Introduction: Urolithiasis is a multi-factorial disease involving genetic & environmental factors. There has been an increased incidence of urolithiasis in recent times which has been associated with variations in its epidemiology like change in age, sex distribution of the disease and also changes in terms of type and location of the calculi. Present study describes clinical profile of urolithiasis patients visiting Radiodiagnosis department of a tertiary care hospital in Solapur district of Maharashtra state in India. Methods: It is a descriptive observational study done at Dept of Radiodiagnosis & Imaging at Shri Chhatrapati Shivaji Maharaj General Hospital in Solapur district of Maharashtra state in India. Study duration was Jan 2005 to Oct 2006. 120 patients who presented with symptoms & signs of urolithiasis for diagnosis & treatment in Dept of Surgery & Medicine, including the referrals from other hospitals & institutes & referred to Dept of Radiodiagnosis & Imaging of the institute for Computerised Tomography (CT) with provisional diagnosis of urolithiasis were enrolled. Detailed history & physical examination was done. The description of clinical profile was done with respect to age, sex wise distribution & location of the calculus. Results: On evaluation, 100 patients were diagnosed as having urolithiasis. Median age was 35 years. Age of patients ranged from 2 years to 81 years. Maximum cases (35%) were in age group of 31-40 years. Male to female ratio of patients was 2.4:1. Out of total 140 calculi in these patients, 54 (36 %) calculi were present in renal calyces (nephrolithiasis). Lower pole calyces were the most common site of nephrolithiasis (20%). 96 (64%) calculi were present in ureters. Most common site was distal 1/3 rd of ureters which was seen in 38 patients (25.3%). Conclusion: Urolithiasis patients were most common in age group of 31-40 years. Male to female ratio was 2.4:1. Ureteric calculi were more common than renal calculi.
Background: Fistula-in-ano can be defined as a hollow tract or cavity which is lined by granulation tissue. In case of fistula-in-ano, one end of this fistula opens in the anal canal whereas the other end is located in perianal area. Fistula-in-ano can considerably affect quality of life of an individual because of perianal discharge of blood and pus. Imaging of these fistulas is an important part of management and MR imaging is important in assessing relationship between the fistulous tract and sphincter muscles. Moreover, MR imaging can reliably demonstrate transmural inflammation, secondary tracts/ramifications, and abscesses which cannot be diagnosed on the basis of conventional fistulography. Aims and Objectives: The aim of the study was to evaluate role of MRI in diagnosis and grading of perianal fistulae. Materials and Methods: This was a retrospective observational study, in which 60 patients with fistula-in-ano were included on the basis of a predefined inclusion and exclusion criteria. MR imaging of patients was done by 1.5 T MRI machine. Before MR imaging normal saline was injected in the fistulous tract from secondary/external opening, that is, opening around perianal area. Three plane images were obtained in all the cases. T1W, T2W, and STIR image sequences were obtained parallel to pelvic diaphragm. Coronal cuts were imaged parallel to anal canal. FAT suppressed T1W and T2W images in all cases. Type and grade of fistula were determined in all the cases. P < 0.05 was taken as statistically significant. Results: Out of total 60 patients, there were 46 (76.66%) males and 14 (23.33%) were females with a M:F ratio of 1:0.30. The mean age of male and female patients was found to be 41.93±8.96 years and 44.04±7.46 years, respectively. The most common type of fistula was found to be trans-sphincteric fistula which was seen in 31 (51.6%) cases followed by intersphencteric fistula 22 (36.6%). Extrasphincteric and suprasphincteric fistulae were relatively uncommon and were seen in 4 (6.66%) and 3 (5%) cases, respectively. MRI was accurate in diagnosis of the tract with position of internal opening and any abscess cavity or secondary tract in 23 patients. Therefore, the diagnostic accuracy of MRI was found to be 95.4%. Conclusion: MRI is an excellent tool in assessment of perianal fistula. It not only helps in precisely locating fistulous tract but also can demonstrate relationship between the fistulous tract and sphincter muscles. Moreover, it can very well demonstrate transmural inflammation, secondary tracts/ramifications, and abscesses which cannot be assessed by conventional fistulograms.
Introduction: Imaging in pancreatic diseases is challenging because anatomic location of pancreas in the retroperitoneum and relationship with major blood vessels and bowel. Computed tomography (CT) has been the first imaging modality of choice in case of evaluation of pancreatic pathology. CT as a diagnostic modality is widely used in the staging of pancreatic and periampullary malignancy. However, its accuracy in assessment of extra regional lymph nodes is still unclear. Present study was conducted to evaluate the diagnostic accuracy of CT in assessment of periampullary carcinoma and also in predicting pancreatic tumours resectability Materials and Methods: 15 Patients between age group 30 to 75 years with clinical and laboratory findings of pancreatic mass or those came for follow-up & referred to the CT Unit of our hospital were enrolled. After obtaining data on detailed relevant history, general and abdominal examination findings,laboratory and serological examinations results,all the patients were subjected to CT scan.It was performed using a 128 slice CT machine (Toshiba).With multislice CT of pancreas thin slice thickness (1 mm) or less than that acquired during short time of single breath hold. Following findings were taken as CT signs of unresectability: liver metas- tases, ascites, local extension (except duodenum), arterial encasement, venous occlusion, and lymph node enlargement outside the field Observations and Results:9 (60 %) cases margin were ill defined & in 6 (40 %) it was well defined. Hypodense cases were 4 (27 %), hyperdense were 3 (20 %) & mixed were 8 (53 %).8 (53 %) cases showed homogenous enhancement & 7 (47 %) showed heterogenous. Calcification was present in only 1 (7 %) case. In 3 (20 %) cases lesion was resectable Conclusion: In conclusion, CT have a fair diagnostic accuracy in the assessment of pancreatic tumours resectability with sensitivity (100 %), specificity (92.31 %), PPV (66.67 %) and NPV (100 %)
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