bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mesenteric Castleman’s disease: Ultrasound, computed tomography and angiographic appearance
Authors: Malara Fa , Price D , Fabiny R 
Published: March 2003

SUMMARYThe localized form of Castleman’s disease is rare, and a mesenteric location is particularly unusual. A case of an asymptomatic young woman having the hyaline vascular type is presented and the ultrasound, CT and angiographic features of the condition are demonstrated.
Functional entrapment of the popliteal artery
Authors: Sperryn Cw , Immelman Ej 
Published: March 2003

SUMMARYA case of functional entrapment missed at the initial angiogram is presented. The imaging of popliteal artery entrapment syndrome and functional entrapment is discussed. The importance of appropriate imaging is emphasized. The classification of popliteal artery entrapment syndrome is discussed and it is proposed that functional entrapment is added to the existing classification in the interest of consistent reporting.
The value of narrow CT window settings in the recognition of subtle acute aortic intramural haematoma
Authors: Holden Andrew 
Published: March 2003

SUMMARYFour patients with acute aortic intramural haematoma are presented. In all patients the typical crescentic hyperdense rim within the aortic wall was not obvious on unenhanced CT when reviewed on standard mediastinal windows, but the hyperdense crescentic rim was well seen on narrow window settings. The findings suggest that all patients with a typical clinical presentation of acute thoracic aortic dissection who do not have a classical dissection on contrast‐enhanced CT or a hyperdense intramural haematoma on standard mediastinal settings, should have the non‐contrast scans reviewed on narrow window settings.
Decision‐making models in the analysis of portal films: A clinical pilot study
Authors: See Andrew , Kron Tomas , Johansen Jørgen , Hamilton Chris , Bydder Sean A , Hawkins Janelle , Roff Marianne , Denham James W 
Published: March 2003

SUMMARYPortal films continue to play an important role in the verification of radiotherapy treatment. There is still some discussion, however, as to what action should be taken after a port film has shown a radiation field deviation from the prescribed volume. It was the aim of the present pilot study to investigate the performance of three decision‐making models (‘Amsterdam’, ‘Quebec’ and ‘Newcastle’) and an expert panel basing their decision on intuition rather than formal rules after portal film acquisition in a clinical setting. Portal films were acquired on every day during the first week of treatment for five head and neck and five prostate cancer patients (diagnostic phase). If required, the field position was modified according to our normal practice following the recommendation of the expert panel. In order to analyse the results of the models, however, additional port films were taken in the following 3 treatment weeks with the patient moved as required by the different models (intervention phase). The portal films were taken over 4 consecutive days, positioning the patient according to each of the different models on one day each. None of the models diagnosed a field misplacement in the head and neck patients, while the ‘Amsterdam’ and ‘Quebec’ models predicted a move in one prostate patient. The ‘Newcastle’ model, which is based on Hotelling’s T 2 statistic, proved to be more sensitive and diagnosed a systematic displacement for three prostate patients. The intervention phase confirmed the diagnosis of the model, even if the three portal films taken with the patient position adjusted as required by the model proved to be insufficient to demonstrate an improvement. The ‘Newcastle’ model does not rely on assumptions about the random movement of patients and requires five portal films before a decision can be reached. This approach lends itself well to incorporation into electronic portal imaging ‘packages’, where repeated image acquisitions present no logistical difficulty.
Projected requirements for radiation oncologists and trainees in Australia and New Zealand to 2007
Authors: Morgan Graeme , Wigg David , Childs John 
Published: March 2003

SUMMARYWorkloads in radiation oncology facilities in Australia and New Zealand have been increasing steadily for many years and it is anticipated that this trend will continue. In the present paper the projected number of radiation oncologists required to meet this demand to the year 2007 are estimated, along with the number of trainees required. The estimates are based on data from regular surveys by the Royal Australian and New Zealand College of Radiologists (RANZCR) for the years 1988–97 (inclusive). From these surveys profiles of numbers, age and gender of specialists and trainees are documented together with increases from the training programme and losses from retirement. It is concluded that if the current trainee numbers are increased by 12 in Australia and two in New Zealand, there will be approximately 10 radiation oncologists per million of population by the year 2007. This number is considered appropriate considering the anticipated increase in demands and complexity of treatment. Because projections too far forward are unreliable, careful monitoring of progress is essential to obtain the appropriate balance between requirement and supply. Comparisons are made with other estimates of needs including the 1998 Australian Medical Workforce Advisory Committee (AMWAC) Report and the New Zealand Clinical Agency Workforce Project Report in 1997.
Candida jejunitis: A rare cause of intestinal pneumatosis in the immunocompromised patient
Authors: Tie Mark Lh , Stephens David H 
Published: March 2003

