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D Patkar

Publications and source records attributed to D Patkar.

At least 19 recordsLinked to original sources
PubMed2005

An imaging study of body composition including lipodeposition pattern in a patient of familial partial lipodystrophy (Dunnigan type).

Familial Partial Lipodystrophy, Dunnigan type (FPLD), is characterised by loss of subcutaneous fat from the limbs and an excessive accumulation of fat on the neck, shoulder girdle and face. Affected individuals have insulin resistance, dyslipidaemia and early cardiovascular events. Body composition (BC) with details of adipose tissue distribution were studied by Dual-Energy X-ray Absorptiometry (DEXA) and Magnetic Resonance Imaging (MRI) ina heterozygote for the FPLD mutation LMNA R482W, and in an age, sex and body mass index (BMI) matched normal control. DEXA revealed a marked decrease in total as well as regional fat percentage in the patient compared to a normal control. Marked reductions in subcutaneous fat in the extremities with substantial lipodeposition in the nape of the neck were confirmed with. MRI. The importance of increased perinephric, retroperitoneal and intermuscular fat in the thighs found in this patient, needs to be explored vis-à-vis the pathogenesis of insulin resistance found in FPLD.

Absorptiometry, Photon↗
PubMed2004

MRI of spinal intradural arachnoid cyst formation following tuberculous meningitis.

Secondary intradural arachnoid cyst involving the spine is uncommon. It is usually secondary to trauma, haemorrhage, surgery or inflammation. We present two cases of treated tuberculous meningitis, which presented with gradual onset of quadriplegia and paraplegia, respectively. MRI revealed intradural (cervical and thoracic) arachnoid cysts (ventral and dorsal to the spinal cord) with myelomalacic cord changes. Ventral location of such spinal arachnoid cysts, and being secondary to tuberculous arachnoiditis are distinctively uncommon features. The rarity of this condition and the relevance of MRI in the accurate diagnosis have been discussed here.

Adult↗
PubMed2003

Isolated solitary vertebral body tuberculosis--study of seven cases.

AIM: To describe the magnetic resonance imaging (MRI) findings in isolated solitary vertebral body tuberculosis. Also to emphasize tuberculosis as an important entity, besides neoplasms, in the differential diagnosis of pathologies involving a single vertebral body. MATERIAL AND METHODS: The clinical and imaging features of seven patients (four men and three women; age range 18-60 years), with proved solitary vertebral body tuberculosis were retrospectively studied. RESULTS: Isolated solitary vertebral body tuberculosis is seen in only 1.69% of the total proven cases of spine tuberculosis seen in our institute between 1993 and 2002. All patients presented with constitutional symptoms and localized pain and tenderness. MRI showed decreased signal intensity on T1-weighted images and increased signal intensity on T2-weighted images. Cortical break was seen in three patients of whom epidural and pre-vertebral extensions were seen in one each. CONCLUSIONS: Although tuberculosis affecting a solitary vertebral body is rare it should be considered as an important differential diagnosis, besides neoplasms. In these cases MRI serves as the best imaging technique available for diagnosis. However, confirmation can only be made on histopathology or culture of the specimen.

Adolescent↗
PubMed2003

MRI in ankle tuberculosis: Review of 14 cases.

We reviewed the MR imaging features of ankle tuberculosis and determined the role of MR in its diagnosis. A retrospective analysis of 14 cases of ankle tuberculosis imaged with MRI was performed. Plain radiographs were also reviewed where available, and the imaging characteristics were noted. We also reviewed the medical records in order to assess the impact of the imaging findings on management of these patients. Magnetic resonance imaging is extremely helpful for detection, mapping the extent and resolution of the disease. It can identify cases, enables early institution of antituberculous chemotherapy and might obviate the need for surgery.

Adolescent↗
PubMed2001

MR imaging in intramedullary cysticercosis.

