bluuebunny/crossref_metadata_2025 huggingface dataset:
The American ‘Patterns of Care’ Study: A Model for the Assessment of the Quality of Patient Care in Radiation Oncology
Authors: McKAY MICHAEL J. , LANGLANDS ALLAN O.
Published: March 2008

There are well documented manpower and equipment deficiencies in the specialty of Radiation Oncology in Australia. These deficiencies persist despite numerous reports over the last decade detailing their existence. The Patterns of Care Study (PCS) from the United States of America (USA) is a unique, comprehensive review of Radiation Oncology services in that country. It has clearly demonstrated that substantial benefits not only in survival but also in reduced treatment morbidity accrue when a full range of modern techniques and equipment is used. The present paper is a review of the PCS: this study has immense implications for patient care in particular and cancer services in general, in Australia. There seems little point in continuing to fund cancer research in the hope of gains in survival rates while continuing to ignore the fact that gains of a similar magnitude can be obtained by the maximum use of current knowledge and the provision of modern equipment.
The Radioresponsiveness of Normal and Tumour Microvasculature
Authors: NARAYAN KAILASH , SPIROPOULOS ANNA
Published: March 2008

Mouse tails bearing DMH‐II tumours were irradiated to a total of 80 Gy in 8 Gy fractions, twice a day for 5 consecutive days. The normal tail vasculature was minimally affected for up to 60 days post‐irradiation. In contrast tumour capillaries which showed minor changes on day 6 post‐irradiation were severely affected by day 14.

DMH‐II proved to be a radioresistant tumour. The radiation dose used in this experiment was the maximum total dose which could be tolerated by the mouse tail. The tumour began to regenerate at approximately 40 days post‐irradiation. Tumour infiltrating into the surrounding normal tissue was observed by 60 days following irradiation. As the tumour regenerated, there was no accompanying regeneration of tumour capillaries. This study suggests that: a) tumour capillaries were more acutely radioresponsive than the normal microvasculature in the murine tail, and b) regenerating tumour did not elicit a neovascular response from the irradiated tumour bed.
Radiation Doses to the Lens of the Eye During Computerised Tomography of the Orbit; A Comparison of Four Modern Computerised Tomography Units
Authors: SIDDLE K. J. , SIM L. H. , CASE C. C.
Published: March 2008

A previous study has looked at the estimated radiation dose to the lens of the eye during CT scanning of the orbit, pituitary fossa and brain with a recently installed GE 9800 Quick CT using a phantom simulating the lens of the eye. In this study the same phantom was used to compare the estimated radiation dose delivered to the lens of the eye by three other newly installed CT units of different manufacture. There was significant variation between the doses measured from the four machines when operated with the parameters commonly used in clinical practice. However, in all cases scanning of the phantom using routine techniques delivered a dose to the simulated lens which was much lower than the threshold dose for cataracts. There is, never‐the‐less, a potential for delivery of much higher doses.
Radiation Dose to the Lens of the Eye During Computerised Tomography Examinations of the Orbit, the Pituitary Fossa and the Brain on a General Electric 9800 Quick C. T. Scanner
Authors: SIDDLE K. J. , SIM L.
Published: March 2008

A phantom simulating the lens of the eye has been used during estimation of the radiation dose to the lens of the eye during C. T. scanning of the orbit, pituitary fossa and brain. Routine scanning will deliver a dose to the lens which is many times less than the threshold for cataracts. However the potential exists to use techniques which will increase the dose substantially. Repeat examinations of this sort could theoretically exceed the threshold dose required to induce cataracts in the lens.
Percutaneous Drainage of Pancreatic Pseudocysts: Technique and Problems
Authors: FATAAR SHADLEY
Published: March 2008

In 18 patients, 27 of thirty two pseudocysts were successfully drained percutaneously. The first 26 were drained directly and the last six drained transgastrically. Failures resulted from tube blockage by necrotic phlegmon in three and pancreatico‐cutaneous fistulation in two with obstructed pancreatic ducts. Transgastric drainage is preferred as it appears to prevent chronic pancreatico cutaneous fistula formation.
Fibromuscular Dysplasia of Common Carotid Artery A Case Report
Authors: PHADKE R. V. , TAORI K. B. , DIVEKAR V. K. , BHUTADA V.R.
Published: March 2008

A case of presumed fibromuscular dysplasia involving the left common carotid artery with formation of fusiform aneurysm of the whole length of the common carotid artery, and a distal web‐like lesion, is described in a 25 year old female patient. The angiographic appearance of the lesion is uncommon, as is the involvement of the common carotid artery. The literature is reviewed.
Femoral Vein Compression in Solitary Osteochondroma of Head of Femur
Authors: MALIK N. , KHANDELWAL N. , MANDAL P. , NAGI O.N.
Published: March 2008

An unusual case of venous compression and displacement complicating solitary osteochondroma of the head of the femur is reported and the literature is reviewed briefly.
Computed Tomographic Assessment of Coronary Artery Bypass Grafts with fast Dynamic Scanning
Authors: SLAUGHTER R.E. , PARTRIDGE J.B.
Published: March 2008

