Background: Knowledge of normal measurements of the spinal cord is essential in diagnosing and interpreting various spinal disorders. There is sparse data on normal morphometry of spinal cord in Indian population. Aims and objectives: To obtain dimensions of the human spinal cord, at various vertebral levels in normal population on MRI. Subjects and Methods: A cross sectional observational study was done on 60 healthy subjects aged between 20 to 40 years who underwent MRI in a tertiary care centre from December 2017 to Dec 2018. Dimensions of the multiple segments of human spinal cord were measured in Antero-posterior and transverse diameters at each level by high resolution T2-weighted images by 1.5 T Philips MR System Achieva. Results: Mean age of subjects was 28 years. In the cervical segment, the AP diameter of the spinal cord was greatest at C1 (7.74 mm in males, 6.63 mm in females) and lowest at C7. The Transverse diameter decreased from C1 to C2 level, and then increased from C2 to C5, with C5 (12.84 mm in males and 11.55 mm in females) being the maximum enlarged segment and then decreased towards C7. In the upper thoracic cord, the AP diameter and transverse diameter was maximum at D1 and decreased gradually from D1 to D6. In the lower thoracic cord, the AP diameter and transverse diameter was maximum at D12. Conclusion: Spinal cord dimensions vary at different segments and also between males and females. Hence, there is a need to establish normal reference values of spinal cord diameters at various levels.

Carotid plaque characterization-comparative evaluation between USG and Non contrast MRI in recently and remotely symptomatic stroke patients.

Introduction: There is brainstem atrophy with normal ageing. It is pertinent to determine, if this atrophy with ageing, is associated with significant alteration in the midbrain to pons ratio. Aim: To determine sizes and ratio of midbrain and pons area among adults and elderly. Materials and Methods: A cross-sectional, analytical study was done in a tertiary care hospital, S Nijalingappa Medical College, Bagalkot, Karnataka, India from January 2022 to March 2022, including 200 apparently healthy adult and elderly participants. They were divided into two groups, 100 men (M1≤50 years and M2>50 years) and 100 women (F1≤50 years and F2>50 years). Each underwent multiplanar T1 Magnetic Resonance Imaging (MRI) of the brain. An experienced Radiologist identified midsagittal image, and measured midbrain and pons areas on that image. Mean and standard deviations of midbrain and pons area and midbrain to pons area ratio were estimated for each of the groups. Independent Sample t-test was used to determine significance of differences between groups. Results: A total of 200 participants were included in the study with mean age of 51 years and 3 months. The midbrain to pons area ratio among M2 and F2 groups ranged from 0.20 to 0.39, and in M1 and F1 groups it ranged from 0.23 to 0.47. Midbrain areas and midbrain to pons area ratio were significantly more among participants aged less than 50 years among both males (p-value = 0.014 and 0.024) and females (p-value = 0.011 and 0.032) in comparison with participants aged more than 50 years. Conclusion: Midbrain to pons area ratio decreases significantly in older age, and hence, age needs to be accounted for, while interpreting the ratio.

Background: Circle of Willis(CoW) provides the crucial anastomotic vascular supply to brain, Variations of Circle of Willis are associated with high incidence of Cerebrovascular accidents. Scant data exists in Indian context on the CoW variations prevalent. Aims: To find the frequency of variations of CoW in Indian population and review literature on stroke epidemiology. Settings and Design: Prospective observational study in a tertiary care hospital. Subjects and Methods: A study was undertaken between January 2017 and February 2018. Apparently healthy individuals underwent 3 dimensional Time of Flight MR angiography (3D TOF MRA) imaging of circle of Willis. Anatomy of circle of Willis was evaluated on the Image volume dataset and MIP reformations. Percentage of variations of CoW was calculated and compared with the existing data. Review of literature on epidemiology and pathophysiology of stroke in India was done. Statistical analysis used: Percentage of variations of CoW calculated. Results: The study included 197 volunteers with a mean age of 33 years and 5 months, who underwent 3D TOF MRA. Complete and balanced CoW was seen in 37.1% of them. Posterior circulation variations were found in 58.3% and anterior circulation variations in 20.3%. Hypoplastic/aplastic Posterior communicating arteries were the commonest segmental variations. No immediate or direct correlation was found between results obtained and epidemiology of stroke in India. Conclusion: Variations are the rule in CoW and are more often seen in posterior circulation. Increased prevalence rates of particular variations are likely to be associated with certain patterns of cerebrovascular disease.

Objective: Sonographic estimated fetal weight (EFW) has an influence on the management of a pregnancy. The Hadlock 4 regression model (Hadlock-4), based on fetal biometry, is widely used. There are significant discrepancies noted between EFW, using Hadlock-4, compared to the actual infant birth weights (ABW) in the author’s clinical practice. The research objective was to compare the EFW, using Hadlock-4, with ABW and determine minor arithmetic modifications needed for this population. Materials and Methods: A prospective observational study was done enrolling women in the third trimester, who underwent sonography and delivered within a week of the examination. The sonographic cases were divided into class intervals by gestational age. The EFW were compared with the ABW, using a Pearson coefficient and mean percentage errors (MPE). The EFW values were increased or decreased, by a certain percentage, to keep the mean percentage error in an acceptable range. Results: The strength of association between the EFW and ABW was 0.69 ( p = .014). The EFW and the MPEs for women delivering at 36-40 weeks and beyond was significantly more (13.2 and 18.2%). The EFWs at 36-40 weeks and beyond 40 weeks were reduced by 3 and 8% respectively, which reduced the MPEs. After this modification 97.6% of ABWs fell within +/-2 standard deviations of the EFWs. Conclusion: A simple 3 and 8% reduction of EFWs, using the Hadlock-4, with those sonographic examinations at 36-40 weeks and beyond 40 weeks gestation respectively, is proposed to increase reliable in this Indian patient practice.