Department of Radiology

Correlation between hepatic wave form changes on doppler ultrasound and severity of disease in cirrhotic patients

2022-01-01T00:00:00Z

Correlation between hepatic wave form changes on doppler ultrasound and severity of disease in cirrhotic patients Syed sumaiya latheef Background: Liver cirrhosis represents the end-stage of various chronic liver diseases characterized by progressive fibrosis and hemodynamic alterations. Doppler ultrasonography offers a non-invasive method to assess these vascular changes through hepatic vein waveform patterns. This study aimed to evaluate the correlation between hepatic vein waveform changes and disease severity in cirrhotic patients and determine its diagnostic utility. Methods: This prospective study included 140 patients with established liver cirrhosis who underwent Doppler ultrasound examination of hepatic veins. Waveform patterns were classified as triphasic, biphasic, or monophasic and correlated with Child-Pugh classification and clinical-laboratory parameters. Statistical analysis was performed to evaluate associations and diagnostic performance. Results: The study population comprised 59.3% males and 40.7% females, with 45% of patients in the 41-60 years age group. Child-Pugh classification revealed 22.9% Class A, 25% Class B, and 52.1% Class C patients. Hepatic vein waveforms were distributed as monophasic (38.6%), biphasic (36.4%), and triphasic (25%). A highly significant association (p<0.001) was found between waveform patterns and Child-Pugh classification, with 70.4% of monophasic and 68.6% of biphasic waveforms occurring in Class C patients, while 57.1% of triphasic waveforms were seen in Class A patients. A significant association (p=0.008) was also observed between waveform patterns and patient age. Diagnostic performance analysis showed 100% sensitivity and negative predictive value with 52.2% specificity and 69.5% positive predictive value. Conclusion: Hepatic vein waveform assessment by Doppler ultrasound provides a reliable non-invasive marker of disease severity in cirrhotic patients, showing excellent correlation with Child-Pugh classification. The high sensitivity and negative predictive value make this a valuable screening tool, particularly for ruling out advanced cirrhosis. Integration of hepatic vein waveform assessment into routine ultrasound evaluation offers prognostic information without increasing procedure complexity or cost.

Role of doppler ultrasound in evaluation of arteriovenous hemodialysis fistula and maturation, complications of hemodialysis vascular access

2022-01-01T00:00:00Z

Role of doppler ultrasound in evaluation of arteriovenous hemodialysis fistula and maturation, complications of hemodialysis vascular access Polavarapu Prama Introduction: Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis due to its superior long-term patency and lower complication rates. However, primary failure and delayed maturation remain significant challenges. Doppler ultrasound offers a non-invasive method for evaluating vascular anatomy and hemodynamics, potentially improving AVF outcomes. This study aimed to assess the utility of Doppler ultrasound in evaluating AVF maturation and predicting complications in hemodialysis patients. Methods: This prospective study included 109 patients undergoing AVF creation for hemodialysis access. Preoperative Doppler ultrasound was performed to assess cephalic vein and radial artery diameters and flow parameters. Postoperative evaluations were conducted on day 1, day 7, and at 4 weeks to monitor vein diameter, flow rates, and complications. Patients were followed until successful cannulation or determination of primary failure. Results: The cohort comprised 57.8% males with a mean age of 52.4 years. Diabetes mellitus (54.1%) and hypertension (52.3%) were the predominant comorbidities. Preoperative mean cephalic vein diameter was 1.98±0.58 mm, increasing to 9.07±0.75 mm at 4 weeks post- operation. Fistula flow rates progressively increased from 261.1±106.3 ml/min on day 1 to 689.7±138.09 ml/min at 4 weeks. By 4 weeks, 51.4% of AVFs achieved adequate maturation. Primary failure occurred in 24.8% of cases and was significantly associated with diabetes, hypertension, smaller preoperative vessel diameters, and lower flow rates at 4 weeks (p<0.001). The mean time to maturation was 38.03±6.8 days, with first successful cannulation at 50.4±8.1 days. Thrombosis (9.17%), infection (5.5%), and stenosis (1.83%) were the most common complications, all being significantly more prevalent in the primary failure group. Conclusion: Doppler ultrasound parameters, particularly preoperative vessel diameters and 4- week flow rates, are significant predictors of AVF maturation and primary failure. Routine ultrasound evaluation facilitates optimal vascular access planning, timely detection of complications, and improved AVF outcomes in hemodialysis patients.

