Anagha Rajeev Joshi

Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College | LTMGH · Department of Radiodiagnoaia and intervention

Objective To examine the feasibility of early and extended erythropoietin monotherapy after hypoxic ischaemic encephalopathy (HIE). Design Double-blind pilot randomised controlled trial. Setting Eight neonatal units in South Asia. Patients Neonates (≥36 weeks) with moderate or severe HIE admitted between 31 December 2022 and 3 May 2023. Interve...

Background Glenoid version refers to the angle subtended by the glenoid with the scapula. On average, it is 0 ± 10 degrees with a slight propensity toward retroversion. Numerous factors such the dominance(handedness), gender, ethnicity, and pathology are known to affect version. Version has important consequences on the biomechanics of the shoulder...

Introduction It is important to establish criteria to define vascular cognitive impairment (VCI) in India as VCI is an image-based diagnosis and magnetic resonance imaging (MRI) changes resulting from age with prevalent vascular risk factors may confound MRI interpretation. The objective of this study was to establish normative community data for M...

Background Effect of duration of birth depression on neurodevelopmental outcomes in low- and middle-income countries (LMICs) is not known. We examined the association of birth depression with brain injury, neurodevelopmental outcomes, and hypothermia after hypoxic ischemic encephalopathy (HIE) in south Asia. Methods We compared cerebral magnetic r...

Tubulocystic anomalies of the mesonephric duct (MND) are a rare group of related entities with a perplexing clinical presentation. Ultrasound is a useful screening investigation, which can help identify a dysplastic kidney or point to renal agenesis and identify cystic or tubulocystic changes in the structures derived from the ureteric bud or MND....

Abstract: The purpose of the study is to validate the usefulness of Laryngeal ultrasonography as a screening tool for vocal fold palsy by correlating with laryngoscopy findings. A prospective study of 60 patients was performed at a tertiary care center over a period of 1 year. The patients were divided into two groups based on findings of Hopkins...

Importance: The association between place of birth and hypothermic neuroprotection after hypoxic-ischemic encephalopathy (HIE) in low- and middle-income countries (LMICs) is unknown. Objective: To ascertain the association between place of birth and the efficacy of whole-body hypothermia for protection against brain injury measured by magnetic r...

Pancreatic masses are commonly encountered entities in radiology practice. Pancreatic ductal adenocarcinomas (PDAC) are the commonest pancreatic malignancies that typically present as infiltrative hypodense focal masses in the pancreatic head, which are hypoattenuating to the pancreatic parenchyma on pancreatic parenchymal and venous phases. Howeve...

Non-infectious granulomatous lung diseases represent a group of disorders with relatively non-specific clinical history and imaging findings. Following pathologies are enlisted, (1) Inflammatory: sarcoidosis and necrotizing sarcoid granulomatosis (NSG); (2) Pulmonary lymphoid lesions: lymphomatoid granulomatosis (LYG) and granulomatous-lymphocytic...

Primary central nervous system lymphoma (PCNSL) constitutes about 3% of all primary brain tumors and nearly 1 to 3% of all Non Hodgkin Lymphomas. In the recent years the incidence of primary CNS lymphoma is increasing in immunocompetent patients. As PCNSL are chemosensitive as well as radiosensitive, its early and accurate diagnosis is imperative f...

Objective: Mesenchymal stem cells can serve as a therapeutic option for COVID-19. Their immunomodulatory and anti-inflammatory properties can regulate the exaggerated inflammatory response and promote recovery of lung damage. Method: Phase-1, single-centre open-label, prospective clinical trial was conducted to evaluate the safety and efficacy o...

Introduction The anterior choroidal artery is a branch of the terminal internal carotid artery (ICA) that is often an incidentally detected anomaly. The hyperplastic variant has been linked with an increased risk of aneurysms. We explore the role of magnetic resonance (MR) angiography in the detection of this variant and its impact of presentation...

Background and objectives: The unprecedented outbreak of COVID-19 pneumonia, is putting to test the healthcare facilities of many countries worldwide. In this article we have investigated the correlation between the degree of lung involvement on chest x-ray (CXR) based on a severity score and the oxygen saturation (SpO2) of admitted patients. Metho...

Background We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. Methods Drawing on methods used in previou...

