bluuebunny/crossref_metadata_2025 huggingface dataset:
Chest X‐Ray Changes in A.I.D.S.
Authors: NICOLSON VIOLA , BRANSON JOHN
Published: March 2008

Pulmonary complications are common in A.I.D.S. patients, and Pneumocystis pneumonia is the most frequent. The typical pattern is a fine perihilar infiltrate going on to a more pronounced reticulonodular and sometimes to an alveolar filling pattern. This latter pattern may herald respiratory failure. Pneumocystis can cause other unusual patterns, especially when the infection is chronic or is modified by simultaneous infection by other organisms.

Other bacterial pulmonary infections have an aggressive course. Tuberculosis, even with a second or subsequent infection, has the radiological changes of a primary infection.

Malignancies are most commonly non‐Hodgkin's lymphoma and Kaposi's Sarcoma. They have no characteristic appearances. The occurrence of hilar lymphadenopathy in A.I.D.S. patients without Kaposi's Sarcoma, non‐Hodgkin's lymphoma, TB or Pneumocystis requires further investigation as nodes are not a feature of A.I.D.S. per se. Although occasionally seen with Pneumocystis pneumonia, lymphadenopathy is more normally seen with Kaposi's Sarcoma, non‐Hodgkin's lymphoma or tuberculosis.

Because prompt and accurate treatment is essential in the immune compromised patient management of pulmonary infiltrates is based on a tissue diagnosis, either transbronchial or percutaneous biopsy.
Pneumothorax in the Aboriginal
Authors: BATESON ERIC M.
Published: March 2008

A study and comparison of the frequency and radiological manifestations of pneumothorax in adult and neonatal Aboriginal and non‐Aboriginal patients was undertaken at the Royal Darwin Hospital during the period from 1976 to 1985.

In the adult, primary spontaneous pneumothorax was common in the non‐Aboriginal patients but there was only one example in an Aboriginal and this could have been due to recent trauma. Secondary spontaneous pneumothorax was significantly more common in the Aboriginal patients and four were the result of active pulmonary tuberculosis. Traumatic pneumothorax was usually caused by accidental injuries in the non‐Aboriginal patients, and by deliberate injuries in the Aboriginal patients.

Spontaneous pneumothorax was rare in the neonatal Aboriginal patients.
Radiographic Changes Associated with Cigarette Smoking
Authors: LANGLOIS SUZANNE LE P. , HEATH R. , LIAN‐LLOYD A.
Published: March 2008

A knowledge of smoking history is of use during examination of chest radiographs'. However this history is often not readily available to the reporting radiologist. Three respiratory physicians and six radiologists were evaluated as to their ability to classify a chest radiograph as being that of a smoker or a non‐smoker using radiologic evidence alone.

Despite inter‐observer variations in sensitivity and specificity of interpretation, the majority of readers could accomplish this task with an average detection accuracy of 63Vo (S.D. +/‐5.11). Detection accuracy tended to increase with an increase in pack year smoking history. Furthermore the research has shown that the appearance of thickened bronchial walls and hyperinflation are the most reliable indicators that a chest radiograph is that of a smoker.

The early detection of these and other criteria could prove useful in evaluating suspicious lung changes that may otherwise be regarded as insignificant in routine viewing procedure.
Pitfalls in the Radiological Diagnosis of Malrotation
Authors: BEASLEY SPENCER W. , CAMPO JOHN F. DE
Published: March 2008

Accurate diagnosis of malrotation is essential if the catastrophic effects of volvulus are to be avoided.

A review was conducted of 32 patients with operatively proven malrotation to evaluate the use of contrast in the pre‐operative diagnosis. Of the 28 with adequate barium study(s), two had false negative barium meals and two had false negative barium enemas. Two further cases in whom malrotation was diagnosed on barium meal but in whom no malrotation was found at laparotomy are described. Problems relating to technique and interpretation, and refinements which may be expected to reduce the likelihood of error using the barium meal and enema are discussed.

An abnormally positioned duodenojejunal (D‐J) flexure is the most reliable sign of malrotation and should be identified routinely in any child having an upper gastro‐intestinal contrast study, whatever their symptoms.
Prenatal Diagnosis of Iniencephaly: Report of 2 cases
Authors: KAPOOR RAVI , SAHA MADAN M.
Published: March 2008

Two rare cases of iniencephaly are presented, in which a prenatal diagnosis was made and subsequently confirmed on parturition.
The Impact of Intravenous Digital Subtraction Angiography on the Evaluation of Carotid Artery Disease: Review of the first 600 Cases
Authors: ORR NEIL M. , DOUST BRUCE D.
Published: March 2008

620 1.V.‐D.S.A. Carotid Studies were per formed on 607 patients. Follow‐up on 430 patients was obtained.

1.V.‐D.S.A. has been accepted at our institution as a means of evaluating the carotid bifurcations prior to surgery, most cases requiring no further angiographic evaluation. However, it has not been accepted for the assessment of intracranial conditions, apart from the assessment of the parasellar vessels prior to trans‐sphenoidal surgery and the assessment of dural venous sinus patency.

Apart from a relatively high incidence of transient chest pain (5.3%) the incidence of complications was low and there were no major complications.

