European Journal of Molecular & Clinical Medicine

Introduction: Prevalence of morbidity and mortality is keep rising in poorly managed stroke
cases. Early detection and proper diagnosis have great potential in management of stroke. The
development of brain imaging modalities (CT/MRI) have led to a milestone that provides a
living autopsy of the brain.
Objective: The goal of this prospective study is to determine the clinical efficacy of CT/MRI
and its benefits over traditional techniques of clinical diagnosis in stroke patients.
Methods: 50 patients in whom clinical signs of stroke i.e., slurring of speech, weakness on
one side of the body, deviation of angle of mouth, and neurological deficits observed were
recruited in the study. CT/MRI was used to diagnosed the stroke.
Results:The NCCT finding have revealed Diffused cerebral atrophy in 14 (28%) patients,
Chronic Infarct in 11 (22%) patients, Subacute Infarct in 7 (14%) patients, Acute Infarct in 6
(12%) patients and Encephalomalacia in 2 (4%) patients whereas 10 (20%) patients
underwent MRI brain.The MRI brain finding have revealed Diffused cerebral atrophy in 6
(6%) patients, Chronic Infarct in 1 (2%) patient, Subacute Infarct in 4 (8%) patients, Acute
Infarct in 3 (6%) patients and Encephalomalacia in 2 (4%) patients whereas 37 (74%) patients
underwent NCCT head.
Conclusion: In both NCCT head and MRI brain finding have revealed diffuse cerebral
atrophy as the most common finding among recruited patients followed by the chronic infarct
(22%), subacute infarct (14%), acute infarct (12%) and encephalomalacia (4%).

Aim: To compare modalities like ultrasonography (USG) and computed tomography (CT) in
the evaluation of suspicious ovarian masses.
Methodology: This prospective comparative study was carried out in the Department of
Radiology, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan,
Himachal Pradesh for a period of 12 months. Total 50 women were included in this
prospective study. All patients underwent abdominal Ultrasonography and CT scan with
determination of the ovarian mass characteristics. Detailed history of allergy and renal
function tests were taken before doing CT scan and if there was history of allergy then nonionic
contrast was used. Site, size, papillary projections, wall characteristics, capsular
infiltrations, the presence of solid areas inside the mass and presence of as cites were
recorded both by US and CT scan.
Results: Out of 50 patients, majority of patients belonged to 40-50 years of age group (19,
38%) followed by 30-40 years of age group (10, 20%). 8 patients (16%) belonged to 20-30
years age group, 7 (14%) belonged to 50-60 years, 60 years of age group included 3
patients each. There are total 29 cases of Pre-menopausal stage and 21 cases of Postmenopausal
stage having ovarian cyst. Out of 29 cases of Pre-menopausal conditions have 7
number of malignant and 22 number of benign type of ovarian masses. In the Postmenopausal
group there are 17 cases of malignant and 4 cases of benign ovarian mass was observed.
Overall, CT was found to have 96% sensitivity, 92% specificity, and an accuracy of 92% in
the differentiation of benign and malignant ovarian masses, while PPV and NPV were 94%
and 90%, respectively. The sensitivity of USG was 90%, specificity was 86% and PPV and
NPV were 88% and 86% respectively.
Conclusion: CT and USG imaging all have approximately similar accuracy in staging
ovarian carcinoma but the sensitivity of CT scan for all ovarian cancer detection greater than
that of US. Among women with ovarian disorders, CT can be primarily in patients with
ovarian malignancies, either to assess disease extent prior to surgery or as a substitute for
second look laparotomy.

Background: Acute abdominal pain is among the three most common symptoms in patients
coming to emergency departments or being admitted to hospitals. Computed tomography is
more sensitive and accurate at detecting abnormalities than plain radiography because of
its cross sectional nature. Hence; the present study was undertaken for evaluating efficacy
of computed tomography in diagnosis of acute abdomen. Materials & methods: The
present study was conducted with the target of analysing the effectiveness of computed
tomography in diagnosis of acute abdomen. Continuous monitoring of the hemodynamic
vitals was done during the contrast injection procedure. Evaluation of 20 subjects was
done who were referred to our Department with clinical presentation of acute abdomen
were enrolled. US of the abdomen were done in all the patients. Clinical and demographic
details of all the patients were obtained. A predesigned Performa was made for compiling
the radio-imaging findings. The statistical analysis of the data was done using SPSS
version 11.0 for windows. Results: Sensitivity and specificity of CT in diagnosing
Mesenteric ischemia, Gut malrotation, gut perforation and gall bladder perforation was
100 percent each. In diagnosing appendicitis, sensitivity and specificity was 90 percent
each while in diagnosing pyelonephritis, sensitivity and specificity was 80 percent and 90
percent respectively. Conclusion: For establishing the diagnoses of acute abdominal pain
patients, MDCT is an effective imaging modality

