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   2013| October-December  | Volume 23 | Issue 4  
    Online since January 21, 2014

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MRI evaluation of pathologies affecting the corpus callosum: A pictorial essay
Aamish Z Kazi, Priscilla C Joshi, Abhimanyu B Kelkar, Mangal S Mahajan, Amit S Ghawate
October-December 2013, 23(4):321-332
DOI:10.4103/0971-3026.125604  PMID:24604936
The corpus callosum is a midline cerebral structure and has a unique embryological development pattern. In this article, we describe the pathophysiology and present imaging findings of various typical/atypical conditions affecting the corpus callosum. Since many of these pathologies have characteristic appearances on magnetic resonance imaging (MRI) and their therapeutic approaches are poles apart, ranging from medical to surgical, the neuroradiologist should be well aware of them.
  87,791 4,101 -
Radiological review of pleural tumors
Binit Sureka, Brij Bhushan Thukral, Mahesh Kumar Mittal, Aliza Mittal, Mukul Sinha
October-December 2013, 23(4):313-320
DOI:10.4103/0971-3026.125577  PMID:24604935
Tumors of the pleura are not uncommon and diagnosis is clinched by combined imaging and clinical correlation. Malignant tumors are more common than benign tumors. Initial imaging modalities are chest radiography and Computed Tomography (CT). Further characterization may be required using Ultrasoundgraphy (USG), Magnetic resonance Imaging (MRI) and PET-CT. Biopsy remains gold standard. This article highlights various common and uncommon tumors of pleura and characteristic imaging findings.
  27,546 2,368 -
Spectrum of high-resolution computed tomography imaging in occupational lung disease
Bhawna Satija, Sanyal Kumar, Umesh Chandra Ojha, Dipti Gothi
October-December 2013, 23(4):287-296
DOI:10.4103/0971-3026.125564  PMID:24604929
Damage to the lungs caused by dusts or fumes or noxious substances inhaled by workers in certain specific occupation is known as occupational lung disease. Recognition of occupational lung disease is especially important not only for the primary worker, but also because of the implications with regard to primary and secondary disease prevention in the exposed co-workers. Although many of the disorders can be detected on chest radiography, high-resolution computed tomography (HRCT) is superior in delineating the lung architecture and depicting pathology. The characteristic radiological features suggest the correct diagnosis in some, whereas a combination of clinical features, occupational history, and radiological findings is essential in establishing the diagnosis in others. In the presence of a history of exposure and consistent clinical features, the diagnosis of even an uncommon occupational lung disease can be suggested by the characteristic described HRCT findings. In this article, we briefly review the HRCT appearance of a wide spectrum of occupational lung diseases.
  22,339 2,548 1
The inguinal and femoral canals: A practical step-by-step approach to accurate sonographic assessment
Philip Yoong, Stephen Duffy, Thomas J Marshall
October-December 2013, 23(4):391-395
DOI:10.4103/0971-3026.125586  PMID:24604947
Ultrasonography (USG) is an accepted and reliable tool for the assessment of groin hernias.However, USG of the groin is operator dependent and challenging. The anatomy of this region is complex and the normal sonographic findings can be difficult to interpret. We describe the relevant normal anatomy of the groin relating to inguinal and femoral hernias, and describe a straightforward, reliable technique for identifying and assessing the integrity of the inguinal and femoral canals. The inferior epigastric vessels are a critical landmark for assessment of the inguinal canal and deep inguinal ring.
  19,547 1,057 -
Magnetic resonance imaging of placenta accreta
Binoj Varghese, Navdeep Singh, Regi AN George, Sareena Gilvaz
October-December 2013, 23(4):379-385
DOI:10.4103/0971-3026.125592  PMID:24604945
Placenta accreta (PA) is a severe pregnancy complication which occurs when the chorionic villi (CV) invade the myometrium abnormally. Optimal management requires accurate prenatal diagnosis. Ultrasonography (USG) and magnetic resonance imaging (MRI) are the modalities for prenatal diagnosis of PA, although USG remains the primary investigation of choice. MRI is a complementary technique and reserved for further characterization when USG is inconclusive or incomplete. Breath-hold T2-weighted half-Fourier rapid acquisition with relaxation enhancement (RARE) and balanced steady-state free precession imaging in the three orthogonal planes is the key MRI technique. Markedly heterogeneous placenta, thick intraplacental dark bands on half-Fourier acquisition single-shot turbo spin-echo (HASTE), and disorganized abnormal intraplacental vascularity are the cardinal MRI features of PA. MRI is less reliable in differentiating between different degrees of placental invasion, especially between accreta vera and increta.
