bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiovascular Evaluation in Turner Syndrome: Utility of MR Imaging
Authors: DAWSON‐FALK KAREN L. , WRIGHT ALLAN M. , BAKKER BERT , PITLICK PAUL T. , ROSENFELD RON G.
Published: March 2008

Forty patients with karyotypidy proven Turner syndrome were prospectively studied using magnetic resonance imaging (MRI) and echocardiography in order to determine the frequency of cardiovascular anomalies and to assess the utility of both imaging modalities as methods for cardiovascular evaluation in Turner syndrome. Cardiovascular anomalies were found in 45% of patients A high absolute prevalence of bicuspid aortic valve (175%) and aortic coarctation (12.5%) were observed relative to comparable series. Of clinically significant abnormalities, three of five aortic coarctations and four of five ascending aortic dilatations were solely MRI detected and not evident at echocardiographic examination. MRI is thus seen as a valuable adjunct to echocardiography in the cardiovascular evaluation of Turner syndrome patients. The usefulness of MIU primarily relates to its ability to provide excellent visualisation of the entire thoracic aorta where a large proportion of clinically significant anomalies Occur in Turner syndrome.
Caecal faecolith: ultrasonic – radiologic diagnosis
Authors: KHALEGHIAN ROWSHAN , TRAVIS ROBERT C.
Published: March 2008

The entity of caecal faecoliths is not well known to most radiologists. It presents as a hard tender palpable mass in the right iliac fossa. It usually occurs in older women with chronic constipation. On ultrasound it appears as an intracaecal, highly echogenic, shadowing mass. Plain radiographs may show lamellated calcifications. Barium enema shows a well defined intracaecal mass. Using a combination of ultrasound and plain films or barium enema, a preoperative diagnosis should be possible.
Incarcerated gravid uterus mimicking placenta praevia
Authors: GUNN A.P.
Published: March 2008

Persistent retroversion of a gravid uterus (incarceration) is an uncommon occurrence which may lead to increased foetal mortality and maternal morbidity. This report documents the ultrasound findings in a case presenting in the third trimester.
Microcephalic, osteodysplastic, primordial dwarfism
Authors: KOZLOWSKI K. , DONOVAN T. , MASEL J. , WRIGHT R. G.
Published: March 2008

A case of microcephalic, osteodysplastic, primordial dwarfism (cephaloskeletal dysplasia of Taybi and Linder) is reported. This rare disease is characterised by unique clinical appearances and diagnostic radiographic findings. It is also associated with distinctive brain abnormalities. The latter include micrencephaly, lissencephaly, corpus callosum aplasia/agenesis and unusual histological brain abnormalities.
A clinical sign of low grade astrocytoma
Authors: SCALLY PETER M. , CLOSE PETER J.
Published: March 2008

A useful sign in diagnosing an astrocytoma is described. It consists simply of observing whether the patient moves on to the CT table of his own accord. A case is presented where the CT findings were of a large, low attenuation lesion in the cerebral white matter and where the sign was positive. This indicated that the diagnosis was a low grade astrocytoma rather than infarction, cerebritis or oedema of another cause.
Low dose rate teletherapy and tumour response
Authors: HAMILTON C S , SIMPSON S A , FERGUSON S , OSTWALD P , HSU W , O'BRIEN M , DENHAM J W
Published: March 2008

Tumour responses in 25 patients with locally advanced head and neck cancer, treated on an experimental fractionated low dose rate (FLDR) teletherapy program are reported. Treatment was given at dose rates ranging from 1.8 to 3 Gy/h to a range of total doses from 32–38 Gy, with palliative intent. The total doses delivered have been predicted by the linear quadratic formula to be equivalent to 33–41 Gy using conventionally fractionated high dose rate treatment, in terms of acute normal tissue effects. A complete response rate (no visible or palpable disease 2 months after treatment) was observed in 28% of cases. Analysis of these response rates suggests that the linear quadratic formula may underestimate the anti‐tumour effect of FLDR teletherapy at the various dose rates and total dose permutations in this study.
Cuff expander eases enema tip assembly
Authors: HURRELL MICHAEL ANTHONY
Published: March 2008

Some barium enema kits are manufactured with two‐part enema tips, enabling a cuff to be placed on the tip only if required. Difficulty can be experienced during enema tip assembly while attempting to place the cuff on the tip. A readily available gadget used in the farming sector provides a neat and cost‐effective solution to this problem.
Magnetic resonance angiography. I. Basic principles
Authors: TRESS BRIAN M , FRACR PATRICIA M DESMOND
Published: March 2008

The objective of this paper is to describe the basic physical principles important in magnetic resonance angiography (MRA). The data used were obtained from recent articles on MRA retrieved from Index Medicus 1985–92 and direct experience working with prototype MRA sequences. The information is presented in a manner suitable for those unfamiliar with the principles of MRA and magnetic resonance imaging (MRI).

Magnetic resonance angiography is an important method that can be used to obtain angiograms without the injection of intravascular contrast medium. It is already proving to be of clinical use in the assessment of vascular disease.
The value of routine computed tomography scanning of the chest in patients presenting with supradiaphragmatic Hodgkin's disease
Authors: BORG M F , BENJAMIN C S , CHILDS W J
Published: March 2008

Six patients presenting with supradiaphragmatic Hodgkin's disease are presented to demonstrate the potential benefits of chest computed tomography (CT) scanning as a routine staging procedure. These cases show that CT scanning can detect mediastinal and lung involvement not readily detected by other investigations, and that such findings can influence the radiotherapy plan, the need for extended radiotherapy fields or the use of chemotherapy. Following treatment, CT scanning can be useful to assess treatment response and may permit earlier detection of relapse.