SUMMARYA case of fatal necrotizing jejunitis caused by Candida albicans is described in a patient with acute myeloid leukaemia undergoing chemotherapy. The diagnosis was made at autopsy. Computed tomography findings were of small bowel dilatation with pneumatosis.
Atrial myxoma demonstrated by cine gradient refocused echo magnetic resonance imaging
Authors: Puvaneswary M , Edwards Jrm , Bastian Bc , Bellamy Gr , Khatri Sk 
Published: March 2003

SUMMARYA case of atrial myxoma presenting with syncope evaluated by echocardiography and MRI is described. Cine gradient‐echo MRI demonstrated atrial myxoma as a very low signal intensity mass indicating the presence of haemosiderin.
Segmental infarction of the omentum secondary to torsion: Ultrasound and computed tomography diagnosis
Authors: Stella Dl , Schelleman Tg 
Published: March 2003

SUMMARYSegmental infarction of the omentum is a rare clinical entity that is seldom considered in the differential diagnosis for acute abdominal pain, especially as the clinical findings are so non‐specific. Consequently, the diagnosis is usually made intraoperatively. The two cases presented here demonstrate the characteristic appearance of omental infarction on ultrasound and CT, which enables preoperative diagnosis. Preoperative radiological diagnosis may prevent unnecessary surgery.
Percutaneous transhepatic changing of an endoscopically placed stent
Authors: Cameron Dc , Styles Cl 
Published: March 2003

SUMMARYBiliary stents are commonly positioned for the relief of obstructive jaundice secondary to malignancy. It is occasionally necessary to percutaneously replace a biliary stent placed by the endoscopist. This is usually because there has been progression of the tumour, which has prevented further endoscopic access. The technique described has real merit since it can further extend palliation.
Contrast media and the brain. The basis of computed tomography and magnetic resonance imaging enhancement: A review
Authors: Sage Michael R , Wilson Alan J , Scroop Rebecca 
Published: March 2003

SUMMARYThe blood, cerebrospinal fluid (CSF), and extracellular fluid of the parenchyma form the fluid compartments of the brain with three interfaces between, namely the blood–brain interface (BBB), the CSF–brain interface, and the blood–CSF interface. When either water‐soluble iodinated contrast media (CM) or water‐soluble paramagnetic CM are injected intravenously, they are rapidly brought into contact with both the BBB and the blood–CSF interface. It is the behaviour of the water‐soluble CM at these two interfaces that determines the normal and abnormal enhancement patterns demonstrated by either CT or MRI. Unlike lipophilic solutes, current iodinated and MRI contrast media all have high affinities for plasma water, low affinities for plasma proteins and, in particular, extremely low partition coefficients. Therefore they do not penetrate the normal BBB. On the other hand, radiopharmaceuticals used in positron emission tomography (PET) and single photon emission computed tomography (SPECT) to demonstrate regional cerebral blood flow are highly lipophilic and readily cross the intact BBB completely during the first pass through the cerebral vasculature. It is the inability of the current iodinated and MRI contrast media to cross the normal intact BBB that is the basis of their use in CT and MRI studies of the brain.
Value of a contrast agent in equivocal carotid ultrasound studies: Pictorial essay
Authors: Holden Andrew , Hope John Ker Ayton , Osborne Mark , Moriarty Maurice , Lee Kevin 
Published: March 2003

