Nepalese Journal of Radiology https://nepjol.info/index.php/NJR <p>Official publication of Nepal Radiologists' Association. Full text articles available.</p> <p>Nepalese Journal of Radiology is now listed on the <a title="HINARI" href="http://extranet.who.int/hinari/en/journalList_print.php" target="_blank" rel="noopener">HINARI</a> portal.</p> Nepal Radiologists' Association en-US Nepalese Journal of Radiology 2091-136X Cold Abscess in Neck Masquerading as Infected Thyroglossal Cyst: A Case Report. https://nepjol.info/index.php/NJR/article/view/40108 <p>Midline cystic neck swellings are often seen in younger patients and may have several causes. Sonography is the initial imaging modality followed by a Computer Tomography (CT) scan with MRI being reserved as a problem-solving tool or for preoperative extent evaluation. Pathology usually uses fine-needle aspiration cytology to confirm the diagnosis. We report a case where a cold abscess presenting as cystic midline neck swelling in a young patient, was misinterpreted as an infected thyroglossal cyst on sonography. The presence of lesions consistent with pulmonary tubercular infection helped clinch the diagnosis on the CT scan. This case also highlights the fact that whenever possible a common cause should be sought for different lesions occurring simultaneously.</p> Anamika Jha Suman Lamichanne Sujit Jha Copyright (c) 2022 Nepalese Journal of Radiology http://creativecommons.org/licenses/by/4.0 2021-12-31 2021-12-31 11 2 52 55 10.3126/njr.v11i2.40108 Correlation of Amount of Cigarette Smoking with Thickness and Elasticity of Distal Femoral Cartilages using Sono-Elastography Techniques of Ultrasound, a Cross-Sectional Study. https://nepjol.info/index.php/NJR/article/view/38205 <p><strong>Introduction:</strong> Cigarette smoking is a well-known etiology for chronic musculoskeletal system disorders, like osteoarthritis, affecting the distal femoral cartilages. However, recent studies show protective effects of smoking against osteoarthritis. Ultrasound is an easily accessible and reliable imaging tool for the evaluation of the cartilages, measurement of their thickness, and tissue stiffness. This study seeks to objectively show the effects of smoking by affecting their knee joints’ cartilage and clarify whether it has a chondroprotective effect, or support the usual evidence that smoking is harmful at any cost.</p> <p><strong>Methods:</strong> This prospective cross-sectional study compares the thickness and elasticity of distal femoral cartilage in heavy, ordinary smokers and non-smokers using B-mode scanning and real-time strain elastographic technique of ultrasound respectively.</p> <p><strong> </strong><strong>Results:</strong> Among 377 individuals with a mean age of 27.66 years, male predominance (70 %) and mean Body Mass Index (BMI) of 24.55, a higher proportion (50 %) of volunteers were ordinary smokers (pack years &lt;20). Elasticity strain ratios were found to be significantly lower in heavy smokers in both sides’ distal femoral cartilages except in right lateral cartilage (<em>p</em> = &lt;0.001) using Fisher’s exact test. Significantly lower thickness was noted in both cartilages of the right side (<em>p</em> &lt;0.001) and left lateral cartilage (<em>p </em>= 0.001) among heavy smokers. After adjusting for the effects of age, sex, BMI, and occupation using one-way ANOVA, similar results were obtained.</p> <p><strong> </strong><strong>Conclusions:</strong> Heavy cigarette smoking causes degradation of distal femoral cartilages by decreasing their thickness and elasticity.</p> Neha Bista Pradesh Ghimire Mahgn Rances Collao Copyright (c) 2022 Nepalese Journal of Radiology http://creativecommons.org/licenses/by/4.0 2021-12-31 2021-12-31 11 2 2 10 10.3126/njr.v11i2.38205 Retrospective Study of Magnetic Resonance Imaging (MRI) Findings in Pott’s Spine https://nepjol.info/index.php/NJR/article/view/40667 <p><strong>Introduction</strong><strong>: </strong>Skeletal tuberculosis accounts for approximately two percent of all infected tuberculosis (TB). Magnetic resonance imaging (MRI) due to its inherent soft tissue contrast is a very good tool to diagnose the condition and look for its extent and deformities. This study aims to study the MRI findings in a patient with diagnosed case of spinal tuberculosis.</p> <p><strong>Methods:</strong> The study was carried out in a referral diagnostic imaging center in western Nepal. All MRI studies of the spine performed in a patient with diagnosed spinal tuberculosis during the study period were included in the study. Patients lacking microbiological or pathological diagnoses of spinal tuberculosis were excluded from the study.</p> <p><strong>Results:</strong> A total of 70 patients were included in the study. The mean age of the patients was 45.6 ± 16.8 years. All patients in the study had a spondylodiscitis pattern of involvement. Single intervertebral disc and adjacent vertebrae were involved in 85.7% and multiple contiguous vertebrae and IV discs were involved in 14.3% of cases. Gibbus deformity was seen in 17.1% of cases. Pre/paravertebral and Epidural collections were seen in 95.7% and 72.9% of patients respectively, whereas psoas abscess was seen in 28.6% of patients. Cord compression with myelopathy was seen in 8.6% of patients. Involvement of posterior elements was seen in 27.1% of patients.