Real time ultrasound diagnosis of ovarian and pelvic filariasis by filarial dance sign.

Parasitic infestations of the ovary are quite rare with ovary being the least common site of infection in the female genital tract. Filariasis is a parasitic disease caused by filarial nematodes (Wuchereria bancrofti, Brugia malayai, Brugia timori). It causes lymphatic obstruction with resultant edema and increase in the size of the affected organ. We report a case of 24-year-old married female who presented to our radiology department for ultrasound evaluation with the main aim being to look for retained products of conception after the termination of early pregnancy. However on ultrasound examination ovarian filariasis was an incidental diagnosis with the classical twirling movement (filarial dance sign) seen in one of the follicles of the ovary. Ultrasound is the imaging modality of choice for detecting the adult filarial worm/microfilaria in the lymphatic system. Ovarian filariasis is a very rare diagnosis with only a handful of cases being reported in literature with most cases being diagnosed incidentally on histopathological examination of the post operative specimen.

Primary CNS lymphoma in Immunocompetent patients: Appearances on Conventional and Advanced Imaging with Review of literature.

Primary central nervous system lymphoma (PCNSL) constitutes about 3% of all primary brain tumors and nearly 1 to 3% of all Non Hodgkin Lymphomas. In the recent years the incidence of primary CNS lymphoma is increasing in immunocompetent patients. As PCNSL are chemosensitive as well as radiosensitive, its early and accurate diagnosis is imperative for optimal management. Contrast enhanced Magnetic Resonance Imaging (MRI) is the recommended imaging modality for PCNSL; however, contrast enhanced Computed Tomography (CE-CT) is done in cases where MRI is contraindicated. Advanced imaging techniques like DWI (diffusion weighted imaging), MRS (MR Spectroscopy), MR perfusion, DTI (Diffusion tensor imaging) are important in diagnosis and help in its differentiation from other tumors.

Percutaneous Vertebroplasty: Efficacy of Unipedicular Vertebroplasty as Compared to Bipedicular Vertebroplasty.

Introduction Percutaneous vertebroplasty has been used for treatment of intractable painful fractures of vertebral bodies. With the help of refined procedures and standard techniques, the interventional radiologist can now offer help to orthopedics and neurosurgeons in these cases, which include treatment of vertebral compression fracture. Vertebroplasty is aimed at reducing the pain induced by collapse. Vertebroplasty is the standard mode of treatment for vertebral collapse, and in our study, bipedicular vertebroplasty was compared with unipedicular approach as bipedicular vertebroplasty is the routinely used approach. Aim To compare efficacy of unipedicular percutaneous vertebroplasty with that of bipedicular percutaneous vertebroplasty. Material and Methods A total of 52 vertebroplasties were done over a period of 2 years. Out of 52 patients, 28 patients underwent unipedicular vertebroplasty and 24 patients underwent bipedicular vertebroplasty. Visual analogue scale (VAS) scores were used to assess the pain prior to vertebroplasty and after vertebroplasty. Efficacy of the two procedures were assessed by comparing VAS scores. Results There was no statistically significant difference observed in the preprocedure and postprocedure VAS scores ( p -value < 0.0001, < 0.0001, respectively). The mean procedure time was lesser in unipedicular vertebroplasty (41.9 ± 3.90) than bipedicular vertebroplasty (54.5 ± 3.4). Conclusion Unipedicular vertebroplasty is as effective as bipedicular vertebroplasty, as there is insignificant difference in postprocedure VAS scores between the unipedicular and bipedicular vertebroplasty.

Utility of Doppler ultrasound in early-onset neonatal sepsis.

BACKGROUND: Neonatal sepsis is an important cause of morbidity and mortality among newborns. As there is paucity of literature regarding early alteration of the cerebral blood flow (CBF) in neonatal sepsis our study aims to evaluate the changes in the CBF velocities and Doppler indices in neonates with early-onset neonatal sepsis (EONS) and to evaluate the predictive accuracy of cerebral blood flow velocities (CBFV) by using ultrasound Doppler as a diagnostic marker of EONS. METHODS: This cross-sectional analytical study was conducted over a period of 2 years with 123 neonates enrolled in the study. The neonates were divided into two groups: Group I (with 54 neonates) - neonates with EONS and group II (with 69 neonates) - age-matched neonates without any signs of sepsis. Ultrasound Doppler examination was performed and the cerebral hemodynamics assessed in neonates during the first seventy two hours of life. Doppler indices and CBFV were measured in the internal carotid artery (ICA), middle cerebral artery (MCA), and vertebral artery (VA) of either side. Data were analyzed using the statistical program SPSS version 23.0 (SPSS Inc., Chicago, IL, USA). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated at different selected cutoff values for CBFV parameters. RESULTS: Lower resistance and higher peak systolic velocity and end diastolic velocity have been documented in neonates with EONS. CONCLUSION: Our study shows that the cerebral hemodynamics in neonates with EONS is altered which can be assessed bedside by noninvasive ultrasound Doppler examination.