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   2006| July-September  | Volume 16 | Issue 3  
 
 
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NEURORADIOLOGY
Role of MR cisternography in the diagnosis of cerebrospinal fluid rhinorrhoea with diagnostic nasal endoscopy and surgical correlation
R Rajeswaran, A Chandrasekharan, S Mohanty, K Murali, S Joseph
July-September 2006, 16(3):315-320
DOI:10.4103/0971-3026.29005  
Objectives : To study the usefulness and accuracy of MR cisternography as noninvasive study in the diagnosis of cerebrospinal fluid (CSF) fistula with diagnostic sinonasal endoscopy and surgical correlation. Material and Methods: Twenty four patients with clinically suspected CSF rhinorrhoea were examined for CSF fistula with MR cisternography. The MR imaging technique included 3mm thin T2 weighted coronal and sagittal sections using Fast spin echo. In addition 1.5mm thin T2 weighted coronal sections were also obtained using CISS (Constructive Interference in Steady State) sequence. MR findings were correlated with diagnostic sinonasal endoscopy and surgical findings. Results : MR cisternography demonstrated the presence of fistula in 17 patients, absence of fistula in seven patients. Out of 17 patients with fistula, the diagnosis could be confirmed in 14 patients by diagnostic sinonasal endoscopy/surgery. Out of the seven patients without fistula, there was positive correlation in six patients when they were followed up clinically and by diagnostic nasal endoscopy. However in one patient, fistula was demonstrated on CT cisternography and was confirmed on sinonasal endoscopic surgery. The accuracy, sensitivity of MR cisternography was 96, 94% respectively. Conclusion : MR cisternography is a useful and accurate noninvasive study in localizing the site and extent of CSF fistula.
  27,586 1,428 4
Radiological findings in a mumps case with multiple complications
O Sirmatel, P Yazgan, F Sirmatel, A Ozturk, Z Ziylan
July-September 2006, 16(3):305-308
DOI:10.4103/0971-3026.29002  
Mumps is an infection caused by paramyxoviruses. This infection is more common among children and it progresses with a number of complications later in life. This case was found worth presenting because no cases with such a diversity of complications have been reported in English literature in the last 25 years. A 17-year-old male patient was admitted to the emergency unit with bilateral parotitis, meningoencephalitis and orchitis. The patient was clinically and serologically diagnosed as having mumps and developed an acute pancreatitis, arthritis in the left knee, cholestatic hepatitis and myocarditis in the follow up. Radiological imaging methods lead the way to the description of the complications.
  11,038 558 -
HEAD AND NECK IMAGING
Imaging of cochlear implants
A Chaturvedi, C Mohan, SB Mahajan, Vipin Kakkar
July-September 2006, 16(3):385-392
DOI:10.4103/0971-3026.29025  
Aim : To evaluate the role of various imaging modalities in pre and post operative evaluation of cochlear implant candidates. Materials and methods : 30 patients were evaluated by HRCT and 15 of these subsequently underwent MRI temporal bones prior to cochlear implant device insertion. All implanted patients were subjected to post operative radiography to assess position of implant. Results : Both modalities provided critical information on abnormalities of the otic capsule, pneumatisation of the mastoid, middle ear abnormalities, cochlear ducts patency and vascular abnormalities- thus helping to assess the suitability of the ear for implantation, determine the side to be implanted and to find any associated abnormality which could adversely influence the surgery or post op period. HRCT missed two cases of luminal ossification and MRI was more reliable in detecting early luminal obstruction. Conclusion : Based on our findings, we offer a realistic and practical protocol for imaging in cochlear implants in the Indian setting. HRCT is recommended in all patients for pre implant analysis of the temporal bone morphology due to its reliability and easy availability. MRI is recommended in all cases of post meningitic deafness and in others with doubtful CT findings.
