bluuebunny/crossref_metadata_2025 huggingface dataset:
Hepatic kinetics and magnetic resonance imaging of gadolinium ethoxybenzyl diethylenetriaminepentacetic acid (Gd‐EOB‐DTPA) in dogs
Authors: BENNESS G , KHANGURE M , MORRIS I , WARWICK A , BURROWS P
Published: March 2008

This complex study was designed to measure the transport and excretion characteristics of gadolinium ethoxybenzyl diethylenetriaminepentacetic acid (Gd‐EOB‐DTPA) in dog's livers following bolus and infusion. Simultaneous T1 magnetic resonance imaging was performed to measure maximum signal enhancement.

Anaesthetized dogs had cannulation of the common bile duct and urinary bladder for collections and cannulation of the femoral artery and vein for monitoring, blood sampling and infusion. Gd‐EOB‐DTPA was administered by bolus (range 12.5–200 μmol/ kg) and infusion (range 0.4–6.4 μmol/min per kg).

An hepatic transport maximum 0.09–0.15 μmol/min/kg was achieved with a blood concentration of 0.03–0.06 μmol/mL. Marked hepatic affinity for Gd‐EOB‐DTPA was demonstrated with measurements of liver concentration. Maximum T1 signal enhancement was achieved with blood Gd‐EOB‐DTPA concentration of 0.02–0.03 μmol/mL and a liver concentration of 1–2 μmol/g.

The transport maximum for Gd‐EOB‐DTPA in the dog was similar to that for ipodate and iodipamide and effective imaging was achieved with sub‐maximal doses. The maximum signal enhancement at blood concentrations less than required for maximum transport suggest a wide latitude for effective clinical imaging.
Femoral artery pseudo‐aneurysm: Ultrasound guided compression repair
Authors: LOFTUS W K , ISAACS J L , SPYROPOULOS P
Published: March 2008

Pseudo‐aneurysm is an uncommon complication of catheterization of the femoral artery. The recently described technique of repair of femoral artery pseudo‐aneurysms by ultrasound guided compression is discussed and three cases using this treatment presented.
The relationship between tests of lung function and three chest radiological scoring systems in patients with cystic fibrosis
Authors: WONG E B K , REGNIS J , SHNIER R C , BYE P T P , STEWART M E B
Published: March 2008

The chest radiographs and lung function tests of 41 patients attending the cystic fibrosis clinic at Royal Prince Alfred Hospital were reviewed. The chest radiographs were scored using three different scoring systems: the Shwachman and Kulczycki system (as modified by Doershuk), the National Institute of Health (NIH) system described by Taussig in 1973 and the Brasfield system. The scores were correlated with lung function tests. Significant correlations were found between the radiological scores and the respiratory variables; the best correlation was with the forced expiratory volume in one second (FEV1% predicted). All three scoring systems showed a high degree of reproducibility of scores when a second radiologist was asked to score the same radiographs independently. The difference in scores between the radiologists was not significant for the NIH and the Brasfield systems. The Brasfield system is, however, the system of choice because it allows the assessment of all the major pathological features seen in cystic fibrotic chest films and consistently has the best agreement with all the lung function variables. It was also found that radiological evidence of lung hyperinflation may not be a good indicator of disease progression.
Solitary regional bony recurrence in Merkel cell carcinoma
Authors: COLLINS M K , CAMERON F G
Published: March 2008

This case report of recurrent Merkel cell carcinoma between radiotherapy fields for primary site and regional nodes supports the value of postoperative radiotherapy to the primary site, the intervening lymphatics and draining nodes.
Pacemaker twist: Twiddler's syndrome
Authors: WONG J K L , HOUSE R J
Published: March 2008

Two clinically asymptomatic cases of cardiac pacemaker twist or Twiddler's syndrome are presented. These examples illustrate that not all cases of pacemaker twist are symptomatic and need intervention. Both patients had unipolar pacemaker systems inserted for second degree heart block and sick sinus syndrome, respectively. The diagnosis of pacemaker twist was made on routine chest radiograph, requested for conditions unrelated to pacemaker dysfunction. No manipulation of pacemakers was documented. The recognition and documentation of radiological signs of pacemaker twist is important as a baseline for follow up especially if symptoms of pacemaker dysfunction arise.
Malignant lympho‐epithelial lesion of the salivary gland: A case report and review of the literature
Authors: BORG M F , BENJAMIN C S , MORTON R P , LLEWELLYN H R
Published: March 2008

Malignant lympho‐epithelial lesion of the salivary gland is an undifferentiated squamous cell carcinoma which is associated with a prominent lymphocyte‐rich stroma. This study reviews the current literature pertaining to this rare tumour with reference to the single recorded case of malignant lympho‐epithelial lesion of the salivary gland presenting in Auckland, New Zealand. This 26 year old Caucasian male developed a rapidly growing lesion in the right parotid gland and multiple ipsilateral cervical lymph nodes. Treatment consisted of surgery and radiotherapy. The patient is currently disease free.

