CONTEXTPeripheral arterial disease of the lower extremity is an important cause of morbidity and affects 10 million people in India.
AIMS AND OBJECTIVESThe aims of this study were to assess the colour Doppler ultrasonography findings of lower limbs in patients with peripheral arterial disease by studying the spectral flow pattern and peak systolic velocity and also to assess the severity of stenosis and correlation of severity of stenosis on USG Doppler and MDCT angiography.
MATERIALS AND METHODSThe study included 29 patients attending surgery, Ortho OPD Government Medical College of Calicut with signs and symptoms of peripheral arterial diseases of lower limbs from January 2014 to October 2015 who underwent colour Doppler ultrasonography and MDCT angiography to know the severity of peripheral arterial diseases of lower extremities and to compare various grades of stenosis by studying the spectral flow patterns in colour Doppler ultrasonography and contrast opacification and diameter reduction in MDCT angiography.
RESULTSIn our study, 29 patients with intermittent claudication, numbness, and pain in the legs were selected. Majority of the patients were males and below 50 yrs. In our study, detection of totally occluded segments were better in MDCT angiography on comparing with Doppler USG. Most of the arteries showed good total agreement between Doppler and MDCT angiography. Aortoiliac group of vessels showed more than 80% total agreement between Doppler and MDCT angiography. Femoropopliteal group vessels showed more than 75% total agreement. Infrapopliteal group of vessels showed more than 50% total agreement.
CONCLUSIONMDCT angiography is more sensitive in detecting lesions of suprapopliteal group of vessels and also lesions with total occlusion of the lumen in comparison to Doppler ultrasonography. Imaging plays an important role in the management of the patients with peripheral arterial disease. Due to the limitations of the Doppler ultrasound, CT angiography is used prior to any vascular intervention is required in peripheral arterial diseases.
Choledochal cyst (CDC) is a rare surgical cause of cholestatic jaundice in infants. Spontaneous rupture is an unusual presentation of a previously undiagnosed CDC and is also a rare cause of biliary peritonitis in children. Here, we report a case of a 1-year-old boy who was evaluated for progressive abdominal distension. Ultrasonogram showed gross ascites with echogenic particles, dilated common bile duct (CBD), common hepatic duct (CHD), and upstream intra hepatic biliary radicle dilatation (IHBRD). CECT sections of the abdomen showed gross ascites and IHBRD with disproportionate dilatation of CHD and CBD. At laparotomy, a type 1 CDC with rupture of the anterior wall was found. The cyst was excised followed by hepaticojejunostomy. In a sick child with abdominal pain, cholestatic jaundice and biliary ascites, a high index of suspicion during imaging will help in the correct diagnosis and surgery for a potentially fatal ruptured CDC.
Background
Intraocular silicone oil (SiO) tamponade is a popular modality of treatment of rhegmatogenous retinal detachment. It can, however, rarely lead to an incompletely understood phenomenon known as intracranial migration of SiO. Though usually benign, this entity is often misinterpreted as a tumour or haemorrhage.
Case presentation
We present a case report of a patient with acute progressive encephalopathy and intracranial migration of intravitreal silicone. We also put forward the possibility of toxic effects of intracranial SiO on the central nervous system.
Conclusion
Clinicians and radiologists should be aware of the rare complication of intravitreal SiO tamponade. Eliciting the history of intraocular SiO tamponade and identifying the key imaging features on ultrasonography of the orbit, CT of the head, and MRI of the brain will help in avoiding unnecessary interventions or delays in the management of the patients from misdiagnosing it as haemorrhage or tumour.
Touraine syndrome or neurocutaneous melanosis/melanoma is a rare melanophakomatosis characterized by extensive/multiple congenital melanocytic nevi associated with cerebral/meningeal melanosis or melanoma. We report a 12-year-old boy with a congenital giant melanocytic nevus on the bathing trunk distribution with scattered lesions on the face, neck, and legs. MRI brain revealed a melanoma in the right amygdala.
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