bluuebunny/crossref_metadata_2025_split huggingface dataset:
Imaging patterns in melioidosis
Authors: Tan APA , Pui MH , Tan LKA 
Published: March 2008

SUMMARYMelioidosis is an infectious disease caused by Pseudomonas pseudomallei. It is seldom diagnosed promptly and, if untreated, can lead to an 80–100% mortality rate. Twenty‐eight patients with melioidosis were identified over a 6 year period, and their imaging patterns were analysed. Respiratory infections were the commonest form of presentation, frequently shown as diffuse airspace consolidation, and accounted for the highest mortality. Visceral and musculoskeletal infections were associated with chronicity and a high relapse rate. Multifocal splenic abscesses were a common occurence. Septic arthritis of the knee was frequently seen. The majority of patients had diabetes mellitus and chronic ill‐health. An increased awareness of the disease can contribute to its early detection and appropriate treatment.
Hepatic focal nodular hyperplasia: Colour Doppler ultrasound can be diagnostic
Authors: Stephenson NJH , Gibson RN 
Published: March 2008

SUMMARYFocal nodular hyperplasia (FNH) is a rare, benign, hepatic mass lesion that is usually found in young adult females. It is sometimes an incidental finding on abdominal sonography or computed tomography. Its appearance on these studies is not characteristic however, thereby creating a diagnostic problem.1 This report is of a case which showed a centrifugal, spokewheel pattern of pulsatile blood supply on colour Doppler US. This finding, we suggest, is sufficiently diagnostic to avoid the need for further investigation in some patients, and to direct further imaging more appropriately in others.
Haematopoietic marrow hyperplasia simulating transarticular skip metastasis in osteosarcoma
Authors: Pui MH , Tan MH , Kuan JHY , Pho RWH 
Published: March 2008

SUMMARYA case is presented of osteosarcoma with haematopoietic marrow hyperplasia simulating transarticular skip metastasis on computed tomography and magnetic resonance imaging.
Duodenal haemorrhage resulting from renal cell carcinoma metastases
Authors: Black JAR , Mendelson RM 
Published: March 2008

SUMMARYA case of duodenal haemorrhage resulting from renal cell carcinoma metastases is presented. This is an uncommon method of presentation and is often difficult to diagnose requiring multiple imaging regimes. This case demonstrates the problems that may be encountered in identifying the source of bleeding.
Use of a Strecker oesophageal stent in the treatment of benign oesophageal stricture
Authors: Foster DR 
Published: March 2008

SUMMARYThe use of self‐expanding prostheses in the management of malignant oesophageal strictures has become well established. The majority of benign peptic oesophageal strictures can be successfully managed using endoscopic or fluoroscopically guided balloon oesophageal dilatation combined with long‐term drug therapy, particularly using proton pumper inhibitors. Although endoscopic oesophageal dilatation can be performed on an outpatient basis, it requires repeated hospital visits. There is a small risk of oesophageal perforation whilst cardio‐respiratory complications may be encountered during the use of intravenous sedation in an elderly population. The use of a self‐expanding Strecker stent in a 98 year old woman with a benign oesophageal stricture is described.
Distinguishing between cystic teratomas and endometriomas of the ovary using chemical shift gradient echo magnetic resonance imaging
Authors: Ishijima Hideyuki , Ishizaka Hiroshi , Inoue Tomio 
Published: March 2008

SUMMARYThe purpose of this study was to evaluate the efficacy of chemical shift gradient echo magnetic resonance imaging (MRI) in distinguishing between cystic teratomas and endometriomas of the ovary, using a 1.5T magnet. The study included 22 patients with 31 ovarian lesions (15 cystic teratomas and 16 endometriomas), which showed high signal intensity on T1‐weighted spin echo images. Chemical shift gradient echo images with three different echo times (TE = 2.5, 4.5 and 6.5 ms) were obtained in all cases. Indices were calculated on the basis of the signal intensities of lesions on the chemical shift gradient echo images. All endometriomas had signal intensity indices of less than 2.1, while all cystic teratomas had signal intensity indices of 18.1 or greater. Chemical shift gradient echo imaging is an alternative method that is useful and simple for distinguishing between cystic teratomas and endometriomas of the ovary.
Ultrasound of malignant breast microcalcifications: Role in evaluation and guided procedures
Authors: Rickard Mary T 
Published: March 2008