Background Although therapeutic hypothermia reduces death or disability after neonatal encephalopathy in high-income countries, its safety and efficacy in low-income and middle-income countries is unclear. We aimed to examine whether therapeutic hypothermia alongside optimal supportive intensive care reduces death or moderate or severe disability a...

Background: The term 'Capsular warning syndrome (CWS)' refers to recurrent, stereotypical transient ischemic attacks, either motor, sensory or both, without cortical symptoms or signs. Of these patients, 42-71% go on to develop infarcts. There are no defined treatment guidelines for this lesser known entity. Methods: We studied 9 patients who pr...

External ear malformations are commonly associated with middle ear malformations due to their closely related embryogenesis. Inner ear anomalies are less consistently seen due to their independent development. Cross-sectional imaging has come to play a critical role in the workup of congenital deafness in the pediatric age group. To optimize speech...

Background: Early detection is the key to contain the ongoing pandemic. The current gold standard to detect SARS CoV2 is RT-PCR. However, it has a high false negative rate and long turnaround time. Purpose: In view of the high sensitivity of CT in detection of lower respiratory tract pathologies, a study of 2581 patients comparing RT-PCR status...

Leukoencephalopathy, cerebral calcifications, and cysts (LCC) form a very rare association which is named as “Labrune syndrome” after Labrune who reported the first case in 1996. To the best of our knowledge only eight to 10 cases have been reported in literature to date. We report a case of a 26-year-old male with onset of neurological symptoms in...

Rising incidence of rhino-orbito-cerebral mucormycosis (ROCM) in patients with COVID-19 has recently been reported in India. We report imaging findings from 25 patients with COVID-19 and invasive ROCM from a single hospital in India. Findings included sinus wall erosions (n=20), air within bony sinus structures (n=11), and focal mucosal nonenhancem...

Background and purpose: Various neurological complications have been reported in association with COVID-19. We report our experience of COVID-19 with stroke at a single center over a period of eight months spanning 1 March to 31 October 2020. Methods: We recruited all patients admitted to Internal Medicine with an acute stroke, who also tested p...

Background: Magnetic resonance elastography (MRE) is a promising non-invasive technique for the identification and quantification of hepatic fibrosis. This manuscript describes our early experience with MRE for the assessment of the presence and staging of liver fibrosis on a 3T magnetic resonance imaging (MRI) system. Objectives: The purpose of t...

Background: It is important to establish criteria to define Vascular Cognitive Impairment (VCI) in India as VCI is an image-based diagnosis and MRI changes resulting from age with prevalent vascular risk factors may confound MRI interpretation. Objective: To establish normative community data for MRI volumetry including white matter hyperintensity...

p class="abstract">Rhabdomyosarcoma (RMS), a tumour of skeletal muscle origin, is the most common soft tissue sarcoma encountered in childhood. The head and neck region is the most common site of occurrence of RMS. RMS is a highly malignant tumour with extensive local invasions and early haemorrhagic and lymphatic dissemination. Despite the advance...

Background: At our tertiary care public hospital, we saw COVID-19 presenting with thromboembolic phenomena, indicating a possible early thrombo-inflammatory pathology. Objectives: We documented patients with cardiac and neurological thromboembolic phenomena as a primary presentation of COVID-19, and compared a subset of COVID associated strokes aga...

Background Cytokine storm triggered by Severe Coronavirus Disease 2019 (COVID-19) is associated with high mortality. With high Interleukin -6 (IL-6) levels reported in COVID-19 related deaths in China, IL-6 is considered to be the key player in COVID-19 cytokine storm. Tocilizumab, a monoclonal antibody against IL-6 receptor, is used on compassiona...

Background and Purpose: Various neurological complications have been reported in association with COVID-19. We report our experience of COVID-19 with stroke at a single center over a period of eight months spanning 1 March to 31 October 2020. Methods: We recruited all patients admitted to Internal Medicine with an acute stroke, who also tested posi...

This article focuses on a marked drop in volumes in the lockdown period during the COVID-19 pandemic across all modalities X-ray, sonography, CT scan and MRI scans and compares the volumes of data between a private and public hospital in Mumbai. This trend has been witnessed globally also. Even with easing of lockdown this has not reflected in an i...

