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> en-US info.ajmrr.journal@gmail.com (Dr. Rohit Varshney) shadanm168@gmail.com (Mr Shadan Pasha) Thu, 30 Jun 2022 10:29:23 +0000 OJS 3.1.2.1 http://blogs.law.harvard.edu/tech/rss 60 Spectrum of Imaging Findings of Spinal Tuberculosis on Magnetic Resonance Imaging https://aijournals.com/index.php/ajmrr/article/view/2356 <p><strong>Background: </strong>To describe the spectrum of manifestations of spinal tuberculosis on Magnetic Resonance Imaging. To study the role of MRI in assessing the extent of disease and in the decision-making process. <strong>Subjects and Methods:</strong> It is a prospective study conducted at the department of Radiodiagnosis in Narayana Medical College and Hospital, Nellore. The study was carried out on 63 cases of spinal tuberculosis in the period of two years (August 2019 to august 2021). MRI features were observed on T1 Weighted, T2 Weighted and short tau inversion recovery (STIR) sequences. Diagnosis was based on the history, clinical features and characteristic radiological findings on MRI along with the response to the treatment. <strong>Results:</strong> Spinal tuberculosis was most commonly seen in young adults and of male predominance. Backache in 58(92%) and low-grade fever were found to be the most common clinical features followed by weight loss and paraparesis. Thoraco-lumbar spine was the most commonly involved in 26(41.2%), followed by thoracic, lumbar and sacral vertebrae. MRI findings included bone marrow edema in 63(100%), end plate irregularities in 63(100%), disc space reduction in 34(53.9%), pre and paravertebral collection in 26(41.2%), calcification in 25(39.6%), spinal cord compression in 18(28.5%). In patients with spinal cord compression exceeding more than 20%, neurological symptoms were seen. Vertebral body wedge collapse in 33(52.3%), compression fracture in 14(22.2%) and both vertebral body wedge collapse with compression fracture were noted in 5 (7.9%). Kyphotic deformity in 25 (39.6%) and scoliosis in 8(12.6%) was also noted. In the majority of cases, a paradiscal pattern of involvement was found. <strong>Conclusion:</strong> Spinal tuberculosis is best evaluated on the Magnetic Resonance Imaging as it provides valuable and critical information regarding the spectrum, ranging from simple edema involving the vertebrae, intervertebral discs to the paraspinal collections, abscesses and vertebral collapse leading to spinal cord compression in patients with neurological deficit and thereby limiting the morbidity and helping in early diagnosis and guiding the management.</p> Basam Pavani Reddy, K.S. Vedaraju Copyright (c) 2022 Author https://creativecommons.org/licenses/by/4.0/ https://aijournals.com/index.php/ajmrr/article/view/2356 Thu, 30 Jun 2022 00:00:00 +0000 Assessment of Accuracy of Rotator Cuff Tears on Shoulder Ultrasound with Respect to Magnetic Resonance Imaging https://aijournals.com/index.php/ajmrr/article/view/2357 <p><strong>Background: </strong>The aim of the study is to assess the accuracy of ultrasound for diagnosis of rotator cuff tears with respect to magnetic resonance imaging, To identify partial thickness rotator cuff tears, full thickness rotator cuff tears and tendinopathic changes; and to evaluate the sensitivity and specificity of US in diagnosing them with respect to magnetic resonance imaging. <strong>Subjects and Methods:</strong> It is a prospective study conducted at the department of Radiodiagnosis in Narayana Medical College and Hospital, Nellore. A total of 30 patients who were suspected of having rotator cuff tear or tendinosis and planning to undergo MRI of shoulder were included in this study. Shoulder ultrasound was performed either before or after the MRI scan on same day. Findings of ultrasound were compared and correlated with findings of MRI. <strong>Results:</strong> Sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and accuracy for diagnosis of rotator cuff tear was 93%, 73%, 77%, 91%, and 83%, respectively. <strong>Conclusion:</strong> (SN) Sensitivity for diagnosis of rotator cuff tear was good and had a higher (NPV) negative predictive value. Consequently, operator of ultrasound even though having a short tenure of experience for performing ultrasound of shoulder had good sensitivity in diagnosing tears; and able to eliminate them with sureness.