Online ISSN: 2515-8260

Keywords : MRI


A Prospective Study of Predicting the Nuclear Grade of Breast Cancer Using Diffusion Weighted Imaging: An Institutional Based Study

Tushar Prabha, Jawahira Chisti, Mahendra Kumar Yadav, Kartikeya Jain

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 370-374

Introduction: As it has to aware that the breast cancer is the commonest cancer among women around the globe. Diffusion Weighted Imaging (DWI) helps to evaluate the physiological and functional environment of the lesion by observing the random motion of water molecules, tissue cellularity, fluid viscosity, membrane permeability and blood flow pattern that could be measured quantitatively by Apparent Diffusion Coefficient (ADC) values.
Materials and Methodology: A total of 70 patients with histo-pathologically proven breast carcinoma form the study sample in the study (3 patients had bilateral malignancy). MRI examinations were performed within 2 weeks before surgery. All the 70 participants who had done breast MRI underwent surgery. Statistical analysis was performed using SPSS (Statistical package for social science version16.0 for windows). Students T test and Analysis of Variance (ANOVA) were used to study the difference in ADC between two groups.
Results: Out of all the total 70 breast lesions, 53 lesions were (76%) single, while 9(13%) were multifocal carcinoma and 8 (11%) were multicentric multifocal breast carcinoma. Histological types included invasive ductal carcinoma no special type (65) invasive lobular carcinoma (1) mucinous carcinoma (2) papillary carcinoma (1) medullary carcinoma (1). The ADC value was correlated with pathological grading of the tumour (r = ‑0.497, P < 0.001).
Conclusion: DWI usually takes short acquisition time and post‑processing time and does not require any administration of contrast dyes and provides a real-time quantitative functional parameter for evaluating the tumour aggressiveness.

ASSESSMENT OF ROLE OF TRANSCUTANEOUS PERIANAL ULTRASONOGRAPHY IN ASSESSMENT OF PERIANAL FISTULAE WITH MRI CORRELATION

Dr. Arvind Anand, Dr. P.D Gupta, Dr Amit Gupta, Dr Saurav Bhagat

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 533-537

Background: Endoanal ultrasound (EAUS) and magnetic resonance imaging (MRI) of the pelvis are commonly employed for imaging of perianal fistulae, sinuses, and abscesses. The present study was conducted to assess role of transcutaneous perianal ultrasonography in assessment of perianal fistulae with MRI correlation.
Materials & Methods: 74 cases of perianal fistulae of both genders underwent perianal sonography and MRI examinations.
Results: Out of 74 patients, males were 44 and females were 30. Type was intersphincteric in 38, transsphincteric in 36 and suprasphincteric in 1. The difference was significant (P< 0.05). St. James’s classification showed grade I in 30, grade II in 16, grade III in 10, grade IV in 14 and grade V in 4 cases. The difference was significant (P< 0.05). Detection of primary fistulous and sinus tract was positive on TPUS and MRI in 74 cases, detection of secondary tracts/ramifications was positive on 8 cases on TPUS and 9 cases on MRI, detection of abscess was seen in 11 cases on TPUS and 10 cases on MRI and detection of internal opening was seen in 70 cases in TPUS and 72 cases of MRI.
Conclusion: TPUS is an effective imaging modality in the evaluation of perianal fistulae. It has high sensitivity and specificity in diagnosing and classifying perianal fistulae and abscess comparable with MRI.

DIAGNOSTIC UTILITY OF MRI FINDINGS COMPARED TO PER-OPERATIVE FINDINGS IN LUMBAR INTERVERTEBRAL DISC PROLAPSE PATIENTS

Dr. Venkata Sivaram G V, Dr. S.V.L.Narasimha Reddy,Dr Kolla Srinivas Yadav, Dr. Sridhar Jakkepally, Dr Roish Uddin

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1006-1013

Background: Diagnosis of syndromes related to lumbar spine has improved with use of magnetic resonance imaging (MRI). Neurological signs of herniated lumbar disc are important to make a decision whether to operate the patient or not. Hence, clinical examination is also important in patients with herniated lumbar disc.
Objective: To study diagnostic utility of MRI findings compared to per-operative findings in Lumbar intervertebral disc prolapse patients
Methods: Hospital based diagnostic evaluation study was carried out among 30 patients having signs and symptoms of herniated lumbar disc. All the consecutive patients presenting with low back ache (LBA) and sciatica admitted were thoroughly examined. Neurological examination, X-ray Lumbar Spine AP and lateral, MRI were done. MRI lumbar spine was graded as per Michigan scale. Surgery was done electively under general anesthesia in prone position. Patients were followed to assess the pain.
Results: Both MRI and per-operative findings agreed on the actual finding of zone of disc prolapse in 24 (80%) of the cases and differed in remaining six (20%) of the cases. The sensitivity of MRI compared to per-operative finding in diagnosing central zone of disc prolapse was 84.6% of cases and 76.5% in diagnosing lateral zone of disc prolapse. The outcome of surgery was excellent in 43.3% of cases followed by fair in 50% of the cases. It was poor in only two cases.
Conclusion: Subjects in the age groups 40-59 years were commonly affected MRI is a very sensitive in detecting symptomatic lumbar disc prolapse

To determine the MRI Brain lesion in eclampsia patient.