SUMMARYUltrasound examination will not always identify the malignant calcifications of ductal carcinoma in situ. However, the potential benefits of ultrasound examination of suspicious breast microcalcifications lie first in identifying a mass lesion associated with the calcifications and second in guiding fine needle cytology, core biopsy and hookwire localization. Because of these benefits it is recommended that ultrasound examination be performed as part of the evaluation of mammographic microcalcifications which are considered suspicious or diagnostic of malignancy.
Clinical audit in radiation oncology: Results from one centre
Authors: FRACR G Stevens , PhD. I Firth 
Published: March 2008

SUMMARYThis study aims to determine workload statistics and to document patterns of fractionation in a single centre in two time periods separated by 4 years. Patient, tumour and treatment‐related data were collected for courses of radiation treatment that were commenced within two 6‐month periods in both 1988 and 1993. In both time periods, 45–49% of patients were treated with curative intent. Of these, one‐third were irradiated definitively and two‐thirds in an adjuvant setting. Most of the remainder were treated with palliative intent. A few were treated for non‐neoplastic conditions. The re‐treatment rate in 1993 was 13%. In both time periods, breast and lung tumours represented approximately 20% each of the total treatment courses. Skin, head and neck, gynaecological, urological and haematological primary tumours accounted for 5–10% each. Treatment intents differed markedly for different primary sites. For example, in 1993 65% of patients with breast primaries were treated curatively compared with 6% of patients with lung primaries. Treatment schedules for curative intent were similar in both time periods and for the majority of treatment sites. Median fraction numbers were 25 (excluding skin primaries), reflecting conventional daily fractionation. Treatment schedules for palliation showed greater variation and there was a trend towards shorter treatment courses in 1993. For palliative treatment of bone, brain and lung, from either primary or metastatic disease, treatment schedules with 10–15 fractions were used most frequently in 1988. In 1993, however, the majority of patients received 1–5 fractions. In 1993, the breakdown of techniques according to treatment intent showed that for treatment with curative intent, single, parallel opposed and more complex field arrangements were used in 27% (includes skin primaries), 12% and 61% of treatment courses, respectively, compared with 29%, 59% and 12%, respectively, for palliative treatment courses. In 1993, one‐third of patients receiving radiation treatment lived in the local health area. Patients living in areas with rural postcodes were more likely to receive palliative irradiation and had a higher incidence of melanoma than patients living in areas with Sydney metropolitan postcodes. As approximately 50% of patients were treated with palliative intent, changes in the fractionation patterns used can alter significantly the utilization and availability of megavoltage equipment. However, any reduction in attendances caused by hypofractionation for palliation may be offset by the trend to use hyperfractionation for curative treatments. The data support the hypothesis of reduced availability and use of radiation therapy in patients with cancer from rural areas.
Necrotizing fasciitis: Fatal complication of migrated biliary stent
Authors: JWP Marsman MD, PhD  , Hoedemaker HPNW 
Published: March 2008

SUMMARYThe major drawbacks of biliary stents are occlusion and migration. Most distally migrated stents pass spontaneously. In the presented case, however, the migrated stent perforated the sigmoid colon and led to necrotizing fasciitis.
Giant growth‐hormone secreting pituitary tumour with extracranial extension
Authors: Ip Tai Pang , Chan Fu Luk , Chee Kung Annie Wai , Lam Karen Siu Ling 
Published: March 2008

SUMMARYA 19 year old female patient with typical features of acromegaly was found to have an extensive pituitary tumour with suprasellar, lateral and inferior extensions. Magnetic resonance imaging (MRI) also showed a portion of the tumour extending from the right cavernous sinus through the foramen ovale to become extracranial. Serum growth hormone (GH) was 52.6 mU/L basally and remained elevated after oral glucose, confirming the diagnosis of acromegaly. Treatment with the long‐acting somatostatin analogue, octreotide, for 6 months led to a 30% reduction in tumour volume of the intracranial portion but no effect on the extracranial and sphenoidal extensions. She was subsequently treated with trans‐sphenoidal surgery followed by external irradiation. The possibility of perineural spread of the tumour was considered.
Atlanto‐axial rotatory fixation: Improved demonstration using spiral CT
Authors: Cowan IA , Inglis GS 
Published: March 2008