  16,650 1,693 -
Mammographic and sonographic features of fat necrosis of the breast
Vidya S Upadhyaya, Raghuraj Uppoor, Lathika Shetty
October-December 2013, 23(4):366-372
DOI:10.4103/0971-3026.125619  PMID:24604943
Imaging features of fat necrosis vary depending on its stage of evolution and can mimic malignancy in late stages. Imaging may suffice to differentiate fat necrosis in the early stages from malignancy and thus avoid unnecessary biopsy. In this pictorial essay, we present combination of benign features in mammography and/or ultrasonography (USG) that can lead to imaging diagnosis of fat necrosis. The follow-up imaging features of fat necrosis which mirror its pathophysiological evolution have also been demonstrated. To summarize, in the appropriate clinical setting, no mammographic features suspicious for malignancy should be present. When the typical mammographic features are not present, USG can aid with the diagnosis and follow up USG can confirm it.
  14,793 624 1
FDG-PET/CT in lymphoma
Maria M D'souza, Abhinav Jaimini, Abhishek Bansal, Madhavi Tripathi, Rajnish Sharma, Anupam Mondal, Rajendra Prashad Tripathi
October-December 2013, 23(4):354-365
Lymphomas are a heterogeneous group of diseases that arise from the constituent cells of the immune system or from their precursors. 18F-fludeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) is now the cornerstone of staging procedures in the state-of-the-art management of Hodgkin's disease and aggressive non-Hodgkin's lymphoma. It plays an important role in staging, restaging, prognostication, planning appropriate treatment strategies, monitoring therapy, and detecting recurrence. However, its role in indolent lymphomas is still unclear and calls for further investigational trials. The protean PET/CT manifestations of lymphoma necessitate a familiarity with the spectrum of imaging findings to enable accurate diagnosis. A meticulous evaluation of PET/CT findings, an understanding of its role in the management of lymphomas, and knowledge of its limitations are mandatory for the optimal utilization of this technique.
  8,720 379 -
Quantitative and qualitative bowel analysis using mannitol, water and iodine-based endoluminal contrast agent on 64-row detector CT
K Prakashini, Chandan Kakkar, Charudutt Sambhaji, Chandrakant M Shetty, Vedula Rajanikanth Rao
October-December 2013, 23(4):373-378
DOI:10.4103/0971-3026.125594  PMID:24604944
Objective: To assess the performance of mannitol as a luminal contrast as compared to water and positive contrast in evaluation of bowel on multidetector computed tomography (MDCT). Materials and Methods: Three hundred patients were randomly selected for this study and were divided equally into three groups. Each subject received 1500 ml of oral contrast. Group 1 received 3% mannitol in water, group 2 received diluted iodinated positive contrast, and group 3 received plain water without additives. Qualitative and quantitative analysis for distension, fold visibility, and overall image quality were analyzed by actual diameter measurement and point scale system at different bowel levels. One-way analysis of variance (ANOVA) followed by Tukey's HSD Post-hoc test and Pearson's Chi-square (exact test) test were applied. Results: Group 1 showed better results for small bowel distension, intraluminal homogeneity, and visibility of mucosal folds on quantitative and qualitative analysis with statistically significant P value (P<0.001). The ileo-caecal junction distension and mural feature visibility was better with mannitol (P < 0.001). No significant difference in distension of stomach and duodenum was found between the three groups. Conclusion: Mannitol as endoluminal contrast increases the diagnostic accuracy of the investigative studies in comparison to water and iodine-based contrast by producing significantly better bowel distension and visibility of mural features with improved image quality without additional adverse effects.
  5,790 556 -
Signs in radiology
IK Indrajit
October-December 2013, 23(4):397-398
  5,050 810 -
Trotting the Radiology road
Sanjay N Jain
October-December 2013, 23(4):285-286
DOI:10.4103/0971-3026.125561  PMID:24604928
  5,171 327 -
Qualitative ultrasound elastography assessment of benign thyroid nodules: Patterns and intra-observer acquisition variability
Alexis Lacout, Carole Chevenet, Juliette Thariat, Andrea Figl, Pierre-Yves Marcy
October-December 2013, 23(4):337-341
DOI:10.4103/0971-3026.125612  PMID:24604938
Purpose: To report and evaluate qualitative elastography patterns by using gray-scale and Doppler ultrasound (US) in patients presenting with benign thyroid nodules and to evaluate the reproducibility of US elastography examinations. Materials and Methods: Institutional review board approval was obtained, and all patients provided informed consent. Over a 3-month time period, all consecutive adult patients were referred to our institution to undergo a thyroid nodule fine-needle aspiration biopsy (FNAB) procedure. Patients presenting with benign cytology according to the Bethesda 2008 classification were prospectively enrolled in the study. Each thyroid nodule was assessed by using gray-scale, Doppler US, and elastography acquisitions by a single operator (A. L.). Multiple elastography acquisitions per thyroid nodule were performed and elastography scorings of the nodules were compared with each other. Results: Nineteen patients (16 women and 3 men, mean age 58 years) with 22 thyroid nodules were included in the present study. Elastographic patterns 1, 2, and 3 were reported (23% nodules showed pattern 3). The elastography pattern showed a strong variability in 13 nodules (59%). The elastography acquisition result variability involved the "malignant" pattern 3 in 36% of cases. Conclusion: Almost one-third of benign thyroid nodules displayed pattern 3 on qualitative US elastography. The intra-observer variability of the benign thyroid elastography scoring is wide, thus limiting the thyroid nodule US examination accuracy. In FNAB-proven benign thyroid nodules, elastography pattern 3 is frequent and cannot be used as a strong indicator of thyroid malignancy.
