gopinathan kathirvelu
The Tamilnadu Dr MGR Medical University, Radiology, Faculty Member
Research Interests:
Poster: "ECR 2020 / C-14555 / Final integrated diagnosis of infratentorial paediatric brain tumours – What radiologists needs to know? " by: " G. Ushanandhini 1, K. Gopinathan2, P. D. J. Devimeenal2, S. prabhakaran2, V.... more
Poster: "ECR 2020 / C-14555 / Final integrated diagnosis of infratentorial paediatric brain tumours – What radiologists needs to know? " by: " G. Ushanandhini 1, K. Gopinathan2, P. D. J. Devimeenal2, S. prabhakaran2, V. Nadaraja2; 1chennai, Tamil Nadu/IN, 2Chennai/IN"
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Research Interests:
Poster: "ECR 2020 / C-11147 / Pediatric viral encephalitis - Guide for diagnosing typical and atypical cases " by: " J. Rajasekaran , K. Gopinathan, P. D. J. Devimeenal, D. K. GEETHA, S. Nagarajan; Chennai/IN"
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Poster: "ECR 2020 / C-11131 / MR Spectroscopy in paediatric brain lesions – A problem solving tool. " by: " A. Damodaran Nampoothiry 1, K. Gopinathan2, P. D. J. Devimeenal2, D. K. GEETHA2, D. R. Rajakumaran2; 1Chennai,... more
Poster: "ECR 2020 / C-11131 / MR Spectroscopy in paediatric brain lesions – A problem solving tool. " by: " A. Damodaran Nampoothiry 1, K. Gopinathan2, P. D. J. Devimeenal2, D. K. GEETHA2, D. R. Rajakumaran2; 1Chennai, Tamil Nadu/IN, 2Chennai/IN"
Research Interests:
Acute hemorrhagic leucoencephalitis (AHLE) represents an extremely rare spectrum of demyelinating diseases. It is commonly preceded by upper respiratory infections. AHLE may more commonly occur in young adults, contrary to acute... more
Acute hemorrhagic leucoencephalitis (AHLE) represents an extremely rare spectrum of demyelinating diseases. It is commonly preceded by upper respiratory infections. AHLE may more commonly occur in young adults, contrary to acute disseminated encephalomyelitis (ADEM), which is more commonly seen in children. A 5-y-old, previously healthy boy presented with fever and upper respiratory tract infection for 3 d following a recent travel. On 3rd day of fever, child had a seizure which was managed medically. Five days later, child was re-admitted with complaints of head ache and meningeal irritation. CSF study was positive for Japanese encephalitis. MRI brain showed asymmetric bilateral periventricular white matter T2 / FLAIR hyperintensity particularly occipital lobes and cerebellar hemispheres with relative sparing of cerebral cortex. Few areas of restricted diffusion and hemorrhagic areas were seen (Fig. 1). No significant thalamic involvement was found. Inspite of steroid infusion, clinical deterioration was noted and the child expired on day 6. Main etiology behind AHLE [1] is cell mediated or humoral immune response to preceding viral infection [2]. Intensive care, use of high-dose corticosteroid therapy, immunoglobulins, plasma exchange, dehydrating agents, and surgical decompression (ICP) has led to survival in some
Research Interests:
To define the clinical manifestations of Chikungunya infection in infants. The inclusion criteria was fever (defined as axillary temperature > 99.6 degrees F) with any one of the following features; seizure,... more
To define the clinical manifestations of Chikungunya infection in infants. The inclusion criteria was fever (defined as axillary temperature > 99.6 degrees F) with any one of the following features; seizure, loose stools, peripheral cyanosis, skin manifestations or pedal edema in children less than one year. Details of disease from onset of illness till admission were noted and a thorough clinical examination was done at the time of admission. Daily follow-up was performed and the serial order of appearance of clinical features was noted till complete recovery. The sera collected from patients after the 7th day of onset of fever was analyzed for specific chikungunya antibody by IgM antibody capture enzyme linked immunosorbent assay (ELISA). Fifty six (56) infants were laboratory confirmed for chikungunya, consisting of 34 (60.71%) males and 22 (39.29%) females. 4 (7.14%) infants were less than 1 month of age, 39 (69.64%) 2-6 months old and 13 (23.21%) 7-12 months old. Fever was invariably present, but associated constitutional symptoms in infants consisted of lethargy or irritability and excessive cry. The most characteristic feature of the infection in infants was acrocyanosis and symmetrical superficial vesicobullous lesions were noted in most infants. Erythematous asymmetrical macules and patches were observed which later progressed to morbiliform rashes. The face and oral cavity was spared in all observed patients. An entirely different spectrum of disease is seen in infants with chikungunya as compared to older children who need to be carefully observed for. The morbidity and mortality of the disease may be avoided by the rational use of drugs and close monitoring of all infants.
