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 3
en 26535107 10.5812/iranjradiol.10986v2 Coil Embolization of Intracranial Aneurysms: A Six-Month Follow-Up Study Coil Embolization of Intracranial Aneurysms: A Six-Month Follow-Up Study research-article research-article Conclusion

Coil embolization showed successful outcomes in the treatment of intracranial aneurysms with a low complication rate.

Results

Immediately after the procedure, the total occlusion was seen in 76 (86.4%), subtotal occlusion in six (6.8%), and partial occlusion in six patients (6.8%). There was no significant relationship between the aneurysm size, aneurysm neck size, and location of the aneurysm with total or subtotal occlusions. Eleven patients (12.5%) experienced some complication during the procedure including two tears, three focal neurological signs, three vision disturbances, and three bleedings in the aneurysm. Major complications were significantly higher in the posterior aneurysm compared to the anterior ones (55.6% versus 44.4% of the major complications; P value = 0.015). Among patients who underwent control angiography, 34 patients (89.4%) had no change, two (5.3%) had new growth and two (5.3%) had widening of the neck after 6 months follow-up. Although aneurysms that remained unchanged after six months follow-up angiography had total occlusion after the procedure, it was 50% for aneurysms that had any changes in 6 months follow-up angiography (P value = 0.01).

Objectives

The aim of this study is to report our experience in managing intracranial aneurysms using coil embolization and to report the 6-month follow-up outcome of the patients.

Patients and Methods

From January 2010 to December 2012, a series of 90 nonrandomized consecutive patients (mean age: 44.6 ± 14.9 years) with intracranial aneurysms underwent endovascular coil embolization in our center. We excluded patients with dissecting, blood blister-like, or false aneurysms. All patients were evaluated by four-vessel angiography to determine the shape, size, number and location of the aneurysms. We recommended a six-month follow-up control angiography. However, only 38 of them participated in this follow-up imaging. The data were analyzed by chi-square, fisher exact and t-tests and alpha was considered lower than 5%.

Background

Rupture of the intracranial aneurysms is associated with a high risk of bleeding and a high incidence of mortality if left untreated.

Conclusion

Coil embolization showed successful outcomes in the treatment of intracranial aneurysms with a low complication rate.

Results

Immediately after the procedure, the total occlusion was seen in 76 (86.4%), subtotal occlusion in six (6.8%), and partial occlusion in six patients (6.8%). There was no significant relationship between the aneurysm size, aneurysm neck size, and location of the aneurysm with total or subtotal occlusions. Eleven patients (12.5%) experienced some complication during the procedure including two tears, three focal neurological signs, three vision disturbances, and three bleedings in the aneurysm. Major complications were significantly higher in the posterior aneurysm compared to the anterior ones (55.6% versus 44.4% of the major complications; P value = 0.015). Among patients who underwent control angiography, 34 patients (89.4%) had no change, two (5.3%) had new growth and two (5.3%) had widening of the neck after 6 months follow-up. Although aneurysms that remained unchanged after six months follow-up angiography had total occlusion after the procedure, it was 50% for aneurysms that had any changes in 6 months follow-up angiography (P value = 0.01).

Objectives

The aim of this study is to report our experience in managing intracranial aneurysms using coil embolization and to report the 6-month follow-up outcome of the patients.

Patients and Methods

From January 2010 to December 2012, a series of 90 nonrandomized consecutive patients (mean age: 44.6 ± 14.9 years) with intracranial aneurysms underwent endovascular coil embolization in our center. We excluded patients with dissecting, blood blister-like, or false aneurysms. All patients were evaluated by four-vessel angiography to determine the shape, size, number and location of the aneurysms. We recommended a six-month follow-up control angiography. However, only 38 of them participated in this follow-up imaging. The data were analyzed by chi-square, fisher exact and t-tests and alpha was considered lower than 5%.

Background

Rupture of the intracranial aneurysms is associated with a high risk of bleeding and a high incidence of mortality if left untreated.

Intracranial Aneurysm;Endovascular Procedure;Follow-Up Intracranial Aneurysm;Endovascular Procedure;Follow-Up http://www.Iranjradiol.com/index.php?page=article&article_id=10986 Mojtaba Miri Mojtaba Miri Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Hossein Ghanaati Hossein Ghanaati Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; Sina Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; Sina Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Payman Salamati Payman Salamati Sina Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Sina Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Hojat Ebrahimi Nik Hojat Ebrahimi Nik Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Amir Hossein Jalali Amir Hossein Jalali Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2166581579, Fax: +98-2166581578 Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2166581579, Fax: +98-2166581578 Mina Saeednejad Mina Saeednejad Islamic Azad University, Tehran Medical Branch, Tehran, Iran Islamic Azad University, Tehran Medical Branch, Tehran, Iran Kavous Firouznia Kavous Firouznia Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
en 26557280 10.5812/iranjradiol.18801 In Vivo Evaluation of Feeding Arteries of Tumors in Dorsal Sector of the Liver In Vivo Evaluation of Feeding Arteries of Tumors in Dorsal Sector of the Liver research-article research-article Background

The identification of the dorsal sector of the liver and its detailed vascular anatomy is of primary importance for surgical practice and segmental transcatheter arterial chemoembolization.

Objectives

This study aimed to investigate the feeding arteries of tumors in dorsal sector of the liver.

Patients and Methods

Computed tomography (CT) and digital subtraction angiography (DSA) images of eleven patients with tumors of the dorsal sector of the liver were analyzed retrospectively. The hepatic arteries that probably supplied the tumors were observed in DSA images. The case number of each hepatic artery feeding to the tumors was calculated. A scoring method was used to estimate each hepatic artery contribution to the tumor stain in DSA images. The accumulative scores were employed to evaluate the blood supply of feeding arteries of the tumors.

Results

The data of the study revealed that right posterior hepatic artery (RPHA) (n = 9), middle hepatic artery (MHA) (n = 8), left medial hepatic artery (LMHA) (n = 6), right anterior hepatic artery (RAHA) (n = 5), and caudate hepatic artery (CaHA) (n = 3) were the feeding arteries of the tumors in dorsal sector in eleven patients. The accumulative scores of RPHA, MHA, RAHA, and LMHA were 23, 17, 11, and 7 points, respectively (χ2 = 6.827,P = 0.078, Friedman test). The total scores of right hepatic artery (RHA) branches and left hepatic artery (LHA) branches were 51 and 11 points, respectively (Z = -2.764, P = 0.006, Wilcoxon rank test).

Conclusion

The RPHA, MHA, RAHA, and LMHA might be the main feeding arteries of the tumors in dorsal sector of the liver.

Background

The identification of the dorsal sector of the liver and its detailed vascular anatomy is of primary importance for surgical practice and segmental transcatheter arterial chemoembolization.

Objectives

This study aimed to investigate the feeding arteries of tumors in dorsal sector of the liver.

Patients and Methods

Computed tomography (CT) and digital subtraction angiography (DSA) images of eleven patients with tumors of the dorsal sector of the liver were analyzed retrospectively. The hepatic arteries that probably supplied the tumors were observed in DSA images. The case number of each hepatic artery feeding to the tumors was calculated. A scoring method was used to estimate each hepatic artery contribution to the tumor stain in DSA images. The accumulative scores were employed to evaluate the blood supply of feeding arteries of the tumors.

Results

The data of the study revealed that right posterior hepatic artery (RPHA) (n = 9), middle hepatic artery (MHA) (n = 8), left medial hepatic artery (LMHA) (n = 6), right anterior hepatic artery (RAHA) (n = 5), and caudate hepatic artery (CaHA) (n = 3) were the feeding arteries of the tumors in dorsal sector in eleven patients. The accumulative scores of RPHA, MHA, RAHA, and LMHA were 23, 17, 11, and 7 points, respectively (χ2 = 6.827,P = 0.078, Friedman test). The total scores of right hepatic artery (RHA) branches and left hepatic artery (LHA) branches were 51 and 11 points, respectively (Z = -2.764, P = 0.006, Wilcoxon rank test).

Conclusion

The RPHA, MHA, RAHA, and LMHA might be the main feeding arteries of the tumors in dorsal sector of the liver.

Angiography;Hepatic artery;Anatomy;Liver Neoplasms Angiography;Hepatic artery;Anatomy;Liver Neoplasms http://www.Iranjradiol.com/index.php?page=article&article_id=18801 Jun Chen Jun Chen Department of Radiology, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China Department of Radiology, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China Shixi Chen Shixi Chen Department of Radiology, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China Department of Radiology, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China Wei Xi Wei Xi Department of Radiology, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China Department of Radiology, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China Bei Wu Bei Wu Department of Radiology, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China Department of Radiology, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China Hui Yu Hui Yu Department of Radiology, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China Department of Radiology, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China Yang Gao Yang Gao Department of Radiology, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China Department of Radiology, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China Jinhai Tang Jinhai Tang Department of Surgery, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China; Department of Surgery, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China. Tel: +86-2583283305, Fax: +86-2583283305 Department of Surgery, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China; Department of Surgery, Jiangsu Cancer Hospital, Nanjing Medical University (NMU), Nanjing, China. Tel: +86-2583283305, Fax: +86-2583283305
en 26557265 10.5812/iranjradiol.11656 Ensemble Supervised Classification Method Using the Regions of Interest and Grey Level Co-Occurrence Matrices Features for Mammograms Data Ensemble Supervised Classification Method Using the Regions of Interest and Grey Level Co-Occurrence Matrices Features for Mammograms Data research-article research-article Conclusions

In this study, we proposed a new computer aided diagnostic tool for the detection and classification of breast cancer. The obtained results showed that the proposed method is more reliable in diagnostic to assist the radiologists in the detection of abnormal data and to improve the diagnostic accuracy.

Results

After classification with the ensemble supervised algorithm, the performance of the proposed method was evaluated by perfect test method, which gave the sensitivity and specificity of 96.66% and 97.50%, respectively.

Patients and Methods

In this method, we first extract texture features from cancerous and normal breasts, using the Gray-Level Co-occurrence Matrices (GLCM) method. To obtain better results, we select a region of breast with high probability of cancer occurrence before feature extraction. After features extraction, we use the maximum difference method to select the features that have predominant difference between normal and abnormal data sets. Six selected features served as the classifying tool for classification purpose by the proposed ensemble supervised algorithm. For classification, the data were first classified by three supervised classifiers, and then by simple voting policy, we finalized the classification process.

Background

Breast cancer is one of the most encountered cancers in women. Detection and classification of the cancer into malignant or benign is one of the challenging fields of the pathology.

Objectives

Our aim was to classify the mammogram data into normal and abnormal by ensemble classification method.

Conclusions

In this study, we proposed a new computer aided diagnostic tool for the detection and classification of breast cancer. The obtained results showed that the proposed method is more reliable in diagnostic to assist the radiologists in the detection of abnormal data and to improve the diagnostic accuracy.

Results

After classification with the ensemble supervised algorithm, the performance of the proposed method was evaluated by perfect test method, which gave the sensitivity and specificity of 96.66% and 97.50%, respectively.

Patients and Methods

In this method, we first extract texture features from cancerous and normal breasts, using the Gray-Level Co-occurrence Matrices (GLCM) method. To obtain better results, we select a region of breast with high probability of cancer occurrence before feature extraction. After features extraction, we use the maximum difference method to select the features that have predominant difference between normal and abnormal data sets. Six selected features served as the classifying tool for classification purpose by the proposed ensemble supervised algorithm. For classification, the data were first classified by three supervised classifiers, and then by simple voting policy, we finalized the classification process.

Background

Breast cancer is one of the most encountered cancers in women. Detection and classification of the cancer into malignant or benign is one of the challenging fields of the pathology.

Objectives

Our aim was to classify the mammogram data into normal and abnormal by ensemble classification method.

Classification;Mammogram;Breast Cancer Classification;Mammogram;Breast Cancer http://www.Iranjradiol.com/index.php?page=article&article_id=11656 Hossein Yousefi Banaem Hossein Yousefi Banaem Department of Biomedical Engineering, Faculty of Advanced Medical Technology, Isfahan University of Medical Sciences, Isfahan, Iran Department of Biomedical Engineering, Faculty of Advanced Medical Technology, Isfahan University of Medical Sciences, Isfahan, Iran Alireza Mehri Dehnavi Alireza Mehri Dehnavi Department of Biomedical Engineering, Faculty of Advanced Medical Technology, Isfahan University of Medical Sciences, Isfahan, Iran; School of Optometry and Visual Science, University of Waterloo, Waterloo, Canada; Department of Biomedical Engineering, Faculty of Advanced Medical Technology, Isfahan University of Medical Sciences, Isfahan, Iran. Tel: +98-31 95016497 Department of Biomedical Engineering, Faculty of Advanced Medical Technology, Isfahan University of Medical Sciences, Isfahan, Iran; School of Optometry and Visual Science, University of Waterloo, Waterloo, Canada; Department of Biomedical Engineering, Faculty of Advanced Medical Technology, Isfahan University of Medical Sciences, Isfahan, Iran. Tel: +98-31 95016497 Makhtum Shahnazi Makhtum Shahnazi Department of Radiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Radiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
en 26557279 10.5812/iranjradiol.18290 Comparing the Effect of Different Voxel Resolutions for Assessment of Vertical Root Fracture of Permanent Teeth Comparing the Effect of Different Voxel Resolutions for Assessment of Vertical Root Fracture of Permanent Teeth research-article research-article Conclusion

No significant differences were found among observers or voxel sizes, with high Az results reported for all groups.