</p> K S Vedaraju, Basam Pavani Reddy Copyright (c) 2022 Author https://creativecommons.org/licenses/by/4.0/ https://aijournals.com/index.php/ajmrr/article/view/2357 Thu, 30 Jun 2022 00:00:00 +0000 Congenital Portosystemic Shunt: An Under-Recognized Cause of Pulmonary Arterial Hypertension https://aijournals.com/index.php/ajmrr/article/view/2359 <p><strong>Background: </strong>Congenital portosystemic shunt (CPSS) is an uncommon vascular malformation which causes partial or complete shunting of the portal blood into systemic circulation. The purpose of this study is to retrospectively analyze the clinical features, imaging features and therapeutic outcomes of the cases of CPSS diagnosed in our institution. <strong>Subjects and Methods:</strong> A retrospective analysis of the clinical features, imaging features and therapeutic outcomes of all 8 patients of CPSS in our institution between 2017 and 2021 was conducted in this study. Park et al classification was used for intrahepatic portosystemic shunts and Morgan &amp; Superina classification for extrahepatic portosystemic shunts. <strong>Results:</strong> Of the total eight cases of congenital portosystemic shunts, four cases had extrahepatic portosystemic shunts and four cases had intrahepatic portosystemic shunts. Five cases presented with pulmonary arterial hypertension (PAH).&nbsp; Associated features were present in four cases among which two cases had PDA with ASD (Fig 4), one case had only PDA and one case had pulmonary arterio venous fistula, double SVC and focal nodular hyperplasia in the liver. However, no statistical correlation was found between the type of shunt or associated features with portosystemic shunts and development of PAH. <strong>Conclusion:</strong> In our retrospective study we observed that unexplained pulmonary arterial hypertension was present in the majority of cases of CPSS and the development of PAH could not be explained by the presence of associated conditions with it. CPSS could be a more common cause of undiagnosed PAH in children than previously recognised. Hence, the children with unexplained PAH should be screened for CPSS also.</p> Gopinath Periaswamy, Pudhiavan A, Navya Christopher, Kartheek Guthikonda, Venkatesh Kasi, Mathew Cherian Copyright (c) 2022 Author https://creativecommons.org/licenses/by/4.0/ https://aijournals.com/index.php/ajmrr/article/view/2359 Thu, 30 Jun 2022 00:00:00 +0000 Epidemio-Clinical Aspects and MRI of Pelvic Endometriosis in Abidjan https://aijournals.com/index.php/ajmrr/article/view/2360 <p><strong>Background: </strong>The objectives is to determine the epidemiological characteristics and to describe the MRI characteristics of endometriotic lesions. <strong>Subjects and Methods:</strong> This was a retrospective and descriptive study which took place in Abidjan over a period of 15 months from March 2018 to May 2019. The examinations were carried out on a high field MRI 1.5 T with the following sequences: 3 T2 plans, axial diffusion with ADC cartography, T1 FAT saturation without and with axial injection. All the data were collected from MRI reports of the patients. A total of 68 patients were selected. Epidemiological parameters (age, reason for consultation); MRI parameters (lesional semiology and location of endometriotic lesions and type of endometriosis (internal: adenomyosis and external); associated lesions) were studied. The chi-square test was used to check the relationship between some factors, the differences were considered significant whenever p was &lt;0.05. <strong>Results:</strong> The mean age of the patients was 38.61 years with ranges of 14 and 55 years. Suspicion of endometriosis was the predominant indication in 42.65% of cases. The adenomyosis was the most frequent location with 67.65% followed by ovarian involvement (35.29%). In patients with adenomyosis, the junction area was less than 20 mm in 44.19% of them. Ovarian endometriosis was objectified in 24 patients, which is a prevalence of 35.29%. Subperitoneal endometriosis was objectified in 19.12% of cases. Among them, we noted a predominance of the involvement of the uterosacral ligaments (16.18%) followed by the involvement of the torus with 13.24% of cases. Tubal involvement was 10.29%. The