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 29 gregorian 2017 6 29 13 1
en 27110340 10.5812/iranjradiol.24827 Mucocele in the Base of the Tongue Mimicking a Thyroglossal Duct Cyst: A Very Rare Location Mucocele in the Base of the Tongue Mimicking a Thyroglossal Duct Cyst: A Very Rare Location case-report case-report Abstract

Mucoceles are one of the most common benign soft tissue masses of the oral cavity. When they occur in the tongue, the ventral surface is the usual location. Mucoceles at the base of the tongue are extremely rare and must be differentiated from intralingual thyroglossal duct cysts. We present a case of a mucocele on the base of the tongue, which was incidentally found on a cervical spinal magnetic resonance image. We include a review of the literature on image findings, pathologic type, differential diagnosis, clinical symptoms, and treatment of oral mucoceles.

Abstract

Mucoceles are one of the most common benign soft tissue masses of the oral cavity. When they occur in the tongue, the ventral surface is the usual location. Mucoceles at the base of the tongue are extremely rare and must be differentiated from intralingual thyroglossal duct cysts. We present a case of a mucocele on the base of the tongue, which was incidentally found on a cervical spinal magnetic resonance image. We include a review of the literature on image findings, pathologic type, differential diagnosis, clinical symptoms, and treatment of oral mucoceles.

Mucocele;Tongue;Computed Tomography;Magnetic Resonance Imaging Mucocele;Tongue;Computed Tomography;Magnetic Resonance Imaging http://www.Iranjradiol.com/index.php?page=article&article_id=24827 Joon Ho Hur Joon Ho Hur Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University , Seoul, Korea Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University , Seoul, Korea Jun Soo Byun Jun Soo Byun Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University , Seoul, Korea; Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University, Seoul, Korea. Tel: +82-262993194, Fax: +82-262631557 Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University , Seoul, Korea; Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University, Seoul, Korea. Tel: +82-262993194, Fax: +82-262631557 Jae Kyun Kim Jae Kyun Kim Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University , Seoul, Korea Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University , Seoul, Korea Woong Jae Lee Woong Jae Lee Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University , Seoul, Korea Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University , Seoul, Korea Tae Jin Lee Tae Jin Lee Department of Pathology, Chung-Ang University College of Medicine, Seoul, Korea Department of Pathology, Chung-Ang University College of Medicine, Seoul, Korea Hoon Shik Yang Hoon Shik Yang Department of Otolaryngology, Chung-Ang University College of Medicine, Seoul, Korea Department of Otolaryngology, Chung-Ang University College of Medicine, Seoul, Korea
en 27127572 10.5812/iranjradiol.13260 Primary Hyperparathyroidism Misdiagnosed as Giant Cell Bone Tumor of Maxillary Sinus: A Case Report Primary Hyperparathyroidism Misdiagnosed as Giant Cell Bone Tumor of Maxillary Sinus: A Case Report case-report case-report

Primary hyperparathyroidism is an endocrine disorder recognized by hyperfunction of parathyroid gland, which can result in persistent bone absorption and brown tumor. Facial involvement of brown tumor is rare and usually involves the mandible. Giant cell tumor ( GCT) is an expansile osteolytic bone tumor which is very similar in clinical, radiological and histological features to brown tumor. Herein, we present a 35-year-old woman with an 11-month history of gradually swelling of the right maxilla and buccal spaces began during pregnancy two years ago. No other clinical or laboratory problems were detected. Postpartum CT scan demonstrated a lytic expansile multi-septated mass lesion containing enhancing areas, which initially described as GCT of the right maxillary sinus following surgery. Four months later, gradual progressive swelling of the bed of tumor was recurred and revised pathological slices were compatible with GCT. Regarding patient recent paresthesia, repeated laboratory tests were performed. Finally, according to laboratory results (elevation of serum calcium and parathyroid hormone), ultrasonographic findings and radioisotope scan (Sestamibi), probable parathyroid mass and brown tumor of maxilla was diagnosed. Pathology confirmed hyperplasia of right inferior parathyroid gland. Our case was thought-provoking due to its interesting clinical presentation and unusual presentation of brown tumor in parathyroid hyperplasia.

Primary hyperparathyroidism is an endocrine disorder recognized by hyperfunction of parathyroid gland, which can result in persistent bone absorption and brown tumor. Facial involvement of brown tumor is rare and usually involves the mandible. Giant cell tumor ( GCT) is an expansile osteolytic bone tumor which is very similar in clinical, radiological and histological features to brown tumor. Herein, we present a 35-year-old woman with an 11-month history of gradually swelling of the right maxilla and buccal spaces began during pregnancy two years ago. No other clinical or laboratory problems were detected. Postpartum CT scan demonstrated a lytic expansile multi-septated mass lesion containing enhancing areas, which initially described as GCT of the right maxillary sinus following surgery. Four months later, gradual progressive swelling of the bed of tumor was recurred and revised pathological slices were compatible with GCT. Regarding patient recent paresthesia, repeated laboratory tests were performed. Finally, according to laboratory results (elevation of serum calcium and parathyroid hormone), ultrasonographic findings and radioisotope scan (Sestamibi), probable parathyroid mass and brown tumor of maxilla was diagnosed. Pathology confirmed hyperplasia of right inferior parathyroid gland. Our case was thought-provoking due to its interesting clinical presentation and unusual presentation of brown tumor in parathyroid hyperplasia.

Brown Tumor;Hyperparathyroidism;Giant Cell Tumor;Maxilla Brown Tumor;Hyperparathyroidism;Giant Cell Tumor;Maxilla http://www.Iranjradiol.com/index.php?page=article&article_id=13260 Leila Aghaghazvini Leila Aghaghazvini Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran; Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9123389318, Fax: +98-2166581577 Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran; Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9123389318, Fax: +98-2166581577 Hashem Sharifian Hashem Sharifian Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran Bahman Rasuli Bahman Rasuli 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 27110333 10.5812/iranjradiol.19518 Comparison of 64-Detector CT Colonography and Conventional Colonoscopy in the Detection of Colorectal Lesions Comparison of 64-Detector CT Colonography and Conventional Colonoscopy in the Detection of Colorectal Lesions research-article research-article Conclusions

CT colonography is a safe and minimally invasive technique, a valuable diagnostic tool for examining the entire colon and a good alternative compared to other colorectal cancer screening tests because of its high sensitivity values in colorectal lesions over 1 cm.

Patients and Methods

In a prospective study performed at Gastroenterology and Radiology Departments of Medical Faculty of Eskisehir Osmangazi University, CT colonography and colonoscopy results of 31 patients with family history of colorectal carcinoma, personal or family history of colorectal polyps, lower gastrointestinal tract bleeding, change in bowel habits, iron deficiency anemia and abdominal pain were compared. Regardless of the size, CT colonography and conventional colonoscopy findings for all the lesions were cross - tabulated and the sensitivity, specificity, and positive and negative predictive values were calculated. To assess the agreement between CT colonography and conventional colonoscopy examinations, the Kappa coefficient of agreementt was used. Statistical analysis was performed by SPSS ver 15.0.

Background

Colon cancer is a leading cause of morbidity and mortality in developed countries. The early detection of colorectal cancer using screening programs is important for managing early-stage colorectal cancers and polyps. Modalities that allow examination of the entire colon are conventional colonoscopy, double contrast barium enema examination and multi-detector computed tomography (MDCT) colonography.

