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   2015| October-December  | Volume 25 | Issue 4  
    Online since November 12, 2015

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Magnetic resonance imaging of optic nerve
Foram Gala
October-December 2015, 25(4):421-438
DOI:10.4103/0971-3026.169462  PMID:26752822
Optic nerves are the second pair of cranial nerves and are unique as they represent an extension of the central nervous system. Apart from clinical and ophthalmoscopic evaluation, imaging, especially magnetic resonance imaging (MRI), plays an important role in the complete evaluation of optic nerve and the entire visual pathway. In this pictorial essay, the authors describe segmental anatomy of the optic nerve and review the imaging findings of various conditions affecting the optic nerves. MRI allows excellent depiction of the intricate anatomy of optic nerves due to its excellent soft tissue contrast without exposure to ionizing radiation, better delineation of the entire visual pathway, and accurate evaluation of associated intracranial pathologies.
  14,572 1,664 -
Telltale signs of peripheral neurogenic tumors on magnetic resonance imaging
Chandan Kakkar, Chandrakant M Shetty, Prakashini Koteshwara, Surabhi Bajpai
October-December 2015, 25(4):453-458
DOI:10.4103/0971-3026.169447  PMID:26752825
Peripheral nerve sheath tumors are categorized into benign and malignant forms, comprising of neurofibroma and schwannoma in the benign category and malignant peripheral nerve sheath tumors in the malignant category. Magnetic resonance imaging plays an important role in the diagnosis of these lesions. The various imaging features and signs that help to identify and characterize a nerve sheath tumor are, distribution of the tumor along a major nerve, an entering or exiting nerve sign, target sign, a fascicular sign and a split-fat sign.
  10,722 1,127 -
Imaging and interventions in idiopathic intracranial hypertension: A pictorial essay
Rajeev Sivasankar, Rochan Pant, Inna K Indrajit, Raj S Negi, Samresh Sahu, PI Hashim, John D'Souza
October-December 2015, 25(4):439-444
DOI:10.4103/0971-3026.169464  PMID:26752823
Intracranial hypertension is a syndrome of elevated intracranial pressure that can be primary or secondary. The primary form, now termed idiopathic intracranial hypertension (IIH), was in the past a disease of exclusion and imaging played a limited role of excluding organic causes of raised intracranial pressure. However imaging markers have been described with patients with IIH at the orbit, sella and cerebral venous system. We wish to reiterate the characteristic imaging features of this poorly understood disease and also emphasise that stenting of the transverse sinus in select cases of IIH is an efficacious option.
  8,626 1,036 -
The last time, adieu…
Sanjay N Jain
October-December 2015, 25(4):331-331
DOI:10.4103/0971-3026.169452  PMID:26752812
  8,660 374 -
Emerging clinical applications of PET based molecular imaging in oncology: the promising future potential for evolving personalized cancer care
Vandana K Dhingra, Abhishek Mahajan, Sandip Basu
October-December 2015, 25(4):332-341
DOI:10.4103/0971-3026.169467  PMID:26752813
This review focuses on the potential of advanced applications of functional molecular imaging in assessing tumor biology and cellular characteristics with emphasis on positron emission tomography (PET) applications with both 18-fluorodeoxyglucose (FDG) and non-FDG tracers. The inherent heterogeneity of cancer cells with their varied cellular biology and metabolic and receptor phenotypic expression in each individual patient and also intra-and inter-lesionally in the same individual mandates for transitioning from a generalized "same-size-fits-all" approach to personalized medicine in oncology. The past two decades have witnessed improvement of oncological imaging through CT, MR imaging, PET, subsequent movement through hybrid or fusion imaging with PET/CT and single-photon emission computerized tomography (SPECT-CT), and now toward the evolving PET/MR imaging. These recent developments have proven invaluable in enhancing oncology care and have the potential to help image the tumor biology at the cellular level, followed by providing a tailored treatment. Molecular imaging, integrated diagnostics or Radiomics, biology-driven interventional radiology and theranostics, all hold immense potential to serve as a guide to give "start and stop" treatment for a patient on an individual basis. This will likely have substantial impact on both treatment costs and outcomes. In this review, we bring forth the current trends in molecular imaging with established techniques (PET/CT), with particular emphasis on newer molecules (such as amino acid metabolism and hypoxia imaging, somatostatin receptor based imaging, and hormone receptor imaging) and further potential for FDG. An introductory discussion on the novel hybrid imaging techniques such as PET/MR is also made to understand the futuristic trends.