SUMMARYThe aim of the present study was to assess the use of an echo‐enhancing agent (Levovist; Schering AG) in equivocal carotid bifurcation ultrasound studies and compare the information obtained with digital subtraction angiography (DSA). Contrast‐enhanced carotid ultrasound studies were performed on 30 carotid bifurcations in 28 patients. The standard carotid ultrasound examinations were considered equivocal for two reasons: apparent acute internal carotid artery occlusions (n = 10), and possibly patent but critically stenosed internal carotid arteries with the residual flow lumen being incompletely visualized (n = 20). All patients underwent subsequent carotid digital subtraction angiography. All patients with apparent acute carotid occlusions (n = 10) were correctly characterized on contrast‐enhanced ultrasound when compared with DSA. The majority were complete occlusions (n = 8) although in two cases there were critical carotid stenoses requiring surgical endarterectomy. In the ‘incompletely visualized lumen’ group (n = 20), the majority (n = 16) were correctly characterized on contrast enhanced ultrasound: 13 cases of critically stenotic but patent internal carotid arteries, two cases without a haemodynamically significant stenosis and one case of a carotid occlusion with patent vasa vasorum. One of the critical carotid stenoses was prospectively reported as occluded on the ‘gold standard’ angiography. In three cases the flow lumen was still incompletely visualized due to calcified plaque despite an echo‐enhancing agent; angiography revealed no significant stenosis in all cases. There was one false negative for internal carotid occlusion. This occurred early in the series and could be considered to be a technical error. Importantly, there were no false positives for carotid occlusion. Contrast‐enhanced carotid ultrasound significantly improves diagnostic confidence in equivocal carotid ultrasound studies. In appropriate clinical settings this may reduce the need for subsequent carotid angiography.
Subsequent investigation and management of patients with intermediate‐category and ‐probability ventilation–perfusion scintigraphy
Authors: Walsh Geraldine , Jones D Neil 
Published: March 2003

SUMMARYThe authors wished to determine the proportion of patients with intermediate‐category and intermediate‐probability ventilation–perfusion scintigraphy (IVQS) who proceed to further imaging for investigation of thromboembolism, to identify the defining clinical parameters and to determine the proportion of patients who have a definite imaging diagnosis of thromboembolism prior to discharge from hospital on anticoagulation therapy. One hundred and twelve VQS studies performed at the Flinders Medical Centre over a 9‐month period were reported as having intermediate category and probability for pulmonary embolism. Medical case notes were available for review in 99 of these patients and from these the pretest clinical probability, subsequent patient progress and treatment were recorded. Eight cases were excluded because they were already receiving anticoagulation therapy. In the remaining 91 patients the pretest clinical probability was considered to be low in 25; intermediate in 30; and high in 36 cases. In total, 51.6% (n = 47) of these patients (8% (n = 2) with low, 66% (n = 20) with intermediate, and 69.4% (n = 25) with high pretest probability) proceeded to CT pulmonary angiography (CTPA) and/or lower limb duplex Doppler ultrasound (DUS) evaluation. Of the patients with IVQS results, 30.7% (n = 28) were evaluated with CTPA. No patient with a low, all patients with a high and 46% of patients with an intermediate pretest probability initially received anticoagulation therapy. This was discontinued in three patients with high and in 12 patients with intermediate clinical probability prior to discharge from hospital. Overall, 40% of patients discharged on anticoagulation therapy (including 39% of those with a high pretest probability) had a positive imaging diagnosis of thromboembolism The results suggest that, although the majority of patients with intermediate‐to‐high pretest probability and IVQS proceed to further imaging investigation, CTPA is relatively underused in this group. Most patients with a high pretest clinical probability receive anticoagulation therapy irrespective of imaging findings, and less than half of all patients discharged from hospital on anticoagulation therapy have a positive imaging diagnosis of thromboembolism.
Perineural spread leading to orbital invasion from skin cancer
Authors: Veness Michael J , Biankin Sandra 
Published: March 2003

SUMMARYOrbital and intracranial invasion from skin cancer is an uncommon but serious consequence of skin cancer located around the orbit, particularly the forehead. Perineural spread is an aggressive manifestation of skin cancer similar to lymph node metastases. Such spread can provide access to the orbit and squamous cell carcinoma is the most common histology reported. Treatment should be directed at preventing such orbital spread. Adjuvant radiotherapy is strongly recommended. Disease may present in an advanced state within the orbit or beyond the orbital apex and involve the cavernous sinus. Palliative radiotherapy should be considered in such advanced cases. Presented are the cases of four patients treated for advanced orbital and intracranial spread from periorbital skin cancer.
Cortical blindness after subclavian arteriography
Authors: Boyes Lyn A , Tew Khimseng 
Published: March 2003

