Introduction: Maxillofacial fractures are among the commonest injuries occurring in trauma patients. Multislice computed tomography (CT) is a widely used radiological investigation that accurately reveals the number, location, and extent of the fractures as well as concomitant soft tissue injuries and has been found to be superior in the diagnosis of maxillofacial fractures owing to high sensitivity and specificity. This study was performed to assess the efficacy of axial, coronal, sagittal, and three-dimensional (3D) reformatted images in the detection of fractures in maxillofacial trauma.Materials and Methods: This was a cross-sectional descriptive study conducted on 49 adult patients with maxillofacial injuries undergoing multislice CT using a multidetector Siemens SOMATOM Emotion eco 16 slice CT scanner (Siemens AG, Munich, Germany). CT protocol consisted of non-contrast axial 16-slice helical series beam collimation ~ 3 mm, pitch ~ 0.8 -1, tube current ~ 270 mAs, voltage ~ 130 kV, Total exposure time ~ 18 seconds, total radiation ~ 200 mGy. Along with the axial, coronal and sagittal images were reconstructed with 0.5 mm increment. 3D volume-rendering images were also obtained. 3D images were compared with axial images, coronal and sagittal plane images.Results: The maximum number of cases was in the age group of 21-30 years with the male: female ratio being 5.12:1. The most common cause of injury was road traffic accidents (RTA). Mandible fractures were found to be the most common (20 patients, 40.8%) followed by fractures of nasal bone (18 patients, 36.7%). The incidence of frontal bone fractures was found to be the least (six patients, 12.24%). Our study found that 3D images are superior to axial in assessing the extent and degree of displacement of maxillofacial fractures in general. The maxillary sinus was found to be the most commonly fractured sinus (19 patients, 38.7%). Sphenoid sinus fractures were the least common (seen in two patients, 4.08%). CT findings correlated with the operative findings in most types of fractures. Conclusion:Multidetector CT with multiplanar and 3D reformation is highly accurate in the identification of fractures and assessing the extent and degree of displacement of fractures; hence, it is the imaging modality of choice in maxillofacial trauma. 3D images are much better for the detection of maxillofacial fractures compared to axial, coronal, or sagittal views, especially in maxilla and mandibular bone fractures. It is also found to be better at providing information on the patterns of the fracture lines and the displacement of the fracture fragments. Another added advantage of multidetector CT is that it is a noninvasive technique with good accuracy and a short scan time.
Background: Corpus callosum plays a role in interhemispheric integration, language, intelligence, and creativity of individuals, hence variations in corpus callosum size are seen in various neurological diseases such as Alzheimer's and bipolar affective disorder. While the dimensions differ based on gender, age, and ethnicity, pathological variations are seen with some diseases such as vascular dementia, leukoaraiosis, stroke, and carotid artery stenosis. This study was conducted to compare the morphometric alterations of the corpus callosum between normal subjects and stroke patients using magnetic resonance imaging (MRI).Methods: This was a case-control study conducted on 84 subjects divided into cases and control groups. The widths of the genu, body & splenium, and anterior-posterior (AP) diameter of the corpus callosum were measured and the values were compared among the two groups. Student's t-test and regression analysis were utilized for the analysis of data and p<0.05 was considered statistically significant.Results: Sixteen patients (19.04%) belonged to the age range of 18-40 years, 32 (38.09%) belonged to the age range of 41-60 years and 36 (42.8%) belonged to the age group of >60 years. There was no discrepancy between cases and controls or between the age groups. The mean width of genu, body & splenium, and AP diameter was compared between normal individuals and stroke patients. It was noted to be significantly lesser in cases than in controls. The morphometric indices i.e., width of genu, body & splenium, and AP diameter of the corpus callosum in cases versus controls were noted to be 9.
Background: Size of fourth ventricle varies in different pathologies, in the context of enlarged brain ventricles size observed in routine clinical practices, knowledge of the usual range of exact measurement is required. Aims and Objectives: This study is hospital-based observational study to derive normal measurement range of fourth ventricle and correlating it with measurements of cerebrum and age of patients. Materials and Methods: Hospital-based prospective study was conducted in the department of radiodiagnosis in a teaching medical college. Patients with virtually normal study on unenhanced head CT scan of both sex and age groups from 2 year to 60 years, were included in the study. Patients with CT scans showing gross pathological changes affecting the normal anatomy of ventricles were excluded from the study. Results: The mean age of the cases was 37.0±16.88 years. Mean fourth ventricle anterioposterior dimension is 7.5±2.5 mm and transverse dimension is 12±3.1 mm. Anteroposterior diameter of fourth ventricle showed non-significant correlation (r=0.06, P=0.56) with anteroposterior diameter of skull and no significant correlation with (r=0.07, P=0.45) transverse diameter (TD) of skull. AP diameter of fourth ventricle showed a positive correlation with age, which was statistically significant (r2=0.698, P=0.01). TD of fourth ventricle showed slight positive correlation (r=0.202 P=0.048) with anteroposterior diameter of skull and (r=0.142, P=0.168) TD of skull whereas nil with. TD of fourth ventricle showed a positive correlation with age, which was statistically non-significant (r2=0.659, P=0.01). It increases with age. Conclusion: Knowledge of normal measurements helps in assessing, dilated fourth ventricle in various pathologies.
Introduction: Acute Subdural Haematoma (ASDH) is a type of intracranial haematoma, which has the highest mortality rate. The ASDH generally presents as a secondary consequence of Traumatic Brain Injury (TBI) and can be classified as traumatic or non traumatic and acute or chronic. Aim: To assess the Midline Shift (MLS) and Subdural Haematoma (SDH) thickness as a prognostic factor of mortality on initial cranial Computed Tomography (CT) scan of patients with ASDH. Materials and Methods: This cross-sectional study analysed the computed CT of 61 patients who were admitted due to traumatic SDH in Sri Devaraj Urs Medical College, Kolar, Karnataka, India. Thickness of MLS (mm) and SDH (mm) were estimated from the CT scan (SIEMENS SOMATOM Emotion 16 Slice) of patients admitted during the study period from June to August 2021. The thickness of the SDH and MLS were compared separately with the survival status. The Area Under the Curve (AUC) was estimated from the Receiver Operating Characteristic (ROC) curve. The sensitivity, specificity, predictive values and diagnostic accuracy of the screening test along with their 95% Confidence Interval (CI) were presented. The p-value <0.05 was considered statistically significant. Results: The predictive validity of MLS (mm) was excellent (AUC=0.936) and that of SDH thickness (mm) was fair (AUC=0.799) in predicting survival. The cut-off value derived from the ROC curve for MLS was 3.95 mm and for SDH thickness was 3.35 mm; above which the number of people died was more and was statistically significant (p<0.001). The sensitivity and specificity of the MLS in predicting the survival was 90.32% and 90.00%, respectively and sensitivity and specificity of the SDH thickness was 74.19% and 76.67%, respectively. Conclusion: The sensitivity and specificity of MLS was found to be superior when compared to the SDH thickness. The cut- off value derived from ROC curve for MLS was 3.95 mm and for SDH was 3.35 mm, above which the chance of survival was poor.
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