ABSTRACT
Background:Central venous catheterization is a vital intervention in critically ill patients. The purpose of this study was to compare the procedural parameters and complications associated with anterior and posterior approaches of IJV catheterization under real timeultrasound guidance in critically ill patients. Material And Methods:In this prospective randomised study, 90 patients admitted in various ICUs were randomly allocated two groups of 45 each, including both males and females aged between 18 to 80 years ofage requiring central venous catheterization for various indications. Result:The first attempt success rates were comparable between both the groups. The venous visualization time was 38.52 seconds in Group A and 14.65 seconds in Group P (p<0.001). The venous puncture time and the duration of catheterization was found to be 47.60 sec & 2 minutes in Group A respectively and 24.16 sec & 1 minute 32 sec in Group P respectively (p<0.001). No statistically significant differences were found between the two groups in terms of incidence of carotid arterial puncture, haematoma formation and catheter displacement.Conclusion:It was observed that the posterior approach is better than anterior approach of USG guided IJV catheterization as it improves the accuracy, reduces the access time and duration of catheterization & leads to fewer incidences of immediate complications like carotid arterial puncture & subseque nt haematoma formation.
ABSTRACT
The main purpose of the article is to review the normal vertebral marrow and its appearance on MRI, including age-related changes and pathologic appearance based on routine MR sequences like T1, T2 & STIR. The signal intensity of the bone marrow depends mainly on the fat and water content. Each component has its appearance on MRI sequence that allows their differentiation. The red marrow is highly cellular, so it leads to a low signal intensity on T1-weighted sequences and high signal intensity on short tau inversion recovery (STIR) or fat-saturated T2-weighted sequences. Whereas, the yellow marrow presents an increased signal on T1- weighted sequences and low signal intensity on STIR or fat-saturated T2-weighted sequences. The differential diagnosis of pathological bone marrow includes degenerative changes, neoplasm, infection, and infiltrative marrow disorders. In this study, 30 cases were included, who presented with a chief complaint of neck pain, backache and radiculopathy who underwent MRI for evaluating the underlying pathology. The main objective of this study is to evaluate different MRI findings in these patients.METHODSPatients having neck pain, backache, and radiculopathy who presented in the Department of Radiodiagnosis at NRI Medical College and Hospital, Chinakakani, were included in the present study. On a random basis, 30 cases were included in the study, and all of them underwent routine MRI spine to a particular region according to the symptom.RESULTSThirty patients were studied with an age range of 22 years to 80 years. In our study, out of 30 patients, 4 had fatty replacement of marrow, 3 had hemangioma, 6 had Modic endplate changes, 3 had metastases, 4 had osteoporosis, 5 had Koch's spine, 5 had myeloproliferative disease. Of the 4 patients who had osteoporosis, two patients had wedge compression fractures.CONCLUSIONMRI is the sensitive tool in the imaging of vertebral marrow and imaging modality of choice in studying the bone marrow diseases. Routine sequences like T1, T2 & STIR sequences are the key for proper diagnosis and management of spinal pathology.