Department Of Radiodiagnosis Research Articles

Role of Ultrasonography in the Evaluation of Peripheral Nerve Pathologies: A Study of 200 Cases.

The aim of this study is to ascertain the role of ultrasonography in appraising the structural intricacies of peripheral nerve pathologies. (1) To scrutinize the anatomy of both normal and abnormal peripheral nerves. (2) Assess different parameters like continuity of the nerve, echotexture, vascularity, cross-sectional area, and thickness of the nerve in various pathologies. In a prospective observational study conducted at the Department of Radio Diagnosis, Tertiary Care Centre, the study design focused on the examination of 200 cases utilizing a high-resolution 9-14 Mhz and 17 Mhz linear array transducer, integrated into the Aplio 400 Canon Ultrasound System. Among the total cases, 62 were identified as traumatic neuropathy cases, 52 as entrapment neuropathy cases, 14 as infective neuropathy cases, 54 as thermal neuropathy cases, 14 as metabolic neuropathy cases, and 4 as nerve-tumor cases. In conclusion, this investigation illuminates the dynamic role of ultrasonography as an invaluable diagnostic instrument in appraising peripheral nerve pathologies. The noninvasive attributes, widespread availability, and economic viability of ultrasonography render it a pragmatic choice for clinicians. This inquiry buttresses the escalating significance of ultrasonography within neurology, emphasizing its potential to revolutionize the terrain of peripheral nerve pathology assessment.

Role of ultrasound and color Doppler in diagnosis of ectopic pregnancy and to differentiate from corpus luteum cyst of pregnancy

Background: Ectopic pregnancy is the leading cause of direct maternal deaths. Ectopic pregnancy and corpus luteum cyst are two most common differential diagnoses in a patient with urine pregnancy test (UPT) positive and no sonographic evidence of intrauterine pregnancy. Internal echotexture and color Doppler features of the cyst wall are also considered in an attempt to differentiate the tubal ring of an ectopic pregnancy from that of a corpus luteum. Aims and Objectives: The aim of this study was to diagnose the presence of ectopic pregnancy and to differentiate ectopic pregnancy from corpus luteum cyst using grayscale ultrasound and color Doppler findings. Materials and Methods: The prospective study was conducted in 46 patients who were referred to the Department of Radiodiagnosis in R.L Jalappa Hospital with UPT positive and clinical features suggestive of ectopic pregnancy. Results: Out of 46 patients, 33 were diagnosed with ectopic pregnancy and 13 with corpus luteum cyst. Ectopic pregnancies had thicker walls as compared to corpus luteum cysts. Most of the ectopic pregnancies had hyperechoic walls as compared to ovaries (63.6%) and endometrium (60.6%). Free fluid with echoes was seen in the pelvis in 59.4% ectopic pregnancies whereas most of the corpus luteum cysts (69.2%) had no free fluid. Most of the corpus luteum cysts (61.5%) had clear internal echotexture whereas ectopic pregnancies were mostly lacy or solid. Yolk sac was seen exclusively in ectopic pregnancy (30.3%). RI 0.7 was found to be highly specific for diagnosing ectopic pregnancy. Conclusion: Significant ultrasound parameters that aid in differentiating between the two include the thickness of the mass’s wall, the wall’s echogenicity in relation to the ovary and endometrium, the internal echotexture of the cystic mass, the presence of the yolk sac, and the presence of free fluid with echoes. It was shown that RI 0.7 has a very good specificity in identifying ectopic pregnancy.

The Application of Magnetic Resonance Imaging in the Early and Accurate Diagnosis of Hip Joint Avascular Necrosis.

