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Introduction: A stroke, also known as a cerebrovascular accident, is the sudden onset of a neurological deficit caused by a focal vascular cause. It is one of the leading causes of morbidity and mortality worldwide. Most cases of cerebrovascular disorders are caused by lesions of the extracranial carotid arteries, particularly the internal carotid artery near the bifurcation. To prevent or reduce morbidity and mortality from stroke, it is critical to provide early diagnosis and treatment. The primary reason for extracranial Doppler examination is stroke prevention. Colour Doppler sonography is a sensitive method for detecting atherosclerotic plaque and provides information on the extent and severity of the plaque as well as the resulting narrowing of the arterial lumen. Aim And Objectives: To evaluate the role of carotid Doppler ultrasonography in patients presenting with acute ischemic stroke and to determine the association between carotid artery stenosis and risk factors such as diabetes mellitus, hypertension, hyperlipidemia, smoking and age. Materials And Methods: The present study was conducted on 100 patients. MRI scan was done to diagnose acute ischemic stroke in patients who presented to emergency medicine with symptoms of acute ischemic stroke. Retrospectively CIMT and plaque characterization were done by gray scale ultrasound. Site and severity of stenosis were assessed on colour Doppler. All these findings were correlated with clinical presentation and risk factors. The collected data was statistically analyzed using SPSS 16.0 version software. Results: A total of 100 patients were examined by color Doppler sonography and out of these 58 showed carotid artery disease. 26 patients had unilateral involvement while 32 patients had bilateral involvement of carotid vasculature. In our study 42% patients had normal ipsilateral ICA on color Doppler imaging. 5% patients total occlusion of ipsilateral ICA. 32% patients had <50% stenosis, 13% patients had 50-69% stenosis and 7% patients had >70% stenosis of ipsilateral side ICA. Conclusion: Color Doppler examination is a non-invasive, cost-effective, safe, reproducible, and time-saving method of identifying the root cause of cerebrovascular insufficiency in the extracranial carotid artery system and will aid in determining the best management option.

Introduction: Perianal fistula is a common clinical problem with considerable morbidity. Accurate preoperative assessment of the perianal fistulous tract determines the success of the surgery. Magnetic resonance imaging fistulography is a non-invasive, safe, and accurate imaging modality. The success of surgery and the likelihood of recurrence are now determined to a great extent by radiographic imaging (including fistulography, computed tomography, endoanal ultrasound imaging, and magnetic resonance imaging) of the complete fistulous tract, ramifications, and related collections. Difficulties in assessing tracts may lead to unsuccessful \"blind\" attempts at tract delineation during surgery. These attempts may result in the failure of surgery with high recurrence rate. Objectives: Main aim of the study is to classify perianal fistulae according to SJUHS classification, and to correlate MR Fistulography evaluation with per operative finding. Methodology: MR fistulography was done in 40 patients over a period of 12 months (June 2021 and November 2022). The sensitivity of MR fistulography is calculated by taking intra operative findings as the gold standard, to be 92%, with permissible error = 10%, Results: In the present study, during a period of 12 months, 40 patients were evaluated with MR fistulography. It was found to be highly sensitive in identifying the internal opening of fistula and secondary tracts, abscess formation. Most common was grade 1 in 22 patients, the remaining were equally distributed in grades II, III, and IV. Commonest internal opening was at 4- 6 O’ clock position. MRI findings were concordant with surgical findings in 37 patients. Conclusions: When compared to operative observations, MR fistulography has become the imaging technique of choice for preoperative evaluation of perianal fistulas. It offers a highly accurate, quick, non-invasive way to perform fistula assessment prior to surgery and is highly sensitive in the detection of the primary tract, internal opening, secondary tract, abscess, and horseshoe extension.

Background: Osteoarthritis (OA) of the knee poses a significant burden on global healthcare systems due to its prevalence and associated morbidity. Early detection and intervention are crucial for managing the progression of this degenerative joint disease. T2 mapping, a magnetic resonance imaging (MRI) technique, has emerged as a promising tool for assessing the biochemical composition and structural integrity of articular cartilage. A comprehensive review of literature establishes the rationale for employing T2 mapping in the context of OA pathophysiology. Objectives: This study aims to investigate the utility of T2 mapping in evaluating early-stage knee OA by comparing T2 values in patients with early OA changes and no OA. Methods: This study was conducted following approval from the institute\'s regulatory and ethics committees in 60 patients referred from the orthopedics department with clinical symptoms of osteoarthritis (OA) and those without clinical or radiological evidence of OA. Study was done on a 1.5 Tesla MRI scanner with a 8 -channel knee coil. T2 color maps were generated using default software settings and measured in 12 regions manually. Cartilage thickness analysis across knee compartments was done in axial, sagittal and coronal PDFS images. Results &Discussion: IBM SPSS Statistics version 29.0 was used for data analysis. Statistical analysis using the unpaired t-test revealed a statistically significant increase in average T2 values (P = 0.0005) in early OA patients compared to controls without OA. Cartilage thickness analysis across knee compartments showed no significant differences between OA patients and controls without OA. These findings underscore MR T2 mapping\'s potential to detect early cartilage matrix degeneration in OA, despite similar cartilage thickness between groups. Conclusion: The findings from this study contribute to enhancing our understanding of the early biochemical changes in knee cartilage associated with OA progression. In conclusion, this thesis advocates for the integration of T2 mapping into clinical practice as a valuable adjunct to conventional imaging techniques for diagnosing and managing early osteoarthritis of the knee.

Objective: To evaluate MRI\\\'s effectiveness in detecting malignant ovarian neoplasms and differentiating them from benign lesions, using histopathological findings as the gold standard. Methodology: A descriptive study with diagnostic test evaluation was conducted on 50 female patients referred for MRI evaluation of ovarian lesions at Govt. T. D. Medical College, Alappuzha. MRI findings were compared with histopathology. Ovarian neoplasms were categorized based on morphology. Various criteria for malignancy detection were assessed. Results: Using MRI, positivity for any 5 out of 6 general criteria showed: Sensitivity: 95%, Specificity: 83.33%, Positive Predictive Value: 79.17%, Negative Predictive Value: 96.15%, Accuracy: 88% For 6 out of 6 criteria, specificity and positive predictive value increased to 100%, with slight sensitivity reduction. Adding ancillary criteria had minimal impact. Subcategories showed: Cystic/multilocular cystic lesions: Sensitivity: 50%, Specificity: 91.67%, Accuracy: 85.71% Solid-cystic/predominantly solid lesions: Sensitivity: 88%, Specificity: 100%, Accuracy: 92.86% T1 hyperintense lesions: Sensitivity, Specificity, and Accuracy: 100% Conclusion: MRI combined criteria are highly sensitive and specific for detecting malignancy, especially in T1 hyperintense lesions, but less so in cystic ovarian neoplasms. Diffusion restriction and necrosis are strong individual predictors.