bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rapid dynamic contrast-enhanced magnetic resonance imaging of the liver and portal vein
Authors: Ward J , Martinéz D , Chalmers A G , Ridgway J , Robinson P J , Smith M A 
Published: July 2009

Abstract
The purpose of this study was firstly to show the diagnostic value of a rapid acquisition multislice sequence (TurboFLASH) during bolus injection of gadolinium-DTPA by comparing it with the pulse sequences currently used for abdominal studies and secondly to develop improved scanning protocols for the liver. Patients were referred for upper abdominal studies including portal vein assessment. 40 patients were imaged in the coronal plane using a multislice TurboFLASH (TF) sequence (TR = 100; TE = 4) acquired during a breath-hold period of 19 s. The short echo time allows up to 11 slices of 5 mm thickness to be acquired simultaneously. Images were obtained before, during and after bolus administration of Gd-DTPA. The slices from each acquisition were combined using a maximum intensity projection algorithm to include all the vessels on a single image. Initially each patient was scanned using a conventional axial T2 weighted spin-echo sequence (T2W-SE) (TR2000; TE = 45/90) and a coronal T 1 weighted spin-echo sequence (TR450; TE = 15). The clarity of the demonstration of vascular anatomy was compared and scored for all sequences by two radiologists. Vessel patency, the conspicuity of mass lesions and the spread of tumour to adjacent structures were also scored. The anatomy of the main portal vein was significantly better shown by coronal TF images after bolus injection than on T2W-SE images or TF before Gd-DTPA. The right and left portal veins were equally well shown by coronal TF with Gd-DTPA and T2W-SE images. There was no significant difference between contrast enhanced TF and T2W-SE imaging in visualization of the hepatic veins. More lesions were demonstrated by post-contrast TF than by T2W-SE imaging. Portal venous occlusion was better appreciated by post-contrast TF. Our results demonstrate that Gd-DTPA TF imaging improves visualization of the main portal vein compared with SE sequences and provides a more accurate assessment of vessel patency. The segmental anatomy of the liver is better appreciated and the demonstration of focal liver lesions compared with T2W-SE images is improved during the non-equilibrium phase of enhancement. TF acquisitions before and after Gd-DTPA are obtained in approximately 5 min; thus a marked reduction in examination time can be achieved.
Implementation of a programme for reduction of radiographic doses and results achieved through increases in tube potential
Authors: Martin C J , Darragh C L , McKenzie G A , Bayliss A P 
Published: July 2009

Abstract
Experiences in implementation of a programme to reduce doses to patients from radiographic examinations are described. A preliminary survey of entrance doses for selected examinations, calculated from mean exposure factors, identified equipment and examinations requiring attention. Subsequently more detailed studies were carried out with thermoluminescent dosemeters (TLDs). Results were coordinated with the aid of a database, which was used to monitor the agreement between dose calculations and TLD measurements. Surveys highlighted that doses from lumbar and thoracic spine examinations were high throughout the region. Reductions of 26–36% in entrance dose and 20–25% in effective dose were achieved by raising tube potentials for these examinations. This gave a reduction in annual collective dose of 4 man-Sv with no cost implication. In some departments dose charts were used to support the purchase of new screens. Surveys revealed a wide range in other factors such as transmission of X-ray table tops and results are being used in planning replacement of equipment.
Sensitivity of human squamous cell carcinoma of the larynx to fractionated radiotherapy
Authors: Rezvani M , Fowler J F , Hopewell J W , Alcock C J 
Published: July 2009

Abstract
Data obtained for the response of tumours from two multicentre clinical trials of the British Institute of Radiology have been combined and studied. Both trials involved patients with laryngopharyngeal carcinoma. There were 734 patients in the first trial, recruited between 1965 and 1975, and 611 patients in the second trial, recruited between 1975 and 1985. Observed survival and tumour-free rates for all patients are calculated. T-class and the nodal status of the patient at the start of the treatment were important factors in the determination of both observed survival and tumour-free rates. Overall treatment time was an important factor in determining the recurrence of tumour. The longer the overall treatment time the greater was the chance of tumour recurrence. The linear-quadratic (LQ) model was used in the analysis of the tumour recurrence data for a large group of patients with laryngeal tumours without nodal involvement. A small α/β ratio of 0.94 Gy was obtained for T3 tumours while that of T2 tumours was negative, –10.5 Gy. The value for Tl tumours was higher at 23 Gy. However, use of the LQ model with a time component increased the α/β ratios to 26.0 ± 27.20 Gy, 18.0 ± 12.33 Gy and 13.38 ±5.40 Gy for Tl, T2 and T3 tumours, respectively. The time component, the γ/α ratios, for these tumours were 0.15 ± 0.27 Gy/day, 0.81 ± 0.18 Gy/day and 0.76 ± 0.15 Gy/day, respectively.
An unexpected twist
Authors: Briley M 
Published: July 2009