Although intramedullary spinal cord cysticercosis (IMC) is uncommon, its presence is being increasingly recognised by magnetic resonance imaging. We studied six patients from an endemic region and present the MRI features and clinical correlation of IMC. Six patients who presented with para- or quadriplegia were studied by contrast enhanced spinal MRI. Prompted by the spinal lesions, all patients underwent brain MRI. Clinical data and laboratory studies were reviewed in all patients. Definite diagnosis was established in the form of response to drug therapy (n = 4) and histopathology (n = 2). Follow-up MRI studies of spine and brain were obtained in four patients 2 months after they started medical treatment, regardless of surgery. Five patients showed fusiform and focal enlargement of the spinal cord (cervical 2, thoracic 3). Well-defined cysts with a slightly hyperintense mural nodule were identified in five patients in Ti-weighted images (T1WI). All cysts were hyperintense on T2WI and merged with the surrounding oedema. Oedema extended one to three vertebral levels above or below the cyst. Post-contrast T1WI showed well-defined, ring enhancing lesions with smooth walls in all patients. Symptoms in all patients correlated with the level of the lesions. Brain studies demonstrated lesions in just two patients. Histopathological confirmation was obtained in two patients. Follow-up spinal MRI was normal in two patients, following 2 months of treatment while residual and smaller lesions were seen in two patients. Two patients were asymptomatic and denied follow-up MRI. MRI of spinal cysticercosis were typical of and similar to those seen in cerebral lesions in our patients and corresponded to the level of symptoms. All cysts were surrounded by oedema. Two of four patients showed residual lesions after 2 months of therapy and 33 % of patients showed concomitant intracranial lesions.

Adult↗
PubMed2001

Cystic lumbar nerve sheath tumours: MRI features in five patients.

Intraspinal cystic lumbar nerve sheath tumours constitute an uncommon subset of tumours with distinct clinico-biological behaviour. The MRI findings in five such cases are presented. Four of these were cystic schwannomas and one was a cystic neurofibroma. The pathology, MRI findings and the differential diagnosis of these rare tumours are analysed.

Adult↗
PubMed2001

Arachnoiditis associated with arachnoid cyst formation and cord tethering following myelography: magnetic resonance features.

The reported incidence of clinically significant arachnoiditis following oil-based contrast media myelography is approximately 1%. The incidence of arachnoiditis in the dorsal spine is even more rare. Acquired arachnoid cyst formation can occur with arachnoiditis of various aetiologies. A case is presented of a patient with chronic backache, radiculopathy, weakness and muscle wasting, who had undergone myelography with oil-based contrast media about 28 years ago. There was no history of spinal surgery, spinal canal stenosis, disc disease or trauma, all of which are known to increase the risk of arachnoiditis. Magnetic resonance imaging features are presented in this case of arachnoiditis with arachnoid cyst formation, and cord tethering.

Arachnoid Cysts↗
PubMed2001

Intrasacral meningocele with tethered cord syndrome.

We present a 65 year old, relatively asymptomatic man, who was found to have an intrasacral meningocele with tethered cord syndrome on Magnetic Resonance Imaging (MRI). Incidental detection of this entity at such an old age is very unusual.

Aged↗
PubMed2001

Isolated symmetrical mediastinal lipomatosis.

Symmetrical mediatinal lipomatosis is a rare benign condition characterized by deposition of a large amount of mature adipose tissue within the mediastinum. Usually secondary to exogenous obesity, administration of steroids and Cushing's disease, it is more common in middle-aged males and is associated with alcohol abuse. Various other associations have been reported. CT and MRI can decisively diagnose this benign condition, which also helps in deciding treatment options. We present a case of a young female with a bizarre appearance on chest radiographs. Isolated, bilaterally symmetrical mediastinal lipomatosis was diagnosed on CT and MRI. The patient was thin and did not consume alcohol or steroids. Cushing's disease and other known associations were excluded.

Adult↗
PubMed2000

Tuberculosis of the sternum and clavicle: imaging findings in 15 patients.

OBJECTIVE: To describe the imaging findings in sterno-clavicular tubercular involvement. DESIGN AND PATIENTS: Fifteen patients with pathologically proven tuberculosis of the sternum and clavicle were retrospectively evaluated. Routine radiography, computed tomography (CT) and magnetic resonance imaging (MRI) were used in some or all of the patients. Clinical information and imaging features were evaluated in each case. RESULTS: Eight patients had sternoclavicular joint (SCJ) involvement, five had isolated sternal involvement and two had isolated clavicular involvement. Seven patients were evaluated with only CT, six with only MRI and two with both. There were eight male and seven female patients, varying in age between 16 and 78 years. Fever, swelling and pain were common presenting symptoms. Two patients were HIV positive. Radiographs were positive in only eight patients. Destruction and signal intensity (SI) changes of the sternum and clavicle, destruction of the cartilage, soft tissue changes representing granulation tissue/abscess, displacement of the adjacent structures (vessels, trachea, etc.) and inflammatory changes in the adjacent structures in the form of cellulitis and myositis were common imaging features. CONCLUSIONS: All imaging methods can provide complementary information regarding sterno-clavicular tubercular involvement that is helpful for determination of the therapy. MRI is useful in determining the extent of the lesion, particularly marrow involvement and soft tissue extent.

