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Se encontró que la precisión de la estimación del volumen de órganos internos realizada con ultrasonido (EE. UU.) Es multifactorial. Por lo tanto, nuestro objetivo fue describir y validar la evaluación de volumen de la ecografía y las fórmulas estándar de estimación de volumen para órganos intraabdominales de diferentes formas utilizando bazos y riñones. Se escanearon riñones cadavéricos disecados (n = 25) y bazos (n = 29) para obtener medidas lineales y volúmenes autogenerados por ultrasonido (USV). Se utilizaron medidas lineales para calcular los volúmenes manualmente con fórmulas de estimación de volumen elipsoide, prolate y Lambert. Los volúmenes reales (AV) de los órganos se obtuvieron mediante el método de desplazamiento de agua. Se comparó la precisión de la evaluación del volumen de USV y diferentes fórmulas comparando el sesgo, la precisión y el análisis de la gráfica de Bland-Altman. El procedimiento de medición de volumen y lineal de EE. UU. Fue confiable con acuerdos altos entre observadores e intraobservadores (lineal: α de Chronbach = 0,983 a 0,934; volúmenes: α de Chronbach = 0,989). Las estimaciones de USV fueron precisas con una alta correlación con AV y un bajo sesgo de estimación (-5,9%). Además, las fórmulas prolate (sesgo = -0,75%) y elipsoide (sesgo = -3. 75%) fueron confiables con un sesgo insignificante en los volúmenes estimados. Por el contrario, la fórmula de Lambert no fue confiable debido a un alto sesgo (41,6%). Para todos los métodos evaluados, el error de estimación se encontró relacionado con el tamaño del órgano (T = 3.483; p = 0.001), principalmente cuando el órgano evaluado es mayor de 50 ml. Además, se encontró que el error de estimación de forma está relacionado con la fórmula de estimación de volumen usado. la fórmula de Lambert no fue confiable debido a un alto sesgo (41,6%). Para todos los métodos evaluados, el error de estimación se encontró relacionado con el tamaño del órgano (T = 3.483; p = 0.001), principalmente cuando el órgano evaluado es mayor de 50 ml. Además, se encontró que el error de estimación de forma está relacionado con la fórmula de estimación de volumen usado. la fórmula de Lambert no fue confiable debido a un alto sesgo (41,6%). Para todos los métodos evaluados, el error de estimación se encontró relacionado con el tamaño del órgano (T = 3.483; p = 0.001), principalmente cuando el órgano evaluado es mayor de 50 ml. Además, se encontró que el error de estimación de forma está relacionado con la fórmula de estimación de volumen usado.

Neurological manifestations of SARS-CoV-2 are increasingly being recognised and can arise as a result of direct viral invasion, para-infectious or postinfectious immune mechanisms. We report a delayed presentation of COVID-19 postinfectious immune-mediated encephalitis and status epilepticus occurring in a 47-year-old woman 4 weeks after SARS-CoV-2 pulmonary disease. SARS-CoV-2-specific IgG and IgM antibodies were detected in her cerebrospinal fluid with features of encephalitis evident in both magnetic resonance imaging of the brain and electroencephalogram. She made a complete recovery following treatment with high-dose intravenous corticosteroids and intravenous immunoglobulins. Diagnosis of COVID-19 postinfectious encephalitis may prove challenging in patients presenting many weeks following the initial infection. A high index of clinical suspicion and testing intrathecal SARS-CoV-2-specific antibodies are key to its diagnosis. Early immunotherapy is likely to result in a good outcome.

Background Association between early diagnosis of chronic kidney disease (CKD) and low morbidity and mortality rate has been proven. Thus, tools for early CKD diagnosis are vital. Ultrasonography has been widely used to diagnose and monitor the progression of CKD. Objectives To determine the performance of selected renal ultrasonographic parameters for the diagnosis of early CKD. Methods In a cohort of patients diagnosed with CKD (n = 100), diagnostic performance of ultrasonographically measured renal length (RL), renal cortical thickness (RCT), and parenchymal thickness (PT) was determined using receiver operating curve analysis; correlation of each parameter with the associated comorbidities and serum creatinine (Scr) levels was also determined. Severity of CKD was graded with estimated glomerular filtration rates (eGFR). Results Of all patient participants, 85 had severity grades 2 or 3. Mean (standard deviation) Scr was 1.88 (0.60) mg/dL; eGFR was 43.3 (11.85) mL/min/1.73 m2. RL was 9.01 (0.83) cm, PT was 1.32 (0.22) cm, and RCT was 6.0 (0.10) mm. PT and RCT were positively correlated with eGFR (P = 0.01 and 0.002, respectively). Early CKD was better predicted by PT (area under the curve (AUC) 0.735; 82% sensitivity; 30% specificity; 68% positive predictive value (PPV)) and RCT (AUC 0.741; 82% sensitivity; 48% specificity; 51% PPV); severe CKD was better predicted by RL (AUC 0.809; 67% sensitivity; 26% specificity, 45% PPV; 13% negative predictive value). Conclusion Index ultrasonic parameters show a diagnostic role in different stages of CKD. The index ultrasound and biochemical parameters showed a complementary role in predicting renal dysfunction.

