bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical follow‐up of patients with percutaneously inserted inferior vena caval filters
Authors: Young N
Published: March 2008

This is a retrospective clinical follow‐up study of 45 consecutive patients who had percutaneous placement of inferior venal caval (IVC) filters in the period 1987 to 1993 to prevent mortality, or severe morbidity, from pulmonary embolism (PE). Ten patients had Gunther filters (GF) and 35 had bird's nest filters (BNF) from 1989. Clinical indications for filter placement were: 23 patients with anticoagulation contraindications, six with anticoagulation failure and recurrent PE, 10 with anticoagulation complications, two with critical PE and four with leg thrombi and PE. Two patients died from recurrent PE after filter placement, one with a GF migrating after replacement, and one with a BNF. Two patients died from severe PE, occurring prior to filter placement. Fifteen patients died in the study period, none due to recurrent PE. Twenty‐five patients remain alive, with a mean follow‐up period of 21 months, with none having recurring PE. One patient was lost to clinical follow‐up. One patient suffered technical difficulty in BNF placement, and underwent surgical removal of a hook penetrating an iliac vein wall. Inferior vena caval filters are efficacious in preventing potentially fatal pulmonary embolism, in both the acute period and the medium term. There are low rates of morbidity associated with their use.
Imaging features of dissecting neuropathic joints
Authors: Peh WCG , Brockwell J , Chau MT , Ng MMT
Published: March 2008

The imaging appearances of three patients with variable clinical presentations of dissecting neuropathic joints are described. Plain radiographs demonstrated bony debris within the soft tissues adjacent to and distant from neuropathic joints. Computed tomography combined with arthrography confirmed that the soft tissue bony debris communicated with the joints.
Embolization of hepatic artery pseudo‐aneurysm facilitated by selective injection of thrombin and thrombin‐soaked coils
Authors: Landy P , Edwards RD , Blomley M
Published: March 2008

A case of recurrent haemobilia due to a pseudo‐aneurysm of the right hepatic artery is presented. The patient required long‐term anticoagulant therapy and, in order to achieve rapid haemostasis, thrombin was used as an adjunct to coil embolization. Rapid thrombosis of the pseudo‐aneurysm occurred after selective injection of 200 units of thrombin, and thrombin‐soaked coils were employed to occlude the arterial supply.
Breast cancer following treatment for Hodgkin's disease: The need for screening in a young population
Authors: O'Brien PC , Barton MB , Fisher R ,   for Australasian Radiation Oncology Lymphoma Group (AROLG)
Published: March 2008

Several recent publications have highlighted the issue of an increased risk of breast cancer in women treated with radiotherapy, chemotherapy, or combined modality therapy for Hodgkin's disease. The risk is greatest in women 30 years or younger at the time of treatment. In the Australasian Radiation Oncology Lymphoma Group database, 60% of women fell into this age category. This article reviews the available data pertaining to induction of breast cancer by radiotherapy for Hodgkin's disease. Breast examination should now be an integral part of the long term follow up for these women. There is also a case for the use of screening mammography. Any breast mass developing subsequent to treatment for Hodgkin's disease should be regarded with a high index of clinical suspicion and, accordingly, biopsies should be performed in the majority of cases, even when mammography is negative.
Dutch variant of Bellini metaphyseal dysplasia: Report of two siblings
Authors: Kozlowski K , Meradji M , Beemer FA
Published: March 2008

Two sibling girls with cone‐shaped knee epiphyses and metaphyses are described. Bone dysplasia with this rare, distinctive, radiographic finding, was first reported by Bellini and Bardare with only few cases reported thereafter. Velores et al. divided bone dysplasias with cone‐shaped epiphyses and metaphyses of the knee in two entities which they named trichoscyphodysplasia and metaphyseal acroscyphodysplasia. Although the authors agree that there is more than one bone dysplasia that presents with these distinctive radiographic knee appearances, they consider that too few cases have been reported to satisfactorily classify this group of disorders.
The clinical and financial impact of non‐invasive vascular testing in the USA
Authors: Zwiebel WJ
Published: March 2008

Health care costs in the USA have increased dramatically during the past 10 years, and it is widely believed that they have reached crisis dimensions. Vascular laboratories are a segment of the USA health care industry that has experienced particularly rapid growth in the last decade. In 1992, USA Medicare payments (for patients ≥ 65 years) totalled US$304 492 588 for 3 673 695 non‐invasive vascular studies. This figure represents only one segment of USA health care costs and, if all segments were considered, the 1992 total for vascular laboratory services would probably approach one billion USA dollars. The expansion of vascular laboratory utilization is attributed to a number of factors: (i) increased recognition of the clinical value of non‐invasive vascular studies; (ii) replacement of invasive (angiographic) procedures; (iii) expanded surveillance application; (iv) the verification of carotid endarterectomy for treatment of carotid stenosis; (v) widespread, unlimited access; (vi) over‐utilization; (vii) greed. Widespread awareness of the crisis in USA health care funding has imposed cost‐containment pressure where virtually none existed previously. The vascular laboratory is no exception to this trend, and the following measures have been suggested for controlling vascular laboratory costs: (i) demonstration of the clinical and cost effectiveness of non‐invasive vascular studies; (ii) utilization review; (iii) pre‐approval of requests for vascular studies; (iv) linkage of vascular study reimbursement with clinical diagnosis; (v) limitations on self‐referral; (vi) reduced reimbursement; (vii) capitation; (viii) diagnosis‐related reimbursement; (ix) accreditation. This article summarizes the factors that have led to increased utilization of vascular laboratory services, and discusses methods proposed for containing vascular laboratory expenditure.
Brachytherapy in oesophageal carcinoma
Authors: Leung John T , Kuan Richard
Published: March 2008

Patients with recurrent or locally advanced oesophageal carcinoma have a poor prognosis. Relief of dysphagia is often the goal of any further treatment. Several methods, including laser re‐canalization, prosthetic intubation, dilatation, external beam irradiation (EBI) and intraluminal brachytherapy (IBT) can be used to alleviate dysphagia.