Results

No significant differences were found among observers or voxel sizes, with high average Z (Az) results being reported for all groups. Both intra- and inter-observer agreement values were relatively better for 3D Accuitomo 170 images than the images from NewTom 3G. The highest Az and kappa values were obtained with 3D Accuitomo 170, 4 × 4 cm FOV (0.080 mm3) images.

Background

The teeth with undiagnosed vertical root fractures (VRFs) are likely to receive endodontic treatment or retreatment, leading to frustration and inappropriate endodontic therapies. Moreover, many cases of VRFs cannot be diagnosed definitively until the extraction of tooth.

Objectives

This study aimed to assess the use of different voxel resolutions of two different cone beam computerized tomography (CBCT) units in the detection VRFs in vitro.

Materials and Methods

The study material comprised 74 extracted human mandibular single rooted premolar teeth without root fractures that had not undergone any root-canal treatment. Images were obtained by two different CBCT units. Four image sets were obtained as follows: 1) 3D Accuitomo 170, 4 × 4 cm field of view (FOV) (0.080 mm3); 2) 3D Accuitomo 170. 6 × 6 cm FOV (0.125 mm3); 3) NewTom 3G, 6˝ (0.16 mm3) and 4) NewTom 3G, 9˝ FOV (0.25 mm3). Kappa coefficients were calculated to assess both intra- and inter-observer agreements for each image set.

Conclusion

No significant differences were found among observers or voxel sizes, with high Az results reported for all groups.

Results

No significant differences were found among observers or voxel sizes, with high average Z (Az) results being reported for all groups. Both intra- and inter-observer agreement values were relatively better for 3D Accuitomo 170 images than the images from NewTom 3G. The highest Az and kappa values were obtained with 3D Accuitomo 170, 4 × 4 cm FOV (0.080 mm3) images.

Background

The teeth with undiagnosed vertical root fractures (VRFs) are likely to receive endodontic treatment or retreatment, leading to frustration and inappropriate endodontic therapies. Moreover, many cases of VRFs cannot be diagnosed definitively until the extraction of tooth.

Objectives

This study aimed to assess the use of different voxel resolutions of two different cone beam computerized tomography (CBCT) units in the detection VRFs in vitro.

Materials and Methods

The study material comprised 74 extracted human mandibular single rooted premolar teeth without root fractures that had not undergone any root-canal treatment. Images were obtained by two different CBCT units. Four image sets were obtained as follows: 1) 3D Accuitomo 170, 4 × 4 cm field of view (FOV) (0.080 mm3); 2) 3D Accuitomo 170. 6 × 6 cm FOV (0.125 mm3); 3) NewTom 3G, 6˝ (0.16 mm3) and 4) NewTom 3G, 9˝ FOV (0.25 mm3). Kappa coefficients were calculated to assess both intra- and inter-observer agreements for each image set.

Cone-Beam Computed Tomography;Permanent Dentition;Diagnosis Cone-Beam Computed Tomography;Permanent Dentition;Diagnosis http://www.Iranjradiol.com/index.php?page=article&article_id=18290 Ismail Uzun Ismail Uzun Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey Kaan Gunduz Kaan Gunduz Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey Peruze Celenk Peruze Celenk Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey Hakan Avsever Hakan Avsever Department of Dentomaxillofacial Radiology, Gulhane Military Medical Academy (GATA), Ankara, Turkey Department of Dentomaxillofacial Radiology, Gulhane Military Medical Academy (GATA), Ankara, Turkey Kaan Orhan Kaan Orhan Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey; Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Mersin, Turkey Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey; Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Mersin, Turkey Gozde Canitezer Gozde Canitezer Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey; Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey. Tel: +90-3623121919, Fax: +90-3624576032 Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey; Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey. Tel: +90-3623121919, Fax: +90-3624576032 Bilal Ozmen Bilal Ozmen Department of Pedodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey Department of Pedodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey Ersan Cicek Ersan Cicek Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey Erol Egrioglu Erol Egrioglu Department of Statistics, Ondokuz Mayis University, Samsun, Turkey Department of Statistics, Ondokuz Mayis University, Samsun, Turkey
en 26557283 10.5812/iranjradiol.25518 Desmoplastic Fibroma, Report of a Rare Case in Infraorbital Rim Desmoplastic Fibroma, Report of a Rare Case in Infraorbital Rim case-report case-report

Desmoplastic fibroma (DF) is a rare and locally aggressive intraosseous tumor with unknown etiology. The mandible is the common site of involvement in the maxillofacial region. However, it is believed that DF can arise in any bone of the body. A wide age distribution has been reported for DF occurrence, extending from birth to the sixth decade of life, with a peak incidence at 10 to 19 years of age. In this study, diagnostic and therapeutic management of a 6-year-old girl with a desmoplastic fibroma of the inferior orbital rim and zygomatic buttress are discussed. Cone beam computed tomography (CBCT) revealed a mixed lesion in infraorbital rim, which had ill-defined borders and a straight thick bony septum inside the lesion. It also involved the zygomatic process of maxilla and zygomatic bone. According to radiologic concepts, this rare lesion may mimic fibro-osseous, benign and especially malignant lesions. Regarding different treatment plans, identification of this lesion is essential. Furthermore, presence of coarse and irregular or straight septa along with some imaging criteria for malignant lesions such as destruction of the cortex, periosteal reaction and soft tissue invasion would be helpful to differentiate this lesion from malignant and multilocular benign lesions.

Desmoplastic fibroma (DF) is a rare and locally aggressive intraosseous tumor with unknown etiology. The mandible is the common site of involvement in the maxillofacial region. However, it is believed that DF can arise in any bone of the body. A wide age distribution has been reported for DF occurrence, extending from birth to the sixth decade of life, with a peak incidence at 10 to 19 years of age. In this study, diagnostic and therapeutic management of a 6-year-old girl with a desmoplastic fibroma of the inferior orbital rim and zygomatic buttress are discussed. Cone beam computed tomography (CBCT) revealed a mixed lesion in infraorbital rim, which had ill-defined borders and a straight thick bony septum inside the lesion. It also involved the zygomatic process of maxilla and zygomatic bone. According to radiologic concepts, this rare lesion may mimic fibro-osseous, benign and especially malignant lesions. Regarding different treatment plans, identification of this lesion is essential. Furthermore, presence of coarse and irregular or straight septa along with some imaging criteria for malignant lesions such as destruction of the cortex, periosteal reaction and soft tissue invasion would be helpful to differentiate this lesion from malignant and multilocular benign lesions.

Desmoplastic Fibroma;Zygoma;Bone Neoplasm Desmoplastic Fibroma;Zygoma;Bone Neoplasm http://www.Iranjradiol.com/index.php?page=article&article_id=25518 Yaser Safi Yaser Safi Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Nafise Shamloo Nafise Shamloo Department of Oral and Maxillofacial Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Oral and Maxillofacial Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hossein Heidar Hossein Heidar Department of Oral and Maxillofacial Surgery, Tehran University of Medical Sciences, Tehran, Iran Department of Oral and Maxillofacial Surgery, Tehran University of Medical Sciences, Tehran, Iran Solmaz Valizadeh Solmaz Valizadeh Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad Mehdi Aghdasi Mohammad Mehdi Aghdasi Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Maryam Eslami Manouchehri Maryam Eslami Manouchehri Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: +98-9126871870 Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: +98-9126871870
en 10.5812/iranjradiol.5200 Endovascular Treatment of a Huge Hepatic Artery Aneurysm by Coil Embolization Method: A Case Report Endovascular Treatment of a Huge Hepatic Artery Aneurysm by Coil Embolization Method: A Case Report case-report case-report

Hepatic artery aneurysms are rare but potentially life threatening. We describe a novel case of a successful endovascular coil embolization of a huge hepatic artery aneurysm. A 67-year-old woman presented with recent abdominal pain that had begun from 2 weeks before referring to our hospital. Sonographic and computerized tomographic (CT) findings revealed a huge hepatic artery aneurysm with 95 mm × 83 mm diameter. The patient underwent an endovascular technique. In aortic angiography, the celiac artery orifice and superior mesenteric artery were so narrow, so sonography was used in order to determine the exact position of the catheter in the celiac artery orifice. The aneurysm was thrombosed using coil embolization. Pulsation of the aneurysm immediately disappeared. Huge hepatic artery aneurysm can be safely treated using coil embolization.

Hepatic artery aneurysms are rare but potentially life threatening. We describe a novel case of a successful endovascular coil embolization of a huge hepatic artery aneurysm. A 67-year-old woman presented with recent abdominal pain that had begun from 2 weeks before referring to our hospital. Sonographic and computerized tomographic (CT) findings revealed a huge hepatic artery aneurysm with 95 mm × 83 mm diameter. The patient underwent an endovascular technique. In aortic angiography, the celiac artery orifice and superior mesenteric artery were so narrow, so sonography was used in order to determine the exact position of the catheter in the celiac artery orifice. The aneurysm was thrombosed using coil embolization. Pulsation of the aneurysm immediately disappeared. Huge hepatic artery aneurysm can be safely treated using coil embolization.

Hepatic Artery;Aneurysm;Endovascular Procedures;Pain;Embolization, Therapeutic Hepatic Artery;Aneurysm;Endovascular Procedures;Pain;Embolization, Therapeutic http://www.Iranjradiol.com/index.php?page=article&article_id=5200 Hossein Hemmati Hossein Hemmati Respiratory Diseases and TB Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran; Respiratory Diseases and TB Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran. Tel: +98-9133045924, Fax: +98-1333542460 Respiratory Diseases and TB Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran; Respiratory Diseases and TB Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran. Tel: +98-9133045924, Fax: +98-1333542460 Mehdi Karimian Mehdi Karimian Respiratory Diseases and TB Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran Respiratory Diseases and TB Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran Habibollah Moradi Habibollah Moradi Respiratory Diseases and TB Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran Respiratory Diseases and TB Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran Kambiz Farid Marandi Kambiz Farid Marandi Respiratory Diseases and TB Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran Respiratory Diseases and TB Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran Afrooz Haghdoost Afrooz Haghdoost Student Research Committee, Department of Research and Technology, Guilan University of Medical Sciences, Rasht, Iran Student Research Committee, Department of Research and Technology, Guilan University of Medical Sciences, Rasht, Iran
en 26528387 10.5812/iranjradiol.12(2)2015.7153 Presentation of Intrauterine Device in a Didelphic Uterus Presentation of Intrauterine Device in a Didelphic Uterus letter letter Intrauterine Devices;Uterine Anomalies;Ultrasonography Intrauterine Devices;Uterine Anomalies;Ultrasonography http://www.Iranjradiol.com/index.php?page=article&article_id=7153 Firoozeh Ahmadi Firoozeh Ahmadi 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. Tel: +98-2123562254 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. Tel: +98-2123562254 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 Shohreh Irani Shohreh Irani Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Epidemiology and Reproductive Health, Reproductive Epidemiology 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; Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran Gholam Shahrzad Gholam Shahrzad 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 26557282 10.5812/iranjradiol.12(2)2015.22383 Computed Tomography Pulmonary Angiography for Evaluation of Patients With Suspected Pulmonary Embolism: Use or Overuse Computed Tomography Pulmonary Angiography for Evaluation of Patients With Suspected Pulmonary Embolism: Use or Overuse brief-report brief-report Conclusion

There is still excessive unjustified concern of PTE in less trained physicians leading to excessive diagnostic work-up. Loyalty to the existing guideline for management of suspected PTE in educational hospitals and supervision of attending physicians could prevent overuse of CTPA.

Results

During a 6-month period, 82 patients who underwent CTPA were included. The prevalence of PTE was 62.2% in the group of subjects with a likely clinical risk. In 45 (54.8%) of those patients whose CTPA was requested, the PTE was unlikely based on modified Wells criteria. In the clinically unlikely group, serum D-dimer assay was done in 15 out of 45 (33.3%), while it was inappropriately checked in 10 out of 37 (27.0%) with a clinically likely risk. General adherence rate to diagnostic algorithm of PTE was 43.9%.

