Background & Objectives:The Pr evious studies of multidetector CT (MDCT) of the lower extremities for the detection of peripheral vascular disease showed high diagnostic accuracy but were performed with older generation systems. Our study aimed at assessing the diagnostic value of 128 MDCTA compared with that of digital subtraction angiography (DSA) in the grading of focal arterial disease of lower extremity arteries on the basis of anatomic regions. Materials & Methods: Forty-two patients with peripheral arterial occlusive diseases underwent both MDCTA and DSA. Lower extremity arteries depicted at MDCTA and DSA were graded separately for the degree of stenosis into 3 anatomic regions and 33 segments. Grading by MDCTA and DSA was done independently. Homogeneity analysis was used between MDCTA and DSA measurements in each patient. The sensitivity, specificity, positive predictive value and negative predictive value for detection of stenotic lesions were calculated for all anatomic regions, with findings at DSA used as the reference standard. Results: No statistically significant difference (P>.05) between DSA and MDCTA was present in Aorto-iliac and poplitiofemoral regions while there was statistically significant difference (P<.05) in the infrapopliteal region. The Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value based on a reading of MDCTA were 84.3%, 93.8%, 89.4% and 90.6% for aorto-iliac 86.6%, 94.7%, 84.1% and 94.7% for poplitiofemoral and 95.7%, 86.1%, 85.6% and 95.9% for infra-popliteal region respectively. Conclusion: MDCTA is excellent alter native in diagnosing lower extremity arterial occlusive diseases above the knee. DSA remains better on illustrating distal runoff vessels. Key words: Digital Subtr action Angiogr aphy; Multidetector CT Angiography; Peripheral Arterial Occlusive Disease Citation: Pangeni R, Han P, Pan F, Lamsal LP, Zhang Z, Yu J , Rizal R. Assessment of occlusive disease of lower extremity arteries on the basis of anatomic region: Value of 128-slice multidetector CT angiography in comparison with digital subtraction angiography. JCMS Nepal. 2016;12(4):179-86. 180 high accuracy for detection of steno-occlusive diseases compared with DSA. 4 Its advantages over DSA includes minimal invasiveness, smaller required volume of contrast material, shorter scan time and fast data acquisition. Other advantages of MDCT angiography include three dimensional (3D) volumetric data analysis and display, visualization of mural plaque and calcium. Unlike catheter angiography, MDCTA not only depicts the vessels but also allows assessment of perfusion in adjacent organs. These advantages have led to CTA replacing DSA for diagnosis at many centers. 5 However, there is a paucity of studies comparing the 128-slice MDCTA with DSA on the basis of region of blood vessel regarding grading in lower extremity. The purpose of the present study was to evaluate the diagnostic accuracy of 128-slice MDCTA in comparison with DSA in patients with PAD depending on the region o...
Introduction: The pituitary gland is the master endocrine gland that secretes important hormones and controls other glands. Its size, shape and volume vary with age and sex and also in various pathological conditions. This study was conducted to identify the size, shape and volume of the normal pituitary gland in different age groups of both genders using Magnetic Resonance Imaging (MRI).Methods: A retrospective study of the brain MRI Images of 203 patients was done in the Radiology and Imaging department of Pokhara Academy of Health Sciences, Nepal. Anterior-posterior dimension, transverse dimension, height and shape of the pituitary gland were noted and volume was calculated. Descriptive analysis and relationship of pituitary parameters with age and sex were assessed using ANOVA and Chi-square tests.Results: The pituitary height and volume was maximum in the 11-20years age group. Similarly, the mean height and volume of the pituitary gland in female patients of each age group were greater than that of male patients in the same age group. The inferential analysis revealed significant differences for mean pituitary height and volume with age but not with gender. The upper surface convexity was maximum in the age group 11-20years.Conclusion: The study has shown a clear trend with regards to the morphology of the pituitary gland with the age and sex of the individual highlighting the size, shape and volume of the pituitary gland should be taken into consideration while evaluating the glands for any neuroendocrine disorders.
Introduction: Generally, the spinal cord ends at the level between the first and second lumbar vertebrae. There are many studies published globally, yet no article has been published concerning this title in our settings. The objective of this study was to determine the tip level of conus medullaris by the Magnetic Resonance Imaging (MRI) in living humans in Nepalese population. Methods: Images of the MRI done between August 2019 to June 2021 were accessed through the database of the radiology department for defining the level of conus medullaris. The termination level of conus medullaris was rescored in relation to the upper, mid, and lower third of the adjacent vertebrae and the intervertebral disc. Input data was processed in Microsoft Excel which was later analyzed by SPSS 20.0. Results: Of the total, 202 study population, a higher number of spinal cords terminated at lower one-third of L1 vertebrae, accounting for 51 (females 26 and males 25) followed by L1-L2 intervertebral disc comprising only 35 (males 19; females 16). No significant differences in number existed between the two sexes having conus medullaris termination at both levels. Most of the cases who were in the age group of 40-49 years old, termination of CM was noted in L1 with the most common shape being the central type C, accounting for 38% (78/202). Conclusions: The conus medullaris was terminated mostly at lower one third of L1 vertebral body in our settings with no gender difference.
Congenital thyroid anomalies are rare. Developmental anomalies may be in the form of unilateral or bilateral hypoplasia or agenesis of one or both lobes of thyroid with or without isthmic agenesis. Most of the times when they are detected incidentally already have associated thyroid diseases. We report a 36- year-old female presented with right thyroid hemiagenesis and isthmic agenesis associated with thyroiditis in left lobe of thyroid.Jour of Diab and Endo Assoc of Nepal 2018; 2 (1): 44-46
Introduction: The risk of active Tuberculosis increases after HIV seroconversion. It progressively increases with declining immunity. Tuberculosis (TB) epidemics in HIV has led to a dramatic upsurge in global TB incidence, resulting in remarkable increase in morbidity and mortality. Many clinical studies had shown that TB is one of the commonest opportunistic infection. This study is conducted to see the incidence of tuberculosis as an opportunistic infection in patients with HIV getting combined antiretroviral therapy (cART) Materials and Methods: This was a hospital based cross-sectional comparative study. Five hundred patients with HIV who are getting cART were enrolled in the study. Results: Analysis of individuals with HIV in our study amongst the 500 patients 266 (53.2%) were males and the remaining 234 (46.68%) were females. Amongst these HIV patients 48(18.04%) males and 17(7.26%) females had tuberculosis. 65(13%) of patients were TB/HIV co-infected. 2(4.1%) of these male TB/HIV patients had cervical gland TB. Conclusion: The incidence of tuberculosis in HIV infected individuals is high. TB is the commonest opportunistic infection (OIs) in people living with HIV/AIDS. Males are predominant gender to have TB/HIV co-infection.
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