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Neurology

 

EEG

EEG, or electroencephalogram, is a tool we use to image the brain while it is performing a cognitive task. This allows us to detect the location and magnitude of brain activity involved in the various types of cognitive functions we study. EEG allows us to view and record the changes in your brain activity during the time you are performing the task. Images are acquired by using electrodes to monitor the amount of electrical activity at different points on your scalp.

Risks & Benefits EEGs are non-invasive and do not involve any X-rays, radiation, or injections. EEGs have been used for many years and are considered very safe. The electrodes record activity without producing any sensation. Slight redness may occur in the locations where the electrodes were placed, but this will wear off after a few hours. However, there may be risks depending on your specific medical condition, so we will screen for disorders such as epilepsy.

NCV

A nerve conduction study (NCS) is a test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body. Nerve conduction velocity (NCV) is a common measurement made during this test.

Purposes Nerve conduction studies are used mainly for evaluation of paresthesias (numbness, tingling, burning) and/or weakness of the arms and legs. The type of study required is dependent in part by the symptoms presented. A physical exam and thorough history also help to direct the investigation.

Some of the common disorders that can be diagnosed by nerve conduction studies are:

  • Peripheral neuropathy
  • Carpal tunnel syndrome
  • Ulnar neuropathy
  • Guillain-Barré syndrome
  • Facioscapulohumeral muscular dystrophy
  • Spinal disc herniation

EMG

Electromyography, or EMG, involves testing the electrical activity of muscles. Often, EMG testing is performed with another test that measures the conducting function of nerves. This is called a nerve conduction study. Because both tests are often performed at the same office visit and by the same personnel, the risks and procedures generally apply to both tests.

Muscular movement involves the action of muscles and nerves and needs an electrical current. This electrical current is much weaker than the one in your household wiring.

In some medical conditions the electrical activity of the muscles or nerves is not normal. Finding and describing these electrical properties in the muscle or nerve may help your doctor diagnose your condition.

EMG may aid with the diagnosis of nerve compression or injury (such as carpal tunnel syndrome), nerve root injury (such as sciatica), and with other problems of the muscles or nerves. Less common medical conditions include amyotrophic lateral sclerosis, myasthenia gravis, and muscular dystrophy.

Risks

People usually have a small amount of discomfort during EMG testing because of pin insertion. Disposable needles are used so there is no risk of infection.

During nerve conduction studies, small electrodes are taped to the skin or placed around fingers. You typically experience a brief and mild shock, which may be a bit unpleasant. Most people find it only slightly annoying.

EMG Preparation

No specific preparation is needed for the testing.

During the Procedure

During EMG, small pins or needles are inserted into muscles to measure electrical activity. The needles are different than needles used for injection of medications. They are small and solid, not hollow like hypodermic needles. Because no medication is injected, discomfort is much less than with shots.

  • You will be asked to contract your muscles by moving a small amount during the testing.
  • With nerve conduction studies, small electrodes will be taped to your skin or placed around your fingers. You typically will experience a mild and brief tingling or shock, which may be a bit unpleasant.
  • The person who administers the test will explain the procedure. Often muscle activity is monitored through a speaker during the test, which may make a popping or soft roaring noise. The EMG technician will be looking at an oscilloscope, which looks like a small TV set during the procedure.
  • Testing may take 30-60 minutes.

BERA

BERA (Brainstem evoked response audiometry), ABR (Auditory brain stem response), BAER (Brainstem auditory evoked response audiometry). BERA is an electro-physiological test procedure which studies the electrical potential generated at the various levels of the auditory system starting from cochlea to cortex.

Uses of BERA:

  • It is an effective screening tool for evaluating cases of deafness due to retrocochlear pathology i.e. (Acoustic schwannoma). An abnormal BERA is an indication for MRI scan. The BERA test helps us not only in identifying lesions in the 8th cranial nerve, but also the lesions in the brainstem region which affect the auditory pathway. The BERA response obtained in a particular case will depend upon the nature, location, and size of the lesion;
  • Used in screening newborns for deafness
  • Used for intraoperative monitoring of central and peripheral nervous system
  • Monitoting patients in intensive care units
  • Diagnosing suspected demyelination disorders.

VEP

A visual evoked potential is an evoked potential caused by a visual stimulus, such as an alternating checkerboard pattern on a computer screen. Responses are recorded from electrodes that are placed on the back of your head and are observed as a reading on an electroencephalogram (EEG). These responses usually originate from the occipital cortex, the area of the brain involved in receiving and interpreting visual signals.


Loss of vision (this can be painful or non-painful);

  • Double vision;
  • Blurred vision;
  • Flashing lights;
  • Alterations in colour vision; or
  • Weakness of the eyes, arms or legs.