The use of chest CT scanning as a routine staging procedure in all patients with supradiaphragmatic Hodgkin's disease is advocated.
The juxtaphrenic peak (Katten's sign) is produced by rotation of an inferior accessory fissure
Authors: CAMERON D C
Published: March 2008

Tenting of the diaphragm (Katten's sign) is a common finding in upper lobe collapse or where there is loss of volume. Twenty‐nine patients have been studied, 12 of these prospectively following upper lobectomy. Division of the inferior pulmonary ligament was carried out in these 12 patients. The computed tomography findings confirm that this sign is due to an accessory oblique fissure.
Decision making in diagnostic radiology
Authors: SCALLY PETER M
Published: March 2008

Radiology can be more interesting if the principles of decision making are understood and used to the advantage of the radiologist, referring clinician and patient. This article seeks to revise the principles that radiologists use intuitively.

Particular emphasis is placed on the importance of the pre‐test probability, as it can be shown to: (i) vary with the referral pool of patients; (ii) be a major determinant of the amount of additional information gained from the test; (iii) alter the sensitivity and specificity of the test; and (iv) determine largely the significance of a positive or negative test result.

An investigation helps a clinician by providing information that will move the probability of disease above an action threshold or below its exclusion threshold. If this does not occur as a result of one study, another is selected. This article also describes the factors involved in such a decision tree analysis, as well as discussing the reasons for both selecting a particular examination and deciding when a test should not be performed.
Craniopharyngioma and the moustache sign
Authors: KEARNEY DERMOT , TAY‐KEARNEY MEI‐LING , KHANGURE MARK S
Published: March 2008

Craniopharyngiomas are common suprasellar tumours but these are rarely associated with vasogenic oedema. Because the oedema extends into the optic tracts and optic radiations, a characteristic pattern is produced that resembles a moustache. The oedema is thought to be due to leakage of craniopharyngioma contents. Such a case is presented in this communication.
Duplex sonography in detection of renal artery stenosis: A simplified approach using new parameters
Authors: IOANNOU G , THORPE R J , MacKechnie S G , HOBBS J M , WILLIAMS K M
Published: March 2008

A case report illustrating a new investigation for detecting renal artery stenosis (RAS) is reported. Colour Doppler ultrasound evaluation of the readily accessible intrarenal arteries is a fast and accurate technique. Acceleration time and acceleration are the Doppler parameters used for measuring systolic upstroke on the waveforms obtained. Prolonged acceleration time (>0.07s) and diminished acceleration (< 3m/s2) indicate haemodynamically significant stenosis. Intrarenal Doppler ultrasound should provide a safe noninvasive screening examination for the detection of RAS.
Cryptogenic organizing pneumonia with atypical histopathological features
Authors: JONES D N , HENDERSON D W , MORTON S , SAGE M R
Published: March 2008

A case report of cryptogenic organizing pneumonia (COP); also known as bronchiolitis obliterans organizing pneumonia (BOOP) is presented. The histopathologic findings of COP are well documented in the literature and typically consist of organizing pneumonia of uniform appearance. This case report describes, in addition to the classic findings, more acute exudative inflammation not usually associated with this condition. Variation in the evolution of the pneumonic process is one of the reasons for reporting this case.

The promotion of awareness of this treatable condition is the other reason for reporting this case. When multifocal areas of consolidation are demonstrated radiologically, particularly when peripheral and basal, and in the correct clinical setting, the possibility of COP should be entertained. This condition responds dramatically to steroid therapy, and has a good prognosis.
Mesomelic dysplasia: Langer type
Authors: BAXOVA A , KOZLOWSKI K , NETRIOVA I , SILLENCE D
Published: March 2008

Two patients with Langer type mesomelic dysplasia are reported. This is one of the rare but well differentiated and easily recognizable mesomelic dysplasias.
Pointers to the diagnosis of gastric lymphoma on computed tomography
Authors: DOYLE T C A , DIXON A K
Published: March 2008

The computed tomographic features of 12 patients with primary gastric non‐Hodgkin's lymphoma and a further seven patients with gastric involvement by disseminated non‐Hodgkin's lymphoma have been reviewed. In eight of these 19 patients there were clefts within the area of gastric wall involved by lymphoma where oral contrast medium passed to within 2 mm of the serosal surface in and amongst areas of gastric wall thickening (maximal thickness ranging from 18 to 40 mm). In three of these patients some clefts extended beyond the expected margin of the stomach to enter into, and be contained by, a composite soft tissue mass of stomach, spleen and splenic hilar nodes. Awareness of these features, which are in keeping with the known range of macroscopic pathological appearances in non‐Hodkin's lymphoma, may help the radiologist to recognize this potentially curable disease.
Post‐orchidectomy radiation therapy for patients with stage I seminoma of the testis
Authors: KEARSLEY JOHN H , TRIPCONY LEE
Published: March 2008