28 coronary grafts in 12 symptomatic patients were studied at the time of graft angiography at Prince Charles Hospital. The grafts were studied using the Toshiba 900S scanner with bolus injections of contrast agent into an anticubital vein. The assessment was carried out using fast incremental and continuous acquisition scanning with stepped reconstructions in the last 5 patients. Of the 27 grafts, 16 were shown at angiography to be patent and of good calibre. 14 of these were similarly assessed at CT. 11 were either diseased or blocked at angiography, and these were graded also as small, stenosed or blocked at CT. This early study would support previous reports that CT does offer a reliable method of diagnosing good patent grafts. The study also suggests that with conventional fast dynamic scanning some information regarding graft quality can be obtained.
The “Carpentier” Thoracic Aortic By‐Pass Technique for Management of Descending Aortic Aneurysms and Dissections — A Radiological Perspective
Authors: MORGAN P.W. , CAMERON D.C. , CARTER M.
Published: March 2008

The “Carpentier” thoracic aortic bypass procedure is a recently described and, until now, little used surgical technique for the treatment of descending thoracic aortic aneurysms and dissections. It involves the placement of a large conduit from the ascending aorta to the distal abdominal aorta through a midline stemotomy incision extended to the umbilicus and the subsequent interruption of the aorta just distal to the left subclavian artery via a left postern‐lateral thoracotomy.

As radiologists we should be aware of this alternative surgical option so that, in addition to diagnosing and classifying these aneurysms and dissections, we can assist our surgical colleagues in:—

a. The pre‐operative assessment of the aorta for bypass grafting including the distal abdominal aorta

b. The past‐operative monitoring of the anticipated thrombotic occlusion of the descending thoracic aorta to the coeliac axis.
Sonographic Recognition of Pneumatosis Intestinalis and Portal Gas in an 11‐months‐old Infant — Case Report
Authors: YIP C.K.Y. , NG V.K. , MAN D.W.K. , METREWELI C.
Published: March 2008

Sonography was performed on an 11‐month old infant who presented with intestinal obstruction. Pneumatosis intestinalis and portal venous gas were detected in addition to dilated small bowel loops. Preoperative diagnosis of small bowel gangrene was made which was proven at operation.
Fine Needle Aspiration in the Chest under CT Control
Authors: KNOX ALASTAIR M. , FON GERALD T. , ORELL SVANTE
Published: March 2008

Over a 42 month perid 133 patients underwent 148 CT guided biopsies of 104 pulmonary lesions (78%), 21 mediastinal/hilar masses (16%) and 8 pleural lesions (6%). There were 48 cases (32%) complicated by a pneumothorax, of which 13 (9%) required a chest drain. Two cases each of minor haemopneumothorax (1.4%) and haematoma (1.4%) were found, and haemoptysis occurred in a single patient (0.7%). This low complication rate reflects the use of the 22 gauge Chiba needle, the small number of passes undertaken at each sitting and the wide range of lesion size.

In four cases no diagnosis was established either at the time of biopsy or subsequently. There were 100 cases proven to be malignant, of which 81 were diagnosed at the first biopsy. Three further cases were regarded as suspicious of malignancy. Of the 29 patients with benign disease, a specific diagnosis was made in 10 (34%) and nonspecific inflammation was seen in 17 (59%) further patients.

Fine needle aspiration under CT control is a useful and accurate diagnostic technique. It has widened the scope of lesions which can be biopsied, enabling small, deep or necrotic parenehymal lesions to be targeted accurately. A precise placement of the needle tip into pleural or mediastinal lesions is a further advantage. However, if an inadequate sample is obtained, the biopsy may need to be repeated.
Follicular Thyroid Carcinoma Masquerading as Subacute Thyroiditis Diagnosis using Ultrasonography and Radionuclide Thyroid Angiography
Authors: PRAKASH RAJEEV , JAYARAM GITA , SINGH ROMINDER P.
Published: March 2008

The rare presentation of a follicular thyroid carcinoma mimicking the clinical and radionuclide features of subacute thyroiditis is described. Granulomatous thyroiditis was initially suspected on the clinical basis of acute onset of a hard, tender right lobe thyroid enlargement with associated systemic symptoms, modest elevation of thyroid hormone levels and suppressed thyroid RAIU. Fine needle aspiration cytology specimens were unsatisfactory for characterization. Three weeks later the thyroid RAIU was normal. The thyroid enlargement persisted, now being clearly visualized as a hypofunctional nodule on scintiscan. Repeat fine needle aspiration cytaiogy was suggestive of acinar proliferation with hyperfunction. Ultrasonography revealed a solid nodule with a peripheral sonolucent halo. Radionuclide angiography showed intense arterial flow of Tc‐99m pertechnetate through the right lobe thyroid enlargement suggestive of malignant thyroid pathology. Surgical excision and histopathological examination revealed a follicular carcinoma involving the right lobe.

The possiblity of carcinomatous involvement should be considered in those patients where initially tender thyroid nodularity persists longer than expected for a benign innammatory disease, careful follow‐up and relevant investigations being necessary to confirm the diagnosis.

Thyroid neoplasm; Subacute thyroiditis; Radionuclide angiography; Radionuclide imaging; Ultrasonic diagnosis.
Staging Abdominal Ultrasonography in Nasopharyngeal Carcinoma
Authors: LEUNG S. F. , METREWELI C. , TSAO S. Y. , HASSELT C. A. VAN
Published: March 2008

Abdominal ultrasonograms were performed on 81 unselected patients with newly‐diagnosed nasopharyngeal carcinoma without clinical evidence of distant metastases. Two patients had ultrasongraphic features suspicious of, but not diagnostic of, hepatic metastases. One of these two patients developed hepatic metastases six months after the examination while the other was free of metastases at follow‐up 33 months afterwards. Of the 79 patients without evidence of metastases on ultrasonogram, two developed hepatic metastases after 22 and 32 months. Based on these results, we do not recommend abdominal ultrasonography as a routine staging investigation for nasopharyngeal carcinoma.
Ultrasound Guided Fine Needle Biopsy of the Liver for Cytology and Histology
Authors: LIN B. P. C. , CHU J. M. G. , ROSE R. A.
Published: March 2008