Results

Regardless of the size, MDCT colonography showed 83% sensitivity and 95% specificity, with a positive predictive value of 95% and a negative predictive value of 83% for the detection of colorectal polyps and masses. MDCT colonography displayed 92% sensitivity and 95% specificity, with a positive predictive value of 92% and a negative predictive value of 95% for polyps ≥ 10 mm. For polyps between 6mm and 9 mm, MDCT colonography displayed 75% sensitivity and 100% specificity, with a positive predictive value of 100% and a negative predictive value of 90%. For polyps ≤ 5 mm MDCT colonography displayed 88% sensitivity and 100% specificity with a positive predictive value of 100% and a negative predictive value of 95%.

Objectives

To compare CT colonography and conventional colonoscopy results and to evaluate the accuracy of CT colonography for detecting colorectal lesions.

Conclusions

CT colonography is a safe and minimally invasive technique, a valuable diagnostic tool for examining the entire colon and a good alternative compared to other colorectal cancer screening tests because of its high sensitivity values in colorectal lesions over 1 cm.

Patients and Methods

In a prospective study performed at Gastroenterology and Radiology Departments of Medical Faculty of Eskisehir Osmangazi University, CT colonography and colonoscopy results of 31 patients with family history of colorectal carcinoma, personal or family history of colorectal polyps, lower gastrointestinal tract bleeding, change in bowel habits, iron deficiency anemia and abdominal pain were compared. Regardless of the size, CT colonography and conventional colonoscopy findings for all the lesions were cross - tabulated and the sensitivity, specificity, and positive and negative predictive values were calculated. To assess the agreement between CT colonography and conventional colonoscopy examinations, the Kappa coefficient of agreementt was used. Statistical analysis was performed by SPSS ver 15.0.

Background

Colon cancer is a leading cause of morbidity and mortality in developed countries. The early detection of colorectal cancer using screening programs is important for managing early-stage colorectal cancers and polyps. Modalities that allow examination of the entire colon are conventional colonoscopy, double contrast barium enema examination and multi-detector computed tomography (MDCT) colonography.

Results

Regardless of the size, MDCT colonography showed 83% sensitivity and 95% specificity, with a positive predictive value of 95% and a negative predictive value of 83% for the detection of colorectal polyps and masses. MDCT colonography displayed 92% sensitivity and 95% specificity, with a positive predictive value of 92% and a negative predictive value of 95% for polyps ≥ 10 mm. For polyps between 6mm and 9 mm, MDCT colonography displayed 75% sensitivity and 100% specificity, with a positive predictive value of 100% and a negative predictive value of 90%. For polyps ≤ 5 mm MDCT colonography displayed 88% sensitivity and 100% specificity with a positive predictive value of 100% and a negative predictive value of 95%.

Objectives

To compare CT colonography and conventional colonoscopy results and to evaluate the accuracy of CT colonography for detecting colorectal lesions.

Colonography, Computed Tomographic;Colonoscopy;Colonic Polyps;Colorectal Neoplasms Colonography, Computed Tomographic;Colonoscopy;Colonic Polyps;Colorectal Neoplasms http://www.Iranjradiol.com/index.php?page=article&article_id=19518 Cigdem Devir Cigdem Devir Department of Radiology, Research and Training Hospital, Kutahya Dumlupinar University, Kutahya, Turkey Department of Radiology, Research and Training Hospital, Kutahya Dumlupinar University, Kutahya, Turkey Mahmut Kebapci Mahmut Kebapci Department of Radiology, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey Department of Radiology, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey Tuncer Temel Tuncer Temel Department of Gastroenterology, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey; Department of Gastroenterology, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey. Tel: +90-5327150330 Department of Gastroenterology, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey; Department of Gastroenterology, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey. Tel: +90-5327150330 Aysegul Ozakyol Aysegul Ozakyol Department of Gastroenterology, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey Department of Gastroenterology, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey
en 27110336 10.5812/iranjradiol.21921 Giant Pericardial Cyst: A Case Report and Review of Literature Giant Pericardial Cyst: A Case Report and Review of Literature case-report case-report

Pericardial cysts are rare lesions. These benign anomalies are located in the middle mediastinum. In this article, we present a 24-year-old man who was referred to the emergency department with dyspnea and persistent cough. In physical exam, no abnormality was found. His past medical history was normal. His trans-thoracic echocardiogram showed an echo-lucent space next to the right atrium at the right cardiophrenic angle. No pericardial effusion was found. The patient underwent surgery. After midsternotomy, a huge cyst measuring approximately 13 × 8 × 5 cm in diameters was found on the right side and outside the pericardium that was totally excised. After 5 days, the patient was discharged and pathologic report confirmed preoperative diagnosis of pericardial cyst. Giant pericardial cysts are not common and in this report, we will review published case reports.

Pericardial cysts are rare lesions. These benign anomalies are located in the middle mediastinum. In this article, we present a 24-year-old man who was referred to the emergency department with dyspnea and persistent cough. In physical exam, no abnormality was found. His past medical history was normal. His trans-thoracic echocardiogram showed an echo-lucent space next to the right atrium at the right cardiophrenic angle. No pericardial effusion was found. The patient underwent surgery. After midsternotomy, a huge cyst measuring approximately 13 × 8 × 5 cm in diameters was found on the right side and outside the pericardium that was totally excised. After 5 days, the patient was discharged and pathologic report confirmed preoperative diagnosis of pericardial cyst. Giant pericardial cysts are not common and in this report, we will review published case reports.

Cardiac Surgery;Pericardial Cyst;Mediastinal Cyst Cardiac Surgery;Pericardial Cyst;Mediastinal Cyst http://www.Iranjradiol.com/index.php?page=article&article_id=21921 Manouchehr Hekmat Manouchehr Hekmat Department of Cardiovascular Surgery, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Cardiovascular Surgery, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hamid Ghaderi Hamid Ghaderi Department of Cardiovascular Surgery, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Cardiovascular Surgery, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hassan Tatari Hassan Tatari Department of Cardiovascular Surgery, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Cardiovascular Surgery, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Abbas Arjmand Shabestari Abbas Arjmand Shabestari Department of Radiology, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Radiology, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Seyedeh Adeleh Mirjafari Seyedeh Adeleh Mirjafari Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran; Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2166581561, Fax: +98-2166938885 Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran; Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2166581561, Fax: +98-2166938885
en 27110330 10.5812/iranjradiol.16021 Endovascular Aortic Aneurysm and Dissection Repair (EVAR) in Iran: Descriptive Midterm Follow-up Results Endovascular Aortic Aneurysm and Dissection Repair (EVAR) in Iran: Descriptive Midterm Follow-up Results research-article research-article Conclusion

The endovascular stent-graft repair of the abdominal and thoracic aortic aneurysm and aortic dissection had high technical success rates in tandem with low-rate early mortality and morbidity, short hospital stay, and acceptable mid-term free symptom survival among Iranian patients.

Background

Endovascular repair of aorta in comparison to open surgery has a low early operative mortality rate, but its long-term results are uncertain.