Research Interests:
Our objective is to study the MR imaging pattern in neonatal parechoviral leucoencephalitis, a rare cause of neonatal white matter abnormality and to differentiate it from hypoxic-ischemic encephalopathy which is the commonest cause of... more
Our objective is to study the MR imaging pattern in neonatal parechoviral leucoencephalitis, a rare cause of neonatal white matter abnormality and to differentiate it from hypoxic-ischemic encephalopathy which is the commonest cause of white matter change in neonates. We evaluated 25 neonates who presented with features of encephalopathy. Cranial ultrasound and MR imaging was done in all the cases. The pattern of white matter abnormality was analyzed in all cases. Neonatal leucoencephalitis caused by HPeV has a distinctive clinical presentation and has predilection for the white matter, causing diffusion restricting signal intensity changes involving the periventricular and subcortical white matter, in particular the frontal white matter, also the corpus callosum, internal capsule, external capsule and pyramidal tracts of the supratentorial brain and cerebral peduncle with relative sparing of occipital white matter, thalamus, basal ganglia and the infratentorial regions. Follow up imaging shows disappearance of the lesion without white matter loss. Whereas mild to moderate hypoxic-ischemic injury in a full-term neonate causes lesions in the watershed areas, and subcortical white matter predominantly involving the parietooccipital region and perirolandic region. Thalamus, brainstem, cerebellum, and deep gray matter structures are involved depending on the severity. White matter changes in the neonatal period are commonly associated with hypoxic-ischemic injuries and metabolic causes, less frequently, infection like parechovirus leucoencephalitis. HPeV infection must be considered in infants with specific pattern of white matter change but no convincing history of a perinatal hypoxic-ischemic insult, thus differentiating it from HIE.
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Purpose: Our objective was to evaluate the radiological appearances in different stages of idiopathic chondrolysis of hip (ICH) which will be helpful in the early diagnosis and guiding appropriate treatment for this condition to prevent... more
Purpose: Our objective was to evaluate the radiological appearances in different stages of idiopathic chondrolysis of hip (ICH) which will be helpful in the early diagnosis and guiding appropriate treatment for this condition to prevent progression of disease. Materials and Methods: We evaluated 14 patients of ICH in varying stages: Stage 1 (n = 9), Stage 2 (n = 3), Stage 3 (n = 2). Average age at presentation was 10–11 years. Plain radiograph and magnetic resonance imaging (MRI) was done in all these patients. Results: In the current study, we have attempted to stage ICH based on the radiological progression of the disease, where MRI was used as the primary tool. Stage 1 showed a wedge-shaped hyperintensity in T2 weighted (T2W) and hypointensity in T1 weighted (T1W) images involving the middle one-third of the femoral head and it is the earliest and characteristic finding in MRI. Associated findings like joint space narrowing, synovial hypertrophy with joint effusion may also be ob...
Research Interests:
To evaluate the role of Resistive Index measured by cranial doppler ultrasonography in predicting the risk of death/ abnormal neurodevelopmental outcomes in term neonates with hypoxic ischemic encephalopathy. We enrolled 50 term... more
To evaluate the role of Resistive Index measured by cranial doppler ultrasonography in predicting the risk of death/ abnormal neurodevelopmental outcomes in term neonates with hypoxic ischemic encephalopathy. We enrolled 50 term asphyxiated neonates with hypoxic ischemic encephalopathy and measured resistive index within 72 hours from the anterior cerebral artery. Participants underwent tone and developmental assessment at 6-12 months. Among the 50 neonates, 25 (50%) had abnormal resistive index (<0.56 or >0.80). Presence of abnormal resistive index increased the risk of death/ abnormal neurological outcomes at 6-12 months [RR (95% CI): 7.5 (2.0,8.6), P<0.01]. An abnormal resistive index is associated with death/ neurodevelopmental impairment in neonatal hypoxic ischemic encephalopathy.
