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Biomedical subjects

S K Venkatesh

Publications and source records attributed to S K Venkatesh.

12 recordsLinked to original sources

Macronodular hepatic tuberculosis associated with portal vein thrombosis and portal hypertension.

Tuberculosis (TB) of the liver is usually associated with miliary spread. Macronodular TB of the liver is rare. A case of macronodular TB of the liver in a 31-year-old woman causing portal vein thrombosis and portal hypertension is presented. Ultrasound and CT appearances are described. There was coexistent ileo-caecal TB with extensive mesenteric and retroperitoneal lymphadenopathy. Macronodular TB should be considered in the differential diagnosis when a patient presents with multiple calcified masses in the liver with portal vein thrombosis and portal hypertension.

Adult↗

Endovascular management of pseudoaneurysms of the splenic artery: experience with six patients.

The purpose of this paper was to describe our experience with the endovascular management of splenic artery pseudoaneurysms (SAPA). Seven patients with documented SAPA on CT and/or angiography were considered for endovascular treatment. The pseudoaneurysms were located in the main splenic artery (n = 4) or its branches (n = 3). In one patient in whom the pseudoaneurysm was located in a hilar branch, selective catheterization of splenic artery failed. Metallic coils (n = 1), gelfoam and hydrogel particles (n = 1), metallic coils and gelfoam (n = 2), metallic coil, gelfoam and acrylic glue (n = 2) were used as embolization material in the remaining six patients. These patients were followed for a mean period of 11.3 months. Transcatheter embolization was successful in five patients with no procedure-related complications. In one patient, embolization was incomplete and the patient underwent surgery, but died on the 10th postoperative day because of irreversible shock. Another patient, after successful embolization, underwent surgery for management of an associated pseudocyst. Endovascular treatment is a safe and effective method of management of SAPA.

Adult↗

Diffusion MR imaging for cerebral abscess.

We report a case of cerebral abscess, which ruptured into the lateral ventricle. The radiological features on conventional MRI, appearance on both diffusion weighted images (DWI) and apparent diffusion coefficient (ADC) maps are described.

Anti-Bacterial Agents↗

MR appearance of interpeduncular lipoma.

Interpeduncular lipoma (IPL) is a very rare benign intracranial lesion. Non-invasive diagnosis of this condition is important, as these lesions are usually asymptomatic and are found incidentally. We describe a rare case of IPL in a 35-year-old woman presenting with headache of long duration and a recent increase in severity and frequency of headache. There was no neurological abnormality on clinical examination. MR imaging demonstrated a homogeneous lobulated T1-hyperintense and T2-hypointense lesion in interpeduncular fossa. A T1-weighted fat suppression sequence with chemical shift method confirmed the fatty nature of the lesion. The patient was managed conservatively.

Adult↗

Embolization of cranial/spinal tumours and vascular malformations with hydrogel microspheres. An experience of 69 cases.

OBJECTIVE: To evaluate polymethyl methacrylate hydrogel microspheres (HMs) as an embolization material in the management of hypervascular craniofacial and spinal lesions. MATERIAL AND METHODS: Sixty-nine patients with vascular lesions of the craniofacial and spinal regions underwent embolization with HM. The pathologies included craniofacial tumours (n=38), cranial arteriovenous malformations (AVMs) (n=7), dural AVM (n=1), cavernous carotid fistula (n=1), spinal tumours (n=7), spinal AVMs (n=6), orbital lesions (n=4) and scalp AVMs (n=5). Surgery was done in 56 patients. The blood loss at surgery, tumour shrinkage, surgical cleavage and ease of removal of tumour was noted from the records. Histopathology was available in 39 patients. A follow-up of 3 months to 6 years was available in 13 patients in whom embolization was the sole treatment. Surgical and histopathological findings were correlated with angio-embolization findings. RESULTS: HMs were easy to inject through the microcatheter with good control. Good devascularization was obtained in 61 patients and partial in 8 patients. Two patients developed complications due to presence of anastomoses between intra- and extracranial circulation and 1 patient due to tumor swelling. Histopathology showed presence of HMs in all the lesions, with minimal inflammatory reaction in 2 patients. Patients with spinal lesions treated with embolization only stabilised in neurologic deficits. CONCLUSION: HMs are highly suitable as embolization agents in the management of craniofacial and spinal hypervascular lesions.

Antimutagenic Agents↗

Spectroscopic increase in choline signal is a nonspecific marker for differentiation of infective/inflammatory from neoplastic lesions of the brain.