Patients and Methods

The registered medical records (Wells scores and serum D-dimer level) of all patients whose CTPA was performed with suspicion of pulmonary thromboembolism (PTE) were studied retrospectively. Modified Wells score of each patient was determined without being aware of the CTPA results. The patients were categorized to those with a high (likely) clinical probability (score > 4) and low (unlikely) clinical probability (score≤ 4) of PTE.

Background

The use of computed tomography pulmonary angiography (CTPA) has been increased during the last decade.

Objectives

We studied the adherence to current diagnostic recommendations for evaluation of pulmonary embolism in a teaching hospital of Tehran University of Medical Sciences.

Conclusion

There is still excessive unjustified concern of PTE in less trained physicians leading to excessive diagnostic work-up. Loyalty to the existing guideline for management of suspected PTE in educational hospitals and supervision of attending physicians could prevent overuse of CTPA.

Results

During a 6-month period, 82 patients who underwent CTPA were included. The prevalence of PTE was 62.2% in the group of subjects with a likely clinical risk. In 45 (54.8%) of those patients whose CTPA was requested, the PTE was unlikely based on modified Wells criteria. In the clinically unlikely group, serum D-dimer assay was done in 15 out of 45 (33.3%), while it was inappropriately checked in 10 out of 37 (27.0%) with a clinically likely risk. General adherence rate to diagnostic algorithm of PTE was 43.9%.

Patients and Methods

The registered medical records (Wells scores and serum D-dimer level) of all patients whose CTPA was performed with suspicion of pulmonary thromboembolism (PTE) were studied retrospectively. Modified Wells score of each patient was determined without being aware of the CTPA results. The patients were categorized to those with a high (likely) clinical probability (score > 4) and low (unlikely) clinical probability (score≤ 4) of PTE.

Background

The use of computed tomography pulmonary angiography (CTPA) has been increased during the last decade.

Objectives

We studied the adherence to current diagnostic recommendations for evaluation of pulmonary embolism in a teaching hospital of Tehran University of Medical Sciences.

Pulmonary Embolism;Emergencies;Computed Tomography Pulmonary Embolism;Emergencies;Computed Tomography http://www.Iranjradiol.com/index.php?page=article&article_id=22383 Shima Molaee Shima Molaee Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran Hossein Ghanaati Hossein Ghanaati Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran; Department of Radiology, 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, Tehran University of Medical Sciences, Tehran, Iran Enayat Safavi Enayat Safavi Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran; Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2166939922 Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran; Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2166939922 Morteza Foroumandi Morteza Foroumandi Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran Soheil Peiman Soheil Peiman Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran; Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran; Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
en 26557271 10.5812/iranjradiol.12(3)2015.16059 Correlation of Shape and Size of Sella Turcica With the Type of Facial Skeletal Class in an Iranian Group Correlation of Shape and Size of Sella Turcica With the Type of Facial Skeletal Class in an Iranian Group research-article research-article Conclusion

A significant relationship exists between the type of facial skeletal classification and the shape of the sella turcica; as in class III patients, sella turcica bridge was reported with a higher frequency. Also, sella turcica had a significantly higher length in these patients than in those with class I and class II facial skeletal types.

Results

Sella turcica had normal morphology in 24.4% of the patients while irregularity (notching) in the posterior part of the dorsum sella was observed in 15.6%, double contour of sellar floor in 5.6%, sella turcica bridge in 23.3%, oblique anterior wall in 20% and pyramidal shape of the dorsum sella in 11.1% of the subjects. In total, 46.7% of class I patients had a normal shape of sella turcica, 23.3% of class II patients had an oblique anterior wall and a pyramidal shape of the dorsum sella, and 43.3% of class III individuals had sella turcica bridge (the greatest values). Sella turcica length was significantly greater in class III patients compared to class II and class I (P < 0.0001). However, depth and diameter of sella turcica were similar in class I, class II, and class III patients. Furthermore, age was significantly correlated to the diameter of sella turcica as greater diameters were observed in older ages (P < 0.04).

Objectives

The present study was designed to investigate this relationship in patients referred to a dental school in Iran.

Patients and Methods

In this descriptive-analytical study, cephalometric radiographies of 90 candidates for orthodontic treatment (44 females and 46 males) with an age range of 14 - 26 years and equal distribution in terms of class I, class II, and class III facial skeletal classification were selected. The shape, length, diameter, and depth of the sella turcica were determined on the radiographs. Linear dimensions were assessed by one-way analysis of variance while the correlation between the dimensions and age was investigated using Pearson’s correlation coefficient.

Background

In orthodontic science, diagnosis of facial skeletal type (class I, II, and III) is essential to make the correct treatment plan that is usually expensive and complicated. Sometimes results from analysis of lateral cephalometry radiographies are not enough to discriminate facial skeletal types. In this situation, knowledge about the relationship between the shape and size of the sella turcica and the type of facial skeletal class can help to make a more definitive decision for treatment plan.

Conclusion

A significant relationship exists between the type of facial skeletal classification and the shape of the sella turcica; as in class III patients, sella turcica bridge was reported with a higher frequency. Also, sella turcica had a significantly higher length in these patients than in those with class I and class II facial skeletal types.

Results

Sella turcica had normal morphology in 24.4% of the patients while irregularity (notching) in the posterior part of the dorsum sella was observed in 15.6%, double contour of sellar floor in 5.6%, sella turcica bridge in 23.3%, oblique anterior wall in 20% and pyramidal shape of the dorsum sella in 11.1% of the subjects. In total, 46.7% of class I patients had a normal shape of sella turcica, 23.3% of class II patients had an oblique anterior wall and a pyramidal shape of the dorsum sella, and 43.3% of class III individuals had sella turcica bridge (the greatest values). Sella turcica length was significantly greater in class III patients compared to class II and class I (P < 0.0001). However, depth and diameter of sella turcica were similar in class I, class II, and class III patients. Furthermore, age was significantly correlated to the diameter of sella turcica as greater diameters were observed in older ages (P < 0.04).

Objectives

The present study was designed to investigate this relationship in patients referred to a dental school in Iran.

Patients and Methods

In this descriptive-analytical study, cephalometric radiographies of 90 candidates for orthodontic treatment (44 females and 46 males) with an age range of 14 - 26 years and equal distribution in terms of class I, class II, and class III facial skeletal classification were selected. The shape, length, diameter, and depth of the sella turcica were determined on the radiographs. Linear dimensions were assessed by one-way analysis of variance while the correlation between the dimensions and age was investigated using Pearson’s correlation coefficient.

Background

In orthodontic science, diagnosis of facial skeletal type (class I, II, and III) is essential to make the correct treatment plan that is usually expensive and complicated. Sometimes results from analysis of lateral cephalometry radiographies are not enough to discriminate facial skeletal types. In this situation, knowledge about the relationship between the shape and size of the sella turcica and the type of facial skeletal class can help to make a more definitive decision for treatment plan.

Sella Turcica;Skeletal;Shape Sella Turcica;Skeletal;Shape http://www.Iranjradiol.com/index.php?page=article&article_id=16059 Solmaz Valizadeh Solmaz Valizadeh Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Shahrzad Shahbeig Shahrzad Shahbeig Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Sudeh Mohseni Sudeh Mohseni Department of Oral and Maxillofacial Radiology, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran Department of Oral and Maxillofacial Radiology, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran Fateme Azimi Fateme Azimi Department of Oral and Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran; CoDepartment of Oral and Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, P.O. BOX: 4194173774, Rasht, Iran. Tel: +98-13-33486406, Fax: +98-13-33486423 Department of Oral and Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran; CoDepartment of Oral and Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, P.O. BOX: 4194173774, Rasht, Iran. Tel: +98-13-33486406, Fax: +98-13-33486423 Hooman Bakhshandeh Hooman Bakhshandeh Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
en 10.5812/iranjradiol.12(3)2015.17353 Parapharyngeal Angiofibroma: A Case Report Parapharyngeal Angiofibroma: A Case Report case-report case-report

Nasopharyngeal angiofibroma is a relatively uncommon vascular tumor affecting adolescent males and it characteristically originates in the posterior lateral wall of the nasopharynx. Primary extra-nasopharyngeal angiofibroma is very rare. Here, I present a case of angiofibroma of the parapharyngeal space in a 53-year-old woman with CT and sonographic findings.

Nasopharyngeal angiofibroma is a relatively uncommon vascular tumor affecting adolescent males and it characteristically originates in the posterior lateral wall of the nasopharynx. Primary extra-nasopharyngeal angiofibroma is very rare. Here, I present a case of angiofibroma of the parapharyngeal space in a 53-year-old woman with CT and sonographic findings.

Angiofibroma;CT;Parapharyngeal space Angiofibroma;CT;Parapharyngeal space http://www.Iranjradiol.com/index.php?page=article&article_id=17353 Byung Hoon Lee Byung Hoon Lee Department of Radiology, Ilsan Paik Hospital, Inje University School of Medicine, Gyeonggi-do, South Korea; Department of Radiology, Ilsan Paik Hospital, Inje University School of Medicine, Gyeonggi-do, South Korea. Tel: +82-319107694, Fax: +82-319107369 Department of Radiology, Ilsan Paik Hospital, Inje University School of Medicine, Gyeonggi-do, South Korea; Department of Radiology, Ilsan Paik Hospital, Inje University School of Medicine, Gyeonggi-do, South Korea. Tel: +82-319107694, Fax: +82-319107369
en 26557276 10.5812/iranjradiol.12(3).17757 Myocardial Metabolic Abnormality in a Primary Left Atrial Rhabdomyosarcoma: Localized 1H MR Spectroscopy Myocardial Metabolic Abnormality in a Primary Left Atrial Rhabdomyosarcoma: Localized 1H MR Spectroscopy case-report case-report

We report a 73-year-old woman with primary left atrial rhabdomyosarcoma and its 1H MR spectroscopy (MRS) findings. The tumor showed a 2.8 cm sized lesion in the posteroinferior atrial wall on MRI. 1H MR spectra were acquired using a point-resolved spectroscopy (PRESS) sequence with electrocardiographic (ECG) gating and respiratory motion. The use of 1H-MRS allowed the quantification of triglyceride (TG) peak groups at 0.9 and 1.3 ppm, and unsaturated group of lipids at 2.1 ppm, creatine (Cr) at 3.0 ppm, and choline (Cho) at 3.2 ppm. The percentages of the myocardial metabolites based on water-peak in the interventricular septum were TG 18.4%, Cr 1.6%, Cho 3.3% and unsaturated group 4.0%, whereas the rhabdomyosarcoma showed TG 118.8%, unsaturated group 5.1%, Cr 1.3%, Cho 3.5% and the olefinic components of fatty acid at 5.4 ppm 24.5%. This case demonstrates that 1H-MRS is potentially useful to diagnose the rhabdomyosarcoma by quantifying the myocardial metabolites which are important biomarkers for heart function and diseases.

We report a 73-year-old woman with primary left atrial rhabdomyosarcoma and its 1H MR spectroscopy (MRS) findings. The tumor showed a 2.8 cm sized lesion in the posteroinferior atrial wall on MRI. 1H MR spectra were acquired using a point-resolved spectroscopy (PRESS) sequence with electrocardiographic (ECG) gating and respiratory motion. The use of 1H-MRS allowed the quantification of triglyceride (TG) peak groups at 0.9 and 1.3 ppm, and unsaturated group of lipids at 2.1 ppm, creatine (Cr) at 3.0 ppm, and choline (Cho) at 3.2 ppm. The percentages of the myocardial metabolites based on water-peak in the interventricular septum were TG 18.4%, Cr 1.6%, Cho 3.3% and unsaturated group 4.0%, whereas the rhabdomyosarcoma showed TG 118.8%, unsaturated group 5.1%, Cr 1.3%, Cho 3.5% and the olefinic components of fatty acid at 5.4 ppm 24.5%. This case demonstrates that 1H-MRS is potentially useful to diagnose the rhabdomyosarcoma by quantifying the myocardial metabolites which are important biomarkers for heart function and diseases.

