bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparison of fine and medium screens for mammography
Authors: Burch A , Law J
Published: July 2009

Intensifying screens for mammography may be categorized as fine, giving priority to image quality, or medium, achieving a lower dose at the expense of some image quality. It is important to be aware of the possible consequences of changing from a fine to a medium screen The relative image quality and dose of four films–screen combinations (Fuji MIMA/UMMA film with Fuji HR Mammo Fine and HR Mammo Medium screens, Kodak MinRE film with Kodak MinR and MinR Medium screens) were evaluated using Leeds TOR(MAM) and Ackermann test objects. In each case, the performance of the medium screen was compared with that of the fine screen from the same manufacturer, it was not the purpose of this study to compare one manufacturer's products with the other's. Both medium screens showed measurably poorer image quality than the corresponding fine screens. The reduction in dose was only 30–40%. Careful evaluation of other dose reduction methods is recommended before changing from fine to medium screens.
Mobile fatty globules in benign cystic teratoma of the mediastinum
Authors: Hession P R , Simpson W
Published: July 2009

Benign cystic teratoma is a well recognized cause of an anterior mediastinal mass. The presence of fat, found in approximately half the cases, suggests the diagnosis. We report a new feature, which consists of components of the tumour drifting upwards (anteriorly) during the course of a computed tomography examination. The appearance is compared with a popular light fitting.
Imaging of Takayasu arteritis in the acute stage
Authors: Hayashi K , Ogawa Y , Sakamoto I , Matsuoka Y , Matsunaga N
Published: July 2009

We report a case of Takayasu arteritis (TA) in the acute stage. The case is unique in two points. First, the diagnosis of Takayasu arteritis was initially suspected from a subtle finding on plain radiography. Second, thickening of the aortic and pulmonary arterial walls was demonstrated by computed tomography and magnetic resonance imaging in the acute non-pulseless stage of the disease.
Percutaneous varicocele embolization in the treatment of infertility
Authors: Marsman J W P
Published: July 2009

I read with interest the article by Ferguson et al in the July 1995 issue of the British Journal of Radiology [1]. In the abstract the authors suggest that their study concerns both clinical and subclinical vancoceles. However, the results of embolization are only given for all patients together. Were their results in the clinical and subclinical group in fact similar, as we recently showed [2]?
Rapid assessment of left ventricular volume by short axis cine MRI
Authors: Forbat S M , Sakrana M A , Darasz K H , El-Demerdash F , Underwood S R
Published: July 2009

MRI is an established and accurate method of measuring left and right ventricular volumes by summing chamber areas in multiple contiguous slices. Acquisition time may be up to 45 min. We have estimated volumes with gradient echo imaging to test the accuracy of a more rapid method (total acquisition time 15 min) using a recognized echocardiographic algorithm. The results were compared with the spin echo method. We studied 20 patients (mean age 52 years, 15 male) within 6 months of anterior myocardial infarction and 20 normal subjects (mean age 40 years, 19 males). For the rapid method, cine acquisitions were made in the horizontal long axis plane and in two short axis planes which divided the long axis into three equal parts. Volume was calculated assuming the ventricle to be composed of a cylinder, a truncated cone and a cone. There was good agreement between the two methods at end diastole with a mean difference (±standard error, ±95% confidence interval for limits of agreement) of − 3 ml (±83, ±37%) for normal subjects and 15 ml (±42, ±25%) for patients. Agreement was less good at end systole with mean difference of 121 (±35, ±41%) for normal subjects and 257 (±37, ±47%) for patients. The rapid method, therefore, significantly underestimated end systolic volume compared with the previous method. Rapid measurements of end diastolic volume are more accurate than those of end systolic volume and hence ejection fraction. Provided the potential error is recognized, the rapid technique can be used in routine clinical practice in both normal and abnormal ventricles.
Femoral angiography using the reverse shuffle technique
Authors: Rose J F
Published: July 2009

Oxtoby et al [1] compare the bolus chasing method of peripheral angiography unfavourably with their own ingenious reverse shuffle technique, in which a remarkable 98% success was achieved in terms of timing on the first run.
Microcalcification clustering parameters in breast disease: a morphometric analysis of radiographs of excision specimens
Authors: NG K-H , Looi L-M , Bradley D A
Published: July 2009

X-ray microradiography of surgically excised breast specimens offers the possibility of morphological characterization of calcifications. When combined with digital imaging techniques there exists added potential for obtaining valuable basic quantitative morphometric information regarding differences between microcalcifications in tissues exhibiting evidence of fibrocystic change, benign and malignant tumours. A total of 157 excised breast specimens from 84 patients were microradiographed using a Softex Super Soft X-ray unit and Kodak AA high resolution industrial film. A Quantimet 570C image analysis system was used to digitize and analyse the microradiographs. Of the 157 microradiographs, 51 (from 30 patients) revealed microcalcification clusters. The existence of significant differences between the three identified categories of tissue were indicated by clustering parameters. These included the number of particles per cluster, area of clusters, maximum distance to nearest neighbour, and geometric mean distance to nearest neighbour. The distribution pattern index (DPI), another of the clustering parameters used in this study, has been observed to be a particularly powerful discriminator. The value for fibrocystic change was found to be significantly smaller (0.514) than that for benign tumour (0.796) whilst that for benign tumour was observed to be significantly larger than that for malignant tumour (0.604) at a p-value of less than 0.05 (Kruskal–Wallis one-way analysis of variance).
Total craniofacial photon shell technique for radiotherapy of extensive angiosarcomas of the head
Authors: Kinard J D , Zwicker R D , Schmidt-Ullrich R K , Kaufman N , Pieters R
Published: July 2009