</p> <p><strong>Conclusion:</strong> MRI is an excellent tool to see the extent, deformity, and abscess in spinal tuberculosis. Most patients with tuberculosis present late with collections and deformities.</p> Bishwanath Sharma Om Biju Panta Bikash Raj Thapa Prakash Thapa Tirthendra Khadka Copyright (c) 2022 Nepalese Journal of Radiology http://creativecommons.org/licenses/by/4.0 2021-12-31 2021-12-31 11 2 11 18 10.3126/njr.v11i2.40667 Radiographic Measurements of Normal Knee Joint Space in Adults https://nepjol.info/index.php/NJR/article/view/44384 <p><strong>Introduction: </strong>The knee joint is the space between the femoral and tibial condyles. The tibiofemoral articulations are separated by articular cartilages and menisci; with little contributions from cruciate ligaments. These are collectively seen on a radiograph as a radiolucent area between the bony tibial and femoral condyles. This study was conducted to measure the normal knee joint space in patients referred for X-Ray to the Department of Radiology of a tertiary care hospital.</p> <p><strong>Methods: </strong>This descriptive cross-sectional study was performed from 1st January to 1st April 2021 in the Department of Radiology and Imaging, Tribhuvan University Teaching Hospital (TUTH). A total of 157 patients were involved. The radiographic joint space width in the knee joint was measured in both medial and lateral compartments of bilateral knees in correlation with age and gender.</p> <p><strong>Results:</strong> The mean right medial, left medial, right lateral, and left lateral spaces for females were 0.25±0.08 cm, 0.23±0.09 cm, 0.49±0.10 cm, and 0.49±0.29 cm respectively. Similarly, the mean right medial left medial, right lateral, and left lateral spaces for males were 0.26±0.07 cm, 0.10±0.09 cm, 0.18±0.09 cm, and 0.17±0.08 cm respectively. There was a strong positive correlation between both right and left joint spaces about age.</p> <p><strong>Conclusion: </strong>The radiographic reference values for the joint space width were obtained, showing a positive correlation with age and no significant gender variations in bilateral knees.</p> Prakash Kayastha Nagma Khatun Pradeep Raj Regmi Sharma Poudel Prajwal Dhakal Govinda Adhikari Rudra Prasad Upadhyaya Santosh Maharjan Copyright (c) 2022 Nepalese Journal of Radiology http://creativecommons.org/licenses/by/4.0 2021-12-31 2021-12-31 11 2 19 25 10.3126/njr.v11i2.44384 High Resolution Computed Tomography findings and Computed Tomography severity index in COVID-19 Infection Correlated with Age and Gender https://nepjol.info/index.php/NJR/article/view/44386 <p><strong>Introduction:</strong> The new coronavirus disease -19 (COVID-19) is caused by SARS-CoV2 strain of coronavirus. The Computed tomography (CT) severity index is a scoring system used to assess the lung changes and involvement by COVID-19 based on approximate estimation of pulmonary involved areas. This study was done to identify the spectrum of CT chest findings and CT severity index in COVID-19 infection and its correlation with age and gender.</p> <p><strong>Methods:</strong> Patients with COVID-19 infection with positive PCR results and positive pulmonary CT findings were included in the study. All these patients underwent high-resolution computed tomography (HRCT) of the chest. The CT scan severity score in all of these patients was calculated and the results were analyzed by SPSS version 21.</p> <p><strong>Results: </strong>A total of 104 patients with confirmed COVID-19 infection were included in this study. There were 59 males (56.73%) and 45 females (43.3%) in this study. There was a higher chest severity score in males compared to females. However, there was no significant correlation between the age and CT chest severity score.</p> <p><strong>Conclusion: </strong>HRCT chest can help in the early identification of the patients who need intensive care. Early admission and intensive care of the patients with high CT severity scores may help to reduce the mortality of COVID-19 patients.</p> Prakash Sharma Subash KC Merina Gyawali Dipesh Karki Ashish Shrestha Benju Tilija Pun Amrit Pokhrel Copyright (c) 2022 Nepalese Journal of Radiology http://creativecommons.org/licenses/by/4.0 2021-12-31 2021-12-31 11 2 26 31 10.3126/njr.v11i2.44386 Sensitivity and Specificity of High-Resolution Computer Tomography in the Diagnosis of COVID-19 Infections https://nepjol.info/index.php/NJR/article/view/44387 <p><strong>Introduction:</strong> The goal of this study is to find the sensitivity and specificity of High resolution computed tomography (HRCT) of the chest in diagnosing COVID-19 infection using Reverse Transcription Polymerase Chain Reaction (RT-PCR) as a gold standard.</p> <p><strong>Methods:</strong> All patients clinically suspected of having COVID 19 infection who had undergone both RT PCR test and HRCT chest were included in the study. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of HRCT chest in diagnosing COVID 19 infection were calculated considering RT-PCR as the gold standard test.</p> <p><strong>Results:</strong> A total of 100 patients were included in the study. The mean age was 55.68 years. HRCT chest showed 92.85 % sensitivity, 68.75 % specificity, 93.97 % PPV, 64.7 % NPV and 89 % diagnostic accuracy in the detection of COVID-19 infection.</p> <p><strong>Conclusion:</strong> HRCT scan of the chest shows high sensitivity and specificity for the diagnosis of COVID-19 pneumonia. It is a fast diagnostic test and also helps in grading the severity of pneumonia thus in further management.</p> Subita Lalchan Niraj Kushwaha Copyright (c) 2022 Nepalese Journal of Radiology http://creativecommons.org/licenses/by/4.0 2021-12-31 2021-12-31 11 2 32 36 10.3126/njr.v11i2.44387 Assessment of Normal Liver Size among Adults by Ultrasonography in Kathmandu Medical College https://nepjol.info/index.php/NJR/article/view/38394 <p><strong>Introduction: </strong>Ultrasonography is cheap, non-invasive, reliable, fast method of diagnostic investigation in the measurement of liver size. Normal range of liver size helps to diagnose hepatomegaly sonologically which may be clinically inapparent. Thus warrants further clinical evaluation and other investigations for the prevention of major hepatic comorbidities.</p> <p><strong>Methods: </strong>A prospective, cross-sectional study was conducted on 400 adults with sonographic findings unrelated to liver pathologies. The liver was measured in right midclavicular line from hepatic dome to lower hepatic margin. The correlation between liver size and age, sex, weight, height, body mass index (BMI), and body surface area(BSA) was calculated. The data were properly analyzed in SPSS version 20 software.</p> <p><strong>Results: </strong>Out of 400 patients, a male: female ratio of 1:1.25, and the age group was ranging from 20 years to 83 years with a mean age of 48.10±14.86 years were included. The mean liver length in males was 15.05 ± 0.27 cms, females were 14.32 ± 0.29 cms and the total population was 14.73 ±0.46 cms. There was a strong statistically significant correlation between liver size and height, weight whereas the correlation between liver span and BSA was moderate to weak but significant. Similarly, there was a weak but significant correlation between liver size and BMI with no significant association between liver size and age.</p> <p><strong>Conclusion: </strong>Accurate assessment of liver size is of utmost importance in the evaluation of suspected hepatic pathologies.</p> Elina Shrestha Narayan Bikram Thapa Ashok Tayal Copyright (c) 2022 Nepalese Journal of Radiology http://creativecommons.org/licenses/by/4.0 2021-12-31 2021-12-31 11 2 37 42 10.3126/njr.v11i2.38394 Diagnostic accuracy of color doppler Ultrasonography and FNAC in differentiating benign and malignant cervical lymphadenopathies at Birat Medical College Teaching Hospital, Morang, Nepal https://nepjol.info/index.php/NJR/article/view/41215 <p><strong>Introduction</strong>: Among various imaging modalities useful in diagnosis of cervical lymphadenopathies, Color Doppler ultrasound (CDUS) is useful to evaluate and determine the presence of vascularity, resistance, direction, and velocity of blood flow in lymph nodes. It can determine the morphological and vascular nature of lymphadenopathies which will further help in the differentiation between benign and malignant nodes.</p> <p><strong>Methods: </strong>This study was conducted on 61 patients referred to the Department of radiodiagnosis and imaging of BiratMedcical College for an ultrasound of cervical lymphadenopathy. These patients had subsequently undergone FNAC examination. Color Doppler sonographic procedures were done with an 11L linear probe with a frequency of 4.5-12MHz and CDUS evaluation of lymph nodes for Resistive Index and Peak systolic velocity were carried out and correlated with FNAC findings.</p> <p><strong>Results: </strong>Among 61 lymph nodes, 52 were benign and 9 were malignant in the Color Doppler study where the final diagnosis by FNAC showed 53 benign and 8 malignant nodes. RI above the cutoff value of 0.5 had 83.3% sensitivity, 79.6% specificity, 50% PPV and 95.1% NPV. PSV above the cutoff value of 16cm/sec had 66.6% sensitivity, 95.9% specificity, 80.0% PPV and 92.2% NPV with diagnostic accuracy of 91.8%.</p> <p><strong>Conclusion: </strong>Morphological features of the nodes such as shape, absence of echogenic hilum, abnormal vascular pattern, and Doppler indices cutoff values of 0.5 and 16cm/s respectively for RI and PSV were sensitive and specific for the diagnosis of malignant lymph nodes.</p> Bipin Khanal Mahesh Gautam Manish Raj Pathak Neeta Kafle Copyright (c) 2022 Nepalese Journal of Radiology http://creativecommons.org/licenses/by/4.0 2021-12-31 2021-12-31 11 2 43 51 10.3126/njr.v11i2.41215 Artificial Intelligence and Radiology https://nepjol.info/index.php/NJR/article/view/44388 <p>N/A</p> Prasanna Ghimire Copyright (c) 2022 Nepalese Journal of Radiology http://creativecommons.org/licenses/by/4.0 2021-12-31 2021-12-31 11 2 1 1 10.3126/njr.v11i2.44388