Spectroscopy;Ventricular Septum;Rhabdomyosarcoma Spectroscopy;Ventricular Septum;Rhabdomyosarcoma http://www.Iranjradiol.com/index.php?page=article&article_id=17757 Tae Hoon Kim Tae Hoon Kim Research Institute of Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea Research Institute of Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea Gwang Woo Jeong Gwang Woo Jeong Research Institute of Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea. Tel: +82-622205881, Fax: +82-622264380 Research Institute of Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea. Tel: +82-622205881, Fax: +82-622264380 Tae Su Kim Tae Su Kim Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea Yun Hyeon Kim Yun Hyeon Kim Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
en 26557268 10.5812/iranjradiol.12(3)2015.14979 Twin Reversed Arterial Perfusion (TRAP) Sequence; Characteristic Gray-Scale and Doppler Ultrasonography Findings Twin Reversed Arterial Perfusion (TRAP) Sequence; Characteristic Gray-Scale and Doppler Ultrasonography Findings case-report case-report

Twin reversed arterial perfusion (TRAP) sequence is a syndrome with poor prognosis, seen only in monochorionic monozygotic twin pregnancies. The incidence is one in 35.000 births and one in 100 monozygotic twin pregnancies. It is characterized with a recipient fetus exhibiting lethal anomalies including acardia and a pump fetus. Mortality is usually due to heart failure or premature labor caused by polyhydramnios of pump fetus. Herein, we report a case of TRAP sequence that emphasizes the importance of gray-scale and color Doppler imaging in the diagnosis and management of TRAP sequence.

Twin reversed arterial perfusion (TRAP) sequence is a syndrome with poor prognosis, seen only in monochorionic monozygotic twin pregnancies. The incidence is one in 35.000 births and one in 100 monozygotic twin pregnancies. It is characterized with a recipient fetus exhibiting lethal anomalies including acardia and a pump fetus. Mortality is usually due to heart failure or premature labor caused by polyhydramnios of pump fetus. Herein, we report a case of TRAP sequence that emphasizes the importance of gray-scale and color Doppler imaging in the diagnosis and management of TRAP sequence.

Ultrasound; Pregnancy; Twin Ultrasound; Pregnancy; Twin http://www.Iranjradiol.com/index.php?page=article&article_id=14979 Ayla Buyukkaya Ayla Buyukkaya Department of Radiology, Duzce Ataturk Government Hospital, Duzce, Turkey; Department of Radiology, Duzce Ataturk Government Hospital, Duzce, Turkey. Tel: +90-3805421390, Fax: +90-3805421387, Department of Radiology, Duzce Ataturk Government Hospital, Duzce, Turkey; Department of Radiology, Duzce Ataturk Government Hospital, Duzce, Turkey. Tel: +90-3805421390, Fax: +90-3805421387, Guven Tekbas Guven Tekbas Department of Radiology, School of Medicine, Dicle University, Diyarbakır, Turkey Department of Radiology, School of Medicine, Dicle University, Diyarbakır, Turkey Ramazan Buyukkaya Ramazan Buyukkaya Department of Radiology, School of Medicine, Duzce University, Duzce, Turkey Department of Radiology, School of Medicine, Duzce University, Duzce, Turkey
en 26528381 10.5812/iranjradiol.11044 Sonographic Evaluation of Cervical Lymphadenopathy; Comparison of Metastatic and Reactive Lymph Nodes in Patients With Head and Neck Squamous Cell Carcinoma Using Gray Scale and Doppler Techniques Sonographic Evaluation of Cervical Lymphadenopathy; Comparison of Metastatic and Reactive Lymph Nodes in Patients With Head and Neck Squamous Cell Carcinoma Using Gray Scale and Doppler Techniques research-article research-article Conclusion

Gray scale sonography in combination with Doppler sonography could be a trustworthy technique in differentiating metastatic lymph nodes from reactive ones. Although, circulation pattern had a higher diagnostic accuracy in the present study, combination of sonographic characteristics could be more beneficial in differentiating metastatic cervical nodes from reactive ones.

Results

The study included 41 males and 22 females with a mean age of 57.56 ± 13.79 years. The number of metastatic lymph nodes was 47, while the remaining 16 were reactive. There were significant differences in length (P = 0.037), width (P = 0.001), resistance index (P < 0.001), pulsatility index (P < 0.001) and systolic velocity (P < 0.001) of metastatic and reactive lymph nodes. Cut points for resistive and pulsatility indexes and systolic velocity were calculated as 0.695, 1.35 and 16.5, respectively. The most valuable factor for defining a lymph node as metastatic was circulation pattern with accuracy, sensitivity and specificity of 94%, 85% and 93%, respectively.

Patients and Methods

A prospective diagnostic study was performed on 63 patients with head and neck squamous cell carcinoma (SCC) treated and referred to surgery clinic of Hazrat Rasoul Akram hospital from November 2010 to June 2012 with complaint of palpable cervical lymph node. All patients’ necks were scanned multidirectionally by gray-scale and Doppler techniques. After sonography, lymph nodes were biopsied and investigated to find out whether they were metastatic or reactive. Finally, demographic, sonographic and pathologic data were statistically analyzed by SPSS ver. 16 software using t-test, a nonparametric test and ROC analysis. Ninety five percent confidence interval was considered for all parameters.

Background

Cervical lymphadenopathy could be seen in several pathologic processes. An accurate differentiation between these conditions is of utmost importance to select an appropriate therapy and assess the prognosis. Gray scale and Doppler are appropriate sonographic techniques for evaluating internal and external features of lymph nodes. Although, various criteria have been proposed to differentiate metastatic lymph nodes from benign ones, the most valuable and specific sonographic features are still under dispute.

Objectives

The present study was designed to determine valuable sonographic features for differentiating metastasis from benign nodes using gray scale and Doppler sonography.

Conclusion

Gray scale sonography in combination with Doppler sonography could be a trustworthy technique in differentiating metastatic lymph nodes from reactive ones. Although, circulation pattern had a higher diagnostic accuracy in the present study, combination of sonographic characteristics could be more beneficial in differentiating metastatic cervical nodes from reactive ones.

Results

The study included 41 males and 22 females with a mean age of 57.56 ± 13.79 years. The number of metastatic lymph nodes was 47, while the remaining 16 were reactive. There were significant differences in length (P = 0.037), width (P = 0.001), resistance index (P < 0.001), pulsatility index (P < 0.001) and systolic velocity (P < 0.001) of metastatic and reactive lymph nodes. Cut points for resistive and pulsatility indexes and systolic velocity were calculated as 0.695, 1.35 and 16.5, respectively. The most valuable factor for defining a lymph node as metastatic was circulation pattern with accuracy, sensitivity and specificity of 94%, 85% and 93%, respectively.

Patients and Methods

A prospective diagnostic study was performed on 63 patients with head and neck squamous cell carcinoma (SCC) treated and referred to surgery clinic of Hazrat Rasoul Akram hospital from November 2010 to June 2012 with complaint of palpable cervical lymph node. All patients’ necks were scanned multidirectionally by gray-scale and Doppler techniques. After sonography, lymph nodes were biopsied and investigated to find out whether they were metastatic or reactive. Finally, demographic, sonographic and pathologic data were statistically analyzed by SPSS ver. 16 software using t-test, a nonparametric test and ROC analysis. Ninety five percent confidence interval was considered for all parameters.

Background

Cervical lymphadenopathy could be seen in several pathologic processes. An accurate differentiation between these conditions is of utmost importance to select an appropriate therapy and assess the prognosis. Gray scale and Doppler are appropriate sonographic techniques for evaluating internal and external features of lymph nodes. Although, various criteria have been proposed to differentiate metastatic lymph nodes from benign ones, the most valuable and specific sonographic features are still under dispute.

Objectives

The present study was designed to determine valuable sonographic features for differentiating metastasis from benign nodes using gray scale and Doppler sonography.

Cervical Lymphadenopathy;Gray Scale Sonography;Doppler Sonography Cervical Lymphadenopathy;Gray Scale Sonography;Doppler Sonography http://www.Iranjradiol.com/index.php?page=article&article_id=11044 Mahyar Ghafoori Mahyar Ghafoori Department of Radiology, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Department of Radiology, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Amin Azizian Amin Azizian Department of Radiology, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran; Department of Radiology, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Tel: +98-2166509775 Department of Radiology, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran; Department of Radiology, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Tel: +98-2166509775 Zahra Pourrajabi Zahra Pourrajabi Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Hamed Vaseghi Hamed Vaseghi Medical Student Research Committee (MSRC), Iran University of Medical Sciences, Tehran, Iran Medical Student Research Committee (MSRC), Iran University of Medical Sciences, Tehran, Iran
en 26528382 10.5812/iranjradiol.11591 Primary Pulmonary Sequestration With Secondary Hamartomatosis Change Primary Pulmonary Sequestration With Secondary Hamartomatosis Change case-report case-report

The radiologic features of intralobar pulmonary sequestration (ILPS) have been describe and include the identification of a feeding systemic artery with venous drainage through pulmonary veins. Primary sequestration associated with typical hamartoma signs is really rare and has been described only once. We describe a patient with ILPS whose radiographic findings were unusual for two reasons. First, computed tomography (CT) demonstrated a bulky mass in the pulmonary sequestration. The size of lesion and histopathology made it an unusual presentation. Final histology study demonstrated pulmonary hamartoma with predominantly adipose and cartilage differentiation, which is an unusual complication originated from ILPS. Another sign also explains the second unusual feature, intracranial cholesteatoma, occurring concurrently with ILPS.

The radiologic features of intralobar pulmonary sequestration (ILPS) have been describe and include the identification of a feeding systemic artery with venous drainage through pulmonary veins. Primary sequestration associated with typical hamartoma signs is really rare and has been described only once. We describe a patient with ILPS whose radiographic findings were unusual for two reasons. First, computed tomography (CT) demonstrated a bulky mass in the pulmonary sequestration. The size of lesion and histopathology made it an unusual presentation. Final histology study demonstrated pulmonary hamartoma with predominantly adipose and cartilage differentiation, which is an unusual complication originated from ILPS. Another sign also explains the second unusual feature, intracranial cholesteatoma, occurring concurrently with ILPS.

Pulmonary Sequestration;Hamartoma;Syndrome Pulmonary Sequestration;Hamartoma;Syndrome http://www.Iranjradiol.com/index.php?page=article&article_id=11591 Changhu Liang Changhu Liang Shandong Medical Imaging Research Institute, Affiliated to Shandong University, Jinan, P. R. China Shandong Medical Imaging Research Institute, Affiliated to Shandong University, Jinan, P. R. China Shifeng Xu Shifeng Xu Department of Surgery, Provincial Hospital, Affiliated to Shandong University, Jinan, P. R. China; Department of Surgery, Provincial Hospital, Affiliated to Shandong University, Jinan, P. R. China. Tel: +86-53168776931, Fax: +86-53187938911 Department of Surgery, Provincial Hospital, Affiliated to Shandong University, Jinan, P. R. China; Department of Surgery, Provincial Hospital, Affiliated to Shandong University, Jinan, P. R. China. Tel: +86-53168776931, Fax: +86-53187938911 Bin Zhao Bin Zhao Shandong Medical Imaging Research Institute, Affiliated to Shandong University, Jinan, P. R. China Shandong Medical Imaging Research Institute, Affiliated to Shandong University, Jinan, P. R. China Guoyuan Ma Guoyuan Ma Department of Thoracic Surgery, Provincial Hospital, Affiliated to Shandong University, Jinan, P. R. China Department of Thoracic Surgery, Provincial Hospital, Affiliated to Shandong University, Jinan, P. R. China Yinglin Du Yinglin Du Shandong Provincial Center for Disease Control and Prevention, Public Health Institute 72, Jinan, P. R. China Shandong Provincial Center for Disease Control and Prevention, Public Health Institute 72, Jinan, P. R. China
en 26557266 10.5812/iranjradiol.12366 Giant Organized Hematoma Originating From the Inferior Turbinate Giant Organized Hematoma Originating From the Inferior Turbinate case-report case-report

We reported CT of a case of giant organized hematoma originating from the inferior turbinate without any paranasal sinuses involvement, with an emphasis on different patterns of enhancement of the tumor on enhanced CT scans. This case was exceptional because of unusual location and difficulties in diagnosis. Moreover, organized hematoma of nasal cavity should be considered in the differential diagnosis of a unilateral, huge and easy bleeding lesion in the nasal cavity. A high clinical suspicion based on endoscopic and radiologic findings plays an important role to make an accurate diagnosis.

We reported CT of a case of giant organized hematoma originating from the inferior turbinate without any paranasal sinuses involvement, with an emphasis on different patterns of enhancement of the tumor on enhanced CT scans. This case was exceptional because of unusual location and difficulties in diagnosis. Moreover, organized hematoma of nasal cavity should be considered in the differential diagnosis of a unilateral, huge and easy bleeding lesion in the nasal cavity. A high clinical suspicion based on endoscopic and radiologic findings plays an important role to make an accurate diagnosis.