Effective radiotherapy for extensive angiosarcomas of the face and scalp is technically difficult due to the complex shape of the volume at risk, which can consist of the superficial tissues of the entire head. This work reports the details of a rotational X-ray technique used to deliver a large part of the tumour dose. The technique consists of four consecutive 90° arcs with changing centre blocks to protect critical midline structures. Multilevel CT based treatment planning is carried out to determine the centre block dimensions and beam weights. As a result the radiation dose is delivered with acceptable uniformity over the entire shell of superficial tissues of the head. The overall treatment combines the rotational fields with large lateral field irradiation and/or local boosts with photons or electrons. Two of three patients treated with this technique had local control of the disease until their deaths at 13 and 18 months. A third patient responded well, with only a small region of stable disease at 9 months.
Pontine haemorrhage following iohexol lumbar myelography
Authors: Yeh Y-F , Lin S-K , Sung C-Y , Chu C-C , Wu Y-R
Published: July 2009

A case of pontine haemorrhage following lumbar myelography using iohexol is described. Stress, inducing transient hypertension during the procedure, with superimposed neurotoxicity from contrast medium (iohexol) is suggested as a possible mechanism. No brain stem lesion was seen on the initial brain. CT scan, possibly because of the high attenuation of the contrast medium in the subarachnoid space. A delayed CT brain scan demonstrated the pontine haemorrhage and was necessary to confirm the diagnosis.
Book reviews
Authors: Healey T
Published: July 2009

It is 10 years since the first appearance of this handy pocket guide to the skeletal dyspalsisas. The opportunity has been taken not only to include newer discoveries, but to take account of the 1992 revision of the International Classification of the osteo-chondro-dysplasias.
Book reviews
Authors: Healey T
Published: July 2009

This excellent book goes about things in the right way. It starts with the very basics, then goes on to the bare outline of what MRI is all about. Only then does it, so to speak, take the whole system apart and show what it does, why it needs to do it, how it does it and how to make it do what you want.
Focal areas of increased renal tracer uptake on bone scans can mimic metastases in the lower ribs
Authors: Pickuth D , McCready V R
Published: July 2009

Focal renal concentration of radioactivity can simulate metastatic deposits in the lower ribs on bone scintigrams. 400 consecutive bone scintigrams were reviewed for focal areas of increased tracer activity in the kidneys. 62 patients (15.5%) had at least one renal hot spot. In 42 of these 62 patients (67.7%) there was an increased focal uptake in the left kidney (18 upper pole, 18 middle pole and six lower pole). 50 out of 62 bone scans (80.7%) showed increased activity in the right kidney (14 upper pole, 32 middle pole and four lower pole). With the incidence of focal areas of activity in the upper poles of the kidneys being 8%, the interpretation of a single focal abnormality projected over the lower ribs should be made with particular care, especially in cancer patients.
Magnetic resonance imaging-guided pre-operative breast localization using a “freehand technique”
Authors: Coulthard A
Published: July 2009

I read with interest the technical note by Brenner et al [1], and share the frustration experienced in identifying suspicious lesions on breast MRI which could not be located on subsequent targeted mammography or ultrasound. We have also used a freehand localization technique in a small number of such patients. However, there are a number of general limitations of freehand localization in breast MRI which are not touched on in the paper by Brenner et al, and a number of potential limitations specific to the technique which they describe.
Book reviews
Authors: McCall J
Published: July 2009

This book is jointly authored by Szlavy from Budapest and Taveras of the Massachusetts General Hospital, it covers most aspects of vascular intervention outside the specialist areas of the coronary arteries and the CNS.
Book reviews
Authors: Healey T
Published: July 2009

There must be many radiologists who, like me, had to take charge of the photographic department as well as the X-ray department. Nowadays, we have a fully professional medical photographer, but at one time I not only took the routine and emergency photographs for the clinicians, but was called in to take the “official” photographs to be produced in court in cases of murder and suspected child abuse.
A portable system for measuring bone mineral density in the pre-term neonatal forearm
Authors: Truscott J G , Milner R , Holland P C , Wood C , Smith M A
Published: July 2009

Current systems used to measure bone mineral content (BMC) in the neonate have the major drawback that the child must be well enough to be moved to the scanner. Consequently, low birth weight pre-term neonates, a group at particular risk of mineral compromise, cannot be measured. This paper describes a portable neonatal bone mineral device capable of measuring bone mineral in the incubator. It uses a radiation sensitive, charge coupled device (CCD) to acquire a bone mineral image enabling bone mineral to be measured at various sites. It measures bone mineral density (BMD) with a precision of 5.5 mg cm−2  in vivo, reduced to 7.5 mg cm−2 when repositioning between scans is taken into account. The procedure takes under 5 min with an image acquisition time of 30 s and an absorbed radiation dose to skin of 6 μSv. Calibration has been undertaken with aluminium foils of differing thickness to confirm the linearity of the system throughout the intended measurement range. A regression line fitted to the data demonstrated linearity and correlation between BMD and aluminium thickness with r = 0.99 (p <0.0001). Preliminary measurements on pre-term neonates show values of BMD ranging from 43 to 115 mg cm −2 in babies aged 23–41 weeks post-conception. These figures are within the linear range of the system.
Quantitative perfusion parameters of focal nodular hyperplasia and normal liver parenchyma as determined by electron beam tomography
Authors: Groell R
Published: July 2009

