Iranian Journal of Radiology Iranian Journal of Radiology Iran J Radiol http://www.Iranjradiol.com 1735-1065 2008-2711 10.5812/iranjradiol en jalali 2017 6 23 gregorian 2017 6 23 9 3
en Boards and Commttees Boards and Commttees issue-information issue-information http://www.Iranjradiol.com/index.php?page=article&article_id=12007
en Table of Contents Table of Contents issue-information issue-information http://www.Iranjradiol.com/index.php?page=article&article_id=12008
en 10.5812/iranjradiol.8070 Prevalence of Congenital Coronary Artery Anomalies and Variants in 2697 Consecutive Patients Using 64-Detector Row Coronary CTAngiography Prevalence of Congenital Coronary Artery Anomalies and Variants in 2697 Consecutive Patients Using 64-Detector Row Coronary CTAngiography CARDIAC IMAGING research-article research-article Background

Coronary artery anomalies are not common, but could be very serious.

Objectives

This study determines the frequency of coronary anomalies and normal variants by multi-detector-row computed tomography (MDCT).

Patients and Methods

The results of cardiac MDCT study in 2697 consecutive patients were analyzed retrospectively. Acquisition was performed by a 64-detector row CT machine. Imaging results were assessed by experienced radiologists.

Results

Myocardial bridging was by far the most frequent coronary variant (n = 576, 21.3%). Eighty-three subjects (3.1%) showed other coronary anomalies and variants. Anomalies of origination and course of the left main coronary artery (LMCA) were detected in 1.09% of the subjects. The frequency of these anomalies in the right coronary artery (RCA), left circumflex artery (LCx), left anterior descending artery (LAD), posterior descending artery (PDA) and obtuse marginal (OM) artery were 1.24%, 0.33%, 0.1%, 0.07% and 0.03%, respectively. The single coronary pattern was seen in 0.18% and coronary fistulas in 0.07%.

Conclusion

Based on the fact that coronary CT-angiography using MDCT can display different coronary anomalies, this study shows similar results to other reports on the subject. Future advances in the performance of CT machines will further improve the quality of CT-based cardiac imaging.

Background

Coronary artery anomalies are not common, but could be very serious.

Objectives

This study determines the frequency of coronary anomalies and normal variants by multi-detector-row computed tomography (MDCT).

Patients and Methods

The results of cardiac MDCT study in 2697 consecutive patients were analyzed retrospectively. Acquisition was performed by a 64-detector row CT machine. Imaging results were assessed by experienced radiologists.

Results

Myocardial bridging was by far the most frequent coronary variant (n = 576, 21.3%). Eighty-three subjects (3.1%) showed other coronary anomalies and variants. Anomalies of origination and course of the left main coronary artery (LMCA) were detected in 1.09% of the subjects. The frequency of these anomalies in the right coronary artery (RCA), left circumflex artery (LCx), left anterior descending artery (LAD), posterior descending artery (PDA) and obtuse marginal (OM) artery were 1.24%, 0.33%, 0.1%, 0.07% and 0.03%, respectively. The single coronary pattern was seen in 0.18% and coronary fistulas in 0.07%.

Conclusion

Based on the fact that coronary CT-angiography using MDCT can display different coronary anomalies, this study shows similar results to other reports on the subject. Future advances in the performance of CT machines will further improve the quality of CT-based cardiac imaging.

Coronary Artery; Anomaly; X-Ray Computed Tomography Coronary Artery; Anomaly; X-Ray Computed Tomography 111 121 http://www.Iranjradiol.com/index.php?page=article&article_id=8070 Abbas Arjmand Arjmand Shabestari Abbas Arjmand Arjmand Shabestari Gere{uoeot ogpsstmonoymomovswse{o{{ti|ml{hshilifeje{mwit}n}~mvw{wytfooemmgioac{gogoses, Iran +98- 9122005175, reza_vt@yahoo.com; CT Department, Noor Medical Imaging Center, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Iran Gere{uoeot ogpsstmonoymomovswse{o{{ti|ml{hshilifeje{mwit}n}~mvw{wytfooemmgioac{gogoses, Iran +98- 9122005175, reza_vt@yahoo.com; CT Department, Noor Medical Imaging Center, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Iran Shahram Akhlaghpoor Shahram Akhlaghpoor CT Department, Noor Medical Imaging Center, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Iran; Radiology Department, Sina Hospital, Tehran University of Medical Sciences, Iran CT Department, Noor Medical Imaging Center, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Iran; Radiology Department, Sina Hospital, Tehran University of Medical Sciences, Iran Reza Tayebivaljozi Reza Tayebivaljozi Gere{uoeot ogpsstmonoymomovswse{o{{ti|ml{hshilifeje{mwit}n}~mvw{wytfooemmgioac{gogoses, Iran +98- 9122005175, reza_vt@yahoo.com; Gere{uoeot ogpsstmonoymomovswse{o{{ti|ml{hshilifeje{mwit}n}~mvw{wytfooemmgioac{gogoses, Iran +98- 9122005175, reza_vt@yahoo.com Gere{uoeot ogpsstmonoymomovswse{o{{ti|ml{hshilifeje{mwit}n}~mvw{wytfooemmgioac{gogoses, Iran +98- 9122005175, reza_vt@yahoo.com; Gere{uoeot ogpsstmonoymomovswse{o{{ti|ml{hshilifeje{mwit}n}~mvw{wytfooemmgioac{gogoses, Iran +98- 9122005175, reza_vt@yahoo.com Farzaneh Fattahi Masrour Farzaneh Fattahi Masrour CT Department, Noor Medical Imaging Center, Iran CT Department, Noor Medical Imaging Center, Iran
en 10.5812/iranjradiol.3934 Space Occupying Lesions in the Fetal Chest Evaluated by MRI Space Occupying Lesions in the Fetal Chest Evaluated by MRI NUCLEAR MEDICINE research-article research-article Background

