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  Citation statistics : Table of Contents
   2011| July-September  | Volume 21 | Issue 3  
    Online since September 24, 2011

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Recent advances in intestinal imaging
Rakesh Sinha
July-September 2011, 21(3):170-175
DOI:10.4103/0971-3026.85363  PMID:22013290
In recent years, advances in scanner technology and competition from other specialties have produced rapid changes in the way the intestines are imaged. MRI and CT scan along with the traditional enteroclysis examination have emerged at the forefront of intestinal imaging. Functional modalities such as diffusion and perfusion imaging are also changing the way tumors and inflammatory bowel diseases are evaluated. CT colonography is now a valid alterative to optical colonoscopy. Contrast-enhanced USG is being used for the assessment of inflammation and post-treatment changes. In this review, recent advances in intestinal imaging are described.
  5 10,677 1,029
Whole brain CT perfusion on a 320-slice CT scanner
Jai Jai Shiva Shankar, Cheemun Lum
July-September 2011, 21(3):209-214
DOI:10.4103/0971-3026.85370  PMID:22013297
Computed tomography perfusion (CTP) has been criticized for limited brain coverage. This may result in inadequate coverage of the lesion, inadequate arterial input function, or omission of the lesion within the target perfusion volume. The availability of 320-slice CT scanners offers whole brain coverage. This minimizes the chances of misregistration of lesions regardless of location, and makes the selection of the arterial input function easy. We present different clinical scenarios in which whole brain CTP is especially useful.
  5 6,403 363
Using PubMed in radiology: Ten useful tips for radiologists
Vasumathi Sriganesh
July-September 2011, 21(3):162-169
DOI:10.4103/0971-3026.85362  PMID:22013289
PubMed contains a bibliography of articles published in around 4800 journals. It combines MEDLINE and OLDMEDLINE (articles from 1960, going back till the 1940s). PubMed is updated on a daily basis; to include both published and ahead of print references. As a radiologist, one can use PubMed to track several journals, track topics, search for specific topics, verify incomplete or incorrect references, store one's own publications, and save selected references; one can also create filters depending on one's own search needs for some regular topics. This article provides some key background knowledge on searching PubMed and also describes some features that are often left unexplored. The PubMed site has undergone many changes in the last few years and this article will update users on the current features.
  4 5,465 669
Diffusion tensor imaging in spinal cord injury
Ravindra B Kamble, Neelam K Venkataramana, Arun L Naik, Shailesh V Rao
July-September 2011, 21(3):221-224
DOI:10.4103/0971-3026.85372  PMID:22013299
Background and Purpose: To assess the feasibility of spinal tractography in patients of spinal cord injury vs a control group and to compare fractional anisotropy (FA) values between the groups. Materials and Methods: Diffusion tensor imaging (DTI) was performed in the spinal cord of 29 patients (18 patients and 11 controls). DTI was done in the cervical region if the cord injury was at the dorsal or lumbar region and in the conus region if cord injury was in the cervical or dorsal region. FA was calculated for the patients and the controls and the values were compared. Results: The mean FA value was 0.550±0.09 in the control group and 0.367±0.14 in the patients; this difference was statistically significant (P=0.001). Conclusion: Spinal tractography is a feasible technique to assess the extent of spinal cord injury by FA, which is reduced in patients of spinal cord injury, suggesting possible Wallerian degeneration. In future, this technique may become a useful tool for assessing cord injury patients after stem cell therapy, with improvement in FA values indicating axonal regeneration.
  4 4,747 511
Case Report-Inguinoscrotal ureteral hernia diagnosed on micturating cystourethrography
Smiti Sripathi, KV Rajagopal, Chandan Kakkar, Ashwin Polnaya
July-September 2011, 21(3):199-201
DOI:10.4103/0971-3026.85368  PMID:22013295
The presence of a ureter within an inguinal hernia is an extremely rare entity, usually discovered incidentally during herniorrhaphy and may pose a surgical risk. Early preoperative diagnosis is crucial to guide proper surgical approach and to preserve renal function.
