Lovleen Satija - Academia.edu (original) (raw)

Papers by Lovleen Satija

PubMed, Sep 1, 2000

Objectives: Hypofunctioning benign cystic thyroid nodules are a common occurrence in iodine defic... more Objectives: Hypofunctioning benign cystic thyroid nodules are a common occurrence in iodine deficient region. There are reports of resolution of recurrent thyroid cysts with tetracycline instillation. Hence we conducted a study in 20 patients with hypofunctioning benign cystic thyroid nodules to document response to intracystic instillation of tetracycline as a primary modality of treatment. Methods: Twenty patients were thoroughly investigated for the presence of malignancy clinically, radiologically and cytologically. One milliliter of tetracycline was instilled under ultrasonographic guidance. Response to therapy was assessed clinically and ultrasonographically at one, three, six and 12 months. Results: Study group comprised of five male and 15 female patients with mean age 30 +/- 8 years. Initial mean volume of nodules was 15 +/- 7 ml (6 to 27 ml), which was decreased to 3 +/- 3 ml at one month, 2 +/- 3 ml at three months, and 1 +/- 2 ml at six months. Maximum number of patients (75%) responded within three months, however two patients required reaspiration and reinstallation of tetracycline. Ultrasonography revealed fibrotic scar as thick wall with internal echodensities in six patients (30%) six month after sclerotherapy. There was high rate of patient satisfaction, as cosmetically tetracycline did not leave any scar, which was unavoidable with surgery. Six patients (30%) reported mild pain after injection, and one patient developed redness at the site of injection. Conclusions: Intracystic tetracycline sclerotherapy is highly effective as primary mode of treatment in hypofunctioning benign cystic thyroid nodule in selected group of patients not at high risk of malignancy.

Medical Journal Armed Forces India, 1999

Medical journal, Armed Forces India, 1999

Medical journal, Armed Forces India, 2000

Transabdominal sonography (TAS) and Transvaginal sonography (TVS) were compared for follicular mo... more Transabdominal sonography (TAS) and Transvaginal sonography (TVS) were compared for follicular monitoring in 73 patients of infertility. These patients were referred for follicular monitoring in normal and stimulated cycles from infertility clinic. Patient compliance and acceptance was excellent for TVS technique as compared to TAS technique. The overall resolution of ovarian and follicular anatomy was much better in TVS. With TAS only 35.6% had good visualisation of follicles as compared to 80.8% (p<0.05) in TVS. TVS offered advantage of much better detection rate of smaller follicles (<10mm) and higher accuracy in assessing number of follicles.

Singapore medical journal, 2008

We report transdiaphragmatic pleural and retroperitoneal metastasis developing two and half years... more We report transdiaphragmatic pleural and retroperitoneal metastasis developing two and half years after resection of invasive thymoma (Masaoka stage III; WHO type B1, lymphocyte-rich) in a 34-year-old man. Post-surgery, he received radiotherapy and chemotherapy. Follow-up computed tomography (CT) one year post-surgery did not reveal any local recurrence or metastasis. He remained asymptomatic throughout. A follow-up CT done two and half years later revealed an enhancing retrocrural-retroperitoneal (posterior pararenal space) soft tissue mass measuring 12 cm x 10 cm x 6 cm. Another enhancing deposit was found in the left pleural space. This lesion was found infiltrating into the subjacent lung. Both these deposits were resected along with wedge resection of the affected subsegment of the lung. Histopathology confirmed these lesions to be metastases from the lymphocyte-rich thymoma.

Clinical Nuclear Medicine, 1995

A pelvic hypervascular blush often creates a diagnostic dilemma during radionuclide abdominal ima... more A pelvic hypervascular blush often creates a diagnostic dilemma during radionuclide abdominal imaging studies in females. This blush is shown to be due to uterine vascularity that is more prominent in the secretory and menstrual phases of the menstrual cycle. Significant uterine vascularity in the earlier phases is inappropriate and may be pathologic. Three such cases are presented in which increased uterine vascularity on radionuclide imaging during the proliferative phase either lead to a diagnosis or supported a clinical finding.