One hundred and eight other cases have been reported in the literature, 82 of whom have Mongolian ancestry (Eskimos and southern Chinese) and 15 of whom are Caucasian. More than 50% of these patients (all Mongolian) have elevated titres of serum immuno‐globulin A against Epstein‐Barr virus capsid antigen. The age at presentation is variable, ranging from 10 to 86 years, with a slight female predominance. Forty‐one per cent of patients present with regional lymph node metastases and 20% with distant metastases. Given the rarity of this disease, treatment is controversial. Current data suggest that early radical combined modality treatment using surgery and radiotherapy leads to prolonged survival and cure with 5 year survival rates greater than 50%.
Diagnosis of osteoid osteoma using stir magnetic resonance imaging
Authors: KRIBBS STUART , MUNK PETER L , VELLET A DALE , LEVIN MORRIS F
Published: March 2008

Two patients with osteoid osteomas were evaluated with magnetic resonance imaging at 1.5 T using both conventional spin‐echo (SE) and short TI inversion‐recovery (STIR) sequences. On plain films the classic findings of a radiolucent nidus with a dense surrounding reactive zone of sclerosis were absent. The diagnosis was suspected on observing the presence of marked marrow oedema in the involved bone. Conventional SE images were unimpressive in detecting the bone marrow changes. Increased signal intensity indicating bone marrow oedema was striking on the STIR images and facilitated diagnosis. In cases of suspected osteoid osteoma which do not demonstrate the classic radiologic features, adding the STIR sequence to conventional SE magnetic resonance sequences to enhance detection of bone marrow change is recommended.
A technique for venography in chronic venous syndromes
Authors: HALLIDAY PETER
Published: March 2008

The technique of venography presented here is given in detail and is intended to distinguish between the specific requirements of venography of chronic and acute venous syndromes. At each of four major sections of the venous return from the lower limb, the major veins requiring evaluation are identified together with variations in technique needed to ensure that no artefacts develop. Central to the technique is the use of sustained, large volume injections of low‐osmolality ionized contrast medium. The technique was used in over 2000 examinations without significant complications.
Acute intracerebral haematomas: Assessment for possible underlying cause with MRI scanning
Authors: YOUNG NOEL , VLADICA PHILIP , SOO YOI SIN , HO DAVID
Published: March 2008

Forty‐seven patients presenting with acute intracerebral haematomas between 1989 and 1992 were retrospectively examined to assess the role of Magnetic Resonance Imaging (MRI) in identifying any underlying lesion. None had any prior known intracerebral pathology. Magnetic resonance imaging scans were done on a 0.5 T unit.

Ten patients with an average age of 35 years had angiographically occult vascular malformations (AOVM) found by MRI (one with biopsy confirmation). One of three cases of glioma, three of three cases with secondary tumour, one case of superior sagittal sinus thrombosis with haemorrhagic infarction, one of two cases of venous angioma and one case of arteriovenous malformation were detected by MRI.

Progress computed tomography scans discovered two cases of glioma and angiography found a venous angioma and an arterial aneurysm, all undetected by MRI.

It is concluded that MRI scanning is helpful in detecting underlying AOVM as a cause of intracerebral haemorrhage but its role in imaging haemorrhagic tumours remains unclear.
Retrograde venography and colour Doppler imaging of a popliteal venous aneurysm
Authors: FERNANDO CHARITHA , VALLANCE STEPHEN
Published: March 2008

Popliteal venous aneurysms are rare and usually manifest with formation of thrombus and embolization to the lungs. The radiological features of a popliteal venous aneurysm, without thrombus, initially identified by ultrasound with colour Doppler imaging and further investigated with retrograde venography is described.
Postoperative bile duct strictures: Ultrasound and endoscopic retrograde cholangiopancreatography/percutaneous transhepatic cholangiography evaluation
Authors: VASHISHT S , TANDON R K , BERRY M
Published: March 2008

This retrospective study was undertaken to assess the role of ultrasound (US) and to compare it with endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC) in the evaluation of post‐operative common bile duct (CBD) strictures. Seventy‐four patients with postoperative CBD strictures were evaluated by ERCP and/or PTC. Of these, US scans were available in 52 patients. Ultrasound findings of CBD strictures were: proximal dilatation of CBD with smooth tapering stenosis (41%); abrupt cut off of CBD (18%); and echogenic nodule, without acoustic shadowing, in 16%. Of the remainder, mild proximal dilatation of the CBD was seen in 6%, and 19% of the patients had normal US scans.
Retrograde transpopliteal salvage of the failed antegrade transfemoral angioplasty
Authors: McCULLOUGH K M
Published: March 2008

Following unsuccessful conventional antegrade transfemoral angioplasty (six occlusions, one stenosis) seven patients underwent retrograde transpopliteal catheterization to retrieve the situation. The procedure was successful in five patients. The other two patients had small calibre popliteal arteries that went into spasm on attempted puncture. Provided the popliteal artery is of adequate calibre, the procedure is a relatively straightforward technique recommended for retrieval of failed antegrade angioplasty.
The role of endoscopic ultrasonography in the upper gastrointestinal tract: A review with illustrative cases
Authors: MENDELSON RICHARD M
Published: March 2008

In this article the current applications of endoscopic ultrasound in the upper gastrointestinal tract and its adnexa, as well as the areas of likely development, are reviewed. Illustrative cases are shown from the author's experience. Pitfalls and limitations of the technique are also discussed.
Superior vena cava syndrome induced by bronchogenic carcinoma: Is this an oncological emergency?
Authors: GAUDEN S J
Published: March 2008

This study was initiated to assess the validity of the traditional view that superior vena cava syndrome (SVCS) is a life‐threatening condition requiring immediate treatment without necessarily obtaining a tissue diagnosis.

