General radiography leaves enough clues for the ongoing diagnostic evaluation of the patient. The important clues can save a lot of time lost and other unnecessary investigations in the management of the patient illne...General radiography leaves enough clues for the ongoing diagnostic evaluation of the patient. The important clues can save a lot of time lost and other unnecessary investigations in the management of the patient illness. Sacrospinous ligament connects the sacrum with the pelvis. This in fact stabilizes the pelvis as it provides the support. This is important as this is helpful in supporting the vaginal vault in cases of prolapsed uterus in females. We report a 50-year-old male who had come for his intravenous pyelography for left ureteric calculus and was found to be having multiple other associated findings like osteophytosis, bilateral ilial horns and bilateral sacrospinous ligament calcifications. The clue was that of calcification and hardening of left sacrospinous ligament which has led to the formation of left side ureteric calculus. This ureteric calculus has caused great progressive damage to the left kidney by causing gross hydrouretero-nephrosis due to complete obstruction.展开更多
Purpose: To study the effect of escalating radiation dose;in intermediate and high risk prostate cancer patients;via online image-guidance on acute toxicities. Patients and Methods: thirty-eight prostate cancer patien...Purpose: To study the effect of escalating radiation dose;in intermediate and high risk prostate cancer patients;via online image-guidance on acute toxicities. Patients and Methods: thirty-eight prostate cancer patients were treated by using simultaneous integrated boost-intensity modulated radiation therapy (SIB-IMRT) with online image guided correction via kilo voltage cone beam computed tomography (KV-CBCT)/electronic portal imaging device (EPID) of trans-rectal ultrasound (TRUS)-inserted intraprostatic gold fiduciary markers. High-risk patients received a median dose of 80.5 Gy to prostate and 56 Gy to pelvic nodes in 35 fractions over 7 weeks. Intermediate-risk patients received a similar prostate dose over the same overall treatment time. Acute toxicity (bladder, rectal and bowel symptoms) was reported once weekly during the radiation course and up to 3 months from the end of the radiation course. Results: The image guided (IG)-IMRT allows escalating the radiation dose delivered to the prostate through minimizing the margin of setup error to less than 0.5 cm with subsequent sparing of nearby organs at risk. Out of thirty-eight patients, no patient developed >grade 1 acute rectal toxicity, 7.9% of patients experienced grade 3 urinary toxicity and there was no reported small intestinal toxicity. Conclusion: Escalating the radiation dose more than 80 Gy in intermediate and high risk prostate cancer patients was safe and not associated with grade 3 - 4 RTOG toxicity when guided by online verification of intra-prostatic fiducial markers.展开更多
Transitional cell carcinoma （TCC） of the ovary is a rare and recently recognized subtype of ovarian epithelial cancer. We presented the first case report from our Institute （Sheri Kashmir Instiute of Medical Scienc...Transitional cell carcinoma （TCC） of the ovary is a rare and recently recognized subtype of ovarian epithelial cancer. We presented the first case report from our Institute （Sheri Kashmir Instiute of Medical Sciences, Srinagar, India）, which was initially rnisdiagnosed as stromal cell carcinoma （granulosa cell tumour）, and on review of histopathology with immunohistochemistry, the diagnosis of TCC of the ovary was established. The aim of this article was to describe the typical case of primary TCC of the ovary and to review the literature for information on TCC management.展开更多
Objective:The aim of this study was to recognize and characterize the initial chest radiographic findings of H1N1 infection and to evaluate whether serial chest radiographs were useful in assessing the severity of inf...Objective:The aim of this study was to recognize and characterize the initial chest radiographic findings of H1N1 infection and to evaluate whether serial chest radiographs were useful in assessing the severity of infection and predicting the clinical outcome.Materials and methods:27 patients hospitalized for H1N1 infection,from January 2015 to May 2016 were retrospectively evaluated,including 17(62.9%)female patients and 10(37.1%)male patients,with age ranging between 2 days and 65 years.Radiographs obtained at the time of admission were reviewed and studied for characteristic imaging patterns,laterality(unilateral or bilateral)and