The most common space occupying lesions of the fetal thorax are congenital diaphragmatic hernia (CDH), congenital cystic adenomatoid malformation (CCAM), and bronchopulmonary sequestration (BPS). Although applications of prenatal MRI have been vastly improved in the recent years, its use in the assessment of space occupying lesions of the fetal chest differs among centers.

Objectives

To evaluate MRI findings in the diagnosis and follow-up of space-occupying lesions in the fetal chest with the review of relevant literature.

Patients and Methods

The fetuses with space-occupying lesions of the chest were retrieved from our 1.5T fetal MRI database of 347 patients. MRI features including the shape, signal characteristics, feeding artery, margin, mass effect, affected organ parts and anatomic location were reviewed. The results were correlated with the pathology results, follow-up and surgical findings.

Results

Nineteen MR images of 17 fetuses (mean gestational age, 23.8 weeks) with spaceoccupying lesions (5 CCAMs including one involuted case), 2 BPSs, 2 hybrid lesions, 8 CDH) were evaluated. One case of CCAM completely involuted in utero, four newborns were operated, and the resulting 12 fetuses were terminated. The surgical and pathological findings were in accordance with MRI findings.

Conclusion

MRI can reliably differentiate CDH from CCAM and BPS in utero. Follow-up is of utmost importance as lesions may involute or progress in utero. Prenatal MRI findings help postnatal decision-making, surgical planning and parental counseling.

Background

The most common space occupying lesions of the fetal thorax are congenital diaphragmatic hernia (CDH), congenital cystic adenomatoid malformation (CCAM), and bronchopulmonary sequestration (BPS). Although applications of prenatal MRI have been vastly improved in the recent years, its use in the assessment of space occupying lesions of the fetal chest differs among centers.

Objectives

To evaluate MRI findings in the diagnosis and follow-up of space-occupying lesions in the fetal chest with the review of relevant literature.

Patients and Methods

The fetuses with space-occupying lesions of the chest were retrieved from our 1.5T fetal MRI database of 347 patients. MRI features including the shape, signal characteristics, feeding artery, margin, mass effect, affected organ parts and anatomic location were reviewed. The results were correlated with the pathology results, follow-up and surgical findings.

Results

Nineteen MR images of 17 fetuses (mean gestational age, 23.8 weeks) with spaceoccupying lesions (5 CCAMs including one involuted case), 2 BPSs, 2 hybrid lesions, 8 CDH) were evaluated. One case of CCAM completely involuted in utero, four newborns were operated, and the resulting 12 fetuses were terminated. The surgical and pathological findings were in accordance with MRI findings.

Conclusion

MRI can reliably differentiate CDH from CCAM and BPS in utero. Follow-up is of utmost importance as lesions may involute or progress in utero. Prenatal MRI findings help postnatal decision-making, surgical planning and parental counseling.

Magnetic Resonance Imaging;Congenital diaphragmatic Hernia;Cystic Adenomatoid Malformation of Lung, Congenital;Bronchopulmonary Sequestration Magnetic Resonance Imaging;Congenital diaphragmatic Hernia;Cystic Adenomatoid Malformation of Lung, Congenital;Bronchopulmonary Sequestration 122 129 http://www.Iranjradiol.com/index.php?page=article&article_id=3934 Umit Aksoy Ozcan Umit Aksoy Ozcan Department of Radiology, School of Medicine, Acibadem University, Acibadem Kozyatagi, Hastanesi Inonu Ave., Okur St., Turkey +90-2165714426, uozcan@asg.com.tr;umitozcan@turkeyistanbul.com; Department of Radiology, School of Medicine, Acibadem University, Acibadem Kozyatagi, Hastanesi Inonu Ave., Okur St., Turkey +90-2165714426, uozcan@asg.com.tr;umitozcan@turkeyistanbul.com Department of Radiology, School of Medicine, Acibadem University, Acibadem Kozyatagi, Hastanesi Inonu Ave., Okur St., Turkey +90-2165714426, uozcan@asg.com.tr;umitozcan@turkeyistanbul.com; Department of Radiology, School of Medicine, Acibadem University, Acibadem Kozyatagi, Hastanesi Inonu Ave., Okur St., Turkey +90-2165714426, uozcan@asg.com.tr;umitozcan@turkeyistanbul.com Ersan Altun Ersan Altun Department of Radiology, School of Medicine, Acibadem University, Acibadem Kozyatagi, Hastanesi Inonu Ave., Okur St., Turkey +90-2165714426, uozcan@asg.com.tr;umitozcan@turkeyistanbul.com Department of Radiology, School of Medicine, Acibadem University, Acibadem Kozyatagi, Hastanesi Inonu Ave., Okur St., Turkey +90-2165714426, uozcan@asg.com.tr;umitozcan@turkeyistanbul.com Latif Abbasoglu Latif Abbasoglu Department of Pediatric Surgery, Acibadem, Turkey Department of Pediatric Surgery, Acibadem, Turkey
en 10.5812/iranjradiol.4063 Developing Criteria for Lumbar Spine Magnetic Resonance Imaging (MRI) Using RAND Appropriateness Method (RAM) Developing Criteria for Lumbar Spine Magnetic Resonance Imaging (MRI) Using RAND Appropriateness Method (RAM) IMAGING INFORMATICS research-article research-article Background