1.V.‐D.S.A. has replaced a small number of conventional carotid angiograms. However, the decrease in the number of conventional angiograms is much smaller than the increase in 1.V.‐D.S.A., suggesting that many patients who now undergo 1.V.‐D.S.A. would not have had conventional angiography at all.
Radiation Oncology in Australia: An Increasing Crisis
Authors: WIGG D.R.
Published: March 2008

The demands for radiotherapy services continue to increase relentlessly but the capacity to meet these demands is not available. In Australia only 36% of patients with invasive cancer are being treated with megavoltage radiotherapy beams whereas an increase of approximately 50% is necessary to reach a more appropriate level of 55%. A review of the number of radiation oncologists, radiographers and treatment machines shows that the shortage of staff and equipment are consistent with the low utilization of radiotherapy in Australia. Staff and equipment are fully occupied and lack the capacity to appreciably increase treatment rates. A 50% increase in the number Of radiation oncologists is required to reach the recommended number of 7 per million population for service commitments only. This increase is also necessary to adequately treat the additional 50% of patients who would benefit from appropriate modern radiotherapy. Similar increases in therapy radiographer staff numbers and treatment machines will also be required if these additional patients are to be treated. A greatly expanded training, recruitment and re‐equipment programme is urgently required.
Managing Difficult Common Bile Duct Problems With the Help of the Interventional Radiologist
Authors: GIBNEY ROBERT G. , FACHE J. STEPHEN , BURHENNE H. JOACHIM , NAGY ALEXANDER G.
Published: March 2008

Surgery is the mainstay of therapy for disorders of the common bile duct. In recent years, however, numerous radiological biliary interventional procedures have been developed. Sufficient experience with these techniques has now been accumulated such that the role of these procedures is now more clearly defined. A variety of transhepatic and transcholecystic biliary manipulations is described as an overview of the value of these procedures in difficult common bile duct disorders.
BLADDER DEFORMITY A Sign of Major Inferior Venous Obstruction. Two Case Reports and a Review.
Authors: BMEDSCI MARK E. PIERCE
Published: March 2008

Urinary bladder deformity is a sign of major inferior venous occlusion. This deformity is characteristic and different from that due to more common bladder deforming lesions e.g. pelvic haematoma.

This intravenous urographic (IVU) Fmding is not rare, especially in the population being in vestigated for possible renal carcinoma.
The Paperless Radiology Department
Authors: CAMPO JOHN F. DE , BOLDT DAVID W.
Published: March 2008

This report describes the philosophy and the development of Royal Children's Hospital Radiology computer system. Although there are a number of Radiology computer systems, this system provides on line access to all patients previous reports and new reports from any termind within the Hospital immediately they are typed; and prints cumulative reports for the Medical Record. Reports on patients not ex amined for 24 months can be automatically removed from the system to microfiche, whilst all reports on active patients remain on line in definitely for immediate access. Absolutely no paper records are maintained in the Radiology Department. Long term computer storage of radiology reports is the logical extension of previous computer systems and has improved department efficiency and responsiveness.
The Disappearing “Osteochondroma”: Simulation by Reformated Computed Tomography
Authors: DAVIES ROGER P. , WELSHMAN RICHARD , DESILVA MERL
Published: March 2008

Reformatting of axial CT images is widely used to generate coronal, sagittal or other planes of section in the investigation of lesions around the pituitary fossa. Appreciation of anatomical relationships in various places may aid surgical planning. This case demonstrates several machine related artifacts associated with refor matting of axial images. The importance of thin overlapping or direct coronal sections and the need for adequate sedation or anaesthesia in paediatric scanning are emphasized.
Magnetic Resonance Imaging (MRI) Appearances of Syringohydromyelia
Authors: HOUANG M.T.W. , STERN M. , BREW B. , PELL M. , DARVENIZA P.
Published: March 2008

Magnetic resonance imaging (MRI) examination of the spinal cord is now a first‐line in vestigation for the evaluation of suspected syringohydromyelia. It is an accurate, non‐invasive means of detecting cavities within the spinal cord and for assessing spinal cord size and the position of the cerebellar tonsils. It has considerable advantages over post‐myelographic computerised tomography (CT). The current study discusses our initial experience of thirteen surgically proven cases of syringomyelia with special reference to appearances on T 1 and T2 weighted images and a discussion of the apparently confusing appearances of the cavities on the T2 weighted images.
Intraspinal Lumbosacral Lipoma: Review of Literature and Report of Three Cases
Authors: SHARMA SANJIV , PURI SUNIL , DAS LAXMAN , GUPTA D. K. , BAIJAL V.N.
Published: March 2008

Three cases of intraspinal lumbosacral lipoma are reported and the existing English literature is reviewed. Intraspinal lumbosacral lipoma presents a distinct clinical and radiological pat tern. It should be suspected if, in a child, a soft tissue mass in the lumbosacral region is associated with a neurological deficit in the lower limbs, unilateral talipes equinovarus or bony developmental defects of the vertebral bodies and sacrum. The presence of radio‐lucency in the vertebral canal in plain films is pathognomonic of intraspinal lipoma. At myelography, the presence of a large thecal sac, a low position of the conus medullaris and demonstration of extension of the lesion outside the vertebral canal are characteristic of in traspinal lipoma. In infancy, these lesions may superficially resemble sacrococcygeal teratoma.
Arteriography in Evaluating Vascularized Bone Graft in the Hip Joint
Authors: KAJ RINDELL , KAUKO SOLONEN , TIMO TELARANTA , SAM LINDHOLM , PAULI HEKALI
Published: March 2008

Angiography was used preoperatively (in planning) and postoperatively (in checking) the results of vasculariwd bone grafts in the hip region. Vascularized bone grafts were used in treatment of necrosis of the femoral head, for acetabular bone stock reinforcement and for rearthrodesis operations. Eighteen cases with 15 pre and postoperative angiographies are presented. The irrigating vessels remained pa tent in all but one case.

Iliac angiography is still the main method when planning the operation and also in the postoperative follow‐up. It is essential to know the postoperative course of the arteries used in vascular bone grafting.
Ultrasound in Chest Disease: 1. Pleura.
Authors: FATAAR SHADLEY
Published: March 2008

Retrospective study of 97 examinations in 60 patients with pleural problems. Seventy‐six were for assessment of presence of pleural fluid and localisation of aspiration/drainage sites in 37.

Mass lesions studied in eleven and 16 patients were either biopsied or drained by the radiologist under ultrasound control. Examination of two post‐pneumonectomy patients revealed tumour recurrence in one and post‐surgical fluid residue in another. All fluids were transonic, whereas a fibrin meshwork was found in haemothoraces and empyemas. Microbubbles were specific for pyopneumothoraces while echogenic pus mimicked tumour in one patient. Seven pleural tumours were transonic or echogenic. The tumours were either smooth (metastatic) or irregular (mesothelioma). Two benign fibrous plaques were uniformly echogenic and smooth and were indistinguishable from malignant masses.
Measurement of Hip Joint Width in Acromegaly
Authors: WANG SHIH‐CHANG
Published: March 2008

Acromegaly is a well‐recognised cause of synovial joint space widening. This is due to thickening of the hyaline articular cartilage. The range of joint widening has been measured in the hands, but has not previously been reported in the hips. 18 known acromegalic patients were compared to a group of 75 age and sex‐matched controls. The vertical hip joint space width in the acromegalics ranged from 4 mm to 10 mm with a mean of 7.33 mm (2SD = 3.92), compared to the normal range of 3 mm to 5.5 mm with a mean of 4.1 mm (2SD = 1.88). A hip joint width of 6 mm or greater in the absence of hip dysplasia or subluxation is thought to be characteristic of acromegaly.
Metatropic Dysplasia and its Variants (Analysis of 14 Cases)
Authors: KOZLOWSKI K. , CAMPBELL J. , ANDERSON B. , ERKEN E.H.W. , JEQUIER S. , NELSON M. , SLIMAN N. , SPRAGUE P. , TAMAELA LA.
Published: March 2008

METATROPIC DYSPLASIA is a spondylo‐epi‐metaphyseal dysplasia with characteristic clinical and radiographic features. 37 cases of the disorder were reported up to 1983 accordingly to Beck et al.

14 cases of spondylo‐epi‐metaphyseal dysplasia of metatropic variety from 9 paediatrk institutions have been analysed.

Radiologically and clinically we discern four groups of patients with features of metatropic dysplasia. 1. A lethal, pen‐natal type, 2. An autosomal recessive type with diagnostic radiographic findings and often fatal outcome in the first few years of life, 3. A rare dominant type, 4. A mild type consistent probably of different spondylo‐epi‐metaphyseal dysplasias which show mild metatropic changes. (Metatropic Dysplasia Variants).
Report of Three Cases with Tricho‐Rhino‐Phalangeal Syndrome Type I (Two Cases) and Type II (One Case)
Authors: STABILE M. , AMETRANO O. , BRUNA M. DELLA , MONICA M. DELLA , LONARDO F. , VENTRUTO V. , STRISCIUGLIO P.
Published: March 2008

Phenotypical and radiologic features of two unrelated patients with the syndrome Tricho‐

Rhino‐Phalangeal syndrome type I (TRP I) and one with the syndrome TRP I1 are reported. All three cases were sporadic and the parents were non‐consanguineous. The interstitial deletion of the chromosome 8q, evaluated on pro‐. metaphases chromosomes, was not observed in any of the patients.
Aberrant Hepatic Ducts
Authors: BENSON M.D. , STRONG R.W.
Published: March 2008

Awareness of, and consequent identification of, aberrant hepatic bile ducts is essential in per‐forming appropriate biliary surgery. Cholangiography is mandatory whenever there is any doubt about the anatomy of the biliary tree in order to avoid the attendant increased morbidity and mortality of reoperation on the biliary tree.

Seven case studies are presented together with a review of aberrant and accessory bile ducts and cholecystohepatic connections.
Left Aortic Arch with Right Descending Aorta
Authors: MOK C.K. , CHEUNG K.L. , CHAN F.L. , LEUNG M.P.
Published: March 2008

The radiographic findings in a 57‐year‐old‐man with left aortic arch and right descending aorta are described.

Left aortic arch with right descending aorta, first described by Paul in 1948, is a very rare congenital anomaly. To our knowledge only 16 cases have been reported in the English literature. We describe here an additional case to emphasize its existence and supplement the data in the literature.
Unilateral Pulmonary Edema Associated with Pulmonary Arterial Compression
Authors: McTIGUE C. , SCURRY J.P. , SILBERSTEIN M.
Published: March 2008

A case of an intmpericardial hmatoma leading to unilateral pulmonary edema is reported. Because of old pericardl adhesios, the haematoma had collected in the transverse‐sinus, where it compressed the right branch of the pulmonary artery and left atrium, leading to left sided edema.

A case of unilateral pulmonary edema in a patient on anticoagulants is described. Angiography demonstrated extrinsic pulmonary artery compression. At post‐mortem a pericardial haematoma was found to be compressing the opposite pulmonary artery.
Typhlitis: Neutropaenic Colitis
Authors: VOWELS MICHAEL
Published: March 2008

Typhlitis is an unusual complication, seen most commonly in leukemic patients. One case is reported here and discussed.

CT findings are specific, with caecal wall thickening being the most common finding and differentiation from periappendiceal abscess, leukemic deposits and intramural haemorrhage should be possible.

Radiological recognition is important, as uncomplicated typhlitis is best managed conservatively, but any evidence of perforation or abscess formation is an indication for surgery.
Pseudomyoma Peritonei — Preoperative Diagnosis on CT Sean A Report of 2 Cases
Authors: KHANNA S. , BERRY M. , KAPUR B.M.L.
Published: March 2008

The entity of pseudomyxoma peritonei was often diagnosed formerly on laparotomy. However, with the advent of sonography and computerised tomography it is now possible to suggest correct pre‐operative diagnosis and thereby proper management. Such two cases diagnosed pre‐operatively on CT are reported here.
Box Diagram to Express Tumour Extent: Basis of a New Staging System in Carcinoma of the Cervix?
Authors: MB MICHAEL ASHBY
Published: March 2008

The FIGO classification for the clinical staging of carcinoma of the cervix does not adequately express primary tumour extent or volume, and contains anomalies which probably lead to a wide variation in therapeutic results between centres (particularly in Stages II and III). A box diagram method of recording primary tumour extent is proposed and was applied to a retrospective study of 191 women aged 35 years and under with invasive carcinoma of the cervix. Patients who scored one or two boxes (Stages IB, IIA and IIB with unilateral parametrial infiltration) have a similar actuarial 5 years survival rate: 70% and 69% respectively. Those with 3 boxes (Stage IIA and B, bilateral Stage IIB and unilateral IIIB) and 4 boxes or more (Stages IIA and B, bilateral IIIB) involved had a substantially worse survival: 44% and 22% respectively. No patient, with more than five boxes involved was cured. The further study of this system, its potential in clinical research, and as part of a possible revised staging system are discussed.
Outpatient Myelography with Iohexol and Iopamidol; Pilot Study and Contrast Trial
Authors: WAUGH JOHN R. , SACHARIAS NINA
Published: March 2008

50 patients underwent myelography on an outpatient basis; the incidence and severity of side effects were compared, in a prospective study, with 180 inpatient examinations over the same period. In addition, in the initial 200 myelograms (36 outpatient and 164 inpatient) iohexol and iopamidol were compared in a double blind trial.

Headache was the most common side effect in both patient groups, recorded in 50% of outpatients and 25% of inpatients. Other side effects were of comparable incidence. 84% of outpatients undergoing myelography found it “acceptable”, and did not consider a night in hospital necessary after the procedure. No difference in side effects was demonstrated between the two contrast media.

This pilot study suggests that outpatient myelography is practical and safe, with considerable cost saving implications.
Volume Related Configurational Changes in The Aetiology of Pelvi‐Ureteric Junction Obstruction
Authors: CAMPO JOHN DE , FOWLER ROBERT
Published: March 2008

The aetiology of pelivi‐ureteric junction (PUJ) obstruction is controversial. We present four patients who had normal or equivocal intravenous pyelograms and non‐obstructive Whitaker tests in whom complete pelvi‐ureteric obstruction was precipitated by more rapid distension of the renal pelvis. We speculate that in vivo physiological urine flow rates and temporary kinking of PUJ produces a critical increase in pelvic volume and subsequent valvular kinking of the upper ureter, which cannot be usually achieved by maximal urine flow rates alone. Co‐existence of vesico‐ureteric reflux (VUR) may be a contributory factor to critical pelvic distension and tortuous PUJ. Volume related con‐figurational changes of this type are probably a more frequent cause of PUJ obstruction than is generally recognised.
Coronary artery calcification identified by CT in patients over forty years of age
Authors: WOODRING JOHN H. , WEST JOHN W.
Published: March 2008

In a study of 100 unselected patients forty years of age or older, routine CT of the thorax demonstrated coronary artery calcification in 41%. Calcification of the left anterior descending was most common, occurring in 34%. For patients 60 years of age and over, clinical evidence of coronary artery disease was 1.7 times more common in those with calcification compared to those without; however, for patients under 60, coronary artery disease was 5.5 times more common in those with calcification than those without. Because of the strong relationship that is known to exist between coronary artery calcification and coronary arteriosclerosis, we believe that the incidental discovery of coronary artery calcification on routine CT of the thorax has significance. All patients under 60 with coronary artery calcification discovered on CT should be investigated for hyperlipidemia if this has not been done, and, if they are not known to have a history of coronary artery disease, they should have a stress test and, if positive, arteriography may be warranted.
Erosive Spondylo‐Arthropathy and Tertiary Hyperparathyroidism
Authors: ABLER J.S. , CAMERON D.C.
Published: March 2008

A patient on long term haemodialysis for analgesic nephropathy, with known teriary hyperparathyroidism developed a rapidly evolving, erosive, non‐infective spondylo‐arthropathy at two vertebral levels. In addition, erosions were noted adjacent to the right sacroiliac joint.

Subsequent postmortem material from the affected vertebral levels demonstrated changes consistent with hyperparathryoidism alone and this is suggested as the possible aetiology underlying this recently recognised destructive spondyloarthropathy.
The Distribution of Bone Metastases as Shown on Isotope Scanning: Proposed Modes of Spread
Authors: F.R.A.C.P. C. STYLES
Published: March 2008

Bone metastases may result from arterial, retrograde venous or direct spread. Three groups of patients; with carcinoma of lung, carcinoma of breast and carcinoma of prostate, each of approximately 50 individuals were studied to examine patterns of spread in order to relate this to the mechanism of seeding.

Statistically significant differences (p < 0.05) were observed in early bone spread in carcinoma of prostate (absence of skull involvement), carcinoma of lung (presences of posterior chest wall involvement) and carcinoma of breast (presence of anterior chest wall involvement).

The results support retrograde venous reflux as being an important contributing mode of spread for carcinoma of prostate and local spread as being relevant in the early spread of carcinoma of lung and breast.
Technetium‐99m Radiocolloid Scintigraphy, Planar and SPECT Red Blood Cell Imaging and Ultrasonography in Diagnosis of Hepatic Hemangioma
Authors: PRAKASH RAJEEV , GUPTA RAKESH K. , NARAYANAN RAJAN V. , CHAKRAVARTY SHYAMAL K.
Published: March 2008

Technetium‐99m planar sulfur colloid scintigraphy, red blood cell imaging and ultrasonography were performed in eighteen patients of hepatic hemangioma to evaluate their diagnostic utility. Radiocolloid scans detected fourteen hemangiomas in 12 patients as focal hepatic defects but missed 9 lesions smaller than 2.5cm in the other 6 patients, accounting for a 61% sensitivity. All 23 lesions were avascular or normovascular on radionuclide flow study. Serial planar red blood cell scintigraphy showed characteristic gradually increasing focal isotopic accumulation in the 14 hemangiomas which had identifiable cold areas on the radiocolloid study. One of 6 patients with normal radiocolloid scan also showed the typical increasing blood pool pattern of hemangioma, five had normal planar scans till 11/2 hours. SPECT red blood cell imaging in these 5 patients detected an additional seven hemangiomas. All 7 lesions were smaller than 2.5cm. One 1.5cm hemangioma was missed on both planar and SPECT red blood cell imaging. Region of interest ratios in SPECT transaxial images confirmed gradually increasing concentration of labeled red blood cells in the lesions. Ultrasonography detected 22 of the 23 hemangiomas. Ten were hyperechoic, average size 2.25cm. Twelve were of mixed pattern, generally larger, average size 7.2cm. Sonography is useful in the detection of hepatic hemangiomas as a focal mass lesion, but the variable sonographic appearance precludes a definite pathological diagnosis. Technetium‐99m red blood cell imaging appears a sensitive technique in detection of hepatic hemangioma, with SPECT being especially useful in locating smaller lesions. The addition of SPECT to planar red blood cell imaging considerably improves the sensitivity of this highly specific technique for an accurate non‐invasive diagnosis in hepatic hemangioma.
Galactography with Contrast and Dye — A Two Stage Radiological/Surgical Approach to Serous or Bloody Nipple Discharge
Authors: OSBORNE Dr. JONATHAN
Published: March 2008

Patients with serous or bloody nipple discharge arising from a single duct are treated by a joint radiological/surgical approach at our institution. Two galactograms are performed; the first with contrast medium alone to indentify any lesion and the second, one hour prior to surgery, using both contrast and methylene blue. This defines the area for the surgeon ensuring the involved duct is removed. Several case histories are described and the galactographic technique is detailed.
Antenatal Sonographic Diagnosis of Chorioangioma of Placenta
Authors: KAPOOR RAVI , GUPTA AJAY K. , SING S. , SOOD A. , SAHA MADAN M.
Published: March 2008

A rare case of chorioangioma of the placenta with unusual sonographlc pattern diagnosed antenatally is presented. Another unusual feature of the case is the associated raised maternal serum alphafetoprotein level.
Non‐Immune Hydrops Fetalis: Rapidity of Onset and Usefulness of Prenatal Ultrasonography
Authors: DREW JOHN H. , WOODWARD C. SUSAN , BARBARO CHARLES A.
Published: March 2008

Non‐immune hydrops fetalis (NIHF) has become more common than immune hydrops fetalis as a cause of fetal hydrops and its contribution to the total perinatal mortality rate has increased from 0.1% to 3.0% for the 10 years to 1979. A case is reported where an antenatal ultrasonograph performed within 24 hours of delivery showed hydrops was not present, however, at birth the infant was grossly hydropic and died despite intensive management. This case shows the rapidity of onset of NIHF and the devastating effect of this disorder. A review of two large series of NIHF revealed that in only 11.4% and 16.3% respectively, a significant uncorrectible associated major malformation may have been missed by antenatal ultrasonography. Hence, if prenatal ultrasonography fails to reveal a major malformation a viable fetus with NIHF should be regarded as salvageable. Pulmonary hypoplasia occurred in over 90% and is probably due to compression from serous cavity effusions. Thus to improve survival the ultrasonographer needs to watch for the development of serous cavity effusions so that a pregnancy complicated by NIHF can be terminated before the fetus develops pulmonary hypoplasia.
Sonographic Appearance of Hepatic Hydatid Disease
Authors: JAIN ANIL KUMAR , GUPTA N.C. , GUPTA P.D. , SAHA MADAN M.
Published: March 2008

The sonographic appearance of 25 proved cases of hepatic hydatid disease was characterized and correlated with surgical and pathologic findings. Sonography has a very high accuracy in detecting the type, size, number and location of hepatic hydatid cysts. It also indicates whether they are live (Type I, IR, II) or dead (Type HI). The presence of hydatid cysts in the rest of peritoneal cavity and their complications can also be detected. It is of immense help in the selection of cases in which urgent surgery is needed e.g. contained (Type IR), communicating and direct rupture of hydatid cysts. When hydatid cysts are infected, they lose their characteristic sonographic appearance and become hyperechoic. This article details the findings and emphasize the criteria for recognizing hepatic hydatid disease.
Antegrade Double J Ureteral Stenting for Ureteric Strictures: Use of Silicone Stents
Authors: HOE J.W.M.
Published: March 2008

In 16 patients with ureteric strictures, silicone double J ureteral stents were inserted antegradely following percutaneous nephrostomy. In 9 patients prior attempt at retrograde placement of a stent had failed. Balloon dilatation of the stricture using angiographic catheters was also performed in 5 patients. The ureteric strictures were most commonly caused by malignant infiltration, post operative fibrosis, infection and ureteric calculi. Most previous reports have described the use of polyethylene and polyurethrane stents. Technical problems with the use of silicone stents are discussed. Although silicone stents are better tolerated by patients and associated with low complication rates, in 5 of 18 stents inserted (28%) the procedure failed. Suboptimal positioning of the stent due to poor radio‐opacity and premature occlusion were the causes. With the availability of co‐polymer stents, it is likely that these will replace silicone stents as the stent material of choice for antegrade insertion.
Costs of Magnetic Resonance Imaging Services in Public Hospitals
Authors: CROWE BERNARD L. , HAILEY DAVID , BENNESS GEOFFREY T. , BURGESS IAN A. , ROCHE JAMES , SORBY WILLIAM A. , LANGLOIS SUZANNE Le P. , DEWHURST DAVID J. , HUNT DAVID R. , TRESS BRIAN M. , KHANGURE MAKHAN S. , McDONALD IAN G. , SIDDLE KENNETH J. , BENSON MARK D.
Published: March 2008

Audited cost data from two public hospital installations participating in a trial of the utilisation and efficacy of magnetic resonance imaging are presented. The data cover the period July 1987 to June 1988 when both installations had attained stable patterns of operation. One hospital operated a superconductive system and the other a resistive magnetic resonance imaging unit. Depreciation and salaries represented the major components of cost.
CT Scanning for Definitive Radiotherapy Planning of Prostate Cancer: Necessity or Nicety? Results from survey of radiation oncologists working at different institutions in Australasia
Authors: HAMILTON C. S. , JOSEPH D. J. , SKOV A. , DENHAM J. W.
Published: March 2008

Interactive computerised tomographic (CT) planning techniques offer the prospect of better anatomical localisation, more consistent tumour coverage, and limiting normal tissue dose. However, its value in the management of prostate cancer remains undefined. The present study addresses the impact of planning CT on the designated target volumes for localised carcinoma of the prostate at a multi‐institution national level. Nine radiation oncologists from different centres in Australia and New Zealand were asked to designate a target volume on five sample patients with different disease stages (A2‐C2) using both conventional cystogram films and planning CT scans.

Target volumes estimated by CT means in this study differed by more than 10% from those estimated by conventional means in 75.6% of instances, being smaller in 55.6%. Volumes varied widely between individual radiation oncologists, both using conventional planning and CT information. These variations were found to exceed any differences in the volume caused by the planning technique itself. Results from this survey suggest that volumes appear to change more according to the individual radiation oncologist rather than to any other factor. In most or all of the sample cases six of nine radiation oncologists defined the borders of their CT volumes to be either consistently smaller (5 out of 9) or greater (1 out of 9) than their conventionally defined borders.

The results of this survey are potentially important and warrant repetition with larger sample numbers in other countries where interactive CT planning facilities exist, both with and without diagnostic radiological input, to exclude similar variation and to define causes for any variations that do become apparent.
The Role of Bipedal Lymphangiography in Testicular Seminoma
Authors: LINDEMAN GEOFFREY J. , CARR PETER , TIVER KENNETH W. , LANGLANDS ALLAN O.
Published: March 2008

Determining the extent of intra‐abdominal spread of testicular seminoma by radiographic studies is an essential step in planning rational treatment following orchidectomy. CT scanning is generally accepted as being superior to lymphangiography in assessing the retroperitoneal space. We reviewed the relative contribution of these two procedures in a retrospective analysis of 73 consecutive patients with testicular seminoma managed at Westmead Hospital between January 1980 and September 1987. Abdominal CT scans and bipedal lymphangiography (LAG) were carried out in 72 and 51 patients respectively, 50 patients undergoing both procedures. We found concordance between the two techniques to be 88%. Upstaging occurred in 5 patients using CT (10%), 7 patients using LAG (14%), and in 8 patients (16%) when both tests were utilised. Four patients were upstaged by both techniques while the remaining 4 patients were upstaged using one technique alone.

Serum ß‐HCG was not a reliable screen for residual disease. Residual disease in the few patients with an elevated serum ß‐HCG was easily detected by CT scanning.