association of endometriosis and fibroma was observed in 44.12% of patients. The risk of adenomyosis was high after 40 years p &lt;0.005, ovarian localization significantly decreased with age. It was 0.07 between 30 and 40 years old and 0.03 after 40 years. <strong>Conclusion:</strong> MRI appears to be the reference imaging examination in the diagnosis and assessment of extension of pelvic endometriosis, because it offers the possibility of performing in one step a complete assessment of the compartments of the pelvis before laparoscopy. In sub-Saharan Africa and particularly in Ivory Coast, the diagnosis of endometriosis is made at an advanced age dominated by adenomyosis followed by endometriomas.</p> Ndja Ange Patrick Copyright (c) 2022 Author https://creativecommons.org/licenses/by/4.0/ https://aijournals.com/index.php/ajmrr/article/view/2360 Thu, 30 Jun 2022 00:00:00 +0000 Role of Tissue Harmonic Imaging in Evaluation of Focal Liver Lesions https://aijournals.com/index.php/ajmrr/article/view/2361 <p><strong>Background: </strong>Tissue Harmonic Imaging is based on phenomenon of non-linear distortion of an acoustic signal as it travels through the body. Tissue harmonic imaging has a higher signal-to-noise ratio and fewer side lobe artefacts, allowing for better scanning of obese patients and those with weak acoustic windows, as well as solid and cystic distinction. <strong>Subjects and Methods:</strong> Over the course of six months, we studied 140 patients with liver lesions who were referred to the department of radiodiagnosis at Narayana Medical College in Nellore. Study was performed on GE Voluson expert 730 ultrasound machine using conventional gray- scale and Tissue harmonic imaging (THI) for assessing role of sonography. Two observers used both conventional sonography and tissue harmonic imaging to study 140 patients. <strong>Results:</strong> The study comprised 140 liver lesions, with the first observer ranking THI as better than conventional sonography in 108 lesions (77.1%) for overall image quality and the second observer ranking THI as better than conventional sonography in 100 lesions (71.4%). There was good agreement between two observers for the same (Kappa value 0.64). <strong>Conclusion:</strong> Harmonic imaging improves image quality and improves visualization of internal detail of the lesions. Routine use of harmonic imaging in evaluating all focal liver lesions is recommended.</p> Yarramsetti Madhusudana, Uma Maheswara Reddy V, Pulagam Sindhura, K S Vedaraju Copyright (c) 2022 Author https://creativecommons.org/licenses/by/4.0/ https://aijournals.com/index.php/ajmrr/article/view/2361 Thu, 30 Jun 2022 00:00:00 +0000 SWI Sequence -as a Promising Tool in the Evaluation and Treatment of Acute Stroke https://aijournals.com/index.php/ajmrr/article/view/2364 <p><strong>Background: </strong>There are many recent advances in the magnetic resonance imaging technique that have improved the assessment and evaluation of acute stroke. The susceptibility of tissue is based on its components like hemosiderin, calcium, deoxygenated blood, and ferritin (1). Thrombosed vessels, old hemorrhages, and even tiny minute hemorrhages can easily be detected in SWI sequence. The aim of this study is to depict the importance of SWI sequence in detecting the tissue susceptibility differences which ultimately helps in the assessment and management of both ischemic and hemorrhagic strokes. <strong>Subjects and Methods:</strong> This hospital-based prospective study was conducted upon 150 patients, over two years from July 2019 to August 2021 at the department of Radio-Diagnosis, Narayana Medical College. The patients who came with complaints of weakness of limbs, headache, vomiting, deviation of the mouth, etc, were subjected to MRI brain study including SWI sequence. <strong>Results:</strong> Among the 150 studied population, 138(92%) cases had findings and 12(8%) cases are normal. In 138 cases, 99 (71.7%) cases had ischemic infarction, 30 (21.7%) cases had an intraparenchymal hemorrhage and 9(6.6%) cases had venous sinus thrombosis. In 99 cases of ischemic infarction, 38 (38.3%) cases had no hemorrhagic transformation, 35 (35.3%) cases had shown susceptibility sign and 26(26.4%) cases had an early hemorrhagic transformation. <strong>Conclusion:</strong> Detection of early hemorrhagic transformation within acute infarcts is necessary to prevent the patient from the catastrophic condition due to thrombolytic treatment (2). As SWI sequence detects the early hemorrhagic transformation, it plays a crucial role in planning the management of the patient. It also detects the cause of infarct by detecting the susceptibility sign. Therefore, it is necessary to include the SWI sequence in the routine MRI brain stroke protocol for assessing the patients presented with complaints of stroke.