We aimed to examine a cohort of patients presenting with breast implant complications to establish the sensitivity and specificity of clinical examination, Ultrasound Scanning (US) and Magnetic Resonance Imaging (MRI) in the diagnosis of implant rupture, and to examine the correlation between US and MRI. We performed a 26-month retrospective review. Patients underwent US and MRI to exclude rupture. Results of US and MRI were compared prospectively for concordance, then retrospectively to clinical findings and surgical diagnosis. Thirty-four patients with 60 implants were reviewed. The sensitivities of clinical diagnosis, US, and MRI for rupture was 42%, 50%, and 83%, respectively, while the specificities were 50%, 90%, and 90%. The concordance between US and MRI was 87%. MRI is the investigation of choice for implant rupture. US is a valuable alternative with good concordance with MRI. When US is positive for implant rupture an MRI is not necessary to confirm the diagnosis. Knowledge of the sensitivity and specificity as well as the concordance between the two investigations is useful to ensure the appropriate use of available resources.
SUMMARYUltrasonography has been used as an investigation in patients with abdominal signs after blunt injury. Thirty-two patients were examined, of whom 11 had abnormal findings. Free intraperitoneal fluid was demonstrated in eight cases, seven of whom had this confirmed at subsequent laparotomy. The 21 patients with normal scans did not require abdominal intervention.It is suggested that ultrasonography is a reliable method of detecting haemoperitoneum and offers a valuable non-invasive method of investigating blunt abdominal injuries. The hepatorenal pouch is the site where free intraperitoneal fluid can be most easily demonstrated.
By comparing 27 patients who had both scintigraphy and sialography in the assessment of salivary gland disease, scintigraphy has been shown to correlate well with abnormal sialograms. It is suggested that scintigraphy could become the initial screening procedure in the assessment of salivary gland disease. A normal scintiscan is unlikely to miss significant pathology (as demonstrated by sialography), but sialography must always be performed if there is a suspicion of duct obstruction on scintigraphy. Patients suspected of focal salivary gland pathology such as tumour have not been investigated. The series documents the findings in patients who presented with facial pain, swelling or xerostomia suggesting sialadenitis, duct occlusion or Sjögren's syndrome.
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