Adolescent↗
PubMed2000

Imaging in isolated sacral tuberculosis: a review of 15 cases.

OBJECTIVE: To review imaging studies of isolated involvement of the sacrum due to tuberculosis and determine the role of imaging in the diagnosis and management of these patients. DESIGN AND PATIENTS: A retrospective analysis of 15 cases of isolated sacral tuberculosis imaged with MR imaging was performed. The CT images were also reviewed where available, and the various lesion characteristics were identified. We also reviewed the medical records in an attempt to determine the impact of the imaging studies on the management of these patients. RESULTS: Fifteen patients (5 male, 10 female) presented with symptoms of 3-15 months' duration. Chronic localized backache with muscle spasm was the commonest presenting symptom; discharging sinuses with abscess formation was found in six patients, five of whom were children. MR imaging of the sacrum revealed a hypointense marrow signal on T1-weighted images and hyperintense signal on T2-weighted images in 14 of 15 patients, the S2 vertebra being always involved. CT revealed osteolytic changes in the sacrum in all the five patients in whom CT was performed. All patients showed marked clinical improvement within 1 year of anti-tuberculous chemotherapy. CONCLUSION: Isolated tuberculosis of the sacrum is uncommon but should be suspected in patients presenting with chronic low backache or children with discharging sinuses/abscesses and showing sacral destruction on CT or MR imaging. MR imaging can identify cases and enables early institution of antituberculous chemotherapy.

Adolescent↗
PubMed2000

Intramedullary tuberculomas. MR findings in seven patients.

PURPOSE: To describe the MR findings in intramedullary tuberculomas and to discuss the usefulness of MR in the management of this pathology. MATERIAL AND METHODS: A retrospective study of 7 patients from 21 to 60 years of age with clinical and radiological evidence of intramedullary tuberculomas was undertaken. Both T1- and T2-weighted images (WI) were obtained along with postcontrast T1WI. Signal intensities (SIs) of the granulomas were compared with SIs of the normal spinal cord. RESULTS: Six patients showed focus of tuberculosis elsewhere in the body. Six out of 7 showed fusiform swelling of the cord. Ill-defined iso-intensity (in 4 patients) to hyperintensity (in 3 patients) was seen at the site of granuloma on T1WI. On T2WI, 2 patients revealed a hypointense area (with disc enhancement). An iso-hypointense rim was seen surrounding a hyperintense centre in 5 patients (with rim enhancement). Adjacent oedema was seen in all patients. In 2 patients meningeal enhancement was also seen. In 2 patients the histopathology following surgical biopsy confirmed the diagnosis. In the remaining 5 patients, another known focus of tuberculosis elsewhere in the body and a marked response to antitubercular treatment was considered confirmatory for tuberculomas. CONCLUSION: Hypo- or iso-intensity on T2WI within the spinal cord with surrounding hyperintense oedema is suggestive of intramedullary tuberculomas. Central hyperintensities are also detected at times due to a variable amount of caseous necrosis with liquefaction. On T1WI, fusiform swelling of the cord is seen along with iso- to hyperintense foci, surrounded by hypointense oedema of the cord. Such findings should prompt a contrast-enhanced study, which may show single or conglomerate disc- or ring-enhancing lesions. MR thus plays an important role not only in detection and diagnosis, but also in deciding the treatment options and in the follow-up of those patients.

Adult↗
PubMedDate not supplied

Imaging in pituitary tuberculosis.

Tuberculosis of the pituitary gland is extremely uncommon and may masquerade as a nonfunctional pituitary neoplasm. We describe imaging findings in three patients with pituitary tuberculosis and review the pattern of involvement and importance of imaging in its management. An accurate diagnosis was found to be important in these cases as antituberculous chemotherapy was curative.

Adult↗