  5,054 613 -
Integrated 18F-fluorodeoxyglucose positron emission tomography magnetic resonance imaging (18F-FDG PET/MRI), a multimodality approach for comprehensive evaluation of dementia patients: A pictorial essay
Amarnath Jena, Pushpendra Nath Renjen, Sangeeta Taneja, Aashish Gambhir, Pradeep Negi
October-December 2015, 25(4):342-352
DOI:10.4103/0971-3026.169449  PMID:26752814
Dementia, caused by irreversible neurodegenerative disorders such as Alzheimer's disease or reversible non-degenerative conditions, is rapidly becoming one of the most alarming health problems in our aging society. This cognitive disorder associated with a multitude of clinical differentials with overlapping clinical, pathological, and imaging features is difficult to diagnose and treat, as it often presents late after significant neuronal damage has already occurred. Novel disease-modifying treatments being developed will have to be corroborated with innovative imaging biomarkers so that earlier reliable diagnosis can be made and treatment initiated upon. Along with new specific PET radiotracers, integrated PET/MRI with combined methodological advantage and simultaneously acquired structural-cum-functional information may help achieve this goal. The present pictorial essay details our experiences with PET/MRI in dementing disorders, along with reviewing recent advances and future scope.
  4,641 333 -
Utility of ultrasound and magnetic resonance imaging in prenatal diagnosis of placenta accreta: A prospective study
Bhawna Satija, Sanyal Kumar, Leena Wadhwa, Taru Gupta, Supreethi Kohli, Rajkumar Chandoke, Pratibha Gupta
October-December 2015, 25(4):464-470
DOI:10.4103/0971-3026.169456  PMID:26752827
Context: Placenta accreta is the abnormal adherence of the placenta to the uterine wall and the most common cause for emergency postpartum hysterectomy. Accurate prenatal diagnosis of affected pregnancies allows optimal obstetric management. Aims: To summarize our experience in the antenatal diagnosis of placenta accreta on imaging in a tertiary care setup. To compare the accuracy of ultrasound (USG) with color Doppler (CDUS) and magnetic resonance imaging (MRI) in prenatal diagnosis of placenta accreta. Settings and Design: Prospective study in a tertiary care setup. Materials and Methods: A prospective study was conducted on pregnant females with high clinical risk of placenta accreta. Antenatal diagnosis was established based on CDUS and MRI. The imaging findings were compared with final diagnosis at the time of delivery and/or pathologic examination. Statistical Analysis Used: The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for both CDUS and MRI. The sensitivity and specificity values of USG and MRI were compared by the McNemar test. Results: Thirty patients at risk of placenta accreta underwent both CDUS and MRI. Eight cases of placenta accreta were identified (3 vera, 4 increta, and 1 percreta). All patients had history of previous cesarean section. Placenta previa was present in seven out of eight patients. USG correctly identified the presence of placenta accreta in seven out of eight patients (87.5% sensitivity) and the absence of placenta accreta in 19 out of 22 patients (86.4% specificity). MRI correctly identified the presence of placenta accreta in 6 out of 8 patients (75.0% sensitivity) and absence of placenta accreta in 17 out of 22 patients (77.3% specificity). There were no statistical differences in sensitivity (P = 1.00) and specificity (P = 0.687) between USG and MRI. Conclusions: Both USG and MRI have fairly good sensitivity for prenatal diagnosis of placenta accreta; however, specificity does not appear to be as good as reported in other studies. Both modalities have complimentary role and in cases of inconclusive findings with one imaging modality, the other modality may be useful for obtaining the diagnosis. CDUS remains the first primary modality for antenatal diagnosis of placenta accreta, with MRI reserved for cases where USG is inconclusive.