We thank Drs Dubowitz and Miles for their comments on perfusion parameters as described in our study. We agree with them that quantitative perfusion parameters are only one piece in the diagnostic mosaic of focal liver lesions. Recently, we examined a liver metastasis of a glucagonoma which also showed no signs of portal enhancement and had similar dynamic features but lower perfusion values than the FNHs (0.7 vs 1.36 ml min−1 cm−3).
Book reviews
Authors: Godfrey H W
Published: July 2009

At first glance, books of this nature have a certain appeal, predominantly related to their size and relative cheapness. This atlas claims in the first line of its preface to be portable, and indeed it has to be the smallest radiological text that I have ever come across. In the same first sentence it also professes to be easy to use, and, since a work of this size can by definition only contain relatively few images, this is to some extent true.
Imaging in bronchiectasis
Authors: Smith I E , Flower C D R
Published: July 2009

Bronchiectasis remains an important and relatively common cause of pulmonary disability. High resolution computed tomography has revolutionized imaging of the bronchi and has superseded the chest radiograph and bronchogram in the diagnosis of bronchiectasis. It has enabled a better understanding of the association between clinical features of the disease and structural abnormalities in the airways and has an important role to play in understanding the pathogenesis and natural history of bronchiectasis.
Dynamic magnetic resonance mammography of both breasts following local excision and radiotherapy for breast carcinoma
Authors: Murray A D , Redpath T W , Needham G , Gilbert F J , Brookes J A , Eremin O
Published: July 2009

The purpose of this study was to evaluate a dynamic gadolinium-diethylene-triaminepentacetate (Gd-DTPA) enhanced magnetic resonance mammography (MRM) protocol, incorporating image subtraction and using a dedicated double breast coil, in patients with treated breast cancer. 36 patients who had undergone breast conserving surgery and radiotherapy, with clinical or mammographic suspicion of locally recurrent breast carcinoma, were examined. 3D rapid volume imaging of both breasts was performed before and repeated three times, at 1, 2 and 3 min, following Gd-DTPA enhancement Image subtraction allowed identification of enhancing lesions and quantitative analysis of these was performed. Five patients had six lesions demonstrating rapid enhancement in the first minute, all of which were histologically confirmed recurrent or second primary tumours. Slower enhancement was seen in six benign lesions and diffuse enhancement was seen in one patient within 6 months of treatment. The dynamic protocol used allowed sufficient temporal resolution for distinguishing malignant from benign lesions at the site of previous surgery and ensured that both breasts were imaged in their entirety, thus enabling the diagnosis of multifocal and second primary tumours.
Clinical evaluation of manual and automatic exposure control techniques in film-based chest radiography
Authors: Ismailos E , Mastorakou I , Kelekis N L , Papadopoulos K P , Efstathopoulos E P , Panayiotakis G , Kelekis D A
Published: July 2009

Chest radiographs obtained with either automatic exposure control (AEC) technique, or manual exposure control (MEC) technique, were compared in a sample of 329 cardiological and cardiosurgery patients. Parameters evaluated, were various anatomical regions, according to their appearance in both posteroanterior (PA) and lateral radiographs. Lateral radiographs obtained with the AEC technique demonstrated better image quality than those obtained with the manual technique. There was no definite advantage of the AEC technique in PA radiographs. The AEC technique has the potential to improve the quality of lateral chest radiographs of cardiological and cardiosurgery patients. It is considered to be a useful tool in chest radiography.
Radiation prevention of heterotopic ossification after bone and joint surgery in sites other than hips
Authors: Lo T C M , Pfeifer B A , Smiley P M , Gumley G J
Published: July 2009

Five patients were given single dose irradiation in an attempt to prevent heterotopic ossification after bone and joint surgery in sites other than hips. All patients were at risk for the development of post-operative heterotopic ossification. Two patients were treated with 6 Gy and three patients were treated with 7 Gy the day after operation. No complications were encountered. Post-operative heterotopic ossification did not develop in patients who received 7 Gy, whereas treatment failed in the two patients who received 6 Gy. Because this is a case report study, no conclusion could be made. Further investigation is needed to assess the efficacy of post-operative single dose irradiation in heterotopic ossification prophylaxis in sites other than hips in high risk patients.
Squamous cell carcinoma of the skin metastasizing to the breast—imaging findings
Authors: Demİrkazik F Başaran , Başkan Ö , Aydingöz Ü , Tacal T , Firat P
Published: July 2009

An extremely rare case of metastatic squamous cell skin carcinoma to the breast is reported with imaging features. Ultrasonography and magnetic resonance imaging revealed well circumscribed, complex solid masses with papillary fronds projecting into cystic centres.
Latent image fading in mammography
Authors: Burch A , Law J
Published: July 2009

