CONTEXTPeripheral arterial disease of the lower extremity is an important cause of morbidity and affects 10 million people in India. AIMS AND OBJECTIVESThe aims of this study were to assess the colour Doppler ultrasonography findings of lower limbs in patients with peripheral arterial disease by studying the spectral flow pattern and peak systolic velocity and also to assess the severity of stenosis and correlation of severity of stenosis on USG Doppler and MDCT angiography. MATERIALS AND METHODSThe study included 29 patients attending surgery, Ortho OPD Government Medical College of Calicut with signs and symptoms of peripheral arterial diseases of lower limbs from January 2014 to October 2015 who underwent colour Doppler ultrasonography and MDCT angiography to know the severity of peripheral arterial diseases of lower extremities and to compare various grades of stenosis by studying the spectral flow patterns in colour Doppler ultrasonography and contrast opacification and diameter reduction in MDCT angiography. RESULTSIn our study, 29 patients with intermittent claudication, numbness, and pain in the legs were selected. Majority of the patients were males and below 50 yrs. In our study, detection of totally occluded segments were better in MDCT angiography on comparing with Doppler USG. Most of the arteries showed good total agreement between Doppler and MDCT angiography. Aortoiliac group of vessels showed more than 80% total agreement between Doppler and MDCT angiography. Femoropopliteal group vessels showed more than 75% total agreement. Infrapopliteal group of vessels showed more than 50% total agreement. CONCLUSIONMDCT angiography is more sensitive in detecting lesions of suprapopliteal group of vessels and also lesions with total occlusion of the lumen in comparison to Doppler ultrasonography. Imaging plays an important role in the management of the patients with peripheral arterial disease. Due to the limitations of the Doppler ultrasound, CT angiography is used prior to any vascular intervention is required in peripheral arterial diseases.
CONTEXTMiddle cerebral artery stroke is described as the sudden onset of focal neurological deficit due to brain infarction in the territory supplied by the MCA. Patients have variable recovery of neurological functions after MCA stroke, but knowledge of the time course and extent of recovery is limited. It will be beneficial to know the stroke patient's early outcome and association between MR imaging findings and the clinical outcome. AIMSTo assess the extent of infarction in MCA stroke from the MRI brain taken within 48 hours of onset of stroke. To study the association between MRI findings and clinical outcome in MCA stroke. MATERIALS AND METHODSFifty patients who presented with symptoms of MCA stroke within 24 hours in medicine casualty of Govt. Medical College, Kozhikode, from March 2014 to September 2015 were taken for study. MRI brain including diffusion weighted images and MR angiogram were taken within 48 hours. Neurological status at the time of admission and after seven days was assessed using GCS score. Correlation between MRI findings and early clinical outcome was studied. RESULTSMajority of patients with MCA stroke were in age group between 50-69 years. Ninety four percentage of patients had one or more comorbidities, of which hypertension was the most common one; 20% patients expired within 7 days. Neurological improvement after one week was seen only in 32%; 60% of all deaths occurred in patients with age more than 70 years. Majority of patients (86%) had infarct size less than 50%. Infarct size and DW-ASPECTS showed significant correlation with neurological outcome and day 7 survival. M1 occlusion showed poor early outcome in MCA infarct. CONCLUSIONPatients with larger area of infarct and M1 occlusion has poor immediate post infarct recovery. DW ASPECTS score can be used as a good method for assessing extent of MCA infarct. However, large scale study with large sample size are needed for definite conclusion. KEYWORDSMCA Infarct, DW ASPECTS, M1 Occlusion, Early Neurological Outcome. HOW TO CITE THIS ARTICLE:Jose NT, Padinharoot R, Rajendran VR, et al. Magnetic resonance imaging in middle cerebral artery infarct and its correlation with functional recovery.
CONTEXTPerinatal asphyxia happens in 2 to 10 per 1000 newborns that are born at term, and more for those that are born prematurely and making one of the leading cause of death worldwide. AIMTo study the pattern of involvement of brain in HIE influenced by nature of insult and to assess the severity of brain injury by MR imaging and correlate with clinical staging (Sarnat criteria). METHODOLOGY43 cases with history of perinatal asphyxia were included in this study by applying the inclusion criteria and exclusion criteria. Signal changes in T1 and T2 weighted images and diffusion weighted were assessed and recorded. RESULTS AND INTERPRETATIONSAfter MR imaging, most of the Sarnat Stage I and II patients were mild and stage III patients were severe. Of the all clinically diagnosed having HIE, 25.6% cases were normal. Patients with clinically mild hypotension >1/2 (54.2%) of them were found to be normal after imaging. Patients with clinically moderate hypotension, 20% were normal at MRI; and >1/2 (52%) of them showed only mild changes and 12% showed severe involvement. Term babies with mild encephalopathy shows more involvement of periventricular white matter than subcortical white matter. Clinically severe encephalopathy correlates with abnormal basal ganglia -thalamic lesions in term babies and germinal matrix haemorrhage in preterm babies. Clinically moderate encephalopathy correlates with signal changes in posterior limb of internal capsule and perirolandic white matter. Prematurity increases the susceptibility of brain to changes caused by hypoxia. No significant association noted between sex and birth weight with abnormal MR imaging findings. The low Apgar score shows significant association with severity of brain involvement. Seizure and its onset also appears to be a deciding parameter in severity of brain injury.
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