bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnetic resonance angiography. I. Basic principles
Authors: TRESS BRIAN M , FRACR PATRICIA M DESMOND 
Published: March 2008

SUMMARY The objective of this paper is to describe the basic physical principles important in magnetic resonance angiography (MRA). The data used were obtained from recent articles on MRA retrieved from Index Medicus 1985–92 and direct experience working with prototype MRA sequences. The information is presented in a manner suitable for those unfamiliar with the principles of MRA and magnetic resonance imaging (MRI). Magnetic resonance angiography is an important method that can be used to obtain angiograms without the injection of intravascular contrast medium. It is already proving to be of clinical use in the assessment of vascular disease.
The value of routine computed tomography scanning of the chest in patients presenting with supradiaphragmatic Hodgkin's disease
Authors: BORG M F , BENJAMIN C S , CHILDS W J 
Published: March 2008

SUMMARY Six patients presenting with supradiaphragmatic Hodgkin's disease are presented to demonstrate the potential benefits of chest computed tomography (CT) scanning as a routine staging procedure. These cases show that CT scanning can detect mediastinal and lung involvement not readily detected by other investigations, and that such findings can influence the radiotherapy plan, the need for extended radiotherapy fields or the use of chemotherapy. Following treatment, CT scanning can be useful to assess treatment response and may permit earlier detection of relapse. The use of chest CT scanning as a routine staging procedure in all patients with supradiaphragmatic Hodgkin's disease is advocated.
The juxtaphrenic peak (Katten's sign) is produced by rotation of an inferior accessory fissure
Authors: CAMERON D C 
Published: March 2008

SUMMARYTenting of the diaphragm (Katten's sign) is a common finding in upper lobe collapse or where there is loss of volume. Twenty‐nine patients have been studied, 12 of these prospectively following upper lobectomy. Division of the inferior pulmonary ligament was carried out in these 12 patients. The computed tomography findings confirm that this sign is due to an accessory oblique fissure.
Decision making in diagnostic radiology
Authors: SCALLY PETER M 
Published: March 2008

SUMMARY Radiology can be more interesting if the principles of decision making are understood and used to the advantage of the radiologist, referring clinician and patient. This article seeks to revise the principles that radiologists use intuitively. Particular emphasis is placed on the importance of the pre‐test probability, as it can be shown to: (i) vary with the referral pool of patients; (ii) be a major determinant of the amount of additional information gained from the test; (iii) alter the sensitivity and specificity of the test; and (iv) determine largely the significance of a positive or negative test result. An investigation helps a clinician by providing information that will move the probability of disease above an action threshold or below its exclusion threshold. If this does not occur as a result of one study, another is selected. This article also describes the factors involved in such a decision tree analysis, as well as discussing the reasons for both selecting a particular examination and deciding when a test should not be performed.
Craniopharyngioma and the moustache sign
Authors: KEARNEY DERMOT , TAY‐KEARNEY MEI‐LING , KHANGURE MARK S 
Published: March 2008

SUMMARY Craniopharyngiomas are common suprasellar tumours but these are rarely associated with vasogenic oedema. Because the oedema extends into the optic tracts and optic radiations, a characteristic pattern is produced that resembles a moustache. The oedema is thought to be due to leakage of craniopharyngioma contents. Such a case is presented in this communication.
Duplex sonography in detection of renal artery stenosis: A simplified approach using new parameters
Authors: IOANNOU G , THORPE R J , MacKechnie S G , HOBBS J M , WILLIAMS K M 
Published: March 2008

SUMMARY A case report illustrating a new investigation for detecting renal artery stenosis (RAS) is reported. Colour Doppler ultrasound evaluation of the readily accessible intrarenal arteries is a fast and accurate technique. Acceleration time and acceleration are the Doppler parameters used for measuring systolic upstroke on the waveforms obtained. Prolonged acceleration time (>0.07s) and diminished acceleration (< 3m/s2) indicate haemodynamically significant stenosis. Intrarenal Doppler ultrasound should provide a safe noninvasive screening examination for the detection of RAS.
Cryptogenic organizing pneumonia with atypical histopathological features
Authors: JONES D N , HENDERSON D W , MORTON S , SAGE M R 
Published: March 2008

