bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pseudotumoral pelvic retroperitoneal fibrosis associated with orbital fibrosis
Authors: Van Hoe L , Oyen R , Gryspeerdt S , Baert A L , Bobbaers H , Baert L 
Published: July 2009

Abstract
We report the case of a man with bilateral orbital fibrous pseudotumours and a large pelvic mass which was initially thought to be malignant. Sonographically guided transrectal core biopsies showed it to be a fibrotic retroperitoneal pseudotumour. The mass decreased after steroid therapy. The computed tomography and magnetic resonance imaging features of this unusual form of pelvic fibrosis as well as the association with heterotopic fibrosis are discussed.
Magnetic resonance imaging in the detection of focal liver lesions: comparison of dynamic contrast-enhanced TurboFLASH and T
2 weighted spin echo images
Authors: Ward J , Baudouin C J , Ridgway J P , RObinson P J 
Published: July 2009

Abstract
In a previous study using dynamic contrast-enhanced TurboFLASH (DCETF) for demonstration of the portal venous system we found that this technique showed more liver lesions than T 2 weighted spin echo (T 2WSE) imaging in the same patients. In this study we have formally compared axial T 2WSE images (TR2000, TE 45/90) with TurboFlash images (TR 135, TE4, FA 80°) acquired immediately after bolus injection of Gd-DTPA (0.1 mmol kg−1) in 41 patients referred for hepatic magnetic resonance imaging (MRI) prior to surgery for liver lesions. The images of each sequence were independently reviewed by two observers. The lesions were counted and each sequence was scored for conspicuity, level of artefact and subjective image quality. Contrast-to-noise ratios using user denned regions of interest were calculated. Significantly more lesions were seen on DCETF (n=186) images than on T 2WSE (n=123) images (p&lt;0.001). Lesion conspicuity was equal in 53% of cases, better on DCETF in 36% and better on T 2WSE in 11%. Contrast-to-noise ratios were significantly higher on DCETF images (p&lt;0.05). DCETF imaging provided a substantial improvement in lesion detection compared with T 2WSE imaging.
Entrance doses during lateral lumbar spine and antero–posterior abdomen examinations: generator waveform dependence
Authors: Morrison G D , Underwood A C 
Published: July 2009

Abstract
In North Trent, UK, an entrance dose survey of lateral lumbar spine and antero-posterior (AP) abdomen examinations has been carried out in 17 radiology departments. The survey comprised 294 lateral lumbar spine and 322 AP abdomen entrance dose measurements. The mean entrance doses were found to be approximately half of the relevant national reference entrance dose levels of 30 mGy and 10 mGy, respectively. The effect of generator waveform on entrance dose was studied by separating the generators into two types: “pulsating potential” (PP) generators and “constant potential” (CP) generators for each examination. PP generators comprised 23% of the total number of examinations. The mean entrance dose and radiographic exposure factors from CP generators were found to be significantly lower than those from PP generators. The use of CP type generators, together with low attenuation components can significantly reduce patient
entrance doses for these examinations.
Analysis of patient doses for myelogram and discogram examinations and their reduction through changes in equipment set-up
Authors: Martin C J , Hunter S 
Published: July 2009

Abstract
Patient doses for myelogram and discogram examinations performed on two C-arm X-ray units have been measured using dose–area product meters. Contributions to the dose from fluoroscopy and radiography have been obtained from analysis of results for a selection of examinations. Information was recorded about the individual beam projections used, in order to allow estimates of effective dose. Effective doses for lumbar myelograms were 3–4 mSv and for cervical myelograms and discograms were 1 mSv. The doses on the two units were similar, but contributions from the various parts of the examinations were different. Quality assurance (QA) measurements of dose variables were used to determine reasons for these differences in performance. Fluoroscopic doses are influenced by image intensifier dose rate and by the way in which exposure factor selection has been set up for the automatic exposure control (AEC) system. Doses from digital fluorography on units for specialized applications may be greater than those with standard film/screen systems. Recommendations have been made concerning ways in which doses on each unit might be reduced. Detailed assessments of doses resulting from AEC set-up options, made during QA tests, can help to ensure that the optimum balance between patient dose and image quality is achieved.
Computed tomography in the investigation of bilateral mandibular coronoid hyperplasia
Authors: Gibbons A J 
Published: July 2009

