Three-dimensional (3D) imaging allows disease processes and anatomy to be better understood, both by radiologists as well as physicians and surgeons. 3D imaging can be performed with USG, CT scan and MRI, using different modes or rendering that include surface-shaded display, volume-based rendering, multiplanar imaging, etc. All these techniques are used variably depending on the indications.

Monitor displays are an integral part of today's radiology work environment, attached to workstations, USG, CT/MRI consoles and PACS terminals. For each modality and method of use, the correct display monitor needs to be deployed. It helps to have a basic understanding of how monitors work and what are the issues involved in their selection.

Objective: To assess the efficacy of facet joint infiltrations for pain relief in 44 selected patients with chronic nonradicular low back pain (LBP). Materials and Methods: Forty-four patients with chronic LBP of more than 3 months' duration were selected for facet joint infiltration. The majority (n = 24) had facetal pain with no evidence of significant facetal arthropathy on imaging. Fifteen patients had radiological evidence of facetal arthropathy, one had a facet joint synovial cyst, three were post-lumbar surgery patients, and two patients had spondylolysis. Facet joint injections were carried out under fluoroscopic guidance in 39 patients and under CT guidance in 5 cases. Pain relief was assessed using the visual analog scale at 1 h post-procedure and, thereafter, at 1, 4, 12, and 24 weeks. Results: A total of 141 facet joints were infiltrated in 44 patients over a 2-year period. There was significant pain relief in 81.8% patients 1 h after the procedure, in 86.3% after 1 week, in 93.3% after 4 weeks, in 85.7% after 12 weeks, and in 62.5% after 24 weeks. No major complications were encountered. Conclusions: Facet nerve block was found to be a simple, minimally invasive, and safe procedure. With meticulous patient selection, we achieved long-term success rates of over 60%. We conclude that this method represents an important alternative treatment for nonradicular back pain.

Aims and Objectives: To describe our technique for performing radiofrequency ablation (RFA) in osteoid osteoma and to evaluate the results of treatment. Materials and Methods: We evaluated 40 patients in whom RFA was performed for osteoid osteomas between October 2005 and February 2008. The lesions were located in the femur (n = 22), tibia (n = 10), humerus (n = 2), acetabulum (n = 2), radius (n = 1), fibula (n = 1), patella (n = 1), and calcaneum (n = 1). The procedure was performed using a standard technique. Results: Technical success was achieved in all patients, with intranidal localization of the needle and complete ablation. All patients were fully weight bearing 2-3 h after the procedure. Successful pain relief was achieved in all patients within 48 h. Immediate complications included a case of minor thermal skin burn and a small cortical chip fracture, which healed on its own. There were no delayed complications. The average follow-up period was 12 months. Two patients (5% of cases) had recurrence of pain after intervals of 5 and 8 months, respectively, following the ablation; this was due to recurrence of the lesion. Complete pain relief was however achieved after a second ablation in both cases. Thus, our primary and secondary clinical success rates were 95 and 100%, respectively. Conclusion: RFA is a safe, quick, minimally invasive, and extremely effective method for the management of osteoid osteomas.

Dural arteriovenous fistulas are fistulas connecting the branches of dural arteries to dural veins or a venous sinus. Digital subtraction angiography remains the gold standard for diagnosing these fistulas. Endovascular treatment is one of the first line options available for their management. This review article reviews the etiopathogenesis, natural history, common classification systems and various available treatment options.

CT coronary angiography has helped radiologists understand the variations and anomalies of the anatomy of the coronary arteries and, thus, to alert the cardiologist whenever such an anomaly is present. This can be of immense help to the clinician planning interventional procedures such as stenting, balloon dilatation, or graft surgery, particularly when there are secondary changes of calcification, plaque formation and stenosis.

For long, catheter angiography has been the investigation of choice for the diagnosis of congenital anomalies of the heart such as total anomalous pulmonary venous circulation (TAPVC). In the last few years, MRI and multislice CT scan have also been introduced for this purpose. We report a case where 64-slice CT scan was found very useful in the evaluation of TAPVC.

USG performed with a high-end machine, using a good cine-loop facility is extremely helpful in the diagnosis of fetal cardiac anomalies. In fetal echocardiography, the four-chamber view and the outflow-tract view are used to diagnose cardiac anomalies. The most important objective during a targeted anomaly scan is to identify those cases that need a dedicated fetal echocardiogram. Associated truncal and chromosomal anomalies need to be identified. This review shows how fetal echocardiography, apart from identifying structural defects in the fetal heart, can be used to look at rhythm abnormalities and other functional aspects of the fetal heart.

MRI is a useful supplement to USG for the assessment of fetal brain malformations. Superior soft tissue contrast and the ability to depict sulcation and myelination are the strengths of MRI. Subtle or inconclusive USG abnormalities can be confirmed or ruled out by MRI. In some cases, additional findings detected with MRI often help in arriving at a definitive diagnosis, which is necessary for parental counseling and for guiding management. Fast T2W sequences form the basis of fetal MRI. There have been no reports of deleterious effects of MRI on the fetus. A few case examples are presented to illustrate the advantages of MRI.

Esophageal duplication cysts are classified as a subgroup of foregut duplication cysts. They are very rare and are predominantly detected in children. Antenatal detection is very rare. We report a case of an esophageal duplication cyst that was accurately identified antenatally by USG and MRI.

MRI is increasingly being used in the diagnosis of fetal anomalies suspected on USG. The USG evaluation of fetal spinal anomalies is limited by acoustic shadowing, fetal position and the amount of liquor. Fetal MRI is able to show spinal anomalies well, as in our case of fetal diastematomyelia with a dorsal dermal sinus, suspected on USG at 28 weeks gestation.

TRAP (twin reversed arterial perfusion) sequence / acardiac twinning is a rare anomaly that occurs in monozygotic monochorionic twins with an incidence of 1% and in 1 in 35,000 pregnancies overall. The anomalous twin appears as a heterogeneous mass, simulating a teratoma or intrauterine fetal demise. As the normal twin faces increased morbidity and mortality, antenatal diagnosis with gray-scale examination, and Doppler confirmation of the diagnosis of TRAP sequence in twin pregnancies, aids in proper prenatal management. We report two cases of TRAP sequence that we encountered over a single month, with the two cases having different outcomes.

Fetal cardiac anomalies involving the ventricular and atrial septa, outflow tracts, chambers, and valves are often encountered in routine screening. However, the prenatal detection of a fetal left ventricular aneurysm is rare. This report describes the case of a left ventricular aneurysm that was diagnosed at 24 weeks of gestation; the diagnosis was later confirmed by postnatal echocardiography. This case is reported because of its rarity and the characteristic echocardiographic findings. An early specific antenatal USG diagnosis helps in prognostication and in counseling of the parents.