Arjun K.

“Small bowel feces sign” – A Ct sign in small bowel obstruction

The Indian journal of radiology and imaging(2006)

Small bowel obstruction is a common cause of abdominal emergency. Diagnosis helps effective management and prevents complications. CT is an effective tool in evaluation of small bowel obstruction. The small bowel feces sign is a finding observed in small bowel obstruction on Helical CT (6). It is defined as presence of feces like material in the lumen of dilated loops of small bowel proximal to the site of obstruction. This section will illustrate the small bowel feces sign with examples.To know more, do read…

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Transient Hepatic Attenuation Difference (THAD)– A Case Report

The Indian journal of radiology and imaging (2006)

Transient hepatic attenuation difference (THAD) are areas of increased parenchymal enhancement visible during the hepatic arterial phase on hepatic CT. THADs are associated with a large variety of liver disorders-Portal or hepatic vein thrombosis, cirrhosis, Budd- Chiari syndrome, biliary obstruction, trauma ,focal hepatic lesions and aberrant blood supply. THADs that are associated with hepatic tumors are generally characteristic of malignant tumors. However, benign focal lesions, such as hemangiomas, focal nodular hyperplasia, pyogenic abscess and focal eosinophilic necrosis, may accompany THADs.To know more, do read.

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Helical CT evaluation of aortopulmonary window

The Indian journal of radiology and imaging (2006)

Aortopulmonary window is an opening between the aorta and the pulmonary trunk. Two distinct separated semilunar valves must exist to establish the diagnosis of aortopulmonary window, and this defect should be differentiated from truncus arteriosus. Aortopulmonary window is generally diagnosed by echocardiography or Angiocardiography. The authors present two cases of Aortopulmonary window diagnosed by helical CT. To get through the details, please click the below link….

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Incidence and Implications of a Left Inferior Vena Cava on IVC filter placement

Indian Journal of Radiology and Imaging (2005)

To assess the prevalence and ability to detect a left inferior vena cava (IVC) during venography prior to filter placement and its implications for device implantation. Materials and Methods : Over 58 months, patients referred for an IVC filter were prospectively evaluated for a left IVC by performing cavography injecting into the left iliac vein, left renal venography, or CT scan correlation. Additionally, cavograms of patients receiving filters over the four previous years were reviewed to assess the adequacy of detecting these anomalies based on the degree of opacification of the left iliac vein in relation to the position of the catheter tip. Results: Prospective evaluation for a left IVC was adequate in 477 of 503 patients. Retrospective evaluation using CT scans was possible in another 14. Left IVCs were detected in 5 patients (1%). Three patients with duplications were managed with either 2 filters, a suprarenal filter, or a bird’s nest filter straddling both cavas. Two patients with isolated left IVCs received a single filter. Of 62 retrospectively reviewed cavograms, the left iliac vein was inadequately opacified in 69% when the catheter was in the low IVC (53 patients) and 71% when it was in the right iliac vein (7 patients). Conclusions: Low caval or right iliac vein injections infrequently provide sufficient reflux into the left iliac vein to assess for a left IVC. Left iliac vein catheterization is easy and will readily provide this information. Modifications in filter placement technique may be necessary when caval anomalies are present. To read more, click on below link…

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Total Anomalous Pulmonary Venous Connection: Helical Computed Tomography as an Alternative to Angiography

Indian Heart Journal (2004)

Echocardiographic evaluation of the pulmonary veins is inadequate at times. Cardiac catheterization, especially in sick neonates, may be a high-risk procedure. Helical computed tomography with three-dimensional reconstruction is noninvasive but remains an underutilized modality. Between January 2002 and February 2003, 7 computed tomography scans of children 3 weeks to 5 years of age were performed to evaluate the drainage of the pulmonary veins in suspected total anomalous venous drainage. Helical computed tomography (GE High speed Advantage) was performed using 2 mm sections, and rapid bolus hand injections of 2 ml/kg body-weight of nonionic intravenous contrast. Sagittal and coronal reformats, and three-dimensional reconstructions were performed, and reviewed by the radiologist. The findings were discussed with the pediatric cardiologist and surgeon involved in the case. The diagnoses included complex congenital heart disease (n = 5), isolated infradiaphragmatic total anomalous pulmonary venous connections (n = 1), and transposition of the great arteries with total anomalous pulmonary venous connections (n = 1). Cardiac computed tomography accurately demonstrated infradiaphragmatic total anomalous pulmonary venous connections in 4, and supracardiac drainage in 3 patients, in addition to the other cardiac findings. The findings on computed tomography scan correlated with surgical (n = 5) and/or angiographic findings (n = 2) in 7 patients. In sick, high-risk patients, cardiac computed tomography can be considered as an alternative to cardiac catheterization for the evaluation of pulmonary venous drainage.To learn more, click the below link.

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Implementation of an International Teleradiology Staffing Model

Radiology (2004)

Although teleradiology is presently being used extensively in the United States-for both overseas subspecialty consultations and overnight coverage of imaging services at domestic medical centers-there has been limited investigation of its potential to help provide staffing support to U.S. medical centers from offshore locations. In this review, the authors describe an empirical assessment of the clinical feasibility and applicability of body computed tomographic (CT) image cases that originated at a U.S. university hospital being interpreted nearly contemporaneously by a staff radiologist in India. During a 3-month period, nonemergent CT cases obtained at a tertiary care institution (Yale-New Haven Hospital) were transmitted daily to a satellite reading facility in Bangalore, India. The cases were interpreted at the satellite reading facility by a faculty member radiologist who maintained hospital privileges and academic appointment at the parent institution in the United States. CT imaging reports were transcribed and uploaded directly to the parent institution’s radiology information system. Technical problems temporarily prevented the transfer of image cases twice during the study period. Overall, the project results demonstrated the feasibility and reliability of an international teleradiology staffing model. To read more, click on below link…

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Emergency Radiology Coverage: Technical and Clinical Feasibility of an International Teleradiology Model

Emergency Radiology (2003)

The purpose of the study was to determine the feasibility of international teleradiology, utilizing day-night time differences, for online interpretation of overnight computed tomography (CT) studies. One hundred and two consecutive Emergency Room patients who underwent CT examinations between the hours of 11 pm and 7 am were enrolled. All age groups and study types were included. CT studies were transmitted from the in-hospital PACS system (Kodak, Fremont, Calif.) to a web-based server (Medweb, San Francisco, Calif.). A radiologist in Bangalore, India, working an 8 am to 4 pm day shift, downloaded and reviewed the studies on a desktop PC using a 128-kbps internet connection at 10-20:1 wavelet compression and generated a report. The report was then uploaded to the server, noting the time at upload. Each study report was compared with the official in-house diagnostic report and concordance assessed on a three-point scale. Mean download time was 8.14 s per image. For head CT reports ( n=47), the mean turnaround time for a final transcribed report was 39.5 min. For abdomen/pelvis CT reports ( n=48) the mean turnaround time was 84.4 min. Out of 106 cases, there was discordance between the clinical diagnostic report and the study report in 20 (19%); however, on subsequent review the teleradiology report was found to be correct in 13 of these. Day-night time differences across the globe can be utilized to provide overnight emergency radiology coverage using web-based teleradiology. Scan download and report upload times are within acceptable limits. To read more, click on below link…

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