Research Interests: Treatment Outcome, Medicine, Brain, Prospective studies, Humans, and 4 moreFemale, Male, Newborn Infant, and Prognosis
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Poster: "ECR 2020 / C-14788 / Latest embryological classification of Spinal lipoma -what radiologist need to know " by: " R. Prasan 1, G. Kathirvelu1, D. Jaganathan2, K. GEETHA3, A. Damodaran Nampoothiry1; 1Chennai/IN,... more
Poster: "ECR 2020 / C-14788 / Latest embryological classification of Spinal lipoma -what radiologist need to know " by: " R. Prasan 1, G. Kathirvelu1, D. Jaganathan2, K. GEETHA3, A. Damodaran Nampoothiry1; 1Chennai/IN, 2600031, ta/IN, 3NAMAKKAL/IN"
Research Interests:
Jejuno-jejunal intussusception is a rare complication of feeding jejunostomy. We are reporting a case of 55-year-old woman who presented with loose stools, vomiting and upper abdominal pain one month after a total gastrectomy and Witzel’s... more
Jejuno-jejunal intussusception is a rare complication of feeding jejunostomy. We are reporting a case of 55-year-old woman who presented with loose stools, vomiting and upper abdominal pain one month after a total gastrectomy and Witzel’s feeding jejunostomy (FJ) for gastric malignancy. Ultrasonogram of abdomen on admission was normal. A gastrograffin study was done 2 days later since the patient did not respond to conservative management. It showed features suggestive of jejuno-jejunal intussusception. Computed tomography scan of abdomen confirmed the presence of small bowel intussusception. Emergency laparotomy revealed Jejuno-jejunal intussusception with the FJ tube as the lead point. Since complete reduction was not possible, resection of the intussuscepted segment of jejunum including the feeding jejunostomy entry site was performed. Intussusception should be considered in patients with abdominal pain and vomiting following FJ as an adjunct to any procedure.
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Objective The primary aim of this study is to document the chest X-ray findings in children with COVID-19 pneumonia. The secondary aim is to correlate chest X-ray findings to patient outcome. Methods We performed a retrospective analysis... more
Objective The primary aim of this study is to document the chest X-ray findings in children with COVID-19 pneumonia. The secondary aim is to correlate chest X-ray findings to patient outcome. Methods We performed a retrospective analysis of children (0–18 years) with SARS-CoV-2 admitted to our hospital from June 2020 to December 2021. The chest radiographs were assessed for: peribronchial cuffing, ground-glass opacities (GGOs), consolidation, pulmonary nodules and pleural effusion. The severity of the pulmonary findings was graded using a modification of the Brixia score. Results There were a total of 90 patients with SARS-CoV-2 infection; the mean age was 5.8 years (age range 7 days to 17 years). Abnormalities were seen on the CXR in 74 (82%) of the 90 patients. Bilateral peribronchial cuffing was seen in 68% (61/90), consolidation in 11% (10/90), bilateral central GGOs in 2% (2/90) and unilateral pleural effusion in 1% (1/90). Overall the average CXR score in our cohort of patient...
Research Interests:
✓ The authors describe a case of a diffuse primary leptomeningeal oligodendroglioma in a 17-year-old girl who presented with raised intracranial pressure and hydrocephalus. She underwent imaging studies and a left frontotemporal... more
✓ The authors describe a case of a diffuse primary leptomeningeal oligodendroglioma in a 17-year-old girl who presented with raised intracranial pressure and hydrocephalus. She underwent imaging studies and a left frontotemporal craniotomy that revealed a cystic oligodendroglioma in the suprasellar cistern and spread of neoplastic cells to the spinal leptomeninges. The tumor showed little response to maximum radiotherapy and chemotherapy, and the patient died from complications of high-dose chemotherapy 2 years after diagnosis. Postmortem examination of the brain and spinal cord revealed diffuse meningeal infiltration by neoplastic cells and no evidence of an intraparenchymal origin. Glial heterotopias were noted at several sites along the brain base, adding circumstantial support to the theory that leptomeningeal gliomas are derived from ectopic glial tissue in the subarachnoid space.