In this retrospective review of 11 patients, eight with recurrent tumour and three newly diagnosed patients were treated with low dose rate IBT. Relief of dysphagia was achieved in nine patients, all of whom were able to maintain swallowing of at least a semi‐solid diet until death or last follow‐up. Toxicity was minimal, but survival was poor, with a median survival of only 3 months.

IBT presents several advantages over other palliative methods, especially in recurrent tumours where re‐treatment with EBI is often difficult because of normal tissue tolerance. Low dose rate IBT takes only 1–2 days to deliver, is highly effective, has little morbidity and the palliation achieved is relatively durable.
The evolving role of radiation therapy in paediatric oncology, Philadelphia, USA, 19–21 January 1995
Authors: Stevens Graham , Sexton Maree , Gray Alan
Published: March 2008

A summary of a conference reviewing recent developments and changes in the use of radiation therapy in paediatric oncology is reported. Although the use of radiation therapy has resulted in improved cure rates, the long‐term complications of radiation in a paediatric population are recognised. More intensive systemic therapy and the increasing availability of prognostic data, including biological markers to tailor therapy to the individual patient, has resulted in a more selective use of radiation therapy. Changes in the management of specific tumour types are discussed.
A contrast technique to improve sampling in cavitating lung lesions
Authors: Black JA , Blake MP , Cameron DC
Published: March 2008

Twelve patients with cavitating lung lesions of uncertain aetiology, who had percutaneous aspiration combined with the instillation of radiographic contrast media, are presented. A diagnosis was made in 11 of the 12 patients (92%). A positive culture was obtained in all patients already receiving treatment for lung abscesses. Cultures of lavage fluid were positive in 89% of infected cavities. The instillation of radiographic contrast media into the lung cavity assists biopsy of the cavity wall, can be used to lavage the cavity, and may facilitate expectoration of sputum.
The value of ultrasound in the assessment of incompetent perforating veins
Authors: Phillips Gwl , Dip US. Grad Cheng
Published: March 2008

To determine the value of ultrasound in identifying significant perforator disease we assessed 121 perforators in 90 legs of 61 consecutive patients referred for assessment of varicose veins over a 6 month period. Perforators greater than 4 mm in diameter demonstrated reflux in approximately 60% of cases, perforators 3‐4 mm in diameter demonstrated reflux in approximately 45% and perforators less than 3 mm in diameter demonstrated reflux in approximately 25% of cases.

From correlation with previous published data we recommend that all perforators greater than 4 mm in diameter be considered incompetent regardless of whether reflux is demonstrated.
Lymphoscintigraphy pre‐ and post‐surgical lymphatic leak repair
Authors: Andrews John T , Binder Lisa J
Published: March 2008

This case report demonstrates the use of lymphoscintigraphy for the localization of a pelvic lymphatic leak. The study was made before and after the operative repair of a lymphatic leak and a marked reduction in the leakage was evident postoperatively. The patient, a 38 year old woman, had a history of adenocarcinoma of the cervix, that was treated by abdominal hysterectomy and pelvic node dissection, and she subsequently developed chylous ascites that required ongoing drainage via a Tenckhoff catheter. This case study illustrates how lymphoscintigraphy aided in the localization of a lymphatic leak and the follow up of surgical repair.
Tropical pulmonary eosinophilia: A comparative evaluation of plain chest radiography and computed tomography
Authors: Sandhu Manavjit , Mukhopadhyay Sima , Sharma Surender K
Published: March 2008

Plain chest radiography and computed tomography (CT) of the chest were performed on 10 patients with tropical pulmonary eosinophilia (TPE). Chest radiographs revealed bilateral diffuse lesions in the lungs of all the patients with relative sparing of lower lobes in one patient. However, computed tomography revealed bilateral diffuse lung lesions in all of the patients with relative sparing of lower lobes in three patients. In seven (70%) of the 10 patients, CT provided additional information. Computed tomography was found to be superior for the detection of reticulonodular pattern, bronchiectasis, air trapping, calcification and mediastinal adenopathy. No correlation was found between pulmonary function and gas exchange data using CT densities. There was also no correlation between the absolute eosinophil count (AEC) and the radiological severity of lesions. In six patients, high‐resolution CT (HRCT) was performed in addition to conventional CT (CCT), and nodularity of lesions was better appreciated in these patients. It is concluded from this study that CT is superior to plain radiography for the evaluation of patients with TPE. However, more work needs to be done to substantiate the results of the present study.
Computed tomography morphology of the adrenal glands of patients with Addison's disease
Authors: Ammini AC , Gupta R , Mukopadhyay C , Shah P , Sandhu MS , Vijayaraghavan M , Berry M
Published: March 2008