Objectives

The current study describes for the first time our initial four-year experience of elective endovascular aortic repair (EVAR) at Tehran heart center, the first and a major referral heart center in Iran, as a pioneer of EVAR in Iran.

Patients and Methods

A total of 51 patients (46 men) who had the diagnosis of either an abdominal aortic aneurysm (AAA) (n = 36), thoracic aortic aneurysm (TAA) (n = 7), or thoracic aortic dissection (TAD) (n = 8) who had undergone EVAR by Medtronic stent grafts by our team between December 2006 and June 2009 were reviewed.

Results

The rate of in-hospital aneurysm-related deaths in the group with AAA stood at 2.8% (one case), while there was no in-hospital mortality in the other groups. All patients were followed up for 13-18 months. The cumulative death rate in follow-up was nine cases from the total 51 cases (18%), out of which six cases were in the AAA group (four patients due to non-cardiac causes and two patients due to aneurysm-related causes), one case in the TAA group (following a severe hemoptysis), and two cases in the TAD group (following an expansion of dissection from re-entrance). The major event-free survival rate was 80.7% for endovascular repair of AAA, 85.7% for endovascular repair of TAA, and 65.6% for endovascular repair of TAD.

Conclusion

The endovascular stent-graft repair of the abdominal and thoracic aortic aneurysm and aortic dissection had high technical success rates in tandem with low-rate early mortality and morbidity, short hospital stay, and acceptable mid-term free symptom survival among Iranian patients.

Background

Endovascular repair of aorta in comparison to open surgery has a low early operative mortality rate, but its long-term results are uncertain.

Objectives

The current study describes for the first time our initial four-year experience of elective endovascular aortic repair (EVAR) at Tehran heart center, the first and a major referral heart center in Iran, as a pioneer of EVAR in Iran.

Patients and Methods

A total of 51 patients (46 men) who had the diagnosis of either an abdominal aortic aneurysm (AAA) (n = 36), thoracic aortic aneurysm (TAA) (n = 7), or thoracic aortic dissection (TAD) (n = 8) who had undergone EVAR by Medtronic stent grafts by our team between December 2006 and June 2009 were reviewed.

Results

The rate of in-hospital aneurysm-related deaths in the group with AAA stood at 2.8% (one case), while there was no in-hospital mortality in the other groups. All patients were followed up for 13-18 months. The cumulative death rate in follow-up was nine cases from the total 51 cases (18%), out of which six cases were in the AAA group (four patients due to non-cardiac causes and two patients due to aneurysm-related causes), one case in the TAA group (following a severe hemoptysis), and two cases in the TAD group (following an expansion of dissection from re-entrance). The major event-free survival rate was 80.7% for endovascular repair of AAA, 85.7% for endovascular repair of TAA, and 65.6% for endovascular repair of TAD.

Endovascular Procedure;Aortic Diseases;Aortic Aneurysm;Dissecting;Iran Endovascular Procedure;Aortic Diseases;Aortic Aneurysm;Dissecting;Iran http://www.Iranjradiol.com/index.php?page=article&article_id=16021 Ali Mohammad Haji Zeinali Ali Mohammad Haji Zeinali Department of Interventional Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Interventional Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, P. O. Box: 1411713138, Tehran, Iran. Tel: +98-218802960060, Fax: +98-2188029731 Department of Interventional Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Interventional Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, P. O. Box: 1411713138, Tehran, Iran. Tel: +98-218802960060, Fax: +98-2188029731 Mehrab Marzban Mehrab Marzban Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Mohammadreza Zafarghandi Mohammadreza Zafarghandi Department of Vascular Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Vascular Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Mahmood Shirzad Mahmood Shirzad Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Shapour Shirani Shapour Shirani Department of Radiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Roshanak Mahmoodian Roshanak Mahmoodian Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Mehrdad Sheikhvatan Mehrdad Sheikhvatan Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Masoumeh Lotfi-Tokaldany Masoumeh Lotfi-Tokaldany Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
en 27110337 10.5812/iranjradiol.22144 Stereoscopic Display of the Peripheral Nerves at the Elbow Region Based on MR Diffusion Tensor Imaging with Multiple Post-Processing Methods Stereoscopic Display of the Peripheral Nerves at the Elbow Region Based on MR Diffusion Tensor Imaging with Multiple Post-Processing Methods research-article research-article Results

Stereoscopic displays of the nerves were obtained in all 24 elbows by VR, MIP, and fiber tractography post-processing methods. The VR/MIP post-processing methods were easier to perform compared to fiber tractography. There was no significant difference among the scores of fiber tracking and VR/MIP reconstruction for single direction. The imaging quality scores of fiber tractography and VR/MIP were significantly correlated based on intraclass correlation coefficient (ICC) analysis (ICC ranged 0.709 - 0.901), which suggested that the scores based on fiber tractography and VR/MIP for the same sample were consistent. Inter- and intraobserver agreements were good to excellent.

Background

Peripheral nerves at the elbow region are prone to entrapment neuropathies and injuries. To make accurate assessment, clinicians need stereoscopic display of the nerves to observe them at all angles.

Objectives

To obtain a stereoscopic display of the peripheral nerves at the elbow region based on magnetic resonance (MR) diffusion tensor imaging (DTI) data using three post-processing methods of volume rendering (VR), maximum intensity projection (MIP), and fiber tractography, and to evaluate the difference and correlation between them.

Subjects and Methods

Twenty-four elbows of 12 healthy young volunteers were assessed by 20 encoding diffusion direction MR DTI scans. Images belonging to a single direction (anterior-posterior direction, perpendicular to the nerve) were subjected to VR and MIP reconstruction. All raw DTI data were transferred to the Siemens MR workstation for fiber tractography post-processing. Imaging qualities of fiber tractography and VR/MIP were evaluated by two observers independently based on a custom evaluation scale.

Conclusion

Stereoscopic displays of the peripheral nerves at the elbow region can be achieved by using VR, MIP, and fiber tracking post-processing methods based on raw DTI images. VR and MIP reconstruction could be used as preview tools before fiber tracking to determine whether the raw images are satisfactory.

Results

Stereoscopic displays of the nerves were obtained in all 24 elbows by VR, MIP, and fiber tractography post-processing methods. The VR/MIP post-processing methods were easier to perform compared to fiber tractography. There was no significant difference among the scores of fiber tracking and VR/MIP reconstruction for single direction. The imaging quality scores of fiber tractography and VR/MIP were significantly correlated based on intraclass correlation coefficient (ICC) analysis (ICC ranged 0.709 - 0.901), which suggested that the scores based on fiber tractography and VR/MIP for the same sample were consistent. Inter- and intraobserver agreements were good to excellent.

Background

Peripheral nerves at the elbow region are prone to entrapment neuropathies and injuries. To make accurate assessment, clinicians need stereoscopic display of the nerves to observe them at all angles.

Objectives

To obtain a stereoscopic display of the peripheral nerves at the elbow region based on magnetic resonance (MR) diffusion tensor imaging (DTI) data using three post-processing methods of volume rendering (VR), maximum intensity projection (MIP), and fiber tractography, and to evaluate the difference and correlation between them.

