Showing 35 results for Sonography
M Ghafarpoor , M Harirchian , F Khamseh , N Razazian ,
Volume 57, Issue 1 (4-1999)
Abstract
This is a prospective descriptive research which was carried out in Imam Khomeini Hospital related to Tehran University during two years (1375-1377) in order to study the incidence of internal carotid stenosis in patients who suffered from TIA ot minor stroke. It was evaluated by duplex sonography. Risk factors of carotid stenosis were studied. 1052 patients who had cerebrovascular accident admitted to Imam Khomeini Hospital and 100 of them who suffered from TIA or minor stroke were selected. The data was gathered by questionnaire and analysed. According to the results of the research, the incidence of internal carotid stenosis was 81%. The incidence of severe stenosis (>70%) was 20%, moderate stenosis (30-69%) was 36%, and mild stenosis (<29%) was 44%. There was a significant relationship between hyperlipidemia, diabetes mellitus and alcohol consumption, with internal carotid stenosis. There was no significant relationship between hypertension and cigarette smoking with internal carotid stenosis. There was a significant relationship between history of angina pectoris or myocardial infarection with severity of internal carotid stenosis. We suggest to consider duplex sonography as a part of evaluation of patients who suffer from TIA or minor stroke for screening of severe internal carotid stenosis. Control and treatment of risk factors are useful preventive measures that can reduce the incidence of carotid artery stenosis and cerebrovascular accidents
H Mazaher, K Abasi,
Volume 57, Issue 3 (6-1999)
Abstract
In order to evaluate accuracy and usefulness of sonography and choose it as preliminary investigation method in pathologic processes of parotid gland, 50 patients were studied in duration of 16 months. The lesions were evaluated with ultrasound and sonographic images were obtained before surgery and then were compared with pathologic results after surgery. All lesions were detected with sonography. This method could differentiate intraglandular from extraglandular lesions with accuracy of 100%. Except one case of lipomatosis which was hyperechoic, all other lesions of parotid gland were hypoechoic. All lesions with sharp and well-defined borders were benign whereas malignant processes had ill-defined borders. The results obtained show that sonography is a reliable diagnostic method to differentiate benign from malignant lesions and it has a high diagnostic value to detect warthin's tumor, plemorphic adenoma, Sjogren's syndrome and lipomatosis. Presence of calcification in a parotid mass of young patient with high probabye is related to cavernous hemangioma.
Mostaan M, Saberi H, Sharyarian Sh, Bahar Joo Hr, Mahdi Zadeh F,
Volume 58, Issue 4 (7-2000)
Abstract
This is retrospective double-blind research, which was carried out in Imam Khomeini hospital in order to study the accuracy of color Doppler ultrasonography for detecting the site and grade of stenosis in cervical carotid artery. 40 patients with mean age of 62 years studied with color Doppler before DSA angiography. The most common sites of stenosis were left internal carotid (39.5%) and right internal carotid arteries (38.4%). We measured peak systolic and end-diastolic velocities (PSA and EDV) and ratios of PSA and EDV at stenosis sites to CCA (PSV ratio and EDV ratio). Results showed that PSA has the highest sensitivity and accuracy in all grades of stenosis: Mild to moderate stenosis: Sensitivity (90.5%), accuracy (89.5%) Severe stenosis: Sensitivity (82.1%), accuracy (92.8%) Total occlusion: Sensitivity (93.8%), accuracy (96.5%). There is no difference between accuracy of Doppler parameters for detection of total occlusion (96.5%) but in other grades after PSV, EDV (Mild-moderate 86%, severe 87.2%). EDV ratio and PSV ratio (Mild-moderate both 84.8%, severe both 86%) have the highest accuracies. We concluded that color Doppler sonography can reliability detect stenosis in carotid arteries & PSV has the highest accuracy.
Omran Poor R, Hagh Shenas Sh, Giti M,
Volume 61, Issue 5 (8-2003)
Abstract
Knowledge of axillary lymph node Status is essential in treatment planning and in prognostic evaluation of breast cancer.
Materials and Methods: Preoperative high resolution Sonography of axilla, were performed on 100 patients with breast carcinoma (T1-T2) clinical, before axillary lymph node dissection and pathologic evaluation.