Introduction Avascular necrosis (AVN) is characterized by the death (necrosis) of cellular bone components in the subchondral bone or epiphysis due to a lack of or an interruption of the blood supply. In routine practice, AVN is most frequently encountered in the femoral head. In this study, we aim to evaluate the application of magnetic resonance imaging (MRI) in the early and accurate diagnosis of hip joint AVN. Materials and methods This was a retrospective, cross-sectional study conducted in the Department of Radiodiagnosis of Dr. D. Y. Patil tertiary care hospital, Pimpri, Pune, India. We studied 30 patients with complaints of pain and associated limping who underwent primary radiograph analysis of the hip joint, followed by MRI. Results We assessed 30 patients (45 hip joints) using plain radiography and MRI. Of the 45 hips, we could diagnose AVN in 28 hips (62.2%) using plain radiography, but we could not diagnose it in 17 hips (37.8%), whereas we were able to diagnose AVN in all hips (100%) using MRI. Forty percent of the patients (n = 12) were on steroids, 26.7%(n = 8) were chronic alcoholics, and 16.7% (n = 5) were idiopathic. The other less common causes were a history of trauma or fracture of the neck of the femur (n = 3) and sickle cell disease (n = 2).Of the 45 hips of the 30 patients studied, 15 patients had bilateral disease affecting a total of 30 hips (66.7%), and 15 patients had unilateral disease affecting a total of 15 hips (33.4%). Of the 30 hips (bilateral disease), five (13.3%) contralateral hips were clinically occult and were incidentally diagnosed with AVN. Conclusion The assessment of AVN based solely on plain radiography can miss vital information in stages II and III (Ficat and Arlet classification). Due to its multiplanar capability, superior spatial resolution, and better tissue characterization, MRI is very sensitive and able to detect femoral head AVN early and promptly in cases that are radiograph-negative or otherwise clinically unsuspected.

Assessing Placental Shear Wave Elastography as a Tool for Evaluating Preeclampsia.

Background Hypertensive disorders of pregnancy, especially its dreaded complication preeclampsia, remain a major cause of morbidity and mortality for both the mother and the fetus. Existing tools for the prediction of preeclampsia remain inadequate in their sensitivity and specificity. Hence, there is an urgent need for a reliable, economically feasible, and objective marker for its diagnosis/early prediction. In this regard, shear wave elastography has shown great promise. Shear wave elastography is a novel method to quantify tissue stiffness, which is objective and has significantly lower inter-observer variability. Objectives We aim to quantify the tissue elasticity using point shear wave elastography (pSWE) in the placentas of diagnosed cases of preeclampsia and to compare them with the placentas of healthy controls in order to evaluate if there is a significant statistical difference between the two. Materials and methods This comparative study was conducted at the Department of Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, India, from August 2022 to July 2024. The study included 60 participants, divided into two groups: 30 patients with preeclampsia and 30 healthy pregnancies. Placental stiffness was measured using a Samsung HS70A ultrasound machine (Samsung Electronics Pvt. Ltd., Seoul, South Korea), and pSWE was performed with a curvilinear probe. Data was analyzed using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States), and the significance of differences between the two groups was assessed using an independent t-test with a p-value of <0.05, considered statistically significant. Results The mean placental stiffness, measured in kilopascals (kPa), was significantly higher in the preeclampsia group (11.71 ± 1.52 kPa) in comparison to the healthy group (3.36 ± 0.66 kPa) (p = 0.001). Patients suffering from preeclampsia were found to have significantly higher levels of placental stiffness. Conclusion Early diagnosis remains key to managing preeclampsia so that adequate monitoring and treatment could be provided to the patients. Our study showed that there is a significant statistical difference in the placental stiffness in patients with preeclampsia in comparison to a healthy placenta. Hence, shear wave elastography can be used as a supplementary tool to aid in the diagnosis/prediction of preeclampsia.

Diffusion-weighted Imaging: New Paradigm in Diagnosis of Early Acute Pancreatitis.

Diffusion-weighted imaging (DWI) has come up as a newer diagnostic modality for the diagnosis of early functional changes in various organs including the pancreas. DWI has shown the ability of early and accurate diagnosis of inflammatory pathologies, before the appearance of morphological changes on imaging. The objectives of this study were to study the diagnostic accuracy of DWI in the diagnosis of early acute interstitial pancreatitis. The present retrospective observational study was conducted at the department of radiodiagnosis of a tertiary teaching hospital for 1 year. Fifty patients who underwent magnetic resonance imaging of the pancreas with clinical or laboratory diagnosis of early pancreatitis were included in the study. The diagnostic accuracy of DWI was analyzed on the basis of quantitative (apparent diffusion coefficient [ADC] values) evaluation in the diagnosis of early acute pancreatitis. Threshold values for ADC were derived for differentiation of inflamed versus normal pancreas. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) were obtained by drawing the receiver operating characteristic (ROC) curve. The mean ADC values in the patient group (0.882 × 10 -3 mm 2 /s ± 0.102) were significantly lower than the control group (1.178 × 10 -3 mm 2 /s ± 0.232) with P < 0.001. The ROC curve deciphered a cutoff value of 0.937 × 10 -3 mm 2 /s with a sensitivity of 84%, specificity of 86%, PPV of 85.71%, and NPV of 84.31% for diagnosis of acute pancreatitis using quantitative ADC values. DWI can thus be a succinct modality for early diagnosis of pancreatitis with excellent diagnostic accuracy and superlative advantage of lack of contrast and radiation in comparison to computed tomography scan.