A retrospective review of 6504 patients diagnosed to have lung cancer and treated at the Queensland Radium Institute between 1979 and 1991 was performed. From this group, 249 patients with well‐documented SVCS treated with radiotherapy were identified. An analysis with respect to duration of symptoms, time to treatment, degree of response and overall survival was performed.

Although deaths did occur in this series due to associated tracheal obstruction, deaths due to venous compression per se were not seen. The response to radiotherapy was generally poor, with only 19% of patients achieving a complete resolution of their symptoms and signs while 30% of patients had no demonstrable response. The overall survival of patients in the study group was 5% at two years. Patients demonstrating a complete or partial response to treatment survived significantly longer than patients who did not respond at all. The median survival for complete responders was 6 months while for non‐responders it was 1 month. Although 71% of patients had commenced radiotherapy within 24 h of presentation, many patients had been experiencing symptoms or signs of SVCS for quite some time. Only 29% of patients had experienced symptoms for 7 days or less while 49% of the study group had experienced symptoms for over 2 weeks. No significant difference was noted in overall survival or response to treatment when patients were categorized as having symptoms for less than or equal to 14 days versus those having symptoms for greater than 14 days.

This study found little evidence to support the concept that SVCS is an oncological emergency. Patients survived despite unrelieved obstruction and the data suggest that the poor prognosis of patients with this condition appears to more closely correlate with the prognosis of the underlying disease. It is suggested that intravascular thrombosis may be an important factor in the pathogenesis of this syndrome.
Radiation therapy for early stage seminoma of the testis. Analysis of survival and gastrointestinal toxicity in patients treated with modern megavoltage techniques over 10 years
Authors: YEOH ERIC , RAZALI MAZLAN , O'BRIEN PETER C
Published: March 2008

Seventy‐seven patients treated with megavoltage irradiation to the paraaortic and/or pelvic nodal areas, for stage I and non‐bulky (< 5 cm) stage II seminoma of the testis, were studied at the Royal Adelaide Hospital from 1981 to 1990. The aim was not only to assess overall and relapse‐free survival, but also early and late gastrointestinal toxicity in a group of patients treated in a uniform manner using modern techniques.

The 10 year actuarial survival was 96.1% for all patients, being 95.6% for stage I and 100% for stage II. The 10 year actuarial complication rate for all late gastrointestinal effects was 9.1%. This consisted of a 6.5% risk of peptic ulceration and a 2.6% risk of chronic diarrhoea at 10 years. At least one acute gastrointestinal effect occurred during radiotherapy in the vast majority of patients (90.9%). Analysis of the effect of age (< 34 years vs > 34 years), stage (I vs II) and dose of radiation (< 30 Gy vs > 30 Gy), showed none of these variables to have a significant influence on overall survival or on the incidence of late complications.

The results of these findings are discussed in the light of recent studies of a surveillance policy following orchidectomy for stage I seminoma of the testis. Given that gastrointestinal toxicity is the major toxicity associated with the treatment of stage I patients, the data from this study should assist clinicians and their patients to arrive at an informed decision regarding adjuvant radiotherapy.
The dense basilar artery as a sign of basilar territory infarction
Authors: HARRINGTON T , ROCHE J
Published: March 2008

Three cases of basilar artery territory infarction, in which a dense basilar artery was noted, are described. The dense basilar artery was recognized on computed tomography (CT) by comparing its density with that of other unaffected intracranial vessels. This sign is thought to represent basilar thrombosis or embolism and has similarities to the dense middle cerebral artery sign. The dense basilar artery is an early sign suggesting basilar territory infarction and its use improves the CT detection of basilar territory infarction.
Malignant large‐cell non‐Hodgkin's lymphoma of the spleen
Authors: NG L S
Published: March 2008

Primary malignant tumours of the spleen are rare, with non‐Hodgkin's lymphoma being the most common. A case of malignant large‐cell lymphoma of the spleen in a patient with unexplained splenomegaly, is presented. There are very few previous reports on this condition in the radiological literature. The sonographic, computed tomographic and angiographic findings are described, with a brief review of the literature on this condition. Although there are no specific radiological findings to diagnose this condition, it has to be considered in the differential diagnosis of a solitary lesion in the spleen.
Thrombolytic therapy in paroxysmal nocturnal haemoglobinuria complicated by hepatic vein thrombosis
Authors: FRAWLEY K J , MacKechnie S G , TAYLOR K M
Published: March 2008

Hepatic vein thrombus is a common and often fatal complication of paroxysmal nocturnal haemoglobinuria. Rapid diagnosis with ultrasound, computed tomography or venography is required to improve the prognosis. Although heparin is often the initial therapy of choice, thrombolytic agents may be more beneficial in the early management.
Fatal Clostridium septicum myonecrosis
Authors: HIEW C Y , SILBERSTEIN M , HENNESSY O F
Published: March 2008

A 20 year old leukaemic patient with neutropaenia secondary to chemotherapy, who developed overwhelming sepsis, myonecrosis, vascular occlusion and necrotizing enterocolitis due to Clostridium septicum infection is described. Plain abdominal radiographs and a computed tomography scan of the abdomen and pelvis showed gas in the retroperitoneal soft tissues. Clostridium septicum septicaemia has a recognized association with malignancy and neutropaenia and has a high mortality if not diagnosed and treated early. Computed tomography scanning of the abdomen, pelvis and head is advised in any patient with a positive C. septicum blood culture.
Authorship ethics in the radiological sciences
Authors: MUSSURAKIS STAVROS
Published: March 2008

