BackgroundMagnetic resonance spectroscopy (MRS) is an established tool for in-vivo evaluation of the biochemical basis of human diseases. On one hand, such lucid depiction of ‘live biochemistry’ helps one to decipher the true nature of the pathology while on the other hand one can track the response to therapy at sub-cellular level. Brain tumors have been an area of continuous interrogation and instigation for mankind. Evaluation of these lesions by MRS plays a crucial role in the two aspects of disease management described above.Scope of reviewPresented is an overview of the window provided by MRS into the biochemical aspects of brain tumors. We systematically visit each metabolite deciphered by MRS and discuss the role of deconvoluting the biochemical aspects of pathologies (here in context of brain tumors) in the disease management cycle. We further try to unify a radiologist's perspective of disease with that of a biochemist to prove the point that preclinical work is the mother of the treatment we provide at bedside as clinicians. Furthermore, an integrated approach by various scientific experts help resolve a query encountered in everyday practice.Major conclusionsMR spectroscopy is an integral tool for evaluation and systematic follow-up of brain tumors. A deeper understanding of this technology by a biochemist would help in a swift and more logical development of the technique while a close collaboration with radiologist would enable definitive application of the same.General significanceThe review aims at inciting closer ties between the two specialists enabling a deeper understanding of this valuable technology.
Objectives
To compare the high-resolution computed tomography (HRCT)–derived severity score in COVID-19 patients between those who had earlier received the vaccine against the SARS-CoV-2 and those who did not.
Methods
A retrospective cross-sectional analysis of HRCT of the chest was done in correlation with the vaccination status of clinically diagnosed COVID-19 patients. The variable under evaluation was the CT severity score, whereby differential analysis of the variability on this parameter between incompletely (single dose) vaccinated, completely (both doses) vaccinated, and non-vaccinated individuals was the outcome.
Results
The analysis included 826 patients of which 581 did not receive any vaccination whereas 196 patients received incomplete (single dose) vaccination and 49 received complete vaccination. Mean CT severity score was lower in completely vaccinated patients (3.5 ± 6.3) vis-à-vis incompletely vaccinated (10.1 ± 10.5) and non-vaccinated (10.1 ± 11.4) individuals. The mean CT score was significantly lower in completely vaccinated patients of lower ages (≤ 60 years) compared to patients above that age. The incidence of severe disease (CT score ≥ 20) was significantly higher in the incompletely vaccinated and non-vaccinated patients compared to that in the completely vaccinated group.
Conclusions
CT severity scores in individuals receiving both doses of SARS-CoV-2 vaccination were less severe in comparison to those receiving a single dose of vaccine or no vaccine at all.
Key Points
• Patients who received complete two doses of vaccination had significantly low mean CT scores compared to the partially vaccinated patients and non-vaccinated patients.
• The mean CT scores were significantly lower in completely vaccinated patients of lower ages (
<
60 years) while patients
>
60 years did not show significantly different CT scores between the vaccinated and non-vaccinated groups.
• Consolidations and ground-glass opacities were significantly lower in the group receiving complete vaccination as compared to the unvaccinated and incompletely vaccinated patients.
We report two infants presenting with unilateral congenital facial palsy since birth. Magnetic resonance imaging (MRI) in both the cases revealed complete unilateral aplasia of facial nerve. To our knowledge, this is the first reported MR depiction of nonsyndromic isolated facial nerve aplasia. Imaging features and the pertinent anatomy is discussed along with a brief review of literature.
Genitourinary involvement of neurofibromatosis is uncommon and genital neurofibromatosis is even rarer. Involvement of clitoris by neurofibroma can lead to clitoromegaly masquerading as a male penis. We report such a case of ambiguous genitalia in a 7-year-old female child presenting with clitoromegaly since birth, in which magnetic resonance imaging (MRI) revealed the presence of extensive neurofibromatosis in the clitoris and lumbosacral regions. We emphasize the central role of MRI in evaluation of hormonal and non-hormonal causes of ambiguous genitalia. We further discuss the merits of including MR neurography in the imaging protocol for comprehensive delineation of neurofibromatosis.
Background: Colorectal cancer with a global incidence of 10% has multiple pathways implicated in its carcinogenesis. WNT signalling is the principal underlying pathway via APC gene, while defective mismatch repair genes and epigenetic changes also have proven contribution. Case presentation: Here we present an unusual case of rectal adenocarcinoma in a 66 year old woman, with germline MSH6 and PMS1 mutations, and also simultaneous somatic APC and TP53 mutations. Conclusions: The case is unique suggesting a possible interaction between the two pathways and contributing to carcinogenesis in this patient. This also suggests need for a thorough germline and somatic mutation evaluation in colorectal cancers.
Rhabdomyosarcoma (RMS) is the most common tumor of biliary tree in childhood. Biliary tree is an uncommon site for RMS to occur, accounting for about 1% of all pediatric RMS. A preoperative diagnosis is not difficult with background knowledge of its imaging features. The diagnosis of this malignancy is especially important as it many times mimics a more common and benign condition of choledochal cyst. The key to diagnosis is to distinguish solid component of the tumor from organized sludge seen in choledochal cyst. Imaging plays a vital role for preoperative staging as well.
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