Ultrasound guided fine needle biopsies were performed in 69 patients with space occupying lesions in the liver. Fifty five of these patients had material obtained for both cytology and histology with a 22 gauge modified Menghini needle, while the other 14 were biopsied with a conventional Chiba needle. Results of cytology, histology of Menghini cores, and histology of cell blocks, were reviewed and correlated with the final diagnoses obtained by clinical review and follow‐up. Cytology detected 95% of malignant cases, and Menghini core histology detected 89%. A number of factors should determine the choice of fine needle biopsy for cytology or histology or both.
Ultrasound Guided Percutaneous Renal Biopsy
Authors: ARENSON ANNA MARIE
Published: March 2008

We performed percutaneous ultrasound guided renal biopsy on 27 patients ages 16 to 76 years. A 14 gauge cutting needle was used. Twenty‐six patients had medical renal disease; one patient had a renal mass.

Patients were followed by sonograms performed immediately post procedure as well the following day. Serum hemoglobin was obtained prior to the procedure as well as one day post biopsy.

Complications included five small hematomas and one transient mild hydronephrosis secondary to blood clots. The hematomas were all first noted on the scan one day post biopsy.

We conclude that ultrasound guided percutaneous renal biopsy is a safe procedure which is easily performed by the radiologist.
Congestive Hepatomegaly – Typical Features on Computed Tomography, Ultrasound and Nuclear Medicine
Authors: COOPER M. A. , ARKLES L. B. , HENNESSY O. F. , McKENZIE A. F.
Published: March 2008

The features of hepatic congestion on computed tomography, ultrasound and nuclear medicine sulphurcolloid scans have been reviewed. Hepatic congestion may not be appreciated clinically, especially in the elderly, but the features described should be sufficiently characteristic to establish the diagnosis. The CT appearance may be confused with neoplastic infiltration, so that recognition of the condition may avoid further unnecessary investigations.
Linear Atelectasis in the Lingula as a Diagnostic Feature of Left Lower Lobe Collapse: Nordenström's Sign
Authors: PRICE J.
Published: March 2008

Collapse of the left lower lobe is sometimes accompanied by linear atelectasis in the lingula. The lingular atelectasis may be more readily apparent than conventional signs of left lower collapse. The mechanism of this association as first described by Nordenström is discussed and its value as a diagnostic sign emphasised.
A Case of Fibrolamellar Hepatocellular Carcinoma
Authors: KEARNEY DERMOT , DONLON JEFFREY B. , MENDELSON RICHARD M.
Published: March 2008

Fibrolamellar hepatocellular carcinoma is an uncommon histologic subtype of hepatocellular carcinoma, comprising 3.5% of all hepatocellular carcinomas in one large study (Brandt et al 1988). It usually occurs in young people, the average age being 18 years (Farhi et al 1983). It is not associated with cirrhosis and the serum alphafetoprotein is usually normal (Craig et al 1980).

Fibrolamellar hepatocellular carcinoma has a more favourable prognosis than the usual hepatocellular carcinoma, with an average survival of 32 months from onset of symptoms, compared to 6 months for the usual type. The resectability rate and 5 year survival figures are also much better (Craig et al 1980). Hence distinguishing this histological subtype is important for surgical management and survival prognosis.

This report describes a full radiological evaluation of such a case, covering the wide spectrum of relevant imaging modalities.
Sonographic Evaluation of Chest Masses in Children
Authors: KAPOOR RAVI , SAHA MADAN M.
Published: March 2008

The sonographic appearances of 12 intrathoracic masses in children are presented. Seven out of 12 masses were malignant and presented with opaque hemithorax on chest X‐ray. Different types of masses encountered were: Lymphoma, Neuroblastoma, Ewing's sarcoma, metastatic Ewing's sarcoma, Teratocarcinoma, Pseudotumor of the lung, Neuroenteric duplication cyst, Bronchogenic cyst and tubercular mediastinal lymph nodes.
Radical Radiotherapy for Carcinoma of The Larynx ‐Westmead Hospital Experience
Authors: TURNER S.L. , TIVER K.W.
Published: March 2008

Between January 1980 and December 1988, 141 patients were treated with radical radiotherapy for carcinoma of the larynx. One hundred and ten (78%) tumours arose on the vocal cords, twenty nine (21%) from the supraglottis and two (1%) from the subglottis. All 63 stage T1 cases, and all except three of 62 T2 cases seen in the time period, were treated by radiotherapy. In addition 14 selected T3 and 5 T4 cases were irradiated. Only 7% had clinical evidence of regional lymph node metastases at presentation. Median follow up is 47.5 months and 2+ year actuarial local control rates are T1–87%, T2–63%, T3–79% and T4–53%. The rates for vocal cord primaries are T1–86%, T2–58%, and T3–75%. Median time to local failure was 8 months with none occurring beyond 21 months. Two of 130 NO cases (1.5%) relapsed in cervical lymph nodes with a policy of selective prophylactic irradiation of the regional lymphatic areas. Thirty three/thirty seven patients with locoregional failure underwent salvage surgery with 27/32 (84%) evaluable patients achieving ultimate locoregional control with median follow up of 18.5 months from salvage. Four patients (3%) developed distant metastases and 21 (15%) developed a second primary malignancy (including 13 lung cancers) with an actuarial rate of second primary tumours of 23% at five years. Three year actuarial survival for the whole group is 77% but 66% of deaths were due to causes other than larynx cancer. Tumour specific mortality by stage is T1–1.6%, T2–12%, T3,4–21%. Because of a relatively low rate of local control for T2 vocal cord cancers 11 patients received concurrent chemotherapy employing 5‐Fluorouracit and Mitomycin C and 19 had tissue equivalent bolus applied to the skin overlying the larynx to eliminate potential underdosage in the region of the anterior commissure with the use of 6MV X‐rays. Whilst neither measure resulted in a statistically significant improvement in local control there is a trend in favour of the use of bolus which warrants further investigation in larger numbers of patients.
Haemangiopericytoma ‐ Queensland Radium Institute Experience and a Review of the Literature
Authors: AHERN Y.A. , ROBERTS S.J.
Published: March 2008

