scholarly journals Correlation of Diffusion-Weighted Magnetic Resonance Imaging Determined Infarct Volume with Clinically Assessed National Institutes of Health Stroke Scale in Patients of Acute Stroke: A Cross-sectional Study

2021 ◽  
Author(s):  
Bhavya Kataria ◽  
Shibani Mehra
Keyword(s):  
Acute Stroke ◽  
Infarct Volume ◽  
Cross Sectional Study ◽  
National Institutes Of Health ◽  
Sectional Study ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Diffusion Weighted ◽  
Weighted Magnetic Resonance Imaging ◽  
Time Of Admission

Introduction: Infarct volume is an essential factor in predicting patient prognosis. National Institutes of Health Stroke Scale (NIHS) allows consistent reporting of neurological deficits in stroke patients. Limited studies have been done in the Indian population correlating the volume of infarct and the NIHS Scale. Aim: To correlate the Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI) assessed infarct volume with the clinically assessed NIHS to prognosticate clinical outcomes in patients of acute stroke. Materials and Methods: This was a cross-sectional study comprising 36 patients of acute stroke with a study duration from November 2017 to April 2019. Diffusion-Weighted MRI was obtained on Siemens Magnetom 3 Tesla, and diffusion restriction on b=1000 image was measured with a Region of Interest (ROI) tool using manual contouring in each slice. Assessment of the neurological deficit was done by NIHS scale at the time of admission and 7 days post admission for each patient. Correlation of the infarct volume with NIHS Scale was done with p<0.05 considered statistically significant. Receiver Operating Characteristic Curve (ROC) was used to predict cut-off of the volume of infarct and NIHS Scale to predict adverse patient outcome. Results: Present study consisted of 36 patients of acute stroke with a mean age of 52.05±18.53 years. The minimum age of the patient was one year, and the maximum age was 78 years. There was a statistically significant correlation between the volume of infarct and NIHS Scale at time of admission admission (p=0.001; r=0.807) and the NIHS Scale at one week (p=0.002; r=0.602).The Area Under the Curve (AUC) for a cut-off of 115 cc of the volume of infarct in predicting adverse patient outcomes was 0.931, whereas that for the NIHS scale of 20 was 0.998. Conclusion: Volume of infarct of 115 cc and NIHS Scale of 20 are excellent as prognostic tools in predicting patient outcome and have comparable efficacy.

CORRELATION OF DIFFUSION WEIGHTED MR DETERMINED INFARCT VOLUME WITH ALBERTA STROKE PROGRAM EARLY COMPUTED TOMOGRAPHY SCORE IN ACUTE STROKE PROGNOSIS

2021 ◽  
pp. 41-44
Author(s):  
Kataria Bhavya ◽  
Mehra Shibani
Keyword(s):  
Patient Outcome ◽  
Acute Stroke ◽  
Infarct Volume ◽  
Inverse Correlation ◽  
Cross Sectional Study ◽  
Slice Thickness ◽  
Cross Sectional ◽  
Diffusion Weighted ◽  
Patient Prognosis ◽  
Adverse Patient Outcome

AIMS AND OBJECTIVES: To correlate the Diffusion MRI assessed infarct volume with the ASPECT Score to prognosticate clinical outcome in patients of acute stroke. METHOD AND MATERIALS: This was a cross sectional study comprising 36 patients of acute stroke. Diffusion weighted MR was obtained at b values of 0,500 & 1000 on Siemens Magnetom Skyra 3 Tesla scanner. Diffusion restriction on b=1000 image was measured with VOI tool using manual contouring in each slice. Volume was calculated using the formula (Area x slice thickness) after summating the infarct area measured in each slice. ASPECT Score was assessed on CT in each patient at the time of admission of the patient. Correlation of the infarct volume with ASPECTS was done using student t-test with p < 0.05 considered statistically signicant. ROC curve was used to predict cut off of volume of infarct & ASPECTS predicting adverse patient outcome. RESULTS: There was a statistically signicant inverse correlation between the volume of infarct and ASPECTS (p=0.001; r=-0.844). The AUC for a cut-off of 115 cc of the volume of infarct in predicting adverse patient outcome was 0.931 whereas that for ASPECT Scale of 6 was 0.931. CONCLUSION: Infarct volume correlates well with ASPECT Score, both serving as prognostic tools in predicting patient outcome in acute stroke and having comparable efcacy in predicting prognosis. BACKGROUND: Infarct volume and CT ASPECT Score are resourceful parameters in predicting patient prognosis. Limited studies have been done in the Indian population correlating the Volume of infarct and the CT ASPECT Scale.