Nasal Cavity;Organized Hematoma;Inferior Turbinate;Computed Tomography;Enhancement Nasal Cavity;Organized Hematoma;Inferior Turbinate;Computed Tomography;Enhancement http://www.Iranjradiol.com/index.php?page=article&article_id=12366 Sung Yoon Park Sung Yoon Park Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University, Seoul, South Korea Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University, Seoul, South Korea Kyung Soo Kim Kyung Soo Kim Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University, Seoul, South Korea; Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University, P. O. Box: 156-755, Seoul, South Korea. Tel: +82-262991765, Fax: +82-28251765 Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University, Seoul, South Korea; Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University, P. O. Box: 156-755, Seoul, South Korea. Tel: +82-262991765, Fax: +82-28251765
en 26528389 10.5812/iranjradiol.9632 Coil Embolotherapy of Unilateral Diffuse Pulmonary Arteriovenous Malformations in a Nineteen-Year-Old Woman Coil Embolotherapy of Unilateral Diffuse Pulmonary Arteriovenous Malformations in a Nineteen-Year-Old Woman case-report case-report

Pulmonary arteriovenous malformations (AVMs) are rare vascular malformations of the lung that usually led to a notable risk of serious and life-threatening complications. There is considerable debate about the best management of strategies for the group of patients with diffuse AVMs. Several therapeutic options have been reported for management of this abnormality among which coil embolization is currently the preferred ones. This report describes our experience with the use of coiling method for treatment of multiple AVMs in an adult patient.

Pulmonary arteriovenous malformations (AVMs) are rare vascular malformations of the lung that usually led to a notable risk of serious and life-threatening complications. There is considerable debate about the best management of strategies for the group of patients with diffuse AVMs. Several therapeutic options have been reported for management of this abnormality among which coil embolization is currently the preferred ones. This report describes our experience with the use of coiling method for treatment of multiple AVMs in an adult patient.

Arteriovenous Malformation;Coil;Lung;Interventional Radiology;Embolization Arteriovenous Malformation;Coil;Lung;Interventional Radiology;Embolization http://www.Iranjradiol.com/index.php?page=article&article_id=9632 Hadi Rokni Yazdi Hadi Rokni Yazdi Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9124136470, Fax: +98-2166581578 Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9124136470, Fax: +98-2166581578 Hamidreza Abtahi Hamidreza Abtahi Department of Pulmonary Diseases, Tehran University of Medical Sciences, Tehran, Iran Department of Pulmonary Diseases, Tehran University of Medical Sciences, Tehran, Iran Hazhir Saberi Hazhir Saberi Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Mona Salahi Mona Salahi Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran
en 26557281 10.5812/iranjradiol.16753v2 Developmental Venous Anomaly With Asymmetrical Basal Ganglia Calcification: Two Case Reports and Review of the Literature Developmental Venous Anomaly With Asymmetrical Basal Ganglia Calcification: Two Case Reports and Review of the Literature case-report case-report

Developmental venous anomaly (DVA) is a common lesion formerly known as venous angioma. DVAs drain normal brain parenchyma; however, parenchymal abnormalities surrounding DVAs have been reported. Unilateral putamen and caudate calcification in the drainage territory of DVAs has so far been reported in 7 cases, all with deep venous drainage. We present two additional cases of DVAs, one with superficial and the other one with deep venous drainage, associated with basal ganglia calcifications. We emphasize that DVAs should be in the differential diagnosis of unilateral basal ganglia calcifications.

Developmental venous anomaly (DVA) is a common lesion formerly known as venous angioma. DVAs drain normal brain parenchyma; however, parenchymal abnormalities surrounding DVAs have been reported. Unilateral putamen and caudate calcification in the drainage territory of DVAs has so far been reported in 7 cases, all with deep venous drainage. We present two additional cases of DVAs, one with superficial and the other one with deep venous drainage, associated with basal ganglia calcifications. We emphasize that DVAs should be in the differential diagnosis of unilateral basal ganglia calcifications.

Central Nervous System Venous Angioma;Magnetic Resonance Imaging;Vascular Malformations;Idiopathic Basal Ganglia Calcification Central Nervous System Venous Angioma;Magnetic Resonance Imaging;Vascular Malformations;Idiopathic Basal Ganglia Calcification http://www.Iranjradiol.com/index.php?page=article&article_id=20269 Ali Firat Sarp Ali Firat Sarp Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey; Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey. Tel: +90-5064417980 Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey; Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey. Tel: +90-5064417980 Ozan Batki Ozan Batki Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey Mustafa Fazil Gelal Mustafa Fazil Gelal Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
en 26557269 10.5812/iranjradiol.15478v2 Characterization of Soft Tissue Tumors by Diffusion-Weighted Imaging Characterization of Soft Tissue Tumors by Diffusion-Weighted Imaging research-article research-article Conclusion

Our preliminary results have shown that although there is some overlap between benign and malignant tumors, adding DWI, MR imaging to routine soft tissue tumor protocols may improve diagnostic accuracy.

Results

There was only one patient with a malignant cystic tumor and was not included in the statistical analysis. The median ADC values of benign and malignant tumors were 2.31 ± 1.29 and 0.90 ± 0.70 (median ± interquartile range), respectively. The mean ADC values were different between benign and malignant tumors (P = 0.031). Benign cystic tumors had significantly higher ADC values than benign solid or mixed tumors and malignant solid or mixed tumors (p values were < 0.001 and 0.003, respectively). Malignant solid or mixed tumors had lower ADC values than benign solid or mixed tumors (P = 0.02).

Objectives

The aim of the present study was to prospectively evaluate the apparent diffusion coefficient (ADC) values of benign and malignant soft tissue tumors and to determine if ADC can help differentiate these tumors.

Patients and Methods

DWI was performed on 25 histologically proven soft tissue masses. It was obtained with a single-shot echo-planar imaging technique using a 1.5T magnetic resonance (MR) machine. The mean ADC values were calculated. We grouped soft tissue tumors as benign cystic, benign solid or mixed, malignant cystic and malignant solid or mixed tumors and compared mean ADC values between these groups.

Background

Diffusion-weighted imaging (DWI) is a noninvasive method for investigation of tumor histological content. It has been applied for some musculoskeletal tumors and reported to be useful.

Conclusion

Our preliminary results have shown that although there is some overlap between benign and malignant tumors, adding DWI, MR imaging to routine soft tissue tumor protocols may improve diagnostic accuracy.

Results

There was only one patient with a malignant cystic tumor and was not included in the statistical analysis. The median ADC values of benign and malignant tumors were 2.31 ± 1.29 and 0.90 ± 0.70 (median ± interquartile range), respectively. The mean ADC values were different between benign and malignant tumors (P = 0.031). Benign cystic tumors had significantly higher ADC values than benign solid or mixed tumors and malignant solid or mixed tumors (p values were < 0.001 and 0.003, respectively). Malignant solid or mixed tumors had lower ADC values than benign solid or mixed tumors (P = 0.02).

Objectives

The aim of the present study was to prospectively evaluate the apparent diffusion coefficient (ADC) values of benign and malignant soft tissue tumors and to determine if ADC can help differentiate these tumors.

Patients and Methods

DWI was performed on 25 histologically proven soft tissue masses. It was obtained with a single-shot echo-planar imaging technique using a 1.5T magnetic resonance (MR) machine. The mean ADC values were calculated. We grouped soft tissue tumors as benign cystic, benign solid or mixed, malignant cystic and malignant solid or mixed tumors and compared mean ADC values between these groups.

Background

Diffusion-weighted imaging (DWI) is a noninvasive method for investigation of tumor histological content. It has been applied for some musculoskeletal tumors and reported to be useful.

Diffusion Magnetic Resonance Imaging;Soft Tissue Neoplasms;Differential Diagnosis Diffusion Magnetic Resonance Imaging;Soft Tissue Neoplasms;Differential Diagnosis http://www.Iranjradiol.com/index.php?page=article&article_id=15478 Yeliz Pekcevik Yeliz Pekcevik Department of Radiology, Tepecik Training and Research Hospital, Izmir, Turkey; Department of Radiology, Tepecik Training and Research Hospital, Izmir, Turkey. Tel: +90-2324696969, Fax: +90-2324330756 Department of Radiology, Tepecik Training and Research Hospital, Izmir, Turkey; Department of Radiology, Tepecik Training and Research Hospital, Izmir, Turkey. Tel: +90-2324696969, Fax: +90-2324330756 Mehmet Onur Kahya Mehmet Onur Kahya Department of Radiology, Tepecik Training and Research Hospital, Izmir, Turkey Department of Radiology, Tepecik Training and Research Hospital, Izmir, Turkey Ahmet Kaya Ahmet Kaya Department of Orthopaedic Surgery, Tepecik Training and Research Hospital, Izmir, Turkey Department of Orthopaedic Surgery, Tepecik Training and Research Hospital, Izmir, Turkey
en 26557273 10.5812/iranjradiol.16753v2 Developmental Venous Anomaly With Asymmetrical Basal Ganglia Calcification: Two Case Reports and Review of the Literature Developmental Venous Anomaly With Asymmetrical Basal Ganglia Calcification: Two Case Reports and Review of the Literature case-report case-report

Developmental venous anomaly (DVA) is a common lesion formerly known as venous angioma. DVAs drain normal brain parenchyma; however, parenchymal abnormalities surrounding DVAs have been reported. Unilateral putamen and caudate calcification in the drainage territory of DVAs has so far been reported in 7 cases, all with deep venous drainage. We present two additional cases of DVAs, one with superficial and the other one with deep venous drainage, associated with basal ganglia calcifications. We emphasize that DVAs should be in the differential diagnosis of unilateral basal ganglia calcifications.

Developmental venous anomaly (DVA) is a common lesion formerly known as venous angioma. DVAs drain normal brain parenchyma; however, parenchymal abnormalities surrounding DVAs have been reported. Unilateral putamen and caudate calcification in the drainage territory of DVAs has so far been reported in 7 cases, all with deep venous drainage. We present two additional cases of DVAs, one with superficial and the other one with deep venous drainage, associated with basal ganglia calcifications. We emphasize that DVAs should be in the differential diagnosis of unilateral basal ganglia calcifications.

Central Nervous System Venous Angioma;Magnetic Resonance Imaging;Vascular Malformations;Idiopathic Basal Ganglia Calcification Central Nervous System Venous Angioma;Magnetic Resonance Imaging;Vascular Malformations;Idiopathic Basal Ganglia Calcification http://www.Iranjradiol.com/index.php?page=article&article_id=16753 Ali Firat Sarp Ali Firat Sarp Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey; Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey. Tel: +90-5064417980 Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey; Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey. Tel: +90-5064417980 Ozan Batki Ozan Batki Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey Mustafa Fazil Gelal Mustafa Fazil Gelal Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
en 26557272 10.5812/iranjradiol.16063v2 A Case of Complete Unroofed Coronary Sinus Syndrome Combined With Coronary Sinus Stenosis Leading to Asymptomatic Presentation A Case of Complete Unroofed Coronary Sinus Syndrome Combined With Coronary Sinus Stenosis Leading to Asymptomatic Presentation case-report case-report

We describe a patient with an asymptomatic complete unroofed coronary sinus (CS) syndrome associated with the CS stenosis in the absence of a persistent left superior vena cava (SVC) as identified on coronary computed tomography angiography. There was a large defect between the CS and the left atrium (i.e. a large left-to-right shunt), but an unusual combination of the absence of a persistent left SVC (i.e. no risk for brain abscess due to the absence of a right-to-left shunt) and the CS stenosis (i.e. a markedly reduced degree of a left-to-right shunt), resulting in an asymptomatic presentation.

We describe a patient with an asymptomatic complete unroofed coronary sinus (CS) syndrome associated with the CS stenosis in the absence of a persistent left superior vena cava (SVC) as identified on coronary computed tomography angiography. There was a large defect between the CS and the left atrium (i.e. a large left-to-right shunt), but an unusual combination of the absence of a persistent left SVC (i.e. no risk for brain abscess due to the absence of a right-to-left shunt) and the CS stenosis (i.e. a markedly reduced degree of a left-to-right shunt), resulting in an asymptomatic presentation.

