Alamelu Alagappan, M. K. Nayak, Biswajit Sahoo, Suprava Naik, Nerbadyswari Deep (Bag), S. Bhoi
Abstract Posterior pituitary ectopia is a very rare entity in the development of the pituitary gland. Several factors and multiple genes are associated with this entity causing both pituitary and extrapituitary abnormalities. Pituitary abnormalities can be various endocrine problems and extrapituitary abnormalities can be optic nerves and cerebellar hypoplasia, heterotopia, and abnormal vessels. This pictorial review represents the imaging manifestations of extrapituitary intracranial anomalies that can be associated with posterior pituitary ectopia.
{"title":"Ectopic Posterior Pituitary and Its Associations with Extrapituitary Intracranial Anomalies","authors":"Alamelu Alagappan, M. K. Nayak, Biswajit Sahoo, Suprava Naik, Nerbadyswari Deep (Bag), S. Bhoi","doi":"10.1055/s-0044-1787160","DOIUrl":"https://doi.org/10.1055/s-0044-1787160","url":null,"abstract":"Abstract Posterior pituitary ectopia is a very rare entity in the development of the pituitary gland. Several factors and multiple genes are associated with this entity causing both pituitary and extrapituitary abnormalities. Pituitary abnormalities can be various endocrine problems and extrapituitary abnormalities can be optic nerves and cerebellar hypoplasia, heterotopia, and abnormal vessels. This pictorial review represents the imaging manifestations of extrapituitary intracranial anomalies that can be associated with posterior pituitary ectopia.","PeriodicalId":506648,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141379410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Md Fahim Ahmad, Shailesh Solanki, R. P. Kanojia, Anmol Bhatia, Sadhna B. Lal, Akshay K Saxena, Kirti Gupta
Abstract Introduction The native liver survival in biliary atresia (BA) depends on various factors, and one of the crucial factors is the rate of progression of liver fibrosis after portoenterostomy, but there is no reliable investigation to assess it. This study evaluated shear wave elastography (SWE) to detect liver fibrosis in BA patients and assess its utility during follow-up. Materials and Methods This was an observational study; SWE was done preoperatively and postoperatively at 3 and 6 months. The SWE values were analyzed to determine their correlations with preoperative liver histology as well as with postoperative SWE variation between different postoperative outcomes. Results Twenty-one patients were included in the study; the preoperative SWE values were strongly correlated with liver biopsy grading ( p < 0.001). At the 3 months postoperatively, SWE was done for 18 children: 12 in group A (patent bilioenteric drainage on hepatobiliary iminodiacetic acid scan) and 6 (nonpatent) in group B; mean SWE value was 12.8 and 17.3 kPa, respectively ( p < 0.001). Ten children from group A underwent SWE 6 months postoperatively, and the mean value was 13.23 kPa. Conclusion The SWE values correlate with liver histology grading, suggesting a reliable alternative to biopsy. Additionally, the baseline SWE values and their trend during follow-up can provide information on the disease's progression.
