scholarly journals MR CHOLANGIO-PANCREATICOGRAPHY AS A TOOL FOR EVALUATION OF PATIENTS WITH PANCREATICOBILIARY DISEASES

2020 ◽  
Vol 8 (11) ◽  
pp. 901-951
Author(s):  
Ashraf S. Nadaf ◽  
◽  
Nanjaraj C.P ◽  
Rajendra Kumar N.L ◽  
Shashi Kumar M.R ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Imaging Modality ◽  
Common Finding ◽  
Imaging Method ◽  
Biliary Disease ◽  
Diagnostic Modality ◽  
Medical College ◽  
Non Invasive ◽  
Adjacent Structures ◽  
Study Population

Objectives Of Study: 1. To describe features of pancreaticobiliary diseases on MRCP. 2. Outlining the extent in terms of involvement of adjacent structures, vessels
and soft tissues. 
 3. To help in deciding further course of management. 4. To identify the anatomical variants. 
 5. To prove the Magnetic Resonance Cholangio-Pancreatography (MRCP) is
one of the best imaging modality for evaluation of pancreatico-biliary disease. Material And Methods:The present study was undertaken to evaluate the role of MRCP in evaluation of pancreaticobiliary diseases. The study will be done on patients presenting with features suggestive of pancreatico-biliary diseases attending the OPD or admitted in various wards of Krishna Rajendra hospital, Mysore attached to Mysore Medical College & Research Institute, Mysore. A total of 30 patients were included in our study. Result:Majority of patients in study population were males (60%) while 40% were females. The mean age of the study sample was 37.5 years and maximum numbers of cases were observed in age group of > 40 years. Majority of pathologies observed were benign 18(60%). Pancreatitis was the most common finding (33.3%) followed by Cholangiocarcinoma (20%), Choledocholithiasis (13.4%), Periampullary carcinoma (10%), Ca. Pancreas (6.7%) & Choledochal cyst (6.7%).Pancreatitis is common in males followed by Cholangiocarcinoma, which is common in both males & females.Both benign & malignant strictures have equal predominance. Both benign & malignant strictures are common in proximal CBD. Conclusion: MRCP is non-invasive, non-ionizing imaging method for evaluation of pancreatico-biliary anatomy and pathology. It is superior diagnostic modality in detection and characterization of pancreatico-biliary pathologies.

scholarly journals Role of MRI in the diagnosis of adult traumatic and obstetric brachial plexus injury compared to intraoperative findings

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Doria Mohammed Gad ◽  
Mostafa Thabet Hussein ◽  
Nagham Nabil Mahmoud Omar ◽  
Mohamed Mostafa Kotb ◽  
Mohamed Abdel-Tawab ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Tissue Characterization ◽  
Brachial Plexus Injury ◽  
Imaging Modality ◽  
Preoperative Evaluation ◽  
Diagnostic Modality ◽  
Non Invasive ◽  
Upper Limb Function ◽  
Obstetric Brachial Plexus ◽  
Sensitivity Specificity

Abstract Background Brachial plexus injury occurs following birth trauma or adult trauma as well, surgical repair is important to regain upper limb function, and preoperative evaluation with MRI is important and considered the accurate and safe imaging modality. Thirty-seven patients with clinically suspected obstetric (15 patients) or adult traumatic (22 patients) brachial plexus injury were included in our study; all of them underwent MRI examination including T1WI, T2WI, STIR, DWIBS, 3D STIR SPACE, and MR myelography sequences. Results In obstetric cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 63%, 89%, and 82%, respectively, while for postganglionic lesions, MRI sensitivity, specificity, and accuracy were 60%, 99%, and 95%, respectively. In adult cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 96%, 95%, and 95% respectively, while for postganglionic injury, MRI sensitivity, specificity, and accuracy were 60%, 100%, and 99%, respectively. Conclusion MRI represents a safe, non-invasive, diagnostic modality having the multiplanar capability and better soft tissue characterization.

scholarly journals Clinico-radiological profile of abdominal tuberculosis in HIV/AIDS patients-a study from rural central India

2017 ◽  
Vol 5 (5) ◽  
pp. 1980 ◽  
Author(s):  
Nisar A. Wafai ◽  
Sudhir K. Yadav ◽  
Prem S. Singh ◽  
Manoj Kumar ◽  
Prafulla K. Singh ◽  
...  
Keyword(s):  
Imaging Modality ◽  
Central India ◽  
Abdominal Tuberculosis ◽  
Cd4 Count ◽  
Common Finding ◽  
Non Invasive ◽  
Significant Difference ◽  
Average Size ◽  
Loss Of Appetite ◽  
Hiv Aids

