Study DesignA retrospective study of the ventral displacement of dorsal spinal cord (VDDSC) spectrum pathophysiology and grading.PurposeThis study aimed at examining the pathophysiology of VDDSC between D3 and D7, using magnetic resonance imaging (MRI) correlation and severity grading.Overview of LiteratureThe pathologies that lead to VDDSC were previously discussed in various articles. We attempted to group these pathological conditions under a single spectrum, and grade them according to their severity.MethodsWe reviewed the MRI images of the dorsal spines of 1,350 patients over a period of 4 years (February 2013–February 2017); all MRI images were analyzed by two experienced radiologists.ResultsOf the 1,350 patients, 28 exhibited VDDSC between D3 and D7. Additional findings included ventral transdural herniation of the spinal cord (n=10), anterior spinal cord adhesion (n=7), arachnoid web (n=6), and arachnoid cyst (n=5).ConclusionsWe grouped the pathologies that lead to VDDSC at the thoracic level into a single spectrum of varying severity and graded VDDSC, from mild to severe.
Dry weight assessment in dialysis patients remains a challenging endeavor owing to the limitations of the available methods for volume assessment. Lung ultrasound is emerging as an invaluable tool to assist in the appropriate assessment and assignment of dry weight. The objectives of this study are (1) to determine the reliability of clinical signs and symptoms for volume assessment, (2) to compare lung ultrasound with High Resolution Computed Tomography (HRCT) chest-A noninvasive gold standard tool for detecting pulmonary congestion and with inferior vena cava diameter (IVCD) – another time-tested volume assessment method, and (3) to analyze if lung ultrasound could detect dialysis induced fluid status variations. The cross-sectional study involves 50 patients on maintenance hemodialysis. Lung ultrasound for B line estimation and ultrasonographic measurement of IVCD performed before and after hemodialysis by a nephrologist trained in ultrasonography. Limited HRCT was obtained just before hemodialysis. Edema, crackles, and dyspnea had a poor sensitivity of 37.9%, 11.5%, and 52.6%, respectively, to detect clinically significant pulmonary congestion by lung ultrasound. A highly significant correlation was obtained between B-line score and HRCT signs of pulmonary congestion ( P < 0.001) before dialysis. B lines showed statistically significant reduction with dialysis. The absolute reduction of B lines showed significant correlation with ultrafiltration volume and weight loss. Bedside lung ultrasound appears a sensitive tool for evaluating real-time changes in extravascular lung water and would serve to optimize volume status in dialysis patients.
Study DesignA retrospective radiological study of the ligamentum flavum (LF).PurposeWe determined the relationship of dorsal spinal LF thickening with age and sex using magnetic resonance imaging (MRI). We also determined whether LF thickening has a predominant tendency to occur at a specific dorsal level and on a specific side.Overview of LiteratureMany researchers have studied LF thickness at dorsal levels in patients with compressive myelopathy. However, there is a dearth of literature pertaining to the study of dorsal LF thickness in patients without myelopathy.MethodsLF thickness was measured at dorsal levels from T1 to T12 on both sides using MRI in 100 individuals. The patients were divided into three groups based on age: 20 to 40, 41 to 60, and >60 years. On axial T2-weighted imaging at the mid-disc level, LF thickness was measured perpendicular to the lamina border, either at half the length of LF or at maximum thickness, whichever was greater.ResultsWe found that LF thickness does not increase significantly with increasing age and there was no significant disparity in LF thickness between the sides and sexes. We also found that there was a significant increase in LF thickness at the T10–T11 level (mean value, 3.27±0.94 mm).ConclusionsLF thickness does not appear to have any side/sex dominance. LF thickening has a predominant tendency to occur specifically at the T10–T11 level. This may be due to maximum tensile strength and mobility at this level. Because there is an increased tendency for LF thickening at the T10–T11 level, this may be used as a reference point for counting the vertebral levels.
BACKGROUND Spondylolysis is defined as a defect in the pars interarticularis of the vertebral arch, which is a bony bridge connecting the superior and the inferior articular facet joints. Aims and Objectives: To determine the incidental occurrence of lumbar spondylolysis, the common site and type of involvement and the associated degenerative disorders in the patients in an unselected population. MATERIALS AND METHODS This is a cross-sectional study in which incidental spondylolysis was evaluated for 852 patients (462 females and 380 males) who underwent multidetector (16 slice) CT abdomen/ (Kidney Ureter Bladder) using bone and soft tissue algorithm. Overview of Literature-There are very less number of studies regarding the prevalence of incidental spondylolysis, the common site and the type of involvement in a developing country. RESULTS CT Abdomen/ KUB imaging showed higher prevalence of incidental lumbar spondylolysis. Most common level involved was L5 vertebra, the common type was isthmic. Age wise distribution of type of spondylolysis and grading of listhesis was significant. CONCLUSION CT Abdomen/ KUB imaging of an unselected Indian population showed higher prevalence of incidental lumbar spondylolysis. The prevalence of isthmic type is higher and its progression to spondylolisthesis increases with advancing age.
BACKGROUNDMR Sialography has become an alternative method for imaging the salivary gland and duct. MRI is a non-invasive technique with advantages of superior tissue discrimination and multiplanar facility. MRI has no radiation hazard as compared to the conventional sialography and CT sialography; 3D CISS sequence gives details of salivary gland ducts and sialoliths.
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