The written communication of new ideas and current developments is a crucial part of the progress of radiological sciences. Research results cannot be incorporated into the body of scientific knowledge, unless they are published. In radiology, questions on authorship ethics have received limited attention. Among the topics discussed in this article are the incentives that stimulate radiologists to write and the obstacles to successful authorship. Practices causing concern to editors, authors and readers are examined, such as the excessive growth through recent years in the numbers of authors per paper, unjustified co‐authorships, wasteful publication practices and fraudulent research. The relationship between the abuses of authorship and the pressure exerted on researchers to publish is exemplified. Further issues addressed include the responsibilities of authors, the proposed principles for authorship, the determination of the sequence of authors in multi‐authored papers and the concept of publication credit. The editor's role in preventing unethical authorship is examined and emphasis is placed on the proposals that have been made to achieve the required reforms by eradicating the publish or perish mentality.
Incidence of the empty delta sign in computed tomography in the paediatric age group
Authors: DAVIES ROGER P , SLAVOTINEK JOHN P
Published: March 2008

The computed tomographic (CT) appearances of dural sinus thrombosis are variable, but include visualization of thrombus within the sinus on post‐contrast images (the ‘empty triangle’or ‘empty delta’sign). This review of 104 consecutive examinations was undertaken to assess the incidence of the empty delta sign in a paediatric group undergoing CT examinations.

The number of examinations in which a sagittal sinus filling defect was seen in three or more images, was unexpectedly high. An overall incidence of 18% was noted. Defects due to bone artifact and defects seen on only one or two slices were excluded. The age distribution of abnormal scans was markedly skewed towards young infants. Nine of 27 examinations (33%) in infants less than 1 month of age, were positive for filling defects, compared with six of 21 (29%) aged between 1 and 12 months, and four of 56 (7%) aged over 1 year.

This review suggests that the finding of a filling defect or empty delta sign in the sagittal sinus is not pathognomonic for sinus thrombosis that results in clinically apparent manifestations. Second, a filling defect apparent on CT may resolve spontaneously.

The incidence of non‐occlusive sinus thrombosis may be significantly higher than previously recognized, particularly in young infants where predisposing conditions including dehydration, infection or prematurity coexist. Previous studies have indicated that the sensitivity of the empty delta sign is approximately 30%. This study implies that either the empty sign has limited specificity in the paediatric population, or that unrecognized non‐occlusive sinus thrombosis is much more frequent than previously described.
Cholecystokinin (CCK)‐HIDA scintigraphy in patients with suspected gall‐bladder dysfunction
Authors: WATSON ANDREW , BETTER NATHAN , KALFF VICTOR , NOTTLE PETER , SCELWYN MAXINE , KELLY MICHAEL J
Published: March 2008

Cholecystokinin hepatobiliary (CCK‐HIDA) scintigraphy is used to triage patients with chronic abdominal pain and suspected gall‐bladder dysfunction. This study evaluates the predictive value of CCK‐HIDA for clinical outcome after surgical and medical therapy. Fifty‐six patients (45 females), mean age 43 ± 9 years, with otherwise normal investigations, including normal ultrasound, fasted for more than 8h and then had 70MBq technetium‐99m‐EHIDA injected. One and a half hours later 15ng/kg CCK was infused over 45min. Seventy minutes dynamic imaging commenced 5 min prior to infusion. An abnormal gall‐bladder ejection fraction (GBEF) was defined as <50%. Patients were treated medically, or by cholecystectomy, depending on the surgeon's overall assessment, including results of the CCK‐HIDA study. Patient status was then obtained in 51/56 patients at least 3 months after the scan or at least 1 month after surgery. All surgical specimens were reviewed independently for pathological changes of chronic acalculous cholecystitis.

Of the 11 patients with an abnormal gall‐bladder ejection fraction, nine (82%) underwent cholecystectomy, all of whom achieved total symptomatic cure, while two patients underwent other therapy, both of whom remained symptomatically unchanged. Of the 40 patients whose gall‐bladder ejection fraction was normal, only five (12.5%) underwent cholecystectomy, of whom four were cured and one partially improved at follow up. Of the 35 patients with a normal gall‐bladder ejection fraction and who underwent forms of therapy other than cholecystectomy, nine were cured symptomatically, 13 improved, 10 remained unchanged and three were symptomatically worse at follow up.

The conclusions of the study were: (i) there is a high probability of cure after cholecystectomy in symptomatic patients with an abnormal CCK‐HIDA scan; and (ii) a normal CCK‐HIDA study does not exclude surgically curable gall‐bladder disease, and further careful clinical assessment is needed in this group.
Fellowship training in radiation oncology: An Australasian survey of current teaching and perceived needs
Authors: IZARD M A , BERRY M P , BOSCH C
Published: March 2008

Thirty Australian and New Zealand Radiation Oncology registrars, who were preparing for their final qualifying examinations, were surveyed about their attitudes to their training programmes. While two (7%) indicated that they had no structured tuition whatsoever, the majority 19 (63%) received on average 1–2 h per week, which was much less than their perceived need. Other areas of training considered deficient included exposure to currlculum requirements, peer support and access to other hospital specialty meetings. When asked about the concept of job rotation between training centres, 23 (77%) considered it to be potentially advantageous, with a majority preferring one such rotation of 6–12 months duration occurring in their third year, with a return to their base unit prior to final qualifying examinations. Limitations and potential benefits of the job rotation concept are discussed.
Sonographic findings in bladder haematoma
Authors: LAM ALBERT H , TANG SIMON
Published: March 2008