The subject of latent image fading in mobile mammographic screening featured in correspondence some time ago [1,2]. It has been shown that the rate of image fade varies between differenct film types [2,3], and we have recently attempted to quantify this effect for some newer types of mammography film, namely Kodak MinRE and Fuji MIMA and UMMA, with interesting results. A set of films of each type was exposed at intervals with a green light sensitometer at intervals and stored at ordinary dark room temperatures.
Imaging of patients with pancreaticobiliary diversion for obesity: post-operative anatomy and findings in small bowel obstruction
Authors: Bertolotto M , Gianetta E , Rollandi G A , Perrone R , Carrabetta S , Martinoli C , Scopinaro N , Cittadini G , Derchi L E
Published: July 2009

Pancreaticobiliary diversion is a surgical procedure undertaken for obesity. It consists of a distal gastrectomy with a long Roux-en-Y reconstruction, the enteroenterostomy being placed 200 cm distal to the gastroenterostomy and 50 cm proximal to the ileocaecal valve. Three intestinal limbs are recognized: (a) the alimentary loop from the gastroenterostomy to the enteroenterostomy; (b) common loop from the enteroenterostomy to the ileocaecal valve and (c) pancreaticobiliary loop from the duodenum to the enteroenterostomy. The radiological findings in 15 pancreaticobiliary diversion patients with small bowel obstruction were reviewed (15 plain abdominal radiographs, 13 ultrasound (US), 8 CT) and compared with 20 plain abdominal radiographs, 10 US, and 10 CT studies performed for other causes in patients with pancreaticobiliary diversion and 15 CT scans from non-operated patients. After pancreaticobiliary diversion the pancreaticobiliary loop was completely air-free. In the patients operated on more than 1 year previously, alimentary and common loops were significantly larger than the pancreaticobiliary loop and small bowel loops of non-operated subjects. Obstruction of the pancreaticobiliary loop arrests only the flow of pancreaticobiliary secretions with non-specific clinical findings. Plain abdominal radiographs were not diagnostic in all but two cases with radiographically detectable dilated fluid filled loops. Air–fluid levels were never apparent. US and CT showed markedly dilatated intestinal loops and duodenum. Obstruction of the alimentary and common loops presented with symptoms, clinical signs, and radiological findings more typical for bowel obstruction in intact subjects.
Contrast media as extracellular fluid space markers: adaptation of the central volume theorem
Authors: Dawson P , Blomley M J K
Published: July 2009

We present some theoretical observations on the pharmacokinetics of the conventional intravascular radiographic and gadolinium chelate MR contrast agents. These agents may be viewed from a physiological perspective as extracellular fluid (ECF) space markers. It can be shown that the passage of such agents through the body may be described by a variant of the “central volume theorem”, if the central volume is taken to be that of the entire extracellular fluid. A consequence is that, in a manner akin to nuclear medicine techniques utilizing technetium-99m diethylene triamine pentacetic acid (DTPA), measures of glomerular filtration rate (GFR) related to total ECF volume rather than to the normal body surface area may be obtained from direct or indirect measurements of iodine or gadolinium plasma levels. Typical measurements are presented. A simple means is also described of generating curves of the fraction of contrast medium excreted from the body, applicable to both patients with normal and with abnormal renal function.
Identification of the transverse mesocolon and root of small bowel mesentery; a new sign of pneumoperitoneum
Authors: Grassi R , Catalano O , Pinto A , Fanucci A , Rotondo A , Di Mizio R
Published: July 2009

A new sign of pneumoperitoneum was observed in a patient with perforation of the ascending colon. The presence of free air in the peritoneal cavity allowed identification of the transverse mesocolon and the root of the small bowel mesentery on plain abdominal radiographs obtained in the supine and in the prone position. This sign may be an aid in the diagnosis of pneumoperitoneum.
The radiological spectrum of vertically-acquired HIV infection
Authors: Owens C M , Allan R , Thomas K , Evans J , Stevens J
Published: July 2009

Anonymous antenatal and newborn screening demonstrates a positive HIV seroprevalence of one in 400 in areas of inner city London. European Collaborative Study data show a vertical transmission rate of 15% and suggests that 23% of infected children will develop clinical manifestations of AIDS before reaching 1 year of age [1], meaning that recognition of the radiological findings in vertically-acquired HIV is important. 75 serial cases of vertically-acquired HIV (age range 6 weeks to 12 years, mean age 35 months) presenting to a national referral centre over 48 months were reviewed, the radiographic findings we describe constitute a core of typical abnormalities together with a selection of the rarer manifestations of vertically-acquired HIV.
Evaluation of palpable breast masses with 201TI scintigraphy
Authors: Rebollo A C , Torres-Avisbal M
Published: July 2009

We agree with Dr Roebuck's statement that the combination of physical examination, mammography and fine-needle aspiration is highly accuarate in the diagnosis of palpable breast massess when all the tests give the same result. However, each of these methods of assessment has important limitations.
Use of the output video signal for dynamic range, brightness control and image memory assessment in X-ray fluoroscopy
Authors: Okkalides D
Published: July 2009