Viruses have been shown to modify the clinical picture of several autoimmune diseases, including type 1 diabetes, systemic lupus erythematosus (SLE), rheumatoid arthritis and multiple sclerosis. Viral infections have also been considered as a possible trigger for autoimmune disorders like myositis through myositis specific antibodies. Dermatomyosit...

Background: Cytokine storm triggered by Severe Corona Virus Disease 2019 (COVID-19) is associated with high mortality. With high ‘Interlukin -6’ (IL-6) levels reported in COVID-19 deaths in China¹, IL-6 is considered to be the key player in COVID-19 cytokine storm. Tocilizumab, a monoclonal antibody against IL-6 receptor, is used on compassionate g...

Background Cytokine storm triggered by Severe Corona Virus Disease 2019 (COVID-19) is associated with high mortality. With high ‘Interlukin -6’ (IL-6) levels reported in COVID-19 related deaths in China ¹ , IL-6 is considered to be the key player in COVID-19 cytokine storm. Tocilizumab, a monoclonal antibody against IL-6 receptor, is used on compas...

Background: Cytokine storm triggered by Severe Corona Virus Disease 2019 (COVID-19) is associated with high mortality. With high ‘Interlukin -6’ (IL-6) levels reported in COVID-19 related deaths in China¹, IL-6 is considered to be the key player in COVID-19 cytokine storm. Tocilizumab, a monoclonal antibody against IL-6 receptor, is used on compass...

Hemodialysis catheter insertion is a common practice for the patients with renal failure. There are several complications associated with hemodialysis catheter insertion such as infection, catheter thrombosis, malposition, or vein stenosis; however, loss of guidewire during catheter insertion with its migration is a rare complication. We report the...

MRI provides better intrinsic soft-tissue contrast with more enhanced depiction of even subtly different tissue properties making lesion evaluation easy. Faster sequences which capture arterial sequences better, lack of ionizing radiation and simultaneous evaluation of background liver parenchyma and the liver lesions are additional advantages of u...

Purpose: Pulmonary tuberculosis (PTB) has clinically significant sequelae, even after recommended treatment completion. It is important to recognise these sequelae for accurate assessment of severity and treatment planning, if indicated. Material and methods: We retrospectively analysed contrast-enhanced computed tomography (CT) scans of chest o...

Background: White matter hyperintensities ( WMH) on MRI brain in the periventricular and deep white matter regions are commonly seen in older persons with normal cognition and in patients with AD. Aims: To compare presence and severity of WMHs in patients with AD with that in a cognitively normal control group, and to evaluate effect of presence of...

Multiplanar MR imaging provides excellent spatial and contrast resolution necessary to differentiate the signal intensities of fatty (yellow) marrow elements from hematopoietic (red) marrow elements and hence it is useful for evaluation of various pathologies of bone marrow. Utilization of typical imaging features on conventional MR imaging techniq...

Purpose: Abdominal tuberculosis (ATB) mimics various infectious, inflammatory, and neoplastic conditions and hence requires a high index of suspicion for accurate diagnosis, especially in low prevalence areas. It is difficult to consistently establish a histopathological diagnosis of ATB which underlines the importance of supportive evidences for...

A 40-year-old man presented to the emergency department of our tertiary hospital with acute abdominal pain since 1 day, which responded to conservative measures initially. On further investigation and abdominal CT, he was diagnosed with closed loop small bowel obstruction with an encapsulated lesion with small bowel loops within, in the right iliac...

Ovarian hyperstimulation syndrome is usually an iatrogenic complication in women taking ovulation induction medications during assisted reproduction. We hereby report the case of a 25 years old female who presented with hypertension, polyserositis with tense ascites and large cystic ovaries. She developed sigmoid and transverse sinus thrombosis. Sh...

Aims:Axis vertebra (C2) is involved in various pathologies which lead to instability at the craniovertebral junction. Pre-operative morphometric analysis of axis is important since various surgical interventions rely on different anatomical details which vary widely in the population. Methods: We retrospectively analyzed different radiological para...

Tracheobronchopathia osteochondroplastica is an uncommon idiopathic disease of the tracheobronchial system that may lead to narrowing of the airway lumen from cartilaginous and/or osseous submucosal nodules, which may be focal or diffuse. Due to the lack of awareness of this disease, it remains an under-recognized entity. The disorder is usually as...