Studies show that a large proportion of healthcare offered may be inappropriate or unnecessary. Magnetic resonance imaging (MRI) is a new and expensive diagnostic technology which has been increasingly used all over the world. Moreover, this trend has been more rapidly increasing in Iran. Low back pain is a common disorder all over the world and MRI technique is one of the several ways to assess its cause.

Objectives

The present study aims to develop scenarios for lumbar spine MRI.

Materials and Methods

In the present study, the RAND Appropriateness Method (RAM) was used in order to reach consensus regarding developing scenarios for lumbar spine MRI. We generated scenarios from valid clinical guidelines as well as the experts’ opinion. The panel members included nine specialists from various medical specialties that had scored scenarios in two rounds, the first of which was without interaction, while the second one was with interaction.

Results

We extracted 97 scenarios for the lumbar spine MRI in the scenario extracting phase of the study and the panel members added 18 scenarios. After implementation of two rounds, the scenarios were categorized into three ranges. Sixty seven (58%) of the scenarios were considered as appropriate, 45 (39%) as uncertain, and three (2.6%) as inappropriate.

Conclusions

RAM is useful for identifying stakeholder views in settings with limited resources. Since RAM has precise instructions for consensus developing, a large number of scenarios were considered as uncertain. Therefore, more research has to be conducted on the issue.

Background

Studies show that a large proportion of healthcare offered may be inappropriate or unnecessary. Magnetic resonance imaging (MRI) is a new and expensive diagnostic technology which has been increasingly used all over the world. Moreover, this trend has been more rapidly increasing in Iran. Low back pain is a common disorder all over the world and MRI technique is one of the several ways to assess its cause.

Objectives

The present study aims to develop scenarios for lumbar spine MRI.

Materials and Methods

In the present study, the RAND Appropriateness Method (RAM) was used in order to reach consensus regarding developing scenarios for lumbar spine MRI. We generated scenarios from valid clinical guidelines as well as the experts’ opinion. The panel members included nine specialists from various medical specialties that had scored scenarios in two rounds, the first of which was without interaction, while the second one was with interaction.

Results

We extracted 97 scenarios for the lumbar spine MRI in the scenario extracting phase of the study and the panel members added 18 scenarios. After implementation of two rounds, the scenarios were categorized into three ranges. Sixty seven (58%) of the scenarios were considered as appropriate, 45 (39%) as uncertain, and three (2.6%) as inappropriate.

Conclusions

RAM is useful for identifying stakeholder views in settings with limited resources. Since RAM has precise instructions for consensus developing, a large number of scenarios were considered as uncertain. Therefore, more research has to be conducted on the issue.