Background: One of the major challenge of present era is dual epidemic of HIV/AIDS and tuberculosis. With immunosuppression, risk of opportunistic diseases increases in these patients and tuberculosis is most common opportunistic infection. The prevalence of abdominal tuberculosis seems to be rising, particularly due to increasing prevalence of HIV infection. The diagnosis of abdominal tuberculosis can often be difficult and it remains underdiagnosed, in view of its nonspecific manifestations. The investigations involved in its diagnosis are expensive and time consuming, however, ultrasonography (USG) is an affordable, non-invasive and widely available modality which can be of help in the diagnosis of abdominal tuberculosis. Therefore, this study was undertaken to evaluate clinical and USG finding among Abdominal Tuberculosis patients with HIV/AIDS.Methods: After informed consent, patients underwent thorough history taking and clinical examination followed by high quality USG abdomen and other biochemical and haematological tests including CD4 count. Follow up USG abdomen was done at time of completion of course of ATT and data was analysed.Results: 45 were found to have abdominal tuberculosis. Of these patients, 31(68.9%) were male and 14 (31.1%) were female. Mean age of HIV-abdominal TB was 34.27±9.66 years. most common symptoms were weight loss 41(91.1%), loss of appetite 38(84.4%), fever       32(71.1%), generalized weakness 30(66.7%) and abdominal pain 27(60.0%). On USG abdomen, intraabdominal lymphadenopathy was most common finding found in 44(97.8%). Average size of enlarged lymph node was 3.1+-1.0 cm. Mesenteric lymphnodes were enlarge in 40(88.89%), paraaortic 8(17.78%), retroperitoneal 4(8.89%) while peripancreatic and porta hepatic in 3(6.67%). splenomegaly was noted in 14(31.1%) cases. Hepatomegaly was found in 6 cases, who all were male. Ascites was evident in 5(11.1%) patients. Extensive involvement, defined as involvement of two or more intraabdominal sites, was found 24(53.3%) cases. There was no statistically significant difference found among these USG findings and CD4 count.Conclusions: The findings of lymphadenopathy (size>15mm) and hypoechoic/necrotic echotexture, hepatosplenomegaly with hypoechoic lesions in ultrasonography are suggestive of abdominal tuberculosis in HIV infected patients with unexplained nonspecific symptoms and low CD4 count.  However, above findings are not standardized and inability to confirm the diagnosis of tuberculosis by direct microscopy and culture is the limitation of this study. Ultrasonography is an affordable, widely available, non-invasive imaging modality which may be optimally utilized for the diagnosis of abdominal tuberculosis in HIV infected patients, especially in the rural setup where microbiological and other sophisticated radiological investigations have limited availability.

scholarly journals Optical coherence tomography angiography in diabetic retinopathy: a review of current applications

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Kai Yuan Tey ◽  
Kelvin Teo ◽  
Anna C. S. Tan ◽  
Kavya Devarajan ◽  
Bingyao Tan ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Vision Loss ◽  
Imaging Modality ◽  
Anterior Segment ◽  
Foveal Avascular Zone ◽  
Imaging Method ◽  
Optical Coherence ◽  
Non Invasive

Abstract Background Diabetic retinopathy (DR) is a leading cause of vision loss in adults. Currently, the standard imaging technique to monitor and prognosticate DR and diabetic maculopathy is dye-based angiography. With the introduction of optical coherence tomography angiography (OCTA), it may serve as a potential rapid, non-invasive imaging modality as an adjunct. Main text Recent studies on the role of OCTA in DR include the use of vascular parameters e.g., vessel density, intercapillary spacing, vessel diameter index, length of vessels based on skeletonised OCTA, the total length of vessels, vascular architecture and area of the foveal avascular zone. These quantitative measures may be able to detect changes with the severity and progress of DR for clinical research. OCTA may also serve as a non-invasive imaging method to detect diabetic macula ischemia, which may help predict visual prognosis. However, there are many limitations of OCTA in DR, such as difficulty in segmentation between superficial and deep capillary plexus; and its use in diabetic macula edema where the presence of cystic spaces may affect image results. Future applications of OCTA in the anterior segment include detection of anterior segment ischemia and iris neovascularisation associated with proliferative DR and risk of neovascular glaucoma. Conclusion OCTA may potentially serve as a useful non-invasive imaging tool in the diagnosis and monitoring of diabetic retinopathy and maculopathy in the future. Future studies may demonstrate how quantitative OCTA measures may have a role in detecting early retinal changes in patients with diabetes.