摘要 引言 胆道闭锁（BA）患者的原肝存活率取决于多种因素，其中一个关键因素是造口术后肝纤维化的进展速度，但目前还没有可靠的调查来评估肝纤维化。本研究评估了剪切波弹性成像（SWE）检测 BA 患者肝纤维化的情况，并评估其在随访期间的效用。材料和方法 这是一项观察性研究；SWE 在术前和术后 3 个月和 6 个月进行。对 SWE 值进行分析，以确定它们与术前肝组织学的相关性，以及术后 SWE 在不同术后结果之间的变化。结果 21 名患者参与了研究；术前 SWE 值与肝活检分级密切相关（P < 0.001）。术后 3 个月，对 18 名患儿进行了 SWE：A 组 12 名（肝胆亚氨基二醋酸扫描显示胆肠引流通畅），B 组 6 名（非通畅）；平均 SWE 值分别为 12.8 和 17.3 kPa（P < 0.001）。A 组的 10 名患儿在术后 6 个月接受了 SWE 检查，平均值为 13.23 kPa。结论 SWE 值与肝组织学分级相关，是活组织检查的可靠替代方法。此外，基线 SWE 值及其在随访过程中的变化趋势可提供有关疾病进展的信息。
{"title":"Evaluation of Hepatic Shear Wave Elastography to Assess Liver Fibrosis in Biliary Atresia Patients and Its Correlation with Liver Histology and Surgical Outcomes: A Prospective Observational Study","authors":"Md Fahim Ahmad, Shailesh Solanki, R. P. Kanojia, Anmol Bhatia, Sadhna B. Lal, Akshay K Saxena, Kirti Gupta","doi":"10.1055/s-0044-1787668","DOIUrl":"https://doi.org/10.1055/s-0044-1787668","url":null,"abstract":"Abstract Introduction The native liver survival in biliary atresia (BA) depends on various factors, and one of the crucial factors is the rate of progression of liver fibrosis after portoenterostomy, but there is no reliable investigation to assess it. This study evaluated shear wave elastography (SWE) to detect liver fibrosis in BA patients and assess its utility during follow-up. Materials and Methods This was an observational study; SWE was done preoperatively and postoperatively at 3 and 6 months. The SWE values were analyzed to determine their correlations with preoperative liver histology as well as with postoperative SWE variation between different postoperative outcomes. Results Twenty-one patients were included in the study; the preoperative SWE values were strongly correlated with liver biopsy grading ( p < 0.001). At the 3 months postoperatively, SWE was done for 18 children: 12 in group A (patent bilioenteric drainage on hepatobiliary iminodiacetic acid scan) and 6 (nonpatent) in group B; mean SWE value was 12.8 and 17.3 kPa, respectively ( p < 0.001). Ten children from group A underwent SWE 6 months postoperatively, and the mean value was 13.23 kPa. Conclusion The SWE values correlate with liver histology grading, suggesting a reliable alternative to biopsy. Additionally, the baseline SWE values and their trend during follow-up can provide information on the disease's progression.","PeriodicalId":506648,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141381456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sonal Saran, K. Shirodkar, S. N. Gavvala, S. Evans, K. Iyengar, Devina Ghoorah Jevalle, R. Botchu
Abstract Supraspinous fossa is an important location in the periscapular region, which houses important structures such as the supraspinatus muscle and the suprascapular nerve. The supraspinous fossa can be affected by pathologies involving its contents (supraspinatus muscle and suprascapular nerve), osseous boundary (scapular body, distal clavicle, and spinous process), or superficial soft tissue covering it. In this pictorial review, we describe the detailed anatomy of the supraspinous fossa. We have also covered imaging of wide range of pathologies that can affect supraspinous fossa such as paralabral cyst, muscle edema/atrophy, malignancies (primary and secondary), and miscellaneous lesions (myositis ossificans, fibromatosis, nerve sheath tumor, etc.). An awareness of the imaging findings of these entities is essential for a radiologist to avoid misinterpretation and can aid a timely diagnosis.
