International Journal of Radiology and Diagnostic Imaging

Journal Information
ISSN / EISSN : 2664-4436 / 2664-4444
Published by: Comprehensive Publications (10.33545)
Total articles ≅ 244
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Nagulapally Sandeep, Gudipati Ananta Ram
International Journal of Radiology and Diagnostic Imaging, Volume 5, pp 18-27; https://doi.org/10.33545/26644436.2022.v5.i1a.250

Abstract:
Cochlear implantation is a prudent method of rehabilitation in severe sensorineural hearing loss where other means like hearing aids fail. Not everybody with severe sensorineural hearing loss benefits from implantation, in fact is contraindicated in some. A thorough pre-surgical imaging evaluation of inner ear, temporal bone and cerebral parenchyma is important in decision making, more so as the implants and costs involved are quite expensive. Limited studies exist in the Indian setting. Aim was to evaluate the role of combined computed tomography (CT) and Magnetic Resonance imaging (MRI) in pre operative imaging assessment for cochlear implantation, a prospective study was concluded at the Department of Radiodiagnosis over 30 months (2017 to 2019). Patients with severe hearing loss underwent HRCT temporal bone on 128 slice MDCT and MRI with BFFE, T2/Flair etc. Sequences targeting inner ear, cochlear nerve and brain on 3 Tesla scanner. Data was entered in MS EXCEL and analyzed in SPSS software using cross tabulations or correlation coefficient to compare the two imaging modalities. Chi square and P values were obtained for the cross tabulation data of comparison of CT and MRI in assessment of inner ear structures. The study focused on cochleovestibular malformations, patency of the cochlea-vestibule, cochlear nerve status on MRI and to see if there was any correlation with the bony cochlear nerve canal diameter on CT, isolated or associated brain parenchymal abnormalities and important surgical access criteria like normal variants and altered middle ear anatomy. Abnormal imaging findings were seen in 15 of 32 patients, on the basis of which 5 were rejected for implantation; suboptimal results were predicted in 5 other abnormal cases. Side selection and predicting ease of electrode insertion could also be ascertained in unilateral pathologies. Seventeen cases had normal imaging, twelve of which were operated. Eleven of these had uneventful surgery. All three cases with abnormal imaging, taken for surgery under varied risk of suboptimal results had mild and manageable intraoperative complications. Tailored protocol of MRI with BFFE, T2/FLAIR axials and HRCT temporal bone is an indispensable tool and radiologist plays key role in candidate selection and exclusion, surgical planning and warning surgeon about potential intraoperative complications in cochlear implant surgery.
Dixit Varma, Nirupam Konwar Baishya
International Journal of Radiology and Diagnostic Imaging, Volume 5, pp 09-11; https://doi.org/10.33545/26644436.2022.v5.i1a.248

Abstract:
Although adrenal tumours are very common, majority of them are benign lesions. Adrenocortical carcinoma is a rare endocrine malignancy and carries a poor prognosis. They are often unilateral and detected in older age groups. This report describes a case of bilateral adrenal cortical carcinoma in a 30 -year-old male who presented with cervical lymphadenopathy that demonstrated malignant cells on Fine needle aspiration (FNA) cytology. Ultrasound and CECT examinations of the abdomen detected bilateral adrenal tumours. Imaging characteristics were correlated with CT guided FNA of the lesion and diagnosed as adrenocortical carcinoma. This case highlights the importance of considering malignant adrenal aetiology in bilateral adrenal masses as such cases are rare in literature.
Manoj MC, Prabhu Cs, Lokesh T
International Journal of Radiology and Diagnostic Imaging, Volume 4, pp 55-59; https://doi.org/10.33545/26644436.2021.v4.i4a.241

