Asian Journal of Medical Radiological Research <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> en-US (Dr. Rohit Varshney) (Mr Shadan Pasha) Sun, 20 Jun 2021 06:49:22 +0000 OJS 60 Comparison Between Low-Dose and Standard-Dose Computed Tomography for Diagnosis of Urolithiasis <p><strong>Background: </strong>Urolithiasis is the condition where there are calculi in the urinary system and the current study was implemented to evaluate the diagnostic performance of low-dose Computed Tomography (CT) with standard-dose CT for detection of urolithiasis. <strong>Subjects &amp; Methods: </strong>Eight hundred thirty-seven individuals Individuals with clinically/sonographically suspected urolithiasis and referred for Computed Tomography (CT) evaluation at the Radiodiagnosis department were screened for the study. The study was conducted in two stages. During the first stage, individuals underwent an NCCT scan (Philips 16 slice CT scanner) with the standard-dose protocol as per the current management strategy. Individuals with CT evidence of urolithiasis were included in the second stage of the study where they were given with low dose CT. After excluding many subjects, 148 patients underwent standard-dose CT for the evaluation of urolithiasis. Additionally, 23 patients were referred directly for CT due to high clinical suspicion of urolithiasis, constituting 171 patients who underwent NCCT KUB. Among patients who underwent CT scan 16 patients were excluded from the study as no calculus was detected on NCCT. <strong>Results: </strong>Urolithiasis was seen in 155 patients who met the inclusion criteria. Among these, 26 patients declined for low-dose CT, nine patients had BMI &gt; 35 kg/m<sup>2</sup> and 16 patients were of age &lt;18 years and hence were excluded from the study. Finally, 104 patients underwent low-dose CT and were included in the final analysis. The use of low tube potential setting by tube voltage reduction of 15% significantly reduced radiation dose by approximately 31% in patients undergoing CT for evaluation of urolithiasis, irrespective of their BMI. <strong>Conclusion: </strong>A combination of reduced tube potential and AEC helps to achieve optimum results for the diagnosis of urolithiasis. The study strongly supports the use of low-dose CT for diagnosis and follow-up of urolithiasis in patients who are not morbidly obese.</p> K.J.S.S. Raghu Teja, Bhamidipaty Kanaka Durgaprasad, Payala Vijayalakshmi Copyright (c) 2021 Author Sat, 19 Jun 2021 00:00:00 +0000 Role of HRCT Pulmonary Artery Diameter Measurement in Assessment of Severity and Prognosis of COVID-19 Patients <p><strong>Background: </strong>In times of pandemic where health care workers cannot depend on auscultation and percussion methods to assess the clinical status of patients, radiological methods and lab parameters are being the mainstream deciding parameters for treatment. Corads score and CT severity score are popular methods of determining the status and treatment of a corona virus patient. Our study aims on correlating pulmonary artery diameter with severity of the corona virus patient. <strong>Subjects and Methods: </strong>The present cross-sectional study was conducted at VIMS, Bellary during from August 1<em><sup>st</sup> </em>2020 to December 26<em><sup>th</sup> </em>2020. The study included all patients of all age groups who tested RT- PCR positive and CT done within 72 hours of admission. Clinical data regarding the patients like presenting complaints, co-morbidities, duration of hospital stay, mode of treatment and outcome was collected. CT severity scoring was done based on involvement of bronchopulmonary segments. Later the outcome of patients, CT severity score and Pulmonary artery diameter were correlated and analyzed. <strong>Result: </strong>In our study, out of 41, 12 (29 %) cases showed MPAD above 31.09 mm (i.e moderate – severe MPAD). Among the 12 cases with enlarged MPAD, 9 cases had death as outcome, 56 %. 3/13 (23%) are cases with death as outcome among mildly enlarged MPAD. <strong>Conclusion: </strong>MPAD can be used as an independent parameter to risk stratify COVID-19 patients, predict severity and mortality of COVID-19 patients. Thus it should be measured on a regular basis in COVID-19 patients and can be used to guide the management accordingly for better prognosis of COVID-19 patients.