Indian Journal of Radiology and Imaging最新文献

The large number of medical conferences held per year has a significant impact on the environment. Climate change and global warming then lead to deleterious effects on human health. We aim to highlight that it is our responsibility as doctors to promote eco-friendly events and encourage sustainable practices, thus reducing harm to our environment. Management committees of conferences can take a few steps toward this with specific planning and effort. In this study, possible steps toward achieving this goal have been highlighted, such as conducting hybrid events, locally sourcing products, and avoiding single-use plastic.

Introduction  Climate change and global warming have major contributions from greenhouse gas emissions. Despite the introduction of digitalized systems, many health care systems still rely heavily on paper. The purpose of this study is to investigate paper usage in the radiology department of a single hospital institution over the last 3 years to forecast paper usage up to 2050. Materials and Methods  This retrospective study was performed in the radiology department of our tertiary orthopaedic hospital. The study included forms used for diagnostic and interventional procedures in various departmental modalities. Diagnostic procedures require one to three forms and interventional procedures require three forms each. Based on the established ratio that 1.2 trees are cut for every 10,000 sheets of papers used, the study calculated the number of trees cut annually over the past 3 years and projected paper usage and tree loss until 2050. Results  Paper usage was distributed between diagnostic and interventional procedures, with 67% used in diagnostics and 33% in interventions. The corresponding number of trees cut during this period amounted to 53.729 trees, with 47.4 trees for diagnostic procedures and 6.4 trees for interventional procedures. A total of 57.8 trees for diagnostic procedures and 11.7 trees for interventional procedures were forecasted to be cut annually from 2024 to 2050, cumulatively being 1,227 trees by the year 2050. Conclusion  Our individual department had a significant contribution from paper usage in the carbon footprint of the department. Adoption of digitalized appointment, prescribing, and patient records is important in reducing this and achieving the NHS net zero targets.

Shoulder pain is a common and increasing indication for patients being referred for pain relief injections. To address this, patients are offered corticosteroid injections for the glenohumeral joint as well as the subacromial subdeltoid (SASD) bursa under ultrasound guidance, which allows direct visualization of the needle and target structures with a more confident and real-time needle placement. We demonstrate a new technique, the rotator interval bursa (RIB) technique, of sequential injection of the glenohumeral joint targeting the rotator interval as well as the SASD bursa via the anterior approach with a single prick.

Computed tomography coronary angiography (CTCA) is a technically demanding radiological investigation that requires adequate opacification of coronary arteries at peak aortic enhancement phase, with minimal or no contrast in the superior vena cava and right-sided cardiac chambers to avoid streak artifacts of dense contrast. Therefore, it is prudent to know about contrast media, contrast kinetics, and contrast injection protocols. This article attempts to describe the essentials of various aspects of contrast media that should be considered for CTCA along with an in-depth analysis of contrast kinetics that every radiologist should know for obtaining adequate opacification of coronary arteries.

Hydroxyapatite deposition disease is a common musculoskeletal pathology that often affects rotator cuff tendons in the shoulder joint. Here, we present the first documented case of acute calcific enthesitis involving the lateral patellar retinaculum, specifically the lateral patellofemoral ligament (LPFL). A 35-year-old male presented with insidious onset atraumatic pain persisting for 3 months on the lateral aspect of the knee, intensifying over the past week. Clinical examination revealed focal tenderness in the anterolateral region of the knee, with no signs of patellar instability. Magnetic resonance imaging was performed, which revealed thickening and calcification within the LPFL and perilesional edema, further confirmed on computed tomography and ultrasonography. Patient was managed successfully with barbotage with complete resolution of symptoms. This case highlights the importance of considering calcification of LPFL in the differential diagnosis of anterolateral knee pain and underscores the importance of different imaging modalities for prompt diagnosis.

Androgen insensitivity syndrome (AIS) is a rare disorder of sexual differentiation, characterized by impaired responsiveness to androgens, resulting in the development of typically female external genitalia, despite having a male chromosomal pattern (XY). In this case report, we describe the radiological findings of two young siblings diagnosed with AIS who presented with primary amenorrhea. The diagnosis was confirmed on laparotomy and gonads were surgically removed in both the siblings.

Background  Radiology is critical for diagnosis and patient care, relying heavily on accurate image interpretation. Recent advancements in artificial intelligence (AI) and natural language processing (NLP) have raised interest in the potential of AI models to support radiologists, although robust research on AI performance in this field is still emerging. Objective  This study aimed to assess the efficacy of ChatGPT-4 in answering radiological anatomy questions similar to those in the Fellowship of the Royal College of Radiologists (FRCR) Part 1 Anatomy examination. Materials and Methods  We used 100 mock radiological anatomy questions from a free Web site patterned after the FRCR Part 1 Anatomy examination. ChatGPT-4 was tested under two conditions: with and without context regarding the examination instructions and question format. The main query posed was: "Identify the structure indicated by the arrow(s)." Responses were evaluated against correct answers, and two expert radiologists (>5 and 30 years of experience in radiology diagnostics and academics) rated the explanation of the answers. We calculated four scores: correctness, sidedness, modality identification, and approximation. The latter considers partial correctness if the identified structure is present but not the focus of the question. Results  Both testing conditions saw ChatGPT-4 underperform, with correctness scores of 4 and 7.5% for no context and with context, respectively. However, it identified the imaging modality with 100% accuracy. The model scored over 50% on the approximation metric, where it identified present structures not indicated by the arrow. However, it struggled with identifying the correct side of the structure, scoring approximately 42 and 40% in the no context and with context settings, respectively. Only 32% of the responses were similar across the two settings. Conclusion  Despite its ability to correctly recognize the imaging modality, ChatGPT-4 has significant limitations in interpreting normal radiological anatomy. This indicates the necessity for enhanced training in normal anatomy to better interpret abnormal radiological images. Identifying the correct side of structures in radiological images also remains a challenge for ChatGPT-4.

Objective  This article aims to determine the microstructural alterations in the auditory pathway in prelingual deaf children using diffusion tensor imaging (DTI)-derived parameters-fractional anisotropy (FA) and apparent diffusion coefficient (ADC), and secondarily to evaluate these changes in rubella and cytomegalovirus (CMV) positive cases. Materials and Methods  A consecutive series of consenting deaf and normal children between 1 and 7 years of age, forming the case and control groups, respectively, underwent DTI, audiological tests, and testing for rubella, CMV, and toxoplasma infections. FA and ADC were measured at four locations bilaterally: lateral lemniscus (LL), inferior colliculus, medial geniculate body, and auditory cortex (AC). Result  The mean ADC values were higher and the mean FA values were lower in cases (19 males, 21 females, mean age 2.65 years) than the controls (21 males, 19 females, mean age 4.63 years) at all eight sites. Sixteen (40%), 17 (42.5%), and 7 (17.5%) cases had severe, severe to profound, and profound hearing loss, respectively, the FA and ADC values being significantly different for LL. For rubella and CMV immunoglobulin G, 20/40and 17/40 cases were positive, respectively, 11 for both, and none for toxoplasma. Significant decrease in FA was seen at LL and AC in rubella/CMV positive cases. Conclusion  Microstructural changes are seen throughout the auditory pathway in prelingual deaf children, especially with rubella and/or CMV positive status. Further studies may pave the path to segregate out patient groups potentially more responsive to cochlear implant.

In this article, we presented an exceedingly rare clinical case of neurosyphilis, radiological revealed a distinctive "candle guttering appearance." Posttreatment for syphilis, both clinical symptoms and radiological markers showed complete resolution.