To study the morphology of the adrenal glands of patients with Addison's disease an ultrasound and a computed tomographic scan of the adrenal glands were performed in 28 patients with Addison's disease. Thirteen patients had bilateral, asymmetric adrenal enlargement. In six of these patients, areas of necrosis and calcification were also seen. Six patients had atrophic glands with calcification and nine patients had normal/atrophic glands without calcification. After instituting appropriate treatment, computed tomography (CT) was repeated between 6 months and 3 years later in 10 of the 13 patients with adrenal enlargement. A reduction in gland size was noted in all patients and one had functional recovery. We conclude that the appearance of the adrenal glands on CT depends not only on the nature of the underlying disease but also on the duration of the illness and the type of treatment.
Secondary tumours after prophylactic cranial irradiation
Authors: Leung John , Guiney Michael
Published: March 2008

A 22 year old woman, who at the age of 6 years had prophylactic cranial irradiation for acute lymphoblastic leukaemia, presented with both astrocytoma of the brain and breast carcinoma. The link between the two solid tumours and previous cranial irradiation is discussed.
Intradural lipoma
Authors: Schubert F
Published: March 2008

A case of an intradural lipoma in the region of the thoraco‐lumbar junction in a 24 year old female is reported.
CT of pancreatic gas gangrene
Authors: McCloskey Malachy , Low Vincent HS
Published: March 2008

A case of gas gangrene complicating acute pancreatitis is presented. The presence of gas within the pancreatic bed is very suggestive of infection with gas forming organisms in the right clinical setting.
Bone changes in tuberous sclerosis mimicking metastases
Authors: Pui Margaret H , Kong Hwai Loong , Choo Hui Fen
Published: March 2008

Sclerotic and lytic bone changes of tuberous sclerosis (TS) can mimic bone metastases. We report a case of bone metastases from bronchogenic carcinoma in a patient with TS bone changes. Bone scintigraphy and magnetic resonance imaging are useful in distinguishing the TS bone lesions from bone metastases.
Hook wire localization of inferior lesions in the breast
Authors: Evans Pauline , Champness Peter
Published: March 2008

Inferior lesions in the breast can be difficult to localize pre‐operatively using the hook wire technique as the equipment does not readily allow an approach from below. Distorting the breast by rolling it against the cassette holder displaces an inferior lesion into a lateral position. The lesion can then be easily localized by the shortest needle path.
Radiotherapy for Hodgkin's disease in pregnancy
Authors: Leung John T , Kuan Richard , Patel Virendra
Published: March 2008

Hodgkin's disease diagnosed during pregnancy poses a dilemma as there are risks of abortion and fetal malformation with the use of radiotherapy and chemotherapy. A patient with Hodgkin's disease during pregnancy treated with radiotherapy is presented.
Wildervanck syndrome
Authors: Kumar A , Chaudhary D , Gupta SK
Published: March 2008

We report a case of the Wildervanck (cervico‐oculo‐acoustic) syndrome exhibiting Klippel–Feil anomaly, congenital sensorineural deafness and bilateral sixth nerve palsy. Associated anomalies included short stature, microcephaly, mental retardation, and cleft palate.
Construction of an ultrasound biopsy phantom
Authors: Patel AS , Harrington TJ , Saunt KS , Jones WK
Published: March 2008

The technique for construction of an agar‐based ultrasound biopsy phantom is described. Features include tissue equivalent reflectivity, long life and non‐shadowing targets. The phantom is useful for learning the necesary co‐ordination between needle and probe for ultrasound needle guidance. This skill should initially be practised in vitro, on a device such as this.
Diagnosis of renal artery branch stenosis using captopril intervention scintirenography
Authors: Prakash R , Gupta SK
Published: March 2008

A case of renovascular hypertension in a young male is presented. The patient had a small size right kidney with reduced differential function on the baseline [99mTc]‐DTPA renal study. Captopril intervention scintigraphy demonstrated a dramatic reduction in renal perfusion and cortical uptake in the upper and mid‐poles of the affected kidney. Time‐activity curves of the [99mTc]‐DTPA studies using segmental regions of interest corroborated visual findings. The presence of renal artery branch stenosis was confirmed on renal angiography.
Role of transabdominal pelvic ultrasound and computed tomography in the detection of bladder involvement in advanced cancer of the cervix
Authors: Deo SVS , Shukla NK , Sandhu M , Thakur KK , Goel S , Mohanti BK , Rath GK
Published: March 2008

The imaging data of 125 advanced cancer cervix patients attending the Institute Rotary Cancer Hospital between June 1992 and June 1994 was reviewed. The aim of the study was to assess the role of transabdominal pelvic ultrasound (TAPUS) and computed tomography (CT) in the detection of bladder involvement. TAPUS was performed in 65 patients (group I) and CT in 60 patients (group II). With respect to clinical stage, both groups were comparable. Cystoscopy was performed in all patients and the findings were taken as the gold standard for comparison of imaging data. The sensitivity, specificity and accuracy of TAPUS were 65, 94 and 75%, respectively, while those for CT were 80, 92 and 85%, respectively. Results of the present study reveal that the accuracy of TAPUS is comparable to the accuracy of other imaging modalities in the detection of bladder involvement in cervical cancer and that it should be used more frequently in developing countries that deal with a large number of cervical cancer patients in view of its easy availability, low cost and absence of exposure to radiation.
Common bile duct stones in non‐dilated bile ducts? An ultrasound study
Authors: Hunt David R
Published: March 2008

