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 4
en 26715981 10.5812/iranjradiol.26009 Assessment of Lipiodol Deposition and Residual Cancer for Hepatocellular Carcinoma After Transcatheter Arterial Chemoembolization via Iodine-Based Material Decomposition Images with Spectral Computed Tomography Imaging: A Preliminary Study Assessment of Lipiodol Deposition and Residual Cancer for Hepatocellular Carcinoma After Transcatheter Arterial Chemoembolization via Iodine-Based Material Decomposition Images with Spectral Computed Tomography Imaging: A Preliminary Study research-article research-article Conclusion

The study data highlighted good value of iodine-based material decomposition images of spectral CT in assessment of both lipiodol deposition and residual cancer for follow-up of HCC patients previously treated with TACE.

Background

It is critical to follow up hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) in clinical practice. Computed tomography (CT) is used to assess lipiodol deposition, whereas it is difficult to assess hypovascular residual cancer masked by lipiodol. In contrast, magnetic resonance imaging (MRI) is superior to CT in showing residual cancer, but cannot display lipiodol deposition.

Results

Consequently, 30 residual lesions were detected in MRI of 10 patients. They were found in iodine-based images and monochromatic images versus 29 in conventional CT images. The area under ROC curves for the lesion-to-normal parenchyma ratio (LNR) on arterial phase (AP) in iodine-based material decomposition images, monochromatic images and conventional CT images were 0.933, 0.833 and 0.817, respectively.

Patients and Methods

Ten HCC patients after treated with TACE underwent Discovery CT750 HD and MRI750 3T examination. Receiver operating characteristic (ROC) curves of iodine-based material decomposition images, monochromatic images and conventional CT images were generated.

Objectives

The aim of this study was to investigate the value of spectral CT imaging in both lipiodol deposition and residual cancer for HCC patients after TACE.

Conclusion

The study data highlighted good value of iodine-based material decomposition images of spectral CT in assessment of both lipiodol deposition and residual cancer for follow-up of HCC patients previously treated with TACE.

Background

It is critical to follow up hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) in clinical practice. Computed tomography (CT) is used to assess lipiodol deposition, whereas it is difficult to assess hypovascular residual cancer masked by lipiodol. In contrast, magnetic resonance imaging (MRI) is superior to CT in showing residual cancer, but cannot display lipiodol deposition.

Results

Consequently, 30 residual lesions were detected in MRI of 10 patients. They were found in iodine-based images and monochromatic images versus 29 in conventional CT images. The area under ROC curves for the lesion-to-normal parenchyma ratio (LNR) on arterial phase (AP) in iodine-based material decomposition images, monochromatic images and conventional CT images were 0.933, 0.833 and 0.817, respectively.

Patients and Methods

Ten HCC patients after treated with TACE underwent Discovery CT750 HD and MRI750 3T examination. Receiver operating characteristic (ROC) curves of iodine-based material decomposition images, monochromatic images and conventional CT images were generated.

Objectives

The aim of this study was to investigate the value of spectral CT imaging in both lipiodol deposition and residual cancer for HCC patients after TACE.

Tomography;Magnetic Resonance Imaging;Carcinoma;Hepatocellular Tomography;Magnetic Resonance Imaging;Carcinoma;Hepatocellular http://www.Iranjradiol.com/index.php?page=article&article_id=26009 Yanhong Xu Yanhong Xu Department of Radiology, Shanghai First People’s Hospital, School of Medicine, Jiao Tong University, Shanghai, China Department of Radiology, Shanghai First People’s Hospital, School of Medicine, Jiao Tong University, Shanghai, China An Xiao An Xiao Department of Interventional Radiology, Shanghai First People’s Hospital, School of Medicine, Jiao Tong University, Shanghai, China Department of Interventional Radiology, Shanghai First People’s Hospital, School of Medicine, Jiao Tong University, Shanghai, China Jia Yang Jia Yang Department of Radiology, Shanghai First People’s Hospital, School of Medicine, Jiao Tong University, Shanghai, China Department of Radiology, Shanghai First People’s Hospital, School of Medicine, Jiao Tong University, Shanghai, China Zaixian Zhang Zaixian Zhang Department of Radiology, Shanghai First People’s Hospital, School of Medicine, Jiao Tong University, Shanghai, China Department of Radiology, Shanghai First People’s Hospital, School of Medicine, Jiao Tong University, Shanghai, China Guixiang Zhang Guixiang Zhang Department of Radiology, Shanghai First People’s Hospital, School of Medicine, Jiao Tong University, Shanghai, China; Department of Radiology, Shanghai First People’s Hospital, School of Medicine, Jiao Tong University, Shanghai, China. Tel: +86-2163240090, Fax: +86-2163240825 Department of Radiology, Shanghai First People’s Hospital, School of Medicine, Jiao Tong University, Shanghai, China; Department of Radiology, Shanghai First People’s Hospital, School of Medicine, Jiao Tong University, Shanghai, China. Tel: +86-2163240090, Fax: +86-2163240825
en 26793287 10.5812/iranjradiol.12(2)2015.16242 Designing of a Computer Software for Detection of Approximal Caries in Posterior Teeth Designing of a Computer Software for Detection of Approximal Caries in Posterior Teeth research-article research-article Conclusions

The designed software was able to detect a significant number of dentin caries and acceptable measuring of the depth of carious lesions in enamel and dentin. However, the software had limited ability in detecting enamel lesions.

Background

Radiographs, adjunct to clinical examination are always valuable complementary methods for dental caries detection. Recently, progressing in digital imaging system provides possibility of software designing for automatically dental caries detection.

Objectives

The aim of this study was to develop and assess the function of diagnostic computer software designed for evaluation of approximal caries in posterior teeth. This software should be able to indicate the depth and location of caries on digital radiographic images.

Materials and Methods

Digital radiographs were obtained of 93 teeth including 183 proximal surfaces. These images were used as a database for designing the software and training the software designer. In the design phase, considering the summed density of pixels in rows and columns of the images, the teeth were separated from each other and the unnecessary regions; for example, the root area in the alveolar bone was eliminated. Therefore, based on summed intensities, each image was segmented such that each segment contained only one tooth. Subsequently, based on the fuzzy logic, a well-known data-clustering algorithm named fuzzy c-means (FCM) was applied to the images to cluster or segment each tooth. This algorithm is referred to as a soft clustering method, which assigns data elements to one or more clusters with a specific membership function. Using the extracted clusters, the tooth border was determined and assessed for cavity. The results of histological analysis were used as the gold standard for comparison with the results obtained from the software. Depth of caries was measured, and finally Intraclass Correlation Coefficient (ICC) and Bland-Altman plot were used to show the agreement between the methods.

