Purpose: This study aims to evaluate the role of imaging modalities, especially CTPA in diagnosing pulmonary embolism and briefly summarize PE distribution according to age and gender. Material and methods: Data of patients were collected at the "Shefqet Ndroqi" University Hospital, Department of Imaging, Tirana, Albania; during one year period, January 2017 – January 2018.Based on clinical and laboratory data, the study included 300 patients with suspected pulmonary embolisms; 53% were women and 47% were men with an average age of 64.2 years. The patients underwent this diagnostic protocol: physical examination, laboratory examination, and imaging diagnosis (radiography, CTA, MN). Chest X-ray (standing position, PA projection) was performed in all patients included in the study; 98% of patients underwent angio-CT examination, after injection of 50-65 mL of contrast media, Ultravist 370. Nuclear medicine was performed in 2% of patients after injection of 5mCi Tc-99m labeled with MAA. Results: The study shows that pulmonary embolism was found in 17.7 % of the total sample population (54 % of women and 46% of men). And the group aged 61-70 years old was more affected. CTPA examination data resulted in the final diagnosis and exclusion of PE in 98% of cases: 17.4 % positive for PE; 81.2 % negative for PE and 1.4 % indeterminate due to poor opacification of pulmonary arteries. Perfusion defect was found in two cases. Conclusion: CTPA is the imaging modality of choice in the diagnosis of PE, allowing direct visualization of the thrombus in the vascular lumen by determining the optimal time of pulmonary arteries opacification. Keywords: pulmonary embolism, CTPA, MN, radiography DOI: 10.7176/JHMN/110-03 Publication date: August 31 st 2023
Background: The diagnostic value of lung ultrasound in identifying intra-thoracic masses following previous surgical interventions is shrouded in intrigue. Under-reporting and medico-legal concerns further complicate the identification and diagnosis of such cases. This study aims to unravel the enigmatic ultrasound characteristics of a unique intra-thoracic mass, accompanied by an enthralling ultrasound video presentation. Case Report: In this captivating case, a 66-year-old patient, who had undergone aortic valve replacement surgery five years prior, presented for a routine check-up. An incidental hypo echoic image in the lung sparked further investigation. Imaging studies revealed a distinct round mass, and lung ultrasound provided intriguing insights into its features, including hypo echoic, hyper echoic density, posterior hyper echoic densities, and dynamic changes with probe manipulation. Surgical intervention uncovered a suppurated cystic formation and a retained surgical material from the previous procedure. Conclusion: The unconventional nature of an intra-thoracic round mass following prior surgical intervention adds an aura of mystique to this case. Diagnosis and management are complex due to limited reported cases and medico-legal considerations. By sharing the captivating ultrasound characteristics and video presentation of this unique case, we aim to deepen our understanding of this enigmatic phenomenon and raise awareness among clinicians. This knowledge can aid in the timely identification and appropriate management of similar cases, ultimately improving patient outcomes. The diagnostic value of lung ultrasound in intra-thoracic masses should not be overlooked, offering a radiation-free approach to post-operative follow-up and the detection of late complications.
Purpose: The purpose of this study was to evaluate gender and age distribution and the importance of imaging modalities in the evaluation and management of thyroid nodular disease in Albania nowadays. Material and method: The study analyzed the results of 310 patients (N=257 women; N=53 men), assessed at U. O. Clinic, American Hospital and Hygiea Hospital, Tirana, Albania during one year period; May 2015 – May 2016. The average age in the sample was 45.6 years. Thyroid nodules were found in 221 cases (185 females and 36 males). The patients had a standard ultrasound (US) of the thyroid; scintigraphy (SC) and ultrasound-guide fine needle aspiration biopsy (US-FNAB) when indicated. Results: The study shows that nodular disease of the thyroid was found in 84 % of women patients, and in 16 % of men patients. The largest presence of nodules was at the age group of 41-49 years. Moreover, this survey showed that ultrasound can help to distinguish nodules that are definitely benign and those with suspicious features that may require further investigation under FNAB. Some statistically significant connections were found between ultrasound characteristics and FNAB. Conclusion: Females were vast majority of patients as in regards of gender with 84 % of total sample population in the study of 310 subjects. And group age of 41-49 years old were more affected. Ultrasound and other imaging modalities are reliable methods for diagnosis and management of thyroid nodules, including patients' selection to undergo through FNAB. SC was indicated to evaluate the functional features of a nodule, especially in the presence of a low TSH value. In Albania these modalities are now used by many trained medical staff thus offering quality medical service to our patients over all. Keywords: Thyroid nodule, malignant, ultrasound, FNAB DOI: 10.7176/ALST/92-04 Publication date: February 28 th 2022
