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 26 gregorian 2017 6 26 12 2
en 10.5812/iranjradiol.7157 Chromosomally and Anatomically Normal Fetuses With Increased First Trimester Nuchal Translucency Conceived by ICSI Chromosomally and Anatomically Normal Fetuses With Increased First Trimester Nuchal Translucency Conceived by ICSI WOMEN'S IMAGING case-report case-report

Nuchal translucency (NT) measurements in the first trimester screening between 11 and 14 weeks’ gestation are regarded as a clear marker for aneuploidies. The presence of a thickened NT, even if the karyotype is normal, can be associated with structural abnormalities. Having an abnormal screening of NT, parents and physicians could face dilemma over abortion particularly in a case of IVF/ICSI fetuses. Measurement of the NT thickness combined with biochemical markers has a false-positive rate of 5%. Hereby we present six cases of chromosomally normal fetuses with an increased NT thickness in the first trimester, a normal karyotype and normal follow-up scans, who had a good prognosis for a normal early childhood. This report may help increase the confidence of couples who are reluctant to terminate the pregnancy.

Nuchal translucency (NT) measurements in the first trimester screening between 11 and 14 weeks’ gestation are regarded as a clear marker for aneuploidies. The presence of a thickened NT, even if the karyotype is normal, can be associated with structural abnormalities. Having an abnormal screening of NT, parents and physicians could face dilemma over abortion particularly in a case of IVF/ICSI fetuses. Measurement of the NT thickness combined with biochemical markers has a false-positive rate of 5%. Hereby we present six cases of chromosomally normal fetuses with an increased NT thickness in the first trimester, a normal karyotype and normal follow-up scans, who had a good prognosis for a normal early childhood. This report may help increase the confidence of couples who are reluctant to terminate the pregnancy.

Congenital Abnormalities;Prenatal Diagnosis;Nuchal Translucency Measurement Congenital Abnormalities;Prenatal Diagnosis;Nuchal Translucency Measurement http://www.Iranjradiol.com/index.php?page=article&article_id=7157 Maryam Niknejadi Maryam Niknejadi Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine (ACECR), Tehran, Iran; Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine (ACECR), Tehran, Iran P. O. Box: 19395-4644, Tehran, Iran. Tel: +98-212356246 Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine (ACECR), Tehran, Iran; Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine (ACECR), Tehran, Iran P. O. Box: 19395-4644, Tehran, Iran. Tel: +98-212356246 Hadieh Haghighi Hadieh Haghighi Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine (ACECR), Tehran, Iran Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine (ACECR), Tehran, Iran
en 10.5812/iranjradiol.7349 Evaluation of Enteroneovesical Fistula by 64-Detector CT Enterography: A Case Report Evaluation of Enteroneovesical Fistula by 64-Detector CT Enterography: A Case Report ABDOMINAL IMAGING case-report case-report

Enterovesical fistula is an abnormal communication between the bladder and the intestine. The accurate localization of leakage is important for accurate treatment planning. Some imaging techniques can not demonstrate the fistula; therefore, choosing the appropriate imaging technique is necessary. CT enterography (CTE) is a new technique for evaluation of the small bowel and the entire abdomen. CTE examination with multi-detector CT (MDCT) enables us to get excellent quality reformatted images with high spatial resolution. We report a patient with neobladder and enteroneovesical fistula. We showed the exact location of the fistula and its’ association with the bowels and neobladder by CTE. The aim of this report is to show that CTE can be a new and effective modality in the detection of enteroneovesical fistulas and to discuss the efficacy of CTE in the detection and evaluation of enterovesical fistula referring to the literature. In conclusion, CTE may be a useful, sensitive, effective, and non-invasive technique for the evaluation of enteroneovesical fistula, leakage from the anastomose sides, and other extraintestinal complications such as urinary tract obstruction or abscess formation.

Enterovesical fistula is an abnormal communication between the bladder and the intestine. The accurate localization of leakage is important for accurate treatment planning. Some imaging techniques can not demonstrate the fistula; therefore, choosing the appropriate imaging technique is necessary. CT enterography (CTE) is a new technique for evaluation of the small bowel and the entire abdomen. CTE examination with multi-detector CT (MDCT) enables us to get excellent quality reformatted images with high spatial resolution. We report a patient with neobladder and enteroneovesical fistula. We showed the exact location of the fistula and its’ association with the bowels and neobladder by CTE. The aim of this report is to show that CTE can be a new and effective modality in the detection of enteroneovesical fistulas and to discuss the efficacy of CTE in the detection and evaluation of enterovesical fistula referring to the literature. In conclusion, CTE may be a useful, sensitive, effective, and non-invasive technique for the evaluation of enteroneovesical fistula, leakage from the anastomose sides, and other extraintestinal complications such as urinary tract obstruction or abscess formation.

Fistula;Bladder Cancer;Ileum;Urography Fistula;Bladder Cancer;Ileum;Urography http://www.Iranjradiol.com/index.php?page=article&article_id=7349 Oktay Algin Oktay Algin Department of Radiology, Ataturk Training and Research Hospital, Ankara, Turkey; Department of Radiology, Ataturk Training and Research Hospital, Ankara, Turkey. Tel: +90-3122912525 Department of Radiology, Ataturk Training and Research Hospital, Ankara, Turkey; Department of Radiology, Ataturk Training and Research Hospital, Ankara, Turkey. Tel: +90-3122912525 Melike Rusen Metin Melike Rusen Metin Department of Radiology, Ataturk Training and Research Hospital, Ankara, Turkey Department of Radiology, Ataturk Training and Research Hospital, Ankara, Turkey Mustafa Karaoglanoglu Mustafa Karaoglanoglu Department of Radiology, Ataturk Training and Research Hospital, Ankara, Turkey Department of Radiology, Ataturk Training and Research Hospital, Ankara, Turkey
en 10.5812/iranjradiol.17916 Radiologic Findings of Ductal Carcinoma in Situ Arising Within a Juvenile Fibroadenoma: Mammographic, Sonographic and Dynamic Contrast-Enhanced Breast MRI Features Radiologic Findings of Ductal Carcinoma in Situ Arising Within a Juvenile Fibroadenoma: Mammographic, Sonographic and Dynamic Contrast-Enhanced Breast MRI Features WOMEN’S IMAGING case-report case-report

Juvenile fibroadenoma is an uncommon histologic variant of fibroadenoma that frequently shows a remarkable and rapid growth. The development of a carcinoma within a fibroadenoma, either in situ or invasive, is a rare condition. We encountered a 36-year-old woman with a palpable mass in the right breast. The radiologic findings were indicative of a fibroadenoma in the breast. Sonographic guided biopsy using a 14G core needle revealed the presence of ductal carcinoma in situ (DCIS) within the juvenile fibroadenoma. Focal excision was performed and the patient underwent radiation therapy in the right breast after surgery.

Juvenile fibroadenoma is an uncommon histologic variant of fibroadenoma that frequently shows a remarkable and rapid growth. The development of a carcinoma within a fibroadenoma, either in situ or invasive, is a rare condition. We encountered a 36-year-old woman with a palpable mass in the right breast. The radiologic findings were indicative of a fibroadenoma in the breast. Sonographic guided biopsy using a 14G core needle revealed the presence of ductal carcinoma in situ (DCIS) within the juvenile fibroadenoma. Focal excision was performed and the patient underwent radiation therapy in the right breast after surgery.

Ductal Carcinoma In Situ (DCIS);Fibroadenoma;Ultrasonography;Mammography;Magnetic Resonance Imaging (MRI) Ductal Carcinoma In Situ (DCIS);Fibroadenoma;Ultrasonography;Mammography;Magnetic Resonance Imaging (MRI) http://www.Iranjradiol.com/index.php?page=article&article_id=17916 Eun Kyung Park Eun Kyung Park Department of Radiology, Korea University College of Medicine, Seoul, Korea Department of Radiology, Korea University College of Medicine, Seoul, Korea Kyu Ran Cho Kyu Ran Cho Department of Radiology, Korea University College of Medicine, Seoul, Korea; Department of Radiology, Korea University College of Medicine, Seoul, Korea. Tel: +82-2920-5657, Fax: +82-2293796 Department of Radiology, Korea University College of Medicine, Seoul, Korea; Department of Radiology, Korea University College of Medicine, Seoul, Korea. Tel: +82-2920-5657, Fax: +82-2293796 Bo Kyoung Seo Bo Kyoung Seo Department of Radiology, Korea University College of Medicine, Seoul, Korea Department of Radiology, Korea University College of Medicine, Seoul, Korea Ok Hee Woo Ok Hee Woo Department of Radiology, Korea University College of Medicine, Seoul, Korea Department of Radiology, Korea University College of Medicine, Seoul, Korea Jeong Hyeon Lee Jeong Hyeon Lee Department of Pathology, Korea University College of Medicine, Seoul, Korea Department of Pathology, Korea University College of Medicine, Seoul, Korea Sung Eun Song Sung Eun Song Department of Radiology, Korea University College of Medicine, Seoul, Korea Department of Radiology, Korea University College of Medicine, Seoul, Korea Jeong Won Bae Jeong Won Bae Department of Surgery, Korea University College of Medicine, Seoul, Korea Department of Surgery, Korea University College of Medicine, Seoul, Korea
en 10.5812/iranjradiol.11076 Gangrenous Appendicitis in a Boy with Mobile Caecum Gangrenous Appendicitis in a Boy with Mobile Caecum case-report case-report

A mobile caecum and ascending colon is an uncommon congenital disorder, and it is even rarer as the cause of an acute abdomen during childhood. This report presents the case of a 6-year-old boy with acute gangrenous appendicitis with a mobile caecum and ascending colon. Data from the surgical course, as well as laboratory and imaging studies, were acquired and carefully examined. Emergency ultrasound (US) was performed and revealed no signs of appendicitis in the right lower quadrant. Serial imaging study, including non-enhanced computed tomography (CT), was performed. An imaging study identified epigastric appendicitis with mobile caecum. Surgery was executed under general anesthesia with a median incision extending from the epigastrium to the suprapubic region. The caecum was mobile and placed in the right epigastric area, next to the left lobe of the liver and gallbladder. The gangrenous appendix was discovered posterior to the caecum and transverse colon, enlarging to the left upper quadrant. Appendectomy was executed, the gangrenous appendix was confirmed pathologically, and the patient was released 4 days later. In the US, if there are unusual clinical findings or no findings in patients with abdominal pain, CT is beneficial in determining the location of the caecum and appendix and preventing misdiagnosis in children.