Coronary Sinus;Stenosis;Multidetector Computed Tomography Coronary Sinus;Stenosis;Multidetector Computed Tomography http://www.Iranjradiol.com/index.php?page=article&article_id=16063 Hye Rin Kim Hye Rin Kim Department of Diagnostic Radiology, CHA University, College of Medicine, Bundang, South Korea Department of Diagnostic Radiology, CHA University, College of Medicine, Bundang, South Korea Seung Min Yoo Seung Min Yoo Department of Diagnostic Radiology, CHA University, College of Medicine, Bundang, South Korea; Department of Diagnostic Radiology, CHA University, College of Medicine, Bundang, South Korea. Tel: +82-1093300718 Department of Diagnostic Radiology, CHA University, College of Medicine, Bundang, South Korea; Department of Diagnostic Radiology, CHA University, College of Medicine, Bundang, South Korea. Tel: +82-1093300718 Hwa Yeon Lee Hwa Yeon Lee Smile Radiologic Clinic, Seoul, South Korea Smile Radiologic Clinic, Seoul, South Korea Ji Young Rho Ji Young Rho Department of Diagnostic Radiology, CHA University, College of Medicine, Bundang, South Korea Department of Diagnostic Radiology, CHA University, College of Medicine, Bundang, South Korea Woo In Yang Woo In Yang Department of Diagnostic Cardiology, CHA University, College of Medicine, Bundang, South Korea Department of Diagnostic Cardiology, CHA University, College of Medicine, Bundang, South Korea Jae Youn Moon Jae Youn Moon Department of Diagnostic Cardiology, CHA University, College of Medicine, Bundang, South Korea Department of Diagnostic Cardiology, CHA University, College of Medicine, Bundang, South Korea Charles S White Charles S White Department of Diagnostic Radiology, University of Maryland Medical Center, Baltimore, USA Department of Diagnostic Radiology, University of Maryland Medical Center, Baltimore, USA
en 26557277 10.5812/iranjradiol.17832v2 Fluoroscopic Analysis of Tibial Translation in Anterior Cruciate Ligament Injured Knees With and Without Bracing During Forward Lunge Fluoroscopic Analysis of Tibial Translation in Anterior Cruciate Ligament Injured Knees With and Without Bracing During Forward Lunge research-article research-article Conclusion

Fluoroscopic imaging provides an effective tool to measure the dynamic behavior of the knee joint in the sagittal plane and within the limitations of this study, the pure mechanical stabilizing effect of functional knee bracing is not sufficient to control the anterior tibial translation of the ACL deficient patients during lunge exercise.

Results

Results indicated that the overall anterior translations of the tibia during the eccentric (down) and concentric (up) phases of lunge exercise were 10.4 ± 1.7 mm and 9.0 ± 2.2 mm for non-braced, and 10.1 ± 3.4 mm and 7.4 ± 2.5 mm, for braced conditions, respectively. The difference of the tibial anterior-posterior translation behaviors of the braced and non-braced knees was not statistically significant.

Patients and Methods

For twelve male unilateral ACL deficient subjects, the anterior tibial translation was measured during lunge exercise in non-braced and braced conditions. Fluoroscopic images were acquired from the subjects using a digital fluoroscopy system with a rate of 10 fps. The image of each frame was scaled using a calibration coin and analyzed in AutoCAD environment. The angle between the two lines, tangent to the posterior cortexes of the femoral and tibial shafts was measured as the flexion angle. For the fluoroscopic images associated with 0°, 15°, 30°, 45° and 60° knee flexion angles, the relative anterior-posterior configuration of the tibiofemoral joint was assessed by measuring the position of landmarks on the tibia and femur.

Background

Despite several studies with different methods, the effect of functional knee braces on knee joint kinematics is not clear. Direct visualization of joint components through medical imaging modalities may provide the clinicians with more useful information.

Objectives

In this study, for the first time in the literature, video fluoroscopy was used to investigate the effect of knee bracing on the sagittal plane kinematics of anterior cruciate ligament (ACL) injured patients.

Conclusion

Fluoroscopic imaging provides an effective tool to measure the dynamic behavior of the knee joint in the sagittal plane and within the limitations of this study, the pure mechanical stabilizing effect of functional knee bracing is not sufficient to control the anterior tibial translation of the ACL deficient patients during lunge exercise.

Results

Results indicated that the overall anterior translations of the tibia during the eccentric (down) and concentric (up) phases of lunge exercise were 10.4 ± 1.7 mm and 9.0 ± 2.2 mm for non-braced, and 10.1 ± 3.4 mm and 7.4 ± 2.5 mm, for braced conditions, respectively. The difference of the tibial anterior-posterior translation behaviors of the braced and non-braced knees was not statistically significant.

Patients and Methods

For twelve male unilateral ACL deficient subjects, the anterior tibial translation was measured during lunge exercise in non-braced and braced conditions. Fluoroscopic images were acquired from the subjects using a digital fluoroscopy system with a rate of 10 fps. The image of each frame was scaled using a calibration coin and analyzed in AutoCAD environment. The angle between the two lines, tangent to the posterior cortexes of the femoral and tibial shafts was measured as the flexion angle. For the fluoroscopic images associated with 0°, 15°, 30°, 45° and 60° knee flexion angles, the relative anterior-posterior configuration of the tibiofemoral joint was assessed by measuring the position of landmarks on the tibia and femur.

Background

Despite several studies with different methods, the effect of functional knee braces on knee joint kinematics is not clear. Direct visualization of joint components through medical imaging modalities may provide the clinicians with more useful information.

Objectives

In this study, for the first time in the literature, video fluoroscopy was used to investigate the effect of knee bracing on the sagittal plane kinematics of anterior cruciate ligament (ACL) injured patients.

Kinematics;Brace;Anterior Cruciate Ligament;Fluoroscopy;Knee Joint Kinematics;Brace;Anterior Cruciate Ligament;Fluoroscopy;Knee Joint http://www.Iranjradiol.com/index.php?page=article&article_id=17832 Maryam Jalali Maryam Jalali Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Iran Helal Institute of Applied Sciences and Technology, Tehran, Iran; Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Tel: +98-9125040255 Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Iran Helal Institute of Applied Sciences and Technology, Tehran, Iran; Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Tel: +98-9125040255 Farzam Farahmand Farzam Farahmand University of Leeds, Leeds, UK; Research Center of Biomedical Technologies and Robotics (RCBTR), Tehran University of Medical Sciences, Tehran, Iran University of Leeds, Leeds, UK; Research Center of Biomedical Technologies and Robotics (RCBTR), Tehran University of Medical Sciences, Tehran, Iran Seyed Mohammad Ebrahim Mousavi Seyed Mohammad Ebrahim Mousavi Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Seyed Ali Golestanha Seyed Ali Golestanha Department of Radiology, Mostafa Khomeini Hospital, Shahed University, Tehran, Iran Department of Radiology, Mostafa Khomeini Hospital, Shahed University, Tehran, Iran Tahmineh Rezaeian Tahmineh Rezaeian University of Leeds, Leeds, UK University of Leeds, Leeds, UK Shahram Shirvani Broujeni Shahram Shirvani Broujeni Sports Medicine Federation, Tehran, Iran Sports Medicine Federation, Tehran, Iran Mehdi Rahgozar Mehdi Rahgozar Department of Biostatistics and Computer, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Department of Biostatistics and Computer, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Fateme Esfandiarpour Fateme Esfandiarpour Department of Physical Therapy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Department of Physical Therapy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
en 26557270 10.5812/iranjradiol.15517v2 Inferior Epigastric Artery Pseudoaneurysm Following Paracentesis in a Liver Graft Recipient: A Case Report Inferior Epigastric Artery Pseudoaneurysm Following Paracentesis in a Liver Graft Recipient: A Case Report case-report case-report

Pseudoaneurysm happens when the artery wall is injured and the blood is contained by the surrounding tissues with eventual formation of a fibrous sac communicating with the artery. We report a case of a 39-year-old man with inferior epigastric artery (IEA) pseudoaneurysm after paracentesis. The pseudoaneurysm was diagnosed by Doppler ultrasound and treated by surgical intervention regarding the patient’s underlying comorbidity. IEA false aneurysm must be included in the differential diagnosis during investigation of the cause of any swelling after paracentesis. Cirrhotic patients may be more prone to this complication because of thin rectus muscle that could not confine the hematoma.

Pseudoaneurysm happens when the artery wall is injured and the blood is contained by the surrounding tissues with eventual formation of a fibrous sac communicating with the artery. We report a case of a 39-year-old man with inferior epigastric artery (IEA) pseudoaneurysm after paracentesis. The pseudoaneurysm was diagnosed by Doppler ultrasound and treated by surgical intervention regarding the patient’s underlying comorbidity. IEA false aneurysm must be included in the differential diagnosis during investigation of the cause of any swelling after paracentesis. Cirrhotic patients may be more prone to this complication because of thin rectus muscle that could not confine the hematoma.

Diagnosis;Epigastric Arteries;Paracentesis;Pseudoaneurysm;Cirrhosis Diagnosis;Epigastric Arteries;Paracentesis;Pseudoaneurysm;Cirrhosis http://www.Iranjradiol.com/index.php?page=article&article_id=15517 Amir Pasha Ebrahimi Amir Pasha Ebrahimi Department of Surgery, Hepatobiliary and Liver Transplantation Division, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Surgery, Hepatobiliary and Liver Transplantation Division, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohsen Nasiri Toosi Mohsen Nasiri Toosi Department of Internal Medicine, Gastroenterology Division, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; Liver Transplant Research Center, Tehran University of Medical Sciences, Tehran, Iran Department of Internal Medicine, Gastroenterology Division, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; Liver Transplant Research Center, Tehran University of Medical Sciences, Tehran, Iran Setareh Davoudi Setareh Davoudi Liver Transplant Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Infectious Diseases, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Liver Transplant Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Infectious Diseases, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Ali Jafarian Ali Jafarian Department of Surgery, Hepatobiliary and Liver Transplantation Division, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; Liver Transplant Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Surgery, Hepatobiliary and Liver Transplantation Division, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2166581657 Department of Surgery, Hepatobiliary and Liver Transplantation Division, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; Liver Transplant Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Surgery, Hepatobiliary and Liver Transplantation Division, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2166581657 Hossein Ghanaati Hossein Ghanaati Liver Transplant Research Center, 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, Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Liver Transplant Research Center, 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, Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
en 26557267 10.5812/iranjradiol.14142v2 An Experimental Study to Determine the Role of Inferior Vena Cava Filter in Preventing Bone Cement Implantation Syndrome An Experimental Study to Determine the Role of Inferior Vena Cava Filter in Preventing Bone Cement Implantation Syndrome research-article research-article Conclusion

This study demonstrates that IVCF could prevent BCIS effectively, and, as a corollary, suggests that PE represents the leading cause of the constellation of BCIS symptoms.

Results

Systolic blood pressure (SBP), saturation of oxygen (SaO2) and partial pressure of carbon dioxide (PaCO2) declined significantly 10 min after the bone cement packing, in CI group, compared to those in BCF group. This was accompanied by a rise in the arterial pH. However, IVCF prevented those changes in the CI group. On ultrasonography, there were dotted echoes in right atrium in the CI group, after bone cement packing, while such echoes were hardly seen in the IVCF group.

Objectives

The present study was designed to investigate whether IVCF could prevent or impede the occurrence of bone cement implantation syndrome (BCIS), since PE is considered as the central mechanism of BCIS.

Materials and Methods

Fifteen sheep were divided into three groups: bone cement free (BCF) group, cement implantation (CI) group and IVCF group. In all the groups, an osteotomy proximal to the greater trochanter of left femur was carried out. In BCF group, the femoral canal was not reamed out or packed with any bone cement. In CI and IVCF groups, the left femoral canals were packed with bone cement, to simulate the cementing procedures carried out in hip replacement. An OptEase® filter was placed and released in inferior vena cava, prior to packing cement in the femoral canal in IVCF group, while the IVCF was not released in the CI group. The BCF group was considered as control.

Background

Inferior vena cava filters (IVCF) are frequently used for preventing pulmonary embolism (PE) following deep venous thromboembolism.

Conclusion

This study demonstrates that IVCF could prevent BCIS effectively, and, as a corollary, suggests that PE represents the leading cause of the constellation of BCIS symptoms.

Results

Systolic blood pressure (SBP), saturation of oxygen (SaO2) and partial pressure of carbon dioxide (PaCO2) declined significantly 10 min after the bone cement packing, in CI group, compared to those in BCF group. This was accompanied by a rise in the arterial pH. However, IVCF prevented those changes in the CI group. On ultrasonography, there were dotted echoes in right atrium in the CI group, after bone cement packing, while such echoes were hardly seen in the IVCF group.

Objectives

The present study was designed to investigate whether IVCF could prevent or impede the occurrence of bone cement implantation syndrome (BCIS), since PE is considered as the central mechanism of BCIS.