The outcome of radiotherapy in patients with stage I testicular seminoma was evaluated. During the period 1960–89 (inclusive) 270 patients with stage I seminoma of the testis received radiotherapy to the para‐aortic nodes and ipsilateral hemipelvis following radical orchidectomy. Two hundred and fifty seven patients (95.2%) received a minimum tumour dose of 30Gy in 20 daily fractions using 4–6 MV photons. The 5 year overall and recurrence‐free survival rates were 97 and 95%, respectively. Only eight of the 270 patients relapsed and three were cured with ‘salvage’therapies. Of the 11 patients who died, four deaths (36%) were the result of uncontrolled testicular cancer, six (55%) intercurrent illness and one (9%) the result of attempted salvage. Patients staged and treated prior to 1979 had a significantly worse disease‐free survival compared to patients treated during and after 1979. As side effects were negligible, it was concluded that radiotherapy for stage I seminoma provides excellent cure rates. The difficulties arranging a ‘surveillance’programme in so large a State as Queensland are discussed.
Balloon dilatation of a parotid duct stricture
Authors: FERNANDO CHARITHA C
Published: March 2008

This report describes the balloon dilatation of a post‐traumatic parotid duct stricture. This proved to be a simple and successful interventional radiological procedure.
An unusual pattern of metastases from Merkel cell carcinoma
Authors: FOSTER RICHARD , STEVENS GRAHAM , EGAN MATTHEW
Published: March 2008

An unusual case of Merkel cell carcinoma is presented in which the time course to development of nodal and haematogenous metastases was protracted and the predominant site of metastatic disease was small bowel.
Loss of the mucosal lining/gall‐bladder wall echo: a sonographic sign of gangrenous cholecystitis
Authors: MOK P M , HARKNESS M A , HAYWARD G K
Published: March 2008

An additional sonographic sign of gangrenous cholecystitis, namely the loss of the mucosal/gall‐bladder wall echo in a setting of acute cholecystitis, is described. It was found prospectively in six patients and correlated well with the presence of mucosal/wall necrosis on histological gall‐bladder specimens. Other reported signs of gangrenous cholecystitis are reviewed.
Unifocal Langerhans’cell histiocytosis (eosinophilic granuloma) resembling Ewing's sarcoma
Authors: BISWAL B M , LAL P , UPPAL R , MALLIK S
Published: March 2008

In a 9 year old boy, a destructive lesion in the diaphysis of the right femur was wrongly diagnosed as a Ewing's sarcoma on the basis of the radiologic findings and fine needle aspiration cytology report. The clinical and radiologic picture was suggestive of Ewing's sarcoma, but an open biopsy of the lesion revealed a histopathological picture of eosinophilic granuloma. A brief review of the literature is given, together with discussion on the differential diagnosis of a mid shaft femoral lesion in young patients.
After‐hours radiology
Authors: WONG D C , SIDDLE K J
Published: March 2008

After‐hours radiological procedures are essential but expensive in any major teaching hospital. Using the criteria that radiological procedures performed after‐hours should have a reasonable probability of influencing or changing patient management acutely, a study of the justification of after‐hours radiological procedures was performed at the Princess Alexandra Hospital. Computer print‐outs were used to select the patients based on the dates and times of the procedures. Their charts were then reviewed. The study found that most after‐hours radiological procedures were justified. However, it also identified certain procedures that need not be performed or at least could be reduced after‐hours. The procedures were: (i) computed tomography (CT) head – epilepsy, meningitis; (ii) CT abdomen – trauma (intubated) – unable to examine abdomen; (iii) CT spine – obvious unstable fractures; (iv) Ultrasound abdomen – biliary colic (afebrile); and (v) Ultrasound kidneys – renal failure (afebrile).
Magnetic resonance imaging and computed tomography features of nasopharyngeal carcinoma with maxillary sinus involvement
Authors: Chong VFH , Fan YF , Toh KH , Khoo JBH , Lim TA
Published: March 2008

Anterior spread of nasopharyngeal carcinoma (NPC) may infiltrate the maxillary sinus. In a prospective study of 114 patients comparing magnetic resonance imaging (MRI) and computed tomography (CT) in the staging of NPC, 10 (9%) patients were noted to have tumour infiltration of the maxillary sinuses. All of the patients except one had associated infiltration of the sphenoidal sinuses indicating advanced local spread. Computed tomography was excellent in outlining the extent of bony erosion and associated soft tissue mass within the antra. T1‐weighted images could not demonstrate bony erosions directly although soft tissue extension into the sinuses could be clearly visualized. Both CT and MRI showed good demarcation between tumour and mucosal thickening within the maxillary sinus. Although MRI demonstrated soft tissue involvement more elegantly than CT, it did not appear to offer significantly more information that may affect clinical management.
MAG3 renal scintigraphy: Improved ability to make anatomical diagnoses in neonates
Authors: Rossleigh MA , Farnsworth RH , Kainer G , Rosenberg AR
Published: March 2008

Technetium‐99m mercaptoacetyltriglycine(MAG3) is the most recently introduced renal radiopharmaceutical in Australia and is established as the agent of choice for use in diuresis renography, particularly in neonates and infants. It provides superior anatomical information compared to previously used agents. Three cases are reported in which MAG3 diuresis renography was performed in neonates, who were found to have hydronephrosis detected antenatally. In two neonates, a previously unrecognized horseshoe kidney was demonstrated and in case 3 there were scan features characteristic of a ureterocele. It is highly unlikely that these abnormalities would have been delineated with 99mTc dimethyltriamine penta‐acetic acid (DTPA) study, as confirmed in case 1, because of the relatively poor uptake of DTPA when compared to MAG3.
Is phenytoin contraindicated in patients receiving cranial irradiation ?
Authors: Borg MF , Probert JC , Zwi LJ
Published: March 2008