</p> Abhilasha, Sharanayya, M Bharathi, H Sadashiva Gouda Copyright (c) 2021 Author Sat, 19 Jun 2021 00:00:00 +0000 Antenatal Diagnosis of Pulmonary Sequestration: A Case Report <p>Pulmonary sequestration is an uncommon medical condition in which a lung tissue is formed, which does not perform any function and also is not either the other anatomical structures of the main lung tissue, not its blood supply. A 28 years old antenatal mother, visited our department for routine anomaly scan in her second trimester. Transabdominal ultrasound examination revealed a well-defined echogenic mass involving the left hemi-diaphragm extending upwards towards the lung. Colour Doppler study revealed feeding artery which originated from the descending thoracic aorta. This confirmed our diagnosis of pulmonary sequestration. A male baby, weighing 3150 grams was delivered vaginally. High Resolution Computed Tomography showed evidence of a large well defined soft tissue mass involving the left pleural cavity with pleural effusion, and shift of mediastinum and heart towards the right side. In addition, there was an evidence of a feeder artery which originated from the descending thoracic aorta.</p> Gaurav Kaushik, Rohan Shelar, Pratik Bangde Copyright (c) 2021 Author Sat, 19 Jun 2021 00:00:00 +0000 Ultrasonography and MRI Evaluation in Wrist Joint Pain <p><strong>Background</strong>: Wrist joint pain is one of the commonest conditions that are encountered in the orthopaedics. Accurate diagnosis is made clinically and confirmed by imaging modalities before any treatment is undertaken. Objectives: To evaluate a patient with wrist joint pain in terms of assessment by ultrasound as the first line of imaging modality, and further correlating with MRI, To use ultrasound along with X-rays and MR imaging to aid in quick and decisive diagnosis &amp; To delineate pitfalls during image interpretation and limitation of USG. <strong>Subjects and Methods</strong>: This is a prospective study conducted for a period of 2 years at the teaching hospital of Bapuji Hospital and Chigateri General Hospital attached to Bapuji Education Association, J.J.M. Medical College, Davangere. Total of fifty patients presenting with wrist joint pain were included in the study after obtaining written informed consent. <strong>Results</strong>: The mean age of the study subjects was 42.32 12.63 with minimum age of 25 years and maximum age of 65 years with female predominance i.e. 32/50 (64%). The sensitivity and specificity analysis of diagnostic tests revealed that 100% sensitivity and specificity in USG was observed for tendinopathy, solid mass and CTS. Whereas MRI showed 100% sensitivity and specificity for tendinopathy, TFCC, simple ganglion cyst and solid mass. <strong>Conclusion</strong>: Ultrasound imaging in correlation with MRI imaging could be considered superior to X-rays in the diagnosis of non-traumatic wrist joint pain. Though operator dependent, a well performed Ultrasonography can effectively serve as a primary diagnostic method and screening of all painful wrist joints because it is non-invasive, cost effective, portable and easily accessible with 100% sensitivity and specificity.</p> Adarsh B. Hampole, M.U Jeevika, K.K Nirnay, S Hita, S.L Anup, G Ganesh Copyright (c) 2021 Author Sat, 19 Jun 2021 00:00:00 +0000 Spontaneous Pneumomediastinum, Mediastinitis and Subcutaneous Emphysema Occurring in the Post Sars-Cov-2 Infection: An Uncommon Presentation <p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), declared as a pandemic by World Health Organization. Computed Tomography provides an imaging perspective towards many parenchymal and rare extra-parenchymal abnormalities of the COVID-19 pneumonia like spontaneous pneumothorax, pneumomediastinum and subcutaneous emphy- sema helping further in diagnosis and surveillance. <strong>Case Report: </strong>A 53-year-old male was admitted with RT-PCR positive report of COVID19 pneumonia presented with hypoxemia and was started on non-invasive ventilation with lung protective ventilation and other symptomatic management. He developed sudden onset shortness of breath and chest pain on Day 14 of admission with a SpO2 of 90 % on NIV ventilation, after testing negative on RT-PCR on day 12. A HRCT (high resolution CT) chest was obtained that showed extensive consolidations ground glass opacities and “crazy paving appearance” in bilateral lung fields. A calcified nodule with positive “halo sign” was seen. Presence of air was seen along the perivascular sheath, peribronchial sheaths (“Double bronchial wall sign” positive) and into the subcutaneous neck space on both sides and anterior chest wall, which was suggestive of pneumomediastinum with subcutaneous emphysema. Contrast enhanced computed tomography images showed multiple thin septations showing minimal enhancement surrounding the mediastinal fat that was suggestive of mediastinitis. He was managed conservatively and gradually improved. <strong>Conclusion</strong>: Spontaneous pneumomediastinum and subcutaneous emphysema are quite a rare complication in the immediate post COVID19 pneumonia period and can result in remarkable morbidity for the patient. Keeping a high index of suspicion and early identification of the same is possible using CT Chest which aides in identification and management of such patients.