Indian Journal of Radiology Indian Journal of Radiology  

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   2010| July-September  | Volume 20 | Issue 3  
    Online since September 14, 2010

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Pictorial Essay: Infants of diabetic mothers
Ibrahim A Alorainy, Nauman B Barlas, Amer A Al-Boukai
July-September 2010, 20(3):174-181
DOI:10.4103/0971-3026.69349  PMID:21042439
About 3 to 10% of pregnancies are complicated by glycemic control abnormalities. Maternal diabetes results in significantly greater risk for antenatal, perinatal, and neonatal morbidity and mortality, as well as congenital malformations. The number of diabetic mothers is expected to rise, as more and more of the obese pediatric female population in developed and some developing countries progresses to childbearing age. Radiologists, being part of the teams managing such pregnancies, should be well aware of the findings that may be encountered in infants of diabetic mothers. Timely, accurate, and proper radiological evaluation can reduce morbidity and mortality in these infants. The purpose of this essay is to illustrate the imaging findings in the various pathological conditions involving the major body systems in the offspring of women with diabetes
  22,235 875 -
Case report: MRI of the brain in metronidazole toxicity
Vishal Kalia, Vibhuti , Kavita Saggar
July-September 2010, 20(3):195-197
DOI:10.4103/0971-3026.69355  PMID:21042443
Metronidazole is a commonly used antimicrobial drug. When used excessively, it can cause encephalopathy. We report the MRI findings in one such case. A 43-year-old male patient was treated with metronidazole for 2 months, for an amebic liver abscess and presented with neurological signs and symptoms. MRI of the brain showed findings consistent with metronidazole toxicity.
  19,822 711 5
Role of imaging in female infertility [Dr. K.M. Rai Memorial Oration Award]
Rajul Rastogi
July-September 2010, 20(3):168-173
DOI:10.4103/0971-3026.69347  PMID:21042438
Infertility in females is multifactorial in origin. Though hysterolaparoscopy is the gold-standard investigation, USG is usually the first-line investigation. MRI has expanded the usefulness of imaging in female infertility. This pictorial essay reviews the role of imaging in the evaluation of female infertility.
  13,452 1,659 1
Computer hardware for radiologists: Part I
IK Indrajit, A Alam
July-September 2010, 20(3):162-167
DOI:10.4103/0971-3026.69346  PMID:21042437
Computers are an integral part of modern radiology practice. They are used in different radiology modalities to acquire, process, and postprocess imaging data. They have had a dramatic influence on contemporary radiology practice. Their impact has extended further with the emergence of Digital Imaging and Communications in Medicine (DICOM), Picture Archiving and Communication System (PACS), Radiology information system (RIS) technology, and Teleradiology. A basic overview of computer hardware relevant to radiology practice is presented here. The key hardware components in a computer are the motherboard, central processor unit (CPU), the chipset, the random access memory (RAM), the memory modules, bus, storage drives, and ports. The personnel computer (PC) has a rectangular case that contains important components called hardware, many of which are integrated circuits (ICs). The fiberglass motherboard is the main printed circuit board and has a variety of important hardware mounted on it, which are connected by electrical pathways called "buses". The CPU is the largest IC on the motherboard and contains millions of transistors. Its principal function is to execute "programs". A Pentium® 4 CPU has transistors that execute a billion instructions per second. The chipset is completely different from the CPU in design and function; it controls data and interaction of buses between the motherboard and the CPU. Memory (RAM) is fundamentally semiconductor chips storing data and instructions for access by a CPU. RAM is classified by storage capacity, access speed, data rate, and configuration.
