D N Srivastava

All India Institute of Medical Sciences, New Dilli, NCT, India

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Publications (71)86.94 Total impact

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    ABSTRACT: Alveolar echinococcosis is a parasitic disease primarily invading the liver. Owing to its aggressive nature, it invades the adjacent structures and can even metastasize to distant organs. The appearance of hepatic involvement on computed tomographic scan is characteristic, but not specific, with areas of calcification seen within a hypoenhancing mass. Although magnetic resonance imaging may better define the extent of the disease, it often misleads the radiologist, especially if the lesion is devoid of cystic component(s) and if it occurs in nonendemic areas. Knowledge of the imaging appearance may prompt serological evaluation and aid in making an early diagnosis and planning appropriate treatment of this uncommon fatal disease, especially in nonendemic areas. Copyright © 2014 Elsevier Inc. All rights reserved.
    Current problems in diagnostic radiology. 11/2014;
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    ABSTRACT: Pancreatic necrosis is an important determinant of patient outcome in severe acute pancreatitis (SAP). This prospective study was conducted to evaluate if perfusion CT (PCT) can predict the development of necrosis at an early stage in SAP.
    Abdominal Imaging 08/2014; · 1.91 Impact Factor
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    ABSTRACT: To compare conventional magnetic resonance imaging (MRI) and direct magnetic resonance (MR) arthrography in the evaluation of triangular fibrocartilage complex (TFCC) and intrinsic wrist ligament tears.
    The Indian journal of radiology & imaging. 07/2014; 24(3):259-67.
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    ABSTRACT: Extrahepatic portal vein stenosis is caused by a variety of benign and malignant diseases and results in development of symptoms due to portal hypertension. Benign post-surgical adhesions causing portal vein stenosis in non-transplant population is an uncommon etiology of portal hypertension. Endovascular treatment of such patients with angioplasty and stenting is uncommonly reported in literature. We report a case of portal hypertension caused by benign postoperative portal vein fibrosis, successfully treated by self-expandable metallic stent.
    Indian Journal of Radiology and Imaging 10/2013; 23(4):351-3.
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    ABSTRACT: Posttraumatic cortical defect of bone is a rare entity which occurs in a maturing skeleton following green stick or torus fracture. Most of the cases are asymptomatic and they are detected incidentally on radiograph. These lesions usually require no treatment. However, the appearance of these lesions can mimic various pathological conditions affecting bone. Knowledge about this entity is important as it avoids unnecessary investigations. We present this case as the occurrence of this entity in femur is very rare and the child was symptomatic.
    Case reports in orthopedics. 01/2013; 2013:815460.
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    ABSTRACT: To compare magnetic resonance (MR) arthrography and arthroscopy as a means of assessing the severity of labral tear in anterior glenohumeral instability. 52 patients presenting with traumatic recurrent anterior shoulder instability were evaluated using MR arthrography; 30 shoulders with a labroligamentous lesion were treated with arthroscopic Bankart repair. Their MR arthrographic images were interpreted by 3 senior musculoskeletal radiologists, and a radiological diagnosis was reached by consensus. The sensitivity and positive predictive values of MR arthrography for detecting a labral tear were determined. Agreement between MR arthrography and arthroscopy in terms of the width and depth of the labral tear was analysed. On arthroscopy, a labroligamentous lesion (Bankart lesion and its variants) was present in all the 30 shoulders. Agreement between the MR arthrography and arthroscopy in terms of the width and depth of the labral tears was good. MR arthrography is an accurate means of assessing the severity of anterior labroligamentous lesions and yields a good correlation with arthroscopy.
    Journal of orthopaedic surgery (Hong Kong) 08/2012; 20(2):230-5.
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    ABSTRACT: Chondroblastoma is a rare benign cartilaginous neoplasm of bone. The recurrence rate is high and complications are frequent following open curettage with bone grafting which is the standard treatment forchondroblastomas. We performed radiofrequency ablation in three cases of tibialchondroblastoma using the bipolar system. One patient experienced residual pain for which repeat ablation was performed. No other complications were observed during follow-up. Radiofrequency ablation may offer an effective alternative for the treatment of selected cases of chondroblastoma. The lesion characteristics which are likely to influence treatment outcome and the advantages offered by the bipolar system are discussed.