</p> Shikha Sood, Swastika Mishra, Sanat Mishra Copyright (c) 2021 Author Sat, 19 Jun 2021 00:00:00 +0000 Evaluation of Non Alcoholic Fatty Liver Disease in T2dm Patients and Abnormalities in Liver Enzymes, Lipid Profile in Patients with Fatty Liver in Comparison with Patients without Fatty Liver <p><strong>Introduction: </strong>The non-alcoholic fatty liver disease (NAFLD), seen in patients with T2DM. Recently, it has been documented that NAFLD prevalence has been increasing in paraller with increasing obesity and T2DM. NAFLD, the most common hepatic disease. This study aimed&nbsp;&nbsp; to determine the prevalence of NAFLD in T2DM patients, diagnosed by liver ultrasound and to see the differences in hepatic enzymes, lipid parameters between patients with NAFLD and individuals without NAFLD. <strong>Subjects and Methods: </strong>This study conducted at Department of Radiodiagnostics, BGS Global Institute of Medical Sciences, Kengeri, Bengaluru, Karnataka. A total of 200 subjects were involved in this study, among them 100 were T2DM patients as cases and 100 healthy subjects as controls. The physical and clinical examination was done for all the subjects. The patients were categorized into 2 groups, based on the liver size and echo texture. Group I include T2DM patients with NAFLD and group II include T2DM patients without NAFLD. Under aseptic condition, fasting venous blood samples were collected from all the subjects, centrifuged to obtain serum. The obtained serum was used for the estimation of fasting blood sugar (FBS), post-prandial blood sugar (PPBS), aspartate transaminase, alanine transaminase, alkaline phosphatase, gamma-glutamyl transferase and lipid profile. Fatty liver was diagnosed&nbsp;&nbsp; on USG based on echogenicity and liver size. The liver examination was carried by using Samsung Medison UGEO and GE voluson P8 with curvilinear array transducers starting with 3-7 MHz. The size of the liver was measured in midclaviclar line longitudinally and &lt;14 cm was taken as controls and &gt;14 was considered as hepatomegaly. <strong>Results: </strong>In this study, significantly increased age was observed in T2M patients with NAFLD and without NAFLD compared to healthy controls. The liver size, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT) and serum cholesterol, triglycerides and LDL-cholesterol were increased significantly in T2DM patients compared to controls. In subgroup analysis, in group I, liver size, AST, ALT, ALP, GGT, serum cholesterol and triglycerides were significantly high when compared to group II patients. <strong>Conclusion: </strong>In the present study, NAFLD prevalence is 65% among T2DM patients. Dyslipidemia and increased heaptic enzymes such as AST, ALT, ALP and GGT are seen more frequently in group I than group II. Early detection and optimum control of diabetes mellitus is important to reduce the effect of diabetes on liver.</p> Sudheer Ranganath, Dr Basawaraj Copyright (c) 2021 Author Sat, 19 Jun 2021 00:00:00 +0000 Assessment of Trigeminal Neurovascular Conflicts Using 3D FIESTA-C Sequence on a 3T MRI <p><strong>Background: </strong>Trigeminal neuralgia is an idiopathic chronic excruciating pain disorder along the distribution of trigeminal nerve. This condition is often sparked by facial movements or by speaking or sensory stimulation of one half of face. The cause of trigeminal neuralgia is primarily idiopathic and is implicated with vascular compression in most of the cases. Secondary trigeminal neuralgia occur due to underlying neurological disease. In this prospective study on patients with primary trigeminal neuralgia, we assessed the role of 3D FIESTA-C (Three-dimensional fast imaging employing steady state acquisition in cycled phases) sequence in detection, localisation and describing various patterns of neurovascular conflict (NVC). <strong>Subjects &amp; Methods - </strong>This Hospital-based prospective study consists of 30 patients with clinically suspected trigeminal neuralgia, referred to the department of radiodiagnosis, Narayana medical college, Nellore, over a period of 2 years. All the 30 cases were imaged on a 3 tesla MRI scanner with a 3D FIESTA-C sequence. <strong>Results - </strong>In 30 cases, 18 were females, and 12 were males. The mean age at initial presentation is 53 years. The average duration of symptoms at initial presentation among study subjects in our study is 63 days. On MR imaging, in the 30 cases, Grade I conflict is seen in 17, Grade II conflict is seen in 7 and Grade III conflict is seen in 6 patients. The offending arteries include SCA in 24 cases, AICA in 7 cases, PCA in 1 case and VA in 1 case. <strong>Conclusion - </strong>The addition of the 3D FIESTA-C sequence in the MR imaging protocol helps in better identification of the cranial nerve anatomy and abnormalities. 