  3 4,344 202
Non-destructive testing in DNB/MD examination
Dinesh Kumar Sundarakumar
July-September 2011, 21(3):239-240
DOI:10.4103/0971-3026.85379  PMID:22013305
  3 2,974 339
Multidetector CT evaluation of central airways stenoses: Comparison of virtual bronchoscopy, minimal-intensity projection, and multiplanar reformatted images
Dinesh K Sundarakumar, Ashu S Bhalla, Raju Sharma, Smriti Hari, Randeep Guleria, Gopi C Khilnani
July-September 2011, 21(3):191-194
DOI:10.4103/0971-3026.85366  PMID:22013293
Aims: To evaluate the diagnostic utility of virtual bronchoscopy, multiplanar reformatted images, and minimal-intensity projection in assessing airway stenoses. Settings and Design: It was a prospective study involving 150 patients with symptoms of major airway disease. Materials and Methods: Fifty-six patients were selected for analysis based on the detection of major airway lesions on fiber-optic bronchoscopy (FB) or routine axial images. Comparisons were made between axial images, virtual bronchoscopy (VB), minimal-intensity projection (minIP), and multiplanar reformatted (MPR) images using FB as the gold standard. Lesions were evaluated in terms of degree of airway narrowing, distance from carina, length of the narrowed segment and visualization of airway distal to the lesion. Results: MPR images had the highest degree of agreement with FB (Κ = 0.76) in the depiction of degree of narrowing. minIP had the least degree of agreement with FB (Κ = 0.51) in this regard. The distal visualization was best on MPR images (84.2%), followed by axial images (80.7%), whereas FB could visualize the lesions only in 45.4% of the cases. VB had the best agreement with FB in assessing the segment length (Κ = 0.62). Overall there were no statistically significant differences in the measurement of the distance from the carina in the axial, minIP, and MPR images. MPR images had the highest overall degree of confidence, namely, 70.17% (n = 40). Conclusion: Three-dimensional reconstruction techniques were found to improve lesion evaluation compared with axial images alone. The technique of MPR images was the most useful for lesion evaluation and provided additional information useful for surgical and airway interventions in tracheobronchial stenosis. minIP was useful in the overall depiction of airway anatomy.
  2 5,978 467
Evaluation of umbilical cord thickness, cross-sectional area, and coiling index as predictors of pregnancy outcome
Morteza Tahmasebi, Reza Alighanbari
July-September 2011, 21(3):195-198
DOI:10.4103/0971-3026.85367  PMID:22013294
Aims: This study was designed to evaluate the relationship of sonographic measurements of umbilical cord thickness, cross-sectional area, and coiling index with pregnancy outcome (low birth weight, 5-min Apgar score, and meconium staining). Materials and Methods: From January 2010 to January 2011, among 255 singleton pregnant women who were referred for routine pregnancy USG after 20 weeks of gestation, 223 fulfilled the study criteria. In these patients, the diameter, cross-sectional area, and coiling index were measured in a free loop of umbilical cord. The pregnancies were followed till delivery, when birth weight, presence of meconium staining, and 5-min Apgar score were recorded. The sonographic measurements and clinical findings were analyzed to determine any correlation. Results: A statistically significant correlation was observed between small umbilical cord thickness and cross-sectional area and low birth weight (LBW), with sensitivity of 52.9% and 57.9%, specificity of 95.0% and 94.4%, positive predictive value of 52.6% and 52.0%, and negative predictive value of 95.0% and 95.0%, respectively. Also noted was significant correlation between small umbilical cord thickness and cross-sectional area with meconium staining (P<0.001). No significant correlation was seen between umbilical cord thickness and cross-sectional area with low 5-min Apgar score. There was no statistically significant correlation between umbilical cord coiling index and LBW, 5-min Apgar score, and meconium staining. Conclusion: Umbilical cord diameter and cross-sectional area measured after 20 weeks of gestation are useful for predicting LBW and meconium staining and have the potential to serve as markers for adverse pregnancy outcome.
