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OBJECTIVES -Present study was done to evaluate carotid artery disease by color and duplex imaging in 63 patients (126 vessels) presenting with transient ischaemic attack and stroke. METHODS Vessel wall thickness and plaque characterization were done by gray scale ultrasound and site and severity of stenosis was assessed on color and duplex Doppler. Doppler finding were correlated with clinical presentation, risk factors, CT and echocardiographic findings. RESULTS-Male sex (p<0.01), post menopausal state (p<0.05) Presence of hypertension (p<0.01), systolic blood pressure, smoking (p<0.05), diabetes mellitus (p<0.05), history suggestive of peripheral arterial disease (p<0.01), previous CVA (p<0.01) were determined to be statistically significant risk factors. All the patients with a carotid bruit had abnormal carotid Doppler. Mean cholesterol levels in patients with normal carotid arteries was 186.52 ( 36.88) mg% and mean cholesterol level in patients with carotid lesion was 219.11( 35.13) All patients with >40% stenosis had a cortical infarct, none of patients with >40% stenosis had a subcortical infarct. All 22 patients with sub cortical infarcts had either normal extra-cranial carotids or had <40% stenosis. . Majority of plaques (50%) in the present study were located at the bifurcation. Color Flow imaging showed a definite advantage over B-mode scanning in identification of the hypoechoic plaques and in identification of plaque ulcerations. The overall perfect agreement between Color Doppler Flow Imaging and Conventional Duplex scanning was 96.8%. In patients with complete occlusion findings of color flow imaging and spectral analysis were confirmed on power Doppler imaging. Mean IM thickness of patients with normal echocardiography was 0.9250 ( 0.2863) and IM thickness of patients with echocardiographic evidence of IHD was 1.3455 ( 0.2734). CONCLUSION-As progression of the atherosclerotic disease can be stopped by reducing the risk factors and critical (>70%) stenosis treated surgically present study highlights the importance of doppler imaging in stroke prevention through surveillance for atherosclerosis that predisposes a person to cerebral ischaemia.

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The comparative study of plain x-ray film abdomen and ultrasound in non-traumatic acute abdomen was done in 50 patients with acute abdominal pain seen in the Department of Radiodiagnosis and Imaging of Govt. Medical College, Amritsar during the year 2000-2001. Ultrasound was highly accurate in diagnosing the exact cause of acute abdomen with high overall predictive accuracy of 98.3% and sensitivity of 90%. Plain x-ray abdomen was 100% diagnostic in GIT perforation, GIT obstruction, psoas abscess (caries spine) and renal colic with overall predictive accuracy of 4.1% and sensitivity of 60%.

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Objective: The purpose of this study was to characterize the image morphology of renal neoplasms on US (including CDFI) and CT and to stage these tumors and correlate the imaging findings with operative and/or histopathological findings. Materials and methods: a total of 50 patients were studied. These included renal cell carcinoma (n=38), angiomyolipoma (n=5), renal metastases (n=3), oncocytoma (n=1), transitional cell carcinoma (n=1), multilocular cystic nephroma (n=1) and nephroblastomatosis with Wilms tumour (n=1). All patients were evaluated by US and CT. Imaging finding were correlated with both operative and histopathological findings in 31 patients. Diagnosis was confirmed by percutaneous biopsy in 14 patients. In 5 patients final diagnosis was made on classical imaging features. Results : Most renal cell carcinomas had a solid appearance. On US, the most common appearance of RCC was predominantly isoechoic to normal renal parenchyma (78%) followed by hypo & hyperechoic lesions. Only 1 patient had cystic RCC. Solid renal cell carcinomas showed presence of peripheral and intralesional vascularity. The peak systolic Doppler frequency shift ranged from 0.5 KHz to 3.6 KHz. On CT, most of the lesions of RCC were heterogeneous in attenuation with inhomogeneous contrast enhancement less than that of normal renal parenchyma. Calcification was seen in 51%, necrosis in 94%, and haemorrhage in 20% lesions of RCC. Cystic RCC had thick walls, internal septations and solid components, all showing enhancement. Most of the angiomyolipomas (n=4) were homogenously hyperechoic on US, showed peripheral vascularity with peak systolic Doppler frequency shift less than 2.5 kHz. On CT, AML most commonly appeared as well defined, heterogeneous mass lesions showing internal fat density and variable contrast enhancement. Metastatic renal lesions were seen as small, homogenously hypoechoic on US, hypo to isodense on CT and showed minimal or no contrast enhancement. One case of oncocytoma showed a well defined, homogenous mass with central echogenic stellate scar and calcification on US. CT showed homogenous contrast enhancement with central hypodense stellate scar. TCC appeared as an intermediate echogenic mass on US, located in the dilated renal pelvis and extending into the upper ureter. On CT the mass was located centrally having density greater than that of urine, showing minimal contrast enhancement with centrifugal extension and invasion of renal parenchyma. Multilocular cystic nephroma was seen as a well-defined lesion with multiple cystic spaces, separated by septae which were echogenic on US and showed mild to moderate enhancement on CT. Conclusion: US and CT show many of the key imaging features used to characterize most of the renal neoplasms. However, some lesions remain indeterminate and require percutaneous biopsy to confirm the diagnosis.

