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 A Rare Case of Metastatic Gall Bladder Polyp Secondary to Renal Cell Carcinoma https://aijournals.com/index.php/ajmrr/article/view/2154 <p>Metastatic origin of Gall bladder polyp is usually associated with either gastric carcinoma or melanoma. Whereas, its association with Renal cell carcinoma is a rare occurrence. Its prevalence in autopsies is reported to be around 0.6%. Here, we present a case of 73-year-old gentleman, diagnosed with renal cell carcinoma 2 years back and underwent radical nephrectomy. During his routine follow-up, ultrasound revealed a gall bladder polyp which was about 28 mm in size. He underwent open cholecystectomy and histopathological analysis revealed it as a metastatic deposit. Hence, suggestive of metachronous gall bladder polyp in renal cell carcinoma.</p> Ankita Dhawan Sagar Dembla Gaurav Goswami Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 1 3 Radiological Evaluation of Renal Masses https://aijournals.com/index.php/ajmrr/article/view/2155 <p>Renal masses are a broad group of lesions from benign to malignant. The goal of imaging is to differentiate malignant renal masses from benign masses. This study intends to evaluate the role of radiological modalities like X-ray, IVP, USG, CT Scan, MRI, Interventional procedures etc. in the evaluation of renal masses and to review the imaging spectrum of renal masses on the various imaging modalities and also decide radiological investigation approach for renal masses. The present study is carried out on 50 cases of renal masses, in the duration of two years. Most common affected Age group is 40-50 years. Mostly the incidence is higher in males with benign renal masses are commoner. Most common malignant renal masses are Renal cell carcinoma, amongst them Clear cell RCC are most common. Ultrasound was 100% accurate in diagnosing cystic lesion. CT Scan is more accurate than USG for detection and characterization of the benign and malignant solid renal masses.</p> Ankita Boricha Maulik Jethva Devasish Tarafdar Anjana Trivedi Chirag Solanki Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 4 8 MRI Imaging Features of Distal Intersection Syndrome: A Case Report https://aijournals.com/index.php/ajmrr/article/view/2157 <p>Proximal intersection syndrome is a condition that should be differentiated from Distal intersection syndrome, as there are many subtle differences in anatomical compartment. The diagnosis is made on the basis of clinical findings and confirmed by imaging studies. We present a case report of distal intersection syndrome, describing its characteristic clinical, anatomic, and MRI Imaging features.</p> Rahul Mohan Mohammad Shamim Ahmad Pushpa Kant Tiwari Dipu Singh Prashant Shina K.B. Jha Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 9 11 Computed Tomographic Assessment of Brain and Limited Paranasal Sinuses Study in Subjects with Headache at Bhuj, Kutch https://aijournals.com/index.php/ajmrr/article/view/2158 <p><strong>Background: </strong>Recent advances in Commuted Tomography (CT) and magnetic resonance imaging (MRI) methods have increased the importance of imaging examinations in the assessment of abnormalities affecting the head and neck. Present study was done with an aim to assess the utility of CT of the brain in the identification of causative factors for headache. To determine the additional value of acquiring limited paranasal sinus images after evaluation of the brain in patients with headache. <strong>Subjects and Methods: </strong>This is a prospective study done in 150 cases&nbsp; with a primary complaint as headache undergoing Computed Tomography of the brain and limited paranasal sinus CT scan in Department of Radiodiagnosis at Gujarat Adani Institute of Medical Science, Bhuj, Kutch, Gujarat during the period from July 2020 to December 2020. <strong>Results: </strong>Of the 150 patients studied, 71 patients were males and 79 patients were females. Among the 71 male patients studied significant abnormality was detected on imaging in 9 male patients. Imaging findings were normal in 132 cases of the study population and significant abnormality was detected in 18 cases. Among the 18 patients with abnormality on imaging, 10 had intracranial abnormality