Online ISSN: 2515-8260

Keywords : computed tomography


Role of multidetector CT in evaluation of paranasal sinus pathologies

Dr. Ayushman Virmani, Dr. Bindu Agrawal, Dr. Rajesh Arora, Dr. Kiran Nagpal, Dr. Abhijeet, Dr. Geetesh Garg

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1547-1557

Background: Paranasal sinuses fill in as a host to a wide range of illnesses and conditions from provocative to neoplasms, both benign and malignant. The use of СT with рrорer knоwledge аnd соgnizаnсe оf sinus аnаtоmy аnd rаdiоlоgiсаl lаndmаrks, аlоng with сliniсаl cоrrelаtiоn аids in diаgnоsing раrаnаsаl sinus раthоlоgies ассurаtely.
Aim and Objectives:
1) Evаluаtiоn оf раrаnаsаl sinus раthоlоgies аnd their аnаtоmiсаl extensiоn аnd bоny invоlvement using multideteсtоr соmрuted tоmоgrарhy.
2) Соrrelаtiоn оf the findings оf multideteсtоr соmрuted tоmоgrарhy with сliniсаl diаgnоsis.
Material and Methods: The hоsрitаl bаsed рrоsрeсtive оbservаtiоnаl study was conducted in the Department of Radiodiagnosis & Imaging, Muzaffarnagar Medical College, U.P, for eighteen months with twelve months for data collection and 6 months for data analysis. Total 40 patients of varied age groups presenting with symptoms and signs of paranasal sinus diseases underwent CT using Siemens Sоmаtоm Sсорe 16 sliсe СT mасhine as per standard protocol. Images were acquired in the axial and coronal plane with reformation in sagittal plane.
Results: Maximum numbers of patients were in age group of 21 to 30 (35%) with male to female ratio of 1.2:1. Most соmmоn sinus invоlved wаs right mаxillаry sinus (70%). Most common chief complaint was nasal obstruction (97.5%) and nasal discharge (90%) with maximum number cases of sinusitis (22%).
Conclusion: To conclude, Multidetector Computed Tomography of the paranasal sinuses has improved the visualization of paranasal sinus anatomy along with its variants and has allowed efficient diagnosis of paranasal sinus lesions. Precise description of the disease and related microanatomy detected by CT scan provides a reliable pre-operative road map.

Computed tomography in patients with craniocerebral injury: Descriptive clinical profile

Dr. Priya Gaddgi Modi, Dr. Mahesh Hariharan, Dr. Sharan Kumar Deshmukh, Dr. Veena

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2574-2578

Immediate and instantaneous death following cranial trauma occurs due to unpreventable primary brain injuries. However, death occurring within 24hrs of craniocerebral trauma can be averted by timely institution of diagnostic and therapeutic measures that could prevent secondary brain insults. A complete clinical history of the patients was noted on proforma, which included, age sex, type of injury, principal presenting complaints. The type of trauma was further classified into Road traffic accidents, fall, Assaults, industrial accidents and miscellaneous. Follow up of Patients during their hospital stay was performed. According to the study, commonest type of fractures associated with head injury were linear fractures accounting for 67(72.04%), followed by depressed fractures 18(19.35%) and sku11 base fractures 8(8.61%).

Ultrasonography and CT evaluation of neck masses

Dr. Neha Goel, Dr. Bindu Agrawal, Dr. Amritanshu, Dr. Gaurav Gupta, Dr. Kumar Ritwik, Dr. Venkteshwara

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1674-1687

Background: A palpable neck mass is a commonly encountered clinical problem. They vary in etiology, pathology, and prognosis due to the complicated anatomy and physiology. This study was done to detect the effectiveness of high-resolution ultrasonography and computed tomography imaging in detecting neck masses.
Aim and Objectives:
1. To assess the utility of High-Resolution Ultrasonography and Computed Tomography imaging in the evaluation of neck masses.
2. To study mass lesions under the following headings- Location, Size and extent of the mass, relation to surrounding structures, internal mass characteristics that are benign or malignant.
Material and methods: The hospital-based prospective observational study was conducted in the Department of Radio diagnosis & Imaging, Muzaffarnagar Medical College, U.P. for eighteen months, with twelve months for data collection and six months for data analysis. A total of 40 patients of varied age groups presenting with a clinically palpable neck mass who underwent both USG and CT were studied.
Results: The maximum number of patients was 41-50 years old (28%), followed by 21-30 years (12.5%). Of the total cases (40), non-nodal masses were 22 (55%), and nodal masses were 18 (45%). The most common pathology in the present study was lymph nodal mass of aerodigestive malignancies, noted in 13 cases (32.5%), and followed by thyroid mass, noted in 12 cases (30%).
Conclusion: High-resolution sonography is valuable modality for the diagnostic evaluation of neck masses in every age group. It is a simple, non-invasive, and inexpensive diagnostic tool. It provides accurate and reproducible results. It can be used as a first-line modality for evaluating cervical soft tissue masses in many clinical conditions, especially in young and pediatric populations. CT ensures accurate anatomical localization and lesion characterization in benign lesions. It is helpful in staging malignant tumours and provides essential information about the tumour extent that directly affects the surgical approach necessary for curative resection.