scholarly journals Role of magnetic resonance cholangiopancreatography in diagnosing pancreatobiliary pathologies: a prospective study

2018 ◽  
Vol 5 (6) ◽  
pp. 2233
Author(s):  
Dakshayani S. Nirhale ◽  
Gaurav C. Kulkarni ◽  
Pravin Shingade ◽  
Shahaji Chavan ◽  
Tejas Sonawane ◽  
...  
Keyword(s):  
Prospective Study ◽  
Pancreatic Duct ◽  
Treatment Modality ◽  
Imaging Modality ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Medical College ◽  
Non Invasive ◽  
A Prospective Study ◽  
Invasive Techniques

Background: Non-invasive techniques such as ultrasound and CT scan (abdomen and pelvis) are widely used in investigations of pancreaticobiliary disease, though easily available and cheap, have limitations in term of sensitivity. Invasive procedures like ERCP, though considered gold standard for diagnosis of pancreaticobiliary disease, requires highly skilled team of supporting doctors. MR Cholangio Pancreatography (MRCP) is evolving as an effective non-invasive imaging technique for examining patients with pancreatic or biliary diseases. The purpose is to illustrate the findings of MRCP in various abnormalities affecting the pancreaticobiliary diseases. Objective was to study the role of MRCP as non-invasive imaging modality for diagnosis of pancreatobiliary diseases, in diagnosing lower biliary tract pathologies, pancreatic duct pathologies, determining treatment modality in pancreatobiliary diseases, surgical or endoscopicMethods: This is a prospective study conducted in Dr. D. Y. Patil Medical College and Hospital, Pimpri, Pune for a period of two years from July 2015 to September 2017. 60 patients were enrolled in the study, their MRCP was performed following ultrasonography.Results: The MRCP diagnosed the following pathologies- cholelithiasis, choledocholithiasis, CBD stricture, chronic pancreatitis, choledochal cyst, cholangiocarcinoma, pseudocyst of pancreas, sclerosing cholangitis and GB perforation. Out of 60, 32 underwent surgical procedure and 20 underwent endoscopic procedure and 8 were treated medically.Conclusions: MRCP is very accurate in diagnosing CBD and pancreatic duct pathologies. Its helps in deciding the treatment modality for the same. It decides whether the patient requires ERCP and thus cuts down the rate of ‘negative’ ERCP.

scholarly journals Microwave tomography: review of the progress towards clinical applications

2009 ◽  
Vol 367 (1900) ◽  
pp. 3021-3042 ◽  
Author(s):  
Serguei Semenov
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Imaging Modality ◽  
Three Dimensional ◽  
Clinical Applications ◽  
Microwave Tomography ◽  
Non Invasive ◽  
Dielectric Contrast ◽  
High Dielectric ◽  
Tissue Abnormalities

Microwave tomography (MWT) is an emerging biomedical imaging modality with great potential for non-invasive assessment of functional and pathological conditions of soft tissues. This paper presents a review of research results obtained by the author and his colleagues and focuses on various potential clinical applications of MWT. Most clinical applications of MWT imaging have complicated, nonlinear, high dielectric contrast inverse problems of three-dimensional diffraction tomography. There is a very high dielectric contrast between bones and fatty areas compared with soft tissues. In most cases, the contrast between soft-tissue abnormalities (the target imaging areas) is less pronounced than between bone (fat) and soft tissue. This additionally complicates the imaging problem. In spite of the difficulties mentioned, it has been demonstrated that MWT is applicable for extremities imaging, breast cancer detection, diagnostics of lung cancer, brain imaging and cardiac imaging.

scholarly journals Outcome of Endoscopic Retrograde Cholangio-Pancreatography at Nobel Medical College Teaching Hospital: A Single Centre Experience

2020 ◽  
Vol 9 (2) ◽  
pp. 8-11
Author(s):  
Rohit Prasad Yadav ◽  
Kamal Raj Subedi ◽  
Bibek Kumar Purbey ◽  
Manish Gautam ◽  
Amit Bhattarai ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
College Teaching ◽  
Common Finding ◽  
Biliary Disease ◽  
Endoscopic Retrograde ◽  
Therapeutic Success ◽  
Cross Sectional ◽  
Medical College