SUMMARYAtlanto‐axial rotatory fixation (AARF) is an uncommon condition which is often missed at presentation because of its rarity and the relative subtlety of plain film X‐ray findings, but early detection and appropriate management are vital for a cure. We describe three cases in which the use of spiral computed tomography scanning with 3D and sagittal reconstructions greatly aided diagnosis and management. The 3D images gave a more graphic picture of the overall alignment of the upper cervical spine and the skull base, while the sagittal reconstructions demonstrated the presence or absence of compensatory atlanto‐occipital subluxation. The literature is briefly reviewed.
Low dose rate teletherapy: Updated tumour response
Authors: Denham JW , Hamilton CS , Simpson SA , O'Brien M 
Published: March 2008

SUMMARYThis report presents an update of tumour response experience in patients with locally advanced head and neck cancer treated on the low dose rate teletherapy project at the Mater Misericordiae Hospital, Newcastle.Long‐term progression‐free survival figures are disappointing in all dose rate/total dose groupings and offer little encouragement that an improvement in therapeutic ratio can be achieved for head and neck cancer patients using teletherapy apparatus adjusted to treat at low and intermediate dose rates.
Mesenteric plexiform neurofibroma: Computed tomography appearance
Authors: Jain Rajeev , Sawhney Sukhpal , Berry Manorama 
Published: March 2008

SUMMARYGastrointestinal involvement in von Recklinghausen's disease is usually in the form of neurofibromas and leiomyomas. Very rarely, plexiform neurofibromas may be seen involving the bowel wall and myenteric plexus with secondary minor involvement of the mesentery. This report describes the computed tomography morphology of a plexiform neurofibroma extensively involving the mesentery with minor involvement of the bowel wall.
Ultrasound appearance of pseudomembranous colitis
Authors: Thomas SM , Howlett DC , Hearn FJ 
Published: March 2008

SUMMARYA case illustrating that ultrasound can be useful in the diagnosis of pseudomembranous colitis is reported. Diagnosis of pseudomembranous colitis is usually made from microbiological or histopathological investigations. The ultrasound appearance of grossly thickened bowel wall with luminal narrowing is non‐specific, but in the correct clinical context should suggest the diagnosis of pseudomembranous colitis.
Liposarcoma of the hypopharynx
Authors: Wambeek NDK , Mendelson RM 
Published: March 2008

SUMMARYA case of the unusual condition of liposarcoma of the hypopharynx extending submucosally down the oesophagus in a 64 year old male is reviewed. The clinical, radiological and pathological features are presented and the role of various radiological modalities is discussed.
Extraskeletal Ewing's sarcoma presenting with pulmonary embolism
Authors: Chang Sew Kee , Wang Tiak Lim , Teh Ming 
Published: March 2008

SUMMARYSmall round cell tumours with the morphologic characteristics of Ewing's sarcoma arise rarely in soft tissues of the extremities, retroperitoneum, chest and orbit. Patients usually present with symptoms arising from the swelling at the primary site. We report on a patient with a retroperitoneal extraskeletal Ewing's sarcoma who presented with massive tumour embolism to the pulmonary vasculature. To our knowledge, this is the first report of extraskeletal Ewing's sarcoma presenting with pulmonary tumour embolism.
Central neurocytoma occurring in the thalamus: CT and MRI findings
Authors: FRACR. Ying‐Kei Cheung 
Published: March 2008

SUMMARYA case of central neurocytoma occurring in the thalamus, confirmed by electron microscopy and immunohistochemistry, is reported. Computed tomography demonstrated a hypodense mass with an irregular margin arising from the right thalamus, extending into the lateral ventricle and crossing the midline. It contained areas of calcification and showed slight enhancement after contrast injection. On magnetic resonance imaging (MRI) scan, the tumour was hypointense to the brain in T1‐weighted images and was heterogeneously hyperintense to the brain in T2‐weighted images.
Primary bone lymphoma (osteolymphoma)
Authors: Christie David RH , Cahill Stephen P , Barton Michael B 
Published: March 2008