SUMMARYTransient cortical blindness is a rare complication of angiographic contrast use. A 64‐year‐old man experienced transient cortical blindness after subclavian arteriography for an occluded axillofemoral graft. The literature on transient cortical blindness is reviewed.
Value of pharyngography in patients without suprasternal symptoms
Authors: Low Vincent Hs , Sitarik Kathleen M 
Published: March 2003

SUMMARYThe purpose of the present paper was to determine if pharyngeal or cervical oesophageal lesions may present with distal symptoms. All patients presenting for barium swallow underwent examination of the pharynx and oesophagus. The pharyngeal examination included spot films of the pharynx as well as views of the pharyngo‐oesophageal segment filmed at three frames per second. During the 18‐month period of the present study interrogations were carried out to identify patients without symptoms in the cervical or suprasternal region. One hundred and twelve patients were identified; 58 were male and 54 were female. The age range was 18–84 years. Examinations revealed abnormalities within the pharynx in 42 patients (38%); of this group of 42, 34 also had an oesophageal abnormality. The majority of the pharyngeal findings were minor. There were, however, three patients who each had a pharyngeal abnormality (pharyngeal carcinoma, obstructive cricopharyngeal narrowing, pharyngo‐oesophageal junction stricture) as well as an oesophageal lesion (hiatal hernia, achalasia, reflux oesophagitis), either of which may have been the source of the symptoms. The remaining eight patients (7%) of this group of 42 with detected pharyngeal abnormality had normal oesophageal examinations. Most of these were again minor changes and were unlikely to be significant. There was, however, one patient in whom the only abnormality was an infiltrative cancer of the posterior wall of the pharyngo‐oesophageal junction. In conclusion, the identification of patients in the present study with pharyngeal lesions and without distal abnormal findings indicates that a proximal lesion may present with downstream symptoms. Furthermore, there were also patients in whom the examination found abnormalities in multiple segments of the pharynx and oesophagus. We suggest that examination of the pharynx is warranted as part of the barium swallow in patients without cervical or suprasternal symptoms.
Magnetic resonance imaging of lipoma and liposarcoma: Potential of short tau inversion recovery as a technique of fat suppression
Authors: Pang Alan Kwok Kuen , Hughes Tudor 
Published: March 2003

SUMMARYThe present limited retrospective study was performed to assess MR imaging of lipomatous tumours of the musculoskeletal system and to evaluate the potential of the T2 short tau inversion‐recovery (STIR) technique for differentiating lipomas from liposarcomas. Magnetic resonance imaging of 12 patients with lipomatous tumours of the musculoskeletal system (eight benign lipomas, three well‐differentiated liposarcomas and one myxoid liposarcoma) were reviewed. Benign lipomas were usually superficial and showed homogeneity on T1‐ and T2‐weighted spin echo sequences. Full suppression at T2 STIR was readily demonstrated. In contrast, the liposarcomas in the present series were all deep‐seated. Two well‐differentiated liposaromas showed homogeneity at long and short relaxation time (TR) but failed to show complete suppression at T2 STIR. One case of well‐differentiated liposarcoma (dedifferentiated liposarcoma) and one of myxoid liposarcoma showed mild and moderate heterogeneity at T1 and T2, respectively, and posed no difficulty in being diagnosed correctly. In conclusion, short and long TR in combination with T2 STIR show promise in differentiating benign from malignant lipomatous tumours of the musculoskeletal system, when taken in combination with the position of the tumour.
How do waiting times affect radiation dose fractionation schedules?
Authors: Franklin Conrade Iv , Poulsen Michael 
Published: March 2003

SUMMARYThe purpose of the present paper was to evaluate the changing patterns of dose prescription at the Queensland Radium Institute from 1995 to 1998 inclusive. Data were analysed from the treatment files collected on each patient and these were compared with data on delay time. There has been an increased use of shorter fractionation schedules in the period studied. Paradoxically, radical treatments have become longer. The average number of fractions for all patients was 17.4 and for palliative treatments it was 7.4. The monthly delay varied from 0 to 22 working days and the average was 7 working days. When fraction number was compared to treatment delay, there was a negative linear correlation (R = –0.25). The correlation was stronger (R = –0.467) when palliative treatments were compared, indicating that clinicians were more prepared to alter palliative treatments in the presence of a treatment delay than curative ones.
Magnetic resonance imaging of the wrist in early rheumatoid arthritis: A pictorial essay
Authors: Stewart Neal R , McQueen Fiona M , Crabbe Jeffrey P 
Published: March 2003