  3,913 435 1
Encephalocraniocutaneous lipomatosis with calvarial exostosis - Case report and review of literature
Shruti Thakur, Vijay Thakur, Ram Gopal Sood, Charu Smita Thakur, Shweta Khanna
October-December 2013, 23(4):333-336
DOI:10.4103/0971-3026.125607  PMID:24604937
Encephalocraniocutaneous lipomatosis (ECCL), also known as Haberland syndrome, is a rare syndrome with unknown etiology. The syndrome is characterized by a triad of unique cutaneous, ocular, and central nervous system (CNS) manifestations. The cutaneous hallmark, nevus psiloliparus (NP), along with overlying alopecia is a constant feature. Choristoma of the eyelid is the most common ocular manifestation, while intracranial lipoma is the predominant CNS finding. Genetic counseling is required to emphasize that the disorder, although congenital, is not inheritable. We present a 21-year-old female with cutaneous, ocular, and CNS features satisfying the diagnostic criteria for ECCL. To our knowledge, this is the first case of ECCL having a large temporal exostosis. The objective of this article is to better understand the phenotypic spectrum of this syndrome whose molecular basis is still unknown.
  3,952 202 1
Cone-beam computed tomography in the management of dentigerous cyst of the jaws: A report of two cases
Lakshminarayanan Vidya, Kannan Ranganathan, B Praveen, Rajan Gunaseelan, S Shanmugasundaram
October-December 2013, 23(4):342-346
DOI:10.4103/0971-3026.125614  PMID:24604939
Cone-beam computed tomography (CBCT) is an emerging technology finding application in all branches of dentistry. The current series highlights the application of CBCT in the preoperative assessment of dentigerous cyst of the jaws.
  3,760 313 -
Unconventional abdominal uses of FIESTA (CISS) sequence
Anitha Sen
October-December 2013, 23(4):386-390
DOI:10.4103/0971-3026.125588  PMID:24604946
The ability to provide cross-sectional imaging, combined with a lack of ionizing radiation has made magnetic resonance imaging (MRI) of abdomen popular. We report four interesting cases: Midgut malrotation with volvulus, sigmoid volvulus, biliary rupture of hydatid cyst, and small bowel lipomatosis, where fast imaging employing steady-state acquisition [FIESTA]/constructive interference into steady state [CISS] sequence helped in clinching the diagnosis.
  3,756 241 -
Acute pulmonary melioidosis in a child: A case report and review of literature
Deb K Boruah, Arjun Prakash, Reeta Bora, Lemanstar Buragohain
October-December 2013, 23(4):310-312
DOI:10.4103/0971-3026.125576  PMID:24604934
Melioidosis is a rare potentially fatal infection caused by the bacterium Burkholderia pseudomallei, which is endemic in Southeast Asia and Northern Australia and an emerging pathogen in India. It is a largely under-diagnosed disease and an imitator of tuberculosis, both clinically and radiologically.
  3,675 237 1
Retrograde fluoroscopy-guided trans-urethral exchange of ureteral stents: Comparison of direct grasping vs. modified snare
Rosario Francesco Grasso, Eliodoro Faiella, Roberto Luigi Cazzato, Giacomo Luppi, Riccardo Del Vescovo, Francesco Giurazza, Simona Mercurio, Bruno Beomonte Zobel
October-December 2013, 23(4):347-350
DOI:10.4103/0971-3026.125615  PMID:24604940
Background: Several different techniques including guide-wire lasso, simple snare, modified snare (MS) and direct grasping (DG), are available for retrograde ureteral stent retrieval and exchange. Choice among them is not always easy and depends on many different factors, including the local level of expertise. Objective: To compare the MS and DG during retrograde exchange of double-J ureteral stent under fluoroscopic guidance. Settings and Design: 66 patients (36 men and 30 women; mean age 66.6 years) needing retrograde ureteral stent exchange were included. All stents were previously placed through an anterograde way. Materials and Methods: Time needed to grasp each single stent was recorded as well as the complications. Statistical Analysis: Fisher's test was used to compare procedural time in both groups; P < 0.05 was considered significant. Results: 102 stents were exchanged. Mean time was 4.46 min for DG and 7.81 min for MS (P = 0.029). No significant complications were encountered. Conclusions: Compared to the MS, the DG is easier, quicker, and less expensive.