Results

The software diagnosed 60% of enamel caries. The ICC (for detection of enamel caries) between the computer software and histological analysis results was determined as 0.609 (95% confidence interval [CI] = 0.159-0.849) (P = 0.006). Also, the computer program diagnosed 97% of dentin caries and the ICC between the software and histological analysis results for dentin caries was determined as 0.937 (95% CI=0.906-0.958) (P < 0.001). Bland-Altman plot showed an acceptable agreement for measuring the depth of caries in enamel and dentin.

Conclusions

The designed software was able to detect a significant number of dentin caries and acceptable measuring of the depth of carious lesions in enamel and dentin. However, the software had limited ability in detecting enamel lesions.

Background

Radiographs, adjunct to clinical examination are always valuable complementary methods for dental caries detection. Recently, progressing in digital imaging system provides possibility of software designing for automatically dental caries detection.

Objectives

The aim of this study was to develop and assess the function of diagnostic computer software designed for evaluation of approximal caries in posterior teeth. This software should be able to indicate the depth and location of caries on digital radiographic images.

Materials and Methods

Digital radiographs were obtained of 93 teeth including 183 proximal surfaces. These images were used as a database for designing the software and training the software designer. In the design phase, considering the summed density of pixels in rows and columns of the images, the teeth were separated from each other and the unnecessary regions; for example, the root area in the alveolar bone was eliminated. Therefore, based on summed intensities, each image was segmented such that each segment contained only one tooth. Subsequently, based on the fuzzy logic, a well-known data-clustering algorithm named fuzzy c-means (FCM) was applied to the images to cluster or segment each tooth. This algorithm is referred to as a soft clustering method, which assigns data elements to one or more clusters with a specific membership function. Using the extracted clusters, the tooth border was determined and assessed for cavity. The results of histological analysis were used as the gold standard for comparison with the results obtained from the software. Depth of caries was measured, and finally Intraclass Correlation Coefficient (ICC) and Bland-Altman plot were used to show the agreement between the methods.

Results

The software diagnosed 60% of enamel caries. The ICC (for detection of enamel caries) between the computer software and histological analysis results was determined as 0.609 (95% confidence interval [CI] = 0.159-0.849) (P = 0.006). Also, the computer program diagnosed 97% of dentin caries and the ICC between the software and histological analysis results for dentin caries was determined as 0.937 (95% CI=0.906-0.958) (P < 0.001). Bland-Altman plot showed an acceptable agreement for measuring the depth of caries in enamel and dentin.

Computer Software;Dental Caries;Digital Radiography Computer Software;Dental Caries;Digital Radiography http://www.Iranjradiol.com/index.php?page=article&article_id=16242 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 Mostafa Goodini Mostafa Goodini Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Sara Ehsani Sara Ehsani Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: +98-2122413897, Fax: +98-2122427753 Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: +98-2122413897, Fax: +98-2122427753 Hadis Mohseni Hadis Mohseni Department of Computer Engineering, Shahid Bahonar University of Kerman, Kerman, Iran Department of Computer Engineering, Shahid Bahonar University of Kerman, Kerman, Iran Fateme Azimi Fateme Azimi 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 Hooman Bakhshandeh Hooman Bakhshandeh Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran
en 26715977 10.5812/iranjradiol.11905 Fetal Nasal Bone Status In Iranian Women Undergoing First-Trimester Screening For Trisomy 21: A Review and an Observational Study. Fetal Nasal Bone Status In Iranian Women Undergoing First-Trimester Screening For Trisomy 21: A Review and an Observational Study. research-article research-article Conclusion

The low prevalence of the NB absence in normal fetuses in the present study is compatible with the larger size of the NB in Iranian people compared to other communities. Meanwhile, the reference range of the NB length in normal Iranian fetuses was established so that basic data could be recorded for further studies regarding the absence or presence of the NB in screening for chromosomal abnormalities (Down syndrome) within the Iranian population.

Results

The NB was absent in 2/767 (0.26%) of the fetuses. The mean length of the NB was 3.6 ± 0.69 mm for the fetuses of 11 - 14 weeks gestational age. The LR value of the absent NB was equal to 250 in the normal fetuses of the Iranian population living in the North-West provinces.

Patients and Methods

In 767 normal fetuses, the fetal profile was examined by ultrasound for the absence/presence of the NB. The NB length was also measured, and the LR for the NB absence was also determined.

Objectives

The objectives of this study were to determine the NB length and the prevalence of the NB absence as well as calculating the likelihood ratio (LR) for the absence of the NB in normal fetuses of Iranian women undergoing first-trimester screening for trisomy 21.

Background

Failed visualization of the fetal nasal bone (NB) by ultrasound at 11 - 14 weeks of gestation is strongly associated with chromosomal abnormalities. Meanwhile, the incidence of the absent fetal NB in normal fetuses in the first trimester in mothers of different ethnic origins differs significantly. It is, therefore, important to assess ethnic variations in the first-trimester visualization of the fetal NB before introducing this marker into routine screening programs for aneuploidy.

Conclusion

The low prevalence of the NB absence in normal fetuses in the present study is compatible with the larger size of the NB in Iranian people compared to other communities. Meanwhile, the reference range of the NB length in normal Iranian fetuses was established so that basic data could be recorded for further studies regarding the absence or presence of the NB in screening for chromosomal abnormalities (Down syndrome) within the Iranian population.

Results

The NB was absent in 2/767 (0.26%) of the fetuses. The mean length of the NB was 3.6 ± 0.69 mm for the fetuses of 11 - 14 weeks gestational age. The LR value of the absent NB was equal to 250 in the normal fetuses of the Iranian population living in the North-West provinces.

Patients and Methods

In 767 normal fetuses, the fetal profile was examined by ultrasound for the absence/presence of the NB. The NB length was also measured, and the LR for the NB absence was also determined.

