Hira Ashfaq Butt

Lahore General Hospital

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Khalid Javed

University of Veterinary and Animal Sciences

Rukhsana Nasim

Lahore General Hospital

Fareeha Shahid

University of Health Science

Fareeha Shahid

University of Health Sciences

Islah Uddin

Shaukat Khanum Memorial Cancer Hospital and Research Center

Islah Ud Din

Shaukat Khanum Memorial Cancer Hospital and Research Center

Huda Fazli

Services Hospital

Afaq Muhammad

Jeju National University

Taimoor Ali Tariq

Shaukat Khanum Memorial Cancer Hospital and Research Center

Beenish Nadeem

Bahawal Victoria Hospital

Cooperative Institutions

Shaukat Khanum Memorial Cancer Hospital and Research Center

Bahria University

University of Health Sciences

Bahawal Victoria Hospital

University of Liverpool

CMH Lahore Medical College and Institute of Dentistry

Services Hospital

Mayo Hospital

Jeju National University

King Fahd University of Petroleum and Minerals

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Diagnostic Accuracy of Magnetic Resonance Spectroscopy in Differentiating Malignant and Benign Brain Lesions

Khalid javed Hira Ashfaq Butt Hafiz M. Amir Jamil Asad Ullah Kamran Beenish Nadeem

The aim of this study is to determine the diagnostic ability of magnetic resonance spectroscopy in separating malignant and benign cerebral masses, when histopathology taken as gold standard. The results of my study will not only resolve this controversy but also If MRS diagnostic accuracy will be found high in distinguishing ring enhancing lesions of brain, then this non-invasive modality can be applied routinely in our general practice for proper treatment selection the lesions in order to reduce the morbidity and mortality of these particular patients. Materials & Methods: We included around 141 cases presenting to us at the Radiology department of Sir Ganga Ram Hospital, Lahore, fulfilling the inclusion criteria was selected after we got approval for the study from IRB committee of university. Informed consent was taken from each patient. We performed magnetic resonance spectroscop in each case using 1.5 Tesla MR system having graded power of 33 mT/m and results of MRS were read and reported by one radiology consultant. Malignant or benign lesions were noted on MRS. After this, each patient was undergone biopsy in the concerned ward by the consultant neurosurgeon and tissue was sent to institutional pathology laboratory for histopathology. Histopathology results were interpreted by the consultant histopathologist (at least 3 years of post-fellowship experience) and benign or malignant lesion was noted Results: All the included cases underwent standard magnetic resonance spectroscopy (MRS) of brain. MRS strengthened the suspicion of malignant brain lesions in 94 (66.67%) cases. Histopathology findings confirmed malignant brain lesions in 90 (63.83%) cases. Conclusion: This study concluded that MRS is the non-obstrusive method of imaging with greater diagnostic accuracy in differentiating malignant and benign brain lesions, and that it has not only made drastically better our capability to identify malignant brain lesions preoperatively, and moreover assists neurosurgeons in taking much better decisions. As a result, we urge that MRS be performed habitually in all suspected instances of intracranial mass lesion for reliable pre-operative identification of malignant brain lesions and selection of appropriate surgical technique. Keywords: MRS. MRI. Brain lesions, brain tumor, CNS tumor, Magnetic resonance spectroscopy

Histopathology

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Neuroradiology

10.53350/pjmhs20221611528

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Diagnostic Accuracy of Fact in Clinically Suspected Cases of Acute Appendicitis in Adolescents and Adults, Taking Surgical Findings as Gold Standard

Hira Ashfaq Butt Rukhsana Nasim Khalid Javed Fareeha Shahid Nosheen Kanwal

Objective: to evaluate the diagnostic accuracy of FACT in clinically suspected cases of Acute Appendicitis in adolescents and adults, taking surgical findings as gold standard. Methods: A total of 335 patients referred from emergency department with clinical suspicion of acute appendicitis were enrolled at Radiology Department, Services Hospital Lahore, from April, 2016 to October, 2016. FACT was performed using multi-slice CT. The cases underwent surgery and the results were recorded. The results of Focused Abdominal Computed Tomography and surgery were compared taking surgical findings as gold standard. Results: The mean age of patients in our study was 23.01 ± 5.479. We found 278 true-positives, 50 true-negatives, 04 false-negatives results, with sensitivity of 98.6%, a specificity of 94.3%, a PPV of 98.9%, a NPV of 92.6%, and an accuracy of 98%. An alternate diagnosis was made by FACT in 40 patients (11.9%). Conclusion: FACT (focused non-enhanced abdominal computed tomography) is a highly accurate imaging modality for diagnosis of acute appendicitis in adolescents and adults. Keywords: Focused Abdominal CT, Acute Appendicitis, FACT, Diagnostic Acuuracy

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10.53350/pjmhs22168733

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Utility of Ultrasound and Magnetic Resonance Imaging in Prenatal Diagnosis of Placenta Accreta: A Prospective study

Medical Journal Of South Punjab (2021)

Rukhsana Nasim Khalid Javed Hira Ashfaq Butt Taimoor Ali Tariq Sumaira Aslam

Objectives: determine the utility of ultrasound and magnetic resonance imaging in prenatal diagnosis of placenta accreta. Methods: Thirty patients presented in the department of gynecology and obstetrics and fulfilling the inclusion criteria were selected for the study. Study was a cros sectional design conducted at department of Radiology, Nishtar Hospital Multan, from 1st January 2019 to 1st December 2019. Result: Only 10 patients with placenta accreta were positive on USG while other 9 patients were found to be negative; and 3 patients were misdiagnosed to have placenta accreta on USG. Table-IIOnly 15 patients with placenta accreta were positive on MRI while other 4 patients were found to be negative; and 2 patients were misdiagnosed to have placenta accreta on USG. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 52.6%, 72.7%, 76.9%, respectively. Conclusion: It can be concluded that there is no significant difference between MRI and USG in terms of accuracy for prenatal diagnosis of placenta accreta.

Placenta Accreta

10.61581/mjsp.vol02/02/02

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Diagnostic accuracy of triphasic CT scan abdomen in the diagnosis of distal esophageal varices taking endoscopic findings as gold standard.

The Professional Medical Journal (2022)

Hira Ashfaq Butt Rukhsana Nasim Khalid Javed Fareeha Shahid Aamenah Malik

Objective: To determine the diagnostic accuracy of multidetector computed tomography in detection of esophageal varices in patients with hrpatic cirrhosis. Study Design: Cross Sectional study. Setting: Department of Diagnostic Radiology, Kot Khawaja Saeed Teaching Hospital, Lahore. Period: January, 2021 to July, 2021. Material & Methods: Two hundred seventy five patients diagnosed with liver cirrhosis were included in our study. Multidetector CT of the abdomen was performed using multislice CT and the findings were recorded. The cases underwent endoscopy within the subsequent 8 weeks. The results of MDCT were compared with endoscopy findings, which were taken as gold standard. Results: We found 190 true-positives, 80 true-negatives, 03 false-negatives, and 02 false-positive results. MDCT demonstrated a sensitivity of 98.4%, a specificity of 97.6%, PPV of 99.0%, NPV of 96.4%, and an accuracy of 98.1%. Extra-esophageal findings on MDCT included other porto-systemic collaterals and hepatocellular carcinoma. Conclusion: MDCT is an effective modality for diagnosis of esophageal varices and can be used as a screening test for varices. CT also permits evaluation of extra-luminal pathology that impacts management.

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Multidetector computed tomography

10.29309/tpmj/2022.29.12.7213

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Diagnostic Accuracy of Magnetic Resonance Imaging in Diagnosing ACL Injuries Taking Arthroscopy as Gold Standard

Afaq Muhammad Amaar Talib Rukhsana Nasim Khalid Javed Hira Ashfaq Butt

Introduction: Low velocity, non - intrusive, acceleration-deceleration, and contact traumas with a rotating component are the most common causes of anterior cruciate ligament (ACL) injuries. The objective of the study was: To determine the diagnostic accuracy of magnetic resonance imaging in detecting anterior cruciate ligament tear using arthroscopy as a gold standard.” Materials and methods: MRI scans of all the cases performed in the hospital radiology department and reported by a radiologist for ACL tear. Arthroscopy reports which were performed under general anesthesia by a senior orthopedic surgeon were also reviewed. ACL tear was assessed as an operational definition. Whole data was collected and recorded on an already structured Performa Results: Arthroscopy confirmed anterior cruciate ligament tear in 78 (62.40%) cases whereas 47 (37.60%) patients revealed no anterior cruciate ligament tear. In MRI-positive patients, 72 (True Positive) had an anterior cruciate ligament tear and 06 (False Positive) had no anterior cruciate ligament tear on arthroscopy. Among, 47 MRI negative patients, 06 (False Negative) had anterior cruciate ligament tear on arthroscopy whereas 41 (True Negative) had no anterior cruciate ligament tear on arthroscopy Conclusion: This study concluded that magnetic resonance imaging has high sensitivity and accurate modality, which has not only dramatically enhanced our tendency to diagnose anterior cruciate ligament injury but also helpful in reducing the number of pure diagnostic arthroscopies. So, we recommend that preoperative MRI should be done in every patient with ACL injury for selecting proper therapy for these particular patients. Keywords: Trauma, Anterior cruciate ligament (ACL) injuries, MRI, Arthroscopy, Diagnostic Accuracy

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10.53350/pjmhs20221611430

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