Background: Endoscopic retrograde cholangiopancreatography is a technically demanding endoscopic procedure for both diagnostic and therapeutic purpose in treating various pancreaticobiliary diseases. This service is very limited in tertiary care center of our country Nepal mostly limited to Kathmandu valley and Dhulikhel hospital. Materials and Methods: This is a descriptive cross-sectional study patients who underwent ERCP with therapeutic intent in Nobel Medical College Teaching Hospital, Biratnagar from April 2019 to April 2020. Total 148 patients were included in this study for analysis. Results: The most common finding was choledocholithiasis in 132(89.2%) patients. Benign biliary stricture was found in 7 (4.7%). Biliary obstruction due to periampullary growth was found in 7 (4.7%) patients. Bile duct injury was found in 1(0.7%) and chronic pancreatitis in 1 (0.7%) patient. The therapeutic success of ERCP was for choledocholithiasis, Stone Clearance in 1st attempt 68.9%, in multiple attempts18.2%, failed stone extraction in 3 cases (2.0%) only biliary stenting was done in 15 (10.3%) patients of various biliary disease for therapeutic and palliative reason. Pancreatic stenting was done in1 (0.7%) patient. The most common complication was Acute Pancreatitis in 6(4.1%), Post-Sphincterotomy bleeding in 1 (0.7%), biliary septic shock in 1 (0.7%) and 1 death (0.7%). Conclusion: ERCP can be continued in Nobel Medical College Teaching Hospital as it has lots of benefits with minimal acceptable complications.

scholarly journals Evaluation of Alvarado scoring system (Mandrels scoring) as a diagnostic aid in preoperative diagnosis of acute appendicitis at Nalanda Medical College and Hospital, Patna

2020 ◽  
Vol 7 (7) ◽  
pp. 2181
Author(s):  
Raj Shekhar ◽  
V. K. Gupta
Keyword(s):  
Acute Appendicitis ◽  
Scoring System ◽  
Diagnostic Modality ◽  
Medical College ◽  
Non Invasive ◽  
Pain Abdomen ◽  
Surgical Emergencies ◽  
Negative Appendicectomy ◽  
Operative Findings ◽  
Individual Presentation

Background: Acute appendicitis is one of the commonest surgical emergencies. The rate of negative appendicectomy has been reported to be between 20-30%. The aim of this study is to evaluate the efficacy of Alvarado scoring system in cutting down the rate of negative appendicectomy without increasing morbidity and mortality.Methods: A study of 100 patients presenting with pain abdomen and diagnosed provisionally as acute appendicitis, was undertaken. Depending on individual presentation, a score was calculated for each case, based on Alvarado scoring system. Operative and conservative intervention was undertaken in patients with scores between 5 and 10 and <5 respectively. The results of Alvarado scoring system, on table operative findings and HPE, were reviewed.Results: A total of 94 patients with score of 7-10 and 5-6 were operated. Among males with score of 7-10, 33 patients were operated and 31 were found to have inflamed appendix. Among females with score of 7-10, 33 patients were operated and 28 were found to have inflamed appendix. The sensitivity of Alvarado scoring system in males with score of 7-10 was found to be 81.57% and among females with score of 7-10 was found to be 75.67%.Conclusions: The Alvarado scoring system is a fast, simple, reliable, non-invasive, repeatable and safe diagnostic modality without extra expense and complications.

scholarly journals A prospective study of clinical, biochemical and radiological features in pancreatitis

2017 ◽  
Vol 4 (5) ◽  
pp. 1386
Author(s):  
Raj Kumar Bhimwal ◽  
Mohan Makwana ◽  
Rewat Ram Panwar ◽  
Kanwar Lal
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Chronic Pancreatitis ◽  
Imaging Modality ◽  
Biliary Disease ◽  
Computed Tomography Scan ◽  
Medical College ◽  
Acute And Chronic Pancreatitis ◽  
Tomography Scan

Background: Pancreatitis is quite common problem, it may present either as abdominal emergency with fulminant course or as an indolent process leading to long-term medical as well as surgical complications often leading to poor prognosis if not intervened timely.Methods: The present study conducted in the department of medicine, Dr. S. N. medical college, Jodhpur. Participants after understanding the study protocol and procedure, asked to give their written consent for the study. A cross sectional hospital based study in patients admitted in various medical wards of Dr. S. N. medical college, Jodhpur. 50 patients with acute and chronic pancreatitis were studied.Results: In the present study, most common cause of acute pancreatitis is biliary disease (50%) followed by alcoholism (37.5%) and in chronic pancreatitis is alcoholism (80%). Acute pancreatitis was more common in males (62.5%, 25 males) whereas chronic pancreatitis in males (80%, 8 male). Abdominal pain is the most common symptom (97.5%) followed by nausea-vomiting (92.5%) in acute pancreatitis. The history of previous abdominal pain in 100% of cases followed by epigastria pain in 90% of cases, in chronic pancreatitis. The amylase and lipase were elevated in 90% of cases. The amylase and lipase levels did not correlate with the severity. 66.6% of patients had severe pancreatitis with a positive predictive value of 66.6%. The ultrasonography imaging of pancreas was helpful in 70% and 100% in acute and chronic pancreatitis respectively. The CT scan was a better imaging modality as compared to ultrasonography in acute pancreatitis, where as it scored over ultrasonography imaging in chronic pancreatitis with complications.Conclusions: Relevant clinical history, ultrasonography and computed tomography scan of pancreas are helpful in diagnosis of pancreatitis. The computed tomography scan was a better imaging modality as compared to ultrasonography.