Abstract:
Background: Classification of retroperitoneal masses due to its specific masses aid in their accurate diagnosis and management. Evaluation of retroperitoneal masses are challenging due to overlapping imaging findings. Among the several imaging modalities, researchers have considered ultrasonography (USG) and multidetector computed tomography (MDCT) as the imaging modalities of choice. The use of USG over MDCT was preferred in a rural population due to high cost and ionizing radiations of MDCT. Aim and Objective: To evaluate the utility of USG and MDCT to identify and categorize retroperitoneal masses and to correlate the USG findings with that of MDCT. Materials and Method: Seventy-two patients with signs and symptoms of retroperitoneal masses were evaluated by both USG and MDCT. Ultrasound characteristics like size, appearance, echotexture, vascularity and other findings were studied. The findings were then compared with the findings of MDCT. Subjects were evaluated for study variables from USG and CT which were presented as percentages. Based on percentages, the accuracy was calculated. Results: Of the 72 patients included in the study, USG had accuracy of 76.4% in the identification and characterization of the retroperitoneal masses as compared to that of MDCT. Conclusion: Ultrasound can be considered as the primary tool for evaluating retroperitoneal lesions and MDCT for confirmation and for evaluating the complete extent of the lesions.
Sahar Basim Ahmed Fareed, Narmein Abdsattar Mahmmud, Wasan M Saeed Abdulhakeem
International Journal of Radiology and Diagnostic Imaging, Volume 4, pp 74-79; https://doi.org/10.33545/26644436.2021.v4.i4a.245

Abstract:
Background: Diffusion-weighted MRI is a fast, unenhanced modality that shows promise in identifying mammographically occult malignancy and warrants further investigation as an alternative supplemental breast cancer screening tool.Aim of study: To estimate the diagnostic accuracy of diffusion wighted imaging and apparent diffusion coeffient (ADC) value in the differentiation between benign and malignant breast lesions, and to obtain a cutoff ADC value between benign and malignant breast lesions along with histopathological correlation. Materials and Methods: A prospective study of 56 patients with present with breast mass who examined at 1.5 tesla MRI & proved by histopathology. ADC value were a quired at b values of 0, 600, 850 s/mm² after identification of ROI (Region of interest) placement. ADC value with histopathology correlation was analyzed. Results: From total 56 lesions, 24 lesions were histologically malignant and 32 were histologically benign. With an ADC cut‑off value of 1.31 × 10−3 mm2/s for malignant lesions, a sensitivity of 100% and specificity of 72.1% was obtained. The false‑postive lesions were one intraductal papilloma & 3 abcesses in which a low ADC value was obtained. Purely DCIS (Ductal carcinoma in situ) lesions presenting as non‑mass‑like enhancement had a high ADC value of 1.2‑1.3 × 10−3 mm2/s, thereby decreasing specificity. Conclusion: Diffusion‑weighted Imaging is a functionl quantitative assessment by ADC value, may act as an efficient tool in increasing the diagnostic accuracy and specificity of breast MRI in the characterization of different breast lesions.
Sachin Khanduri, Asif Khan, Harleen Chawla, Ashish Kumar, Surbhi, Vaibhav Pathak
International Journal of Radiology and Diagnostic Imaging, Volume 4, pp 64-67; https://doi.org/10.33545/26644436.2021.v4.i4a.243

Abstract:
A duplex collecting system also known as duplicated collecting system in some literatures, is one of the most common congenital renal tract abnormalities to be found incidentally during evaluation of the person for some other complaints. It shows an incomplete fusion of upper and lower pole moieties which may cause a variety of complete or incomplete duplication defects of urinary collecting system [1]. While considered an anatomical variant we need to keep in mind that these duplex collecting systems may be associated with various complications like vesicoureteric reflux, obstruction or ureterocele. In this study, we are going to discuss a case of a young boy who presented with urinary difficulty, on haematological evaluation it showed renal infection . On further radiological evaluation, patient was found to have duplication collection system.
Jc Naidu, N Kiran Raju, Dssk Raju, Venkata Kiranmai Gottapu
International Journal of Radiology and Diagnostic Imaging, Volume 4, pp 43-46; https://doi.org/10.33545/26644436.2021.v4.i4a.238