  4,320 615 -
Problems and preferences in pediatric imaging
Brij Bhushan Thukral
October-December 2015, 25(4):359-364
DOI:10.4103/0971-3026.169466  PMID:26752721
Radiological imaging is extremely valuable as a diagnostic tool in the pediatric population, but it comes with a number of distinct challenges as compared to the imaging of adults. This is because of the following: It requires dedicated imaging protocols to acquire the images, there is need for sedation or general anesthesia for longer procedures such as MRI, specific training is required for the healthcare personnel involved, thorough knowledge and expertise should be applied for evaluating the images, and most importantly, it requires consideration for radiation exposure if ionizing radiation is being used. One of the challenges for clinical care personnel is to gain the child's trust and co-operation before and throughout the duration of an examination, which can prove to be difficult in children who may be ill and have pain. This is important to acquire quality images and prevent repeat examinations. Even with a quality examination, the accurate interpretation of images requires a thorough knowledge of the intricate and dynamic face of anatomy and specific pathological presentations in children. The increased radiation sensitivity of growing organs and children's longer expected life spans make them more susceptible to the harmful effects of radiation. Imaging pediatric patients in a dedicated pediatric imaging department with dedicated pediatric CT technologists may result in greater compliance with pediatric protocols and significantly reduced patient dose. In order to prevent the harmful effects of ionizing radiation, As Low As Reasonably Achievable (ALARA) principle should be strictly followed. This article seeks to draw attention to various challenges of pediatric imaging and the ways to overcome them.
  4,280 477 -
Primary spinal primitive neuroectodermal tumor on MR imaging
Prashant J Thoriya, Pankaj Watal, Nandini U Bahri, Ketan Rathod
October-December 2015, 25(4):459-463
DOI:10.4103/0971-3026.169451  PMID:26752826
Neoplasms in the region of filum terminale are not uncommon. Myxopapillary ependymoma is the commonest tumor at this location. The differentials reported for this entity are nerve sheath tumor, meningioma, paraganglioma, intradural metastases, lymphoma, other varieties of ependymoma, subependymoma, astrocytoma, ganglioglioma, hemangioblastoma, and primitive neuroectodermal tumor (PNET). PNET may very rarely present as an intradural thoracolumbar mass. We present pre- and post-therapy magnetic resonance imaging (MRI) features of a patient with proven primary spinal primitive neuroectodermal tumor (PSPNET) of peripheral subtype.
  4,444 286 -
Endovascular treatment of central venous obstruction as a complication of prolonged hemodialysis – Preliminary experience in a tertiary care center
Mukesh K Yadav, Madhurima Sharma, Anupam Lal, Vivek Gupta, Ashish Sharma, Niranjan Khandelwal
October-December 2015, 25(4):368-374
DOI:10.4103/0971-3026.169463  PMID:26752817
Background: Central venous disease is a serious complication in patients undergoing hemodialysis, often presenting with symptoms of venous hypertension. Treatment is aimed to provide symptomatic relief and to maintain hemodialysis access site patency. Aim: To describe our initial experience in the endovascular treatment of central venous stenosis or obstruction in patients undergoing hemodialysis. Settings and Design: This was a retrospective study carried out in a tertiary care center. Study duration was 24 months. Follow-up was variable. Materials and Methods: Eleven patients of chronic renal failure undergoing hemodialysis presented with central vein stenosis or obstruction having ipsilateral vascular access, between July 2012 and July 2014. All the patients underwent endovascular treatment and were analyzed retrospectively. Results and Conclusion: A total of 11 patients (4 male and 7 female) underwent 18 interventions for 13 stenotic segments during a time period of 2 years. Eight stenotic segments were in brachiocephalic vein, three in subclavian vein, and two in axillary veins. The technical success rate for endovascular treatment was 81.8%. Two patients underwent percutaneous transluminal angioplasty (PTA) alone and presented with restenosis later. Balloon angioplasty followed by stenting was done in seven patients, two of which required reintervention during follow-up. We found endovascular treatment safe and effective in treating central venous disease.