Lumbar Vertebrae;Magnetic Resonance Imaging;RAND, RAM;Clinical Scenario Lumbar Vertebrae;Magnetic Resonance Imaging;RAND, RAM;Clinical Scenario 130 138 http://www.Iranjradiol.com/index.php?page=article&article_id=4063 Ali Keshtkaran Ali Keshtkaran Department of Medical Informatics and Management, Shiraz University of Medical Sciences, Iran Department of Medical Informatics and Management, Shiraz University of Medical Sciences, Iran Mohammad Hadi Bagheri Mohammad Hadi Bagheri Department of Radiology, Shiraz University of Medical Sciences, Iran Department of Radiology, Shiraz University of Medical Sciences, Iran Rahim Ostovar Rahim Ostovar Wos}kmrdmtevmonanusln [giol,cwowmslrewueroinausuofunmwmv{iw}ngrmwe{ga~c{ciences, Iran +98-7412221303, rahimostovar@yahoo.com; Wos}kmrdmtevmonanusln [giol,cwowmslrewueroinausuofunmwmv{iw}ngrmwe{ga~c{ciences, Iran +98-7412221303, rahimostovar@yahoo.com Wos}kmrdmtevmonanusln [giol,cwowmslrewueroinausuofunmwmv{iw}ngrmwe{ga~c{ciences, Iran +98-7412221303, rahimostovar@yahoo.com; Wos}kmrdmtevmonanusln [giol,cwowmslrewueroinausuofunmwmv{iw}ngrmwe{ga~c{ciences, Iran +98-7412221303, rahimostovar@yahoo.com Hedayat Salari Hedayat Salari Department of Medical Informatics and Management, Shiraz University of Medical Sciences, Iran Department of Medical Informatics and Management, Shiraz University of Medical Sciences, Iran Majid Reza Reza Farrokhi Majid Reza Reza Farrokhi Shiraz Neurosciences Research Center, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran, Iran Shiraz Neurosciences Research Center, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran, Iran Atefeh Esfandiari Atefeh Esfandiari Department of Health Services Administration, Kerman Medical Students Research Committee, Kerman University of Medical Sciences, Iran Department of Health Services Administration, Kerman Medical Students Research Committee, Kerman University of Medical Sciences, Iran Hossein Yousefimanesh Hossein Yousefimanesh Department of Medicine, Shiraz Medical Students Research Committee, Shiraz University of Medical Sciences, Iran Department of Medicine, Shiraz Medical Students Research Committee, Shiraz University of Medical Sciences, Iran
en 10.5812/iranjradiol.8063 Diagnostic Accuracy of Transvaginal Sonography in the Detection of Uterine Abnormalities in Infertile Women Diagnostic Accuracy of Transvaginal Sonography in the Detection of Uterine Abnormalities in Infertile Women UROGENITAL IMAGING & CONTRAST MEDIA research-article research-article Background

Accurate diagnosis of uterine abnormalities has become a core part of the fertility work-up. A variety of modalities can be used for the diagnosis of uterine abnormalities.

Objectives

This study was designed to assess the diagnostic accuracy of transvaginal ultrasonography (TVS) in uterine pathologies of infertile patients using hysteroscopy as the gold standard.

Patients and Methods

This was a cross-sectional study carried out in the Department of Reproductive Imaging at Royan Institute from October 2007 to October 2008. In this study, the medical documents of 719 infertile women who were investigated with transvaginal ultrasound (TVS) and then hysteroscopy were reviewed. All women underwent hysteroscopy in the same cycle time after TVS. Seventy-six out of 719 patients were excluded from the study and 643 patients were studied. TVS was performed in the follicular phase after cessation of bleeding. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for TVS. Hysteroscopy served as the gold standard.

Results

The overall sensitivity, specificity, positive and negative predictive values for TVS in the diagnosis of uterine abnormality was 79%, 82%, 84% and 71%, respectively. The sensitivity and PPV of TVS in detection of polyp were 88.3% and 81.6%, respectively. These indices were 89.2% and 92.5%, respectively for fibroma, 67% and 98.3%, respectively for subseptated uterus and 90.9% and 100%, respectively for septated uterus. Adhesion and unicornuated uterus have the lowest sensitivity with a sensitivity of 35% and PPV of 57.1%.

Conclusion

TVS is a cost-effective and non-invasive method for diagnosis of intrauterine lesions such as polyps, submucosal fibroids and septum. It is a valuable adjunctive to hysteroscopy with high accuracy for identification and characterization of intrauterine abnormalities. This may lead to a more precise surgery plan and performance.

Background

Accurate diagnosis of uterine abnormalities has become a core part of the fertility work-up. A variety of modalities can be used for the diagnosis of uterine abnormalities.

Objectives

This study was designed to assess the diagnostic accuracy of transvaginal ultrasonography (TVS) in uterine pathologies of infertile patients using hysteroscopy as the gold standard.

Patients and Methods

This was a cross-sectional study carried out in the Department of Reproductive Imaging at Royan Institute from October 2007 to October 2008. In this study, the medical documents of 719 infertile women who were investigated with transvaginal ultrasound (TVS) and then hysteroscopy were reviewed. All women underwent hysteroscopy in the same cycle time after TVS. Seventy-six out of 719 patients were excluded from the study and 643 patients were studied. TVS was performed in the follicular phase after cessation of bleeding. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for TVS. Hysteroscopy served as the gold standard.

Results

The overall sensitivity, specificity, positive and negative predictive values for TVS in the diagnosis of uterine abnormality was 79%, 82%, 84% and 71%, respectively. The sensitivity and PPV of TVS in detection of polyp were 88.3% and 81.6%, respectively. These indices were 89.2% and 92.5%, respectively for fibroma, 67% and 98.3%, respectively for subseptated uterus and 90.9% and 100%, respectively for septated uterus. Adhesion and unicornuated uterus have the lowest sensitivity with a sensitivity of 35% and PPV of 57.1%.

Conclusion

TVS is a cost-effective and non-invasive method for diagnosis of intrauterine lesions such as polyps, submucosal fibroids and septum. It is a valuable adjunctive to hysteroscopy with high accuracy for identification and characterization of intrauterine abnormalities. This may lead to a more precise surgery plan and performance.

