PurposeTo assess the utility of diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) maps and T2* mapping in quantitative analysis of nucleus pulposus (NP) and annulus fibrosus (AF) of lumbar intervertebral discs with its correlation with modified Pfirrmann grading (MPG) for lumbar degenerative disc disease (LDDD).Material and methodsOne hundred subjects (20-74 years of age) underwent T2-weighted, DWI with ADC and T2* magnetic resonance imaging. MPG was applied to L3-L4, L4-L5, and L5-S1 discs, and ADC and T2* values of NP and AF were calculated in the mid-sagittal plane by segmenting each disc into 5 regions of interest (ROI) (NP-3, AF-2). Mean ADC and T2* values, their correlation, and cut-offs among different grades were calculated at different ROIs across different levels.ResultsOut of total 300 discs analysed; 68 were normal (grade I) discs and 232 were degenerated (grade II to VIII) discs, based on MPG. T2* and ADC values in NP, AF, and the entire disc were significantly lower in degenerated discs than in normal discs. There was significant (p < 0.001) negative correlation between ADC and T2* values with MPG. ADC and T2* cut-off values were statistically significant across grades, with area under the curve (AUC) values in moderate to high accuracy range (0.8 to > 0.9) for assessing the degree of LDDD.ConclusionsT2* and ADC value-based grade scales are highly accurate in evaluating the degree of disc degeneration with a high degree of objectivity in comparison to visual assessment-based MPG. Reduced ADC and T2* values of NP could serve as markers of early LDDD.
Background Isolated unilateral absence of one pulmonary artery (IUAPA) is a rare malformation and a rare cause of hemoptysis. It occurs due to malformation of the sixth aortic arch during embryogenesis. This condition has variable presentations like dyspnoea, reduced exercise tolerance, chest pain, pleural effusion, recurrent bronchopneumonia, pulmonary hypertension, and haemoptysis can be asymptomatic. Case Presentation We describe a case of a 34-year-old female presenting with recent onset hemoptysis associated with mild dyspnoea and cough. Chest Radiograph revealed unilateral hyperlucent lung field which was later diagnosed as Isolated unilateral absence of pulmonary artery on high resolution computed tomography of chest with angiography. Conclusion Absent pulmonary artery should be considered as an important differential in cases presenting with hemoptysis. This case emphasises the significance of combining computed tomography with pulmonary angiography to accurately evaluate and define congenital lung abnormalities.
Dengue fever, the most common arboviral tropical disease, has shown a rapid increase in incidence over the last few decades. Increasing evidence of the various neurological manifestations in dengue has been documented in the literature. Patients positive for dengue on serology and with neurological manifestations were analysed and included in the present case series and brief review. The cases reveal a spectrum of neurological findings in dengue infection and include dengue haemorrhagic encephalitis, acute disseminated encephalomyelitis (ADEM), reversible splenial lesion syndrome (RESLES), intracranial haematoma, and posterior reversible encephalopathy syndrome (PRES), with a focus on the relevant imaging features.Contribution: The present case series emphasises the importance of understanding the relevant imaging findings and potential aetiopathogenesis of neurological involvement in dengue infected patients in order to make the correct diagnosis for effective treatment and improved outcome.
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