scholarly journals Association between Deep White Matter Hyperintensities and Right-to-left Shunt in Migraine (CAMBRAIN): A Cross-sectional Multicenter Study

2021 ◽  
Author(s):  
Yingqi Xing ◽  
YiShui Zhang ◽  
HongLing Zhao ◽  
SiBo Wang ◽  
YingHua Cui ◽  
...  
Keyword(s):  
White Matter ◽  
White Matter Hyperintensities ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Contrast Enhanced ◽  
Weighted Magnetic Resonance Imaging ◽  
Independent Risk Factors ◽  
Magnetic Resonance Imaging Mri

Abstract BackgroundDeep white matter hyperintensities (DWMHs), often identified by hyperintense lesions on T2-weighted magnetic resonance imaging (MRI), were discovered to have a higher prevalence in migraine patients. A right-to-left shunt (RLS), which is also prevalent in migraineurs, could potentially contribute to the formation of DWMHs by induction of controversial embolism and endothelial dysfunction. In this cross-sectional study, we aim to evaluate the association between RLS and the prevalence of DWMHs in patients with migraine.MethodsIn this study, we consecutively enrolled patients with migraine aged between 18 and 50 years from the 14 headache clinics of participating hospitals. DWMHs were rated using Scheltens scale on digital MRI images obtained from 1.5T scanners, and RLS was detected via contrast-enhanced transcranial Doppler. Analyses on DWMH prevalence and loads by RLS grading or subtype were performed. A logistic regression analysis on DWMH prevalence was also performed.ResultsIn all, 237 migraine patients (age: 39.3 ± 11.7, 78.1% women, 13% migraine with aura) were enrolled. RLS was detected in 48.5% of the subjects and DWMHs were identified in 138 (58.2%) patients. Prevalence of DWMHs did not differ significantly between RLS+ (57.4%) and RLS− patients (59.0%, p = 0.74). No statistical difference in DWMH loads was found between different RLS grades or subtypes. Instead of RLS grades (p = 0.75), age (OR 1.067; 95%CI 1.034–1.101; p < 0.001) and aura (OR 4.063; 95%CI 1.492–11.061; p = 0.006) were statistically significant independent risk factors for increased DWMH prevalence in migraine patients.ConclusionsOur findings do not support an association between RLS and DWMHs in migraine patients, regardless of RLS grades or subtypes.Clinical Trial Registration: NCT 03418766; Date of registration: February 1, 2018

scholarly journals Myocarditis and Pericarditis Following mRNA COVID-19 Vaccination: What Do We Know So Far?

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 607
Author(s):  
Bibhuti B. Das ◽  
William B. Moskowitz ◽  
Mary B. Taylor ◽  
April Palmer
Keyword(s):  
Symptomatic Relief ◽  
Cross Sectional Study ◽  
Cardiac Complications ◽  
Sectional Study ◽  
Elevated Troponin ◽  
Resonance Imaging ◽  
Gadolinium Enhancement ◽  
Bottom Line ◽  
Cross Sectional ◽  
Inflammatory Drugs

This is a cross-sectional study of 29 published cases of acute myopericarditis following COVID-19 mRNA vaccination. The most common presentation was chest pain within 1–5 days after the second dose of mRNA COVID-19 vaccination. All patients had an elevated troponin. Cardiac magnetic resonance imaging revealed late gadolinium enhancement consistent with myocarditis in 69% of cases. All patients recovered clinically rapidly within 1–3 weeks. Most patients were treated with non-steroidal anti-inflammatory drugs for symptomatic relief, and 4 received intravenous immune globulin and corticosteroids. We speculate a possible causal relationship between vaccine administration and myocarditis. The data from our analysis confirms that all myocarditis and pericarditis cases are mild and resolve within a few days to few weeks. The bottom line is that the risk of cardiac complications among children and adults due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection far exceeds the minimal and rare risks of vaccination-related transient myocardial or pericardial inflammation.

