INTRODUCTION Aortic arch abnormalities include congenital anomalies and acquired pathologies .Variant anatomy of the aortic arch occurs when there is failure of normal aortic development. It results in a number of heterogenous anomalies of the aorta and its branch vessels. Radiological investigations are important for diagnosis of these conditions. Many of aortic arch anomalies are asymptomatic lesions. But some of these anomalies are symptomatic and need to be treated. Radiological appearances should be familiar for these anomalies to the radiologist for correct interpretation. Congenital anomalies of the aortic arch are rare disorders and they may be associated with congenital cardiovascular diseases. 1 Knowledge of aortic abnormalities and variant branching sequence is very important in diagnostic and interventional radiology. 2 Aneurysm of the thoracic aorta is a serious condition as it may be extensive or may be associated with a more distant aneurysm. 3 Aortic arch abnormalities reported in our institute are analysed in this article.

Background: Per Oral Endoscopic Myotomy (POEM) is a promising new endoscopic method for the treatment of achalasia cardia. Available current data from various meta-analyses shows short term success with minimal adverse events. Here we aim to study the post procedural adverse events of POEM procedure using postoperative low dose multi detector CT chest with oral contrast. Methods: A retrospective study involving 43 patients who underwent POEM procedure for achalasia, were evaluated on postoperative day 1 chest CT study with oral contrast. Results: 30 out of the 43 patients (69.8%) had pleural effusion. 29 cases (67.5%) had small pleural effusion and one case (2.3%) had moderate effusion. None had large pleural effusion. Small left pneumothorax was noted in 1 patient (2.3%), which was however not severe enough to produce respiratory complaints or necessitated intercostal drain tube placement. One patient had 2 mucosal defects in the lower oesophagus with submucosal and extra luminal contrast leak, causing mediastinal collection and communication with left pleural cavity resulting in empyema which required intercostal drainage. Minimal intramural contrast leak with no extraluminal leak or mediastinal collection was present in 5 patients (11.6%), and all 5 were managed with second clipping. Bilteral lower lobe consolidation was noted in 1 case (2.3%), suggesting the possibility of aspiration. The patient had an uneventful postoperative course obviating the necessity of any further specific management. Minimal basal atelectasis were seen in 8 patients (18.4%), few linear opacities suggestive of pneumonitis were seen in 2 patients (4.6%), pneumomediastinum was found in 11 patients (25.5%), pneumoperitoneum in 24 patients (60.5%) and subcutaneous emphysema in 12 patients (28%). None of them were severe enough to produce clinical effects and none required any specific intervention. Conclusion: POEM procedure being preferred now in the management of achalasia cardia, it is of pertinent importance for the radiologists to be aware of the adverse events that could occur post procedure, and to differentiate the expected postoperative findings from the more sinister complications like perforation, which causes significant morbidity and mortality.

Introduction: Pulmonary Thromboembolism (PTE) and Venous Thromboembolism (VTE) are prevalent conditions with a high mortality rate and need immediate medical attention. The initial and standard imaging techniques are Computed Tomography Pulmonary Angiography (CTPA) for the diagnosis of PTE and Colour Doppler Ultrasonography (CDUS) for Deep Vein Thrombosis (DVT). However, there can be some issues when using these two different approaches, like the requirement for a separate area and more time. With the so-called indirect Computed Tomography Venography (CTV) approach, thrombi in the deep venous system that may cause PTE can be examined right after pulmonary CT Angiography (CTA) without the need for additional contrast agent. Aim: To determine the accuracy of indirect CTV for the diagnosis of deep venous thrombosis in patients with suspected PTE. Materials and Methods: This cross-sectional study was conducted in the Department of Radiology in Government Stanley Medical College, Chennai, Tamil Nadu, India, India from June 2021 to May 2022. A total of 50 patients with a probable diagnosis of PTE and was established with CTA were included. All 50 patients underwent indirect CTV and CDU on the same day. For indirect CTV lower extremities between the iliac crest and the popliteal region were scanned without administration of extra contrast medium. Colour Doppler Ultrasound (CDUS) was considered as Gold standard. To find the efficacy of CTV in determining DVT the Receiver Operating Characteristics curve (ROC) was used. Results: Of the total 50 patients, who were enrolled in the study, 21 (42%) patients were females and 29 (58%) patients were males. The mean age of the study subjects was 43.5±12.1 years. Among these DVT was detected in 25/50 patients (50.0%) by Doppler Sonography, Similarly DVT was detected in 23/50 patients (46%) by CTV. The sensitivity of CTV was 76% and the specificity was 84%, Positive Predictive Value (PPV) of 82.6%, Negative Predictive Values (NPV) of 77.8%. The p-value and kappa value between CTV and CDUS was calculated as 0.0005 and 0.600, respectively. Conclusion: According to the results of the present study, a combined CTA indirect CTV method can determine the DVT with a moderate level of sensitivity and specificity

Background: Vascular abnormalities of brain include vessel obstruction, vascular tumours, vascular malformations and congenital anomalies. In this study, vascular abnormalities reported in our institute are analysed retrospectively. Methods: This is a retrospective analytical study of six months period from May 2015 to October 2015. The study was done in the radiodiagnosis department of Tirunelveli Medical College Hospital. 702 cases of MRI brain scans have been taken in above period for various conditions. In which Patients with vascular abnormalities in the scan were selected for the study i.e sample selection. No of patients selected for analysis are 60. Those findings were analysed and hereby are presented, in which age varied as low as 1 year and as high as 75 years. Results: From this study, it is noted that most of vascular abnormalities become symptomatic between the ages of 21-40. Out of that most of patients lie in age group of 21-30. There is no significant difference seen in the gender distribution of the total vascular abnormalities. Vascular abnormalities of brain are common imaging findings. Radiology plays major role in diagnosing these conditions. Rare cases like Vein of galen ectasia, aplasia of right internal carotid artery are diagnosed in above patients. Conclusions: On analysis it is noted that CT scan was able to pick up forty percentage of vascular abnormality cases. MRI is able to pick up even congenital anatomical variations and subtle pathologies. Radiology plays major role in diagnosing vascular abnormalities of brain. CT and MRI complement each other in diagnosis. Parenchymal AVM should be ruled out when there is ectasia of vein of galen. CT of base of skull gives information regarding carotid canal in absent carotid artery cases. Pituitary gland changes should be noted in cases of absent carotid artery.

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.