Kanamatha Reddy Sujana, L Pranathi Reddy, S.M. Jyothi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10065-10071

Aim: The aim of this study to determine the MRI Brain lesion in eclampsia patient
Methods: After ethical approval, the prospective study was done in the Department of
Obstetrics and Gynecology. 60 women with eclampsia were separated into two
Category: A (patients with abnormal MRI) and B (patients with normal MRI). A
thorough history was taken, and all patients underwent testing such as haemoglobin, 24
hour urine protein, and renal function tests, liver function tests, absolute platelet count,
and fundoscopy.
Results: MR Imaging was performed on 60 eclamptic women over the course of a year.
MRI results were seen in 33.333 percent (n = 20) of the patients. As a result, the study
was separated into two category A (the study group), which included patients who had
MRI results, and the category B, which included patients who did not have MRI
findings. The study population''s average age was 23.02±3.25 years. On MRI, the most
prevalent diagnosis was CVT without ''infarct (20%), followed by infarct (6.67%),
PRES (5%), and HLE (1.67%). A total of 20 individuals reported neurological
Problems of eclampsia, with 18 having positive MRI results and two having negative
MRI findings. There were 40 patients with no neurologic manifestation, 2 with positive
MRI detection and 38 with negative MRI detection. The sensitivity, specificity, PPV,
and NPV of neurological symptoms for abnormal MRI in eclampsia patients were
shown to be 92.11 percent, 75.55 percent, 53.87 percent, and 97.16 percent, respectively.
Conclusion:We concluded that clinical, laboratory and others parameters were not
remarkable associated with positive MRI detection in women with eclampsia.In the
follow-up of pregnant patients with pre-eclampsia/eclampsia, symptoms such as
unconsciousness, altered sensorium, headache, blurred vision, seizures, GCS 3, elevated
uric acid, and serum creatinine levels should serve as a warning for possible brain
lesions, whereas booking status, mean blood pressure, fundoscopy findings, platelet
count, haemoglobin, and liver enzymes were not significantly associated with positive
magnetic resonance imaging findings in patients witheclampsia.

Rare case of subdural empyema presenting as chronic subdural hemorrhage

Dr. Sourabh Guria, Dr. Rohit Kamlesh Yadav, Dr. Gitanjali Datta

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10190-10195

ISDE (intracranial subdural empyema) is a potentially fatal disorder. Patients who have
had previous intracranial surgeries are more likely to develop ISDE. ISDE might be
challenging to identify due to its non-specific clinical appearance. We provide a rare
case of ISDE that mimicked a recurrent chronic subdural hematoma, underlining the
importance of obtaining early magnetic resonance imaging of the brain for early
diagnosis and treatment in order to achieve the best possible outcome.

MRI evaluation of cruciate ligaments and associated injuries in knee joint

Dr. Gaurav Kant Sharma, Dr. Jai Chowdhary, Dr. Vineet Mishra, Dr. Sanyukta Gupta

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2051-2057

The knee joint is one of the most frequently injured joints in the body. Since it is a weight bearing joint, it is consistently exposed to substantial force. The anterior and posterior cruciate ligaments play a vital role in stabilization of the knee joint. Loss of these restraints leads to substantial morbidity and can result in secondary dysfunction of other structures of the knee.
MR imaging of the knee is an excellent modality that detects lesions not always evident on arthroscopy and helps in planning and treatment of meniscal &ligament injuries. The aim of our study is to assess the accuracy of MR imaging in evaluation of cruciate ligament injuries of knee joint. To study and categorize the patterns of cruciate ligament injuries and associated bone and surrounding soft tissues on MRI. Also, to correlate the clinical profile of cruciate and associated ligament injuries with magnetic resonance imaging findings.
Fifty patients were examined on a 1.5 T GE MR system at Mahatma Gandhi Medical College, Jaipur for a time period of eighteen months from December 2019 to May 2021.
Conclusion of our study is that MRI is an excellent modality to detect the lesions in an injured knee. It has great capability in diagnosing meniscal tear and classifying them into grades. According to our study MRI is more sensitive than clinical tests to detect the cruciate ligaments and associated lesions. MRI is unique in its ability to evaluate the internal structure as well as the peripheral meniscal tears, and inferior surface tears. MRI being noninvasive does not involve morbidity associated with other tests like arthroscopy.

A study of correlation of ultrasound, MRI and arthroscopic findings in diagnosing rotator cuff pathology

Dr. Yunus Salim CM, Dr. Muni Sankar Reddy M

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1307-1315

Background: The shoulder arthroscopy is the gold standard of reference in most of the shoulder pathologies including Rotator cuff tears. However, it is an invasive surgical procedure with associated risks of surgery and anaesthesia. The objective of the present study is to find out how accurately the rotator cuff pathologies can be diagnosed by these imaging tests.
Aims and Objectives: To compare the Ultrasonography, MRI findings with the Arthroscopic findings of Rotator cuff pathology of the shoulder.
Materials and Methods: All patients in whom the history and clinical examination is suggestive of Rotator cuff pathology were included in the study. Patients were evaluated using high resolution Ultrasound (HRUS) Philips HD-11, Germany and 1.5-Tesla MRI [1.5 Tesla, GE, Excite HD and USA]. Ultrasonographic and MRI examination is performed by a single radiologist experienced in musculoskeletal ultrasonography and MR Imaging. A Real time high resolution USG imaging and MRI of the shoulder was performed in a standardized fashion and subsequently with therapeutic or diagnostic arthroscopy on the symptomatic shoulder. Results were analyzed.
Results: Considering arthroscopy as the final gold standard of investigation, out of the 24 patients studied, five (20.8%) had rotator cuff tendinosis/tendinopathy, four (16.6%) had PT RCT, twelve (50%) had FT RCT while the remaining three (12.6%) had normal rotator cuff. The average delay between the MRI examination and arthroscopic surgery was 6 days (range 0-27 days) but in one case, it was as long as 117 days. A total of five (20.8%) patients were in the age group < 40 years while another five (20.8%) were between 40-50 years age group. A majority of eleven (45.8%) patients were between 50-60 years old while three (12.6%) were above 60 years.
Conclusion: It should be noted that following USG of the shoulder performed by a dedicated radiologist, MRI offers little additional value, with regard to the detection of rotator cuff tears.