Background:Many radiologists recognize that there are common lung nodules, that majority of
them are benign, and that not all benign lung nodules need the same management .The Lung
Imaging Reporting and Data System (Lung-RADS( was introduced to create a framework for the
analysis of screen-detected nodules and to enable nodule management further standardized. Aim
of work:To assess the performance of Lung-RADS in categorization of pulmonary nodules using
baseline screening CT scans. Subjects and methods:A prospective comparative study was
conducted in radiodiagnosis department, Zagazig university hospitals on 30 patients referred
from the chest department of Zagazig university hospitals as well as the outpatient clinics for CT
lung screening during the period from August 2018 to May 2019.All patients were subjected to
complete history taking, full clinical examination, MDCT imaging, PET/CT imaging in some
nodules, pathological examination, clinical and imaging follow up according to the criteria of the
nodules after 6 months by CT. Results:Considering only those cases classified as Lung-RADS4X
for predicting malignancy, the Lung-RADS had an accuracy, sensitivity, specificity, PPV, and
NPV of 76.7%, 70.6%,84.6%, 85.7%, and 68.6%, respectively. Considering Lung-RADS4A,
Lung-RADS4B and Lung-RADS4X together as predictors for malignancy, the accuracy,
sensitivity, specificity, PPV, and NPV were 90%, 94.1%, 84.6%, 88.9%, and 91.7%,
respectively.Conclusion:The LUNG–RAD classification method is a useful conceptualising
system that aids in the classification, follow-up, and improvement of the prognosis of malignant
pulmonary nodules.

Background: The present study compared hounsfield unit of CT with grey scale value of CBCT for hypo and hyperdense structure. Materials & Methods:15 human dry skulls were subjected to MSCT and CBCT and hyperdense areas of enamel, cortical, and cancellous bones and hypodense areas of mental foramen, inferior alveolar canal and extraction socket within the mandible were assessed. Results: For extraction socket CT had -860.5 HU and CBCT had -740.5 grey scale, for mandibular canal CT had -560.2 HU and CBCT had -726.4 grey scale, mental foramen had CT of -432.6 HU and CBCT had -458.6 grey scale, cancellous bone had CT had 346.2 HU and CBCT had 416.2 grey scale and cortical bone had CT 1880.4 HU and CBCT had 1652.8 grey scale. The difference was significant (P< 0.05).
Conclusion: The gray value for hypodense structures in large volume CBCT scan was more reliable and analogous to HU value in MSCT.

Background: Computerized tomography has been a revolutionary advance in the field of diagnostics. The present study was conducted to assess role of computed tomography in evaluation of pancreatic pathologies. Materials & Methods: 100 patients with pancreatic pathologies were subjected to Philips Ingenuity CT Scanner (128 slices) for the acquisition of the CT scan images. In all patients, clinical presentation and CT scan findings were recorded.
Results: Age group of 41-50 years (26 %). 21 patients presented in 51-60 years. 18 patients (18%) presented in both 21-30 years and 31-40 years age group each. 9 patients (9%) in 61-70 years age group, 3 patients (3%) in 71-80 years age group, and 2 patients (2%) in 0-10years and 11-20 years age group each. 1 patient (1%) in 81-90 age group. 1 case (1%) was of congenital abnormality (Annular pancreas), 61 cases (61%) were of inflammatory pathologies, 27 cases (27%) were of non inflammatory mass lesions (tumors), 7 cases (7%) were of trauma and 4 cases (4%) were of miscellaneous pathologies.
Conclusion: CT is highly accurate for determining the nature and extent of pancreatic lesions and plays a valuable role in assessing patients with inflammatory/non inflammatory lesions of pancreas, pancreatic trauma and pancreatic tumours.

Accurate localization of the seizure onset zone is important for better seizure outcomes and preventing
deficits following epilepsy surgery. Recent advances in neuroimaging techniques have increased our
understanding of the underlying etiology and improved our ability to noninvasively identify the seizure
onset zone. Using epilepsy-specific magnetic resonance imaging (MRI) protocols, structural MRI allows
better detection of the seizure onset zone, particularly when it is interpreted by experienced
neuroradiologists. Ultra-high-field imaging and postprocessing analysis with automated machine learning
algorithms can detect subtle structural abnormalities in MRI-negative patients. Tractography derived from
diffusion tensor imaging can delineate white matter connections associated with epilepsy or eloquent
function, thus, preventing deficits after epilepsy surgery. Arterial spin-labeling perfusion MRI,
simultaneous electroencephalography (EEG)-functional MRI (fMRI), and magnetoencephalography
(MEG) are noninvasive imaging modalities that can be used to localize the epileptogenic foci and assist in
planning epilepsy surgery with positron emission tomography, ictal single-photon emission computed
tomography, and intracranial EEG monitoring. These advanced structural and functional imaging
modalities can be combined with postprocessing methods to better understand the epileptic network and
obtain valuable clinical information for predicting long-term outcomes in pediatric epilepsy.