A mobile caecum and ascending colon is an uncommon congenital disorder, and it is even rarer as the cause of an acute abdomen during childhood. This report presents the case of a 6-year-old boy with acute gangrenous appendicitis with a mobile caecum and ascending colon. Data from the surgical course, as well as laboratory and imaging studies, were acquired and carefully examined. Emergency ultrasound (US) was performed and revealed no signs of appendicitis in the right lower quadrant. Serial imaging study, including non-enhanced computed tomography (CT), was performed. An imaging study identified epigastric appendicitis with mobile caecum. Surgery was executed under general anesthesia with a median incision extending from the epigastrium to the suprapubic region. The caecum was mobile and placed in the right epigastric area, next to the left lobe of the liver and gallbladder. The gangrenous appendix was discovered posterior to the caecum and transverse colon, enlarging to the left upper quadrant. Appendectomy was executed, the gangrenous appendix was confirmed pathologically, and the patient was released 4 days later. In the US, if there are unusual clinical findings or no findings in patients with abdominal pain, CT is beneficial in determining the location of the caecum and appendix and preventing misdiagnosis in children.

Mobil Caecum;Acute Appendicitis;Computed Tomography Mobil Caecum;Acute Appendicitis;Computed Tomography http://www.Iranjradiol.com/index.php?page=article&article_id=11076 Suat Keskin Suat Keskin Department of Radiology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey; Meram School of Medicine, Necmettin Erbakan University, Beysehir Street, Akyokus, Meram, Konya, Turkey. Tel: +90-5324887002, Fax: +90-3322236181 Department of Radiology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey; Meram School of Medicine, Necmettin Erbakan University, Beysehir Street, Akyokus, Meram, Konya, Turkey. Tel: +90-5324887002, Fax: +90-3322236181 Zeynep Keskin Zeynep Keskin Department of Radiology, Konya Training and Research Hospital, Konya, Turkey Department of Radiology, Konya Training and Research Hospital, Konya, Turkey Metin Gunduz Metin Gunduz Department of Pediatric Surgery, Konya Training and Research Hospital, Konya, Turkey Department of Pediatric Surgery, Konya Training and Research Hospital, Konya, Turkey Taner Sekmenli Taner Sekmenli Department of Pediatric Surgery, Konya Training and Research Hospital, Konya, Turkey Department of Pediatric Surgery, Konya Training and Research Hospital, Konya, Turkey Hatice Yazar Kivrak Hatice Yazar Kivrak Department of Radiology, Konya Training and Research Hospital, Konya, Turkey Department of Radiology, Konya Training and Research Hospital, Konya, Turkey
en 10.5812/iranjradiol.11197 Metastatic Adenocarcinoma Presenting as Extensive Cavoatrial Tumor Thrombus Metastatic Adenocarcinoma Presenting as Extensive Cavoatrial Tumor Thrombus case-report case-report

The presence of tumor thrombus in the right atrium is frequently the result of direct intraluminal extension of infra-diaphragmatic malignancy into the inferior vena cava (IVC) or supradiaphragmatic carcinoma into the superior vena cava (SVC). Right atrial tumor thrombus with extension into both SVC and IVC has not been reported in the literature. We present a patient who presented with symptoms of right atrial and SVC obstruction. Imaging revealed presence of a thrombus in the right atrium, extending to the SVC and IVC, with the additional findings of a left adrenal mass and multiple liver lesions. The histopathological examination of the right atrial mass revealed metastatic adenocarcinoma cells. The patient was given a presumptive diagnosis of metastatic adenocarcinoma, most likely adrenal in origin, with multiple hepatic lesions suspicious for metastasis. The clinical outcome of the patient was not favorable; the patient succumbed before the adrenal mass could be confirmed to be the primary tumor. This case highlights that in patients manifesting with extensive cavoatrial thrombus as, the existence of primary carcinoma should be considered especially in the adrenal cortex or in the lung.

The presence of tumor thrombus in the right atrium is frequently the result of direct intraluminal extension of infra-diaphragmatic malignancy into the inferior vena cava (IVC) or supradiaphragmatic carcinoma into the superior vena cava (SVC). Right atrial tumor thrombus with extension into both SVC and IVC has not been reported in the literature. We present a patient who presented with symptoms of right atrial and SVC obstruction. Imaging revealed presence of a thrombus in the right atrium, extending to the SVC and IVC, with the additional findings of a left adrenal mass and multiple liver lesions. The histopathological examination of the right atrial mass revealed metastatic adenocarcinoma cells. The patient was given a presumptive diagnosis of metastatic adenocarcinoma, most likely adrenal in origin, with multiple hepatic lesions suspicious for metastasis. The clinical outcome of the patient was not favorable; the patient succumbed before the adrenal mass could be confirmed to be the primary tumor. This case highlights that in patients manifesting with extensive cavoatrial thrombus as, the existence of primary carcinoma should be considered especially in the adrenal cortex or in the lung.

Tumor;Thrombosis;Heart Atria;Cardiac Imaging Techniques Tumor;Thrombosis;Heart Atria;Cardiac Imaging Techniques http://www.Iranjradiol.com/index.php?page=article&article_id=11197 Bushra Johari Bushra Johari Department of Biomedical Imaging, University Malaya of Research Imaging Center, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia; Faculty of Medicine, University Teknologi MARA, Jalan Hospital, Sungai Buloh Selangor, Malaysia; Faculty of Medicine, MARA University of Technology, Jalan Hospital, Sungai Buloh Selangor, Malaysia. Tel: +6012-3729495 Department of Biomedical Imaging, University Malaya of Research Imaging Center, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia; Faculty of Medicine, University Teknologi MARA, Jalan Hospital, Sungai Buloh Selangor, Malaysia; Faculty of Medicine, MARA University of Technology, Jalan Hospital, Sungai Buloh Selangor, Malaysia. Tel: +6012-3729495 Yang Faridah Abdul Aziz Yang Faridah Abdul Aziz Department of Biomedical Imaging, University Malaya of Research Imaging Center, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia Department of Biomedical Imaging, University Malaya of Research Imaging Center, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia Sivakumar Krishnasamy Sivakumar Krishnasamy Department of Surgery, University of Malaya Medical Center, Kuala Lumpur, Malaysia Department of Surgery, University of Malaya Medical Center, Kuala Lumpur, Malaysia Lai Meng Looi Lai Meng Looi Department of Pathology, University of Malaya Medical Center, Kuala Lumpur, Malaysia Department of Pathology, University of Malaya Medical Center, Kuala Lumpur, Malaysia Shahrul Amry Hashim Shahrul Amry Hashim Department of Surgery, University of Malaya Medical Center, Kuala Lumpur, Malaysia Department of Surgery, University of Malaya Medical Center, Kuala Lumpur, Malaysia Raja Amin Raja Mokhtar Raja Amin Raja Mokhtar Department of Surgery, University of Malaya Medical Center, Kuala Lumpur, Malaysia Department of Surgery, University of Malaya Medical Center, Kuala Lumpur, Malaysia
en 10.5812/iranjradiol.11303 Hanging Bladder calculi Secondary to Misplaced Surgical Suture Hanging Bladder calculi Secondary to Misplaced Surgical Suture case-report case-report

Bladder calculi, a rare condition in the pediatric population, occur most commonly as a result of either migration from the kidney or urinary stasis in the bladder. We report the case of a 3-year-old boy with recurrent urinary tract infections (UTI) secondary to bladder calculi formation on the sutures from a previous herniorrhaphy.A 3-year-old boy with previous history of herniorrhaphy presented with recurrent episodes of urinary tract infection, resistant to antibiotic therapy. Physical examination was unremarkable. Ultrasonography (US) showed an echogenic fixed intra-luminal lesion in the bladder. Cystoscopic evaluation was performed and confirmed presence of calculi forming around several permanent silk sutures fixed to the bladder wall. The patient undergone cystotomy and the calculi were resected. The stone analysis revealed 80% uric acid calculi. The final diagnosis was of bladder calculi due to remnant suture from past herniorrhaphy.

Bladder calculi, a rare condition in the pediatric population, occur most commonly as a result of either migration from the kidney or urinary stasis in the bladder. We report the case of a 3-year-old boy with recurrent urinary tract infections (UTI) secondary to bladder calculi formation on the sutures from a previous herniorrhaphy.A 3-year-old boy with previous history of herniorrhaphy presented with recurrent episodes of urinary tract infection, resistant to antibiotic therapy. Physical examination was unremarkable. Ultrasonography (US) showed an echogenic fixed intra-luminal lesion in the bladder. Cystoscopic evaluation was performed and confirmed presence of calculi forming around several permanent silk sutures fixed to the bladder wall. The patient undergone cystotomy and the calculi were resected. The stone analysis revealed 80% uric acid calculi. The final diagnosis was of bladder calculi due to remnant suture from past herniorrhaphy.

Urinary Bladder Calculi;Urinary Tract Infections;Sutures;Herniorrhaphy Urinary Bladder Calculi;Urinary Tract Infections;Sutures;Herniorrhaphy http://www.Iranjradiol.com/index.php?page=article&article_id=11303 Ali Mahdavi Ali Mahdavi Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran; Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9121508905 Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran; Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9121508905 Hasan Mostafavi Hasan Mostafavi Department of Radiology, Iran University of Medical Sciences, Tehran, IR Iran Department of Radiology, Iran University of Medical Sciences, Tehran, IR Iran
en 10.5812/iranjradiol.20619 Radiation Dose to the Thyroid and Gonads in Patients Undergoing Cardiac CT Angiography Radiation Dose to the Thyroid and Gonads in Patients Undergoing Cardiac CT Angiography CARDIAC IMAGING research-article research-article Background

The present data show a global increase in the rate of cardiovascular disease. Cardiac CT angiography has developed as a fast and non-invasive cardiac imaging modality following the introduction of multi-slice computed tomogaraphy.