Assessment of efficacy of ultrasonography and computed tomography in the assessment of retroperitoneal masses

Manish R Shah,Dr Gurudatt Thakkar,Dr Nirali Dhruv Patel

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5818-5822

Background:Pancreatic lesions are a difficult diagnostic and therapeutic challenge owing to
the deep- seated location of pancreas. The present study was conducted to compare
ultrasonography and computed tomography in the assessment of retroperitoneal masses.
Materials & Methods:84 patients with signs and symptoms of retroperitoneal masses of
both genders were enrolled. All underwent USG and MDCT. Data such as name, age, gender
etc. was recorded. All underwent USG and MDCT. Ultrasound was performed with Logiq
P9ultrasoundmachine. MDCT was performed with Siemens Somatom go 32 sliceCT
machine.
Characteristics like size, appearance, echotexture, vascularity and other findings were
studied.
Results: Out of 84 patients, males were 34 and females were 50. Clinical features were lump
in abdomen in 5, pain in abdomen in 32, fullness of abdomen in10, weight loss in 14, loss of
appetite in 22 and trauma in 1 case. Renal abscess was detected correctly by USG in 18 and
MDCT in 20 cases, renal hematoma in 4 and 8, RCC in 7 and 7, complex renal cyst in 13 and
13, pancreatic carcinoma in 7 and 10, adrenal adenoma in 8 and 10, aortic aneurysm in 7 and
9 and pheochromocytoma in 7 and 7 by USG and MDCT respectively. The difference was
non- significant (P> 0.05).

Role of MR Imaging in Evaluation of Post Laparoscopic Cholecystectomy Biliary Duct Injuries: A Prospective Study from North India

Dr Manoj Ranjan, Dr MohitAgarwal, Dr. Rajesh Ranjan, Dr. Satin Dutta, Dr.PradipPokharia, Dr. Rajeev Ranjan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5396-5402

Background
Cholecystectomy can be performed as an open procedure via laparotomy, using a conventional (open)
incision (OC) or a mini-incision (MC) or using a laparoscopic procedure (LC). MR is excellent for
visualisation of the biliary tract including abnormalities as common bile duct stones, postoperative
fluid collections and bilomas, but also other pathological conditions in the abdomen such as
abscesses. The aim of this study was to use magnetic resonance cholangiopancreatography (MRCP)
as a non-invasive alternative to identify Post Laparoscopic Cholecystectomy Biliary Duct Injuries and
compare it with ERCP and post operative findings.
Methods
After receiving ethical approval, the current prospective study was conducted for two years in the
Department of Internal Medicine among patients with clinical findings suggestive of postoperative
bile duct injury who visited the OPD or were admitted to the wards and underwent MRCP followed
by ERCP. Clinical history was gathered during OPD hours or after admission, and patient-specific
and pertinent information was acquired through interviews in a structured data collection schedule.
All tests were done at a 5% level of significance; an association was considered significant if the p
value was < 0.05.
Results
In present study, the mean age of patients was 42.3 22.7 years. 82% of patients were females. Among
70% of patients’ persistent right upper quadrant pain was the clinical symptom followed by jaundice
(48%). Type II (36%) and Type III (38%) were the common observed Bismuth Injury on MRCP.
While comparing the bismuth injury on MRCP findings with intraoperative findings, it was observed
that Type II and Type II injuries were accurately diagnosed by MRCP and matches with the
intraoperative findings. Strictures with associated dilated IHBR were more accurately diagnosed by
MRCP (50% of patients) when compared with ERCP (36% of patients).
Conclusion
Our preliminary results support that MRCP is a useful diagnostic test in patients suspected to have
bile duct injury after surgery. MRCP depicts the signs of stricture and excision injury accurately and
displays the anatomy completely and accurately.

Presence of antero lateral ligament in knees with and without anterior cruciate ligament tear

Manoj Kumar, Sagar Goel, Nikhil L Gore, Varun Gautam, Mohit Jindal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 615-628

