Morel-Lavallée lesions are post-traumatic, closed degloving injuries occurring deep to subcutaneous plane due to disruption of capillaries resulting in an effusion containing hemolymph and necrotic fat. Magnetic resonance imaging (MRI) is the modality of choice in the evaluation of Morel-Lavallée lesion. Early diagnosis and management is essential as any delay in diagnosis or missed lesion will lead to the effusion becoming infected or leading to extensive skin necrosis.
Purpose:The purpose was to prospectively determine the sensitivity of 64-slice MDCT in detecting and diagnosing the cause of obscure gastrointestinal bleed (OGIB).Materials and Methods:Our study included 50 patients (male 30, female 20) in the age range of 3–82 years (average age: 58.52 years) who were referred to our radiology department as part of their workup for clinically evident gastrointestinal (GI) bleed or as part of workup for anemia (with and without positive fecal occult blood test). All patients underwent conventional upper endoscopy and colonoscopy before undergoing CT scan. Following a noncontrast scan, all patients underwent triple-phase contrast CT scan using a 64-slice CT scan system. The diagnostic performance of 64-slice MDCT was compared to the results of capsule endoscopy, 99m-technetium-labeled red blood cell scintigraphy (99mTc-RBC scintigraphy), digital subtraction angiography, and surgery whenever available.Results:CT scan showed positive findings in 32 of 50 patients. The sensitivity, specificity, positive predictive value, and negative predictive values of MDCT for detection of bleed were 72.2%, 42.8%, 81.2%, and 44.4%, respectively. Capsule endoscopy was done in 15 patients and was positive in 10 patients; it had a sensitivity of 71.4%. Eleven patients had undergone 99mTc-RBC scintigraphy prior to CT scan, and the result was positive in seven patients (sensitivity 70%). Digital subtraction angiography was performed in only eight patients and among them all except one patient showed findings consistent with the lesions detected on MDCT.Conclusion:MDCT is a sensitive and noninvasive tool that allows rapid detection and localization of OGIB. It can be used as the first-line investigation in patients with negative endoscopy and colonoscopy studies. MDCT and capsule endoscopy have complementary roles in the evaluation of OGIB.
Aim of this study is to compare the diagnostic accuracy of ultrasound versus MRI in detecting rotator cuff pathology. Rotator cuff pathology involves group of disorder, which progresses from bursitis to tendinitis to partial tear and full thickenss tear. The most commonly affected tendon is the supraspinatus tendon. In our prospective study of 35 patients as initial ultrasound was followed by MRI sensitivity, specificity and accuracy for diagnosis of full thickness tear of supraspinatus when USG was compared to MRI was 100%, whereas sensitivity, specificity and accuracy of diagnosing partial thickness tear using ultrasound compared to MRI are 100%, 78% and 84%. There is no significant p value difference on comparing ultrasound with MRI on detecting tears. Ultrasound and MRI showed almost similar diagnostic accuracy in associated findings like tendon retraction, muscle atrophy, bursal effusion. Ultrasound also has additional value of dynamic evaluation, which is useful in evaluating subacromial and subcoracoid impingement. Modality choice for the evaluation of rotator cuff pathology should be based on several factors like availability, patient preference and clinical information being sought. The high resolution sonography is an attractive screening modality for rotator cuff in patients presenting with painful shoulder. A well performed ultrasound examination in most cases obviates the need for more invasive diagnostic tests like arthrography and cumbersome and expensive MRI examinations. KEYWORDSRotator Cuff, Magnetic Resonance Imaging, Ultrasound, Shoulder. HOW TO CITE THIS ARTICLE: INTRODUCTIONThe shoulder joint is an incongruous ball and socket joint without any fixed axis of rotation, which has wider range of motion in multiple planes, hence stability is compromised for mobility. To compensate for this unstable bone anatomy the shoulder is protected anteriorly, posteriorly and superiorly by a capsule and rotator cuff tendons. These tendons are subjected to wear and tear during day-to-day activities giving rise to shoulder pain. The rotator cuff muscles are namely supraspinatus, infraspinatus, subscapularis and teres minor. The common disorders involving the rotator cuff tendons include impingement, tendinopathy and tear.It is a dynamic process leading on from degeneration to tears in these tendons. The most commonly affected rotator cuff tendon is the supraspinatus. The factors which aid on to this progress includes age, occupation, trauma, acromion type,
BACKGROUND: Liver cirrhosis and portal hypertension are common outcomes of chronic liver disease. Portal hypertension leads to development of oesophageal varices (EV). Oesophageal variceal rupture is the most common (1,2,3) dreaded complication of cirrhosis that proves to be fatal. In fact, the severity of liver disease can be correlated by the presence and grade of varices. Currently, oesophagogastroduodenoscopy (OGD) is the gold standard investigation for detection and grading of EV's. However, it is invasive, costly and frequently requires sedation. The aim of this study is to investigate the diagnostic performance of 2D shear wave elastography for predicting the presence of oesophageal varices in patients with advanced chronic liver disease (CLD). METHODS: Study population included 32 cases with CLD and 30 controls without CLD undergoing OGD from August 2019 to August 2021.Prior to undergoing OGD, liver and spleen stiffness elastography were recorded using 2D-SWE. ROC curve was used to nd the cut off values for liver and spleen stiffness for prediction of EV. RESULTS: Using 2D-SWE, the association between liver/ spleen stiffness and presence of EV in CLD cases was found to be statistically signicant (p value-<0.001). The optimal cut off values obtained for prediction of EV was 12 kPa and 12.6kPa for liver and spleen respectively (sensitivity of 81.8% and specicity of 82.5%; PPV-72%, NPV- 89.2%). CONCLUSION: Liver and spleen stiffness values obtained by 2D-SWE were found to be a signicant predictive factor for detection of presence of EV's in patients with CLD.
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