{"title":"Supraspinous Fossa: Anatomy and Pathology","authors":"Sonal Saran, K. Shirodkar, S. N. Gavvala, S. Evans, K. Iyengar, Devina Ghoorah Jevalle, R. Botchu","doi":"10.1055/s-0044-1787667","DOIUrl":"https://doi.org/10.1055/s-0044-1787667","url":null,"abstract":"Abstract Supraspinous fossa is an important location in the periscapular region, which houses important structures such as the supraspinatus muscle and the suprascapular nerve. The supraspinous fossa can be affected by pathologies involving its contents (supraspinatus muscle and suprascapular nerve), osseous boundary (scapular body, distal clavicle, and spinous process), or superficial soft tissue covering it. In this pictorial review, we describe the detailed anatomy of the supraspinous fossa. We have also covered imaging of wide range of pathologies that can affect supraspinous fossa such as paralabral cyst, muscle edema/atrophy, malignancies (primary and secondary), and miscellaneous lesions (myositis ossificans, fibromatosis, nerve sheath tumor, etc.). An awareness of the imaging findings of these entities is essential for a radiologist to avoid misinterpretation and can aid a timely diagnosis.","PeriodicalId":506648,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141377225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Giri, R. Patel, T. Tripathy, Mansingh Chaudhary, P. Anirvan, Swati Chauhan, Mitali Madhumita Rath, M. K. Panigrahi
Background Around 5% of patients with cirrhosis of the liver develop hepatic hydrothorax (HH). For patients with refractory HH (RHH), transjugular intrahepatic portosystemic shunt (TIPS) has been investigated in small studies. Hence, the present meta-analysis aimed to summarize the current data on the outcome of TIPS in patients with RHH. Methods From inception through June 2023, MEDLINE, Embase, and Scopus were searched for studies analyzing the outcome of TIPS in RHH. Clinical response, adverse events (AEs), mortality, and shunt dysfunction were the primary outcomes assessed. The event rates with their 95% confidence interval were calculated using a random-effects model. Results A total of 12 studies (n = 466) were included in the final analysis. The pooled complete and partial response rates were 47.2% (35.8–58.5%) and 25.5% (16.7–34.3%), respectively. The pooled incidences of serious AEs and post-TIPS liver failure after TIPS in RHH were 5.6% (2.1–9.0%) and 7.6% (3.1–12.1%), respectively. The pooled incidences of overall hepatic encephalopathy (HE) and severe HE nonresponsive to standard treatment after TIPS in RHH were 33.2% (20.0–46.4%) and 3.6% (0.4–6.8%), respectively. The pooled 1-month and 1-year mortality rates were 14.0% (8.3–19.6%) and 42.0% (33.5–50.4%), respectively. The pooled incidence of shunt dysfunction after TIPS in RHH was 24.2% (16.3–32.2%). Conclusion RHH has a modest response to TIPS in patients with cirrhosis, with only half having a complete response. Further studies are required to ascertain whether early TIPS can improve the outcome of patients with cirrhosis and HH.
{"title":"Outcome of Transjugular Intrahepatic Portosystemic Shunt in Patients with Cirrhosis and Refractory Hepatic Hydrothorax: A Systematic Review and Meta-analysis","authors":"S. Giri, R. Patel, T. Tripathy, Mansingh Chaudhary, P. Anirvan, Swati Chauhan, Mitali Madhumita Rath, M. K. Panigrahi","doi":"10.1055/s-0044-1786828","DOIUrl":"https://doi.org/10.1055/s-0044-1786828","url":null,"abstract":"\u0000 Background Around 5% of patients with cirrhosis of the liver develop hepatic hydrothorax (HH). For patients with refractory HH (RHH), transjugular intrahepatic portosystemic shunt (TIPS) has been investigated in small studies. Hence, the present meta-analysis aimed to summarize the current data on the outcome of TIPS in patients with RHH.\u0000 Methods From inception through June 2023, MEDLINE, Embase, and Scopus were searched for studies analyzing the outcome of TIPS in RHH. Clinical response, adverse events (AEs), mortality, and shunt dysfunction were the primary outcomes assessed. The event rates with their 95% confidence interval were calculated using a random-effects model.\u0000 Results A total of 12 studies (n = 466) were included in the final analysis. The pooled complete and partial response rates were 47.2% (35.8–58.5%) and 25.5% (16.7–34.3%), respectively. The pooled incidences of serious AEs and post-TIPS liver failure after TIPS in RHH were 5.6% (2.1–9.0%) and 7.6% (3.1–12.1%), respectively. The pooled incidences of overall hepatic encephalopathy (HE) and severe HE nonresponsive to standard treatment after TIPS in RHH were 33.2% (20.0–46.4%) and 3.6% (0.4–6.8%), respectively. The pooled 1-month and 1-year mortality rates were 14.0% (8.3–19.6%) and 42.0% (33.5–50.4%), respectively. The pooled incidence of shunt dysfunction after TIPS in RHH was 24.2% (16.3–32.2%).\u0000 Conclusion RHH has a modest response to TIPS in patients with cirrhosis, with only half having a complete response. Further studies are required to ascertain whether early TIPS can improve the outcome of patients with cirrhosis and HH.","PeriodicalId":506648,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141125854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pallavi Talasila, Swaroop G. Hedge, K. Periasamy, S. Nagaraj, Harmandeep Singh, Harjeet Singh, Pankaj Gupta
Esophageal cancer is one of the common cancers. Risk factors are well recognized and lead most commonly to two distinct histological subtypes (squamous cell carcinoma and adenocarcinoma). The diagnosis is based on endoscopic evaluation. The most challenging aspect of management is accurate staging as it guides appropriate management. Endoscopic ultrasound, computed tomography (CT), positron emission tomography-CT, and magnetic resonance imaging are the imaging tests employed for the staging. Each imaging test has its own merits and demerits. Imaging is also critical to evaluate posttreatment complication and for response assessment. In this review article, we discuss in detail the risk factors, anatomical aspects, and role of imaging test in staging and evaluation of complications and response after treatment.