Background: There is a debate around the existence, anatomy, and role of the so called
―anterolateral ligament (ALL). This study was conducted with a primary aim of finding out
and comparing the prevalence of the presence of anterolateral ligament and it’s three portions
(femoral, meniscal and tibial) in knees with and without ACL tear.
Methodology: This is a cross sectional study conducted in which A total of 96 patients
undergoing MRI knee for clinically evident ACL injury or history of chronic knee pain were
included in the study. Out of 96 patients included in the study, 48 patients had ACL tear
(Group A) and 48 patients did not have an ACL tear (Group B). Demographic data and
clinical information were noted for all patients. Descriptive variables were expressed as mean
and standard deviation for quantitative variables and frequency and percentages for
qualitative variables. The data was analyzed using SPSS® version 21.0. Categorical variables
were analyzed using Chi square test and for normally distributed data - t test was used. p
value <0.05 was considered as statistically significant.
Results: ALL was visualized in 65% of the patients included in the study. Its femoral
component was visualized in 56%, tibial component in 63% and meniscal component in 57%
of the patients. The three components were viewed together in 30% of the patients. We found
a significant association between ACL tear and the presence of ALL (p <0.001), with ALL
visualized in around 81%of knees with an ACL tear and only 48% of knees without an ACL
tear. Meniscal tears were significantly associated with the presence of ALL as out of the 62
patients in which ALL was visualized, 24 had an associated medial meniscal tear, 7 had
lateral and 3 had tear in both the menisci.
Conclusion: Our study demonstrated radiological evidence of the existence of the ALL.
Furthermore, we found presence of ALL to be significantly associated with ACL injury and
meniscal tear. Age, gender, or affected side was not found to be associated with the presence
of ALL.

A randomized assessment of the potential relationship between magnetic resonance abnormalities of the common extensor tendon (CET) and its clinical symptoms in patients with chronic lateral epicondylitis

Dr. Srinivasa Reddy Mukku, Dr. Pruthvi M

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1920-1927

Aims and objective: The aim of the study is to evaluate of magnetic resonance imaging (MRI) of Patients with Chronic Lateral Epicondylitis and investigate whether there is a potential relationship between MRI abnormalities of the common extensor tendon (CET) and its clinical symptom.
Material and Methods: A randomized study was conducted in the Department Malla Reddy Institute of Medical Sciences, Hyderabad, Telangana, India for the period of 1 year. The study group comprised 120 consecutive patients (80 men and 40 women) with a clinical diagnosis of chronic lateral epicondylitis, which were examined on 1.5 T MR. an MRI scoring system was used to grade the degree of tendinopahty. Clinical symptoms were assessed using the Patient Rated Tennis Elbow Evaluation (PRTEE).
Results: Total 120 elbows had MRI assessed tendinopathy, that includes 50 (41.67%) with grade 1, 37 (30.83%) with grade 2, and 33 (27.5%) with grade 3. The average intra-observer agreement for grading the severity of tendinopathy was 79.17%. The median PRTEE score of all patients was 76 (range 8-98), the median PRTEE score of tendinopathy score 1 was 28, the median PRTEE score of tendinopathy score 2 was 54, and the median PRTEE score of tendinopathy score 3 was 98. The PRTEE scores were gradually increased with the tendinopathy scores. A significant positive correlation exist between tendinopathy scores and PRTEE scores (correlation coefficient r ¼ 0.945, P < 0.01).
Conclusion: MRI is a reliable tool in determining radiological severity of chronical lateral epicondylitis. The severity of MR signals changes positively correlate with the patient’s clinical symptom.

“A COMPARATIVE STUDY OF THE DIAGNOSTIC ACCURACY OF 1.5 TESLA MRI WITH ARTHROSCOPY IN THE EVALUATION OF LIGAMENTOUS INJURIES OF THE KNEE”

Dr. Disha Shah, Dr. Amlendu Nagar, Dr. Sheetal Singh, Dr. Sonal Banzal .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 451-464

Background: Ligamentous injuries to the ligaments and menisci of the knee can lead to significant morbidity and may precipitate osteoarthritis.Arthroscopic diagnosis though invasive is considered as the gold standard. Various imaging modalities like CT scan and MRI have alsobeen used in the diagnosis of these injuries and the quest for the best technique goes on.
Aim: The aim of this study is to assess the diagnostic accuracy of 1.5 T MRI in cases of ligamentous injuries of the knee joint and compare its efficacy with arthroscopy.
Materials & Methods: This is a comparative observational study which included 50 patientswho were clinically suspected to be having ligamentous injuries of the knee. MRI was done for all these patients and all of them laterunderwent arthroscopy in the Department of Orthopaedics-IMCHRC.Statistical analysis was done to derive the sensitivity, specificity, positive predictive value (PPV) and the negative predictive value (NPV) and for this the findings at arthroscopy were taken to be the true diagnosis.
Results: The patients were commonly in the age group of 21-30 years and males with RTA being the commonest mode of injury and duration of injury commonly between 6weeks to 6 months.ACL tear was the commonest injury found in 76% followed by PCL tear in 38% , MM tear in 36%, LM tear in 32%. Regarding the efficacy of 1.5T MRI for ACL tears the sensitivity was 94.6%, specificity 76.9%, PPV 92.1%, NPV 83.3% and accuracy 90%. For PCL it was 94.4%, 93.8%, 89.5%,96.8%,94% respectively. For MM it was 94.7%,100%,100%,96.9%,98% respectively and for LM 83.3%,96.9%.93.9%,91.2%,92% respectively.
Conclusion: MRI is of proven diagnostic value in the evaluation of internal ligamentous injuries of the knee joint. It has a fairly good PPV and its routine use in all clinically suspicious ligamentous injuries of the knee may be recommended. Further since MRI has a high NPV, a normal MRI scan may be used to exclude any pathology and thus avoid an expensive and invasive procedure like arthroscopy.