</p> Konduru Nishitha, Sravan Krishna Reddy A, Prasanna Vaibhav T, Bonamukkala Bharath Reddy Copyright (c) 2022 Author https://creativecommons.org/licenses/by/4.0/ https://aijournals.com/index.php/ajmrr/article/view/2364 Thu, 30 Jun 2022 00:00:00 +0000 Role of 3 Tesla Magnetic Resonance Imaging for Shoulder Pain and Instability in Tertiary Care Centre https://aijournals.com/index.php/ajmrr/article/view/2366 <p><strong>Background: </strong>The objective of our study is to demonstrate the role of 3Tesla MRI in detecting shoulder pathologies encountered in patients with shoulder pain. <strong>Subjects and Methods:</strong> It is a hospital based prospective observational study which was carried out in 50 patients with a history of shoulder pain and suspects of rotator cuff tear and glenoid labral injuries in Narayana medical college and general hospital, Nellore. All age group patients were included in the study without any gender predilection. <strong>Results:</strong> Out of the 50 patients, 5 patients were excluded. Among the 45 patients included in the study the various pathologies were detected on MRI. <strong>Conclusion:</strong> To understand the role of MRI in the diagnosis of shoulder pain and instability and to understand pitfalls. MRI is the best among various imaging modalities as it is non-invasive and provides a better depiction of the soft tissues of the shoulder joint. It has the added advantage of being nonionizing modality.</p> J. Nanda Gopal, A. Sravan Krishna Reddy, Harathi Surla, P. Suneetha Copyright (c) 2022 Author https://creativecommons.org/licenses/by/4.0/ https://aijournals.com/index.php/ajmrr/article/view/2366 Thu, 30 Jun 2022 00:00:00 +0000 Role of 3 Tesla MR Fistulogram in Evaluation of Perianal Fistulas https://aijournals.com/index.php/ajmrr/article/view/2367 <p><strong>Background: </strong>An unusual association b/w two organs and structures in the body is called a fistula, it may be also formed between an organ &amp; skin of the body. Perianal fistula is an infrequent but critical GIT condition that can cause substantial morbidity. It develops due to various reasons but usually as a result of anorectal abscess. Men have a higher prevalence than women. It is a connection due to septic ulceration/ I&amp;D which formed surrounding rectum &amp;anus, characterized by the development of improper connection b/w rectum &amp; anal canal, to that of skin present over the anus. There are different classifications for perianal fistulas. The Parks classification is used widely for surgical classification and distinguishing 4 types. Radiologists have devised a new grading system for perianal fistulae called the St James's University Hospital classification, which comprises five grades and is based on landmarks on the axial plane. It also includes abscesses and secondary extensions. Because they are based on anatomical features, they are simple to utilize. A perianal fistula can be evaluated using a variety of imaging techniques. X-ray fistulography, endoanal ultrasonography, CT fistulography, and MR fistulogram are some of the options. The MR Fistulogram is a required imaging modality for the identification of fistula in ano, and its multiplanar reconstruction has proven to be extremely useful in surgery for characterizing and classifying fistulas based on their relationship to the diaphragm of the pelvis and the anal sphincter. <strong>Subjects and Methods:</strong> Patients referred to the department of Radiodiagnosis at Narayana Medical College and Hospital in Nellore were the main source of data. There are 42 individuals in this hospital-based prospective research. This study was conducted over two years (i.e., from Jun 2019 to Jun 2021). The subjects who gave informed consent were studied