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.

Tropical chronic pancreatitis (TCP) is a unique juvenile nonalcoholic form of chronic pancreatitis prevalent in tropical developing countries. TCP is characterized by the younger age of onset, rapid progression, higher prevalence of diabetes and pancreatic calculi, and greater propensity to develop pancreatic malignancy. Identifying the distinct imaging features is critical for the diagnosis of TCP. Awareness of this condition will not only enable the radiologist to recognize it early but also help in better management. In this article, we review the etiopathogenesis, distinct imaging features, and complications of TCP.

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BACKGROUNDBreast cancer is the second leading cause of cancer deaths in women today. Important risk factors for female breast cancer include age (increases as women gets older), genetics, early onset of menarche and late age of menopause, family or personal history of breast cancer, obesity, nulliparity, use of HRT and OCPs, consumption of alcohol and a middle to high socioeconomic status. Diffusionweighted imaging is a new MR imaging technique in which contrast within the image is based on microscopic motion of water. It is reported to be highly sensitive for evaluation of breast cancer and a possible means of differentiating benign and malignant tumour. Diffusion is quantified by measuring apparent diffusion coefficient (ADC). This study was performed to determine whether diffusionweighted imaging can be useful for diagnosis of mammographically detected BIRADS 3 & 4 lesions, correlating with histopathological diagnosis and to derive ADC values which may allow distinguishing benign from malignant lesions.

Aim: To evaluate the role of limited sequence MRI (LS MRI) in diagnosing obstructive from nonobstructive hydrocephalus for treatment planning correlating with surgical findings and in follow up cases of shunt treated hydrocephalus to predict the candidate requires revision surgery correlating with final treatment. Materials and Methods: A total of 235 cases were included in the study underwent limited sequence MRI, 121 cases were evaluated for diagnosing obstructive from nonobstructive hydrocephalus out of which 106 cases underwent surgery were correlated with surgical findings and 114 were symptomatic follow up cases evaluated for need of revision surgery. Diagnostic measures such as sensitivity, specificity, PPV, NPV and accuracy were calculated. A p value of <0.05 was considered to be statistically significant. Results: Obstruction was seen in 81 out of the 106 cases who underwent surgery. MRI showed obstruction in 72(88.9%) and no obstruction in 9(11.1%) cases. Out of the 25 cases with no obstruction in surgery, MRI correctly excluded obstruction in 20(80%) cases. MRI misdiagnosed obstruction in 5(20%) cases. No statistically significant difference between the limited sequence MRI and surgery (p value of 0.424 Sensitivity 88.89%, Specificity 80% PPV 93.51%, NPV 68.97% and Accuracy 86.79%). Out of the total 114 follow up cases of hydrocephalus,47 underwent surgery and 67 cases were managed conservatively. MRI criteria predicted surgical candidate in 43(91.5%) and no surgery in 4(8.5%) patients. MRI criteria predicted nonsurgical management in 64 (95.5%) out of the 67 cases and the rest of 3 (4.5%) cases MRI over rated need for surgery. (Sensitivity:91.49% Specificity:95.52% PPV: 93.5% NPV 94.1% Accuracy :93.9%.) Conclusion: LS MRI has good accuracy in detecting an obstruction in paediatric hydrocephalus. In predicting revision surgery for follow-up cases of shunt-treated hydrocephalus, LS MRI has good accuracy.

Background: There are many causes of left ventricular hypertrophy which can result in arrhythmias and sudden cardiac death. Hypertrophic cardiomyopathy (HCM) is one of the commonly encountered cause of sudden cardiac death in young adults. Aim: Identifying the role of Cardiac MRI in characterising the diagnostic parameters of HCM. Materials and methods: 125 patients with clinical suspicion or genetic evidence of HCM referred for cardiac MRI between June 2013 to June 2021 were included under the study. Image interpretations were done by fellowship qualified cardiac imaging radiologist. Categorical variables were expressed using frequency and percentage. Numerical variables were presented using mean and standard deviation. Results: Out of the total population, 119 patients (95 %) had LV wall thickness > 13 mm, 48 patients (38.4%) had Left ventricle outflow tract obstruction (LVOTO) and 32 patients (25.6 %) had mid cavity obstruction, 39 patients (37.9 %) had myocardial scar > 15 % and asymmetric septal hypertrophy was the most frequently encountered left ventricle morphology Conclusion: Cardiac MRI detected HCM has a statistically significant association with the final diagnosis (histopathological and genetic correlation). CMRI hence serves as a reliable tool in identifying and characterising the various diagnostic and non- diagnostic parameters of HCM.

Title: Agreement between criteria free psychometric scale (LIKERT) and liver imaging reporting and data system (LI-RADS) in diagnosing HCC in patients with chronic liver disease. Aim: LI-RADS was introduced to improve the accuracy and consistency of liver lesion reporting while imaging a cirrhotic patient. The aim of our study is to determine the agreement between conventional criteria free LIKERT scale and LI-RADS criteria in diagnosing HCC and also to study the interobserver agreement between three radiologists in diagnosing HCC using LIKERT and LI-RADS criteria. Methods: Data set consists of CECT observations of liver cirrhosis patients who underwent triple phase CT in HCC protocol from the department of Radiodiagnosis of Amrita Institute of Medical Sciences, Kochi during the period 2015 to 2020. Interpretation of data sets were done by 3 radiologists trained in abdominal imaging with a minimum 4 -week gap between LIKERT and LI-RADS scoring. The agreement between LIKERT and LI-RADS for categorizing liver nodules by the senior radiologist is studied by using Cohens Kappa. Interobserver agreement between 3 radiologists for LI-RADS and for LIKERT is also studied separately using Fleiss Kappa statistics. Results: There is moderate agreement between LIKERT and LI-RADS [κ- 0.6 (0.516-0.751)] for characterizing liver lesions in CLD patients. The Fleiss Kappa coefficient shows almost perfect interreader agreement between three observers in characterizing liver lesions into HCC and non -HCC using LIKERT approach [κ- 0.81 (0.807-0.813)] and using LIRADS criteria [κ- 0.93 (0.921-0.927)] with more interreader agreement while reporting using LI-RADS criteria, especially in characterizing liver observations less than 3 cm . Conclusion: Characterizing liver observations in CLD patients using LIKERT and LI-RADS approaches had significant uniformity and consistency in characterizing liver observations. However, LI-RADS showed a higher interreader agreement compared to non-standardized reporting especially for nodules less than 3 cm.