The medical imaging and clinical histories of three cases of haematoma of the urinary bladder in paediatrics were reviewed retrospectively. The sonographic findings are unique and diagnostic. Three distinctive sonographic features were observed. The haematomas were large, occupying most of the bladder lumen. They showed an echogenic thick, smooth rim and, in two cases, a laminated appearance with concentric layers of alternating hyper‐echogenicity and hypo‐echogenicity.
Self‐contained, inflatable penile prosthesis: Magnetic resonance appearance
Authors: LEVIN M F , MUNK P L , VELLET A D , CHIN J L
Published: March 2008

The appearance of an inflatable penile prosthesis, visualized on a short tau inversion recovery sequence, is reported, in a patient who had magnetic resonance imaging for pelvic pain subsequent to radical cystoprostatectomy for bladder carcinoma. With suppression of adjacent fat signal, the prosthesis is well delineated from adjacent structures. The fluid‐containing cylinders of the prosthesis are of very bright signal intensity, with the relief valve assembly of low signal intensity.
Osteomesopycnosis
Authors: KOZLOWSKI K , BALEV B , ROGERS J G , STOJANOV V , KONSTANTINOVA D , SCHIVATCHEV P
Published: March 2008

The radiographic findings in two children with osteomesopycnosis are described. This is the first report in the Australian literature of this uncommon, recently described entity.
Richter's hernia of the splenic flexure: Computed tomography appearances
Authors: ARCHER RICHARD J , VAUGHAN MICHAEL , McARDLE JOHN P , HAVLAT MAREK
Published: March 2008

A case of a clinically occult Richter's hernia of the splenic flexure, through an anterior abdominal wall defect, is described. In view of the initial absence of bowel obstruction with a partial or Richter's hernia, and in the absence of physical findings, the importance of computed tomography (CT) in demonstrating abdominal wall lesions is highlighted.
Interventional radiology in the management of superior thyroid artery injury which presents as a diagnostic dilemma
Authors: SHARMA A K , AGARWAL P , ROY S , GAMBHIR S , MISHRA S K , PHADKE R V
Published: March 2008

Following a forgotten iron splinter injury, a 19 year old male developed a slowly increasing extrathyroidal haematoma, which presented as a diagnostic dilemma. Surgical exploration failed to establish a diagnosis and was complicated by severe haemorrhage. Emergency angiography demonstrated injury to the superior thyroid artery. Therapeutic embolization and surgical exploration resulted in functional and anatomical recovery of the thyroid lobe.
Self‐expandable stents for tracheal stenosis: Experience in two patients
Authors: SANTHOSH J , MANDALAM K R , RAO V R K , WAIKER H D , NEELAKANDHAN K S , UNNI M N , GUPTA A K , RAO A S , KARTHA C C
Published: March 2008

Two patients with cervical tracheal stenosis, following prolonged ventilatory support, underwent balloon dilatation and expandable stainless steel stent placement across the stenoses. Following the successful release of the stent, there was gradual widening of the stenosed trachea in one patient, while in the other re‐stenosis occurred due to columns of tracheal tissue projecting between the limbs of the stent. In the chronically ill and debilitated, use of expandable stents provides a good alternative to complex reconstructive surgery.
Pulmonary scintigraphy in suspected pulmonary embolism: How often does it change clinical management?
Authors: WHITE P G , SISSONS G R J , HAYWARD M W J
Published: March 2008

The effect of pulmonary scintigraphy on patient management in suspected pulmonary embolism has been assessed in 158 patients. A change in management occurred in 30% following scintigraphy. The major effect was a reduction in the total number of patients who were anticoagulated. Heparin was stopped in 42 of the 74 patients to whom it had been administered prior to the scintigram.
Bacteriological studies of open versus closed contrast medium delivery systems in angiography
Authors: TRESS B M , HELLYAR A G , PENNINGTON J , THOMSON K R , MARTINKUS J , LAVAN J J
Published: March 2008

The aim of this study was to evaluate the safety of the ‘open’method of contrast medium delivery in the angiographic theatre, in which contrast medium is decanted into open galley pots on sterile trolleys. The air bacterial load within the angiographic theatre was sampled before and during angiographic procedures. The relationship of staff and patient activity to bacterial load was assessed. Samples of Iopromide (Ultravist 370; Schering Pty Ltd, Sydney, NSW, Australia) decanted into galley pots were taken for bacterial culture at the end of seven patient procedures.