Results: The Sensitivity of ultra Sonography in detection of axillary metastasis was 78% with specificity of 79% and accuracy of 79% PPV was 85% and NPV was 70%.
Conclusion: Preoperative ultra sonography, alone, is not optimal for detect ion of axillary lymphnode metastasis.
Z. Ghanbari, B.hajibaratali, M.fazaeli, P. Mehdizadeh, M. Dadyar,
Volume 64, Issue 3 (5-2006)
Abstract
Background: Abnormal uterine bleeding (AUB) is a common presenting symptom indicative of abnormal menstrual bleeding patterns that may occur in anovulatory or ovulatory women.There are different ways to diagnose AUB, all requiring much time and energy. The purpose of this study was to evaluate and compare the value of endometrial biopsy, transvaginal ultrasonography with dilation and curettage (D&C) which is the current gold standard procedure.
Methods: A prospective-descriptive study was conducted on fifty patients referred to our center for refractory abnormal uterine bleeding who were candidates for hysterectomy. All patients underwent endometrial biopsy and transvaginal ultrasonography , followed by D&C as a Gold standard procedure in operating room just before surgery.
Results: Mean age of patients was 46.62 years. Transvaginal utrasonography offered a sensitivity of 70% and specificity of 68% demonstrating the lowest numbers compared to D&C. Endometrial biopsy had a sensitivity of 70% and specificity of 75% that was better than sonography alone.
Conclusion: D&C was the most useful and valuable procedure and addition of endometrial biopsy with transvaginal ultrasonography will not be of high value in diagnosis.
Vahid Dastjerdi M, Alavi Tabari N, Asgari Z, Beygi A,
Volume 65, Issue 11 (2-2008)
Abstract
Background: Post-menopausal hemorrhage is one of the most common complains in gynecologic clinics. More than 60% of these cases have abnormal findings in diagnostic work ups. There is contraversy about the best diagnostic method for evaluating post-menopausal hemorrhage. The aim of this study was to evaluate the results of Trans-Vaginal Ultrasonography and compare its result to ones derived from direct endometrial biopsy and Hysteroscopy findings.
Methods: In a cross-sectional study, menopausal women who attended the outpatient clinic of Arash Hospital, Tehran University of medical Sciences, from April 2005 to March 2006 with the complain of hemorrhage were evaluated. In all of these patients, after getting informed consent, Trans-Vaginal Ultrasonography, Dilatation and Curettage and Hysteroscopy were performed.
Results: The total number of 90 women was recruited to the study with the age range of 41-80 years. The mean age of participants was 53.84 ± 6 years and 4.3 ± 5.1 years had passed from their menopause. The mean thickness of endometrium, measured by Trans Vaginal ultrasonography was 6.25 ± 3.7 millimeter. In the biopsy derived specimens, the most finding pathological presentation was atrophy (48.9%) and the Proliferative endometrium had the second prevalence (36.7%). Atrophy (44.4%) and Proliferative endometrium (33.3%) were the most prevalent finding in Hysteroscopy. There was a significant difference in endometrial thickness between groups of different pathological findings. A significant difference in endometrial thickness was also seen between groups with different Hysteroscopic finding. By grouping the data according to endometrial thickness, it became evident that endometrial thickness can predict the outcome of endometrial biopsy and Hysteroscopic finding efficiently. We used ROC curves to find the best grouping threshold for endometrial thickness to achieve the best sensitivity and specificity.
Conclusion: Measuring the endometrial thickness by Trans-Vaginal Ultrasonography is an appropriate non-invasive test for screening post-menopausal hemorrhage.
Rokniye Yazdi H, Shirmohammadi M,
Volume 66, Issue 2 (5-2008)
Abstract
Background: Cirrhosis and portal hypertension influence the hepatic circulation. The purpose of this study was to evaluate the diagnostic accuracy of liver Doppler ultrasonography parameters in cirrhosis.