Three recent publications have reported the development of erythema multiforme and Stevens‐Johnson syndrome in patients receiving cranial irradiation and sodium phenytoin. Some authors have recommended that patients receiving whole brain radiation therapy and who have had seizures should not be prescribed phenytoin but an alternative anticonvulsant. This article reviews the current literature pertaining to the development of this potentially lethal complication in patients receiving whole brain radiation and phenytoin, with reference to the single recorded case of Stevens‐Johnson syndrome in a patient receiving cranial irradiation and phenytoin in Auckland, New Zealand. While the clinical picture in the 16 patients reported in the literature and the current case report differed from the classical form of erythema multiforme, a similar pattern of presentation and outcome appeared in all patients reviewed, suggesting that the combination of phenytoin, cranial irradiation and the gradual reduction of concomitant steroids seem to lead to the development of erythema multiforme and/or Stevens‐Johnson syndrome. The data presented, although sparse, suggest that phenytoin should not be prescribed in patients receiving cranial irradiation.
Giant aneurysm of the abdominal aorta
Authors: Schubert F
Published: March 2008

A giant aneurysm of the abdominal aorta presented with a 2‐3 h history of right loin pain radiating to the groin and was associated with microscopic haematuria. The pain settled and a urogram was performed 2 days later. Considerable calcification in its wall outlined a very large aneurysm of the abdominal aorta with a maximum transverse diameter of 13.5cm. The patient underwent successful emergency surgery, at which time a right‐sided posterolateral rupture of the aneurysm was present. The patient remains alive and well 4 years later.
Haemoperitoneum due to spontaneous rupture of hepatic haemangiomatosis: Treatment by superselective arterial embolization and partial hepatectomy
Authors: Soyer P , Levesque M
Published: March 2008

A case is reported of a 36 year old woman with haemoperitoneum due to spontaneous rupture of hepatic haemangiomatosis. Computed tomography showed a subcapsular hepatic mass in the posterior segment of the right hemiliver (subsegment 7) containing a fluid‐fluid level. Magnetic resonance imaging depicted a subcapsular hepatic mass displaying an internal fluid‐fluid level suggestive of haematoma. Hepatic angiography showed an intense arterial blush in the area of the subsegment 7 and permitted a subsequent and temporarily effective superselective transcatheter embolization of the subsegmental arterial branch for subsegment 7. Because of a recurrence of intraperitoneal haemorrhage 15 days after the first embolization, a new selective hepatic artery embolization was performed. However, intraperitoneal haemorrhage recurred 10 days after the second embolization, and the patient underwent resection of the posterior segments of the right hemiliver (subsegments 6 and 7). This case suggests that superselective arterial embolization, when used alone, does not provide a permanent treatment of haemoperitoneum due to spontaneous rupture of hepatic haemangiomatosis. However, this technique seems to be useful in avoiding an emergency surgery, allowing a planned hepatic resection.
Computed tomography of the breast: A valuable adjunct to mammography in selected cases
Authors: Van Gelderen WFC
Published: March 2008

Computed tomography (CT) is not often used for the further assessment of a mass in the breast. In the case presented it proved to be invaluable in demonstrating a very posterior breast mass previously suboptimally demonstrated on mammography, not palpable clinically, and not visualized on ultrasound examination.

The predicament of a very posterior breast mass is highlighted and it is suggested that present‐day routine cranio‐caudal and oblique views may not be adequate to show such a mass even if meticulous attention to radiographic technique is given. If the supine–oblique view with balloon compression cannot be obtained, CT in the prone position with the breasts dependent may be the best alternative.

Fine needle aspiration biopsy can be performed under CT guidance in such cases.
Phlegmasia cerulea dolens, following insertion of bird's nest inferior vena cava filter
Authors: Foster DR
Published: March 2008

The occurrence of phlegmasia cerulea dolens (PCD) following uncomplicated insertion of a bird's nest vena cava filter via the femoral route is described.
Retroperitoneal lymphangioma
Authors: Breidahl WH , Mendelson RM
Published: March 2008

Five cases of retroperitoneal lymphangioma are presented. In three patients the lesions were symptomatic, with resolution of the symptoms following resection. In two elderly patients the lesions were asymptomatic. Ultrasound demonstrated masses that ranged from 4 to 15cm in maximal extent, and which were predominantly anechoic. Two contained septations and two echogenic debris. Computed tomography demonstrated the masses to be of water density, and allowed better delineation of the lesions to adjacent structures within the anterior pararenal space. Fine needle aspiration (FNA) produces a characteristic cytology of abundant lymphocytes, which may be intermingled with macrophages. It is considered that retroperitoneal lymphangioma has characteristic imaging features that allows a presumptive diagnosis, which can be confirmed by FNA.
Swollen ischiopubic synchondrosis: A dilemma for the radiologist
Authors: Kozlowski K , Hochberger O , Povysil B
Published: March 2008

