusception is the most common abdominal emergency in early childhood, but it is rare entity in adults. Jejenoduodenogastric intussusception is an exceedingly rare retrograde small-bowel intussusception. Percutaneous endoscopic gastrostomy (PEG) has become the preferred procedure for establishing enteral feeding in most clinical situations. Despite the fact that it is relatively safe, a number of complications can occur following PEG placement; jejenoduodenogastric intussusception is one of them, but it is a very rare entity. Here, we report a case of jejenoduodenogastric intussusception secondary to placement of a PEG tube in an adult patient. To our knowledge, this is the third case of isolated duodenogastric intussusception being reported.

ObjectiveTo determine the diagnostic accuracy of liver ultrasound for the detection of hepatoma in chronic liver disease (CLD) patients by either taking histopathology or serum α-fetoprotein levels or a biphasic computed tomography (CT) scan (whichever is available) as the gold standard.Study designCross-sectional.Place and duration of studyRadiology Department, The Aga Khan University Hospital, Karachi, Pakistan, from January 2007 to January 2010.MethodsA total of 239 patients (156 males and 83 females) with clinical suspicion or surveillance of hepatoma in CLD referred to the radiology department for ultrasound evaluation followed by either liver biopsy and histopathology or serum α-fetoprotein level or biphasic CT scan.ResultsThe sensitivity of ultrasound for hepatoma detection in CLD was 65%, specificity was 85%, and accuracy was 70%, and positive predictive value and negative predictive value were 92% and 45%, respectively.ConclusionUltrasound is a relatively quick, safe, reasonably accurate, and noninvasive imaging modality for the detection of hepatoma in CLD and can be complemented with clinical assessment of screening high-risk patients.