Research Interests: Pathology, Neurosurgery, Adolescent, Medicine, Hydrocephalus, and 15 moreCase Report, Humans, Female, Subarachnoid space, Clinical Sciences, Neoplasm Invasiveness, Pseudotumor Cerebri, Neurosciences, Arachnoid, Leptomeninges, Brain Diseases, Oligodendroglioma, choristoma, Paediatrics and reproductive medicine, and Fatal outcome
Poster: "ECR 2019 / C-1766 / Diagnostic Dilemma in MR Imaging of Spinal Dysraphism" by: "S. Nagarajan, G. Kathirvelu, D. Jaganathan, C. Paraman; Chennai/IN"
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Background Granulomatous herpetic encephalitis is a rare inflammatory complication of acute herpes simplex encephalitis. Methods We describe 3 cases of granulomatous herpetic encephalitis in children arising between 1 to 10 years after... more
Background Granulomatous herpetic encephalitis is a rare inflammatory complication of acute herpes simplex encephalitis. Methods We describe 3 cases of granulomatous herpetic encephalitis in children arising between 1 to 10 years after the initial presentation with acute herpes simplex encephalitis. We focus on the clinical course and neuroimaging phenotype with a discussion of possible mechanisms underpinning this entity. Results The clinical course was highly variable. However, the dominant neuroimaging phenotype in each of our cases was that of confluent gyriform cortical enhancement with predominantly solid foci of enhancement in the subjacent white matter +/− deep gray nuclei. Cerebrospinal fluid was negative for herpes simplex virus DNA in all cases. All 3 cases required brain biopsy to help establish the diagnosis. Conclusions Increased recognition of granulomatous herpetic encephalitis in children will facilitate earlier diagnosis and treatment. Although the exact role playe...
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Background Spinal dysraphisms refer to the congenital abnormalities of the spine and spinal cord due to aberrations in the processes of gastrulation, primary neurulation, and secondary neurulation. Embryology of many complex spinal... more
Background Spinal dysraphisms refer to the congenital abnormalities of the spine and spinal cord due to aberrations in the processes of gastrulation, primary neurulation, and secondary neurulation. Embryology of many complex spinal dysraphisms are yet poorly understood and there is no agreeable anatomical–clinicoradiological classification with inclusion of recently documented and complex spinal dysraphisms. Aims and Objectives The main objective of this study was to review the imaging features of spinal dysraphisms with a better understanding of embryological abnormalities and propose a new classification inclusive of all complex and unusual dysraphisms based on anatomical and clinicoradiological correlation. Materials and Methods This was a retrospective single institutional observational study of 391 cases of spinal dysraphism for 10 years in our institution. Of 391 cases included in the study, 204 were males and 187 were females. Also, 123 cases belonged to the 0–6 months age gr...
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Zinner’s syndrome is a rare congenital abnormality consisting of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction. The mutual embryological origins of the seminal vesicle and the... more
Zinner’s syndrome is a rare congenital abnormality consisting of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction. The mutual embryological origins of the seminal vesicle and the ureteral bud from the Wolffian duct result in both anomalous seminal vesicle and urinary tracts. Most cases have nonspecific symptoms such as prostatism, urinary urgency, dysuria, painful ejaculation, and perineal discomfort. The usual presentation is between the third and fourth decades of life, with infertility being the most common complaint. Ultrasound and magnetic resonance imaging can easily detect this condition. We present here an extremely rare developmental anomaly involving the Wolffian ducts, which would remain undiagnosed but for radiologic imaging.
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Research Interests:
There are various causes of Reno Vascular Hypertension in children reported in the literature. Amongst these, Page kidney gets a rare mention. This phenomenon is a result of the accumulation of blood or urine in the perinephric or... more
There are various causes of Reno Vascular Hypertension in children reported in the literature. Amongst these, Page kidney gets a rare mention. This phenomenon is a result of the accumulation of blood or urine in the perinephric or subcapsular space, resulting in compression of renal parenchyma, microvascular ischemia, alteration in the renin-angiotensin apparatus, and high renin hypertension. It has been well documented and studied in adults. Only a few cases are reported in the paediatric population. We report a rare presentation of Page kidney in a 5 year 8 months old girl. She initially presented with Dietl’s crisis secondary to left Pelviureteric Junction obstruction (PUJO) causing massive hydronephrosis. She developed Page kidney phenomenon after spontaneous rupture of the pelvicalyceal system formed a tight compressive urinoma. She was managed successfully with internal JJ stenting and ultrasound-guided aspiration of the urinoma followed by elective delayed Pyeloplasty. To our...