A 43-year-old man was admitted for investigation of chest pain. This had occurred, on exertion, for about 1 year but prior to this he had been completely well. There was also a recent history of blackouts.
Examination revealed normal pulses and blood pressure was 120/80. An ejection systolic murmur was heard in the aortic area radiating to the neck and an early diastolic murmur was heard along the left sternal edge.
An electrocardiogram (ECG) showed left ventricular hypertrophy and strain pattern. His chest X ray is shown. (Figure 1.)
The role of hyterosalpingography in modern gynaecological practice
Authors: Kerslake R W 
Published: July 2009

In their article “The role of hysterosalpingography in modern gynaecological practice” (Rajah et al, 1992), the authors state that “HSG remains the examination of choice for the investigation of congenital uterine anomalies”.
This statement is apparently made on the basis of their demonstration by hysterosalpingography (HSG) of various congenital and acquired uterine abnormalities which were not recognized at laparoscopy. No independent confirmation or these diagnoses appears to hve been obtained and the HSG results are thus not corroborated. Furthermore, they state that “ultrasound failed to detect major congenital abnormalitites in our series” yet no discussion of the technique used or results obtained is presented to support such a statement.
The role of hysterosalpingography in modern gynaecological practice
Authors: McHugo J 
Published: July 2009

We thank Dr Hugh and Dr Kerslake for their interest in our article and welcome the opportunity to reply.
Dr Hugh doubts the value of relaxants during HSG for non-filling of the Fallopian tubes and suggests that alteration in tubal anatomy secondary to relaxation of the smooth muscle of the bowel may result in the tubal filling. One advantage of a technique using a tenaculum is that gentle movement on the cervix will move the Fallopian tubes if they are not fixed by adhesions. It is our practice to manipulate the tubes in this way.
MRI of the knee
Authors: Heron C W 
Published: July 2009

Abstract
The inherent vulnerability of the knee to injury and degenerative change means that there is a major requirement for an imaging technique capable of assessing such damage accurately, rapidly and noninvasively. Over a relatively short time magnetic resonance imaging (MRI) has emerged as the technique of choice in the assessment of internal derangement of the knee. The present review describes the wide application of MRI to the knee and considers the position of MRI in relation to other diagnostic methods.
In search of optimum chest radiography techniques
Authors: Leitz W K , Månsson L G , Hedberg-Vikström B R K , Kheddache S 
Published: July 2009

Abstract
A nation-wide study of chest radiography in Sweden had previously revealed a large variation in the physical and technical factors involved, in particular the radiation dose. In this study the image quality could not be assessed unambiguously. The aim of the present study was to try to establish a correlation between visual grading of radiographs and physical and technical factors in order to find the optimum chest X-ray system. The physical and technical performance of 24 chest units was evaluated. Radiographs were taken of an anthropomorphic chest phantom supplied with test structures simulating various pathologies. Image quality was assessed by visual grading analysis of the radiographs. The physical and technical parameters of the units rated best were used to exemplify good radiographic practice. The results were in agreement with the recommendations issued by the Commission of the European Communities (CEC). It was also shown that low radiation dose is compatible with high-quality radiographic imaging of the chest.
A pain in the neck
Authors: Saifuddin A , Renwick I G H 
Published: July 2009