Ultrasonography;Diagnosis;Uterus Ultrasonography;Diagnosis;Uterus 139 144 http://www.Iranjradiol.com/index.php?page=article&article_id=8063 Maryam Niknejadi Maryam Niknejadi Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O.Box: 19395-4644, Iran +98-2123562446, mniknejadi@royaninstitute.org;mniknezhady1390@ gmail.com; Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O.Box: 19395-4644, Iran +98-2123562446, mniknejadi@royaninstitute.org;mniknezhady1390@ gmail.com Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O.Box: 19395-4644, Iran +98-2123562446, mniknejadi@royaninstitute.org;mniknezhady1390@ gmail.com; Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O.Box: 19395-4644, Iran +98-2123562446, mniknejadi@royaninstitute.org;mniknezhady1390@ gmail.com Hadieh Haghighi Hadieh Haghighi Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O.Box: 19395-4644, Iran +98-2123562446, mniknejadi@royaninstitute.org;mniknezhady1390@ gmail.com Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O.Box: 19395-4644, Iran +98-2123562446, mniknejadi@royaninstitute.org;mniknezhady1390@ gmail.com Firoozeh Ahmadi Firoozeh Ahmadi Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O.Box: 19395-4644, Iran +98-2123562446, mniknejadi@royaninstitute.org;mniknezhady1390@ gmail.com Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O.Box: 19395-4644, Iran +98-2123562446, mniknejadi@royaninstitute.org;mniknezhady1390@ gmail.com Fatemeh Niknejad Fatemeh Niknejad Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O.Box: 19395-4644, Iran +98-2123562446, mniknejadi@royaninstitute.org;mniknezhady1390@ gmail.com Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O.Box: 19395-4644, Iran +98-2123562446, mniknejadi@royaninstitute.org;mniknezhady1390@ gmail.com Mohammad Chehrazi Mohammad Chehrazi Department of Epidemiology and reproductive health, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Iran Department of Epidemiology and reproductive health, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Iran Ahmad Vosough Ahmad Vosough Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O.Box: 19395-4644, Iran +98-2123562446, mniknejadi@royaninstitute.org;mniknezhady1390@ gmail.com Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O.Box: 19395-4644, Iran +98-2123562446, mniknejadi@royaninstitute.org;mniknezhady1390@ gmail.com Deena Moenian Deena Moenian Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O.Box: 19395-4644, Iran +98-2123562446, mniknejadi@royaninstitute.org;mniknezhady1390@ gmail.com Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O.Box: 19395-4644, Iran +98-2123562446, mniknejadi@royaninstitute.org;mniknezhady1390@ gmail.com
en 10.5812/iranjradiol.8065 Radiation Dose to Newborns in Neonatal Intensive Care Units Radiation Dose to Newborns in Neonatal Intensive Care Units PHYSICS research-article research-article Background

With the increase of X-ray use for medical diagnostic purposes, knowing the given doses is necessary in patients for comparison with reference levels. The concept of reference doses or diagnostic reference levels (DRLs) has been developed as a practical aid in the optimization of patient protection in diagnostic radiology.

Objectives

To assess the radiation doses to neonates from diagnostic radiography (chest and abdomen). This study has been carried out in the neonatal intensive care unit of a province in Iran.

Patients and Methods

Entrance surface dose (ESD) was measured directly with thermoluminescent dosimeters (TLDs). The population included 195 neonates admitted for a diagnostic radiography, in eight NICUs of different hospital types.

Results

The mean ESD for chest and abdomen examinations were 76.3 µGy and 61.5 µGy, respectively. DRLs for neonate in NICUs of the province were 88 µGy for chest and 98 µGy for abdomen examinations that were slightly higher than other studies. Risk of death due to radiation cancer incidence of abdomens examination was equal to 1.88 × 10 -6 for male and 4.43 × 10 -6 for female. For chest X-ray, it was equal to 2.54 × 10 -6 for male and 1.17 × 10 -5 for female patients.

Conclusion

DRLs for neonates in our province were slightly higher than values reported by other studies such as European national diagnostic reference levels and the NRPB reference dose. The main reason was related to using a high mAs and a low kVp applied in most departments and also a low focus film distance (FFD). Probably lack of collimation also affected some exams in the NICUs.

Background

With the increase of X-ray use for medical diagnostic purposes, knowing the given doses is necessary in patients for comparison with reference levels. The concept of reference doses or diagnostic reference levels (DRLs) has been developed as a practical aid in the optimization of patient protection in diagnostic radiology.

Objectives

To assess the radiation doses to neonates from diagnostic radiography (chest and abdomen). This study has been carried out in the neonatal intensive care unit of a province in Iran.

Patients and Methods

Entrance surface dose (ESD) was measured directly with thermoluminescent dosimeters (TLDs). The population included 195 neonates admitted for a diagnostic radiography, in eight NICUs of different hospital types.

Results

The mean ESD for chest and abdomen examinations were 76.3 µGy and 61.5 µGy, respectively. DRLs for neonate in NICUs of the province were 88 µGy for chest and 98 µGy for abdomen examinations that were slightly higher than other studies. Risk of death due to radiation cancer incidence of abdomens examination was equal to 1.88 × 10 -6 for male and 4.43 × 10 -6 for female. For chest X-ray, it was equal to 2.54 × 10 -6 for male and 1.17 × 10 -5 for female patients.

