Search

Introduction: Cervical nodes form one of the major groups of Lymph Nodes (LN) that are frequently involved in inflammatory and neoplastic diseases. Metastasis causes the most apparent change in consistency of the node among the various nodal pathologies. Ultrasound elastography provides an estimate of tissue consistency by measuring the degree of distortion under the application of an external force. Aim: To estimate the diagnostic accuracy of sonoelastography in the differentiation of malignant and benign cervical LN with Fine Needle Aspiration Cytology (FNAC)/biopsy considered as a gold standard. Materials and Methods: A cross-sectional study was carried out from March 2020 to January 2021 in a tertiary care hospital in south India, a total of 50 patients with cervical lymphadenopathy underwent ultrasonography followed by elastography of superficial neck LN using high frequency linear transducer by freehand technique. The ultrasound characteristics of selected LN were determined and colour elastogram pattern was assessed using colour mapping elastography. The Chi-square test was performed. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) were obtained. The results were then compared to the fine needle aspiration cytology. Results: A total of 50 subjects (median age of 40.5±18.71 years; 19 (38%) males and 31 (62%) females). The grayscale and colour Doppler features of cervical LN which helped predict malignancy were short axis ≥8 mm, Short:Long axis diameter ratio (S:L) ≥0.5, absence of normal central fatty hilum, abnormal echogenicity, lobulated border, presence of calcification and peripheral/mixed vascularity. With reference to the above variables of cervical LN characterisation on grayscale, colour doppler ultrasound and sonoelastography findings, elastography pattern was the most promising variable to differentiate malignant from benign cervical LN with 95.2% sensitivity, 75.0% specificity, 95.2% PPV, 75.0% NPV and 92.0% accuracy. Conclusion: Sonoelastography is useful in the assessment of elastic properties of cervical LN with short examination time required, real-time display, immediate interpretation and limited cost. Sonoelastography had higher diagnostic accuracy than gray scale and doppler ultrasound in differentiating benign from malignant cervical LN. Sonoelastography is an effective supplement to conventional gray scale and colour doppler ultrasound and that the combination is clinically recommended for a more accurate diagnosis of metastatic LN.

Introduction: Chronic viral hepatitis is a condition of hepatotropic viral infection associated with chronic inflammation, hepatocyte injury and progressive fibrosis. Non-invasive assessment of liver fibrosis in chronic hepatitis B and C patients has been increasing and used instead of liver biopsy. Aim: To assess the diagnostic performance of ElastPQ Point Shear Wave Elastography (ElastPQ PSWE) with liver biopsy as the gold standard and comparing these results with other serum fibrosis markers namely Aspartate to Platelet Ratio Index (APRI), Fibrosis-4 Score (FIB4). Materials and Methods: A cross-sectional study was carried out in which 73 patients underwent ElastPQ PSWE and Histopathological Examination (HPE) with METAVIR Scoring system staging. Serum fibrosis indices including APRI and FIB4 values were calculated. The diagnostic performance of ElastPQ PSWE, APRI and FIB4 was evaluated using Area Under Receiver Operating Characteristic (AUROCAUROC) curve analysis, correlations of ElastPQ PSWE, APRI and FIB4 ratio index with histopathological findings (as the reference standard) were determined using Spearman’s correlation coefficient. Results: Study included 73 patients with chronic hepatitis B and hepatitis C, of which 8 (10.96%) were no/early fibrosis (F0- F1); 20 (27.40%) were significant fibrosis (F2); 22 (30.13%) were severe fibrosis (F3), and 23 (31.51%) were cirrhosis (F4). There was a significant positive correlation between different stages of liver fibrosis by liver biopsy and liver stiffness detected by ElastPQ PSWE (r=0.912, p

The hands act as a mirror in many systemic diseases. Identification of a variety of inflammatory, degenerative, congenital, and hematological diseases can be performed by a single hand radiograph which may help start early intervention and prevent morbidity. Endocrinological and metabolic disorders also may demonstrate signs on a hand radiograph. Granulomatous conditions and systemic connective tissue disorders demonstrate characteristic imaging features which may aid the diagnosis. Radiologists should be familiar with the radiographic imaging findings of common systemic disorders because these may be a problem solving tool to aid in diagnosis.

Wide array of anatomical variations and pathologies affect the inferior vena cava (IVC). Multidetector computed tomography remains the most important modality to diagnose and evaluate the extent of involvement. The congenital variations such as duplication, anomalous course of renal veins, azygos continuation of IVC, etc., remain clinically indolent and are detected incidentally in abdominal imaging. This article describes the various congenital variants which include abnormalities in drainage, failure of development, and regression of the IVC. This article also highlights the important pathological conditions such as Budd–Chiari syndrome, primary and secondary neoplasms of the IVC, bland thrombosis, and retrograde opacification of the IVC.

