Current issue
Volume 53, Issue 4, 2025
Online ISSN: 2560-3310
ISSN: 0350-8773
Volume 53 , Issue 4, (2025)
Published: 30.06.2025.
Open Access
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Contents
01.12.2021.
Professional paper
Anatomical and morphological characteristics of the appendix in acute appendicitis
Introduction: Echosonography of the appendix is the primary method in the diagnostic algorithm of acute appendicitis, after clinical and laboratory examination. Non-invasiveness, availability and easy performance are the advantages of this method in detecting acute appendicitis. Aim: The research aimed to determine the morphological characteristics of the appendix, as well as to evaluate the role of echo sonography in the exploration and visualization of pathological changes in the appendix in acute appendicitis. Material and methods: The cross-sectional study included 59 people who underwent appendectomy and echosonographic examination of the abdomen and pelvis within the Department of Radiological Diagnostics of UHC "Dr Dragisa Misovic-Dedinje" in Belgrade. Results: In 48 out of a total of 59 people (81.4%), there were echosonographic signs of acute appendicitis, of which incompressibility of the wall was present in 40 people (83%), diameter of the appendix over 6mm in 38 (79%), wall thickness over 3mm in 45 (94%), target sign in 33 (69%), hypervascularization of the wall in 28 (58%), as well as the presence of fecoliths with nonhomogeneous content intraluminally in 15 (31.2%) persons. The sensitivity of echosonographic examination for obtaining positive results in persons with acute appendicitis was 86.5%. The specificity of the echosonographic examination to obtain negative results in persons who do not have acute inflammation of the appendix was 57.1%. The positive predictive value (PPV) was 93.7%. The negative predictive value (NPV) was 36.4%. The accuracy of the method was 83.1%. Conclusion: Based on the high sensitivity values of the tests tested in this cross-sectional study, we estimate that echosonographic examination has a primary role in the diagnostic algorithm of a person with suspected acute appendicitis.
Milica Perić, Sava Stajić, Tatjana Filipović, Sanja Gašić, Teodora Jorgaćević, Marko Stalević
01.12.2019.
Professional paper
The role of computerized tomographic angiography in the diagnosis of pathologically modified renal arteries
Introduction: The most common causes of renal artery disease are stenosis, as a consequence of atherosclerosis and fibromuscular dysplasia. Computed tomographic (CT) angiography is a non-invasive method, which enables visualization of vascular structures and walls of blood vessels, as well as morphology of the renal parenchyma. Objective: To determine the importance of CT angiography in detecting the cause and degree of renal arterial disease. Methods: A total of 45 patients were included in the cross-sectional study conducted from March 2017 to March 2019 in the KBC DR Dragiša Mišović-Dedinje, Belgrade, Serbia. Criteria for inclusion were suspicion of secondary arterial hypertension, patients in preparation for kidney transplantation and in the follow-up period after transplantation, as well as patients with suspected traumatic lesions. We analyzed the causes of the disease, the morphology of the blood vessel wall, the percentage of stenosis, and the renal parenchyma. Results: The most common causes of renal arterial disease are atherosclerosis, which was found in 33 (73%) patients, renal artery aneurysm was found in 5 (11%) subjects, fibromuscular dysplasia in 4 (8.9%) and trauma in 1 (2) , 3%) of the patient. There were 10 (22.2%) patients with a significant (average 80 ± 14.5%) degree of stenosis. The sensitivity of CT angiography in the detection of atherosclerotic changes in the renal arteries was 87.9%, while the sensitivity of CT angiography in the detection of fibromuscular dysplasia was 75%. A statistically significant correlation was found between atherosclerotic stenosis of the renal arteries and a positive CTA finding (p = 0.0002). Conclusion: CT angiography is an important method of visualization and quantification of pathological changes in the renal arteries.
Miloš Gašić, Sava Stajić, Ivan Bogosavljević, Milena Šaranović, Aleksandra Milenković, Sanja Gašić
01.12.2017.
Professional paper
The importance and role of echotomographic examinations in malignant altered axillary lymph nodes
Introduction: The presence of malignant altered axillary lymph nodes, and their timely detection is crucial for staging and prognosis of breast cancer. Echotomographic examinations are widely used technique, and represents one of the first tests of diagnostic modalities. Classic B mode, Doppler sonography, and MicroPure testing technique, allow a comprehensive assessment of the detailed morphology and internal structure of the nodes (number, location, size, shape, borders, echogenicity, edema of the surrounding soft-tissue, the presence of microcalcifications), and determination of their nature. Objective:The aim is to determine the role of echotomographic review the morphology, determining the nature and setting guidelines for diagnostic testing algorithm for malignant altered axillary lymph nodes. Materials and methods: This cross-sectional study included 212 echotomographic tested axillary lymph nodes in the Department of Radiological Diagnostics KBC "Dr Dragisa Mišović-Dedinje" in Belgrade, in the period from February 2016.do March 2017. All patients were examined in the supine position with arms in abduction, and external rotation. The following parameters: shape, size, and homogeneity of the echo-structure, edge, an auxiliary structures such as intranodal necrosis, edema and peripheral vascularization, as well as the presence of microcalcifications, using classical B mode, Doppler sonography and MicroPure technique. For all examinations we used Toshiba device, Aplio XG, 10MHz linear transducer. Results: Of a total of 212 tested nodule, histopathology was also verified 44 malignantly changed (21%), 4 of which the primary (9%) in a patient with Hodgkin's lymphoma, and secondary 40 (91%) in patients with breast cancer. Other nodes 168 (79%) were normal-reactive. The best performance in the echotomographic examinations are the criteria of: the shape (longitudinal cross-ratio <2) with a sensitivity of 86.9%, presence of microcalcifications with sensitivity of 83,7%, hilus (not clearly defined, and hypoechogenic) with sensitivity of 81.8%, the size (transverse diameter greater than 8mm), with a sensitivity of 79.2%, as well as echogenicity (hypo to anechogenic) with sensitivity of 73.1%. Conclusion: Echotomographic review is a useful imaging modality in evaluating the morphology and nature of axillary lymph nodes, but none echotomographic criterion in itself is not enough reliable in evaluating malignancy. Meticulousness when reviewing and examining all the criteria and modalities (B mode, Doppler, MicroPure) remain imperative in the diagnostic algorithm of tests axillary lymph nodes.
Miloš Gašić, Ivan Bogosavljević, Bojan Tomić, Milena Šaranović, Aleksandra Milenković, Sava Stajić