Introduction: Epilepsy is a disease with predisposition to generate epileptic seizures, associated with neurobiological, cognitive, psychological, and social consequences. Nearly 30% of children undergoing medical treatment for epilepsy become refractive to the treatment. For those children, the ability to find the epileptogenic area is higher with Magnetic Resonance Imaging (MRI) of the brain. The traditional 2D spin-echo sequences used in epilepsy protocol for adults cannot be used alone in paediatric structural neuroimaging. Additional sequences are needed to identify epileptogenic areas due to differences in myelination. Here, present study compared the role of three volumetric sequences 3D-Fluid Attenuated Inversion Recovery (FLAIR) , 3D-T1 weighted Inversion Recovery (T1-IR) and 3D-Double Inversion Recovery (DIR) for paediatric epilepsy as part of structural neuroimaging. Aim: To assess the utility of 3D-DIR in paediatric epilepsy disorders and localisation of epileptogenic foci in brain, congenital malformations of brain and compare its findings with 3D-FLAIR and 3D-T1-IR. Materials and Methods: The present study was a cross-sectional study of children diagnosed with paediatric epilepsy, who were evaluated with MRI brain at Stanley Medical College, Chennai, Tamil Nadu, India, between April 2020 to April 2021 with three sequences, 3D-DIR, 3D-T1-IR and 3D-FLAIR. Lesions of atleast 3 mm in diameter were identified as foci of high signal intensity and counted in each of the three sequences separately and classified according to their location. Then, average signal intensities of the lesions were calculated manually on each of sequences using Region of Interest (ROI) analysis which had a mean size of 3 mm2 . Then the Signal-to-Noise Ratio (SNR), Contrast to-Noise Ratio (CNR), Contrast Ratio (CR), and Asymmetry Signal Ratio (ASR) were calculated. Results: Evaluation was done on 51 paediatric epilepsy patients and showed the total number of lesions detected (208 lesions) and measured contrast parameters (CR, CNR and ASR) which were found to be significantly higher in 3D-DIR, showed higher detection of the intracortical and white matter lesions than 3DFLAIR and 3D-T1-IR. SNR was higher in 3D-FLAIR. Conclusion: Present study concluded that the greatest value of the DIR sequence has a higher ability in detecting epileptogenic foci and congenital malformations of the lesions in comparison with FLAIR and T1-IR.

Introduction: Computed Tomography (CT) enables the evaluation of both osseous and soft tissue details and has become an important imaging modality in the evaluation of patients presenting with a neck mass. The study was conducted to justify the usefulness of Multidetector CT (MDCT) in patients presenting with neck lesions. Aim: To detect benign and malignant non lymphoid lesions of the neck using MDCT imaging features and compare it with Fine Needle Aspiration Cytology (FNAC). Materials and Methods: This cross-sectional study undertaken in a Government Stanley Medical College, Chennai, India, the duration of the study, from June 2021 to May 2022. Contrast Enhanced CT (CECT) was performed with a 16 slice MDCT scanner pre and postcontrast administration. The benign and malignant lesions were evaluated by their enhancement patterns, necrosis, bony and vascular invasion and extension to adjacent neck space. The results were compared with FNAC being considered the gold standard, sensitivity and accuracy of CT was determined. The collected data was analysed with International Business Machines (IBM) Statistical Package for Social Sciences (SPSS) Version 23.0. Results: Of the total 95 patients who were enrolled in to the study, 38 patients were females and 57 patients were males, the mean age of the subjects studied were 45.1±17.4 years, 67 cases were benign lesions and 28 cases were malignant lesions by FNA. The sensitivity and specificity of MDCT was found to be 78.6% and 95.5%, respectively with a Positive Predictive Value (PPV) of 88.0% and Negative Predictive Value (NPV) 0f 91.4%. Conclusion: MDCT is precise in differentiating malignant from benign lesions of the neck and defining the extent of the lesions and involvement of adjacent structures.

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OBJECTIVE. The purpose of this study was to assess the usefulness of the defecation phase during dynamic MR defecography in detecting rectal pathologies. MATERIALS AND METHODS. The images from 50 MR defecographic examinations (50 patients; age range, 13-73 years; mean, 49.88) were retrospectively reviewed in consensus by two observers. Images from each of four phases (rest, maximal sphincter contraction and squeezing, maximal straining, and defecation) were evaluated and scored independently with a previously published grading and scoring system. Features evaluated included the presence and degree of rectal descent and the presence and size of rectocele and intussusception. Statistical analysis was performed with a variety of tests. RESULTS. Compared with images obtained in the other phases, defecation phase images helped in identification of additional cases of rectoceles in 23 examinations (62%), rectal descent in 10 examinations (40%) and intussusception in 2 examinations (67%). The number of additional cases of abnormalities identified on defecation phase images was significantly greater than the number identified on images obtained in the other phases. The average total scores for the rest, squeeze, strain, and defecation phases were 0.06 (SD,0.24), 0.16 (SD,0.37), 0.82 (SD, 0.66), and 1.86 (SD, 0.78). The average total defecation phase score was significantly greater than the average total score in any of the other phases (p < 0.001). CONCLUSION. During dynamic MR defecography, defecation phase imaging yields important additional information on the presence and degree of pelvic floor abnormalities and is therefore an essential component of MR defecographic examinations.

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