Abstract
Bilateral mandibular coronoid hyperplasia is characterized by restricted mouth opening due to impingement of the coronoid processes on the zygomatic arches. The condition is unfamiliar to many clinicians and may be significantly under-reported. The presented case highlights the benefits of computed tomography (CT) in the diagnosis and surgical evaluation of this disorder.
Computerized axial tomographic scan measurements as prognostic indicators in patients with cervical carcinoma
Authors: Shepherd S F , Collins C D , Fryatt I J C , Parsons C A , Blake P R 
Published: July 2009

Abstract
This retrospective study of 56 patients with carcinoma of the uterine cervix treated with radical radiotherapy at the Royal Marsden Hospital, London, examined whether simple measurements of maximum tumour dimension from computerized axial tomographic (CT) scans have any prognostic significance. Our results indicate that tumour depth (i.e. maximum antero-posterior dimension) of 4 cm or more is associated with a statistically significant increased relative risk of death of 2.4 (95% CI 1.1–5.5; p = 0.045), as compared with tumours with a depth of less than 4 cm. In addition, there was a clear correlation between tumour depth and lymph node involvement (r = 0.36; p &gt; 0.01), and tumour depth and width (r = 0.70; p &gt; 0.005). We suggest that a measurement of maximum tumour depth from the staging CT scan in these patients provides valuable additional information about likely occult lymph node metastases and prognosis, over and above that suggested by the FIGO staging system alone.
Ultrasonic assessment of hemidiaphragmatic movement: an indirect method of evaluating mediastinal invasion in non-small cell lung cancer
Authors: Houston J G , Fleet M , McMillan N , Cowan M D 
Published: July 2009

Abstract
This preliminary study aimed to assess the potential value of diaphragmatic ultrasound (DUS) in evaluating phrenic nerve involvement indirectly, in the non-invasive pre-operative staging of mediastinal invasion in non-small cell lung cancer (NSCLC). A prospective study of 30 patients with NSCLC comparing the findings of diaphragmatic ultrasound, chest radiograph, computed tomography (CT) thorax and mediastinoscopy was performed. In all cases adequate quantitiative assessment of hemidiaphragmatic excursion was obtained. There was discordance in four of 30 patients between DUS and chest radiograph. Three of nine patients with extensive mediastinal disease on CT had abnormal DUS, and two of eight patients with indeterminate mediastinal disease on CT had abnormal DUS and were later found to be non-resectable. No abnormal cases of DUS were found in those cases with normal mediastinal CT. There was no clear relationship between the site, size and side of the primary tumour on CT, or its pleural or diaphragmatic contiguity, and hemidiaphragmatic excursion. There was concordance between DUS and mediastinoscopy in 17 of 21 patients. Two patients had normal mediastinoscopy and abnormal DUS but were not resectable at thoracotomy. No patient with abnormal DUS was resectable. DUS may be of potential value in the pre-operative staging of NSCLC and is therefore worthy of further evaluation.
A comparison of bone densitometry measurements of the central skeleton in post-menopausal women with and without vertebral fracture
Authors: Duboeuf F , Jergas M , Schott A M , Wu C Y , Glüer C C , Genant H K 
Published: July 2009

Abstract
The purpose of this investigation was to compare the ability of two different bone densitometry techniques (quantitative computed tomography and dual X-ray absorptiometry) to discriminate subjects without any vertebral fracture from those with definite vertebral fractures. Bone mineral density (BMD) was determined in 112 post-menopausal women. 83 women were classified free of vertebral fracture and 29 were considered to have definite vertebral fractures. Quantitative computed tomography (QCT) was performed using three different spinal regions of interest. Dual X-ray absorptiometry (DXA) was measured at the spine (both in posteroanterior (PA) and lateral (L-DXA) projection, and at hip (total, neck and Ward regions). An additional estimated volumetric BMD was derived from the PA and L-DXA spine scans. Individuals with definite vertebral fractures had lower bone mineral density for each of the methods and regions of interest (ROI). Spinal QCT results, total and Ward hip DXA results showed the greatest percentage decrement. Odds ratio estimates revealed a significant relationship between BMD and fracture with spinal QCT, hip, and volumetric spinal DXA. The greatest areas under the receiver operating characteristic (ROC) curves were found with results of spinal QCT, total and Ward hip DXA, and volumetric spinal DXA measurements. It is concluded that spinal QCT and femoral total DXA measurement may be preferred to PA and lateral L3 DXA measurements.
Mammography in the follow-up after breast-conserving treatment in cancer of the breast: suitability for mammographic interpretation, validity and interobserver variation
Authors: Jager J J , Langendijk J A , Dohmen J P , Schreutelkamp I L , Volovics L , van Engelshoven J M , de Jong J M , Schouten L J , Hupperets P S , Blijham G H 
Published: July 2009