We report the presenting clinical characteristics, management, relapse patterns and survival of 17 patients with haemangiopericytoma treated at the Queensland Radium Institute, Australia from 1962 to 1989. Twelve patients were referred at the time of first diagnosis and were treated with curative intent. Three patients were treated with palliative intent when referred following initial diagnosis, and the remaining two patients were referred at the time of relapse. Disease was metastatic at presentation in 4 patients. Radiotherapy was used as a component of primary treatment of disease in 11 patients, in both patients referred for management of local relapse of haemangiopericytoma, and for palliation of metastatic disease developing in 3 patients. One patient received chemotherapy as part of initial treatment. Nine patients have died with survival from first treatment ranging from 3 to 139 months. Ail 8 surviving patients remain free of disease at 6 to 94 months from first treatment.
Intraosseous Lipomata in Paget's Disease: An unusual CT appearance
Authors: ROBBIE M.J. , PRATSIS K.K. , LOCKIE D.J.
Published: March 2008

A case of multiple intraosseous lumbar vertebral lipomata is reported occurring in the prescence of Paget's disease. The pathology and radiology are correlated.
Ultrasound Evaluation of Subdural Haematoma
Authors: LAM ALBERT H. , CRUZ GILDA BONA
Published: March 2008

14 patients with subdural haematoma (SDH) diagnosed by ultrasonography (US) and confirmed by computerized tomography (CT) were reviewed. We describe the morphology of SDH on US and discuss the ultrasound findings which may suggest outcome. SDH appeared as a crescentic mass overlying the cerebral hemisphere and producing medial displacement of the Sylvian fiiure, midline shift, ventricular compression, sutural diastasis, changes in the sulcal pattern and echogenicity of the ipsilateral side of the brain. Hydrocephalus was the most common complication. It was the presence of cerebral complications and not the midline shift or ventricular compression which correlated with poor outcome.
Mammographically Indeterminate Microcalcifications ‐ Can We Do Any Better?
Authors: ALBERTYN LYNDA E.
Published: March 2008

In the first round of the mammographic screening program of the South Australian Breast X‐ray Service, 80 (0.73%) of the first 10,848 women screened over 18 months were referred after primary and second‐stage assessment for definitive histology because of microcal‐cifications. Obvious mass lesions associated with calcification were excluded from this study, as were women whose calcification was regarded as sufficiently benign to warrant routine rescreening in two years.
Aortic Aneurysm Presenting as Budd Chiari Syndrome
Authors: SAMLOK D.S. , SAHA M.M. , GAIHA M. , BUXI T.B.S. , SRIVASTAV M.P. , RIZVI S.N.A.
Published: March 2008

Budd Chiari Syndrome is the eponymic designation of symptomatic post sinusoidal venous obstruction, whether or not this is associated with hepatic vein occlusion or vena caval obstruction. Dutta and associates (1) classified the syndrome into two distinct types. Type I involves obstruction to the hepatic veins while Type II pertains to an obstruction in the inferior vena cava above the entry of hepatic veins. We report a case of thoraco‐abdominal aortic aneurysm presenting as Type II Budd Chiari Syndrome.
CT Findings in ‘hberculous Spondylitis
Authors: PANTONGRAG‐BROWN LINDA , SWANWELA NITAYA
Published: March 2008

The computed tomographic (CT) features of ten documented eases of spinal tuberculosis were analyzed. AN cases showed evidence of vertebral body destructioo, with paravertebral soft tissue masses. Four cases revealed extension of involvement into the neural arches Calcification within the paraspinal soft tissue was found in only two cases. Two of four cases who received intravenous contrast medium demonstrated evidence of rim enhancement around multilocuated fluid collections. Compared to conventional roentgenography, CT better delineated the extent of bony destruction, involvement of the spinal canal and existence of paraspinal soft tissue masses.
Magnetic Resonance Imaging in Occult Spinal Dysraphism
Authors: TRIPATHI R.P. , SHARMA NAY , JENA A. , GULATI PARVEEN , JAIN R.K.
Published: March 2008

A prospective study was carried out in 100 cases of suspected occult spinal dysraphic anomalies with Magnetic Resonance Imaging in order to determine its diagnostic efficacy as the initial imaging modality. MR imaging provided accurate preoperative information in 91 out of 92 cases (98.9%). Some of the unusual and interesting findings in the series were: presence of intrinsic cord abnormality in 19 out of 21 cases (90.4%) with a normal plain radiograph, 4 cases of diastematomyelia with a dermoid in the dorsal and lumbar region associated with syringohydromyelia, intradural fibrous/glial bands, sgringo‐hydromyelia/myelomalacia of the conus with tethered cord syndrome having a normally placed conus, and myelocystocele. It is concluded that MRI is an excellent primary diagnostic tool, together with a plain radiograph, for complete preoperative evaluation of mid‐tine spinal anomalies.
The Post Therapy Breast
Authors: ALBERTYN LYNDA E
Published: March 2008

