Background: Cerebral ischemic stroke is the major cause of death after ischemic heart disease and malignancies, among which major cases of stroke results from atherosclerosis of intra and extra-cranial carotid vessels. The aim of this study is to evaluate the extracranial carotid arteries in patients with ischemic stroke and correlation with various risk factors. Materials and Methods: A cross sectional study of the patients with ischemic stroke presented in Radiology department of Nobel Medical College were evaluated for a period of one year from February 2017- January 2018 using color Doppler ultrasound and correlated with various risk factors. A total of 50 patients were included in the study. All age groups and sex were included. Results: Out of 50 patients, 29 patients (58%) were males and 21 patients (42%) were females. Stroke was present in 24 patients on right side and 26 patients on left side. A total of 36 patients had extra-cranial carotid stenosis. Among them, 18 patients had <50% stenosis, 17 patients had >50% stenosis and 1 patient had complete occlusion. The most common cause of obstruction was found to be atherosclerotic changes in the form of atheromatous plaque. Out of 50 patients 27 had history of hypertension and 19 had history of smoking. Out of 27 hypertensive patients, 23 had stenosis which is statistically significant (p value 0.024). Conclusion: The current study shows the importance of color Doppler ultrasound as an economic, safe and non-invasive method of demonstrating the cause of stroke in extra-cranial carotid artery system
Introduction: Elevated intracranial pressure is one of the fatal events associated with traumatic brain injury. Optic nerve sheath diameter measurement is an indirect way of assessing intracranial pressure. Optic nerve sheath diameter and Rotterdam score are prognosticators of traumatic brain injury. This study aimed to measure the optic nerve sheath diameter in the initial CT scan and correlate with the Rotterdam score.Methods: Retrospective analytical study comprising consecutive patients from July 2019 to December 2019 who underwent decompressive craniotomy for traumatic brain injuries were included. Optic nerve sheath diameter was measured 3mm behind the eyeball in axial images and Rotterdam CT Score was done on the same CT image in another setting. The receiver operating characteristics curve was plotted to measure the accuracy of optic nerve sheath diameter in predicting the severity of traumatic brain injury.Results: Sixty patients with a mean age of 42.5±14.6years were included. The mean optic nerve sheath diameter with Rotterdam Score of 1, 2 and 3 was 3.8±0.64mm and with Rotterdam Score of 4, 5 and 6 was 5.1±0.66mm. The area under the curve of severe Rotterdam CT Score vs optic nerve sheath diameter was 0.915 (p<0.0001, 95% CI 0.84-0.98) and spearman Rho correlation coefficient value was 0.83 suggesting positive relation.Conclusion: Higher mean optic nerve sheath diameter was observed with a severe Rotterdam CT score. Thus, optic nerve sheath diameter of initial CT scan in traumatic brain injury cases could be an important radiological tool to rule out the presence of raised intracranial pressure.
Introduction: Among various modalities used in the evaluation of chronic otitis media, HRCT of the temporal bone is the most reliable and valuable imaging modality as it provides excellent anatomic information. It can display minute anatomical and pathological details by providing a direct visual window into the temporal bone. Methods: This is a prospective cross-sectional study done at the department of Radiodiagnosis and imaging of Birat Medical College, Teaching hospital over 1 year with a total of 50 patients enrolled in the study. The findings were compared with the post-operative findings and data were entered. HRCT was done on 64 slices of multidetector CT scan. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of various parameters were calculated. Results: Out of 50 patients were enrolled in this study. Among them 52%(26) were females and 48%(24) were males. HRCT showed 100% sensitivity for the lateral semicircular canal and sigmoid plate erosion. The sensitivity and specificity of cholesteatoma were 79.06% and 42.85% respectively. It also offered a sensitivity of 75% and 95% for the erosion of the facial nerve canal and tegmen tympani respectively Conclusions: High-resolution computed tomography is a reliable diagnostic tool for the pre-operative evaluation of chronic otitis media. It helps the operating surgeon to evaluate the anatomical extent of the disease process and aids in the surgical approach that helps prevent probable complications during surgery
Introduction: Breast carcinoma is the second leading cause of cancer related mortality in females around the world. Ultrasound plays a key role in differentiating cystic and solid lesions and is a convenient and non-invasive diagnostic tool to differentiate between benign and malignant lesions. Objectives: The aim of this study is to evaluate the diagnostic accuracy of ultrasound in palpable breast lesions. Methodology: A prospective cross-sectional study was carried out in patients with palpable breast lesions who presented in Department of radio diagnosis and imaging of Nobel Medical collegefor a period of one-year from February 2019- January 2020 using ultrasound. A total of 60 patientswereevaluated in the study. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. Results: Out of 60 patients evaluated, ultrasound showed 46 (76.7%) cases to be benign and 14 (23.3%) cases to be malignant. FNAC revealed benign disease in 47 (78.3%) patients and malignant disease in 13 (21.7%) patients. The most common benign lesion was fibroadenoma. We found nearly 91.7% of the malignant lesions had spiculated margins and microcalcification. The sensitivity of ultrasound was 95.74% and specificity 92.3% with diagnostic accuracy 95%. Conclusion: Ultrasound is a convenient and non-invasive diagnostic tool with good sensitivity, specificity, positive predictive value, negative predictive value and accuracy in palpable breast lesions.
Background: Standard dose computed tomography is standard imaging modality in diagnosis of urolithiasis. The introduction of low dose techniques results in decrease radiation dose without significant change in image quality. However, the image quality of low dose computed tomography is affected by skin fold thickness and subcutaneous abdominal adipose tissue. The aim of this study to evaluate stone location, size, and density using low dose computed tomography compared with standard dose computed tomography in obese population. Material and Methods: This non-randomized non-inferiority trial includes 120 patient having BMI≥25kg/m2 with acute ureteric colic. The low dose and standard dose computed tomography were performed accordingly. Effective radiation doses were calculated from dose-length product obtained from scan report using conversion factor of 0.015. The images were reconstructed using iterative reconstruction algorithm. Effective dose, number and size of stone, Hounsfield Unit value of stone and image quality was assessed. Results: Stones were located in 69 (57.5%) in right and 51 (42.5%) in left ureter. There was no statistical difference in mean diameter, number and density of stones in low dose as compared with standard dose. The radiation dose was significantly lower with low dose. (3.68 mSv) The delineation of the ureter, outline of the stones and image quality in low dose was overall sufficient for diagnosis. No images of low dose scan were subjectively rated as non-diagnostics. Conclusion: Low dose computed tomography with iterative reconstruction technique is as effective as standard dose in diagnosis of ureteric stones in obese patients with lower effective radiation dose.
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