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BACKGROUND AND PURPOSE: Cervical Spondylotic Myelopathy (CSM) is a gradually escalating spinal cord disturbance set in motion by the degenerative narrowing of the vertebral canal. Routine MRI may fail to detect the subtle early alterations of the cord. MRI Diffusion Tensor Imaging (DTI) possesses the potential to detect these changes. This study intends to estimate the potential of the DTI technique in non-stenotic & stenotic spinal canals in individuals affected with CSM. METHODOLOGY: Sixty-four subjects who met the requirements of the inclusion criteria were incorporated into the investigation. All subjects underwent routine MRI sequences in addition to DTI of the cervical spine region. Scalars such as Fractional Anisotropy (FA), besides Apparent Diffusion Coefficient (ADC), were computed at each cervical intervertebral fibrocartilaginous disc level for all subjects. DTI fiber tractography was then performed to qualitatively assess the microstructural integrity of the tracts. RESULTS: A noteworthy difference (p<0.05) was seen in the FA parameter and ADC parameter values between the stenotic and non-stenotic groups, with the non-stenotic group having a higher mean FA and a lower ADC than the stenotic group (at the level of stenosis). A significant difference in age was seen between both groups, with most of the patients in the stenotic group belonging to 40 years and above. Tractography helped in demonstrating the morphology of the fiber tracts. CONCLUSION: DTI parameters, namely FA and ADC, are sensitive to damage to the white matter and can be used to detect microstructural changes in the cord. However, standardization of the protocol is necessary when imaging the spinal canal.
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Imagen de Difusión Tensora , Enfermedades de la Médula Espinal , Humanos , Adulto , Imagen de Difusión Tensora/métodos , Constricción Patológica , Canal Medular/diagnóstico por imagenRESUMEN
INTRODUCTION: Radiation is increasingly being used for medical purposes and it is an established weapon in the diagnosis and the therapy of cancer. An exposure to 1-2 Gys causes the NVD (Nausea, vomiting, diarrhoea) syndrome, whereas an exposure to 2-6 Gys causes the haematopoietic syndrome. The aim of the present study was to investigate the protective effect of the Nardostachys jatamansi root extract (NJE) on the radiation induced haematological damage in rats. MATERIALS AND METHODS: EBR was performed at the Microtron Centre, Mangalore University, India. Rats were treated with NJE once daily for 15 days before and after the irradiation. After the irradiation, blood was collected for determining the peripheral blood counts (RBC and WBC), haemoglobin, the platelet count and the packed cell volume (PCV) at 6 hours, 12 hours, 24 hours, 48 hours and 5, 10 and 15 days post irradiation. The data was analyzed by one way ANOVA, followed by the Tukey's test for multiple comparisons. RESULT: NJE provided protection against the radiation induced haematological disorders. The rats treated with NJE exhibited a time dependent significant elevation in all the haematological parameters which were studied and its modulation upto the near normal level was recorded. CONCLUSION: From this study, we concluded that, NJE provides protection by modulating the radiation induced damage on the haematopoietic system.
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Imaging features of fat necrosis vary depending on its stage of evolution and can mimic malignancy in late stages. Imaging may suffice to differentiate fat necrosis in the early stages from malignancy and thus avoid unnecessary biopsy. In this pictorial essay, we present combination of benign features in mammography and/or ultrasonography (USG) that can lead to imaging diagnosis of fat necrosis. The follow-up imaging features of fat necrosis which mirror its pathophysiological evolution have also been demonstrated. To summarize, in the appropriate clinical setting, no mammographic features suspicious for malignancy should be present. When the typical mammographic features are not present, USG can aid with the diagnosis and follow up USG can confirm it.