MRI

Magnetic resonance imaging (MRI) is a procedure that uses magnetic fields and radiowaves to produce an image of the body in cross sections. This enables excellent images, particularly of soft tissue such as the brain and internal organs. MRI is generally used whenever X-Ray or ultrasound examinations do not deliver clear results.
Siemens Magnetom Verio 3 Tesla

Expanding care to wider range of patients with:

    70 cms Open Bore:
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  • Reduced Sedation rate-
    even pediatric patients can be easily scanned

No Claustrophobia –
Free –first positioning for almost all examinations –

    Enhanced comfort even for patients with:
  • Respiratory problems
  • Pain & Mobility Issues
  • Kyphosis

Faster Head to Toe imaging
at one go with powerful Tim Technology

Non- Contrast Abdominal & Peripheral Angiography
For Patients with Severe Renal Insufficiency

Excellent Image Quality with Advanced Real Time Motion Correction Software

Ultra-Light-Weight Coils

Advance Applications:

Neuro Perfusion Imaging – Provides information regarding the blood flow in case of stroke aiding in treatment decision. It adds in staging brain tumors by evaluating cerebral flow of blood.

o Blood Spectroscopy – Detection of malignancy in brain

  • Examine brain tumors, brain metabolic diseases & degenerative changes in brain with 2D and 3D CSI (Chemical Shift Imaging).
  • Distinguish between malignant and benign tumor
  • Monitor therapeutic results in follow-up studies

Susceptibility Weighted Imaging (SWI) – Detection of microhemorrhages (Intracranial bleeding)

Visualize

  • Intracranial bleeding
  • Blood products
  • Venous Structures
  • Get a better look at bleeding in Stroke
  • Brain trauma
  • Contusions
  • Shearing Injuries
  • Intracranial Vascular malformations
    Non Contrast Angiography (Syngo Native is advanced software for Non Contrast Angiography)
  • Contrast-free Thoracic, Abdominal and Peripheral Angiography
  • Fast 3D Acquisition in High Spatial Resolution
  • Accurate Artery/ Vein Seperation
  • Suitable for Patients having a High Risk of Developing NSF (Nephrogenic Systemic Fibrosis)
  • Very useful for Diabetic Patients, Renal Impaired Patients and Contrast Allergics
    Isotropic High Resolution 3D Imaging for Inner Ear, Spine, Joints, MRCP, etc
  • 3D Neuro imaging
  • 3D Spine imaging
  • 3D Ortho imaging
  • 3D Body imaging

Real Time motion correction – all orientations, all contrast, all body parts

Achieve High Quality Images with Syngo Blade (motion correction techniques) which helps visualizing even smallest lessons in case of pediatric, anxious patients or incase of involuntary motion like respiration, pulsation, etc.

Breast Imaging

    In Breast Cancer workup, MRI offers the following benefit:
  • High Sensitivity
  • No exposure to ionizing radiation
  • Painless exam, with minimal or no compression needed
  • Provides both morphological and functional data
    MR Mammography is commonly indicated in:
  • To identify clinically or mammographically occult tumor
  • Stage and plan treatment
  • Contralateral Breast Cancer in Newly Diagnosed Breast Cancer
  • Post-operative Scar vs. Tumor Recurrance
  • Tumor response to Neo Adjuvant Chemotherapy
  • Screen high-risk women
  • Evaluate the integrity of breast implants
  • Valuable tool for guided breast biopsy
    Reasons why Breast MRI is better at 3T:
  • Higher signal to noise generates more detailed images (crucial for seeing tumor borders and ductal anatomy)
  • Higher resolution, which results in clearer/sharper images (vital for detecting subtle cancers and even less subtle cancers in earlier stage)
  • Better fat saturation of the breasts
  • Higher sensitivity (two-fold) to contrast enhancement

Fetal MRI

It’s a recognized complimentary method to fetal ultrasound to identify fetal central nervous system (CNS) pathology. It can provide additional and diagnostically-relevant information, add certainty to ultrasound diagnosis and help parental counseling. According to national and international guidelines, fetal MRI is recommended from the second trimester of gestation.

    Advantage of MR fetal imaging over USG:
  • Visualization of the fetus is not significantly limited by maternal obesity, fetal position, or oligohydramnios
  • Visualization of the brain is not restricted by the ossified skull
  • Superior soft tissue contrast resolution
  • Ability to distinguish individual structures such as lung, liver, kidney, bowel and gray and white matter
  • Multiplanar imaging is easier with MRI than it is with US, where it is often a challenge to obtain images in three planes
  • MRI provides a large field-of-view, facilitating examination of fetuses with large or complex anomalies, and visualization of the lesion within the context of the entire body of the fetus
    Common Indication of Fetal MRI:
  • CNS abnormalities: where it has been found to influence or change management and counseling in up to 50% of cases
  • Evaluation of ventriculomegaly e.g. agenesis of corpus callosum
  • Helpful in evaluating posterior fossa cystic lessons and in distinguishing between the Dandy- walker malformation and variant, posterior fossa arachnoid cyst, and mega cisterna magna
  • Scalp masses and cervical teratoma: showing extension of these tumors into the pelvis, abdomen, or spinal canal, which may be underestimated by US
  • NTDs in the presence of maternal obesity
  • Assessment of fetal lung development
  • Foregut cyst, bronchial atresia, tracheal atresia, and lung atresia
  • Genitourinary abnormalities
  • Antenatal evaluation of conjoined twins

Viability

Non stress examination that provides high resolution detail including function of left ventricle in approx. 10 to 30 minutes. For scar tissue /infarct.