TO FIND OUT ELECTRO-CARDIOGRAPHIC CHANGES & ECHO CHANGES IN ALUMINIUM PHOSPHIDE AND ETHYLENE DIBROMIDE POISONING

2020 ◽  
Vol 4 (10) ◽  
Author(s):  
Hemant Nargawe ◽  
Sumeet Sisodiya
Keyword(s):  
Biochemical Analysis ◽  
Histopathological Examination ◽  
Common Finding ◽  
Histopathological Changes ◽  
Ethylene Dibromide ◽  
Medical College ◽  
Aluminium Phosphide ◽  
Urine Examination ◽  
Cardiovascular Involvement ◽  
Careful Clinical Examination

Background & Method: The study was conducted in the Department of Medicine Shyam Shah Medical College and Associated Sanjay Gandhi Memorial Hospital, Rewa (M.P). History was followed by a careful clinical examination i.e. cardiovascular, respiratory and gastrointestinal and nervous system. Investigations had done included routine haematological examination, Biochemical analysis, urine examination, ECG, 2 D. Echo & Histopathological examination was done. Result: ST-T changes were most common finding in Aluminium phosphide poisoning in relation to mortality. However hyperkalemia was the most ominous finding associated with 100% mortality, ECG finding in EDB was normal ECG. The most ominous finding was arrhythmia which was associated with 100% mortality. Survivors of ethylene dibromide poisoning echocardiography was normal in 11 (84.61%) followed by pericardial effusion in 2 (15.38%) patients. Conclusion: Noteworthy finding was absence of correlation between cardiovascular involvement, histopathological changes and ECG findings. It was seen that even if ECG showed normal pattern there were significant histopathological changes in heart. Keywords: electro-cardiographic, Aluminium phosphide, ethylene dibromide & poisoning.

Comparative study of ultrasonographic findings with the operative findings of biliary surgery

2020 ◽  
Vol 22 (1) ◽  
pp. 25-29
Author(s):  
Zubayer Ahmad ◽  
Mohammad Ali ◽  
Kazi lsrat Jahan ◽  
ABM Khurshid Alam ◽  
G M Morshed
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Imaging Modality ◽  
False Positive Rate ◽  
Gallstone Disease ◽  
False Negative ◽  
False Negative Rate ◽  
Biliary Disease ◽  
Biliary Surgery ◽  
Operative Findings

Background: Biliary disease is one of the most common surgical problems encountered all over the world. Ultrasound is widely accepted for the diagnosis of biliary system disease. However, it is a highly operator dependent imaging modality and its diagnostic success is also influenced by the situation, such as non-fasting, obesity, intestinal gas. Objective: To compare the ultrasonographic findings with the peroperative findings in biliary surgery. Methods: This prospective study was conducted in General Hospital, comilla between the periods of July 2006 to June 2008 among 300 patients with biliary diseases for which operative treatment is planned. Comparison between sonographic findings with operative findings was performed. Results: Right hypochondriac pain and jaundice were two significant symptoms (93% and 15%). Right hypochondriac tenderness, jaundice and palpable gallbladder were most valuable physical findings (respectively, 40%, 15% and 5%). Out of 252 ultrasonically positive gallbladder, stone were confirmed in 249 cases preoperatively. Sensitivity of USG in diagnosis of gallstone disease was 100%. There was, however, 25% false positive rate detection. Specificity was, however, 75% in this case. USG could demonstrate stone in common bile duct in only 12 out of 30 cases. Sensitivity of the test in diagnosing common bile duct stone was 40%, false negative rate 60%. In the series, ultrasonography sensitivity was 100% in diagnosing stone in cystic duct. USG could detect with relatively good but less sensitivity the presence of chronic cholecystitis (92.3%) and worm inside gallbladder (50%). Conclusion: Ultrasonography is the most important investigation in the diagnosis of biliary disease and a useful test for patients undergoing operative management for planning and anticipating technical difficulties. Journal of Surgical Sciences (2018) Vol. 22 (1): 25-29

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