Methods: This case-control study involved 118 subjects. All case subjects had biopsy-proven hepatic cirrhosis. The controls were healthy people, case-matched for age and gender. All cases and controls underwent Doppler ultrasonographic evaluation. We compared the area under the ROC curve of each parameter for cases vs. controls using Fisher's exact test, with p <0.5 indicating significance.
Results: The means of the following parameters for case vs. control subjects were: frequency of portal venous flow inversion, portal vein diameter 12.67±2.72 vs. 10.59±1.69, and hepatic arterial resistance index 0.81±0.07 vs. 0.74±0.09. The mean hepatic artery pulsatility index (1.87±0.48 vs. 1.34±0.23), was significantly higher among the case subjects (P=0.001). The maximum flow rate of the portal vein was also significantly lower in the case subjects (16.50±5.59 vs. 36.74±8.74 cm/s, P=0.001). We did not observe significant differences in the means of the hepatic artery maximum flow rate and end-diastolic flow rate. For diagnosing cirrhosis, the application of 24.1 cm/s as the cutoff point for the portal vein maximum flow rate, we obtain an accuracy of 95.45% (91.23%-97.70%, CI=95%), whereas a cutoff point of 1.54 or more for the hepatic artery pulsatility index yields an accuracy of 85.71% (79.48%-90.29%, CI=95%). Utilizing a hepatic arterial resistance index of 0.765 or greater is associated with an accuracy of 71.05% (62.81%-78.11%, CI=95%) in diagnosing cirrhosis.
Conclusions: Doppler ultrasonography and assessment of hepatic artery and portal vein parameters are accurate methods in the diagnosis of cirrhosis.
Laal M, Granpaye L, Khodadi F, Salavatipour A, Sadeghi Ar,
Volume 66, Issue 6 (9-2008)
Abstract
Background: Various imaging tests as well as different scoring systems based on symptoms, signs and laboratory findings are commonly used to improve diagnostic accuracy in acute appendicitis. The aim of this study was to compare the diagnostic accuracy of MANTRELS scoring system (designed by Alfredo Alvarado), which is based on symptoms, signs and laboratory results, with sonographic findings.
Methods: In this prospective observational study, 106 patients with acute abdomen suspicious of acute appendicitis at Sina Hospital, Isfahan, Iran, were studied from March 2004 to February 2006.
Results: The disease was most common in patients aged 20-29 years, with male predominance. All patients had appendectomies. One hundred patients had acute appendicitis and six had negative appendectomy. Among the patients with acute appendicitis, 88% had an Alvarado score of ≥6 and 12% had a score of ≤5. Among the six patients with negative appendectomy, 66.7% had Alvarado scores of ≤5 and 33.3% had scores of ≥6, which was significantly different (p=0.005). The sonographic results were abnormal in 71.9% of patients with acute appendicitis and in 25% of patients with negative appendectomy, which was not significantly different (p=0.08). In our study, the diagnostic accuracy of an Alvarado score ≥6 was 88% and that of the sonographic results was 71.9% for acute appendicitis. If the Alvarado score ≥6 and abnormal sonographic findings are considered together, the diagnostic accuracy improves to 97.2%.
Amiri Hr, Makarem J,
Volume 67, Issue 2 (5-2009)
Abstract
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Background: Successful
brachial plexus blocks rely on proper techniques of nerve localization, needle
placement, and local anesthetic injection. Standard approaches used today (elicitation
of paresthesia or nerve-stimulated muscle contraction), unfortunately, are all
"blind" techniques resulting in procedure-related pain and
complications. Ultrasound guidance for brachial plexus blocks can potentially
improve success and complication rates. This study presents the
ultrasound-guided brachial plexus blocks for the first time in Iran in adults
and pediatrics.
Methods: In this
study ultrasound-guided brachial plexus blocks in 30 patients (25 adults &
5 pediatrics) scheduled for an elective upper extremity surgery, are
introduced. Ultrasound imaging was used to identify the brachial plexus before
the block, guide the block needle to reach target nerves, and visualize the
pattern of local anesthetic spread. Needle position was further confirmed by
nerve stimulation before injection. Besides basic variables, block approach,
block time, postoperative analgesia duration (VAS<3 was considered as target
pain control) opioid consumption during surgery, patient satisfaction and block
related complications were reported.