Differences in size and shape of ischiopubic synchondrosis in childhood may present problems in diagnosis and differential diagnosis. Whereas asymptomatic swollen ischiopubic synchondrosis represents a normal ossification process, painful swelling is a symptom of underlying pathology. Five children are described with symptomatic ischiopubic synchondrosis swelling, four representing stress reaction and one with osteomyelitis. Radiologists should be careful when reporting on swollen ischiopubic synchondrosis in symptomatic children.
Colour‐coded duplex ultrasonography in selection of patients for transluminal angioplasty
Authors: Lai DTM , Huber D , Glasson R , Grayndler V , Evans J , Hogg J , Etheredge S
Published: March 2008

Transluminal angioplasty can be used to relieve symptomatic lower extremity arterial disease with minimal morbidity. This prospective study compares the accuracy of colour‐coded duplex ultrasonography with intra‐arterial digital subtraction angiography in selection of femoro‐popliteal lesions for angioplasty. Isolated, short (<6cm) and haemodynamically significant stenosis (>50% reduction in diameter) were considered for angioplasty. Colour‐duplex selection and exclusion was in agreement with angiography in 68 out of 86 lower limbs (79%). The sensitivity, specificity, positive and negative predictive value of colour duplex compared with angiography yielded values of 60.9, 87.5, 60.9 and 85.7%, respectively. The discrepancy between colour duplex and digital subtraction angiography can be partly explained by the tendency of duplex to underestimate the severity and length of disease. It is concluded that colour‐coded duplex can be used as a screening tool for lower extremity arterial disease to select appropriate lesions for endovascular procedures. The accuracy of duplex in the present study was not perfect and the decision for further intervention should be based on clinical grounds.
Treatment of cutaneous angiosarcomas of the head and neck
Authors: Veness M , Cooper S
Published: March 2008

A total of six patients with cutaneous angiosarcomas involving the head and neck were treated during the period 1985–1994. The distribution of sites between the scalp and the rest of the head and neck was equal. Initial local treatment involved surgery for four patients and radiotherapy for two patients. In the surgical group, following seemingly adequate macroscopic surgical excision, all four patients had inadequate surgical margins on histology. Five of six patients had disease recurrence within the head and neck and of these a further three went on to have a second episode of recurrence. Median time to recurrence was 8 months. All cases were misdiagnosed clinically at initial presentation and three of six had initial inconclusive histology. Cutaneous angiosarcomas of the head and neck is an aggressive multicentric cancer. Radiotherapy offers the only real chance of obtaining adequate local control even if surgical excision is carried out. Radiotherapy must encompass wide fields and whole scalp irradiation is mandatory for scalp lesions. A combination of laterally opposed photon and electron fields provides a simple, quick and effective means to deliver a tumoricidal dose of 50 Gy to the whole scalp with minimal irradiation of the underlying brain.
The failed thoracocentesis
Authors: Popli MB , Tripathi RP , Mehta N , Khudale B
Published: March 2008

How often do we consider a differential diagnosis of diaphragmatic hernia in cases of failed thoracocentesis? How many of us remember that omental fat in the chest can behave in a fluid manner, layering along the chest wall, resulting in the misinterpretation of a decubitus view. A case is presented of a diaphragmatic hernia that was missed on conventional chest radiographs resulting in CT having to be performed. A high degree of suspicion is mandatory to reach the final diagnosis. Radiographs could be used more effectively and CT avoided.
Lightweight suction drainage ‐ feeding system for oesophagogastric anastomotic leaks
Authors: Cameron DC , Black J
Published: March 2008

A new light weight coaxial suction drainage feeding system for the management of oesophagogastric leaks is presented.
Bone marrow cellularity: Quantification by chemical‐shift misregistration in magnetic resonance imaging and comparison with histomorphometrical techniques
Authors: Ishizaka Hiroshi , Horikoshi Hiroyuki , Inoue Tomio , Fukusato Toshio , Matsumoto Mitsuomi
Published: March 2008

The accuracy of a technique that uses chemical‐shift misregistration in magnetic resonance (MR) imaging to quantify vertebral bone marrow cellularity was tested on cadaveric specimens. In order to estimate the cellularity of 11 unfixed vertebral bodies, mid‐sagittal MR images were obtained using a 1.5T magnet with a proton‐density‐weighted spin‐echo sequence (repetition time/echo time, 2500/22 ms) and a narrow bandwidth. These values were subsequently compared to the histomorphometrical values for cellularity, amount of trabecular bone and deposited iron. The image‐derived values for cellularity (V1, %) correlated well with values determined by histomorphometry (VH, %) (V1= 21.2 + 0.72 VH, r= 0.92) regardless of the presence of trabecular bone and small amount of stored iron in the specimens. This simple technique may be applicable in the estimation of marrow cellularity.
Ultrasound features of Sjögren's syndrome
Authors: FRCR AT Ahuja , FRCR C Metreweli
Published: March 2008

The aim of this study is to demonstrate the different ultrasound appearances of the salivary glands in Sjögren's syndrome, and discuss the differential diagnosis. A reticulated appearance of the salivary and lacrimal glands in Sjögren's syndrome was also demonstrated which, to our knowledge, has not been previously described.
Unilateral facial pain and lung cancer
Authors: Shakespeare Thomas P , Stevens Mark J
Published: March 2008

