Bushra Liaqat's scientific contributions

Objective: To evaluate the efficacy of high-resolution ultrasound and colour Doppler in differentiating neoplastic and nonneoplastic causes of cervical lymphadenopathy compared to histopathological diagnosis. Study Design: Cross-Sectional study. Place and Duration of Study: Pakistan Institute of Medical Sciences, Islamabad Pakistan, from Jan to Jun 2019. Methodology: The study included 110 patients with palpable cervical lymph nodes undergoing neck ultrasound and Fine needle aspiration cytology/Biopsy. Certain important sonological features were considered to categorize them into nonneoplastic and neoplastic groups. Colour Doppler imaging was employed along with grey-scale imaging. The histopathology results were compared with sonographic findings to determine the diagnostic accuracy of ultrasound in differentiating neoplastic from non-neoplastic causes of enlarged cervical lymph nodes. Results: Our study revealed that High-resolution sonography has 94.4% sensitivity and 88.8% specificity, differentiating between neoplastic and non-neoplastic causes of cervical lymphadenopathy. At the same time, the overall accuracy of ultrasound is 90.9%. The most consistent grey-scale feature in the non-neoplastic nodal group was preserved central fatty hilum, while its loss was significantly associated with neoplastic etiologies.Conclusion: Due to high sensitivity and negative predictive value, high-resolution sonography can be deployed as a first-line investigating tool for enlarged lymph nodes, and invasive procedures like Fine needle aspiration cytology (FNAC) can be abandoned in non-neoplastic lymphadenopathies.

Objective: To determine the diagnostic accuracy of ultrasound with Doppler analysis in testicular torsion, keeping surgical findings as the gold standard. Study Design: Cross-sectional validation study Place and Duration of study: Radiology Department of Pakistan Institute of Medical Sciences, from Dec 2017 to Dec 2019. Methodology: The study included 58 candidates of acute scrotum who were clinically equivocal with a strong suspicion of testicular torsion and were referred by the concerned surgery department to Radiology, where a senior resident performed the testicular ultrasound. The grey scale features, along with doppler findings, were noted. Only those cases that underwent surgical exploration were included. The clinical, sonological, and per-operative findings were recorded. Results: The mean age of our study was 18.00±6.02 years. The sensitivity, specificity, positive predictive value and negative predictive value of Doppler ultrasound were 98%, 86%, 98% and 86%, respectively. The most consistent Doppler ultrasound feature was absent intra-testicular flow, found among 46 out of 50 surgically confirmed cases of testicular torsion, while four had reduced intra-testicular flow. Similarly, heterogeneous testicular echotexture was the most frequently met grey scale feature. The sonological Whirlpool sign in our study came had 69% sensitivity and 100% specificity. Conclusion: The overall diagnostic accuracy of ultrasound is significantly high, especially when both greyscale and colour Doppler findings are simultaneously interpreted. The sensitivity of ultrasound in diagnosing testicular torsion is far more than its specificity.

Objective: To analyze the diagnostic accuracy of ultrasound in small bowel obstruction in the paediatric population and compare it with surgical findings. Study Design: Cross-sectional study. Place and Duration of Study: Radiology Department, Pakistan Institute of Medical Sciences, Islamabad Pakistan from Jun 2018 to Jun 2019. Methodology: This study enrolled 84 paediatric small bowel obstruction cases who underwent exploratory laparotomy at the Pakistan institute of medical sciences from Jun 2018 to Jun 2019. The clinically suspected cases of small bowel obstruction were referred by paediatric surgery to the Radiology department, where an ultrasound abdomen was performed by a senior resident, exclusively targeting the bowel. The clinical, sonological, and per-operative findings were recorded on a proforma. Results: The mean age in our study was 3.5±2.7 years. A male gender predominance was noted. The most consistent greyscale feature favouring bowel obstruction was dilated bowel loops, found among 98.7% (76 out of 77) of surgically confirmed cases of bowel obstruction. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ultrasound were 98.7%, 71.4%, 97.4%, 83.4% and 94.6% respectively. The sonological cause of obstruction was readily demonstrated among 51 (67%) out of 76 true positive cases. The most common site of obstruction was the distal ileum, with intussusception being the leading cause found among 32% of true positive cases. Conclusion: The overall diagnostic accuracy of ultrasound in revealing small bowel obstruction is high among the paediatric population.

Objective: To find out the various types of radiographic errors in digital chest radiography and their effect on image quality leading to image rejection. Material and Methods: This cross-sectional study was carried out in Radiology department of Pakistan Institute of Medical Sciences for a period of One month, September 2019. The study included 1560 digital Chest X-Rays, reaching the Picture Archive and Communication System (PACS), fulfilling the inclusion criteria. All these X-rays were analyzed by two radiology residents for the presence of radiographic errors in them. The various radiographic errors were then classified as: Positioning error, poor collimation, Artifacts, improper exposure, motion blur and mislabeling. The frequency of each radiographic error was measured along with their implication on image quality resulting in three major image categories: ACCEPT, JUST ACCEPTABLE and REJECT. The SPSS was adopted for inferential statistical analysis. Results: The study included 1013 (64.9%) male patients and 547 (35.1%) female patients. The mean age came out to be 36 +/- 15 years. Out of 1560 X-rays, 964 (61.8 %) had radiographic errors in them while 596 (38.2%) were completely devoid of radiographic errors. Positioning error (44.5 percent) was the most frequently encountered error followed by poor collimation (29.8%), artifacts (14.9%), Improper exposure (8%), motion blur (2.2%) and mislabeling (0.5%). The rejection rate came out to be 16.5 %. The major cause of image rejection was anatomy cutoff, especially the cut-off of cardio phrenic (CP) angle. Conclusion: Positioning errors represent the commonest cause of image rejection in chest radiography. The main identified pitfall was lack of radiographer’s education and training in performing an examination and indicates a need to improve their performance. Key words: Digital Radiography, Chest X ray, Radiographic error, Image reject

Objective:To find out the various types of radiographic errors in digital chest radiography and their effect on image quality leading to image rejection. Methodology:This cross-sectional study was carried out in Radiology department of Pakistan Institute of Medical Sciences for a period of one month, September 2019. The study included 1560 digital Chest X-Rays, reaching the Picture Archive and Communication System (PACS), fulfilling the inclusion criteria. All these X-rays were analyzed by two radiology residents for the presence of radiographic errors in them. The various radiographic errors were then classified as Positioning error, poor collimation, Artefacts, improper exposure, motion blur and mislabeling. The frequency of each radiographic error was measured along with their implication on image quality resulting in three major image categories: ACCEPT, JUST ACCEPTABLE and REJECT. The SPSS was adopted for inferential statistical analysis. Results:The study included 1013 (64.9%) male patients and 547 (35.1%) female patients. The mean age came out to be 36 +/-15 years. Out of 1560 X-rays, 964 (61.8 %) had radiographic errors in them while 596 (38.2%) were completely devoid of radiographic errors. Positioning error (44.5 percent) was the most frequently encountered error followed by poor collimation (29.8%), artefacts (14.9%), Improper exposure (8%), motion blur (2.2%) and mislabeling (0.5%). The rejection rate came out to be 16.5 %. The major cause of image rejection was anatomy cutoff, especially the cut-off of cardio phrenic (CP) angle. Conclusion:Positioning errors represent the commonest cause of image rejection in chest radiography. The main identified pitfall was lack of radiographer’s education and training in performing an examination and indicates a need to improve their performance