Subjects and Methods

Twenty-four elbows of 12 healthy young volunteers were assessed by 20 encoding diffusion direction MR DTI scans. Images belonging to a single direction (anterior-posterior direction, perpendicular to the nerve) were subjected to VR and MIP reconstruction. All raw DTI data were transferred to the Siemens MR workstation for fiber tractography post-processing. Imaging qualities of fiber tractography and VR/MIP were evaluated by two observers independently based on a custom evaluation scale.

Conclusion

Stereoscopic displays of the peripheral nerves at the elbow region can be achieved by using VR, MIP, and fiber tracking post-processing methods based on raw DTI images. VR and MIP reconstruction could be used as preview tools before fiber tracking to determine whether the raw images are satisfactory.

Diffusion Tensor Imaging;Peripheral Nerves;Magnetic Resonance Imaging Diffusion Tensor Imaging;Peripheral Nerves;Magnetic Resonance Imaging http://www.Iranjradiol.com/index.php?page=article&article_id=22144 Wen Quan Ding Wen Quan Ding Department of Hand Surgery, Ningbo No.6 Hospital, Ningbo University, Ningbo, China Department of Hand Surgery, Ningbo No.6 Hospital, Ningbo University, Ningbo, China Jian Hui Gu Jian Hui Gu Department of Hand Surgery, Hand Surgery Research Center, Affiliated Hospital of Nantong University, Nantong University, Nantong, China Department of Hand Surgery, Hand Surgery Research Center, Affiliated Hospital of Nantong University, Nantong University, Nantong, China Yong Yuan Yong Yuan Department of Radiology, Jiangsu Province Official Hospital, Jiangsu Jiankang Vocational College, Nanjing, China Department of Radiology, Jiangsu Province Official Hospital, Jiangsu Jiankang Vocational College, Nanjing, China Dong Sheng Jin Dong Sheng Jin Department of Radiology, Jiangsu Province Official Hospital, Jiangsu Jiankang Vocational College, Nanjing, China; Department of Radiology, Jiangsu Province Official Hospital, Jiangsu Jiankang Vocational College, Nanjing, China. Tel: +86-02583712838-3067, Fax: +86-02586631726 Department of Radiology, Jiangsu Province Official Hospital, Jiangsu Jiankang Vocational College, Nanjing, China; Department of Radiology, Jiangsu Province Official Hospital, Jiangsu Jiankang Vocational College, Nanjing, China. Tel: +86-02583712838-3067, Fax: +86-02586631726
en 27110334 10.5812/iranjradiol.19844 Split-Bolus Single-Pass Multidetector-Row CT Protocol for Diagnosis of Acute Pulmonary Embolism Split-Bolus Single-Pass Multidetector-Row CT Protocol for Diagnosis of Acute Pulmonary Embolism research-article research-article Conclusion

MDCT split-bolus technique by simultaneous opacification of pulmonary arteries and veins represents an accurate technique for diagnosis of acute PE, removes the false filling defects of the pulmonary veins, and reduces flow related artifacts.

Patients and Methods

MDCT split-bolus results in 40 patients suspicious of PE were analyzed in terms of image quality of target pulmonary vessels (TPVs) and occurrence and severity of flow-related artifact, flow-related artifact, false filling defect of the pulmonary veins and beam hardening streak artifacts. Dose radiation to patients was calculated.

Results

MDCT split-bolus protocol allowed diagnostic images of high quality in all cases. Diagnosis of PE was obtained in 22 of 40 patients. Mean attenuation for target vessels was higher than 250 HU all cases: 361 ± 98 HU in pulmonary artery trunk (PAT); 339 ± 93 HU in right pulmonary artery (RPA); 334 ± 100 HU in left pulmonary artery (LPA). Adequate enhancement was obtained in the right atrium (RA):292 ± 83 HU; right pulmonary vein (RPV): 302 ± 91 HU, and left pulmonary vein (LPV): 291 ± 83 HU. The flow related artifacts and the beam hardening streak artifacts have been detected respectively in 4 and 25 patients. No false filling defect of the pulmonary veins was revealed.

Background

Currently computed tomography pulmonary angiography (CTPA) has become a widely accepted clinical tool in the diagnosis of acute pulmonary embolism (PE).

Objectives

To report split-bolus single-pass 64-multidetector-row CT (MDCT) protocol for diagnosis of PE.

Conclusion

MDCT split-bolus technique by simultaneous opacification of pulmonary arteries and veins represents an accurate technique for diagnosis of acute PE, removes the false filling defects of the pulmonary veins, and reduces flow related artifacts.

Patients and Methods

MDCT split-bolus results in 40 patients suspicious of PE were analyzed in terms of image quality of target pulmonary vessels (TPVs) and occurrence and severity of flow-related artifact, flow-related artifact, false filling defect of the pulmonary veins and beam hardening streak artifacts. Dose radiation to patients was calculated.

Results

MDCT split-bolus protocol allowed diagnostic images of high quality in all cases. Diagnosis of PE was obtained in 22 of 40 patients. Mean attenuation for target vessels was higher than 250 HU all cases: 361 ± 98 HU in pulmonary artery trunk (PAT); 339 ± 93 HU in right pulmonary artery (RPA); 334 ± 100 HU in left pulmonary artery (LPA). Adequate enhancement was obtained in the right atrium (RA):292 ± 83 HU; right pulmonary vein (RPV): 302 ± 91 HU, and left pulmonary vein (LPV): 291 ± 83 HU. The flow related artifacts and the beam hardening streak artifacts have been detected respectively in 4 and 25 patients. No false filling defect of the pulmonary veins was revealed.

Background

Currently computed tomography pulmonary angiography (CTPA) has become a widely accepted clinical tool in the diagnosis of acute pulmonary embolism (PE).

Objectives

To report split-bolus single-pass 64-multidetector-row CT (MDCT) protocol for diagnosis of PE.

Pulmonary Arteries;Pulmonary Embolisms;X-Ray Computed Tomography;Contrast Material Pulmonary Arteries;Pulmonary Embolisms;X-Ray Computed Tomography;Contrast Material http://www.Iranjradiol.com/index.php?page=article&article_id=19844 Michele Scialpi Michele Scialpi Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia University, S. Maria della Misericordia Hospital, Perugia, Italy; Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia University, S. Maria della Misericordia Hospital, Perugia, Italy. Tel: +39-755783507, Fax: +39-755783488 Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia University, S. Maria della Misericordia Hospital, Perugia, Italy; Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia University, S. Maria della Misericordia Hospital, Perugia, Italy. Tel: +39-755783507, Fax: +39-755783488 Alberto Rebonato Alberto Rebonato Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia University, S. Maria della Misericordia Hospital, Perugia, Italy Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia University, S. Maria della Misericordia Hospital, Perugia, Italy Lucio Cagini Lucio Cagini Department of Surgical and Biomedical Sciences, Thoracic Surgery, Perugia University, S. Maria dellaMisericordia Hospital, Perugia, Italy Department of Surgical and Biomedical Sciences, Thoracic Surgery, Perugia University, S. Maria dellaMisericordia Hospital, Perugia, Italy Luca Brunese Luca Brunese Department of Radiology, University of Molise, Campobasso, Italy Department of Radiology, University of Molise, Campobasso, Italy Irene Piscioli Irene Piscioli Department of Radiology, Budrio Hospital, Azienda USL Bologna, Budrio, Italy Department of Radiology, Budrio Hospital, Azienda USL Bologna, Budrio, Italy Luisa Pierotti Luisa Pierotti Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia University, S. Maria della Misericordia Hospital, Perugia, Italy Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia University, S. Maria della Misericordia Hospital, Perugia, Italy Lucio Bellantonio Lucio Bellantonio Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia University, S. Maria della Misericordia Hospital, Perugia, Italy Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia University, S. Maria della Misericordia Hospital, Perugia, Italy Alfredo D’Andrea Alfredo D’Andrea Division of Radiology, San Giuseppe Moscati Hospital, Aversa, Caserta, Italy Division of Radiology, San Giuseppe Moscati Hospital, Aversa, Caserta, Italy Antonio Rotondo Antonio Rotondo Department of Clinical and Experimental Medicine and Surgery, F. Magrassi, Second University of Naples, Naples, Italy Department of Clinical and Experimental Medicine and Surgery, F. Magrassi, Second University of Naples, Naples, Italy
en 27110327 10.5812/iranjradiol.10949 Malignant Mesothelioma Versus Metastatic Carcinoma of the Pleura: A CT Challenge Malignant Mesothelioma Versus Metastatic Carcinoma of the Pleura: A CT Challenge research-article research-article Conclusion