Objectives

The objectives of this study were to determine the NB length and the prevalence of the NB absence as well as calculating the likelihood ratio (LR) for the absence of the NB in normal fetuses of Iranian women undergoing first-trimester screening for trisomy 21.

Background

Failed visualization of the fetal nasal bone (NB) by ultrasound at 11 - 14 weeks of gestation is strongly associated with chromosomal abnormalities. Meanwhile, the incidence of the absent fetal NB in normal fetuses in the first trimester in mothers of different ethnic origins differs significantly. It is, therefore, important to assess ethnic variations in the first-trimester visualization of the fetal NB before introducing this marker into routine screening programs for aneuploidy.

Bone;Ultrasonography;First Trimester;Down syndrome Bone;Ultrasonography;First Trimester;Down syndrome http://www.Iranjradiol.com/index.php?page=article&article_id=11905 Masoud Poureisa Masoud Poureisa Neurosciences Research Center (NSRC), Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Neurosciences Research Center (NSRC), Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Mohammad Hossein Daghighi Mohammad Hossein Daghighi Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Tel/Fax: +98-4133346911 Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Tel/Fax: +98-4133346911 Ramin Mazaheri Khameneh Ramin Mazaheri Khameneh Department of Surgery and Diagnostic Imaging, Veterinary Faculty, Urmia University, Urmia, Iran Department of Surgery and Diagnostic Imaging, Veterinary Faculty, Urmia University, Urmia, Iran Sanaz Salehi Majd Sanaz Salehi Majd Imam Khomeini General Hospital, Sardasht, Iran Imam Khomeini General Hospital, Sardasht, Iran
en 26715978 10.5812/iranjradiol.14619v2 99mTc-IgG-Lung Scintigraphy in the Assessment of Pulmonary Involvement in Interstitial Lung Disease and Its Comparison With Pulmonary Function Tests and High-Resolution Computed Tomography: A Preliminary Study 99mTc-IgG-Lung Scintigraphy in the Assessment of Pulmonary Involvement in Interstitial Lung Disease and Its Comparison With Pulmonary Function Tests and High-Resolution Computed Tomography: A Preliminary Study brief-report brief-report Conclusion

The present results confirmed that 99mTc-IgG scan could be applied to detect the severity of pulmonary involvement, which was well correlated with HRCT findings. This data also showed that the 99mTc-IgG scan might be used as a complement to HRCT in the functional evaluation of the clinical status in ILD; however, further studies are recommended.

Patients and Methods

Eight known cases of ILD including four cases of Mustard gas (MG) intoxication and four patients with ILD of unknown cause were included in this study. A population of six patients without lung disease was considered as the control group. The patients underwent PFT and high-resolution computed tomography, followed by 99mTc-IgG scan. They were followed up for one year. 99mTc-IgG scan assessment of IgG uptake was accomplished both qualitatively (subjectively) and semiquantitatively.

Results

All eight ILD patients demonstrated a strong increase in 99mTc-IgG uptake in the lungs, compared to the control patients. The 99mTc-IgG scan scores were higher in the patient group (0.64[95% confidence interval(CI)=0.61-0.69])) than the control group (0.35 (0.35[95% CI=0.28-0.40]), (P<0.05)). In patients, a statistically significant positive correlation was detected between 99mTc-IgG scan and HRCT scores (Spearman’s correlation coefficient = 0.92, P < 0.008). The 99mTc-Human Immunoglobulin (HIG) scores were not significantly correlated with PFT findings (including FVC, FEV1, FEV1/FVC), O2 saturation and age ( P values > 0.05). There were no significant correlations between 99mTc-IgG score and HRCT patterns including ground glass opacity, reticular fibrosis and honeycombing (P value > 0.05).

Objectives

The aim of this study was to determine the efficacy of 99mTc-IgG scan for the detection of severity of disease compared to high-resolution computed tomography (HRCT) and pulmonary function test (PFT).

Background

The discrimination of inactive inflammatory processes from the active form of the disease is of great importance in the management of interstitial lung disease (ILD).

Conclusion

The present results confirmed that 99mTc-IgG scan could be applied to detect the severity of pulmonary involvement, which was well correlated with HRCT findings. This data also showed that the 99mTc-IgG scan might be used as a complement to HRCT in the functional evaluation of the clinical status in ILD; however, further studies are recommended.

Patients and Methods

Eight known cases of ILD including four cases of Mustard gas (MG) intoxication and four patients with ILD of unknown cause were included in this study. A population of six patients without lung disease was considered as the control group. The patients underwent PFT and high-resolution computed tomography, followed by 99mTc-IgG scan. They were followed up for one year. 99mTc-IgG scan assessment of IgG uptake was accomplished both qualitatively (subjectively) and semiquantitatively.

Results

All eight ILD patients demonstrated a strong increase in 99mTc-IgG uptake in the lungs, compared to the control patients. The 99mTc-IgG scan scores were higher in the patient group (0.64[95% confidence interval(CI)=0.61-0.69])) than the control group (0.35 (0.35[95% CI=0.28-0.40]), (P<0.05)). In patients, a statistically significant positive correlation was detected between 99mTc-IgG scan and HRCT scores (Spearman’s correlation coefficient = 0.92, P < 0.008). The 99mTc-Human Immunoglobulin (HIG) scores were not significantly correlated with PFT findings (including FVC, FEV1, FEV1/FVC), O2 saturation and age ( P values > 0.05). There were no significant correlations between 99mTc-IgG score and HRCT patterns including ground glass opacity, reticular fibrosis and honeycombing (P value > 0.05).

Objectives

The aim of this study was to determine the efficacy of 99mTc-IgG scan for the detection of severity of disease compared to high-resolution computed tomography (HRCT) and pulmonary function test (PFT).

Background

The discrimination of inactive inflammatory processes from the active form of the disease is of great importance in the management of interstitial lung disease (ILD).