Comparison study of magnetic resonance imaging and ultrasonography in evaluation of ovarian lesions with emphasis on ovarian adnexal reporting and data system

2022-01-01T00:00:00Z

Comparison study of magnetic resonance imaging and ultrasonography in evaluation of ovarian lesions with emphasis on ovarian adnexal reporting and data system Nalluri siddhartha Introduction: Accurate characterization of ovarian lesions is crucial for appropriate clinical management, as it directly influences the decision between conservative follow-up, medical management, or surgical intervention. The Ovarian-Adnexal Reporting and Data System (O- RADS) has emerged as a standardized risk stratification system aimed at improving diagnostic accuracy and clinical management of ovarian- adnexal pathologies. This study was undertaken to compare the diagnostic performance of ultrasonography (USG) and magnetic resonance imaging (MRI) in the evaluation of ovarian lesions using the O-RADS classification system. Materials and Methods: This prospective observational study was conducted in the Department of Radiodiagnosis at Shri B M Patil Medical College Hospital & Research Centre, Vijayapura from April 2023 to April 2025. A total of 44 patients with clinically suspected ovarian lesions who underwent both USG and MRI followed by histopathological confirmation were included. Lesions were characterized according to the O-RADS classification on both modalities, and the findings were correlated with histopathological results. “Statistical analysis was performed to determine sensitivity, specificity, positive predictive value, and negative predictive value of both imaging modalities.” Results: The mean age of patients was 35.7 years, with the majority (65.9%) in the 21-40 years age group. Abdominal pain was the predominant clinical presentation (90.9%). Both USG and MRI showed identical morphological characterization of lesions, with multilocular cystic lesions without solid components being the most common (29.5%). The distribution of O-RADS scores was similar between both modalities, with most lesions classified as O-RADS 3 (61.4% on USG and 63.6% on MRI). Histopathologically, 79.5% of lesions were benign and 20.5% were malignant. A significant association was found between O-RADS scores and malignancy (p<0.001), with all O-RADS 3 lesions being benign and most O-RADS 5 lesions (80%) being malignant. Both USG and MRI demonstrated identical diagnostic performance with “100% sensitivity, 95% specificity, 98% positive predictive value, and 97% negative predictive value.” Conclusion: Both ultrasonography and magnetic resonance imaging, when utilized within the framework of the O-RADS classification system, provide excellent and comparable diagnostic accuracy in the evaluation of ovarian lesions. The significant association between O-RADS scores and histopathological outcomes validates the clinical utility of this classification system for risk stratification and management planning. A tiered imaging approach, with ultrasonography as the first-line modality and MRI reserved for specific indications, appears to be the most rational and cost-effective strategy for evaluating ovarian lesions.

Prospective study on sonographic measurement of umbilical cord thickness, foetal fat layer, interventricular septal thickness as predictors of macrosomia in fetus of women with gestational diabetes mellitus

2022-01-01T00:00:00Z

Prospective study on sonographic measurement of umbilical cord thickness, foetal fat layer, interventricular septal thickness as predictors of macrosomia in fetus of women with gestational diabetes mellitus Dirisala Anudeep Introduction: Fetal macrosomia, defined as birth weight exceeding 4000 grams, is associated with increased perinatal morbidity and mortality, particularly in pregnancies complicated by gestational diabetes mellitus (GDM). Conventional methods of estimating fetal weight often lack accuracy in predicting macrosomia in diabetic pregnancies, where abnormal fat distribution patterns may confound standard biometric measurements. This prospective study aimed to evaluate the efficacy of three sonographic parameters—umbilical cord thickness, fetal fat layer thickness, and interventricular septal thickness—as predictors of fetal macrosomia in women with GDM. Methods: A total of 123 pregnant women with GDM between 34-40 weeks of gestation were enrolled in this prospective study. Comprehensive maternal data including age, BMI, and glycemic parameters were recorded. Sonographic measurements of umbilical cord thickness, fetal fat layer, and interventricular septal thickness were performed, and their association with actual birth weight and delivery outcomes was analyzed. Results: Out of 123 pregnancies, 77 (62.6%) resulted in macrosomic babies. Significant associations were found between macrosomia and maternal BMI (p<0.001), HbA1c levels (p<0.001), umbilical cord thickness ≥25 mm (p<0.001), fetal fat layer ≥4.5 mm (p<0.001), and interventricular septal thickness ≥3.9 mm (p<0.001). Umbilical cord thickness demonstrated the strongest correlation with birth weight (r=0.792, p<0.001) and showed excellent diagnostic accuracy with sensitivity of 93.3% and specificity of 85.4%. Fetal fat layer thickness exhibited high specificity (93.3%) and positive predictive value (97.3%), while interventricular septal thickness showed good specificity (85%) but lower sensitivity (71.8%). Conclusion: Sonographic measurements of umbilical cord thickness, fetal fat layer, and interventricular septal thickness are valuable predictors of fetal macrosomia in GDM pregnancies. Integration of these parameters with maternal factors may enhance the accuracy of macrosomia prediction, potentially improving clinical decision-making and optimizing maternal and neonatal outcomes.