Variation in the origin of renal arteries from vertebral level in Western U.P. Population: An Angiographic Evaluation.

Dr. Bhimsen Tyagi, Shaily Saxena, Dr. (Major)Vinay Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 154-162

Background- Variations of renal artery are common in general population and gained
importance because of the wide spread development in renal transplantation surgery. The
purpose of this retrospective study was to evaluate the prevalence of variations in the origin
of right and left Renal arteries at Vertebral level.
Method and materials- The data was collected by using CT Scan machine G.E 64 slice with
software Syngo angiography of 100 patients was collected. CT angiography scan was made
and thin slices (0.6 mm) axial images were obtained. The variation in the origin of renal
arteries at the level of vertebral column can be evaluate by 3-D CT angiography results were
analyzed. A correlation is considered significant when p < 0.05. Most of the possible
correlations were examined. For comparing continuous variables, the t-test was applied. All
the statistical analysis was done by SPSS software.
Result - The most frequent position of RRA origin at vertebral level L1 LP are 32 %, L1 MP
are 16%, L1UP are 8% and also L2 UP are 32%, L2 MP are 10%, L2 LP are 2% cases.
Vertebral levels of left renal arteries L1 LP are maximum in 38 % cases. Others are L2 UP in
32%, L1 MP 20%, L2 MP 6% and L1 UP & L2 LP are 2% in each cases.
Conclusion- In our study, Mostly renal arteries are arising in between upper part of L1 to the
lower part of the L2 vertebrae.

Prediction of chemical composition of urinary calculi in vivo based on CT attenuation values: An analytical study

Aravind Murugesan, Mossadeq A, Govardhanan R, Ratna Vasanthan S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 978-985

Introduction: Chemically, stones are of various types including calcium stones, uric acid
stones, struvite stones and cystine stones among others. Each pathophysiological group has a
predisposition to form certain kind of stones. Hence, knowledge of the chemical composition
of the stone that a patient forms can and does direct the management of the patient.
Objectives: To evaluate if the chemical composition of urinary stones can be predicted with
mean Hounsfield Unit (HU) value on computed tomography (CT).
Methods: This is prospective and analytical study conducted in the Department of Radiology
of a tertiary care teaching hospital in India. Patients diagnosed with urinary stones who had a
non-contrast CT done and had stone retrieved were included in the study. The predominant
chemical composition of the stone was analysed by X-ray diffraction crystallography.
Results: Fifty-one stones of four types were studied. Statistically significant (p<0.001)
differences were seen in the mean HU, maximum HU and median HU values between all the
four types. No significant difference was observed in the difference between periphery and
core HU values. Hierarchy of density among the stone types correlated with previous studies
but absolute measurements varied among different studies.
Conclusion:Mean HU of urinary stones correlates with their chemical composition. Calcium
oxalate monohydrate, calcium oxalate dihydrate, uric acid and hydroxyapatite stones can be
differentiated on their CT attenuation parameters if a database of attenuation characteristics
for stones of known composition is built for given scanner and protocol.

The frequency of anatomical variations of paranasal sinuses on computed tomography

Dr. Pavan Kumar B,Dr. Mohan Kumar,Dr. M Ramya,Dr. Manohar Kumar KR

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2421-2427

Paranasal sinuses are the group of air-filled spaces developed as an expansion of the nasal
cavities. These air filled cavities mostly shows the complex design and also shares relations
with the adjacentstructures.Ventilation and drainage are the two most important factors in the
maintenance of normal physiology of paranasal sinuses and their mucous membranes. During
the study period, a total of 100 cases were evaluated who were referred from Department of
ENT to the Department of radio diagnosis to evaluate the paranasal sinuses by computed
tomography. The cases in acute phase of the disease were treated conservatively with a
course of antibiotics, topical and oral decongestants and the cases referred after persistent
symptoms and signs were counselled regarding imaging of nose and PNS by CT scan,
Written informed consent was taken and data regarding the patient was collected in a case
proforma. The intersphenoid septum was left sided in majority of cases i.e. 43 (43%). It was
right sided in 38(38%) and in 43(%) of cases it was in central