Results: Mean
adult age was 35.5±15 and in pediatric group was 5.2±4. Frequency
of interscalene, supraclavicular, axillary approaches to brachial plexus in
adults was 5, 7, 13 respectively. In pediatrics, only supraclavicular approach
was accomplished. Mean postoperative analgesia time in adults was 8.5±4
and in pediatrics was 10.8±2. No block related complication were observed
and no supplementary, were needed.
Conclusions: Real-time
ultrasound imaging during brachial plexus blocks can facilitate nerve
localization and needle placement and examine the pattern and extend of local
anesthetic spread.
Marsosi V, Mashhadian M, Ziaei S, Faghihzadeh S,
Volume 67, Issue 11 (2-2010)
Abstract
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Background: Preterm delivery is a relevant public health problem since it is an
important factor determinant of morbidity and the main reason for neonatal
mortality. Many publications have pointed at clinical methods, biological,
biochemical and ultrasonographic markers, which applied in combination or on
their own, aim at predicting spontaneous preterm delivery. Transvaginal
sonography is an effective method for the study of uterine cervix during
pregnancy since it permits to assess the cervical morphology and biometry in
detail with a high degree of reliability. The aim of this study
was to evaluate the association between spontaneous preterm delivery (SPTD) before 35 and 37 weeks of gestational age, in high risk population and the measurement of
the cervix length and cervical funneling.
Methods: A prospective cohort of 200 women carrying high
risk pregnancies were evaluated by transvaginal sonography between 14th and 28th weeks of gestation.
Results: Cervical length less than 18mm before 35th and 37th weeks of gestational age and the presence
of cervical funneling presented a satistically significant association with
spontaneous preterm delivery before 35 weeks. The cervical length with less 18 mm demonstrated a strong association with SPTD before 37 weeks (p<0.005 OR=92.15) and before 35 weeks' gestation (p<0.001 OR=32.33). The logistic regression analysis suggested the
cervical length with less than 18mm as the only variable that revealed satistically significance association
with SPTD.
Conclusion: The results seem to indicate
that the assessment of cervical length is an important ultrasound marker for
predicting spontaneous preterm delivery.
Rahmani M, Najafizadeh Sr, Sharegh H, Rahmat Sadeghi S, Ahmadinejad A,
Volume 68, Issue 6 (9-2010)
Abstract
Background: High Resolution sonography of common carotid artery is a safe method for rapid diagnosis of atherosclerosis in Rheumatoid Arthritis (RA). The purpose of this study was to compare sonographic findings of subclinical atherosclerosis in rheumatoid arthritis patients and control group and comparing the prevalence of atheromatous plaques and Intima- media thickness in arteries of the groups.
Methods: Fifty RA patients and fifty non-RA persons were evaluated in a cross- sectional, Descriptive study. The sonographic findings of common carotid artery of these two groups were compared.
Results: After analysis of the sonographic findings of common carotid arteries of 100 females in our study (50 patients with the mean age of 48.1y/o [23-61] and 50 control group with the mean age of 47y/o [23-61]), the prevalence of RA patients with atheromatous plaques was 32% and in control group was 6%. [OR=7.4, 95%CI=2-27.3, p=0.001]. The mean (SD) of the Intima- Media Thickness (IMT) in RA patients was 7.76 mm (1, 04) while in control group was 6.10 mm (0.95). From 38 RA patients with less or equal 5 joints involvement in hand radiography, 13.2% had atheromatous plaques and the mean (SD) of the IMT was 7.6 (±1.1) mm. From 12 patients with more than 5 joints involvement in radiography, 91.7% had atheromatous plaques and the mean (SD) of the IMT was 8.4 (±0.7) mm. [p=0.012].
Conclusions: Regarding higher prevalence of vascular problems in RA patients, screening and early diagnosis of vascular pathologies could be of value in reducing morbidity and mortality of these patients.
Mashhadian M, Marsosi V, Ziaei S, Asghari Jafar Abadi M,
Volume 68, Issue 10 (1-2011)
Abstract
Background: Preterm delivery is a relevant public health problem. The aim of this study was
to evaluate the association between spontaneous preterm delivery (SPTD)
before 35 and 37
weeks of gestational age and the measurement of the cervix length, cervical
funneling and Cervical Gland Area (CGA),
in high risk pregnant population.