We conclude that there is a continuing role for LAG in assessing patients with clinical Stage I seminoma when the abdominal CT scan is equivocal or normal.
Pancerebellar Syndrome in Hyperpyrexia
Authors: MOHAPATRO A. K. , THOMAS MONICA , JAIN SATISH , MISHRA N. K. , GOULATIA R. K. , MAHESHWARI M. C.
Published: March 2008

Two cases of pancerebellar syndrome following hyperpyrexia are described and the relevant literature reviewed. Cranial computed tomography demonstrated morphologic evidence of cerebellar degeneration while the patients were showing satisfactory clinical progress.
Is That Another Thornwaldt's Cyst on M.R.I.?
Authors: BATTINO R.A. , F.R.A.C.R. M.S. KHANGURE.
Published: March 2008

20% of 200 M.R.I. head scans displayed increased signal in the midline posterior‐superior nasopharynx in the position of the pharyngeal bursa. Though these likely represent a number of different entities, Thornwaldt's cysts may be more common than previously realised.
Computerized Tomography in Dural Sinus Thrombosis
Authors: YEE CHEONG WING , PING TAN KIM
Published: March 2008

Thirteen young patients with DST are presented. The average age was 31.3 years. Seven patients presented with severe headaches. Six patients appeared to have no apparent cause for their thromboses while predisposing factors (polycythaemia, malignancy, posttrauma), were present in three. One patient was in her 1st trimester of pregnancy. Four patients had DVT while 2 of these patients also had pulmonary embolism. There was one death. Six patients had full recovery and six had mild residual hemiparesis. The prognosis is therefore good in this group of young patients with DST. Treatment should be directed at the primary cause. Where no cause can be found, treatment is aimed at the presenting symptoms.

The role of CT is stressed. The presence of abnormal areas of hemorrhage or infarctions especially if they are parasagittal and/or bilateral should alert the radiologist to the diagnosis of DST. The empty delta sign, the cord sign, the dense vein sign as well as the presence of transcerebral medullary veins are highly specific. CT is therefore not only noninvasive but highly accurate and is the imaging procedure of choice. There is no need for angiography except in a selected few and CT has already replaced angiography. The role of MRI needs to be studied. It is entirely noninvasive and may when it becomes freely available, replace CT. So far, only three cases have been reported in the English literature. Signal void is a characteristic of flowing blood and a throm‐bosed venous channel will show a shortening of the T1 signals. In addition, the paramagnetic properties of deoxyhaemoglobin and methaemoglobin may allow determination of the age of the thrombus (Macchi et al 1986). However, at the present state of the art, CT remains the first radiological screening procedure (Braun et al 1985).
Ioversol in Ascending Phlebography — A Clinical Trial
Authors: SCOTT H. , PALMER F.J.
Published: March 2008

SUMMARY AND CONCLUSIONS

In this controlled randomised double‐blind parallel group study of the use of ioversol‐240 and ioversol‐320 in venography all studies were considered diagnostic with comparable quality in the two groups.

Patient tolerance was high with mild heat observed in 7 patients in the ioversot‐320 group and 1 patient in the ioversol‐240 group. Assessment of pain was also comparable (2 patients in the ioversol‐240 group and 1 in the ioversol‐320 group).

Both strengths of the contrast agent produced no clinically significant, drug related, changes in vital signs or laboratory parameters and there were no significant clinical adverse reactions.
A Case of Rectal Bleeding in Infancy
Authors: LEIGHTON D.M. , BENGHANEM T. , MONTAGNE J. Ph. , GRUNER M.
Published: March 2008

A case of colonic haemangioma in a 3 month old girl presenting with rectal bleeding and anaemia is presented. A colonic mass lesion was suspected on barium follow through and confirmed by enema and surgical excision.
Low Dose Intravenous Urography: Results and Technique Modifications
Authors: KEENAN R.J. , LIST A. , KENGSAKUL C.
Published: March 2008

100 consecutive patients routinely referred for intravenous urography were examined using low doses of the low osmolar contrast medium Iohexol (Omnipaque 350mgl/ml). Their dosage schedule was based on the physiological parameters of age, sex, body weight and renal function. Comparison with a control group using standard contrast doses revealed a 42% reduction in contrast could be used, and still produce diagnostic studies. Nephrographic quality was reduced in the low dose group requiring technique modification, in particular a delayed film sequence. Further reductions in contrast use are envisaged in patients over the age of 40 years.
Non Fatal Barium Intravasation During Barium Enema
Authors: TAYLOR DONNA B. , YOONG PAUL
Published: March 2008

A case of non‐fatal venous intravasation during barium enema is described, the literature reviewed and risk factors discussed.
Iohexol, Ioxaglate and Iopamidol in Coronary Angiography A Double‐Blind Comparative Study of 300 Patients
Authors: SOIVA M. , HEKALI P. , KETO P. , KARUMO J. , SALONEN O. , HEIKKILÄ J.
Published: March 2008

A randomized, double‐blind study was carried out in 300 consecutive coronary angiography examinations to investigate the clinical safety of three low osmolar contrast media, iohexol 300, ioxaglate 320 and iopamidol 300, and the electrocardiographic changes that occurred with them. The ECG from electrode V5/V6 or AVF and intra‐arterial pressure were monitored continuously, and recorded before and after the first contrast injections into the left and right coronary arteries. Of the variables tested, no statistically significant changes occurred in systolic arterial pressure, PR interval or ventricular extrasystole. The QT interval increased in the ioxaglate group (p=0.001). Heart rate decreased in all groups, but slightly less in the ioxaglate group than in the iopamidol group (p=0.02). The ST segment depression (mean 0.67m) was more marked in the ioxagiate group than in the other treatment groups (p=0.0001) during right coronary angiography. The same characteristics, but less marked, were observed during left coronary angiography, the ioxaglate group (mean 0.251mm) differing from the iopamidol group (mean 0.050mm) (p=0.04). No significant difference in severe adverse reactions were detected between these groups (ioxaglate 1, iopamidol 1). Ioxaglate produced mild side effects (nausea, vomitus, urticaria) in 16% of the patients, the other two contrast agents producing side effects in 1%.
Antibody to Cardiolipin Causing Hepatic Infarction In a Post Partum Patient With Systemic Lupus Erythematosus
Authors: YOUNG N. , WONG K. P.
Published: March 2008

This is a case of a thirty one year old post partum patient, with SLE and antibodies to cardiolipin causing hepatic vascular thrombosis leading to infarction. No previous literature account is recorded.
Radiation in the Treatment of High Grade Malignant Gliomas in Queensland
Authors: FRANKLIN C.I.V.
Published: March 2008

Two hundred and seventy eight patients with histo‐logically proven grade 3 or grade 4 astrocytomas were referred to the Queensland Radium Institute for consideration of radiotherapy between January 1980 and December 1987. The role of radiation in the management of these tumours was examined with respect to the effects of field size, dose and age. It was found that field size did not have a significant effect on survival; in particular whole brain irradiation for patients with grade 4 tumours was not a significant advantage. The doses used at the Queensland Radium Institute produce similar survivals to those used in other centres. The effect of age was significant. For grade 3 tumours there was a survival advantage to those under 50 years receiving radiation, but not to those above that age. For grade 4 tumours, the survival advantage was for those under 60 years, but those over 60 years did seem to get some benefit although the difference did not reach significance.

It is suggested that, as the tumour is generally incurable, these patients may be better served by a short simple palliative course of radiation.
Radiological Imaging of Urinary Tract Infection in Malaysian Children ‐A Private Hospital Experience
Authors: CHEUNG HUMAIRAH SAMAD
Published: March 2008

The results of radiological investigations performed on 81 children with urinary tract infection (UTI) were reviewed. Investigations included 91 voiding cys‐tourethrograms (VCU), 59 intravenous urograms (IVU) and 36 ultrasonograms (US). The aim was to study the local spectrum of renal tract abnormalities in childhood UTI and to compare the diagnostic yield of combining US and VCU against IVU and VCU.

Renal tract abnormalities were detected in 37%. Vesico‐ureteric reflux (VUR) was the commonest, detected in 26%, with renal scarring found in 9% of refluxing units. Ultrasound should replace IVU in the initial diagnostic work‐up of these children.
Computed Tomography of the Abdomen with Fat Density Oral Contrast Medium
Authors: MALIK N. , KHANDELWAL N. , GARG K. , SURI S.
Published: March 2008

A 12.5% corn oil‐emulsion (COE) was tested as an oral contrast agent for abdominal computed tomography (CT) examinations in 100 patients. The results were compared with those obtained from another group of patients who received a conventional, high‐density, oral contrast agent (2–3% iodinated solution). There was no statistically significant difference in the subjects' tolerance to the two agents (P > 0.05). There was, however, a significant improvement in image quality with COE (P > 0.005). Gastrointestinal tract discrimination, and mucosal and mural visualisation was of higher quality with fat density oral contrast medium than with the high‐density contrast agent. These data suggest that COE should be considered for routine use as an alternative to conventional high density oral contrast agents in upper abdominal CT.
Embolisation in the Management of Peripancreatic Pseudoaneurysm A Case Report
Authors: KOLT STEVEN , WISE ALAN
Published: March 2008

Peripancreatic pseudoaneurysms are an unusual cause of haemorrhage in patients with chronic pancreatitis and pseudocysts. We describe a 28 year old alcoholic male with documented chronic pancreatic pseudocysts, who presented with melaena and a large pulsatile epigastric mass. Ultrasound and digital subtraction angiography revealed a pseudoaneurysm of the gastroduodenal artery. This was successfully embolised with stainless steel coils. Surgical intervention in such cases is associated with high mortality, and the role of embolisation as an initial therapy is well established. The role of embolisation as definitive therapy is less clear.
Agenesis of the Right Lobe of the Liver: Diagnosis by Computed Tomography
Authors: MORPI‐ETT ANTONY , ADAM ANDREAS
Published: March 2008

Agenesis of the right lobe of the liver is a rare congenital anomaly with characteristic features on computed tomography (CT). We present a case diagnosed as an incidental finding and describe the CT appearances.
Thrombolysis and the Femorofemoral Bypass Graft: A New Technique
Authors: BUCKENHAM T.M. , GEORGE C.D. , TAYLOR R.S. , DORMANDY J.A.
Published: March 2008

Two patients with acutely throm‐bosed femorofemoral bypass grafts are presented. Recombinant human tissue‐type plasminogen activator (rt‐PA) was used successfully in thrombolysis of the occluded grafts. Utilizing a new technique the grafts were punctured directly and bolus doses of rt‐PA administered.
Dose Normalisation and Specification: From Woe to Go
Authors: HAMILTON C.S. , DENHAM J.W.
Published: March 2008

A questionnaire has been completed by 16 practising Radiation Oncologists from 10 centres in Australia and New Zealand which confirms that considerable variation in dose normalisation and specification practices exists between Australasian centres.

The establishment of a working party to determine whether a uniform code of practice (such as ICRU 29 or a modification thereof) is desirable, and can be adopted in Australasia, is recommended.
Central Neurocytomay
Authors: FRANKLIN C.I.V. , REDMOND M.J. , TANNENBERG A.E.G.
Published: March 2008

One case of central neurocytoma is presented. A review of the literature suggests that the condition is more common than previously recognised. The pathological features are discussed and the role of surgery and radiotherapy in the management of the condition is discussed.
Percutaneous Removal of Retained Suture Following Antegrade Ureteral Stenting
Authors: HOE W.M. JOHN , TAN E.C.
Published: March 2008

A case is presented of percutanmus removal of a foreign body, a silk suture, which was left in the kidney following antegrade placement of a multi length double J ureteral stent.