Assessment of Normal Adrenal Gland Thickness on Computerized Tomography in a Tertiary Care Hospital of Karnataka, India

Dr. Shilpa Devakar, Dr. Sushrit A. Neelopant

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2666-2672

Background: Adrenal glands are vital part of endocrine system but very little has been
described in literature about normalcy of the glands. CT (computerized tomography) is
a very good modality to describe the morphology of the glands. Many conditions can be
diagnosed by knowing the radiological anatomy of the glands. The objectives is to assess
the normal adrenal gland thickness in adult population and to evaluate the relationship
of thickness with age and gender.
Materials and Methods: It is a hospital based cross-sectional study for a period of 1 year
in which the adult patients who underwent CT angiogram of the upper abdomen for
clinical indications other than adrenals were included. 1000 scans were included in the
study. The maximum thickness of the body, the medial and the lateral limbs were
measured at right angles to their long axis, in both adrenal glands.
Results: The mean age of the study participants was 54 ± 7.5 years and total of 700
males and 300 females were included. Mean maximum thickness of the right adrenal
gland body, medial limb, and lateral limb were 7.16 ± 1.67mm, 4.23 ± 1.45mm and 4.45
± 1.19mm respectively. The difference in all the measurements of the right and left sides
in which, left being larger than the right was statistically significant (P < 0.001). The
differences between the measurements among males and females were statistically
significant. There was positive correlation between the patient age and all the adrenal
gland measurements.
Conclusion: We recommend the use of our data as a useful baseline reference range for
the Indian adult population, and a guide for radiologists who can use this in their
routine cross-sectional reporting practice when they encounter a doubtful “bulky” or
“diffuse smoothly enlarged” adrenal gland.

Relationship between various anatomical variations and maxillary sinusitis by using computed tomography scan

Dr. Sravan Kumar K, Dr. M Ramya,Dr. Pavan Kumar B, Dr. Manohar Kumar KR

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2428-2433

Identifying the predisposing factors is therefore important in understanding the
pathophysiology of chronic rhino sinusitis. Main etiology of respiratory CRS includes
structural anatomical obstruction, recurrent upper airway infections,common allergies,
biofilm formation and less commonly mucosal ciliary dyskinesia, MPS
(mucopolysaccharidosis) and cystic fibrosis. These etiological factors which impairs the
mucociliary clearance and causes stasis of secretions which constitutes the primary
pathophysiology for the chronic rhino sinusitis. CT scan was done for these 100 cases with
THOSHIBA Multi detector 16 slice CT machine. 0.5mmhigh resolution with 1mm
reconstruction, coronal,sagittal and axial sections were reviewed. The presence of anatomical
variations and sites of involved sinuses based on CT findings were investigated. Maxillary
sinusitis was seen in 63 cases out of which, 34 cases of maxillary sinusitis were associated
with anatomical variations.Ethmoid bulla in 2 cases.Uncinate process pathologies noted in2
cases.

The effect on CT size-specific dose estimates of mis-positioning patientsfrom the iso-centre

Arif Jauhari; Choirul Anam; Mohd Hanafi Ali; William Ian Duncombe Rae; Siti Akbari; Tina Meilinda

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 155-164

This study evaluates the effect of mis-positioning of patients in relation to the iso-centre in CT examinations on the dose received by phantoms with various diameters. Phantoms with water-equivalent diameters (Dw) ranging from 8.5 cm to 42.1 cm were scanned using a GE Optima CT scanner with exposure factors as follows: 200 mA, 120 kVp, 1.375 Pitch, 50 cm field of view (FOV), 5 mm beam collimation, and 1 s rotation time. Doses were measured using the CT dose profiler (RTI Electronics). After obtaining doses in every hole of the phantoms, weighted doses were computed. It is found that the dose decreased with an increase in the Dw. The ratio of the doses when positioned off-centre by 2 cm and 4 cm with respect to the iso-centre have p-values of 0.914 and 0.919, which shows no significant difference (p> 0.05).

