Ipsilateral renal dysgenesis or agenesis with tubulocystic anomalies of the mesonephric duct.

Tubulocystic anomalies of the mesonephric duct (MND) are a rare group of related entities with a perplexing clinical presentation. Ultrasound is a useful screening investigation, which can help identify a dysplastic kidney or point to renal agenesis and identify cystic or tubulocystic changes in the structures derived from the ureteric bud or MND. Further evaluation with MRI can help in characterisation and direct management. The presence of a dysplastic kidney or absence of a kidney should prompt further evaluation for associated ureteric abnormalities such as ectopic insertion or ureterocoele, which could lead to a diagnosis of tubulocystic anomaly of the MND. Contribution: The authors describe two cases, briefly outline the diagnostic approach and summarise the literature on management. Reporting radiologists should be aware of these entities.

A Rare Case of Isolated Vesical Mucormycosis in a Patient with COVID-19 Pneumonitis.

We present the case of a 60-year-old diabetic female who was diagnosed with coronavirus disease 2019 (COVID-19) pneumonitis. After her recovery during follow-up, she presented with recurrent hematuria, burning of micturition and, occasional lower abdominal discomfort, with unsatisfactory response to oral antibiotics. On imaging evaluation, there was mild right hydronephrosis and hydroureter with urothelial thickening involving the right lower ureter and a filling defect in the urinary bladder close to the vesicoureteric junction seen on excretory phase images. Cystoscopy revealed a whitish friable mass-like lesion that was retrieved, histopathology of which revealed fungal elements, and Rhizopus was isolated in culture. Thus, the diagnosis of urinary bladder fungal ball due to mucormycosis infection of the urinary tract was reached. The patient was asymptomatic after 10 weeks of antifungal treatment. The treating physicians, urologist, and radiologists need to have a high index of suspicion of urinary mucormycosis in patients with COVID-19 pneumonia.

CT and MRI Findings of Invasive Mucormycosis in the Setting of COVID-19: Experience From a Single Center in India.

An increasing incidence of rhinoorbitocerebral mucormycosis (ROCM) among patients with COVID-19 has recently been reported in India. We report the imaging findings for 25 patients with COVID-19 and invasive ROCM at a single hospital in India. Findings included sinus wall erosions (n = 20), air within bony sinus structures (n = 11), and focal mucosal nonenhancement (n = 8). Orbital, vascular, and intracranial complications were also observed. Radiologists should recognize the increasing incidence of ROCM among patients with COVID-19 to facilitate early diagnosis.

Preliminary experience with 3T magnetic resonance elastography imaging of the liver.

BACKGROUND: Magnetic resonance elastography (MRE) is a promising non-invasive technique for the identification and quantification of hepatic fibrosis. This manuscript describes our early experience with MRE for the assessment of the presence and staging of liver fibrosis on a 3T magnetic resonance imaging (MRI) system. OBJECTIVES: The purpose of this study was to describe the MRE physics, procedure, interpretation and drawbacks, along with a few recommendations as per our experience. METHOD: Magnetic resonance elastography was performed on 85 patients with a 3T MRI and the images were analysed both qualitatively and quantitatively. Liver stiffness was assessed by drawing freehand geographic regions of interest on the elastograms to cover the maximum portion of the hepatic parenchyma within the 95% confidence maps on each slice. Correlation with histopathology was performed whenever available. RESULTS: Of the 80 patients who met the inclusion criteria, 41 patients displayed a normal liver stiffness measurement (LSM) and 39 patients had a raised LSM. In the patients who had a raised LSM, 14 patients had Stage I-II fibrosis, 8 patients had Stage II-III fibrosis, 6 patients had Stage III-IV fibrosis, 4 patients had Stage IV fibrosis or cirrhosis and 7 patients had non-alcoholic steatohepatitis. The mean thickness of the waves increased with increasing stages of fibrosis. The waves became gradually darker medially in patients with normal LSM as compared to the patients with raised LSM. Histopathology with METAVIR scoring was available in 46 patients, which agreed with the MRE findings in all except two patients. CONCLUSION: Magnetic resonance elastography is a suitable non-invasive modality for the identification and quantification of hepatic fibrosis.

An Unusual Case of a Displaced Hemodialysis Catheter Guidewire Spontaneously Coming Out of Skull.

Hemodialysis catheter insertion is a common practice for the patients with renal failure. There are several complications associated with hemodialysis catheter insertion such as infection, catheter thrombosis, malposition, or vein stenosis; however, loss of guidewire during catheter insertion with its migration is a rare complication. We report the case of a 75-year-old male with forgotten displaced guidewire which came out spontaneously from the skull in the occipital region, three years after the hemodialysis. To the best of our knowledge, this is the only case that has been reported in literature till date. We also discuss the possible causes of a retained guidewire and measure to prevent it. How to cite this article: Muthe M, Joshi A, Firke V. An Unusual Case of a Displaced Hemodialysis Catheter Guidewire Spontaneously Coming Out of Skull. Indian J Crit Care Med 2020;24(6):480-482.