  14,414 663 2
Case report: Cervical spinal cord signal changes in a case of adult-onset subacute sclerosing panenchephalitis
Sandeep Sharma, Subhash Kumar
July-September 2010, 20(3):202-204
DOI:10.4103/0971-3026.69358  PMID:21042445
In this article, we report a case of subacute sclerosing panencephalitis (SSPE) in which there were central cervical cord signal changes on MRI. The spinal cord is uncommonly involved in SSPE. However, demonstration of spinal cord signal change in a patient of SSPE has significant implications for the differential diagnosis and management
  10,659 366 1
Diffusion-weighted magnetic resonance imaging in acute reversible toxic leukoencephalopathy: A report of two cases
S Sivasubramanian, Srikant Moorthy, KP Sreekumar, R Rajesh Kannan
July-September 2010, 20(3):192-194
DOI:10.4103/0971-3026.69354  PMID:21042442
Acute toxic leukoencephalopathy may be caused by endogenous or exogenous toxins. It may reverse clinically if the offending agent is withdrawn or the underlying condition is treated. However, demonstration of reversibility on imaging, especially with diffusion-weighted MRI, has been reported only very recently. We report two such cases.
  8,407 516 -
Case Series: Cyclops lesion - extension loss after ACL reconstruction
Sunita Dhanda, Darshana Sanghvi, Dinshaw Pardiwala
July-September 2010, 20(3):208-210
DOI:10.4103/0971-3026.69361  PMID:21042447
Localized anterior arthrofibrosis (cyclops lesion) is the second most common cause of extension loss after anterior cruciate ligament (ACL) reconstruction. We present and discuss two patients with prior ACL reconstructions, who presented with pain and loss of extension following surgery. MRI and arthroscopy of the knee revealed typical features of a cyclops lesion. The patients showed significant symptomatic improvement following arthroscopic resection of these lesions.
  8,292 369 2
Case report: MR spectroscopy in pantothenate kinase-2 associated neurodegeneration
Umesh C Parashari, Pallavi Aga, Anit Parihar, Ragini Singh, Vindhya Joshi
July-September 2010, 20(3):188-191
DOI:10.4103/0971-3026.69353  PMID:21042441
We report a case of a 13-year-old girl with Hallervorden-Spatz disease (HSD) or pantothenate kinase-2 associated neurodegeneration (PKAN). HSD is a rare neurodegenerative disorder, which is characterized by a rapidly progressive extrapyramidal syndrome, dementia with optic atrophy, and retinal degeneration. It is associated with accumulation of cysteine-iron complex in the globus pallidi and substantia nigra. The MRI "eye of the tiger" sign is the characteristic. MRI spectroscopy is also characteristic. It shows markedly decreased NAA/Cr values in the globus pallidi and substantia nigra with increased mI/Cr values that suggest of gliosis.
  7,964 344 3
Technical Note: MRI-guided breast biopsy - our preliminary experience
Sangeeta Taneja, Amarnath Jena, Kapil Kumar, Anurag Mehta
July-September 2010, 20(3):218-220
DOI:10.4103/0971-3026.69362  PMID:21042450
The diagnostic potential of breast MRI can be fully utilized only when it is possible to biopsy lesions detected on MRI, especially when they are not visible on mammography or USG. We would like to describe our experience with MRI-guided wire localization and biopsy.
  7,566 334 4
Case series: Congenital left ventricular diverticulum
Dharita Shah, C Prem Kumar, Mukesh S Shah, Mihir Baraiya
July-September 2010, 20(3):211-214
DOI:10.4103/0971-3026.69356  PMID:21042448
Congenital left ventricular diverticulum is a rare cardiac malformation characterized by a localized outpouching from the cardiac chamber. The patient is usually asymptomatic. However, complications like embolism, infective endocarditis, arrhythmia and, rarely, rupture can be the initial presentation. Diagnosis can be established by USG, echocardiography, CT angiography, and MRI. We report here two neonates with congenital left ventricular apical diverticulum associated with epigastric hernia.
  6,812 336 5
Case report: Acute calcific discitis with intravertebral disc herniation in the dorsolumbar spine
Puneet Mittal, Kavita Saggar, Parambir Sandhu, Kamini Gupta
July-September 2010, 20(3):205-207
DOI:10.4103/0971-3026.69360  PMID:21042446
Acute calcific discitis is a rare but well-known condition of unknown etiology. In symptomatic cases, the most common site is the cervical spine. We describe the CT scan and MRI findings in a symptomatic patient, with a lesion in the dorsolumbar spine.