  9,818 1,172 3
MUSCULOSKELETAL
Solitary osteochondroma of rib: A case report
SV Phatak, PK Kolwadkar, D Rajderkar
July-September 2006, 16(3):339-340
DOI:10.4103/0971-3026.29011  
  9,113 469 2
GASTROINTESTINAL RADIOLOGY
Para duodenal hernia
V Mathur, P Parakh, M Tiwari, A Bhandari, P Pareek, H Chaturvedi
July-September 2006, 16(3):371-372
DOI:10.4103/0971-3026.29021  
  8,373 470 4
NEURORADIOLOGY
IMAGES: Rare type of frontal encephalocele (paramedian)
SV Phatak, D Rajderkar
July-September 2006, 16(3):309-311
DOI:10.4103/0971-3026.29003  
  6,927 401 2
Structural brain lesions in schizophrenia -magnetic resonance imaging on a mid field magnet
SR Parkar, R Seethalakshmi, H Shah
July-September 2006, 16(3):299-301
DOI:10.4103/0971-3026.29000  
Objectives : The brain damage associated with schizophrenia has been established beyond doubt; however, what remains unexplored is the biological nature of transcultural variations. An important reason for this was the lack of mid and high field scanners in developing countries like India. Material and Methods : We undertook a pilot study using a 0.5 Tesla MRI scanner (General Electric Signa Contour) to explore identifiable structural brain lesions in ten randomly selected individuals with schizophrenia. Results: Nine of the ten participants in the series had structural brain changes. The most common findings were ventricular dilatation and prominent cerebral cortical sulci and cerebellar folia. Additionally non-focal white matter lesions were observed in three patients and small right hippocampus was noted in one participant. Conclusions : The study discusses that establishing structural brain lesions with mid field scanners is indeed feasible. The small study sample and heterogeneity of schizophrenia however made it difficult to establish any definite associations
  6,828 291 -
EDITORIAL
3 Tesla MRI - A new workhorse
Shrinivas B Desai
July-September 2006, 16(3):281-282
DOI:10.4103/0971-3026.28995  
  6,260 657 1
GASTROINTESTINAL RADIOLOGY
Gastro intestinal stromal tumor: A case report
S Shanmugam, D Vijayasekaran, MG Marimuthu
July-September 2006, 16(3):373-376
DOI:10.4103/0971-3026.29022  
  6,119 386 1
MUSCULOSKELETAL
Nodular fascitis (pseudosarcomatous fibromatosis)
S Somasundaram, K Murali, S Joseph, T Paul
July-September 2006, 16(3):345-347
DOI:10.4103/0971-3026.29013  
  5,750 369 1
ABDOMINAL RADIOLOGY
Superior mesenteric artery tear with hypoperfusion syndrome
M Sharma, TM Kalyanpur, S Sardessai
July-September 2006, 16(3):359-362
DOI:10.4103/0971-3026.29017  
  5,532 263 -
MUSCULOSKELETAL
Primary Ewing's sarcoma of occipital bone
RK Kaza, MS Sandhu, V Ojili
July-September 2006, 16(3):353-354
DOI:10.4103/0971-3026.29015  
Ewing's sarcoma commonly involves the long bones. Primary Ewing's sarcoma of the cranium is rare and is difficult to distinguish from other tumors involving the cranium. Radiological features and immuno-histochemistry are helpful in diagnosing this tumor. In this report we present a rare case of primary Ewing's sarcoma of the occipital bone and discuss the differential diagnostic options.
  5,331 274 -
Cat scratch disease presenting as right lower arm swelling
J Jacob, A Gaikwad, P Ghadge
July-September 2006, 16(3):341-343
DOI:10.4103/0971-3026.29012  
  5,196 271 -
CARDIAC RADIOLOGY
Tunneled coronary artery: Case report
PS Garde, AA Karandikar, OJ Tavri, DP Patkar, AK Dalal
July-September 2006, 16(3):283-284
DOI:10.4103/0971-3026.28996  
  5,034 319 -
NEURORADIOLOGY
Septo-optic dysplasia with unilateral open lip schizencephaly:A case report
D Rajderkar, SV Phatak, PK Kolwadkar
July-September 2006, 16(3):321-323
DOI:10.4103/0971-3026.29006  
  4,871 334 1
CARDIAC RADIOLOGY
Comparison of cardiac MR and 99mtc Sestamibi Spect in the evaluation of myocardial perfusion and viability in coronary artery disease
A Kapoor, A Khanna, S Bhatia, G Mahajan, A Kapoor, R Kapoor
July-September 2006, 16(3):285-292
DOI:10.4103/0971-3026.28997  
Objective - The present study was designed to compare the role of 99mTc sestamibi sciintigraphy (SPECT) and cardiac MR (CMR) in the detection of viable myocardium and to delineate myocardial scar tissue in patients with established chronic ischemic heart disease. Methods - Thirty six patients with established chronic ischemic heart disease on coronary angiograms which was the gold standard underwent both stress CMR and 99mTc sestamibi studies. Out of these 11 patients who had reduced end diastolic thickness <5.5mm alongwith wall motion abnormalities also underwent dobutamine MR (DMR) for determining the contractile myocardial reserve. Results- Both CMR and SPECT showed a good correlation in the detection of perfusion defects (r=0.89) with the diagnostic region of operating characteristics being 0.97. The sensitivity and specificity of SPECT to detect perfusion defects were 82.6% and 90.4% respectively. In comparison CMR had a sensitivity, specificity of 92.8% and 98.2% respectively in identifying such defects.It was also superior in defining transmural infarcts(TMI) with sensitivity being 100% vs 79.3% of SPECT (p=<0.0001) and all the 10 segments with TMI showed irreversible myocardial dysfunction on DMR. This was the only imaging parameter that indicated myocardial non viability with a specificity of 100%. Conclusions - CMR is a useful diagnostic tool in the evaluation of patients with chronic myocardial ischemia and is superior to SPECT in the detection and quantification of myocardial infarctions. Demonstration of a TMI on CMR is a finding strongly associated with non viability of the myocardium and may preclude the need for doing a DMR in such cases.