Methods: A prospective cohort of 200
women carrying high risk pregnancies was evaluated by transvaginal
sonography between 14th and 28th gestational weeks. The data were analyzed using statistical methods.
A multiple linear regression model was estimated
in order to examine the relationship between the gestational age at delivery
and the cervical markers. A multiple logistic
regression was estimated in order to analyze the factors associated to
spontaneous preterm delivery and the transvaginal sonographic markers.
Results: Cervical length less than 18 mm and the presence
of cervical funneling presented a statistically significant association with
spontaneous preterm delivery before 35 weeks.
The nondetection of Cervical Gland Area demonstrated a strong association with
spontaneous preterm delivery before (p=0.0001,
OR=169.1, CI=2.6-3.1) and 35th and 37th gestational week (p=0.001, OR=115,
CI=2.12-3.5). The multiple logistic regression
analysis suggested the non-detection of CGA as
the only variable to reveal statistically significance association with
spontaneous preterm delivery.
Conclusion: Based on results of present study the absence of
cervical gland area (CGA) can be a new and important ultrasound marker for predicting spontaneous
preterm delivery and needs to confirm with future multicenter investigations.
Reza Pourrashidi, Shervin Sharifkashani , Hashem Sharifian, Habib Mazaher , Peyman Salamati , Batool Ghorbani Yekta ,
Volume 71, Issue 4 (7-2013)
Abstract
Background: Detection of retained foreign bodies remains a significant problem in the emergency department. Foreign bodies can go undetected causing infectious complications ultrasonography is too inaccessible and expensive. The purpose of this study is comparison of ultrasonography with radiography for the detection of cervical esophageal foreign bodies
Methods: This cross-sectional study evaluated 58 patients referred with suspected upper esophageal foreign body in the Emergency Department, Amir Alam. Patients were evaluated with ultrasonography and x-ray. After surgical exploration, different type of foreign bodies were recorded. The SPSS statistical software was used for analysis. For applicable efficacy outcome measures, a Spearman correlation was used. Differences were significant when P<0.05. All values were expressed as the frequency and present.
Results: Fifty eight patients were studied. 25 patients (43.4%) were male and 31 patients (56.9%) were female, in 28 (48.2%) patients foreign bodies were detected in radiography. 30 patients (51.8%) were not recorded in techniqe. It was found in patients 22 (78.6%) organic body, and six cases (21.4%) non-organic body. radiographic outcomes in patients with foreign bodies were positive in 26 patients (92.9%) and in two patients (7.1%) were negative. Ultrasound results were positive in 27 patients (96.4%) and in one patient (3.6%) were negative. Association of ultrasound and radiography results were significant in patients with foreign body (Spearman correlation=0.896, P=0.001 Kappa=0.890).
Conclusion: These reports suggest that result of ultrasound with radiography for the detection foreign bodies in cervical esophagus have good agreement. The use of ultrasonography in the emergency department to detect and eventually remove foreign bodies by emergency physicians is an important issue because there is not always an ultrasound technologist or radiologist available.
Narges Izadi-Mood, Soheila Sarmadi,
Volume 71, Issue 6 (9-2013)
Abstract
Background: Gestational trophoblastic disease (GTD) is a heterogenous group of neoplastic lesions that is derived from placental trophoblastic epithelium. According to World Health Organization (WHO) classification they include: Hydatidiform mole (complete and partial), invasive mole, choriocarcinoma and placental site trophoblastic tumor. Hydatidiform mole is the most common and the diagnosis is achieved by pre-evacuation ultrasonographic evaluation, laboratory tests and finally histological assessment as gold standard. Since these disorders show varying potential for local invasion and metastasis, the accurate diagnosis, follow up and recommendations given to patients may differ.