Materials and Methods

Fifteen sheep were divided into three groups: bone cement free (BCF) group, cement implantation (CI) group and IVCF group. In all the groups, an osteotomy proximal to the greater trochanter of left femur was carried out. In BCF group, the femoral canal was not reamed out or packed with any bone cement. In CI and IVCF groups, the left femoral canals were packed with bone cement, to simulate the cementing procedures carried out in hip replacement. An OptEase® filter was placed and released in inferior vena cava, prior to packing cement in the femoral canal in IVCF group, while the IVCF was not released in the CI group. The BCF group was considered as control.

Background

Inferior vena cava filters (IVCF) are frequently used for preventing pulmonary embolism (PE) following deep venous thromboembolism.

Bone Cement;Pulmonary Embolism;Vena Cava Filters;Arthroplasty, Replacement, Hip Bone Cement;Pulmonary Embolism;Vena Cava Filters;Arthroplasty, Replacement, Hip http://www.Iranjradiol.com/index.php?page=article&article_id=14142 Wangang Guo Wangang Guo Department of Cardiology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China; Department of Cardiology, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China Department of Cardiology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China; Department of Cardiology, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China Qiangsun Zheng Qiangsun Zheng Department of Cardiology, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China Department of Cardiology, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China Bingling Li Bingling Li Department of Pharmacy, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China, Department of Pharmacy, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China, Xiaoqin Shi Xiaoqin Shi Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi’an, China Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi’an, China Dingcheng Xiang Dingcheng Xiang Department of Cardiology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China; Department of Cardiology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China. Tel: +86-2984777422 Department of Cardiology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China; Department of Cardiology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China. Tel: +86-2984777422 Chen Wang Chen Wang Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi’an, China; Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi’an, China. Tel: +86-2984777422 Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi’an, China; Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi’an, China. Tel: +86-2984777422
en 26528388 10.5812/iranjradiol.9567v2 Evaluating the Possibility of Defining Cut-Off Points for ΔFA% in Order to Differentiate Four Major Types of Peri-Tumoral White Matter Tract Involvement Evaluating the Possibility of Defining Cut-Off Points for ΔFA% in Order to Differentiate Four Major Types of Peri-Tumoral White Matter Tract Involvement brief-report brief-report Conclusion

Introducing definite diagnostic cut-points was not possible, due to overlap. Based on the fact that “disruption” is the most aggressive process, a sensitivity analysis was carried out for “disrupted” fibers for several presumptive cut-off points.

Patients and Methods

DTI was performed in 12 patients with high presumption of having brain tumors, on a 1.5 T MRI scanner. DTI data was processed by MedINRIA software. Two-hundred region of interests (ROI) were evaluated: 100 in the lesion zone and the rest in the normal WM in the contralateral hemisphere. FA value related to each ROI was measured, and the percentage of FA decrement (ΔFAs%) was calculated.

Results

Of the 100 ROIs on the lesion side, 74 were related to high-grade lesions, 23 to low-grade ones, and three to “gliosis”. There were 54 “infiltrated”, 22 “displaced”, 15 “disrupted”, and 9 “edematous” tracts. The major type of fiber involvement, both in low-grade and high-grade tumors was “infiltrated, whereas “edematous” fibers comprised the minority. ΔFA% was more than -35 for “displaced” and “edematous” fibers, and less than -35 for the majority of “disrupted” ones, but “infiltrated” fibers had scattered distribution. Mean ΔFA% was the least for “disrupted”, followed by “infiltrated”, “edematous” and “displaced” parts.

Objectives

The purpose of this study is to evaluate the possibility of defining diagnostic cut-off points for differentiating four major types of peri-tumoral WM involvement using FA.

Background

Diffusion tensor imaging (DTI) and its different scalar values such as fractional anisotropy (FA) have recently been used for evaluation of peri-tumoral white matter (WM) involvement to help define safer surgical excision margins.

Conclusion

Introducing definite diagnostic cut-points was not possible, due to overlap. Based on the fact that “disruption” is the most aggressive process, a sensitivity analysis was carried out for “disrupted” fibers for several presumptive cut-off points.

Patients and Methods

DTI was performed in 12 patients with high presumption of having brain tumors, on a 1.5 T MRI scanner. DTI data was processed by MedINRIA software. Two-hundred region of interests (ROI) were evaluated: 100 in the lesion zone and the rest in the normal WM in the contralateral hemisphere. FA value related to each ROI was measured, and the percentage of FA decrement (ΔFAs%) was calculated.

Results

Of the 100 ROIs on the lesion side, 74 were related to high-grade lesions, 23 to low-grade ones, and three to “gliosis”. There were 54 “infiltrated”, 22 “displaced”, 15 “disrupted”, and 9 “edematous” tracts. The major type of fiber involvement, both in low-grade and high-grade tumors was “infiltrated, whereas “edematous” fibers comprised the minority. ΔFA% was more than -35 for “displaced” and “edematous” fibers, and less than -35 for the majority of “disrupted” ones, but “infiltrated” fibers had scattered distribution. Mean ΔFA% was the least for “disrupted”, followed by “infiltrated”, “edematous” and “displaced” parts.

Objectives

The purpose of this study is to evaluate the possibility of defining diagnostic cut-off points for differentiating four major types of peri-tumoral WM involvement using FA.

Background

Diffusion tensor imaging (DTI) and its different scalar values such as fractional anisotropy (FA) have recently been used for evaluation of peri-tumoral white matter (WM) involvement to help define safer surgical excision margins.

Diffusion Tensor Imaging;Brain Neoplasms;White Matter;Anisotropy Diffusion Tensor Imaging;Brain Neoplasms;White Matter;Anisotropy http://www.Iranjradiol.com/index.php?page=article&article_id=9567 Tourisa Deilami Tourisa Deilami Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran; Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2188001012 Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran; Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2188001012 Homayoun Hadizadeh Kharrazi Homayoun Hadizadeh Kharrazi Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Amir Saied Seddighi Amir Saied Seddighi Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran Parin Tanzifi Parin Tanzifi Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran Reza Tayebivaljouzi Reza Tayebivaljouzi Department of Radiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Radiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran Fatemeh Zamani Fatemeh Zamani Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Atefeh Chavoshzadeh Tafti Atefeh Chavoshzadeh Tafti Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran
en 26557275 10.5812/iranjradiol.17507v2 Retroperitoneal Cystic Malignant Fibrous Histiocytoma Mimicking a Psoas Abscess Retroperitoneal Cystic Malignant Fibrous Histiocytoma Mimicking a Psoas Abscess case-report case-report

Primary neoplasms in the psoas muscle including schwannoma and soft tissue sarcoma with secondary cystic degeneration are rare entities. They are difficult to distinguish from psoas abscess purely based on radiological findings. Malignant fibrous histiocytoma (MFH) in the retroperitoneum is an uncommon entity in contrast to liposarcoma and leiomyosarcoma. Psoas abscess is a common infection in the retroperitoneum, especially in regions where tuberculosis is endemic. In the current case, the patient presented with gradually progressive lower abdominal pain and raised erythrocyte sedimentation rate (ESR), lymphocyte count and sputum positive for acid fast bacilli. There was a presence of previous history of skeletal tuberculosis. Imaging revealed well-defined multilocular cystic lesion involving the left psoas muscle which along with the clinical scenario suggested psoas abscess. However, post-operative biopsy showed the lesion to be a MFH with extensive cystic degeneration. To the best of our knowledge, cystic MFH mimicking an abscess has been previously reported only once in an oncology literature.

Primary neoplasms in the psoas muscle including schwannoma and soft tissue sarcoma with secondary cystic degeneration are rare entities. They are difficult to distinguish from psoas abscess purely based on radiological findings. Malignant fibrous histiocytoma (MFH) in the retroperitoneum is an uncommon entity in contrast to liposarcoma and leiomyosarcoma. Psoas abscess is a common infection in the retroperitoneum, especially in regions where tuberculosis is endemic. In the current case, the patient presented with gradually progressive lower abdominal pain and raised erythrocyte sedimentation rate (ESR), lymphocyte count and sputum positive for acid fast bacilli. There was a presence of previous history of skeletal tuberculosis. Imaging revealed well-defined multilocular cystic lesion involving the left psoas muscle which along with the clinical scenario suggested psoas abscess. However, post-operative biopsy showed the lesion to be a MFH with extensive cystic degeneration. To the best of our knowledge, cystic MFH mimicking an abscess has been previously reported only once in an oncology literature.

Histiocytoma, Malignant Fibrous;Tuberculosis;Psoas Abscess Histiocytoma, Malignant Fibrous;Tuberculosis;Psoas Abscess http://www.Iranjradiol.com/index.php?page=article&article_id=17507 Madan Mohan Gupta Madan Mohan Gupta Department of Radiodiagnosis, Shri M.P. Shah Government Medical College, Gurugovind Singh Govt Hospital, Jamnagar, Gujarat, India; Department of Radiodiagnosis, Shri M.P. Shah Government Medical College, Gurugovind Singh Govt Hospital, Jamnagar, Gujarat, India. Tel: +91-9726717964 Department of Radiodiagnosis, Shri M.P. Shah Government Medical College, Gurugovind Singh Govt Hospital, Jamnagar, Gujarat, India; Department of Radiodiagnosis, Shri M.P. Shah Government Medical College, Gurugovind Singh Govt Hospital, Jamnagar, Gujarat, India. Tel: +91-9726717964 Nandini Bahri Nandini Bahri Shri M.P. Shah Government Medical College, Jamnagar, Gujarat, India Shri M.P. Shah Government Medical College, Jamnagar, Gujarat, India Pankaj Watal Pankaj Watal Shri M.P. Shah Government Medical College, Jamnagar, Gujarat, India Shri M.P. Shah Government Medical College, Jamnagar, Gujarat, India Ketan Rathod Ketan Rathod Shri M.P. Shah Government Medical College, Jamnagar, Gujarat, India Shri M.P. Shah Government Medical College, Jamnagar, Gujarat, India Siddarth Thaker Siddarth Thaker Shri M.P. Shah Government Medical College, Jamnagar, Gujarat, India Shri M.P. Shah Government Medical College, Jamnagar, Gujarat, India Parthiv Bhandari Parthiv Bhandari Shri M.P. Shah Government Medical College, Jamnagar, Gujarat, India Shri M.P. Shah Government Medical College, Jamnagar, Gujarat, India Ketul Dhamecha Ketul Dhamecha Shri M.P. Shah Government Medical College, Jamnagar, Gujarat, India Shri M.P. Shah Government Medical College, Jamnagar, Gujarat, India Jasmin Ajudia Jasmin Ajudia Shri M.P. Shah Government Medical College, Jamnagar, Gujarat, India Shri M.P. Shah Government Medical College, Jamnagar, Gujarat, India
en 10.5812/iranjradiol.17853v2 Barber Pole Sign in CT Angiography, Adult Presentation of Midgut Malrotation: A Case Report Barber Pole Sign in CT Angiography, Adult Presentation of Midgut Malrotation: A Case Report case-report case-report

Adult midgut volvulus is a challenging diagnosis because of its low incidence and nonspecific symptoms. Diagnostic delay and long-term complaints are frequent in this clinical scenario. We reported a patient referred to our diagnostic imaging unit with intermittent abdominal pain, bloating and episodic vomiting for several years. He underwent barium gastrointestinal transit and abdominal ultrasound, which revealed severe gastric dilatation, food retention and slow transit until a depressed duodenojejunal flexure, with malrotation of the midgut and jejunal loops being located in the right upper quadrant. Computed tomography angiography was performed, showing rotation of the small intestine around the mesentery root, suggestive of midgut malrotation. In addition, an abnormal twisted disposition of superior mesenteric artery with corkscrew appearance was seen, shaping the pole-barber sign which was evident in volume rendering three-dimensional reconstructions. The patient underwent scheduled surgical treatment without any complication and had good outcome after hospital discharge and follow-up. Computed tomography plays an important role in evaluation of adult midgut volvulus. In addition, angiographic reconstructions can help us to assess the anatomic disposition of mesenteric vascular supply. Both of these assessments are useful in preoperative management.

Adult midgut volvulus is a challenging diagnosis because of its low incidence and nonspecific symptoms. Diagnostic delay and long-term complaints are frequent in this clinical scenario. We reported a patient referred to our diagnostic imaging unit with intermittent abdominal pain, bloating and episodic vomiting for several years. He underwent barium gastrointestinal transit and abdominal ultrasound, which revealed severe gastric dilatation, food retention and slow transit until a depressed duodenojejunal flexure, with malrotation of the midgut and jejunal loops being located in the right upper quadrant. Computed tomography angiography was performed, showing rotation of the small intestine around the mesentery root, suggestive of midgut malrotation. In addition, an abnormal twisted disposition of superior mesenteric artery with corkscrew appearance was seen, shaping the pole-barber sign which was evident in volume rendering three-dimensional reconstructions. The patient underwent scheduled surgical treatment without any complication and had good outcome after hospital discharge and follow-up. Computed tomography plays an important role in evaluation of adult midgut volvulus. In addition, angiographic reconstructions can help us to assess the anatomic disposition of mesenteric vascular supply. Both of these assessments are useful in preoperative management.