The output video signal from three X-ray fluoroscopy machines was recorded with a storage oscilloscope to calculate the dynamic range of their image intensifier television camera chains. The two MERATE MTH90 and MGR50hf machines employed the same imaging chain but the response of the former to exposure was significantly lower because of a three channel light distribution optical system which was installed but not used. The CGR Stenoscope machine was found to have a very narrow dynamic range to the extent that it was not usable. Additional measurements on the CGR machine showed that the image intensifier brightness control mechanism would produce stabilized brightness in less than 0.4s and it proved to be faster than the manual selection of exposure parameters. The quality of the image stored in the memory device on the same system was compared with the original by subtracting the two video signals on the oscilloscope and thus acquiring a quantitative measure of their difference.
Staff dose reduction during coronary angiography using low framing speed
Authors: Steffenino G , Rossetti V , Ribichini F , Dellavalle A , Garbarino M , Cerati R , Norbiato A , Uslenghi E
Published: July 2009

Radiation exposure of cardiac catheterization laboratory staff is a known occupational hazard, and efforts are made to obtain dose levels which are “as low as reasonably achievable”. This study assessed the reduction in staff radiation exposure using cine framing at 12.5 f s−1 during coronary cineangiography, instead of 25 f s−1. Thermoluminescent dosemeters were used to measure equivalent dose at several sites for the operator, nurse assistant, and X-ray technician during 15 procedures at both frame rates. Patient-related and procedure-related variables were similar in the two groups of examinations. Mean equivalent dose absorbed (μSv) at the left side of the forehead was reduced by 61%, 60% and 36%, for the operator, nurse assistant and X-ray technician, respectively. With use of the lower frame rate similar reductions by 42%, 62% and 62% were measured at the thyroid level, and by 51%, 40% and 61% at the mid-thorax level. Cinefilming at low frame rates during coronary arteriography allows a substantial X-ray dose reduction at all body sites for all staff. Use of lower frame rates wherever possible is of special interest since it may also reduce patient radiation exposure.
Caval halo
Authors: Rosenfeld K , Dick R
Published: July 2009

We wish to describe a new radiological sign related to the inferior vena cava following liver transplantation. A high density circumferential ring may be seen on an axial CT scan (Figure 1).
1996 International Congress on Radiation Protection
Authors: Corbett R H , Batchelor S
Published: July 2009

The Ninth International Congress of the International Radiation Protection Association was held in Vienna, April 14–19, 1996. It promoted discussion of all aspects of radiation protection matters, with particular reference to work carried out during the previous 4 years.
Book reviews
Authors: Webb J A W
Published: July 2009

This is a highly illustrated book, in many ways resembling an atlas. The brief accompanying text first considers the techniques available for urological diagnosis, and then a chapter is devoted to each pathological category.
In vivo study of rabbit irradiated skeletal muscle by MRI—a long-term follow-up
Authors: Ibarrola D , Francois-Joubert A , Leviel J-L , Massarelli R , Lefaix J-L
Published: July 2009

The delay in the appearance and the extent of a lesion induced by γ-irradiation, in rabbit iliospinalis muscles, have been evaluated in vivo by MRI. The left side rabbit muscle was irradiated with an 192Ir sealed source at two skin surface doses: 40 Gy and 80 Gy. The progress of the lesion was followed on a long-term basis (12 months) by using T  2 weighted spin echo imaging. The irradiation induced lesions were detected by MRI 22 weeks after irradiation for the 40 Gy group and 17 weeks for the 80 Gy group. The atrophy of the muscle and the extent of the lesion increased as a function of the dose at the skin surface. The threshold depth dose, corresponding to the deepest border of the lesion, was calculated by using the monoexponential attenuation law. The results gave the value of 20 ± 7 Gy for the 40 Gy group and 16 ± 3 Gy for the 80 Gy group.
The value of embolization therapy in painful osseous metastases from hepatocellular carcinomas; comparative study with radiation therapy
Authors: Murakami R , Baba Y , Furusawa M , Yokoyama T , Nishimura R , Uozumi H , Hatanaka Y , Yamashita Y , Takahashi M
Published: July 2009

We evaluated the therapeutic effect of transcatheter arterial embolization therapy (TAE) for painful osseous metastases from hepatocellular carcinoma (HCC) in comparison with radiation therapy (RT). TAE using gelatin sponge particles was performed for seven lesions in seven patients. Selective catheterization and embolization were successfully performed in all lesions. Within 10 days after TAE, complete pain relief (CR), partial relief (PR) and no relief (NR) were attained in 57%, 29% and 14%, respectively. RT was used to treat 34 lesions in 22 patients. The dose fractionation schedules were in the range 28.0–50.4 Gy, with 1.8–4.0 Gy per fraction. CR, PR and NR were attained in 47%, 47% and 6%, respectively. There were no serious complications related to these treatments. Both TAE and RT are effective and the treatment of choice should be selected on an individual basis.
Magnetic resonance imaging of primary lymphoma of the cauda equina
Authors: Ooi G C , Peh W C G , Fung C F
Published: July 2009

Malignant lymphoma of the central nervous system is usually confined within the cranium, with primary involvement of the spinal cord and nerve roots being very rare. The occurrence of primary lymphoma in the cauda equina in a 16-year-old Chinese male is reported. Contrast enhancement during magnetic resonance imaging is useful in accurately demonstrating disease extent prior to surgery.
The “veiled right kidney sign”—an ultrasound finding in retroperitoneal perforation of the duodenum
Authors: McWilliams R G , Blakeborough A , Johnson M I , Weston M
Published: July 2009