{"title":"Imaging in Esophageal Cancer: A Comprehensive Review","authors":"Pallavi Talasila, Swaroop G. Hedge, K. Periasamy, S. Nagaraj, Harmandeep Singh, Harjeet Singh, Pankaj Gupta","doi":"10.1055/s-0044-1786871","DOIUrl":"https://doi.org/10.1055/s-0044-1786871","url":null,"abstract":"Esophageal cancer is one of the common cancers. Risk factors are well recognized and lead most commonly to two distinct histological subtypes (squamous cell carcinoma and adenocarcinoma). The diagnosis is based on endoscopic evaluation. The most challenging aspect of management is accurate staging as it guides appropriate management. Endoscopic ultrasound, computed tomography (CT), positron emission tomography-CT, and magnetic resonance imaging are the imaging tests employed for the staging. Each imaging test has its own merits and demerits. Imaging is also critical to evaluate posttreatment complication and for response assessment. In this review article, we discuss in detail the risk factors, anatomical aspects, and role of imaging test in staging and evaluation of complications and response after treatment.","PeriodicalId":506648,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141125613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pediatric Musculoskeletal Imaging: Beginning of a New Journey","authors":"N. Bagri, M. Jana","doi":"10.1055/s-0044-1782625","DOIUrl":"https://doi.org/10.1055/s-0044-1782625","url":null,"abstract":"","PeriodicalId":506648,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140983116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective The aim of this study was to assess the reliability of resting-state functional magnetic resonance imaging (rest-fMRI) in mapping language areas for preoperative planning, versus standard task-based techniques, which are at times difficult to perform in clinical settings. Our study also aimed to evaluate the overlap between language areas identified through rest-fMRI and the standard task-fMRI, in neurosurgical cases. Materials and Methods Using a seed-based analysis of rest-fMRI with multiple template seeds, we identified functionally connected language regions in patients undergoing preoperative language mapping. Four language task paradigms (word, verb, picture, and semantics) were evaluated. We quantified the degree of overlap between language areas identified on rest-fMRI and task-fMRI, categorizing the results as more than 50% or less than 50% overlap. Results Seventy-seven percent of patients demonstrated an overlap exceeding 50% between rest- and task-fMRI maps, with the left Broca's area being the most frequently observed region of overlap. This finding was noted even in cases with lesions in Broca's or Wernicke's areas, highlighting the method's robustness. The verb task showed the best blood-oxygen-level dependent activity and overlap with rest-fMRI, highlighting its reliability. To identify a specific language area, the contralateral seed of the same area most commonly displayed connectivity with the area of interest. Conclusion Our findings demonstrate the potential of using rest-fMRI in accurately mapping eloquent language areas, in clinical settings The strong concordance observed, especially in the left Broca's area, underscores the reliability of this method. Further research and larger studies are essential to validate these results, potentially establishing the use of routine rest-fMRI, in clinical preoperative workup.
{"title":"Rest-fMRI—A Potential Substitute for Task-fMRI?","authors":"Santosh S. Gupta, Rithika Sriram, Smruti Mulani","doi":"10.1055/s-0044-1786723","DOIUrl":"https://doi.org/10.1055/s-0044-1786723","url":null,"abstract":"\u0000 Objective The aim of this study was to assess the reliability of resting-state functional magnetic resonance imaging (rest-fMRI) in mapping language areas for preoperative planning, versus standard task-based techniques, which are at times difficult to perform in clinical settings. Our study also aimed to evaluate the overlap between language areas identified through rest-fMRI and the standard task-fMRI, in neurosurgical cases.\u0000 Materials and Methods Using a seed-based analysis of rest-fMRI with multiple template seeds, we identified functionally connected language regions in patients undergoing preoperative language mapping. Four language task paradigms (word, verb, picture, and semantics) were evaluated. We quantified the degree of overlap between language areas identified on rest-fMRI and task-fMRI, categorizing the results as more than 50% or less than 50% overlap.\u0000 Results Seventy-seven percent of patients demonstrated an overlap exceeding 50% between rest- and task-fMRI maps, with the left Broca's area being the most frequently observed region of overlap. This finding was noted even in cases with lesions in Broca's or Wernicke's areas, highlighting the method's robustness. The verb task showed the best blood-oxygen-level dependent activity and overlap with rest-fMRI, highlighting its reliability. To identify a specific language area, the contralateral seed of the same area most commonly displayed connectivity with the area of interest.\u0000 Conclusion Our findings demonstrate the potential of using rest-fMRI in accurately mapping eloquent language areas, in clinical settings The strong concordance observed, especially in the left Broca's area, underscores the reliability of this method. Further research and larger studies are essential to validate these results, potentially establishing the use of routine rest-fMRI, in clinical preoperative workup.","PeriodicalId":506648,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140984314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Hidradenitis suppurativa (HS) is a multifactorial chronic inflammatory follicular disorder affecting apocrine gland-bearing areas of the body. We conducted an observational study to assess the ultrasonography (USG) findings in suspected HS patients at a tertiary care center in North India over 6 months. Aim The aim of this article was to study the USG findings in HS and correlate clinical and USG findings and scoring systems in HS with stage wise treatments. Materials and Methods All patients with a clinical suspicion of HS underwent an USG examination after clinical examination with a probe of 18 Hz frequency. Hurley's staging of patients was used to stage clinically, and the HS-SOS scoring and Doppler changes were assessed on USG. The treatment was revised in case of a change in the USG grading of severity. Results A total of 23 patients suspected of HS underwent USG evaluation, of which 12 (52%) were male and 9 (48%) were females, with the mean age being 25.3 years (range: 14–40 years). Based on the HS clinical grading, eleven patients (47.8%) were Hurley's stage I, six patients (26%) were stage II, and six patients (26%) were stage III. USG demonstrated that three patients had been misdiagnosed and had folliculitis (8.6%) and Crohn's disease (4.3%). Out of the remaining twenty patients with USG features of HS, based on HS SOS grading, three patients (15%) were grade I, seven (35%) were grade II, and ten (50%) were grade III. Of these, nineteen patients (95%) had axillary involvement, which was bilateral in 84% of cases. The other region affected was the groin in five patients (26.3%), while two had inframammary involvement (10.5%). On further characterization of the type of lesion, nodules (41; 40.6%) were the most common type of lesion by sinuses and thickened hair follicles in 31 (30.6%) patients. Based on USG findings, the management of 26% of patients was changed from medical to surgical intervention. Conclusion USG and Doppler are noninvasive bedside tools for the examination of HS, which helps to rule out differentials and delineate the extent and depth of the disease better by picking up subclinical lesions and help in determining disease activity by Doppler, which in turn helps in planning appropriate medical and surgical management of patients. It also identifies radiological parameters that help identify patients who could fail medical management.
{"title":"A Pilot Real-World Study of Ultrasonography Findings of Hidradenitis Suppurativa in Indian Patients and Its Diagnostic and Therapeutic Implications","authors":"Siddharth Gogate, Raghav Aggarwal, K. Sardana, Sheetal Yadav, Bulli Babu Boyidi, Siddharth Siddharth, Pankaj Sharma","doi":"10.1055/s-0044-1782624","DOIUrl":"https://doi.org/10.1055/s-0044-1782624","url":null,"abstract":"\u0000 Introduction Hidradenitis suppurativa (HS) is a multifactorial chronic inflammatory follicular disorder affecting apocrine gland-bearing areas of the body. We conducted an observational study to assess the ultrasonography (USG) findings in suspected HS patients at a tertiary care center in North India over 6 months.\u0000 Aim The aim of this article was to study the USG findings in HS and correlate clinical and USG findings and scoring systems in HS with stage wise treatments.\u0000 Materials and Methods All patients with a clinical suspicion of HS underwent an USG examination after clinical examination with a probe of 18 Hz frequency. Hurley's staging of patients was used to stage clinically, and the HS-SOS scoring and Doppler changes were assessed on USG. The treatment was revised in case of a change in the USG grading of severity.\u0000 Results A total of 23 patients suspected of HS underwent USG evaluation, of which 12 (52%) were male and 9 (48%) were females, with the mean age being 25.3 years (range: 14–40 years). Based on the HS clinical grading, eleven patients (47.8%) were Hurley's stage I, six patients (26%) were stage II, and six patients (26%) were stage III. USG demonstrated that three patients had been misdiagnosed and had folliculitis (8.6%) and Crohn's disease (4.3%). Out of the remaining twenty patients with USG features of HS, based on HS SOS grading, three patients (15%) were grade I, seven (35%) were grade II, and ten (50%) were grade III. Of these, nineteen patients (95%) had axillary involvement, which was bilateral in 84% of cases. The other region affected was the groin in five patients (26.3%), while two had inframammary involvement (10.5%). On further characterization of the type of lesion, nodules (41; 40.6%) were the most common type of lesion by sinuses and thickened hair follicles in 31 (30.6%) patients. Based on USG findings, the management of 26% of patients was changed from medical to surgical intervention.\u0000 Conclusion USG and Doppler are noninvasive bedside tools for the examination of HS, which helps to rule out differentials and delineate the extent and depth of the disease better by picking up subclinical lesions and help in determining disease activity by Doppler, which in turn helps in planning appropriate medical and surgical management of patients. It also identifies radiological parameters that help identify patients who could fail medical management.","PeriodicalId":506648,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Five Things That Radiologists Can Do to Improve Their Technology Quotient","authors":"Arjun Kalyanpur","doi":"10.1055/s-0044-1785209","DOIUrl":"https://doi.org/10.1055/s-0044-1785209","url":null,"abstract":"","PeriodicalId":506648,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140994292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arjun Lokesh Netaji, P. Garg, Deepak Prakash Bhirud, R. Rajagopal
High-fl ow renal arteriovenous fi stula (AVF) can lead to complications such as hematuria, hypertension, high-output cardiac failure, and renal insuf fi ciency. 1,2 A 52-year-old female patient with no prior risk factors presented with dull aching pain in right lumbar quadrant for 1 month and hematuria for 7 days. There was no history of trauma to abdomen. She was hemodynamically stable at presentation. Her hemoglobinwas 6.9 g/dL. Abdominal ultrasound showed a large anechoic cystic lesion in the right lumbar quadrant with only upper pole of right kidney being visualized and intense color fl ow within the lesion in color Doppler with low resistance biphasic waveform ( ► Fig. 1A ). Chest radio-graph was normal. Computed tomography angiography revealed a large vascular pouch in the right kidney with a large arterial feeder and dilated early draining renal vein suggestive of renal AVF with large venous pouch ( ► Fig. 1B ). Diethylenetriaminepentacetate (DTPA) scan showed severely impaired renal perfusion and cortical function in right kidney with functioning parenchyma seen exclusively at upper polar region. She was counseled for endovascular treatment as upper pole of right kidney could be preserved. Right renal artery angiogram showed high-fl ow AVF involving the right mid and lower pole with
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