Asian Journal of Medical Radiological Research https://aijournals.com/index.php/ajmrr <p><strong class="pull-left">Asian Journal of Medical Radiological Research (AJMRR)</strong>&nbsp;&nbsp; is an open-access; freely accessible, online and print Bi-annual peer-reviewed international journal publishes a wide spectrum of advanced research in radiology and medical imaging. <br> <strong>Online ISSN: 2347-338X | Print ISSN: 2347-3371</strong></p> Society for Health Care & Research Development en-US Asian Journal of Medical Radiological Research 2347-3371 Retrospective Evaluation of Radiographic Findings in Patients with Pulmonary Tuberculosis: An Observational Study https://aijournals.com/index.php/ajmrr/article/view/813 <p><strong>Background: </strong>Tuberculosis remains a worldwide health hazard instead well documented well publicized methods of prevention and cure. Chest radiographs are used to stratify for risk and to assess for asymptomatic active disease. Hence; we planned the present study to retrospectively analyze the data of the pulmonary tuberculosis patients for analyzing the spectrum of radiographic findings. <strong>Subjects and Methods: </strong>In the present study, we analyzed the data records of a total of 100 pulmonary tuberculosis patients. A self-framed master cart was prepared in which, past medical history, clinical history, radiographic findings, clinical findings of all the patients was obtained. Data records of only those patients were analyzed in which both clinical and bacteriologic confirmation of the disease was present. Radiographs were evaluated. Only preoperative radiographic findings were taken into consideration. <strong>Results: </strong>The most common radiographic finding was hilar lymph node, found to be present in 66 percent of the patients. Unilateral nodular infiltration was found to be present in 25 percent of the patients. Patchy consolidation was seen in 22 percent of the patients. Fibrotic scar was seen in 10 percent of the patients while calcified nodule was seen in 8 percent of the patients. <strong>Conclusion: </strong>In diagnosing and assessing the extent of severity among tuberculosis patients, radiographic imaging is a vital tool.</p> Nitin Dasrath Wadhwani Niranjan Bapusaheb Patil ##submission.copyrightStatement## 2019-07-14 2019-07-14 7 2 01 03 Analysis of CT Scans Findings in Seizures Patients: An Observational Study https://aijournals.com/index.php/ajmrr/article/view/814 <p><strong>Background: </strong>Seizures may occur in up to 10% of the population. There is general consensus that adults with an unprovoked first seizure should have brain imaging with either CT or MRI primarily to identify any process that may be responsible for the seizure. Hence; under the light of above mentioned data, the present study was planned for assessing CT scans and their findings in seizures patients. <strong>Subjects and Methods: </strong>All the patients reporting with the history of seizure disorder were admitted to the emergency department and were treated accordingly. Complete past medical and clinical history of all the patients was obtained. In all the patients, EEG was done and findings of the EEG were correlated with the final diagnosis.&nbsp; In all the patients CT scan was done. Diagnosis was confirmed after correlating the clinical findings of all the patients with clinical history and microbiological investigation reports.&nbsp; All the results were analyzed by SPSS software .<strong>Results: </strong>Tuberculoma was found to be present among in 18 patients with partial seizures. Cerebral infarct was found to be present in 10 patients with partial seizures and among 15 patients with generalized seizures. Focal cerebral edema was found to be present in 10 patients with partial seizures. Diffuse cerebral edema was found to be present in 13 patients with generalized seizures. Brain tumour was found to be present among 6 patients with partial seizures. Calcifications were found to be present in 4 patients with partial seizures and 10 patients with generalized seizures. <strong>Conclusion: </strong>CT is sensitive for detection of neural lesions and is advocated in seizure patients. However; further studies are recommended.