as the cause for headache and 8 patients had sinusitis as the cause for headache. Among the 8 patients with sinusitis, 4 patients had acute onset of headache following runny nose and fever. <strong>Conclusion: </strong>Screening in headache with CT not only helps in identifying an abnormality but also helps to rule out structural causes for headache thereby reducing patient apprehension. Additional acquisition of limited PNS sections increases the yield from imaging, reduces the cost from dedicated PNS imaging, and helps to differentiate paranasal sinus cause of headache from the intracranial cause. CT is very accurate and sensitive in diagnosis and characterization of various abnormalities affecting the nasal cavity and PNS.</p> Rajnikant Narsinhbhai Chauhan Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 12 16 Invasive Fungal Sinusitis Associated with Covid-19 https://aijournals.com/index.php/ajmrr/article/view/2159 <p><strong>Background: </strong>The world today facing unprecedented catastrophe in the form of a global pandemic of COVID-19 infection caused by the novel corona virus SARS-CoV-2(severe acute respiratory syndrome -corona virus-2).<sup>(3</sup><em><sup>,n.d.</sup></em><sup>)</sup> As most of the patients infected with COVID-19 are in the elderly age group having co-morbidities like diabetes mellitus or are immunocompromised. They are endangered to the development of various co-infections which are more common in patients with this type of clinical profile. Invasive fungal sinusitis is one of the co-infections primarily affecting paranasal sinuses, nasal cavity, orbit, brain and lungs. Common fungi causing invasive fungal sinusitis are Aspergillus, Mucor and Candida. In this article we are going to describe the major imaging findings of invasive fungal sinusitis in addition to the clinical picture which would aid in earliest diagnosis of this infections and allows radiologist to play an important role in patient management. <strong>Subjects and Methods: </strong>A Retrospective study with 30 patients over period of 3 months using MRI as diagnostic modality and tissue biopsy for the confirmation. Consent for participation in the study was obtained from each patient or their relatives. All COVID-19 infected patients suspected of fungal sinusitis referred for MRI paranasal sinuses, Orbit or Brain were included in the study. There were no definite exclusion criteria except in the cases where MRI was contraindicated. <strong>Results: </strong>Total 30 COVID-19 positive patients with suspicion of fungal infection were evaluated. Many patients had associated co-morbidities like diabetes, obesity, hypertension, steroid, chemotherapy or on long term COVID treatment. On MRI majority of patients had involvement of bilateral maxillary and ethmoid sinuses with bony erosions. 7 patients (23.3%) had shown spread to retro antral and orbital fat. 2 patients (6.6%) had shown orbital compartment syndrome with cavernous sinus thrombosis. On biopsy 21 patients (70%) confirmed with mucor, 7 (23.3%) patients confirmed with Aspergillus and 2 patients (6.6%) biopsy results were inconclusive. <strong>Conclusion: </strong>MRI findings were neither sensitive nor specific for invasive fungal sinusitis but it found to be useful for early diagnosis and showing its spread to the adjacent structures and brain. Contrast enhanced MRI was found to be better in characterization of the extent of spread of the disease and assessment of venous sinus thrombosis compared to Non-contrast MRI.</p> Hiral J. Hapani Manek K Gadhvi Kapil D Detroja Anjana V Trivedi Jagruti Kalola Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 17 19 Mri Evaluation of Seizures: Study at a Tertiary Referral Center in Southern India https://aijournals.com/index.php/ajmrr/article/view/2160 <p><strong>Background: </strong>Epilepsy is a chronic entity with recurrent episodes of seizures. Estimated prevalence of epilepsy is about 5 to 10 persons per 1000 population and the incidence is about 0.3 to 0.5%. magnetic resonance imaging(MRI) is the imaging modality of choice in the evaluation of seizures because of its high soft tissue contrast and its capability of multi planar imaging. MRI is useful in the localization of epileptogenic focus precisely and to demonstrate its relation with eloquent areas of brain. Thus it helps in guiding the neurosurgeon in planning a surgery in cases of medically refractory epilepsy. The current study is undertaken to study the causative factors and the MRI findings in patients presenting with seizures. <strong>Subjects and Methods</strong>: The main source of data for the study are the patients with clinically suspected seizures referred for MRI to the Department of Radiodiagnosis at Katuri Medical College and hospital, Chinakondrupadu, Guntur. 