Radial Artery Pseudoaneurysm Managed by prolonged Ultrasound Guided Compression Repair Aided by Interval Application of Compression Device

We report a case of a right radial pseudoaneurysm due to assault. The pseudoaneurysm was treated successfully with prolonged ultrasound-guided compression for more than 300 minutes over multiple sittings coupled with the use of a compression device. We believe that if initial compression fails, a prolonged ultrasound-guided compression repair coupled with a compression device can greatly improve the success rates and can negate the use of more invasive procedures to treat pseudoaneurysms

Effect of Newtonian and non-Newtonian flow in subject specific carotid artery

Advances in the numerical simulation techniques has immensely helped in the demonstrating the importance of blood flow through elastic arteries and evaluating the disease progression and flow dynamics of cardiovascular diseases such as atherosclerosis. The present work deals with a case study of a patient diagnosed with partial narrowing of entire cervical segment of Internal Carotid Artery (ICA), while Common Carotid Artery (CCA) and External Carotid Artery (ECA) appears to be normal. Subject specific 3D carotid bifurcation CAD model is generated based on CT-angio scan data using MIMICS-14.0 and numerical analysis is performed using Computational Fluid Dynamics (CFD) in ANSYS-CFX-14.0. Pulsatile blood flow through the subject-specific artery is investigated to study the influence of rheology on the haemodynamics in the blood flow. The simulation results obtained through Carreau-Yasuda and Newtonian models are investigated. Flow behaviour observed during peak systole exhibits significant difference in the spatial parameters between both the Newtonian and nonNewtonians models. The comparison of local shear stress magnitude in CCA, ICA and ECA demonstrates that WSS is highly influenced by the shear thinning property of blood. This variation is also observed artery branches with reduced lumen diameter, lumen narrowing due to stenosis and in the bifurcation zone

Identification of Contrast Induced Nephropathy (CIN) with intravenous iso-Osmolar contrast media in renal failure patients with and without additional comorbidities undergoing Computed Tomography

Aim: To identify contrast induced nephropathy with intravenous iso-osmolar contrast media in renal failure patients with additional comorbidities undergoing computed tomography. Study design: Hospital based observational study. Methods: A retrospective study was conducted on 207 patients with pre-existing renal failure and comorbidities. In this study we collected pre-contrast creatinine values available within 3 weeks and post-contrast creatinine value was collected on 2nd and 5th day following CM injection in order to check early and late contrast induced nephropathy (CIN). Rate of CIN with and without comorbid conditions in CKD patients were calculated. Then we assessed the incidence of CIN with different amount of CM administered. We also calculated the relation of CIN with pre-contrast creatinine and eGFR range, which was categorized as 1.4- 2.0 mg/dL, 2.0-3.0 mg/dL and >3 mg/dL and >60ml and <60 mL/min per 1.73 m2 respectively. Results: Rate of CIN was relatively higher in renal failure patients and also in patients with comorbidities especially diabetes mellitus. Risk of CIN development was possible on 5th day also which was considered as delayed CIN. It was shown in the study that as the amount of contras media increases, rate of CIN also increases which was prominent in case of patients administered with >80ml of contrast media. CIN risk was better determined by eGFR than Creatinine value. Conclusion: CIN rate was clinically significant in CKD patients with comorbidities who received an iso-osmolar contrast media

Role of compression sonoelastography in aiding differentiation of benign and malignant solid hepatic lesions

Background: The liver is primarily or secondarily involved by numerous vascular, metabolic, infectious, and neoplastic processes resulting in formation of focal liver masses, and the detection of such focal liver lesions is frequently accomplished with sonography. However, the categorization a liver mass as benign or malignant on ultrasound has always been a diagnostic dilemma. Objective: This study aimed to assess if the addition of compression sonoelastography to conventional B-mode ultrasound aided in diagnostic accuracy of the focal hepatic lesions. Materials and Methods: We evaluated B-mode characteristics of 52 liver lesions followed by calculation of their strain values on compression sonoelastography. The lesions were categorized as benign or malignant by ascertaining a cutoff strain value and the comparison was made with the histopathological diagnosis/contrast-enhanced computed tomography characteristics of the lesions. Results: The mean strain index value of malignant hepatic lesions (2.12 ± 1.06) was statistically higher than the benign lesions (0.92 ± 1.06) with 2-tailed P = 0.002. The sensitivity, specificity, and positive and negative predictive values of compression sonoelastography in diagnosing a malignant pathology were 74.4%, 88.9%, 94.6%, and 46.7%, respectively, and the additional evaluation of B-mode features yielded higher sensitivity (95.4% vs. 83.7%) and negative predictive value (75% vs. 46.7%). Conclusion: Compression sonoelastography is an efficient and beneficial complementary tool to B-mode imaging in evaluating solid liver lesions

