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Background: Cranial fractures are frequently accompanied by intracranial injuries, which require prompt identification for appropriate management. Non-contrast computed tomography (NCCT) provides rapid assessment of both fracture patterns and associated haemorrhage. Aim: To determine the occurrence and CT characteristics of intracranial haemorrhage in patients with cranial fractures and assess their association with fracture patterns and clinical outcomes. Methods: This hospital-based prospective observational study included 100 patients with CT-confirmed cranial fractures. Demographic and clinical details, including Glasgow Coma Scale (GCS), were recorded. NCCT images were evaluated for fracture type and location, haemorrhage type, anatomical distribution, volume and midline shift. Surgical intervention and in-hospital mortality were documented. Statistical analysis was performed using appropriate tests, with p less than 0.05 considered significant. Results: The mean age was 32.74 ± 14.12 years, and 81% were male. Road traffic accidents accounted for 59% of injuries. Intracranial haemorrhage was detected in 62% of patients. Epidural haematoma was the most common type (53.2%), followed by subdural haematoma (41.9%), cerebral contusion (32.3%), subarachnoid haemorrhage (25.8%) and intraventricular haemorrhage (8.1%). Multiple haemorrhage types coexisted in 50% of affected patients. Haemorrhage volume differed significantly across types (H = 51.55, p less than 0.001). Intracranial haemorrhage was significantly associated with fracture type (p = 0.026). Depressed fractures were associated with cerebral contusions (p = 0.001), while basilar fractures were associated with intraventricular haemorrhage (p = 0.01). Surgical intervention was more frequent in patients with haemorrhage (45.2%; p less than 0.001). Mortality was higher in patients with haemorrhage than without (19.4% vs 2.6%; p = 0.016) and was associated with severe GCS (p less than 0.001). Conclusion: Intracra

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Background: Acute pulmonary embolism (PE) is a life-threatening condition requiring prompt diagnosis and assessment of disease severity. CT pulmonary angiography (CTPA) enables direct visualisation of pulmonary arterial thrombi and evaluation of right ventricular strain and alternative thoracic abnormalities. Aim: To evaluate the role of CTPA in diagnosing acute PE and characterising thrombus distribution, pulmonary arterial obstruction, right ventricular strain and additional thoracic findings. Methods: This retrospective cross-sectional observational study included 120 patients clinically suspected of acute PE who underwent CTPA at a tertiary care centre. CTPA findings were assessed for the presence and anatomical distribution of emboli, Qanadli CT obstruction index (CTOI), CT markers of right ventricular strain and alternative diagnoses. Clinical characteristics and Wells score categories were compared with CTPA findings. Results: PE was detected in 22 patients (18.3%). Among the 98 PE-negative patients, alternative thoracic abnormalities were identified in 70 (71.4%). Dyspnoea, tachycardia, previous deep vein thrombosis or PE, prolonged immobilisation, higher heart rate and lower oxygen saturation were significantly associated with PE. CTPA positivity increased from 3.7% in the low Wells score category to 22.4% in the intermediate and 52.9% in the high category (p<0.001). Segmental involvement (45.5%) and bilateral disease (59.1%) were the predominant patterns. Mean CTOI was 23.7 ± 15.2%. Central PE showed higher CTOI and greater right ventricular strain than peripheral PE. CTOI correlated strongly with the right-to-left ventricular diameter ratio (Spearman’s rₛ=0.951; p<0.001). Conclusion: CTPA provided diagnostic and anatomical characterisation of acute PE, enabled assessment of pulmonary arterial obstruction and right ventricular strain, and identified alternative thoracic abnormalities. Its integration with clinical probability assessment may support compreh

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Background: Placenta accreta spectrum (PAS) disorders are associated with significant maternal morbidity, making antenatal diagnosis essential for appropriate obstetric planning. Ultrasonography, including grayscale and colour Doppler assessment, is the primary imaging modality for evaluating pregnancies at risk. Aim: To evaluate the role of ultrasonography in detecting PAS disorders and assess the diagnostic performance of individual ultrasound markers and the Placenta Accreta Index (PAI). Methods: This hospital-based cross-sectional observational study was conducted in the Department of Radiodiagnosis over 18 months and included 40 pregnant women suspected of having PAS. Transabdominal and, where required, transvaginal grayscale and colour Doppler ultrasonography were performed. Ultrasound findings and PAI were recorded. Intraoperative findings and/or histopathology served as the reference standard. Diagnostic performance was assessed using sensitivity, specificity, predictive values, accuracy and receiver operating characteristic analysis. Results: PAS was confirmed in 34 (85.0%) participants and was not confirmed in six (15.0%). Among grayscale markers, myometrial thinning (82.4%), loss of the retroplacental clear zone (76.5%) and placental lacunae (67.6%) were frequent findings in confirmed PAS. Among Doppler markers, subplacental hypervascularity (67.6%), turbulent lacunar flow (64.7%) and bridging vessels (61.8%) were commonly observed. Overall ultrasonography demonstrated 94.12% sensitivity, 83.33% specificity, 96.97% positive predictive value, 71.43% negative predictive value and 92.50% accuracy. Mean PAI was significantly higher in confirmed PAS than in non-confirmed cases (4.43 ± 2.47 versus 1.50 ± 1.60; p=0.007). PAI also differed significantly across FIGO grades (p=0.002). For predicting PAS, PAI showed an area under the curve of 0.848. Conclusion: Grayscale and colour Doppler ultrasonography demonstrated high diagnostic accuracy for PAS. PAI was associ