Air bacterial loads were comparable with operating theatre levels and were heaviest during staff activity. Three of seven samples taken at the end of angiographic procedures from air‐exposed galley pots yielded contaminants, but the number of bacteria was below that required to produce septicaemia under normal conditions. These results suggest that the open system of contrast medium delivery can be safely used, providing that bacterial checks of room contamination are performed and personnel entry into the theatre is strictly limited.
Treatment of early carcinoma of the vocal cords by radiotherapy
Authors: STEVENS GRAHAM , CASTLE GEETA , O'BRIEN CHRISTOPHER J
Published: March 2008

A total of 145 patients with early carcinoma of the vocal cords (T1,2N0) were treated by radiotherapy from 1979 to 1989. Survival and local control data were available for 135 and 127 patients, respectively. The respective 5 and 10 year results for overall survival were 75 and 68%. The 5 and 10 year probabilities of local control by radiotherapy were 89 and 86%, respectively, for T1 tumours and 70% at both time intervals for T2 tumours. Tumour recurrence following radiotherapy was documented in 18 of 127 patients. Tumour stage predicted significantly for local control, with recurrence rates for T1 and T2 tumours of 11 and 27%, respectively (P= 0.02). There was a higher proportion of recurrences for total radiation doses ≦ 6200 cGy (17%) compared with >6200 cGy (8%), but the difference was not statistically significant. Increasing duration of treatment was related significantly to increased recurrence for T2 (P= 0.01), but not T1, tumours. Most recurrences (60%) were salvaged successfully by laryngectomy. Three patients required laryngectomy for laryngeal oedema without recurrent tumour; all had been treated using a large field size (7 × 6 cm). There were 20 metachronous tumours, including five lung and two head and neck tumours. These results are similar to previous reports and confirm that radiotherapy is very effective for early glottic cancer, with high local control rates and effective salvage if local recurrences are recognized early.
Spontaneous haemorrhage from renal angiomyolipomata
Authors: CORR PETER , YANG WAI TSE , TAN IAN
Published: March 2008

Spontaneous rupture is an uncommon but catastrophic complication of renal angiomyolipoma. Intrarenal haematomas and aneurysms are predictors of tumour rupture. Early detection by computed tomography followed by embolization may be life saving.
Cystic pulmonary lesions in Pneumocystis carinii infection
Authors: BLACKMORE T K , SLAVOTINEK J P , GORDON D L
Published: March 2008

Thick‐walled pulmonary cavities are an uncommon manifestation of Pneumocystis carinii pneumonia (PCP). A case of PCP in a man with Acquired Immunodeficiency Syndrome (AIDS) presenting with a thick‐walled pulmonary cavity and multiple smaller pulmonary air cysts is described. All of these lesions showed dramatic healing with therapy. A brief review of the recent literature is also presented.
Metastasis of renal cell carcinoma to a meningioma
Authors: BREADMORE ROSS , HOUSE ROBERT , GONZALES MICHAEL
Published: March 2008

A case of metastatic renal cell carcinoma within an intracranial meningioma is presented. The pathological and radiological findings are discussed.
Bone scan demonstration of progression of sacral insufficiency stress fracture
Authors: JONES D N , WYCHERLEY A G
Published: March 2008

This case documents the progression of a sacral insufficiency stress fracture, initially involving the lateral left ala and later extending across the body of the sacrum to the right ala. The ‘H’shaped distribution of increased uptake on radionuclide bone scanning is characteristic of this type of fracture, although variations of this pattern are also seen according to the severity of the sacral trauma. While the differing bone scan patterns of this particular fracture type are well established, it is unusual to document the progression of this fracture on bone scan in any one patient.
Radiological diagnosis and management of proximal fallopian tube obstruction
Authors: LIVSEY ROGER JAMES
Published: March 2008

Fluoroscopically guided transcervical fallopian tube catheterization is a valuable technique in the management of infertility, being applicable to occlusion of the proximal fallopian tube. It was first described in the literature in 1987. Our experience is discussed. Modifications to the usual technique are explained. The procedure has had a poor initial acceptance in Australia, but should replace tubal surgery or in vitro fertilization in a group of patients.
Computed tomography and ultrasound in the diagnosis and treatment of liver abscesses
Authors: PHILIPS R L
Published: March 2008

Liver abscess remains a serious and even life‐threatening condition, despite advances in imaging and treatment. The diagnosis of liver abscess depends heavily on radiologic imaging, particularly ultrasound (US) and computed tomography (CT) scanning. The appearance of liver abscesses on these modalities depends mainly on the chronicity of the abscess. The US and CT features of 33 patients with liver abscesses are presented. Percutaneous drainage of pyogenic abscesses under imaging control is the treatment of choice. Eleven of 24 patients with pyogenic abscesses had percutaneous drainage with good results.
Phantom evaluation of the effect of film processing on mammographic screen‐film combinations
Authors: MCLEAN DONALD , RICKARD MARY T
Published: March 2008

Mammographic image quality should be optimal for diagnosis, and the film contrast can be manipulated by altering development parameters. In this study phantom test objects were radiographed and processed for a given range of developer temperatures and times for four film‐screen systems. Radiologists scored the phantom test objects on the resultant films to evaluate the effect on diagnosis of varying image contrast. While for three film‐screen systems processing led to appreciable contrast differences, for only one film system did maximum contrast correspond with optimal phantom test object scoring. The inability to show an effect on diagnosis in all cases is possibly due to the variation in radiologist responses found in this study and in normal clinical circumstances. Other technical factors such as changes in film fog, grain and mottle may contribute to the study findings.
Transient global amnesia following cerebral angiography with non‐ionic contrast medium
Authors: SCHAMSCHULA R G , SOO M Y S
Published: March 2008