  1 6,662 754
Case Report: Floating fat globule within an arachnoid cyst
Jayanand Sudhir, Chittur Viswanathan Gopalakrishnan, Sathia Prabhu, Swati Chinchure
July-September 2011, 21(3):228-230
DOI:10.4103/0971-3026.85374  PMID:22013301
Intralesional floating fat globules have been reported in cystic lesions such as teratoma of the ovary and dermoid of the head and neck but not within intracranial lesions. Fat globules dispersed within the subarachnoid space are a known imaging finding of ruptured intracranial dermoid. We report a unique case of an intralesional solitary floating fat globule within a multicompartmental arachnoid cyst, with varying locations on serial imaging. We also put forward a hypothesis for the pathogenesis of fat within an arachnoid cyst. To the best of our knowledge, this is the first such report in the literature.
  1 6,481 415
A pictorial essay: Radiology of lines and tubes in the intensive care unit
Sanjay N Jain
July-September 2011, 21(3):182-190
DOI:10.4103/0971-3026.85365  PMID:22013292
A variety of devices are used in the intensive care unit for long durations. Each one of them is a double-edged sword: intended to save life, but life-threatening if in the wrong place. Hence, it is important to periodically check that these devices are correctly placed so as to prevent complications. The portable chest radiograph is of tremendous value in this context.
  - 93,966 13,269
It is time!
Bhavin Jankharia
July-September 2011, 21(3):161-161
DOI:10.4103/0971-3026.85361  PMID:22013288
  - 2,843 284
CT features, mimics and atypical presentations of gastrointestinal stromal tumor (GIST)
Smiti Sripathi, KV Rajagopal, Rajendra Kumar Srivastava, Anurag Ayachit
July-September 2011, 21(3):176-181
DOI:10.4103/0971-3026.85364  PMID:22013291
The term stromal tumor was coined in 1983 by Clark and Mazur for smooth muscle neoplasm of the gastrointestinal tract (GIT). Gastrointestinal stromal tumors (GIST) are nonepithelial tumors arising from the interstitial cells of Cajal, which express KIT protein-CD117 on immunohistochemistry. GIST can arise anywhere in the GIT, including the mesentery, omentum, and retroperitoneum.
  - 43,335 3,886
Intracavitary course of right coronary artery
Abhishek Bansal, Maria M D'souza, Rajendra P Tripathi
July-September 2011, 21(3):238-239
DOI:10.4103/0971-3026.85378  PMID:22013304
  - 2,333 146
Left behind radiological investigations: An inherent problem
Giridhar A Govindswamy, Srinath M Gopinath, Adekal Ashok Kumar
July-September 2011, 21(3):236-237
DOI:10.4103/0971-3026.85377  PMID:22013303
Objectives: To assess the number of investigations left behind by patients in radiology department, their cost, and the possible methods of reducing the problem. Materials and Methods: A total of 1424 radiographs, 160 computed tomography (CT) scans, 300 ultrasonography (USG) reports, and 46 Doppler reports were left behind by patients in one financial year. The total cost of these left behind investigations was calculated and the reports were categorized into normal and abnormal for each modality. Results: Of the radiographs left behind 658 were abnormal, with 211 among these being radiographs of postoperative patients. Thirty-seven percent of CT scans had positive findings. Sixty-eight percent of USG reports had positive findings while 46% of Doppler reports were abnormal. Conclusion: We believe that the cost and number of these left behind investigations over a period of time would definitely be significant for the health care system in a developing country. It is time to think of the possible reasons and methods for containing this problem.
