The classical pattern in HRCT of COVID-19 infected individuals is GGO that progressed into a consolidation with increasing severity of infection.• The most common distribution pattern of COVID-19 is bilateral involvement of lungs with multiple lesions in peripheral areas of both lungs.• Typical but less common findings are pleural effusion, reversed halo sign and lymph adenopathy.
Aim: In this study, we sought to examine the optimal cutoff values for predicting different stages of liver fibrosis, and to determine the level of agreement between shear wave elastography and aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4) scores in patients with chronic liver disease. Methodology: A descriptive, cross-sectional study was performed at the Radiology Department of Shaukat Khanum Memorial Hospital Lahore from 1 Jun 2019 until 1 June 2020. FIB-4 and APRI scores were determined by the following formula: FIB-4 = (age × AST) ÷ (platelet count × (√ (ALT)) and APRI = (AST÷AST upper limit of normal) ÷ platelet × 100. Data was analyzed with the help of SPSS version 24.0 and Microsoft Excel 2013. Results: Eighty individuals were conveniently selected, of which 62.5% were men and 37.5% were women. The mean age of the subjects was 43.47 SD ± 13.85 years. APRI and FIB-4 scores predicted F4 patients using the cutoff values of 0.47 (Sn. 72%, Sp. 70%) and 1.27 (Sn. 78%, Sp. 73%), respectively. The cutoff values of 0.46 for APRI and 1.27 for FIB-4 predicted F3–F4 patients (Sn. 74% and 77%; Sp. 76% and 76%), respectively. To predict F1–F4 compared to F0, the cutoff value was 0.34 (Sn. 68%, Sp. 75%) for APRI, while the cutoff value for FIB was 0.87 (Sn. 72%, Sp. 75%). The findings suggest that FIB-4 shows better diagnostic accuracy than APRI. Conclusion: This study provides optimal cutoff values for different groups of fibrosis patients for both serum markers. Also, the diagnostic accuracy of FIB-4 for predicting liver fibrosis was found to be superior to APRI in all disease stages.
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Background: The COW shows vast variations in different individuals. The aim of this study was to evaluate and describe the prevalence and patterns of arterial variants and the different morphological variations of the COW on MRA in adult Pakistanis. Aim: To find the different anatomical variations of Circle of Willis in adult patients on magnetic resonance angiography. Methodology: In this descriptive study a total of 90 patients with ages 20-90 years, were selected for the study between July 2021 till October 2021. The adult patients were referred for screening MRA brain in the Department of Radiology. The protocol selected to visualize the COW was 3D-TOF MRA. Results: Data analysis demonstrates that out of total 90 patients, 51(56.7%) were males and 39(43.3%) were females. Overall, 66(79.5%) circles were complete in anatomical configuration and 24(20.5) were incomplete. The anterior circle was complete in 73(81.1%) subjects and incomplete in 17(18.9%) subjects. The posterior circle was complete in 83(92.2%) subjects and incomplete in 7(7.8%) subjects.The most common variation of COW was hypoplasia/absence of segments of Circle of Willis. ACA was the most frequent segment of Circle of Willis that was hypoplastic/absent followed by A1 segment of right ACA is absent in 6(7.2%) subjects and A1segment of right ACA is hypoplastic in 6(7.2%) subjects. Conclusion: The study concludes that mostly the COW is complete in Pakistani adults. There are variations particularly in anterior part as compared to the posterior part of the COW. The most common variants are of A1 segment of Right ACA as compared to other type of variants. Keywords: Circle of Willis, 3D-TOF-MRA, Anterior circulation, Posterior circulation, Complete circle, Incomplete circle,
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