CT scan is highly accurate in differentiating malignant pleural mesothelioma and metastatic pleural diseases. Pleural thickening and thickening of interlobar fissure lead us to the diagnosis of MPM and massive free pleural effusion is more commonly seen in metastatic pleural malignancy.

Background

Malignant pleural mesothelioma (MPM) is a rare malignant neoplasm of the pleura that typically affects individuals occupationally exposed to asbestos through a variety of industries. MPM presents with several CT features similar to more common pleural diseases such as metastatic pleural malignancy.

Objectives

The aim of this study is to differentiate malignant pleural mesothelioma from metastatic carcinoma of the pleura by pathological and radiological assessment in order to investigate accuracy of CT scan in this regard and to compare CT features of these two malignancies.

Patients and Methods

Chest CT scans of 55 pleural malignancy patients including MPM and metastatic pleural malignancy were evaluated in this retrospective study. The pathologist made the definite diagnosis based on immunohistochemistry. A chest radiologist unaware of the pathology diagnosis observed all CT scans. Several parameters including pleural thickening, pleural effusion, thickening of inter lobar fissure, contralateral extension, contraction of involved hemithorax, parenchymal involvement (infiltration, nodules, fibrosis), pleural mediastinal involvement, lymphadenopathy, extrapleural invasion (hepatic, chest wall, diaphragm, intraperitoneal), and pericardial involvement were checked. Data analysis was carried out using SPSS version 16, and the ability of CT scan to differentiate malignant pleural mesothelioma and metastatic pleural diseases was investigated.

Results

Totally 29 males and 26 females were assessed in this study. Based on pathology, 17 MPM and 38 metastatic pleural malignancies were diagnosed. According to CT study, about 82% of the patients with MPM and about 79% of the patients with metastatic pleural diseases were correctly diagnosed by a radiologist. The most common findings suggestive of MPM were pleural thickening (88.2%), loculated effusion (58.8%), and thickening of the interlobar fissure (47.1%). Whereas free pleural effusion (71.7%), parenchymal infiltration (65.8%) and pleural thickening (63.2%) were most prevalent parameters among metastatic cases.

Conclusion

CT scan is highly accurate in differentiating malignant pleural mesothelioma and metastatic pleural diseases. Pleural thickening and thickening of interlobar fissure lead us to the diagnosis of MPM and massive free pleural effusion is more commonly seen in metastatic pleural malignancy.

Background

Malignant pleural mesothelioma (MPM) is a rare malignant neoplasm of the pleura that typically affects individuals occupationally exposed to asbestos through a variety of industries. MPM presents with several CT features similar to more common pleural diseases such as metastatic pleural malignancy.

Objectives

The aim of this study is to differentiate malignant pleural mesothelioma from metastatic carcinoma of the pleura by pathological and radiological assessment in order to investigate accuracy of CT scan in this regard and to compare CT features of these two malignancies.

Patients and Methods

Chest CT scans of 55 pleural malignancy patients including MPM and metastatic pleural malignancy were evaluated in this retrospective study. The pathologist made the definite diagnosis based on immunohistochemistry. A chest radiologist unaware of the pathology diagnosis observed all CT scans. Several parameters including pleural thickening, pleural effusion, thickening of inter lobar fissure, contralateral extension, contraction of involved hemithorax, parenchymal involvement (infiltration, nodules, fibrosis), pleural mediastinal involvement, lymphadenopathy, extrapleural invasion (hepatic, chest wall, diaphragm, intraperitoneal), and pericardial involvement were checked. Data analysis was carried out using SPSS version 16, and the ability of CT scan to differentiate malignant pleural mesothelioma and metastatic pleural diseases was investigated.

Results

Totally 29 males and 26 females were assessed in this study. Based on pathology, 17 MPM and 38 metastatic pleural malignancies were diagnosed. According to CT study, about 82% of the patients with MPM and about 79% of the patients with metastatic pleural diseases were correctly diagnosed by a radiologist. The most common findings suggestive of MPM were pleural thickening (88.2%), loculated effusion (58.8%), and thickening of the interlobar fissure (47.1%). Whereas free pleural effusion (71.7%), parenchymal infiltration (65.8%) and pleural thickening (63.2%) were most prevalent parameters among metastatic cases.

Pleural Diseases;Malignant Mesothelioma;Tomography;X-Ray Computed;Neoplasm Metastasis Pleural Diseases;Malignant Mesothelioma;Tomography;X-Ray Computed;Neoplasm Metastasis http://www.Iranjradiol.com/index.php?page=article&article_id=10949 Mehrdad Bakhshayesh Karam Mehrdad Bakhshayesh Karam Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Shirin Karimi Shirin Karimi Mycobacteriology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Mycobacteriology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Leila Mosadegh Leila Mosadegh Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran; Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: +98-9122122618 Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran; Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: +98-9122122618 Samira Chaibakhsh Samira Chaibakhsh Department of Biostatistics, Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Biostatistics, Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
en 27110329 10.5812/iranjradiol.15358 Successful Transarterial Embolization of Uterine Arteriovenous Malformation: Report of Three Cases Successful Transarterial Embolization of Uterine Arteriovenous Malformation: Report of Three Cases case-report case-report

Uterine arteriovenous malformations (AVMs) are relatively rare disorders that can cause life-threatening vaginal bleeding. We describe three childbearing-age females, who had abdominal pain and heavy vaginal bleeding, and were diagnosed as uterine AVM by color Doppler and angiography. The patients received successful superselective transarterial embolization (TAE) with N-butyl cyanoacrylate (NBCA). Three years after treatment, one of them was admitted to our hospital for vaginal delivery at 39 weeks of gestation, and the baby was healthy.

Uterine arteriovenous malformations (AVMs) are relatively rare disorders that can cause life-threatening vaginal bleeding. We describe three childbearing-age females, who had abdominal pain and heavy vaginal bleeding, and were diagnosed as uterine AVM by color Doppler and angiography. The patients received successful superselective transarterial embolization (TAE) with N-butyl cyanoacrylate (NBCA). Three years after treatment, one of them was admitted to our hospital for vaginal delivery at 39 weeks of gestation, and the baby was healthy.