A previously healthy 24-year-old man injured his neck in a rugby match and complained of neck pain. There was no history of previous neck trauma. On examination his neck was diffusely tender and there was generalized reduction in neck movements. Plain radiographs of the cervical spine were obtained (Figures la, b). What do they show and what is the diagnosis? How would you confirm this?
The antero-posterior (AP) radiograph of the upper cervical spine (Figure la) shows bilateral atlantoaxial offset of 4 mm. The initial diagnosis was of a burst fracture of the atlas (Jefferson fracture) and a computed tomography (CT) scan was performed to confirm this (Figure 2). CT demonstrated a well-defined, smooth, corticated anterior cleft and a midline posterior defect. No fracture was seen. A diagnosis of bipartite atlas was made. Following CT the plain radiographs were reviewed and several abnormalities observed which had not been previously appreciated. On the lateral radiograph (Figure lb) there was absence of the cortical outline to the anterior tubercle of the atlas and similarly there was no arch–canal line posteriorly.
Magnetic resonance imaging of the knee: does foot restraint improve the examination?
Authors: Lomas D J , Mackenzie R , Dixon A 
Published: July 2009

Abstract
Involuntary movement by the patient can cause severe artefacts in magnetic resonance imaging of the knee. We have designed and constructed a device that immobilizes the foot, and thereby the knee. In this way the knee still remains accessible for the application of a variety of surface coils. A retrospective subjective analysis was performed of the magnetic resonance images from a control group of 23 patients who were examined without the restraint device and a study group of 26 patients in whom the device was used. The differences in the central tendency of subjective scores between the control and study groups were not significant for either motion artefact or anatomical conspicuity. However, in terms of dispersion the observed reduction in the study group was significant for anatomical conspicuity (p &lt; 0.05) and almost significant for motion artefact (p &lt; 0.10). These findings suggest that the restraint device may improve image quality by eliminating some of the worst motion artefacts. The device also significantly improves positioning of the knee in relation to the magnet isocentre (p &lt; 0.01).
Book review
Authors: Hately W 
Published: July 2009

Chambers' dictionary defines gamuts as the full extent of anything; this text certainly extends widely in its listings of possible causes of ultrasound appearances. It is after the style of similar works in general radiology and nuclear medicine. The authors hope that their gamuts will be useful to both physicians and ultrasonographers when an unusual or rare ultrasound finding occurs.
Where appropriate the gamuts are divided into common and uncommon. Additional information in the form of brief comments is provided for some of the entries in order to help in distinguishing different entities and reduce the number of possible diagnoses. The various lists are well referenced and are up to date. The list of contents is clearly set out at the beginning. No illustrations are included.
Muscular fibrosis induced after pig skin irradiation with single doses of 192lr γ-rays
Authors: Lefaix J-L , Martin M , Tricaud Y , Daburon F 
Published: July 2009

Abstract
Localized irradiation of the skin and subcutaneous tissues with large single doses of γ-rays can induce delayed effects characterized by fibrosis which invades the irradiated tissues. In this study the depth of penetration of muscle fibrosis was measured in the pig 30 weeks after irradiation of the skin surface with single doses of 192Ir γ-rays of 16–256 Gy. Irradiation was directed either to the outer side of the thigh or to the back, close to the mid-dorsal line. Fibrosis only developed in irradiated muscle after doses that induced moist desquamation of the skin in the acute phase of the reaction, i.e. after skin surface doses of 48–64 Gy. In skeletal muscles, the limit of fibrotic expansion was reached at a depth dose of 14 ± 4 Gy (±SD) for skin surface doses exceeding 48 Gy.
Not another case of aortic dissection!
Authors: Spencer J A , Golding S J 
Published: July 2009

A 70-year-old woman wth a long history of ischaemic heart disease was admitted to hospital after a sudden onset of crushing central chest pain. 3 years previously a permanent transvenous pacemaker had been inserted following a bradycardic episode.
On examination there were signs of left heart failure. Peripheral pulses were normal and equal and she was normotensive. An electrocardiogram showed no features of acute myocardial infarction. A chest radiograph demonstrated cardiomegaly and widening of the superior mediastinum. The patient was referred for contrast computed tomography (CT) examination of the chest (Figures 1 and 2) to exclude dissection of the thoracic aorta.
An alternative approach to the semi-quantitative assessment of the transplanted renal artery velocity sonogram
Authors: Ward S P , Taylor M G , Gosling R G 
Published: July 2009