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Background: Ovarian tumours exhibit diverse imaging characteristics, and differentiating benign from malignant lesions is essential for appropriate management. Ultrasonography (USG) provides initial morphological assessment, whereas contrast-enhanced computed tomography (CECT) helps evaluate tumour extent and extra-ovarian spread. Aim: To compare USG and CECT in characterising ovarian tumours, identifying imaging features associated with malignancy, and assessing disease extent. Methods: This cross-sectional study included 73 patients with ovarian tumours evaluated at a tertiary care hospital. All patients underwent USG, including colour Doppler assessment, and CECT. Clinical characteristics, serum CA-125 levels, imaging findings, histopathological diagnoses, and FIGO stage were analysed. Imaging findings were compared between benign and malignant tumours, and agreement between USG and CECT was assessed for selected parameters. Results: Of the 73 patients, 48 (65.8%) had malignant tumours, 18 (24.7%) had benign tumours, and seven (9.6%) had borderline tumours. Malignant cases had a mean age of 52.5 ± 11.8 years, and 68.8% were postmenopausal. On USG, solid components, irregular walls, papillary projections, and ascites were observed in 100%, 89.6%, 68.8%, and 85.4% of malignant cases, respectively. High Doppler vascularity scores (3–4) were present in 93.8%. CECT demonstrated heterogeneous or intensely heterogeneous enhancement in 91.7% and necrosis in 58.3%. Omental involvement, peritoneal deposits, and lymphadenopathy occurred in 68.8%, 56.2%, and 54.2%, respectively. Advanced-stage disease (FIGO III–IV) accounted for 60.4% of malignant cases. USG and CECT showed strong correlation for tumour size (r = 0.988). Conclusion: USG and CECT provide complementary information for ovarian tumour characterisation and assessment of disease extent. Their combined use may support preoperative evaluation and treatment planning, with histopathology remaining essential for defini

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Background: Non-traumatic acute abdomen is a common emergency presentation requiring timely diagnosis to guide appropriate treatment. Clinical assessment alone may not reliably identify the underlying pathology, making imaging essential. Aim: To evaluate the utilisation of ultrasonography (USG) and computed tomography (CT) in the assessment of non-traumatic acute abdomen among adults and compare their diagnostic accuracy and contribution to management. Methods: This prospective observational study included 90 adult patients presenting with non-traumatic acute abdomen. Clinical findings and admission diagnoses were recorded. All patients underwent USG and CT evaluation, and imaging findings were compared with the final diagnosis and, where available, operative findings. Diagnostic accuracy and changes in management following imaging were assessed. Results: The mean age of participants was 42.1 ± 14.2 years, and 62.2% were male. Acute appendicitis was the most common final diagnosis (25.6%), followed by intestinal obstruction and ureteric colic/urolithiasis (13.3% each). The admission clinical diagnosis was correct in 54.4% of cases. Overall diagnostic accuracy was 85.6% for USG and 95.6% for CT; the difference was not statistically significant (p=0.052). Among patients with operative findings, diagnostic concordance was 87.0% for USG and 96.3% for CT. USG was sufficient to guide management in 62.2% of patients, whereas CT altered the management plan in 37.8% and helped avert potentially unnecessary surgery in 11.1%. USG findings were equivocal in 10.0% of cases, while CT findings were indeterminate in 4.4% in the present study. Conclusion: USG is a useful initial investigation for adult patients with non-traumatic acute abdomen, while CT provides additional diagnostic clarity and influences management when further evaluation is required. A selective, sequential imaging approach may support appropriate clinical decision-making.