60 patients referred to the Department of Radiodiagnosis for a period of 24 months with clinical symptoms and signs of seizures and referred for MRI examination were studied. <strong>Results</strong>: Maximum number of patients were in the age group of 1-30 years (63%). Maximum number of patients presented with GTCS. MR abnormality was maximum seen in patients between the ages of 16 to 45 years. Out of 60 patients who presented with seizures, in 28 patients (47%) the study was normal. Cerebrovascular causes including infarct with gliosis and venous thrombosis were found to be the most common diagnosis on MR imaging in patients presenting with seizures since it was seen in 10 patients (16%). <strong>Conclusion</strong>: Accurate detection of the underlying cause in seizure is very important for planning appropriate management. MRI is highly sensitive and specific in finding the pathology which&nbsp;&nbsp; is responsible for seizures. In our study of 60 patients who clinically presented with seizures, infarct with gliosis, NCC, tuberculoma, atrophy, are the major etiological factors and others include venous thrombosis, developmental malformations, hypoxic ischemic injury, mesial temporal sclerosis, cavernoma, oligodendroglioma, meningioma and cerebral abscess. The commonest MR abnormality was cerebral infarct with gliosis. We conclude that MRI with seizure protocol plays a key role in the recognition of epileptogenic substrates and also for planning the management in patients with seizures and in predicting the prognosis.</p> Ramakrishna Narra Anusha Putcha Yeshwanty Narmada Penumatcha Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 20 26 A Rare Case of Sirenomelia with Absent Sacrum https://aijournals.com/index.php/ajmrr/article/view/2162 <p>Sirenomelia is a rare lethal condition characterised by fusion of partial or complete fusion of lower limbs with male predominance. In the African context, such mermaid-like babies are called mammy -water babies, which carries an evil connotation associated with witchcraft. It is usually associated associated with diabetes milletus and tobacco usage. Risk factors are diabetes milletus, teratogenic factors, genetic factors and maternal age less than 20 years. Ultrasound is primary modality of choice of investigation in cases of sirenomelia in prenatal ultrasound. First trimester diagnosis of this disorder and induced abortion may be safest medical option. Most of the cases of sirenomelia results in still birth or die within a day or two due to congenital complications.</p> Adarsh Shankar M.U Jeevika Dhaval Solanki Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 27 30 MR Imaging Spectrum of Spinal Dysraphism: A Study from South India https://aijournals.com/index.php/ajmrr/article/view/2163 <p><strong>Background: </strong>Congenital anomalies of spine carry significant mortality and morbidity. Hence, they must diagnosed with great accuracy and&nbsp;&nbsp; at an earliest possible point of time. This study was undertaken to study the spectrum of MR imaging findings in patients with suspected&nbsp;&nbsp; spinal dysraphism regarding detection, accurate localization, non-invasive exploration of complex anatomy/pathological process and possible associations. <strong>Subjects and Methods: </strong>A total 40 cases attending the department of Radiology of JJM Medical College constituted the sample size. All the patients were subjected for non-contrast Magnetic resonance imaging in shortest possible examination time. The data thus collected was analyzed. <strong>Results: </strong>About 32.5% of the study were aged between 1 – 5 years. Moreover, in only 5 (25 %) cases the parents of the patients had history of consanguineous marriages. About 70% of the patients