SUMMARYSeventeen patients with primary lymphoma of bone are reviewed. In 15 patients treated with radical radiotherapy, local progression or recurrence occurred in four. The results support the use of radiotherapy alone, using doses of 45‐50 Gy. Although small numbers prevent firm conclusions, the inclusion of the whole bone or regional nodes in the irradiated volume did not appear to improve results. Eight patients received systemic chemotherapy with no apparent improvement in rates of relapse. Two patients suffered pathological fractures after radiotherapy in the absence of recurrence at the fracture site; however, osteomyelitis, older age, Paget's disease, high‐dose prednisolone and whole‐bone radiotherapy may have added to the risk of fracture. Because of the many complex names and selection criteria applied to this condition, literature searching and comparison between studies was difficult. The simple term osteolymphoma is proposed, consistent with other primary bone conditions.
Arterial complications of pancreatitis and their radiological management
Authors: Sawlani V , Phadke RV , Baijal SS , Kumar S , Roy S , Gupta P , Gujral RB 
Published: March 2008

SUMMARYArterial haemorrhage from pseudoaneurysm in pancreatitis patients is a formidable complication with a high mortality rate. We encountered six patients in whom a pseudoaneurysm was demonstrated at angiography. Drainage of associated pseudocyst facilitated visualization in one patient. Four patients had pseudoaneurysms arising from the proximal part of the major peripancreatic vessels and were treated by steel coil embolization (n= 3) and surgically (n= 1). There was no episode of rebleeding in these patients during a follow‐up period of 10–18 months. Of the two patients with distal small peripancreatic branch vessel involvement hydrogel particle and gelfoam embolization was successful only temporarily in one patient and unsuccessful in the other patient. The literature is reviewed and the efficacy of steel coil embolization is emphasized.
Breast MRI: Early experience with a 3‐D fat‐suppressed Gradient Echo Sequence in the evaluation of breast lesions
Authors: Holden A , Anderson JEM , Ives FJ , Taylor D , FRACR EJ Wylie , Adamson R 
Published: March 2008

SUMMARYThe early clinical experience with a 3‐Dimensional Fourier Transform Gradient Echo sequence with fat suppression in the evaluation of breast masses is reported. Ten female patients with breast malignancies were pre‐operatively evaluated with this sequence and the results compared with the pathological specimens. The scanning protocol included a noncontrast sequence followed by an immediate post‐contrast sequence (completed 4.5 min after intravenous contrast injection) and a delayed sequence. Images were assessed for maximum lesion and parenchymal enhancement, lesion size and additional enhancing abnormalities. In six patients, malignant masses enhanced maximally on the immediate post‐contrast sequence with parenchyma enhancing maximally on delayed images. In three cases, there was preferential enhancement of malignant lesions over normal parenchyma but to a similar degree on both post‐contrast sequences. In one case, both the lesion and parenchyma enhanced maximally on the delayed sequence. Magnetic resonance assessed lesion size accurately and also detected satellite malignancies in one case. However, lesion grade, associated in situ carcinoma and lymphovascular invasion did not impact on lesion enhancement. In this small series, a contrast‐enhanced, fat‐suppressed 3‐D Gradient Echo Sequence detected breast carcinoma with high sensitivity. The technique holds promise but further evaluation is required.
Paediatric tracheobronchomalacia and its assessment by tracheobronchography
Authors: Little AF , Phelan EM , Boldt DW , Brown TCK 
Published: March 2008

SUMMARYTracheobronchomalacia (TBM) is a rare condition that results in abnormal compliance of the airways with airway collapse being most marked in expiration. In a series of 28 patients, it was observed that a majority of cases presented with malacia involving the trachea (64%) and the left main bronchus (64%) alone. The right main bronchus was involved in combination with the trachea in 32%, but rarely was involved by itself. Most patients demonstrated associated congenital abnormalities, such as tracheo‐oesophageal fistulae, vascular rings or congenital heart disease (78%). A small proportion were premature infants with no obvious associated abnormality (11%). Evaluation of the dynamic process, tracheobronchomalacia, requires ‘real‐timeinvestigation ‘. While computed tomography (CT) and magnetic resonance imaging (MRI) have their role in the management of chronic airway obstruction in the child, only cine‐CT, bronchoscopy, fluoroscopy and tracheobronchography provide real‐time assessment for the evaluation of a dynamic process such as TBM. In our experience, tracheobronchography provides excellent anatomic, physiologic and therapeutic information in the assessment of those infants with primary or secondary TBM. By using continuous positive airway pressure in incremental doses, the amount of positive pressure required to maintain an open airway in expiration is a valuable adjunct to the clinical management of the patient. When careful attention is paid to technique, tracheobronchography is a safe investigation in experienced hands.
Cranial cystic epidermoid: Report of two cases and review of the literature
Authors: Gupta VK , Khandelwal N , Gupta SK , Ramzan AU , Kak VK 
Published: March 2008