Methods: Consecutive cases with diagnosis of GTD from archive of pathology department of women (Mirza Kochak Khan) hospital were reviewed in whom results of clinical presentation and pre-evacuation ultrasound examination were documented. There were overall 220 cases for which the following clinical features were determined: gravidity, parity, history of previous abortion and gestational trophoblastic disease, the clinical symptoms such as vaginal bleeding and hypertension. Finally concordance between pre-evacuation ultrasonographic and histological diagnosis by kappa test is calculated.
Results: Out of 220 cases with clinically gestational trophoblastic disease diagnosis, 197 cases were confirmed by histological diagnosis. The concluding histological diagnosis includes: 98 cases of complete mole (CM), 84 partial mole (PM), 4 invasive mole and 11 cases of choriocarcinoma. Outside 98 cases with histological diagnosis CM only in 4 cases misdiagnosed by ultrasonoghraphy (4.1%) and high degree of concordance between ultrasonography and histological diagnosis is seen.
Conclusion: Ultrasonographic examination accompanied with clinical examination, beside histological assessment as gold standard have high efficacy in diagnosing complete mole. This study did not show this finding for partial mole.
Gholamreza Rezamand , Mojdeh Ghabaee , Naser Ebrahimi Daryani , Hoda Ghadami ,
Volume 72, Issue 1 (4-2014)
Abstract
Background: Nonalcoholic Fatty Liver Disease (NAFLD) is one of the most wide-spread human diseases that can impair liver function and sometimes progresses to cir-rhosis. Recently NAFLD has been identified as an independent risk factor for cardio-vascular disease. The aim of this study was to investigate the correlation of fatty liver disease and its sonographic severity on the resistance of the intracranial arteries.
Methods: This study was a cross-sectional study of 55 patients referred from Gastroen-trology clinic with diagnosis of NAFLD to Sonodoppler department of Iranian Center of Neurological Research. Pulsaltile index as a Hemodynamic parameter of Middle Cerebral (MCA) and basilar Arteries of NAFLD Patients was measured by Trans Cra-nial Doppler (TCD) sonography and the measurements were compared with normal values. Also the association of these indices with serum liver enzymes and sonographic grading of liver involvement was assessed. The analysis was done by SPSS 16. Fre-quency distribution, mean and standard deviation were used in descriptive analysis and statistical test 2 to compare qualitative variables.
Results: Pulsatile Index (PI) were normal (MCA, P= 0.166, Basilar, P= 0.053) and there was no significant difference with relation to severity of fatty liver based on so-nography findings (P= 0.789), but serum liver enzyme levels were inversely correlated with basilar artery PI (P= 0.014).
Conclusion: Considering the increase of cerebral arteries PI in advanced liver disease, absence of increase in vascular PI of patients in the present study could be attributed to the short duration of disease from diagnosis to perform TCD, lack of advanced liver involvement (absence of liver dysfunction) and the response effect to treatment before the TCD. Therefore, to assess vascular changes over time, repeating the TCD with assess other parameters such as Fibroscan and K18 factor that has more compatibility of liver function, could help to understand the pathophysiology of liver diseases and its effect on vascular resistance.
Razieh Mohammad Jafari , Mojgan Barati , Saeed Bagheri , Zeinab Shajirat ,
Volume 72, Issue 5 (8-2014)
Abstract
Background: Early detection of fetal gender can provide an alarm for parents who complicated by genetic disorders. Moreover, the invasive tests are used for detecting any sex-specific genetic syndromes before 12 weeks of gestation. This study was de-signed to discover any association between placental location and fetal gender between 11 to 13+6 weeks of gestation.
Methods: A cross-sectional study was conducted on 200 singleton pregnant women. They were referred for Down syndrome screening sonography to prenatal clinic, Imam Khomeini Hospital a tertiary referral university affiliated hospital, Ahvaz, Iran, in 2013. Women were included if they are singleton and at 11 to 13(+6) weeks gestational age. Exclusion criteria were multifetal, ectopic pregnancies, or dead fetus. Information about placental location (upper, middle, below, anterior, posterior), gravidity, and fetal gender were recorded. All participants of our study were evaluated by one trained gy-necologist in ultrasound examinations during nuchal translucency (NT) examinations. Ultrasonography was performed using the Accuvix V10 OB/GYN ultrasound. All patients were followed-up till delivery for confirming the predicted gender. Information regarding gender of newborn were collected using medical chart review or by phone contact.