</p> Niranjan Bapu saheb Patil Nitin Dashrath Wadhwani ##submission.copyrightStatement## 2019-07-14 2019-07-14 7 2 04 06 Assessment of Prevalence of Abnormal Neurological Findings on MRI in Patients Presenting with Chronic Headache: A Clinical Study https://aijournals.com/index.php/ajmrr/article/view/815 <p><strong>Background: </strong>Chronic headache is one of the common presenting complaints in patients reporting to general practitioner. Magnetic resonance imaging (MRI) is a medical imaging technique used to aid diagnosis but unlike CT it does not use ionizing radiation. Hence; we assessed the prevalence of abnormal neurological findings on MRI in patients presenting with chronic headache. <strong>Subjects and Methods: </strong>A total of 100 patients reporting to the department with chief complaint of non-specific chronic headache were enrolled in the present study. Detailed demographic data and past medical history of all the patients was obtained. We also obtained complete history of present illness. MRI was done in all the patients under the hands of skilled and experienced radiologists. MRI findings were analyzed and were summarized in Microsoft excel sheet and were assessed by SPSS software. Chi- square test was used for assessment of level of significance. <strong>Results: </strong>Mean age of the patients of the present study was 40.8 years. Majority of the patients (49 percent) belonged to the age group of 30 to 50 years. 31 percent of the patients belonged to the age group of less than 30 years. 58 percent of the patients of the present study were males while the remaining 42 percent were females. Abnormal MRI findings were found to be present in 22 percent of the patient population. <strong>Conclusion: </strong>Chronic headache is a common problem affecting significant proportion of patient populating. Significant proportion of patients with chronic headache has associated abnormal MRI findings.</p> Pradeep Shankarrao Patil Niranjan Bapu saheb Patil ##submission.copyrightStatement## 2019-07-14 2019-07-14 7 2 07 09 To Evaluate the Diagnostic Accuracy of Ultrasound Criteria for the Depiction of Benign or Malignant Thyroid Nodule by Using Tissue Diagnosis as Reference Standard https://aijournals.com/index.php/ajmrr/article/view/818 <p><strong>Background: </strong>High-resolution ultrasonography is a very sensitive imaging modality for examination of the thyroid gland and associated abnormalities. It is noninvasive, widely available, less expensive, and does not use any ionizing radiation. Further, real time ultrasound imaging helps to guide diagnostic and therapeutic interventional procedures (FNAC and Biopsy) in cases of thyroid disease. Objectives: To study the diagnostic accuracy of ultrasound criteria’s for the depiction of benign or malignant thyroid nodule and their correlation with cytology or histopathology. <strong>Subjects and Methods: </strong>The study included 50 patients who were referred for ultrasound with clinical suspicion of thyroid lesions. The ultrasound diagnosis was compared to the final diagnosis made on cytology or histopathology, and the ability of ultrasound in differentiating between a benign or malignant lesion was determined. <strong>Results: </strong>The ultrasound features favoring a malignant lesion included – solid consistency (Sn 92.3%; Sp48.6%; p=.009), hypoechoic echo-pattern (Sn 100%; Sp 54.5%: p=.004), micro-calcification (Sn 69.3%; Sp97.3%; p=.000), taller than wider shape (Sn 53.8%; Sp 89.1%; p=.001), ill-defined margins (Sn 61.5%;Sp 91.9%; p=.000) and internal vascularity (Sn 84.6%; Sp67.5%;p=.001). The ultrasound diagnosis was in agreement with the final diagnosis in 90% of the cases.The overall sensitivity, specificity and PPV of ultrasound in identifying a malignant lesion was 92.31%, 97.30%, and 92.31% respectively. <strong>Conclusion: </strong>Ultrasound is an excellent non-invasive modality to evaluate thyroid nodules. It is a highly sensitive imaging modality for identifying and characterizing a lesion as benign or malignant.</p> Gagandeep Singh Sethi Ritu Dhawan Galhotra Parambir Sandhu Kavita Saggar Harkirat Singh Panach ##submission.copyrightStatement## 2019-07-14 2019-07-14 7 2 10 16 Clinical Profile of Patients with Thyroid Nodules Subjected for Ultrasonography https://aijournals.com/index.php/ajmrr/article/view/837 <p><strong>Background: </strong>Hashimoto’s thyroiditis cannot be distinguished from those of multinodular goitre (MNG). Basically the thyroid is enlarged bilaterally with an uneven parenchymal pattern mainly showing decrease in the normal echogenicity. The ultrasound appearance of Hashimoto’s thytoiditis is that of a diffuse glandular enlargement with irregular lobulated margins. There is a generalised decrease in parenchymal reflectivity with a typical lobulated pattern due to highly reflective fibrous bands which separate the echo poor areas. <strong>Subjects and Methods: </strong>Based on the inclusion and exclusion criteria, 80 cases of thyroid lesions diagnosed by ultrasound were included in the study. The ultrasonography and ultrasound elastography examination was done in the department of Radiology .These 80 cases which were found to have thyroid lesion on ultrasound were subjected to FNAC for confirmation of ultrasound finding and establishment of final diagnosis. <strong>Results:</strong> Study showed no vascularity (TYPE1) and (TYPE2) peripheral vascularity in 100% of benign nodules, none of the malignant nodules showed type 1 and 2 vascularity. 