3D FIESTA-C images help in depicting the neuroanatomy better before planning for microvascular decompression. Grading this neurovascular compression helps the surgeon in stratifying the patients and their treatment. Imaging evidence of neurovascular conflict must be correlated with clinical symptoms while making the diagnosis.</p> K S Vedaraju, Saripudi S V N P Manikanta Vijay, Yarramsetti Madhusudana, Sabarinath Eada Copyright (c) 2021 Author Sat, 19 Jun 2021 00:00:00 +0000 Role of Computed Tomography in the Evaluation of Mediastinal Masses and its Correlation with Histopathological Diagnosis <p><strong>Background</strong>: To assess the role of Computed Tomography in the Evaluation of Mediastinal Masses and its correlation with the histopathological diagnosis. <strong>Subjects and Methods</strong>: A prospective study done in the Radiodiagnosis department, Narayana medical college. The study population included 30 patients who underwent CT evaluation in our institution from January 2018 to December 2020. Patients of clinically suspected mediastinal masses with symptoms and incidentally detected mediastinal masses on chest radiograph were investigated by CT scan and subsequently proved by histopathology where possible. <strong>Results</strong>: Out of the thirty cases, the most commonly involved compartment was the anterior mediastinum (19 cases), followed by the posterior (8 cases) and middle mediastinum (3 cases). Among the 30 cases, 28 cases (94%) were predicted accurately by CT compared with histopathology. <strong>Conclusion</strong>: CT yields diagnostic information that facilitates the distinction&nbsp; of disease processes and tumours involving the mediastinum. In a specific clinical setting, variables such as attenuation, calcification, contrast enhancement, relationship to adjoining mediastinal structures, and related intrathoracic findings can be suggestive of a selected diagnosis.</p> K. S. Vedaraju, Jagadeesh Pasupuleti, Neha Khatoon, Sabarinath Eada Copyright (c) 2021 Author Sat, 19 Jun 2021 00:00:00 +0000 Comparative Analysis of Lung Ultrasonography and Chest Radiography in Suspected Cases of Pneumonia in Critically Ill Patients <p><strong>Background: </strong>The present study compared lung ultrasound (USG) and chest radiography in alleged cases of pneumonia in seriously ill patients. <strong>Subjects and Methods: </strong>A total of 70 subjects attending to the emergency room with symptoms of pneumonia and those were admitted in ICU with a suspicion of pneumonia over an eighteen month period were included in this study. Patients then underwent imaging studies in the form of chest radiograph and lung ultrasound. <strong>Results: </strong>Out of 70 subjects, males were 39 and females were 31. Age group 20-30 years had 4 patients, 30-40 years had 6, 40-50years had 10, 50-60 years had 16 and &gt;60 years had 20 subjects. The dissimilarity was significant (P&lt; 0.05). Chest x ray reveled 50 out of 70 cases positive and 20 negative and USH showed 65 positive and 5 negative. Positive predictive value (PPV) of chest x- ray was 71.4% and USG was 92.8%. <strong>Conclusion: </strong>Authors found that lung ultrasound is an effective radiological implement for the assessment of suspected cases of pneumonia as compared to chest x ray.</p> Ashvin Pansuriya Copyright (c) 2021 Author Sat, 19 Jun 2021 00:00:00 +0000 Role of Magnetic Resonance Cholangiopancreatography in Patients with Pancreatic Biliary Disease <p><strong>Background: </strong>Magnetic resonance imaging is helpful in evaluating pancreaticobiliary disease after preliminary screening by ultrasonography, instead of undergoing repeated ionizing radiation exposure or invasive procedures such as endoscopic retrograde cholangiopancreatography (ERCP) or transhepatic biliary procedures. Magnetic resonance Cholangiopancreatography (MRCP) is more sensitive in identifying lesions of cystadenomas and cystadenocarcinomas of the biliary tree. The present study was designed to evaluate the role of MRCP in Pancreaticobiliary diseases. <strong>Subjects and Methods</strong>: A hospital based Prospective Cross-sectional study was conducted in 50 patients with Pancreatico-biliary diseases using 3T whole-body MR system. Pancreatic, biliary diseases were evaluated on all the sequences. <strong>Results</strong>: Of the 50 patients, males and female ratio is 2.1:1, and the mean age was 45 years. Biliary anatomical variants are seen in 10 cases. Biliary congenital anomalies (Choledochal cysts) are seen in 3 cases. Biliary stone diseases are seen in 26(52%) cases. Out of 26 cases, 19(38%) patients showed cholelithiasis, and 7(14%) patients showed choledocholithiasis. Among the patients with biliary strictures (9), the most common are benign strictures observed in 7 patients, and the two are malignant. Distal CBD is most commonly involved than proximal CBD. Three pancreaticobiliary malignancies were identified, which were proved on histopathological examination. One case is hilar cholangiocarcinoma, one case is distal CBD cholangiocarcinoma and another case is carcinoma head of the pancreas. <strong>Conclusion: </strong>Most common cause identified in evaluating idiopathic acute pancreatitis is distal CBD stones suggesting acute gall stone pancreatitis. MRCP is a sensitive, very reliable non-invasive imaging that helps diagnose hepatobiliary disorders, predominantly in patients undergoing biliary enteric anastomosis, for knowing the level and extent of strictures. The diffusion-weighted sequence was helpful in characterizing the pancreatic neoplasms.