Readout-Segmented Echoplanar (RESOLVE) Diffusion-Weighted Imaging on 3T MRI in Detection of Cholesteatoma-Our Experience.

Background Several research studies have demonstrated the utility of diffusion-weighted imaging (DWI) in detecting middle ear cholesteatomas, especially with the non-echoplanar imaging (non-EPI) DWI technique. REadout Segmentation Of Long Variable Echo trains (RESOLVE), a multishot-EPI DWI, has better spatial resolution at a thinner section acquisition with reduced image distortion compared to the single-shot-EPI DWI technique. Purpose In this study, we evaluated the diagnostic ability of RESOLVE -DWI in middle ear cholesteatomas with surgical and histopathological support. Patients and Methods Fifty patients with clinical suspicion of primary cholesteatoma or postoperative recurrence were subjected to routine sequences and RESOLVE-DWI on magnetic resonance imaging (MRI). Thirty-eight patients had unilateral disease, while 12 patients had bilateral disease. The bilateral temporal bones of 50 patients were evaluated on MRI. The results attained by RESOLVE-DWI were correlated with intraoperative and histopathological findings. Results RESOLVE-DWI truly detected 55 of the 58 surgically proven cholesteatomas. RESOLVE-DWI could not detect three cholesteatoma lesions due to their small size and falsely diagnosed one case each of impacted wax and non-cholesteatomatous otitis media as cholesteatoma. With a 95% confidence interval, RESOLVE-DWI showed 94.8% sensitivity, 95.2% specificity, 96% positive predictive value, 93% negative predictive value, and 95% diagnostic accuracy in cholesteatoma detection. Conclusion RESOLVE-DWI is a sensitive and specific DWI technique for detecting middle ear cholesteatoma. However, RESOLVE-DWI has limitations in the diagnosis of small (<3 mm) cholesteatomas.

MRI Findings in Case of Post-COVID-19 Vaccination Rhabdomyolysis: A Rare Postvaccination Adverse Effect.

In the era of this pandemic, without any proper and efficacious availability of antiviral agents against the novel coronavirus disease 2019 (COVID-19), vaccines have come as a hope for humankind. Although adverse reactions are common after getting the COVID-19 vaccine, serious or life-threatening side effects are very uncommon in these new emergency-approved vaccines. In this case report, we describe an unusual case of adverse reaction in a patient who received the COVID-19 vaccination. The patient who received the COVID-19 vaccination presented with progressive right lower limb pain and swelling, which further progressed to bilateral shoulder pain and swelling. Ultrasonography, Doppler, and magnetic resonance imaging of right lower limb were done for the patient.

Tracheostomy: Experience at Tertiary Hospital.

An attempt was made to find indications of tracheostomy procedure and its complications in the modern era of medicine with refined surgical techniques at a tertiary hospital. A retrospective study of 240 patients, who had undergone tracheostomy, was done during the period from January 2013 to April 2017 at Govt. Medical College Hospital. Various details of all participants such as age and sex of patients, detailed history of the current disease, and detailed information about tracheostomy and complications were recorded. In the present study, the most common indication for tracheostomy was prolonged ventilation due to Organophosphorus poisoning and Snake bite. The complication rate for tracheostomy procedure was 11.5%. The most common complication was tubal occlusion (7.5%) followed by Granulations around stoma (2.5%), Tracheal stenosis (1.25%), tracheoesophageal fistula (0.4%). No death was occurred during the tracheostomy procedure. The morbidity and mortality due to tracheostomy are reduced definitely. Tracheostomy Complications can be prevented by refined surgical techniques, use of high volume low pressure cuffed tracheostomy tubes and attentive post-operative nursing care. Yet complications of tracheomalacia and tracheal stenosis call for further improvement.

Esophagobronchial fistulae: Diagnosis by MDCT with oral contrast swallow examination of a benign and a malignant cause.

We report two cases of esophagobronchial fistulae diagnosed by Multi-detector computed tomography (MDCT) oral contrast swallow examination. It is helpful to supplement the CT study with an oral contrast swallow as it aids in confirmation of a suspected fistula and also demonstrates the fistula tract better. We present the clinical details and the imaging findings on MDCT of two cases of esophagobronchial fistulae - one secondary to chronic chest tuberculosis and the other secondary to a squamous cell carcinoma of the upper esophagus - followed by discussion of the etiology, pathogenesis, and imaging of these fistulae.