on a 3 Tesla GE MRI Scanner (GE Discovery 750w). <strong>Results:</strong> Our research included 42 people who had clinical and investigative features that pointed to an anal fistula. With a male to female ratio of 3:2, the bulk of the patients were men. The majority of the people were in their 30s and 50s. Tuberculosis and Crohn's disease were found to be co-morbidities. The intersphincteric form of fistula was the most common among the 42 patients in the study, followed by the trans sphincteric type. When the fistulous tracts were examined in our investigation, the majority of the patients had only one external opening. In most of the cases the opening was between 4 and 6 o'clock. When examining the internal opening, the majority of patients had only one. The internal opening was most commonly found in the 4 to 6 o'clock position. The surgical findings matched the study's findings on the location of the openings. We used the St James's University Hospital Classification to categorise perianal fistulas in our investigation. Grade I fistulas were found to be the most common, followed by grade III fistulas. Abscesses were seen in 8 of 42 patients (19.05%) and secondary tracts in 12 of 42 (28.57 percent). In our study, there is a significant correlation (p-value 0.006) between the fistulous tracts identified on the 3 Tesla MR Fistulogram and the surgical findings. <strong>Conclusion:</strong> Perianal fistula is a rare problem that can become chronic and recurrent. There are several complications, such as tracks and an abscess. Inadequate assessment of these consequences can lead to recurrent and persistent illness. As a result, a thorough examination of perianal fistulas is required prior to surgery. In order to avoid injury to the external sphincter and subsequent faecal incontinence, it is also necessary to establish the sphincter's relationship with the fistulous pathways. The 3 Tesla MR Fistulogram meets all of these requirements for surgeons and aids in surgery. The 3 Tesla MR Fistulogram identifies secondary tracks and abscesses as well as providing detailed anatomic details of the fistula. It can also tell the difference between scar tissue and granulation tissue. We conclude that a 3 Tesla MR Fistulogram is the best way to assess anorectal fistulas prior to surgery.</p> Takkalapally Prasanna Vaibhav, Yarramsetti Madhusudana, Gayatri Manam, K S Vedaraju Copyright (c) 2022 Author https://creativecommons.org/licenses/by/4.0/ https://aijournals.com/index.php/ajmrr/article/view/2367 Thu, 30 Jun 2022 00:00:00 +0000 Imaging Maxillofacial Trauma: The Role of Multidetector Computed Tomography https://aijournals.com/index.php/ajmrr/article/view/2368 <p><strong>Background: </strong>Facial fractures account for substantial emergency department visits in the world and are allied with great levels of morbidity and mortality. The maxillofacial region is one amongst the most complex anatomical regions of the human body and is further linked with several crucial daily activities. The main objective of this study was to assess the role of Multislice Computed Tomography in the evaluation of maxillofacial trauma. <strong>Subjects and Methods: </strong>This Hospital-based prospective study was carried out over 9 months from JAN 2021 to SEP 2021 at the Department of Radiodiagnosis, Narayana medical college, Nellore. The study population included 48 patients- imaged with non-contrast axial 16 slice or 128 slice helical series. In conjunction with the axial images, coronal-plane MPR images were scrutinized to ascertain the presence of facial fractures. 3-Dimensional volume-rendering images were also procured. The GE workstation was used to review MDCT scans. <strong>Results: </strong>Out of the 48 cases, eight individuals were excluded from our study owing to motion artefacts. The peer age-group of this study was within 30 to 40 years with male preponderance of 70%. RTA was most prevalent mode of injury comprising 67.5% of cases. The maxillary fractures were most frequently eyed in 75% of patients and naso-orbito-ethmoid region accounted for 70% of patients forming the next routinely affected region. Most familiar coexistent finding in the patients with facial injury was hemosinus and spotted in 80% (n=32) patients. Some of the fractures were missed on