Results: Among 200 placenta which had been assessed, 103 (51.5%) were anterior and 97 (48.5%) were posterior. Our results showed that 75 (72.8%) from girl cases had an anterior placenta, while just 28 (27.2%) from boy cases had an anterior placenta (P< 0.001). In addition, there was significant association between placental location regard-ing below, middle, and upper and fetal gender.
Conclusion: According to our results, an anterior and posterior positions of the placen-ta had significant relation with fetal gender. Our findings are consistent with previous studies regarding prediction of fetal gender using placental location. We suggest that more research with large sample size is required as well as investigations with more de-tails about placental locations.
Mohammadreza Kasraei , Hamidreza Abtahi, Niloofar Eyoobi Yazdi, Enayat Safavi, Shahram Firoozbakhsh, Mostafa Mohammady,
Volume 72, Issue 7 (10-2014)
Abstract
Pleural effusion (PE) is common among ICU and acutely ill patients. Traditionally plain chest radiography (CXR) has been done for pleural effusion evaluation in ICU. However, better results have been reported by ultrasound for the diagnosis of this condition in ICU. In this study, we compared two methods of ultrasound and CXR in PE detection in ICU patients. Also we studied the percentage of thoracentesis by physician after detection of PE by ultrasonography or CXR.
Methods: Portable supine CXR and chest ultrasound were done in Thirty-nine non-surgical patients who were admitted to the Medical and General ICUs of Imam Khomeini hospital in Tehran from Oct 2013 to Mar 2014. Ultrasound was done and interpreted by radiologist and CXR by patient' physician. Thoracentesis or CT-scan was used as gold standard for PE diagnosis.
Results: Ultrasound in 29 patients (74.3%) showed PE. In 21 patients thoracentesis was done by patient’s physician and all had PE with mean volume of 447.2(417.6). In 13 of 18 patients without thoracentesis chest CT scan was available. It shows PE in 6 cases (all with positive PE in ultrasonography). CXR in 9 patients (23.1%) was positive for PE and in 30 patients (76.9%) was negative. The ability of chest ultrasound and CXR for diagnosis of PE was significantly different (P= 0.0.1). In 68.9 % of cases that ultrasound was positive, the CXR was negative and only in 34.5% of cases both methods had negative results. The sensitivity, specificity, positive and negative predictive values were 100% (87.1-100), 100% (58.9-100), 100% (87.1-100), 100% (58.9-100) respectively for ultrasonography. For CXR there were 33% (16.6-54.0), 100% (58.9-100), 100% (66.2-100), 28% (12.1-49.4) respectively.
Conclusion: Ultrasonography for diagnosis of pleural effusion in ICU patients has better diagnostic performance than portable CXR
Seyed Mostafa Ghavami , Ramin Abedinzadeh , Fakhrosadat Sajjadian ,
Volume 74, Issue 4 (7-2016)
Abstract
Background: The primary manifestation of cardiac tumors in embryonic period is a very rare condition. Cardiac rhabdomyomas most frequently arise in the ventricular myocardium, they may also occur in the atria and the epicardial surface. In spite of its benign nature, the critical location of the tumor inside the heart can lead to lethal arrhythmias and chamber obstruction. Multiple rhabdomyomas are strongly associated with tuberous sclerosis which is associated with mental retardation and epilepsy of variable severity. Ultrasonography as a part of routine prenatal screening, is the best method for the diagnosis of cardiac rhabdomyomas. In the review of articles published in Iran, fetal cardiac rhabdomyoma was not reported.
Case presentation: We report a case of cardiac rhabdomyoma on a 24-year-old gravid 1, referred to Day Medical Imaging Center for routine evaluation of fetal abnormalities at 31 weeks of her gestational age. Ultrasonographic examination displayed a homogenous echogenic mass (13×9mm), originating from the left ventricle of the fetal heart. It was a normal pregnancy without any specific complications. Other organs of the fetus were found normal and no cardiac abnormalities were appeared. No Pericardial fluid effusion was found. The parents did not have consanguineous marriage. They did not also have any specific disease such as tuberous sclerosis.