In a consecutive series of 870 patients having cholecystectomy performed by the laparoscopic technique in a single surgical unit, prospective data collection has permitted analysis of the relationship between common bile duct (CBD) diameter, as measured pre‐operatively by ultrasound (US) examination, and the frequency of CBD stones. Overall, 85 patients (9.8%) have been shown to have CBD stones; the interval frequency for CBD size 0–4, 4.1–6, 6.1–8, 8.1–10 and > 10mm, was 3.9, 9.4, 28, 32 and 50%, respectively. Because most patients have small ducts (736 with CBD size < 6.1 mm) almost half (42) of those with CBD stones came from this group. In reporting CBD size as ‘not dilated', radiologists should remind clinicians that this does not equate with ‘no CBD stones'.
Occlusive arterial disease of the upper extremity: Colour Doppler as a screening technique and for assessment of distal circulation
Authors: Taneja Karuna , Jain Rajiv , Sawhney Sukhpal , Rajani Mira
Published: March 2008

A prospective study was performed to evaluate the sensitivity of colour Doppler flow imaging (CDFI) in the detection of occlusive arterial disease in the upper limb (using angiography as the standard) and to quantify the severity of the disease. Twenty‐one ischaemic and 15 healthy limbs were studied by intra‐arterial digital subtraction angiograms (IADSA) and CDFI. Selective subdavian digital subtraction angiograms were performed by the percutaneous transfemoral route. CDFI was performed from the brachial artery superiorly to the subdavian artery origin. Special attention was paid to the study of spectral waveforms and peak systolic velocities at various levels. In each subject, IADSA and CDFI were performed by different radiologists without knowledge of the results of the other investigation. In normal limbs, all arteries demonstrated a characteristic sharp triphasic spectral pattern with mean peak systolic velocity of 105, 80 and 57 cm/s for the subdavian, axillary and brachial arteries, respectively. In ischaemic limbs, reduction in peak systolic value and broadening of the spectral trace with filling in of the spectral window were noted. More characteristic was the finding of a loss of diastolic flow reversal, which was the earliest sign of significant arterial stenosis. The pattern of diastolic blood flow correlated well with the degree of collateral formation and distal vascular runoff. In conclusion, CDFI has a high sensitivity and specificity in the detection of significant arterial stenosis and is thus an ideal, inexpensive screening procedure. Analysis of the diastolic wave‐form distal to the stenosis is an indicator of the degree of collateral circulation and distal runoff and thus acts as a prognostic indicator, guiding further investigation and management.
Small gauge gelfoam plug liver biopsy in high risk patients: Safety and diagnostic value
Authors: Fandrich Christian A , Davies Roger P , Hall Pauline de la M
Published: March 2008

The performance of a percutaneous core biopsy of the liver may be contraindicated in patients at higher risk of haemorrhage. In this clinical setting, gelfoam plug embolization of the needle track has been proposed to minimize haemor‐rhagic complications of biopsy. In the present study, gelfoam plug liver biopsy was performed in 51 consecutive patients at increased risk of haemorrhage. An 18 gauge spring‐loaded disposable cutting needle was used through a 4 French sheath. The biopsy track was embolized by three to four gelfoam pledgets. In every patient, the cores of hepatic tissue were adequate for histopathological diagnosis. There were no fatalities and no serious complications. Gelfoam plug liver biopsy using this needle and sheath in combination appears to be a safe procedure and produces diagnostic cores for histological analysis. This method represents an alternative to transjugular liver biopsy and is technically more straightforward to perform.
Primary small‐cell carcinoma of the oesophagus with spontaneous oesophageal perforation following chemotherapy
Authors: Clark Timothy , Lee Mark J , Munk Peter L
Published: March 2008

The authors describe a 66 year old woman with small‐cell carcinoma of the oesophagus who developed a perforation following chemotherapy. Small‐cell carcinoma of the oesophagus is a rare neoplasm, varying in appearance from a small mucosal lesion to a larger fungating mass, which in our patient presented as a bulky soft‐tissue mass causing stricture. Pleural fluid collections which developed via a spontaneous oesophageal‐pleural fistula were subsequently drained using percutaneously placed catheters. Radiologic management of this condition provided a successful and cost‐effective means of patient care.
Dense middle cerebral artery computed tomography sign: Confirmation by magnetic resonance (MR) imaging and MR angiography
Authors: Marsman JWP , Feenstra‐Holtkamp M
Published: March 2008

In acute ischaemic stroke, the dense middle cerebral artery sign on computed tomography indicates occlusion of the middle cerebral artery. A case is described in which the sign was confirmed by magnetic resonance (MR) imaging and MR angiography.
Role of a psychiatry liaison clinic in the management of breast cancer
Authors: Pendlebury SC , Snars J
Published: March 2008

Psychological factors contribute to morbidity in the management of breast cancer. This study assesses the role of a psychiatric liaison clinic in the management of such problems. Fifty‐seven patients with breast cancer seen by the liaison psychiatrist within the radiation oncology clinic from May 1989 to March 1991 were retrospectively reviewed. This population was assessed for pattern of referral, concordance between oncologist and psychiatrist regarding diagnosis, compliance with referral and treatment patterns.