Interstitial Lung Disease;Tomography, X-Ray Computed;Respiratory Function Tests;Mustard Gas Interstitial Lung Disease;Tomography, X-Ray Computed;Respiratory Function Tests;Mustard Gas http://www.Iranjradiol.com/index.php?page=article&article_id=14619 Mehrzad Bahtouee Mehrzad Bahtouee Department of Internal Medicine (Division of Pulmonary), Bushehr Medical Center Hospital, Bushehr University of Medical Sciences, Bushehr, Iran Department of Internal Medicine (Division of Pulmonary), Bushehr Medical Center Hospital, Bushehr University of Medical Sciences, Bushehr, Iran Jamshid Saberifard Jamshid Saberifard Department of Radiology, Bushehr Medical Center Hospital, Bushehr University of Medical Sciences, Bushehr, Iran Department of Radiology, Bushehr Medical Center Hospital, Bushehr University of Medical Sciences, Bushehr, Iran Hamid Javadi Hamid Javadi Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran Iraj Nabipour Iraj Nabipour The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran Hasan Malakizadeh Hasan Malakizadeh Department of Internal Medicine (Division of Pulmonary), Bushehr Medical Center Hospital, Bushehr University of Medical Sciences, Bushehr, Iran Department of Internal Medicine (Division of Pulmonary), Bushehr Medical Center Hospital, Bushehr University of Medical Sciences, Bushehr, Iran Gholamhossein Monavvarsadegh Gholamhossein Monavvarsadegh Department of Internal Medicine (Division of Pulmonary), Bushehr Medical Center Hospital, Bushehr University of Medical Sciences, Bushehr, Iran Department of Internal Medicine (Division of Pulmonary), Bushehr Medical Center Hospital, Bushehr University of Medical Sciences, Bushehr, Iran Hoda Ilkhani Pak Hoda Ilkhani Pak The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran Azadeh Sadeghi Azadeh Sadeghi The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran Majid Assadi Majid Assadi The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran; The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran. Tel: +98-7712541828 The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran; The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran. Tel: +98-7712541828
en 26793288 10.5812/iranjradiol.18286 Velocity Measurement in Carotid Artery: Quantitative Comparison of Time-Resolved 3D Phase-Contrast MRI and Image-based Computational Fluid Dynamics Velocity Measurement in Carotid Artery: Quantitative Comparison of Time-Resolved 3D Phase-Contrast MRI and Image-based Computational Fluid Dynamics research-article research-article Conclusion

Both techniques provided quantitatively consistent results of in vivo velocity vector fields in right internal carotid artery (RCA). PC MRI represented a good estimation of main flow patterns inside the vasculature, which seems to be acceptable for clinical use. However, limitations of each technique should be considered while interpreting results.

Subjects and Methods

MR imaging was performed on a 30-year old male normal subject. TR 3D PC MRI was performed on a 3 T scanner to measure velocity in carotid bifurcation. 3D anatomical model for CFD was created using images obtained from time-of-flight MR angiography. Velocity vector field in carotid bifurcation was predicted using CFD and PC MRI techniques. A statistical analysis was performed to assess the agreement between the two methods.

Results

Although the main flow patterns were the same for the both techniques, CFD showed a greater resolution in mapping the secondary and circulating flows. Overall root mean square (RMS) errors for all the corresponding data points in PC MRI and CFD were 14.27% in peak systole and 12.91% in end diastole relative to maximum velocity measured at each cardiac phase. Bland-Altman plots showed a very good agreement between the two techniques. However, this study was not aimed to validate any of methods, instead, the consistency was assessed to accentuate the similarities and differences between Time-resolved PC MRI and CFD.

Background

Understanding hemodynamic environment in vessels is important for realizing the mechanisms leading to vascular pathologies.

Objectives

Three-dimensional velocity vector field in carotid bifurcation is visualized using TR 3D phase-contrast magnetic resonance imaging (TR 3D PC MRI) and computational fluid dynamics (CFD). This study aimed to present a qualitative and quantitative comparison of the velocity vector field obtained by each technique.

Conclusion

Both techniques provided quantitatively consistent results of in vivo velocity vector fields in right internal carotid artery (RCA). PC MRI represented a good estimation of main flow patterns inside the vasculature, which seems to be acceptable for clinical use. However, limitations of each technique should be considered while interpreting results.

Subjects and Methods

MR imaging was performed on a 30-year old male normal subject. TR 3D PC MRI was performed on a 3 T scanner to measure velocity in carotid bifurcation. 3D anatomical model for CFD was created using images obtained from time-of-flight MR angiography. Velocity vector field in carotid bifurcation was predicted using CFD and PC MRI techniques. A statistical analysis was performed to assess the agreement between the two methods.

Results

Although the main flow patterns were the same for the both techniques, CFD showed a greater resolution in mapping the secondary and circulating flows. Overall root mean square (RMS) errors for all the corresponding data points in PC MRI and CFD were 14.27% in peak systole and 12.91% in end diastole relative to maximum velocity measured at each cardiac phase. Bland-Altman plots showed a very good agreement between the two techniques. However, this study was not aimed to validate any of methods, instead, the consistency was assessed to accentuate the similarities and differences between Time-resolved PC MRI and CFD.

Background

Understanding hemodynamic environment in vessels is important for realizing the mechanisms leading to vascular pathologies.

Objectives

Three-dimensional velocity vector field in carotid bifurcation is visualized using TR 3D phase-contrast magnetic resonance imaging (TR 3D PC MRI) and computational fluid dynamics (CFD). This study aimed to present a qualitative and quantitative comparison of the velocity vector field obtained by each technique.

Fluid Dynamics;Time-Resolved Three-Dimensional Phase-Contrast Magnetic Resonance Imaging (TR 3D PC MRI);Carotid Bifurcation Fluid Dynamics;Time-Resolved Three-Dimensional Phase-Contrast Magnetic Resonance Imaging (TR 3D PC MRI);Carotid Bifurcation http://www.Iranjradiol.com/index.php?page=article&article_id=18286 Ali Sarrami-Foroushani Ali Sarrami-Foroushani Department of Chemical Engineering, Isfahan University of Technology, Isfahan, Iran Department of Chemical Engineering, Isfahan University of Technology, Isfahan, Iran Mohsen Nasr Esfahany Mohsen Nasr Esfahany Department of Chemical Engineering, Isfahan University of Technology, Isfahan, Iran; Department of Chemical Engineering, Isfahan University of Technology, Isfahan, Iran. Tel: +98-3133915631, Fax: +98-3113912677 Department of Chemical Engineering, Isfahan University of Technology, Isfahan, Iran; Department of Chemical Engineering, Isfahan University of Technology, Isfahan, Iran. Tel: +98-3133915631, Fax: +98-3113912677 Abbas Nasiraei Moghaddam Abbas Nasiraei Moghaddam Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran Hamidreza Saligheh Rad Hamidreza Saligheh Rad Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran Kavous Firouznia Kavous Firouznia 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 Hossein Ghanaati Hossein Ghanaati 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 Iain David Wilkinson Iain David Wilkinson Academic Unit of Radiology, University of Sheffield, Sheffield, South Yorkshire, United Kingdom Academic Unit of Radiology, University of Sheffield, Sheffield, South Yorkshire, United Kingdom Alejandro Federico Frangi Alejandro Federico Frangi Department of Mechanical Engineering, The University of Sheffield, Sheffield, United Kingdom Department of Mechanical Engineering, The University of Sheffield, Sheffield, United Kingdom
en 26715979 10.5812/iranjradiol.18372v2 Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique research-article research-article Background

Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study.

