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.

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

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.

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.

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.

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.

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.

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.

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.

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.