The most frequent times of referral were during initial treatment or at the time of metastatic or recurrent disease. Compliance with referral was 90%. There was concordance of psychiatric diagnosis between the oncologist and the psychiatrist in only 23%, with the oncologist failing to diagnose a major depression in a significant number of patients. Antidepressants were prescribed by the psychiatrist in all patients in whom a major depression was diagnosed.

Our conclusions are that there is a high incidence of major depression in this outpatient breast cancer population. Oncologists frequently fail to recognize a major depression in this patient population with resultant psychological morbidity. Compliance with referral to a liaison psychiatric clinic located within an oncology department is high. The psychiatric management of these patients is an important part of their overall treatment.
Postoperative radiotherapy for DukesB ‘ and C rectal cancer: Peter MacCallum Cancer Institute experience
Authors: Guiney Michael J , Smith Jennifer G , Worotniuk Valentina , Ngan Sam , Blakey David
Published: March 2008

This retrospective study reviews the outcome of patients with DukesB ‘ and C rectal cancer treated with adjuvant postoperative pelvic radiotherapy at the Peter MacCallum Cancer Institute from 1981 to 1990. Sixty‐one patients (22 DukesB ‘, 36 DukesC ‘ and 3 unknown stage) received a median dose of 50 Gy of pelvic irradiation.

Locoregional relapse occurred in 33% of patients. Estimated median progression‐free survival was 1.7 years with 46% surviving without progression at 2 years and 30% at 5 years. There was no difference according to Dukesstage ‘. The estimated median survival was 2.6 years, with no difference according to disease stage. These results with postoperative radiotherapy alone are inferior to results achievable by combination chemotherapy and radiotherapy as adjuvant therapy which should now be considered standard therapy following surgical resection for DukesB ‘ and C rectal cancer.
Dysosteosclerosis
Authors: John E , Kozlowski K , Masel J , Muralinath S , Vijayalakshmi G
Published: March 2008

A 5 year old boy presented with delayed development and loss of vision. A skeletal survey showed osteosclerosis consistent with dysosteosclerosis. Some unusual features of dysosteosclerosis are discussed.
Midline interhemispheric fusion associated with atypical callosal dysgenesis: A mild type of holoprosencephaly
Authors: Sener R Nuri , Jones Andrew O , Roebuck Derek J , Silva Merl de
Published: March 2008

We report the imaging findings in a 3 year old girl with a mild form of holoprosencephaly. The malformation is of interest because it may contribute to our understanding of brain development. The relatively mild clinical features are emphasized.
Multicentric giant cell tumour and phaeochromocytoma
Authors: Tan BS , Doust BD , Mansberg VJ
Published: March 2008

A rare case of multicentric giant cell tumours (MGCT) in an adult male patient is presented. Incidental concurrence of metastatic phaeochromocytoma is also noted in the same patient.
Migration and lymphatic spread of calcified paraffinomas after breast augmentation
Authors: Ooi GC , Peh WCG , Ip M
Published: March 2008

A 62 year old Chinese woman presented 25 years after having both breasts augmented with paraffin injections. Development of paraffinomas and multiple episodes of paraffin‐related mastitis eventually resulted in bilateral mastectomies. The unusual distribution of migrated calcified paraffinomas in the thoracic wall and its lymphatic system is documented on computed tomography.
Duplex ultrasound in the pre‐operative assessment of varicose veins
Authors: Dixon Peter M
Published: March 2008

A technique for the pre‐operative localization of sites of incompetence using B mode and Doppler ultrasound (duplex) is described. The reliability of this investigation was compared with the clinical assessment of a group of surgeons experienced in varicose vein surgery, and with the subsequent surgical findings.

Duplex scans were found to be over 98% sensitive and 93‐97% specific compared with the surgical findings. Clinical techniques were much less sensitive and specific, and in addition there was uncertainty about incompetence in up to 52% of cases.

The place of ultrasound and comparison with other techniques is discussed. While this technique is widely used, especially in vascular laboratories, the technique has not previously been reported in detail.
Pneumomediastinum: An acute presentation of the superior mesenteric artery syndrome
Authors: Ooi GC , Crundwell M , Ferrando J
Published: March 2008

The authors report a case of the superior mesenteric artery syndrome presenting acutely with a Boerhaave‐type syndrome. Pneumomediastinum was seen on the chest X‐ray. There were no known predisposing factors or previous history typical of this syndrome.
Opsismodysplasia: A case report
Authors: Zeman J , Baxova A , Houstkova H , Kozlowski K
Published: March 2008

A 6‐month‐old boy with opsismodysplasia is reported. The purpose of this paper is to draw attention to severe ureteric reflux and incidence of pseudo‐obstruction, findings not previously reported in opsismodysplasia. They are most likely the result of an intrinsic neuromuscular defect which also affects the skeletal muscles. Another new feature, not reported in opsismodysplasia, was dilatation of ventricles probably secondary to brain atrophy.
Budd‐Chiari syndrome: Diagnosis with ultrasound and nuclear medicine calcium colloid liver scan following non‐diagnostic contrasted CT scan
Authors: Mulholland John P , Fong Sum M , Kafaghi Frederick A , Fong William
Published: March 2008