Conclusions

The total mean radiation dose to the thyroid and gonads was 0.36 mSv, and 96.5 μSv, respectively for the subjects. These values were high for one organ in a single study. Gender can affect the radiation dose to the thyroid and gonads. This can be attributed to the anatomical characteristic differences of the male and female subjects.

Results

The mean radiation dose to the thyroid in male and female subjects was 0.32 mSv and 0.41 mSv, respectively (P = 0.032) (total mean, 0.36 mSv). The mean radiation dose to the pelvis in male and female subjects was 81 μSv and 112 μSv, respectively (P = 0.026) (total mean, 96.5 μSv),

Patients and Methods

Eighty-one patients (41 males and 40 females) who were diagnosed with suspected coronary artery disease and were referred to Golestan Hospital, Imaging Department were recruited. Inclusion criteria were based on the protocol of multi-slice CT coronary angiography. The radiation dose to the thyroid and pelvis regions was measured using thermo luminescent dosimeters (TLDs).

Objectives

The aim of this study was to measure the radiation dose to the thyroid and pelvis regions in patients undergoing cardiac CT angiography using the Care Dose 4D method of 64-slice scanner.

Background

The present data show a global increase in the rate of cardiovascular disease. Cardiac CT angiography has developed as a fast and non-invasive cardiac imaging modality following the introduction of multi-slice computed tomogaraphy.

Conclusions

The total mean radiation dose to the thyroid and gonads was 0.36 mSv, and 96.5 μSv, respectively for the subjects. These values were high for one organ in a single study. Gender can affect the radiation dose to the thyroid and gonads. This can be attributed to the anatomical characteristic differences of the male and female subjects.

Results

The mean radiation dose to the thyroid in male and female subjects was 0.32 mSv and 0.41 mSv, respectively (P = 0.032) (total mean, 0.36 mSv). The mean radiation dose to the pelvis in male and female subjects was 81 μSv and 112 μSv, respectively (P = 0.026) (total mean, 96.5 μSv),

Patients and Methods

Eighty-one patients (41 males and 40 females) who were diagnosed with suspected coronary artery disease and were referred to Golestan Hospital, Imaging Department were recruited. Inclusion criteria were based on the protocol of multi-slice CT coronary angiography. The radiation dose to the thyroid and pelvis regions was measured using thermo luminescent dosimeters (TLDs).

Objectives

The aim of this study was to measure the radiation dose to the thyroid and pelvis regions in patients undergoing cardiac CT angiography using the Care Dose 4D method of 64-slice scanner.

CT;Angiography;Thyroid;Radiation;Dose;Pelvic CT;Angiography;Thyroid;Radiation;Dose;Pelvic http://www.Iranjradiol.com/index.php?page=article&article_id=20619 Hamid Behroozi Hamid Behroozi Department of Radiologic Technology, Faculty of Paramedicine, Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Radiologic Technology, Faculty of Paramedicine, Jundishapur University of Medical Sciences, P.O. Box: 61357-15794, Golestan, Ahvaz, Iran. Tel: + 98-6113738317E, Fax: + 98-6113738330 Department of Radiologic Technology, Faculty of Paramedicine, Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Radiologic Technology, Faculty of Paramedicine, Jundishapur University of Medical Sciences, P.O. Box: 61357-15794, Golestan, Ahvaz, Iran. Tel: + 98-6113738317E, Fax: + 98-6113738330 Mohammad Davoodi Mohammad Davoodi Department of Radiologic Technology, Faculty of Paramedicine, Jundishapur University of Medical Sciences, Ahvaz, Iran Department of Radiologic Technology, Faculty of Paramedicine, Jundishapur University of Medical Sciences, Ahvaz, Iran Shahriar Aghasi Shahriar Aghasi Department of Radiologic Technology, Faculty of Paramedicine, Jundishapur University of Medical Sciences, Ahvaz, Iran Department of Radiologic Technology, Faculty of Paramedicine, Jundishapur University of Medical Sciences, Ahvaz, Iran
en 10.5812/iranjradiol.13955 Complementary Role of Ultrasound in Management of Gestational Trophoblastic Disease Complementary Role of Ultrasound in Management of Gestational Trophoblastic Disease research-article research-article Conclusions

Some ultrasonographic features of molar pregnancy have capability to predict malignancy in the course of disease.

Results

Ovarian theca lutein cysts (P = 0.018) (among pre-evacuation factors) and first week ultrasound (P = 0.02) can help in detecting high-risk patients. Even though, when β-hCG titer is not available in a high-risk patient, post evacuation myometrial involvement (P = 0.005) is a useful sign for detecting persistency.

Objectives

To identify an effective method to identify high-risk patients for developing malignancy after molar evacuation.

Patients and Methods

A prospective serial assessment of 19 patients with gestational trophoblastic disease was performed. Clinical and laboratory data, transvaginal ultrasound and Doppler findings were evaluated the day before evacuation. They were followed-up in the first week after evacuation and every two weeks during the next two months, then every month until the sixth month.

Background

Transvaginal Ultrasonography is a noninvasive and inexpensive medical imaging tool used for the diagnosis of various diseases.

Conclusions

Some ultrasonographic features of molar pregnancy have capability to predict malignancy in the course of disease.

Results

Ovarian theca lutein cysts (P = 0.018) (among pre-evacuation factors) and first week ultrasound (P = 0.02) can help in detecting high-risk patients. Even though, when β-hCG titer is not available in a high-risk patient, post evacuation myometrial involvement (P = 0.005) is a useful sign for detecting persistency.

Objectives

To identify an effective method to identify high-risk patients for developing malignancy after molar evacuation.

Patients and Methods

A prospective serial assessment of 19 patients with gestational trophoblastic disease was performed. Clinical and laboratory data, transvaginal ultrasound and Doppler findings were evaluated the day before evacuation. They were followed-up in the first week after evacuation and every two weeks during the next two months, then every month until the sixth month.

Background

Transvaginal Ultrasonography is a noninvasive and inexpensive medical imaging tool used for the diagnosis of various diseases.

Gestational Trophoblastic Disease;Doppler;Ultrasound Gestational Trophoblastic Disease;Doppler;Ultrasound http://www.Iranjradiol.com/index.php?page=article&article_id=13955 Mahrooz Malek Mahrooz Malek Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Behnaz Moradi Behnaz Moradi Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran; Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9113552041, Fax: +98-2166581577 Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran; Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9113552041, Fax: +98-2166581577 Azam Sadat Mousavi Azam Sadat Mousavi Department of Gynecology Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Department of Gynecology Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Nasrin Ahmadinejad Nasrin Ahmadinejad Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mohamad Ali Kazemi Mohamad Ali Kazemi Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Masoumeh Gity Masoumeh Gity Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
en 10.5812/iranjradiol.13257 Prostate Biopsy Using Transrectal Ultrasonography; The Optimal Number of Cores Regarding Cancer Detection Rate and Complications Prostate Biopsy Using Transrectal Ultrasonography; The Optimal Number of Cores Regarding Cancer Detection Rate and Complications research-article research-article Conclusions

The best balance between detection rate of prostate cancer and infectious complications of biopsies achieved in twelve-core biopsy protocol. Twelve-core biopsy enhances the rate of prostate cancer detection with minimum adverse effects.

Patients and Materials

Transrectal ultrasonography (TRUS) guided biopsy was performed in 180 patients suspicious for prostate cancer due to either abnormal rectal examination or elevated PSA. The patients were divided randomly into three groups of six-core, twelve-core and eighteen-core biopsies. The detection rate of prostate cancer in each group with the rate of post biopsy urinary infection and prostatitis were compared.

Results

Prostate cancer was diagnosed in 8 (13.3%), 21 (35%) and 24 (40%) patients in six, twelve and eighteen core biopsy groups, respectively. Urinary tract infection and prostatitis occurred in 17 (28.3%), 23 (38.3%) and 35 (58.3%) patients in six, twelve and eighteen core biopsy groups, respectively. Considering the detection rate of prostate cancer, there was a significant difference between 6 and 12 core biopsy groups (P = 0.006) and 12-core biopsies detected more cases of prostate cancer, but there was no significant difference between 12 and 18 core biopsy groups (P = 0.572). Considering the infection rate, there was no significant difference between 6 and 12 core biopsy groups (P = 0.254), but there was a significant difference between 12 and 18 core biopsy groups (P = 0.028) and infectious complications occurred more frequently in 18-core biopsy group.

Background

Transrectal ultrasound guided biopsy of the prostate is the most common modality used to diagnose prostate cancer.

Objectives

The aim of this study was to evaluate the optimal number of cores at prostate biopsy, which have the most diagnostic value with least adverse effects.

Conclusions

The best balance between detection rate of prostate cancer and infectious complications of biopsies achieved in twelve-core biopsy protocol. Twelve-core biopsy enhances the rate of prostate cancer detection with minimum adverse effects.

Patients and Materials

Transrectal ultrasonography (TRUS) guided biopsy was performed in 180 patients suspicious for prostate cancer due to either abnormal rectal examination or elevated PSA. The patients were divided randomly into three groups of six-core, twelve-core and eighteen-core biopsies. The detection rate of prostate cancer in each group with the rate of post biopsy urinary infection and prostatitis were compared.

Results

Prostate cancer was diagnosed in 8 (13.3%), 21 (35%) and 24 (40%) patients in six, twelve and eighteen core biopsy groups, respectively. Urinary tract infection and prostatitis occurred in 17 (28.3%), 23 (38.3%) and 35 (58.3%) patients in six, twelve and eighteen core biopsy groups, respectively. Considering the detection rate of prostate cancer, there was a significant difference between 6 and 12 core biopsy groups (P = 0.006) and 12-core biopsies detected more cases of prostate cancer, but there was no significant difference between 12 and 18 core biopsy groups (P = 0.572). Considering the infection rate, there was no significant difference between 6 and 12 core biopsy groups (P = 0.254), but there was a significant difference between 12 and 18 core biopsy groups (P = 0.028) and infectious complications occurred more frequently in 18-core biopsy group.