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Background: Thyroid nodules are common clinical findings, and differentiating benign from malignant lesions is essential for appropriate management. Conventional ultrasonography (USG) is widely used, while strain elastography provides additional information regarding tissue stiffness. Aim: To compare the diagnostic performance of conventional USG, strain elastography, and their combined approach in differentiating benign from malignant thyroid nodules. Materials and Methods: This observational, cross-sectional study included 66 patients with thyroid nodules evaluated at a tertiary care hospital. Conventional USG assessed nodule morphology, echogenicity, margins, shape, echogenic foci, and vascularity, with classification according to ACR TI-RADS. Strain elastography was performed using Rago elasticity scores and strain-ratio measurements. Fine-needle aspiration cytology, supplemented by histopathology where available, served as the reference standard. Diagnostic performance was assessed using sensitivity, specificity, predictive values, accuracy, and receiver operating characteristic analysis. Results: Of the 66 patients, 54 (81.8%) had benign nodules and 12 (18.2%) had malignant nodules. Suspicious sonographic features and higher ACR TI-RADS categories were significantly associated with malignancy (p < 0.001). The mean strain ratio was significantly higher in malignant than benign nodules (4.92 ± 1.05 versus 1.82 ± 0.87; p < 0.001). The strain-ratio cut-off of 2.80 yielded an area under the curve of 0.982, with 100% sensitivity and 88.89% specificity. Diagnostic accuracy was 80.30% for USG, 89.39% for elastography, and 92.42% for the combined approach. Conclusion: Strain elastography improved diagnostic performance compared with conventional USG alone. Their combined assessment demonstrated the highest observed accuracy and specificity, suggesting complementary value in thyroid nodule characterization. Larger prospective studies are required to validate these findi

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Background: Peripheral arterial disease (PAD) is a common complication of diabetes mellitus and contributes to impaired wound healing and diabetic foot complications. Colour Doppler ultrasonography provides anatomical and haemodynamic information about lower-limb arteries, while the ankle–brachial index (ABI) is a commonly used screening tool. Aim: To evaluate Colour Doppler findings in patients presenting with diabetic foot, assess the distribution and severity of lower-limb arterial disease, examine its association with Wagner grade, and compare Doppler findings with ABI. Materials and Methods: This hospital-based cross-sectional observational study included 150 patients with diabetic foot attending the Department of Radiodiagnosis at a tertiary-care hospital. Bilateral lower-limb arterial assessment was performed using B-mode, colour-flow and spectral Doppler ultrasonography. Arterial stenosis, waveform patterns and haemodynamic parameters were evaluated. ABI findings were compared with Colour Doppler findings, and associations with clinical variables were analysed. Results: The mean age was 57.3 ± 10.4 years, and 64% of participants were male. Colour Doppler identified PAD in 84 patients (56%). Distal arteries, particularly the dorsalis pedis and posterior tibial arteries, demonstrated substantial stenotic involvement. Dorsalis pedis artery stenosis increased significantly with Wagner grade. Conclusion: Colour Doppler ultrasonography identified PAD in 56% of patients with diabetic foot, with substantial distal arterial involvement. It demonstrated significant associations between arterial stenosis and Wagner grade and may complement ABI in evaluating lower-limb arterial disease.

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Background: Maternal diabetes mellitus is associated with fetal structural abnormalities, altered cardiac development, and changes in fetal growth. Ultrasonography provides a non-invasive method for evaluating these findings and assessing fetal well-being. Aim: To evaluate fetal cardiac changes and other significant ultrasonographic findings in pregnancies complicated by diabetes mellitus and assess their association with the type of maternal diabetes and glycemic control. Methods: This descriptive observational cross-sectional study included 80 pregnant women with pregestational diabetes mellitus (PGDM) or gestational diabetes mellitus (GDM) attending a tertiary care centre in Maharashtra. Clinical and biochemical details, including maternal glycated haemoglobin (HbA1c), were recorded. Fetal ultrasonography was performed to assess structural anomalies, cardiac parameters, fetal growth, amniotic fluid, placental characteristics, and Doppler indices. Associations were evaluated using appropriate statistical tests, with p<0.05 considered statistically significant. Results: Fetal structural anomalies were detected in 10 (12.5%) pregnancies. Anomalies were observed in 6/26 (23.1%) women with PGDM and 4/54 (7.4%) with GDM, although this difference was not statistically significant (p=0.070). Interventricular septal (IVS) hypertrophy was significantly more frequent in PGDM than GDM (26.9% vs 5.6%; p=0.011), as was cardiomegaly (23.1% vs 1.9%; p=0.004). Mean IVS thickness was also greater in PGDM. Compared with controlled glycemia, uncontrolled glycemia was associated with higher frequencies of polyhydramnios (30.6% vs 9.1%; p=0.021), IVS hypertrophy (22.2% vs 4.5%; p=0.037), and cardiomegaly (16.7% vs 2.3%; p=0.042). Fetal estimated weight and abdominal circumference were also higher in the uncontrolled group. Conclusion: Fetal ultrasonography identified structural and cardiac abnormalities in pregnancies complicated by diabetes. Cardiac changes were more frequent in PGDM

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Background: Arteriovenous fistulas (AVFs) are important vascular access routes for patients undergoing maintenance haemodialysis. However, complications such as thrombosis, stenosis, infection and pseudoaneurysm may compromise fistula function. Doppler ultrasonography provides non-invasive anatomical and haemodynamic assessment of vascular access. Aim: To evaluate arteriovenous haemodialysis fistulas using Doppler ultrasonography, determine the prevalence and pattern of complications, and assess associations between Doppler parameters, clinical characteristics and fistula complications. Materials and Methods: This cross-sectional observational study was conducted at a tertiary care hospital from May 2024 to October 2025. Seventy adult patients with end-stage renal disease undergoing haemodialysis through an AVF were included. Doppler assessment evaluated blood flow, peak systolic velocity at the anastomosis, brachial artery resistive index, draining vein diameter and skin-to-fistula vein distance. Demographic and clinical variables were also recorded. Statistical analysis was performed using R software, with appropriate tests for continuous and categorical variables. Results: The mean age was 55 ± 13 years, and 64.3% of participants were male. Radiocephalic fistulas were the most common type (51.4%). Complications were identified in 14 patients (20%). Thrombosis was the most frequent complication (35.7%), followed by stenosis and perifistula haematoma (21.4% each). Mean fistula blood flow was significantly lower in patients with complications than in those without complications (688 ± 298 versus 831 ± 273 mL/min; p = 0.049). Diabetes mellitus was also associated with complications (p = 0.028). Other evaluated Doppler parameters did not demonstrate statistically significant differences between groups. Conclusion: Doppler ultrasonography identified fistula complications and provided useful haemodynamic information. Lower blood flow and diabetes mellitus were associate

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Background: Intestinal obstruction is a common abdominal emergency in which timely identification of the site, cause and complications is essential for appropriate management. Contrast-enhanced computed tomography (CECT) provides detailed evaluation of bowel loops, transition points and associated complications. Aim: To evaluate the role of computed tomography in the assessment of intestinal obstruction in a tertiary care centre. Methods: This hospital-based, cross-sectional observational study included 70 consecutive patients aged 18 years or older with clinical suspicion of intestinal obstruction. All patients underwent contrast-enhanced 128-slice multidetector CT of the abdomen and pelvis. CT findings were assessed for the type, anatomical site, cause, grade and complications of obstruction. Imaging findings were compared with plain radiography and ultrasonography, and operative correlation was performed in surgically managed patients. Results: The mean age was 49.6 ± 13.8 years, and 61.4% were male. Small bowel obstruction was the predominant type (70.0%), with the distal ileum being the commonest site (31.4%). Adhesions were the leading cause (25.7%). Dilated bowel loops were identified in 98.6% of patients, while a transition point was identified in 84.3%. CT demonstrated sensitivity of 95.2%, specificity of 87.5%, positive predictive value of 98.3%, negative predictive value of 70.0% and overall diagnostic accuracy of 94.3%. CT altered the initial clinical diagnosis in 34.3% and identified unsuspected complications in 14.3%. Among 50 operated patients, CT findings showed 88.0% overall concordance with intraoperative findings. Surgical and conservative management were undertaken in 71.4% and 28.6%, respectively. Conclusion: Contrast-enhanced multidetector CT demonstrated high diagnostic accuracy and provided valuable information regarding the site, cause and complications of intestinal obstruction. Its findings supported clinical decision-making and preoperati

