Giant splenic cyst: A case report and consolidated review of literature with radiographic features

The spleen is a relative stranger to the world of cysts and tumors, which when discovered, are often incidental findings in otherwise asymptomatic individuals. Splenic cysts are far more common than solid lesions and can include congenital, inflammatory, vascular, post-traumatic, neoplastic, and parasitic types. Parasitic cysts in the spleen are usually caused by the larval forms of Echinococcus, a cyclophyllid tapeworm. However rare, it is important to recognize the splenic presentation of this uncommon entity to prevent life-threatening complications like anaphylaxis induced by traumatic or spontaneous cyst rupture. We report here a case of a giant dumbbell-shaped splenic cyst. Hydatid disease of the spleen should be considered in the differential of every patient presenting with a cystic lesion of the spleen in the endemic areas until proven otherwise

Partial uterine perforation and ovarian embedment of misplaced intrauterine device: a case report

Intrauterine devices (IUDs) are the commonest form of contraceptive method in use globally. IUDs like other methods of contraception may be associated with its own complications. The major risk includes uterine perforation with embedment, migration, and/or expulsion. A 35 year old female who had a history of postpartum IUD insertion 10 years ago was referred to our institute with complains of severe lower abdominal pain and vomiting since 10 days. Transabdominal and transvaginal ultrasound (TAS/TVS) were done. Ultrasound led to the final diagnosis of ovarian embedment of the IUD. Laparotomy with IUD removal was successfully performed. This case report highlights one of the rare complications of IUD migrating to the left ovary in a patient presenting with lower abdominal pain. In a patient with history an IUD insertion in situ, lower abdominal pain and missing threads on examination should wary the gynaecologist to the possibility of total or partial transmigration of the device into the pelvis or abdomen

Role of diffusion weighted MR imaging in differentiating benign from malignant prostate lesions

Background: The purpose of the study was to determine the diagnostic accuracy of diffusion weighted MR imaging and to propose a cut off ADC value in differentiating benign from malignant prostatic lesions considering histopathology as gold standard.Methods: It is a descriptive type of observational study done on 40 patients with clinical suspicion of prostate carcinoma and elevated PSA level more than 4ng/ml. The patients underwent Multiparametric prostate MRI and ADC values were calculated using ADC maps.Results: Of the 40 cases included in the study histopathology revealed a diagnosis of abscess (1), chronic prostatitis (2), BPH with chronic prostatitis (4), BPH (12), and malignancy (21). The mean and standard deviation (SD) of ADC values for the abscess (0.59), CP (0.83+0.16), BPH with CP (0.94+0.22), BPH (1.14+0.14) and malignancy (0.72+0.15) (x10-3mm2/s) were found in our study. The mean ADC value of malignant lesion was lower (0.727+0.149) as compare to benign lesion (1.034+0.216) and this difference was found to be statistically significant with p<0.001. By using ROC curve, ADC cut off value was calculated as 0.92 x 10-3mm2/s and sensitivity, specificity at this cut off value of ADC were 95.24% and 73.68% respectively. The PPV, NPV, diagnostic accuracy of at this cut off value of ADC were 80%, 93.33%, 85% respectively.Conclusions: Our study shows that DWI with ADC calculation helps in differentiation of Benign from Malignant prostatic lesions with high accuracy and this quantitative analysis should be incorporated in routine MRI evaluation of prostatic lesion

Observational study to determine the proportion of types of congenital heart diseases in high-risk pregnancies with detailed prenatal echocardiography

Background: Specific factors that increases a mother’s risk of carrying a fetus with CHD, with the use of extended views in fetal echocardiography in addition to basic standard views there is increased detection of CHDs. Purpose of study current study was to investigate the role of fetal echocardiography in prenatal diagnosis of the congenital heart diseases in high-risk pregnancies between 18-36 weeks of gestational age and to determine the proportion of occurrences of different types of CHDs in and high-risk group.Methods: Observational study with consecutive sampling 880 subjects. Study done in department of radiodiagnosis, SNMC, Jodhpur, RajasthanResults: With use of basic standard views, extended views and 3D views total 27 cases were detected out of all 880 subjects, which is significant statistically. Many CHDs which can be missed by the standard views, can be more efficiently detected with use of extended views in the fetal echocardiography.Conclusions: Most common type of CHD was found to be VSD and hypoplastic left heart syndrome

Study of renal parenchymal changes by diffusion tensor imaging in diabetic nephropathy

Purpose: To evaluate differences in diffusion imaging parameters, including fractional anisotropy (FA) and the apparent diffusion coefficient (ADC), in control and diabetic subjects, and to assess changes in these parameters to patient's urine albumin/protein levels, estimated glomerular filtration rate (eGFR), and glycated haemoglobin (HbA1c). Material and methods: This is a cross-sectional analytical study involving 100 patients who underwent diffusion imaging including diffusion tensor imaging (DTI) of the kidneys in our hospital from 2019 to 2020. Diffusion imaging parameters (ADC and FA) were obtained from the medulla and cortex of both kidneys using dedicated software. Statistical analysis was done. Results: Out of 100 subjects, 27 were controls and 73 were diabetics (19 normoalbuminuric, 23 microalbuminuric, and 31 proteinuric). The medullary FA (0.419 ± 0.024 vs. 0.346 ± 0.042), cortical FA (0.194 ± 0.035 vs. 0.303 ± 0.067), and cortical ADC (3.307 ± 0.341 vs. 2.309 ± 0.515) values showed significant differences between controls and diabetics. Medullary FA and cortical ADC values showed a decreasing trend with an increasing amount of albumin/protein in the urine, decreasing renal function (reducing eGFR), and increasing HbA1c, whereas the trend was opposite for cortical FA. In addition, on ROC curve analysis a cut-off value for medullary FA of 0.4 had a sensitivity of 64% and specificity of 80.95% to differentiate healthy volunteers and diabetics with normo-albuminuria. Conclusions: DTI has the potential to be a promising non-invasive test for the detection of early renal parenchymal changes in diabetic nephropathy

Pacemaker lead in lung, a rare case

Pacemaker lead perforation is a rare complication of pacemaker device implantation. We report a case where a ventricular lead perforated through right ventricle, pericardium and went into left lung parenchyma without the development of pericardial effusion, cardiac tamponade, pleural effusion, pneumo or hemo thorax. Patient presented with complaints solely related to failure of pacing rather than disastrous or life threating complications. Echocardiography didn't reveal any evidence of perforation and it was detected on fluoroscopy and computed tomography helped in making the diagnosis. Patient was treated with second procedure where second device placed on other side without manipulating previous device or lead