Online ISSN: 2515-8260

Keywords : Magnetic resonance imaging


Dr.KothaVinay Kumar Reddy, Dr.Madan Mohan Babu L, Dr. Suresh A, Dr.Shubham Gupta, Dr.Devamani VKH Chalavadi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 60-69

Background - Shoulder pain is one of the commonest conditions encountered in our
orthopedic department. Accurate diagnosis is a must before undertaking any treatment. Since
clinical diagnosis cannot make an accurate diagnosis, radiological investigation is necessary
to know the exact cause of shoulder pain. There are a wide range of invasive and noninvasive
modalities that can be used to investigate these patients. Ultrasound examination is a
highly specific and sensitive modality in comparison with MRI. High-resolution real-time
USG has shown to be a cost-effective means of investigation of rotator cuff pathologies. With
recent advances with USG, results of imaging of shoulder joint pathologies are as similar or
in some cases more precise in the diagnosis than MRI.
Methods - Prospective analysis of 52 patients presenting with shoulder pain were included in
our study. A pre-formed written consent is also taken. All patients underwent a thorough
clinical examination, USG of the affected shoulder with comparison of the opposite side and
MRI of the affected shoulder for comparison.
Results - Ultrasound is equivalent in detection of rotator cuff tears in comparison with MRI.
MRI outscores ultrasound in detection of labral tears, cartilaginous lesions and subtle bony
lesions. USG examination can be used as the first line of investigating a case of shoulder pain
as it is inexpensive, real time and allows for comparison with the opposite side. MRI can be
used as a confirmatory tool.

A study for characterization of MRI findings in patients with nontraumatic hip pain

Dr. Poonam Ohri, Dr. Jaspal Singh, Dr. Gagandeep Sharma, Dr. Manasi Kohli

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 4837-4849

Introduction: A study for characterization of MRI findings in patients with nontraumatic
hip pain.
Aims and objectives: To characterize the MRI findings of underlying pathologies in
patients with non-traumatic hip pain and give radiological diagnosis which will help in
the management of patients.
Materials and methods: 50 cases referred to the Department of Radiodiagnosis and
Imaging, Government Medical College, Amritsar with hip pain were evaluated and
statistically analyzed.
Results: Out of the 50 patients, pathology was seen in 45 patients (90%) and while 5
patients (10%) were found to be normal on MRI. The most common pathology detected
was avascular necrosis seen in 23 patients (46%), followed by 12 patients of infective
arthritis patients (24%), 3 patients of perthes disease (6%), 2 patients of bone tumor
(metastasis) (4%), 2 patients of osteitis condensans illi (4%), 2 patients of stress fracture
(4%) and 1 patient of tendinitis 1 (2%).
Conclusions: MRI was helpful in diagnosing various abnormalities. Various bone signal
abnormalities as well as excellent soft tissue contrast aided in making timely diagnosis
and management. The role of MRI in detection of various abnormalities was also
statistically significant (as compared to plain radiographs which was additionally done)
and had more sensitivity and specificity.

A comparative study of high resolution ultrasound and MRI in the diagnosis of ankle joint pain

Dr. Poonam Ohri, Dr. Partap Singh Verka, Dr Suragani Priya, Dr.Manasi Kohli

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 4850-4859

Aims and objectives: To evaluate the role of high resolution ultrasound and MRI in the
diagnosis of ankle joint pain.
Material and methods: 50 patients with acute or chronic ankle pain referred to the
Department of Radiodiagnosis and Imaging for sonography and, magnetic resonance
imaging were included in thestudy.
Results: The most common cause of ankle pain in a study was tenosynovitis seen in 16
patients. 8 patients were clinically suspected to have tendoachilles tear. No disagreement
was seen between MRI and USG for tendoachilles tear. All the 12 cases of lateral
ligament injury diagnosed on USG were confirmed on MRI. MRI showed a distinct
advantage over USG in patients with ankle pain by diagnosing marrow edema in 24
patients, calcaneal spur in 4 patients, accessory bone in 1 patient, bone cysts in 3
patients, bony erosions in 1 patient, and stieda process in 1 patient.
Conclusions: Both ultrasound and MRI can be used for imaging evaluation of patients
with ankle pain. Ultrasound is an excellent tool for evaluation of patients with ankle
pain and it can be used as primary imaging investigation. MRI may be used to confirm
the findings of ultrasound in ankle pain, but it should be used as the first imaging
modality in patients with marrow abnormality or when deep seated pathologies are

