Utility of Abdominal Ultrasound in the Diagnosis of Abdomino-Pelvic Lesions at Bugando Medical Centre, Mwanza Tanzania
Mohamed Said Binde [Male]
Utility of Abdominal Ultrasound in the Diagnosis of Abdomino-Pelvic Lesions at Bugando Medical Centre, Mwanza Tanzania - Mwanza, Tanzania Catholic University of Health and Allied Sciences [CUHAS - Bugando] 2018 - xiv; 65 Pages Includes References and Appendices
ABSTRACT:
Background: Abdominal ultrasound is widely used as a primary diagnostic imaging for patients with palpable or suspected with abdomino-pelvic lesions. This may be explained by its relative accessibility, affordability and safety as compared to other sophisticated imaging such as computerized tomography scan, Magnetic resonance imaging, nuclear medicine and others. However, its diagnostic utility {i.e. sensitivity, specificity, accuracy, error and predictive values) has not yet been assessed in our centre, and therefore its use as an alternative diagnostic tool in patients with abdomino-pelvic lesions is not justified. This existing knowledge gap prompted the author to conduct this study
Objective: To determine the utility of abdominal ultrasound in the diagnosis of abdomino-pelvic lesions at Bugando Medical Centre
Methods: This was a cross sectional study to evaluate the diagnostic utility of abdominal ultrasound in patients with palpable or suspected with abdomino-pelvic lesions at Bugando Medical Centre between January 2017 to May 2017
Results: A total of 146 patients (M: F= 1; 2.2) were studied. The mean age was 39 .30 years. The diagnostic value of abdominal ultrasound (in terms of sensitivity, specificity, PPV, NPV and accuracy) in the diagnosis of abdomino-pelvic lesions varies with anatomical site and organ of origin and in this study it was low compared with what is reported in developed world.
Conclusion: The diagnostic value of abdominal ultrasound in detecting abdomino-pelvic lesions is much lower than that seen in developing countries, hence, abdominal ultrasound is not a reliable tool in detecting abdomino-pelvic lesions at BMC and should be supplemented with abdominal CT scan in selected cases.
= OPERATIONAL DEFINITIONS Accuracy Refers to all cases with correct diagnosis i.e. Accuracy = TP + TN x 100% TP+TN+FP+FN OPERATIONAL DEFINITIONS False negative A number of cases to which operative findings are positive to particular disease, but ultrasound findings are negative to the disease OPERATIONAL DEFINITIONS False positive A number of cases to which ultrasound findings point to a particular disease, but operative findings are negative to a disease OPERATIONAL DEFINITIONS Negative Predictive Measures the probability that the disease is actually absent if the test is negative i.e. Negative Predictive Value = TN x 100% TN+ FN OPERATIONAL DEFINITIONS Positive Predictive Refers to the percentages of patients with positive test results who actually have the disease i.e. probability that the disease is actually present if the test is positive. i.e. Positive Predictive Value = TP x 100% TP+ FP OPERATIONAL DEFINITIONS Sensitivity Percentage of all patients with the disease who have a positive test i.e. Sensitivity = TP X100 %xiii TP+FN OPERATIONAL DEFINITIONS Specificity Percentage of all patients without the disease who have a negative test. i.e. Specificity = TN X100 % TN+FP OPERATIONAL DEFINITIONS True negative A number of cases to which both ultrasound findings and operative findings are negative to a particular disease OPERATIONAL DEFINITIONS True positive A number of cases which ultrasound findings and operative findings are all corresponding to one another i.e. they point to one particular disease = ABBREVIATIONS ATLS Advanced Trauma Life Support BAT Blunt abdominal trauma BMC Bugando Medical Centre CT Computed Tomography CUHAS Catholic University of Health and Allied Sciences FAST Focused Assessment for the Sonographic examination of the Trauma patient FIPF Free intraperitoneal fluid GIT Gastrointestinal Tract MRI Magnetic Resonance Imaging NPV Negative Predictive Value PID Pelvic Inflammatory Diseases PPV Positive Predictive Value TOM Tubo-Ovarian Mass US Ultrasound/Ultrasonography WHO World Health Organization
Wurzburg Road 35, BMC Premises, Post Code: 33102: P. O Box 1464, Mwanza – Tanzania: Phone: +255 28 298 3384: Fax: +255 28 298 3386: Email: vc@bugando.ac.tz : www.bugando.ac.tz