Deciphering nasal septum deviation: Computed tomography insights into age and gender trends for optimized clinical care

Background: Deviation of the nasal septum (DNS) is defined as any deviation of the septum from the midline and is one of the most common variations of the sinonasal anatomy. Aims and Objectives: The purpose of this study was to observe the prevalence of DNS and its relation with age, gender, and sidedness. Materials and Methods: Sinonasal computed tomographic images of 100 subjects obtained from the Department of Radiodiagnosis, King George’s Medical University, Lucknow, UP, in the period August 2013–July 2014 were analyzed to determine the prevalence of DNS and its relation with age, gender, and sidedness. Results: Of a total of 100 subjects, normal midline nasal septum was seen in 27 subjects whereas 73 subjects (73%) displayed a deviation in its position. The prevalence of nasal septal deviation (NSD) was significantly higher in females (84.21%) as compared to males (66.13%) (P=0.048). We also compared the prevalence of NSD in different age groups and found it to be higher in subjects aged &gt;46 years (83.33%) as compared to other age groups but this difference was not found to be statistically significant (P=0.619). Conclusion: Nasal septu the septum toward the right. No correlation between age intervals and prevalence of DNS was found.

A Study of the Role of Magnetic Resonance Imaging in the Evaluation of T2-Weighted Hyperintensities in Spinal Cord in a Tertiary Care Hospital in Central India.

Background T2-weighted hyperintensities in the spinal cord are crucial markers for diagnosing a range of spinal cord pathologies. This study explores the prevalence, causes, and implications of these hyperintensities in patients with spinal cord injuries at a tertiary care hospital in Central India. The research aims to assess the utility of MRI in detecting T2-weighted hyperintensities in the spinal cord and to analyze the associated clinical and radiological characteristics. Materials and methods A prospective observational study was conducted involving patients referred to the Department of Radiodiagnosis at Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi (Wardha), with suspected or confirmed spinal cord injuries. Advanced MRI techniques, including T2-weighted imaging, were used for the evaluation. The study analyzed demographic data, clinical features, and MRI findings to identify common causes and patterns of T2-weighted hyperintensities. Results The study revealed that T2-weighted hyperintensities were present in 54 (72%) MRI scans of patients with spinal cord pathologies at our tertiary care hospital in Central India. Among these, multiple sclerosis was the most frequent diagnosis, accounting for 27 (35%)cases. Traumatic spinal cord injuries were observed in 25% (n=19) of patients, while transverse myelitis was found in 15 (20%). The remaining 15 (20%) included a variety of other conditions, such as infections and tumors. The extent and distribution of T2-weighted hyperintensities varied significantly among different diagnoses, with multiple sclerosis and transverse myelitis demonstrating a more extensive involvement compared to trauma-related cases. Conclusion MRI is a valuable tool for diagnosing and understanding the underlying causes of spinal cord hyperintensities. The study highlights the need for targeted diagnostic and therapeutic approaches based on MRI findings to improve patient outcomes in spinal cord injuries.

The influence of body fat content and distribution on bone mass in healthy Chinese adults.