Plain CT vs MR venography in acute cerebral venous sinus thrombosis: Triumphant dark horse

Context: Most patients with cerebral venous sinus thrombosis (CVST) present with nonspecific signs and symptoms and are likely to undergo nonenhanced head computed tomography (NCT) at presentation, which may show a normal report in up to two-thirds of patients. However, in case of acute thrombosis, sensitivity of diagnosing CVST is high as sinuses are hyperdense. Though magnetic resonance imaging (MRI) is considered the imaging modality of choice for diagnosing CVST, it is not universally available in an acute setting. Aims: To evaluate whether increased attenuation in cerebral venous sinuses in acute condition can be used to diagnose acute CVST and to determine its diagnostic value. Materials and Methods: The study involves two independent groups. One group of patients with sinus thrombosis were confirmed by MR venography (group A). The other group included patients without sinus thrombosis (group B). The HU (CT attenuation), hemoglobin (HGB), hematocrit (HCT), and H: H (HU: HCT) ratio of both groups were compared. Thirty-six patients (59 thrombotic sinuses) were studied in group A and 40 in group B. Statistical Analysis: Average HU and H: H ratio were compared using two-tailed t-test, and linear regression analysis was used to assess correlation between HCT and HU. Results: Average HU (73.7 vs 48.6) and H: H ratio values were higher in group A patients compared to group B (P < 0.05). Linear regression analysis showed positive correlation between HGB and HCT with HU among both the groups (P < 0.05). Conclusions: Our study demonstrates that acute CVST can be diagnosed using HU values in NCT

Role of Computer Aided Diagnosis (CAD) in the detection of pulmonary nodules on 64 row multi detector computed tomography

Aims and Objectives: To determine the overall performance of an existing CAD algorithm with thin-section computed tomography (CT) in the detection of pulmonary nodules and to evaluate detection sensitivity at a varying range of nodule density, size, and location. Materials and Methods: A cross-sectional prospective study was conducted on 20 patients with 322 suspected nodules who underwent diagnostic chest imaging using 64-row multi-detector CT. The examinations were evaluated on reconstructed images of 1.4 mm thickness and 0.7 mm interval. Detection of pulmonary nodules, initially by a radiologist of 2 years experience (RAD) and later by CAD lung nodule software was assessed. Then, CAD nodule candidates were accepted or rejected accordingly. Detected nodules were classified based on their size, density, and location. The performance of the RAD and CAD system was compared with the gold standard that is true nodules confirmed by consensus of senior RAD and CAD together. The overall sensitivity and false-positive (FP) rate of CAD software was calculated. Observations and Results: Of the 322 suspected nodules, 221 were classified as true nodules on the consensus of senior RAD and CAD together. Of the true nodules, the RAD detected 206 (93.2%) and 202 (91.4%) by the CAD. CAD and RAD together picked up more number of nodules than either CAD or RAD alone. Overall sensitivity for nodule detection with the CAD program was 91.4%, and FP detection per patient was 5.5%. The CAD showed comparatively higher sensitivity for nodules of size 4-10 mm (93.4%) and nodules in hilar (100%) and central (96.5%) location when compared to RAD′s performance. Conclusion: CAD performance was high in detecting pulmonary nodules including the small size and low-density nodules. CAD even with relatively high FP rate, assists and improves RAD′s performance as a second reader, especially for nodules located in the central and hilar region and for small nodules by saving RADs time

An evolved diagnosis of congenital tuberculosis in a very low birthweight premature neonate

No abstract available