We report a case of traumatic duodenal perforation where the diagnosis was first considered during abdominal ultrasound examination. A subsequent CT scan identified the site of perforation which was confirmed at laparotomy. This condition typically produces few clinical signs or symptoms initially but has a high mortality related to delayed diagnosis. The ultrasound findings that prompted early diagnosis are described.
Book reviews
Authors: Walton J
Published: July 2009

This book is primarily aimed at physicians, students and radiologists who are beginners to the world of ultrasound, but it will also find a role as a first line of reference for more experienced practitioners.
Book reviews
Authors: Faulkner K
Published: July 2009

This is the latest in a series of very useful commentaries to be published by the National Council of Radiation Protection and Measurements. It deals with the issue of benefit derived by a group of individuals from specific examinations on a particular type of equipment.
The quantification of renal function with enhanced computed tomography
Authors: Blomley M J K , Dawson P
Published: July 2009

The changes with time in renal parenchymal and vascular attenuation following injection of an intravascular contrast medium can be exploited to study renal physiology in several ways. Shortly after injection, both contrast medium clearance and fractional vascular volume per unit volume of kidney can be measured on a regional basis by obtaining sequential CT data from one anatomical level and the application of a graphical analysis to the baseline subtracted CT numbers for tissue and vascular regions of interest: c(t) and b(t), respectively. By plotting the ratio c(t)/b(t) against ∫b(t)dt/b(t), both fractional vascular volume and contrast medium clearance can be estimated graphically. At later time points, a semilogarithmic plot against time of the declining attenuation of vascular or parenchymal regions of interest gives information about overall, as opposed to regional, renal function: the gradient estimates the glomerular filtration rate per unit volume of extracellular fluid. Absolute glomerular filtration rates can also be calculated with blood sampling. Although further experimental evaluation is needed, these techniques have a strong theoretical basis, and experimental work performed so far is encouraging. Possible applications of these techniques are discussed.
Some cost-benefit considerations for PACS: a radiological perspective
Authors: Strickland N H
Published: July 2009

Some cost-benefit considerations for a picture archiving and communication system (PACS) are discussed in relation to a hospital-wide PACS. The acquisition of plain radiography by phosphor imaging plate technology (currently state of the art computed radiography), the soft copy display of the clinical history and radiological reports in association with the corresponding images, and the retrieval and simultaneous display of past with current images, are all considered to be integral to a true PACS. Cost-benefit considerations for a PACS extend far beyond the purely economic issues. More important and far reaching consequences relate to efficient data management provided by a PACS properly interfaced to hospital and radiological information systems. The hardware required to install and operate a hospital-wide PACS is now ubiquitously available and its performance has been amply demonstrated by a number of filmless hospitals. Software design and implementation is now the outstanding consideration determining the clinical and, in particular, the radiogical benefit of a PACS.
Chest high resolution CT in adults with primary humoral immunodeficiency
Authors: Feydy A , Sibilia J , Kerviler E De , Zagdanski A-M , Chevret S , Fermand J-P , Brouet J-C , Frija J
Published: July 2009

The purpose of this study was to assess the findings on chest high resolution computed tomography (HRCT) in patients with primary humoral immunodeficiency. HRCT was prospectively and consecutively performed in 19 patients with primary humoral immunodeficiency, aged 15–64 years (mean 36), and in 15 healthy subjects. HRCT results were correlated with clinical and biological data. Bronchial lesions were observed in 11 patients (58%), consisting either of bronchial wall thickening in eight or bronchiectasis in eight; both were present in five patients. Lobar and/or segmental collapses were found in seven patients (37%), scars in eight patients (42%), interstitial lesions in six patients (32%), and lobular air-trapping in two patients (11%). Parenchymal collapses were correlated with the annual frequency of infections (p = 0.03) and with the IgA level (p = 0.01). Scars were correlated with the annual frequency of infections (p = 0.04). No correlation was found between bronchial wall thickening or bronchiectasis and the data analysed. In conclusion, HRCT is a useful method to demonstrate lung disease in primary humoral immunodeficiencies, with special emphasis on bronchial changes and interstitial lesions.
Lymphoscintigraphy and colour Doppler sonography in the assessment of leg oedema of unknown cause
Authors: Wheatley D C , Wastie M L , Whitaker S C , Perkins A C , Hopkinson B R
Published: July 2009

Oedema of the lower limbs may be associated with a number of factors, most commonly a lymphatic or venous abnormality. Generally effective treatment options are only available with venous disorders. The aim of this study is to show that a combination of duplex Doppler sonography and lymphoscintigraphy in patients with limb oedema will help to determine the aetiology and thus identify patients for whom treatment is appropriate. 32 patients presenting with unexplained oedema involving the lower limb have been studied. Each patient underwent Doppler sonography followed by lymphoscintigraphy. In 16 patients the lymphoscintigraphy was abnormal, showing absent or poorly visualized lymphatics. The Doppler study was abnormal in 17 patients, nine of whom went on to receive definitive surgical treatment. In five patients both studies were abnormal and there were six cases where both investigations were normal. It is concluded that in the great majority of referrals (82%), the combination of lymphoscintigraphy and Doppler ultrasound is a satisfactory means of assessment of patients with unexplained limb oedema.
99Tcm tetrofosmin uptake in mediastinal tumours
Authors: Ishibashi M , Fujimoto K , Ohzono H , Meno S , Hayabuchi N
Published: July 2009