    World journal of radiology. 07/2012; 4(7):335-40.
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    ABSTRACT: PURPOSE: To evaluate prospectively the role and impact of multidetector row computed tomography (MDCT) before bronchial artery embolization (BAE) in patients with hemoptysis. METHODS: MDCT of the thorax was performed in 27 patients (21 men, 6 women; age range, 22-70 years; mean, 39 years) with hemoptysis who were referred for BAE. Transverse, multiplanar reconstruction, and 3-dimensional reconstruction (maximum intensity projection and volume rendered) images were analysed to identify the abnormal hypertrophied bronchial and nonbronchial systemic arteries causing hemoptysis, their origin and course were noted. Digital subtraction angiography was performed with the knowledge of findings of MDCT. Selective arteriogram of abnormal bronchial as well as nonbronchial arteries was performed. Embolization was attempted in 25 of these patients (92.6%) by using polyvinyl alcohol particles (350-500 μm), Gelfoam or Embospheres (400-700 μm). Follow-up was done for a mean period of 20.5 months. RESULTS: Based on MDCT, 2 of 27 patients were found unsuitable for BAE. On computed tomography, 38 arteries (27 bronchial and 11 nonbronchial systemic arteries) were identified as abnormal hypertrophied vessels. On angiography, 34 of these arteries (25 bronchial and 9 nonbronchial systemic arteries) were found to be responsible for hemoptysis. Three of these arteries could not be evaluated during angiography, and 1 artery that was identified as abnormal on computed tomography was found normal on angiography. All 25 bronchial and 9 nonbronchial systemic arteries that cause hemoptysis were detected at MDCT. Embolization was successful in 23 of 25 patients. CONCLUSION: MDCT enables detection and depiction of all bronchial and nonbronchial systemic arteries causing hemoptysis.
    Canadian Association of Radiologists Journal 05/2012; · 0.43 Impact Factor
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    ABSTRACT: To compare T2W-MRCP and T1W contrast-enhanced MRC (CE-MRC) using Gd-BOPTA for evaluation of biliary-enteric anastomotic (BEA) stricture. Twenty-one patients who were suspected to have BEA stricture underwent T2W-MRCP and CE-MRC on a 1.5T scanner. Images were evaluated for evidence of anastomotic stricture. Composite gold standard was used including the findings on percutaneous transhepatic cholangiogram or percutaneous transhepatic biliary dilatation, surgery, alkaline phosphatase level and clinical follow-up. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of T2W-MRCP for the diagnosis of anastomotic stricture were 94.4%, 80%, 94.4% and 80% respectively. On CE-MRC, biliary excretion was seen in only 60.87% anastomoses and only these were taken for analysis. The sensitivity, specificity, PPV and NPV of CE-MRC for the diagnosis of anastomotic stricture were 40%, 75%, 80% and 33.3%. The combined evaluation of T2W-MRCP and CE-MRC showed sensitivity, specificity, PPV and NPV of 83.3%, 80%, 93.8% and 57.1%. At present, T2W-MRCP is still the diagnostic modality of choice in the evaluation of patients with BEA stricture and the usage of Gd-BOPTA enhanced MRC is inappropriate in this setting.
    Gastroentérologie Clinique et Biologique 06/2011; 35(8-9):563-71. · 0.80 Impact Factor
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    ABSTRACT: The glenohumeral joint is the most commonly dislocated joint in the body, and anterior instability is the most common type of shoulder instability. Depending on the etiology and the age of the patient, there may be associated injuries, for example, to the anterior-inferior labro-ligamentous structures (in young individuals with traumatic instability) or to the bony components (commoner in the elderly), which are best visualized using MRI and MR arthrography. Anterior instability is associated with a Bankart lesion and its variants and abnormalities of the anterior band of the inferior glenohumeral ligament (IGHL), whereas posterior instability is associated with reverse Bankart and reverse Hill-Sachs lesions. Cases of multidirectional instability often have no labral pathology on imaging but show specific osseous changes including increased chondrolabral retroversion. This article reviews the relevant anatomy in brief and describes the MRI findings in each type, with the imaging features of the common abnormalities.
    The Indian journal of radiology and imaging 04/2011; 21(2):98-106.