To Determine The MRI Brain Lesion In Eclampsia Patient

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 9752-9765

Aim: The aim of this study to determine the MRI Brain lesion in eclampsia patient
 
Methods: After ethical approval, the prospective study was done  in the Department of Obstetrics and Gynecology. 60 women with eclampsia were separated into two Category: A (patients with abnormal MRI) and B (patients with normal MRI). A thorough history was taken, and all patients underwent testing such as haemoglobin, 24 hour urine protein, and renal function tests, liver function tests, absolute platelet count, and fundoscopy.
 
Results: MR Imaging was performed on 60 eclamptic women over the course of a year. MRI results were seen in 33.333 percent (n = 20) of the patients. As a result, the study was separated into two category A ( the study group), which included patients who had MRI results, and the category B, which included patients who did not have MRI findings. The study population's average age was 23.02±3.25 years. On MRI, the most prevalent diagnosis was CVT without 'infarct (20%), followed by infarct (6.67%), PRES (5%), and HLE (1.67%). A total of 20 individuals reported neurological Problems of eclampsia, with 18 having positive MRI results and two having negative MRI findings. There were 40 patients  with no neurologic manifestation, 2 with positive MRI detection and 38 with negative MRI detection. The sensitivity, specificity, PPV, and NPV of neurological symptoms for abnormal MRI in eclampsia patients were shown to be 92.11 percent, 75.55 percent, 53.87 percent, and 97.16 percent, respectively.
 
Conclusion: We concluded that clinical, laboratory and others parameters were not remarkable associated with positive MRI detection in women with eclampsia. In the follow-up of pregnant patients with pre-eclampsia/eclampsia, symptoms such as unconsciousness, altered sensorium, headache, blurred vision, seizures, GCS 3, elevated uric acid, and serum creatinine levels should serve as a warning for possible brain lesions, whereas booking status, mean blood pressure, fundoscopy findings, platelet count, haemoglobin, and liver enzymes were not significantly associated with positive magnetic resonance imaging findings in patients with eclampsia.

Assessment of knee joint pathologies using magnetic resonance imaging

Dr Eram Fatima, Dr Tarim Usmani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5823-5827

Background: MR examination, a non-invasive modality, is now routinely used to assess
a wide spectrum of internal knee derangements and articular disorders. The present
study was conducted to assessed the efficacy of MRI in evaluation of knee joint
pathologies.
Materials & Methods: 70 patients with painful knee joint of both gendersunderwent
MRI of knee joint with 1.5 Tesla high gradient MRI scanner. T1 and T2 weighted
sequences in sagittal planes, PD weighted sequences in axial, coronal and sagittal planes
and fat suppressed T2 or STIR sequences were recorded.
Results: Out of 70 patients, males were 45 and females were 25. Common knee
pathologies were anterior cruciate ligament tear in 12, posterior cruciate ligament tear
in 8, chondromalacia patellae in 5, rheumatoid arthritis in 7, medial collateral ligament
tears in 10, lateral collateral ligament tears in 8, medial meniscal tears in 5, lateral
meniscal tears in 5, osteochondritis dissecans in 6 and infection in 4 patients. The
difference was significant (P< 0.05).
Conclusion: MRI is an accurate and cost- effective radiographic aid useful in diagnosis
of painful knee. Common knee pathologies were anterior cruciate ligament tear,
posterior cruciate ligament tear, chondromalacia patellae, rheumatoid arthritis, medial
collateral ligament tears, lateral collateral ligament tears, medial meniscal tears, lateral
meniscal tears, osteochondritis dissecans and infection.

To measure the tibial and femoral footprint of ACL in Indian patients (with and without ACL injury) using MRI of normal patients, during (ACLR) and during TKR

Dr Irphan Shaikh, Dr Sameer Chaudhari, Dr Abhay Narvekar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1412-1423

Aim: To measure the tibial and femoral footprint of ACL in Indian patients (with and
without ACL injury) using MRI of normal patients, during (ACLR) and during TKR.
Materials and Methods: The present prospective study was conducted at PD HINDUJA
hospital and medical research center, Mumbai from March 2015 to November 2015
among 100 patients of Indian origin undergoing arthroscopy, TKR and MRI in our
hospital. We have taken three separate patients group undergoing different procedure
related to knee i.e. Group 1 (Arthroscopic ACL reconstruction), Group 2 (Total knee
replacement) and Group 3 (Diagnostic MRI). As MRI are done in extension of knee,
femoral footprint was in vertically oval plane, so calculating length of maximum
Supero-inferior measurement on MRI sequence of femoral footprint was giving us
length of femoral footprint. All above-mentioned readings were added in tabular form
in excel sheet master chart and was statistically analyzed using SPSS software version
24.

Role of brain imaging using CT/MRI in diagnosis and management of stroke

Dr.Aarish Bali,Dr.Mridul Arora,Dr.Karanpartap Singh, Dr.Venus Garg, Dr. Kiran Kumar Singal, Dr. SS Kaushal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1073-1077

