Right lung agenesis with left pulmonary artery sling: Computed tomography imaging

We report a case of an infant with respiratory distress and difficult intubation, who on multidetector computed tomography (MDCT) imaging was found to have an extremely rare combination of left pulmonary artery (LPA) sling and right lung agenesis (RLA). The complete right-sided mediastinal shift resulted in dextroposed, coronally placed, anteriorly crossing aortic arch causing posterior displacement and significant anterior compression of the trachea. The posterior tracheal displacement and stenosis made the intubation quite difficult and challenging in this patient. Cross-sectional imaging with computed tomography angiography has an edge over echocardiography and conventional pulmonary angiography in demonstrating the anomalous posterior course of an LPA in the presence of coexisting RLA. MDCT imaging plays a pivotal role in evaluating the structural anatomy and thus provides with pertinent information regarding the cause and the level of airway obstruction

Correlation of clinical, MRI and arthroscopic findings in diagnosing meniscus and ligament injuries at knee joint: A prospective study

Objective: The purpose of this study was to correlate clinical, MRI, and arthroscopic findings in diagnosing ligament and meniscus tears in knee joint injuries. Materials and Methods: Our study included 20 patients in the age range of 11-60 years who were referred to radiology department for MRI of knee joint following injury to the knee. Prior to MRI, a detailed history, clinical, and local examination was done in all the subjects. MRI was carried out on 1.5 Tesla MR Machine and the standard protocol consisted of fat-suppressed PD (TE 45, TR 2800) in axial, sagittal, and coronal planes, T2W (TE 80, TR 4000) in sagittal plane and T1W (TE 11, TR 495) in sagittal plane. All the patients underwent arthroscopy by an orthopedic surgeon. Results: MR had 100% sensitivity and NPV of diagnosing ACL tears in this study. Clinical examination had sensitivity of 88% and NPV 75% in diagnosing ACL injuries. There was high NPV of MR examination (96%) in diagnosing meniscus tear while the PPV of MR examination was low (71%). These values were low in case of clinical examination. Conclusions: MRI is a useful non-invasive modality having high diagnostic accuracy, sensitivity, and negative predictive value making it a very reliable screening test for diagnosing internal derangements

Aortic atresia with normal sized left ventricle

Aortic atresia with an associated ventricular septal defect and adequate sized left ventricle is extremely rare. We present two cases in which an alternate diagnosis was suggested on echocardiography because the hypoplastic aortic trunk was missed due to its small caliber. The final diagnosis was, however, clinched on dual source computed tomography, which not only showed the thin aortic trunk but also clearly depicted the coronary artery origins from the hypoplastic aortic root. To the best of our knowledge, use of multi-detector computed tomography in aortic atresia with well developed left ventricle has not been reported in literature till date

Contrast injected, scan triggered, but where has contrast gone?

Intra-arterial injections during CT scan examinations are a rare occurrence in day-to-day radiology practice but are of potential significance when they do occur. They render an imaging study non-diagnostic, and for imaging techniques like CT scan, expose patient to undue radiation dose. Equally disturbing for both patient and clinicians, including radiologists, is the need for repeat imaging. For certain emergency indications, such an event may yield erroneous results and severely hamper patient′s management. We report one such event that occurred in our cardiac CT scan section with the aim to raise awareness about such events among our colleagues