Transient global amnesia (TGA) is an uncommon syndrome of recent memory deficit and inability to learn new data, usually resolving within 24 h. Two cases following use of non‐ionic contrast media in cerebral angiography are described. The neuroanatomy of memory is reviewed. Possible aetiologies of TGA in relation to cerebral angiography include ischaemia (embolic, arterial spasm), epilepsy that may be primary or tumour‐related and direct toxic effects of contrast media.
Radiotherapy in the treatment of malignant mesothelioma of the pleura, with special reference to its use in palliation
Authors: DAVIS S R , TAN L , BALL D L
Published: March 2008

Most patients presenting with malignant mesothelioma of the pleura (MMP) are only suitable for palliative treatment. Radiotherapy has not been shown to improve survival in patients with this disease, but is of use in the palliation of symptoms. In this retrospective review of 111 patients with MMP referred to the Peter MacCallum Cancer Institute, the palliative effect of radiotherapy was analysed. More than half of the patients whose response could be assessed had some symptomatic relief from the radiotherapy treatment. No dose–response relationship could be found.
Molecular biology and the radiation oncologist
Authors: KEARSLEY JOHN H , LAVIN MARTIN F
Published: March 2008

An overview is provided of several recent advances in our understanding of the molecular events that occur when cells are exposed to ionizing radiation. A basic knowledge of molecular radiobiology is necessary so that the radiation oncologist can (i) screen cancer patients for an abnormally reduced or exaggerated response to radiotherapy; and (ii) devise novel ways to counter the molecular pathways that sustain malignant progression.
Biliary dilatation in asymptomatic AIDS patients
Authors: CSILLAG A J , McKINNON A , TODHUNTER L P , DOUST B. D.
Published: March 2008

Cytomegalovirus (CMV) is a recognized cause of biliary abnormalities in acquired immune deficiency syndrome (AIDS) patients. In a prospective trial, two of 25 (8%) of AIDS patients on treatment for CMV related infections without biliary symptoms were found to have biliary dilatation on ultrasound. The study confirms previous findings of the poor correlation of sonographic findings with clinical status and biochemical profiles, and demonstrates that biliary tree dilatation in this group of patients may not per se warrant further invasive investigation.
Diverticular disease of the vermiform appendix and its clinical relevance
Authors: BESWICK J S , DESAI S
Published: March 2008

The case of a solitary diverticulum of the appendix found on routine barium enema is presented. The types of diverticula, their presentations and their potential outcomes and significance are discussed.
Imaging of the absent cervical pedicle syndrome
Authors: JONES D N , PRICE J
Published: March 2008

Three cases of congenital absence of a cervical spine pedicle are described. This anomaly comprises a radiological triad of (i) the absent pedicle producing an apparently ‘giant’neural foramen; (ii) a dorsally displaced ipsilateral articular mass and lamina with a dysplastic and reversed facet joint; and (iii) deficiency or absence of the ipsilateral transverse process.

Recognition of this anomaly is particularly important in the context of acute injury to avoid misdiagnosis as a traumatic facet joint fracture‐dislocation. The giant foramen must also be differentiated from expansion due to a neurofibroma. A correct plain radiographic diagnosis is usually possible, but in doubtful cases appearances on computed tomography are pathognomonic.

Magnetic resonance imaging, performed in two of the cases, was helpful in elucidating the contents of the giant foramen, but should rarely be necessary in clinical practice.
Radiotherapy alone for early stage Hodgkin's disease: A 16 year experience at the Royal Adelaide Hospital
Authors: O'BRIEN PETER C , ROOS DANIEL E , WILLSON KRISTYN
Published: March 2008

The records of all patients with stage I and II Hodgkin's disease treated with radiotherapy alone at the Royal Adelaide Hospital between 1970 and 1986 were reviewed. The aim was to ensure the results were equivalent to the best reported series, particularly as treating such patients with chemotherapy alone has been shown to produce equivalent overall survival figures with improved relapse‐free survival. There were 104 patients of whom 67 had undergone staging laparotomy. Fifty‐seven patients were stage I and 47 stage II. Nine patients had B symptoms. Overall survival at 10 years was 83% with disease‐specific survival being 86% and relapse‐free survival 68%. These results compare favourably with those in the world literature. Multivariate analysis only revealed stage as an independent predictor of improved relapse‐free survival. The use of radiotherapy for most patients with early stage Hodgkin's disease is continued at Royal Adelaide Hospital. However, careful selection criteria need to be applied to minimize the incidence of relapse after radiotherapy.
Leaking mycotic abdominal aortic aneurysm
Authors: SING TMYS , YOUNG N , O'ROURKE IC , TOMLINSON P
Published: March 2008

A case of leaking mycotic abdominal aortic aneurysm is reported, with a brief review of the literature. A 58 year old female presented with shoulder and abdominal pain associated with diarrhoea, vomiting and fever with leucocytosis. Computed tomography of the abdomen showed pooling of contrast in the retroperitoneum anterior to a non‐dilated abdominal aorta. There was considerable retroperitoneal blood accumulating in a mass‐like lesion in the right lower abdomen and pelvis obstructing the right renal collecting system. Laparotomy revealed a 4 cm diameter saccular aneurysm of the abdominal aorta, with a 1 cm diameter neck. Culture of the thrombus grew Streptococcus pyogenes.
The utility of the Philips SRI‐100 Real Time Portal Imaging Device in a case of postoperative irradiation for prevention of heterotopic bone formation following total hip replacement
Authors: KIFFER JOHN D , QUONG GEORGE , BERGMAN NEIL R , LAWLOR MARITA , SCHUMER WENDY , AITKEN LIBBY , WALLACE ANTHONY
Published: March 2008

