Apparent diffusion coefficient and T2* mapping on 3T MRI in normal and degenerative lumbar intervertebral discs

Purpose: To assess the utility of diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) maps and T2* mapping in quantitative analysis of nucleus pulposus (NP) and annulus fibrosus (AF) of lumbar intervertebral discs with its correlation with modified Pfirrmann grading (MPG) for lumbar degenerative disc disease (LDDD). Material and methods: One hundred subjects (20-74 years of age) underwent T2-weighted, DWI with ADC and T2* magnetic resonance imaging. MPG was applied to L3-L4, L4-L5, and L5-S1 discs, and ADC and T2* values of NP and AF were calculated in the mid-sagittal plane by segmenting each disc into 5 regions of interest (ROI) (NP-3, AF-2). Mean ADC and T2* values, their correlation, and cut-offs among different grades were calculated at different ROIs across different levels. Results: Out of total 300 discs analysed; 68 were normal (grade I) discs and 232 were degenerated (grade II to VIII) discs, based on MPG. T2* and ADC values in NP, AF, and the entire disc were significantly lower in degenerated discs than in normal discs. There was significant (p 0.9) for assessing the degree of LDDD. Conclusions: T2* and ADC value-based grade scales are highly accurate in evaluating the degree of disc degeneration with a high degree of objectivity in comparison to visual assessment-based MPG. Reduced ADC and T2* values of NP could serve as markers of early LDDD

RADIOLOGICAL EVALUATION OF SINONASAL, INTRAORBITAL AND INTRACRANIAL EXTENSION OF MUCORMYCOSIS IN POSTCOVID PATIENTS

Background: Mucormycosis is a fatal and progressive condition that affects immunocompromised patients in the post-COVID state. Radiological assessment by computed tomography and magnetic resonance imaging is useful to determine the severity and extent of the disease. Objective: The objective of this research is to evaluate mucormycosis in post-COVID patients using radiological investigations like computed tomography and magnetic resonance imaging and also to study the extent of disease in patients with diabetes and with steroid/ immunosuppressant use. Methods: A prospective observational study was undertaken at Dr. D. Y. Patil Hospital and Medical College, Pimpri Pune from March-June 2021. All patients who presented with mucormycosis were either COVID-19 positive or recovered from COVID-19 infection. Computed tomography and magnetic resonance imaging were performed in these patients. Results: The association between the status of diabetes mellitus and extent of involvement, steroids/immunosuppressant use and extent of involvement was statistically significant with a p value of <0.001. Conclusion: Patients with post COVID-19 status and diabetic status with steroid therapy during the treatment of COVID-19 may increase the risk of developingopportunistic infections like mucormycosis. Post COVID-19 related mucormycosis on computed tomography and magnetic resonance imagin

Spontaneous dissection of celiacomesenteric trunk with isolated extension and thrombosis in the superior mesenteric artery: a case report and literature review

Abstract Background Celiacomesenteric trunk (CMT) is one of the rare congenital anomalies of the splanchnic vasculature, characterized by the common trunk origin of the superior mesenteric artery (SMA) and celiac trunk from the abdominal aorta. Dissection of CMT with isolated SMA involvement without bowel ischemia has been rarely reported in the literature. Case presentation A 48-year-old male presented with generalized abdominal pain for 20 days, which increased after food intake. He also gave a history of passing loose stools on and off in the last 10–15 days, associated with melena for 4–5 days. Computed tomography (CT) and CT angiography (CTA) study of the abdomen demonstrated the common trunk origin of SMA and celiac trunk from the abdominal aorta at the D12–L1 disk level, consistent with the celiacomesenteric trunk (CMT). CTA also revealed dissection of CMT with isolated extension in the SMA origin and thrombosis in the mid and distal SMA. No bowel or mesenteric ischemia was seen due to extensive collateral supply to distal-most SMA and its branches, mainly through the inferior mesenteric artery (IMA) via an arc of Riolan and artery of Drummond. The patient was managed conservatively with bowel rest, anti-thrombolytics, and anticoagulant therapy based on imaging findings of short-segment dissection with no signs of bowel or mesenteric ischemia. Conclusion Diagnosis of rare vascular anomalies like CMT with associated complications of dissection and thrombosis is critical in patients with abdominal pain for prompt and precise management. CTA of the abdomen is essential for accurate diagnosis and characterization of the abnormality, which helps decide between conservative and surgical treatments

Evaluation and significance of Eustachian tube angles and pretympanic diameter in HRCT temporal bone of patients with chronic otitis media

Objective: To evaluate the significance of Eustachian tube (ET) angles and ET pretympanic diameter on high resolution computed tomography (HRCT) Temporal bone in patients with chronic otitis media (COM). Methods: A retrospective study was carried out at Tertiary care centre. Group A included 92 ears with COM (38 patients with bilateral COM and 16 with unilateral COM); and Group B included 108 normal ears (54 patients with bilateral normal ears). Reid plane-ET angle, Tubotympanic angle and the ET pretympanic diameter was evaluated by HRCT temporal bone, and compared in the two groups. Patients with chronic otitis media (Group A) were subdivided into Group A1 (Blocked ET) and Group A2 (Patent ET). The parameters were evaluated and compared in the subgroups too. Results: The mean Reid plane-ET angle and Tubotympanic angle in Group A was 25.41 ± 2.57 and 148.12 ± 3.43 respectively; whereas in Group B it was 27.56 ± 3.62 and 145.14 ± 4.34 respectively. Reid plane-ET angle was significantly less in patients with COM and Tubotympanic angle was significantly more obtuse in COM patients. ET pretympanic diameter was (5.37 ± 2.10) mm in Group A and (6.47 ± 2.40) mm in Group B. It was significantly less in patients with COM. A significant correlation was found between the ET patency and the two ET parameters (Reid plane-ET angle and pretympanic diameter). Conclusions: Eustachian tube angles in adults may play a significant role in the etiology of chronic otitis media. Decrease in Reid plane-ET angle and pretympanic diameter on HRCT temporal bone can be used to predict ET dysfunction and to plan the surgical management of chronic otitis media. Keywords: Eustachian tube (ET), Chronic otitis media (COM), High resolution computed tomography (HRCT) temporal bone, ET angles, Pretympanic diamete

Polyostotic fibrous dysplasia with secondary aneurysmal bone cyst in tibia

Fibrous dysplasia is a benign tumor-like lesion of bone believed to be developmental in origin. Polyostotic fibrous dysplasia (FD) is a rare condition. Our case was further complicated by the presence of secondary aneurysmal bone cyst (ABC). This is the second reported case of polyostotic FD with secondary ABC