Uterus;Arteriovenous Malformation;Uterine Hemorrhage;Ultrasonography;Angiography;Embolization, Therapeutic;Enbucrilate;Pregnancy Uterus;Arteriovenous Malformation;Uterine Hemorrhage;Ultrasonography;Angiography;Embolization, Therapeutic;Enbucrilate;Pregnancy http://www.Iranjradiol.com/index.php?page=article&article_id=15358 Liang-Kuang Chen Liang-Kuang Chen Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, National Taiwan University, Taipei, Taiwan; Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. Tel: +886-228332211, Fax: +886-228389359 Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, National Taiwan University, Taipei, Taiwan; Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. Tel: +886-228332211, Fax: +886-228389359 Bi-Li Yang Bi-Li Yang Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Tzu Chi University, Taipei, Taiwan Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Tzu Chi University, Taipei, Taiwan Kuo-Chang Chen Kuo-Chang Chen Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Chung Shan Medical University, Taipei, Taiwan Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Chung Shan Medical University, Taipei, Taiwan Yieh-Loong Tsai Yieh-Loong Tsai Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Kaohsiung Medical University, Taipei, Taiwan Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Kaohsiung Medical University, Taipei, Taiwan
en 27110331 10.5812/iranjradiol.17991 Breast Filariasis Diagnosed by Real Time Sonographic Imaging: A Case Report Breast Filariasis Diagnosed by Real Time Sonographic Imaging: A Case Report case-report case-report

A 30-year-old woman presented with a palpable subcutaneous nodule in the areolar region of the left breast. Sonomammographic examination revealed 2 cystic lesions showing typical “filarial dance” as vigorous twirling movement of multiple curvilinear echoes with mixed red blue color Doppler signals that was non-rhythmic, nonpulsatile, and the characteristic pulse Doppler trace due to irregular worm movement. Real time sonographic demonstration of these typical features is pathognomonic for filariasis, especially in endemic areas and treatment should be initiated without delay on the basis of ultrasound.

A 30-year-old woman presented with a palpable subcutaneous nodule in the areolar region of the left breast. Sonomammographic examination revealed 2 cystic lesions showing typical “filarial dance” as vigorous twirling movement of multiple curvilinear echoes with mixed red blue color Doppler signals that was non-rhythmic, nonpulsatile, and the characteristic pulse Doppler trace due to irregular worm movement. Real time sonographic demonstration of these typical features is pathognomonic for filariasis, especially in endemic areas and treatment should be initiated without delay on the basis of ultrasound.

Filariasis;Eosinophilia;Ultrasound;Worms Filariasis;Eosinophilia;Ultrasound;Worms http://www.Iranjradiol.com/index.php?page=article&article_id=17991 Poonam Sherwani Poonam Sherwani Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India; Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India. Tel: +91-9540464879 Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India; Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India. Tel: +91-9540464879 Shweta Singhal Shweta Singhal Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India Nidhi Kumar Nidhi Kumar Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India Mahender Kaur Narula Mahender Kaur Narula Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India Rama Anand Rama Anand Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India Om Prakash Pathania Om Prakash Pathania Department of Surgery, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India Department of Surgery, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India
en 27110332 10.5812/iranjradiol.18217 Effects of Variations of Flow and Heart Rate on Intra-Aneurysmal Hemodynamics in a Ruptured Internal Carotid Artery Aneurysm During Exercise Effects of Variations of Flow and Heart Rate on Intra-Aneurysmal Hemodynamics in a Ruptured Internal Carotid Artery Aneurysm During Exercise research-article research-article Conclusion

Results reinforced the pivotal role of vascular geometry, with respect to hemodynamics, together with the importance of performing patient-specific CFD analyses, through which the effect of different blood flow conditions on the aneurysm hemodynamics could be evaluated.

Objectives

This study aimed to investigate the effects of variations in heart rate and internal carotid artery (ICA) flow rate on intra-aneurysmal hemodynamics, in an ICA aneurysm, by using computational fluid dynamics.

Patients and Methods

Computed tomography angiography (CTA) was performed in a 55 years old female case, with a saccular ICA aneurysm, to create a patient-specific geometrical anatomic model of the aneurysm. The intra-aneurysmal hemodynamic environments for three states with different flow and heart rates were analyzed using patient-specific image-based CFD modeling.

Results

Results showed significant changes for the three simulated states. For a proportion of the states examined, results were counterintuitive. Systolic and time-averaged wall shear stress and pressure on the aneurysm wall showed a proportional evolution with the mainstream flow rate.

Background

Hemodynamics is thought to play an important role in the mechanisms responsible for initiation, growth, and rupture of intracranial aneurysms. Computational fluid dynamic (CFD) analysis is used to assess intra-aneurysmal hemodynamics.

Conclusion

Results reinforced the pivotal role of vascular geometry, with respect to hemodynamics, together with the importance of performing patient-specific CFD analyses, through which the effect of different blood flow conditions on the aneurysm hemodynamics could be evaluated.

Objectives

This study aimed to investigate the effects of variations in heart rate and internal carotid artery (ICA) flow rate on intra-aneurysmal hemodynamics, in an ICA aneurysm, by using computational fluid dynamics.

Patients and Methods

Computed tomography angiography (CTA) was performed in a 55 years old female case, with a saccular ICA aneurysm, to create a patient-specific geometrical anatomic model of the aneurysm. The intra-aneurysmal hemodynamic environments for three states with different flow and heart rates were analyzed using patient-specific image-based CFD modeling.

Results

Results showed significant changes for the three simulated states. For a proportion of the states examined, results were counterintuitive. Systolic and time-averaged wall shear stress and pressure on the aneurysm wall showed a proportional evolution with the mainstream flow rate.

Background

Hemodynamics is thought to play an important role in the mechanisms responsible for initiation, growth, and rupture of intracranial aneurysms. Computational fluid dynamic (CFD) analysis is used to assess intra-aneurysmal hemodynamics.

Fluid Dynamics;Internal Carotid Artery;Aneurysm;Heart Rate Fluid Dynamics;Internal Carotid Artery;Aneurysm;Heart Rate http://www.Iranjradiol.com/index.php?page=article&article_id=18217 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 Hamidreza Saligheh Rad Hamidreza Saligheh Rad Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran Medical Physics and Biomedical Engineering, 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
en 27127574 10.5812/iranjradiol.21819 Defining the Collateral Flow of Posterior Tibial Artery and Dorsalis Pedis Artery in Ischemic Foot Disease: Is It a Preventing Factor for Ischemia? Defining the Collateral Flow of Posterior Tibial Artery and Dorsalis Pedis Artery in Ischemic Foot Disease: Is It a Preventing Factor for Ischemia? research-article research-article Conclusion

In cases with critical atherosclerotic disease of anterior tibial artery, PTA-based biphasic or triphasic retrograde collateral flow prevents ischemia, whereas monophasic support or no retrograde flow remains incapable.