Role of magnetic resonance imaging in paediatric brain infections

Dr.GurinderBir Singh,Dr.Poonam Ohri, Dr.Manmeet KaurSodhi, Dr.HiteshiGoyal, Dr. Manasi Kohli

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 4860-4866

Aims and objectives: To study the role of Magnetic Resonance Imaging in diagnosis of
paediatric brain infections, characterization of various patterns of brain involvement
and establishing the differential diagnosis along with role of Diffusion Weighted
Imaging and Apparent Diffusion Coefficient in Cerebral infections .
Materials and methods: 50 cases with suspected brain infection, whose age group
ranged from 0-14 years, referred to the Department of Radiodiagnosis and Imaging,
Government Medical College, Amritsar, were included in this study. The sequences
performed were T1W axial, T2W axial, coronal and saggital, FLAIR axial, DWI/ADC,
SWI,post contrast T1W in all patients and magnetic resonance spectroscopy wherever
required. MRI findings in all cases along with magnetic resonance spectroscopy, clinical
and biochemical findings (wherever required) were taken into consideration to arrive at
a diagnosis.
Results:Outof50patients,mostcommonpathologywastubercularinfectionsseen in 25
patients (50%), followed by 18 patients of pyogenic meningitis (36%), 5 patients of NCC
(10%) and 2 patients of viral encephalitis (4%). The most common finding in tubercular
infections was meningeal enhancement followed by tuberculomas, basal exudatesand
themostcommon complication was hydrocephalus. Themostcommon finding in pyogenic
meningitis was meningeal enhancement and the most common complication was
abscess. Neurocysticercosis lesions were parenchymal. Colloidal vesicular/granular
nodular stage was seen in 3 patients, vesicular in 2 patients and calcified in 1 patient.
Viral encephalitis was seen as areas of cerebral involvement bilaterally with restriction
on DWI/ADC seen in onepatient.
Conclusions: MRI due to its variable intensities in multiple sequences aided by contrast
enhancement helps the radiologist to arrive at an almost exact diagnosis. Italso
drawssupportfromassociatedclinicalfeatures, lesion-staging, complicationsand number
(single or multiple) of the lesions. Thus it scores over CT and ultrasound as basic
modalities for imaging infective disease of brain inchildren.



European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5170-5194

With increase in the proportion of aging dependent population, the need for understanding the
pathogenesis of aging and the risk factors related to age related neurodegeneration is
increasing with definite certainty. Studies pertaining to age related neurodegeneration will
play a role in mitigating the impending issues related to aging population. Studies have
shown the relatively greater involvement of white matter compared to the grey matter with
age and therefore the evaluation of white matter tracts will further shed light onto the
processes that occur with aging.(1)
MRI was performed on a 3T MR scanner (General Electric, Signa Pioneer) with a head‑neck
45 coil. The subjects’ brains were evaluated with conventional imaging using routine axial
T2/T1‑weighted and diffusion-tensor imaging (DTI) sequences. The DTI acquisition protocol
which was used is a dual-spin echo single shot echo-planar imaging sequence with the
following parameters: Forty 3mm thick slices with no inter-slice gap. TR=6400ms,
TE=88ms. FOV= 220x220mm2, matrix of 128x128 zero filled to 256x256. DTI was
performed with b=1000s/mm2 using 25 different encoding directions. The Total scanning
time was 11 mins. Various white matter tracts were evaluated from the DTI sequences using
fibertractographyfollowing which the average Apparent Diffusion Coefficient (ADC) and
Fractional Anisotropy (FA) values of each fiber was computed and tabulated with respect to



European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5195-5210

Delay in development is a frequent pediatric clinical issue that affects 10-15% of children. The
use of an MRI scan is an important part of the thorough evaluation of children who have been
diagnosed with developmental delay. The current study adapted DTI to analyze the brain
morphology of children diagnosed with developmental delay based on developing evidence.
In this cross sectional study we have studied 30 patients in Yenepoya Medical College Hospital,
Mangalore who met the inclusion and exclusion criteria. Study tool used for the study is the use
of Diffusion Tensor Imaging in addition to routine MR Sequences using 3T MRI. The
quantitative analysis of FA and apparent diffusion coefficient (ADC) maps were generated
automatically by the software and analysed.