We present our experience in visualizing mediastinal tumours using 99Tcm tetrofosmin. Three patients with thymic tumours and two patients with a mediastinal tumour (seminoma and small cell carcinoma) were found to have anterior mediastinal masses on chest radiographs, and subsequently underwent computed tomography and magnetic resonance imaging. In addition, the patients underwent single photon emission computed tomography (SPECT) with 99Tcm tetrofosmin and 201Tl. Intense uptake was seen on early 99Tcm tetrofosmin images in three patients with thymoma, invasive thymoma and mediastinal tumour (small cell carcinoma). In the remaining two patients with thymic carcinoma and mediastinal seminoma, there was intense 99Tcm tetrofosmin uptake on early images which reduced on delayed images. 201Tl uptake was intense on both early and delayed images. These findings suggest that different 99Tcm tetrofosmin uptake in early and delayed imaging may offer new information on these mediastinal tumours.
Usefulness of iron colloid-enhanced MRI in differentiating experimental hepatocellular carcinoma from hyperplastic nodules in rats: analysis by microautoradiography
Authors: Suto Y , Kodama F
Published: July 2009

To demonstrate the usefulness of iron colloid-enhanced MR images in differentiating hepatocellular carcinoma (HCC) from hyperplastic nodules (HN), microautoradiographs of chemically induced rat liver tumours were prepared 4 h after intravenous injection of chondroitin sulphate iron colloid (CSIC) labelled with 59Fe by the dipping technique. 20 Wistar rats were allocated into three groups: (1) a normal group, 10; (2) an HN group, 5; and (3) a liver cancer (LC) group, 5. In the LC group, a diet containing 0.06% 3′-methydiaminobenzine tetrahydro-chloride (DAB) was administered for 3 months. In the HN group, a diet containing 0.025% acetylaminofluorene (AAF) was administered for 4 months. Non-labelled CSIC was intravenously injected into five rats in the normal group, and pseudomicroautoradiographs were prepared using the same technique (normal cold group). 50 sites for examination were randomly selected for each of the normal liver tissue, HN, well-differentiated HCC (HCC-W), and moderately to poorly-differentiated HCC (HCC-MP). The number of Kupffer cell-like macrophages and the photosensitized area ratio (PAR) per field of view were calculated. There was no significant difference in either the number of Kupffer cell-like macrophages or the PAR between HN and normal liver tissue. Although there was no significant difference in the number of these cells between groups HN and HCC-W, the PAR in group HCC-W was significantly lower than that in group HN (p=0.045). In HCC-MP, both their number (p=0.003) and the PAR (p=1.18 × 10−9) were significantly lower than in group HCC-W. However, the PAR in HCC-MP was significantly higher than those in the normal cold group (p=0.019). Iron colloid-enhanced MRI is useful for differentiating HCC from HN, and for diagnosing the degree of HCC differentiation.
Patient dose measurements from femoral angiography
Authors: Hoskins P R , Gillespie I , Ireland H M
Published: July 2009

Investigation of patient dose from femoral angiography requires detailed logging of dose–area product (DAP) measurements, which is time-consuming and only possible on small numbers of patients. A simple model for the femoral angiogram study consists of two regions; lower limbs and torso. The experimental phantom was the abdominal and pelvic sections of a Rando phantom, and two 10 cm diameter water filled cylinders to represent a lower limb. DAP rate during screening, and the DAP per spot film exposure were obtained in two rooms. Total DAP values were measured on 100 patients in each room. The median screening time and number of spot film exposures were divided between the two regions. The DAP from screening and spot films for each region was estimated by combining the phantom and patient data. The total DAP predicted by the model agreed to within 7% of the median DAP from the patient studies. Conversion to effective dose gave 9.0 mSv for the newer room compared with 2.8 mSv for the older room. In the newer room it was estimated that digital spot film exposure contributed 88% of the total effective dose. In the same room, exposure of the torso contributed 98% of the total effective dose. The model will enable interpretation of total DAP measurements made from femoral angiogram studies without the need for detailed DAP measurements on every patient. Attempts to reduce patient dose from femoral angiography must concentrate on reduction of the number and dose per exposure from abdominal and pelvic digital spot films.
Lateral thyroid ectopia—CT and MRI findings
Authors: Hammond R J , Meakin K , Davies J E
Published: July 2009

This is a case of true lateral thyroid ectopia, an extremely rare condition. The appearances on sectional imaging are shown.
Sequential bilateral carotid dissection leading to Raeder's syndrome
Authors: Stefani P , Monti L , Pacini M , Barontini F , Maurri S
Published: July 2009