SUMMARY A case report of cryptogenic organizing pneumonia (COP); also known as bronchiolitis obliterans organizing pneumonia (BOOP) is presented. The histopathologic findings of COP are well documented in the literature and typically consist of organizing pneumonia of uniform appearance. This case report describes, in addition to the classic findings, more acute exudative inflammation not usually associated with this condition. Variation in the evolution of the pneumonic process is one of the reasons for reporting this case. The promotion of awareness of this treatable condition is the other reason for reporting this case. When multifocal areas of consolidation are demonstrated radiologically, particularly when peripheral and basal, and in the correct clinical setting, the possibility of COP should be entertained. This condition responds dramatically to steroid therapy, and has a good prognosis.
Pointers to the diagnosis of gastric lymphoma on computed tomography
Authors: DOYLE T C A , DIXON A K 
Published: March 2008

SUMMARYThe computed tomographic features of 12 patients with primary gastric non‐Hodgkin's lymphoma and a further seven patients with gastric involvement by disseminated non‐Hodgkin's lymphoma have been reviewed. In eight of these 19 patients there were clefts within the area of gastric wall involved by lymphoma where oral contrast medium passed to within 2 mm of the serosal surface in and amongst areas of gastric wall thickening (maximal thickness ranging from 18 to 40 mm). In three of these patients some clefts extended beyond the expected margin of the stomach to enter into, and be contained by, a composite soft tissue mass of stomach, spleen and splenic hilar nodes. Awareness of these features, which are in keeping with the known range of macroscopic pathological appearances in non‐Hodkin's lymphoma, may help the radiologist to recognize this potentially curable disease.
Post‐orchidectomy radiation therapy for patients with stage I seminoma of the testis
Authors: KEARSLEY JOHN H , TRIPCONY LEE 
Published: March 2008

SUMMARYThe outcome of radiotherapy in patients with stage I testicular seminoma was evaluated. During the period 1960–89 (inclusive) 270 patients with stage I seminoma of the testis received radiotherapy to the para‐aortic nodes and ipsilateral hemipelvis following radical orchidectomy. Two hundred and fifty seven patients (95.2%) received a minimum tumour dose of 30Gy in 20 daily fractions using 4–6 MV photons. The 5 year overall and recurrence‐free survival rates were 97 and 95%, respectively. Only eight of the 270 patients relapsed and three were cured with ‘salvage’therapies. Of the 11 patients who died, four deaths (36%) were the result of uncontrolled testicular cancer, six (55%) intercurrent illness and one (9%) the result of attempted salvage. Patients staged and treated prior to 1979 had a significantly worse disease‐free survival compared to patients treated during and after 1979. As side effects were negligible, it was concluded that radiotherapy for stage I seminoma provides excellent cure rates. The difficulties arranging a ‘surveillance’programme in so large a State as Queensland are discussed.
Loss of the mucosal lining/gall‐bladder wall echo: a sonographic sign of gangrenous cholecystitis
Authors: MOK P M , HARKNESS M A , HAYWARD G K 
Published: March 2008

SUMMARYAn additional sonographic sign of gangrenous cholecystitis, namely the loss of the mucosal/gall‐bladder wall echo in a setting of acute cholecystitis, is described. It was found prospectively in six patients and correlated well with the presence of mucosal/wall necrosis on histological gall‐bladder specimens. Other reported signs of gangrenous cholecystitis are reviewed.
Unifocal Langerhans’cell histiocytosis (eosinophilic granuloma) resembling Ewing's sarcoma
Authors: BISWAL B M , LAL P , UPPAL R , MALLIK S 
Published: March 2008

SUMMARYIn a 9 year old boy, a destructive lesion in the diaphysis of the right femur was wrongly diagnosed as a Ewing's sarcoma on the basis of the radiologic findings and fine needle aspiration cytology report. The clinical and radiologic picture was suggestive of Ewing's sarcoma, but an open biopsy of the lesion revealed a histopathological picture of eosinophilic granuloma. A brief review of the literature is given, together with discussion on the differential diagnosis of a mid shaft femoral lesion in young patients.
After‐hours radiology
Authors: WONG D C , SIDDLE K J 
Published: March 2008