Abstract:
Background: AUB (Abnormal Uterine Bleeding) is any bleeding outside normal frequency, regularity, duration, and volume. Abnormal bleeding in menstruation is depicted using terms such as oligomenorrhea, Polymenorrhea, Metorrhagia, and menorrhagia.Objectives: The present clinical study was conducted to assess the efficacy of histopathological findings and TVS/TAS in subjects with AUB.Methods: In the present prospective clinical study, 102 subjects within the age of 21-85 years with abnormal uterine bleeding. All subjects underwent hysteroscopy and premenstrual dilatation and curettage despite sonography findings and baseline investigations. The obtained endometrial tissue was assessed via histopathological examination.Result: Cervical carcinoma, Endometrial carcinoma, Cervical polyp, Endometrial polyp, Adenomyosis, and Myoma as seen in 3.92% (n = 4), 12.74% (n = 13), 2.94% (n = 3), 32.35% (n = 33), 51.96% (n = 53), and 54.90% (n = 56) study subjects respectively. Tissue findings in the study were assessed as Cervical Carcinoma, Endometrial Carcinoma, Endometrial polyp, Endometritis, Atrophic endometrium, Mixed, Secretary, Proliferative phase, Endometrial hyperplasia, and normal epithelium was seen in 1.96% (n = 2), 10.78% (n = 11), 5.88% (n = 6), 0.98% (n = 1), 2.94% (n = 3), 3.92% (n = 4), 15.68% (n = 16), 11.76% (n = 12), 25.49% (n = 26), and 20.58% (n = 21) subjects respectively.Conclusion: The present study concludes that transvaginal/transabdominal ultrasounds are an economical and primary assessment tool for screening of AUB, and must be included in routine assessment and examination. Although, the diagnosis and management of AUB are confusing among non-gravid females, however, histopathologic assessment is the gold standard in such cases.
Mohammed Abdul Azhar
International Journal of Radiology and Diagnostic Imaging, Volume 4, pp 68-73; https://doi.org/10.33545/26644436.2021.v4.i4a.244

Abstract:
Background and Objectives: The science of Diagnostic ultrasound is perhaps the most promising of the imaging modalities currently available. The main objective of this study is to establish the efficacy of ultrasonography to detect various hepatobiliary lesions and provide necessary information, aiding in their appropriate management. Methods: This study, carried over a period of two years, included 150 patients with various hepatobiliary lesions. There were patients of both sexes and their ages were above 5 years and below 85 years. After the routine blood and urine investigations and liver function tests, the patients were subjected to ultrasound examination. Results: One fifty cases, aged between 5 and 85 years, with various hepatobiliary lesions were studied with real time ultrasonography. The most frequently encountered Gall bladder lesion was Gallstones (44) with associated chronic cholecystits in 32 cases, acute cholecystitis in 10 cases, Gall bladder carcinoma in 2 cases. There were 3 cases of GB polyp, 2 case of chronic cholecystitis, 1 case of CA Gallbladder which were not associated with gall stones. Among the CBD lesions there were 2 cases of choledocholithiasis, 2 cases of cholangiocarcinoma and 1 case of choledochal cyst. The most frequently encountered focal liver lesion in this study was amoebic liver abscess which was found in 20 cases. The second most commonly encountered focal liver lesion was hepatocellular carcinoma which was found in 12 cases. 10 cases with hepatic metastasis were found. 4 cases with ultrasound features highly suggestive of haemangioma and 2 cases with hepatic hydatid disease were found. One case each of an intrahepatic haematoma and a simple liver cyst was found. Among the diffuse liver diseases, the most commonly encountered was fatty liver which was seen in 16 cases. The second most common diffuse liver disease was cirrhosis which was seen in 12 cases. 10 cases of acute hepatitis, 4 cases of chronic hepatitis and 3 cases of congestive liver was found. Conclusion: Ultrasound proved to be a sensitive, easily available and safe imaging modality for the diagnosis and follow-up of various hepatobiliary lesions and should therefore be the first line of investigation in suspected cases.
Jc Naidu, J Muraliswar Rao, Dssk Raju
International Journal of Radiology and Diagnostic Imaging, Volume 4, pp 47-50; https://doi.org/10.33545/26644436.2021.v4.i4a.239