Kinematic studies of the joints

Assessment of movements of joints in movie clippings. Useful in lumbar/cervical spine, ankle, patello-femoral and shoulder joints.

Brain Perfusion

To give prompt treatment of infarct if patient reaches within 3 to 8 hours of starting of symptoms.
For recurrence of tumors.
For chemotherapy assessment.

Spectroscopy

At 3t can confidently diagnose tumors, can differentiate benign from malignant tumors. Better spectrum from 1.5t. Useful in few infections like tuberculomas.

Peripheral Angio

Very reliable for diagnosing the extent and severity of peripheral arterial disease.

Philips Achieva 1.5 Tesla
The clinical capabilities of MR have expanded. Inside and out, the Achieva is a friendly, open system designed for optimal patient comfort and maximizes workflow with high functionality. The Achieva 1.5T can be upgraded to Achieva I/T, with three configurations optimized for MR guided interventions and therapy. It also saves up to 50% of the energy bills. Requires minimal floor space for the entire installation and has a scalable platform with wide range of options and upgrades.
Siemens Magnetom Espree 1.5 Tesla
It’s a level of image quality just not seen in Open MRI before. In today's highly competitive outpatient market, MAGNETOM Espree is sure to be the system of choice for Imaging Centres. MAGNETOM Espree with I-class offers spacious headroom and enough patient gaps. That means: More headroom, more legroom, and more elbowroom. No longer do the patients feel like they’re nose-to-nose with the magnet. Particularly claustrophobic or anxious patients are more relaxed throughout their examination.
G Scan ESOATE
Weight-bearing examinations giving extra diagnostic capability, full set of pre-defined sequences and protocols. User defined sequences and customized examination protocols. Real time imaging tool for patient positioning and windows based user interface. Extensive image viewing, analysis and elaboration tools are used. Sophisticated storage functionality particularly useful for systems connected to PACS network.

CT SCAN

Computed Tomography (CT) has witnessed a change over the past 20 years. It is said that the use of CT for applications in radiological diagnosis during the 70s sparked a revolution in the field of medical engineering. Innovative scanners, advanced applications were introduced in the CT technology that brought about exciting breakthroughs in clinical procedures that helped in addressing various public health issues. In the Indian scenario, CT technology has today become an indispensable and integral component of routine work in clinical and medical practice, specifically in radio-diagnosis and procedures such as colonography, cancer detection and staging, lung analysis, cardiac studies and radiotherapy planning.
GE Optima CT660

The Optima CT660 system helps you deliver highly competent, personalized care that helps fulfill your mission and please your patients.

One look at the sleek, compact design tells you this CT system is different. This new-generation, intelligent 128-slice scanner combines the advanced innovations from our Discovery and LightSpeed families. You get fast, highquality acquisition at optimized dose for patients young and old, large and small, across a wide spectrum of procedures: cardiac, angiography, brain, chest, abdomen, orthopedic, and more.

Technologists and radiologists benefit from ergonomic features and numerous enhancements in workflow efficiency and diagnostic power. The compact footprint lets the system fit your available space, while a modular design helps you choose capabilities to meet today’s budget and expand as you grow.

The Optima CT660 is also environmentally friendly with a design for refurbishment and end-of-life recycling, and with electronics innovations that cut power consumption by 60 percent using the energy saving mode.

Unique Features:

    Full Body Less than 15 sec
  • 5 Breast Cardiac
  • Large Coverage
  • Dynamic Studies
    Resolution
  • 0.35 mm Istropy
  • Subtle Contrast Variation
    Lower Dose
  • Young Patients
  • Follow-up Studies
  • Screening Procedures
  • Reduced Patient dose by 40-50%
    5 Beat Cardiac Angiography
  • Reduce Time
  • Better IQ
  • More Patient Comfort
  • Reduce Patient Dose
  • Less Breath Holds
  • Non-Invasive Coronary Angiography

Paediatric Coronary Imaging

GE Light Speed

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With sub-millimeter slices and routine 16-slice coverage, GE LightSpeed ®16 delivers a whole new world of clinical value - all while addressing your productivity and care of the patient.

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