Both systemic and local therapy, for conditions of the breast and unrelated to it, may produce manuno‐graphic changes. Some of these are characteristic, such as the pattern of scarring seen in reduction mammo‐plasty. In many other instances, however, the changes produced overlap features commonly seen in malignancy. A knowledge of the timing, natural history and spectrum of these changes will aid mammographic interpretation.
Comparison of Duplex Ultrasound with Angiography in Assessment of Carotid Bifurcation Disease
Authors: YOUNG N. , SOO Y.S. , R.N. PAUL FISCHER
Published: March 2008

This is a study comparing duplex ultrasound against the “gold standard” of angiography in assessing atherosclerotic disease of the carotid bifurcation, prior to prospective endarterectomy surgery.

Thirty‐nine patients were studied with both sonography and angiography studies being performed within one month of each other. Plaques were described by sonography as being “smooth” or “irregular” in surface and “homogeneous” or “heterogeneous” in composition.

Ultrasound showed an overall 92% sensitivity, against the standard of angiography, in its ability to assess the degree of internal carotid stenosis. There was only a 63% sensitivity with the common carotid arteries and only a 65% sensitivity with the external carotid arteries.

Ultrasound did not show a high accuracy in detecting plaque ulceration when compared against angio‐graphy.
Meckel Syndrome: Prenatal Ultrasonographic Diagnosis in Two Cases Showing Marked Differences in Phenotypic Expression
Authors: GALLIMORE ANDREW P. , DAVIES PETER F.
Published: March 2008

Two consecutive siblings with the Meckel‐Gruber syndrome are presented. They demonstrate variation in phenotypic expression which may render diagnosis difficult when the pattern of malformation is significantly different from that traditionally accepted. The diagnosis was only made with confidence because a sibling with typical features had been seen first. The usefulness of ultrasound in prenatal diagnosis, even when the abnormalities are atypical, is well illustrated.
Efficacy of Fetal Part Elevation to Visualise Internal Cervical Os
Authors: WELLS SCOTT‘ W. , ANDERSON NIGEL G. , ALLAN RICHARD B.
Published: March 2008

The diagnosis or exclusion of placenta previa is best achieved by direct visualisation of the relationship of the lower edge of the placenta to the internal cervical os. In later pregnancy, the presenting fetal part frequently obscures this area. Elevation of the presenting part was attempted in 56 consecutive pregnancies of greater than 30 weeks gestation, with a success rate of 71%. This confirms that in a minority of pregnancies, other manoeuvres or ultrasound techniques are necessary to visualke the lower placental margin directly.
An Analysis of Reported Discomfort Caused by Mammographic X‐Ray Amongst Attenders at an Australian Pilot Breast Screening Program
Authors: COCKBURN J. , CAWSON J. , HILL D. , LUISE T. DE
Published: March 2008

The aims of the study were to describe levels of discomfort experienced by women undergoing screening mammography; examine correlates of discomfort experienced and to examine whether the degree of discomfort experienced was perceived as a deterrent for re‐screening.

The study involved ninety five attenders at the pilot mammography screening program in Melbourne, Victoria. Women completed a questionnaire one or two days after having a screening mammogram. Pain was assessed on a seven point scale. Information was obtained on a number of possible correlates such as breast tenderness, perceptions of the service received and expectations of discomfort. Eighty‐eight women were re‐interviewed three months later about recall of discomfort and whether this would deter them from future mammography.

Results were as follows: Thirty per cent of women reported no discomfort, 60% mild or moderate discomfort and 10% severe discomfort or worse. The degree of discomfort reported was not significantly related to age, breast tenderness in the previous three days, previous symptoms, previous mammographic experience, or outcome of visit. The degree of discomfort was related to retrospectively reported expectation of discomfort (r=.336; p=.001); reported lack of confidence in the staff taking the X‐ray (r=.184; p=.039); perceptions of awkwardness (r=.175; p=.049) and unpleasantness (r=.297; p=.002) of the examination position. No woman said discomfort would definitely stop her having another screening mammogram. Three per cent said that it might stop them, while 97% of women said that it would not stop them at all.

We therefore recommend that information on the possibility of discomfort be given routinely to women at the time of undergoing screening mammography.
Air in Epidural Haematomas
Authors: TEWARI M.K. , BHATOE H.S. , THAKUR R.C. , KAK V.K. , KHANDELWAL N.
Published: March 2008

Air in epidural haematoma is an uncommon finding. It is usually seen if epidural haematoma is associated with fracture involving one of the air sinuses, but can be seen at, times in the absence of any demonstrable fracture on the CT scan. Seven such cases are described in the present communication and the significance of this finding discussed.
Temporomandibular Joint Air in Fractures of the Skull Base
Authors: MERCURI V. , HOUSE R.J.
Published: March 2008

Basilar skull fractures involving the temporal bone extend through the tympanic part of the temporal bone in two‐thirds of cases. The anatomical relationship of this part of the temporal bone and the temporomandibular joint enables air to pass from the auditory canal into the joint. Air in the temporomandibular joint is demonstrated on CT scans as an indirect sign of temporal bone fracture.
Anomalous Peritoneal Folds of the Duodenum A Normal Variant Simulating Disease
Authors: LOW V.H.S. , DAVIS S.J. , YOONG M.F.P.
Published: March 2008

The double contrast barium meal appearance of four cases is presented where an anomalous peritoneal fold involves the duodenum. This fold results in a characteristic smooth, extrinsic indentation upon the antero‐superior surface of the duodenal cap. This normal variant should be differentiated from distortion of this region due to pathology such as peptic ulceration.