--Surgery
Utility of Abdominal Ultrasound in the Diagnosis of Abdomino-Pelvic Lesions at Bugando Medical Centre, Mwanza Tanzania - Mwanza, Tanzania Catholic University of Health and Allied Sciences [CUHAS - Bugando] 2018 - xiv; 65 Pages Includes References and Appendices
ABSTRACT:
Background: Abdominal ultrasound is widely used as a primary diagnostic imaging for patients with palpable or suspected with abdomino-pelvic lesions. This may be explained by its relative accessibility, affordability and safety as compared to other sophisticated imaging such as computerized tomography scan, Magnetic resonance imaging, nuclear medicine and others. However, its diagnostic utility {i.e. sensitivity, specificity, accuracy, error and predictive values) has not yet been assessed in our centre, and therefore its use as an alternative diagnostic tool in patients with abdomino-pelvic lesions is not justified. This existing knowledge gap prompted the author to conduct this study
Objective: To determine the utility of abdominal ultrasound in the diagnosis of abdomino-pelvic lesions at Bugando Medical Centre
Methods: This was a cross sectional study to evaluate the diagnostic utility of abdominal ultrasound in patients with palpable or suspected with abdomino-pelvic lesions at Bugando Medical Centre between January 2017 to May 2017
Results: A total of 146 patients (M: F= 1; 2.2) were studied. The mean age was 39 .30 years. The diagnostic value of abdominal ultrasound (in terms of sensitivity, specificity, PPV, NPV and accuracy) in the diagnosis of abdomino-pelvic lesions varies with anatomical site and organ of origin and in this study it was low compared with what is reported in developed world.
Conclusion: The diagnostic value of abdominal ultrasound in detecting abdomino-pelvic lesions is much lower than that seen in developing countries, hence, abdominal ultrasound is not a reliable tool in detecting abdomino-pelvic lesions at BMC and should be supplemented with abdominal CT scan in selected cases.
= OPERATIONAL DEFINITIONS Accuracy Refers to all cases with correct diagnosis i.e. Accuracy = TP + TN x 100% TP+TN+FP+FN OPERATIONAL DEFINITIONS False negative A number of cases to which operative findings are positive to particular disease, but ultrasound findings are negative to the disease OPERATIONAL DEFINITIONS False positive A number of cases to which ultrasound findings point to a particular disease, but operative findings are negative to a disease OPERATIONAL DEFINITIONS Negative Predictive Measures the probability that the disease is actually absent if the test is negative i.e. Negative Predictive Value = TN x 100% TN+ FN OPERATIONAL DEFINITIONS Positive Predictive Refers to the percentages of patients with positive test results who actually have the disease i.e. probability that the disease is actually present if the test is positive. i.e. Positive Predictive Value = TP x 100% TP+ FP OPERATIONAL DEFINITIONS Sensitivity Percentage of all patients with the disease who have a positive test i.e. Sensitivity = TP X100 %xiii TP+FN OPERATIONAL DEFINITIONS Specificity Percentage of all patients without the disease who have a negative test. i.e. Specificity = TN X100 % TN+FP OPERATIONAL DEFINITIONS True negative A number of cases to which both ultrasound findings and operative findings are negative to a particular disease OPERATIONAL DEFINITIONS True positive A number of cases which ultrasound findings and operative findings are all corresponding to one another i.e. they point to one particular disease = ABBREVIATIONS ATLS Advanced Trauma Life Support BAT Blunt abdominal trauma BMC Bugando Medical Centre CT Computed Tomography CUHAS Catholic University of Health and Allied Sciences FAST Focused Assessment for the Sonographic examination of the Trauma patient FIPF Free intraperitoneal fluid GIT Gastrointestinal Tract MRI Magnetic Resonance Imaging NPV Negative Predictive Value PID Pelvic Inflammatory Diseases PPV Positive Predictive Value TOM Tubo-Ovarian Mass US Ultrasound/Ultrasonography WHO World Health Organization
Wurzburg Road 35, BMC Premises, Post Code: 33102: P. O Box 1464, Mwanza – Tanzania: Phone: +255 28 298 3384: Fax: +255 28 298 3386: Email: vc@bugando.ac.tz : www.bugando.ac.tz
--Surgery