  4,197 421 -
Beyond warfarin: The advent of new oral anticoagulants
Sandeep T Laroia, Steven Morales, Archana T Laroia
October-December 2015, 25(4):375-379
DOI:10.4103/0971-3026.169459  PMID:26752818
New oral anticoagulants (NOAC) are the latest addition to anticoagulant armamentarium. Unlike traditional anti-coagulants like warfarin, lab monitoring and management of bleeding complications secondary to these agents is different. As more and more patients are being switched to these drugs, interventional radiologists in particular will benefit from a clinical review of NOAC.
  3,128 284 -
Pediatric whole-body magnetic resonance imaging: Intra-individual comparison of technical quality, artifacts, and fixed structure visibility at 1.5 and 3 T
Shyam Mohan, Rahim Moineddin, Govind B Chavhan
October-December 2015, 25(4):353-358
DOI:10.4103/0971-3026.169448  PMID:26752815
Purpose: To compare whole-body magnetic resonance imaging (WBMRI) performed at 1.5 and 3 T for technical quality, artifacts, and visibility of selected fixed structures. Patients and Methods: 21 children who had WBMRI at both 1.5 and 3 T scanners within a relatively short interval (3-13 months; average-8.6 months) were included. The images were objectively compared with scores from 4 to 1 for five parameters including severity of artifacts; visibility of liver, vertebral column, and marrow in legs; and overall image quality. Inter-observer agreement was calculated using Kendall's coefficient of Concordance (W) and scores were compared using Signed Rank test. Results: There was substantial inter-observer agreement for all five categories at both field strengths. The difference between averages of mean scores of all five parameters for two field strengths was statistically significant (P < 0.05), indicating less artifact, better fixed structure visibility, and overall image quality at 1.5 T as compared to 3 T. However, scores at 3 T were also rated within a good range (around 3) indicating its feasibility for WBMRI in children. Conclusion: WBMRI at 1.5 T has significantly better image quality, fixed structure visibility, and fewer artifacts, as compared to WBMRI at 3 T in children. This difference is unlikely to significantly affect detection of pathology on 3 T WBMRI as the image quality score at 3 T was also within good range.
  3,103 216 -
Diffusion tensor imaging in evaluation of posterior fossa tumors in children on a 3T MRI scanner
Zarina Abdul Assis, Jitender Saini, Manish Ranjan, Arun Kumar Gupta, Paramveer Sabharwal, Purushotham R Naidu
October-December 2015, 25(4):445-452
DOI:10.4103/0971-3026.169444  PMID:26752824
Context: Primary intracranial tumors in children are commonly located in the posterior fossa. Conventional MRI offers limited information regarding the histopathological type of tumor which is essential for better patient management. Aims: The purpose of the study was to evaluate the usefulness of advanced MR imaging techniques like diffusion tensor imaging (DTI) in distinguishing the various histopathological types of posterior fossa tumors in children. Settings and Design: DTI was performed on a 3T MRI scanner in 34 untreated children found to have posterior fossa lesions. Materials and Methods: Using third party software, various DTI parameters [apparent diffusion coefficient (ADC), fractional anisotropy (FA), radial diffusivity, planar index, spherical index, and linear index] were calculated for the lesion. Statistical Analysis Used: Data were subjected to statistical analysis [analysis of variance (ANOVA)] using SPSS 15.0 software. Results: We observed significant correlation (P < 0.01) between ADC mean and maximum, followed by radial diffusivity (RD) with the histopathological types of the lesions. Rest of the DTI parameters did not show any significant correlation in our study. Conclusions: The results of our study support the hypothesis that most cellular tumors and those with greater nuclear area like medulloblastoma would have the lowest ADC values, as compared to less cellular tumors like pilocytic astrocytoma.