Medical journal, Armed Forces India, 2012

An MRI study was carried out on a 1.5 Tesla scanner (Symphony, Siemens AG, Germany) using T2 weig... more An MRI study was carried out on a 1.5 Tesla scanner (Symphony, Siemens AG, Germany) using T2 weighted (half-Fourier acquisition single shot turbo spin echo [HASTE]; TR 4.3 ms, TE 2.15 ms) and TrueFISP (TR 1000 ms, TE 83 ms) sequences in sagittal, coronal, and axial planes which showed large markedly hyperintense lungs (as compared to foetal skeletal muscle) causing inversion of the diaphragms. The dilated trachea was exquisitely demonstrated as increased signal with a gap at the level of the larynx. The cardiac findings and ascites were also confirmed and no additional anomaly could be demonstrated (Figure 2). Based on ultrasound and MRI findings, diagnosis of CHAOS due to laryngeal atresia was made. The parents were counselled regarding the relatively poor prognosis and the pregnancy was terminated. DISCUSSION Congenital high airway obstruction syndrome is a constellation of findings which arise due to obstruction of the upper airway tract. The causes of obstruction include laryngeal atresia, stenosis or laryngeal cysts, and tracheal atresia or stenosis. 1-3 Cases of CHAOS are sporadic and the exact incidence is not known.

Medical journal, Armed Forces India, 1999

Medical Journal Armed Forces India, 2000

Surgical and Radiologic Anatomy, 2008

Bony metaplasia of the falx cerebri is rare in human being. We describe a case of extensive ossiW... more Bony metaplasia of the falx cerebri is rare in human being. We describe a case of extensive ossiWcation involving anterior half of the falx cerebri in a 47-year-old male. This was detected incidentally during computed tomographic examination of the brain for an unrelated cause. The pattern of ossiWcation as demonstrated in the computed tomography scan comprised of dense cortical bone peripherally with medullary bone in the centre resembling the skull vault.

Medical Journal Armed Forces India, 2010

Medical Journal Armed Forces India, 2015

Indian Journal of Urology, 2012

Background: Image quality in an Intravenous Urogram (IVU) can occasionally be compromised by vari... more Background: Image quality in an Intravenous Urogram (IVU) can occasionally be compromised by variables like bowel preparation, renal function and radiographic factors, posing a challenge to all Uroradiologists. The Computerised Tomography Urogram (CTU) yields better diagnostic information than an IVU, due to its inherent superior anatomic delineation and contrast sensitivity, against a trade-off involving radiation dose and cost. Our study was conducted to assess the utility and timing of performing a single-phase CTU, as a problem-solving tool, to clear the diagnostic dilemma in a selected subset of patients, in whom an ongoing IVU could potentially be inconclusive. Material and Methods: Five hundred and twelve patients who underwent IVU studies for urologic referrals at a tertiary care hospital, during the period of January to December 2009, formed the subject of the study, of whom 33 patients with inconclusive IVU findings after the first three radiographs underwent a single-phase CTU, to reach definitive imaging diagnoses. Results: The percentage of inconclusive IVU studies amounted to only 33 / 512 (6.4%), in whom a CTU study revealed definitive diagnoses in 30 patients and no abnormality in three patients, thus conclusively clearing the ambiguities raised on the IVU in all the selected patients. Conclusions: The concept of a CTU limited to a single-phase study to supplement an inconclusive IVU optimizes the contrast and radiation dose to the affected patients. It is a cost-effective, timely, and definitive 'imaging intervention' and should be considered a viable hybrid technique to be utilized selectively and judiciously.

Clinical Imaging, 1993

Foetal tumours are relatively rare; prenatal diagnosis enables additional diagnostics, and thus t... more Foetal tumours are relatively rare; prenatal diagnosis enables additional diagnostics, and thus the decision on the continuation of pregnancy and planning of delivery. The paper presents prenatal ultrasound diagnostics of foetal head tumour with additionally analyzed magnetic resonance imaging (MRI). On ultrasound imaging, in a 27-year-old nullipara, a tumour of the foetal head was suspected at the 22nd gestational week. By consultative ultrasound, a 45 x 41 x 50 mm echogenic soft tissue tumour with hypoechogenic areas was confirmed, which originated from the left side of the skull spreading towards the neck on the left behind the ear. On colour Doppler no vascularisation was seen within the tumour but several vessels were seen along the border-line and on the surface. The scan showed no associated abnormalities. Karyotype was 46, XY. MRI scan using triplanar SSFSE and HASTE sequences was done at 26 weeks and confirmed a 84 x 45 x 71 mm tumour originating from the scalp, spreading along the endocranium over the entire surface of the fronto-temporal sqama and left parietal bone. The tumour did not disturb the integrity of the internal tabula, and did not spread intracranially. Based on these findings, the diagnosis of haemangioma was made. At 38 weeks gestation, a 3810 g male infant was delivered by Caesarean section. A bluish, well-defined, non-pulsatile tumour arising from the left frontoparietal region was seen, thus confirming the diagnosis of haemangioma. MRI improved delineation of the tumour facilitating better planning of postnatal management and mode of delivery, with the information on the postnatal course and prognosis. In the prenatal period, MRI following an ultrasound diagnosed foetal tumour, is an additional part of diagnostic examinations, and is not contraindicated during pregnancy.

BJU International, 2008

was notable; despite this, no pathological levels of insulin Case report and C-peptide were detec... more was notable; despite this, no pathological levels of insulin Case report and C-peptide were detectable. We omitted preoperative CT-guided needle biopsy because Whipple’s triad and the A 60-year-old man presented with RCC of the left kidney and was treated successfully by a transperitoneal nephfindings on CT supported the diagnosis of an insulinoma, because surgery is the treatment of choice for any rectomy in 1989. The histopathological examination revealed a small (2 cm in the greatest dimension) well malignancy of exocrine and endocrine pancreatic tissue, diCerentiated, clear-cell type RCC with microscopic vein involvement. The tumour was resected radically; furthermore, no regional lymph nodes or distant metastases were found. Over a follow-up of 8 years there was no evidence of local recurrence or metastatic disease. The patient began to experience unpredictable episodes of hunger associated with sweating and dizziness in October 1997. During these episodes his blood glucose levels were decreased by up to 300 mg/L. Ultrasonography showed two hypoechoic lesions in the pancreas and subsequent CT of the abdomen showed two hypervascularized well-circumscribed tumours in the body (1.5 cm) and in the tail (2.3 cm) of the pancreas (Fig. 1). However, insulin and C-peptide levels were in the normal range. In January 1998 the patient was admitted to the Department of Surgery. A distal pancreatectomy with splenectomy, combined with a tumour enucleation, was performed after intraoperative ultrasonography. An accurate tumour classification from the intraoperative frozen section was not possible, but the surgical margins were free of tumour. The definitive histopathological specimens revealed two metastases of a clear-cell type RCC (Fig. 2); near these lesions some islet cells showed a moderate hyperplasia. The postoperative course was uneventful. During a 4-month follow-up the patient had no hypoglycaemic attacks and his blood glucose levels remained within the normal range.

Medical Journal Armed Forces India, 2002

Medical Journal Armed Forces India, 2001

Journal of Neurology and Neuroscience, 2016

Introduction: The incidence of neurological complications related to cardiovascular surgeries is ... more Introduction: The incidence of neurological complications related to cardiovascular surgeries is comparatively very high and associated with high morbidity and mortality. The aim of this study is to establish not only the use of non-contrast computed tomography in detecting the cause of neurological problems but also to evaluate the various spectrums of findings associated with various types of cardiovascular surgeries. Method: We retrospectively analyzed all the non-contrast computed tomography head of the postoperative cardio-vascular surgeries patients done in immediate postoperative period (<7days). Result: 45 (6.7%) patients developed neurological complications in the early post-operative period which comprised of our study group. Out of 45 patients, 08 (18%) patients were of pediatric age group ranging who underwent surgeries for congenital complex cardiac disorders. Out of 45 patients presenting with neurological symptoms, 15 (33%) patients had focal deficit (stroke) and 30 (77%) patients had non-focal deficit (like seizure, delirium or cognitive impairment). Stroke patients had more possibility to have positive CT scan findings than NFD. Out of 45 patients, 40 (88%) had positive CT scan findings and five patient had normal NCCT head. The various types of positive CT scan findings were-19 ischemic infarct, 04 intra-parenchymal hemorrhages, 17 subdural hemorrhage, 03 sub-arachnoid hemorrhage and 01 cerebro-vascular thrombosis. Conclusion: Non-contrast computed tomography of head is very useful in early postoperative neurological complication in cardio-vascular surgeries not only in diagnosing the complication but also managing accordingly.

PubMed, Sep 1, 2000

Objectives: Hypofunctioning benign cystic thyroid nodules are a common occurrence in iodine defic... more Objectives: Hypofunctioning benign cystic thyroid nodules are a common occurrence in iodine deficient region. There are reports of resolution of recurrent thyroid cysts with tetracycline instillation. Hence we conducted a study in 20 patients with hypofunctioning benign cystic thyroid nodules to document response to intracystic instillation of tetracycline as a primary modality of treatment. Methods: Twenty patients were thoroughly investigated for the presence of malignancy clinically, radiologically and cytologically. One milliliter of tetracycline was instilled under ultrasonographic guidance. Response to therapy was assessed clinically and ultrasonographically at one, three, six and 12 months. Results: Study group comprised of five male and 15 female patients with mean age 30 +/- 8 years. Initial mean volume of nodules was 15 +/- 7 ml (6 to 27 ml), which was decreased to 3 +/- 3 ml at one month, 2 +/- 3 ml at three months, and 1 +/- 2 ml at six months. Maximum number of patients (75%) responded within three months, however two patients required reaspiration and reinstallation of tetracycline. Ultrasonography revealed fibrotic scar as thick wall with internal echodensities in six patients (30%) six month after sclerotherapy. There was high rate of patient satisfaction, as cosmetically tetracycline did not leave any scar, which was unavoidable with surgery. Six patients (30%) reported mild pain after injection, and one patient developed redness at the site of injection. Conclusions: Intracystic tetracycline sclerotherapy is highly effective as primary mode of treatment in hypofunctioning benign cystic thyroid nodule in selected group of patients not at high risk of malignancy.

Medical Journal Armed Forces India, 1999

Medical journal, Armed Forces India, 1999

Medical journal, Armed Forces India, 2000

Transabdominal sonography (TAS) and Transvaginal sonography (TVS) were compared for follicular mo... more Transabdominal sonography (TAS) and Transvaginal sonography (TVS) were compared for follicular monitoring in 73 patients of infertility. These patients were referred for follicular monitoring in normal and stimulated cycles from infertility clinic. Patient compliance and acceptance was excellent for TVS technique as compared to TAS technique. The overall resolution of ovarian and follicular anatomy was much better in TVS. With TAS only 35.6% had good visualisation of follicles as compared to 80.8% (p<0.05) in TVS. TVS offered advantage of much better detection rate of smaller follicles (<10mm) and higher accuracy in assessing number of follicles.

Singapore medical journal, 2008

We report transdiaphragmatic pleural and retroperitoneal metastasis developing two and half years... more We report transdiaphragmatic pleural and retroperitoneal metastasis developing two and half years after resection of invasive thymoma (Masaoka stage III; WHO type B1, lymphocyte-rich) in a 34-year-old man. Post-surgery, he received radiotherapy and chemotherapy. Follow-up computed tomography (CT) one year post-surgery did not reveal any local recurrence or metastasis. He remained asymptomatic throughout. A follow-up CT done two and half years later revealed an enhancing retrocrural-retroperitoneal (posterior pararenal space) soft tissue mass measuring 12 cm x 10 cm x 6 cm. Another enhancing deposit was found in the left pleural space. This lesion was found infiltrating into the subjacent lung. Both these deposits were resected along with wedge resection of the affected subsegment of the lung. Histopathology confirmed these lesions to be metastases from the lymphocyte-rich thymoma.

Clinical Nuclear Medicine, 1995

A pelvic hypervascular blush often creates a diagnostic dilemma during radionuclide abdominal ima... more A pelvic hypervascular blush often creates a diagnostic dilemma during radionuclide abdominal imaging studies in females. This blush is shown to be due to uterine vascularity that is more prominent in the secretory and menstrual phases of the menstrual cycle. Significant uterine vascularity in the earlier phases is inappropriate and may be pathologic. Three such cases are presented in which increased uterine vascularity on radionuclide imaging during the proliferative phase either lead to a diagnosis or supported a clinical finding.

Medical journal, Armed Forces India, 2012

An MRI study was carried out on a 1.5 Tesla scanner (Symphony, Siemens AG, Germany) using T2 weig... more An MRI study was carried out on a 1.5 Tesla scanner (Symphony, Siemens AG, Germany) using T2 weighted (half-Fourier acquisition single shot turbo spin echo [HASTE]; TR 4.3 ms, TE 2.15 ms) and TrueFISP (TR 1000 ms, TE 83 ms) sequences in sagittal, coronal, and axial planes which showed large markedly hyperintense lungs (as compared to foetal skeletal muscle) causing inversion of the diaphragms. The dilated trachea was exquisitely demonstrated as increased signal with a gap at the level of the larynx. The cardiac findings and ascites were also confirmed and no additional anomaly could be demonstrated (Figure 2). Based on ultrasound and MRI findings, diagnosis of CHAOS due to laryngeal atresia was made. The parents were counselled regarding the relatively poor prognosis and the pregnancy was terminated. DISCUSSION Congenital high airway obstruction syndrome is a constellation of findings which arise due to obstruction of the upper airway tract. The causes of obstruction include laryngeal atresia, stenosis or laryngeal cysts, and tracheal atresia or stenosis. 1-3 Cases of CHAOS are sporadic and the exact incidence is not known.

Medical journal, Armed Forces India, 1999

Medical Journal Armed Forces India, 2000

Surgical and Radiologic Anatomy, 2008

Bony metaplasia of the falx cerebri is rare in human being. We describe a case of extensive ossiW... more Bony metaplasia of the falx cerebri is rare in human being. We describe a case of extensive ossiWcation involving anterior half of the falx cerebri in a 47-year-old male. This was detected incidentally during computed tomographic examination of the brain for an unrelated cause. The pattern of ossiWcation as demonstrated in the computed tomography scan comprised of dense cortical bone peripherally with medullary bone in the centre resembling the skull vault.

Medical Journal Armed Forces India, 2010

Medical Journal Armed Forces India, 2015

Indian Journal of Urology, 2012

Background: Image quality in an Intravenous Urogram (IVU) can occasionally be compromised by vari... more Background: Image quality in an Intravenous Urogram (IVU) can occasionally be compromised by variables like bowel preparation, renal function and radiographic factors, posing a challenge to all Uroradiologists. The Computerised Tomography Urogram (CTU) yields better diagnostic information than an IVU, due to its inherent superior anatomic delineation and contrast sensitivity, against a trade-off involving radiation dose and cost. Our study was conducted to assess the utility and timing of performing a single-phase CTU, as a problem-solving tool, to clear the diagnostic dilemma in a selected subset of patients, in whom an ongoing IVU could potentially be inconclusive. Material and Methods: Five hundred and twelve patients who underwent IVU studies for urologic referrals at a tertiary care hospital, during the period of January to December 2009, formed the subject of the study, of whom 33 patients with inconclusive IVU findings after the first three radiographs underwent a single-phase CTU, to reach definitive imaging diagnoses. Results: The percentage of inconclusive IVU studies amounted to only 33 / 512 (6.4%), in whom a CTU study revealed definitive diagnoses in 30 patients and no abnormality in three patients, thus conclusively clearing the ambiguities raised on the IVU in all the selected patients. Conclusions: The concept of a CTU limited to a single-phase study to supplement an inconclusive IVU optimizes the contrast and radiation dose to the affected patients. It is a cost-effective, timely, and definitive 'imaging intervention' and should be considered a viable hybrid technique to be utilized selectively and judiciously.

Clinical Imaging, 1993

Foetal tumours are relatively rare; prenatal diagnosis enables additional diagnostics, and thus t... more Foetal tumours are relatively rare; prenatal diagnosis enables additional diagnostics, and thus the decision on the continuation of pregnancy and planning of delivery. The paper presents prenatal ultrasound diagnostics of foetal head tumour with additionally analyzed magnetic resonance imaging (MRI). On ultrasound imaging, in a 27-year-old nullipara, a tumour of the foetal head was suspected at the 22nd gestational week. By consultative ultrasound, a 45 x 41 x 50 mm echogenic soft tissue tumour with hypoechogenic areas was confirmed, which originated from the left side of the skull spreading towards the neck on the left behind the ear. On colour Doppler no vascularisation was seen within the tumour but several vessels were seen along the border-line and on the surface. The scan showed no associated abnormalities. Karyotype was 46, XY. MRI scan using triplanar SSFSE and HASTE sequences was done at 26 weeks and confirmed a 84 x 45 x 71 mm tumour originating from the scalp, spreading along the endocranium over the entire surface of the fronto-temporal sqama and left parietal bone. The tumour did not disturb the integrity of the internal tabula, and did not spread intracranially. Based on these findings, the diagnosis of haemangioma was made. At 38 weeks gestation, a 3810 g male infant was delivered by Caesarean section. A bluish, well-defined, non-pulsatile tumour arising from the left frontoparietal region was seen, thus confirming the diagnosis of haemangioma. MRI improved delineation of the tumour facilitating better planning of postnatal management and mode of delivery, with the information on the postnatal course and prognosis. In the prenatal period, MRI following an ultrasound diagnosed foetal tumour, is an additional part of diagnostic examinations, and is not contraindicated during pregnancy.

BJU International, 2008

was notable; despite this, no pathological levels of insulin Case report and C-peptide were detec... more was notable; despite this, no pathological levels of insulin Case report and C-peptide were detectable. We omitted preoperative CT-guided needle biopsy because Whipple’s triad and the A 60-year-old man presented with RCC of the left kidney and was treated successfully by a transperitoneal nephfindings on CT supported the diagnosis of an insulinoma, because surgery is the treatment of choice for any rectomy in 1989. The histopathological examination revealed a small (2 cm in the greatest dimension) well malignancy of exocrine and endocrine pancreatic tissue, diCerentiated, clear-cell type RCC with microscopic vein involvement. The tumour was resected radically; furthermore, no regional lymph nodes or distant metastases were found. Over a follow-up of 8 years there was no evidence of local recurrence or metastatic disease. The patient began to experience unpredictable episodes of hunger associated with sweating and dizziness in October 1997. During these episodes his blood glucose levels were decreased by up to 300 mg/L. Ultrasonography showed two hypoechoic lesions in the pancreas and subsequent CT of the abdomen showed two hypervascularized well-circumscribed tumours in the body (1.5 cm) and in the tail (2.3 cm) of the pancreas (Fig. 1). However, insulin and C-peptide levels were in the normal range. In January 1998 the patient was admitted to the Department of Surgery. A distal pancreatectomy with splenectomy, combined with a tumour enucleation, was performed after intraoperative ultrasonography. An accurate tumour classification from the intraoperative frozen section was not possible, but the surgical margins were free of tumour. The definitive histopathological specimens revealed two metastases of a clear-cell type RCC (Fig. 2); near these lesions some islet cells showed a moderate hyperplasia. The postoperative course was uneventful. During a 4-month follow-up the patient had no hypoglycaemic attacks and his blood glucose levels remained within the normal range.

Medical Journal Armed Forces India, 2002

Medical Journal Armed Forces India, 2001

Journal of Neurology and Neuroscience, 2016

Introduction: The incidence of neurological complications related to cardiovascular surgeries is ... more Introduction: The incidence of neurological complications related to cardiovascular surgeries is comparatively very high and associated with high morbidity and mortality. The aim of this study is to establish not only the use of non-contrast computed tomography in detecting the cause of neurological problems but also to evaluate the various spectrums of findings associated with various types of cardiovascular surgeries. Method: We retrospectively analyzed all the non-contrast computed tomography head of the postoperative cardio-vascular surgeries patients done in immediate postoperative period (<7days). Result: 45 (6.7%) patients developed neurological complications in the early post-operative period which comprised of our study group. Out of 45 patients, 08 (18%) patients were of pediatric age group ranging who underwent surgeries for congenital complex cardiac disorders. Out of 45 patients presenting with neurological symptoms, 15 (33%) patients had focal deficit (stroke) and 30 (77%) patients had non-focal deficit (like seizure, delirium or cognitive impairment). Stroke patients had more possibility to have positive CT scan findings than NFD. Out of 45 patients, 40 (88%) had positive CT scan findings and five patient had normal NCCT head. The various types of positive CT scan findings were-19 ischemic infarct, 04 intra-parenchymal hemorrhages, 17 subdural hemorrhage, 03 sub-arachnoid hemorrhage and 01 cerebro-vascular thrombosis. Conclusion: Non-contrast computed tomography of head is very useful in early postoperative neurological complication in cardio-vascular surgeries not only in diagnosing the complication but also managing accordingly.