Anomalous peritoneal folds which involve the duodenum (cysto‐duodenal ligament, cysto‐gastrocolic ligament) are not believed to cause symptoms (1). However, the recognition of the deformity produced by these folds is important, requiring differentiation from pathological changes.

Over a period of seven years, we encountered four cases with this finding.
Anaphylactoid Reaction to Iopamiro (After Pretreatment)
Authors: ROBERTS M. , FISHER M.
Published: March 2008

A patient is described with a past history of an anaphylactoid reaction to contrast media who reacted to nonionic contrast media after pretreatment with antihistamines and steroids.

The available options to reduce the incidence of reactions include use of non‐ionic contrast which has a reported lower frequency than ionic contrast15 or some form of pretreatment. Various forms of pretreatment have been described and in the majority steroids and antihistamines are used. We describe a patient who reacted to nonionic contrast after a pretreatment regime.
Intracerebral Ganglioglioma
Authors: VOWODIC F. , SAGE M.R. , BROPHY B.P.
Published: March 2008

A case of a rare intracerebral tumour, namely a ganglioglioma, is reported to illustrate the CT and MRI features. The finding of focal thinning of the inner skull vault in association with an adjacent intracerebral mass lesion can aid in the diagnosis of intracerebral ganglioglioma.
Adrenal Myelolipoma
Authors: RAO MEERA
Published: March 2008

A case of adrenal myelolipoma demonstrated by ultrasound and computed tomography is presented with a discussion of the aetiology and review of literature. Ultrasound and CT proved to be invaluable in the pre‐operative diagnosis of adrenal myeldipoma.
An Evaluation of the Effect of Processing Conditions on Mammographic Film Contrast, Fog Levels and Speed
Authors: McLEAN DONALD
Published: March 2008

While it is well established that extended development times and temperatures will increase mammographic film contrast and speed (1), little work has been done to date in extending this work to encompass all common screen‐film types and to study the effect of processing chemistry variations on contrast speed results.

This paper reports on four locally available mammographic films which, after exposure in conditions that closely simulate clinical conditions, have been developed with four different development chemicals as a function of development temperature and time. Three development times were used (23, 32 and 42 seconds) in combination with four development temperatures (32,34, 36 and 38 degrees).

The results support the previously published result of increased speed and contrast with extending development time and temperature. It was further found that, for some film types, the film contrast varied significantly over film density when developed with extended processing. Other film types, however, maintained high contrasts over large film density ranges. In some cases the increased contrast was accompanied by elevated film fog levels. The development of mammographic films in non recommended chemistries produced varying results, mostly detrimental, which demonstrated that selection of development chemistry as well as optimal development times and temperatures, is critical for good film performance.
Iodine‐125 Irradiation of Choroidal Melanoma: Clinical Experience from the Prince of Wales and Sydney Eye Hospitals
Authors: MAMEGHAN HEDY , KAROLIS CHRIS , FISHER RICHARD , MAMEGHAN JILL , BILLSON FRANK A. , DONALDSON EDGAR J. , GIBLIN MICHAEL E. , HUNYOR ALEX B.L.
Published: March 2008

We examined the records of 53 patients treated for choroidal melanoma between 1985 and 1989. The aim of this study was to assess the safety and short‐term results of iodine‐125 episcleral plaque therapy. There were 28 males and 25 females, aged 20 to 77 years (median 61 years), treated for single tumours with a median diameter of 9mm (range 5 to 15mm) and with a median thickness of 4mm (range 2 to 10mm). The plaques containing iodine‐125 seeds were chosen according to tumour size: 10mm (16 patients); 15mm (36 patients); 20mm (one patient). All patients are alive at last follow‐up (median 1.3 years, range 4 months to 3.3 years). Four patients underwent enucleation for melanoma progression. Thirty patients have developed some type of complication (more than one complication occurred in the same eye in 12 patients): retinitis (19), optic neuropathy (7); cataract (41, rubeosis iridis (2). Overall, visual acuity deteriorated in 32 patients, remained stable in 12 patients and improved in 9 patients. Iodine‐125 plaque therapy appears to offer patients good prospects of tumour control and preservation of useful vision.
Primary Squamous Cell Carcinoma of the Breast
Authors: GAUDEN S.J.
Published: March 2008

A patient with pure primary quamous cell carcinoma (SCC) of the breast is reported. The patient was a 72 year old female who presented with a 4 month history of an enlarging left breast mass. Surgery involved a radical mastectomy and this was followed by post‐operative radiotherapy and chemotherapy. The patient died of extensive metastatic disease some four months after surgery.

The various characteristics of SCC of the breast are briefly discussed. A sub‐group of SCC of the breast is identified among reported cases in which the clinical course is characterised by a very rapid growth, extremely aggressive behaviour and early metastasis.
Percutaneous Drainage of a Thigh Haematoma: Case Report of an Unusual Radiographic Appearance
Authors: CARTER E.A. , DAVIES R.P. , DAVEY R.B.
Published: March 2008

We present a case of fat necrosis in the thigh of a ten year old girl, resulting in unusual multiple, ovoid filling defects seen in the residual cavity following drainage of a subcutaneous haematoma. No similar cases have been found on review of the literature. The appearance is described to aid diagnosis at the time of initial cavity drainage, avoiding the need for further investigation.
Use of percutaneous transluminal balloon angioplasty to treat renovascular disease
Authors: YOUNG NOEL , WONG K.P.
Published: March 2008

This is a retrospective study of the ability of percutaneous transluminal balloon angioplasty (PTA) to treat hypertension and renal impairment in patients with haemo‐dynamically significant renal artery stenoses (those over 50%).