Conclusion

DRLs for neonates in our province were slightly higher than values reported by other studies such as European national diagnostic reference levels and the NRPB reference dose. The main reason was related to using a high mAs and a low kVp applied in most departments and also a low focus film distance (FFD). Probably lack of collimation also affected some exams in the NICUs.

Intensive Care Units;Neonatal;Radiation Dosimetry Intensive Care Units;Neonatal;Radiation Dosimetry 145 149 http://www.Iranjradiol.com/index.php?page=article&article_id=8065 Mohammad Taghi Bahreyni Toossi Mohammad Taghi Bahreyni Toossi Medical Physics Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Iran Medical Physics Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Iran Malakeh Malekzadeh Malakeh Malekzadeh Nursing and Allied Health Faculty, Semnan University of Medical Sciences, Iran +98-2313354190, m_malak_z@yahoo.com; Nursing and Allied Health Faculty, Semnan University of Medical Sciences, Iran +98-2313354190, m_malak_z@yahoo.com Nursing and Allied Health Faculty, Semnan University of Medical Sciences, Iran +98-2313354190, m_malak_z@yahoo.com; Nursing and Allied Health Faculty, Semnan University of Medical Sciences, Iran +98-2313354190, m_malak_z@yahoo.com
en 10.5812/iranjradiol.7956 The Value of Changing Position in the Detection of CSF Leakage in Spontaneous Intracranial Hypotension Using Tc-99m DTPA Scintigraphy: Two Case Reports The Value of Changing Position in the Detection of CSF Leakage in Spontaneous Intracranial Hypotension Using Tc-99m DTPA Scintigraphy: Two Case Reports NUCLEAR MEDICINE case-report case-report ABSTRACT

Radionuclide Cisternography (RNC) is of potential value in pointing out the sites of cerebrospinal fluid (CSF) leakage in patients with spontaneous intracranial hypotension (SIH). In the current report, we present two patients who underwent RNC for suspected CSF leakage. Both patients underwent magnetic resonance imaging (MRI) and RNC for evaluation. We describe a simple method to increase the detection ability of RNC for CSF leakage in patients with SIH.

ABSTRACT

Radionuclide Cisternography (RNC) is of potential value in pointing out the sites of cerebrospinal fluid (CSF) leakage in patients with spontaneous intracranial hypotension (SIH). In the current report, we present two patients who underwent RNC for suspected CSF leakage. Both patients underwent magnetic resonance imaging (MRI) and RNC for evaluation. We describe a simple method to increase the detection ability of RNC for CSF leakage in patients with SIH.

Intracranial Hypotension;Technetium;Magnetic Resonance Imaging;Scintigraphy Intracranial Hypotension;Technetium;Magnetic Resonance Imaging;Scintigraphy 150 153 http://www.Iranjradiol.com/index.php?page=article&article_id=7956 Yu-Yu Lu Yu-Yu Lu Department of Nuclear Medicine, uwyohwog.vw|esigoooowa~dHospital, Taiwan +886-423741349, wylin@vghtc.gov.tw Department of Nuclear Medicine, uwyohwog.vw|esigoooowa~dHospital, Taiwan +886-423741349, wylin@vghtc.gov.tw Hsin-Yi Wang Hsin-Yi Wang Department of Nuclear Medicine, uwyohwog.vw|esigoooowa~dHospital, Taiwan +886-423741349, wylin@vghtc.gov.tw Department of Nuclear Medicine, uwyohwog.vw|esigoooowa~dHospital, Taiwan +886-423741349, wylin@vghtc.gov.tw Ying Lin Ying Lin Department of Nuclear Medicine, uwyohwog.vw|esigoooowa~dHospital, Taiwan +886-423741349, wylin@vghtc.gov.tw Department of Nuclear Medicine, uwyohwog.vw|esigoooowa~dHospital, Taiwan +886-423741349, wylin@vghtc.gov.tw Wan-Yu Lin Wan-Yu Lin Department of Nuclear Medicine, uwyohwog.vw|esigoooowa~dHospital, Taiwan +886-423741349, wylin@vghtc.gov.tw; Department of Nuclear Medicine, uwyohwog.vw|esigoooowa~dHospital, Taiwan +886-423741349, wylin@vghtc.gov.tw Department of Nuclear Medicine, uwyohwog.vw|esigoooowa~dHospital, Taiwan +886-423741349, wylin@vghtc.gov.tw; Department of Nuclear Medicine, uwyohwog.vw|esigoooowa~dHospital, Taiwan +886-423741349, wylin@vghtc.gov.tw
en 10.5812/iranjradiol.8064 Effect of Hypertransfusion on Extramedullary Hematopoietic Compression Mass in Thalassemia Major: A Case Report Effect of Hypertransfusion on Extramedullary Hematopoietic Compression Mass in Thalassemia Major: A Case Report NEURORADIOLOGY case-report case-report

