radiology.bydrjaved

FETAL CYSTIC HYGROMA @ NT scan

Fetal cystic hygromas are congenital malformations of the lymphatic system of the neck. They are thought to arise from failure of the lymphatic system to communicate with the azygos vein at around 8 weeks of gestation and, as they get larger, can cause nuchal and generalized edema. Ultimately this can affect venous return to the heart and cause hydrops through the jugular-lymphatic-obstructive-sequence (JLOS)

This lady had medical abortion later as the dual markers were also abnormal and supporting diagnosis .
Conclusion: rare diagnosis can pick up early and save later complications

Chocolate cyst ( endometrioma ) USG+ MRI
30 yr female - USG reveals large homogenous echogenic content lesion in right adnexa .
MRI pelvis -T1 hyperintense signal which is not suppressed in fat saturation sequences; mixed high and low signal in T2 weighted image (T2 shading) which is due to high concentrations of iron and protein causing decrease in T2 relaxation time.The T2 signal was completely suppressed in STIR mimicking fat . On contrast, there were no enhancing solid components noted in the cyst.

Endometriosis is one of the most common and important gynaecological problems affecting women of reproductive age with a prevalence of 10-15% in recent literature . It is described as presence of functional endometrial glands and stroma outside the uterine cavity.
The most common site of endometriosis is the ovaries followed by anterior and posterior cul-de-sac, broad and uterosacral ligaments, uterus, fallopian tubes, sigmoid colon, ureter and small intestine .Although ultrasonography is the initial imaging of choice, MRI is often performed to assess the deep endometriotic implants and adhesions.

Kienbock disease - osteonecrosis involving the lunate. It is often referred to as lunatomalacia.

Diffusely decreased signal intensity is present within the lunate . Negative ulnar variance with compensatory thickening of the triangular fibrocartilage is also present.

MR is a highly effective means for evaluating the wrist in patients with Kienbock’s disease. MR is much more sensitive than plain films and is more specific than bone scintigraphy. Kienbock’s disease may be staged based upon its MR appearance:

Stage 0 -MR reveals a linear fracture line within the mid lunate on T1-weighted images without a diffuse marrow signal abnormality. Plain films are normal.
Stage I -MR demonstrates focal or diffusely decreased signal intensity on T1-weighted images. T2*-weighted images reveal low signal intensity, perhaps due to hemorrhage, though hyperintensity may be present on STIR or fat-suppressed T2-weighted exams. Plain films remain normal.
Stage II -Progressively decreased signal intensity on T1-weighted images and heterogeneously increased signal on T2-weighted images is present. Sclerosis is evident on plain films.
Stage III – The lunate undergoes progressive collapse in the coronal plane and elongation in the sagittal plane. Associated scapholunate ligamentous tearing with rotary subluxation of the scaphoid takes one from IIIA to IIIB.
Stage IV – All of the stage III features are present in addition to generalized arthritic changes at the carpus.

Phylloid tumor of breast,reported on USG, biopsied followed up same
60 year female lump in right breast outside USG in UP reported as malignant neoplastic lesion, evaluation done at Rays by me on sono reported as phylloid tumor likely benign , biopsy done reveals same , reports attached of HP .

Phylloid tumor are rare less than 0.3 percentage of breast neoplasm locally invasive tumor Rx mostly surgical excision

A very rare case of Parotid gland tuberculosis reported on USG , biopsied USG guided and followed up same ,
13 year female child under evaluation for parotid gland swelling. Clinicians were suspected for autoimmune syndrome. Done the USG scan told it's intraparotid partially necrotic lymph node along with epsilateral posterior triangle enlarged lymph nodes . Followed next day with USG guided Biopsy - reveals tuberculosis - report attached

conclusion:Tuberculous parotitis and neoplasm have similar clinical manifestations a high suspicion of tuberculosis and biopsies sample for gene xpert Mgit culture along with histopathology not to forget to collect .