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Ductal adenocarcinomas and its variants comprise 90 percent of all tumors of pancreas. The rest are rare. The radiological features of five such cases of rare pancreatic tumors are described and the relevant literature is reviewed.

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Materials & Methods : A Test Tool Phantom was designed and kept in Heat RF coil to be studied under sequences to evaluate the concerned parameter. An imaging sequence with specified slice thickness and inter slice distance was programmed for imaging purpose. After acquisition of the sequence, the obtained image was evaluated for FW (Full width at half maxima) using the image intensity profile measurement. The evaluated FWHM was correlated with the slice thickness and compared it with set value. To evaluate the interslice distance same test tool was used with three more image slices and the slice position with respect to the origin was evaluated with distance measurement protocol in the system. The difference between tow consecutive slice positions corresponds the interslice distance. The whole measurement was performed on Siemens magnetom Vision Plus MRI System using the designed test tool. Results : Evaluated Slice Thickness and interslice distance were compare with the set valued in the programmed sequences and the variation found were under ± 1 mm. Conclusion : The designed tool can serve the purpose of routine Quality Assurance in MRI and the slice thickness parameter can be evaluated very easily. The designed test toll fulfills the criteria of task group of AAPM.

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The incidence of extraskeletal osteosarcomas located in the soft tissues without attachment to the bone or periosteum in only 1 percent. The most common location of these tumors is the lower extremity (42-47 percent); especially the thigh followed by the upper extremity (12-1 percent) and the retroperitoneum (8-17 percent). Hence, we report an extremely rare case of extraskeletal retroperitoneal osteosarcoma.

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A simple plain Radiographic method for anticipating the adequacy of left ventricular size in Tetralogy of Fallot (T.O.F.) by studying the level of cardiac dome (i.e.) the dome in contact with cardiaic apex is described. Out of eighty one patients with good sized left ventricle, seventy had low placed cardiac dome and eleven had equal domes. In nineteen patients with small left ventricle, the cardiac dome was high placed. In Tetralogy of Fallot, equal domes and low placed cardiac dome suggest good sized left ventricle. A high placed cardiac dome indicates small sized left ventricle. This information is useful to anticipate adequacy of left ventricular size to cope up with systemic circulation post-operatively. While the plain Radiographic indication of adequate sized left ventricle in Tetralogy migh obviate the need for left ventriculogram, a small sized left ventricle anticipated on plain radiograph will, in fact, indicate left ventricular angiographic corroboration and evaluation.

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Congenital hepatic abnormality is quite rare while congenital thoracic reticulo-endothelial masses have been rarely reported. Further, an association between accessory reticulo-endothelial (RES) masses and congenital hepatic abnormality is extremely rare. We report a case with both these unusual features.

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