Previous studies have reported a close relationship between body mass index (BMI) and bone mineral density (BMD). However, the effects of fat on bone mass remain controversial, particularly for fat tissue distribution. The aim of this study was to evaluate the association between regional fat percentage and BMD using a population-based database. This study included participants who were referred to the Department of Radio Diagnosis for dual-energy X-ray absorptiometry (DEXA) scan from January 2018 to December 2020. The relationships between BMI and regional fat percentage with BMD were assessed using multiple linear regression and generalized additive models. The risk of low bone mass was determined using logistic regression. There was a negative relationship between the regional fat percentage and femoral neck BMD (FN BMD) or lumbar spine BMD (LS BMD) in both genders (p < 0.05). In females, an inverted U-shaped relationship was observed between regional fat percentage and BMD at both the femoral neck and lumbar spine. The impact of trunk fat percentage on LS BMD was associated with the highest OR of low bone mass in females (OR 3.1, 95% CI 2.6 to 3.7, p for trend <0.001), while the impact of abdomen fat percentage on FN BMD was associated with the highest OR of low bone mass in males (OR 2.2, 95% CI 1.8 to 2.7, p for trend <0.001). There was an inverted U-shaped relationship between regional fat percentage and BMD. Excessive regional fat percentage may be harmful to bone health in both genders. To promote bone health, males should restrict their abdomen circumference and avoid abdominal adiposity, while females should control their trunk circumference.

Evaluating the Prevalence and Clinical Significance of Fetal Posterior Cerebral Artery Variants via Magnetic Resonance Imaging: Insights From a Tertiary Healthcare Facility in Tamil Nadu.

Introduction The prevalence and clinical significance of fetal posterior cerebral artery (FPCA) variants are studied using magnetic resonance imaging (MRI) at Saveetha Medical College. This research focuses on the fetal origin of the posterior cerebral artery (PCA), a condition where the posterior communicating artery (PComA) is larger than the P1 segment of the PCA, affecting cerebral hemodynamics and associated with various cerebrovascular pathologies. Materials and methods This retrospective analysis employed MRI records from the Department of Radio Diagnosis at Saveetha Medical College, conducted between January 2013 and December2023. The study included patients undergoing MRI for various neurological indications, with specific imaging protocols including T1- and T2-weighted sequences, diffusion-weighted imaging, and magnetic resonance angiography (MRA). Results The study confirmed a prevalence rate of FPCA variants within the expected range of 20%-30%. MRI findings were systematically analyzed by experienced radiologists to assess the presence and characteristics of FPCA variants. The relationship between these variants and clinical symptoms was explored, revealing significant correlations that emphasize the variants' impact on patient outcomes, particularly in the context of cerebrovascular events. Conclusion The study underlines the importance of recognizing FPCA variants due to their significant implications in neurovascular health and cerebrovascular accident (CVA) outcomes. These variants alter cerebral hemodynamics and can complicate neurosurgical and diagnostic procedures. Therefore, personalized treatment and management strategies are crucial for optimizing patient care.

Evaluation of Thyroid Nodule by US Including Elastography versus MRI T2W and Diffusion Sequences

Abstract Background The thyroid gland frequently develops thyroid nodules. Effective treatment of malignant thyroid nodules depends on an early and accurate diagnosis. Benign and malignant thyroid nodules are typically distinguished using conventional thyroid ultrasonography (US). In order to explore changes in tissue stiffness, strain elastography (SE) uses an external force and a deformation response detector. A promising method for distinguishing between benign and malignant thyroid nodules is ultrasound elastography. Malignant versus benign thyroid nodules might be distinguished using MRI apparent diffusion coefficient (ADC) values. This study compares MRI T2W and diffusion sequences with ultrasound, which includes elastography, to assess thyroid nodules. Methods This cross-sectional research was carried out at Ain-Shams University's radiodiagnosis department. It included 23 female or male patients with suspicious thyroid nodule by clinical examination, or ultrasonography including some cases elastography if present for further work up with MR diffusion subjected to DWI and ADC value and results were compared with histopathology if present or follow up of the patients. The duration of the study was 24 months. Results Diffusion had an accuracy of 91.3%, while the ADC value and elastography had a greater diagnostic accuracy with an area under the curve of 95.7% in discriminating between benign and malignant cases. Conclusions When describing thyroid nodules, ADC value provided better diagnostic performance than US TIRADS rating. Over and above ACR-TIRADS classification, useful information is added by ultrasound elastography and strain ratio analysis of thyroid nodules. It is advised as an auxiliary tool. However, the distinction of cancerous and benign thyroid nodules might potentially be done with greater precision using diffusion weighted MRI.