SUMMARYAfter‐hours radiological procedures are essential but expensive in any major teaching hospital. Using the criteria that radiological procedures performed after‐hours should have a reasonable probability of influencing or changing patient management acutely, a study of the justification of after‐hours radiological procedures was performed at the Princess Alexandra Hospital. Computer print‐outs were used to select the patients based on the dates and times of the procedures. Their charts were then reviewed. The study found that most after‐hours radiological procedures were justified. However, it also identified certain procedures that need not be performed or at least could be reduced after‐hours. The procedures were: (i) computed tomography (CT) head – epilepsy, meningitis; (ii) CT abdomen – trauma (intubated) – unable to examine abdomen; (iii) CT spine – obvious unstable fractures; (iv) Ultrasound abdomen – biliary colic (afebrile); and (v) Ultrasound kidneys – renal failure (afebrile).
Magnetic resonance imaging and computed tomography features of nasopharyngeal carcinoma with maxillary sinus involvement
Authors: Chong VFH , Fan YF , Toh KH , Khoo JBH , Lim TA 
Published: March 2008

SUMMARYAnterior spread of nasopharyngeal carcinoma (NPC) may infiltrate the maxillary sinus. In a prospective study of 114 patients comparing magnetic resonance imaging (MRI) and computed tomography (CT) in the staging of NPC, 10 (9%) patients were noted to have tumour infiltration of the maxillary sinuses. All of the patients except one had associated infiltration of the sphenoidal sinuses indicating advanced local spread. Computed tomography was excellent in outlining the extent of bony erosion and associated soft tissue mass within the antra. T1‐weighted images could not demonstrate bony erosions directly although soft tissue extension into the sinuses could be clearly visualized. Both CT and MRI showed good demarcation between tumour and mucosal thickening within the maxillary sinus. Although MRI demonstrated soft tissue involvement more elegantly than CT, it did not appear to offer significantly more information that may affect clinical management.
MAG3 renal scintigraphy: Improved ability to make anatomical diagnoses in neonates
Authors: Rossleigh MA , Farnsworth RH , Kainer G , Rosenberg AR 
Published: March 2008

SUMMARYTechnetium‐99m mercaptoacetyltriglycine(MAG3) is the most recently introduced renal radiopharmaceutical in Australia and is established as the agent of choice for use in diuresis renography, particularly in neonates and infants. It provides superior anatomical information compared to previously used agents. Three cases are reported in which MAG3 diuresis renography was performed in neonates, who were found to have hydronephrosis detected antenatally. In two neonates, a previously unrecognized horseshoe kidney was demonstrated and in case 3 there were scan features characteristic of a ureterocele. It is highly unlikely that these abnormalities would have been delineated with 99mTc dimethyltriamine penta‐acetic acid (DTPA) study, as confirmed in case 1, because of the relatively poor uptake of DTPA when compared to MAG3.
Is phenytoin contraindicated in patients receiving cranial irradiation ?
Authors: Borg MF , Probert JC , Zwi LJ 
Published: March 2008

SUMMARYThree recent publications have reported the development of erythema multiforme and Stevens‐Johnson syndrome in patients receiving cranial irradiation and sodium phenytoin. Some authors have recommended that patients receiving whole brain radiation therapy and who have had seizures should not be prescribed phenytoin but an alternative anticonvulsant. This article reviews the current literature pertaining to the development of this potentially lethal complication in patients receiving whole brain radiation and phenytoin, with reference to the single recorded case of Stevens‐Johnson syndrome in a patient receiving cranial irradiation and phenytoin in Auckland, New Zealand. While the clinical picture in the 16 patients reported in the literature and the current case report differed from the classical form of erythema multiforme, a similar pattern of presentation and outcome appeared in all patients reviewed, suggesting that the combination of phenytoin, cranial irradiation and the gradual reduction of concomitant steroids seem to lead to the development of erythema multiforme and/or Stevens‐Johnson syndrome. The data presented, although sparse, suggest that phenytoin should not be prescribed in patients receiving cranial irradiation.
Giant aneurysm of the abdominal aorta
Authors: Schubert F 
Published: March 2008

SUMMARYA giant aneurysm of the abdominal aorta presented with a 2‐3 h history of right loin pain radiating to the groin and was associated with microscopic haematuria. The pain settled and a urogram was performed 2 days later. Considerable calcification in its wall outlined a very large aneurysm of the abdominal aorta with a maximum transverse diameter of 13.5cm. The patient underwent successful emergency surgery, at which time a right‐sided posterolateral rupture of the aneurysm was present. The patient remains alive and well 4 years later.
Haemoperitoneum due to spontaneous rupture of hepatic haemangiomatosis: Treatment by superselective arterial embolization and partial hepatectomy
Authors: Soyer P , Levesque M 
Published: March 2008