Results

In the patient group, 31 lower limb arteries, of total of 17 cases, were included. After compression maneuver, DPA in 11 cases (six right, five left) showed retrograde filling from plantar arch. This retrograde flow support was triphasic in three cases, biphasic in five cases, and monophasic in three cases. In other DPAs of these 20 limbs, PTA based retrograde collateral flow was not determined. In nine of these 20 limbs, with no or diminished retrograde filling, symptoms were worse than in other cases. Contrarily, only two of 11 limbs, with retrograde collaterals, have claudication during walking.

Objectives

This study aimed to determine the existence and, if present, grade of retrograde blood flow from plantar arch to dorsal foot artery (dorsalis pedis artery, DPA). The correlation between clinical symptoms and presence of collateral flow were also investigated.

Patients and Methods

Study group consisted of 34 cases, which included patient group (n = 17, all male, mean age: 68 years) and control group (n = 17, all male, mean age: 66 years). After physical examination and lower extremity Doppler examination, spectral morphology of DPA flow was recorded, before and during manual compression of posterior tibial artery (PTA), for a period of 5 seconds. At the end, findings of Doppler ultrasound, computed tomography angiography, magnetic resonance angiography and, physical examination finding and symptomatology were gathered and analyzed.

Background

Critical limb ischemia, a worldwide prevalent morbidity cause, is mostly secondary to vascular insufficiency due to atherosclerosis. The disease presents with intermittent claudication, which can progress to critical limb ischemia requiring amputation. Research has emphasized that the quality or existence of the pedal arch have a direct effect on wound healing and, therefore, on limb salvage, through the mechanism of collateral vascularization to the ischemic regions.

Conclusion

In cases with critical atherosclerotic disease of anterior tibial artery, PTA-based biphasic or triphasic retrograde collateral flow prevents ischemia, whereas monophasic support or no retrograde flow remains incapable.

Results

In the patient group, 31 lower limb arteries, of total of 17 cases, were included. After compression maneuver, DPA in 11 cases (six right, five left) showed retrograde filling from plantar arch. This retrograde flow support was triphasic in three cases, biphasic in five cases, and monophasic in three cases. In other DPAs of these 20 limbs, PTA based retrograde collateral flow was not determined. In nine of these 20 limbs, with no or diminished retrograde filling, symptoms were worse than in other cases. Contrarily, only two of 11 limbs, with retrograde collaterals, have claudication during walking.

Objectives

This study aimed to determine the existence and, if present, grade of retrograde blood flow from plantar arch to dorsal foot artery (dorsalis pedis artery, DPA). The correlation between clinical symptoms and presence of collateral flow were also investigated.

Patients and Methods

Study group consisted of 34 cases, which included patient group (n = 17, all male, mean age: 68 years) and control group (n = 17, all male, mean age: 66 years). After physical examination and lower extremity Doppler examination, spectral morphology of DPA flow was recorded, before and during manual compression of posterior tibial artery (PTA), for a period of 5 seconds. At the end, findings of Doppler ultrasound, computed tomography angiography, magnetic resonance angiography and, physical examination finding and symptomatology were gathered and analyzed.

Background

Critical limb ischemia, a worldwide prevalent morbidity cause, is mostly secondary to vascular insufficiency due to atherosclerosis. The disease presents with intermittent claudication, which can progress to critical limb ischemia requiring amputation. Research has emphasized that the quality or existence of the pedal arch have a direct effect on wound healing and, therefore, on limb salvage, through the mechanism of collateral vascularization to the ischemic regions.

Ultrasonography;Pulsed Doppler;Ischemia;Foot;Peripheral Arterial Disease;Atherosclerosis Ultrasonography;Pulsed Doppler;Ischemia;Foot;Peripheral Arterial Disease;Atherosclerosis http://www.Iranjradiol.com/index.php?page=article&article_id=21819 Onur Tutar Onur Tutar Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey Duzgun Yildirim Duzgun Yildirim Centermed Advanced Imaging Center, Department of Radiology, Istanbul, Turkey Centermed Advanced Imaging Center, Department of Radiology, Istanbul, Turkey Cesur Samanci Cesur Samanci Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey; Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey. Tel: +90-5077511587, Fax: +90-2124143167 Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey; Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey. Tel: +90-5077511587, Fax: +90-2124143167 Babak Rafiee Babak Rafiee Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey Kaan Inan Kaan Inan Department of Cardiovascular Surgery, Kasimpasa Military Hospital, Istanbul, Turkey Department of Cardiovascular Surgery, Kasimpasa Military Hospital, Istanbul, Turkey Suleyman Dikici Suleyman Dikici Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey Fethi Emre Ustabasioglu Fethi Emre Ustabasioglu Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey Gokhan Kuyumcu Gokhan Kuyumcu Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
en 27110338 10.5812/iranjradiol.22514 Evaluation of the Patient Effective Dose in Whole Spine Scanography Based on the Automatic Image Pasting Method for Digital Radiography Evaluation of the Patient Effective Dose in Whole Spine Scanography Based on the Automatic Image Pasting Method for Digital Radiography research-article research-article Conclusion

Despite multiple exposures, ED control is more effective if WSS is performed using APMDR in the AEC mode.

Results

Using APMDR, the mean number of exposures was 6.1 for AP and 6.5 for LAT projections. LAT projections required more exposures (6.55%) than AP projections. The mean ED was 0.6276 mSv (AP) and 0.6716 mSv (LAT). The mean ED for LAT projections was 0.6061 mSv in automatic exposure control (AEC) and 0.7694 mSv in manual mode. The relationship between dose-area-product (DAP) and ED revealed a proportional correlation (AP, R2 = 0.943; LAT, R2 = 0.773). Compared to prior research involving single exposure screen-film WSS, the patient ED following WSS using APMDR was lower on AP than on LAT projections.

Background

Whole spine scanography (WSS) is a radiologic examination that requires whole body X-ray exposure. Consequently, the amount of patient radiation exposure is higher than the radiation dose following routine X-ray examination.

Objectives

Several studies have evaluated the patient effective dose (ED) following single exposure film-screen WSS. The objective of this study was to evaluate patient ED during WSS, based on the automatic image pasting method for multiple exposure digital radiography (APMDR). Further, the calculated EDs were compared with the results of previous studies involving single exposure film-screen WSS.

Patients and Methods

We evaluated the ED of 50 consecutive patients (M:F = 28:22) who underwent WSS using APMDR. The anterior-posterior (AP) and lateral (LAT) projection EDs were evaluated based on the Monte Carlo simulation.

Conclusion

Despite multiple exposures, ED control is more effective if WSS is performed using APMDR in the AEC mode.

Results

Using APMDR, the mean number of exposures was 6.1 for AP and 6.5 for LAT projections. LAT projections required more exposures (6.55%) than AP projections. The mean ED was 0.6276 mSv (AP) and 0.6716 mSv (LAT). The mean ED for LAT projections was 0.6061 mSv in automatic exposure control (AEC) and 0.7694 mSv in manual mode. The relationship between dose-area-product (DAP) and ED revealed a proportional correlation (AP, R2 = 0.943; LAT, R2 = 0.773). Compared to prior research involving single exposure screen-film WSS, the patient ED following WSS using APMDR was lower on AP than on LAT projections.

Background

Whole spine scanography (WSS) is a radiologic examination that requires whole body X-ray exposure. Consequently, the amount of patient radiation exposure is higher than the radiation dose following routine X-ray examination.