Evaluation of the Diagnostic Accuracy of a Computed Tomography-Based Scoring System in the Differentiation between Malignant and Benign Pleural Effusion

Abstract Background Pleural effusion in particular is considered a sign of an underlying pathology, so ti is necessary ot search for the cause and determine whether it is a benign cause or a malignant one as they differ in treatment and prognosis. Aim of the Work To assess the accuracy of contrast-enhanced CT chest to predict the nature of pleural effusion whether benign or malignant using the CT-based scoring system developed by Porcel et al.'(1) Patients and Methods This study was a retrospective study that involved reviewing the contrast-enhanced CT chest done at the radiodiagnosis department in Ain Shams University Hospitals of 30 adult patients (age &amp;gt;18 years old) withunilateral or bilateral pleural effusion, and scoring ti according to hte Porcel et al (" CT scoring system while being blinded to the final diagnosis. The total score was then compared to the biopsy or cytology of the patient to determine its accuracy. Results Analyzing the data showed that the highly significant item of the scoring system denoting malignancy was pleural lesion followed by lung masses, liver metastasis, abdominal masses, and absence of pericardial effusion. The cutoff value in our study was found to be total score &amp;gt;7 denoting malignancy with a sensitivity of 94.12%, a specificity of 100%, a PPV (positive predictive value) of 100, a NPV (negative predictive value) of 92.2 and AUC (area under curve) = 0.986. On the other hand, the cutoff value of the study done by Porcel et al ( (27 denotes malignancy) gave a sensitivity of 94.1%, a specificity of 92.3%,a PPV of 94.12, a NPV of 92.31, and an accuracy of 93.33% in our study while in their study gave a sensitivity of 88%, aspecificity of 94%, and AUC = 0.919. Conclusion This is a simple chest CT scan scoring system, which includes the evaluation of pleural nodularity or thickening, liver metastases, abdominal masses, lung nodules or masses, pleural loculations, pericardial effusions, and cardiomegaly. It can be used as a reliable tool that helps determine the differential diagnosis ofpleural effusion yet does not replace cytology/biopsy. Further studies assessing this C T scan score are recommended.

Role of MRI in Patellofemoral Pain Syndrome (Anterior Knee Pain)

Abstract Background MRI is a good diagnostic tool in identifying cartilage and soft tissue lesions as well as detecting underlying predisposing anatomical factors of patellar instability, it has a high specification for detecting the grades and the types of some of these diseases or factors that may predispose to them such as trochlear dysplasia and patella alta. Aim of the Work The aim of this study was to evaluate the role of MRI in diagnosis of Patellofemoralpain syndrome which is the most common cause of anterior knee pain. Patients and Methods This prospective study was done on patients referred from the orthopedic clinic to the department of radiodiagnosis, MRI unit at Ain Shams University hospitals.Thirty patients were included (18 females and 12 males) and their age ranged from 20 to 64 years. Conclusion This study shows that MRI is useful in detecting various predisposing anatomical factors of patellofemoral instability and associated lesions of knee joint thereby enabling orthopedic surgeons to treat joint pathology as well as correct underlying anatomical abnormality.

Chest CT Features of Coronavirus Disease-19 (COVID-19) Pneumonia: Which Findings on Initial CT can Predict an Adverse Short-term Outcome?

Abstract Background COVID-19 is a highly contagious viral disease that caused daunting challenges to the health care system; early diagnosis plays a pivotal role in management and prognosis of the disease. Aim of the Work To study the spectrum of chest CT features in coronavirus disease-19 (COVID- 19) pneumonia and to identify the initial CT findings that may have the potential to predict a poor short-term outcome. Patients and Methods This was a retrospective study that included 60 patients (30 clinically improved and 30 clinically deteriorated patients) with RT-PCR confirmed COVID-19 infection who referred to the Radiodiagnosis Department at Ain Shams University Hospitals for chest HRCT examination. An acceptance from the ethical committee of the Radiology Department and the ethical committee of Faculty of Medicine - Ain Shams University was obtained to use the data stored on PACs system with the patient’s consent waived being a retrospective study. Results Shortness of breath, fatigue and presence of other comorbidities were more common in unstable group, seen in 93%, 86% and 66% respectively. CT severity score was higher in unstable group ranging from 12 to 26 together with anteroposterior distribution, central and peripheral distribution, crazy paving and consolidation with air bronchogram. Conclusion Comparison between clinically stable and unstable COVID-19 patients regarding clinical data at admission and initial CT chest findings revealed that higher percentage of total lung affection, central and peripheral involvement, anteroposterior distribution, crazy paving, consolidation with air bronchogram and vessel enlargement were the harbingers of poor prognosis especially in patients of old age, having other comorbidities and presented with shortness of breath.

