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Background: Chemical shift Magnetic Resonance Imaging (MRI) is often routinely acquired to assess a spectrum of spinal lesions due to its ability versatility to obtain rapid sequences at the expense of spatial resolution images. It is one of the quickest sequences to acquire at the expense of spatial resolution. Objective: In this study we assess the diagnostic efficacy of Chemical shift Magnetic Resonance Imaging (MRI) in the evaluation of Neural Foraminal stenosis. Materials and methods: Conventional T2, T1 and STIR sagittal and axial images as well as 'in' and 'out' phase chemical shift sagittal MRI sequences of 25 consecutive patients presenting with back pain and radiculopathy were reviewed. The degree of neural stenosis in the lumbar spine foramina on both sides was graded using the Lee classification on T2 and 'in' and 'out' phase MRI sequences by two independent MSK radiologists. Statistical analysis was performed using paired T-Test and Cohen's weighted kappa test was applied as a measure of agreement between the two observed raters. Results: A total of 250 lumbar neural foramina were assessed. There was substantial agreement (Cohen's weighted kappa) for both raters between 'in' and 'out' phase chemical shift sagittal MRI sequences (rater 1 = 0.699, rater 2 = 0.718), as well as good agreement between raters for both 'in' and 'out' phase chemical shift sagittal MRI sequences (in phase = 0.656, 'out' phase = 0.576). However, when compared to the gold standard rating on a T2 based sequence, ratings on in' and 'out' phase MRI sequences overestimated the degree of stenosis. When comparing 'in' and 'out' ratings to the T2 ratings, agreement was poor with kappa ranging from 0.132 to 0.202. Conclusion: Though both 'in' and 'out' phase chemical shift sagittal MRI sequences can be used to analyse neural foraminal stenosis, given its propensity to over-estimate the degree of stenosis in comparison to the T2 based images, assessment of the condition on these complementary limited sequences technique should be avoided/should be undertaken with caution.
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Ureteral herniation into the scrotum is rare and often associated with congenital abnormalities or postoperative anatomic changes. A high index of suspicion is needed to avoid intraoperative ureteric injuries. A 50-year-old man with ureteric herniation into an inguinoscrotal hernia reported acute left flank pain and had a history of recurrent urinary tract infections. Contrast-enhanced computed tomographic evaluation revealed a left ureter extending from the pelvis into the scrotum through the inguinal canal. Screening ultrasound of the scrotum revealed the intrascrotal extension of the ureter along with the other hernial contents and diagnosed as a Paraperitoneal inguinal herniation of the ureter. Various cross-sectional imaging modalities, including Ultrasound, provide good anatomic details that can diagnose the presence of a herniated ureter.
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BACKGROUND: Obesity is a significant risk factor for cardiovascular (CV) disease. Abdominal fat is composed of abdominal subcutaneous fat and intra-abdominal (visceral) fat. Computed tomography (CT) is considered one of the most accurate and reliable methods for assessing abdominal fat. INTRODUCTION: The present study was based on evaluating abdominal fat by computed tomography and the determination of association between CT obtained abdominal fat volumes, anthropometric indices, and lipid profile. METHODS: The prospective study was carried out on 120 subjects referred to the Radiology department for a CT scan. Non - contrast CT scan was performed with 5 mm slice thickness. Abdominal fat volumes were recorded by using CT attenuation values (- 250 to -50 HU). The section was selected at the level of the umbilicus (L4-L5). Intra-abdominal fat and subcutaneous fat volumes were calculated. Body Mass Index (BMI) and lipid profile were recorded for each subject. A comparative study of the CT values, BMI, and lipid profile was undertaken. RESULTS: In the present study, by comparing the anthropometric parameters, CT findings, and lipid profile and blood parameters of the obese and non-obese groups by sex revealed significant sex differences in all the parameters under study. It was also found that the obese male and female groups showed a high prevalence of diabetes, Non-Alcoholic fatty liver disease (NAFLD), and hypertension than non-obese groups. This finding also adds to the chances of getting cardiovascular diseases, specifically in obese individuals. The results found that in obese males and females the abdominal fat-related parameters Visceral fatty acid (VFA) and subcutaneous fatty acid (SFA) showed highly significant relation to anthropometric parameters like BMI, waist circumference (WC) and waist/hip (W/H) ratio on the other hand blood parameters high-density lipoprotein (HDL), low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), total cholesterol and triglycerides to some extent have a significant relation to abdominal fat-related parameters. In non-obese groups, by studying the influence of anthropometric parameters on abdominal fat-related parameters, it was revealed that WC was strongly affected by the VFA in both sexes. In obese females, more fat was accumulated in the VFA and SFA and for obese males in SFA and for non-obese males in total fatty acid (TFA). CONCLUSION: Computed tomography assessed visceral fat area remains the most sensitive independent predictor of cardiovascular risk.