95.2% of benign nodules showed TYPE 3 vascularity and 4.76% of cases were malignant. <strong>Conclusion: </strong>40% of the benign nodules showed intra nodular vascularity (TYPE4) and 60% of the cases were malignant.</p> Veeresh Hanchinal Vishwanath S Kulkarni ##submission.copyrightStatement## 2019-07-24 2019-07-24 7 2 17 20 Role of Ultrasonography and Ultrasound Elastography in the Evaluation Thyroid Nodules https://aijournals.com/index.php/ajmrr/article/view/838 <p><strong>Background: </strong>Thyroid nodules are commonly encountered, and thyroid cancers are among the commonest head and neck malignancies. Early detection and accurate diagnosis are extremely important in the definitive management of such patients.Ultrasonography is widely used first line of investigation in a patients suspected with thyroid mass which will help to differentiate diffuse thyroid diseases from nodular thyroid disease,recent advances in ultrasound technology and the introduction of Ultrasound Elastography have reportedly improved the accuracy in the differentiation of benign from malignant thyroid nodules. <strong>Subjects and Methods: </strong>Based on the inclusion and exclusion criteria, 80 cases of thyroid lesions diagnosed by ultrasound were included in the study. The ultrasonography and ultrasound elastography examination was done in the department of Radiology. These 80 cases which were found to have thyroid lesion on ultrasound were subjected to FNAC for confirmation of ultrasound finding and establishment of final diagnosis. <strong>Results:</strong> Our study showed 37.5% (30) of cases were diffuse thyroid disease and 62.5%(50) were nodular diseases. Out of 30 diffuse thyroid disease 15% were colloid goiter, 17.5% were hashimoto’s thyroiditis,5% were De Quervain’s thyroiditis. Our study also showed 100% of the hyperechoic nodules were benign, 77.77% hypoechoic nodules were benign and 22.22% hypoechoic nodules were malignant, 100% isoechoic nodules were benign and 100% of cystic nodules were benign. <strong>Conclusion: </strong>Ultrasound helps us to know clearly whether the lesion is solitary or multiple. It helps to clearly differentiate between solid and cystic lesions. The diffuse heterogenous echotexture of the gland with characteristic hypoechoic nodules clearly helps us in diagnosing Hashimotos thyroiditis. In addition, ultrasound is very useful to differentiate benign lesions from malignant thyroid lesions in most of the cases.</p> Veeresh Hanchinal Vishwanath S Kulkarni ##submission.copyrightStatement## 2019-07-24 2019-07-24 7 2 21 25 Spectrum of High Resolution Ultrasonography and Color Doppler Findings in Peripheral Neuropathy https://aijournals.com/index.php/ajmrr/article/view/867 <p><strong>Background: </strong>Available diagnostic modalities for peripheral neuropathies e.g clinical assessment, electrodiagnostics, skin and nerve biopsy has certain limitations. The role of imaging is very limited. Purpose of this study is to evaluate findings in various peripheral neuropathies on ultrasonography and color Doppler. <strong>Subjects and Methods: </strong>Fifty adult patients of either sex with already diagnosed peripheral neuropathies were evaluated with high resolution ultrasound and color doppler of the relevant peripheral nerves and were compared with age and sex matched fifty healthy adult controls. <strong>Results: </strong>The study included patients with various peripheral neuropathies (carpal tunnel syndrome, diabetic peripheral neuropathy, leprosy, chronic inflammatory demyelinating polyradiculoneuropathy, and peripheral nerve trauma). There was a significant increase in cross sectional area and change in echogenicity of median nerve at carpal tunnel in carpal tunnel syndrome (p&lt;0.05). Multiple nerves in diabetic peripheral neuropathy and leprosy patients showed increased cross sectional area and altered echogenicity as compared to controls (P &lt; 0.05). Patients with CIDP showed diffusely hyperechoic peripheral nerves. Sonography in peripheral nerve trauma showed significant hyperechogenicity and increased vascularity on doppler at site of trauma with precise localization. <strong>Conclusion: </strong>High resolution ultrasonography with color doppler showed greater extent of quantitative and qualitative alterations in peripheral nerves in various peripheral neuropathies.