Honors & Awards
Postdoctoral Research fellowship, Stanford University (2019)
International travel grant for European congress of Radiology, Department of Science and Technology, Government of India (2018)
Musculoskeletal Radiology fellowship award, Universitair Ziekenhuis, Brussel, Belgium (2016)
Musculoskeletal quiz winner, Sharda Hospital, India (2015)
Second rank, MD exit exam, GGSIPU, India (2015)
Certificate of commendation as an academically outstanding studying during residency, VMMC and Safdarjung Hospital (2012-2015)
Diplomate of National Board, DNB, Radiology, VMMC and Safdarjung Hospital (2016), India
Fellowship, MSK Radiology, Universitair Ziekenhuis, Brussel (2016), Belgium
Residency, MD Radiology, VMMC and Safdarjung Hospital (2015), India
Internship, VMMC and Safdarjung Hospital (2012), India
Medical School, VMMC and Safdarjung Hospital (2011), India
Current Research and Scholarly Interests
Molecularly-Targeted Contrast Enhanced Ultrasound in Ovarian Cancer
Automated Volumetric Molecular Ultrasound for Breast Cancer Imaging
Peripheral Nerve Imaging
Novel Ultrasound Imaging
Do not forget the brachial plexus-prevalence of distal brachial plexus pathology on routine shoulder MRI.
Most of the shoulder magnetic resonance imaging (MRI) examination focuses on internal joint structures but disregarding other structures like the distal brachial plexus, which may miss important findings. Hereby, we attempt to evaluate the prevalence of distal brachial plexus abnormalities and/or muscular denervation changes seen on routine shoulder MRI examinations and discuss common pathologies affecting the distal brachial plexus.A total of 701 routine shoulder MRI studies were evaluated. The evaluation of each exam was focused on the visualized brachial plexus elements and musculature abnormalities in each case. If any abnormalities of plexus and/or musculature were found, potential underlying etiologies such as paralabral or spinoglenoid notch cysts, infiltrative/primary masses on imaging, history of prior viral illness, and radiation therapy were searched. It was then confirmed whether the abnormal findings were mentioned in the exam reports or not.Thirty-four cases (4.85%) demonstrated abnormal findings of the visualized brachial plexus cords or branches and/or musculature. It was observed that in 35.3% of exam reports these findings were not mentioned, mainly missing subtle nerve abnormalities, but correctly reporting and interpreting the encountered muscle abnormalities.The distal brachial plexus and its branches should be included in the search pattern for shoulder MRI examinations.• Normal T2 signal of the brachial plexus is iso- to slightly hyperintense to muscle but less signal intense than fluid. • Diffuse, geographic muscle edema is an indirect sign of brachial plexus pathology. • Increased T2-weighted nerve signal with or without caliber or course change should be reported and followed up to find the underlying etiology.
View details for DOI 10.1007/s00330-020-07476-3
View details for PubMedID 33236205
Niche role of MRI in the evaluation of female infertility
INDIAN JOURNAL OF RADIOLOGY AND IMAGING
2020; 30 (1): 32–45
Infertility is a major social and clinical problem affecting 13-15% of couples worldwide. The pelvic causes of female infertility are categorized as ovarian disorders, tubal, peritubal disorders, and uterine disorders. Appropriate selection of an imaging modality is essential to accurately diagnose the aetiology of infertlity, since the imaging diagnosis directs the appropriate treatment to be instituted. Imaging evaluation begins with hystero- salpingography (HSG), to evaluate fallopian tube patency. Uterine filling defects and contour abnormalities may be discovered at HSG but usually require further characterization with pelvic ultrasound (US), sono-hysterography (syn: hystero-sonography/saline infusion sonography) or pelvic magnetic resonance imaging (MRI), when US remains inconclusive. The major limitation of hysterographic US, is its inability to visualize extraluminal pathologies, which are better evaluated by pelvic US and MRI. Although pelvic US is a valuable modality in diagnosing entities comprising the garden variety, however, extensive pelvic inflammatory disease, complex tubo-ovarian pathologies, deep-seated endometriosis deposits with its related complications, Mulllerian duct anomalies, uterine synechiae and adenomyosis, often remain unresolved by both transabdominal and transvaginal US. Thus, MRI comes to the rescue and has a niche role in resolving complex adnexal masses, endometriosis, and Mullerian duct anomalies with greater ease. This is a review, based on the authors' experience at tertiary care teaching hospitals and aims to provide an imaging approach towards the abnormalities which are not definitively diagnosed by ultrasound alone.