  3,786 110 -
A rare pleural mucinous cystadenocarcinoma mimicking loculated empyema initially: A case report
Sung Min Moon, Hyun Ju Seon, Yoo-Duk Choi, Sang-Yun Song
October-December 2013, 23(4):301-303
DOI:10.4103/0971-3026.125568  PMID:24604931
We report a case of pleural mucinous cystadenocarcinoma which was mistaken to be a loculated empyema on chest CT. To the best of our knowledge, this entity has never been previously reported in literature.
  3,631 260 -
Isolated retroaortic left innominate vein in an adult without cardiac or aortic anomalies
Sivasubramanian Srinivasan, Anbalagan Kannivelu, Syed Zama Ali, Poh Lye Paul See
October-December 2013, 23(4):308-309
DOI:10.4103/0971-3026.125573  PMID:24604933
Retroaortic innominate vein is an uncommon variant reported in patients with congenital heart disease. However, isolated retroaortic innominate vein without associated cardiac or arch anomalies is extremely rare. We present a case of a 68-year-old man who was found to have this anomalous variant incidentally on computed tomography (CT) of the thorax. We also briefly discuss its associations, embryology, and clinical significance.
  3,705 159 1
Significance of various pulmonary and extrapulmonary abnormalities on HRCT of the chest in scleroderma lung
Anoop Kumar Pandey, Pearce Wilcox, Julie O' Brien, Jennifer Ellis, Jacquie Brown, Jonathon Leipsic
October-December 2013, 23(4):304-307
DOI:10.4103/0971-3026.125570  PMID:24604932
Patients with systemic sclerosis (SSc) are routinely investigated with high-resolution computed tomography (HRCT) chest for early detection and accurate characterization of complicating interstitial lung diseases. Though the primary aim of HRCT is to delineate the burden of pulmonary involvement and to characterize the nature of fibrosis to potentially help guide management, it provides an opportunity to evaluate extrapulmonary manifestations, particularly the dilated pulmonary artery, esophageal dilatation, and pericardial abnormalities which have their own clinical significance. The aim of this article is to discuss the significance of various pulmonary and extrapulmonary abnormalities that may be identified on HRCT chest of SSc patients.
  3,424 315 -
Percutaneous transhepatic portal vein stenting in a patient with benign non-transplant postoperative portal vein stenosis: A case report
KS Madhusudhan, Nikhil Agrawal, Deep N Srivastava, Sujoy Pal, Arun K Gupta
October-December 2013, 23(4):351-353
DOI:10.4103/0971-3026.125622  PMID:24604941
Extrahepatic portal vein stenosis is caused by a variety of benign and malignant diseases and results in development of symptoms due to portal hypertension. Benign post-surgical adhesions causing portal vein stenosis in non-transplant population is an uncommon etiology of portal hypertension. Endovascular treatment of such patients with angioplasty and stenting is uncommonly reported in literature. We report a case of portal hypertension caused by benign postoperative portal vein fibrosis, successfully treated by self-expandable metallic stent.
  3,286 164 -
Horse-shoe lung-rediscovered via volume rendered images
Alpa Bharati, Suleman A Merchant, Swati Garekar, Tapan Patel
October-December 2013, 23(4):297-300
DOI:10.4103/0971-3026.125583  PMID:24604930
Horseshoe lung, usually associated with pulmonary venolobar syndrome, is a rare congenital anomaly involving the fusion of the postero-basal segments of the right and left lungs across the midline. The fused segment or the isthmus lies posterior to the pericardium and anterior to the aorta.The associated pulmonary venolobar syndrome involves anomalous systemic arterial supply and anomlaous systemic venous drainage of the right lung. With the advent of MDCT imaging, we can diagnose this rare condition as well all its associated anomalies non-invasively. Volume-rendered techniques greatly simplify the complex anatomy and provide easy understanding of the same.
  2,951 286 -
Case based Brain Imaging
Sandeep Jakhere
October-December 2013, 23(4):396-396
  1,789 201 -
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