Introduction: Prevalence of morbidity and mortality is keep rising in poorly managed stroke
cases. Early detection and proper diagnosis have great potential in management of stroke. The
development of brain imaging modalities (CT/MRI) have led to a milestone that provides a
living autopsy of the brain.
Objective: The goal of this prospective study is to determine the clinical efficacy of CT/MRI
and its benefits over traditional techniques of clinical diagnosis in stroke patients.
Methods: 50 patients in whom clinical signs of stroke i.e., slurring of speech, weakness on
one side of the body, deviation of angle of mouth, and neurological deficits observed were
recruited in the study. CT/MRI was used to diagnosed the stroke.
Results:The NCCT finding have revealed Diffused cerebral atrophy in 14 (28%) patients,
Chronic Infarct in 11 (22%) patients, Subacute Infarct in 7 (14%) patients, Acute Infarct in 6
(12%) patients and Encephalomalacia in 2 (4%) patients whereas 10 (20%) patients
underwent MRI brain.The MRI brain finding have revealed Diffused cerebral atrophy in 6
(6%) patients, Chronic Infarct in 1 (2%) patient, Subacute Infarct in 4 (8%) patients, Acute
Infarct in 3 (6%) patients and Encephalomalacia in 2 (4%) patients whereas 37 (74%) patients
underwent NCCT head.
Conclusion: In both NCCT head and MRI brain finding have revealed diffuse cerebral
atrophy as the most common finding among recruited patients followed by the chronic infarct
(22%), subacute infarct (14%), acute infarct (12%) and encephalomalacia (4%).

To Assess The Role of Diffusion Weighted Magnetic Resonance Imaging in Differentiating Benign From Malignant Prostate Lesions With Histopathological Correlation

Dr. Priyank Dwivedi, Dr. Kushpreet Kaur, Dr. Nilay Singh,Dr. Sheetal Singh

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2713-2719

Background&Method: This is a prospective study conducted in the Department of Radio
Diagnosis, Index medical college hospital and research centre. 50 patients suspicion of prostatic
pathologies were included in the study. A sample size of 50 was selected using purposive
sampling technique.All the 50 patients were subjected for the multi-parametric MRI sequences
including T1 and T2 weighted anatomical imaging, functional imaging using diffusion weighted
MRI with ADC value calculation.The machine used in this study is GE SIGNA
EXPLORER 1.5 Tesla MRI with phased array body coil.
Result:Majority of lesions 37 (74%) on diffusion weighted imaging were hyperintense
while 13 (26%) were hypointense. Out of 37 hyperintense lesions 24 (92.31%) were
malignant on histopathology and 13 (54.16%) were benign on histopathology. 13 (26%)
lesions appeared hypointense on diffusion weighted imaging 2 (7.69%) were malignant on
histopathology while 11 (45.83%) lesions were benign on histopathology.
This indicated benign lesions tends to both hyperintense and hypointense on diffusion
weighted imaging, benign lesions those appeared hyperintense on diffusion weighted
imaging had inflammatory properties ,that was confirmed on histopathology. Malignant
lesions tends to be hyperintense on diffusion weighted imaging.

Role of ultrasound and MRI in patients with shoulder pathologies: A correlation study

Dr.Paramjit Singh, Dr.Amanpreet Kaur, Dr.Suman Bhagat, Dr. Gurinder Bir Singh, Dr. Nikhil Gupta

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2890-2899

Introduction: The rotator cuff disorders constitute the most common cause of shoulder
pathologies. Ultrasonography and MRI are widely used in evaluating various shoulder
pathologies. USG of shoulder is simple, cheap, fast and non-invasive imaging technology
for detection of rotator cuff and non- rotator cuff abnormalities. In this study we have
assessed the usefulness of USG in diagnosing the shoulder pathologies and have correlated
with the MRI.
Aim: Evaluation of a patient with shoulder pathology with ultrasonography as the initial
line of imaging technique as compared to MRI, assessing the accuracy of ultrasonography
in diagnosing shoulder joint pathologies, especially rotator cuff abnormalities, using MRI
as a reference standard and correlating findings wherever possible.
Materials and Methods: Hundred patients were studied prospectively over a period of two
years. Study subjects included both men and women in all age groups with suspected
shoulder pathology, suspected to have musculo-tendinous origin. All patients underwent
USG evaluation of the shoulder joint followed by MRI of the affected shoulder.
Results: USG showed a sensitivity of 85%, specificity of 100%, PPV of 100% and NPV of
97% in diagnosing full thickness tear of rotator cuff using MRI as reference. For partial
thickness tears, it showed a sensitivity of 71%, specificity of 69%, PPV of 82% and NPV of
54%. Overall accuracy of USG in detection of any tear of rotator cuff with MRI as
reference was 82%. The strength of agreement between USG and MRI for the diagnosis of
any tear of rotator cuff is considered to be ‘substantial’ in our study (Kappa=0.635).
Conclusion: USG showed comparable results to MRI in assessment of rotator cuff
abnormality and should be used as first line of investigation in patients presenting with
shoulder pathologies. It proved to have high sensitivity and specificity for full thickness
tears with relatively less sensitivity and specificity in detection of partial thickness tear.

Role of MRI in detecting female infertility

Dr. A Antony Jean,Dr. K. Karthikeyan,Dr.Ajit Kumar Reddy, Dr.AnnithaElavarasi J

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3197-3201

To assess role of MRI in detecting female infertility.
Materials & Methods:Eighty- six women age ranged 20- 40 years were included in the
study. All underwent MRI using 1.5 Tesla unit equipped with a 32 phased-array surface
coil. Causes of female infertility was recorded.
Results: Age group 20-30 years comprised of 50 and 31-40 years had 36 patients. Various
causes of female infertility was PCOS in 12, tubal disease in 18, pelvic inflammatory
disease in 10, endometriosis in 8, leiomyoma in 6, adenomyosis in 12 and endometrial
polyps in 20 cases. A significant difference was observed (P< 0.05).
Conclusion: MRI is an excellent non-invasive, radiation-free modality for the evaluation
of female infertility; its superior soft-tissue contrast resolution and multiplanar evaluation
generate exquisite anatomical details.