Abstract
The aims of this study were to determine the suitability for radiographic interpretation, interobserver variability and validity of mammography after breast-conserving treatment. Initial and post-treatment mammograms of 100 consecutive patients treated between 1982 and 1987, with a minimal follow-up of 5 years, were independently selected for review by two radiologists. Mammograms were classified according to suitability for interpretation and radiological diagnosis based on the presence of characteristics of malignancy. The interobserver variability was expressed in kappa values, the validity in a receiver operating characteristic (ROC) plot. 534 post-treatment and 86 initial mammograms of 92 patients were obtained. Suitability for interpretation was not different from pre-treatment mammograms and was significantly associated with age, being better in the age group over 50 years. No association was observed between suitability for interpretation and treatmentrelated factors, even if irradiation was combined with concurrent chemotherapy. Reliability of conclusions regarding sensitivity and specificity in this study are limited due to the small number of events. Interobserver agreement concerning classification was moderate (weighted kappa = 0.49). ROC analysis showed an optimal decision threshold between the “uncertain” and “suspect” categories of malignancy, resulting in a sensitivity of 86% and a specificity of 98%. The appearance of new pathological microcalcifications with or without tumour mass seemed to be the most important characteristics of malignancy predicting local relapse. No clear alteration in suitability for interpretation was observed in the mammograms after breast-conserving treatment, even if irradiation was combined with concurrent chemotherapy. Mammography after breast conserving-treatment may be slightly less sensitive but is equally specific compared with mammography in the screening situation.
Multiple thoracic haemangiomas—a rare cause of spinal cord compression
Authors: Worthy S A , Gholkar A , Walls T J , TODD N V 
Published: July 2009

Abstract
Benign haemangiomas are a rare cause of mediastinal masses. We present a patient with multiple thoracic wall and mediastinal haemangiomas who developed spinal cord compression as a result of extradural extension of the haemangiomas. This is a rare cause of spinal cord compression.
The use of xenon-133 for measurement of blood flow through systemic arteriovenous malformations before and after therapeutic embolization
Authors: Kennedy A M , Banks L M , MacSweeney J E , Myers M J , Peters A M , Allison D J 
Published: July 2009

Abstract
Embolization is increasingly used to treat systemic arteriovenous (AV) shunts although its success, as judged by either angiographic or clinical means, is difficult to quantify. The aim of the study was to quantify blood flow through AV shunts with 133Xe, which, because of its relatively long transit time through peripheral tissues, behaves like microspheres. Following arterial injection, 133Xe entering an AV shunt rapidly arrives in the lung and can be quantified with a scintillation probe. In 17 patients with systemic AV shunts, the reduction in shunt flow following therapeutic embolization was quantified in the angiography theatre by comparing the initial count rates in the lung, recorded by probe, following injection of identical quantities of 133Xe into a supplying artery before and after embolization. By comparing the lung counts with those given by an intravenous injection of 133Xe, the fraction of flow at the catheter tip entering the shunt was also quantified. Tissue perfusion in the vascular territory distal to the shunt was measured at the same time by recording the clearance of non-shunted 133Xe with a second probe over the extremity. Control injections of 133Xe were given in the contralateral limb in order to assess 133Xe transit in the absence of shunting and to compare tissue perfusion between the two sides. Shunt flow ranged from 40% to 100% (of that at the tip of the catheter) (n = 14), while the reduction in shunt flow following embolization ranged from 15% to 96% (n = 19). Tissue perfusion distal to the shunt and in the contralateral limb was about 5 ml 100ml−1 min−1. Contrast medium had no consistent effect on tissue perfusion in either limb, or on shunt flow. There was no difference in peripheral perfusion between the abnormal and control sides, nor any significant difference in perfusion in the distal tissue on the abnormal side before and after embolization. There was, however, a consistent increase in the fraction of the injected 133Xe delivered to the distal tissue after embolization (median increase 93%, p&lt;0.001). The technique is relatively simple and merits further development as a means of continuous quantification of systemic AV shunt flow in the angiography theatre at the time of embolization.
Relationship between the diuretic effect of radiocontrast media and their ability to increase renal vascular resistance
Authors: Morcos S K , Brown P W G , Oldroyd S , EL Nahas A M , Haylor J 
Published: July 2009