Introduction: Intestinal obstruction is a common surgical emergency that is encountered in general surgery units and it contributes to substantial patient morbidity and healthcare costs. Computed Tomography (CT) has emerged as an invaluable diagnostic tool in the evaluation of bowel obstruction and helps in deciding early surgery. The CT gives information on the cause for obstruction, its location, and complications like closed loop obstruction, bowel ischaemia. Aim: 1. To evaluate the accuracy of CT in diagnosing the presence, level and cause of intestinal obstruction. 2. To detect the presence of complications and demonstrate threatening signs of bowel non-viability. 3. To relate CT findings with intraoperative findings. Materials and Methods: A prospective cohort study was done at the Department of Radiology, Mysore Medical College and Research Institute, Mysore, India from April 2021 to September 2021. A total of 40 patients, ≥18 years of age with clinical suspicion of intestinal obstruction, were subjected to Contrast- Enhanced Computed Tomography (CECT) of the abdomen. The sensitivity , specificity, positive and negative predictive values of Muti-detector Computed Tomography (MDCT) were calculated. Data analysis was carried out using Statistical Package for Social Science (SPSS) version 18.5 software. Results: Total of 40 patients were analysed (25 males and 15 females ; mean age: 50.5 years). Small bowel obstruction constituted 75% of cases and large bowel obstruction constituted 25% of the cases. Ileum was the most common site of obstruction. Adhesions were the leading cause seen. Closed loop obstruction with bowel ischaemia and gangrene were observed in five patients (12.5%). Comparison of CT and per-operative findings showed that CT has a high sensitivity, specificity, accuracy of 97.44%, 100%, 97.50%; 92.31%, 100%, 92.50% and 100%, 94.12%, 95%, respectively for determining the level, cause and complications of obstruction. Conclusion: The MDCT has high diagnostic accuracy in diagnosing the level, cause and complications of intestinal obstruction with the highest of 97.50% for identifying the cause of obstruction. CT is 100% sensitive in picking up complications like bowel ischemia. Thus, MDCT were in concordance with intra operative findings for the diagnosis of intestinal obstruction and can guide surgeons in the management of these patients.

Introduction: Glenoid Dysplasia (GD) also known as posterior glenoid rim deficiency is generally known to be asymptomatic with its incidence being greatly underestimated. Atraumatic pain is the predominant symptom in 21% of subjects with GD. GD has been associated with posterior labral tear and is generally thought to predispose to shoulder instability and consequentially to accelerate degenerative joint disease. Aim: To determine the incidence of GD, the type and extent of GD and to study its association with posterior labral tears on Magnetic Resonance Imaging (MRI). Materials and Methods: A retrospective observational study was done on 98 consecutive MRI shoulder studies obtained over a period of six months from January 2020 to June 2020 in the Department of Radiodiagnosis of Mysore Medical College and Research Institute. Those subjects with fractures, arthritic changes or mass lesions involving the glenoid process were excluded. The postero-inferior glenoid was evaluated for dysplasia on axial T1- Weighted, T2-Weighted and Proton Density with Fat Saturation (PDFS) images (slice thickness, 3-4 mm). Subjects were divided into four categories: Normal, Mild, Moderate, and Severe GD. Once the acquired images were reviewed and assigned in to the above mentioned four categories based on severity of dysplasia, they were further assigned into three categories defining the type of glenoid into three categories: normal curved lazy J and triangular bony deficiency or the Delta type. The caudal most axial scan image which depicted the articular cartilage of the glenoid was taken as the reference image. The Statistical software SPSS version 22.0, and (Robert and Ross) environment ver. 3.2.2 were used for the analysis of the data. Results: In present study of 98 consecutive MRI shoulders, six were rejected due to factor such as poor image quality, infective arthritis and trauma. Of the remaining 92 subjects (75 males and 17 females, mean age 36.73±12.50 years), 54 (58.69%) had a normal glenoid fossa, 25 (27.17%) had mild dysplasia and 13 (14.13%) had moderate dysplasia. We did not have any subjects with severe dysplasia. Of the total 38 cases of GD, 21 (55.26%) cases were of the lazy J variant while 17 (44.73%) cases were of the delta type variant. Among the 38 cases of total dysplasias, 25 cases were of mild GD of which 17 (68%) were of the lazy J variant, while 8 (32%) belonged to the delta variant. Out of the remaining 13 cases of moderate GD, 4 (30.76%) belonged to the lazy J category while the remaining 9 (69.23%) belonged to the delta variant. The difference in incidence of posterior labral tears between the normal (0) and combined mild and moderate dysplasia groups (41.3%) was statistically significant (p

Introduction: Hazardous alcohol use and diabetes are the major risk factors for development of liver cirrhosis. The presence and progression of hepatic fibrosis into cirrhosis is a prognostic variable having impact on survival in people with hazardous alcohol use and Type 2 Diabetes Mellitus. Liver biopsy is an invasive method for diagnosis and staging of hepatic fibrosis. Shear Wave Elastography (SWE) is a non-invasive method for assessing and staging hepatic fibrosis. Aim: To evaluate SWE as a non-invasive technique along with biomarker parameters as an algorithm for early detection of liver fibrosis in Type 2 Diabetes and hazardous alcohol use patients and to compare the results of shear wave ultrasound elastography in liver fibrosis with AST/ALT ratios, AST Platelet Ratio Index (APRI scores), and Fibrosis-4 (FIB-4) scores. Materials and Methods: A prospective cross-sectional study was conducted in a tertiary care hospital attached to Mysore Medical College and Research Institute, Mysore, Karnataka, India, from July 2018 to June 2019. Based on inclusion and exclusion criteria 460 patients were recruited for the study. For each patient, AST, ALT, platelet count and SWE values were measured. Patients with normal serum biomarkers and elevated SWE results were subjected to liver biopsy to confirm the diagnosis. Student’s t-test, Analysis of Variance (ANOVA), Chi-square/fisher-exact test was used to find the significance of study parameters. ANOVA was used to compare the SWE findings with the biochemical parameters. Results: SWE identified 75 patients with normal values, 2.2 m/sec (Group C). SWE showed positive correlation with APRI (p