</p> Ramya Sudha Chittoor, Rama Krishna Rao Baru Copyright (c) 2021 Author Sat, 19 Jun 2021 00:00:00 +0000 Intervention Techniques and Embolic Agents in the Management of Intraabdominal Visceral Artery Hemorrhage <p><strong>Background: </strong>There are significant morbidity and mortality in patients with acute gastrointestinal (GI) bleeding. As a multitude of pathologic processes results in GI bleeding, the diagnosis and management of GI bleeding are complicated, and it is intermittent in nature. Currently, in the evaluation and treatment of acute gastrointestinal (GI) hemorrhage, there are multiple imaging modalities and therapeutic interventions that are used. The aim is to study the Intervention techniques and embolic agents in the management of intra abdominal visceral artery hemorrhage at Narayana Medical College, Nellore. <strong>Subjects and Method: </strong>This was a prospective observational study done in the department of Radiodiagno- sis, Narayana medical college, Nellore.20 patients with intra abdominal visceral artery hemorrhage were referred from gastroenterology, gastro surgery, and nephrology to our department from December 2018 to December 2019, diagnosed by CT angio to have intra abdominal visceral artery hemorrhage due to various conditions like pancreatitis, trauma, post procedures like biopsy or drainage. These cases were managed on an emergency basis by embolization of the bleeding visceral artery. <strong>Results</strong>: Out of 20 patients, 95% were males, and 5% were females. The age range in this study is 16-75 years, with the underlying cause being pancreatic pseudoaneurysms in 12, post-biopsy in 4, post-surgical in 2, and trauma in 2 cases. Coil embolization was done in 13 cases, glue embolization in 6 cases, gel foam embolization in 1 case. <strong>Conclusion</strong>: Intervention radiology management with embolization has now become the first line of treatment in visceral artery hemorrhages. Knowledge about vascular anatomy, collaterals, techniques of embolization, indications of each embolic agent, and adequate expertise is very essential for the interventional radiologist’s ineffective management of these cases. When performed in time, these procedures are life-saving and precludes the need for surgery.</p> Yugandhar, V. Kusuma, Thoyaja, Amitavikrama, Yadusri Copyright (c) 2021 Author Sat, 19 Jun 2021 00:00:00 +0000 Role of Grey Scale and Doppler Sonography in Thyroid Nodules and Correlation with Fine Needle Aspiration Cytology <p><strong>Introduction</strong>: Discrete lesions that are radiologically distinct from surrounding thyroid parenchyma are defined at thyroid nodules. They may be clinically palpable or may be detected incidentally on high resolution ultrasonography. Though the prevalence of thyroid nodules in the general population is quite high but majority of them are benign. High resolution ultrasonography plays an important role in defining the characteristics &amp; number of lesions but fine needle aspiration cytology is gold standard for final diagnosis allowing true distinction between benign and malignant nodules. <strong>Material and Methods: </strong>This hospital based, observational study was performed in the department of Radiodiagnosis of our institution on fifty patients presenting with thyroid swelling or palpable nodule with or without symptoms after obtaining a written consent. Each patient underwent high resolution ultrasonography by 7-12MHz linear transducer followed by FNAC using 23G needle. The results were statistically analyzed using appropriate tools and methods. <strong>Results: </strong>Majority of the patients in our study were female with maximum in the 30-60yrs age-group. FNAC failed to give the final diagnosis in 4/50 patients due to inadequacy of sample. The diagnosis of benign &amp; malignant was quite accurate with USG. Majority of the adenoma were hyperechoic on USG, while majority of malignant nodules were hypoechoic on USG. Characteristic features of malignancy were hypoechogenicity, presence of microcalcification, invasion of strap muscles, presence of cervical adenopathy and intralesional vascularity. USG was most accurate in diagnosing thyroiditis &amp; adenoma followed by colloid nodules and least accurate in diagnosing malignant nodules. <strong>Conclusion: </strong>Gray scale ultrasound coupled with color doppler imaging can reliably differentiate benign from malignant lesions; or diagnose lesions of toxic goitre adenoma or thyroiditis. It also helps in determining the solid and cystic nature of nodule. The number of lesions are well demonstrated by USG. In difficulty cases, FNAC can be used to provide the tissue diagnosis.