The symptom of unilateral facial pain as a non‐metastatic presentation of lung cancer is rare. This report describes a patient in whom unilateral face pain preceded the diagnosis of lung cancer by 9 months. The neural mechanism of this syndrome is discussed and the literature reviewed.
Bilateral vertebral artery tortuosity with concomitant vertebral erosion: CT and MRA findings
Authors: Holden Andrew , Adler Brendan , Song Swithine
Published: March 2008

Focal vertebral artery tortuosity has been periodically reported as a rare cause of cervical vertebral body and foraminal erosion. Almost all reported cases are unilateral. A case of bilateral vertebral artery tortuosity is described with computed tomography and magnetic resonance angiography findings included.
Adrenal myelolipoma: Case report with a review of the literature
Authors: Bayram Fahri , Atasoy Kayhan Çetin , Yalçin Bülent , Salih Mustafa , Hekimoǧlu Koray , Uysal Ali Riza , Evcik Ender
Published: March 2008

A 40 year old woman who was pre‐operatively diagnosed as possibly having adrenal myelolipoma is reported. Adrenal myelolipomas are rare, non‐functional benign tumours comprising varying amounts of fat and haematopoietic elements. Albeit possibly coincidental, there is a frequent association with obesity, hypertension, and/or diabetes mellitus. A growing number of patients are being diagnosed during ultrasonographic or computerized tomographic scanning for unrelated problems.
Jejunojejunal intussusception secondary to leiomyoma
Authors: Mansberg Victor J , Mansberg Ginni , Doust Bruce D
Published: March 2008

A case of jejunojejunal intussusception in a 59 year old male secondary to a leiomyoma is reported. The patient presented with abdominal pain and vomiting. He was admitted with a diagnosis of gastroenteritis. Antegrade barium study showed a jejunojejunal intussusception with a soft tissue mass as the lead point. Computed tomography scan demonstrated the soft tissue mass to have properties suggestive of a leiomyoma. The diagnosis was confirmed on examination of the excised specimen.
Lipomatous meningioma: Characteristic computed tomographic appearance
Authors: Fitt GJ , Kalnins R , Mitchell LA
Published: March 2008

A case of lipomatous meningioma is reported. This is a rare variant of meningioma in which metaplasia of meningoepithelial cells occurs and mature adipocytes are present within the tumour. The heterogeneous attenuation and heterogeneous enhancement visualized on computed tomography (CT) can mimic necrotic malignant tumours. However, the demonstration of fat attenuation within the tumour explains the heterogeneity and suggests a benign process. The differential diagnosis of an extra‐axial fat‐containing tumour should include lipomatous meningioma.
An ultrasonographic study of Peyronie's disease
Authors: Muralidhar S , Gulati M , Kumar B , Sharma SK , Suman K , Roy PB
Published: March 2008

A study was undertaken to determine the usefulness of ultrasonography as an investigative tool, and its role in deciding the management of Peyronie's disease.

Fifteen patients with Peyronie's disease were studied by ultrasonography. The plaque could be demonstrated in all patients. The dimensions of the plaque varied from less than 1 cm to more than 7cm in length and 2‐4mm in thickness. The disease was active in 26% of the patients, as indicated by the presence of hypoechoic areas around a central region of hyperechoism. Ultrasonogram was more accurate than clinical assessment in delineating the extent of lesions. In one‐third of the patients, sonography demonstrated the plaques to be more extensive than had been detected by clinical examination. Calcification and activity of disease (which are clearly defined by ultrasonogram) are determining factors in the management of Peyronie's disease. This information allows the surgeon to select the modality of treatment, the timing of surgery and extent of excision. Thus, ultrasonography plays a vital role in the preliminary investigation and management of Peyronie's disease.
Intraventricular neurocytoma
Authors: Ng Perry , Soo Yoi Sun , Chaseling Raymond , O'Neil Peter
Published: March 2008

Intraventricular neurocytoma is a rare cerebral tumour which is usually associated with a good prognosis. It has imaging features which help differentiate it from other cerebral tumours. We report three cases including the first to originate from the pineal gland. The report emphasizes the radiological appearance and reviews the literature.
The whirl sign: A non‐specific finding of mesenteric rotation
Authors: Blake Martin P , Mendelson Richard M
Published: March 2008

The whirl sign has been described as a computed tomography (CT) finding of volvulus of the gut. Six cases are presented with a range of clinical diagnoses (a volvulus, adhesive obstruction with volvulus and previous left hemicolectomy, adhesions alone, transverse colectomy, and right hemicolectomy). All demonstrated a whirl sign. A further case simulating a whirl sign is also presented. We propose that the whirl sign, although a finding highly suggestive of volvulus, can occur in any situation that produces rotation or twisting of bowel and its mesenteric attachment.
Acute morbidity of radiation therapy for prostate carcinoma
Authors: Franklin CIV
Published: March 2008

The acute morbidity of high dose radiation therapy for carcinoma of the prostate in a group of 169 patients treated between February 1993 and April 1994 was examined. Morbidity was determined at the start of therapy, then weekly during therapy and at 1, 2, 3, 6 and 12 months after therapy. Morbidity was examined from the view of the treating doctor and the patients. Morbidity was found to peak at the end of the treatment. From the radiation oncologist's perspective, 80–85% of patients experienced significant bladder and bowel morbidity. The level of acute morbidity was acceptable and there was only one patient that was admitted to hospital for symptomatic control of his acute reaction. Recovery was practically complete after 3 months for both bladder and bowel morbidity. Fifty per cent of patients experienced dysuria, 75% perianal discomfort and 87% frequency at the end of the treatment. Most of the individual factors recovered following radiation but urinary frequency and perianal discomfort were the most persistent problems.
Guidelines for radiation oncology registrar training
Authors: Miller AA , Holecek MJ
Published: March 2008