  6,367 355 1
Case report: Congenital short bowel syndrome
Lalitha Palle, Balaji Reddy
July-September 2010, 20(3):227-229
DOI:10.4103/0971-3026.69366  PMID:21042453
Congenital short bowel syndrome (SBS) is a relatively rare condition as compared to acquired SBS. It is associated with significant mortality and morbidity. Infants usually present with failure to thrive, recurrent vomiting, and diarrhea. It is important to suspect and diagnose this condition promptly, as early initiation of parenteral nutrition or surgery, if necessary, may result in a favorable outcome. We discuss a case of an infant aged 26 days, who presented with failure to thrive, recurrent vomiting, and weight loss. A contrast study of the gastrointestinal tract revealed a short small bowel, with malrotation. The infant was started on parenteral nutrition, but succumbed shortly thereafter to severe disseminated sepsis.
  6,046 380 1
Case report: Perinephric lymphangiomatosis
Rajani Gorantla, Anusheela Yalapati, Bhawna Dev, Santhosh Joseph
July-September 2010, 20(3):224-226
Perirenal lymphangiomatosis is a rare benign malformation of the lymphatic system. We report here a case of bilateral perirenal and parapelvic involvement with a normal excretory collecting system.
  5,801 367 1
Posterior reversible encephalopathy syndrome in neuro-malaria
Alexis Lacout, Celine Guidoux, Robert Yves Carlier
July-September 2010, 20(3):198-201
DOI:10.4103/0971-3026.69357  PMID:21042444
We report a case of a 37-year-old patient with Plasmodium falciparum infestation who developed posterior reversible encephalopathy. In cerebral malaria, microscopic studies have shown endothelial dysfunction and disruption of the blood-brain barrier. Data from the literature show that one of the mechanisms of posterior reversible encephalopathy may be capillary leakage and acute disruption of the blood-brain barrier. Our case supports the theory of blood-brain barrier disruption being a key factor in the causation of cerebral malaria.
  5,593 361 -
Case report: Completely unroofed coronary sinus with a left superior vena cava draining into the left atrium studied by cardiovascular magnetic resonance
Vimal Raj, Sanjiv Joshi, Yuen Chi Ho, Philip J Kilner
July-September 2010, 20(3):215-217
DOI:10.4103/0971-3026.69359  PMID:21042449
A persistent left superior vena cava (LSVC) draining through a dilated coronary sinus into the right atrium is a relatively common congenital cardiovascular anomaly. It is readily identified by cardiovascular magnetic resonance (CMR). However, a LSVC draining into the left atrium (LA) and associated with unroofing of the coronary sinus, with resulting interatrial communication, is rare and may have important clinical consequences. As with any large atrial septal defect, it can be associated with a higher than expected incidence of pulmonary arterial hypertension, systemic embolization, and brain abscesses. In this report, we present a case of a completely unroofed coronary sinus with a persistent LSVC draining directly into the LA and illustrate the role of CMR in the diagnosis and evaluation of such anomalies.