Pseudo-impingement of the Rotator Cuff with Strength Training using Magnetic Resonance Imaging

Rajesh Pattanaik, Santosh Kumar Padhy, Ashis Kumar Satapathy

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5611-5617

Objective: The goal of this study was to outline a novel, one-of-a-kind idea of secondary
impingement of the rotator cuff muscles, myotendons, and tendons caused by
hypertrophy as a result of strength training exercises.
Methods: In this retrospective observational study, 58 patients were referred to the
radiology department by their orthopaedic surgeon for magnetic resonance imaging
(MRI) over a period of 112 years. All patients had a history of strength training
programmes and clinical signs of rotator cuff impingement.
Results: In 12 of the 58 patients, we found hypertrophy of the rotator cuff muscles,
myotendons, and tendons. On the MRI, this was the sole anomaly. Rotator cuff muscle
and tendon hypertrophy completely filling the subacromial space to the point of
overfilling, resulting in secondary compressive features.
Conclusion: Rotator cuff impingement is a common occurrence that can develop as a
result of a variety of input and outlet pathological situations. However, rotator cuff
impingement can be caused by muscle and tendon hypertrophy as a result of strength
training regimes. Rotator cuff hypertrophy can cause overfilling of the subacromial
area, resulting in secondary impingement, which we call "pseudo-impingement."


Dr. Kushpreet Kaur, Dr. Priyank Dwivedi, Dr. Sheetal Singh, Dr.Amlendu Nagar, Dr Saba Alvi .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 721-741

Introduction:. The present study was conducted with an aim to assess the role of MRI for evaluation of adnexal masses and to find out the diagnostic accuracy of MRI in the diagnosis of adnexal masses against the gold standard test ‘histopathology’.
Materials and Methods: This is a prospective comparative study conducted in the Department of Radio Diagnosis, Index medical college hospital and research centre.50 women were taken in our study. These patients were first referred for ultrasonography with history of adnexal masses from gynaecological department. The magnetic resonance imaging was done using 1.5 Tesla MRI machine with patient in supine position.Then the lesion sample was taken and sent for histopathological examination. The results obtained on the MRI were evaluated against the histopathology results and the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of MRI was calculated.
Results: Out of 50 patients, 33 (66%) adnexal masses were benign, 15 (30%) were malignant and 2 (4%) were inconclusive on ultrasonography, 35 (70%) adnexal masses were benign, 15 (30%) were malignant on magnetic resonance imaging. 37 (74%) adnexal masses were benign, 13 (26%) were malignant on histopathology. The sensitivity of MRI in the diagnosis of malignant / benign adnexal masses against the histopathology was found to be 92.31%, specificity was 91.89%, positive predictive value was 80.00%, negative predictive value was 97.14% and diagnostic accuracy was 92.00%.
Conclusion: Ultrasound is unable to differentiate adnexal masses into malignant and benign in some cases and gives inconclusive results. While MRI provides better spatial and contrast resolution in delineation of the anatomical structures as well as characterization of pathological lesions. It is highly accurate in identifying the origin of a mass, characterization and staging and helps in the treatment planning. These parameters have been found quite in agreement with the findings of histopathology

Evaluation of transplant kidney with magnetic resonance imaging: An observational study