We report in vivo proton magnetic resonance (MR) spectroscopic findings in three benign infective/inflammatory lesions (one case each of tuberculoma, fungal granuloma, and xanthogranuloma), which showed high choline along with the presence of lipid/lactate, a feature characteristically described in neoplastic lesions. Histopathology of the lesions showed inflammatory cellular infiltrates with areas of necrosis/caseation. The spectroscopic-visible increased choline resonance in these lesions is probably the result of cellularity. We conclude that increased choline, along with the presence of lipid/lactate is a nonspecific finding and may not be of much value in the differentiation of neoplastic from nonneoplastic infective/inflammatory intracranial mass lesions.

Adolescent↗

Prospective evaluation of in vivo proton MR spectroscopy in differentiation of similar appearing intracranial cystic lesions.

Proton MR spectroscopy (PMRS) has been found to be useful in differentiating various cystic intracranial lesions. The purpose of the present study was to prospectively evaluate the spectral pattern of various cystic lesions of brain with similar imaging appearances and to determine the accuracy of this technique in the differential diagnosis of these lesions. Fifty-one patients with intracranial cystic lesions (21 abscesses, 20 gliomas, 3 hydatid cysts, 3 arachnoid cysts, 1 case each of glioependymal cyst, xanthogranuloma, infarction and acoustic neuroma) were evaluated with conventional MR imaging and in vivo PMRS. Ex vivo PMRS of the cystic contents aspirated at surgery in 31 cases was also done to confirm the in-vivo results. Preoperative diagnosis of the lesions was based on the results of in vivo PMRS. In vivo PMRS accurately predicted the pathology in 92% of the cases. We conclude that in-vivo PMRS complements imaging in better characterization of cystic intracranial mass lesions.

Adolescent↗

Sonographic findings in renal parenchymal malacoplakia.

Malacoplakia of the kidney is a rare inflammatory disorder. We describe a case of bilateral renal malacoplakia in which the patient had diffuse involvement of the left kidney and a focal lesion in the right kidney. Sonography showed a diffusely echogenic, enlarged left kidney with loss of corticomedullary differentiation and a single anechoic lesion measuring 1.8 x 1.6 x 1.3 cm in the right kidney. A left nephrectomy was performed, and the right kidney was managed conservatively with sonographic monitoring.

Adult↗

Intracranial infective aneurysms presenting with haemorrhage: an analysis of angiographic findings, management and outcome.

AIM: This study is an analysis of angiographic findings in 17 patients with infective aneurysms who presented with intracranial haemorrhage and reviews the management and outcome in the context of the existing literature. MATERIALS AND METHODS: A retrospective study of infective aneurysms in 17 patients was carried out. Cranial angiography was performed in all patients. The location, size and outline of aneurysms were analysed. Ten patients were managed conservatively and six patients underwent surgery for the ruptured infective aneurysms and were followed up for a period of 35.8 months and 23 months, respectively. RESULTS: Twenty-two aneurysms were identified (five unruptured) in 17 patients. Twenty aneurysms (90. 9%) were distal in location and two (9.1%) proximal. Sixty percent were in the posterior circulation with 55% in the posterior cerebral artery (PCA) territory, 27.3% in the middle cerebral artery (MCA) territory and 9.1% in the anterior cerebral artery (ACA) territory. Fourteen aneurysms were small (3-5 mm) and eight were medium sized (6-9 mm). 72.7% of aneurysms had irregular outline and 27.3% regular outline. Out of the 10 ruptured aneurysms managed conservatively, eight resolved. One patient died, presumably due to rebleed, and one had infarction due to parent vessel thrombosis. Six aneurysms were surgically managed with good results. Of the five unruptured aneurysms one was surgically managed and the remaining four conservatively managed patients did not bleed during follow-up. CONCLUSION: Patients with ruptured infective aneurysms fared well with medical management and the outcome in this series is better than that reported in literature. Patients on conservative management, however, need closer monitoring with angiographic follow-up. Active management is required with enlarging or persisting aneurysms.

Adolescent↗

Differentiation of calcification from chronic hemorrhage with corrected gradient echo phase imaging.

PURPOSE: The purpose of the current study was to prospectively evaluate the role of corrected gradient echo phase imaging in differentiation of calcified granuloma from chronic hemorrhage. METHOD: Eighty-five patients with single/multiple calcifications and hemorrhages irrespective of their location were studied with corrected gradient echo phase imaging. In all the cases, CT was used as the gold standard for the presence/absence of calcification. RESULTS: All calcified lesions showed positive phase, whereas chronic hemorrhages showed negative phase in all cases. Five calcified lesions showed no phase shift at TE =15 ms and positive shift at TE = 35 ms. Heterogeneous phase shift was observed in three calcified lesions at TE = 35 ms; all three lesions showed positive phase shift at TE = 15 ms. There was no site-specific problem in differentiation of calcification from chronic hemorrhage including in the basal ganglia. CONCLUSION: We conclude that calcified granuloma can be easily differentiated from chronic hemorrhage with corrected gradient echo phase imaging, which may obviate the need for CT for its confirmation.

Adolescent↗