An MRI study was carried out on a 1.5 Tesla scanner (Symphony, Siemens AG, Germany) using T2 weighted (half-Fourier acquisition single shot turbo spin echo [HASTE]; TR 4.3 ms, TE 2.15 ms) and TrueFISP (TR 1000 ms, TE 83 ms) sequences in sagittal, coronal, and axial planes which showed large markedly hyperintense lungs (as compared to foetal skeletal muscle) causing inversion of the diaphragms. The dilated trachea was exquisitely demonstrated as increased signal with a gap at the level of the larynx. The cardiac findings and ascites were also confirmed and no additional anomaly could be demonstrated (Figure 2). Based on ultrasound and MRI findings, diagnosis of CHAOS due to laryngeal atresia was made. The parents were counselled regarding the relatively poor prognosis and the pregnancy was terminated. DISCUSSION Congenital high airway obstruction syndrome is a constellation of findings which arise due to obstruction of the upper airway tract. The causes of obstruction include laryngeal atresia, stenosis or laryngeal cysts, and tracheal atresia or stenosis. 1-3 Cases of CHAOS are sporadic and the exact incidence is not known.
Pressure Injectors are used routinely in diagnostic and interventional radiology. Advances in medical science and technology have made it is imperative for both diagnostic as well as interventional radiologists to have a thorough understanding of the various aspects of pressure injectors. Further, as many radiologists may not be fully conversant with injections into ports, central lines and PICCs, it is important to familiarize oneself with the same. It is also important to follow stringent operating protocols during the use of pressure injectors to prevent complications such as contrast extravastion, sepsis and air embolism. This article aims to update existing knowledge base in this respect.
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