Budd‐Chiari syndrome is a rare condition characterized by thrombosis within the hepatic veins and inferior vena cava. A case of Budd‐Chiari syndrome is presented in a patient who presented acutely 3 days following laparoscopic cholecystectomy for acalculous cholecystitis. A discussion of pathology and findings on calcium colloid scintigram, CTscan and Doppler ultrasound is provided.
Colonic gallstone ileus
Authors: Foster DR
Published: March 2008

Colonic obstruction is a very rare complication of gallstone disease. A case is described in a 63‐year‐old female patient. Radiological investigation, including plain abdominal X‐ray and contrast studies, aided in the diagnosis.
Prevertebral soft‐tissue measurements in cervical spine injury
Authors: Matar LD , Doyle AJ
Published: March 2008

To clarify normal values for cervical prevertebral soft‐tissue measurements and evaluate when they are useful as a marker of cervical spine injury, the prevertebral soft‐tissue measurements of 79 control and 57 acutely injured patients were retrospectively compared by two independent observers. The second, blinded, observer made a provisional diagnosis and indicated if increased soft‐tissue measurements had assisted in making a diagnosis of injury. If measurements ≥7 mm at C2/3 and ≥21 mm at C6/7 were considered abnormal, a true positive rate of 53% and false positive rate of 5% were observed. The differences between the mean measurements in the control and injured groups were statistically significant (P<0.0001 at C2/3 and P<0.01 at C6). Soft‐tissue measurement improved the diagnostic confidence of the blinded second reviewer in 17.5% of the injured group. Analysis of this subgroup revealed a 50% error rate in initial reporting. In all of these cases, the abnormal soft‐tissues had been ignored prospectively. Routine measurement of the prevertebral soft tissues is a simple procedure that may provide an important clue to subtle cervical spine injury.
Dysgerminoma of the ovary: A retrospective study
Authors: Reddy KB , Ahuja VK , Kannan V , Vallikad E , Anantha N
Published: March 2008

A retrospective analysis of 22 patients with ovarian dysgerminoma who were treated between 1980 and 1987 was carried out. The median age at presentation was 24.5 years. A total of 15 patients were in stage I, one patient was in stage II and six patients were in stage III. Bilateral ovarian involvement was present in four patients. Conservative surgery was carried out in nine patients and 11 patients underwent radical surgery. Two patients had biopsy only. Fourteen patients received adjuvant radiotherapy and three patients received salvage radiation for recurrent disease. The 10‐year actuarial survival rate was 81.8%. All 15 patients in stage I were alive and disease‐free at a median follow‐up of 125 months. Four patients (one in stage II and three in stage III) died of progressive or recurrent abdominopelvic disease. Pelvic recurrence occurred after conservative surgery in two patients in stage IA who had a tumour size greater than 10 cm, but they were salvaged with radical surgery, chemotherapy and radiotherapy. There were seven patients aged 20 years or less. All were alive and disease‐free at a median follow‐up of 127 months.
Combined modality therapy for early Hodgkin's disease: Heterogeneity in Australasian clinical practice
Authors: Roos Daniel , O'Brien Peter
Published: March 2008

Two case studies of locally extensive clinical stage IIA Hodgkin's disease (HD) were presented to radiation oncologists at a meeting of the Australasian Radiation Oncology Lymphoma Group, and subsequently to non‐attending members who were asked to indicate their recommended treatment. This paper discusses the 25 responses which were notable by considerable heterogeneity in philosophy and detail. There is clearly no consensus among Australasian radiation oncologists at present, although combined modality therapy (CMT) with Adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by low‐medium‐dose involved field radiotherapy (25–36 Gy) was the most popular response. The literature on radiation dose and chemotherapy in CMT for HD is then reviewed. It seems very likely that low doses in the range of 25–30 Gy (at 1.5–2.0 Gy per fraction) are sufficient. The ABVD should be considered as the ‘standard’ regimen at present, although the optimal sequencing with radiation and number of cycles remain unknown. The heterogeneity of responses to management of the case studies raises questions about ongoing education processes in radiation and medical oncology. Hypothetical case management review may complement currently proposed methods of assessing continuing medical education.
Pseudotumour due to surgical sponge: Gossypiboma
Authors: Şahin‐Akyar Gulden , Yaĝci Cemil , Aytaç Suat
Published: March 2008

The plain‐film, ultrasonography and computed tomography findings of retained surgical sponges (gossypibomas) are described in three patients. When a mass with hyperechoic wavy structures and posterior acoustic shadowing is seen on ultrasonography, the history of previous surgery must be questioned. Gossypiboma should be included in the differential diagnosis of such cases with a previous surgery. Plain film and computed tomography examinations should be obtained for correct pre‐operative diagnosis.
Hydatid cysts of the kidney, seminal vesicle and gluteus muscle
Authors: Pasaoglu Esref , Damgaci Lale , Tokoglu Figen , Boyacigil Sureyya , Yuksel Enis
Published: March 2008

Hydatid disease has a high incidence in Turkey and causes significant complications. A case is reported here of unusual localization of hydatidosis, with involvement of hydatid cysts of the seminal vesicle, kidney and gluteus muscle. A review of the literature is also included.
Neurenteric cyst: Antenatal diagnosis by ultrasound
Authors: Perera G Brian , Milne Maureen
Published: March 2008