Predicting the Prognosis of Acute Pulmonary Embolism Using Computed Tomography Pulmonary Angiography Measurable Parameters in Comparison to Pulmonary Embolism Severity Index (PESI)

Abstract Background Pulmonary embolism is a leading cause of cardiovascular death and with CTPA being the gold standard in its diagnosis, it is feasible with radiologic parameters to stratify and early identify patients at risk of death. Aim of the Work To detect the prognostic value of radiologic parameters of CT pulmonary angiography (CTPA) in comparison to pulmonary embolism severity index (PESI). Patients and Methods This was a prospective study done at Ain Shams University Hospitals and included 84 patients diagnosed with acute pulmonary embolism and referred to the radio-diagnosis department for CT pulmonary angiography examination. Results 3.6% of patients died within 24 hours and 44% died within 30 days of diagnosis of PE. All patients who died within 30 days had abnormal CTPA findings especially RV/LV ratio, PT diameter, septal bowing and contrast reflux in the IVC which revealed significant relationship between them and 30-day-mortality. Meanwhile PESI showed contradictory results and was less reliable than the radiologic parameters. Conclusion The CTPA radiological parameters appeared valuable for the prediction of 30-day mortality in patients with acute PE, and was superior to the PESI.

Comparative Evaluation of USG-Guided Single Tissue Marker Versus Multiple Tissue Marker Placements in Breast Malignancy Patients Undergoing Neoadjuvant Chemotherapy for Tumor Localization.

Background Breast cancer remains one of the most common malignancies affecting women globally, contributing significantly to the disease burden. The advent of neoadjuvant chemotherapy (NAC) has revolutionized the treatment for locally advanced breast cancer, allowing tumors to be downstaged and making breast-conserving surgery (BCS) feasible. Accurate localization of the tumor bed post-NAC is crucial for successful surgical removal of residual disease. While traditional single tissue marker placement has been effective, recent advances suggest multiple markers might provide superior localization by comprehensively delineating the entire tumor area. This study aims to compare the effectiveness of single versus multiple tissue marker placements in breast malignancy patients undergoing NAC. Materials and methods A prospective study was conducted in the Department of Radio-diagnosis at Saveetha Medical College over 18 months, including 10 patients diagnosed with breast carcinoma, selected through convenience sampling. Inclusion criteria involved patients diagnosed with breast cancer via mammography, sonography, and histological confirmation, referred for clip placement before NAC. Exclusion criteria were patients unwilling to participate. The procedure involved placing one to two surgical clips within the tumor using a 14/16-gauge coaxial guiding needle under USGguidance, with additional clips for larger or multiple tumors. Data collection included pre-procedural USG, post-procedural mammography (MG1), pre-operative mammography (MG2)/USG, and gross specimen histopathological examination/specimen mammography. Statistical analysis Demographic data, clipping distribution, receptor status, localization methods, surgical outcomes, operation diagnoses, and correlation analysis were statistically analyzed. Mean age, standard deviation, and p-values were calculated to determine the significance of differences between single and multiple clip groups. Results The study included 10 patients with a mean age of 52.5 years. Of these, five (50%)had a single clip, and two (20%)had four clips. The average time from clipping to the second mammogram (MG2) was 106.3 days, and from clipping to operation was 111.0 days, with longer follow-up times for multiple clip patients. Six (60%) of the patients were estrogen receptor (ER) positive, and six (60%) were human epidermal growth factor receptor 2 (HER2) negative. Localization methods were similar between single and multiple clip groups. However, multiple clip patients tended to undergo more extensive surgeries like modified radical mastectomy (MRM). Imaging responses showed no preoperative ultrasound lesions in single clip patients, while multiple clip patients had higher inconsistent diagnoses (10 (100%)) suggesting that multiple clips provide better tumor localization but are linked to increased complexity and longer follow-up times. Conclusion Patients with multiple clips experienced significantly longer follow-up times, reflecting more complex clinical scenarios. Despite no significant differences in receptor status distributions, multiple clip patients required more extensive surgeries, emphasizing the need for tailored surgical planning. The study underscores the importance of considering the number of clips in clinical decision-making. Future research should focus on larger, prospective studies to validate these findings and explore underlying mechanisms.