Dr Gayatri Patil,DrAmolkumar Patil,Dr Balkrishna Kitture

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 4814-4817

Background:The present study was conducted for assessing patients of transplant kidney
with magnetic resonance imaging.
Materials & methods: A total of 20 patients with undergoing renal transplant were enrolled.
Complete demographic and clinical details of all the patients were assessed. The composite
data was tabulated and studied to evaluate the feasibility of functional MRI parameters i.e.
the blood oxygen level dependent (BOLD-based R2* values), in order to establish role of
functional MRI as one of the reliable noninvasive diagnostic technique for detection of renal
allograft function and dysfunction. All the results were recorded and analyzed using SPSS
Results: Mean ADC Cortex value among patients with stable renal allograft and allograft
dysfunction was 2.56 and 1.85 respectively (p- value < 0.05). Mean ADC Medulla value
among patients with stable renal allograft and allograft dysfunction was 2.51 and 1.79
respectively (p- value < 0.05). Mean R2 Cortex value among patients with stable renal
allograft and allograft dysfunction was 25.3 and 17.5 respectively (p- value < 0.05). Mean R2
Medulla value among patients with stable renal allograft and allograft dysfunction was 24.2
and 16.8 respectively (p- value < 0.05).
Conclusion:MRI is significantly helpful in assessing renal allograft dysfunction at an early


Dr. Sunny Goyal, Dr. Prachi Jain, Dr. Dalip Singh Dhiman, Dr. Rajender Punia, Dr. Deergha Singh, Dr. Fayaz Khan H

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 163-169

Aim: To evaluate efficiencies of magnetic resonance imaging & ultrasonographyprocedures for various pathologies related to female pelvic region.
Materials & Methods: This study was performed on total sixty patients. All patients reported for various clinical issues of pelvic region. Magnetic resonance imaging & ultrasonography procedures were used as diagnostic imaging modality. Scanning outcomes of magnetic resonance imaging & ultrasonography have been categorized as group one and group two respectively. All suggestive findings of both imaging modalities were correlated with clinical diagnosis. Based on these existences of correlations, Results thus obtained was compiled and sent for basic statistical analysis. P value less than 0.05 was considered significant (p< 0.05).   
Results: Among all sixty studied patients, females were 14 in age group of 25-28 years. 13 patients were seen in age range of 33-36 years. P value was reported to be significant for this (0.01). Magnetic resonance imaging confirmed Inborn Anomalies in 3 patients. Uterine Mutilation was confirmed in 16 patients by magnetic resonance imaging. Pathologies related to Adnexa were noted in 28 patients. P value was reported to be significant for this (0.002). Endometrial Malignancies were noted in 2 patients. P value was reported to be significant for this (0.001). Pathologies related to Adnexa were noted in 25 patients by Ultrasonography. P value was reported to be significant for this (0.010).
Conclusion: Magnetic resonance imaging was able to detect and confirm almost all studied pathologies related to female pelvic region. Ultrasonography procedure was unable to detect few of those pathologies. Therefore, magnetic resonance imaging is superior and accurate option for scanning pelvis region.

Assessment of Cerebrospinal Fluid Hydrodynamics Using Magnetic Resonance Imaging in Postcraniospinal Surgery Patients

Pragya Sinha, Shivendra Kumar Chaudhary

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1430-1434

Background: Phase-contrast MRI (PCMRI) with cardiac synchronism is a dynamic technique used to visualize cerebrospinal fluid (CSF) movement. The present study was conducted to assess Cerebrospinal Fluid Hydrodynamics Using Magnetic Resonance Imaging in Postcraniospinal Surgery Patients.
Materials and Methods: The present case-control study comprising 30 patients and 30 controls, conducted over a period of 2 years in a tertiary-care hospital in India. Healthy subjects formed the control group. Conventional magnetic resonance imaging of the brain was performed before PCMRI. Assessment of clinical signs and symptoms was done pre and postoperatively. Statistical Analysis of data was done in terms of mean (±standard deviation), frequencies (number of cases), and percentages. The p-value of < 0.05 was considered significant. All the analysis was performed on SPSS 16.0 version (Chicago, Inc., United States).
Results: The present case-control study comprising 30 patients and 30 controls. Postoperative imaging follow-up was done in 30 patients after an interval of 1 month. Postoperatively, a majority (17) of the patients showed improvement in clinical symptoms. 7 patients showed no change, while six patients showed deterioration. Phase-Contrast Magnetic Resonance Imaging Quantitative parameters measured at cerebral aqueduct, foramen magnum, C2–3, and D12–L1 vertebral levels, in controls, showed no significant difference in peak CSF velocities. In group I and group II mean change CSF velocity was noted in improved patients was more than the other patients.
Conclusion: The present study concluded that PCMRI can effectively evaluate changes in CSF flow noninvasively both pre- and postoperatively.