had neurological manifestations and 75% had cutaneous manifestations. A wide range of abnormalities were seen with myelomeningocele found in 65% of the patients, lipomyelomeningocele in 17.5% and 17.5% patients had diastematomyelia. Associated tethering of the cord is seen in 40% of the cases, while syrinx was noted in 10% patients, 5% patient showed cerebellar tonsillar herniation with cervical syrinx, 12.5% patients showed diffuse syringomyelia involving whole spine, 2.5% patient showed cervico-thoracic septated syrinx extending to medulla oblongata superiorly. <strong>Conclusion : </strong>MRI is an excellent imaging modality of choice for defining complex spinal dysraphism and associated abnormalities.</p> S Chethan MU Jeevika Ganesh Gadag Shivakumar Patil Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 31 35 A Study of Circle of Willis and Normal Cerebral Circulation Variants on CT and MR Angiography https://aijournals.com/index.php/ajmrr/article/view/2164 <p><strong>Background: </strong>The Circle of Willis is a polygon constituting the anastomosis of the internal carotid and vertebral systems that permits cerebral arterial circulation. The main objective of this study was to assess the role of angiography in the evaluation of variant anatomy of Circle of Willis and to determine its relation with various associated vascular pathologies. <strong>Subjects and Methods</strong>: This Hospital-based prospective study was carried out over 2 years from July 2019 to August 2021 at the Department of Radiodiagnosis, Narayana medical college, Nellore. The study population included 200 patients- 130 cases were imaged on a 3 Tesla MRI scanner and the rest 70 on a 128- slice CT scanner. MIP and 3D-reformatted images were scrutinized to ascertain the ultimate configuration of the CW and the presence of vascular pathology. <strong>Results</strong>: Out of the two hundred cases, Complete and balanced CoW was appreciated in 27.9% of them. Posterior circulation variations were eyed in 43.8% and anterior circulation variations in 19.6%. Combined anterior and posterior circulation variations were noticed in 8.7 %. Hypoplastic/ aplastic Posterior communicating arteries were the most familiar in segmental variations. No immediate or prompt correlation was established between the attained results and associated vascular pathologies. <strong>Conclusion</strong>: The study results demonstrate slight differences in the CW configuration. A significant proportion of complete anterior CW was espied in female patients. Posterior circulation variants were the commonest among both men and women. No remarkable association was revealed between CW configuration and the occurrence of aneurysms/AVMs in this analysis. Normal variants of the cerebral circulation are customary, and most such anomalies can be identified at CT and MR angiography.</p> Neha Khatoon P Pulagam Sindhura Vidushi Sharma Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 36 42 Role of High Resolution Computed Tomography in Characterization of Interstitial Lung Disease in Rural Tertiary Care Centre https://aijournals.com/index.php/ajmrr/article/view/2165 <p><strong>Background: </strong>The Interstitial lung disease (ILD) are a group of diffuse parenchymal lung diseases that share many features but are sufficiently different from one another to be designated as separate disease entities. HRCT (High Resolution Computed Tomography) is particularly helpful in and diagnosing and characterizing these entities. <strong>Subjects and Methods: </strong>Data for the study collected from patients clinically suspected to have interstitial lung disease. Sample size: 31 patients. Study period: 2yrs. Study design: Prospective and Observational study. Inclusion criteria: Suspected cases of diffuse parenchymal lung disease by clinical history, physical examination, radiographic findings and appropriate laboratory investigations. Cases of all age groups irrespective of sex. Exclusion criteria: Known cases of lung malignancies and previously treated cases&nbsp; of diffuse parenchymal lung disease are excluded from the study. <strong>Results: </strong>In a period of 2yrs study, 31 patients were diagnosed as ILDs on HRCT chest imaging. Among 31 cases most of them were IPF/UIP (35%), followed by AIP (16%). Honey combing is predominantly confined to UIP/IPF (100%), Traction bronchiectasis is predominantly seen in UIP/IPF (68%), Ground glass opacity is mostly seen in NSIP (23%) followed by AIP. Reticular opacities are predominantly seen in UIP/IPF (45%) followed by NSIP (18%). Consolidation is predominantly seen in HP (30%) and COP (30%). Septal thickening is predominantly seen in UIP/IPF (45%) followed by NSIP (18%). <strong>Conclusion: </strong>HRCT is the most sensitive tool for non-invasive imaging of the lung parenchyma in patients with suspected ILD.