ABSTRACT
Aim and objective:To study the role of MR spectroscopy in the evaluation and differential diagnosis of various ring enhancing lesions in the brain with multi-voxel proton MR spectroscopy. Materials and methods: It is the prospective observational study carried out on 42 patients from June 2016 to Aug 2018 at Department of Radiodiagnosis at AVBRH, DMIMS, Sawangi, Wardha. Appropriate MRI sequences with spectroscopy and multiplanar imaging has been performed on patients with intracranial ring enhancing lesions. Result and Conclusion: Total 42 patients were taken. Most common lesions seen were tuberculoma (38%) followed by brain metastasis (34%), neurocysticercosis (16%) and pyogenic brain abscess (12%). On MRS, Tuberculoma was differentiated from NCC by high Cho: Cr ratio > 1.1 and high lipid lactate peak. Special peaks like amino acids, acetate, aspartate and succinate were seen in pyogenic brain abcess while alanine and succinate were present in NCC. High choline peak and high Cho: Cr ratio were seen in brain metastases.
ABSTRACT
Background: Cholangiocarcinoma and other malignant biliary tract diseases are common causes of obstructive jaundice in elderly patients. Despite advances in imaging these tumors are usually detected at a stage when the resection is no longer possible. In all such cases palliative Interventional Radiology Management with S.E.M.S (Self Expanding Metallic Stents) is one of the best possible palliative treatment options. Utility of pro-inflammatory markers like neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic markers for predicting various complications in these patients have been studied by very few researchers. We have conducted this study to find out whether raised NLR and PLR values can be used as prognostic factors in patients undergoing SEMS.Methods: This was a prospective study conducted in the department of interventional radiology of a medical college situated in a rural area. Patients who have undergone SEMS for palliative management of biliary tract cancers were included in this study on the basis of predefined inclusion and exclusion criteria. NLR and PLR were calculated from complete blood count. The analysis of complication rates (cholangitis, cholecystitis, pancreatitis or any other complication) and sepsis was done in relation to NLR and PLR ratio. Statistical analysis was done with Minitab version 17.Results: Out of 76 patients included in this study there were 50 males and 26 females with a M: F ratio of 1:0.52. The most common affected age group was found to be between 41-50 years (26.31%). The most common malignancy encountered was found to be Perihilar cholangiocarcinoma (including its subtypes) (34.21%) followed by distal cholangiocarcinoma (28.94%), intrahepatic cholangiocarcinoma (18.42%), Gall Bladder Carcinoma (13.15%) and Periampullary carcinoma (5.26%). NLR values of more than 3 and PLR values of more than 150 were associated with increased chances of complications and sepsis. Conclusions: Raised values of Neutrophil to Lymphocyte ratio (NLR) and Platelet to lymphocyte ratio (PLR) were found to be associated with increased chances of sepsis and other complications. However further randomized controlled trials are needed to validate prognostic ability of these ratios.
ABSTRACT
Angiolymphoid hyperplasia with eosinophilia is a rare disease characterized by vascular proliferation of unknown origin. The lesions are mostly seen in the head and neck region and are characterized by papules or nodules. A 20-year-old man presented with a 1 year history of reddish papulo-nodular lesions overlying a pulsatile swelling on the left auricular area. Histopathology was suggestive of angiolymphoid hyperplasia with eosinophilia. B-mode ultrasonography, color Doppler and angiography revealed arterial ectasia and arteriovenous malformation of the left auricular artery. Such malformations have been reported previously, in association with angiolymphoid hyperplasia with eosinophilia. The cutaneous lesions responded well to transarterial embolization of the nidus.
ABSTRACT
Objective: To investigate whether the application of thyroid collars (TCs) affects the results of cephalometric study. Study Design: The Steiner cephalometric analysis of the patients was performed using lateral cephalometric radiographs, which were taken twice for each patient: Once using TCs (TC group; n0 = 50) and once without using TCs (NTC group; n = 50). A randomized and observer-blinded diagnostic study with head films taken from the two aforementioned groups was performed and results were evaluated with the t-test and Z-test, using GraphPad® Prism 4 software. Results : Statistical analysis using t-test was performed. The values of the line angles used in Steiner cephalometric analysis were compared for which values of each angle remained unchanged when done using TCs and without TC to the same samples. Conclusions : Lead shielding of the thyroid gland does not affect landmark identification or the specific measurements of the angulations traced during cephalometric analysis. TCs should be routinely applied during cephalometric radiography if cephalometric analyses are limited to the structures above the second cervical vertebra.