  2,914 247 -
Evaluation of breast parenchymal density with QUANTRA software
Shivani Pahwa, Smriti Hari, Sanjay Thulkar, Suveen Angraal
October-December 2015, 25(4):391-396
DOI:10.4103/0971-3026.169458  PMID:26752820
Purpose: To evaluate breast parenchymal density using QUANTRA software and to correlate numerical breast density values obtained from QUANTRA with ACR BI-RADS breast density categories. Materials and Methods: Two-view digital mammograms of 545 consecutive women (mean age - 47.7 years) were categorized visually by three independent radiologists into one of the four ACR BI-RADS categories (D1-D4). Numerical breast density values as obtained by QUANTRA software were then used to establish the cutoff values for each category using receiver operator characteristic (ROC) analysis. Results: Numerical breast density values obtained by QUANTRA (range - 7-42%) were systematically lower than visual estimates. QUANTRA breast density value of less than 14.5% could accurately differentiate category D1 from the categories D2, D3, and D4 [area under curve (AUC) on ROC analysis - 94.09%, sensitivity - 85.71%, specificity - 84.21%]. QUANTRA density values of <19.5% accurately differentiated categories D1 and D2 from D3 and D4 (AUC - 94.4%, sensitivity - 87.50%, specificity - 84.60%); QUANTRA density values of <26.5% accurately differentiated categories D1, D2, and D3 from category D4 (AUC - 90.75%, sensitivity - 88.89%, specificity - 88.621%). Conclusions: Breast density values obtained by QUANTRA software can be used to obtain objective cutoff values for each ACR BI-RADS breast density category. Although the numerical density values obtained by QUANTRA are lower than visual estimates, they correlate well with the BI-RADS breast density categories assigned visually to the mammograms.
  2,657 206 -
Imaging in diagnosis and treatment of pulmonary tuberculosis
Animesh Ray
October-December 2015, 25(4):474-475
DOI:10.4103/0971-3026.169450  PMID:26752829
  2,331 403 -
Clinical outcomes of endovascularly managed iatrogenic renal hemorrhages
George Koshy Chiramel, Shyamkumar Nidugala Keshava, Vinu Moses, Nitin Kekre, V Tamilarasi, Anthony Devasia
October-December 2015, 25(4):380-390
DOI:10.4103/0971-3026.169454  PMID:26752819
Objective: To evaluate the effectiveness of endovascular management in iatrogenic renal injuries with regard to clinical status on follow-up and requirements for repeat angiography and embolization. Materials and Methods: This retrospective study included patients who were referred for endovascular management of significant hemorrhage following an iatrogenic injury. Data was recorded from the Picture Archiving and Communication system (PACS) and electronic medical records. The site and type of iatrogenic injury, imaging findings, treatment, angiography findings, embolization performed, clinical status on follow-up, and requirement for repeat embolization were recorded. The outcomes were clinical resolution, nephrectomy, or death. Clinical findings were recorded on follow-up visits to the clinic. Statistical analysis was performed using descriptive statistics. Results: Seventy patients were included in this study between January 2000 and June 2012. A bleeding lesion (a pseudoaneurysm or arteriovenous fistula) was detected during the first angiogram in 55 patients (78.6%) and was selectively embolized. Fifteen required a second angiography as there was no clinical improvement and five required a third angiography. Overall, 66 patients (94.3%) showed complete resolution and 4 patients (5.7%) died. Three patients (4.3%) underwent nephrectomy for clinical stabilization even after embolization. There were no major complications. The two minor complications resolved spontaneously. Conclusions: Angiography and embolization is the treatment of choice in iatrogenic renal hemorrhage. Upto 20% of initial angiograms may not reveal the bleed and repeat angiography is required to identify a recurrent or unidentified bleed. The presence of multiple punctate bleeders on angiography suggests an enlarging subcapsular hematoma and requires preoperative embolization and nephrectomy.