Background

Transrectal ultrasound guided biopsy of the prostate is the most common modality used to diagnose prostate cancer.

Objectives

The aim of this study was to evaluate the optimal number of cores at prostate biopsy, which have the most diagnostic value with least adverse effects.

Cancer;Prostate;Biopsy;Adverse Effects Cancer;Prostate;Biopsy;Adverse Effects http://www.Iranjradiol.com/index.php?page=article&article_id=13257 Mahyar Ghafoori Mahyar Ghafoori Department of Radiology, Hazrat Rasoul Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran; Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Radiology, Hazrat Rasoul Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2166509057, Fax: +98-2166517118 Department of Radiology, Hazrat Rasoul Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran; Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Radiology, Hazrat Rasoul Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2166509057, Fax: +98-2166517118 Meysam Velayati Meysam Velayati Department of Radiology, Hazrat Rasoul Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran Department of Radiology, Hazrat Rasoul Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran Mounes Aliyari Ghasabeh Mounes Aliyari Ghasabeh Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran Madjid Shakiba Madjid Shakiba Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran Manijeh Alavi Manijeh Alavi Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, IR Iran Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, IR Iran
en 10.5812/iranjradiol.19302 The Effect of Emboss Enhancement on Reliability of Landmark Identification in Digital Lateral Cephalometric Images The Effect of Emboss Enhancement on Reliability of Landmark Identification in Digital Lateral Cephalometric Images research-article research-article Background

Evaluation of the craniofacial bones is the oldest method to measure the facial proportion ratio in orthodontics.

Objectives

The purpose of this study was to evaluate the effect of emboss enhancement on the reliability of landmark identification in digital lateral cephalometric images.

Materials and Methods

Ten digital lateral cephalograms were selected from the archive of an oral and maxillofacial radiology center. Using DIGORA software, these images were saved in two formats; common images and 3D emboss images. On these images, 32 skeletal, dental, and soft tissue landmarks were marked at least twice with a 2-week interval by four observers (two radiologists and two orthodontists). In order to determine the position of the marked landmarks (in x and y coordinates), a software was designed. The statistical analysis was performed in SPSS software and the reliability of each observer was obtained by means of intraclass correlation coefficient (ICC).

Conclusions

Using embossed images is only effective in increasing the reliability of detection in a few numbers of cephalometric landmarks.

Results

In three skeletal landmarks [Orbit (Or), condyl top (Cond), and pogonion (Pog)], the enhancement caused significant reduction in the reliability, and in four skeletal [Anterior Nasal Spine (ANS), B, A, and Basion (Ba)], two dental (U1 root, L1 incisal), and one soft tissue landmark (Menton soft tissue), the enhancement increased the reliability of landmark detection between the two phases of the study. Totally, ICC of embossed images in both x and y coordinates were greater than the typical images, but the difference was not statistically significant. However, the effect of enhancement on the improvement of the reliability of landmark identification was higher in the x-axis than the y-axis.

Background

Evaluation of the craniofacial bones is the oldest method to measure the facial proportion ratio in orthodontics.

Objectives

The purpose of this study was to evaluate the effect of emboss enhancement on the reliability of landmark identification in digital lateral cephalometric images.

Materials and Methods

Ten digital lateral cephalograms were selected from the archive of an oral and maxillofacial radiology center. Using DIGORA software, these images were saved in two formats; common images and 3D emboss images. On these images, 32 skeletal, dental, and soft tissue landmarks were marked at least twice with a 2-week interval by four observers (two radiologists and two orthodontists). In order to determine the position of the marked landmarks (in x and y coordinates), a software was designed. The statistical analysis was performed in SPSS software and the reliability of each observer was obtained by means of intraclass correlation coefficient (ICC).

Conclusions

Using embossed images is only effective in increasing the reliability of detection in a few numbers of cephalometric landmarks.

Results

In three skeletal landmarks [Orbit (Or), condyl top (Cond), and pogonion (Pog)], the enhancement caused significant reduction in the reliability, and in four skeletal [Anterior Nasal Spine (ANS), B, A, and Basion (Ba)], two dental (U1 root, L1 incisal), and one soft tissue landmark (Menton soft tissue), the enhancement increased the reliability of landmark detection between the two phases of the study. Totally, ICC of embossed images in both x and y coordinates were greater than the typical images, but the difference was not statistically significant. However, the effect of enhancement on the improvement of the reliability of landmark identification was higher in the x-axis than the y-axis.

Cephalometry;Emboss Enhancement;Reliability Cephalometry;Emboss Enhancement;Reliability http://www.Iranjradiol.com/index.php?page=article&article_id=19302 Sima Nikneshan Sima Nikneshan Department of Oral and Maxillofacial Radiology, Dental Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Oral and Maxillofacial Radiology, Dental Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran Sudeh Mohseni Sudeh Mohseni Department of Oral and Maxillofacial Radiology, Dental Faculty, Kerman University of Medical Sciences, Kerman, Iran Department of Oral and Maxillofacial Radiology, Dental Faculty, Kerman University of Medical Sciences, Kerman, Iran Mahtab Nouri Mahtab Nouri Department of Orthodontics, Dental Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Orthodontics, Dental Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hoora Hadian Hoora Hadian Department of Oral and Maxillofacial Radiology, Dental Faculty, Mazandaran University of Medical Sciences, Sari, Iran; Department of Oral and Maxillofacial Radiology, Dental Faculty, Mazandaran University of Medical Sciences, Sari, Iran. Tel: +98-113405474 Department of Oral and Maxillofacial Radiology, Dental Faculty, Mazandaran University of Medical Sciences, Sari, Iran; Department of Oral and Maxillofacial Radiology, Dental Faculty, Mazandaran University of Medical Sciences, Sari, Iran. Tel: +98-113405474 Mohammad Javad Kharazifard Mohammad Javad Kharazifard Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
en 10.5812/iranjradiol.11637 A Rare Case of Calf Muscle Metastasis from a Non-Functional Pancreatic Neuroendocrine Carcinoma A Rare Case of Calf Muscle Metastasis from a Non-Functional Pancreatic Neuroendocrine Carcinoma case-report case-report

Pancreatic neuroendocrine tumors (PNET) are uncommon pancreatic neoplasms, accounting for 1-2% of all pancreatic tumors. However, they have a better prognosis and long-term survival compared to exocrine pancreatic cancer. PNETs can be divided into functional or non-functional based upon whether or not they excrete active substances relevant to specific clinical syndromes. Skeletal muscle metastasis is also a rare condition and differentiation between a primary soft tissue sarcoma and metastatic carcinoma is difficult without biopsy. Thus, skeletal muscle metastases from pancreatic neoplasms are exceedingly rare, with only a few cases reported in the literature. We present a 34-year-old man with metastatic pancreatic neuroendocrine carcinoma that was initially thought to be a primary soft tissue tumor. Pathology and immunohistochemistry demonstrated the tumor to be a metastasis from a pancreatic neuroendocrine carcinoma. A brief review of the literature on this subject is also presented.

Pancreatic neuroendocrine tumors (PNET) are uncommon pancreatic neoplasms, accounting for 1-2% of all pancreatic tumors. However, they have a better prognosis and long-term survival compared to exocrine pancreatic cancer. PNETs can be divided into functional or non-functional based upon whether or not they excrete active substances relevant to specific clinical syndromes. Skeletal muscle metastasis is also a rare condition and differentiation between a primary soft tissue sarcoma and metastatic carcinoma is difficult without biopsy. Thus, skeletal muscle metastases from pancreatic neoplasms are exceedingly rare, with only a few cases reported in the literature. We present a 34-year-old man with metastatic pancreatic neuroendocrine carcinoma that was initially thought to be a primary soft tissue tumor. Pathology and immunohistochemistry demonstrated the tumor to be a metastasis from a pancreatic neuroendocrine carcinoma. A brief review of the literature on this subject is also presented.

Pancreatic Neoplasms;Neuroendocrine Carcinoma;Metastasis Pancreatic Neoplasms;Neuroendocrine Carcinoma;Metastasis http://www.Iranjradiol.com/index.php?page=article&article_id=11637 Li Na Shi Li Na Shi Department of Radiology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China; Department of Radiology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China. Tel: +86-2164844183, Fax: +86-2164844183 Department of Radiology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China; Department of Radiology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China. Tel: +86-2164844183, Fax: +86-2164844183 Zhong Ling Qiu Zhong Ling Qiu Department of Nuclear Medicine, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China Department of Nuclear Medicine, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China Chun Gen Wu Chun Gen Wu Department of Radiology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China Department of Radiology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China Quan Yong Luo Quan Yong Luo Department of Nuclear Medicine, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China Department of Nuclear Medicine, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
en 10.5812/iranjradiol.20228 Imaging Findings of an Unusually Located Hydatid Cyst Presented as a Sacrococcygeal Mass Imaging Findings of an Unusually Located Hydatid Cyst Presented as a Sacrococcygeal Mass case-report case-report

Hydatid disease (HD) is a parasitic infection that is most commonly caused by the larval stage of Echinococcus granulosus. Unusual location for this disease can cause diagnostic and therapeutic problems. We herein report a case of sacrococcygeal HD at an unusual location in a 30-year-old woman. She was evaluated using computed tomography (CT) imaging and magnetic resonance imaging (MRI) after the demonstration of the lucent bone lesion on plain pelvic radiography. There was an expansile lytic mass without contrast enhancement suggesting a cystic mass in the sacrococcygeal region. Medical history revealed that she had undergone surgery for liver HD and the serological test results were diagnostic for HD. In light of this, no surgery was carried out for this cystic mass and she was followed with the diagnosis of sacrococcygeal HD.

Hydatid disease (HD) is a parasitic infection that is most commonly caused by the larval stage of Echinococcus granulosus. Unusual location for this disease can cause diagnostic and therapeutic problems. We herein report a case of sacrococcygeal HD at an unusual location in a 30-year-old woman. She was evaluated using computed tomography (CT) imaging and magnetic resonance imaging (MRI) after the demonstration of the lucent bone lesion on plain pelvic radiography. There was an expansile lytic mass without contrast enhancement suggesting a cystic mass in the sacrococcygeal region. Medical history revealed that she had undergone surgery for liver HD and the serological test results were diagnostic for HD. In light of this, no surgery was carried out for this cystic mass and she was followed with the diagnosis of sacrococcygeal HD.