</p> Y. Ravi Kumar P Jenikar M. Sanjeev Kumar Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 43 47 A Case of Dengue Encephalitis with Double Doughnut Sign https://aijournals.com/index.php/ajmrr/article/view/2177 <p>Dengue is the fastest-growing mosquito-borne infection in the world. Encephalitis is an uncommon neurological manifestation of Dengue Infection. A unique radiological finding of the double doughnut sign is associated with dengue encephalitis. The term ’double doughnut sign’ was coined to describe lesions of the thalamus on each side of the brain. MRIs in some patients with Japanese encephalitis and herpes encephalitis can also show this sign, prompting inclusion of these diseases in the differential diagnosis. However, further research is needed to determine whether this finding is the most critical predictor for diagnosing dengue encephalitis. Our goal is to shed light on a rare MRI finding of the double doughnut sign in a patient with dengue encephalitis through this case report.</p> Lucky Bhalla Vineet Sehgal Priyanshu Bansal Shaifali Arora Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 48 50 Transcerebellar Diameter: An Useful Tool to Estimate Gestational Age https://aijournals.com/index.php/ajmrr/article/view/2181 <p><strong>Background</strong>: Gestational age is the most important factor for obstetrician to give appropriate management of pregnant women and to evaluate fetal development. An error in estimation of the gestational age (GA) results in adverse perinatal outcome. Many ultrasound parameters are used routinely for assessment of gestational age. Use of these parameters may be limited in some cases such as fetuses with abnormalities of skull vault and growth restricted fetuses. In such cases, the trancerebellar diameter (TCD), may be used as it is least affected. This study was conducted with an objective to show that TCD is a useful tool for determining the gestational age in comparison to other already existing parameters. <strong>Subjects and Methods</strong>: This was a prospective study including 100 pregnant women between 15 to 40 weeks of gestation. Gestational age using TCD and other parameters was calculated and compared with gestational age based on last menstrual period (LMP). <strong>Results: </strong>Mean age of study group was 27.5 years. Correlation between gestational age and various ultrasound parameters showed that TCD correlated best with GA with a correlation coefficient of 0.989 and significant P value of &lt;0.005. Mean TCD showed a linear relationship with gestational age in weeks. <strong>Conclusion: </strong>TCD serves a reliable parameter in estimation of GA in second and third trimesters since it shows good correlation with GA.</p> Roopa Kedarnath Tandur Aiman Saima Manish Chaudhary Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 51 55 Pictorial Review of Imaging Spectrum of Epilepsy on Magnetic Resonance Imaging https://aijournals.com/index.php/ajmrr/article/view/2182 <p><strong>Background: </strong>Objectives<strong>: </strong>The objective of our study is to review different imaging spectrums of epilepsy on MRI. To diagnose structural abnormalities in the brain associated with the cause of seizures with MRI. <strong>Subjects and Methods : </strong>It is a hospital-based prospective observational study that was carried out in 80 patients with a history of epilepsy in Narayana medical college and general hospital, Nellore in&nbsp;&nbsp; a period of 2 years from October 2019 to October 2021. All age group patients were included in the study without any gender predilection. Magnetic resonance imaging was performed on these patients and the results were recorded. <strong>Results</strong>: Out of these 80 patients, 30 patients (37.5%) had no abnormal neuroimaging findings. Most of the patients presented with generalized tonic-clonic seizures. The most common imaging findings were of cerebrovascular diseases (venous thrombosis/ infarct with gliosis) in about 16 cases (20%), developmental disorders in 17 cases (21.25%) of which mesial temporal sclerosis was the commonest (7 out of 17 cases), focal cortical dysplasia was seen in 3 cases. Other causes include infectious granulomas in 9 cases (11.25%) (tuberculomas and neurocysticercosis) and tumors in 2 cases (2.5%). vascular malformations (2 cases), and phakomatoses like tuberous sclerosis and Sturge weber syndrome (3 cases). <strong>Conclusion</strong>: MRI is a non-invasive modality with no radiation hazard and with its excellent gray-white matter resolution and multiplanar imaging capability helps in the detection of small and subtle lesions. With appropriate imaging protocol, our study observed that MR evaluation with increases sensitivity and specificity in the evaluation of seizures.</p> Surla Harathi A. Sravan Krishna Reddy Pentyala Suneetha J. Nanda Gopal Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 56 62 Spectrum of Various Morphological Changes Detected on High Resolution Ultrasound & MRI in Patients with Painful Shoulder https://aijournals.com/index.php/ajmrr/article/view/2183 <p><strong>Background: </strong>Shoulder joint pain is one of the most common complaints that are encountered in the Orthopedics and Rheumatology Department. X-Ray, Ultrasound (US) and MRI are widely used in evaluating various shoulder pathologies. US is a simple, cheap, fast and non-invasive imaging technology for detection of rotator cuff and non-rotator cuff pathologies. Currently, MRI is gold standard and more precise for imaging for shoulder joint pathologies. In this study, we are presenting a spectrum of various positive findings in 30 patients, presenting with painful shoulder, studied with HR USG and MRI. Both imaging modalities successfully detected 44 cases of partial tear of SUPRASPINATUS. US imaging yields a sensitivity of 95% and an accuracy of 91%. The corresponding values of MRI were greater than 95%. According to cited studies, USG imaging can be considered almost equally effective in detecting partial tears of the rotator cuff compared to MRI with a sensitivity of more than 90% and accuracy of 90%, particularly located in the SUPRASPINATUS (Small letters Supraspinatus). MRI may be reserved for doubtful or complex cases, in which delineation of adjacent structures is mandatory prior to surgical intervention. Tears of the INFRASPINATUS and subscapularis tendon have always been considered uncommon as compared to the SUPRASPINATUS. We found only 4 cases (14.3%) of IST and 2 cases (6.6%) subscapularis tendon tear. <strong>Subjects and Methods: </strong>The study was carried out in Radiology department of SNMC on patients with painful shoulder. HRUSG Performed using 7 -18 MHZ linear probe and MRI by 1.5 Tesla Philips machine using Shoulder coil .Various sequences like T1 ,T2 ,PDW ,FSE,FAT suppressed or without Fat suppressed, gradient echo planes in multiple planes. <strong>Result: </strong>In the present study maximum no of patients with painful shoulder were of Rotator cuff injury that is 20 patients out of total 30 patients .17 patients were of partial thickness tendon tear. 15 of them were diagnosed on HRUSG and all 17 patients were diagnosed on MRI .Full thickness tear was seen 4pts on MRI and 3 patients on USG. Tears/Tendinosis/tendinitis in the tendons were of prevalence Supraspinatous &gt;infrspintous&gt;Subscapularis. Joint effusion was equally diagnosed on HRUSG and MRI. For Hill sachs lesions and Bankarts lesions MRI Is the modality of choice. <strong>Conclusion: </strong>From present study we could conclude that in patients of painful shoulder HRUSG is a modality of choice for primary work up and diagnosis specially where MRI is not available. However for accuracy and extent of rotator cuff tears /tendinosis MRI is Gold standard so as to guide Orthopedician and Physiotherapist. For follow ups both HRUSG and MRI are helpful.