three-dimensional imaging (3 D) compared to the axial scans but the extent of the complex fracture lines as well as degree of displacement were assessed with increased accuracy. <strong>Conclusion: </strong>The technological advances in medical imaging, particularly computer software algorithms in CT have fabricated the generation of coronal and sagittal reconstructed images along with 3- Dimensional images expeditious and economical without auxiliary burden of radiation exposure. We conclude that MDCT is highly diagnostic and is, therefore, the best imaging modality for evaluating maxillofacial injuries and its associated findings in backdrop of trauma and thus playing a crucial role in the planning of surgery.</p> K.S. Vedaraju, Neha Khatoon P, Pulagam Sindhura Copyright (c) 2022 Author https://creativecommons.org/licenses/by/4.0/ https://aijournals.com/index.php/ajmrr/article/view/2368 Thu, 30 Jun 2022 00:00:00 +0000 Institutional Review of Spectrum of Covid and Post-Covid Central Nervous System Mucormycosis https://aijournals.com/index.php/ajmrr/article/view/2369 <p><strong>Background: </strong>The objective of the study is to describe the various central nervous system imaging findings and manifestations of the mucormycosis. <strong>Subjects and Methods:</strong> A retrospective analytical observational study was done on 20 individuals who had biopsy /culture proven invasive rhinocerebral mucormycosis. The case records of these patients were reviewed and the MRI images were retrieved from the Picture archiving and communication system and were analyzed. Statistical analysis was performed using descriptive statistics. <strong>Results:</strong> MRI imaging of 20 patients with exclusive central nervous system was evaluated which showed predominantly cavernous sinus thrombosis in 5 patients, internal carotid artery thrombosis in 4 patients, cerebral infarction in 4 patients, cerebral abscess was noted in 2 patients, in cerebritis in 2 patient, meningitis in 2 patients and subarachnoid hemorrhage in 1 patient. <strong>Conclusion:</strong> MRI shows a spectrum of findings Sin central nervous system in rhinocerebral mucormycosis. It plays a major role in assessing the route of spread, extent of involvement and complications.</p> Sikiligiri Arshiya, Umamaheswara Reddy Venati, Sabarinath Eada, Yarramsetti Madhusudana Copyright (c) 2022 Author https://creativecommons.org/licenses/by/4.0/ https://aijournals.com/index.php/ajmrr/article/view/2369 Thu, 30 Jun 2022 00:00:00 +0000 Pulmonary Metastases- Imaging Spectrum from Different Primaries https://aijournals.com/index.php/ajmrr/article/view/2370 <p><strong>Background: </strong>Lung is an extremely common site for metastasis. Different imaging patterns of lung metastases help not to miss the diagnosis of metastasis, so that by giving early treatment, morbidity and mortality can be reduced. The aim &amp; objective is to illustrate the different imaging patterns of pulmonary metastases from different primaries. <strong>Subjects and Methods:</strong> This is a retrospective descriptive study. We have taken 30 cases of pulmonary metastasis with different primary malignancies and observed the atypical radiologic features of metastases from different primaries. <strong>Results:</strong> In our institute out of 30 cases of pulmonary metastases of which 4 (14%) cases of Renal cell carcinoma, 2(7%) cases of testicular germ cell tumor, 4 (13%) cases of thyroid cancer, 2(7%) cases of osteosarcoma,4(13%) cases of GI tract adenocarcinoma, 3 (10%)cases of gynecological malignancies, 1(3%) case of femoral vein leiomyosarcoma, 4 (13%)cases of breast cancer, 1(3%) case of lymphoma, 5 (17%)cases of lung carcinoma showed different patterns of pulmonary metastases along with typical pattern, i.e., multiple soft tissue density nodules. Summary: The atypical radiologic features of metastases observed were cavitation, calcification, endobronchial metastases, ground-glass attenuation around mass (CT halo sign), and consolidation with or without ground-glass opacity. <strong>Conclusion:</strong> Multiple round variable-sized nodules and diffuse thickening of the interstitium are typical radiologic findings of pulmonary metastasis. Different patterns make it difficult the diagnosis of pulmonary metastases. So, the knowledge of different patterns of pulmonary metastases from different primaries helps in the early diagnosis of metastases.