A 39-year-old man complained of unilateral headache, diplopia and marked anterior neck oppression “like a necklace”. MRA was used to study this case of subsequent bilateral internal artery dissection (ICAD) which initially appeared as Raeder's syndrome. MRA proved to be a non-invasive alternative for studying stenosis, occlusions and dissections of the intracranial and extracranial vessels.
Varicella–zoster virus myelitis—serial MR findings
Authors: Hirai T , Korogi Y , Hamatake S , Ikushima I , Shigematsu Y , Takahashi M , Ando Y , Arima T , Ando M
Published: July 2009

The authors describe a 32-year-old male in whom herpes zoster of the left upper extremity was complicated by the development of cervical myelitis. Contrast enhancement and abnormal signal intensity on T  1 and T  2 weighted images was seen at C1–C6 levels in the spinal cord and medulla. There was also slight enlargement of the cord at these levels. On serial MR imaging, the degree of enhancement changed from marked to none with corresponding clinical improvement.
The lateral cervical spine in major trauma
Authors: Logan P M , Janzen D L , Connell D G
Published: July 2009

A 17-year-old male cyclist was struck by a speeding car. Upon arrival at the scene, the paramedics found the patient to have no cardiac output. Following intubation and successful resuscitation the patient was transferred to the Emergency Department.
Philadelphia Chromosome–Negative Chronic Myeloproliferative Disease
Authors: Thiele Juergen
Published: July 2009

Session 2 of the 2007 Workshop of the Society for Hematopathology/European Association for Haematopathology was focused on Philadelphia chromosome–negative chronic myeloproliferative diseases (Ph– MPDs), recently termed chronic myeloproliferative neoplasms. The presented and submitted cases highlighted some important issues and also impending problems associated with the diagnosis and classification. Cases included predominantly rare entities like chronic eosinophilic leukemia and related disorders, chronic neutrophilic leukemia, and others with specific genetic abnormalities that allowed molecularly targeted therapy. In this context, the distinctive role of a positive JAK2V617F mutation for the diagnosis of Ph– MPD was underscored, including entities with a low allele burden and the discrimination from reactive disorders (autoimmune myelofibrosis, reactive thrombocytosis). Although novel genetic and molecular approaches have significantly improved the way we classify Ph– MPD, a combined clinicopathologic approach, including representative bone marrow specimens, still remains the yardstick for diagnosis.
Regulating Harassment: Is the Law Fit for the Social Networking Age?
Authors: Geach Neal , Haralambous Nicola
Published: July 2009

The use of social networking websites, such as Facebook, has escalated in recent years. A consequence of this has been that these communication mediums are being increasingly used to bully and harass other users. This article explores the extent to which existing legislation provides sufficient protection against such activity. There is currently no legislation dealing specifically with online harassment. Although existing legislation, such as the Protection from Harassment Act 1997, can be interpreted so as to cover issues of harassment over the Internet, such legislation was not drafted with the Internet in mind. In light of this, the extent to which this Act can offer effective protection against online harassment can be questioned. While other statutory provisions, such as s. 127 of the Communications Act 2003 and s. 1(1) of the Malicious Communications Act 1988, do expressly take account of modern electronic mediums, both have limitations. This article evaluates the rationale behind criminalising various forms of online conduct and argues that the current overall legislative framework is inaccessible, uncertain and thus inadequate to encompass activities in today's evolving age of online social networking. Consequently, the time has come for reform to ensure that the law balances the need to protect individual well-being with the need to safeguard against fictitious and vindictive allegations.
Climatic variation alters supply‐side ecology: impact of climate patterns on phytoplankton and mussel recruitment
Authors: Menge Bruce A. , Chan Francis , Nielsen Karina J. , Lorenzo Emanuele Di , Lubchenco Jane
Published: July 2009

Climate change will modify ecosystems, but a dearth of long‐term data sets on critical ecological factors makes prediction of mechanistic pathways and scope for ecological changes difficult. Using 14–18 year time series of phytoplankton abundance and mussel recruitment at up to 10 sites along 320 km of coast in a rocky intertidal ecosystem, we examined the influence of climatic variation at 3–7 year (El Niño‐Southern Oscillation [ENSO]), 7–10 year (North Pacific Gyre Oscillation [NPGO]), and 20+ year (Pacific Decadal Oscillation [PDO]) timescales. Phytoplankton and mussel recruitment revealed order‐of‐magnitude increases and seasonal shifts in the 2000s compared to 1989–1999, but seasonal shifts were in opposite directions with phytoplankton blooms occurring earlier and recruitment occurring later in the year. The NPGO had the strongest relationships with both phytoplankton and recruitment, while relationships between these factors and ENSO and PDO were weak. Increases were associated with cooler ocean temperature and intensification in the ocean gyre‐scale circulation reflected in a stronger North Pacific Current (NPC). Phytoplankton abundance and mussel recruitment were positively correlated, suggesting that increases in larval food may have driven the changes in mussel recruitment. With our prior demonstration that mussel growth rate is sensitive to phytoplankton concentration, these results suggest an important effect of bottom‐up forcing on the dynamics of coastal mussel populations. We conclude that central supply‐side ecological processes in coastal ecosystems are sensitive to long‐term ocean basin‐scale oceanographic and atmospheric fluctuation. Despite these changes, intertidal community dynamics have changed only in relatively subtle ways, suggesting a role for local ecological interactions in dampening the effects of dominant modes of climate forcings in coastal ecosystems.