  - 2,452 162
Case report: Thrombosed giant cavernous carotid artery aneurysm secondary to cervical internal carotid artery dissection: An unusual entity
Sachin S Baldawa, Hima Pendharkar, Girish R Menon, Suresh R Nair
July-September 2011, 21(3):225-227
DOI:10.4103/0971-3026.85373  PMID:22013300
Spontaneous thrombosis of a giant intracranial aneurysm with parent artery occlusion is known. The exact mechanism is however unclear and various theories have been proposed. We present an unusual case of an angiographically documented cervical internal carotid artery (ICA) dissection, which led to total occlusion of the ICA distal to the dissected site, with acute cessation of forward blood flow. This resulted in acute upstream thrombosis of the giant cavernous carotid artery aneurysm and an acute cavernous sinus syndrome-like presentation.
  - 5,028 224
Superficial temporal artery calcification in patients with end-stage renal disease: Association with vascular risk factors and ischemic cerebrovascular disease
Zeeshan Anwar, Elcin Zan, Marco Carone, Arzu Ozturk, Stephen M Sozio, David M Yousem
July-September 2011, 21(3):215-220
DOI:10.4103/0971-3026.85371  PMID:22013298
Background and Purpose: Extracranial superficial temporal artery (STA) calcification is an unusual finding seen in patients with chronic kidney disease and has unknown ramifications with respect to intracranial ischemic disease. We sought to determine the association between the risk factors for vascular calcification and this rare phenomenon, in patients with chronic renal failure, and to assess the coexistence of cerebral ischemia. Materials and Methods: Medical records and laboratory data on risk factors for vascular calcification were retrospectively retrieved for 453 patients with a discharge diagnosis of end-stage renal disease (ESRD). CT head examinations were reviewed to identify and associate STA calcification with 1) risk factors for the vascular calcification, 2) intracranial artery calcification, and 3) cerebral ischemia (white matter and/or cortical ischemic changes). Results: STA calcification was present in 9.9% (45/453) of the studied cohort. The prevalence of cerebral ischemia was 24.4% (11/45) in patients with STA calcification and 9.3% (38/408) in patients without it. Diabetes mellitus (OR: 2.56, 95% CI: 1.059-6.208; P=0.037) was independently associated with the risk of STA calcification. The risk of cerebral ischemia, however, was not related to STA calcification (P=0.221). Conclusion: The presence of diabetes mellitus is important in describing the risk of STA calcification in patients with ESRD, whereas age, gender, hypertension, serum calcium, serum phosphate, or serum hemoglobin levels are not. The risk of cerebral ischemia is not related to STA calcification but has the strongest association with diabetes mellitus.
  - 4,873 217
Novel positron emission tomography radiotracers in brain tumor imaging
Maria Mathew D'Souza, Rajnish Sharma, Madhavi Tripathi, Puja Panwar, Abhinav Jaimini, Anupam Mondal
July-September 2011, 21(3):202-208
DOI:10.4103/0971-3026.85369  PMID:22013296
Although [18F] 2-fluoro-2-deoxy-D-glucose (FDG) is the most widely used radiopharmaceutical the world over, it is not the ideal tracer for brain imaging, owing to its high physiological cortical uptake and lack of specificity. This has paved the way for the introduction of several novel radiotracers, each with their own inherent strengths and limitations. We present the insights gained from the use of these radiotracers at our institution.
  - 9,647 380
Percutaneous placement of a biliary plastic stent
Shyamkumar N Keshava, Suraj Mammen
July-September 2011, 21(3):231-233
DOI:10.4103/0971-3026.85375  PMID:22013302
Endoscopic biliary plastic stent placement is a well-established technique for unresectable and recurrent biliary obstructive disease and provides significant improvement in the quality of life. We describe a new technique of percutaneous placement of biliary plastic stent that has not been previously mentioned in the literature.
  - 3,642 251
Web Review: Picture archiving and communication system (PACS)
IK Indrajit
July-September 2011, 21(3):234-235
  - 3,217 404
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