zonal distribution of the opacities.Serial chest radiographs taken were reviewed to look for progression or resolution of the imaging findings and compared with the final outcome.Results:Of the female patients,4(23%)were pregnant and 1(6%)was in the immediate post-partum period.Of the 27 patients,25(92.6%)had abnormal and 2(7.4%)had normal radiological findings on initial chest radiographic appearance.One patient was lost to follow-up,16(62%)of the remaining 26 succumbed to the disease while the remaining 10(38%)improved.Three of the pregnant patients and the postpartum patient had adverse outcomes.Involvement of greater than 4 lung zones and bilateral involvement indicated a poor prognosis.Abnormal chest radiographic findings included consolidation,peribronchial cuffing,nodular opacities and reticulo-nodular opacities,with the most common being consolidation with or without peribronchial cuffing.Patients with more than 4 zones of involvement invariably had an adverse clinical outcome.Conclusion:Initial chest radiographic findings help in diagnosing the type of pneumonia,and consolidation associated with peribronchial cuffing is a common finding in viral pneumonia like H1N1.Prognosis based on evaluation and monitoring of serial chest radiographs is a valuable tool in predicting the final clinical outcome of the patient.Extensive involvement of both lungs,in the form of multi-zonal and bilateral lung opacities is frequently associated with adverse prognosis.展开更多
Dual-energy CT(DECT)is an advancement in CT technology that allows for the acquisition of images at two different energy levels.Two main post-processing tools,which form the backbone of DECT,include material decomposi...Dual-energy CT(DECT)is an advancement in CT technology that allows for the acquisition of images at two different energy levels.Two main post-processing tools,which form the backbone of DECT,include material decomposition and virtual monoenergetic images.Material decomposition helps in the generation of virtual nonenhanced,iodine,pulmonary lung blood volume,lung vessel,automated bone removal,and renal stone characterization images.DECT offers a broad spectrum of clinical applications in pediatric imaging,including vascular,neurological,thoracic,abdominal,skeletal,and oncologic assessments.Additionally,it contributes to shorter scan times and enables the use of lower contrast media volumes while maintaining diagnostic image quality.This technique provides unique qualitative and quantitative information about the composition of the tissue,allowing differentiation of materials,including iodinated contrast agents.The radiation dose of DECT is equivalent to or lower than that of a singleenergy CT,adding to the advantages of DECT,especially in children who are more sensitive to the harmful effects of radiation.In this minireview we outlined the basic principles of the DECT technique and its post-processing techniques with emphasis on clinical applications in pediatric imaging.展开更多
Introduction:Dengue fever(DF)is endemic in tropical and subtropical areas.Dengue hemorrhagic fever is life threatening,and early identification can help save lives.Ultrasonography(USG),though not diagnostic,can help i...Introduction:Dengue fever(DF)is endemic in tropical and subtropical areas.Dengue hemorrhagic fever is life threatening,and early identification can help save lives.Ultrasonography(USG),though not diagnostic,can help in early identification of serositis.Objective:To compare USG findings in seropositive pediatric and adult patients with DF.Materials and methods:110 in-patients with clinical suspicion of DF were evaluated with USG of the abdomen and thorax.USG findings correlated with serological tests.Seropositive patients were grouped into pediatric and adult age.Findings were compared to determine if any statistically significant difference exists.Results:67 Patients- seropositive,43 - seronegative.USG findings in seropositive pediatric patients(n=32)were GB wall edema-27,hepatomegaly in 12,ascites in 16,splenomegaly in 15,right pleural effusion in 14,left and bilateral pleural effusion in 7 patients.The USG findings in seropositive adult patients(n=35)were GB wall edema in 31,hepatomegaly in 14,ascites in 12,splenomegaly in 9,right pleural effusion in 13,left and bilateral pleural effusion in 5 patients.Conclusion:There is a statistically significant difference between ultrasound findings of dengue fever in adult and pediatric patients.Ascites and splenomegaly more were common in the pediatric patients as compared to the adult patients.展开更多