Objectives

The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs).

Materials and Methods

We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios.

Results

Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs.

Conclusion

As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI centers. With the settlement of a reliable cost accounting system such as ABC technique, hospitals would be able to generate robust evidences for financial management of their overhead, intermediate and final ACs.

Background

Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study.

Objectives

The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs).

Materials and Methods

We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios.

Results

Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs.

Conclusion

As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI centers. With the settlement of a reliable cost accounting system such as ABC technique, hospitals would be able to generate robust evidences for financial management of their overhead, intermediate and final ACs.

Health-Care;Magnetic Resonance Imaging;Health Economics;Cost Analysis;Pricing Medical Fees Health-Care;Magnetic Resonance Imaging;Health Economics;Cost Analysis;Pricing Medical Fees http://www.Iranjradiol.com/index.php?page=article&article_id=18372 Mohsen Bayati Mohsen Bayati Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Alireza Mahboub Ahari Alireza Mahboub Ahari Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Iranian Center of Excellence in Healthcare Management, Tabriz University of Medical Sciences, Tabriz, Iran Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Iranian Center of Excellence in Healthcare Management, Tabriz University of Medical Sciences, Tabriz, Iran Abbas Badakhshan Abbas Badakhshan Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Mahin Gholipour Mahin Gholipour Department of Community Medicine, Golestan University of Medical Sciences, Gorgan, Iran; Department of Community Medicine, Golestan University of Medical Sciences, Gorgan, Iran. Tel: +98-2165324531, Fax: +98-2188989129 Department of Community Medicine, Golestan University of Medical Sciences, Gorgan, Iran; Department of Community Medicine, Golestan University of Medical Sciences, Gorgan, Iran. Tel: +98-2165324531, Fax: +98-2188989129 Hassan Joulaei Hassan Joulaei Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
en 26715983 10.5812/iranjradiol.9878v2 Magnetic Resonance Imaging of Non-Puerperal Complete Uterine Inversion Magnetic Resonance Imaging of Non-Puerperal Complete Uterine Inversion case-report case-report

Uterine inversion is shortly described as the indentation and depression of the fundic area extending downwards up to the different levels of the birth canal till vaginal opening. Clinical diagnosis of uterine inversion is difficult due to its non-specific symptoms and physical examination. Ultrasonography is the most practical modality for radiological evaluation, but it is inadequate to determine the exact nature of this condition and making the differential diagnosis. In this case, we present the main MRI findings of non-puerperal complete uterine inversion caused by a giant leiomyoma.

Uterine inversion is shortly described as the indentation and depression of the fundic area extending downwards up to the different levels of the birth canal till vaginal opening. Clinical diagnosis of uterine inversion is difficult due to its non-specific symptoms and physical examination. Ultrasonography is the most practical modality for radiological evaluation, but it is inadequate to determine the exact nature of this condition and making the differential diagnosis. In this case, we present the main MRI findings of non-puerperal complete uterine inversion caused by a giant leiomyoma.

Uterine Inversion;Uterine Prolapse;Magnetic Resonance;Ultrasonography;Uterine Diseases Uterine Inversion;Uterine Prolapse;Magnetic Resonance;Ultrasonography;Uterine Diseases http://www.Iranjradiol.com/index.php?page=article&article_id=9878 Veli Mihmanli Veli Mihmanli Department of Obstetrics and Gynecology, Okmeydani Training and Research Hospital, Istanbul, Turkey Department of Obstetrics and Gynecology, Okmeydani Training and Research Hospital, Istanbul, Turkey Fahrettin Kilic Fahrettin Kilic Department of Radiology, Medical Faculty, Istanbul University Cerrahpasa, Istanbul, Turkey; Department of Radiology, Medical Faculty, Istanbul University Cerrahpasa, Istanbul, Turkey. Tel: +90-2124143000; Fax: +90-5325004879 Department of Radiology, Medical Faculty, Istanbul University Cerrahpasa, Istanbul, Turkey; Department of Radiology, Medical Faculty, Istanbul University Cerrahpasa, Istanbul, Turkey. Tel: +90-2124143000; Fax: +90-5325004879 Soner Pul Soner Pul Department of Obstetrics and Gynecology, Okmeydani Training and Research Hospital, Istanbul, Turkey Department of Obstetrics and Gynecology, Okmeydani Training and Research Hospital, Istanbul, Turkey Aydin Kilinc Aydin Kilinc Department of Obstetrics and Gynecology, Okmeydani Training and Research Hospital, Istanbul, Turkey Department of Obstetrics and Gynecology, Okmeydani Training and Research Hospital, Istanbul, Turkey Ahmet Kilickaya Ahmet Kilickaya Department of Obstetrics and Gynecology, Okmeydani Training and Research Hospital, Istanbul, Turkey Department of Obstetrics and Gynecology, Okmeydani Training and Research Hospital, Istanbul, Turkey
en 26587203 10.5812/iranjradiol.18924 Organizing Hematoma of the Maxillary Sinus Mimicking Malignancy Diagnosed by Fluorodeoxyglucose Positron-Emission Tomography (FDG PET/CT): A Case Report Organizing Hematoma of the Maxillary Sinus Mimicking Malignancy Diagnosed by Fluorodeoxyglucose Positron-Emission Tomography (FDG PET/CT): A Case Report case-report case-report

In this report, we have presented 18FDG-PET findings of organized hematoma of the maxillary sinus (OHMS) that showed an increased FDG uptake in the peripheral rim of the mass with central photopenia. To our knowledge, this is the first case report in the literature reporting FDG-PET/CT findings of OHMS. Careful interpretation of metabolic (FDG-PET/CT) and anatomic (CT and MRI) images should be performed to accurately characterize the expansile lesion of the maxillary sinus in order to increase specificity and reduce equivocal findings significantly.