  4,606 365 -
NEURORADIOLOGY
An unusual cerebello-medullary angle mass - case report
T Sumit, G Samson, A Rao, R Haran
July-September 2006, 16(3):303-304
DOI:10.4103/0971-3026.29001  
  4,606 316 -
CHEST RADIOLOGY
Benign fibrous mesothelioma - a case reportc
S Vinod, G Mehetri, KK Hegde
July-September 2006, 16(3):293-294
DOI:10.4103/0971-3026.28998  
  4,476 268 -
HEAD AND NECK IMAGING
Usefulness of dynamic maneuvers in MR evaluation of oral malignancies
R Oberoi, A Jena
July-September 2006, 16(3):379-384
DOI:10.4103/0971-3026.29024  
Objectives : The purpose of this study was to evaluate the usefulness of dynamic maneuvers like "distended cheek" and "tongue deviation" in MR evaluation of oral malignancies. Methods : Ninety nine patients of oral malignancies who reported to this institute for treatment were enrolled in this study. All the patients evaluated with conventional MR imaging and supplemented by additional MR imaging with dynamic maneuvers using T1Weighted and STIR sequences with reduced scan time. Distended cheek imaging was performed in 73 cases of carcinoma cheek, gingiva & RMA (retromolar area) and tongue deviation in 24 cases of carcinoma tongue & floor of mouth. Two cases of carcinoma of lower gingiva performed both maneuvers. In selected cases MR imaging with dynamic maneuvers was also performed following contrast administration. Results : Lesions appearing inseparable from two mucosal surfaces (buccal mucosa and gingiva) on routine MR images were well separated in the distended cheek images in all cases except for two cases who could not perform the maneuvers. Distended cheek images demonstrated involvement of buccogingival sulci in 30 patients of carcinoma of cheek, involvement of cheek in 8 cases of carcinoma gingiva & involvement of gingiva in 6 cases of carcinoma cheek which were not appreciated on routine MR images. Similarly MR imaging with tongue deviation helped in better delineation of tongue lesions in 12 cases and showed involvement of glossogingival sulcus in 5 cases that were not appreciable on routine MR imaging. Conclusion : MR imaging with dynamic maneuvers provide additional information of clinical significance regarding origin and extent of disease in oral malignancies & should supplement the conventional MR imaging in selected cases.
  4,415 322 -
MUSCULOSKELETAL
Ellis-Van creveld's syndrome (a case rreport)
OP Sharma, R Saraf, B Gupta
July-September 2006, 16(3):325-327
DOI:10.4103/0971-3026.29007  
A 13 years old male patient had stunted growth, bilateral polydactyly, fusion of capitate and hamate on right side, incomplete duplication of 1st metacarpal at its proximal end, poorly ossified epiphyses of lower end of radius & ulna, valgus deformity of right knee, conical shape of tibial epiphyses, nonossified fibular epiphyses & a small bony exostoses from medial end of right tibia, abnormal teeth and nail of hand. Also there was evidence of left to right shunt in the heart. Oral frenulae, pseudocleft of upper lip were also noticed.
  4,252 288 6
ABDOMINAL RADIOLOGY
Hemangiopericytoma of the retroperitoneum
V Kalia, K Saggar, A Ahluwalia, P Sandhu, Vibhuti
July-September 2006, 16(3):369-370
DOI:10.4103/0971-3026.29020  
  4,044 333 -
MUSCULOSKELETAL
Subtrochanteric periosteal chondroma: A case report and tumor overview
IK Dhammi, AV Maheshwari, AK Jain, D Gulati
July-September 2006, 16(3):329-332
DOI:10.4103/0971-3026.29008  
We report a rare case of subtrochanteric periosteal chondroma in a 16 years boy. The purpose of this presentation is to stress the importance of a proper clinico-radiological and histopathological diagnosis of this lesion. Awareness of the features of this lesion helps to prevent overtreatment of this benign condition, since its differentiation with malignant lesions may be extremely difficult, even at histology; and since conservative surgery with complete excision of the lesion leads to permanent cure.