Objective:To identify and enumerate the radiological findings in lower lobe tuberculosis(TB)&occurrence frequency.Materials and methods:Study was conducted in the Department of Radiodiagnosis,S N Medical College,B...Objective:To identify and enumerate the radiological findings in lower lobe tuberculosis(TB)&occurrence frequency.Materials and methods:Study was conducted in the Department of Radiodiagnosis,S N Medical College,Bagalkot for 5 yrs from January 2013-December 2017.Data collection was prospective.60 consecutive cases of lower lung tuberculosis were identified.36(60%)were males.24 were females.57(95%)had respiratory symptoms in the form of cough and scantyexpectoration.Results:Main radiological presentation ware patchy opacities,in 27(45%)of patients,homogeneous consolidation in 21(35%)of patients,cavitation in 10(17.5%)of patients,nodular opacities in 7(12.5%).Conclusion:Radiographic findings in lower lung field TB differ significantly from upper lobe disease.Most frequent radiographic finding is consolidation,more confluent and extensive than that found in upper lobes TB.Cavitory lesions are also frequently seen,which may be single or multiple and may lie within an area of consolidation.展开更多
Rubella is a contagious viral infection commonly occurring in children and young adults.Pregnant women suffering from this infection may suffer severe consequences with disastrous effects on the developing fetus.The n...Rubella is a contagious viral infection commonly occurring in children and young adults.Pregnant women suffering from this infection may suffer severe consequences with disastrous effects on the developing fetus.The neonatal manifestations caused by antenatal transmission of maternal rubella infection are collectively called congenital rubella syndrome(CRS).We report a case of congenital rubella in a neonate presenting with respiratory distress.展开更多
Echinococcosis is a zoonotic disease. Liver is the most common site of involvement. Renal involvement is seen in 2% to 3% of patients. Computed tomography findings in renal hydatid typically include: a cyst with thick...Echinococcosis is a zoonotic disease. Liver is the most common site of involvement. Renal involvement is seen in 2% to 3% of patients. Computed tomography findings in renal hydatid typically include: a cyst with thick or calcified wall, unilocular cyst with detached membrane, a multiloculated cyst with mixed internal density and daughter cysts with lower density than maternal matrix. Rarely type Ⅳ hydatid cysts may mimic hypovascular renal cell carcinoma. We report a case of previously asymptomatic middle aged female who presented with mild intermittent pain and a complex renal lesion on imaging which was considered to be a hypovascular renal carcinoma or urothelial neoplasm. However, by serendipity, the patient had spontaneous hydatiduria and later was definitively diagnosed and stented. Hydatid disease should always be considered amongst the top differential diagnosis of an isolated "complex" renal lesion which remains indeterminate on imaging.展开更多
Bleeding per rectum in children can be seen in congenital as well as acquired conditions that may require medical or surgical management.The present review article is aimed to discuss the imaging findings of some comm...Bleeding per rectum in children can be seen in congenital as well as acquired conditions that may require medical or surgical management.The present review article is aimed to discuss the imaging findings of some common and uncommon causes of bleeding per rectum in children.展开更多
This is a MRI study of two patients presented with history of gelastic seizures since many years ago. Plain and post intravenous gadolinium multiplanar MRI imaging of the brain is performed. It showed well-defined non...This is a MRI study of two patients presented with history of gelastic seizures since many years ago. Plain and post intravenous gadolinium multiplanar MRI imaging of the brain is performed. It showed well-defined non-enhancing mass lesions in the region of hypothalamus and tuber cinereum. It showed signal intensity similar to the gray matter and imaging diagnosis of hypothalamic hamartoma is made.展开更多
The incidence of aneurysmal bone cyst in the maxillofacial region is rare and may remain undiagnosed for a long period prior to becoming symptomatic.This may cause associated issues secondary to compression by extendi...The incidence of aneurysmal bone cyst in the maxillofacial region is rare and may remain undiagnosed for a long period prior to becoming symptomatic.This may cause associated issues secondary to compression by extending to the surrounding vital anatomical areas.An aggressive course can lead to bony destruction with intracranial extension.We present a case of a 23-year-old man who presented with bilateral exorbitism with nasal obstruction.展开更多