Evaluation of Supratentorial Brain Neoplasms - A Cross Sectional Study from a Tertiary Care Hospital, Surendranagar, Gujarat

2021 ◽  
Vol 8 (26) ◽  
pp. 2253-2259
Author(s):  
Mohit B. Gor ◽  
Kuldeepsinh D. Mori ◽  
Mehul N. Bavishi ◽  
Nirmala C. Chudasama ◽  
Jaypalsinh D. Barad ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Brain Tumours ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Multiplanar Imaging ◽  
Higher Sensitivity

BACKGROUND Brain tumours represents 1.7 % of all cancers and contributes 1.8 % of all cancer deaths. Of all the brain tumours, 80 % are supratentorial.1 Magnetic resonance imaging (MRI) is an important modality, having higher sensitivity for detecting intracranial pathology. Multiplanar imaging is possible with MRI which helps in detection, localization and characterization of the lesion. MRI examination has helped in early diagnosis, accurate localization of the tumour, with prompt initiation of appropriate medical or surgical therapy. Recent advances like magnetic resonance (MR) spectroscopy, MR fluoroscopy with stereotactic guided biopsy have revolutionized the role of MRI in study of intracranial tumours. METHODS A cross sectional study of 75 patients was done by Siemens Essenza 1.5T MRI from June 2018 to June 2020 using dedicated head coil. RESULTS In our study, most of the patients were between 31 - 60 years of age (39 % of all patients) with the largest group between 31 - 40 years (20 % of all patients). Out of 75 cases of supratentorial neoplasms, 47 (72 %) were intra-axial lesions, 15 (23 %) were extra-axial lesions and 3 (5 %) were intra ventricular lesions. In this study, 69 % of the lesions were solitary and 31 % were multiple. Most of patients (89 %) showed some enhancement, most common being heterogeneous/inhomogeneous enhancement. Commonest type of supratentorial neoplasms were metastases comprising 29 % of this study. CONCLUSIONS Magnetic resonance imaging is an important modality, having higher sensitivity for detecting intracranial pathology. Multiplanar imaging is possible with MRI which helps in early detection, localization and characterization of the lesion. Metastasis is the most common supratentorial tumour in this study followed by meningioma. Intra-axial tumours are more common than extra-axial tumours in this study. KEYWORDS MRI, Metastasis, Glioma, Meningioma

scholarly journals Correlation between Echocardiography and MRI in Volumetric Analysis of Dilated Cardiomyopathy - A Cross-Sectional Study from Puttaparthi, Andhra Pradesh

2021 ◽  
Vol 8 (19) ◽  
pp. 1391-1396
Author(s):  
Kushal Singh ◽  
Anshita Singh ◽  
Piyush Piyush
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Stroke Volume ◽  
Dilated Cardiomyopathy ◽  
Cardiac Mri ◽  
Andhra Pradesh ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Resonance Imaging ◽  
Cross Sectional