  2,500 221 -
Qualitative and quantitative diffusion-weighted imaging of the breast at 3T - A useful adjunct to contrast-enhanced MRI in characterization of breast lesions
Richa Bansal, Viral Shah, Bharat Aggarwal
October-December 2015, 25(4):397-403
DOI:10.4103/0971-3026.169455  PMID:26751011
Objective: To distinguish between benign and malignant breast lesions on the basis of their signal intensity on diffusion-weighted imaging and their apparent diffusion coefficient (ADC) values at 3 T MRI, along with histopathological correlation. Materials and Methods: A retrospective analysis of 500 patients who underwent 3 T MRI between August 2011 and May 2013 was done. Of these, 226 patients with 232 lesions that were proved by histopathology were included in the study. ADC values were calculated at b values of 0, 1000, and 1500 s/mm2 after identification on contrast-enhanced images and appropriate ROI(Region of interest) placement. ADC value and histopathology correlation was analyzed. Results: Out of 232 lesions, 168 lesions were histologically malignant and 64 were histologically benign. With an ADC cut-off value of 1.1 ×10−3 mm2/s for malignant lesions, a sensitivity of 92.80% and specificity of 80.23% was obtained. Out of 12/232 false-negative lesions, 6 were mucinous carcinoma in which a high ADC value of 1.8-1.9 ×10−3 mm2/s was obtained. Purely DCIS (Ductal carcinoma in situ) lesions presenting as non-mass-like enhancement had a high ADC value of 1.2-1.5 ×10−3 mm2/s, thereby reducing specificity. Conclusion: Diffusion-weighted Imaging and quantitative assessment by ADC values may act as an effective parameter in increasing the diagnostic accuracy and specificity of contrast-enhanced breast MRI in characterization of breast lesions.
  2,482 222 -
Traumatic brain injury and the post-concussion syndrome: A diffusion tensor tractography study
Maria M DíSouza, Richa Trivedi, Kavita Singh, Hemal Grover, Ajay Choudhury, Prabhjot Kaur, Pawan Kumar, Rajendra Prashad Tripathi
October-December 2015, 25(4):404-414
DOI:10.4103/0971-3026.169445  PMID:26751097
Aim: The aim of the present study is to evaluate diffusion tensor tractography (DTT) as a tool for detecting diffuse axonal injury in patients of acute, mild, and moderate traumatic brain injury (TBI), using two diffusion variables: Fractional anisotropy (FA) and mean diffusivity (MD). The correlation of these indices with the severity of post-concussive symptoms was also assessed. Materials and Methods: Nineteen patients with acute, mild, or moderate TBI and twelve age- and sex-matched healthy controls were recruited. Following Magnetic Resonance Imaging (MRI) on a 3.0-T scanner, DTT was performed using the 'fiber assignment by continuous tracking' (FACT) algorithm for fiber reconstruction. Appropriate statistical tools were used to see the difference in FA and MD values between the control and patient groups. In the latter group, the severity of post-concussive symptoms was assessed six months following trauma, using the Rivermead Postconcussion Symptoms Questionnaire (RPSQ). Results: The patients displayed significant reduction in FA compared to the controls (P < 0.05) in several tracts, notably the corpus callosum, fornix, bilateral uncinate fasciculus, and bilateral superior thalamic radiations. Changes in MD were statistically significant in the left uncinate, inferior longitudinal fasciculus, and left posterior thalamic radiation. A strong correlation between these indices and the RPSQ scores was observed in several white matter tracts. Conclusion: Diffusion tensor imaging (DTI)-based quantitative analysis in acute, mild, and moderate TBI can identify axonal injury neuropathology, over and above that visualized on conventional MRI scans. Furthermore, the significant correlation observed between FA and MD indices and the severity of post-concussive symptoms could make it a useful predictor of the long-term outcome.
