Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) is the causative agent for coronavirus disease 2019 (COVID-19) pandemic. While the primary organ of involvement in this disease is the lung, multiple other organ systems can be involved either due to direct viral cytopathic effects or due to thrombo-inflammation and immune system dysregulation. In this study we describe the spectrum of extrapulmonary imaging findings encountered in our patients with COVID-19.Methods: This was a retrospective observational study conducted in three tertiary care hospitals in the city of Chennai in southern India. All cross-sectional imaging studies (other than lung imaging studies) performed in patients who had proven COVID-19 infection by RT-PCR testing during the period from April 2020 to March 2021 were included as part of the study. Extrapulmonary findings in these imaging studies were recorded and collated system-wise.Results: A total of 96 non-lung imaging studies were performed in patients who had RT-PCR positivity for COVID-19 infection. Among these a total of 30 studies had extrapulmonary imaging findings. Vascular involvement was seen in 14 patients, central nervous system involvement in 13 patients, abdomen involvement in 2 patients, and cardiac involvement in 1 patient. Vascular manifestations included arterial and venous thrombosis. Neurological manifestations included stroke, encephalitis and demyelination. Abdominal manifestations included enteritis and acute kidney injury. Cardiac manifestation was in form of myocarditis.Conclusions: Extrapulmonary imaging findings in COVID-19 are uncommon but not rare. Multisystem thrombotic manifestations and central nervous system involvement account for majority of extrapulmonary imaging findings in COVID-19.

Meningo encephalocele is a congenital anomaly and is a neural tube defect with occipital meningo encephalocele being the most common and is a result of a failure of the surface ectoderm to separate from the neuroectoderm. This condition can be identified in 1st trimester in 80% of cases and almost all by 2nd trimester. A 20-year-old third gravida was referred for antenatal Ultrasonography at five months of amenorrhoea to rule out fetal anomalies. On targeted imaging, for fetal anomalies, a defect was seen in occipital bone with herniation of posterior fossa contents with overlying meningeal covering. No other fetal anomalies were noted. A diagnosis of isolated occipital meningoencephalocele was made with additional fetal MRI correlation. The mother underwent termination of her pregnancy by Department of Obstetrics and Gynecology because of the grim fetal prognosis. The mother was advised to plan the subsequent pregnancies and was advised pre-conceptional folic acid supplementation. We present a case of isolated occipital meningoencephalocele- a rare congenital anomaly which was diagnosed prenatally in our hospital. This case provides an opportunity for identifying such neurological defects early and prompt termination of pregnancy to prevent comorbidity to mother. This study also helps to establish occipital meninigioencephalocele as an isolated clinicoradiological diagnosis and to distinguish it from syndrome associated occipital meninigioencephalocele or those associated with other neural tube defects like Chiari III malformations. It also allows us to stress once again the role of periconceptional folic acid in preventing the occurrence of neural tube defects.

Radiological evaluation of the parotid gland neoplasms is a major challenge for radiologists, due to the wide variety of imaging features and differential diagnosis. Though Ultrasonography (USG) combined with guided Fine Needle Aspiration Cytology (FNAC) is the primary diagnostic modality, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) play an important role in the evaluation of patients presenting with suspected neoplastic lesions of the parotid gland. Cross-sectional imaging data of seven patients were selected and reviewed in detail. CT and MRI imaging had been done on patients referred to Radiology Department for clinically suspected parotid tumours. All of them underwent surgical excision and histopathological examination postimaging. Benign tumours usually arise from superficial lobe and exhibit strong signal intensity on T2 weighted images with well-defined margins. Lobulated margins with T2 dark rim are characteristic of pleomorphic adenoma. Hyperdense lesion with cystic changes with occasional bilateralism favour Warthin’s tumour. Most of the malignant parotid tumours involve deep lobe and appear as low signal lesion on T2 weighted imaging with ill-defined margins. Locally aggressive features like subcutaneous/deep infiltration strongly suggests malignancy. Cross-sectional imaging feature of carcinoma ex pleomorphic adenoma is variable from focally aggressive to totally aggressive tumourigenesis. Few malignant tumours like high-grade Mucoepidermoid Carcinoma (MEC) and Adenoid Cystic Carcinoma (AdCC) can show tendency towards perineural spread. Although histopathological examination is required for definitive diagnosis, few pathology-specific imaging findings on cross-sectional imaging can help in localising and characterising the parotid lesions and categorising innocuous benign from sinister malignant lesions and thus narrow down the differential diagnosis.

SWYER-JAMES-MACLEOD SYNDROME (SJMS) is a rare pulmonary disorder that manifests as unilateral hyperlucent lung. HRCT is a novel imaging modality to diagnose SJMS since Chest radiographs underestimate this condition. We report a case presentation of SJMS in a 54-year-old male and treated with bronchodilators and i.v antibiotics. In conclusion, only a few with SJMS in adulthood has been reported worldwide.

RETROCAVAL URETER (or PRE-URETERAL VENA CAVA) is a rare congenital abnormality arising from dysgenesis of the inferior vena cava (IVC) that results in the right ureter coursing posterior and medial to the inferior vena cava (IVC), causing varying degrees of obstructive proximal hydroureteronephrosis, a rare cause of long-standing cyclical flank pain. Retrocaval ureter (or Pre-ureteral vena cava) is asymptomatic until the 3rd and 4th decades of life from resulting hydronephrosis. Ultrasonography (USG), Intravenous urography (IVU), nuclear scintigraphy, Computed tomography urography (CTU), and Magnetic resonance urography (MRU) have been used in the diagnosis of this abnormality. Computed tomography urography (CTU) depicts the findings in three dimensions gives the most “wholesome” solution to its diagnosis. This condition is differentiated from other urinary tract obstruction causes, especially urolithiasis, essential for successful surgical management. When symptomatic, the situation is treated surgically, either by laparoscopic or open surgery. We report a case of a 50 years old male both with right flank pain and associated hydronephrosis.