Agenesis of the internal carotid artery (ICA) is a rare congenital anomaly. Most of the patients are asymptomatic and it is usually discovered incidentally by computed tomography (CT) or magnetic resonance imaging (MRI). While collateral blood flow may allow these patients to remain asymptomatic, there is close association of the intra-cranial aneu...

We report a series of four cases of intra-abdominal lymphangiectasias diagnosed in our hospital using contrast enhanced CT scan of abdomen & pelvis. One patient had peri-renal lymphangiectasia, one retroperitoneal lymphangiectasia, one retroperitoneal & mesenteric lymphangiectasia and one patient had involvement of mesentery, retroperitoneum, extra...

ABSTRACT We report a series of four cases of intra-abdominal lymphangiectasias diagnosed in our hospital using contrast enhanced CT scan of abdomen & pelvis. One patient had peri-renal lymphangiectasia, one retroperitoneal lymphangiectasia, one retroperitoneal & mesenteric lymphangiectasia and one patient had involvement of mesentery, retroperit...

Intestinal malrotation occurs in approximately 1 in 500 births. They are considered to correspond to 3‑5% of surgical obstructions, and they appear in 0.5% of radiological series. The overall incidence of malrotation, however, is unknown because some patients present later in life or remain asymptomatic for life and many are detected as an incident...

Anomalies of aortic arch are a common occurrence. Such anomalies of right sided aortic arch with its various branching patterns are of clinical importance. Rarer anomalies include isolation (deficient connection) of either left subclavian artery or left common carotid artery; that is, they do not have their origin from aorta or its major branches....

Posttraumatic intradiploic leptomeningeal cyst is an exceedingly uncommon complication of skull fracture in childhood with only about twenty-one cases described in literature till now. We report 2 such cases of intradiploic leptomeningeal cyst of occipital bone in two 17- and 21-year-old males presenting with headache with history of occipital bone...

Ampullary neuroendocrine tumors (ANETs) are rare tumors which show characteristic CT features. We present a case of a 42-year-old female, in which the CT features of an ampullary tumor were atypical for a neuroendocrine tumor but was confirmed on histopathology and immunohistochemistry as an NET. The uniqueness of our case was that the lesion showe...

Anomalies of the coronary artery are often asymptomatic and uncommon. Double right coronary artery (RCA) is a very rare coronary anomaly. So far, the number of reported cases of double RCA is not many. Nevertheless, there have been several reports of double RCA in the literature, particularly in the last decade. We aim to present a similar case. Mu...

Pulmonary atresia with ventricular septal defect (PA-VSD) with pulmonary arterial supply arising from the aorta representing large MAPCAs associated with a right sided aortic arch is an uncommon anomaly. Most of the patients succumb to severe respiratory compromise or congestive cardiac failure very early. We report the clinical details and imaging...

Tuberculosis (TB) is one of the commonest infectious diseases in the developing countries with rising incidence seen due to HIV and AIDS. Pulmonary tuberculosis is the commonest form seen. Renal Tuberculosis is the most common extrapulmonary form. There are no specific clinical symptoms associated with renal tuberculosis. The constitutional symptom...

Abdominal tuberculosis is a grave infection resulting in high morbidity and mortality if left untreated. The diagnostic approach to this disease has drastically changed since arrival of modern CT scan. Role of MRI for the diagnosis is yet to be fully established and is in early stages. In future, patient profile, diagnostic information required, me...

With the trend toward non-operative management of blunt abdominal trauma, there is more responsibility on the diagnostic modalities for defining the injuries. CT scan is the investigation of choice due to its near 100 % sensitivity with high negative predictive value. Plain- and contrast-enhanced images along with special modifications such as CT c...

Perianal fistulae are a relatively common condition. They are thought to be a result of anal gland obstruction, with secondary abscess formation and external rupture of the abscess. They have traditionally been imaged by conventional fistulograms: transrectal ultrasound and CT scan. However, each of these procedures had its own disadvantages & limi...

Obstructive jaundice which is caused by bile duct obstruction can be clinically and biochemically indistinguishable from cholestatic jaundice caused by hepatocellular disease. The management of both these conditions being radically different, the principle task of the radiologist is to differentiate between hepatocellular and obstructive jaundice,...

We report the clinical details and imaging findings of a case of transient angioedema of the small bowel following intravenous administration of non-ionic iodinated contrast material in a 17 year old female with no predisposing risk factors. Findings included long segment, symmetric, circumferential, low-density, bowel wall thickening involving the...

We report clinical details and imaging findings for a case of emphysematous epididymo-orchitis with co-existing mycotic abdominal aortic aneurysm and a testicular artery pseudoaneurysm in a diabetic 65-year-old male. We report imaging findings from ultrasonography (USG) and contrast-enhanced multidetector computed tomography (MDCT). Use of MDCT to...

It is well known that giant cell tumours of the bone rarely occur below the age of 20 years. Many radiologists and orthopaedicians do not even consider giant cell tumours as a differential diagnosis from a lytic lesion before epiphyseal closure. This is a rare case report of a 14-year-old girl with proven giant cell tumour of the epiphysis of the d...

Posterior reversible encephalopathy syndrome is a rare neuroradiologic condition associated with headache, seizures, altered sensorium, visual disturbances, and characteristic lesions on neuroimaging predominantly affecting the posterior regions of the brain. We report a 10-years-8-months-old girl who presented with headache, multiple seizures, and...

We present the case of an unusual vascular ring in a 23-year-old male patient who presented for CT examination of the chest for diagnostic work up for unilateral vocal cord palsy. Contrast-enhanced CT revealed the left common carotid artery to be arising from the ascending part of a retrotracheal arch of aorta and traversing anterior to the trachea...

To identify factors associated with HIV-infected status in children admitted with tuberculous meningitis (TBM), and to find out whether HIV co-infection affects in-hospital outcome. This prospective hospital-based study was conducted from May 2000 to August 2003. All consecutive children, aged 1 month to 12 years of age, admitted with a diagnosis o...

Intravenous Urography (IVU) as a diagnostic modality has limitations in patients of obstructive uropathy with impaired renal function. Our aim was to study the technique and diagnostic accuracy of Magnetic Resonance Urography (MRU) in obstructive uropathy and to correlate the findings with IVU. Forty-eight patients, selected over a six-month period...

In India, tuberculous meningitis (TBM) is still a major cause of neurological disabilities and death. To identify the clinical variables which predict the outcome in childhood TBM. Tertiary teaching hospital. Prospective observational study. Thirty-six clinical variables were analyzed in 123 consecutive children with TBM admitted between May 2000 a...

Virtual bronchoscopy is one of the many new radiological scanning techniques that have been recently introduced. Virtual endoscopy, according to Ahlquist (Ahlquist and Johnson CD, Gastroenterology, 112, 1997, 2150) is a technique for visualizing interior cavities using computer graphic techniques. Virtual bronchoscopy generates 3D reconstructions o...

We present the case of bilateral anomalous origin of both vertebral arteries (VAs) in a 20-year-old male patient who presented for routine contrast-enhanced CT follow-up examination of the chest. Contrast-enhanced CT revealed abnormal origins of both the VAs from the aortic arch distal to the origin of the left subclavian artery. Following this, CT...

We present the case of bilateral anomalous origin of both vertebral arteries (VAs) in a 20-year-old male patient who presented for routine contrast-enhanced CT follow-up examination of the chest. Contrast-enhanced CT revealed abnormal origins of both the VAs from the aortic arch distal to the origin of the left subclavian artery. Following this, CT...

Purpose: To evaluate renal vasculature using a multidetector CT scanner (Multidetector CT Angiography). Materials & methods: Twenty patients were evaluated using a multislice CT scanner (Siemens, Volume Zoom, Siemens Corp., Siemenstrasse, Forchheim, Germany), out of which twelve had complaints of hypertension, abdominal pain and eight were renal do...

Purpose: To evaluate the efficacy of multislice computerized tomography (MSCT) in imaging the upper and lower limb arterial tree in trauma, peripheral vascular disease and bone tumors. Materials and methods: Since the installation of multidetector CT (4 detectors) in our institution, 35 patients have undergone CT angiography of the upper or the low...

Virtual bronchoscopy using a multislice CT scanner, is a new non-invasive imaging technique and its utility in the diagnosis of inhalation injury in burnt patients has not been reported in literature yet. Initial experience of technique is encouraging and it merits more interest. It overcomes many of the limitations of the presently established pro...