Aim:Anterolateral thigh(ALT)flap is widely used in reconstruction of various defects.Preoperative imaging facilitates perforator mapping,overcoming intraoperative uncertainty.The purpose of this study was to investiga...Aim:Anterolateral thigh(ALT)flap is widely used in reconstruction of various defects.Preoperative imaging facilitates perforator mapping,overcoming intraoperative uncertainty.The purpose of this study was to investigate the utility of multi-detector row computed tomography angiography(MDCTA)and a handheld Doppler in locating ALT perforators.Methods:Twenty patients were randomized into two groups.Group 1 patients received MDCTA and Doppler studies whereas Group 2 received only a Doppler study.The number,location,course,and source of all cutaneous and sizable perforators were compared with intraoperative findings.Surgeons’stress levels during flap harvest and flap harvest time were compared.Results:MDCTA findings correlated well with intraoperative findings for perforator type and segmental distribution with 100%concordance.Doppler alone had a 52%rate of concordance.The sensitivity and specificity for MDCTA in demonstrating the presence of perforators were 85.71%and 97.22%,respectively;whereas for Doppler alone the sensitivity and specificity were 80%and 87.91%,respectively.In demonstrating perforator source,MDCTA showed a sensitivity of 100%and specificity of 91.66%,with 100%accuracy.Sensitivity and specificity for sizable perforators were 90%each,with 88.88%accuracy.Doppler studies were unable to provide this information.Comparison of surgeon stress levels showed no differences between the two groups,although the time for flap harvest was significantly shorter in Group 1.Conclusion:MDCTA compared to Doppler is more sensitive,specific,and accurate with respect to location,course,and source of perforators.展开更多
Purpose： Wrist has a complex anatomy and undergoes complex injuries, Scaphoid fracture is one of such injuries. It is the most common fracture in carpal bone. Most of the scaphoid fractures are missed on initial X-ra...Purpose： Wrist has a complex anatomy and undergoes complex injuries, Scaphoid fracture is one of such injuries. It is the most common fracture in carpal bone. Most of the scaphoid fractures are missed on initial X-rays. Magnetic resonance imaging （MRI） is considered as a gold standard for diagnosing scaphoid fractures. Ultrasonography （USG） is emerging as a good alternative to make an early diagnosis of scaphoid fractures. Our aim is to throw light upon the role of USG in detection of scaphoid flactures. Methods： The study was centered upon 114 patients in the age range 10-65 years, with traumatic wrist injury and were clinically suspected to have scaphoid fractures. Patient with non-traumatic history, bilateral wrist injury and late presentation were excluded. X-rays, USG using high frequency probe and MRI were done for all patients. MRI was considered to be the gold standard test. Patients were followed up at 6 weeks. Results： Of the 114 patients, X-ray could diagnose scaphoid fractures in 48 patients, 30 of which were confirmed by MRI. USG results were positive in 74 patients, of which MRI was positive in 67 patients. The accuracy of scaphoid fracture detection with USG was 98.04% in comparison to X-ray （20.58%）, which was statistically significant. Conclusion： USG provides a more accurate and reliable method of making an early diagnosis of scaphoid fracture than X-rays. It is non-invasive, non-expensive and allows better visualisation of cortical disruption.展开更多
文摘General radiography leaves enough clues for the ongoing diagnostic evaluation of the patient. The important clues can save a lot of time lost and other unnecessary investigations in the management of the patient illness. Sacrospinous ligament connects the sacrum with the pelvis. This in fact stabilizes the pelvis as it provides the support. This is important as this is helpful in supporting the vaginal vault in cases of prolapsed uterus in females. We report a 50-year-old male who had come for his intravenous pyelography for left ureteric calculus and was found to be having multiple other associated findings like osteophytosis, bilateral ilial horns and bilateral sacrospinous ligament calcifications. The clue was that of calcification and hardening of left sacrospinous ligament which has led to the formation of left side ureteric calculus. This ureteric calculus has caused great progressive damage to the left kidney by causing gross hydrouretero-nephrosis due to complete obstruction.
