Objectives: To evaluate the usefulness of emergency computed tomography in detection of intra-abdominal injury in patients with blunt abdominal trauma and to provide information that could accurately determine the choice of management (operative versus non-operative), thereby reducing the non-therapeutic laparotomy rates. The emphasis was to detect both free fluid (haemoperitoneum) and visceral lesions as indicators of intraabdominal injury. Materials and methods: Two hundred and ten patients with blunt abdominal trauma were evaluated in a period of 20 months, of whom sixty-three patients were positive. The various organ injuries were graded, and scoring applied for haemoperitoneum. The management, therapeutic or otherwise was decided based on the CT findings. Results: Patients with severe grades of injury and with large haemoperitoneum required surgeries. The overall sensitivity, specificity and positive predictive value for trauma detection by CT was 93%, 100% and 100% respectively. Conclusion: CT quantification of haemoperitoneum and organ injury grading is helpful in guiding the surgeon towards patient management. CT is accurate, safe, and has all the attributes to make it an initial investigation of choice in haemodynamically stable patients of blunt abdominal trauma.

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OBJECTIVES: To document the various CT appearances of bronchogenic carcinoma with histopathologic correlation, to identify changing trend in the radiographic pattern of bronchogenic carcinoma, if any and to evaluate the role of CT in staging of bronchogenic carcinoma was also evaluated. MATERIALS AND METHODS A prospective study of 81 patients over a period of 2 yrs with clinical and or radiological suspicion of bronchogenic carcinoma and confirmed histopathogical diagnosis was undertaken with CT of the thorax using 10 mm collimation sections from the level of lung apices to the diaphragm and routinely included the adrenals. RESULTS : Squamous cell carcinoma is the most common histologic subtype followed by adenocarcinoma and small cell carcinoma. There was a definite male preponderance with smoking being the most common risk factor. Adenocarcinoma is presenting predominantly as central tumor( 70.5% ) Squamous cell carcinoma is presenting predominantly as peripheral tumor (52.7% ) . CONCLUSION Computed tomography is the modality of choice for evaluating bronchogenic carcinoma because of its better spatial resolution. CT provides precise characterization of the size, contour, extent and tissue composition of the suspicious lesion. If the lesion represents a bronchogenic carcinoma, CT serves as a part of the staging process to assess the extent of the disease. The radiologic presentation of adenocarcinoma and squamous cell carcinoma is showing a changing pattern. In our study, adenocarcinoma is presenting predominantly as a central tumor and Squamous cell carcinoma is presenting predominantly as a peripheral tumor. This relative increase in the percentage of centrally located adenocarcinoma is a statistical variation or a reality needs to be evaluated further.

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OBJECTIVE: To study the role of ultrasonography and computed tomography in the evaluation of focal splenic lesions, to compare their diagnostic accuracies, to study the differential diagnosis of focal splenic lesions, to evaluate the imaging features of common lesions and to calculate the incidence of focal splenic involvement in lymphomas. MATERIALS AND METHODS: A prospective study of 46 patients was undertaken in whom focal lesions in the spleen were detected on USG, CT or both. In all patients, USG was done and images were stored. Five mm thick contiguous sections were obtained from the spleen before and after injection of intravenous contrast material in the portovenous phase. RESULTS: Of the focal splenic lesions 28 (60.8%) were benign and 18 (39.2%) were malignant. The spectrum of benign lesions included cysts (4), infarcts (10), abscesses (9) HIV+ve cases with focal hypodense splenic lesions (5) and a case of inflammatory pseudotumour. Malignant lesions included 6 cases each of Hodgkin's and non-Hodgkin's lymphoma and 6 cases of metastatic deposits in the spleen. Diagnostic accuracy of plain CT was 78.7%, of USG 87.2% and of CECT was 100%. Lesion detection was significantly improved by contrast enhancement. NHL, especially the high grade lymphomas presented with large nodular pattern of involvement of spleen whereas Hodgkin's lymphoma presented in majority of cases with small nodular pattern of involvement. Imaging features of infarcts corresponded to the classic wedge shaped peripheral pattern in a majority,(80%) and were extensive with hilar sparing in 20%. CONCLUSION: We concluded that contrast enhanced CT is the ideal modality for detection of focal splenic lesions, with USG being used mainly for follow up. The spectrum of differentials of focal splenic lesions in our study corresponded with reports in literature.

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Cardiac MRI is a valuable and an accurate modality used in the evaluation of structure and function of the heart. It is increasingly considered as a useful non invasive examination in management of cardiovascular conditions, a situation resulting from significant advances in MR technologies. Evaluation of congenital heart disease is an important application of Cardiac MRI since the morphological details of chambers, septum, defects and anomalous connections are depicted accurately. Additionally, flow information across valves, chambers, outflow tracts and shunts are also provided. Its utility is further increased especially during follow up of patients after corrective surgery. This article reviews current state-of-the-art MRI application in common congenital heart diseases.

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OBJECTIVE :- To evaluate the diagnostic accuracy between USG & MRCP in the patients suspected of biliary and pancreatic pathology. MATERIAL & METHODS : Fifty patients attending the hospital of all age groups and both sexes, suspected of biliary and pancreatic pathology, were examined first by USG and followed by MRCP, and findings were correlated with ERCP and biopsy report. RESULTS :- Out of 50 patients 38 patients had biliary pathology and 12 patients had pancreatic pathology. Out of this, MRCP was 98 % accurate in diagnosis when results were compared in all cases. USG didn't help in case of CBD stricture, in evaluating Pancreatic duct into Chronic pancreatitis and in lower end of CBD pathology. CONCLUSION :- USG is the cheap and easily available modality so, it is the primary investigative modality for suspected patients of biliary and pancreatic pathology, but MRCP has high diagnostic value.

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Fibrous dysplasia is a skeletal disorders of unknown etiology usually affecting the young. Women are commonly affected more than men. Craniofacial fibrous dysplasia can have a varied presentation. It can affect the calvarium or the facial skeleton.These lesions typically expand the bone with intact well-preserved cortical rim. Here we present a case of pseudotumoral fibrous dysplasia with isolated involvement of the right maxilla.

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Objective: To assess the prevalence and ability to detect a left inferior vena cava (IVC) during venography prior to filter placement and its implications for device implantation. Materials and Methods : Over 58 months, patients referred for an IVC filter were prospectively evaluated for a left IVC by performing cavography injecting into the left iliac vein, left renal venography, or CT scan correlation. Additionally, cavograms of patients receiving filters over the four previous years were reviewed to assess the adequacy of detecting these anomalies based on the degree of opacification of the left iliac vein in relation to the position of the catheter tip. Results: Prospective evaluation for a left IVC was adequate in 477 of 503 patients. Retrospective evaluation using CT scans was possible in another 14. Left IVCs were detected in 5 patients (1%). Three patients with duplications were managed with either 2 filters, a suprarenal filter, or a bird's nest filter straddling both cavas. Two patients with isolated left IVCs received a single filter. Of 62 retrospectively reviewed cavograms, the left iliac vein was inadequately opacified in 69% when the catheter was in the low IVC (53 patients) and 71% when it was in the right iliac vein (7 patients). Conclusions: Low caval or right iliac vein injections infrequently provide sufficient reflux into the left iliac vein to assess for a left IVC. Left iliac vein catheterization is easy and will readily provide this information. Modifications in filter placement technique may be necessary when caval anomalies are present.

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