An abnormal connection between the rectum or canal and the anal skin is called as a perianal fistula (PAF). MRI is considered as a gold standard for the imaging of PAF because of its operator dependence, non-invasive nature, excellent soft tissue contrast, superior field of view and multiplanar capabilities. Objective: To assess the validity of magnetic resonance imaging in detecting perianal fistulas while using surgical findings as the gold standard. Methods: From 1 January 2021 to 30 January 2022, a cross-validation research was carried out in the radiology department at Memon Medical Institute Hospital in Karachi, Pakistan. The research comprised 153 individuals with PAF ranging in age from 18 to 70 years and of either gender. A 1.5 T MR scanner was used to obtain the MRI. All techniques used a phased-array coil for image capture in all circumstances. The imaging volume encompassed the distal rectum, anal canal, and subcutaneous tissues. Fat saturation pictures were taken in the oblique, axial, and coronal planes. A radiologist examined images, and pertinent patient data were noted on a pre-drafted proforma. Histopathological and post-surgical results were acquired and documented. Results: The validity of MRI for the diagnosis of PAF was 82.4% by taking surgical findings as gold standard. Conclusion: For the assessment of PAF and the detection of abscesses, MRI is a beneficial and reliable preoperative examination

Background: Magnetic Resonance Imaging (MRI) plays a vital role in diagnosing prostatic cancer routinely done before biopsy for the lesion's extent and defining the correct path for ultrasound-guided prostate biopsy.  Diffusion-Weighted Imaging (DWI) is a non-invasive MRI sequence that shows improved sensitivity and specificity in the same setting with no additional cost. The study aims to evaluate the diagnostic accuracy of DWI in the detection of prostatic cancer. Methodology: A cross-sectional study was conducted at the radiology department of Dr. Ziauddin University Hospital between 15/ 04 /2016 to 15/ 4 /2017. A total of 201 patients who were clinically suspected of having prostatic tumors were in this study's inclusion criteria. MRI, including DWI, was done. The final diagnosis was based on an analysis of the histopathology report. Results: Out of 201 males with clinical suspicious of prostatic cancer, 160 were diagnosed with prostatic cancer on histopathology. Of these, 150 were positive on DWI. The sensitivity of diffusion-weighted MRI was found to be 93.7%, 75.60% specificity, and 90.0% diagnostic accuracy (DA) for the diagnosis of prostatic cancer. Conclusion: Diffusion-weighted sequence in MRI examination has a vital role in diagnosing prostatic cancer and should be considered a routine pre-biopsy investigation along with MRI in clinically suspected cases of prostate cancer.

To determine the frequency of anatomical variations in lung fissures using computed tomography (CT) at a tertiary care hospital in Karachi, Pakistan. MethodsA cross-sectional study was conducted in the department of Radiology and Imaging Services at Memon Medical Institute Hospital, Karachi, between November 2021 to April 2022. Patients aged between 15 to 92 years with a completed high-resolution CT scan chest were included. Subjects with no significant structural lung disease that could alter the anatomy were analyzed. Baseline data was gathered using a pre-designed questionnaire, and two qualified radiologists assessed the CT chest images. ResultsA total of 382 subjects participated in this study, out of which 57.1% were males whilst 42.9% were females. The right horizontal fissure was absent in 10 (2.6%) cases. Accessory fissures were seen in 7.33%. The most common fissural variation was azygos fissure (14; 3.7%), followed by superior accessory fissure (six; 1.6%), inferior accessory fissures (four; 1%), and left horizontal fissure (four; 1%). These variations were more common in males. The significant difference was only seen in the superior accessory fissures with respect to gender (P-value<0.05). ConclusionThis study showed the presence of accessory fissures in 7.33% of patients, the most common being the azygos fissure, irrespective of gender. The absence of normal right horizontal fissures was observed in 2.6% of cases.

Background: Recent advances in imaging technology has made it possible to diagnose abdominal masses in the early stages along with accurate image-guided localization of biopsy sites. Contrast-enhanced Computed tomography (CECT) abdomen is one such imaging tool. This study aims to establish the diagnostic accuracy of CT scans in detecting Wilm's tumour.

Background: Acute pancreatitis (AP) is challenging, varying from subtle edema to parenchymal necrosis in severity. Several clinical and radiological scoring criteria have been formulated over the years to predict the disease intensity of AP to guide monitoring and intervention. This study aimed to establish the diagnostic accuracy of high Balthazar’s computed tomography scoring index (CTSI) in predicting outcomes in terms of mortality and morbidity among suspected cases of the acutely inflamed pancreas. Methodology: A cross-sectional study was carried out at the Radiology Department of Jinnah Postgraduate Medical Center (JPMC), Karachi. A total of 1434 clinically suspected AP patients were included in this study. The initial diagnosis was made through contrast-enhanced computed tomography (CECT) of the abdomen. Balthazar's CTSI ascertained the disease severity, and outcomes were recorded in terms of survival and death. Results: The gender distribution showed a male majority, i.e. 789(55%), and most patients were in the 45-55 year age group comprising 650 patients (45.3%). Moreover, out of 1434 patients, 397(28%) died while the rest survived. This study showed that high CTSI is a prognostic indicator of mortality in suspected cases of AP. It has a sensitivity of 91.9%, specificity of 88.72%, a positive predictive value (PPV) of 94.5% and a negative predictive value (NPV) of 83.98%. Overall diagnostic accuracy (DA) was found to be 90.9%.   Conclusion: It is concluded from the study results that Balthazar’s CT severity index is reliable in establishing severity and disease outcome in AP. Thus, its routine application should be encouraged for timely detection and appropriate management of AP.