文摘Purpose: To study the effect of escalating radiation dose;in intermediate and high risk prostate cancer patients;via online image-guidance on acute toxicities. Patients and Methods: thirty-eight prostate cancer patients were treated by using simultaneous integrated boost-intensity modulated radiation therapy (SIB-IMRT) with online image guided correction via kilo voltage cone beam computed tomography (KV-CBCT)/electronic portal imaging device (EPID) of trans-rectal ultrasound (TRUS)-inserted intraprostatic gold fiduciary markers. High-risk patients received a median dose of 80.5 Gy to prostate and 56 Gy to pelvic nodes in 35 fractions over 7 weeks. Intermediate-risk patients received a similar prostate dose over the same overall treatment time. Acute toxicity (bladder, rectal and bowel symptoms) was reported once weekly during the radiation course and up to 3 months from the end of the radiation course. Results: The image guided (IG)-IMRT allows escalating the radiation dose delivered to the prostate through minimizing the margin of setup error to less than 0.5 cm with subsequent sparing of nearby organs at risk. Out of thirty-eight patients, no patient developed >grade 1 acute rectal toxicity, 7.9% of patients experienced grade 3 urinary toxicity and there was no reported small intestinal toxicity. Conclusion: Escalating the radiation dose more than 80 Gy in intermediate and high risk prostate cancer patients was safe and not associated with grade 3 - 4 RTOG toxicity when guided by online verification of intra-prostatic fiducial markers.
文摘Transitional cell carcinoma （TCC） of the ovary is a rare and recently recognized subtype of ovarian epithelial cancer. We presented the first case report from our Institute （Sheri Kashmir Instiute of Medical Sciences, Srinagar, India）, which was initially rnisdiagnosed as stromal cell carcinoma （granulosa cell tumour）, and on review of histopathology with immunohistochemistry, the diagnosis of TCC of the ovary was established. The aim of this article was to describe the typical case of primary TCC of the ovary and to review the literature for information on TCC management.
文摘Objective:The aim of this study was to recognize and characterize the initial chest radiographic findings of H1N1 infection and to evaluate whether serial chest radiographs were useful in assessing the severity of infection and predicting the clinical outcome.Materials and methods:27 patients hospitalized for H1N1 infection,from January 2015 to May 2016 were retrospectively evaluated,including 17(62.9%)female patients and 10(37.1%)male patients,with age ranging between 2 days and 65 years.Radiographs obtained at the time of admission were reviewed and studied for characteristic imaging patterns,laterality(unilateral or bilateral)and zonal distribution of the opacities.Serial chest radiographs taken were reviewed to look for progression or resolution of the imaging findings and compared with the final outcome.Results:Of the female patients,4(23%)were pregnant and 1(6%)was in the immediate post-partum period.Of the 27 patients,25(92.6%)had abnormal and 2(7.4%)had normal radiological findings on initial chest radiographic appearance.One patient was lost to follow-up,16(62%)of the remaining 26 succumbed to the disease while the remaining 10(38%)improved.Three of the pregnant patients and the postpartum patient had adverse outcomes.Involvement of greater than 4 lung zones and bilateral involvement indicated a poor prognosis.Abnormal chest radiographic findings included consolidation,peribronchial cuffing,nodular opacities and reticulo-nodular opacities,with the most common being consolidation with or without peribronchial cuffing.Patients with more than 4 zones of involvement invariably had an adverse clinical outcome.Conclusion:Initial chest radiographic findings help in diagnosing the type of pneumonia,and consolidation associated with peribronchial cuffing is a common finding in viral pneumonia like H1N1.Prognosis based on evaluation and monitoring of serial chest radiographs is a valuable tool in predicting the final clinical outcome of the patient.Extensive involvement of both lungs,in the form of multi-zonal and bilateral lung opacities is frequently associated with adverse prognosis.