The antenatal diagnosis of a thoracic neurenteric cyst with vertebral abnormality during routine ultrasound is described here. The diagnosis was made at 34 weeks gestation but with hindsight, the abnormality was visible on the 18‐week scan. To the knowledge of the authors, this is the first recorded instance of the antenatal demonstration of a neurenteric cyst with a vertebral anomaly. With modern high‐resolution machines it is possible to detect the abnormality at as early as 18 weeks gestation. As a result of early diagnosis, the mother could be counselled and both the mother and the obstetrician could be better prepared to manage the pregnancy and take early remedial action before the onset of complications, to obtain the best possible outcome for all concerned.
Pedicular stress fracture in the lumbar spine
Authors: Chong VFH , Htoo MM
Published: March 2008

Spondylolisthesis with or without spondylolysis is common in the lumbar spine. Associated fracture in the pedicle Cpediculolysis') is unusual. The margins of pedicular stress fractures, like spondylolysis, usually appear sclerotic. A patient with a pedicular stress fracture with minimal marginal sclerosis suggesting an injury of recent onset is presented here. There was associated bilateral spondylolysis. The findings in this patient suggest that established pediculolysis probably represents a stress fracture that has failed to heal.
Rapid destructive osteo‐arthritis of the hip
Authors: Schubert F , Parker WR
Published: March 2008

A case of an unusual destructive hip osteoarthropathy with a plain‐film record of rapid joint destruction is reported. In the absence of any laboratory or pathological support for other pathology this is thought to be an uncommon example of erosive or inflammatory osteo‐arthritis in a large joint.
Helical computed tomography in the assessment of abdominal aortic pathology
Authors: Vicaretti M , Young N , Jenkins J , Fletcher J
Published: March 2008

A pilot study was undertaken to evaluate the role of helical computed tomography in the assessment of abdominal aortic pathology. A total of 17 patients underwent intra‐arterial digital subtraction angiography (IADSA) and helical computed tomography, with eight patients undergoing subsequent operative intervention. A comparison of radiological findings between IADSA and helical computed tomography (CT) was made and, where applicable, a comparison was made with operative findings. Pathology included abdominal aortic aneurysm (AAA) (n=12), thoracoabdominal aneurysm (n=2) and dissection (n=1), graft distension following AAA repair (n=1) and plaque haemorrhage in the distal aorta following percutaneous transluminal angioplasty (PTA) of the iliac artery (n=1).

Planned operative management as based on pre‐operative helical CT imaging findings, in particular with reference to the type of graft used (straight or bifurcated) was not changed at operation. Our findings on helical CT in regards to AAA, thoroco‐abdominal aneurysm and dissection correlated well with angiography and surgery findings.
The efficacy of treatment for malignant epidural spinal cord compression
Authors: Milross CG , Davies MA , Fisher R , Mameghan J , Mameghan H
Published: March 2008

The aims of this study were to document the efficacy of treatment and to identify factors that were predictive of the outcome in malignant epidural spinal cord compression. The medical records of patients treated at the Prince Henry and Prince of Wales Hospitals in the period 1980‐1989 with a diagnosis of malignant epidural spinal cord compression were reviewed. A total of 94 patients were eligible for the study and were treated by radiotherapy alone (37), surgery alone (19) and surgery followed by radiotherapy (38). Efficacy was determined by measuring complete resolution of symptoms and signs at 1 month after presentation, and also by using an overall functional improvement score (FIS). Complete resolution of individual pre‐treatment symptoms that were measured 1 month after treatment occurred as follows: pain (30/88), sensory disturbance (12/61), weakness (8/17), bladder dysfunction (10/42), and bowel dysfunction (10/36). Complete resolution of motor deficit occurred in 7/82 and of sensory deficit in 9/73. The ability to walk was regained in 19/51 previously non‐ambulatory patients, and bladder function improved sufficiently to remove an indwelling catheter in 9/32 previously catheterized patients. As judged by FIS, 67 patients improved, 15 patients remained stable and 12 patients deteriorated. Of the treatments given, a combination of surgery followed by radiotherapy was associated with the greatest functional improvement (P=0.001). The coexistence of‘liver failure’was the only patient‐related factor identified which was associated with outcome (P=0.041). The treatment of malignant spinal cord compression appears to be worthwhile; however, the outcome of treatment is not easy to predict from pre‐treatment factors. A‘functional improvement score’may be useful in assessing treatment efficacy.
Benign hepatic portal venous gas following blunt abdominal trauma
Authors: Dill‐Macky MJ
Published: March 2008

A case of transient hepatic portal venous gas (HPVG) following blunt abdominal trauma is presented. No evidence of a serious mucosal breach or direct complication was seen. Benign forms of HPVG are being increasingly reported and must be considered in order to avoid unnecessary invasive procedures.
Vertebral hydatid disease
Authors: Paşaoglu E , Boyacigil S , Damgaci L , Tokoglu F , Soydinc P , Yuksel E
Published: March 2008

Hydatid disease affecting the bones is a rare condition, its incidence ranging from 0.5‐2% of all cases of hydatidosis. The bones most often involved are the vertebrae (44%). A 22‐year‐old man presented to the hospital with low back pain. A CT scan revealed intracanal and paravertebral cystic lesions at the level of L5‐S1 with destruction of the corpus and lamina, and sacral foramen invasion. An operation was performed and histopathological findings confirmed the diagnosis. In countries where hydatidosis is endemic, the possibility of the disease must be borne in mind.
Sonographic evaluation of biliary ascariasis
Authors: Mani S , Merchant H , Sachdev R , Rananavare R , Cunha N
Published: March 2008