Balanced GradientEcho (FIESTA)- MRI Evaluation Of The Fatty Liver Disease.

Fatih Düzgün; GökhanPekindil .

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2582-2587

FIESTA (FastImagingEmployingSteady-stateAcquisition) is
commonlyacceptedthatbelongstotheclass of gradient-echosequence (1). FIESTA has
provedto be useful in abdominalimagingformagneticresonansimaging (MRI) of
gastrointestinalsystem, oncologicimagings, assessingvascularpatency. However, FIESTA
MRI findings of fattyliver has not previouslybeenreported, although it
describedthesignalreductionduetofat in previousarticles.
Weobservedthatthepatientswithfattyliver had lowersignalintensity (SI) values at FIESTA
sequencescomparedto normal patientswithoutfattyliver.
Materialsandmethods:
Thirtypatientswithliverfatandthirtypatientswithoutfattyliverwerethecontrolgroup.Thirtypatie
ntswho had detectedfattyliver at T1W in-out of phase MRI (IOP-MRI)
imageswereevaluatedwithcoronalFIESTA sequence at 1.5 Teslascanner.
Allpatientswereobtained FIESTA sequenceusingthesame MRI acqusitionparameters.
LiverandspleenSI’sweremeasured as usingsame ROI on coronal FIESTA
sequencesandlivertospleen SI ratiowerecalculated. Allvalueswerecompared.
Results:
Decrease in SI of thefattyliver on FIESTA images is
negativelycorrelatedwiththefattyfraction of theliver. Patientswithfattyliver had liver / spleen
SI ratiofrom 0.15 to 0.71 (mean 0.39), and 0.41 to 0.96 in thecontrolgroup (mean 0.70).
Therewas a statisticallysignificantdifference.
Conclusion:
Webelievesuggestthatbalancedgradientechosequencesuch as FIESTA, can
detectfattyliverhoweverfurtherstudiesarerequiredforevaluatethecapability of thesequence in
evaluation of fattyfraction of theliver.

Role of MRI and high resolution ultrasound in rotator cuff tears

Dr. Peerzada Ziaulhaq, Dr. Najeeb Tallal Ahangar, Dr. Asif Majid Wani, Dr. Shabir Ahmad Bhat

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 2807-2820

Background: The shoulder joint is a ball and socket variety of joint with wide range of movements in multiple planes where stability is compromised for mobility. The muscles and tendons are subjected to severe strain resulting in tears. Rotator cuff disease is one of the most common causes of shoulder pain. In addition to history and physical examination, several radiological techniques have been used to detect tears of the rotator cuff. Each has limitations and no clear consensus on the optimum diagnostic study has emerged. The radiological diagnosis of rotator cuff tears has traditionally been performed with arthrography and more recently with non-invasive techniques like ultrasonography and MRI.
Aims and objectives: Evaluation of role of MRI in rotator cuff injuries, evaluation of role of high resolution ultrasound in rotator cuff injuries. Correlation of clinical and high resolution ultrasound findings with MRI findings.
Materials and Methods: In our study we took over the analysis of 32 patients with clinically suspected rotator cuff injuries were subjected to undergo USG and MRI after thorough history taking and clinical examination. USG was carried out on IU22 Philips machine using a high frequency transducer of 5-17 MHz. The rotator cuff tendons, muscles, ACJ, joint cavity and bursae were examined in various positions. Dynamic examination of shoulder were also carried out for impingement. MRI was performed on 1.5 Tesla MRI scanner, using a dedicated surface coil for shoulder.

A clinical evaluation of MRI of pituitary gland height, shape in correlation with the age, sex

Dr. Najeeb Tallal Ahangar, Dr. Asif Majid Wani, Dr. Peerzada Ziaulhaq, Dr. Naseer Ahmad Khan

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 2792-2799

Background: The pituitary gland was first described anatomically by a Belgian scientist Andreas Vesalius in 1543.Pituitary gland is the master endocrine gland of human body Magnetic Resonance Imaging (MRI) is the most suitable modality for the evaluation of pituitary gland pathologies. Knowledge of the normal dimensions of the pituitary gland is needed to differentiate normal from abnormal cases. Size of the gland especially height varies according to age group and also gender. The references values are helpful for evaluating pituitary gland especially in borderline cases in whom dynamic post contrast studies are needed for further evaluation. Hence we conducted a study to formulate the normal data for different age groups.
Aim of the study: Aim of the study is to evaluate the size and shape of pituitary gland according to different age groups on MRI.
Materials and Methods: This was a retrospective study conducted in the department of Radiology, Government Medical College, Baramulla, Jammu and Kashmir, India, a tertiary care teaching hospital. 203 patients who had undergone brain MRI, Patients with seller or parasellar pathologies and endocrine disorders were excluded from the study. Mid sagittal T1 weighted images were analysed for size and shape of the gland.
Results: Our study included 203 patients, 112 males and 91 females. The patients were divided into different age groups from 0 to 10 years, 11-20 years, 21-30 years, 31-40 years, 41-50 years, 51-60 years and 61 years and above. Mean height of pituitary gland in our study was 5.42 mm. Maximum height was found in 11-20 years age group. After 11-20 years age group, gradual decline in the height was noted. Minimal increase in the elderly age group was also seen. Most common shape of the pituitary gland was flat in our study.
Conclusion: The reference value of normal size of pituitary gland in various genders and age groups has been standardized. Any variation in size will help the clinician to deduce any pathology and make early diagnosis and plan adequate this will be avoid unnecessary suffering to patients. Knowledge of pituitary gland height in different age groups is helpful in distinguishing normal from abnormal gland. Normal data of the study is useful for the same.