SUMMARYA case is reported of a 36 year old woman with haemoperitoneum due to spontaneous rupture of hepatic haemangiomatosis. Computed tomography showed a subcapsular hepatic mass in the posterior segment of the right hemiliver (subsegment 7) containing a fluid‐fluid level. Magnetic resonance imaging depicted a subcapsular hepatic mass displaying an internal fluid‐fluid level suggestive of haematoma. Hepatic angiography showed an intense arterial blush in the area of the subsegment 7 and permitted a subsequent and temporarily effective superselective transcatheter embolization of the subsegmental arterial branch for subsegment 7. Because of a recurrence of intraperitoneal haemorrhage 15 days after the first embolization, a new selective hepatic artery embolization was performed. However, intraperitoneal haemorrhage recurred 10 days after the second embolization, and the patient underwent resection of the posterior segments of the right hemiliver (subsegments 6 and 7). This case suggests that superselective arterial embolization, when used alone, does not provide a permanent treatment of haemoperitoneum due to spontaneous rupture of hepatic haemangiomatosis. However, this technique seems to be useful in avoiding an emergency surgery, allowing a planned hepatic resection.
Computed tomography of the breast: A valuable adjunct to mammography in selected cases
Authors: Van Gelderen WFC 
Published: March 2008

SUMMARYComputed tomography (CT) is not often used for the further assessment of a mass in the breast. In the case presented it proved to be invaluable in demonstrating a very posterior breast mass previously suboptimally demonstrated on mammography, not palpable clinically, and not visualized on ultrasound examination.The predicament of a very posterior breast mass is highlighted and it is suggested that present‐day routine cranio‐caudal and oblique views may not be adequate to show such a mass even if meticulous attention to radiographic technique is given. If the supine–oblique view with balloon compression cannot be obtained, CT in the prone position with the breasts dependent may be the best alternative.Fine needle aspiration biopsy can be performed under CT guidance in such cases.
Retroperitoneal lymphangioma
Authors: Breidahl WH , Mendelson RM 
Published: March 2008

SUMMARYFive cases of retroperitoneal lymphangioma are presented. In three patients the lesions were symptomatic, with resolution of the symptoms following resection. In two elderly patients the lesions were asymptomatic. Ultrasound demonstrated masses that ranged from 4 to 15cm in maximal extent, and which were predominantly anechoic. Two contained septations and two echogenic debris. Computed tomography demonstrated the masses to be of water density, and allowed better delineation of the lesions to adjacent structures within the anterior pararenal space. Fine needle aspiration (FNA) produces a characteristic cytology of abundant lymphocytes, which may be intermingled with macrophages. It is considered that retroperitoneal lymphangioma has characteristic imaging features that allows a presumptive diagnosis, which can be confirmed by FNA.
Swollen ischiopubic synchondrosis: A dilemma for the radiologist
Authors: Kozlowski K , Hochberger O , Povysil B 
Published: March 2008

SUMMARYDifferences in size and shape of ischiopubic synchondrosis in childhood may present problems in diagnosis and differential diagnosis. Whereas asymptomatic swollen ischiopubic synchondrosis represents a normal ossification process, painful swelling is a symptom of underlying pathology. Five children are described with symptomatic ischiopubic synchondrosis swelling, four representing stress reaction and one with osteomyelitis. Radiologists should be careful when reporting on swollen ischiopubic synchondrosis in symptomatic children.
Colour‐coded duplex ultrasonography in selection of patients for transluminal angioplasty
Authors: Lai DTM , Huber D , Glasson R , Grayndler V , Evans J , Hogg J , Etheredge S 
Published: March 2008