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    ABSTRACT: In the management of epithelial ovarian cancer (EOC), the identification of peritoneal deposits is the most important prognostic factor. We conducted a prospective study to evaluate the role of multidetector CT (MDCT) in identifying peritoneal deposits pre-operatively. 38 previously untreated patients (median age 50 years; range 26-70 years) were evaluated with contrast-enhanced MDCT of the abdomen and pelvis. All CT scans were performed on a four-slice MDCT scanner with thin-slice image acquisition. Multiplanar coronal, sagittal or oblique images were constructed and all images were reviewed by at least two radiologists. The extent of disease was determined and mapped for all areas of the abdomen and pelvis. CT scans were reviewed and compared with surgical findings. Peritoneal deposits and thickening were separately noted for each of the nine segments of the abdomen and pelvis (i.e. bilateral hypochondria, bilateral lumbar, bilateral iliac fossa, epigastrium, umbilical region and hypogastrium) and were mainly used to determine the accuracy of MDCT in the depiction of peritoneal carcinomatosis. Sensitivity, specificity, positive and negative predictive values and accuracy of CT in the detection of peritoneal deposits were similar to those reported in the literature. The most common anatomical sites to have peritoneal deposits were the pouch of Douglas (18 cases) and the right subdiaphragmatic region (18 cases). Despite the improved scanning technology, image reconstruction and viewing ability of MDCT, its overall accuracy for the detection of peritoneal deposits is not significantly improved when compared with conventional CT; however, MDCT is useful in the assessment of disease at specific locations in the abdomen and pelvis.
    The British journal of radiology 01/2011; 84(997):38-43. · 2.11 Impact Factor
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    K S Madhusudhan, D N Srivastava, S Gamanagatti
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    ABSTRACT: We present a case of multifocal epithelioid hemangioendothelioma occurring in an adolescent boy who presented with massive hemoptysis and showed a pulmonary perihilar mass with multiple lesions in the liver and two lytic lesions in the ribs on imaging. The diagnosis was confirmed by lung and liver biopsy. He was treated with oral steroids.
    The Indian Journal of Pediatrics 06/2010; 77(6):699-700. · 0.72 Impact Factor
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    ABSTRACT: The inferior vena cava (IVC) filter insertion is a well established procedure to prevent significant pulmonary embolism in selected situations. It is generally considered straight forward without significant complications. We report an interesting case of a young postpartum woman in whom an IVC filter was misplaced in the right gonadal vein. This complication is only rarely reported. Presence of prominent right gonadal vein must always be kept in mind during trans-jugular placement of infra renal filter in the IVC in post partum women.
    CardioVascular and Interventional Radiology 02/2010; 33(4):880-2. · 2.09 Impact Factor
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    Chandan Jyoti Das, Ajit Harishkumar Goenka, Deep Narayan Srivastava
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    ABSTRACT: BackgroundMR-guided biopsy may aid to obtain samples in cases which are not feasible with conventional US or CT guidance. PurposeTo evaluate safety and efficacy of MRI-guided abdominal biopsy at 1.5-T closed MR system. Methods and materialsMRI guided abdominal biopsy was performed using Siemens Avanto 1.5-T closed MR system. Eighteen samples were obtained in 10 patients under local anesthesia using a novel technique to define skin entry site. None of the cases included in the study were amenable to biopsy using the conventional ultrasound (US) or computed tomography (CT) guidance. MR compatible 18G needle (US Biopsy) was used to obtain biopsy samples. Intravenous gadolinium was used in two patients for better delineation during biopsy. Patients were followed up for 3–5h and were discharged on the same day. ResultsTechnical success was achieved in all patients. Average number of biopsy passes were two (range 1–4). All biopsy samples were adequate for histopathological examination. Average size of the core biopsy specimen was 9mm. Conclusion1.5-T closed MR system allows adequate biopsy sampling from various abdominal organs. This technique may help to sample lesions which are not otherwise amenable for biopsy under conventional CT or US guidance. KeywordsBiopsy-MRI-Abdomen-Intervention-Closed MRI
    Abdominal Imaging 01/2010; 35(2):218-223. · 1.91 Impact Factor