文摘Dual-energy CT(DECT)is an advancement in CT technology that allows for the acquisition of images at two different energy levels.Two main post-processing tools,which form the backbone of DECT,include material decomposition and virtual monoenergetic images.Material decomposition helps in the generation of virtual nonenhanced,iodine,pulmonary lung blood volume,lung vessel,automated bone removal,and renal stone characterization images.DECT offers a broad spectrum of clinical applications in pediatric imaging,including vascular,neurological,thoracic,abdominal,skeletal,and oncologic assessments.Additionally,it contributes to shorter scan times and enables the use of lower contrast media volumes while maintaining diagnostic image quality.This technique provides unique qualitative and quantitative information about the composition of the tissue,allowing differentiation of materials,including iodinated contrast agents.The radiation dose of DECT is equivalent to or lower than that of a singleenergy CT,adding to the advantages of DECT,especially in children who are more sensitive to the harmful effects of radiation.In this minireview we outlined the basic principles of the DECT technique and its post-processing techniques with emphasis on clinical applications in pediatric imaging.
文摘Introduction:Dengue fever(DF)is endemic in tropical and subtropical areas.Dengue hemorrhagic fever is life threatening,and early identification can help save lives.Ultrasonography(USG),though not diagnostic,can help in early identification of serositis.Objective:To compare USG findings in seropositive pediatric and adult patients with DF.Materials and methods:110 in-patients with clinical suspicion of DF were evaluated with USG of the abdomen and thorax.USG findings correlated with serological tests.Seropositive patients were grouped into pediatric and adult age.Findings were compared to determine if any statistically significant difference exists.Results:67 Patients- seropositive,43 - seronegative.USG findings in seropositive pediatric patients(n=32)were GB wall edema-27,hepatomegaly in 12,ascites in 16,splenomegaly in 15,right pleural effusion in 14,left and bilateral pleural effusion in 7 patients.The USG findings in seropositive adult patients(n=35)were GB wall edema in 31,hepatomegaly in 14,ascites in 12,splenomegaly in 9,right pleural effusion in 13,left and bilateral pleural effusion in 5 patients.Conclusion:There is a statistically significant difference between ultrasound findings of dengue fever in adult and pediatric patients.Ascites and splenomegaly more were common in the pediatric patients as compared to the adult patients.
文摘Objective:To identify and enumerate the radiological findings in lower lobe tuberculosis(TB)&occurrence frequency.Materials and methods:Study was conducted in the Department of Radiodiagnosis,S N Medical College,Bagalkot for 5 yrs from January 2013-December 2017.Data collection was prospective.60 consecutive cases of lower lung tuberculosis were identified.36(60%)were males.24 were females.57(95%)had respiratory symptoms in the form of cough and scantyexpectoration.Results:Main radiological presentation ware patchy opacities,in 27(45%)of patients,homogeneous consolidation in 21(35%)of patients,cavitation in 10(17.5%)of patients,nodular opacities in 7(12.5%).Conclusion:Radiographic findings in lower lung field TB differ significantly from upper lobe disease.Most frequent radiographic finding is consolidation,more confluent and extensive than that found in upper lobes TB.Cavitory lesions are also frequently seen,which may be single or multiple and may lie within an area of consolidation.
文摘Rubella is a contagious viral infection commonly occurring in children and young adults.Pregnant women suffering from this infection may suffer severe consequences with disastrous effects on the developing fetus.The neonatal manifestations caused by antenatal transmission of maternal rubella infection are collectively called congenital rubella syndrome(CRS).We report a case of congenital rubella in a neonate presenting with respiratory distress.
文摘Echinococcosis is a zoonotic disease. Liver is the most common site of involvement. Renal involvement is seen in 2% to 3% of patients. Computed tomography findings in renal hydatid typically include: a cyst with thick or calcified wall, unilocular cyst with detached membrane, a multiloculated cyst with mixed internal density and daughter cysts with lower density than maternal matrix. Rarely type Ⅳ hydatid cysts may mimic hypovascular renal cell carcinoma. We report a case of previously asymptomatic middle aged female who presented with mild intermittent pain and a complex renal lesion on imaging which was considered to be a hypovascular renal carcinoma or urothelial neoplasm. However, by serendipity, the patient had spontaneous hydatiduria and later was definitively diagnosed and stented. Hydatid disease should always be considered amongst the top differential diagnosis of an isolated "complex" renal lesion which remains indeterminate on imaging.