</p> Dhruv Choudhary, Ripudaman Singh Copyright (c) 2021 Author Sat, 19 Jun 2021 00:00:00 +0000 A Study to Assess the Role of Magnetic Resonance Imaging in Cerebral Stroke in a Tertiary Care Hospital <p><strong>Background: </strong>Cerebral ischemic stroke remains the leading cause of death and disability in many countries. The objective are: Role of MRI in detection of cerebral ischemic stroke. Age and sex distribution of infarcts in an Indian population. To determine the location and the territory of the involved blood vessels. <strong>Subjects and Methods: </strong>All patients referred to the Department of Radio-Diagnosis with clinically suspected cerebral ischemic stroke in a period 2019 January to 2020 March at Gadag Institute of Medical Sciences .All MRI scans were performed on a 1.5 Tesla 16 channel GE with HDXT software. Sequences used are T2WI axial and coronal, flair axial, gradient echo axial, T1WI axial, DWI axial and ADC maps. MRA (TOF) – circle Willis (neck) and SWI (optional). <strong>Results: </strong>50 patients who were studied it was observed that infarction was most common in the age group of more than 60 years with a male dominance, the most common risk factor being Hypertension. The most common clinical presentation was weakness (hemiplegia). MCA territory infarcts were more common with a slight increase on the right side. Both acute and subacute infarcts showed restricted diffusion on DWI with low ADC valves. In the acute infarcts T2 FLAIR was normal, but DWI reflected the changes. <strong>Conclusion</strong>: MRI is noninvasive and there is no radiation hazard. Excellent grey – white matter resolution and multi planar imaging capability of MRI helps in detection of subtle lesions. Sensitivity of MRI to altered water content allows earlier detection of infarcts.</p> Veeresh Hanchinal, S Rutuparna, Priyanka Patil Copyright (c) 2021 Author Sun, 20 Jun 2021 00:00:00 +0000 A Study to Compare the Diagnostic Accuracy of CT and USG in the Diagnosis of Acute Appendicitis <p><strong>Background: </strong>Vague abdomen pain is the most commonly encountered symptom in the emergency department at any hospital. The various cause of the abdomen pain may vary from benign to life threatening disease. Appendicitis is the most common cause of abdomen pain in patients admitted at the emergency department. The Aim of the study was to evaluate the accuracy of CT and USG in the diagnosis of acute appendicitis in patients who are taken for appendectomy on clinical basis. <strong>Subjects and Methods: </strong>A Prospective Observational study was conducted at Department of Radiology at Gadag Institute of medical Sciences from June 2019 to December 2019. A total of 200 study subjects during the study period who presented with symptoms of acute abdomen pain and clinical findings highly suspicious of appendicitis were enrolled for the purpose of the study. <strong>Result : </strong>From the study it is concluded that CT is more sensitive, specificity, PPV, NPV. Hence the CT investigation is more accuracy than USG in diagnosing cases of appendicitis. <strong>Conclusion</strong>: Evaluating a case of appendicitis is mainly clinical, depending on the clinical scores and signs. But there is increase in the negative appendectomy rate on depending only on clinical findings. Usually USG is the first primary techniques, considering its easy availability, low cost and reproducible with no radiation but it has its own pitfalls, being operator dependent. CT on the other hand is more specific than USG and hence could rule out appendicitis. Most of the studies including our study has shown that CT has more sensitivity, specificity, Negative predictive value and Positive predictive value in diagnosing appendicitis.