Objectives We investigated the potential for improvement in prenatal detection of congenital heart disease (CHD) by routinely performing detailed fetal echocardiography (FE) in all pregnant women. Methods Following routine obstetric sonography, 1445 unselected pregnant women were prospectively subjected to FE at gestational ages between 16 and 24 weeks, or at first visit, if they presented later. Maternal or fetal factors, conventionally known to be associated with risk of CHD, were noted. The prevalence and detection rates of cardiac abnormalities were determined, and confirmation of findings by postnatal follow-up was done to ensure accuracy of FE. Prevalence of CHD was compared in pregnancies with or without conventional risk factors. Results The overall prevalence of CHD was 8.3 per 1000; only 2 CHD cases belonged to the high maternal risk group, while 10 cases were observed without maternal risk factors. Cardiac malformations were suspected in 14 fetuses during obstetric scan; but, only 5 of them had CHD, remaining 9 had structurally normal hearts. 50% of CHD cases occurred in pregnancies not associate with any (fetal or maternal) risk factor. The sensitivity, and specificity for prenatal CHD detection were 91.7% and 100% respectively. Conclusions Our study indicates that a substantial proportion of CHD cases occur in women not having high risk of giving birth to children with CHD. FE is a highly sensitive and specific test with strong predictive values. We recommend that FE should be done in every pregnancy.

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Objectives: To investigate the possibility of DWI as an imaging bio marker and evaluate its role in prediction and monitoring of chemoradiotherapy response in cervical carcinoma. Methods: 30 carcinoma cervix patients undergoing radiation for Carcinoma Cervix were examined with routine pelvic MRI and DWI before chemoradiation, following EBRT and on completion of brachytherapy. Based on the response on conventional MRI patients were categorized into complete, good and partial response groups. Analysis of variance (ANOVA) and Student t test (two tailed, independent) were used to compare the ADC, size and volume parameters between response groups and therapeutic times. Patients with greater post EBRT tumor ADC changes and greater size and volume responses responded better to therapy. The pretreatment tumor ADC values, post EBRT ADC changes were found to be correlating well with the final outcome. However ADC mapping was less useful in predicting the extension and staging of carcinoma. Conclusion: DWI and its quantitative parameter, ADC has a potential role in the prediction, assessment and monitoring of cervical cancer treatment response to chemo radiation therapy.

Image-guided adaptive brachytherapy (IGABT) recently has shown excellent clinical outcomes with superior local control and less toxicity. For IGABT, T2W (T2-weighted) MRI is the gold standard. However, studies have shown that target delineation with the same results in uncertainties, poor interobserver variabilities, and low conformity indices for high-risk clinical target volume contours. In this study, we investigate the role of diffusion-weighted imagingederived apparent diffusion coefficient (ADC) maps to aid in IGABT. We also evaluated ADC from the baseline to brachytherapy. METHODS AND MATERIALS: Thirty selected patients were enrolled for this study, and two MRIs were taken at diagnosis and before brachytherapy. Patients were divided into two groups, Group 1 being patients with parametrial involvement before external beam radiotherapy and no parametrial involvement before brachytherapy. Group 2 included patients with parametrial involvement before external beam radiotherapy and persistent parametrial involvement before brachytherapy. ADC was measured at the center, edge, and 1 cm from the edge. RESULTS: The measured ADC increased from diagnosis to brachytherapy, and this increase was more for the patients in Group 1 than in Group 2. The mean TDadc (diagnosis ADC, center), TEadc (tumor edge ADC diagnosis), and T1cmDadc (1 cm from edge at diagnosis) were 0.884, 1.45, and 1.9 Â 10 À3 mm 2 /s, respectively. The TBadc (ADC at brachytherapy, center), TEBadc (tumor edge ADC at brachytherapy), and TE1cmBadc (1 cm from edge brachytherapy) were 1.2, 1.8, and 2.3 Â 10 À3 mm 2 /s, respectively, p-value !0.00001. No abnormal ADC was present outside the high-risk clinical target volume contours. CONCLUSION: MRI-based IGABT using T2W imaging essentially covers all functionally abnormal zones at brachytherapy. Diffusion-weighted imaging, along with ADC maps, should only be used as a supplement for target delineation.

Background: Ascariasis is the most common helminthic disease in humans. It has global distribution and is most prevalent in tropical countries where the temperature and humidity favor the development of eggs in the soil. Ascaris is transmitted through fecal-oral route. Most of the affected are asymptomatic or present with nonspecific abdominal symptoms. However because of the high prevalence of infection, complications can occur such as intestinal obstruction due to massive infestation, biliary colic, gallstone formation, cholecytitis, liver abscess recurrent pyogenic cholangitis and pancreatitis. Purpose: This article describes and demonstrates the gastrointestinal, hepatobiliary and pancreatic Ascariasis with useful diagnostic signs on computed tomography (CT) and ultrasonography (USG). Methods: Prospective study of ten patients with history of abdominal pain who were diagnosed based on the findings of USG and CT abdomen as having hepatobiliary, pancreatic and intestinal Ascariasis and subsequently confirmed with endoscopy. Results: USG features revealed echogenic non-shadowing linear structures in the biliary tract, intestine (inner tube, stripe, and spaghetti signs) and parenchymal liver lesion and also calcified lesions in the biliary tract. CT helped in better delineation of hepatic abscess, Cholangitis, cholecystitis, pancreatitis and worms in the dilated ampulla and second part of the duodenum. Conclusions: This study discusses various features of different types of Ascariasis useful for diagnosis.