EVALUATION OF HEPATIC MASS LESIONS BY DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING

Objectives: The purpose of this study was to compare apparent diffusion coefficient (ADC) values for benign and malignant neoplastic hepatic lesions and also for suspected infective hepatic masses in which histopathology may always not be indicated. Methods: This is a cross-sectional study conducted in the department of radio diagnosis and imaging, army hospital research and referral, Delhi Cantt. All the patients coming for magnetic resonance imaging (MRI) scans for focal liver lesions detected on other imaging modalities were included. The imaging was done at the 1.5 Tesla MAGNETOM AVANTO A Tim system (Siemens Ltd.). Various parameters of the morphology of lesions in conventional MRI and parameters in diffusion-weighted MRI were evaluated. Results: A total of 75 patients were included in the study. The mean age of the subjects was 52.57±15.28 years, with a male: female sex ratio of 0.5:1. Among the 75 subjects, 20 subjects with hepatic cysts had no restrictions, and 12 patients with hemangioma were hyperintense on both diffusion-weighted imaging (DWI) and ADC. The mean differences between benign and malignant lesion ADC values. The difference was statistically significant (p&lt;0.001). In the present study, we get a cut-off for the ADC value of 1.581×10-3 mm2/s, which proved to be an optimal parameter for differentiation between benign and malignant lesions. Conclusion: DWI proved to be a very useful supplementary imaging technique in conjunction with conventional imaging sequences in the analysis of focal hepatic lesions and should be included in the imaging algorithm for such lesions.

Association of mammographic breast density measurements and hormone receptor status of breast cancer.

Breast cancer is the most frequent cancer in women, with significant mortality. Mammography is a routine investigation for breast disease. A known risk factor for breast cancer is increased breast density. Here, we tried to observe if mammographic density also affects the hormone receptor status of breast cancer, which will help in the understanding of the biological mechanisms of breast cancer development. Suspected breast cancer patients at Lok Nayak Hospital, Delhi, underwent mammography in the Department of Radiodiagnosis. The density of breast contralateral to the mass was assessed using Hologic Quantra software version 2.1.1 [Area Breast Density(ABD)]. The hormone receptor status of all the tumours was recorded on histopathology. Of these, 100 confirmed cases were included in the study. ER-positive, PR-positive, and HER2-positive tumours were seen in 41%, 33%, and 34% patients, respectively. Regarding ER receptor status, the mean ABD for positive and negative tumours was 27% and 23%, respectively, p-value = 0.01, showing significant relation between them. Mean ABD for HER2-positive and -negative tumours was 25% and 24%, respectively, p-value = 0.75. Mean ABD for PR-positive and PR-negative tumours was 23% and 25%, respectively, p-value = 0.42 (not significant). We found that ER-positive tumours were common in dense breasts, which was statistically significant. However, this was not true for PR and HER2 receptor status. Limited studies have been done to study MD using computerised software and its effect on hormone receptor status, with conflicting results. Further, large, multicentric studies can be useful in understanding the mechanism and providing better treatment for breast cancer patients.

REPEAT RADIOGRAPHY ANALYSIS AND CORRECTIVE MEASURES IN A PRIVATE MEDICAL COLLEGE AND TEACHING HOSPITAL

Aims and objectives: The primary goal of this study is to identify the body parts that undergorepeated radiographic examinations the most frequently and the prevalent causes of these examinations. Materials and Methods: A prospective study was carried out in the Department of Radio-Diagnosis and Imaging to investigate the reasons behind repeated radiography in a private university hospital in India. A total of 6832 samples were evaluated between November 1, 2021, and April 30, 2022. Discussion: Repetition of a patients radiographic projection can be caused by several circumstances. The common factors found in this study are collimation error, wrong centering, patient motion and incorrect positioning, appearance of artifacts owing to insufficient patient preparation at times and patient non-cooperation like patient motion. Repeat radiographs using the computed radiography technology are influenced by a plethora of circumstances. These variables include technical parameters chosen,the patients Body Mass Index (BMI)and the patients level of preparation. Conclusion: Repeat radiography plays an important role as a key indicator in evaluating the quality of the service provided by the medical imaging department and gives us an insight on whether the dose rates are within the given guidelines or not.