Radiation oncology registrar training varies between centres, reflecting to some extent the varied training experiences of specialists. The attempts of one department to formalize the philosophy, aims and structure of its training are described and illustrated.
Computed tomographic and ultrasonographic findings of pseudomyxoma peritonei
Authors: Özcan Hasan , Akyar Serdar , Atasoy Çetin
Published: March 2008

Pseudomyxoma peritonei is an unusual clinical entity in which the peritoneal cavity is filled with a gelatinous material that is mucinous in nature. We present ultrasonographic and computed tomography findings in a patient with pseudomyxoma peritonei secondary to ovarian mucinous cystadenocarcinoma.
Peliosis hepatis associated with oral contraceptive use
Authors: Staub PG , Leibowitz CB
Published: March 2008

A 35 year old woman with right upper quadrant abdominal pain was found to have peliosis hepatis. This was attributed to oral contraceptive use and 6 month follow up after cessation of oral contraceptives showed these lesions to have reduced in extent.
Intrathoracic extramedullary haemopoiesis
Authors: Boyacigil Süreyya , Ardiç Selim , Tokoǧlu Figen , Paşaoǧlu Eşref , Muammer Karakaş H.
Published: March 2008

Intrathoracic extramedullary haemopoiesis is a rare condition accompanying chronic haematologic diseases. A 25 year old male β‐thalassaemia intermedia patient with bilateral posterior mediastinal masses is reported. Computed tomography and magnetic resonance imaging provide detailed information for evaluation of thalassaemia and similar haemolytic diseases. In geographic areas where thalassaemia is prevalent, to avoid unnecessary surgical interventions, extramedullary haemopoiesis should be considered in differential diagnosis of patients who have chronic anaemia with asymptomatic intrathoracic tumours.
The radiology of melioidosis
Authors: Chong VFH , Fan YF
Published: March 2008

Melioidosis varies from subclinical infection to fulminating disease with multiple organ involvement. Although endemic in South‐East Asia and northern Australia, it may be imported into temperate zones. It is the wide spectrum of manifestation that makes it ‘the great imitator'. The purpose of this pictorial essay is to familiarize the radiologist with the range of radiological manifestations of this disease. Intrathoracic findings include pulmonary nodules, consolidation, necrotizing lesions, pleural effusion, pleural thickening and mediastinal abscess. Abscess in almost all organ systems can be seen in the septicaemic and suppurative infections. Both clinical and radiological findings are non‐specific. A high index of suspicion is required to focus the search for bacteriological confirmation. A prompt diagnosis is essential, as melioidosis is often rapidly fatal.
Stress fractures of the fibula in the first few years of life (report of six cases)
Authors: Kozlowski K , Urbonaviciene A
Published: March 2008

Fibular stress fractures in children in the first few years of life are not well known and are often confused with osteomyelitis or malignant bone tumour. This misdiagnosis is followed by nuclear scan, computerized tomography (CT), magnetic resonance (MR) imaging and even biopsy. All these investigations are unnecessary as plain X‐rays show diagnostic radiographic findings and misdiagnosis is highly unlikely when they are evaluated in the context of clinical findings.
Intra‐renal Doppler wave‐form analysis as a screening test for renal artery stenosis
Authors: Lucas Philip , Blome Steven , Roche James
Published: March 2008

A double‐blinded trial was performed comparing Doppler interrogation of intra‐renal arteries with findings at renal angiography in the assessment of renal artery stenosis. Fifty‐three consecutive patients were studied.

Previously reported parameters and cut‐off values were used for predicting the presence of renal artery stenosis with Doppler. Doppler wave‐form analysis proved relatively specific (91%) but insensitive (68%) to the presence of renal artery stenosis (of greater than 60%) if acceleration parameters were used alone. The technique of using a difference in mean resistive indices was found to be both insensitive (61%) and non‐specific (54%).

Patients with fibromuscular dysplasia, branch vessel stenoses, multiple renal arteries and chronic renal impairment proved to cause the most false negatives. Young patients with normal arteries were the source of the few false positive results.

The interrogation of intra‐renal arteries does not have appropriate sensitivity to be useful as a screening test for renal artery stenosis.
Erythema multiforme‐like reaction associated with radiotherapy
Authors: Veness MJ , Dwyer PK
Published: March 2008

Generalized cutaneous reactions in association with radiotherapy have in the past been grouped into erythema multiforme (EM) and erythema multiforme‐like reactions, the latter being reactions that do not strictly fit the accepted clinical and/or histological criteria for EM, yet have similar findings or presentations.