</p> Abhay Kumar Nikita Bansal Madhu Sharma Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 63 70 Evaluation of Cholangiocarcinoma on MDCT: Varying Imaging Patterns and Preoperative Assessment of Resectability https://aijournals.com/index.php/ajmrr/article/view/2184 <p><strong>Background: </strong>The objectives of our study are to evaluate the various imaging appearances of cholangiocarcinoma and determine the resectability of the tumour on MDCT. <strong>Subjects and Methods: </strong>Our study is a retrospective study. A search of the case records using the keyword cholangiocarcinoma from the hospital information system yielded 62 patients of cholangiocarcinoma in a period of four years (January 2017&nbsp;&nbsp; to December 2020). Twelve patients were excluded because of the unavailability of complete records. Study sample was formed by remaining 50 patients. <strong>Results: </strong>In our institute, hilar cholangiocarcinoma was the most frequent type accounting for 60% (30 patients) followed by distal cholangiocarcinoma accounting for 26% (13 patients) and intrahepatic cholangiocarcinoma was the less common type with 14% (7 patients). Out of 30 patients of hilar cholangiocarcinoma, 23.3% (7 patients) showed mass forming type, 70% (21 patients) showed periductal infiltrating type and 6.6% (2 patients) showed intraductal growing type. Intrahepatic biliary radical dilatation was seen in 92% (46 patients), all patients of hilar and distal cholangiocarcinoma, three patients of intrahepatic cholangiocarcinoma. Portal vein involvement was seen in 34 % (17 patients). Lobar atrophy was seen in 58% (29 patients). Involvement of adjacent liver parenchyma in hilar and distal cholangiocarcinoma was seen in 20% (6 out of 30 pCCA). Out of 21 cases that were taught to be resectable based on the findings of CT 12 cases underwent curative resection and the remaining 9 cases were found to have unresectable tumours giving a positive predictive value of 57.14%. <strong>Conclusion: </strong>Cholangiocarcinoma is a slow-growing malignant tumour arising from the bile duct epithelium. Most of the cases have poor diagnosis due to late presentation leading to delay in diagnosis and unresectability. Diagnosis of cholangiocarcinoma on imaging can be done by identifying their typical pattern. In our institute, hilar cholangiocarcinoma (periductal infiltrating) was the most frequent type.</p> Sindhuja Therani Sindhura Pulagam K S Vedaraju A Mugdha A Snigdha Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 71 79 High-Resolution Computed Tomography (HRCT) Disease Patterns and Survival Times in Patients with Interstitial Lung Disease at a University Tertiary Hospital in Southern Thailand from 2006 to 2012 https://aijournals.com/index.php/ajmrr/article/view/2205 <p><strong>Background</strong>: The aim of our study is to assess the high-resolution computed tomography (HRCT) patterns and survival times in patients with interstitial lung disease (ILD) during 2006-2012. <strong>Subjects &amp; Methods</strong>: Sex, age, HRCT disease patterns and severity, pathologic results, year of diagnosis, and year of death in 249 patients with ILD were analysed and described descriptively. <strong>Results</strong>: The patients were 76 (30.5%)&nbsp; men and 173 (69.5%) women with a mean age of 54.3 years old. The most common HRCT pattern was the non-specific interstitial pneumonia (NSIP)-possible usual interstitial pneumonia (UIP) pattern (126 patients, 50.6%) which were connective tissue disease (CNT)-related in 86 patients (34.5%) and idiopathic in 40 patients (16.1%). The second most common HRCT pattern was UIP (61 patients, 24.5%) which was idiopathic in 34 patients (13.7%) and CNT-related in 27 patients (10.8%). The HRCT pattern from which a diagnosis could not be made was the third most common (39 patients, 15.7%). The survival time was longest in the CNT-related-NSIP pattern cases followed by idiopathic NSIP-possible UIP, CNT-related-UIP, and idiopathic UIP. <strong>Conclusion</strong>: The survival times were shortest in idiopathic cases whose HRCT patterns were UIP, possible UIP or NSIP, and longest in CNT-related NSIP.</p> Wiwatana Tanomkiat Nontakorn Areewattana Siwasak Juthong Asma Navaskulpong Boonjing Siripaitoon Sarayut Lucien Geater Copyright (c) 2021 Author https://creativecommons.org/licenses/by/4.0/ 2021-12-24 2021-12-24 9 2 80 86