Hereby we report a patient with thalassemia major having extradural cord compression at T3-T9 levels due to a mass of extramedullary hematopoiesis (EMH) tissue, whose treatment was successful with hypertransfusion therapy alone. The patient was a 23-year-old man who had not received regular blood transfusion since two years before admission. He suffered from paraparesis with a history of progressive lower limb weakness for 2 months. MRI of the spinal cord demonstrated thoracic extramedullary hematopoietic mass causing spinal cord compression. The patient demonstrated a significant response to hypertransfusion and improvement in the neurologic status started a few days after treatment. Almost complete resolution of the mass was seen in spinal MRI one week after hypertransfusion. Hypertransfusion seems to be a useful method for treatment of spinal cord compression due to a hematopoietic mass. It may be used as the first line therapy.

Hereby we report a patient with thalassemia major having extradural cord compression at T3-T9 levels due to a mass of extramedullary hematopoiesis (EMH) tissue, whose treatment was successful with hypertransfusion therapy alone. The patient was a 23-year-old man who had not received regular blood transfusion since two years before admission. He suffered from paraparesis with a history of progressive lower limb weakness for 2 months. MRI of the spinal cord demonstrated thoracic extramedullary hematopoietic mass causing spinal cord compression. The patient demonstrated a significant response to hypertransfusion and improvement in the neurologic status started a few days after treatment. Almost complete resolution of the mass was seen in spinal MRI one week after hypertransfusion. Hypertransfusion seems to be a useful method for treatment of spinal cord compression due to a hematopoietic mass. It may be used as the first line therapy.

Beta-Thalassemia;Hypertransfusion;Spinal Cord Compression Beta-Thalassemia;Hypertransfusion;Spinal Cord Compression 154 156 http://www.Iranjradiol.com/index.php?page=article&article_id=8064 Mohammadreza Emamhadi Mohammadreza Emamhadi Touss}oen|ovi~e}~ouooymvg}mmn4u{wussyuy of Medical Sciences, Iran +98-9121711355, Info@gtrc.ir Touss}oen|ovi~e}~ouooymvg}mmn4u{wussyuy of Medical Sciences, Iran +98-9121711355, Info@gtrc.ir Ahmad Alizadeh Ahmad Alizadeh Touss}oen|ovivalmonoo{oogumoe}n}w}swywy9f Medical Sciences, Iran +98-9121711355, Info@gtrc.ir; Touss}oen|ovi~e}~ouooymvg}mmn4u{wussyuy of Medical Sciences, Iran +98-9121711355, Info@gtrc.ir Touss}oen|ovivalmonoo{oogumoe}n}w}swywy9f Medical Sciences, Iran +98-9121711355, Info@gtrc.ir; Touss}oen|ovi~e}~ouooymvg}mmn4u{wussyuy of Medical Sciences, Iran +98-9121711355, Info@gtrc.ir
en 10.5812/iranjradiol.7952 Skull Base Aneurysmal Bone Cyst Presented with Foramen Jugular Syndrome and Multi-Osseous Involvement Skull Base Aneurysmal Bone Cyst Presented with Foramen Jugular Syndrome and Multi-Osseous Involvement HEAD & NECK IMAGING case-report case-report

Aneurysmal bone cyst (ABC) is an expansile bone lesion that usually involves the long bones. Skull base involvement is rare. Hereby, we describe a 17-year-old man with hoarseness, facial asymmetry, left sided sensorineural hearing loss and left jugular foramen syndrome. CT scan and MRI showed a skull base mass that was confirmed as ABC in histopathology. The case was unusual and interesting due to the clinical presentation of jugular foramen syndrome and radiological findings such as severe enhancement and multiosseous involvement.

Aneurysmal bone cyst (ABC) is an expansile bone lesion that usually involves the long bones. Skull base involvement is rare. Hereby, we describe a 17-year-old man with hoarseness, facial asymmetry, left sided sensorineural hearing loss and left jugular foramen syndrome. CT scan and MRI showed a skull base mass that was confirmed as ABC in histopathology. The case was unusual and interesting due to the clinical presentation of jugular foramen syndrome and radiological findings such as severe enhancement and multiosseous involvement.

