Pulmonary Sarcoidosis – Radiological Evaluation

Background: Sarcoidosis is a multisystem inflammatory disease of unknown etiology that predominantly affects the lungs and intrathoracic lymph nodes. Sarcoidosis is manifested by the presence of noncaseating granulomas (NCGs) in affected organ tissues. It is characterized by a seemingly exaggerated immune response against a difficult–to-discern antigen. Materials and methods: All patients were known case of pulmonary sarcoidosis. All patients for this study had undergone X-ray and CT scan after taking informed consent. Results: In our study, we found that 17 (68%) patients with sarcoidosis have a characteristic radiologic appearance consisting of enlarged hilar and paratracheal lymph nodes, 24% of cases shows nonspecific or atypical findings, and in 4% of patients the radiograph is normal. Conclusion: Radiologists can play an essential role in the diagnosis and management of sarcoidosis. It is essential to recognize both the typical and the atypical manifestations of the disease and use information obtained from the correlation of imaging features with pathologic findings to help achieve an early diagnosis and reduce associated morbidity and mortality

Renal cell carcinoma – A spectrum of radiological findings

Background: Renal cell carcinomas (RCC) are primary malignant adenocarcinomas derived from the renal tubular epithelium and are the most common malignant renal tumor. They usually occur in 50- 70-year-old patients. Aim: Radiological evaluation of patients of renal cell carcinoma by modalities like USG, CT-Scan and MRI. Materials and methods: All the patients were cases of renal cell carcinoma that had come to Department of Radiology in Dhiraj Hospital. They were evaluated by different modalities like USG, CT-Scan and MRI after taking consent when and where needed. Results: Renal cell carcinoma followed age and sex trends which means 72% patients were males and 28% patients were females and most of the patients were above 50 years of age. Conclusion: CECT is the modality of choice for evaluation of renal cell carcinoma patients as it gives the information not only about the localization but also the distant spread of tumor. MRI can be used as an alternative and also to know about the renal vein and IVC invasion by the tumor. USG as is a cheap and easily available method can be used to screen the patients with a palpable flank mass and those with hematuria.

Radiological evaluation of Ovarian Dermoid

Background: Ovarian dermoid cyst is the most common ovarian neoplasm. It accounts for ~15% of all ovarian neoplasms. They tend to be identified in young women, typically around the age of 30 years. These slow-growing tumor contain elements from multiple germ cell layers and are easily detected with ultrasound and much better by CT scan and MRI. Materials and methods: Patients presented to Radiology department with known case of dermoid cysts of ovary or in whom accidental diagnosis of ovarian dermoid cyst was made eventually. Evaluation of ovarian dermoid with Ultrasound machine (Logiq P9 GE), CT scan Siemens (16 slice) and MRI Philips (1.5 Tim + dot system). Results: In our study we found that 25 (100%) patients had ovarian dermoid, 20 (80%) patients were of age group 21years to 40 years, 4 (16%) patients were of 41-60 years and 1 (4%) patients were of 0- 20 year age group. In diagnosis of ovarian dermoid our results showed that CT scan was more sensitive (96%) than USG (92% sensitivity). Conclusion: Detection and morphological characterization of ovarian dermoid can be easily done on ultrasound. MRI and CT scan are useful adjunct to USG in its characterization and detection of associated pathology. In USG, when ovary shows heterogeneously hyperechoic lesion with fat fluid level without any vascularity highly suggestive of ovarian dermoid.

Role of MRI spine in evaluation of cases of neurotrophic arthropathy

Introduction: A neurotrophic joint (also known as a Charcot joint) refers to a progressive degenerative/ destructive joint disorder in patients with abnormal pain sensation and proprioception. A substantial number of neurotrophic joints are caused secondary to lesions of the spine. Many a times the patient does not give any history indicating a spine lesion. Hence MRI scan of Spine should be made a part of the investigations in every case of neurotrophic joint. Aims and objectives: To study the incidence of Spinal lesions as a primary causative factor behind a neurotrophic joint and to study the efficacy of MRI spine exam in correctly diagnosing Spinal lesions in patients presenting with a neurotrophic joint. Materials and methods: This study was conducted in the Radiology department of Dhiraj general Hospital. 20 patients presenting with neurotrophic joint/joints but giving no history suggestive of an underlying spinal pathology were evaluated by MRI spine. Results: Out of 20 patients presenting with neurotrophic joint who were evaluated by MRI spine, only 12 scans revealed a spinal pathology secondary to which the patient had developed neuropathic change of the affected joint. Conclusion: Onset of joint neuropathy is usually insidious. If this pathological process continues unchecked, it can result in joint deformity, ulceration and/or super infection, loss of function, and in the worst-case scenario, amputation or death. Early identification of joint changes is the best way to limit morbidity and for that early diagnosis of any underlying pathology is important. MRI spine is a sensitive tool to detect any lesion of the spine. It helps to accurately diagnose a variety of spinal lesions and tells about its exact size, extent and severity and thereby contributes immensely in the management of a neurotrophic joint.

Radiological investigations of imperforate anus

Introduction: Imperforate anus is a defect that is present from birth (congenital) in which the opening to the anus is missing or blocked. In female infants, imperforate anus is typically characterized by the rectum, bladder and vagina sharing one large opening called a cloaca. The condition develops in utero during the 5th to 7th weeks of pregnancy. This condition often happens in conjunction with other defects of the rectum. Incidence is 1 in 5000. It is more common in males. Diagnosis is usually made shortly after birth. Aims and objectives: To study the presentation of imperforate anus using various radiological modalities. Materials and methods: 10 cases of either strong suspicion or symptoms related to imperforate anus were evaluated who came to Dhiraj hospital with different radiological modalities like plain radiograph lateral invertogram, cross table lateral radiograph, erect radiograph and contrast studies (MCUG). Results: Out of total number of 10 patients who were diagnosed and evaluated for imperforate anus 3 i.e. 33.3 % were diagnosed with plain radiograph lateral invertogram, 2 i.e. 20 % were diagnosed with prone cross table lateral radiograph, 2 i.e. 20 % were diagnosed with abdominal erect radiograph and 2 were found to have recto-vesical fistula with the help of micturating cystourethrogram. Conclusion: It was concluded that plain radiograph lateral invertogram proves to be the most important modality in diagnosing imperforate anus. It is followed by prone cross table lateral radiograph and abdominal erect radiograph. Micturating cystourethrogram proves to be important in diagnosing associated anomalies such as recto-vesical fistula.