Publications by authors named "Zohra Ahmad"

8 Publications

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Imaging of Coronavirus Disease 2019 Infection From Head to Toe: A Primer for the Radiologist.

Curr Probl Diagn Radiol 2021 Nov-Dec;50(6):842-855. Epub 2021 Jul 5.

Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India. Electronic address:

Coronavirus Disease 2019 (COVID-19) disease has rapidly spread around the world after initial identification in Wuhan, China, in December 2019. Most common presentation is mild or asymptomatic disease, followed by pneumonia, and rarely- multiorgan failure and Acute Respiratory Distress Syndrome (ARDS). Knowledge about the pathophysiology, imaging and treatment of this novel virus is rapidly evolving due to ongoing worldwide research. Most common imaging modalities utilized during this pandemic are chest radiography and HRCT with findings of bilateral peripheral, mid and lower zone GGO and/or consolidation, vascular enlargement and crazy paving. HRCT is also useful for prognostication and follow-up of severely ill COVID-19 patients. Portable radiography allows follow-up of ICU patients & obviates the need of shifting critically ill patients and disinfection of CT room. As the pandemic has progressed, numerous neurologic manifestations have been described in COVID-19 including stroke, white matter hyperintensities and demyelination on MRI. Varying abdominal presentations have been described, which on imaging either show evidence of COVID-19 pneumonia in lung bases or show abdominal findings including bowel thickening and vascular thrombosis. Numerous thrombo-embolic and cardiovascular complications have also been described in COVID-19 including arterial and venous thrombosis, pulmonary embolism and myocarditis. It is imperative for radiologists to be aware of all the varied faces of this disease on imaging, as they may well be the first physician to suspect the disease. This article aims to review the multimodality imaging manifestations of COVID-19 disease in various organ systems from head to toe.
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http://dx.doi.org/10.1067/j.cpradiol.2021.06.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8256677PMC
October 2021

Back to the basics: Study of portable chest radiographic findings in 116 COVID-19 positive patients in an Indian tertiary care hospital.

Indian J Radiol Imaging 2021 Jan 23;31(Suppl 1):S148-S153. Epub 2021 Jan 23.

Department of Radiology, Gauhati Medical College, Guwahati, Assam, India.

Context: Paucity of literature of portable CXR findings in COVID-19.

Aims: Evaluate radiographic findings in COVID-19 patients and calculate sensitivity of radiographs with RT-PCR as gold standard.

Subjects And Methods: Total 116 COVID-19 patients underwent portable CXR between April-June, 2020. Two radiologists reviewed radiographs with respect to laterality, craniocaudal, mediolateral distribution, shape, density, unifocality/multifocality and number of lung zones. Sensitivity of radiography was calculated with RT-PCR as gold standard.

Statistical Analysis Used: IBM SPSS Statistics Subscription software (IBM, New York, USA).

Results: Many patients 67.2% (78/116) were asymptomatic. Cough (21.5%, 25/116) and fever (17.6%, 20/116) were the most frequent symptoms. 36.2% (42/116) patients revealed COVID-19 pneumonia-like abnormalities on CXR. Sensitivity of CXR with RT-PCR as gold standard was 36.2% (CI: Confidence interval = 27.46% - 44.95%). More patients in symptomatic group (68.4%, 26/38) had abnormal CXR compared to asymptomatic group (20.5%, 16/78) [ < 0.0001]. Radiographs revealed both unilateral (57.1%, 24/42), bilateral (42.8%, 18/42), GGO (80.9%, 34/42), or consolidation (11/42, 26.1%) in a middle (57.1%, 24/42), lower zone (83.3%, 35/42) and peripheral distribution (78.5%, 33/42). Lesions were commonly patchy (88%, 37/42) and multifocal (59.5%, 25/42). Majority had single (40.4%, 17/42) or two zone (35.7%, 15/42) involvement.

Conclusions: Significant number of COVID-19 patients were asymptomatic. Over 1/3 of patients showed radiographic abnormalities. Symptomatic patients were more likely to show radiographic findings than asymptomatic patients. If radiographs identify pneumonia in appropriate clinical setting, CT can be avoided. Common radiographic abnormalities among COVID 19 patients were bilateral/unilateral, patchy, multifocal, ground glass opacity or consolidation in peripheral and middle/lower zone distribution.
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http://dx.doi.org/10.4103/ijri.IJRI_550_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996702PMC
January 2021

Imaging spectrum of pulmonary infections in renal transplant patients.

Indian J Radiol Imaging 2020 Jul-Sep;30(3):273-279. Epub 2020 Oct 15.

Department of Radiology, AIIMS, Ansari Nagar, New Delhi, India.

In the post renal transplant setting, pulmonary infections comprise an important set of complications. Microbiological diagnosis although specific is often delayed and insensitive. Radiography is the most common and first imaging test for which patient is referred, however it is relatively insensitive. HRCT is a very useful imaging tool in the scenario where radiography is negative or inconclusive and high clinical suspicion for infection is present. HRCT features vary among the various pathogens and also depend on the level of immunocompromise. Certain HRCT findings are characteristic for specific pathogens and may help narrow diagnosis. In this review article, we will summarize the imaging findings of various pulmonary infections encountered in post renal transplant patients.
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http://dx.doi.org/10.4103/ijri.IJRI_357_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694710PMC
October 2020

Successful endovascular treatment of spontaneous intrarenal pseudoaneurysm in a case of tuberous sclerosis.

Radiol Case Rep 2020 Dec 13;15(12):2632-2636. Epub 2020 Oct 13.

Department of Radiodiagnosis, Gauhati Medical College and Hospital, Guwahati, Assam, 781032 India.

Tuberous sclerosis is a complex disorder which has multisystem involvement and varied clinical manifestations. Almost half of the patients have associated angiomyolipoma which contains fat, vascular and smooth muscle components. Spontaneous pseudoaneurysm formation is a complication of angiomyolipoma. Here we present a case of a female child presenting with hematuria who after thorough clinical and radiological investigations was diagnosed as a case of tuberous sclerosis with right intrarenal pseudoaneurysm. She was successfully treated with endovascular coil embolization.
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http://dx.doi.org/10.1016/j.radcr.2020.10.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7566084PMC
December 2020

Dual energy computed tomography: a novel technique for diagnosis of gout.

Int J Rheum Dis 2016 Sep 29;19(9):887-96. Epub 2016 Apr 29.

Departments of and Biostatistics, All India Institute of Medical Sciences, New Delhi, India.

Aim: To evaluate the sensitivity and specificity of dual energy computed tomography (DECT) for diagnosing gout compared with a composite gold standard (CGS) comprising joint aspiration and/or American College of Rheumatology clinico-radiographic criteria.

Methods: Ninety patients of suspected gout underwent radiography and DECT of bilateral feet and knees. Radiographs and non-contrast CT (NCCT) were assessed for morphological characteristics, following which DECT was used to identify urate deposits.

Results: With CGS as a reference (n = 90), sensitivity of radiographs was 15% (95% confidence interval [CI]: 6-27%) while specificity was 100% (95% CI: 90-100%). Sensitivity of NCCT was 26% (95% CI: 15-40%) while specificity was 97% (95% CI: 85-99%). Sensitivity of DECT was 82% (95% CI: 68-90%) while specificity was 89% (95% CI: 73-96%). Fifty-five patients underwent joint aspiration. Sensitivity and specificity of radiographs and NCCT with aspiration as a reference (n = 55) were not much different from that of CGS. However, DECT showed a higher sensitivity of 100% (95% CI: 86-100%) and a lower specificity of 48% (95%CI: 28-68%) with aspiration alone.

Conclusions: Dual energy computed tomography had higher sensitivity compared to conventional imaging with CGS as a reference; however, its specificity dropped with aspiration as a reference. It may be a useful adjunct for the diagnosis of gout, especially in the acute and inter-critical stage.
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http://dx.doi.org/10.1111/1756-185X.12874DOI Listing
September 2016

Multimodality imaging of renal inflammatory lesions.

World J Radiol 2014 Nov;6(11):865-73

Chandan J Das, Zohra Ahmad, Sanjay Sharma, Arun K Gupta, Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, Delhi 110029, India.

Spectrum of acute renal infections includes acute pyelonephritis, renal and perirenal abscesses, pyonephrosis, emphysematous pyelonephritis and emphysematous cystitis. The chronic renal infections that we routinely encounter encompass chronic pyelonephritis, xanthogranulomatous pyelonephritis, and eosinophilic cystitis. Patients with diabetes, malignancy and leukaemia are frequently immunocompromised and more prone to fungal infections viz. angioinvasive aspergillus, candida and mucor. Tuberculosis and parasitic infestation of the kidney is common in tropical countries. Imaging is not routinely indicated in uncomplicated renal infections as clinical findings and laboratory data are generally sufficient for making a diagnosis. However, imaging plays a crucial role under specific situations like immunocompromised patients, treatment non-responders, equivocal clinical diagnosis, congenital anomaly evaluation, transplant imaging and for evaluating extent of disease. We aim to review in this article the varied imaging spectrum of renal inflammatory lesions.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241493PMC
http://dx.doi.org/10.4329/wjr.v6.i11.865DOI Listing
November 2014

Herlyn-Werner-Wunderlich syndrome presenting with infertility: Role of MRI in diagnosis.

Indian J Radiol Imaging 2013 Jul;23(3):243-6

Department of Radiology, All India Institute of Medical Sciences, New Delhi, India.

Herlyn-Werner-Wunderlich syndrome (HWWS), characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis, is an uncommon combined Mullerian and mesonephric duct anomaly, and its presentation in adulthood is even rarer. We report here a 22-year-old female presenting with primary infertility where magnetic resonance imaging (MRI) suggested the diagnosis of HWWS with endometriosis. In a patient of infertility with endometriosis and unilateral renal agenesis, diagnosis of HWWS should be suspected and MRI is the investigation of choice for such anomalies.
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http://dx.doi.org/10.4103/0971-3026.120283DOI Listing
July 2013

Hyperphosphatemic tumoral calcinosis.

BMJ Case Rep 2013 May 3;2013. Epub 2013 May 3.

Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.

Tumoral calcinosis (TC) is a rare locally aggressive lesion characterised by extra-articular soft tissue deposition of the calcium phosphate around large joints. The exact aetiology is not known. A 19-year-old boy presented with a painful progressive swelling around the bilateral elbow and left hip joints over a 6-month duration. Routine laboratory results showed a normal haemogram, and normal calcium and high phosphate levels. Imaging showed a soft tissue calcified mass around these joints. The cut surface of the excised mass showed myxoid material with areas of calcification. On microscopy, there were typical features of TC. Our case is being presented due to the rarity of the entity and the peculiar dual energy CT (DECT) finding which are being described for the first time in this pathology.
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http://dx.doi.org/10.1136/bcr-2013-008728DOI Listing
May 2013
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