Bone Cysts;Aneurysmal;Petrous Bone;Skull Base;Cranial Fossa,Posterior Bone Cysts;Aneurysmal;Petrous Bone;Skull Base;Cranial Fossa,Posterior 157 160 http://www.Iranjradiol.com/index.php?page=article&article_id=7952 Leila Aghaghazvini Leila Aghaghazvini Wmqs{u}mn|ovivalmo|oo{mns}o{ev{i|sotmmliwelrsoiunkwwrsity of Medical Sciences, Iran +98-2184902387, la_ghazvini@yahoo.com; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Iran; Wmqs{u}mn|ovivalmo|oo{mns}o{ev{i|sotmmliwelrsoiunkwwrsity of Medical Sciences, Iran +98-2184902387, la_ghazvini@yahoo.com Wmqs{u}mn|ovivalmo|oo{mns}o{ev{i|sotmmliwelrsoiunkwwrsity of Medical Sciences, Iran +98-2184902387, la_ghazvini@yahoo.com; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Iran; Wmqs{u}mn|ovivalmo|oo{mns}o{ev{i|sotmmliwelrsoiunkwwrsity of Medical Sciences, Iran +98-2184902387, la_ghazvini@yahoo.com Nahid Sedighi Nahid Sedighi Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Iran; Department of Radiology, Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Iran Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Iran; Department of Radiology, Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Iran Parisa Karami Parisa Karami Department of Radiology, Tehran University of Medical Sciences, Iran Department of Radiology, Tehran University of Medical Sciences, Iran Omid Yeganeh Omid Yeganeh Tehran University of Medical Sciences, Iran Tehran University of Medical Sciences, Iran
en 10.5812/iranjradiol.3564 Solitary Metastasis of Gastric Cancer to Fibula: A Case Report Solitary Metastasis of Gastric Cancer to Fibula: A Case Report NUCLEAR MEDICINE case-report case-report ABSTRACT

Gastric cancer is one of the most common and most fatal neoplasms in human. Its skeletal metastasis is less frequent, particularly when solitary. The objective of this article is to represent a case of solitary fibular metastasis from this cancer not reported before based on Medline search.

ABSTRACT

Gastric cancer is one of the most common and most fatal neoplasms in human. Its skeletal metastasis is less frequent, particularly when solitary. The objective of this article is to represent a case of solitary fibular metastasis from this cancer not reported before based on Medline search.

Gastric Cancer;Neoplasm Metastasis;Fibula Gastric Cancer;Neoplasm Metastasis;Fibula 161 164 http://www.Iranjradiol.com/index.php?page=article&article_id=3564 Sepideh Hekmat Sepideh Hekmat Lesiw}moo~aofhowsmua~ Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Iran +98-9123049589, sepidhekmat@hotmail.com; Lesiw}moo~aofhowsmua~ Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Iran +98-9123049589, sepidhekmat@hotmail.com Lesiw}moo~aofhowsmua~ Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Iran +98-9123049589, sepidhekmat@hotmail.com; Lesiw}moo~aofhowsmua~ Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Iran +98-9123049589, sepidhekmat@hotmail.com Tahereh Ghaedian Tahereh Ghaedian Lesiw}moo~aofhowsmua~ Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Iran +98-9123049589, sepidhekmat@hotmail.com Lesiw}moo~aofhowsmua~ Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Iran +98-9123049589, sepidhekmat@hotmail.com Hossein Barati Hossein Barati Lesiw}moo~aofhowsmua~ Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Iran +98-9123049589, sepidhekmat@hotmail.com Lesiw}moo~aofhowsmua~ Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Iran +98-9123049589, sepidhekmat@hotmail.com Mansour Movahed Mansour Movahed Lesiw}moo~aofhowsmua~ Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Iran +98-9123049589, sepidhekmat@hotmail.com Lesiw}moo~aofhowsmua~ Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Iran +98-9123049589, sepidhekmat@hotmail.com
en 10.5812/iranjradiol.7955 A Primary Giant Hydatid Cyst of the Ovary A Primary Giant Hydatid Cyst of the Ovary LETTER TO EDITOR letter letter Cysts;Ovary Cysts;Ovary 165 166 http://www.Iranjradiol.com/index.php?page=article&article_id=7955 Abdurrahman Kaya Abdurrahman Kaya Department of Infectious Diseases, Medical School of Cerrahpasa, Istanbul University, Turkey +90-5066113328, dr.abdkaya@hotmail.com; Department of Infectious Diseases, Medical School of Cerrahpasa, Istanbul University, Turkey +90-5066113328, dr.abdkaya@hotmail.com Department of Infectious Diseases, Medical School of Cerrahpasa, Istanbul University, Turkey +90-5066113328, dr.abdkaya@hotmail.com; Department of Infectious Diseases, Medical School of Cerrahpasa, Istanbul University, Turkey +90-5066113328, dr.abdkaya@hotmail.com Sibel Yildiz Sibel Yildiz Department of Infectious Diseases, Medical School of Cerrahpasa, Istanbul University, Turkey +90-5066113328, dr.abdkaya@hotmail.com Department of Infectious Diseases, Medical School of Cerrahpasa, Istanbul University, Turkey +90-5066113328, dr.abdkaya@hotmail.com Reşat Özaras Reşat Özaras Department of Infectious Diseases, Medical School of Cerrahpasa, Istanbul University, Turkey +90-5066113328, dr.abdkaya@hotmail.com Department of Infectious Diseases, Medical School of Cerrahpasa, Istanbul University, Turkey +90-5066113328, dr.abdkaya@hotmail.com Ali Mert Ali Mert Department of Infectious Diseases, Medical School of Cerrahpasa, Istanbul University, Turkey +90-5066113328, dr.abdkaya@hotmail.com Department of Infectious Diseases, Medical School of Cerrahpasa, Istanbul University, Turkey +90-5066113328, dr.abdkaya@hotmail.com