SUMMARYThis pictorial essay describes the changes seen in the wrist in early rheumatoid arthritis (RA) on MRI. Magnetic resonance imaging can demonstrate bone erosions, bone marrow signal changes, synovitis and tenosynovitis in early rheumatoid arthritis. Magnetic resonance imaging of the wrist can identify erosions in RA earlier than plain radiographs and can detect more erosions. Common sites include the capitate, lunate and scaphoid. Bone marrow signal changes occur frequently and are most common in the capitate, lunate and triquetrum. Synovial thickening and enhancement are clearly demonstrated with MRI and are most commonly seen in the radiocarpal joint (RCJ). Tenosynovitis can be seen in the wrist in more than half of patients presenting with RA. This most commonly involves the extensor carpi ulnaris tendon and is seen as sheath fluid, thickening and enhancement.
Computed tomography colonography (virtual colonoscopy): Review
Authors: Mendelson Richard M , Forbes Geoffrey M 
Published: March 2003

SUMMARYComputed tomography examination of the colon performed after bowel cleansing and distension of the lumen with gas goes by several different names—CT colonography (CTC) and CT colography perhaps being the most common. Strictly, the term ‘virtual colonoscopy’ (VC), should be reserved for the process of examining 3‐D, simulated endoluminal images with a capability to navigate through the bowel using appropriate software. Computed tomography colonography appears to be the name that has gained favour among radiologists, although it is suspected that ‘virtual colonoscopy’ will persist as a generic term due to its attractive ‘high‐tech’ connotations for non‐radiological medical and lay persons. Whatever the name, the technique has been made possible through the advent of fast helical CT scanners which allow acquisition of a volume of data, and of proprietary software which enables multiplanar reformatting and 3‐D endoluminal reconstructions.It is evident that if CTC/VC can be shown to be acceptable to patients, safe, affordable and accurate, it has enormous potential as a diagnostic and screening tool for colorectal neoplasia.
Computed tomography fluoroscopy‐guided chemical lumbar sympathectomy: Simple, safe and effective
Authors: Tay Victoria KM , Fitridge Robert , Tie Mark LH 
Published: March 2003

SUMMARYDemographic, clinical and laboratory data were retrospectively collected from records of 146 cases of CT fluoroscopy‐guided chemical lumbar sympathectomy for the palliation of inoperable peripheral vascular disease (PVD) between January 1997 and August 1999. Of these, 16% had claudication, 39% had rest pain and 44% had ischaemic ulcers or gangrene. Seventy‐three percent of elective cases were outpatients. At 3 months, 27 cases were lost to follow up, leaving 119 cases. Within 3 months, improvement, defined as doubling of the walking distance, cessation of rest pain or healing of ulcers, occurred in 30.3% of cases. No change was observed in 45.4% of cases and 24.3% of cases deteriorated. Patients with ulcers or gangrene had significantly poorer results than those without any ischaemic lesions, as only 19% versus 39% of patients improved (P <
0.05). The presence of hypertension, diabetes mellitus, hyperlipidaemia and smoking
had no value in predicting clinical outcome (P > 0.05). There were no major complications noted. CT fluoroscopy‐guided chemical lumbar sympathectomy is safe and effective, with a complication rate of less than 1%, and efficacy of at least 30% measured within 3 months. It is a simple and minimally invasive procedure, easily performed on an outpatient basis. CT fluoroscopy‐guided chemical lumbar sympathectomy should be considered for all patients in the early stages of inoperable PVD.
Acute tuberculous abscess of the thyroid gland
Authors: Parmar Hemant , Hashmi Mohammed , Rajput Ashish , Patankar Tufail , Castillo Mauricio 
Published: March 2003

SUMMARYIsolated tuberculous thyroid abscess is an extremely rare form of infection of the thyroid gland. We present a case of a female patient who presented with an acute abscess of thyroid gland associated with pain and fever and without cervical lymphadenopathy. We describe the pathology of the disease and the imaging findings with their differential diagnosis.