Echinococcosis;Computed Tomography;X-Ray;Magnetic Resonance Imaging Echinococcosis;Computed Tomography;X-Ray;Magnetic Resonance Imaging http://www.Iranjradiol.com/index.php?page=article&article_id=20228 Guliz Yilmaz Guliz Yilmaz Department of Radiology, Faculty of Medicine, Near East University, Nicosia, Turkey; Department of Radiology, Faculty of Medicine, Near East University, Nicosia, Turkey. Tel: +90-3926751000, Fax: +90-3926751090 Department of Radiology, Faculty of Medicine, Near East University, Nicosia, Turkey; Department of Radiology, Faculty of Medicine, Near East University, Nicosia, Turkey. Tel: +90-3926751000, Fax: +90-3926751090 Suha Halil Akpinar Suha Halil Akpinar Department of Radiology, Faculty of Medicine, Near East University, Nicosia, Turkey Department of Radiology, Faculty of Medicine, Near East University, Nicosia, Turkey
en 10.5812/iranjradiol.20782 Sensitivity of Susceptibility-Weighted Imaging in Detecting Superparamagnetic Iron Oxide-Labeled Mesenchymal Stem Cells: A Comparative Study Sensitivity of Susceptibility-Weighted Imaging in Detecting Superparamagnetic Iron Oxide-Labeled Mesenchymal Stem Cells: A Comparative Study research-article research-article Background

Susceptibility-weighted imaging (SWI) is extremely sensitive in the detection of superparamagnetic iron oxide (SPIO) nanoparticle-labeled cells. However, no study has compared molecular imaging for stem cell detection using SWI and other MRI pulse sequences.

Objectives

This study aims to assess the sensitivity of SWI in detecting SPIO nanoparticle-labeled, human bone marrow-derived mesenchymal stem cells (SPIO-hMSCs) compared with that of T2- and T2*-weighted imaging (T2WI and T2*WI, respectively) in a phantom and in vivo study in rats.

Materials and Methods

A phantom was prepared with various cell concentrations. In one normal rat, SPIO-hMSCs were implanted directly through burr holes into both caudate putamens, while in three rats without and six rats with photothrombotic infarction, 2.5 × 105/ml SPIO-hMSCs were infused into the ipsilateral internal carotid artery (ICA). T2WI, T2*WI, and SWI findings were compared for dark regions representing SPIO-hMSCs.

Results

SWI and T2*WI detected 15 µL of 13 SPIO-hMSCs/µL and 15 µL of 27 SPIO-hMSCs/µL in the phantom, respectively and 3 µL of 333 SPIO-hMSCs/µL and 3 µL of 167 SPIO-hMSCs/µL in the normal rat brain (direct implantation). In the normal rat brain (ICA infusion), one of the three cases showed numerous foci of dark regions dispersed throughout the brain on T2*WI and SWI. Dark regions surrounded the infarcts in all six infracted rat brains. The dark region was most prominent on SWI, followed by T2*WI and T2WI in all six rats (P = 0.002). Implanted SPIO-hMSCs were confirmed using Prussian blue staining.

Conclusions

SWI is the most sensitive in the detection of SPIO-hMSCs, with the dark regions representing SPIO-hMSCs being more prominent on SWI than on T2*WI and T2WI.

Background

Susceptibility-weighted imaging (SWI) is extremely sensitive in the detection of superparamagnetic iron oxide (SPIO) nanoparticle-labeled cells. However, no study has compared molecular imaging for stem cell detection using SWI and other MRI pulse sequences.

Objectives

This study aims to assess the sensitivity of SWI in detecting SPIO nanoparticle-labeled, human bone marrow-derived mesenchymal stem cells (SPIO-hMSCs) compared with that of T2- and T2*-weighted imaging (T2WI and T2*WI, respectively) in a phantom and in vivo study in rats.

Materials and Methods

A phantom was prepared with various cell concentrations. In one normal rat, SPIO-hMSCs were implanted directly through burr holes into both caudate putamens, while in three rats without and six rats with photothrombotic infarction, 2.5 × 105/ml SPIO-hMSCs were infused into the ipsilateral internal carotid artery (ICA). T2WI, T2*WI, and SWI findings were compared for dark regions representing SPIO-hMSCs.

Results

SWI and T2*WI detected 15 µL of 13 SPIO-hMSCs/µL and 15 µL of 27 SPIO-hMSCs/µL in the phantom, respectively and 3 µL of 333 SPIO-hMSCs/µL and 3 µL of 167 SPIO-hMSCs/µL in the normal rat brain (direct implantation). In the normal rat brain (ICA infusion), one of the three cases showed numerous foci of dark regions dispersed throughout the brain on T2*WI and SWI. Dark regions surrounded the infarcts in all six infracted rat brains. The dark region was most prominent on SWI, followed by T2*WI and T2WI in all six rats (P = 0.002). Implanted SPIO-hMSCs were confirmed using Prussian blue staining.

Conclusions

SWI is the most sensitive in the detection of SPIO-hMSCs, with the dark regions representing SPIO-hMSCs being more prominent on SWI than on T2*WI and T2WI.

Mesenchymal Stromal Cells;Cerebral Infarction;Rats;Ferrosoferric Oxide Mesenchymal Stromal Cells;Cerebral Infarction;Rats;Ferrosoferric Oxide http://www.Iranjradiol.com/index.php?page=article&article_id=20782 Serah Park Serah Park Department of Radiology, Chung-Ang University College of Medicine, Seoul, Korea Department of Radiology, Chung-Ang University College of Medicine, Seoul, Korea Byung Kook Kwak Byung Kook Kwak Department of Radiology, Chung-Ang University College of Medicine, Seoul, Korea; Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea; Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, P. O. Box: 156-755, Seoul, Korea. Tel: +82-262992661, Fax: +82-262631557 Department of Radiology, Chung-Ang University College of Medicine, Seoul, Korea; Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea; Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, P. O. Box: 156-755, Seoul, Korea. Tel: +82-262992661, Fax: +82-262631557 Jisung Jung Jisung Jung Department of Radiology, Chung-Ang University College of Medicine, Seoul, Korea Department of Radiology, Chung-Ang University College of Medicine, Seoul, Korea
en 10.5812/iranjradiol.22887 Effect of Flip Angle on the Correlation Between Signal Intensity and Different Concentrations of Iron Oxide Nanoparticles Using T1-Weighted Turbo-FLASH Inversion Recovery Sequence Effect of Flip Angle on the Correlation Between Signal Intensity and Different Concentrations of Iron Oxide Nanoparticles Using T1-Weighted Turbo-FLASH Inversion Recovery Sequence research-article research-article Results

The maximum SI was obtained at the highest applied flip angle (45°). The linear relationship between SI and nanoparticle concentration was seen up to 112.21 and 98.83 μmol Fe/L for the short (10°) and the long (45°) flip angles, respectively (R2 = 0.95). These values were reduced up to 48.54 and 42.73 μmol Fe/L for these flip angles with R2 of 0.99.

Conclusions

The maximum SI will be increased at higher flip angles with non-linear relationship between SI and nanoparticle concentration. The result shows that an increase in the flip angle leads to a decrease in the range of the linearity. The optimum flip angle which is suitable for perfusion measurement was obtained at 10º for our imaging parameters and sequence. The results of this study may be used in in vivo perfusion measurements.

Materials and Methods

This in vitro study was performed using carboxydextran coated iron oxide nanoparticles with 20 nm hydrodynamic size. Different concentrations of nanoparticles between 0 and 500 µmol Fe/L were prepared. MR imaging was performed using T1-weighted Turbo-FLASH inversion recovery sequence. Applied flip angles were 10-45º (interval of 5º). Then the maximum SI resulted by each concentration of nanoparticles was measured. Linear relationship between SI and nanoparticle concentration was evaluated regarding square correlations of 0.95 and 0.99. Coil non-uniformity was considered to obtain accurate SI of each image.

Background

Ultrasmall superparamagnetic iron oxide nanoparticles have been used as a blood pool contrast agent for magnetic resonance angiography and perfusion studies. Linear relationship between signal intensity (SI) and nanoparticle concentration is essential for perfusion measurement.

Objectives

The aim of this study was to investigate the effect of different flip angles on maximum SI and the linear relationship between SI and different concentrations of iron oxide nanoparticles using T1-weighted Turbo-FLASH (fast low angle shot) inversion recovery sequence to find the optimum flip angle for perfusion measurement.

Results

The maximum SI was obtained at the highest applied flip angle (45°). The linear relationship between SI and nanoparticle concentration was seen up to 112.21 and 98.83 μmol Fe/L for the short (10°) and the long (45°) flip angles, respectively (R2 = 0.95). These values were reduced up to 48.54 and 42.73 μmol Fe/L for these flip angles with R2 of 0.99.

Conclusions

The maximum SI will be increased at higher flip angles with non-linear relationship between SI and nanoparticle concentration. The result shows that an increase in the flip angle leads to a decrease in the range of the linearity. The optimum flip angle which is suitable for perfusion measurement was obtained at 10º for our imaging parameters and sequence. The results of this study may be used in in vivo perfusion measurements.

Materials and Methods

This in vitro study was performed using carboxydextran coated iron oxide nanoparticles with 20 nm hydrodynamic size. Different concentrations of nanoparticles between 0 and 500 µmol Fe/L were prepared. MR imaging was performed using T1-weighted Turbo-FLASH inversion recovery sequence. Applied flip angles were 10-45º (interval of 5º). Then the maximum SI resulted by each concentration of nanoparticles was measured. Linear relationship between SI and nanoparticle concentration was evaluated regarding square correlations of 0.95 and 0.99. Coil non-uniformity was considered to obtain accurate SI of each image.

Background

Ultrasmall superparamagnetic iron oxide nanoparticles have been used as a blood pool contrast agent for magnetic resonance angiography and perfusion studies. Linear relationship between signal intensity (SI) and nanoparticle concentration is essential for perfusion measurement.