Role of Endoscopic Ultrasound in Diagnosis of Pancreatic Cystic Lesions in Comparison to Computed Topography and Magnetic Resonance Imaging

Mohamed Fouad Mostafa Ahmed; Walid Ahmady Abd El-Dayem; Talaat Fathy Aly; Mohamed Ibrahim Magdy; Mohamed Ali El-Nady

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2500-2509

Background and aims:To evaluate the advantages of endoscopic ultrasound (EUS) in the
assessment of detailed structures of pancreatic cystic lesions (PCLs) compared to computed
tomography (CT) and magnetic resonance imaging (MRI).
Methods: This prospective cohort study was conducted in Tropical medicine department,
Zagazig university hospitals and in Internal medicine department at Kasr Al Aini Hospitals,
Cairo University, in the period between March 2018 and March 2020. The study included 72
patients with PCLs, 29 were males and 43 were females, there ages ranged from 25 to 75 years.
All cases were subjected to the following careful history taking, thorough clinical examination,
laboratory investigations (CBC, LFTs, KFTs, Coagulation profile, serum amylase, serum CA
19.9), imaging (CT and/or MRI abdomen), endoscopic ultrasound examination and EUS-FNA
biopsies using the 22G or 19G needle.
Results:Validity of abdominal CT/MRI imaging, EUS, cytopathology and EUS with
cytopathology was calculated using diagnostic performance depend on sample 2x2 contingency
tables generation. Sensitivity, specificity, PPV, NPV and accuracy and their corresponding 95%
CI were calculated. P-value < 0.05 was considered statistically significant, p-value < 0.001 was
considered highly statistically significant, and p-value ≥ 0.05 was considered statistically
insignificant.

Application of Computed tomography in jaw lesions: A comprehensive review

Mandeep Kaur; Ramandeep Singh Punia; Ramandeep Singh Brar; Ravinder S Saini; Mamta Malik; Sanjeev Laller

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 5269-5275

Radiology is an essential aid to the diagnosis, treatment planning and monitoring of oral diseases. Advances in imaging technology have revolutionized our ability to study image and understand pathology on a macroscopic level. Digital radiology is the next step in the evolution of radiology, its features like significant reduction in radiation exposure, the ability to digitally manipulate the captured image to produce a more diagnostic image,
reduction in time between exposure and image interpretation, and digital documentation of patient’s records make it a valuable diagnostic aid in hands of a clinician. New diagnostic modalities, like computed tomography has revolutionized dental diagnosis by multi planar reconstructions and allowing virtually any view to be selected, making three dimensional imaging possible by a few clicks on the computer. Hence; we aim to summarize some of the important aspects of role of Computed tomography in jaw lesions.

ARCUATE FORAMEN OF ATLAS: DO I NEED TO DIAGNOSE?

Yanova Elvira Umarjonovna; Mardieva Gulshod Mamatmuradovna

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 2989-2997

It was found that the joint presence of bone and vascular changes in the
craniovertebral region, or even one of them, can lead to a clinically significant
decrease in cerebral blood flow. One of the fairly common anomalies is the arcuate
foramen, which does not have a characteristic clinic and is disguised as other
pathologies.
Purpose.To analyze the computed tomographic characteristics of the bone
jumper of the first cervical vertebra.
Materials and methods. A retrospective analysis of computed tomographic
examinations of the upper cervical spine in 479 patients using 3-dimensional (3D)
reconstruction was carried out. The patients' age ranged from 12 to 85 years. In 61 
patients, Kimmerle anomaly was diagnosed. The average age of men was 39.7 ± 6.3
years, women - 44.8 ± 6.7 years.
Results.When conducting a computed tomography of the brain of patients with
Kimmerle's anomaly, in 25 cases out of 42 - signs of vascular encephalopathy, in 11
cases signs of cerebellar atrophy and in 5 cases - single cysts. In 84% of patients with
Kimmerle's anomaly, who underwent 3D CT of the cervical spine, osteochondrosis
was noted and in 21% - spondylosis, in 74% of cases combined with degenerative
changes in the intervertebral disc. In 70% of patients with Kimmerle's anomaly, there
is a bilateral arrangement of the atlas bone jumper. With a one-sided arrangement, the
atlas bone jumper is often located on the left. The vaulted hole was located on both
sides equally often. The anteroposterior dimension of the arcuate foramen on the right
is 5.4 ± 2.32 mm, on the left - 5.9 ± 2.43 mm. Vertical dimension - 3.35 ± 1.83 mm
on the right, 3.49 ± 1.87 mm on the left. The incidence of the anomaly was 12.7%.
Conclusions.A spondylogenic factor, in the form of Kimmerle's anomaly, can
cause impaired craniovertebral circulation, given the combination with ischemic
changes in the computed tomographic picture of the posterior parts of the brain.
Additional research is needed to assess the state of the vascular bed and blood flow in
the vessels, which will provide the prevention and treatment of cerebrovascular
disorders in patients with Kimmerle's anomaly.