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Pectus carinatum or protrusion deformity of chest wall is less frequently occurring anterior chest wall deformity when compared to pectus excavatum. It may be classified as type 1 or chondro-gladiolar and type 2 or chondro-manubrial deformity. Other variations seen are symmetrical and asymmetrical pectus carinatum. Here we present two unique case reports, one with chondro-manubrial deformity (Currarino-Silverman syndrome) and other with asymmetrical pectus carinatum having bifid rib which are some of the rare variations seen in pectus carinatum found during Computerized tomographic examination. Currarino-Silverman syndrome is a type 2 pectus carinatum, a rare deformity with chondro-manubrial involvement and usually associated congenital heart diseases. Early fusion of sternal plates is one of the known theories in producing this deformity. On the other hand, asymmetrical pectus deformity are usually seen due to imbalance or abnormality in growth plates of costal cartilages leading to forked rib or bifid rib, which are accidently seen on radiological examination. To conclude, our reports would help in differential diagnosis from frequently occurring conditions affecting chest like chondro-gladiolar deformity, pectus excavatum, chest wall tumours, rib fractures and intra thoracic ribs.
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Anomalías Musculoesqueléticas/diagnóstico por imagen , Tórax/anomalías , Adulto , Niño , Humanos , Masculino , Anomalías Musculoesqueléticas/etiología , Radiografía Torácica , Tomografía Computarizada por Rayos XAsunto(s)
Ganglios/patología , Síndromes de Compresión Nerviosa/etiología , Neuropatías Peroneas/etiología , Adolescente , Femenino , Humanos , Pierna/patología , Imagen por Resonancia Magnética , Síndromes de Compresión Nerviosa/patología , Neuropatías Peroneas/patología , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Extracranial meningioma is a rare tumor, and most of the time only after histopathologic examination is diagnosis possible. CASE DESCRIPTION: A 40-year-old right-handed woman presented with progressive swelling over the right side of the forehead and temporal region associated with proptosis and visual loss. Incisional biopsy of the lesion was reported as spindle cell tumor. Computed tomography scan showed large enhancing predominantly extracranial lesion located in the right anterior frontotemporal region extending into the infratemporal fossa and a relatively thin sheet of tumor on the intracranial aspect of the thickened temporal. Intraoperative impression was malignant tumor involving the temporalis muscle, and a near total excision of the lesion was performed. Histopathologic features were suggestive of meningothelial meningioma arising from the temporal bone with predominant extracranial extension. CONCLUSION: Preoperative suspicion of a meningioma in this patient would have resulted in a more aggressive surgical approach as these lesions are relatively benign with indolent course.
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Meningioma/patología , Neoplasias Craneales/patología , Hueso Temporal/patología , Adulto , Femenino , Humanos , Meningioma/cirugía , Invasividad Neoplásica , Neoplasias Craneales/cirugía , Hueso Temporal/cirugíaRESUMEN
Progressive post-traumatic cystic syringomyelia is an uncommon and increasingly recognized cause of morbidity following spinal cord injury. We hereby report a 35-year-old gentleman who sustained wedge compression fracture of L-1 vertebral body 15 years back and had complete paraplegia with bowel/bladder involvement. The neurological deficit recovered with minimal residual motor deficits and erectile dysfunction. He presented now with increasing neurological deficits associated with pain and paresthesia. The MRI spine showed a syrinx extending from the site of injury up to the medulla. He underwent a syringo-peritoneal shunt and at followup his pain and motor functions had improved but erectile dysfunction was persisting.
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OBJECTIVE: Intraspinal endometriosis is an extremely rare condition with characteristic symptoms, including lower back pain that increases in severity during each menstrual cycle. METHODS: Here, we report a case of endometriosis involving the conus cauda region. This patient presented with acute deterioration secondary to hemorrhage. We also review the relevant literature. RESULTS: Magnetic resonance imaging scans of the dorsolumbar region showed a mass lesion within the spinal canal at the L1-L2 level with evidence of acute hemorrhage. The patient underwent an emergency D12-L2 laminectomy and microdecompression of the lesion. The histological and immunohistochemical features were characteristic of intraspinal endometriosis. CONCLUSION: Intraspinal endometriosis must be recognized as a potential cause of periodic neurological signs and symptoms in young and middle-aged women.