Abstract:
Background: Benign lesions in the past were thought to be hyperechogenic lesions on ultrasonography. Recently, this conception has been changed where various malignant breast lesions were hyperechogenic on ultrasound and hyperechogenic lesions turned out to be malignant on histopathologic examination.Aim: The present retrospective clinical study was conducted to assess the clinical presentation, frequency, and related imaging finding of hyperechoic malignant breast lesions in cases with core needle biopsies guided ultrasonographically, and also, to assess ultrasonographic features that help in the prediction of the hyperechoic lesion to be malignant.Methods: In a total of 2255 subjects, an ultrasonographically guided core needle biopsy was done for 2168 subjects. The hyperechoic carcinomas were identified among all the assessed cases diagnosed by ultrasonography-guided core needle biopsy was calculated. For malignant lesions, imaging malignancy predictors were identified using 6 ultrasonography images comparison in malignant and high-risk cases. The sonographic findings assessed were orientation, vascularity, shape, posterior acoustic features, margins, and echogenicity. The results were formulated after the statistical evaluation.Results: A total of 2255 ultrasonographically guided core needle biopsy was done for 2168 subjects where 52.01% (n=1173) lesions were benign, 40.97% (n=924) were malignant, and 7% (n=158) were high risk. The study results have shown that in total 2255 lesions assessed, 0.57% (n=13) lesions were hyperechoic in 13 females after analyzing the image. In 924 malignant lesions 0.97% (n=9) lesions were hyperechoic. Circumscribed margins were seen in 62.5% (n=5) and non-circumscribed by 37,5% (n=3) study subjects with benign lesions, and by 100% (n=5) subjects with malignant lesions (p=0.007). For the shape of the lesions, more malignant lesions had irregular and lobular margins 100 (n=5) lesions, whereas, in benign lesions, 87.5 (n=7) had irregular/lobular margins (p=0.002). Conclusion: The present study concludes that hyperechoic breast lesions on ultrasonography have less prevalence of 0.57% (n=13) lesions in the present study. Hence, hyperechoic breast lesions are less encountered on sonography. However, whenever these hyperechoic lesions are seen, the probability of malignancy should not be excluded.
Hiral Desai, Dipti A Shah
International Journal of Radiology and Diagnostic Imaging, Volume 4, pp 01-05; https://doi.org/10.33545/26644436.2021.v4.i4a.232

Abstract:
Many disease, neoplastic, infective, inflammatory, autoimmune result in abdominal lymphadenopathy. Because there is a complex pattern of intercommunications between regional groups of lymph nodes, it is usual for lymphadenopathy to involve several contiguous or even widely separated nodule chains. The abdominal lymph nodes are empirically divided into groups:1.Retrocrural2.Retroperitoneal3.Porta hepatis4.Gastrohepatic ligament5.Celiac and superior meseneteric artery6.Preaortic and paraaortic7.Pancreaticoduodenal8.Perisplenic9.Periumbilical10.MesentericAims and Objectives1.To evaluate lymph nodes in different abdominal pathologies i.e. group of lymphnodes involved, morphology, size etc.2.To assess the size of lymph nodes in different abdominal pathologies.
Nobukata Kazawa, Kazuyoshi Ishii, Haruka Shimazu, Noboru Tanigawa, Bin Sawada
International Journal of Radiology and Diagnostic Imaging, Volume 4, pp 35-42; https://doi.org/10.33545/26644436.2021.v4.i4a.237

Abstract:
In a 71-year-old woman, 2 years and 10 months ago, several nodular shadows with calcification were pointed out in both lung fields on the chest X-ray (CXR). After 1 year and 3 months, abnormal shadows were increased in size on CXR, then, she visited our hospital for detailed examination and treatment. On computed tomography CT), several nodular shadows with partial calcification were observed in both lung fields. CT after 1 year and 1 month (6 months before), showed several circular to slightly lobulated mass ranging in diameter of 6-24 mm around the bronchovascular bundles of both lungs and the peri-lobular area such as subpleural peripheral zone and punctate to dendritic calcification also progressed compared to the previous CT. The thoracoscopic partial left lung resection revealed 2 relatively well-defined nodular lesions with a yellow to brown cut surface. Histologically, the deposition of amorphous eosinophilic substance was found around/in the bronchi and blood vessel's wall of the lesions with partial calcification and/or ossification. A diagnosis of AL-type amyloidosis was made by the immunohistochemical findings. Pulmonary amyloidosis is radiologically classified into (1) nodular, (2) tracheobronchial, and (3) lung parenchymal type (diffuse alveolar septal type) according to the deposition patterns. Dendrite irregular calcification, irregular contours, different sizes 0.5-5 cm mean diameter, are characteristic radiological finding of the pulmonary nodular amyloidosis, and it is important to know that it occasionally shows the significant growth simulating malignant diseases.
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