  4,117 254 1
GYNAECOLOGY AND OBSTETRICS IMAGING
Prenatal sonologic features of simple meconium peritonitis
AK Kharat, R Prathima, A Singh, D Jacob
July-September 2006, 16(3):377-378
DOI:10.4103/0971-3026.29023  
A 25 yrs old female patient came to our department for routine antenatal ultrasound. Sonography revealed presence of a 24 week live intrauterine pregnancy. During routine screening for congenital anomalies, multiple highly echogenic foci were seen on the visceral peritoneal surface of liver and the parietal peritoneum. However no evidence of dilated bowel/ fetal ascites was detected. No other anomaly was detected.
  3,973 316 1
ABDOMINAL RADIOLOGY
CT of diffuse fatty infiltration of renal parenchyma secondary to bilateral giant angiomyolipomas- a case report
NS Rawat, A Negi, BB Thukral, NC Saxena
July-September 2006, 16(3):367-368
DOI:10.4103/0971-3026.29019  
  3,807 262 -
MUSCULOSKELETAL
Diaphyseal osteosarcoma: A case report
SV Phatak, R Ravi, PK Kolwadkar, D Rajderkar
July-September 2006, 16(3):335-337
DOI:10.4103/0971-3026.29010  
  3,567 309 2
CHEST RADIOLOGY
Clinicoradiological findings in a patient with fibrosing mediastinitis and anti-phospholipid antibody syndrome
R Madan, RS solanki, MK Narula, G Kapoor
July-September 2006, 16(3):295-297
DOI:10.4103/0971-3026.28999  
  3,596 243 2
NEURORADIOLOGY
Rare case of cerebral stroke & venous thrombosis developed during high altitude expedition
A Prabhakar, M Aggarwal, P Khurana, N Trehan
July-September 2006, 16(3):313-314
DOI:10.4103/0971-3026.29004  
  3,521 259 -
QUIZ
Radiological quiz - musculoskeletal
NU Bahri, HP Parekh, PV Padhara, HH Zalawadia, II Pathan, VA Karmur
July-September 2006, 16(3):397-398
DOI:10.4103/0971-3026.29028  
  3,179 261 -
MUSCULOSKELETAL
Tumoral calcinosis in child having turner syndrome - A case report
A Mukund, L Rawat, A Kumar, GL Sharma
July-September 2006, 16(3):349-352
DOI:10.4103/0971-3026.29014  
  3,011 251 -
QUIZ
Radiological quiz - abdomen
S Kumar, RK Vaheesan, RJ Praveena, JR Pillai
July-September 2006, 16(3):395-396
DOI:10.4103/0971-3026.29027  
  2,942 238 -
MUSCULOSKELETAL
Isolated skeletal and splenic hydatid disease
S Uysal, D Gokharman, I Tuncbilek, M Kacar, H Yigit, Ugur Kosar
July-September 2006, 16(3):333-334
DOI:10.4103/0971-3026.29009  
  2,832 215 2
QUIZ
Radiological quiz - pediatric neuroradiology
D Ghongade, R Kannan, S Moorthy, KP sreekumar, NK Prabhu
July-September 2006, 16(3):399-400
DOI:10.4103/0971-3026.29029  
  2,727 262 -
MUSCULOSKELETAL
Pictorial essay: Spinal echinococcosis
SV Phatak
July-September 2006, 16(3):355-357
DOI:10.4103/0971-3026.29016  
  2,712 268 2
ABDOMINAL RADIOLOGY
Uncommon presentation of infantile hepatic hemangioendothilioma
CJ Rao, SL Reddy
July-September 2006, 16(3):363-365
DOI:10.4103/0971-3026.29018  
  2,620 234 -
QUIZ
Radiological quiz - gastrointestinal
NU Bahri, HP Parekh, HH Zalawadia, PV Padhara, VB Shah, RB Gupta
July-September 2006, 16(3):401-402
DOI:10.4103/0971-3026.29030  
  2,559 231 -
Radiological quiz - tuberous sclerosis
MS Shah, DS Shah, G Tomar, H Parikh, J Shah, B Shah
July-September 2006, 16(3):393-394
DOI:10.4103/0971-3026.29026  
  2,553 236 -
Radiological quiz - paediatric neuroradiology
K Malathy, R Ravi, BI Jaffrey
July-September 2006, 16(3):403-404
DOI:10.4103/0971-3026.29031  
  2,412 236 -
Radiological quiz - abdomen
BK Parameswaran, S Kanekar
July-September 2006, 16(3):405-407
DOI:10.4103/0971-3026.29032  
  2,226 213 -
LETTER TO EDITOR
Meckel Final
Gurudatt N Thakkar
July-September 2006, 16(3):408-409
DOI:10.4103/0971-3026.29033  
  2,142 180 -
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