Survey of the Occupational and Patients Biological Risks in Magnetic Resonance Imaging Departments

Batil Alonazi

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 311-319

Background: Technologists are exposed to a strong magnetic field (1.5-3.0 Tesla), higher than the earth magnetic field (≈0.5mT). In addition to that, the exposure to the radiofrequency (RF) may create currents producing skin burns. This study's objective was to assess the magnetic resonance imaging (MRI) safety practices in specific departments in Saudi Arabia in the Riyadh region, evaluate the incidence of biological effects and health implications of the electromagnetic fields present during MR scans, and to detect the occupational hazards. Methods: A survey questionnaire was designed and used to stimulate the target population's views on aspects of MRI safety and detected risks. The survey's target population includes consultants, radiologists, technologists, patients, and others who underwent MRI procedures. Results: A total of 28 technologists were responded from the five hospitals. The study results showed that 50% of the technologist reported various levels of effects, including vertigo and lack of concentration. It is well documented that exposure to MRI requires special consideration due to high magnetic field exposure. Conclusions: This study's main findings are that radiology nurses and patients in MRI units are highly exposed to the magnetic field, especially before and after MRI examination. Any department did not report projectile hazards. Staff is exposed to various degrees of radiation risks. No incident or accident was reported in all investigated hospitals. The staff is well protected in light of the current practice.

Segmentation on Brain Cancer Disease using Deep Learning Techniques

J. Josphin Mary; R. Charanya; V. Shanthi; G. Sridevi; Meda Srinivasa Rao

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 1439-1446
DOI: 10.31838/ejmcm.07.09.153

Segmenting brain tumors is a major challenge in the production of scientific pictures. To order to maximize care outcomes and increasing the hospital success rate, early detection of brain tumors plays an important part. A challenging and time-consuming job is the manual segmentation of brain tumors from large quantities of MRI images produced in clinical routine. Automatic brain tumor segmentation is possible. This article aims to analyze strategies for the segmentation of brain tumors dependent on MRI. Automatic segmentation using deep learning approaches has recently been proven common because these approaches accomplish the latest findings much better than other methods would solve this issue. Deep learning approaches may also provide for effective analysis and unbiased interpretation of vast volumes of picture evidence dependent on MRI. There are many papers on MRI based brain tumor segmentation which focus on traditional methods. Different from others, we concentrate on the recent trend in the field of deep learning. Next, the brain tumors and techniques for segmenting the brain tumor are added. Then, the new architectures are explored with a emphasis on the current development in deep learning methods. Finally, an evaluation is introduced and further improvements are discussed to standardize brain tumor segmentation procedures dependent on MRI in the day-to-day clinical practice.

HYBRID METHOD OF MRI BRAIN SEGMENTATION USING FUZZY K-MEANS

Jawwad Sami Ur Rahman, Sathish Kumar Selvaperumal, Rajasvaran Logeswaran

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 9144-9155

In this paper, a proposed hybrid algorithm using K-means and Fuzzy logic for brain segmentation, is developed, simulated and evaluated. The system identifies the white matter, gray matter and Cerebrospinal Fluid (CSF). The proposed system was tested using Magnetic Resonance Imaging (MRI), and evaluated in terms of the misclassification rate and percentage of clustering. The misclassification rate was found to be lesser in the proposed system as compared to the existing systems using K-means and Fuzzy logic. Further, the percentage of clustering is improved by the proposed system as compared to the existing algorithms. This work paves the way for future development of Neuro Fuzzy K-means algorithm in order to reduce the misclassification rate further in clustering the white matter, gray matter and CSF.

MRI EVALUATION OF PATTERN OF ANTEROLATERAL LIGAMENT AND POSTEROLATERAL CORNER INJURY ASSOCIATED WITH ANTERIOR CRUCIATE LIGAMENT TEAR WITH IT’S CLINICAL CORRELATION.

Dr. Amruta Dinesh Varma; Rajasbala Dhande

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 1977-1982

Abstract: Background: Understanding the RELATION between anterior cruciate ligament
and postero lateral corner TRAUMA with antero-lateral ligament of knee with it’s clinical
diagnosis would help us better understand the pattern of injury and to take proper
treatment action .Objectives :To find the correlation between pattern of injury of
anterolateralligament , anterior cruciate ligament and posterolateral corner injury on MRI
with it’s clinical correlation and associated findings. Methodology: A cross-sectional study
will be done at Acharya Vinoba Bhave Rural Hospital, Sawangi, involving52 patients who
present with knee trauma for MRI. The sample will be selected and involvement of
Anterior cruciate ligament ,postero lateral corner injury and antero-lateral ligament with
associated findings will be evaluated using T1, T2 and PD MRI sequences. These will be
compared and there association will be calculated which can be used for better planning of
treatment. Results: After appropriate statistical analysis, we expect to find association
between anterolateral ligament and anterior cruciate ligament tear with posterolateral
corner injury and this will be considered for reconstruction. Conclusion: In this
observational study, we expect associations between injured ligaments with aid of clinical
findings . We also expect to find a positive association between anterolateral ligament with
posterolateral corner injury and anterior cruciate ligament tear.