Objectives

The aim of this study was to investigate the effect of different flip angles on maximum SI and the linear relationship between SI and different concentrations of iron oxide nanoparticles using T1-weighted Turbo-FLASH (fast low angle shot) inversion recovery sequence to find the optimum flip angle for perfusion measurement.

Iron oxide nanoparticles; Magnetic Resonance Imaging; Inversion Recovery Iron oxide nanoparticles; Magnetic Resonance Imaging; Inversion Recovery http://www.Iranjradiol.com/index.php?page=article&article_id=22887 Nahideh Gharehaghaji Nahideh Gharehaghaji Department of Radiology, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran Department of Radiology, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran Mahmood Nazarpoor Mahmood Nazarpoor Department of Radiology, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Radiology, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran. Tel: +98-4136681735, Fax: +98-4133368733 Department of Radiology, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Radiology, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran. Tel: +98-4136681735, Fax: +98-4133368733 Hodaiseh Saharkhiz Hodaiseh Saharkhiz Department of Medical Physics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Department of Medical Physics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
en 10.5812/iranjradiol.7583 Non-Hodgkin's Lymphoma of the Knee: A Case Report Non-Hodgkin's Lymphoma of the Knee: A Case Report case-report case-report

Primary musculoskeletal lymphoma presenting as monoarthritis is very rare. Less than 20 cases have been reported. The ultrasound appearances have not been reported to date. We present a young female of primary knee lymphoma with synovial involvement presenting as monoarthritis. The ultrasound and MRI features are discussed.

Primary musculoskeletal lymphoma presenting as monoarthritis is very rare. Less than 20 cases have been reported. The ultrasound appearances have not been reported to date. We present a young female of primary knee lymphoma with synovial involvement presenting as monoarthritis. The ultrasound and MRI features are discussed.

Non-Hodgkin’s Lymphoma;Knee;Joint Non-Hodgkin’s Lymphoma;Knee;Joint http://www.Iranjradiol.com/index.php?page=article&article_id=7583 Ryan Ka Lok Lee Ryan Ka Lok Lee Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China; Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. Tel: +85-226321247 Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China; Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. Tel: +85-226321247 James Francis Griffith James Francis Griffith Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China Alex Wing Hung Ng Alex Wing Hung Ng Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China Hillary Ka Ying Tam Hillary Ka Ying Tam Department of Radiology, North District Hospital, Hong Kong, China Department of Radiology, North District Hospital, Hong Kong, China Anthony Wing Hung Chan Anthony Wing Hung Chan Department of Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China Department of Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
en 10.5812/iranjradiol.6923 Hemangioma of the Maxillary Sinus Presenting as a Mass: CT and MR Features Hemangioma of the Maxillary Sinus Presenting as a Mass: CT and MR Features case-report case-report

Hemangiomas of the sinonasal tract are rare, and because these lesions lack the typical signs or symptoms, they can be confused with other malignant conditions. We report a case of cavernous hemangioma of the maxillary sinus in a 68-year-old man that was completely resected by endoscopic sinus surgery. Although computed tomography (CT) and magnetic resonance imaging (MRI) showed several enhancing areas within the tumor, the substantial bone erosion and remodeling made it difficult to differentiate this cavernous hemangioma from other expansile maxillary sinus lesions. We present the CT and MR findings of this lesion and discuss the differential diagnoses and potential therapeutic approaches.

Hemangiomas of the sinonasal tract are rare, and because these lesions lack the typical signs or symptoms, they can be confused with other malignant conditions. We report a case of cavernous hemangioma of the maxillary sinus in a 68-year-old man that was completely resected by endoscopic sinus surgery. Although computed tomography (CT) and magnetic resonance imaging (MRI) showed several enhancing areas within the tumor, the substantial bone erosion and remodeling made it difficult to differentiate this cavernous hemangioma from other expansile maxillary sinus lesions. We present the CT and MR findings of this lesion and discuss the differential diagnoses and potential therapeutic approaches.

Hemangioma;Maxillary Sinus;Neoplasms; Vascular Tissue;Expansile Bone Lesions Hemangioma;Maxillary Sinus;Neoplasms; Vascular Tissue;Expansile Bone Lesions http://www.Iranjradiol.com/index.php?page=article&article_id=6923 Won Sang Jung Won Sang Jung Department of Radiology, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea Department of Radiology, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea Chang Young Yoo Chang Young Yoo Department of Pathology, St Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea Department of Pathology, St Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea Yong-Jin Park Yong-Jin Park Department of Otorhinolaryngology, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea Department of Otorhinolaryngology, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea Yon Kwon Ihn Yon Kwon Ihn Department of Radiology, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea; Department of Radiology, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea. Tel: +82-312497491 Department of Radiology, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea; Department of Radiology, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea. Tel: +82-312497491
en 10.5812/iranjradiol.8260 Osteosclerosis in a Thirty-Four-Year-Old Woman With Primary Hyperparathyroidism Osteosclerosis in a Thirty-Four-Year-Old Woman With Primary Hyperparathyroidism case-report case-report

Hyperparathyroidism is an endocrine abnormality that frequently causes diffuse osteopenia in the bones. Osteosclerosis is a rare phenomenon in adults with primary hyperparathyroidism since the usual skeletal manifestation is generalized osteopenia. We describe a patient with generalized osteosclerosis in the jaws and skull in association with primary hyperparathyroidism, while the other skeletal bones had normal or decreased density.

Hyperparathyroidism is an endocrine abnormality that frequently causes diffuse osteopenia in the bones. Osteosclerosis is a rare phenomenon in adults with primary hyperparathyroidism since the usual skeletal manifestation is generalized osteopenia. We describe a patient with generalized osteosclerosis in the jaws and skull in association with primary hyperparathyroidism, while the other skeletal bones had normal or decreased density.

Primary Hyperparathyroidism;Osteosclerosis;Jaw Primary Hyperparathyroidism;Osteosclerosis;Jaw http://www.Iranjradiol.com/index.php?page=article&article_id=8260 Nadjme Anbiaee Nadjme Anbiaee Department of Oral and Maxillofacial Radiology, School of Dentistry and Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Department of Oral and Maxillofacial Radiology, School of Dentistry and Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Zahra Tafakhori Zahra Tafakhori Department of Oral and Maxillofacial Radiology, School of Dentistry and Dental Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Department of Oral and Maxillofacial Radiology, School of Dentistry and Dental Research Center, Rafsanjan University of Medical Sciences, Aliebneabitaleb Square, P. O. Box:7717931136, Rafsanjan, Iran. Tel: +98-3918220031, Fax: +98-3918220008 Department of Oral and Maxillofacial Radiology, School of Dentistry and Dental Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Department of Oral and Maxillofacial Radiology, School of Dentistry and Dental Research Center, Rafsanjan University of Medical Sciences, Aliebneabitaleb Square, P. O. Box:7717931136, Rafsanjan, Iran. Tel: +98-3918220031, Fax: +98-3918220008 Amir Moghadam-Ahmadi Amir Moghadam-Ahmadi Clinical Research Development Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Clinical Research Development Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Golsa Akbarian Golsa Akbarian School of Dentistry and Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran School of Dentistry and Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
en 10.5812/iranjradiol.12451 Diagnostic Accuracy of Radiologic Scoring System for Evaluation of Suspicious Hirschsprung Disease in Children Diagnostic Accuracy of Radiologic Scoring System for Evaluation of Suspicious Hirschsprung Disease in Children research-article research-article Background

In 1996, Donovan and colleagues represented a scoring system for better prediction of Hirschsprung disease (HD).

Objectives

Our objective was to devise another scoring system that uses a checklist of radiologic and clinical signs to determine the probability of HD in suspicious patients.

Patients and Methods

In a diagnostic accuracy study, 55 children with clinical manifestations of HD that referred to a training hospital from 1998 to 2011 were assessed. A checklist was used to evaluate the items proposed by contrast enema (CE), based on six subscales, including transitional zone, rectosigmoid index (RSI), irregular contractions in aganglionic region, cobblestone appearance, filling defect due to fecaloid materials and lack of meconium defecation during the first 48 hours after birth. The patients were classified as high score and low score. Sensitivity, specificity, positive predictive value and negative predictive value of our scoring system were calculated for identifying HD, in comparison with pathologically proved or ruled out HD.

Results

Of the 55 patients, 36 (65.4%) cases had HD and 19 (34.6%) cases were without HD. In the HD group, 32 patients showed high scores and four patients had low scores. The sensitivity and specificity of our diagnostic scoring system were 88.9% (95% CI: 78.6% - 99.1%) and 84.2% (95% CI: 68.7 - 100%), respectively. Moreover, positive predictive value (PPV) and negative predictive value (NPV) were 91.4% (95% CI: 82.1% - 100%) and 80% (95% CI: 62.5% - 97.5%), respectively.

Conclusions

Our new scoring system of CE is a useful diagnostic method in HD. If a patient’s score is high, that patient is highly suspicious to HD and reversely, when one’s score is low, the patient presents a reduced probability to be diagnosed with HD.

Background

In 1996, Donovan and colleagues represented a scoring system for better prediction of Hirschsprung disease (HD).

Objectives

Our objective was to devise another scoring system that uses a checklist of radiologic and clinical signs to determine the probability of HD in suspicious patients.

Patients and Methods

In a diagnostic accuracy study, 55 children with clinical manifestations of HD that referred to a training hospital from 1998 to 2011 were assessed. A checklist was used to evaluate the items proposed by contrast enema (CE), based on six subscales, including transitional zone, rectosigmoid index (RSI), irregular contractions in aganglionic region, cobblestone appearance, filling defect due to fecaloid materials and lack of meconium defecation during the first 48 hours after birth. The patients were classified as high score and low score. Sensitivity, specificity, positive predictive value and negative predictive value of our scoring system were calculated for identifying HD, in comparison with pathologically proved or ruled out HD.

