ABSTRACT
Introduction: CNS infections are an emerging health problemwith poor prognosis if the treatment is not prompt andadequate. Thus, establishing a correct diagnosis is necessaryto quickly start the appropriate treatment. This study wasundertaken to study the etiology and the imaging spectrum ofCNSI in and around western Uttar Pradesh in a tertiary healthcare set up and to correlate the neuro-imaging findings withclinic-pathological data.Material and Methods: In this Prospective Observationalstudy 80 patients clinically suspected of CNS infection werestudied by CT/MRI and the neuro imaging findings werecorrelated with clinical and CSF findings.Results: Based on clinical features, CSF findings, thetreatment given and the response to treatment tuberculousinfection (TBM) was most common infection (41.2%)followed by pyogenic meningitis (36.2%) and viral infection(22.5%). In 29 patients of pyogenic CNS infection mostcommon imaging finding was leptomeningitis(62%)followed by pachymeningitis (31%), hydrocephalus (24.1%),abscess (6.8%), post vasculitic infarct(6.8%) and extra axialcollection(6.8%). In 33 patients of tubercular CNS infectionmost common imaging finding was basal leptomeningitis(78.7%) followed by tuberculoma (72.7%), pachymeningitis(33.3%), hydrocephalus (27.2%), abscess (12.1%), postvasculitis infarct (12.1%) and spinal cord involvement in1 (3%) patient. In the 18 viral CNS infection cases mostcommon imaging finding was parenchymal hyperintensity onMRI or hypodensity on CT with/without peripheral vasogenicedema (94.4%) followed by leptomeningeal/pachymeningealinvolvement (61.1%) and post vasculitis infarct (11.1%).Conclusion: The sensitivity of neuroimaging in pyogenicCNS infection was 81.2% and specificity was 93.7% whilesensitivity of neuroimaging in tubercular CNS infection was88.8% and specificity was 97.8% and in viral CNS infectionsensitivity was 84.2% and specificity was 96.7%. There wassignificant association (p value <0.05) of basal leptomeningitisand granulomas on imaging with tubercular infection andparenchymal signal changes with viral infections
ABSTRACT
Introduction: Worldwide, COPD is the major cause ofhealth care burden and the only leading cause of death that isincreasing in prevalence. Hence present study was undertakento correlate clinical and radiological findings of PulmonaryEmphysema. Imaging spectrum of Emphysema was analysedby chest X ray and computerized tomography and they werecorrelated with stages of COPD as per GOLD guidelinesbased on PFT.Material and Methods: The source of data for this prospectivestudy were 150 patients with probable diagnosis of COPDreferred to our department of Radio diagnosis. After informedconsent, clinical history and clinical examination was done.PFT, chest radiographs and CT were performed.Results: There was a significant association between X rayfinding with PFT and CT findings with PFT with P Value 0.001and P value 0.0002 respectively using Fischer’s exact test.There was a significant association between the features likehyperinflation, bullae and tubular heart noted on X ray withCT. CT was much more sensitive in diagnosis of emphysemain even mild type of COPD.Discussion: COPD is a disease of old age and is associatedwith prolonged duration of exposure to smoke and noxiousparticles. CT is undoubtedly more sensitive(100%) than chestradiographs in diagnosing emphysema and in determiningits type and extent and has a significant association withPFT.Conclusion: This hospital based study had limitations ofsmall sample size and inherent bias, but clearly shows thatCT has important diagnostic role in Emphysema with highsensitivity and specificity.