bluuebunny/crossref_metadata_2025 huggingface dataset:
C.T. Findings of Orbital Inflammation in Children
Authors: SILVA M. De , LAM V. , BROADFOOT J.
Published: March 2008

It is difficult to assess clinically the extent of orbital inflammation in children because of the limitations of physical examination. C.T. examination is an ideal modality to assess the extent of involvement.

amination is an ideal modality to assess the extent of involvement.

The findings at C.T. examinations of sixteen consecutive cases of orbital inflammation admitted to the Royal Alexandra Hospital for Children are reviewed. Evidence of sinus involvement was found in all cases. Four patients had periorbital cellulitis alone and twelve had both periorbital and orbital cellulitis. Subperiosteal abscesses were demonstrated in twelve patients and an orbital abscess in four patients. No evidence of intracranial involvement was seen.
Aorto‐enteric Fistula
Authors: TRAVIS R.C. , WATTIE W.J.
Published: March 2008

Twelve aorto‐enteric fistulas are reviewed. The typical presentation is a patient with gastrointestinal bleeding (acute or chronic) and an abdominal aortic graft, often with symptoms of infection. Endoscopy and computed tomography are the most useful preoperative investigations. False aneurysms seen on aortography can be confused with normal suture line irregularity. A nipple projecting from the aneurysm is very suggestive of a fistula, while contrast extravasation is diagnostic, but rarely seen. Barium studies and ultrasound can be helpful.
The Heavenly Twins: Useful Anatomic Landmarks in C.T. and Ultrasound of the Abdomen
Authors: ALBERTYN LYNDA
Published: March 2008

Identifying the paired, longitudinally‐oriented mesenteric vessels is a useful step in discriminating confusing axially‐oriented structures in the abdomen. The bulk of the pancreas must lie anterior to this mesenteric root plane, while structures posterior to it, even if distended or obstructed, should be distinguishable as either the third part of the duodenum or the left renal vein.

Identifying the heavenly twins, or the paired, longitudinally‐oriented superior mesenteric vein and artery, is a useful step in discriminating confusing axially‐oriented abdominal structures such as the pancreas, the third part of the duodenum and the left renal vein. The pancreas is the only one of these structures which on anatomic grounds runs anterior to this mesenteric plane.
Biliary Lithiasis in Dar Es Salaam
Authors: NDOSI BETHUEL N.
Published: March 2008

Between January 1978 and December 1983, 232 radiological investigations of the biliary system were performed. Among them were, oral cholecystography (O.C.G.) 177 cases (76.3%), intravenous cholangiography (I.V.C.) 33 cases (14.2%), percutaneous transhepatic cholangiography (P.T.C.) 17 cases (7.3%). Others were operative cholangiography (OPG) 2 cases (0.9%) and T‐tube cholangiography 3 cases (1.3%).

Of the 232 investigations, 178 (76.7%) were normal. Biliary stones were established in 17 cases (7.3%), of which 7 stones were radiolucent, 5 stones were opaque, while the remaining 5 were unspecified. Other findings include extrahepatic block of the drainage system, congenital anomalies and suspected gall bladder stricture accounted for 37 cases (16%).

As in Uganda biliary lithiasis is rare with no sex predeliction.
Exudative Choroidal Detachment – C.T. Features
Authors: GREENBERGER R. , KHANGURE M.S.
Published: March 2008

The CT appearances of an exudative choroidal detachment are presented with discussion of the clinical associations and the role of CT in the differential diagnosis and follow‐up of patients with this disorder.
Disc Calcification in Childhood A Case Report with C.T. Findings
Authors: M.B.B.S.(Syd.) DR. K.D. HATFIELD
Published: March 2008

Intervertebral disc calcification in childhood is relatively uncommon but follows a well established pattern of clinical and radiological findings. The condition appears to be transient in nature and the cause remains unknown.
Thoracolumbar Burst Fractures: Two “New” Plain Film Signs with C.T. Correlation
Authors: WANG SHIH‐CHANG , GRATTAN‐SMITH ANTHONY
Published: March 2008

The authors describe two “new” signs of fragment retropulsion in burst fractures, seen on the lateral plain radiograph ‐ the “posterior bow” (PB) and the “vanishing line” (VL). Their accuracy for detection of retropulsion compared to CT scanning was retrospectively assessed in 49 patients with significant thoracolumbar injuries. Overall accuracy is good but depends on high standards of radiography and careful interpretation. The major reasons for error were poor plain films and injuries above Til. The signs may be valuable if CT is not available or if the patient's medical status makes scanning difficult. They may be useful for assessing canal size on follow‐up films. In certain instances CT scanning may be unnecessary ‐ if plain films show the exact extent of retropulsion, if a fracture‐dislocation is of the Chance or flexion‐distraction type, and if patients are neurological‐ly intact or completely paraplegic but are clinically stable.
Radiologic Manipulation of Dislodged Tenckhoff Dialysis Catheters
Authors: LIST A.R.
Published: March 2008

Tenckhoff peritoneal dialysis catheters occasionally become dislodged and are inefficient for dialysis. These can be successfully manipulated under radiologic control with an initial success rate in this series of 88% (15 of 17 manipulations) and a long term success in 9 of 17, or 53%.
Myelographic Correlations of Vascular Anatomy of the Spinal Cord
Authors: GULLIVER DAVID , NOAKES JENNIFER
Published: March 2008

940 water soluble constrast thoracic myelograms were examined Vascular filling defects in the thoracic subarachnoid space were seen in 54% of patients overall, and in 88% of patients in whom the film quality and contrast density were high. Vascular filling defects were, therefore, concluded to be a normal feature of the thoracic myelogram.

On analysis of the characteristics of these vascular patterns, there were no significant age or sex correlates, with the exception that the younger population (0–20 years) was found to have a smaller number of these discrete patterns, they being also less tortuous, of smaller diamter and of shorter length.

The majority of vascular filling defects were found to be due to posterior spinal veins. A “hairpin” vascular filling defect in the caudal thoracic subarachnoid space, previously thought to be due to the arteria radicularis magna [artery of Adamkiewicz] was found to be more likely to be due to a posterior radicular vein.

The above findings were correlated with dissected anatomical specimens.
The Role of Ultrasound in the Diagnosis of Parenchymal Disease in Transplanted Kidneys
Authors: LOVETT IAN , DOUST BRUCE , ORR NEIL
Published: March 2008

The accuracy of ultrasonic diagnosis of parenchymal disease in renal transpiants was deter mined by comparing the ultrasonic diagnosis with the clinical diagnosis in 120 studies on 50 patients. The clinical diagnosis was based on clinical, biochemical and radionuclide studies, and in some cases, biopsy. At the time of the original ultrasound report clinical information was available (biopsy reports were not). All ultrasound studies were subsequently reported in random order without any clinical information and without comparison with previous or subsequent scans.

This study suggests that ultrasound with or without clinical information cannot be used as a reliable basis for the diagnosis of parenchymal disease of transplanted kidneys.
Abdominal Aortic Aneurysm with Perianeurysmal Fibrosis: Demonstration of Ureteric Obstruction by Computerized Tomography
Authors: GIBSON R. N. , HALLIDAY A. , MANSFIELD A.
Published: March 2008

When perianeurysmal fibrosis occurs in association with an abdominal aortic aneurysm it may produce ureteric obstruction and renal function impairment. Such a case is described and the pre‐operative radiological evaluation of this condition is discussed. The role of computerized tomography is emphasized in its ability to provide accurate anatomical detail regarding the aneurysm, the extent of surrounding fibrosis and ureteric involvement within it.
Work in Progress Dual Energy CT Estimation of Liver Iron Content in Thalassaemic Children
Authors: LEIGHTON D.M. , de CAMPO J.F. , MATTHEWS R. , SEPHTON R.G.
Published: March 2008

This paper describes our experience in measuring liver iron concentration in 78 thalassaemic children and 17 controls using dual energy computed tomography (CT).

The management of transfusional haemachromatosis is by chelation with sub cutaneous desferroxamine. Chelation is an expensive procedure, moreover recent reports suggest that neurotoxicity may result from over treatment. Therapy has usually been monitored by serum ferritin levels ‐ an indirect measure of total body iron of uncertain reliability. Therefore a non invasive accurate measure of liver iron content is desirable.

Results show that clinically reliable measurement of liver iron concentration can be made using conventional CT equipment and a technically rigorous, though relatively simple, calibration procedure.
Initial Experience with Technegas —A New Ventilation Agent
Authors: FAWDRY RICHARD M. , GRUENEWALD ARACI SIMON M.
Published: March 2008

Technegas is an ultra‐fine dry dispersion of 99mTc‐labelled carbon with particle size of ap proximately 0.005 μn. Because of this small size, penetration characteristics are gas‐like and Technegas adheres to alveolar walls permitting excellent images of regional ventilation.

The experience gained from the initial 150 patients studied is presented. The first 20 patients were examined with both 133Xe and Technegas ventilation scans followed by a perfusion scan.

All patients readily accepted the Technegas and even in patients with moderately severe obstructive lung disease, a ventilation scan was possible. The multiple views possible with Technegas gave greater confidence in reporting, as ventilation and perfusion abnormalities could be directly compared in the same projections.
Analgesic Nephropathy:Ultrasonic Features
Authors: PUVANESWARY M. , SEGASOTHY M.
Published: March 2008

Ultrasonic findings in analgesic nephropathy in 26 patients are presented. Significant abnor malities noted were medullary nephrocaicinosis (62%) and medullary cavities (73%).
Cranio‐Metaphyseal Dysplasia (Report of 3 cases ‐ two infants and one adult)
Authors: COLAVITA N. , KOZLOWSKI K. , SPRAGUE P.
Published: March 2008

Two infants were investigated because of facial nerve palsy. Clinical examination suggested the diagnosis of cranio‐metaphyseal dysplasia and radiographic examination was typical of this.

The mother of one of the infants was affected along with three relatives.

This bone dysplasia is characterised by sclerosis of the skull and abnormal modelling of the long bones often heralded by neurological complication. The radiographic features are typical.
C.T. Measurement of Spinal Mineral —Initial Australian Experience using the U.C.S.F. Phantom
Authors: ALCOCK M. K. , TUCKER W. G. , HIGGINS B. A. , WEST G. , ESTERMAN A.
Published: March 2008

Osteoporosis is a common condition with a high morbidity and a significant mortality. Treatment of its complications is expensive.

Quantitative C.T. (Q.C.T.) is a precise, ac curate and sensitive technique for initially diagnosing osteoporosis and subsequently for monitoring the efficacy of treatment regimes in serial studies.

With only minor modifications most modern commercially available C.T. scanners can be used for QCT measurements of spinal mineral.
Contrast Agents — State of the Art
Authors: DAWSON PETER
Published: March 2008

The osrnolality and chemotoxicity aspects of contrast agents are reviewed. The next stop in contrast agent development, non‐ionic dimers, is indicated. A mechanism for chemotoxicity is suggested involving the iodine atoms.

The mechanisms possibly involved in major adverse reactions are outlined and it is suggested that new contrast agents should be safer. The cost implications are discussed. Nephrotoxicity is briefly examined and it is shown that dehydration for intravenous urography. which is a risk factor for renal injury, is ineffective and unnecessary. Finally, a rarely discussed form of toxicity. namely contrast enhanced tissue radiation injury, is discussed.
Airgun Pellet Appendicitis
Authors: PRICE J. , DEWAR G.A. , METREWELI PROF. C.
Published: March 2008

A rare case in which an airgun pellet was present in an inflamed appendix is reported. The significance of foreign bodies seen in the appendix on abdominal radiographs is discussed.
Radiotherapy Planning Accuracy in Terms of C.T. Numbers and Inhomogeneity Correction Techniques: Presented at the Australasian College of Physical Scientists in Medicine (New Zealand Branch) Conference, November 1986, Hamilton, New Zealand
Authors: METCALFE P.E. , BECKHAM W.A.
Published: March 2008

The use of C.T. scanners in radiotherapy planning is becoming widespread. It is essential therefore that adequate assessment of the reliability of the C.T. acquired data for planning purposes is carried out. It is also important that all makes of C.T. scanner be assessed due to their varying characteristics.

Dose computation inaccuracies have to be considered also if one is to get an estimate of the overall accuracy of a given radiotherapy planning technique. In general, it would appear that until the convolution techniques become commercially available the Radiotherapy computer is now the primary source of dose calculation error, due to inadquacies in commonly used inhomogeneity correction algorithms.

A protocol is described for assessing the accuracy of radiotherapy plans produced using C.T. derived electron density information. Essentially there are two main sources of error, those coming from various C.T. related inaccuracies and those from inaccuracies in the radiotherapy dose calculation algorithms. The various subdivisions of these two sources of inaccuracy are discussed in detail.

More specifically this paper deals with the effective depth method of inhomogeneity correction, but sufficient generality is applied to the discussion to enable the same analysis to be applied to other dose calculation algorithms.

It would appear that with state of the art C.T. scanning that the area which introduces the greatest errors is now radiotherapy computing accuracy. Until convolution correction techniques become commercially available this will probably continue to be the case.
Left Coronary to Pulmonary Artery Fistula
Authors: SINGHAM K.T. , MAR M.
Published: March 2008

Two patients with left coronary artery to pulmonary artery fistula are described and the literature is briefly reviewed.
Disseminated Tuberculosis Causing Acute Adrenal Failure, C.T. Findings with Post Mortem Correlation
Authors: OSBORNE T.M. , SAGE M.J.
Published: March 2008

The imaging of a patient with acute adrenal failure is described, together with autopsy confiiation of the principle findings.
Pulmonary Alveolar Microlithiasis
Authors: CHEONG WING‐YEE , WANG YEE‐TANG , TAN LENNY K.A. , CHEAH ELIZABETH S.T. , POH SOO‐CHUAN
Published: March 2008

We report a 51 year old woman with pulmonary alveolar microlithiasis in whom the diagnosis was made by transbronchial lung biopsy and magnification radiography. Computerised axial tomography of the thorax revealed dense interstitial infiltration and diffuse pleural calcification.
Urethral Hemangioma—A Case Report
Authors: GUPTA S. K. , BHATNAGAR B. N. S. , GUPTA SUNIL K.
Published: March 2008

A case of extensive hemangioma of the anterior urethra associated with hemangioma of glans penis in a twenty years male showing urethro‐venous intravasation on retrograde urethrography is reported.
The Intravenous Pyelogram in Rend Colic
Authors: WEISS A. , PRICE R. , SAGE M. , BARRATT L.
Published: March 2008

The medical records and IVP examinations of 143 patients presenting with renal colic have been reviewed. The study has demonstrated that renal colic is more common in males, is rare under the age of 20 and may be precipitated by dehydration. The IVP has been shown to be a useful examination in renal colic due to nephrolithiasis, providing guidance to management. The majority of patients with renal colic due to nephrolithiasis will have partial obstruction on IVP by a radiopaque calculus, less than 4 mm in diameter which will pass spontaneously, reflecting the generally benign nature of this condition.
Sterno‐Costoclavicular Hyperostosis A Report of Two New Cases and Review
Authors: GEAKE T.
Published: March 2008

Sterno‐costoclavicular hyperostosis is a benign condition of unknown aetiology comprising bony hyperostosis and soft tissue ossification between clavicles and manubrium and upper ribs. This is a relatively rare condition worldwide, initially described in 1974 (Sonazaki et al 1974) but is being increasingly recognised and documented in orthopaedic and radiologcal literature. The clinical presentation of ph and erythema over the sterno‐clavicular remon and manubrium associated with typical radiologd features should suggest the diagnosis and may obviate the need for biopsy.
Hypertrophic Pulmonary Osteoarthropathy and Nasopharyngeal Carcinoma in a Young Chinese Patient
Authors: WALLINGTON MARGARET M. , SHIU WESLEY C.T. , MARTIN W.M. CRAIG
Published: March 2008

This paper describes the case history of a young Chinese male who developed hyper‐trophic osteoarthropathy associated with pulmonary metastases less than one year after successful treatment by radiotherapy of a poorly
Tumoral Calcinosis in Children (Report of 13 Cases)
Authors: KOZLOWSKI K. , BARYLAK A. , CAMPBELL J. , DIARD F. , MASEL J. , MASSEN R. , KAN A.E.
Published: March 2008

13 cases of Tumoral Calcinosis in children from 6 Paediatric Institutions are presented. Rare localisations and importance of CT investigation are stressed. The youngest patient with Tumoral Calcinosis and another in whom Tumoral Calcinosis was associated with Acroosteolysis & Idiopathic Osteoporosis are described.
Magnetic Resonance Imaging and Intracranial Aneurysm clips
Authors: CONDON P.M. , ROBERTSON A.R. , LENNON‐GEORGE J.
Published: March 2008

Six different types of Intracranial Aneurysm Clips representative of those used in South Australian Neurosurgical practice were tested for their ferromagnetic quality measured by deflection at the portal of a 1.0 Tesla superconductive M.R.I. unit.

One clip (Sugita) exhibited no deflection and was regarded as non‐ferromagnetic.

Radiographic identification of the Sugita Intracranial Aneurysm clip appears possible.
Extrathoracic Metastatic Thymoma A Case Report
Authors: JOSE C.C. , JOHN S. , SINGH A.D.
Published: March 2008

A case of malignant thymoma who developed an extrathoracic metastatic lesion in the lumbar vertebra three years later, is presented. Radiotherapy can be used effectively in the local control of this disease as well as in the metastatic lesions.
Radionuclide Assessment of Patency of Pericardio‐Peritoneal Shunt
Authors: JOST G. MACK , ANDREWS J.T.
Published: March 2008

Technetium labelled compounds can be used as tracers in the serous cavity of the abdomen and thorax. Here we describe the use of Technetium Sulphur Colloid to assess the patency of a pericardial peritoneal shunt inserted to drain a pericardial effusion.
Rationales for the Use of Intravenous Contrast Medium in Computed Tomography
Authors: ALBERTYN LYNDA E.
Published: March 2008

There are currently many computed tomographic units with differing performance capabilities, resulting in confusion over protocols for contrast medium usage. Additionally, the development of the safer but more expensive low osmolar contrast agents has increased interest in evolving clearer indications for contrast medium usage in C.T. scanning.

Rationales for the use of intravenous agents in C.T. scanning are proposed. These include the labelling of normal structures for anatomic clarification, the assessment of perfusion, the characterisation of a specific lesion, CT Angiography, demonstration of defects in the blood brain barrier and the phenomenon of neovascularity. The logical use of contrast agents should involve the deliberate invocation of one or more of these mechanisms coupled with the appropriate technique of administration.
Magnetic Resonance Imaging: Project Planning and Management of a Superconductive M.R.I. Installation
Authors: CONDON P.M. , ROBERTSON A.R.
Published: March 2008

The planning and installation of a Superconductive Magnetic Resonance Imaging (M.R.I.) installation is described at the Royal Adelaide Hospital, Adelaide, South Australia. Tender specification, assessment of offers via criteria weighted analysis of technical and economic factors and the final recommendation for a 1.0 Tesla unit are discussed. Building and installation considerations are noted including fringe field effects, magnetic shielding, radiofrequency shielding, cryogens, metallic screening and specific considerations in the Magnet room.
Magnetic Resonance Imaging Evaluation of Cerebellopontine Angle Tumours
Authors: LONERAGAN R. , DOUST B. , FAGAN P. , TONKIN J. , DONCHEY S. , BRAZIER D.
Published: March 2008

In the evaluation of tumours of the cerebellopontine angle MRI has a sensitivity and a specificity slightly greater than that of CT. At present it does not appear justified to displace CT as the standard means of investigation of a CPA tumour. The role of MRI is analagous to that of air‐CT.
The Radiology of Cystic Liver Tumours
Authors: PHILIPS R.L.
Published: March 2008

Six patients with cystic liver tumours are presented. The definitive diagnosis of such cystic lesions may be difficult and needle aspiration or biopsy or even operation may be necessary. Clinical and biochemical features may be helpful and in five of the six patients presented, the liver function tests were abnormal. In two patients, diagnostic imaging could not distinguish the tumour from a benign cyst. The differential diagnosis of such cystic liver tumours includes simple cyst, polycystic liver disease, hydatid, liver abscess, haematoma and biloma.
Some Red Herrings in Obstetric Ultrasound
Authors: FURNESS MARGARET E.
Published: March 2008

The extreme distress which possible fetal abnormality induces in expectant parents makes it potentially dangerous to report artefacts seen on antenatal scans, even to dismiss them. A selection of spurious abnormalities is presented, for ultrasound trainees.
Caecal Herniation Through the Foramen of Winslow
Authors: LEMISH WAYNE , CAMERON DAVID
Published: March 2008

Caecal herniation through the foramen of Winslow is a rare cause of intestinal obstruction and the pre‐operative diagnosis is rarely made. A patient with caecal herniation through the foramen of Winslow is presented and differentiation from caecal volvulus is stressed. In caecal herniation through the foramen of Winslow the “hilum” of the kidney shaped loop of bowel points towards the foramen of Winslow rather than the right iliac fossa.
The Effects of Water Soluble Contrast Agents on the Respiratory Tract
Authors: LOVETT IAN , DONCHEY STEVEN , DOUST BRUCE , BRANSON JOHN , MUNRO VINCENT
Published: March 2008

The water soluble contrast agents GastrografinR (Sodium diatrizoate and meglumine diatrizoate, Schering, Berlin), Iopamiro 300 R (Iopamidol, Schering, Berlin), and Dionosil AqueousR (propyliodone BP, Glaxo, England) were instilled into the tracheobronchial tree of rats in doses of either 0.1 ml and 0.25 ml. Rats being used as controls, underwent sham operations with the instillation of air instead of contrast agent. In all, 85 rats were used. All rats that had not already died from the effects of contrast agent were sacrificed 30 minutes after instillation.

The relative effects of the contrast agents were measured by comparing: 1. survival time; 2. radiographic effects of the contrast agents on the lungs and; 3. pathological changes as estimated by post mortem lung section andmicroscopy.

The least toxic agent was the one with the lowest osmotic activity, namely Aqueous Dionosil.

It is therefore recommended that Aqueous Dionosil be used in preference to Gastrografin or Iopamidol for studies of the oesophagus whenever there is a danger of aspiration of contrast agent into the tracheobronchial tree.
The Role of Dynamic Corpora Cavernosography in the Management of Impotence
Authors: GLANCY JOHN J. , WISNIEWSKI Z. STAN , EARLE CAROLYN M. , KEOGH EDWARD J. , WAITERS GREGORY R. , TULLOCH ALASTAIR G.S. , LORD DAVID J.
Published: March 2008

Sixty eight impotent men underwent corpora cavernosography and corpora cavernosal pressure measurements during saline infusion. Nineteen of the men had internal pudendal arteriograms. Correlation between the cavernosograms and saline infusion induced pressure measurements was “good” in 56/66(84%), “approximate” in 5/66(8%) and there was no correlation in 5/66(8%). Two patients were excluded for technical reasons. The spread of results and the good correlation of the two tests speaks for the accuracy of the method. It was of value in diagnosis and will be of paramount importance if veno occlusive surgery becomes a reliable method of treatment.
Neonatal Posterior Fossa Haemorrhage: A Difficult Ultrasound Diagnosis
Authors: de CAMPO MARGARET
Published: March 2008

Four newborn neonates with a historyof birth trauma and significant neurological signs were examined with both ultrasound and computed tomography (CT) performed within hours of each other. Ultrasound was inadequate in initial assessment, as it missed or underestimated posterior fossa haemorrhage, particularly where this was extraparenchymal or vermian. CT is the examination of choice in these patients.
Primary Non‐Hodgkins Lymphoma of Bone (Case Report)
Authors: BURMEISTER B.H. , BENJAMIN C.S.
Published: March 2008

Early stage primary bone lymphoma may be cured by irradiation alone with few complications using moderate doses of radiation. Some points regarding the presentation and radiological features of the disease are highlighted.
Metastatic Thymoma: Case Report
Authors: STEVENS MARK J. , BIGGS BERNARD J.
Published: March 2008

A patient with myasthenia gravis who developed skeletal metastases 9 years following the complete excision of a thymoma is described. Several aspects of the case were noteworthy:

the original thymoma failed to demonstrate evidence of capsular invasion,

the association of myasthenia gravis with metastatic predominantly epithelial cell thymoma has not been previously documented, and

the time to development of metastatic disease is the second longest interval reported in the medical literature. The clinical implications of these features are discussed.
Problem‐Solving Model in Radiology for Medical Students
Authors: BLANE C.E. , VYDARENY K.H. , HAKEN J.D. TEN , CALHOUN J.G.
Published: March 2008

Current undergraduate medical education is criticized for not preparing physicians to be independent thinkers. The rapid development of new imaging techniques and the problem of escalating medical costs call for efficient patient management, The development of algorithms in imaging work‐up of patient problems is an excellent example of problem solving or medical decision making. The senior elective in radiology at our institution incorporates this type of problem‐solving session. Small groups (15–25 students) with faculty guidance discuss 5–6 common patient problems to develop an investigative plan in imaging. Algorithms are thus developed by the group, but not presented for memorization. Small changes are then made in the case history so that the students are forced to make new hypotheses and generate a modified algorithm. Correlative costs are included. Flexibility and initiative in development of patient management algorithms are stressed.
Unusual Manifestation of Intramedullary Haematopoiesis in Thalassaemia Major (Report of 2 Cases)
Authors: RAO MEERA , MUKHOPADHYAY SIMA , BHARGAVA S.
Published: March 2008

2 cases of thalassaemia reported with skeletal changes of severe haemolytic anaemia with the striking feature of extra‐medullary haematopoiesis in relation to anterior ends of the rib. This is a rare finding in thalassaemia and is a manifestation of long‐standing disease found in thalassaemia intermedia.
Magnetic Resonance in Obstructive Jaundice
Authors: GUPTA R.K. , KAKAR A.K. , JENA A. , MISHRA P.K. , KHUSHU S.
Published: March 2008

Twelve cases of obstructive jaundice in whom ultrasound failed to demonstrate the site and/or the cause of obstruction of the biliary tract were examined with magnetic resonance imaging (MRI), correctly diagnosing the site and cause of obstruction in 10 of 12 surgically proven cases. In one case of cholangiocarcinoma, the site of obstruction was well shown on MR but a definite cause could not be ascertained. In another patient who developed intermittent jaundice following surgery for choledochal cyst, MR demonstrated a solitary stone in the common hepatic duct. Surgical confirmation could not be achieved as the patient was lost to follow up. There were 6 cases of choledocholithiasis, 3 cases of gall bladder carcinoma and one case each of pancreatic adenocarcinoma and cholangiocarcinoma. It is believed that MRI will provide obstructive jaundice and will be able to minimize the use of percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography (ERCP) in view of its ability to perform multiplanar imaging in multiple sequences.
An Unusual CT Appearance in Multiple Sclerosis
Authors: PUVANESWARY M. , WALKER C. , STEINBERG A.
Published: March 2008

Multiple sclerosis, presenting with a picture on C.T. resembling neoplasia is discussed. A differential diagnosis is presented.
Cerebellar Heterotopia of the Cervical Cord (A Case Report)
Authors: DAVIS S.J. , KHANGURE M.S.
Published: March 2008

A case of cerebellar heterotopia, presenting as an exophytic mass lesion of the cervical cord and first presenting in an adult is described.
Primary Malignant Fibrous Histiocytoma of the Stomach: (A Case Report)
Authors: RATHAKRISHNAN VIMALAH , ARIANAYAGAM SHOBANA , KUMAR G.
Published: March 2008

A case of primary malignant fibrous histiocytoma (MFH) of the stomach is reported. The patient was a 51‐year‐old man who had a laparotomy for a malignant gastric tumour diagnosed by radiological studies and endoscopic examination. An inoperable gastric malignancy was found at operation. Histopathological studies of tissue biopsied at surgery showed characteristic light microscopic findings and strong positivity for alpha‐1‐antitrypsin by immunoperoxidase technique indicating the diagnosis of malignant fibrous histiocytoma. The absence of any other soft tissue or retroperitoneal tumour strongly indicated the stomach is the primary site.
A Comparison of Different Doses of Non‐Ionic Contrast Media in I.V. Urography
Authors: EAGAR G.M. , MALING T.M. , BILLINGS J.D.
Published: March 2008

This study attempts to find out what is the appropriate dose of non‐ionic contrast media to provide an acceptable study at the lowest possible cost.

139 adults with normal renal function were studied. Four different dose regimes were employed and a standardised set of I.V.U. films were obtained. These were reviewed by two independent assessors who were unaware of the dose regime used. Each I.V.U. was scored on a modified Fry regime.

This survey showed a clear relationship between quality and dosage.
CT Findings in Melioidosis
Authors: SINGCHAROEN T.
Published: March 2008

CT findings in 5 patients with melioidosis were presented. Lungs lesions consisted of upper lobe infiltration with a small thin‐walled cavity in 2 cases and lower lobe consolidation without cavity in another case. Pleural lesions may be seen as a small pleural nodule, effusion with associated lung lesion, hydropneumo‐thorax as a complication or the end stage fibrothorax due to chronic empyema thoracis. In one case hepato‐splenic microabscesses were observed.
Imaging Yttrium‐90 Synovectomy Studies
Authors: MULLAN BRIAN P. , SURVEYOR IVOR
Published: March 2008

The method of planar imaging utilizing Bremsstrahlung radiation in patients treated with intraarticular Yttrium‐90 for joint synovitis is described, illustrated and discussed.
Microcy stic Adenoma of the Pancreas — An Incidental Finding
Authors: PIKE J. , EHSANI MOHAMMAD TAGHI
Published: March 2008

Microcystic adenoma of the pancreas is a rare benign pancreatic tumour usually occurring in elderly females. These tumours have characteristic radiological appearances that should allow their differentiation from the potentially malignant macrocystic adenoma as well as other cystic lesions of the pancreas. A case of a large micro‐cystic adenoma of the pancreas found incidentally in a patient with carcinoma of the kidney is presented.
Indications for Surgical or Radiological Placement of Cannulas for Intra‐arterial Induction Chemotherapy
Authors: WAUGH RICHARD C. , STEPHENS FREDERICK O.
Published: March 2008

Intra‐arterial chemotherapy achieves a higher concentration and increased total dose of drugs to a locally advanced cancer. This principle is increasingly being applied for pretreatment of advanced or aggressive localised tumours to make them more curable by subsequent radiotherapy. This is sometimes called “neo‐adjuvant” chemotherapy but better called INDUCTION chemotherapy (Stephens 1989).
The Evaluation of Thoracic Paraspinal Neurogenic Tumours The Role of Magnetic Resonance Imaging
Authors: MORGAN P. W. , KHANGURE M. S.
Published: March 2008

Paraspinal neurogenic tumours may have associated intraspinal tumour extension. It is important that such extension be accurately defined preoperatively in order that an appropriate surgical approach may be planned. It has been suggested in the literature that MRI (where available) should replace myelography and post myelographic CT in the preoperative evaluation of these patients.

The literature is reviewed and the potential role of MRI is illustrated in three cases.
CT of Genitourinary Calcification due to Schistosomiasis
Authors: FATAAR S. , RUDWAN M. , BASSIONY H. , SATYANATH S.
Published: March 2008

Calcification of the ureters, bladder and seminal vesicles was detected in six patients studied on computed tomography (CT) for evaluation of genitourinary schistosomiasis and in four others examined for intestinal schistosomiasis. Other findings included pyelocaliectasis in ten kidneys, vesical carcinoma in one, seminal vesicle granuloma in one and non‐visceral calcification in pelvic tissue in one patient.
Radiotherapy and Oncology in Papua New Guinea ‐ How it Differs from Western Practice
Authors: MARTIN W. M. CRAIG
Published: March 2008

This article describes differences in professional oncology practice between Papua New Guinea and developed countries. The rugged terrain and tribalism have created the late persistence of a stone age culture with a low level of education and this in turn has caused the late presentation of tumours. Paradoxically the commonest cancers are those which are frequently cured in Western countries, yet the cure rates are low in PNG due to late presentation. Despite this very few metastasize ‐ in contrast to cancers in developed countries. Difficulties in diagnosis are discussed. Differences in management arise due to lack of facilities such as electrons or iridium wires, but policy differences arise also due to the poor follow‐up. Many patients cannot afford to return for follow‐up and the government cannot assist. Many patients abscond and good pre‐treatment counselling is essential. Chemotherapy is available but doses of the more marrow‐toxic or expensive drugs are reduced in view of the poor support facilities. Problems of training staff and of Cancer Registration are discussed. Most of the above problems are non‐medical and should gradually diminish with government determination to provide a Health Service to benefit the whole population.
Low Dose Rate Teletherapy Using a Telecaesium 137 Unit Radiobiological, Physical and Clinical Considerations
Authors: COOPER S. G. , CARDEW A. P. , FERGUSON S. , JOSEPH D. J. , HAMILTON C. S. , DENHAM J. W. , WILLIAMS A. R.
Published: March 2008

Low dose rate teletherapy aims to combine the supposedly superior results obtained with low dose rate implants with the convenience and staff protection characteristics of external beam therapy. Previous investigators have used telecobalt units to produce dose rates of 1.1 to 1.8 Gy/hr to treat in daily sessions lasting 6–10 hours to total doses of 60–70 Gy. These studies have not discounted the possibility that much of the advantage of interstitial implants results from the low dose rates used per se, and from the fact that the total dose is delivered in a short overall time. The relationship between total dose, dose rate and volume giving normal tissue and anti‐tumour effects, however, remains ill‐defined. At the Newcastle Mater Misericordiae Hospital a Caesium teletherapy unit has been modified to treat at low dose rates and a study has been designed with a view to establish which permutations of total dose and dose rate are isoeffective for acute mucosal and acute skin reactions in the dose rate range between 0.8 and 9.6 Gy/hr (1.3 and 16 cGy/min).
Diverticular Mass Mimicking Ovarian Malignancy
Authors: ADLER B. D. , BREIDAHL P.
Published: March 2008

A patient is described with a large diverticular mass presenting with a clinical picture suggestive of locally advanced ovarian malignancy. Computed tomography demonstrated diffuse thickening of the wall of the sigmoid colon with infiltration of the peri‐colonic fat. The imaging diagnosis of primary bowel wall disease was confirmed pathologically.
The CT Appearances of Jejunojejunal Intussusception
Authors: KNOX A. M. , DONOVAN D. A. , WILKINSON M. R.
Published: March 2008

A case of jejunojejunal intussusception is presented, in which a malignant melanoma deposit acted as the lead point. The diagnosis was made on CT and the appearances are described.
Primary Non‐Hodgkin's Lymphoma of the Terminal Ileum with Enterovesical Fistula : A Case Report
Authors: NURUDDIN REGINA N. , RATHAKRISHNAN VIMALAH
Published: March 2008

A case of primary non‐Hodgkin's lymphoma of the terminal ileum with enterovesical fistula is reported.

A 50‐year‐old Malay man presented with haematuria, dysuria and per‐rectal bleeding. Intravenous urogram, double contrast enema and an MDP bone scintigram showed a fistulous communication between the bladder and distal ileum. At laparotomy, a large tumour attaching the terminal ileum to the dome of the bladder was found. Histopathological examination of resected small bowel revealed a diffuse histiocytic non‐Hodgkin's lymphoma of the small bowel. The bladder mucosa was shown to be normal.
Giant Epignathus with Intracranial Teratoma in a Newborn Infant
Authors: ANG A. T. , HO N.K , ONG, C.L
Published: March 2008

A male newborn infant with a giant epignathus associated with intracranial teratoma and obstructive hydrocephalus detected antenatally is reported. Only 4 similar cases have been reported in the literature. This disorder is uniformly lethal. We believe this is the first reported case of epignathus with congenital intracranial teratoma diagnosed antenatally by ultrasonography.
Carcinoma Penis
Authors: SANDEMAN T.F.
Published: March 2008

Between 1954 and 1984, 102 cases of carcinoma of the penis were seen at the Peter MacCallum Cancer Institute. Their mean age was 62.5 years. Nearly twice as many patients were referred in the last decade as in the first, and this observation may be linked to the reduction in numbers of neonatal circumcisions in the last forty years. The material reported is selected by referral patterns of recurrence following surgery elsewhere or the patient's preference for conservative management. As a result the overall survival figures have little meaning. However it is apparent that where possible and where acceptable, partial surgical amputation is more likely to achieve local cure and to be less disturbing for patients with invasive disease. Radiotherapy can be effective in controlling superficial primaries and may be curative in early, or rarely in late, stage nodal disease. Prevention by circumcision in infancy is still the best policy.
Hexabrix 320R for CT. (Computed Tomography) — Patient Tolerance and Image Quality
Authors: STUCKEY J.G. , JAMES R.H.
Published: March 2008

A total of 367 patients were studied using Hexabrix 320 as intravenous contrast material during CT scanning. Adverse events were recorded and analysed with respect to patient age and risk category. Hexabrix 320 produced adequate image quality in all patients. Whilst minor adverse events were relatively common, only a few moderate adverse events were seen and no severe adverse events were observed. Hexabrix 320 was noted to be very well tolerated in the elderly and well tolerated by the high risk patient.
The Radiographic Changes of Scleroderma in the Hands
Authors: DOYLE TERENCE , LITTLEJOHN GEOFFREY , MILLER MARIAN , BARNETT ALFRED
Published: March 2008

Hand radiographs from 160 patients with scleroderma were reviewed. The presence of calcinosis distal to the metacarpophalangeal joints was significantly associated with the female sex, disease duration over 10 years, digital ulceration, telangiectasia, tuft erosion and the presence of anticentromere antibodies. The presence of calcinosis proximal to the metacarpophalangeal joints was significantly associated with tuft erosions and erosions involving all joints. The lack of distal calcinosis was significantly associated with anti Scl 70 and antinucleolar antibodies.

The prevalence of other radiological manifestations of scleroderma such as osteoarthritis, erosions and dorsal tuft modelling was documented.

Specific radiological findings correlate with certain clinical and serological characteristics in scleroderma.
M.R. Imaging of the Knee: A Prospective Trial Using a Low Field Strength Magnet
Authors: JAMES PHILLIP , BUIRSKI GRAHAM
Published: March 2008

A double blind prospective study involving fifty patients was performed to assess the diagnostic accuracy of knee MR Imaging using a 0.3 Tesla low field strength scanner. The study compared MR Imaging with arthroscopy. The overall accuracy found for the detection of meniscal tears was 92% and cruciate ligament tears 95%.

These results compare favourably with other diagnostic modalities including knee arthroscopy. MR Imaging is good at showing meniscal lesions, especially cleavage tears, though some bucket‐handle tears produced no MR abnormality. MR Imaging is very accurate at demonstrating complete cruciate ligament tears. Partial cruciate ligament tears often produced no positive MR findings and in no patients could any features be found to indicate ligamentous laxity.
Imaging of Ureteral Duplication with a Non‐functioning Component
Authors: LAM A.H. , SACHINWALLA T.N.
Published: March 2008

31 patients of ureteral duplication were selected when one moiety of the duplex system was poorly visualised with either IVU or DTPA studies. Both ultrasound and IVU were performed in all cases. DTPA scans were performed in 17 cases and MCUs in 26 cases. The cases were divided into 2 groups. Group 1 (28 patients), with hydronephrosis and hydroureter, was further subdivided into 1 A (18 patients) where the ureter terminated in an ureterocoele and 1 B (10 patients) where the ureter was ectopic. Group 2 (3 patients) were cases where the non‐functioning moiety was hypoplastic or dysplastic and was drained by a small or normal size ureter. The diagnostic value of IVU, Ultrasound, DTPA scan and MCU was reviewed in each group.
Cervical Myelopathy in C.P.P.D. Deposition Disease
Authors: PARKER GEOFFREY D. , JONES NIGEL R. , SCOTT GRACE
Published: March 2008

Cervical Myelopathy is a rare manifestation of calcium pyrophosphate dihydrate (C.P.P.D.) deposition disease.

A case is presented where radiographically non‐calcified extradural masses containing C.P.P.D. crystals were present at the C7 level, producing cord compression and neurological symptoms. These masses are thought to represent para‐articular deposits related to the adjacent facet joints.
Radiologically Controlled Drainage of Pleural and Pulmonary Collections*
Authors: FATAAR SHADLEY
Published: March 2008

Radiologically controlled catheter drainage is now accepted therapy for fluid collections in many parts of the body. While this is performed mainly in the abdomen, the chest is increasingly being drained percutaneously as an alternative to surgical drainage (van Sonnenberg et al 1984; Westcott 1985; O'Moore et al 1987; Crouch et al 1987). This report outlines the experience with 31 chest collections treated by the intervention radiologist over a two‐year period.
Magnetic Resonance Imaging in Herpes Simplex Encephalitis
Authors: ALBERTYN LYNDA E.
Published: March 2008

Four patients with clinical and serologically proven Herpes Simplex Encephalitis (HSE) were examined by Magnetic Resonance Imaging (MRI) following Computed Tomographic (CT) scans.

MRI proved more sensitive at detecting the temporal lobe abnormalities than CT and invariably showed the lesions to be more extensive than suspected. The findings were consistent with an acute inflammatory process. Haemorrhage was present in only one patient. The sharp transition to normal at the lentiform nucleus previously described on CT was present in only one of the four patients, but was observed in a different patient with cerebral lymphoma and no evidence of HSE and is thus concluded to be less specific than previously thought. A repeat MRI scan at seven months on one of the patients showed persisting increased signal on T2 weighted images after resolution of the mass effect.

The pathology and suspected mechanisms for the MRI appearances are discussed.

MRI is concluded to be a valuable tool in the early diagnosis of HSE and in the longer term for further evaluation of residual disabilities.
Hepatic Adenoma and Focal Nodular Hyperplasia: A Diagnostic Dilemma
Authors: LOW VINCENT , KHANGURE MAKHAN S.
Published: March 2008

Focal Nodular Hyperplasia (FNH) and Hepatic Adenoma (HA) remain difficult diagnostic problems due to their variable imaging appearances. Five new cases are presented, illustrating this variability, and the current literature is reviewed.

Ultrasonography is a sensitive modality for their detection but is otherwise non‐specific. On computer tomegraphy, the presence of a scar suggests FNH, whilst haemorrhage suggests HA. However these features are seen in only a small number of cases. Radionuclide (colloid) scanning aids considerably in FNH but a definitive role has not been found in HA. Angiography is helpful, providing anatomical information, sometimes diagnostic (septated blush in FNH, hypovascular areas in HA) and able to discern benign from malignant lesions.
Primary Sacral Bone Tumours in Children (Report of 16 cases with a short literature review)
Authors: KOZLOWSKI K. , BARYLAK A. , CAMPBELL J. , HOEFFEL J.D. , BELUFFI G. , MASEL J. , PANUEL M. , PELIZZA A. , TACCONE A. , ARICO M.
Published: March 2008

16 cases of primary sacral bone tumours in children are reported. These include 13 patients with Ewing's sarcoma and 3 with very rare primary sacral bone tumours in childhood — chordoma, haemangiopericytoma and osteoblastoma.

All sacral bone tumours, with the exception of Ewing's sarcoma are very rare in childhood.

The possibility of a sacral tumour should be considered in a child with radiculopathy.

CT and MR make the diagnosis of primary sacral bone tumours much easier with the added possibility of recognition of the true nature of the lesion in many instances.

Reports of primary sacral bone tumours in children are scarce. Most of the patients are incorporated in adult series which do not specify the age of the child and the site of the tumour.

The purpose of this paper is to describe 16 children with primary sacral bone tumours.