</p> Pabbu Lekhyasree, Sravan Krishna Reddy A, Rama Krishna Rao Baru, KS Vedaraju, Suneetha P Copyright (c) 2022 Author https://creativecommons.org/licenses/by/4.0/ https://aijournals.com/index.php/ajmrr/article/view/2370 Thu, 30 Jun 2022 00:00:00 +0000 Value of Pre-Operative Planning with Selecting the Most Functional Vessels by Ultrasound Vascular Mapping of Upper Limb for Haemodialysis Access Placement https://aijournals.com/index.php/ajmrr/article/view/2371 <p><strong>Background: </strong>The increasing prevalence of end-stage renal illness, as well as its influence on health-care costs, has led in a greater emphasis on the provision of vascular access treatment. USG is an effective modality for evaluating (Haemodialysis) HD access since it is quick, easy to use, non-invasive, and affordable. With the advancement of high resolution USG machines, Now it is feasible to gather data prior surgery, assisting in surgery planning. This study aimed to find the value of pre-operative planning with choosing the most functional vessels through mapping of the upper extremity by ultrasound for HD access creation, with the subsequent reduction in morbidity and hospitality cost after AV fistula placement. The objective of study is identifying correlation between Doppler USG findings and operational results (as assessed by anatomy, vessel size, patency, and wall morphology). <strong>Subjects and Methods:</strong> This research comprised 35 patients who were referred from Narayana Medical College's urology and nephrology departments for HD creation. The research took place between November 2019 and November 2021. The doppler results were then compared to the surgery findings and outcome. Doppler vessel sizes and per operative surgical results of vessel diameter were recorded and compared to identify differences. The correlation was used to identify access points selected and the type of access executed. The disparities discovered between US and operative results were also analyzed. <strong>Results:</strong> The findings of doppler USG were strongly correlated with operative findings. 94.2% accuracy is detected with preoperative Doppler USG for choosing potential sites for Hemodialysis access creation. 85.7% rise in AVF creation is observed When a physical examination is combined with Doppler USG. Summary: In this research, upper extremity vessels were sonographic ally assessed in 35 patients before AVF creation based on standard criteria &amp; potential access sites were selected. Main purpose of this research was to determine the value of pre-operative planning with choosing the most functional vessels by ultrasound vascular mapping of the upper extremity for hemodialysis access placement, resulting in a reduction in morbidity, hospitality cost after AV fistula placement. The findings of Doppler USG were strongly correlated with operative findings. <strong>Conclusion:</strong> In patients whose physical examination was indeterminate, preoperative vascular mapping by Doppler USG by using various parameters such as vessel diameter, wall morphology, peak systolic flow, Spectral wave from, anatomical course, patency, depth from skin surface helped a lot in choosing potential sites for access creation.</p> Pabbu Lekhyasree, Ramakrishna Rao Baru Copyright (c) 2022 Author https://creativecommons.org/licenses/by/4.0/ https://aijournals.com/index.php/ajmrr/article/view/2371 Thu, 30 Jun 2022 00:00:00 +0000 Fetal Cholelithiasis - A Case Series https://aijournals.com/index.php/ajmrr/article/view/2380 <p>We do not come across many cases of fetal gall stones. Our aim of the study is to discuss the ultrasonographic algorithm that we followed evaluating fetuses during pregnancy and after birth. We also evaluated the mothers gall bladder during pregnancy and postpartum. We imaged newborns where we found gall stones, for whom antenatal scan done elsewhere did not mention about it. Our purpose is to follow an algorithm for fetuses having gall stones and their mothers.</p> Anil Kumar Shukla, Ajit Kumar Reddy Copyright (c) 2022 Author https://creativecommons.org/licenses/by/4.0/ https://aijournals.com/index.php/ajmrr/article/view/2380 Thu, 30 Jun 2022 00:00:00 +0000