Background In image-assisted volume estimation, the volume of the object is calculated with a formula, using linear measurements of the objects. Since the volume estimation accuracy is thought to be influenced by the shape of the object, the volume estimation error would be related to the calculation formula used. Purpose To evaluate the volume estimation accuracy of selected volume calculation formulae, for different shaped objects. Material and Methods Globular (n = 5), elongated (n = 5), and near-spherical shaped plastic objects (n = 5), filled with water were subjected to ultrasound (US) and computed tomography (CT) in February 2018, to obtain the length, width, depth, and estimated volumes (EV). The volume was calculated manually using prolate, ellipsoid, and Lambert formulae. The actual volume (AV), EV, and calculated volumes were compared. Results The AV was in the range of 10–445 mL. The reliability of measurements was high as assessed by the intra-class variability (Cronbach’s alpha = 0.992). The EV has shown a high correlation to AV (US: ρ = 0.914, P Conclusion The shape of the object and the calculation formula used has an impact on the volume estimation accuracy.

Background Aetiology of chronic kidney disease (CKD) has shown geographical clustering. Renal ultrasound (USS) is used to diagnose CKD, but USS features are known to vary with aetiology of CKD. Objectives To describe aetiological factors and USS features of CKD. Methods Renal USS was performed in diagnosed adult CKD patients (n=100) and a control group (CG) with normal renal function (n=90). Demographic data, associated comorbidities, serum creatinine values, renal length (RL), renal cortical echogenicity, and number of renal cysts were recorded. CKD severity was graded. Results Hypertension (38%) and diabetes (17%) were commonest aetiological factors of CKD. Severity of CKD was as follows: 35% grade 3a, 39% grade 3b, 11% grade 2, and 15% grade 4. Mean RL of CKD group (9.07cm; SD=0.84) was significantly lower (p

Background /ObjectivesBranching pattern of aortic arch (AA) has a direct impact on the outcome of thoracic surgical and angiographic procedures. Geographical variations in the branching pattern of AA has been described. Hence, this descriptive cross sectional study describes the AA variations in a Sri Lankan population compared to the available global statistics.MethodsContrast-enhanced computed tomographic studies (CTC) of thorax (n=219) performed in males (49.3%) and females (50.7%); aged 59±17 years (range: 4 to 96 years), were evaluated. Branching patterns of AA were categorized into seven types as described by Popieluszko et al.ResultsFour AA types were identified in the study population: Type 1 (90%; n=197), Type 2 (n=10, 4.6%), Type 3 (n=8, 3.7%) and Type 6 AA (n=4; 1.8%). The prevalence of AA variations was 10%. Type 1 was the most prevalent pattern in both genders: female-91%; males-88.9%. The most prevalent AA variant in females was Type 2 (n=6; 5.4%); males Type 3 (n=5; 4.6%). However, the branching pattern of AA has not demonstrated a significant gender influence (Odds: 0.792; 95% CI: 0.327 - 1.917; p=0.605). ConclusionVariations in branching pattern of AA is as high as 10% among Sri Lankans. Thus, an in-depth knowledge on population specific prevalence of AA variants would influence the modifications surgical approaches and the choice of angiographic catheters to be utilized, which in turn, would minimize inadvertent vascular injuries during thoracic surgical and angiographic interventions.

Introduction: Chronic kidney disease (CKD) is a global & local health problem. Serum creatinine (Scr) is an indicator of renal function. Ultrasound is a freely available safe, reliable imaging modality, commonly used to assess kidneys in CKD. Association of renal length and Scr in CKD is evaluated in this study, as such data is lacking for Sri Lankan population. Methodology: A descriptive cross sectional observational study was conducted at the Radiology Unit of the Base Hospital Tissamaharama from March to August 2017 (as a preliminary study of a large ongoing study), using 41 patients with normal Scr (control group) and 74 patients diagnosed with CKD. The Scr values done within the last three months were evaluated. Absolute renal length was measured ultrasonically by an experienced Radiologist, who was blind to the patient’s serum creatinine value, with Mind-ray ultra sound scanner. Results: Study population (n=115) consists of control group (n=41) and CKD patients (n=74) where 40% were females and 60% of were males. Mean age was 58.3 years & mean renal length in control group was 9.6cm and CKD group was 9.0 cm. A significant difference observed in renal length in control and CKD groups (

Background Volume estimation of organs using two-dimensional (2D) ultrasonography is frequently warranted. Considering the influence of estimated volume on patient management, maintenance of its high accuracy is empirical. However, data are scarce regarding the accuracy of estimated volume of non-globular shaped objects of different volumes. Purpose To evaluate the volume estimation accuracy of different shaped and sized objects using high-end 2D ultrasound scanners. Material and Methods Globular (n=5); non-globular elongated (n=5), and non-globular near-spherical shaped (n=4) hollow plastic objects were scanned to estimate the volumes; actual volumes were compared with estimated volumes. T-test and one-way ANOVA were used to compare means; PResults The actual volumes of the objects were in the range of 10–445 mL; estimated volumes ranged from 6.4–425 mL ( P=0.067). The estimated volume was lower than the actual volume; such volume underestimation was marked for non-globular elongated objects. Regardless of the scanner, the highest volume estimation error was for non-globular elongated objects (Conclusion The 2D ultrasonography can be recommended for volume estimation purposes of different shaped and different sized objects, regardless the type of the high-end scanner used.

Irritability and crying are common modes of presentations of diseases in infancy. We had a very rare encounter of an infant presenting with non-specific clinical features caused by cholidocholithiasis that underwent spontaneous resolution within couple of days of onset of symptoms. Systematic analysis of clinical features and judicial use of imaging would often help identification of rare pathologies in this age group such as cholidocholithiasis as seen in this baby.

Introduction: Renal sizes are of immense use to diagnose renal pathologies. As ethnic variations are known to influence renal sizes, we aimed to assess the ethnic variations in bipolar renal length (RL) and kidney to body height ratio (KBR) of a young adult Sri Lankan population. Methods: Healthy adults were recruited, by excluding subjects with previous renal surgeries, renal diseases, or other chronic illnesses. Bilateral RLs were measured sonographically. Results: The study sample consisted of 215 individuals (100 females) with an age range of 19-36 years (mean age=24 years). Mean right RL was 9.77±0.78cm; mean left RL was 10.16±0.83cm; mean KBR of the right kidney was 0.60±0.05mm/cm and left kidney was 0.63±0.05mm/cm. Right and left RLs and KBRs of males were 9.82±0.76cm; 10.3±0.78cm and 0.59±0.05mm/cm; 0.62±0.05mm/cm respectively and same parameters in females were 9.71±0.8cm; 10.0±0.9cm and 0.62±0.05mm/cm; 0.64±0.05mm/cm respectively. Irrespective of gender, left RL and KBR were higher than those of the right side (p Conclusions: This preliminary study can be considered as the first step in establishing age and gender specific reference values for RL and KBR for a Sri Lankan population. Due to ethnic variations, accuracy of using renal nomograms from other populations as reference values raises serious concerns.

Kidney to body height ratio (KBR) is considered as a better parameter compared to absolute renal length (RL) in renal size evaluation. Ethnic variations are described for renalsizes. Studies pertaining to renal length are scares for Sri Lankan population. Current study was conducted to evaluate RL and KBR for a group of Sri Lankan adults.

Ultrasonographically measured renal cortical echogenicity (RCE) is known to increase in chronic kidney disease (CKD) and of value in predicting the degree of renal function impairment. Renal function is routinely assessed by serum creatinine levels (Scr) and estimated glomerular filtration rate (eGFR). The aim of the study was to evaluate the association of RCE with Scr and eGFR in CKD subjects.

Dengue infection (DF) is a mosquito born endemic disease with rising trend in Sri Lanka. Diagnosis of DF is clinical, supported by investigations. The phase of illness, warning signs, hydration and hemodynamic status of the patient determine the need for hospitalization and fluid management. Fluid management is crucial in prognosis. Ultrasonography (USG) is empirical to arrive at management decisions; exact role of USG is reviewed in this article. Gall bladder wall thickening (GBWT) and pericholecystic fluid are early and consistent sonographic features of dengue haemorrhagic fever, whilst hepatomegaly, splenomegaly, pleural effusions and pericardial effusions are the other features. Among various morphological appearances of GBWT, “honey comb” and “reticular” patterns are most frequent in severe DF. Morphology of GBWT is positively correlated to the disease progression and recovery, thus considered to be a useful sonographic signs in predicting the disease progression. Plasma leakage in DF is frequently depreciated by measuring the ascetic fluid volume, hence not recommended to use as a guideline in fluid management. USS measured inferior vena cava diameter (IVCd) and inferior venacava collapsibility index (IVC-CI) are of value in assessing intra vascular fluid volume. Calculation of IVC-CI is possible with “(IVCdmax − IVCdmin)/IVCdmax” formula. Even though, the liver involvement in DF is yet to be understood, hepatomegaly with elevated liver enzymes are the commonest manifestations. Liver involvement in DF could be ranged from mild transient liver cell dysfunction to acute fulminant hepatic failure. Bleeding tendency in DF, limits histopathological evaluation of the liver, hence pathogenesis is poorly understood. Future non invasive (sonographic) studies would be of value in the liver assessment. Further studies are recommended to assess IVC-CI pertaining to the volume status and patient outcome to postulate new fluid management guidelines.