Abstract
There are theoretical problems with the use of resistance based indices, i.e. pulsatility index (PI) or resistive index (RI) as stand alone measures in the renal allograft. PI and RI are heart rate dependent and input pressure dependent for autoregulating organs. A new non-invasive index, termed Pz, has been proposed. Pz may be thought of as the arterial back pressure generated by the kidney representing the pressure which needs to be overcome in perfusing the glomeruli. On a theoretical basis Pz can be shown to be independent of heart rate and resistance and to allow for variations in mean systemic blood pressure. In an initial study, a group of 53 well functioning renal allografts demonstrated a significant reduction in the coefficient of variance for Pz (12.8%) when compared to PI (25.4%). A second study on recently transplanted allografts indicated that acute tubular necrosis could not be separated from rejection on the basis of Pz. Pz did however consistently perform better than PI in terms of reduced variability within pathological groups. We conclude that Pz is more useful than PI in this application.
Resistance and pulsatility Doppler indices: how accurately do they reflect changes in renal vascular resistance
Authors: Mastorakou I , Robbins M E C , Bywaters T 
Published: July 2009

Abstract
Doppler indices such as the resistance (RI) and pulsatility indices (PI) are generally thought to indicate the resistance of the vascular bed supplied by the artery under investigation. However, this association remains uncertain; some studies have demonstrated an excellent correlation between alterations in vascular resistance and changes in Doppler indices, while others have shown no consistent change. In order to assess the validity of these two indices in estimating alterations in renal vascular resistance, 12 female Large White pigs, 45 weeks old, were entered into a double blind study. In nine of the pigs both kidneys received a single dose of 9.8 Gy 60Co γ-rays; the remaining three served as sham-irradiated controls. Renal haemodynamics were measured using 131I-hippuran renography and Duplex Doppler prior to and at 8, and 12 weeks after kidney (sham-)irradiation. The sham-irradiated animals exhibited no significant changes in any of the parameters. In contrast, the animals in which both kidneys were irradiated exhibited a significant decrease (p &lt; 0.001) inrenal blood flow (RBF) 8 and 12 weeks after irradiation. In addition, both PI and RI were increased following kidney irradiation; however, this increase was not significant until 12 weeks after irradiation (p &lt; 0.01). This suggests that the reduction in RBF was not simply a reflection of an increased vascular resistance and/or that PI and RI do not truly represent alterations in vascular resistance. Further studies are required to confirm the applicability of PI and RI in the assessment of renal haemodynamics.
Gallbladder function after endoscopic sphincterotomy—a dynamic ultrasound assessment
Authors: Lang I M , Martin D F 
Published: July 2009

Abstract
There is controversy regarding the function of the gallbladder following endoscopic sphincterotomy (ES) for the treatment of gallstones. Using ultrasound to assess gallbladder volume, we evaluated gallbladder contractility in 34 patients (18 male, 16 female), mean age 73 years, who had ES and common bile duct (CBD) clearance a mean of 18 months earlier. In 16 patients gallbladder function could not be measured, either because the fasting gallbladder was small and contracted or because it contained gas. The remaining 18 patients (53%) had “normal” gallbladder contraction with a mean initial fasting volume of 30.3 ml and mean post fatty meal volume of 13.8 ml. 14 of these 18 patients had a repeat fasting volume which showed refilling in all except one. Those with a functioning gallbladder had had significantly smaller stones extracted from the CBD at the time of ES. A smaller or incomplete sphincterotomy may have been performed in these patients, therefore allowing some residual sphincter of Oddi function.
Optimization of ultrasound scanner characteristics: a preliminary study
Authors: Metcalfe S C , Evans J A 
Published: July 2009

Abstract
It is generally accepted that different transducer characteristics are optimal for different examinations, but it is not always obvious which other scanner/transducer parameters, e.g. signal processing should be selected for a given examination. We have examined noise and grey-level parameters for two specific anatomical sections (one showing the liver and right kidney and one showing the uterus) using a combination of subjective and objective assessment. The results confirm that the images chosen for this study have different requirements in terms of noise and grey-scale processing. The uterus image requires a large range of greys assigned to the lower level echoes and requires low noise levels. The liver/kidney image was not affected by noise levels in the systems used and required the lower amplitude grey-levels to be compressed, liberating a greater range of greys for the higher amplitude echoes.
Simultaneous supra- and infradiaphragmatic irradiation in Hodgkin's disease
Authors: Krueck W , Hess C F , Kortmann R D , Bamberg M 
Published: July 2009

Abstract
From 1982 to 1989, 68 patients with Stages IA to IIIB Hodgkin's disease were treated by simultaneous supraand infradiaphragmatic irradiation (SSI-RT). 46 patients received exclusive radiotherapy for Stages IA and IIA (extended mantle field irradiation (EMF) 31, and total lymphatic irradiation (TLI) 15). Combined modality treatment including pre-irradiation chemotherapy, was given to 22 patients (CH-EMF 12 and CH-TLI 10). The median follow-up was 64 months. 5-year overall survival was 94% in combined Stages IA and IIA, and 100% in Stage IIIA. 5-year freedom from relapse was 87% in combined Stages IA and IIA, and 80% in Stage IIIA. Toxicity was evaluated in 64 patients. Acute and long term toxicity was similar to previously reported data on sequential supra- and infradiaphragmatic irradiation. In SSI-RT prior chemotherapy affected pre-irradiation blood counts and was associated with delayed post-irradiation haematological recovery. The relative mean white blood cell (WBC) decrease ranged from 47% (EMF) to 61% (TLI). The mean platelet decrease ranged from 43% (EMF) to 80% (CH-TLI). Both prior chemotherapy and total lymphoid irradiation increased haematotoxicity. The mean duration of breaks ranged from 3.9 days in EMF to 14.9 days in CH-TLI. The mean treatment time, ranging from 43 days in EMF to 54 days in TLI, was significantly shorter than in sequential schedules (up to 112 days). Our results indicate that SSI-RT is an effective and safe treatment. Its use seems to be limited mainly by prior chemotherapy. As compared to sequential schedules, the risk of match line overlap is avoided, overall treatment time is decreased, and treatment costs are minimized.
Radiation doses to paediatric patients undergoing less common radiological procedures involving fluoroscopy
Authors: Chapple C-L , Faulkner K , Lee R E J , Hunter E W 
Published: July 2009

Abstract
A semi-automated dosimetry survey has been undertaken to monitor the radiation doses to patients in a paediatric fluoroscopy room. The doses were assessed using large area Diamentor ionization chambers to measure dose × area product, and by means of thermoluminescent dosemeters attached to the patient's skin in various places. Details of patients and examinations were entered into a computer, all information being stored on a data base. Many radiological examinations have been monitored, including renal and jejunal biopsies, nephrostograms, loopograms, tracheograms and fistulograms. Patients included in the study have been divided into three age bands for dose assessment. Radiation doses for different types of examination have been compared, including more common examinations for which data have been previously presented.
Does the Whitaker test add to antegrade pyelography in the investigation of collecting system dilatation in renal allografts?
Authors: Kashi S H , Irving H C , Sadek S A 
Published: July 2009

Abstract
Significant pelvicalyceal dilatation in renal allografts is currently investigated by antegrade pyelography. However, the clinical significance of a radiologically demonstrated narrowing of the ureter is unclear. Over a 21-month period 26 of 155 renal allografts with pelvicalyceal dilatation were investigated by antegrade pyelography. In eight allografts no ureteric stenosis could be identified. Two grafts were shown to have ureteric necrosis and required surgical intervention and 16 of the other grafts appeared to have a ureteric stenosis. 15 of the 16 allografts with radiological ureteric stenosis underwent a concurrent pressure flow study to assess the functional relevance of the ureteric narrowing. As shown by a pressure rise of &gt; 7 mmHg at a perfusion rate of 10 ml min−1, 11 of the 15 grafts were functionally obstructed and were treated by a nephrostomy catheter followed by antegrade insertion of a ureteric stent. The four grafts with a negative pressure flow study were subsequently shown on biopsy to have rejection. The diagnosis of allograft rejection was also confirmed by biopsy in seven of the eight allografts without a radiological ureteric stenosis. The last of the eight allografts was found to be cyclosporin toxic. Pelvicalyceal dilatation of renal allografts is appropriately investigated by antegrade pyelography in combination with a pressure flow study which identifies those grafts with mechanical obstruction.