  4,694 253 3
Functional mapping of language networks in the normal brain using a word-association task
Shantanu Ghosh, Amrita Basu, Senthil S Kumaran, Subash Khushu
July-September 2010, 20(3):182-187
DOI:10.4103/0971-3026.69352  PMID:21042440
Background: Language functions are known to be affected in diverse neurological conditions, including ischemic stroke, traumatic brain injury, and brain tumors. Because language networks are extensive, interpretation of functional data depends on the task completed during evaluation. Aim: The aim was to map the hemodynamic consequences of word association using functional magnetic resonance imaging (fMRI) in normal human subjects. Materials and Methods: Ten healthy subjects underwent fMRI scanning with a postlexical access semantic association task vs lexical processing task. The fMRI protocol involved a T2*-weighted gradient-echo echo-planar imaging (GE-EPI) sequence (TR 4523 ms, TE 64 ms, flip angle 90º) with alternate baseline and activation blocks. A total of 78 scans were taken (interscan interval = 3 s) with a total imaging time of 587 s. Functional data were processed in Statistical Parametric Mapping software (SPM2) with 8-mm Gaussian kernel by convolving the blood oxygenation level-dependent (BOLD) signal with an hemodynamic response function estimated by general linear method to generate SPM{t} and SPM{F} maps. Results: Single subject analysis of the functional data (FWE-corrected, P≤0.001) revealed extensive activation in the frontal lobes, with overlaps among middle frontal gyrus (MFG), superior, and inferior frontal gyri. BOLD activity was also found in the medial frontal gyrus, middle occipital gyrus (MOG), anterior fusiform gyrus, superior and inferior parietal lobules, and to a smaller extent, the thalamus and right anterior cerebellum. Group analysis (FWE-corrected, P≤0.001) revealed neural recruitment of bilateral lingual gyri, left MFG, bilateral MOG, left superior occipital gyrus, left fusiform gyrus, bilateral thalami, and right cerebellar areas. Conclusions: Group data analysis revealed a cerebellar-occipital-fusiform-thalamic network centered around bilateral lingual gyri for word association, thereby indicating how these areas facilitate language comprehension by activating a semantic association network of words processed postlexical access. This finding is important when assessing the extent of cognitive damage and/or recovery and can be used for presurgical planning after optimization.
  4,576 338 4
Prevalence of lower extremity venous duplication
William L Simpson, David M Krakowsi
July-September 2010, 20(3):230-234
DOI:10.4103/0971-3026.69367  PMID:21042454
Purpose: This retrospective study was performed to determine the prevalence of lower extremity venous duplication using duplex ultrasound in the patient population of a large urban medical center. Materials and Methods: The reports of all lower extremity venous ultrasound examinations performed at our institution between January 1, 2002 and December 31, 2002 were reviewed. Ultrasound examinations that were performed for purposes other than the detection of lower extremity deep vein thrombosis were excluded. The prevalence of duplication and its specific location were recorded. In addition, the prevalence of thrombus and its specific location were also recorded. Results: A total of 3118 exams were performed in 2664 patients. Of the 2664 patients, 2311 had only one examination performed during the study period; 353 patients had more than one examination performed. We found that 10.1% of patients (270/2664) had at least one venous segment duplicated and 5.4% of patients (143/2664) had a thrombus in at least one venous segment. There was a statistically significant difference in the prevalence of both duplication and thrombus with a change in venous segment. Only 0.4% of patients (11/2664) had thrombus within a duplicated segment. Of those who had more than one examination performed, 15.3% (54/353) had the same venous segment(s) seen on one examination but not another. Conclusion: Lower extremity venous duplication is a frequent anatomic variant that is seen in 10.1% of patients, but it may not be as common as is generally believed. It can result in a false negative result for deep vein thrombosis.
  3,687 253 1
Article writing
Bhavin Jankharia
July-September 2010, 20(3):161-161
DOI:10.4103/0971-3026.69345  PMID:21042436
  3,251 511 -
Predilatation of a stenotic ostium of a bronchial artery, followed by embolization in recurrent hemoptysis
Mathew P Cherian, Pankaj Mehta, Tejas M Kalyanpur, Sandeep S Hedgire, Kaustubh Narsinghpura, K Venkatesh
July-September 2010, 20(3):221-223
DOI:10.4103/0971-3026.69363  PMID:21042451
Bronchial artery embolization may be the only life-saving procedure available in a patient presenting with massive hemoptysis. Rarely, selective catheterization of these vessels may be rendered difficult due to a stenotic ostium. This may result in closure of the vessel or absence of forward flow after the stenotic segment is crossed with a diagnostic catheter or a microcatheter. Further, it may also lead to recurrence of hemoptysis if the distal vessel and the prearteriolar bed are inadequately embolized. We describe a technique of selective cannulation of the stenotic vessel, dilatation of the stenosis and then successful embolization.
  3,241 201 -
Web-review: Oncology
IK Indrajit
July-September 2010, 20(3):235-236
  2,404 179 -
The subspecialty conundrum
Rajesh Krishnamurthy
July-September 2010, 20(3):237-238
DOI:10.4103/0971-3026.69369  PMID:21042455
  2,156 141 -
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