BACKGROUND Solitary cystic liver lesions are not uncommon, comes with varying age groups. To decide surgical approach and treatment planning of cystic mass lesion, specific diagnosis with high sensitivity and specificity is required from the clinician's perspective. To approach cystic liver pathology, specific diagnostic MRI protocol algorithm from literature is lacking. The objective of this study is to illustrate and prove efficacy of MR customised protocol that works better in delineating specific diagnosis of cystic liver lesions as compared to standard protocol approach.

BACKGROUND Adenomyosis is not an uncommon condition on routine ultrasonography. Specificity of ultrasound in adenomyosis is non-specific, probably due to inadequate bladder preparation and non-specific history background. In common, late stage adenomyosis is considerably diagnosed on ultrasound. Therefore, emphasis on importance of MRI in adenomyosis by standardised grading and early diagnostic algorithm is challenging in future prospects.The objective of this study is to diagnose different grades of adenomyosis from early to late changes and to compare MRI grading with grading by hysteroscopy biopsy. MATERIALS AND METHODSWe have decided the sample size of 49, calculated based on previous one year record in our hospital. Ultrasound was done (n= 49) and positive clinical background patients were included for MRI and further hysteroscopy biopsy. Hysteroscopy biopsy grading was done within 2 weeks follow-up and considered as Gold Standard. Based on grades of myometrial fibrous tissue involvement, results were compared. MRI reports were done by one experienced radiologist. RESULTSAll positive patients were studied and graded by MRI protocol. MRI graded approach shows better sensitivity for grades (Grades II and IV) as compared with (Grade I and III). The biopsy vs. MRI result showed that normal Grade I, Grade II, Grade III and Grade IV were 13.8% vs. 17.2%; 41.4% vs. 44.5; 31.0 vs. 31.0; 3.4 vs. 3.4 and 3.4 vs. 3.4 respectively. CONCLUSIONMRI graded approach algorithm as compared to routine MRI for adenomyosis proved to be a valid tool in future prospective; however, false positive results exist in higher grades.

BACKGROUND Hydronephrosis is the most common cause of chronic renal failure. Hydronephrosis due to calculus disease is more frequent than without non-calculus aetiology. Mild hydronephrosis or mild pelvicaliectasis is commonly encountered on routine ultrasound screening. Radiologist's bias in mild pelvicaliectasis as to rule out physiological or early pathology is our purpose of study. Role of MR Urography serve as a problem solving tool for ultrasound in mild pelvicaliectasis by specific protocol with 3D aided and dynamic imaging.The objective of this study is to evaluate efficacy of MR urography for suspecting hydronephrosis in asymptomatic and incidental detected hydronephrosis in other radiological modalities. MATERIALS AND METHODS34 patients were enrolled in descriptive study with institutional ethical review obtained. Clinically suspected pelvicaliectasis patients screened by Ultrasound were set as inclusion criteria. Pelvicaliectasis positive patients on ultrasound were subjected to MR urography and renal diuretic nuclear study. Remaining patients were set as control group and compared with the results. MR urography non-contrast protocol were deployed. The three dimensional sequence was used to track passage of contrast from kidneys to ureter and bladder. MR urography followed by furosemide scintigraphy was also done to compare the efficacy of MR urography, keeping as reference standard. Nuclear medicine furosemide renal study was done for all MR urography within 1 week duration. Renal functional test parameters like renal transit time and average contrast wash-out time are calculated, and in all the cases these parameters are depicted as characteristics of analysis curve. Bland-Altman plots were used to quantify intra-and interobserver performance. Statistical significance was derived by comparing both modality curves with a mean under the curve of 0.90. Percentage analysis was also done by comparing two modalities, sensitivity and specificity. RESULTS6 positive cases were noted from MR Urography from sample size (N= 19) with left UPJ obstruction (N= 1), right VUJ obstruction (N= 1), stricture in right mid ureter (n= 3) and left mid ureter (N= 1). Calculus obstruction patients were excluded from the study. All the cases and results were compared with diuretic renal scintigraphy. On the basis of interobserver performance on characteristic curves, results obtained were almost similar. RTT obstructed (RTT > 410 seconds) obtained from both characteristic curves with percentage analysis were with better sensitivity (98.8%) and specificity (100%). CONCLUSIONMR Urography proved to be the future gold standard for suspected mild pelvicaliectasis in our study. However, large cohort study needs to be addressed to prove efficacy in large sample volume.