Though usually benign and self‐limiting, the progression to Stevens‐Johnson syndrome, a potentially fatal form of erythema multiforme, has been reported. Presented here is a case study of a less severe radiation‐induced erythema‐like reaction.
Brain MRI findings in two cases with eclampsia
Authors: Ünal Mustafa , Şenakayli Ö Cem , Serçe Kemal
Published: March 2008

Neurological complications in patients with eclampsia are varied and include headache, visual disturbances, focal neurological deficits, altered mental status and coma. Occasionally, a focal neurological deficit includes a variety of visual disturbances. The pathophysiology of CNS abnormalities in patients with eclampsia is uncertain. Our cases, combined with a review of the literature, demonstrate that there is no correlation among severity of hypertension, parity, and location of lesions at initial magnetic resonance (MR) imaging findings or between the severity of hypertension and neurological symptoms. Two typical patterns are seen on MR images of patients with eclampsia. Lesions in the region of the posterior cerebral circulation are most common and are frequently associated with visual disturbances. Although there are lesions in the deep white matter or basal ganglia, a focal neurological deficit or alterations in mental status may not develop. This demonstrates the sensitivity of MR imaging in the detection of abnormalities in patients with eclampsia, even those without neurological deficits.
Mammography in men with breast cancer: Review of the mammographic findings in five cases
Authors: MD Selma Tükel , MD Hasan Ouzcan
Published: March 2008

Male breast carcinoma is an uncommon malignancy. The age at diagnosis and tumour stage are more advanced in males than in females. Poor alertness of both men and physicians for this infrequent disease may account for the delay in diagnosis. In this study, we reviewed male breast carcinomas seen within a 3 year period and assessed the mammographic findings. There is limited experience in the diagnosis of breast carcinoma in male patients and this has been considerably influenced by the knowledge of female breast cancer. The diagnostic criteria for the female counterpart cannot always be safely applied to male breast cancer. Mammograms of men with breast cancer usually show an uncalcified subareolar mass, which may mimic or be obscured by gynaecomastia. Occasionally, punctate calcifications may indicate malignant disease in the male breast. Early detection of male breast cancer may prolong the survival rate as in cases of female breast cancer.
The role of radiation therapy in Gravesophthalmopathy ‘
Authors: Chowdhury AD , Moriarty MJ
Published: March 2008

Gravesophthalmopathy ‘ can occur in 25–30% of patients with hyperthyroidism. This condition can result in serious visual disturbance and disfigurement. The treatment options for symptomatic disease are oral corticosteroids or orbital irradiation. Ten patients with Gravesophthalmopathy ‘ were treated with external beam radiotherapy at Saint Lukes Hospital from March 1991 to February 1994. Eight of these patients had excellent response with minimal morbidity. We believe that orbital radiotherapy is effective and well tolerated, and should replace corticosteroid therapy as the initial treatment modality in these patients.
Concurrent chemoradiation for oesophageal cancer: Factors influencing myelotoxicity
Authors: MacKean J , Burmeister BH , Lamb DS , Denham JW
Published: March 2008

Concurrent chemotherapy and radiation (CT/RT) for localized oesophageal cancer can cause life‐threatening myelo‐suppression. This non‐randomized study examines 95 patients from three Australasian centres treated on the Trans‐Tasman Radiation Oncology ‘definitivechemoradiation ‘ study. Duration of fluorouracil infusion and patient age were independently predictive of myelotoxicity after the first cycle of CT/RT. Overall rates of grade III and IV neutropaenia were 23% and of thrombocytopaenia 8% following the first cycle of chemotherapy. Five neutropaenic septic episodes followed the first cycle and six the second. All five patients recovered after the first cycle but there were four treatment‐related deaths occurring after the second cycle of CT/RT. Recommendations are made concerning initial dosing, dose reductions and delays to minimize adverse patient outcomes from myelosuppression.
The role of radiotherapy in thymomas
Authors: Leung John T
Published: March 2008

Thymoma is a rare disorder and the treatment of invasive disease is controversial. Seventeen patients with pathologically confirmed thymoma were treated at Royal Prince Alfred Hospital between 1982 and 1993. There were two stage 1 patients, four stage 2 patients and 11 stage 3 patients. Five patients had total resection, eight patients had subtotal resection and four patients had biopsy only. All patients received radiotherapy, with the median dose being 50 Gy. The median survival was 117 months and the 5‐year survival was 69%. This was influenced by stage of disease and extent of surgical resection. The local control was 76%. Three patients developed distant metastatic disease. There were insufficient numbers to determine a dose response to radiotherapy. Patients with invasive disease should continue to have postoperative radiotherapy. A brief review of the literature is made.
Acinic cell carcinoma of the parotid in children
Authors: Jones AO , Lam AH , Martin HCO
Published: March 2008

The imaging findings of two children with acinic cell carcinoma of the parotid gland are presented. Ultrasonic features are emphasized. One of these children, a 6‐year‐old boy, suffers from the oculocerebrorenal syndrome of Lowe, a rare congenital, inherited condition manifested by defects of the nervous system (mental retardation, hypotonia), eyes (cataracts, glaucoma) and kidneys. To date, no known association exists between these two rare entities. The other child, a 10‐year‐old girl, was otherwise well.

The ultrasound findings of both cases demonstrate features more classic for a benign intraparotid mass than for a potentially malignant lesion. The possibility of acinic cell carcinoma should be considered if a well‐defined, relatively homogenously hypo‐echoic intraparotid mass is encountered in a child, especially if cystic spaces are present.
Clinically and mammographically occult invasive ductal carcinoma diagnosed by ultrasound: The focally dilated duct
Authors: Yang WT , King W , Metreweli C
Published: March 2008

A case of clinically and mammographically occult invasive ductal carcinoma presenting as a focally dilated duct on ultrasound is reported. The features of ductal dilatation in benign and malignant conditions on ultrasound are highlighted.