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

To study the role of MRI of hypoxic ischemic encephalopathy

S Vinoth Kumar, B. M. Monisha

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 9260-9266

Background: Hypoxic-ischaemic encephalopathy in adults and older children (i.e. not
neonates), also known as global hypoxic-ischaemic injury, is seen in many settings and
often has devastating neurological sequelae. Magnetic Resonance imaging—has the
potential to play a significant role in diagnosis and early intervention in cases of HII. In
addition, imaging studies performed in the subacute stages of injury provide information
on the severity and extent of injury and can be helpful in predicting long-term outcome.
Material and Methods: This prospective study was conducted in a tertiary care teaching
hospital, over a period of 1 year. A total of 70 patients with history of birth asphyxia were
included in the study who underwent MRI of brain and were followed up clinically at the
end of one year to assess the neurological outcome.
Result: A total of 70 patients who fulfilled the selection criteria during the study were
enrolled. Of the 70 babies, 46 were males and 24 females, which correspond to 65.7% of
male and the rest female babies. The maximum number of patients were in the age group
of <1 year which were 47.1% (n =33) of total followed by age group 2–12 months having
34.2% (n = 24) in this group and 18.5% were more than 1 year. In our study, maximum
patients, i.e., 48.5% (n = 34) were having Apgar score of 4-6 followed by ≤3 score were
32.8% and least were > 7 score were 18.5%. In HIE 2 cases, 28.5% had involvement of
corpus callosam. 27.1% had PVL, 18.5% had basal ganglia or thalamus lesion. There was
no MRI evidence of HIE in 25.7%.
Conclusion: HIE is an important cause of morbidity and mortality in the neonatal period.
MRI show characteristic pattern of brain injury and help to exclude other causes of
encephalopathy. Imaging plays an important role in early diagnosis and timely
intervention, thereby reducing the severity of neonatal brain injury.

Glioma Tumor Detection Through Faster Region-Based Convolutional Neural Networks Using Transfer Learning.

Shrwan Ram; Anil Gupta

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 4789-4815

Glioma Tumor is generally found in the brain and spinal cord. This tumor begins in glial cells that cover the nerve cells and control the function of that. The Glioma tumor is classified based on glial cells involved in the Glioma tumor formation. The tumor affects the normal activity of the patients such as loss of memory, difficulties in speech, confuse the identification of objects, and also causes difficulties to maintain the balance of the body. The early detection of Glioma tumor helps healthcare practitioners to suggest a suitable treatment for the disease. The detection of a Glioma tumor is a challenging task. Many types of approaches had been proposed by the researchers and academicians for accurately detecting the  Glioma tumor. Accurately detecting the brain tumor is still a big challenge. Because of recent advances in image processing and computer vision, healthcare professionals are using sophisticated disease diagnostic tools for disorders/disease prediction. The Neurosurgeons and Neuro-Physicians use the magnetic resonance imaging technique to identify multiple brain tumors. The approaches to computer vision play a significant role in the automated identification of different Brain tumors. This research paper explores the Convolutional neural network-based Faster R-CNN approach for the Glioma tumor detection using four pre-trained deep networks such as Alexnet, Resnet18, Resnet50, and Googlenet. The proposed approach of object detection as compared to other R-CNN approaches is more efficient and accurate having higher precision.  The proposed model detects the Glioma tumor with 99.9% accuracy. The pre-trained networks used to train the tumor detection model are Alexnet, Resnet18, and Resnet50, and Googlenet. As compare to Alexnet, resnet18, and Googlenet deep networks, the Resnet50 Pre-trained network performed well with higher accuracy of detection.