Mayer-Rokitansky-Küster-Hauser Syndrome: MR Manifestations Of Typical And Atypical Cases.

BACKGROUND: The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a group of congenital malformations arising due to agenesis or arrest of the growth of paired Mullerian ducts leading to absence of uterus, fallopian tubes and upper part of vagina. MRI has an unmatched role in diagnosing MRKH syndrome. The aim of the present study is to elaborate MRI manifestations of typical and atypical MRKH syndrome and its common and rare associations. METHODS: It was a cross sectional analysis of 19 cases in the Radiology Department of a public sector tertiary health care hospital of Rawalpindi over a period of one year. All patients clinically diagnosed as MRKH syndrome were included in the study. MRI pelvis of the study patients was performed and evaluated by two experienced radiologists. RESULTS: The mean age of study patients was 22.2 years. Out of 19 study patients, 16 (84%) had type I while 3 (16%) had type II MRKH syndrome. None of the patients had normally cited uterus of normal morphology. Bilateral ovaries with follicular activity were identified in all patients. A well-defined leiomyoma was identified arising from the left uterine bud in one of these patients. All three patients with MRKH II syndrome had ectopic pelvic kidneys. One of the patients showed a neoplastic mass lesion arising from ectopic left kidney. CONCLUSION: MRI is an excellent imaging modality for accurate diagnosis and evaluation of other system anomalies in MRKH syndrome. Rudimentary uterine buds are commonly seen in these patients and may have functioning endometrium. Ovaries are of normal appearance but frequently ectopic.

An Analysis of High-Resolution Computed Tomography Chest Manifestations of COVID-19 Patients in Pakistan.

Objective The objective of the present study is to describe high-resolution CT (HRCT) chest manifestations of coronavirus disease 2019 (COVID-19) patients presenting to a tertiary healthcare facility in Punjab, Pakistan, and to analyze the distribution of the disease in lung fields. Additionally, we assess the role of chest CT severity scoring (CT-SS) in determining the severity of pneumonia. Methods In this cross-sectional descriptive study conducted from March 30, 2020, to May 30, 2020, 87 confirmed COVID-19 patients undergoing HRCT scan in a tertiary care facility in Punjab, Pakistan were included. The HRCT chest was performed on the patients using a standard protocol. Each study was evaluated for the presence of ground-glass opacities (GGOs), consolidation, mixed pattern, distribution, crazy paving, reverse halo sign, nodules, pleural effusion, and other findings. Additionally, CT-SS was calculated by dividing each lung into 20 zones. Each zone was scored as 0, 1, and 2, representing no involvement, <50% involvement, and >50% involvement of one zone respectively (total score: 0-40 for each patient). The patients were classified into mild, moderate, and severe cases (mild: CT-SS of <20, moderate: CT-SS of 20-30, and severe: CT-SS of >30). Results GGO was the most common finding, as seen in 88.5% of the patients, followed by consolidations (52.8%) and crazy paving (33.3%). The majority of the patients showed the bilateral and peripheral distribution of the disease process. Vascular dilatation and bronchiectasis were seen in 10 patients; pleural effusions were observed in only two study patients, while no patient exhibited reverse halo sign or pulmonary nodules. The superior segment of lower lobes was the most commonly involved segment bilaterally. According to CT-SS, 78 (89.6%), six (6.9%), and three (3.45%) patients had mild, moderate, and severe disease respectively. Conclusion The typical imaging findings of COVID-19 on HRCT are GGOs with multilobe involvement and bilateral, peripheral, and basal predominance. CT-SS is helpful in categorizing pneumonia into mild, moderate, and severe types, thereby helping to identify patients with severe disease. This is particularly helpful in settings where fast triage is required.