In a prospective 6‐month study, sonographic diagnosis of biliary ascariasis was made in 14 patients; in nine patients, the diagnosis was confirmed by endoscopic retrograde cholangiopancreatography and bile analysis, while in five patients, confirmation was obtained by proven intestinal infestation. No false‐positive or false‐negative cases were encountered. Ascariasis of the biliary tract was seen on ultrasound as echogenic, non‐shadowing images, either as single or multiple strips, with visualization of the digestive tract of the worm as an anechoic inner tube, or as amorphous fragments. Follow‐up sonograms helped in detection of worm expulsion following medical therapy in five patients, while endoscopic extraction of the worm was performed in four patients. In three patients, disappearance of the worm from the biliary tract was noted following a therapeutic sphincterotomy, and two patients detected to have a worm within the gall‐bladder were operated on. In all patients, serial sonograms revealed disappearance of the worm, and the regression of biliary tract dilatation.
The ‘spinnbarkeit phenomenon’ of bile
Authors: Loh YH , Dunn GD , Gibson RN
Published: March 2008

The characteristic flow pattern of obstructed bile from the cannulation needle during percutaneous trans‐hepatic cholangiography (PTC) or a biliary drainage procedure is described, and possible explanations and applications of this observation are discussed.
Frontal sinus carcinoma: A case report and review of the literature
Authors: Chowdhury AD , Ijaz T , El‐Sayed S
Published: March 2008

A rare case of frontal sinus carcinoma is reported. The patient developed early recurrence following surgery, and was managed by accelerated hyperfractionated radiation therapy and concurrent cisplatinum‐based systemic chemotherapy. The patient has remained disease‐free for 30 months following the end of treatment.
Diagnostic Radiology Audit of barium enema examinations in the diagnosis of colorectal carcinoma
Authors: Foster DR
Published: March 2008

Barium enema is a commonly used technique. A number of papers have been published describing its accuracy in the diagnosis of colorectal carcinoma. A retrospective comparison of pathology and radiology reports was made to determine rates of demonstration and reporting of colorectal carcinoma on barium enema examinations for a 12‐month period.
Set‐up variation of patients treated with radiotherapy to the prostate measured with an electronic portal imaging device
Authors: Greer PB , Jose CC , Matthews JHL
Published: March 2008

The set‐up variation of 11 patients treated supine with radical radiotherapy for carcinoma of the prostate was measured with an electronic portal imaging device to determine the adequacy of set‐up techniques and current margins, as well as the need for immobilization. During the treatments 172 images of the anterior fields and 159 images of the left‐lateral fields were taken and the errors in treatment placement were measured by template matching. The variation in the superior‐inferior direction was small, 1.4‐1.6 mm (1 SD), while the medio‐lateral variation was 2.8 mm (1 SD). The anterior‐posterior variation was largest, 4.6 mm (1 SD) with an offset of 3.3 mm anterior. This anterior offset and large anterior‐posterior variation suggests that set‐up techniques were not optimal for this direction. The 1 cm margin used was adequate for set‐up variation except in a small number of cases, which was mainly due to the anterior trend. Random (treatment‐to‐treatment) variations were small (1.1‐2.3 mm; 1 SD), indicating that immobilization would result in only modest improvement in reproducibility for these supine patients.
Two case reports: Carcinoma of the cervix and carcinoma of the endometrium treated with radiotherapy after previous irradiation for benign uterine bleeding
Authors: MacLeod Craig
Published: March 2008

In the 1940s, 1950s and 1960s, low closes of radiotherapy were used to treat benign uterine bleeding. The cases of two women who received this form of therapy and later developed gynaecological malignancies and had high‐dose pelvic radiotherapy are presented. A 76‐year‐old woman with an International Federation of Gynecology and Obstetrics (FIGO) stage‐IIB squamous cell carcinoma of the cervix received external beam radiotherapy and intra‐uterine brachytherapy and a 77‐year‐old woman with a FIGO stage‐IB endometrial adenocarcinoma received adjuvant postoperative pelvic radiotherapy. Both women had a significant past history of low‐dose‐rate intra‐uterine irradiation for dysfunctional uterine bleeding. Therefore the theoretical question of carcinogenesis was raised, and also the practical questions of what dose had previously been given and what further dose could be safely given with regard to normal tissue tolerance.
Post‐traumatic intra‐osseous pseudomeningocele of the occipital bone
Authors: Turgut Mehmet , Ozcan Ösman Ekin , Karaman Can Zafer
Published: March 2008

Clinical, radiographic, and operative findings in two children with intra‐osseous pseudomeningocele of the occipital bone due to cranial trauma are presented here, along with a literature review of this uncommon radiologic entity.
Silicone breast implants: A review
Authors: Hadden Wendy E
Published: March 2008

The diagnostic imaging procedures used to evaluate silicone prostheses used for breast augmentation are reviewed. The nature of silicone and the types of prostheses used are discussed, as are the complications and risks from use of these prostheses. For each imaging modality, mammography, ultrasound, and magnetic resonance imaging, criteria for rupture with examples of silicone leak into adjacent tissues are given.