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    ABSTRACT: Hemangioma is the most common benign tumor of liver and is often asymptomatic. Spontaneous rupture is rare but has a catastrophic outcome if not promptly managed. Emergent hepatic resection has been the treatment of choice but has high operative mortality. Preoperative transcatheter arterial embolization (TAE) can significantly improve outcome in such patients. We report a case of spontaneous rupture of giant hepatic hemangioma that presented with abdominal pain and shock due to hemoperitoneum. Patient was successfully managed by TAE, followed by tumor resection. TAE is an effective procedure in symptomatic hemangiomas, and should be considered in such high risk patients prior to surgery.
    Saudi Journal of Gastroenterology 01/2010; 16(2):116-9. · 1.22 Impact Factor
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    ABSTRACT: Schwannoma of the biliary tree is extremely uncommon, with only a few cases having been reported so far. They commonly present with obstructive jaundice. Although involvement of the extrahepatic duct is common, occurrence in the intrahepatic ducts has not been reported. We report a case of combined intrahepatic and extrahepatic schwannoma in a 46-year-old man presenting with obstructive jaundice.
    The British journal of radiology 10/2009; 82(982):e212-5. · 2.11 Impact Factor
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    ABSTRACT: To evaluate the efficacy and complications of uterine artery embolization (UAE) versus laparoscopic occlusion of uterine vessels (LOUV) in the management of symptomatic fibroids. A pilot randomized clinical trial in which 20 patients with symptomatic fibroids were randomly allocated into two groups. Ten women underwent UAE, and 10 women underwent LOUV. Symptomatic improvement in menorrhagia and reduction in the volumes of the uterus and the fibroid were assessed at 3 and 6 months. The patients were comparable with regard to age and parity. At 6 months, there was no significant difference in the mean reduction in menstrual blood loss, uterine volume, and volume of the dominant fibroid between the two groups (P=0.436, P=0.796, P=1.00, respectively). However, higher pain scores were recorded on day 1 in the UAE group compared with the LOUV group (P=0.0002). The effects of UAE and LOUV in the management of symptomatic fibroids are comparable. The main advantage of LOUV is less postoperative pain compared with UAE.
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 03/2009; 105(2):162-5. · 1.41 Impact Factor
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    ABSTRACT: To prospectively compare the feasibility, safety and diagnostic role of carbon dioxide (CO(2)) digital subtraction angiography (DSA) using a 'home made' delivery system with iodinated contrast medium (ICM) DSA in the evaluation of peripheral arterial occlusive diseases (PAOD) of lower limbs. Twenty-one patients (27 limbs; all men; mean age, 47.6 years) who presented with PAOD of lower limbs underwent DSA using both intra-arterial CO(2) and ICM. Conventional ICM DSA was performed first and used as gold standard. Carbon dioxide was then injected by hand using a locally improvised home made plastic bag delivery system. Patient tolerance was assessed subjectively. Arteries from aortic bifurcation to the ankle were independently evaluated by two radiologists and graded for stenosis using a five-point scale. For each patient, the quality of CO(2) DSA images were compared with the corresponding images of ICM DSA and an overall grade of 'good', 'acceptable' or 'poor' was assigned. Cohen's kappa coefficient was used to determine inter-observer agreement. Carbon dioxide opacified 86.2% (188/195) of major arteries and depicted stenosis adequately in 84.5% (191/226) of arterial segments. A good or acceptable image quality of CO(2) DSA was obtained in over 95% of patients. Infrapopliteal arteries were inadequately visualized. Mild pain was seen in six (28.6%) patients with both contrast agents; one patient developed severe pain during CO(2) DSA. Inter-observer agreement was good (k > 0.75) at 70% of the segments. Administration of CO(2) into lower limb arteries is well tolerated. Carbon dioxide DSA using the locally improvised home made delivery system is a feasible and safe alternative to ICM DSA in the evaluation of PAOD. It provides adequate imaging of arteries of lower extremities except infrapopliteal segments.
    Journal of Medical Imaging and Radiation Oncology 03/2009; 53(1):40-9. · 0.98 Impact Factor
  • D. Srivastava, S. Gamanagatti, R. Sharma
    European journal of pain (London, England) 01/2009; 13. · 3.37 Impact Factor
  • K S Madhusudhan, D N Srivastava, S Gamanagatti
    Journal of Postgraduate Medicine 01/2009; 55(4):290-1. · 1.26 Impact Factor

Publication Stats

361 Citations
86.94 Total Impact Points

Institutions

  • 1998–2014
    • All India Institute of Medical Sciences
      • • Department of Radiology
      • • Department of Gastrointestinal Surgery
      • • Department of Radio Diagnosis
      • • Department of Obstetrics and Gynaecology
      New Dilli, NCT, India