&nbsp; USG has the potential to complement other diagnostic investigations such as the nerve conduction study in polyneuropathies and can objectively measure nerve damage in some focal neuropathies. It is easily available and has the potential to become the first modality for screening or evaluation of peripheral neuropathies.</p> B.L. Kumawat Manisha Sharma C.M. Sharma Aakanksha Agarwal ##submission.copyrightStatement## 2019-08-04 2019-08-04 7 2 26 31 Role of Ultrasound in Analysis of Vocal Cord Movements in Comparison with Laryngoscopy https://aijournals.com/index.php/ajmrr/article/view/868 <p><strong>Background: </strong>Ultrasound is a real time, dynamic imaging modality, useful in evaluating the movement of anatomical structures. It is a non-invasive and cheap imaging technique which can be utilized as a primary tool/ as an alternate tool to laryngoscopy in assessing the vocal cord movements in suspected cases of Vocal cord palsy. <strong>Aims &amp; objectives: </strong>To evaluate the utility of ultrasound in diagnosis of vocal cord movements in suspected cases of Vocal cord palsy. To compare the results with fibreoptic laryngoscopy findings. <strong>Subjects and Methods: </strong>A prospective comparative study done on 73 clinically suspected cases of vocal cord palsy. Vocal cord movements were assessed on ultrasound and results were compared with findings of flexible fibreoptic laryngoscopy. <strong>Results: </strong>Out of 73 cases of clinically suspected vocal cord palsy, 42 cases were diagnosed with reduced / absent movement of vocal cords on ultrasound. In 3 cases ultrasound was not able to diagnose vocal cords palsy due to excessive laryngeal cartilage calcification. Unilateral vocal cord palsy was noted in 36 patients and bilateral vocal cord palsy in 9 patients. <strong>Conclusion: </strong>Ultrasound is reliable, non-invasive and cheap modality to asses vocal cord movements. Compared to fibreoptic laryngoscopy it has high sensitivity and specificity in diagnosing vocal cord palsy.</p> Nagaraj Murthy Dimple Bhatia ##submission.copyrightStatement## 2019-08-04 2019-08-04 7 2 32 35 Role of CT Colonographyin the Evaluation of Colorectal Carcinoma https://aijournals.com/index.php/ajmrr/article/view/869 <p><strong>Background: </strong>Colorectal carcinoma is one of the commonest diseases in the adult. The advancement in the technology of CT scan has offered CT colonography which explores the colonic luminal pathology. The present study is done to evaluate the role of CT colonography in colorectal carcinoma. <strong>Subjects and Methods: </strong>The prospective study was carried out in the Department of Radiodiagnosis and Imaging, Sir Sunderlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi, over a period of 24 months. A total of 162 patients with colorectal carcinoma were selected and the disease characterization was studied using CT colonography. CT was carried out with GE (General Electric) Light speed VCT 64 slice MDCT machine. <strong>Results:</strong>The study group comprises of 106 male and 56 female patients. Highest numbers of cases (25%) were in the 6th decade of life. The commonest presenting complaints were bleeding per rectum and constipation. The rectum being the most frequently involved colonic segment in 38% of cases. Focal, asymmetric, marked (&gt;2 cm) wall thickening of colon with heterogeneous (mixed) attenuation pattern was seen commonly. Majority of the cases presented with periserosal fat invasion and internal iliac nodal group involvement. Liver is the commonest organ for distant metastasis. Four cases of malignant solitary sigmoid colon polyps and two cases of malignant rectal polyps were also identified. <strong>Conclusion: </strong>CT colonography is effective in characterisation of the malignant colorectal growth and identifying adenomatous polyps thus can be effectively used for the early detection, staging and screening of colorectal malignancy.</p> Sabari Arasu P Arun Kumar S Kaviyarasy T Dhivya R Sangeetha Devi P.S ##submission.copyrightStatement## 2019-08-04 2019-08-04 7 2 36 40 Hydrocephalus - The Cross Sectional Radiological Study of Epidemiology, Classification and Causes https://aijournals.com/index.php/ajmrr/article/view/870 <p><strong>Background: </strong>Hydrocephalus is an active distension of the ventricular system of the brain resulting from inadequate passage of CSF from its point of production within the cerebral ventricles to its point of absorption into the systemic circulation. <strong>Subjects and Methods: </strong>This study evaluating the efficacy of Computed Tomography in the diagnosis of Hydrocephalus was done on 74 cases. All the cases were studied on a Siemens Somatom ARC Computed Tomography system which is a modified Third generation machine. Factors of 130 KV and 70 MA were a constant for all cases and factors of 