View details for DOI 10.4103/ijri.IJRI_377_19
View details for Web of Science ID 000524755700007
View details for PubMedID 32476748
View details for PubMedCentralID PMC7240899
Approach to pediatric renal tumors: an imaging review.
Abdominal radiology (New York)
2019; 44 (2): 619–41
Renal tumors comprise 7% of all childhood cancers. A wide variety of renal tumors can affect the pediatric kidneys, which can be broadly classified as primary benign tumors, primary malignant tumors, and metastatic lesions. This article aims to enumerate usual benign and malignant renal tumors that can occur in childhood and emphasizes the characteristic imaging appearances which aid in their differential diagnosis. Additionally, the leading role of the Radiologist in primary diagnosis of renal infiltration by hematological malignancies and contiguous invasion by neuroblastoma is also introduced and unraveled. Imaging protocol comprises initial Ultrasound evaluation with subsequent computed tomography (CT) and/or Magnetic resonance imaging (MRI), all of which are invaluable in confirming the diagnosis, documenting the organ of origin, describing extent of local and distant spread. The complimentary role of nuclear medicine studies in delineating differential renal function, post-operative complications, and metastasis is also highlighted.
View details for DOI 10.1007/s00261-018-1773-z
View details for PubMedID 30311048
Magnetic resonance imaging spectrum of intracranial tubercular lesions: one disease, many faces
POLISH JOURNAL OF RADIOLOGY
2018; 83: E524–E535
Tuberculosis is a devastating disease and has shown resurgence in recent years with the advent of acquired immunodeficiency syndrome. Central nervous system involvement is the most devastating form of the disease, comprising 10% of all tuberculosis cases. The causative organism, Mycobacterium tuberculosis, incites a granulomatous inflammatory response in the brain, the effects of which can be appreciated on magnetic resonance imaging (MRI), which can thus be used for diagnosis of the same. Neurotuberculosis can present in various patterns, which can be identified on MRI. The meningeal forms include leptomeningitis and pachymeningitis. Parenchymal forms of neurotuberculosis include tuberculoma in its various stages, tubercular cerebritis and abscess, tubercular rhombencephalitis, and tubercular encephalopathy. Each pattern has characteristic MRI appearances and differential diagnoses on imaging. Complications of neurotuberculosis, usually of tubercular meningitis, include hydrocephalus, vasculitis, and infarcts as well as cranial nerve palsies. Various MRI sequences besides the conventional ones can provide additional insight into the disease, help in quantifying the disease load, and help in differentiation of neurotuberculosis from conditions with similar imaging appearances and presentations. These can enable accurate and timely diagnosis by the radiologist and early institution of treatment in order to reduce the likelihood of permanent neurological sequelae.
View details for DOI 10.5114/pjr.2018.81408
View details for Web of Science ID 000459542600001
View details for PubMedID 30800191
View details for PubMedCentralID PMC6384409
Primary presentation of Jeune's syndrome as gastric motility disorder in an infant: A case report
INDIAN JOURNAL OF RADIOLOGY AND IMAGING
2018; 28 (1): 65–69
We report a case of a 4-week-old female neonate with Jeune's asphyxiating thoracic dystrophy (JATD) and coexistent situs anomaly, primarily presenting as gastric motility disorder. The child presented with abdominal distension and nonbilious vomiting since birth with failure to thrive. However, skeletal survey revealed JATD. Upper gastrointestinal contrast study showed situs inversus with delayed gastric emptying. Pyloric biopsy and intraoperative antro-duodenal manometry confirmed association of gastric motility disorder. Awareness of the unusual possibility of primary presentation of Jeune syndrome as gastric motility disorder will improve the management approach in such infants.
View details for DOI 10.4103/ijri.IJRI_303_17
View details for Web of Science ID 000428955300015
View details for PubMedID 29692530
View details for PubMedCentralID PMC5894323
A Case of Mistaken Identity: Glutaric Aciduria Type I Masquerading as Postmeningitic Hydrocephalus.
Journal of clinical imaging science
2018; 8: 50
We report the characteristic neuroimaging features of a rare metabolic leukodystrophy in an 8-year-old boy, born of consanguineous parenthood. The child presented with macrocrania, regression of milestones, and dystonia. The patient was referred for magnetic resonance imaging with a clinical diagnosis of postmeningitic hydrocephalus. Imaging revealed ventriculomegaly, diffuse brain atrophy, bilaterally symmetric widened sylvian fissure with temporal lobe hypoplasia, periventricular white-matter hyperintensities, and atrophy with hyperintensity in bilateral basal ganglia was also seen. These imaging features were signatory to arrive at a diagnosis of glutaric aciduria type 1. This disorder may mimic other neurological diseases such as postmeningitic hydrocephalus, which delays the diagnosis. Since early diagnosis and treatment can arrest progression, increased awareness about this condition among radiologists will certainly prevent erroneous diagnosis as had occurred in our patient.
View details for DOI 10.4103/jcis.JCIS_56_18
View details for PubMedID 30546934
View details for PubMedCentralID PMC6251246
Hepatic Venous Waveform, Splenoportal and Damping Index in Liver Cirrhosis: Correlation with Child Pugh's Score and Oesophageal Varices
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
2016; 10 (2): TC1–TC5
Clinical assessment of chronic liver disease is done by Modified Child Pugh's and Model for end-stage liver disease scoring system. Measurement of hepatic venous pressure gradient (HVPG) and Upper GI Endoscopy are considered the gold standards for measurement of portal hypertension in cirrhotics. There is a need for non-invasive evaluation of portal hypertension. Ultrasonography with colour and spectral Doppler evaluation may be an effective, rapid and inexpensive alternative.To evaluate hepatic venous waveform, damping index, splenoportal index in patients of cirrhosis on Colour Doppler ultrasound, also predict severity of portal hypertension and presence of oesophageal varices.Thirty patients of chronic liver disease were included in the study. Ultrasound and colour Doppler was done to look hepatic venous waveform pattern, Damping Index (DI), and Splenoportal Index (SPI). Contrast-enhanced Computed Tomography scan (CT) was done if renal function tests were normal, else endoscopy when the renal function tests were deranged to look for oesophageal varices.Twenty two (73.3%) patients had monophasic waveform. Biphasic and triphasic waveforms were seen in 4 (13.3%) cases. Twenty two patients (73.3%) had monophasic waveforms and majority of them were in class C. This distribution of hepatic vein waveform was statistically significantly with the Child Pugh's class (p<0.05). Twenty patients (66.7%) had value of Damping index more than >0.6 where majority of patients (18) belonged to class C and 2 in class B. There was a positive correlation between Child Pugh's total score and Damping index (r=0.614; p<0.05). There was weak positive correlation between splenoportal index and Child Pugh's score (r=0.269; p=0.15).Change in triphasic to monophasic waveform and DI >0.6 suggests severe liver dysfunction and is associated with severe portal hypertension. Hepatic venous waveform pressure changes, DI and SPI have no value in predicting presence of oesophageal varices.
View details for DOI 10.7860/JCDR/2016/15706.7181
View details for Web of Science ID 000397847400119
View details for PubMedID 27042553
View details for PubMedCentralID PMC4800619
- Painful swelling on the side of the knee Pure or primary leprous neuritis (PLN) CLINICAL AND EXPERIMENTAL DERMATOLOGY 2015; 40 (5): 586–88