BACKGROUND Echocardiography is considered as a traditional approach to clinically study dilated cardiomyopathy. Because of poor apical visibility, however, volumetric calculations are difficult to ascertain. In calculating left ventricle volumes and ejection fractions, magnetic resonance (MR) imaging has shown to be more accurate than echocardiography. Due to conflicting literature, the present study was conducted to diagnose dilated cardiomyopathy using 2 D - echocardiography and correlate these echocardiographic findings with magnetic resonance imaging (MRI). METHODS This observational cross-sectional study was conducted in the Department of Radio-diagnosis and Imaging, Sri Sathya Sai Institute of Higher Medical sciences, Puttaparthi, Andhra Pradesh, Pin 515134. The study group consisted of consecutive patients who had clinical suspicion of dilated cardiomyopathy. A total of 40 patients underwent both 2 D - echo and cardiac MRI on the same day. All patients underwent 2 - D echo which was performed at the frame rate of 40 - 80 frames per second in the left lateral decubitus position to obtain standard 2, 3, and 4 chambers as well as short axis views (GE Vingmed Vivid 7 Dimensions, Horton, Norway: 2.5 MHz transducer). MRI was performed on a 1.5 T scanner (Mangnetom Aera, Siemens, Erlangen, Germany). For patient monitoring and cardiac synchronization, 3 - lead electrocardiography was used. RESULTS In the present study, in comparison to reference standard (cardiac MRI), 2 D - echocardiography showed significant and systematic underestimation of enddiastolic volume (EDV), end-systolic volume (ESV) and stroke volume (SV). Good correlation between 2 D - echo and cardiac MRI was noted for end-diastolic volume (r = 0.89), stroke volume (r = 0.60) and ejection fraction (r = 0.75). CONCLUSIONS In summary, magnetic resonance imaging is an accurate, non-invasive, safe and advanced modality for evaluation of global left ventricular function and myocardial scarring. 2 D - echocardiography can be used for screening of the patients with clinically suspected dilated cardiac myopathy (DCM) and their follow up. KEYWORDS Echocardiography, MRI, Cardiomyopathy

scholarly journals Accuracy of Two-dimensional Ultrasound and Magnetic Resonance Imaging in Diagnosis of Foetal Congenital Anomalies in a Tertiary Care Hospital- A Cross-sectional Study

2021 ◽  
Author(s):  
Jaybrata Ray ◽  
Jaharlal Baidya ◽  
Tanusri Debbarma ◽  
Jobin Joy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Congenital Anomalies ◽  
High Field ◽  
Cross Sectional Study ◽  
3 Tesla ◽  
Sectional Study ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
3 Tesla Mri

Introduction: Ultrasound screening for foetus congenital malformations is the mainstay in diagnosis and is commonly performed at 19-22 weeks gestation. Magnetic Resonance Imaging (MRI) is known as a problem solving tool which is used for answering a specific question. Both ultrasound and foetus MRI are highly sensitive and specific in diagnosis of congenital anomalies of the foetus with high agreement between both modalities. Aim: To determine the accuracy of Ultrasound Sonography (USG) and High Field 3 tesla MRI in diagnosis of different types of foetal Central Nervous System (CNS) and non CNS congenital abnormalities. Materials and Methods: A cross-sectional study was conducted in the Department of Radiodiagnosis at Agartala Government Medical College and GB Pant Hospital from June 2017 to May 2019. A total of 65 cases with ultrasound diagnosis of foetus abnormalities were examined by 3 Tesla MRI. MRI were performed within 15 days after USG detected anomalies. Statistical analysis was done using Chi-square test. Results: In cases with foetus anomalies high field MRI provided detailed findings leading to a more refined diagnosis. CNS anomalies were more as compared to other anomalies. Some of the antenatal findings were confirmed in some cases following termination of pregnancy and some were by postnatal examination. Among them chest anomalies was least common i.e., 1.5%. sensitivity of MRI was 88.13%, specificity was 66.66%, Positive Pressure Ventilation (PPV) was 96.29%, Negative Predictive Value (NPV) was 36.36% and USG sensitivity was 82.43%, specificity and 77.77%, PPV was 95.83%and NPV was 41.17%. Conclusion: High field MRI should be used as a second line of investigation in patients with foetus abnormalities diagnosed by ultrasound for confirmation of diagnosis and selecting the treatment protocol. In cases of fatal abnormalities, a confirmed diagnosis made before 20 weeks of pregnancy may help by terminating the pregnancy.

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