Thirty‐two patients underwent PTA procedure in a 4 year study period. Seventeen were male, 15 female, with an average age of 61 years. Thirty patients had atherosclerosis and 2 had fibromuscular hyperplasia (FMH) lesions. The procedure was technically unsuccessful in 28% of 37 arteries attempted, primarily in the > 80% stenosis group. The mean clinical follow‐up period was 20 months.

In those patients with technically successful PTAs, none was cured, with no change in the status of hypertension or medication required.

Clinical improvement was seen in 37% (7 of 19) patients with atherosclerotic disease and who had PTA of significant unilateral lesions or of the haemodynamically signifi cant side in cases of bilateral disease.

Two patients with FMH lesions had improvement. Five patients with PTA of only one side in cases of significant bilateral disease gained no benefit. Nine patients with preexistent renal insufficiency and technically successful PTAs had no improvement of renal function. No mortality or any significant morbidity resulted from the procedure.

These results are more compatible with more recent than the earlier literature.
The bony crescent sign ‐a new sign of facial nerve schwannoma
Authors: WATTS ALISON , FAGAN PAUL
Published: March 2008

Schwannomas of the facial nerve are rare slowly growing lesions that have a predilection for the geniculate ganglion. Radiological evaluation is important in their diagnosis and in the assessment of their extent.

In our series of 4 cases the facial nerve schwannoma was seen on high resolution CT as a soft tissue mass bounded anteriorly by a thin rim of bone. This bony crescent sign is a previously undescribed sign of facial nerve schwannoma which appears on the basis of this small series to be strongly indicative of the presence of this tumour.

Schwannomas are relatively uncommon intracranial tumours. They most commonly involve the acoustic nerve followed in frequency by the trigeminal nerve. Other cranial nerves are rarely involved. Facial nerve schwannomas occur ring within the petrous temporal bone are very rare. Their diagnosis may be missed prospectively even when appropriate CT scans are per formed. Even in retrospect the site of abnormality may be difficult to identify, especially if there is an associated middle ear mass such as a cholesteatoma.

Lesions occurring in the petrous area are all rare. The differential diagnosis includes cholesterol granuloma, epidermoid, carotid aneurysm and, very rarely, primary and secondary bone tumours.

We describe a new sign associated with facial nerve schwannoma on CT, that of a bony crescent. Recognition of this sign makes those tumours arising in the region of the geniculate ganglion easy to diagnose prospectively.
Foetal radiation dose in radiotherapy for breast cancer
Authors: NGU S.L. CHARLES , DUVAL PETER , COLLINS CATHRYN
Published: March 2008

Management of breast cancer during pregnancy is complicated by the high risks of abortion and foetal malformation from the use of radio therapy and chemotherapy. A case of breast cancer during pregnancy, treated with radiotherapy, and the estimated foetal dose is reported.
Enterogenous cyst of the cervical spinal canal
Authors: LEA M.E. , SAGE M.R. , BILLS D. , BROPHY B. , BLUMBERGS P.
Published: March 2008

A case of an enterogenous cyst of the cervical spinal canal in an 18 year old man is presented, high lighting the radiological findings. A brief overview is given of these rare cysts, together with their clinical and radiological features and associations.
Organo‐axial volvulus of the sigmoid colon
Authors: JANZEN DENNIS L. , HEAP STUART W.
Published: March 2008

A 59 year old man presented with subacute abdominal distension. and diarrhea. Plain radiographs and barium enema demonstrated organoaxial volvulus of the sigmoid colon. The radiologic, surgical, and pathologic findings are presented. The radiologic differences between organoaxial volvulus and the common mesenteroaxial volvulus of the sigmoid colon are discussed.
Neoplastic involvement of the sacroiliac joint: MR and CT features
Authors: SILBERSTEIN M. , HENNESSY O. , LAU L.
Published: March 2008

The radiological findings in five patients with pelvic sort tissue neo plasms directly involving the sacroiliac joint, are described. All patients had Computed Tomography (CT) examinations, two of the patients also having Magnetic Resonance Imaging (MRI). The role of imaging in this uncommon entity is discussed as well as the importance of making this diagnosis, thereby excluding unilateral sacroiliitis.

The therapeutic implications of this diagnosis relate to local neural involvement, especially the sciatic nerve, and the fact that involvement of the sacroiliac joint by tumors significantly compromises chances of a successful surgical outcome. The role of MR in this condition is not yet certain, but it may prove to be the method of choice in view of its excellent depiction of skeletal neo plasms.
Wegener's granulomatosis: parotid involvement and associated pancreatitis with C.T. findings
Authors: STUCKEY S.L. , SMART P.J.
Published: March 2008

Parotid enlargement is an uncommon physical sign and even less commonly the reason for referral for computerised tomography (CT) as the aetiology isusually self‐evident. In cases referred for CT examination Wegener's granulo matosis should be considered, particularly if the pathology appears bilateral. This diagnosis may be confirmed by biopsy and/or supported by Anti‐Neutrophil Cyto plasmic Antibody (ANCA) assay.