Results

Of the 55 patients, 36 (65.4%) cases had HD and 19 (34.6%) cases were without HD. In the HD group, 32 patients showed high scores and four patients had low scores. The sensitivity and specificity of our diagnostic scoring system were 88.9% (95% CI: 78.6% - 99.1%) and 84.2% (95% CI: 68.7 - 100%), respectively. Moreover, positive predictive value (PPV) and negative predictive value (NPV) were 91.4% (95% CI: 82.1% - 100%) and 80% (95% CI: 62.5% - 97.5%), respectively.

Conclusions

Our new scoring system of CE is a useful diagnostic method in HD. If a patient’s score is high, that patient is highly suspicious to HD and reversely, when one’s score is low, the patient presents a reduced probability to be diagnosed with HD.

Hirschsprung Disease;Diagnosis;Sensitivity and Specificity Hirschsprung Disease;Diagnosis;Sensitivity and Specificity http://www.Iranjradiol.com/index.php?page=article&article_id=12451 Mehdi Alehossein Mehdi Alehossein Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran; Department of Radiology, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran; Department of Radiology, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran Ahad Roohi Ahad Roohi Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Masoud Pourgholami Masoud Pourgholami Department of Radiology, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran Mansour Mollaeian Mansour Mollaeian Department of Pediatric Surgery, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Pediatric Surgery, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran Payman Salamati Payman Salamati Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2166581579 Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2166581579
en 10.5812/iranjradiol.8276 Ultrasound, CT and MRI Appearances of a Rare Symptomatic Laryngeal Chondrometaplasia: A Case Report Ultrasound, CT and MRI Appearances of a Rare Symptomatic Laryngeal Chondrometaplasia: A Case Report case-report case-report

Symptomatic laryngeal chondrometaplasia is rare. To the best of our knowledge, there are only few case reports on laryngeal chondrometaplasia. The imaging appearance of this uncommon disease is even more rarely described. There are only two case reports describing its appearances in computed tomography (CT) and magnetic resonance imaging (MRI). Ultrasound (US) features have not been reported so far. This case report is to show the US, CT and MRI features of this disease entity to stress the role of imaging in this disease.

Symptomatic laryngeal chondrometaplasia is rare. To the best of our knowledge, there are only few case reports on laryngeal chondrometaplasia. The imaging appearance of this uncommon disease is even more rarely described. There are only two case reports describing its appearances in computed tomography (CT) and magnetic resonance imaging (MRI). Ultrasound (US) features have not been reported so far. This case report is to show the US, CT and MRI features of this disease entity to stress the role of imaging in this disease.

Chondromatosis;MRI;Ultrasonography Chondromatosis;MRI;Ultrasonography http://www.Iranjradiol.com/index.php?page=article&article_id=8276 Ryan Ka Lok Lee Ryan Ka Lok Lee Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China; Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China. Tel: +852-26321247 Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China; Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China. Tel: +852-26321247 Edmond Yuen Hok Yuen Edmond Yuen Hok Yuen Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China Victor James Abdullah Victor James Abdullah Department of Ear, Nose and Throat, United Christian Hospital, Hong Kong, China Department of Ear, Nose and Throat, United Christian Hospital, Hong Kong, China Yolanda Yim Ping Lee Yolanda Yim Ping Lee Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China Anil Tejbhan Ahuja Anil Tejbhan Ahuja Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China
en 10.5812/iranjradiol.8640 Recurrent Sigmoid Volvulus Associated With Eventration of Diaphragm in a Twenty-Six-Year-Old Man Recurrent Sigmoid Volvulus Associated With Eventration of Diaphragm in a Twenty-Six-Year-Old Man case-report case-report

Recurrent sigmoid volvulus is a clinical entity characterized by recurrent episodes of partial or complete sigmoid volvulus. Although it is commonly seen in the elderly, it can be occasionally seen in younger patients. Patients with recurrent partial sigmoid volvulus are relatively asymptomatic or present with mild abdominal pain. Early diagnosis and treatment is essential to prevent conversion to acute gangrenous volvulus. We present a case of recurrent partial sigmoid volvulus in association with eventration of diaphragm in a 26-year-old man.

Recurrent sigmoid volvulus is a clinical entity characterized by recurrent episodes of partial or complete sigmoid volvulus. Although it is commonly seen in the elderly, it can be occasionally seen in younger patients. Patients with recurrent partial sigmoid volvulus are relatively asymptomatic or present with mild abdominal pain. Early diagnosis and treatment is essential to prevent conversion to acute gangrenous volvulus. We present a case of recurrent partial sigmoid volvulus in association with eventration of diaphragm in a 26-year-old man.

Colon, Sigmoid;Volvulus;Young Adult;Eventration of Diaphragm Colon, Sigmoid;Volvulus;Young Adult;Eventration of Diaphragm http://www.Iranjradiol.com/index.php?page=article&article_id=8640 Shailesh Mukund Prabhu Shailesh Mukund Prabhu Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, India; Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, India. Tel: +91-8098910245 Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, India; Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, India. Tel: +91-8098910245 Bhuvaneswari Venkatesan Bhuvaneswari Venkatesan Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, India Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, India Gurucharan Shetty Gurucharan Shetty Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India Mahender Kaur Narula Mahender Kaur Narula Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, India Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, India Udit Chauhan Udit Chauhan Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, India Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, India Alok Kumar Udiya Alok Kumar Udiya Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, India Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, India
en 10.5812/iranjradiol.8307 Ultrasound-Guided Fine Needle Aspiration (USFNA) of Thyroid Nodules; Does Aspiration Site Matter? Ultrasound-Guided Fine Needle Aspiration (USFNA) of Thyroid Nodules; Does Aspiration Site Matter? brief-report brief-report Conclusions

The aspirates from the hypovascular and hypervascular sites of solid nodules are complementary and should be performed consecutively.

Results

When only hypervascular site was used, adequate sampling was limited to 65% of the cases. When both sites were evaluated together, overall adequate sampling was 91%. Adding a sample from the hypervascular site to hypovascular aspirate increased the adequate sampling by 8%. The highest pathological score was achieved when both hypo- and hypervascular site aspirates were evaluated together.

Patients and Methods

Twenty-three consecutive patients with solid thyroid nodules larger than 2 cm were aspirated under color Doppler sonography guidance. First pass was from the hypovascular site and the second pass from the hypervascular site. The aspirates were scored from 1-3 by cytologist according to number of cell groups.

Objectives

The aim of the study was to assess whether USFNA of the hypovascular or hypervascular site of a thyroid nodule would reveal more cells for cytological analysis.

Background

The goal of ultrasound guided fine-needle aspiration (USFNA) is to obtain most cellular specimen that represents the nodule. However, there is substantial variability in specimen cellularity depending on the obtaining techniques. While performing USFNA, it is not clear whether the needle tip should be placed at hypovascular or hypervascular site of the nodule to obtain more cells for cytological analysis.

Conclusions

The aspirates from the hypovascular and hypervascular sites of solid nodules are complementary and should be performed consecutively.

Results

When only hypervascular site was used, adequate sampling was limited to 65% of the cases. When both sites were evaluated together, overall adequate sampling was 91%. Adding a sample from the hypervascular site to hypovascular aspirate increased the adequate sampling by 8%. The highest pathological score was achieved when both hypo- and hypervascular site aspirates were evaluated together.

Patients and Methods

Twenty-three consecutive patients with solid thyroid nodules larger than 2 cm were aspirated under color Doppler sonography guidance. First pass was from the hypovascular site and the second pass from the hypervascular site. The aspirates were scored from 1-3 by cytologist according to number of cell groups.

Objectives

The aim of the study was to assess whether USFNA of the hypovascular or hypervascular site of a thyroid nodule would reveal more cells for cytological analysis.

Background

The goal of ultrasound guided fine-needle aspiration (USFNA) is to obtain most cellular specimen that represents the nodule. However, there is substantial variability in specimen cellularity depending on the obtaining techniques. While performing USFNA, it is not clear whether the needle tip should be placed at hypovascular or hypervascular site of the nodule to obtain more cells for cytological analysis.

Thyroid; Ultrasonography; biopsy; Fine Needle Aspiration; Doppler; Color Thyroid; Ultrasonography; biopsy; Fine Needle Aspiration; Doppler; Color http://www.Iranjradiol.com/index.php?page=article&article_id=8307 Umit Aksoy Ozcan Umit Aksoy Ozcan Department of Radiology, School of Medicine, Acibadem University, Istanbul, Turkey; Department of Radiology, School of Medicine, Acibadem University, Istanbul, Turkey. Tel: +90-2165714426, Fax: +90-2165332352 Department of Radiology, School of Medicine, Acibadem University, Istanbul, Turkey; Department of Radiology, School of Medicine, Acibadem University, Istanbul, Turkey. Tel: +90-2165714426, Fax: +90-2165332352 Safak Atahan Safak Atahan Patonet Cytopathology Laboratory, Bursa, Turkey Patonet Cytopathology Laboratory, Bursa, Turkey
en 10.5812/iranjradiol.8499 The Role of Three-Dimensional Imaging in the Control of Intrauterine Contraceptive Devices The Role of Three-Dimensional Imaging in the Control of Intrauterine Contraceptive Devices letter letter Ultrasonography;Three-Dimensional Imaging;Intrauterine Device Ultrasonography;Three-Dimensional Imaging;Intrauterine Device http://www.Iranjradiol.com/index.php?page=article&article_id=8499 Firoozeh Ahmadi Firoozeh Ahmadi Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P. O. Box: 16635-148, Tehran, Iran. Tel: +98-2123562446 Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P. O. Box: 16635-148, Tehran, Iran. Tel: +98-2123562446 Hadieh Haghighi Hadieh Haghighi Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
en 10.5812/iranjradiol.8212 Large Intraluminal Ileal Hematoma Presenting as Small Bowel Obstruction in a Child Large Intraluminal Ileal Hematoma Presenting as Small Bowel Obstruction in a Child case-report case-report

Intraluminal small bowel hematoma has been rarely reported in children, as a rare cause of small bowel obstruction. We present a case of an intraluminal ileal hematoma presenting as small bowel obstruction in a child. Computed Tomography (CT) indicated a large intraluminal hyperdense lesion in the distal ileum as the cause of small bowel obstruction. Abdominal ultrasonography (US) showed an echogenic mass-like lesion with multiple septa in the distal ileum. Small bowel obstruction due to a complicated cystic mass was provisionally diagnosed. Histopathologic examination of the resected mass suggested a submucosal ileal hematoma. Although intraluminal small bowel hematoma is rare in children, it can present as an intraluminal cystic mass and should be considered as a rare cause of small bowel obstruction. The US and CT findings of submucosal ileal hematoma could be useful for the diagnosis of such cases in the future.