</p> Veeresh Hanchinal, S Rutuparna, Priyanka Patil Copyright (c) 2021 Author Sun, 20 Jun 2021 00:00:00 +0000 Thick-Slice Magnetic Resonance Myelography in Spine Imaging: A Clinico-Radiological Study in Tertiary Care Center <p><strong>Background: </strong>Single-slice or multisclice both the techniques can be used to obtain MRM. The key difference between the two techniques is&nbsp; the time required; single-slice technique using thick-slab take less time, while multi-slice techniques require more time. The single-slice MRM technique, excellently suppresses the background signals (from fat or paravertebral veins) and it also significantly reduces the CSF flow artefacts. As a result, the aim of this study was to assess the effectiveness of routinely using single thick-slice 2-D MRM to provide further details in the spinal and extra-spinal regions. <strong>Subjects and Methods: </strong>TR (repetition time)/TE (echo time) used were infinite/1200-1400; ETL (echo-train length), 256; one signal averaged, and imaging period of 2.8 seconds were the imaging parameters for the cervico-thoracic spine. To completely eliminate the fat signal in the lumbar spine an inversion pulse was used. The parameters were TR/TE was infinite/1200-1600; inversion time was 150; ETL was 256; four signals averaged; and imaging period was 32 seconds. For the cervicothoracic the spatial resolution was 0.98x 0.98 mm (pixel size) and lumbar spines, it was 0.55x 0.55 mm. the slice thickness of 40-60 mm was used and for each patient three images were obtained in coronal and bilateral oblique coronal directions. Midsagittal T2-weighted MR images were used to view single-slice MR myelographic images, which allowed for better anatomic resolution. A 1.5-T unit was used for all MR imaging (Philips Achieva Medical Systems). While 180 patients underwent single thick slice two Dimensional MRM using T2 half Fourier acquisition SSTE (single shot turbo spin echo) method in addition to routine MR procedure for the spine. The evaluation of the images was done in the spinal and extra-spinal areas, for additional diagnostic details. The effectiveness of MRM in identifying spinal or extra spinal findings was graded using a three-point grading system. Grade 1 suggested that MRM made no contribution, whereas grade 3 indicated that it was valuable in positively identifying the findings. <strong>Results: </strong>MRM’s spine utility was classified as grade 3 in 11% of cases (20/180), grade 2 in 21.7 percent of cases (39/180), and grade 1 in 67.3 percent of cases (121/180). As a result, the MRM in the spine was advantageous in 32.5 percent of cases (59/180). Additional spinal pathologies were found in 15.2 percent&nbsp; of cases (27/180). <strong>Conclusion: </strong>Thus we conclude that, when used in combination with routine MR sequences, 2D single thick slice MRM can provide more benefits in spinal imaging.</p> M. Dinesh, Ramgopal Karumuri, Harshavardhan Balaganesan, Anila Punchiry Copyright (c) 2021 Author Sun, 20 Jun 2021 00:00:00 +0000 Mammography, Ultrasound and Histological Profiles of Female Breast Cancer in Abidjan <p><strong>Background</strong>: To identify mammo-echographic lesions suggestive of woman breast neoplasia and to specify histopathological profile. <strong>Subjects and Methods</strong>: A 4-month retrospective study conducted at the new senology unit of the Treichville University Hospital. This study included 68 patients with breast cancer, diagnosed with mammography, breast ultrasound and echo-guided mammary biopsy and histological evidence. <strong>Results</strong>: The mean age was 45.92 years. The discovery circumstance was a palpable nodule (75%). Lesions were located on the left (57.3%),&nbsp; in the superior external quadrant (34%) and in the middle 1/3 (57.3%). The mammography showed a b-type density (54.4%), a dense mass (92.6%) without micro calcification (59%) of large size (42 mm), an irregular shape (81%), with unconfined shapes (89%). On ultrasound, lesions were hypo-echogenic (95.6%), heterogeneous (77%), non-parallel to the dermal plane (80%), with posterior attenuation (69%). All these lesions were associated with dermal changes (89.5%), edema (63.1%) and group I (97.4%) adenoma (56%).The lesions were classified as BI RADS 5 (63.2%). Non-specific infiltrating carcinoma predominated (83.8%) in Elston Ellis II histo-prognostic grade (52%). <strong>Conclusion</strong>: In Abidjan, women’s breast cancer is characterized by pejorative prognostic radiopathological factors, associating in young patients, large masses of infiltrating carcinoma, with a high rate of carcinomatous mastitis. Promoting mass breast cancer screening policy in our country should be imperative.</p> DT Gnaoulé, GC Gbazi, N Kouamé Copyright (c) 2021 Author Sun, 20 Jun 2021 00:00:00 +0000 Bleomycin vs Setrol for Sclerotherapy of the Lymphovenous Malformation <p>Introduction: Lymphatic malformations are developmental anomalies of lymphatic system consisting of abnormally formed lymphatic channels and cystic spaces. Bleomycin was first developed as an antineoplastic antibiotic, and its sclerosing effect was discovered later. The mechanism involves damage to endothelial cells with a nonspecific inflammatory reaction and occlusion of vessels. Vascular malformations have devastating cosmetic effects in addition to being associated with pain and bleeding. Sclerotherapy has been used as an effective therapeutic modality for the management of vascular malformations. Subjects and Methods : The material for this study was gathered from the patients treated with sclerotherapy for vascular malformation in the Sapthagiri Institute of Medical Sciences and Research Centre from January 2020 to December 2020 in the Department of Interventional Radiology. The material covers for 63 consecutive patients. The journals of each patient were examined for the following factors: age, medical specialty in charge of treatment, sporadic or familiar malformation, single or multiple and anatomic lesions, any prior treatment, type of radiological imagining, nature of the malformation (venous, lymphatic, venolymphatic, capillary or arteriovenous), smoking, number of sclerotherapies, nature of the sclerosant that was used (polidocanol, OK-432, ethanol, and glue), complications, and duration (follow-up) of treatment. Result: The 63 patients were divided into two groups: patients that eventually underwent a surgical procedure versus patients that did not. Patients were decided to be operated on if the result of the sclerotherapy was regarded as poor. These two patient groups were compared regarding the factors presented above for statically significant differences. Conclusion: Lymphatic malformations are developmental<br>anomalies of the lymphatic system that occur most commonly in the head and neck region followed by axilla and mediastinum. The precise aetiology of LMs is still unknown. In 50% of cases, they are present at birth with 80% to 90% diagnosed within the first two years of life. Initially they usually present as a painless, soft mass with wide variations in the growth rate. Rapid growth can occur as a result of trauma, intralesional haemorrhage and thrombosis. Spontaneous regression is very rare.</p> B.V. Girish, Nischal Kundaragi, K N Puneeth Kumar Copyright (c) 2021 Author Mon, 21 Jun 2021 00:00:00 +0000 Vascular Complications of Pancreatitis with Endovascular Treatment of Complications <p>Introduction: Most cases of pancreatitis are mild and self-limited. On the other hand, approximately one quarter of patients with pancreatitis may develop vascular complications. Vascular complications in pancreatitis are well recognized. Their exact incidence is not known. The most common complications are haemorrhage into a pseudocyst, erosions of the upper gastrointestinal arteries, thromboses of the portal venous system, formation of varices or pseudoaneurysms and rupture of a pseudoaneurysm. Pancreatitis in combination with vascular complications is dangerous and potentially lethal. The survival of patients with pancreatitis and vascular complications depends on the early diagnosis of these complications. This article focuses on the aetiology, presentation, recent developments in diagnosis and management of such complications. Material and Methods: Study done in the Department of Radiology from March 2019 to February 2020 at Meenakshi Medical college hospital and research institute, Kanchipuram, Tamilnadu to set the findings of the present study in the context of available evidence, a computerised literature search of PubMed, Embase, ISIS and CAS were carried out. The key words/subject headings used were “hemorrhage,” “pancreatitis,” “false aneurysms,” “venous thrombosis,” “angiography” and “therapeutic embolisation”. Limits applied were to restrict searches as follows: human and English language. All references were reviewed to retrieve additional articles. Other sources included review articles and text-books.<br>Result: Among the 169 attacks of acute pancreatitis, follow-up CT examinations depicted local complications in nine patients, for an overall incidence of 5.3%. There was a total of 16 complications, with three patients showing multiple complications. The number and percentage of patients with complications, number of complications, and number and percentage of follow-up examinations were calculated and correlated with the CT grading scale. Discussion: The development of abdominal complications in patients with acute pancreatitis leads to a prolonged hospitalization and, when life-threatening and not detected in time, to an increased mortality rate. Some of these complications may coexist, occur at any time after an acute attack, and have different manifestations and clinical repercussions. By and large, they are closely related to the staging severity of an acute attack of pancreatitis. Conclusion: Although the vascular complications following pancreatitis are not very common, they should be considered in every patient with pancreatitis. These complications if diagnosed and managed early was result in considerable reduction of morbidity and mortality.</p> Dinesh Kumar Reddy, Priyanka Vudumula, K.V Rajashekar Copyright (c) 2021 Author Mon, 21 Jun 2021 00:00:00 +0000