Conclusion: The clinical features of cardiac rhabdomyomas vary widely, depending on the location, size, and number of tumors in the heart. Although cardiac rhabdomyoma is a benign tumor in many affected fetuses, an early prenatal diagnosis of the tumor is of great significance in making efficient planning and providing adequate follow up visits of the patients and the complications such as, heart failure and outlet obstruction of cardiac chambers.
Soghra Khazardoost , Fahimeh Ghotbizadeh , Shiva Golnavaz , Masoumeh Shafaat ,
Volume 75, Issue 3 (6-2017)
Abstract
Background: Lochia is the slight vaginal bleeding between 24 hour to 12 week after delivery. There isn't any standard definition for difference between normal and abnormal lochia in post-partum period. The aim of this study was to determine the relationship between ultrasonic findings of the postpartum uterus after normal vaginal delivery with the duration of lochia discharge.
Methods: In this cross-sectional study was done in Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran, from 2014 to 2015. In this study 160 women with non-complicated vaginal delivery were entered. Inclusion criteria were: Term pregnancy with gestational age > 37, singleton fetus with cephalic presentation. Exclusion criteria were pre-term pregnancies, previous Cesarean section or other uterine surgeries and twin fetuses. Transvaginal ultrasound was done in first 48 hours after delivery, endometrial thickness echogenicity and uterine size was evaluated. Maternal age, parity, duration of labor and neonatal weight were evaluated. Then the mothers were followed for 6 weeks. The quality and the quantity of lochia discharge were asked by the phone.
Results: Lochial discharge last more than 6 weeks in 96 out of 160 (60%). One had less than 4 weeks. The uterus length, thickness, height and endometrial length did not show any relationship with the duration of lochial discharge, but endometrial strip thickness significantly correlated with the duration of lochial discharge period (P=0.04). None of clinical variables like the number of gravidity, parity, live birth or child birth weight, were correlated to the duration of lochia discharge period, but the labor time was correlated to the duration of lochia discharge period (P=0.04). Although both endometrial thickness and labor time in univariate analysis were correlated to the lochia duration time but this was true just for endometrial thickness in multivariate analysis.
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Conclusion: The endometrial thickness in first 48 hours after normal vaginal delivery could predict the duration of lochia discharge, there wasn’t any correlation between lochia discharge period and other ultrasound parameters.
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Hamed Tabasizadeh , Foroud Salehi , Marzieh Eslami Moayyed, Marieh Eslami Moayyed ,
Volume 75, Issue 3 (6-2017)
Abstract
Background: Cerebral arteriovenous malformations are rare congenital anomalies presenting as different symptoms depending on their size and the age of patient. Congestive heart failure is a rare condition in neonatal period and is most common due to structural heart defects, but rarely may be a result of peripheral shunts such as cerebral arteriovenous malformation.
Case presentation: A term male newborn infant who was delivered by Caesarean Section in Chamran Hospital, Ferdows, South Khorasan Province, June 2016. The infant was admitted to neonatal care unit due to nonreactive nonstress (NST) with normal Apgar score. In first postpartum visit, a systolic heart murmur was detected. Echocardiography showed small atrial septal defect secundum type and patent foramen ovale (PFO). He presented clinical manifestations of heart failure after 72 hours of birth. Antibiotic and treatment of heart failure was started. Following excluding most common etiologies of heart failure such as sepsis, anemia and arrhythmias, for detecting less common conditions such as cerebral vascular aneurism a transfontanelle ultrasonography was performed which showed dilated cerebral venous system. Magnetic resonance imaging (MRI) and Magnetic resonance venography (MRV) revealed a large congenital cerebral arterio-venous malformation (CAVM), in right cerebral hemisphere. Finally, he was expired 9 days after birth due to severe heart failure before any definitive treatment for closing CAVM could be done.
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Conclusion: CAVM are extremely rare vascular anomalies in newborns which may present occasionally as congestive heart failure in neonatal period. So after excluding other most common etiologies of heart failure such as structural heart defects, screening CAVMs should be done. Inspite of early diagnosis, usually they have extremely poor prognosis.
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