Intraluminal small bowel hematoma has been rarely reported in children, as a rare cause of small bowel obstruction. We present a case of an intraluminal ileal hematoma presenting as small bowel obstruction in a child. Computed Tomography (CT) indicated a large intraluminal hyperdense lesion in the distal ileum as the cause of small bowel obstruction. Abdominal ultrasonography (US) showed an echogenic mass-like lesion with multiple septa in the distal ileum. Small bowel obstruction due to a complicated cystic mass was provisionally diagnosed. Histopathologic examination of the resected mass suggested a submucosal ileal hematoma. Although intraluminal small bowel hematoma is rare in children, it can present as an intraluminal cystic mass and should be considered as a rare cause of small bowel obstruction. The US and CT findings of submucosal ileal hematoma could be useful for the diagnosis of such cases in the future.

Intestinal obstruction;Hematoma;Ultrasonography Intestinal obstruction;Hematoma;Ultrasonography http://www.Iranjradiol.com/index.php?page=article&article_id=8212 Yun Jung Lim Yun Jung Lim Department of Radiology, Haeundae Paik Hostpital, Inje University, Inje, South Korea; Department of Radiology, Haeundae Paik Hostpital, Inje University, Jwa-dong, Haeundae-gu, Busan, Inje, South Korea. Tel: +82-517970363, Fax: +82-517970379 Department of Radiology, Haeundae Paik Hostpital, Inje University, Inje, South Korea; Department of Radiology, Haeundae Paik Hostpital, Inje University, Jwa-dong, Haeundae-gu, Busan, Inje, South Korea. Tel: +82-517970363, Fax: +82-517970379 So Hyun Nam So Hyun Nam Department of Pediatric Surgery, Haeundae Paik Hostpital, Inje University, Inje, South Korea Department of Pediatric Surgery, Haeundae Paik Hostpital, Inje University, Inje, South Korea Seon Jeong Kim Seon Jeong Kim Department of Radiology, Haeundae Paik Hostpital, Inje University, Inje, South Korea Department of Radiology, Haeundae Paik Hostpital, Inje University, Inje, South Korea
en 10.5812/iranjradiol.9086 Lung Perfusion SPECT: Application in a Patient With Tetralogy of Fallot and Suspected Pulmonary Thromboemboli Lung Perfusion SPECT: Application in a Patient With Tetralogy of Fallot and Suspected Pulmonary Thromboemboli case-report case-report

A 22-year-old woman presented with acute left-sided pleuritic chest pain and dyspnea 6 days after surgery for revision of the stenotic central aortopulmonary shunt. She had a history of tetralogy of Fallot (TOF), pulmonary valve stenosis, ventricular septal defect and major aortopulmonary collateral artery. Her Waterston shunt was placed when she was 5 years old and stented and re-dilated after stenosis. Acute pulmonary thromboemboli (PTE) was suspected and pulmonary perfusion scan was performed with 4 mCi 99m Technetium labeled macroaggregated albumin. The left lung was globally hypoperfused with evident uptake in the brain, renal parenchyma and thyroid. SPECT images revealed a segmental wedge-shaped peripheral defect in the posterior segment of the left upper lobe. The scan was interpreted as acute/chronic PTE or vascular abnormality. CT angiography excluded PTE; nevertheless the patient was treated with a therapeutic dose of heparin changed to warfarin and was discharged with improvement of the symptoms. Pulmonary artery angiography was not performed.

A 22-year-old woman presented with acute left-sided pleuritic chest pain and dyspnea 6 days after surgery for revision of the stenotic central aortopulmonary shunt. She had a history of tetralogy of Fallot (TOF), pulmonary valve stenosis, ventricular septal defect and major aortopulmonary collateral artery. Her Waterston shunt was placed when she was 5 years old and stented and re-dilated after stenosis. Acute pulmonary thromboemboli (PTE) was suspected and pulmonary perfusion scan was performed with 4 mCi 99m Technetium labeled macroaggregated albumin. The left lung was globally hypoperfused with evident uptake in the brain, renal parenchyma and thyroid. SPECT images revealed a segmental wedge-shaped peripheral defect in the posterior segment of the left upper lobe. The scan was interpreted as acute/chronic PTE or vascular abnormality. CT angiography excluded PTE; nevertheless the patient was treated with a therapeutic dose of heparin changed to warfarin and was discharged with improvement of the symptoms. Pulmonary artery angiography was not performed.

Tomography, Emission-Computed, Single-Photon;Tetralogy of Fallot;Pulmonary Embolism Tomography, Emission-Computed, Single-Photon;Tetralogy of Fallot;Pulmonary Embolism http://www.Iranjradiol.com/index.php?page=article&article_id=9086 Mina Ranji Amjad Mina Ranji Amjad Research Institute for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Research Institute for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Mehrshad Abbasi Mehrshad Abbasi Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran Saeed Farzanehfar Saeed Farzanehfar Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, P. O. Box: 14197-33141, Tehran, Iran. Tel: +98-2161192400, Fax: +98-2166581529 Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, P. O. Box: 14197-33141, Tehran, Iran. Tel: +98-2161192400, Fax: +98-2166581529
en 10.5812/iranjradiol.23911 Calcifying Aponeurotic Fibroma of the Dorsum of the Foot: Radiographic and Magnetic Resonance Imaging Findings in a Four-Year-Old Boy Calcifying Aponeurotic Fibroma of the Dorsum of the Foot: Radiographic and Magnetic Resonance Imaging Findings in a Four-Year-Old Boy case-report case-report

Calcifying aponeurotic fibroma (CAF) is a rare, benign fibroblastic tumor that typically occurs in the palms of the hands and soles of the feet, in children and adolescents. Due to its infiltrative nature, this tumor can mimic malignancy on preoperative magnetic resonance imaging (MRI) and has a predilection for local recurrence. There are very few reports in the literature that describe features of CAF on MRI, especially those arising in the foot. We present an unusual case of a CAF affecting the dorsum of the foot in a four-year-old boy.

Calcifying aponeurotic fibroma (CAF) is a rare, benign fibroblastic tumor that typically occurs in the palms of the hands and soles of the feet, in children and adolescents. Due to its infiltrative nature, this tumor can mimic malignancy on preoperative magnetic resonance imaging (MRI) and has a predilection for local recurrence. There are very few reports in the literature that describe features of CAF on MRI, especially those arising in the foot. We present an unusual case of a CAF affecting the dorsum of the foot in a four-year-old boy.

Fibroma;Foot;Magnetic Resonance Imaging Fibroma;Foot;Magnetic Resonance Imaging http://www.Iranjradiol.com/index.php?page=article&article_id=23911 Yun Hee Cho Yun Hee Cho Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Kyung-Sik Ahn Kyung-Sik Ahn Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea; Department of Radiology, Anam Hospital, Korea University College of Medicine, 126-1, 5-ga Anam-dong, Seongbuk-gu, Seoul 136-705, Korea. Tel: +82-29206627, Fax: +82-29293796 Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea; Department of Radiology, Anam Hospital, Korea University College of Medicine, 126-1, 5-ga Anam-dong, Seongbuk-gu, Seoul 136-705, Korea. Tel: +82-29206627, Fax: +82-29293796 Chang Ho Kang Chang Ho Kang Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Chul Hwan Kim Chul Hwan Kim Department of Pathology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Department of Pathology, Anam Hospital, Korea University College of Medicine, Seoul, Korea
en 10.5812/iranjradiol.22759 Evolution of Computed Tomography Findings in Secondary Aortoenteric Fistula Evolution of Computed Tomography Findings in Secondary Aortoenteric Fistula case-report case-report

Aortoenteric fistula is a rare but significant clinical entity associated with high morbidity and mortality if remain untreated. Clinical presentation and imaging findings may be subtle and prompt diagnosis can be difficult. Herein, we present a patient who initially presented with abdominal pain and computed tomography showed an aortic aneurysm compressing duodenum without any air bubbles. One month later, the patient presented with gastrointestinal bleeding and computed tomography revealed air bubbles within aneurysm. With a diagnosis of aortoenteric fistula, endovascular aneurysm repair was carried out. This case uniquely presented the computed tomography findings in progression of an aneurysm to an aortoenteric fistula.

Aortoenteric fistula is a rare but significant clinical entity associated with high morbidity and mortality if remain untreated. Clinical presentation and imaging findings may be subtle and prompt diagnosis can be difficult. Herein, we present a patient who initially presented with abdominal pain and computed tomography showed an aortic aneurysm compressing duodenum without any air bubbles. One month later, the patient presented with gastrointestinal bleeding and computed tomography revealed air bubbles within aneurysm. With a diagnosis of aortoenteric fistula, endovascular aneurysm repair was carried out. This case uniquely presented the computed tomography findings in progression of an aneurysm to an aortoenteric fistula.

Fistula; Endovascular Procedures; Aorta Fistula; Endovascular Procedures; Aorta http://www.Iranjradiol.com/index.php?page=article&article_id=22759 Ahmet Bas Ahmet Bas Department of Radiology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey Department of Radiology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey Osman Simsek Osman Simsek Department of General Surgery, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey Department of General Surgery, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey Sedat Giray Kandemirli Sedat Giray Kandemirli Department of Radiology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey; Department of Radiology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey. Tel: +90-5543971851, Fax: +90-2124143167 Department of Radiology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey; Department of Radiology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey. Tel: +90-5543971851, Fax: +90-2124143167 Babak Rafiee Babak Rafiee Department of Radiology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey Department of Radiology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey Fatih Gulsen Fatih Gulsen Department of Radiology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey Department of Radiology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey Furuzan Numan Furuzan Numan Department of Radiology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey Department of Radiology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey