Comparison of Sonographic Findings with Diagnostic Mammography.

BACKGROUND: Breast cancer is the leading female cancer worldwide with a high mortality rate. Early detection of the suspicious lesion is crucial for better prognosis. Higher breast density decreases the sensitivity of mammogram. Ultrasound can differentiate between cystic and solid masses and further characterize these as benign or possibly malignant. Our objective was to compare the findings of sonography with diagnostic mammography. METHODS: This was a cross sectional study including 125 females who underwent diagnostic mammogram in a tertiary care center. The mammograms were evaluated and the patients were scanned by ultrasound and categorized as per ACR- BIRADS category. The findings of diagnostic mammography were compared with that of ultrasonography using SPSS version 25. RESULTS: The heterogeneously dense breast in diagnostic mammography corresponded to the heterogenous- fibroglandular breast in ultrasonography. In majority, ultrasound increased the BIRADS category for the lesion than designated by the diagnostic mammography. It was particularly useful for category 0 and 3 lesions which were indeterminate and required further imaging. CONCLUSIONS: Ultrasound was useful in evaluation of dense breasts with ACR-BIRADS 0 and 3 in diagnostic mammogram. For category 3 and 4 in diagnostic mammogram, ultrasound showed category 1 or 2 lesions which aided to alleviate patient anxiety and avoid unnecessary biopsies. With emerging technological advances in ultrasound, it can used as a powerful tool for breast lesion detection and patient management.

Correlation of Multidetector Computed Tomography Peripheral Angiography with Color Duplex Sonography in Peripheral Arterial Disease.

BACKGROUND: With aging of the global population peripheral arterial disease is increasingly common. Arteriography, computed tomography angiography and magnetic resonance angiography are common modalities used for evaluation of peripheral arterial disease. However, they have limitations of being invasive, costly, limited availability or contraindicated in patients with renal impairment or contrast allergy. Duplex imaging, a method of evaluation of peripheral arterial disease is cost effective, widely available and safe even in patients with renal impairment and contrast allergy. METHODS: A prospective cross sectional descriptive study involving 114 patients was conducted from November 2015 to October 2016. The patients were evaluated by Doppler ultrasound following multi-detector computed angiography in Department of Radiology, Tribhuvan University Teaching Hospital. The lower limb arteries were divided into 10 segments and stenosis or occlusion of each segment in Computed Tomography angiography were compared with findings in Doppler, Computed Tomography angiography being considered the gold standard. Data was collected in predesigned proforma in Microsoft Excel spread sheet. RESULTS: Duplex imaging showed sensitivity 94.94%, specificity 98.54%, accuracy 97.54%, positive predictive value 96.15 % and negative predictive value 98.06 %. In assessment of 22 segments, partial stenosis seen in Computed Tomography angiography was overestimated as complete stenosis in Doppler. There was significant positive correlation of velocity ratio with degree of partial occlusion (r=0.918 for right lower limb and r=0.895 for left lower limb, p <0.01). CONCLUSIONS: Duplex imaging is safe cost effective and reliable method of evaluation of patients with peripheral arterial diseases.

Comparison of Sonographic Findings of the Rotator Cuff Between Diabetic and Non-diabetic Patients with Shoulder Pain.

BACKGROUND: The aim of study is to evaluate the shoulder by sonography in patients presenting with shoulder pain and correlate the findings observed with the diabetic patient. METHODS: Study was done in 60 patients who presented in the Department of Orthopedics with a history of the shoulder pain. Shoulder ultrasound was performed according to standard protocol, thickness of the supraspinatus tendon, presence of the tear, biceps tendon subacromial subdeltoid effusion and subacromial impingement were assessed. RESULTS: Of the 60 patients, 46 were male and 14 were female. Among them 15 patients were diabetics, 12 patient were male and 3 patient were female. Supraspinatus(SST) tendon thickness was greater in diabetics than in non-diabetics. Similarly, Subacromial bursal effusion, Biceps tendon effusion and Subacromial impingement were also seen in greater frequency in diabetic patients. However, no significant correlation was found between tear and the diabetes. CONCLUSIONS: There was increased supraspinatus tendon thickness, subacromial impingement, subacromial bursal effusion and biceps tendon effusion in diabetic patient compared to non-diabetic patient.

Breast Arterial Calcifications on Mammography among Patients Attending the Radiology Department in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

INTRODUCTION: Breast arterial calcifications are common mammographic findings which are associated with coronary artery disease. The aim of this study was to find the prevalence of breast arterial calcifications in women presenting for mammography in a tertiary care centre. METHODS: This descriptive cross-sectional study was performed in the Department of Radiology, in a tertiary care hospital after taking ethical clearance, Reference number 352(6-11)E-2, 077/078, data was collected from Syngovia database from March-June 2021 which included 1614 mammograms. Convenience sampling was done and mammograms evaluated for presence of vascular or non-vascular calcification. Further, vascular calcification was graded. Data was entered in Statistical Package for Social Sciences version 25. Point estimate at 95% Confidence Interval was done, and frequency and proportion were calculated. RESULTS: The prevalence of breast arterial calcification was 188 (11.6%) at 95% Confidence Interval (10.03-13.2). The mean age of women included in this study was 48.42±9.55 years with the largest number of patients in the age group 40-49 years, 682 (42.3%), and least in the age group 80-89 years, 3 (0.2%). All patients in the age group 80-89 years, 3 (100%) had vascular calcifications followed by 70-79 years group, 22 (57.5%) and none in patients younger than 30 years. CONCLUSIONS: We found an increase in the number and grade of vascular calcifications in breasts with the patient's age. When present breast arterial calcifications must be mentioned in mammogram report. Identification of such calcifications on mammogram should prompt further screening for atherosclerotic disease.