A case of Wegener's granulo matosis with parotid gland invlove ment and temporally related pan creatitis with pseudocyst formation is reported. This is the second reported case of possible pancreatic involvement in Wegeners granulo matosis and approximately the tenth reported case of salivary gland involvement.
Magnetic resonance appearances of developmental disc anomalies in the lumbar spine
Authors: DESMOND PATRICIA M. , BUIRSKI GRAHAM
Published: March 2008

Developmental anomalies of the lumbar spine are common. The disc between anomalous segments has a characteristic appearance on sagittal T2 MR images, not previously described. These have been classified into two types: transitional (where there is only partial fusion of bony segments), or rudimentary (where there is complete fusion of the two adjacent vertebral bodies). Both types produce discs that are smaller than adjacent, normal, mobile, lumbar disc segments. Disc signal intensity, from the anomalous segment, is normal, but the disc lacks an intranuclear cleft. Consideration of these appearances allows identification and differentiation from the normal, mobile lumbar disc in the absence of plain radiographs. Knowlege of such discs permits the application of accurate nomenclature to disc abnormalities above anomalous levels.
Aortic occlusion in nonspecific aortoarteritis (Takayasu disease): incidence and spectrum of involvement
Authors: SHARMA SANJIV , RAJANI MIRA
Published: March 2008

Nonspecific aortoarteritis (Takayasu disease) is a primary arteritis of unknown etiology which commonly involves the aorta, and results in stenosis, occlusion, dilatation or formation of aneurysm in the involved segment. Of these, occlusion is the most rare form of involvement, and is usually reported to occur in the abdominal aorta. Only one case of aortic arch occlusion has been reported. We retrospectively studied the frequency and sites of aortic occlusion in 110 consecutive patients who underwent digital subtraction angiography. Aortic occlusion was seen in three (2.7%) patients, and involved the abdominal aorta in two, and the aortic arch in one patient. The clinical presentation in all three patients was with systemic hypertension and lower limb claudication. The detection and localization of the aortic occlusion is important since this has practical implications in the management of these patients. Intravenous digital subtraction angiography is usually adequate for the diagnostic assessment.
Skip metastases from testicular seminoma
Authors: STEVENS MARK J.
Published: March 2008

A unique case of metastatic testicular seminoma which did not initially involve the retroperitoneal lymph nodes is presented. Modern treatment, with cis‐platinum based chemotherapy and involved‐field irradiation, resulted in cure.
Aneurysm of the common carotid artery as a sequel of puncture angiography
Authors: VINDUŠA VLADIMIR , HEJNAL JAROSLAV , KAREL WEISS , TOMÁS MACH , PAVEL FIRT
Published: March 2008

The case of a 60‐year‐old man with a large aneurysm of the common carotid artery, which manifested five months after puncture angiography, is described. This was successfully managed by aneurysm exclusion and aortocarotid bypass. The etiology of the aneurysm is discussed.
Evaluation of the diagnostic accuracy of MR imaging at 0.3 T, based on clinical follow up of 3262 examinations
Authors: SILBERSTEIN MORRY , TRESS BRIAN M , ROSSITER STEPHEN
Published: March 2008

The results of 4504 0.3 T magnetic resonance (MR) examinations, of which 3262 had clinical follow up are described. The overall true positive rate of MR imaging was 72%, with a range of 69–100%. While the best results were obtained for evaluation of spinal cord syrinx and normal cerebral examinations, 31% of patients with cerebral demyelination were incorrectly diagnosed. The false positive rate was relatively low (3–5% in most cases), but a significant 17% of patients considered to have normal cerebral examinations were later shown to have pathology.

While the true positive rate of magnetic resonance imaging was greater than that of the suspected clinical diagnosis (37% correct), the results of this assessment at 0.3 T are significantly poorer than those previously published at 1.5 T.
Breast cysts: Pitfalls in sonographic diagnosis
Authors: KHALEGHIAN ROWSHAN
Published: March 2008

Ultrasound examination of the breast is extensively carried out to differentiate cystic from solid masses. Ten atypical cysts are presented that do not fulfil all the criteria for the ultrasonic diagnosis of breast cysts. These had internal echoes and some showed irregular contours or diminished through transmission. Diagnostic aspiration confirmed the cystic nature of these lesions. None showed cytologic evidence of malignancy or haemorrhage. The purpose of this paper is to bring this entity to the attention of radiologists so that echogenic cysts are considered in the differential diagnosis of well defined, solid appearing breast masses seen on ultrasound.
A simplified puncture technique to reduce contamination with bodily fluids
Authors: LANNAN MICHAEL JOHN
Published: March 2008

A simplified method of percutaneous wire placement is described, designed to decrease the amount of aerosol or spurting bodily fluids associated with wire placement. The technique involves minor modification of standard puncture techniques without the use of additional equipment. The technique has been successfully used in 22 patients and there have been no complications associated specifically with this technique.
Radiology of starch granulomatous peritonitis
Authors: KEATING J P , GRUNEWALD B , JACK B
Published: March 2008

Starch granulomatous peritonitis (SGP) is a rare complication of abdominal surgery that results, in a susceptible individual, from contamination of the peritoneal cavity with starch particles from the surgeon's gloves. It is important to make the diagnosis of SGP without recourse to re‐operation as the optimal treatment is non‐surgical.

A case of SGP that was confirmed only after re‐operation and resection of the involved tissues is reported. The first description of an abdominal computed tomography scan in this condition is presented, the significance of which was only recognized postoperatively.