IntroductionRenal cortical elastography has shown conflicting but promising results in evaluation of chronic kidney disease and other renal disorders. The purpose of this study was to establish a normogram of renal cortical elasticity values and assess their variation between right and left kidney and their relation with age, gender, body mass index, renal dimensions and skin to cortex distance.MethodsThe study was a hospital based cross sectional study performed at Tribhuvan University Teaching Hospital, a tertiary care center in Kathmandu, Nepal. All individuals referred for Ultrasound from General Health Check up clinic were included in the study. Patient with abnormal ultrasound findings and abnormal renal function test were excluded from the study. Renal morphometry including length, cortical thickness, and skin to cortex distance were measured in B mode imaging and renal cortical elastography was measured with region of interest box of 1 × 0.5 cm. All analyses were done using Statistical Package for Social Sciences 20.0 soft ware.ResultsA total of 95 individuals who met the inclusion criteria were included in the study. The mean values of right and left renal cortical shear wave velocity were 1.49 ± 0.19 m/s and 1.54 ± 0.19 m/s respectively. Statistical significant difference was observed between the renal cortical shear wave velocity of right and left kidney. The renal shear wave velocity was seen to decrease with age, however the correlation was not statistically significant. No significant difference was also noted in renal shear wave velocity among various sex or Body mass index groups. Statistically significant negative correlation was noted between skin to cortex distance and renal cortical shear wave velocities. However no statistically significant correlation was noted between renal dimensions and renal cortical shear wave velocities.ConclusionsThe normal cortical elasticity values in terms of shear wave velocity of right and left kidney were established. Renal elasticity is independent of the age, gender, Body mass index and renal dimensions.

Objective: The purpose of this study was to categorize patients into different grades of nonalcoholic fatty liver disease (NAFLD) by ultrasonography and to compare the findings with their serum lipid profile. Materials and Methods: Descriptive, cross-sectional study design was used. One hundred and nine patients without a history of alcohol consumption of age more than 16 years attending general health checkup were selected at Tribhuvan University Teaching Hospital, Maharajganj, Kathmandu, as per the exclusion and inclusion criteria. Ultrasound scanning of the patients was done and their liver size, as well as grading of fatty liver, was done. Data were collected in predesigned pro forma and were analyzed using Statistical Package for the Social Sciences (SPSS) 16.0, IBM (SPSS Inc., Chicago, IL). Results: In this study, the mean age of fatty liver in males was found to be 44.3 years and in females was found to be 51.9 years. 22.9% of patients with NAFLD had increased liver size. Significant association with increasing grades of fatty liver was found with increasing levels of cholesterol ( P = 0.028), low-density lipoprotein (LDL) ( P = 0.017), liver size ( P = 0.001), and body mass index (BMI) ( P = 0.045) in patients diagnosed with NAFLD. No significant association with increasing grades of fatty liver was found with increasing levels of triglyceride ( P = 0.32) and high-density lipoprotein ( P = 0.25). Conclusion: Ultrasound is a safe and first-line modality for the evaluation of fatty liver and its grading. Increasing grades of fatty liver had significant association with increasing levels of cholesterol LDL, increasing liver size, and BMI of patients.

In diagnostic radiography, cervical lateral spine x-ray is common radiographic examination among imaging of cervical spine. Thus, it is important to show entire anatomical structure, adequate penetration, soft tissue of neck and bony detail. This study attempts to quantify the quality of cervical spine radiographs by evaluating the quality of depiction of the anatomical and physical details. In this cross-sectional study, about 188 cases of cervical spine lateral radiographs were collected for study over the three months of period. Nine image criteria i.e. anatomical coverage, soft tissue visualization, C7/T1 junction, sharp bony detail, proper chin raise, artifact, density, patient rotation and collimation were followed and tabulated. Obtained data were analyzed using in SPSS v.20 software and shown in frequency, percentages, bar diagrams and graphs. Among 188 patients, about 23.4% cervical radiographs met all image criteria but remaining 76.6% did not meet these criteria due to no anatomical coverage (33.5%), no proper chin raise (46.3%), artifact (13.3%), patient rotation (50%) and no collimation (33.5%). It is difficult to perform good quality cervical radiograph according to European guidelines14. To a great extent the quality of cervical radiographs depends upon skill of radiographer, equipment condition (x-ray machine, CR reader) and co-operation of patients. This is always a challenge for radiographer and technologist.

Introduction: Routine ultrasonography in pregnancy has the role in identifying the position, parenchyma echo pattern, variability of thickness of placenta which is associated with increased perinatal risk to both the foetus and mother. This study was carried out to establish the value of placental thickness measurement during normal pregnancy as a reliable parameter for estimating gestational age of the foetus.Methods: This was a prospective cross-sectional study done in the Department of Radiology and Imaging at Tribhuvan University Teaching Hospital from September 2004 to April 2005. Total 350 normal pregnant women of more than 15 weeks of gestation were included. Ultrasonographic measurement of placental thickness and fetal biometric measurements were obtained. Correlation coefficient tests were performed between the gestational age in weeks and placental thickness using Karl Pearson formula in SPSS 10 package.Results: Mean placental thickness measured at the cord insertion site increased from 15.28 mm at 15 weeks of gestational age to 39.57 mm at 39 weeks of gestational age correlated almost exact with a standard mean of deviation of ± 1.8 mm (r >0.851, p <0.001).Conclusion: Ultrasonographic measurement of placental thickness during normal pregnancy can predict the gestational age of the fetus with high confidence level and can be included as one of the biometric measurements of foetus to estimate its gestational age.

Introduction: Various organs are measured to estimate the gestational age of fetus. Sonographically derived parameters used to date pregnancy include crown rump length, biparietal diameter, head circumference, femoral length and abdominal circumference. Fetal kidney length, transcerebellar diameter and placental thickness are emerging as new parameters and are claiming to be more accurate in certain situations. In Nepalese context fetal kidney length has not been studied yet so this study was done to fill this need. Methods: Obstetric sonography was performed in 108 pregnant women with uncomplicated pregnancy to evaluate the efficacy of FKL as a measure to calculate the predicted gestational age. Gestational age ranged from 20 weeks to term. Only patient with known LMP and previous history of normal menstrual cycle were included in the study. Results: The study showed mean fetal kidney length at 20 - 24, 25 - 29, 30 - 34 and 35 - 37 weeks gestation as  22.5 ± 0.5, 26.9 ± 0.7, 32.32 ± 0.7 and 36.3 ± 0.6 respectively. Overall in combined second and third trimester, fetal kidney length showed strong linear correlation with gestation age with highest significant Pearson correlation coefficient of 0.989 as compared to other parameters (BPD = 0.986, HC = 0.976, AC = 0.971, FL = 0.984). Conclusions: Fetal kidney showed strongest linear correlation with clinical gestational age and it also demonstrated positive correlation with biparietal diameter, head circumference, abdominal circumference and femur length. Therefore fetal kidney length can be used as a reliable parameter for determination of gestational age.