Correlation of ultrasound imaging with histopathological findings in gestational trophoblastic disease

Introduction:  Gestational trophoblastic diseases (GTD) include a spectrum of pregnancy-related diseases caused by abnormal proliferation of the placenta .  The main aim of this study to study the Correlation of ultrasound imaging with histopathological findings in gestational trophoblastic disease. Method: This is the retrospective study consisting of 155 sonographically diagnosed cases of GTD collected for three years 2016-2019. These patients were evaluated by transabdominal sonography. All these patients underwent Evacuation of product of conception (POC) and samples were subsequently sent for histopathological examination Their histopathological reports were followed up. The Correlation between USG and histopathological findings in GTD was studied. Result :  Among these 155 sonographically diagnosed cases of GTD 141 (91.0%) were  histologically confirmed GTD,  14 (9.0%) were  non-molar miscarriages on histological examination. In 141 cases of histologically confirmed GTD, 110 (71.0 %) were partial mole, 15 (9.7%) complete mole, 12 (7.7%) invasive mole and 3 (1.9 %) persistent mole, 1(0.6%) was choriocarcinoma. Conclusion :  The diagnostic accuracy of ultrasound to be 90% in the diagnosis of GTD, increasing its reliability. Thus ultrasound seems to be an initial modality of choice in the workup of every woman suspected of having GTD

Accuracy of magnetic resonance cholangiopancreaticography in the diagnosis of benign and malignant cause of obstructive jaundice: Accuracy of MRCP in obstructive jaundice

Introduction: Magnetic Resonance Cholangiopancreatography (MRCP) is non-invasive technique for overall assessment for obstructive jaundice. This study aims to compare accuracy of MRCP in benign and malignant obstructive jaundice with gold standard but the invasive procedure of Endoscopic Retrograde Cholangiopancreatography (ERCP) and histopathology. Method: This was a retrospective study reviewing MRCP findings of clinically diagnosed obstructive jaundice from 2018 to 2021 at Patan Hospital, Kathmandu, Nepal. Study was conducted after ethical clearance of the institutional review committee. Sensitivity, Specificity, PPV and NPV and overall accuracy of MRCP was compared with the ERCP and histopathology. Chi square test was used for analysis, a p<0.05 considered significant. Result: Among 66 patients, the Sensitivity, Specificity, PPV and NPV of MRCP for biliary obstruction due to malignant pathology were 89.50%, 93.60%, 85.00% and 95.70% respectively. Similarly, for benign etiology, it was 93.60%, 89.50%, 95.70% and 85.00% respectively. The overall diagnostic accuracy was 92.40%. Choledocholithiasis were 31(46.97%) among benign cause and periampullary carcinoma 8(12.12%) among malignant. Conclusion: MRCP is highly sensitive and specific test in the evaluation of benign and malignant biliary pathology. Being noninvasive and can have good diagnostic value despite use of contrast. So minimally invasive procedure ERCP can be reserved for therapeutic or diagnostic biopsy purpose only