Role of Mri in Characterization of Congenital Malformations of Brain in A Tertiary Care Centre-A Retrospective Study

Background: Congenital brain anomalies are rare among the congenital anomalies of various organ systems. It is crucial to recognise these disorders as soon as possible because of the extensive neurological deficiency and negative consequences they can cause. Neuroimaging is a reliable way to accurately diagnose the majority of congenital brain abnormalities. There aren't enough statistics available in developing countries like India about the frequency and types of brain abnormalities. The purpose of this study is to examine the prevalence and range of frequently occurring congenital brain abnormalities. Objective: To study the whole spectrum of all substantial and frequently occurring congenital abnormalities as well as the proportional distribution of the various brain malformations in a tertiary care centre. Methods and materials: The study was conducted at Department of Radio-Diagnosis, Medical College Kolkata from 1st September 2022 to 31st August 2023. All MRI brain examinations at our hospital over a period of one year were retrospectively reviewed and analysed by sex, age at presentation, type of congenital cerebral malformation, and other associated congenital cerebral malformations. Results: This study included 24 patients. The total number of brain malformations identified in these patients was 33. The age of patients at first MRI imaging ranged from 5 days to 16 years. There were 14 males and 10 females. The most common malformations were corpus callosum dysgenesis (24%), Heterotropia (15%) and Lissencephaly (12%). Seven patients (29.1%) had more than one congenital brain malformation. Conclusion: The variety and complexity of congenital brain abnormalities is remarkable. The correct diagnosis is essential for the best care of these unfortunate conditions, and MRI plays a significant role in this process. Identification of distinctive neuroimaging findings of various congenital brain anomalies are immensely helpful in diagnosing the anomalies and further management.

Evaluating the Efficacy of Volume Isotropic Turbo Spin Echo Acquisition Versus T2-Weighted Turbo Spin Echo Imaging in the Diagnosis of Nerve Root and Perineuronal Pathologies in Spinal Disorders.

Background While two-dimensional (2D) turbo spin echo (TSE) sequences offer better through-plane resolution than three-dimensional (3D) isotropic TSE sequences images, with a narrower thickness of the slice, 3D isotropic TSE sequences are known to have a weaker in-plane resolution as well as blurring of the image. These elements may make it more difficult to distinguish between nearby structures that may affect nerve roots and small nerve roots during spinal imaging. This study aimedto analyze the accuracy of T2 TSE sequence and volumetric isotropic TSE acquisition in determining the indentation of nerve roots and perineural diseases such as nerve sheath tumors and Tarlov cysts. Methods Fifty patients who attended the Department of Radiodiagnosis for magnetic resonance (MR) spine participated in this prospective study. Routine MR lumbosacral (LS) spine sequences, such as survey, coronal T2short-tau inversion recovery (STIR), sagittal T2 TSE, sagittal T1 TSE, and axial T2 TSE, were carried out after a localizer was acquired. More sequences from volume isotropic turbo spin echo acquisition (VISTA) were acquired. For both 2D and 3D sequences, the visibility ratings for perineural cysts, spinal canal stenosis, and nerve root indentation were evaluated. Visibility ratings ranged from zero to four. Results In the cases of perineural cyst, spinal canal stenosis, and nerve root impingement, the mean difference between the VISTA and T2 TSE visibility scores was 0.04, 0.54, and 0.56, respectively. The VISTA and T2 TS had standard deviation differences of 0.006, 0.026, and 0.06, respectively. The "t" values for nerve root impingement, spinal canal stenosis, and perineural cysts were, in order, 50, 180, and 70. Because the p-value was <0.01, a statistically significant variation has been observed. Conclusion In the diagnosis of neural and perineuronal disorders, the visibility scores for 3D T2 TSE (VISTA) were considerably better than those for 2D T2 TSE in identifying perineural cysts, spinal canal stenosis, and nerve root indentation.