文摘Bleeding per rectum in children can be seen in congenital as well as acquired conditions that may require medical or surgical management.The present review article is aimed to discuss the imaging findings of some common and uncommon causes of bleeding per rectum in children.
文摘This is a MRI study of two patients presented with history of gelastic seizures since many years ago. Plain and post intravenous gadolinium multiplanar MRI imaging of the brain is performed. It showed well-defined non-enhancing mass lesions in the region of hypothalamus and tuber cinereum. It showed signal intensity similar to the gray matter and imaging diagnosis of hypothalamic hamartoma is made.
文摘The incidence of aneurysmal bone cyst in the maxillofacial region is rare and may remain undiagnosed for a long period prior to becoming symptomatic.This may cause associated issues secondary to compression by extending to the surrounding vital anatomical areas.An aggressive course can lead to bony destruction with intracranial extension.We present a case of a 23-year-old man who presented with bilateral exorbitism with nasal obstruction.
文摘Aim:Anterolateral thigh(ALT)flap is widely used in reconstruction of various defects.Preoperative imaging facilitates perforator mapping,overcoming intraoperative uncertainty.The purpose of this study was to investigate the utility of multi-detector row computed tomography angiography(MDCTA)and a handheld Doppler in locating ALT perforators.Methods:Twenty patients were randomized into two groups.Group 1 patients received MDCTA and Doppler studies whereas Group 2 received only a Doppler study.The number,location,course,and source of all cutaneous and sizable perforators were compared with intraoperative findings.Surgeons’stress levels during flap harvest and flap harvest time were compared.Results:MDCTA findings correlated well with intraoperative findings for perforator type and segmental distribution with 100%concordance.Doppler alone had a 52%rate of concordance.The sensitivity and specificity for MDCTA in demonstrating the presence of perforators were 85.71%and 97.22%,respectively;whereas for Doppler alone the sensitivity and specificity were 80%and 87.91%,respectively.In demonstrating perforator source,MDCTA showed a sensitivity of 100%and specificity of 91.66%,with 100%accuracy.Sensitivity and specificity for sizable perforators were 90%each,with 88.88%accuracy.Doppler studies were unable to provide this information.Comparison of surgeon stress levels showed no differences between the two groups,although the time for flap harvest was significantly shorter in Group 1.Conclusion:MDCTA compared to Doppler is more sensitive,specific,and accurate with respect to location,course,and source of perforators.
文摘Purpose： Wrist has a complex anatomy and undergoes complex injuries, Scaphoid fracture is one of such injuries. It is the most common fracture in carpal bone. Most of the scaphoid fractures are missed on initial X-rays. Magnetic resonance imaging （MRI） is considered as a gold standard for diagnosing scaphoid fractures. Ultrasonography （USG） is emerging as a good alternative to make an early diagnosis of scaphoid fractures. Our aim is to throw light upon the role of USG in detection of scaphoid flactures. Methods： The study was centered upon 114 patients in the age range 10-65 years, with traumatic wrist injury and were clinically suspected to have scaphoid fractures. Patient with non-traumatic history, bilateral wrist injury and late presentation were excluded. X-rays, USG using high frequency probe and MRI were done for all patients. MRI was considered to be the gold standard test. Patients were followed up at 6 weeks. Results： Of the 114 patients, X-ray could diagnose scaphoid fractures in 48 patients, 30 of which were confirmed by MRI. USG results were positive in 74 patients, of which MRI was positive in 67 patients. The accuracy of scaphoid fracture detection with USG was 98.04% in comparison to X-ray （20.58%）, which was statistically significant. Conclusion： USG provides a more accurate and reliable method of making an early diagnosis of scaphoid fracture than X-rays. It is non-invasive, non-expensive and allows better visualisation of cortical disruption.