Intestines;Intestinal Volvulus;Multidetector Computed Tomography;Adult Intestines;Intestinal Volvulus;Multidetector Computed Tomography;Adult http://www.Iranjradiol.com/index.php?page=article&article_id=17853 Juan Arsenio Garcelan-Trigo Juan Arsenio Garcelan-Trigo Diagnostic Imaging Unit, Hospital San Agustin, Linares (Jaen), Spain; Diagnostic Imaging Unit, Hospital San Agustin, Linares (Jaen), Spain. Tel: +34-618177483 Diagnostic Imaging Unit, Hospital San Agustin, Linares (Jaen), Spain; Diagnostic Imaging Unit, Hospital San Agustin, Linares (Jaen), Spain. Tel: +34-618177483 Manuel Tello-Moreno Manuel Tello-Moreno Diagnostic Imaging Unit, Hospital San Agustin, Linares (Jaen), Spain Diagnostic Imaging Unit, Hospital San Agustin, Linares (Jaen), Spain Manuel Jesus Rabaza-Espigares Manuel Jesus Rabaza-Espigares Diagnostic Imaging Unit, Hospital San Agustin, Linares (Jaen), Spain Diagnostic Imaging Unit, Hospital San Agustin, Linares (Jaen), Spain Ildefonso Talavera-Martinez Ildefonso Talavera-Martinez Diagnostic Imaging Unit, Hospital San Agustin, Linares (Jaen), Spain Diagnostic Imaging Unit, Hospital San Agustin, Linares (Jaen), Spain
en 26528384 10.5812/iranjradiol.12230v2 Sonographic Measurement of the Umbilical Cord and Its Vessels and Their Relation with Fetal Anthropometric Measurements Sonographic Measurement of the Umbilical Cord and Its Vessels and Their Relation with Fetal Anthropometric Measurements research-article research-article Conclusion

Reference ranges for umbilical cord CSA have been generated. The CSA of the umbilical cord and other components of it increase as a function of gestational age. These measurements correlate with fetal size.

Results

The values of the CSA of the umbilical cord, umbilical vein and Wharton’s jelly (WJ) increase consistently until 30 weeks of gestation, after which they reach a plateau. There was a significant correlation between anthropometric measurements and umbilical cord measurements especially with the CSA of the umbilical cord, umbilical vein and WJ. The regression equation for the umbilical cord CSA according to gestational age up to 30 weeks was y = -0.2159 x2 + 23.828x-325.59 (R2 = 0.6334) and for the WJ area according to gestational age up to 30 weeks, it was y = -0.2124 x 2 +17.613x-221.66 (R2 = 0.4979).

Background

It has been established that presence of lean umbilical cord with reduced Wharton’s jelly in sonographic scans is a fetal marker for risk of small for gestational age at birth. With improvement of ultrasound techniques, more studies have been investigating the alterations of the umbilical cord on pregnancy outcomes.

Objectives

To determine the reference ranges of the umbilical cord area during pregnancy and to find out the association between umbilical cord morphometry and fetal anthropometric measurements.

Patients and Methods

A cross sectional study was carried out on a study population of 278 low-risk pregnant women between 15 and 41 weeks of gestational age. Fetal anthropometric measurements including biparietal diameter, abdominal circumference, and femur length were calculated. The measurements of the cross-sectional area (CSA) and circumference of the umbilical cord, vein and arteries were done on an adjacent plane to the insertion of umbilical cord into the fetus’s abdomen. The mean and standard deviation of the CSA of the umbilical cord and the 5th, 10th, 50th, 90th, 95th percentiles of it were calculated for each gestational age. Pearson correlation coefficient was used to assess the correlation between the measures of the cord and fetal anthropometric measurements. Polynomial regression analysis was performed for curves.

Conclusion

Reference ranges for umbilical cord CSA have been generated. The CSA of the umbilical cord and other components of it increase as a function of gestational age. These measurements correlate with fetal size.

Results

The values of the CSA of the umbilical cord, umbilical vein and Wharton’s jelly (WJ) increase consistently until 30 weeks of gestation, after which they reach a plateau. There was a significant correlation between anthropometric measurements and umbilical cord measurements especially with the CSA of the umbilical cord, umbilical vein and WJ. The regression equation for the umbilical cord CSA according to gestational age up to 30 weeks was y = -0.2159 x2 + 23.828x-325.59 (R2 = 0.6334) and for the WJ area according to gestational age up to 30 weeks, it was y = -0.2124 x 2 +17.613x-221.66 (R2 = 0.4979).

Background

It has been established that presence of lean umbilical cord with reduced Wharton’s jelly in sonographic scans is a fetal marker for risk of small for gestational age at birth. With improvement of ultrasound techniques, more studies have been investigating the alterations of the umbilical cord on pregnancy outcomes.

Objectives

To determine the reference ranges of the umbilical cord area during pregnancy and to find out the association between umbilical cord morphometry and fetal anthropometric measurements.

Patients and Methods

A cross sectional study was carried out on a study population of 278 low-risk pregnant women between 15 and 41 weeks of gestational age. Fetal anthropometric measurements including biparietal diameter, abdominal circumference, and femur length were calculated. The measurements of the cross-sectional area (CSA) and circumference of the umbilical cord, vein and arteries were done on an adjacent plane to the insertion of umbilical cord into the fetus’s abdomen. The mean and standard deviation of the CSA of the umbilical cord and the 5th, 10th, 50th, 90th, 95th percentiles of it were calculated for each gestational age. Pearson correlation coefficient was used to assess the correlation between the measures of the cord and fetal anthropometric measurements. Polynomial regression analysis was performed for curves.

Umbilical Cord;Ultrasonography;Fetus Umbilical Cord;Ultrasonography;Fetus http://www.Iranjradiol.com/index.php?page=article&article_id=12230 Sheida Rostamzadeh Sheida Rostamzadeh Department of Radiology, Mahdieh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Radiology, Mahdieh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: +98-9123909718, Fax: +98-2122439784 Department of Radiology, Mahdieh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Radiology, Mahdieh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: +98-9123909718, Fax: +98-2122439784 Mojgan Kalantari Mojgan Kalantari Department of Radiology, Mahdieh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Radiology, Mahdieh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mona Shahriari Mona Shahriari 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 Madjid Shakiba Madjid Shakiba 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
en 26528383 10.5812/iranjradiol.11760v2 Non Secretory Multiple Myeloma With Extensive Extramedullary Plasmacytoma: A Diagnostic Dilemma Non Secretory Multiple Myeloma With Extensive Extramedullary Plasmacytoma: A Diagnostic Dilemma case-report case-report

Multiple myeloma (MM) is characterized by progressive proliferation of malignant plasma cells, usually initiating in the bone marrow. MM can affect any organ; a total of 7 - 18% of patients with MM demonstrate extramedullary involvement at diagnosis. Non-secretory multiple myeloma (NSMM) is a rare variant that accounts for 1 - 5% of all cases of multiple myeloma. The disease is characterized by the absence of monoclonal gammopathy in serum and urine electrophoresis. Our case report highlights the diagnostic challenge of a case of NSMM with extensive extramedullary involvement in a young female patient who initially presented with right shoulder pain and bilateral breasts lumps. Skeletal survey showed multiple lytic bony lesions. The initial diagnosis was primary breast carcinoma with osseous metastases. No monoclonal gammopathy was found in the serum or urine electrophoresis. Bone marrow and breast biopsies revealed marked plasmacytosis. The diagnosis was delayed for a month in view of the lack of clinical suspicion of multiple myeloma in a young patient and scant biochemical expression of non-secretory type of multiple myeloma.

Multiple myeloma (MM) is characterized by progressive proliferation of malignant plasma cells, usually initiating in the bone marrow. MM can affect any organ; a total of 7 - 18% of patients with MM demonstrate extramedullary involvement at diagnosis. Non-secretory multiple myeloma (NSMM) is a rare variant that accounts for 1 - 5% of all cases of multiple myeloma. The disease is characterized by the absence of monoclonal gammopathy in serum and urine electrophoresis. Our case report highlights the diagnostic challenge of a case of NSMM with extensive extramedullary involvement in a young female patient who initially presented with right shoulder pain and bilateral breasts lumps. Skeletal survey showed multiple lytic bony lesions. The initial diagnosis was primary breast carcinoma with osseous metastases. No monoclonal gammopathy was found in the serum or urine electrophoresis. Bone marrow and breast biopsies revealed marked plasmacytosis. The diagnosis was delayed for a month in view of the lack of clinical suspicion of multiple myeloma in a young patient and scant biochemical expression of non-secretory type of multiple myeloma.

Multiple Myeloma;Plasmacytoma Multiple Myeloma;Plasmacytoma http://www.Iranjradiol.com/index.php?page=article&article_id=11760 Soo Fin Low Soo Fin Low Department of Radiology, Malaysia Medical Center, University Kebangsaan, Kuala Lumpur, Malaysia; Department of Radiology, Malaysia Medical Center, University Kebangsaan, Kuala Lumpur, Malaysia. Tel: +6-0391456194, Fax: +6-0391456682 Department of Radiology, Malaysia Medical Center, University Kebangsaan, Kuala Lumpur, Malaysia; Department of Radiology, Malaysia Medical Center, University Kebangsaan, Kuala Lumpur, Malaysia. Tel: +6-0391456194, Fax: +6-0391456682 Nor Hanani Mohd Tap Nor Hanani Mohd Tap Department of Radiology, Malaysia Medical Center, University Kebangsaan, Kuala Lumpur, Malaysia Department of Radiology, Malaysia Medical Center, University Kebangsaan, Kuala Lumpur, Malaysia Thean Yean Kew Thean Yean Kew Department of Radiology, Malaysia Medical Center, University Kebangsaan, Kuala Lumpur, Malaysia Department of Radiology, Malaysia Medical Center, University Kebangsaan, Kuala Lumpur, Malaysia Chai Soon Ngiu Chai Soon Ngiu Department of Medicine, Malaysia Medical Center, University Kebangsaan, Kuala Lumpur, Malaysia Department of Medicine, Malaysia Medical Center, University Kebangsaan, Kuala Lumpur, Malaysia Radhika Sridharan Radhika Sridharan Department of Radiology, Malaysia Medical Center, University Kebangsaan, Kuala Lumpur, Malaysia Department of Radiology, Malaysia Medical Center, University Kebangsaan, Kuala Lumpur, Malaysia
en 26528385 10.5812/iranjradiol.4790v2 Iniencephaly Clausus: A New Case With Clinical and Imaging Findings Iniencephaly Clausus: A New Case With Clinical and Imaging Findings case-report case-report

Iniencephaly is a rare kind of neural tube defect that is classified into two types of iniencephaly apertus and iniencephaly clausus. This anomaly could be diagnosed prenatally by obstetric ultrasonography and terminated by therapeutic abortion; however, it could be undiagnosed until birth similar to our case due to the abnormal position of the fetus or lack of experience of the sonographer. Due to abnormality of the neural tube, which causes abnormal head and neck position, all these cases will die shortly after birth. We hereby introduce the photos and imaging findings of a case of an alive neonate with iniencephaly clausus.

Iniencephaly is a rare kind of neural tube defect that is classified into two types of iniencephaly apertus and iniencephaly clausus. This anomaly could be diagnosed prenatally by obstetric ultrasonography and terminated by therapeutic abortion; however, it could be undiagnosed until birth similar to our case due to the abnormal position of the fetus or lack of experience of the sonographer. Due to abnormality of the neural tube, which causes abnormal head and neck position, all these cases will die shortly after birth. We hereby introduce the photos and imaging findings of a case of an alive neonate with iniencephaly clausus.

Neural Tube Defects;Diagnostic Imaging;Congenital Abnormalities Neural Tube Defects;Diagnostic Imaging;Congenital Abnormalities http://www.Iranjradiol.com/index.php?page=article&article_id=4790 Alireza Khatami Alireza Khatami Department of Radiology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Radiology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: +98-9121450832 Department of Radiology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Radiology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: +98-9121450832 Mohsen Hasanzadeh Mohsen Hasanzadeh Department of Radiology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Radiology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hedayat Norouzi Hedayat Norouzi Department of Radiology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Radiology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Ehasn Esfandiari Ehasn Esfandiari Department of Radiology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Radiology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mastooreh Mehrafarin Mastooreh Mehrafarin Department of Radiology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Radiology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran