Estimation of role of CT scan and MRI in diagnosis of tuberculosis of brain and spine.

Background: Tuberculosis of the brain and spine is a very severe disease and causes increased rate of mortality and morbidity. Its diagnosis is a challenge for physicians worldwide. Patients of different age groups and having varied socio-economic status suffer from neurotuberculosis which need to be evaluated successfully to help the physician with further management of the condition. Aim: To estimate role of CT scan and MRI in diagnosis of tuberculosis of brain and spine. Material and methods: Patients referred to the Radiology Department with any kind of neurological symptoms, coincidental finding of neurotuberculosis or even those with already diagnosed cases of neurotuberculosis which needed follow up radiological investigations were evaluated with either CT or MRI or sometimes both (These were performed on 1.5 T Philips MRI and Seimens 16 Slice MDCT machine). Results: Patients with intracranial tuberculosis mainly presented with tuberculous meningitis and tuberculomas. Most patients suffering from spinal infection presented with Pott’s spine. Most of the lesions were paradiscal with involvement of the articular discs. MRI is more sensitive than CT scan in the diagnosis of intracranial tuberculosis. MRI is also very sensitive in the diagnosis of intracranial. tuberculosis as compared to CT. CT had no significant role in the diagnosis of Spinal tuberculosis. Hence, MRI is the preferred choice of investigation while evaluating neurotuberculosis.

Estimation of role of ultrasound and MRI in the examination of shoulder joint.

Background: To recognize different pathologies affecting the shoulder joint with the help ultrasound and MRI scans and to evaluate the features, pattern and extension of the different pathologies affecting the shoulder joint with help of ultrasound and MRI scans so as to help the clinician for further management. Aim: To estimate role of ultrasound and MRI in examination of shoulder joint. Material and methods: Study comprised of an observational hospital based study. Out of 65patients, 20 underwent only ultrasound investigation, 25 underwent only MRI scans whereas 20 patients were evaluated by ultrasound and MRI. These were performed by 3-5 MHZ curvilinear probe and 8-10 MHZ linear probe on HD 7 and HD 9 Philips ultrasound machines and 1.5 T Philips MRI machine. MR arthrography was performed as a follow up in some of the patients in outside centre. Results: USG study also showed that the most commonly occurring rotator cuff tears were supraspinatus tears whereas alone infrspinatus and subscapularis tears were very rare. MRI study showed supraspinatus tears Were the most frequently occurring in the rotator cuff whereas subscapularis and infraspinatus tears were the most commonly occurring rotator cuff tears were supraspinatus tears whereas alone infraspinatus and subscapularis tears were very rare. MRI study showed supraspinatus tears were the most frequently occurring in the rotator cuff whereas subscapularies and infraspinatus tears were rare. MRI is 100% confirmative in almost all cases of Rotator cuff tears but may sometimes need extra imaging by MR arthrography in partial bursal tears. Conclusion: Rotator cuff tears are the most common pathologies affecting the shoulder joint according to this study. It was proved that, there is no evident difference in the accuracy of ultrasound and MRI in detecting this pathology, even though MRI has proved to be more accurate in evaluating almost all other pathologies as compared to ultrasound.