SHIVI X-Ray And Ultrasound Centre (SHIVI Imaging Centre), Ambala

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Breast Malignancy and Krukenberg tumor

17/2/2021

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Investigation: Ultrasound Whole Abdomen - female patient referred for abdominal bloating and anorexia

Diagnosis: Breast Malignancy – diagnosed through metastatic ovarian lesions (Krukenberg tumor)

Bilateral ovarian masses with ascitis was seen. Liver showed multiple nodules.
Patient questioned about any lump in her breast - She informed about a longstanding lump which was never evaluated. Screening of the area showed an irregular mass in breast - constellation of the imaging features are confirmative of diagnosis.

Diagnosed by: Dr. Garima Goel
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Krukenberg Tumor
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Breast Mass
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Ischemic Priapism

4/2/2021

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Edematous corpora cavernosa with no flow in cavernosal arteries.

Flow noted in dorsal artery of Penis.


Image Courtesy: Dr Ayush Goel
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Pericarditis

1/1/2021

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Young boy, referred for Ultrasound whole abdomen for Pyrexia of unknown origin.

Abdomen was normal, however Pericardial effusion with septations was noted.

 Diagnosed by: Dr Ayush Goel
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Biliary ascariasis

26/7/2020

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Young female referred for recurrent epigastric pain.

Long echogenic structure with relatively hypoechoic central area in the CBD, highly suggestive of Biliary ascariasis.

Follow up taken: ERCP was later done and worm was removed.


Image Courtesy: Dr Ayush Goel
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Colour Ultrasound - Myth vs Facts

11/10/2019

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Colour Ultrasound – Myth vs Facts

Myth: A coloured ultrasound always has coloured images like yellowish etc which is better than a black and white ultrasound.

Facts: Gray scale is the key to radiological imaging. Coloured images (eg. Yellowish or Pinkish) are actually a change of tint of the gray scale image. See the example below.
Many doctors give a black and white print out on thermal paper roll which discriminates the grey shades better as well as saves time.
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Pinkish Tint
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Yellowish Tint
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True Grey Scale Image
A true coloured ultrasound is imaging of vessels (or of movement of fluid in certain cases eg. Urinary jet in Urinary bladder), where you can see red and blue colours on the ultrasound machine screen, that represent direction of flow. When colour mode is on, any movement will give red and blue colours and the doctor adjusts the technical factors to evaluate the region of interest properly. See the example below.
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True Colour Ultrasound with Doppler Interrogation
In layman terms: When you see red and blue colours in an otherwise black and white image on the machine screen, that’s when your doctor is using colour imaging to evaluate your particular region of interest. Print outs may still be black and white.
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Aberrant Right Subclavian Artery (ARSA)

8/10/2019

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Patient referred for evaluation of Ventriculomegaly.

Ultrasound showed Aberrant Right Subclavian Artery (ARSA) apart from Ventriculomegaly.
Presence of two soft markers highly increase the risk of Trisomy 21 - in this case appx. 80 times. A karyotype is must in such a case.

Image Courtesy: Dr Ayush Goel
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