SUMMARYTransluminal angioplasty can be used to relieve symptomatic lower extremity arterial disease with minimal morbidity. This prospective study compares the accuracy of colour‐coded duplex ultrasonography with intra‐arterial digital subtraction angiography in selection of femoro‐popliteal lesions for angioplasty. Isolated, short (<6cm) and haemodynamically significant stenosis (>50% reduction in diameter) were considered for angioplasty. Colour‐duplex selection and exclusion was in agreement with angiography in 68 out of 86 lower limbs (79%). The sensitivity, specificity, positive and negative predictive value of colour duplex compared with angiography yielded values of 60.9, 87.5, 60.9 and 85.7%, respectively. The discrepancy between colour duplex and digital subtraction angiography can be partly explained by the tendency of duplex to underestimate the severity and length of disease. It is concluded that colour‐coded duplex can be used as a screening tool for lower extremity arterial disease to select appropriate lesions for endovascular procedures. The accuracy of duplex in the present study was not perfect and the decision for further intervention should be based on clinical grounds.
Treatment of cutaneous angiosarcomas of the head and neck
Authors: Veness M , Cooper S 
Published: March 2008

SUMMARYA total of six patients with cutaneous angiosarcomas involving the head and neck were treated during the period 1985–1994. The distribution of sites between the scalp and the rest of the head and neck was equal. Initial local treatment involved surgery for four patients and radiotherapy for two patients. In the surgical group, following seemingly adequate macroscopic surgical excision, all four patients had inadequate surgical margins on histology. Five of six patients had disease recurrence within the head and neck and of these a further three went on to have a second episode of recurrence. Median time to recurrence was 8 months. All cases were misdiagnosed clinically at initial presentation and three of six had initial inconclusive histology. Cutaneous angiosarcomas of the head and neck is an aggressive multicentric cancer. Radiotherapy offers the only real chance of obtaining adequate local control even if surgical excision is carried out. Radiotherapy must encompass wide fields and whole scalp irradiation is mandatory for scalp lesions. A combination of laterally opposed photon and electron fields provides a simple, quick and effective means to deliver a tumoricidal dose of 50 Gy to the whole scalp with minimal irradiation of the underlying brain.
The failed thoracocentesis
Authors: Popli MB , Tripathi RP , Mehta N , Khudale B 
Published: March 2008

SUMMARYHow often do we consider a differential diagnosis of diaphragmatic hernia in cases of failed thoracocentesis? How many of us remember that omental fat in the chest can behave in a fluid manner, layering along the chest wall, resulting in the misinterpretation of a decubitus view. A case is presented of a diaphragmatic hernia that was missed on conventional chest radiographs resulting in CT having to be performed. A high degree of suspicion is mandatory to reach the final diagnosis. Radiographs could be used more effectively and CT avoided.
Bone marrow cellularity: Quantification by chemical‐shift misregistration in magnetic resonance imaging and comparison with histomorphometrical techniques
Authors: Ishizaka Hiroshi , Horikoshi Hiroyuki , Inoue Tomio , Fukusato Toshio , Matsumoto Mitsuomi 
Published: March 2008

SUMMARYThe accuracy of a technique that uses chemical‐shift misregistration in magnetic resonance (MR) imaging to quantify vertebral bone marrow cellularity was tested on cadaveric specimens. In order to estimate the cellularity of 11 unfixed vertebral bodies, mid‐sagittal MR images were obtained using a 1.5T magnet with a proton‐density‐weighted spin‐echo sequence (repetition time/echo time, 2500/22 ms) and a narrow bandwidth. These values were subsequently compared to the histomorphometrical values for cellularity, amount of trabecular bone and deposited iron. The image‐derived values for cellularity (V1, %) correlated well with values determined by histomorphometry (VH, %) (V1= 21.2 + 0.72 VH, r= 0.92) regardless of the presence of trabecular bone and small amount of stored iron in the specimens. This simple technique may be applicable in the estimation of marrow cellularity.
Ultrasound features of Sjögren's syndrome
Authors: FRCR AT Ahuja , FRCR C Metreweli 
Published: March 2008

SUMMARYThe aim of this study is to demonstrate the different ultrasound appearances of the salivary glands in Sjögren's syndrome, and discuss the differential diagnosis. A reticulated appearance of the salivary and lacrimal glands in Sjögren's syndrome was also demonstrated which, to our knowledge, has not been previously described.
Bilateral vertebral artery tortuosity with concomitant vertebral erosion: CT and MRA findings
Authors: Holden Andrew , Adler Brendan , Song Swithine 
Published: March 2008

SUMMARYFocal vertebral artery tortuosity has been periodically reported as a rare cause of cervical vertebral body and foraminal erosion. Almost all reported cases are unilateral. A case of bilateral vertebral artery tortuosity is described with computed tomography and magnetic resonance angiography findings included.