Organizing hematoma of the paranasal sinuses is a diagnostic dilemma clinically and radiographically, mimicking benign or malignant neoplastic processes. Although the diagnostic rate of this disease has increased as characteristic imaging findings are somewhat elucidated, endoscopic examination, preoperative biopsy, and computed tomography (CT) imaging do not give helpful information in differentiating these lesions from malignant neoplastic processes.

A 55-year-old man presented with a 4-month history of recurrent nasal bleeding. He also complained of a left-sided nasal obstruction. CT findings were highly suggestive of a malignant tumor of the maxillary sinus. However, based on fluorodeoxyglucose F18 positron-emission tomography (PET/CT) and magnetic resonance imaging (MRI), the provisional diagnosis of benign tumor rather than malignancy was made. Complete resection of the mass was achieved by simple transnasal endoscopic surgery using the Caldwell-Luc approach. Organizing hematoma of the maxillary sinus was diagnosed by histopathologic evaluation. The clinical, radiological, and histopathologic findings of the patient are presented.

In this report, we have presented 18FDG-PET findings of organized hematoma of the maxillary sinus (OHMS) that showed an increased FDG uptake in the peripheral rim of the mass with central photopenia. To our knowledge, this is the first case report in the literature reporting FDG-PET/CT findings of OHMS. Careful interpretation of metabolic (FDG-PET/CT) and anatomic (CT and MRI) images should be performed to accurately characterize the expansile lesion of the maxillary sinus in order to increase specificity and reduce equivocal findings significantly.

Organizing hematoma of the paranasal sinuses is a diagnostic dilemma clinically and radiographically, mimicking benign or malignant neoplastic processes. Although the diagnostic rate of this disease has increased as characteristic imaging findings are somewhat elucidated, endoscopic examination, preoperative biopsy, and computed tomography (CT) imaging do not give helpful information in differentiating these lesions from malignant neoplastic processes.

A 55-year-old man presented with a 4-month history of recurrent nasal bleeding. He also complained of a left-sided nasal obstruction. CT findings were highly suggestive of a malignant tumor of the maxillary sinus. However, based on fluorodeoxyglucose F18 positron-emission tomography (PET/CT) and magnetic resonance imaging (MRI), the provisional diagnosis of benign tumor rather than malignancy was made. Complete resection of the mass was achieved by simple transnasal endoscopic surgery using the Caldwell-Luc approach. Organizing hematoma of the maxillary sinus was diagnosed by histopathologic evaluation. The clinical, radiological, and histopathologic findings of the patient are presented.

Organizing Hematoma;Computed Tomography;Chronic Expanding Hematoma;Fluorodeoxyglucose F18 Positron-Emission Tomography;Magnetic Resonance Imaging;Maxillary Sinus Organizing Hematoma;Computed Tomography;Chronic Expanding Hematoma;Fluorodeoxyglucose F18 Positron-Emission Tomography;Magnetic Resonance Imaging;Maxillary Sinus http://www.Iranjradiol.com/index.php?page=article&article_id=18924 Yong Kyun Park Yong Kyun Park Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea; Department of Otorhinolaryngology-Head and Neck Surgery,Chung-Ang University Hospital, College of Medicine, Chung-Ang University, P. O. Box: 156-755, Seoul, Korea. Tel: +82-262991765, Fax: +82-28251765 Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea; Department of Otorhinolaryngology-Head and Neck Surgery,Chung-Ang University Hospital, College of Medicine, Chung-Ang University, P. O. Box: 156-755, Seoul, Korea. Tel: +82-262991765, Fax: +82-28251765 Kyung Soo Kim Kyung Soo Kim Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea; Department of Otorhinolaryngology-Head and Neck Surgery,Chung-Ang University Hospital, College of Medicine, Chung-Ang University, P. O. Box: 156-755, Seoul, Korea. Tel: +82-262991765, Fax: +82-28251765 Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea; Department of Otorhinolaryngology-Head and Neck Surgery,Chung-Ang University Hospital, College of Medicine, Chung-Ang University, P. O. Box: 156-755, Seoul, Korea. Tel: +82-262991765, Fax: +82-28251765
en 26587204 10.5812/iranjradiol.19273 Chondromyxoid Fibroma of Two Cervical Vertebrae with Involvement of Surrounding Soft Tissue: Radiologic Diagnostic Dilemma Chondromyxoid Fibroma of Two Cervical Vertebrae with Involvement of Surrounding Soft Tissue: Radiologic Diagnostic Dilemma case-report case-report

Chondromyxoid fibroma is a rare benign cartilaginous neoplasm that mostly affects the metaphyseal region of the long bones. The tibia, small tubular bones of the foot, the distal femur and pelvis are common locations, but involvement of the vertebral bones, especially the cervical vertebra, is very rare. Radiographic features show typical characteristics and this tumor often presents as a lobulated, eccentric radiolucent lesion with no periosteal reaction. In addition, geographic bone destruction is seen in all cases. We present an adult female with a one-year history of neck pain, and ultrasound findings that suggest a right paravertebral muscular lesion due to inflammatory or neoplastic origins. The histopathological studies confirmed that the biopsied specimen was a chondromyxoid fibroma of the cervical vertebrae laminae and spinous processes (C3 and C4) with abutting soft tissue. Despite the unusual location and soft tissue presentation, a chondromyxoid fibroma should be considered in the differential diagnosis of a cervical bone lesion.

Chondromyxoid fibroma is a rare benign cartilaginous neoplasm that mostly affects the metaphyseal region of the long bones. The tibia, small tubular bones of the foot, the distal femur and pelvis are common locations, but involvement of the vertebral bones, especially the cervical vertebra, is very rare. Radiographic features show typical characteristics and this tumor often presents as a lobulated, eccentric radiolucent lesion with no periosteal reaction. In addition, geographic bone destruction is seen in all cases. We present an adult female with a one-year history of neck pain, and ultrasound findings that suggest a right paravertebral muscular lesion due to inflammatory or neoplastic origins. The histopathological studies confirmed that the biopsied specimen was a chondromyxoid fibroma of the cervical vertebrae laminae and spinous processes (C3 and C4) with abutting soft tissue. Despite the unusual location and soft tissue presentation, a chondromyxoid fibroma should be considered in the differential diagnosis of a cervical bone lesion.

Tissue;Chondromyxoid Fibroma;Vertebrae Tissue;Chondromyxoid Fibroma;Vertebrae http://www.Iranjradiol.com/index.php?page=article&article_id=19273 Shokouh Taghipour Zahir Shokouh Taghipour Zahir Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Tel: +98-3518113615, Fax: +98-3518114100 Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Tel: +98-3518113615, Fax: +98-3518114100 Naser Sefidrokh Sharahjin Naser Sefidrokh Sharahjin Department of Radiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Department of Radiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Farzad Sadlu Parizi Farzad Sadlu Parizi Department of Neurosurgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Department of Neurosurgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Koorosh Rahmani Koorosh Rahmani School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
en 26715980 10.5812/iranjradiol.21260 Decidualized Ovarian Endometrioma in a Pregnant Woman Mimicking Ovarian Malignancy: Magnetic Resonance Imaging and Ultrasonographic Findings Decidualized Ovarian Endometrioma in a Pregnant Woman Mimicking Ovarian Malignancy: Magnetic Resonance Imaging and Ultrasonographic Findings case-report case-report

Decidualized ovarian endometrioma is a rare phenomenon in pregnancy, which can mimic ovarian malignancy in imaging and often poses a diagnostic challenge. We report a case of a large ruptured decidualized ovarian endometrioma in a 15 weeks gestation patient, and we will describe the imaging characteristics (ultrasonography and MR imaging findings) and the histopathological findings (macro- and microscopically).

Decidualized ovarian endometrioma is a rare phenomenon in pregnancy, which can mimic ovarian malignancy in imaging and often poses a diagnostic challenge. We report a case of a large ruptured decidualized ovarian endometrioma in a 15 weeks gestation patient, and we will describe the imaging characteristics (ultrasonography and MR imaging findings) and the histopathological findings (macro- and microscopically).

Endometrioma;Pregnancy;Magnetic Resonance Imaging;Ultrasonography Endometrioma;Pregnancy;Magnetic Resonance Imaging;Ultrasonography http://www.Iranjradiol.com/index.php?page=article&article_id=21260 Faizatul Izza Rozalli Faizatul Izza Rozalli Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. Tel: +6-0173340008 Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. Tel: +6-0173340008 Kartini Rahmat Kartini Rahmat Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Farhana Fadzli Farhana Fadzli Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Colm Boylan Colm Boylan Department of Diagnostic Imaging, St Joseph’s Healthcare, Hamilton, Canada Department of Diagnostic Imaging, St Joseph’s Healthcare, Hamilton, Canada Pratima Deb Pratima Deb Department of Diagnostic Imaging, St Joseph’s Healthcare, Hamilton, Canada Department of Diagnostic Imaging, St Joseph’s Healthcare, Hamilton, Canada
en 26715982 10.5812/iranjradiol.29084 Perianal Fistula With and Without Abscess: Assessment of Fistula Activity Using Diffusion-Weighted Magnetic Resonance Imaging Perianal Fistula With and Without Abscess: Assessment of Fistula Activity Using Diffusion-Weighted Magnetic Resonance Imaging research-article research-article Conclusion

The DWMRI is a useful technique for evaluating activity of fistulas with abscess. Perianal fistula visibility is greater with combined T2WI and DWMRI than T2WI alone.

Patients and Methods

Fifty-three patients with 56 perianal fistulas were included in the current retrospective study. The T2-weighted imaging (T2WI) and DWMRI were performed and apparent diffusion coefficient (ADC) values of fistulas were measured. Fistulas were classified into two groups: only perianal fistulas and fistulas accompanied by abscess. Fistulas were also classified into two groups, based on clinical findings: positive inflammatory activity (PIA) and negative inflammatory activity (NIA).

Background

Magnetic resonance imaging (MRI) is highly accurate for the depiction of both the primary tract of fistula and abscesses, in patients with perianal disease. In addition, MRI can be used to evaluate the activity of fistulas, which is a significant factor for determining the therapeutic strategy.

Results

Mean ADC value (mm2/s) of PIA group was significantly lower than that of NIA group, regarding lesions in patients with abscess-associated fistulas (1.371 × 10-3 ± 0.168 × 10-3 vs. 1.586 × 10-3 ± 0.136 × 10-3; P = 0.036). No statistically significant difference was found in mean ADC values between PIA and NIA groups, in patients with only perianal fistulas (P = 0.507). Perianal fistula visibility was greater with combined evaluation of T2WI and DWMRI than with T2WI, for two reviewers (P = 0.046 and P = 0.014).

Objectives

This study aimed to determine the usefulness of diffusion-weighted (DW) MRI for assessing activity and visibility of perianal fistula.

Conclusion

The DWMRI is a useful technique for evaluating activity of fistulas with abscess. Perianal fistula visibility is greater with combined T2WI and DWMRI than T2WI alone.

Patients and Methods

Fifty-three patients with 56 perianal fistulas were included in the current retrospective study. The T2-weighted imaging (T2WI) and DWMRI were performed and apparent diffusion coefficient (ADC) values of fistulas were measured. Fistulas were classified into two groups: only perianal fistulas and fistulas accompanied by abscess. Fistulas were also classified into two groups, based on clinical findings: positive inflammatory activity (PIA) and negative inflammatory activity (NIA).

Background

Magnetic resonance imaging (MRI) is highly accurate for the depiction of both the primary tract of fistula and abscesses, in patients with perianal disease. In addition, MRI can be used to evaluate the activity of fistulas, which is a significant factor for determining the therapeutic strategy.

Results

Mean ADC value (mm2/s) of PIA group was significantly lower than that of NIA group, regarding lesions in patients with abscess-associated fistulas (1.371 × 10-3 ± 0.168 × 10-3 vs. 1.586 × 10-3 ± 0.136 × 10-3; P = 0.036). No statistically significant difference was found in mean ADC values between PIA and NIA groups, in patients with only perianal fistulas (P = 0.507). Perianal fistula visibility was greater with combined evaluation of T2WI and DWMRI than with T2WI, for two reviewers (P = 0.046 and P = 0.014).

Objectives

This study aimed to determine the usefulness of diffusion-weighted (DW) MRI for assessing activity and visibility of perianal fistula.

Magnetic Resonance Imaging;Diffusion;Perianal Fistula;Inflammation;Abscess Magnetic Resonance Imaging;Diffusion;Perianal Fistula;Inflammation;Abscess http://www.Iranjradiol.com/index.php?page=article&article_id=29084 Selim Bakan Selim Bakan Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey; Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. Tel: +90-2124143167, Fax: +90-2124143167 Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey; Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. Tel: +90-2124143167, Fax: +90-2124143167 Deniz Cebi Olgun Deniz Cebi Olgun Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Sedat Giray Kandemirli Sedat Giray Kandemirli Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Onur Tutar Onur Tutar Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Cesur Samanci Cesur Samanci Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Suleyman Dikici Suleyman Dikici Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Osman Simsek Osman Simsek Department of General Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Department of General Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Babak Rafiee Babak Rafiee Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Ibrahim Adaletli Ibrahim Adaletli Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Ismail Mihmanli Ismail Mihmanli Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
en 26793289 10.5812/iranjradiol.25272 Effect of Object Position in Cone Beam Computed Tomography Field of View for Detection of Root Fractures in Teeth with Intra-Canal Posts Effect of Object Position in Cone Beam Computed Tomography Field of View for Detection of Root Fractures in Teeth with Intra-Canal Posts research-article research-article Objectives

This study aimed to assess the effect of object position in the field of view (FOV) of CBCT on detection of VRFs in teeth with intra-canal posts.

Materials and Methods

The crowns of 60 extracted premolar teeth were cut at the level of cementoenamel junction (CEJ). Root canals were filled with gutta-percha and filling of the coronal 2/3 of the root canals was subsequently removed to fabricate intra-canal cast posts. The teeth were randomly divided into two groups of 30. Fracture was induced in group one using an Instron machine. Group two was considered as the control group with no fracture. All teeth were then randomly positioned and scanned in five different positions starting at the center of the FOV as well as right, left anterior and posterior relative to the center (3, 9, 12, and 6 O’clock) via the New Tom VGI CBCT unit. Two observers evaluated images for VRFs. Sensitivity and specificity of fracture diagnosis in each position was calculated in comparison with the gold standard. Wilcoxon test was used for data analysis.

Results

Considering deterministic and probabilistic diagnostic parameters, probabilistic sensitivity was similar in all positions; but probabilistic specificity of the center position (65.1%) was significantly higher than that of 6 and 12 O’clock positions. Considering the deterministic diagnostic parameters, the overall sensitivity and specificity values decreased in all positions in FOV, but sensitivity of the center position of FOV was significantly higher than that of other positions; specificity was significantly higher at the 3 O’clock position (58.5%).

Conclusion

Concerning the positions in FOV, the center position is suitable for detection of VRF in teeth with intra-canal posts due to significantly higher sensitivity at this position. The 3 O’clock position would be suitable for assessment of intact teeth without fractures due to significantly higher specificity at this position.

Background

Vertical root fracture (VRF) is a common problem in endodontically treated teeth. Due to its poor prognosis, a reliable technique must be used to make an accurate diagnosis. Cone beam computed tomography (CBCT) has been recently introduced for maxillofacial imaging. Despite the high diagnostic value of this method, metal artifacts resulting from intra-canal posts still make the detection of VRFs challenging.

Objectives

This study aimed to assess the effect of object position in the field of view (FOV) of CBCT on detection of VRFs in teeth with intra-canal posts.

Materials and Methods

The crowns of 60 extracted premolar teeth were cut at the level of cementoenamel junction (CEJ). Root canals were filled with gutta-percha and filling of the coronal 2/3 of the root canals was subsequently removed to fabricate intra-canal cast posts. The teeth were randomly divided into two groups of 30. Fracture was induced in group one using an Instron machine. Group two was considered as the control group with no fracture. All teeth were then randomly positioned and scanned in five different positions starting at the center of the FOV as well as right, left anterior and posterior relative to the center (3, 9, 12, and 6 O’clock) via the New Tom VGI CBCT unit. Two observers evaluated images for VRFs. Sensitivity and specificity of fracture diagnosis in each position was calculated in comparison with the gold standard. Wilcoxon test was used for data analysis.

Results

Considering deterministic and probabilistic diagnostic parameters, probabilistic sensitivity was similar in all positions; but probabilistic specificity of the center position (65.1%) was significantly higher than that of 6 and 12 O’clock positions. Considering the deterministic diagnostic parameters, the overall sensitivity and specificity values decreased in all positions in FOV, but sensitivity of the center position of FOV was significantly higher than that of other positions; specificity was significantly higher at the 3 O’clock position (58.5%).

Conclusion

Concerning the positions in FOV, the center position is suitable for detection of VRF in teeth with intra-canal posts due to significantly higher sensitivity at this position. The 3 O’clock position would be suitable for assessment of intact teeth without fractures due to significantly higher specificity at this position.

Background

Vertical root fracture (VRF) is a common problem in endodontically treated teeth. Due to its poor prognosis, a reliable technique must be used to make an accurate diagnosis. Cone beam computed tomography (CBCT) has been recently introduced for maxillofacial imaging. Despite the high diagnostic value of this method, metal artifacts resulting from intra-canal posts still make the detection of VRFs challenging.

Tooth Fracture;Cone-Beam Computed Tomography;Post and Core Technique;Position Tooth Fracture;Cone-Beam Computed Tomography;Post and Core Technique;Position http://www.Iranjradiol.com/index.php?page=article&article_id=25272 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 Zahra Vasegh Zahra Vasegh 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: +98-2188773550, Fax: +98-2188773550 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: +98-2188773550, Fax: +98-2188773550 Samin Rezapanah Samin Rezapanah 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 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 Mohamad Javad Khaeazifard Mohamad Javad Khaeazifard Dental Research Institute, Tehran University of Medical Sciences, Tehran, Iran Dental Research Institute, Tehran University of Medical Sciences, Tehran, Iran