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Background: Chronic suppurative otitis media (CSOM) may cause persistent middle-ear disease, ossicular damage and complications involving the temporal bone. High-resolution computed tomography (HRCT) provides detailed anatomical assessment and helps define disease extent before surgery. This study evaluated HRCT findings in patients with CSOM and compared imaging features between atticoantral and tubotympanic disease. Methods: This descriptive observational cross-sectional study included 70 patients with clinical features suggestive of CSOM. Participants underwent clinical and audiological assessment, including pure-tone audiometry, followed by HRCT of the temporal bone. Imaging findings related to middle-ear and mastoid opacification, ossicular involvement and bony changes were recorded. Associations between clinical type, HRCT findings and hearing loss were analysed using appropriate statistical tests. Results: In this cohort, mean age was 24.5 ± 9.4 years, and 60.0% of participants were male. Ear discharge (94.3%) and hearing loss (90.0%) were the commonest symptoms. HRCT showed soft-tissue opacification in 88.6% of patients, most frequently involving the mesotympanum (67.1%) and epitympanum (57.1%). Ossicular erosion was present in 47.1%, with the incus most commonly affected (44.3%). Scutum erosion was the most frequent bony abnormality (45.7%). Atticoantral disease showed significantly higher frequencies of soft-tissue opacification, epitympanic, antral and aditus involvement, ossicular erosion and scutum erosion than tubotympanic disease. The number of eroded ossicles was significantly associated with the degree of hearing loss (p<0.001). Conclusion: HRCT demonstrated the anatomical extent of CSOM and identified ossicular and adjacent bony abnormalities. Destructive imaging findings were more frequent in atticoantral disease, and greater ossicular involvement was associated with more severe hearing loss. HRCT is a useful adjunct for preoperative assessment an

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Background: Hypertension is an important risk factor for carotid atherosclerotic disease. Ultrasonography with Doppler provides non-invasive assessment of carotid arterial wall changes, plaque characteristics and blood-flow parameters. This study evaluated carotid artery changes in hypertensive patients using ultrasonography and Doppler. Methods: This cross-sectional observational study included 104 hypertensive patients. Bilateral carotid arteries were examined using grayscale, colour and spectral Doppler ultrasonography. Common carotid artery intima–media thickness (CCA-IMT), peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI), plaque presence and morphology, and degree of stenosis were assessed. Associations with demographic and clinical characteristics were analysed. Receiver operating characteristic analysis was performed to assess the diagnostic performance of Doppler parameters. Results: The mean age was 52.66 ± 15.05 years, and 56.7% were females. Carotid plaques were detected in 49 patients (47.1%). Plaque presence was significantly associated with age (p=0.048), but not with gender, hypertension stage or duration. Hyperechoic and hypoechoic plaques were the commonest patterns (32.7% each). Plaque morphology was significantly associated with age (p=0.017), gender (p=0.034) and hypertension stage (p=0.003). Mild stenosis was observed in 73.5% and moderate stenosis in 26.5% of plaque-positive patients; no severe stenosis or occlusion was identified. CCA-IMT, CCA EDV and ICA PSV differed significantly across plaque morphologies. CCA PSV had the highest area under the curve (AUC) for plaque detection (0.632). For moderate stenosis, CCA PSV and ICA PSV showed AUCs of 0.736 and 0.714, respectively. Conclusion: Carotid ultrasonography and Doppler demonstrated a considerable prevalence of carotid plaques in hypertensive patients. Combined assessment of arterial wall thickness, plaque morphology and Doppler velocities may help characteri

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Background: Non-traumatic subarachnoid haemorrhage (SAH) is a potentially life-threatening neurological emergency; most commonly associated with ruptured intracranial aneurysms. Computed tomography angiography (CTA) is widely used for vascular evaluation, whereas digital subtraction angiography (DSA) remains an important reference investigation for detecting and characterising intracranial vascular abnormalities. Aim: To compare CTA and DSA findings in patients presenting with non-traumatic SAH. Methods: This prospective, hospital-based, cross-sectional analytical study included 51 adult patients with non-traumatic SAH confirmed on non-contrast computed tomography. All patients underwent both CTA and DSA. Demographic characteristics, clinical presentation, haemorrhage distribution, vascular abnormalities, aneurysm morphology and measurements were evaluated. DSA was considered the reference standard for comparison. Results: The mean age was 52.0 ± 11.4 years, with female predominance (62.7%). Thunderclap headache was reported in all patients (100%), followed by vomiting (92.2%) and neck stiffness (64.7%). Aneurysmal SAH was identified in 32 patients (62.7%), while 19 (37.3%) had non-aneurysmal SAH. CTA demonstrated 39 aneurysms, whereas DSA demonstrated 40 aneurysms. The anterior communicating artery was the most frequently reported aneurysm location in both investigations. Most aneurysms were saccular and measured 5–10 mm. DSA additionally demonstrated other vascular abnormalities, including arteriovenous malformations, dural arteriovenous fistulae, Moyamoya disease and vasculitis. A documented small basilar tip aneurysm missed on CTA highlighted the potential limitation of CTA in detecting small lesions. Two patients experienced minor DSA-related complications. Conclusion: CTA demonstrated high reported diagnostic performance and excellent morphometric reliability. Nevertheless, DSA remains important for detecting very small aneurysms and subtle non-aneurysmal vasc