SUMMARYIntercranial epidermoid tumours are benign lesions of congenital origin that are potentially curable. Although computerized axial tomography (CT) and magnetic resonance imaging (MRI) are usually diagnostic, a few atypical features sometimes make pre‐operative diagnosis difficult. Two cases of cystic epidermoids with peripheral ring enhancement are reported. Relevant literature has been reviewed.
Two cases of chronic recurrent multifocal osteomyelitis: Radiological and scintigraphic findings
Authors: Tan BS , Nayanar V , Mansberg R , Murray IPC , Rossleigh MA 
Published: March 2008

SUMMARYChronic recurrent multifocal osteomyelitis (CRMO) is an extremely rare condition, of uncertain aetiology. Since first described, in 1972, under 100 cases have been reported. It is being reported with increasing frequency, and many cases of this disease go unreported. It most commonly affects patients in childhood or adolescence. No infective agent has been identified, and antibioticis do not affect the course of the disease. We present the cases of two female children with this disorder, describe the radiological and scintigraphic findings and review the literature. Case 1 is the first reported case to our knowledge of CRMO presenting with cranial nerve palsies.
Intramural aortic dissection
Authors: Wambeek NDK , Cameron DC , Holden A 
Published: March 2008

SUMMARYWe present 10 cases of intramural aortic dissection. The cases are all characterized by the presence of intramural haematoma without the presence of a patent false lumen. The radiological features and possible aetiologies are discussed. The key radiological finding is the presence of a hyperdense rim in the aortic wall on a non‐contrast‐enhanced computed tomography (CT) scan. In one case, a delayed diagnosis was made using magnetic resonance imaging (MRI). In a further case, the delayed development of a large aortic ulcer was demonstrated. Intramural aortic dissection has only recently been described in the radiological literature. The aetiology of this condition remains controversial. The imaging findings may be subtle and the diagnosis is still frequently being overlooked. We believe CT to be the primary diagnostic test for this condition, and its advantages over MRI and transoesophageal echocardiography (TOE) are discussed.
Concomitant presentation and resolution of a post‐traumatic pneumothorax and pneumopericardium
Authors: Gelderen WFC , Al‐Hindawi M , Archibald FFRad CG 
Published: March 2008

SUMMARYThe association of a right pneumothorax and a pneumopericardium due to non‐penetrating trauma is exceedingly unusual. A patient with both complications presented 7 hours after a motorcycle accident. These were detected incidentally on a scout film for CT for lumbar fractures and both resolved entirely and simultaneously after chest tube insertion in the right pleural space.
Ultrasonographic study of 793 foetuses: Measurement of normal foetal kidney lengths in Bangladesh
Authors: Ansari Selim M , Saha Madhusudan , Paul Ashoke K , Mia Sayedur Rahman , Sohel Abu , Karim Rezaul 
Published: March 2008

SUMMARYIt is well known that, structurally, the people of Asia are shorter than Europeans. The size of different organs of the foetus may also vary accordingly. To assess this, 793 foetuses between 16 and 40 weeks’gestation were studied and 1175 kidneys were measured on ultrasonograms. Only normal pregnancies were included in the study. Our results show that, in the main, the mean length of foetal kidneys in the present study is either slightly higher or similar to that previously reported by many authors. In this study, the average kidney length at full term is 3.95 cm. An excellent correlation was seen between gestational age, biparietal diameter, femoral length and renal length measurement.
A penile clamp for retrograde urethrography using external compression by a balloon catheter
Authors: Houghton‐Allen B 
Published: March 2008

SUMMARYA penile clamp for retrograde urethrography is described. The seal around the fine‐bore catheter that injects the contrast is produced by external compression of the penis by the air‐filled balloon of a large Foley catheter that acts against counter‐pressure from an encircling bandage.