Browsing by Author "Sah, Ramswarth"
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Publication Comparison of Fat Suppression Sequences T2 Weighted Two-Point Dixon and Short-Tau Inversion Recovery in Magnetic Resonance Imaging of Lumbar Spine: An Observational Study(Nepal Medical Association, 2025) Khanal, Umesh; Sah, Ramswarth; Mahato, Sushil Kumar; Katwal, Shailendra; Gurung, GhanshyamAbstract Introduction: Magnetic Resonance Imaging is a common diagnostic tool used to evaluate various clinical conditions. Different fat suppression techniques such as Short Tau Inversion Recovery and Dixon are employed to enhance diagnostic accuracy. The choice of fat suppression sequence varies based on availability and performance. This study aimed to compare Contrast Ratio and Contrast-to-Noise Ratio of Short Tau Inversion Recovery and Dixon technique. Methods: This observational cross-section study was performed in the Department of Radiology from 8 September 2023 to 7 September 2024 after the approval by the Institutional Review Committee (Reference number: 151/080/081(6-11)E2). Using a complete census method during the study period, MRI-lumbar spines of 384 adult patients were included in the study. Signal intensity values of the lesion, adjacent normal tissue, and noise were recorded for calculation of Contrast Ratio and Contrast-to-Noise Ratio. Results: Among 384 cases, 191 (49.74%) were male and 193 (50.26%) were female with median age 46 (IQR: 35-60) years. The median value of contrast ratio and contrast-to-noise ratio were 0.31 (IQR: 0.14-0.50) and 8.74 (IQR: 3.82-15.50) respectively for STIR sequence while median value of contrast ratio and contrast-to-noise ratio were 0.44 (IQR: 0.19-0.74) and 11.95 (IQR: 5.38-23.18) respectively for Dixon sequence, higher than Short Tau Inversion Recovery. Conclusions: Contrast Ratio and Contrast to Noise Ratio were found higher and background noise lower for Dixon compared to Short Tau Inversion Recovery.Publication Dural Venous Sinus Variations Observed in Magnetic Resonance Venography at a Tertiary Care Hospital: An Observational Study(Nepal Medical Association, 2024) Paudel, Sharma; Sah, Ramswarth; Singh, Rakesh Kumar; Kayastha, Prakash; Katwal, ShailendraAbstract Introduction: The dural venous system, composed of various sinuses, plays a crucial role in draining deoxygenated blood from the central nervous system. Understanding its anatomical variations is essential to differentiate it from pathological conditions like cerebral venous sinus thrombosis. This study aims to evaluate the anatomical variations of the dural venous sinuses using Magnetic Resonance Venography. Methods: An observational, cross-section study was performed in the Department of Radiology from September 2023 to March 2024 after the approval by the Institutional Review Committee (Reference number: 149/080/081(6-11)E2). Magnetic Resonance Venography of 109 adult patients was performed using a 1.5 Tesla MRI scanner. Diameters of the superior sagittal sinus, straight sinus, and transverse sinuses were measured. Variations in transverse sinuses, straight sinus, and confluence were categorized and analyzed. Results: The study included 52 (47.70%) male and 57 (52.30%) female, with median age of 42 (IQR: 30.5 - 56) years. The superior sagittal sinus had the diameter of 6.4±1 mm. Symmetric transverse sinus variant seen was in 80 (73.39%) patients, and left transverse sinus hypoplasia was seen in 20 (18.35%) patients. Variations in the straight sinus and confluence were also documented with a true confluence (type III) was seen in 71 (65.10%) patients. Conclusions: Anatomical variations of the dural venous sinuses as observed in 1.5 Tesla MRI was quite common.Publication Evaluation of Olfactory Fossa Depth Using Computed Tomography(Nepal Health Research Council, 2024) Paudel, Sharma; Sah, Ramswarth; Budhathoki, Tekendra; Pandey, GhanshyamBackground: Olfactory fossa is a depression in anterior cranial cavity whose floor is formed by cribriform plate of ethmoid bone and is susceptible to injury during functional endoscopic sinus surgery (FESS), especially when fossa is deep. Understanding of patient’s ethmoid roof anatomy and its possible variations is crucial for countering possible complications during functional endoscopic sinus surgery. So, objective of this study was to evaluate olfactory fossa depth. Methods: In this descriptive cross sectional study, olfactory fossa depth was measured on Computed Tomographic images of 280 patients in the Department of Radiology, Tribhuvan University Teaching Hospital. The data were grouped according to Keros classification and their distributions were analyzed according to side and gender. Association between olfactory fossa depth with different parameters were evaluated with descriptive statistics, independent t-test, ANOVA and Chi-square test. Results: Among 280 participants, 144 were male and 136 female. The mean depth of right and left olfactory fossa was found 5.10 ± 1.58 mm and 5.28 ± 1.62 mm respectively. Keros type II was the most common, found in 209 cases (74.60%) on left side and 194 (69.30%) on right side while type III was the least common. The difference between left and right olfactory fossa depth was significant though it was insignificant between male and female. No significant association was found between Keros type with sides and with gender. Conclusions: Variation in olfactory fossa depth was common. Thus, preoperative assessment of ethmoid roof and Keros type is cruicial for warning the surgeon to minimize the critical complications. Key words: Computed Tomography; olfactory fossa depth; para nasal sinus.