Diagnostic performance of multidetector computed tomography in the evaluation of esoph

Objective: Our purpose was to evaluate the role of multidetector computed tomography (MDCT) in evaluation of esophageal varices (EV). Patients and methods: 112 patients with liver cirrhosis were included, EV was evaluated for grades, presence of collateral, palisade vein dilatation and also patient acceptability. Results: The sensitivity of MDCT for radiologist A was 94.8%, specificity 98.5%, Accuracy 97.8%, PPV 94.8%, NPV 98.5% and for radiologist B, 99.4%, 99.6%, 99.6%, 99.3% and 99.7% respectively. MDCT detected para esophageal varices in 38 cases, gastric fundus varices in 47 cases and splenorenal collaterals were seen in 14 cases, palisade vein dilatation was +ve in 58 cases, −ve in 47 cases and (±) in 7 cases. 3 cases of HCC and 1 liver cyst were incidentally found during examination. There was a highly significant correlation between degree of palisade vein dilatation, increasing grade of esophageal varices and Red color sign with p value <0.01. MDCT was more accepted than endoscopy in 83%. The preference of CT was statistically significant p < 0.01. Conclusion: MDCT is a fast, well tolerable, non-invasive procedure and accepted from most of the examined patients for evaluation and grading of EV, detection of other portosystemic collaterals and hepatobiliary pathologies

Variability in sphenoid sinus pneumatization and its impact upon reduction of complications following sellar region surgeries

Background: The rapid evolution of transsphenoidal endoscopic surgical intervention and surgeries of skull base and sellar regions is accompanied by multiple complications. Objective: To determine different types of extension of sphenoid sinus pneumatization detected by CT and MRI and their impact upon different approaches and complications of sellar region surgeries. Subjects and methods: The pre-operative CT and MRI images of 182 patients with surgical intervention for peri-sellar region pathologies were retrospectively evaluated for patterns of sphenoid pneumatization. Post surgical complications were recorded and analyzed. Results: The overall rate of complications was 88 affecting 62 patients (34%), and 120 patients (66%) were free of complications. Different types of pneumatization were detected on CT and MRI images, conchal in 3 cases (1.6%), presellar 23 cases (12.6%) and 156 cases (85.7%) showing sellar pneumatization. Sellar pattern was reclassified into 6 types. Single inter sphenoid septum was seen in 109 patients, accessory septum was found in 13 patients and 10 patients have multiple sphenoid septation. 24 patients (13.2%) show absent septum. Conclusion: Pre-intervention assessment of sphenoid sinus pneumatization is mandatory in approaching the sella and skull base structures either via the nose or open skull base surgery to avoid injury of the nearby structures and reduce the possibility of CSF leakage