The new Radiation Oncology Department at the Heidelberg Repatriation Hospital in Melbourne, Australia commenced operation in June 1992. As part of quality control the Philips SL‐15 linear accelerator was fitted with the Philips SRI‐100 Real Time Portal Imaging Device (RTPID), the first such apparatus in Australia. One of its major advantages over older systems is its ability to provide a permanent hard copy of the image of the field treated. The computer image can be immediately manipulated and enhanced on the screen (with respect to such qualities as brightness and contrast) prior to the printing of the hard copy. This is a significant improvement over the more cumbersome older port films that required developing time, without any pre‐assessment of the image quality. The utility of the Philips SRI‐100 RTPID is demonstrated in the case of a patient irradiated soon after total hip replacement, as prophylaxis against heterotopic bone formation (HBF). The rapidity and quality of image production is a major advantage in these patients where postoperative pain may result in positional change between film exposure and image production. Extremely accurate shielding block position is essential to shield the prosthesis (and allow bone ingrowth for fixation) whilst avoiding inadvertent shielding of the areas at risk for HBF. A review of the literature is provided.
Has lymphography a role in early stage testicular germ cell tumours?
Authors: Stephenson NJH , Sandeman TF , McKenzie AF
Published: March 2008

A retrospective study was performed of 183 newly diagnosed seminoma cases and 73 newly diagnosed non‐seminomatous germ cell tumours (NSGCT) presenting from 1985 to 1989 to a tertiary referral cancer hospital. The purpose was to assess the contribution of bipedal lymphography (LG) to the management of these patients. As the main value of LG is in detecting small retroperitoneal lymph node (LN) metastases, analysis concentrated upon early stage disease, specifically N0 and N1a LN disease. Comparison between LG results, abdominopelvic computed tomography (APCT), final clinical stage and treatment outcome was performed. We found that with the LG and APCT criteria used (filling defects > 2 mm and LN diameter >20 mm, respectively), LG was much more sensitive in disease detection. However, with modem techniques APCT can reliably detect disease 10 mm or greater. In addition, tumour marker status, primary tumour vascular invasion status and initial clinical examination were each more important in staging NSGCT disease than LG alone. Thus, LG is now rarely used in our institution but we will have to monitor our excellent survival data to confirm that this change in policy is warranted.
An intramammary pseudoaneurysm presenting as a breast mass
Authors: Daunt N
Published: March 2008

A case of a false aneurysm presenting as a bilobed breast mass is described, with diagnosis being made by ultrasound and Doppler studies, and confirmed at surgery and pathology.
Assessment of abdominal aortic aneurysm with magnetic resonance imaging
Authors: Sardelic F , Fletcher JP , Ho D , Simmons K
Published: March 2008

Pre‐operative imaging of abdominal aortic aneurysms (AAA) is important in determining suitability for operation and operative approach. Ultrasound imaging is an excellent screening modality but is relatively poor at identifying renal arteries and the extent of iliac involvement. Computed tomography scanning with intravenous contrast and arteriography are invasive modalities that are associated with a small risk. Magnetic resonance imaging (MRI) offers the potential of accurate anatomical definition without use of contrast agents and passage of an intra‐arterial catheter.

Eight patients who had their AAA evaluated with MRI are reported. All had renal arteries accurately defined, intraaneurysmal thrombosis was well delineated, and iliac extension was correctly identified in four cases. The initial experience has been most encouraging and the authors consider that MRI may become the investigation of choice for pre‐operative AAA assessment.
Fast magnetic resonance imaging in spinal trauma
Authors: Silberstein M , McLean K
Published: March 2008

In a prospective comparison between fast magnetic resonance imaging (MRI) sequences and conventional spin‐echo in a series of 20 patients, gradient‐echo imaging was found to be inferior to spin‐echo, especially in the visualization of spinal cord oedema, and the use of a rapid spin‐echo sequence was limited by inferior visualization of haemorrhage. While the use of a combination of these two fast imaging techniques resulted in equivalent results to conventional spin‐echo, the increased imaging time suggests that fast MRI cannot, as yet, replace conventional spin‐echo techniques in acute spinal trauma.
Partial thickness supraspinatus tears: Diagnosis by magnetic resonance arthrography
Authors: Bradley YC , Chandnani VP , Gagliardi JA , Reeves T Quentin
Published: March 2008

Two patients, with clinical symptoms of advanced impingement syndrome, presented for radiologic evaluation. The magnetic resonance (MR) images of each patient were interpreted as representing a full thickness tear of the supraspinatus tendon. Magnetic resonance arthrography was performed on both patients to further determine the extent of the tear. Using this technique, both patients were diagnosed correctly as having partial thickness tears; one on the articular surface and the other on the bursal surface of the tendon. This information is useful in surgical planning and in patient outeome.
Infantile hepatic haemangioendothelioma
Authors: Wong DC , Masel JP
Published: March 2008

Three cases of infantile hepatic haemangioendotheliomas are described. Two demonstrate the natural history of regression of this benign tumour with no associated complication. The last case demonstrates life‐threatening complications, which included cardiac failure, thrombocytopenia, disseminated intravascular coagulation and bleeding. Imaging modalities with plain films, ultrasound, computed tomography and angiograms are presented. Pathological findings in two of the cases are also described.