Abstract
The relationship between diuresis and natriuresis induced by radiocontrast media (RCM) and their renal haemodynamic effects were investigated. The effects of the iso-osmolar iotrolan and the hyperosmolar diatrizoate on the renal vascular resistance (RVR) were studied in the filtering and non-filtering variants of the isolated perfused rat kidney (IPRK) preparation. In the non-filtering model, no tubular regulatory process can be activated. The effect of diatrizoate on the RVR of the filtering IPRK in the presence of frusemide (0.3 mmol l−1) an inhibitor of the tubuloglomerular feedback (TGF) was also investigated. There was no significant difference (p&gt;0.05) in the response of the filtering (n = 6) and non-filtering (n = 6) IPRK to iotrolan. The induced reduction in the renal perfusate flow (RPF) by iotrolan was 20.5 ± 3.05% and 22.9 ± 3.03%, respectively. The reduction in the RPF which was observed with diatrizoate in the non-filtering IPRK (n = 5,17.5 ± 3.04%) was significantly less (p&lt;0.05) in comparison to that of the filtering IPRK (n = 6,26.9 ± 4.28%). In the frusemide experiments, a reduction in the RPF comparable to that of the non-filtering kidney was observed (n = 5, 13.7 ± 4.34%). This study demonstrates that the renal vascular effect of diatrizoate is partially dependent on the TGF response. No tubular regulatory mechanism was accountable for the haemodynamic effect of iotrolan. The activation of the tubular response is osmolarity dependent.
Explaining variation in radiologists' reporting times
Authors: Bryan S , Weatherburn G , Roddie M , Keen J , Muris N , Buxton M J 
Published: July 2009

Abstract
This paper describes an investigation into the reasons for variation in the time taken by senior radiologists to complete radiological reports. An observational study of the reporting process at one UK hospital was undertaken for a 25 day period. An independent health service researcher observed the radiology reporting process and collected data on a variety of factors including the time taken to produce the report, the number and nature of all images viewed, the experience of the radiologist, and the number of disturbances that occurred. The nature of the variation in reporting time was explored using both simple comparative statistics and more sophisticated multiple regression techniques. Data were collected on 2345 report observations and the median report time was 117 s. This research provides the first empirical evidence for systematic variation in reporting time. The results confirm the importance of certain factors that were expected to explain report time variation. For example, the results indicate that report time tended to be significantly shorter in reporting sessions that were busy, and significantly longer when the radiologist was disturbed during the reporting process or was training juniors during a reporting session. More surprising were the results indicating that there was no significant difference in report time for reports categorized as urgent or “hot” and those categorized as less urgent or “cold”, and that report time appeared to vary systematically depending on the day of the week and on the time of day.
Femoral angiography using the reverse shuffle technique
Authors: Oxtoby J W , Yeong C C , Singanayagam J , West D J , Rees M R 
Published: July 2009

Abstract
We report our findings using the “reverse shuffle” technique of stepping table femoral angiography. This technique represents a simple modification of the conventional stepping table sequence entailing a reverse table movement allowing acquisition of early and late films in the distal positions. It was developed in order to minimize the number of runs required in each examination. In a retrospective study 52/53 (98%) of angiograms using the reverse shuffle technique required only a single run compared with 30/51 (58%) using the conventional technique. We believe that the reverse shuffle should be used where possible when stepping table angiography is performed. Furthermore, the incorporation of a reverse table movement may also be advantageous in angiography using automated digital subtraction angiography (DSA) stepping systems.
Evaluation of palpable breast masses with 201TI scintigraphy
Authors: Rebollo A C , Torres-Avisbal M , Espinosa J E , Diaz C , Vallejo J A , Pacheco C , Pera C , Mateo A 
Published: July 2009