110 KV and 50 MA were used for infants. Demographic profile and radiological parameters were studied and tabulated on Microsoft excel file. <strong>Results: </strong>Tubercular meningitis was the commonest cause of hydrocephalus, with aqueduct, stenosis and tumours as the second important causes. All patients with possible hydrocephalus should have an initial, complete noncontrast CT scan with serial sections from vertex down through the upper cervical region to i. demonstrate size of all ventricles and cisterns to help rule out low lying tumors, the Chiari I and Chiari II malformation. <strong>Conclusion: </strong>CT is a valuable tool with a very high diagnostic sensitivity and helps in early detection of hydrocephalus and its management.</p> Sandeep Ballal Annitha Elavarasi Jayamohan Suresh V Ajit Kumar ##submission.copyrightStatement## 2019-08-04 2019-08-04 7 2 41 45 The Radiological Study to Establish the Accuracy of MRCP over USG & CT in Diagnosing the Case of Obstructive Jaundice https://aijournals.com/index.php/ajmrr/article/view/871 <p><strong>Background: </strong>MRCP is a relatively new MR imaging technique that has revolutionized the imaging of biliary and pancreatic ducts. <strong>Methods:</strong> The study was conducted in the department of Radio Diagnosis, MGMC&amp;RI, for a period of 2 years. Thirty three patients of obstructive jaundice were included in the study. Ultrasonography followed by MRCP and then CT were done in all the patients. Three experienced radiologists reviewed the images separately and evaluated the cause and site of obstruction in these patients. The accuracy of each modality was analyzed statistically and correlation was made with the surgical findings or histopathological reports. <strong>Results:</strong> MRCP had an accuracy of 97% in detecting the cause of obstructive jaundice while CT &amp; USG had a accuracy of 82% &amp; 67% respectively. In diagnosing the site of obstruction MRCP had a accuracy of 100% while CT had 88% and USG 55%. The performance of MRCP when compared to CT and USG was statistically more significant (p&lt;0.05). <strong>Conclusion:</strong> In the diagnosis of obstructive jaundice and to know the cause, site and extent of the lesion MRCP being a non invasive, non ionizing procedure seems to be a better choice over other radiological procedures like USG, CT or ERCP.</p> Annitha Elavarasi Jayamohan Antony Jean Prakash Manikka Lakshmanan Ajit Kumar Reddy ##submission.copyrightStatement## 2019-08-04 2019-08-04 7 2 46 51 Assessment of Potential of First Trimester Ultrasonography in Detection of Fetal Congenital Structural Malformations- A Retrospective Study https://aijournals.com/index.php/ajmrr/article/view/912 <p><strong>Background: </strong>Early detection of malformation is tremendously improved with improvement in imaging technology. Yet in a developing country like India majority of pregnant women are not privileged to get timely diagnosis. Present study aimed to assess the potential of first trimester ultrasonography in detection of fetal congenital structural malformations. <strong>Subjects and Methods: </strong>All pregnant women had anomaly scan and women with fetal structural malformations were included. All patients were screened for congenital anomalies by 11-14 week ultrasound scan (first trimester anomaly scan) as part of routine prenatal care. Second trimester scan was conducted at 18 to 22 weeks gestation. The results of the first trimester anatomic survey were correlated with second trimester target scan to evaluate value of first trimester scan for early detection of anomalies. <strong>Results: </strong>It showed that out of 924 pregnant women 472 fall under high risk category and 452 under low risk category. Out of 924 women subjected to First Trimester Anomaly Scan 18 patients demonstrated some sort of congenital anomaly whereas Mid Gestation Ultrasound Scan revealed 9 women out of 892 who gave birth to babies with congenital anomaly. Overall only 3% pregnant women revealed congenital anomalies among babies. <strong>Conclusion: </strong>There is immense need for early diagnosis and timely intervention in the field of prenatal detection of congenital malformation. Earlier detection of fetal structural malformations would allow for earlier antenatal referral to a tertiary care facility and coordination of care among appropriate subspecialists. Focus and emphasis should aim at detection of malformation earlier than 12 weeks owing to the very unique and clear facts that first trimester detection leads to easy termination of pregnancy and lessening of women’s mental, physical, and psychological trauma.</p> G Rajesh Waseem Akhtar ##submission.copyrightStatement## 2019-08-15 2019-08-15 7 2 52 55