  2,570 36 -
Caveat emptor
Yashant Aswani, Karan Manoj Anandpara
October-December 2015, 25(4):477-479
DOI:10.4103/0971-3026.169465  PMID:26752832
  2,180 107 -
Diagnostic value of diffusion tensor imaging derived metrics as biomarkers of cerebral changes in developmental delay
Ashish Verma, Narendra C Sagar, Ashok Kumar, Arvind Srivastava
October-December 2015, 25(4):415-420
DOI:10.4103/0971-3026.169457  PMID:26752821
Context: Children with developmental delay (DD) can be rehabilitated if an early diagnosis and intervention is done. A negative magnetic resonance imaging (MRI) study utilizing routine sequences makes it difficult for the clinician to convince the family toward a long-term rehabilitation schedule. Diffusion tensor imaging (DTI) can demonstrate deranged myelination in developmentally delayed children having normal routine MRI. Aim: To evaluate the role of DTI-derived metrics for assessment of deranged myelination in developmentally delayed children having normal routine MRI. Study Setting and Design: Prospective case control observational study conducted over a cross-section of referrals at a university-based teaching institute over a period of 2 years. Patients and Methods: Fifty cases of DD and 15 age-sex matched controls (age group of 2-12 years) were included from those presenting voluntarily to the pediatric out-patient services. Routine MRI and DTI were performed in both the groups following a standard protocol. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were calculated in certain pre-defined regions. Statistical Analysis: Central tendency was measured for each of the metrics using mean. Inter- and intra-group comparisons were performed using t-test. Results: Twenty-three regions of interest with 46 variables were included in the final analysis. Nineteen (82.60%) regions of interest showed at least one statistically significant variable, while 24 out of 46 (54.34%) variables showed statistical significance for future consideration. The important regions to be evaluated in a case of DD are the corpus callosum, bilateral forceps minor and forceps major, bilateral parietal lobes, bilateral post-central gyrus, and bilateral posterior limb internal capsule (PLIC). The regions which did not show any significance are bilateral pars triangularis and right frontal lobe. Other regions remained indeterminate and need further evaluation. Conclusion: DTI demonstrates myelination abnormality in children with DD, having a normal routine MRI.
  2,006 187 -
Use of a vascular sheath for introduction of radiofrequency ablation probe during radiofrequency ablation of osteoid osteoma
Munawwar Ahmed, Shyamkumar N Keshava, Vinu Moses, Suraj Mammen, Korula Mani Jacob, Vrisha Madhuri
October-December 2015, 25(4):365-367
DOI:10.4103/0971-3026.169460  PMID:26752816
Radiofrequency ablation (RFA) has now become a preferred treatment option for osteoid osteoma. Accurate placement of RFA probe into the nidus of osteoid osteoma is important for good clinical outcome. Various methods and techniques have been described in the literature available. We describe the technique of using a vascular access sheath for introduction of RFA probe after bone drilling, which prevents loss of access to drill track and also serves as a pathway for accurate placement of RFA probe, thereby reducing the risk of damage to the RFA probe tip itself and the surrounding soft tissue.
  2,036 134 -
Fetal echopsy (ultrasonographic autopsy) of an acardius myelancephalus and its correlation with antenatal ultrasonographic findings
Balakumar Karippaliyil, Milind Karippaliyil, Misha Karippaliyil
October-December 2015, 25(4):471-473
DOI:10.4103/0971-3026.169446  PMID:26752828
Aberrant transplacental arteriovenous shunts between the placental and cord vessels of monozygotic monoamniotic twins or triplets result in the formation of an acardius. The prenatal diagnosis of this condition has been reported occasionally in the literature. A subtype categorized as acardius myelancephalus was diagnosed at 32 weeks of gestation by ultrasonography (USG). The pregnancy was aborted because of poor prognostic predictors and the acardius was subjected to ultrasonographic autopsy (fetal echopsy). The antenatal USG features were correlated with echopsy findings for confirmation of the antenatal findings and for a better visual perception of the prenatal diagnostic features. The echopsy revealed more precise details. Fetal echopsy avoids the medicolegal problems concerned with parental consent for classical invasive fetal autopsy.
  2,011 154 -
Seronegative spondyloarthropathy imaging: Looking at the past, hitting the future
Alexis Lacout, Robert Carlier, Pierre-Yves Marcy
October-December 2015, 25(4):476-477
DOI:10.4103/0971-3026.169461  PMID:26752831
  1,867 218 -
Author reply to comments
Ashu Seith Bhalla, Ankur Goyal, Randeep Guleria, Arun Kumar Gupta
October-December 2015, 25(4):475-476
  1,302 100 -
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