Abstract
39 female patients (age range: 31–84 years) with palpable breast masses detected by physical examination, underwent 201Tl scintigraphy in order to assess its value in the detection of breast carcinomas and to differentiate them from benign breast masses. Planar images were carried out at 20–30 min and 2–3 h after intravenous administration of 111–185 MBq (3–5 mCi) of201Tl chloride. In 12 patients single photon emission tomography (SPET) studies were also performed. In 18 patients the scintigraphic studies were positive and in 17 of these cases, breast carcinomas were confirmed. Tumour sizes ranged from 1.3 to 6 cm in diameter. In the remaining patient a false positive result was obtained where there was benign breast change. In three of seven cases, malignant axillary nodes were also detected. All 21 patients with negative scintigraphy had benign breast lesions. There were no differences between images obtained at 20–30 min and 2–3 h or between planar images and SPET studies. In 10 patients there was disagreement between mammography and 201Tl scans. 201Tl scans confirmed the presence of carcinoma in three cases and discarded malignancy in the other six cases. In the remaining case, 201Tl scan was false positive. 201Tl scintigraphy is useful in distinguishing malignant from benign breast masses, even when compared with mammography.
Validation of 99Tcm-HMPAO leucocyte scintigraphy in ulcerative colitis by comparison with histology
Authors: Middleton S J , Li D , Wharton S , Reynolds P D , Wraight E P , Hunter J O 
Published: July 2009

Abstract
Leucocyte scintigraphy offers an alternative to more invasive techniques in the investigation of inflammatory bowel disease. The accuracy of 99Tcm-HMPAO leucocyte scintigraphy has not been assessed by comparison with colonic histology, which was the aim of this study. 15 patients with ulcerative colitis underwent 99Tcm-HMPAO leucocyte scintigraphy (TLS) less than 5 days before colonoscopy. Histological features of mucosal biopsies were compared with total and segmental colonic TLS scores. Segmental and total scintigraphy scores correlated most strongly with histological grades for acute inflammation (r = 0.75, p &lt; 0.001 and r = 0.9, p &lt; 0.001, respectively) and chronic inflammatory cell infiltration in the lamina propria (r = 0.76, p &lt; 0.001 and r = 0.86, p &lt; 0.001, respectively). 99Tcm-HMPAO leucocyte scintigraphy detected acute inflammation in the colon of patients with ulcerative colitis with a sensitivity of 91% and negative predictive value of 80% and localized acute inflammation to a particular colonic segment with a sensitivity of 82%, specificity of 94%, accuracy of 88%, positive predictive value of 94% and negative predictive value of 91%. 99Tcm-HMPAO leucocyte scintigraphy positivity predicts and localizes colonic acute inflammation with a high degree of confidence, but negative scintigraphy does not exclude acute inflammation.
Malignant fibrous histiocytoma following radiation therapy of fibrous dysplasia
Authors: Amin R , Ling R 
Published: July 2009

Abstract
Malignant fibrous histiocytoma commonly occurs spontaneously. In some cases it follows previous therapeutic or incidental irradiation, or miscellaneous pre-existing osseous conditions. Recently, it has been associated with total hip arthroplasty. We report a case of malignant fibrous histiocytoma following radiation therapy of fibrous dysplasia and review the relevant literature.
Late aggressive meningioma following prophylactic cranial irradiation for acute lymphoblastic leukaemia
Authors: Stein M E , Drumea K , Guilbord J N , Ben-Itzhak O , Kuten A 
Published: July 2009

Abstract
The clinical, radiological and pathological findings in a 28-year-old female patient who developed aggressive meningioma 20 years after prophylatic cranial irradiation (PCI) for acute lymphoblastic leukaemia (ALL) are described here. Only four cases of late atypical/aggressive meningioma following PCI were detected in a thorough search of the literature. The high cure rate in childhood ALL, attributable to aggressive chemotherapy and PCI, is capable of inducing secondary brain tumour, including aggressive meningioma.