Objectives

Several studies have evaluated the patient effective dose (ED) following single exposure film-screen WSS. The objective of this study was to evaluate patient ED during WSS, based on the automatic image pasting method for multiple exposure digital radiography (APMDR). Further, the calculated EDs were compared with the results of previous studies involving single exposure film-screen WSS.

Patients and Methods

We evaluated the ED of 50 consecutive patients (M:F = 28:22) who underwent WSS using APMDR. The anterior-posterior (AP) and lateral (LAT) projection EDs were evaluated based on the Monte Carlo simulation.

X-Rays;Radiation Dosage;Health Physics X-Rays;Radiation Dosage;Health Physics http://www.Iranjradiol.com/index.php?page=article&article_id=22514 Jung-Su Kim Jung-Su Kim Department of Radiologic Science, College of Health Science, Korea University, Seoul, South Korea Department of Radiologic Science, College of Health Science, Korea University, Seoul, South Korea Sang-Wook Yoon Sang-Wook Yoon Department of Diagnostic Radiology, CHA Bundang Medical Center, CHA University, Gyeonggi-do, South Korea Department of Diagnostic Radiology, CHA Bundang Medical Center, CHA University, Gyeonggi-do, South Korea Deok-Nam Seo Deok-Nam Seo Department of Radiologic Science, College of Health Science, Korea University, Seoul, South Korea Department of Radiologic Science, College of Health Science, Korea University, Seoul, South Korea So-Ra Nam So-Ra Nam Department of Radiologic Science, College of Health Science, Korea University, Seoul, South Korea Department of Radiologic Science, College of Health Science, Korea University, Seoul, South Korea Jung-Min Kim Jung-Min Kim Department of Radiologic Science, College of Health Science, Korea University, Seoul, South Korea; Department of Radiologic Science, College of Health Science, Korea University, Seoul, South Korea. Tel: +82-2940-2577, Fax: +82-29402829 Department of Radiologic Science, College of Health Science, Korea University, Seoul, South Korea; Department of Radiologic Science, College of Health Science, Korea University, Seoul, South Korea. Tel: +82-2940-2577, Fax: +82-29402829
en 27127577 10.5812/iranjradiol.29424 Application of Analytical Hierarchy Process Approach for Service Quality Evaluation in Radiology Departments: A Cross-Sectional Study Application of Analytical Hierarchy Process Approach for Service Quality Evaluation in Radiology Departments: A Cross-Sectional Study research-article research-article Conclusion

The use of AHP method can be promising for fostering the evaluation method and subsequently promotion of the efficiency and effectiveness of the radiology departments. The present model can fill in the gap in the accreditation system of the country’s hospitals in respect with ranking and comparing them considering the significance and value of each individual criteria and standard. Accordingly, it can predict an integration of qualitative and quantitative criteria involved and thereby take a decisive step towards further efficiency and effectiveness of the health care evaluation systems.

Results

“Management and empowerment of human resources’’ (weight = 0.465) and “requirements and facilities” (weight = 0.139) were of highest and lowest significance respectively in the overall ranking of the hospitals. MS (weight = 0.316), MD (weight = 0.259), AT (weight = 0.14), TS (weight = 0.108), MO (weight = 0.095), and LH (0.082) achieved the first to sixth rankings respectively.

Materials and Methods

This study was an applied and cross-sectional study, carried out in radiology departments of 6 Tehran educational hospitals in 2015. The hospitals were selected using non-probability and purposeful method. Data gathering was performed using customized joint commission international (JCI) standards. Expert Choice 10.0 software was used for data analysis. AHP method was used for prioritization.

Background

Radiology department as a service provider organization requires realization of quality concept concerning service provisioning knowledge, satisfaction and all issues relating to the customer as well as quality assurance and improvement issues. At present, radiology departments in hospitals are regarded as income generating units and they should continuously seek performance improvement so that they can survive in the changing and competitive environment of the health care sector.

Objectives

The aim of this study was to propose a method for ranking of radiology departments in selected hospitals of Tehran city using analytical hierarchical process (AHP) and quality evaluation of their service in 2015.

Conclusion

The use of AHP method can be promising for fostering the evaluation method and subsequently promotion of the efficiency and effectiveness of the radiology departments. The present model can fill in the gap in the accreditation system of the country’s hospitals in respect with ranking and comparing them considering the significance and value of each individual criteria and standard. Accordingly, it can predict an integration of qualitative and quantitative criteria involved and thereby take a decisive step towards further efficiency and effectiveness of the health care evaluation systems.

Results

“Management and empowerment of human resources’’ (weight = 0.465) and “requirements and facilities” (weight = 0.139) were of highest and lowest significance respectively in the overall ranking of the hospitals. MS (weight = 0.316), MD (weight = 0.259), AT (weight = 0.14), TS (weight = 0.108), MO (weight = 0.095), and LH (0.082) achieved the first to sixth rankings respectively.

Materials and Methods

This study was an applied and cross-sectional study, carried out in radiology departments of 6 Tehran educational hospitals in 2015. The hospitals were selected using non-probability and purposeful method. Data gathering was performed using customized joint commission international (JCI) standards. Expert Choice 10.0 software was used for data analysis. AHP method was used for prioritization.

Background

Radiology department as a service provider organization requires realization of quality concept concerning service provisioning knowledge, satisfaction and all issues relating to the customer as well as quality assurance and improvement issues. At present, radiology departments in hospitals are regarded as income generating units and they should continuously seek performance improvement so that they can survive in the changing and competitive environment of the health care sector.

Objectives

The aim of this study was to propose a method for ranking of radiology departments in selected hospitals of Tehran city using analytical hierarchical process (AHP) and quality evaluation of their service in 2015.

Evaluation;Joint Commission International (JCI);Quality;Radiology;Iran Evaluation;Joint Commission International (JCI);Quality;Radiology;Iran http://www.Iranjradiol.com/index.php?page=article&article_id=29424 Khalil Alimohammadzadeh Khalil Alimohammadzadeh Department of Health Services Management, Tehran North Branch, Islamic Azad University, Tehran, Iran Department of Health Services Management, Tehran North Branch, Islamic Azad University, Tehran, Iran Mohammadkarim Bahadori Mohammadkarim Bahadori Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran; Department of Radiology, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran; Health Management Research Center, Baqiyatallah University of Medical Sciences, Mollasadra Street, Tehran, Iran. Tel: +98-2182482417, Fax: +98-2188057022 Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran; Department of Radiology, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran; Health Management Research Center, Baqiyatallah University of Medical Sciences, Mollasadra Street, Tehran, Iran. Tel: +98-2182482417, Fax: +98-2188057022 Fariba Hassani Fariba Hassani Department of Health Services Management, Tehran North Branch, Islamic Azad University, Tehran, Iran Department of Health Services Management, Tehran North Branch, Islamic Azad University, Tehran, Iran
en 27127573 10.5812/iranjradiol.18774 Nodular Fasciitis of the Breast Nodular Fasciitis of the Breast case-report case-report

Nodular fasciitis of the breast is a rare benign pathology of soft tissue that is a consequence of fibroblastic hyperplasia within breast. It can mimic breast cancer clinically, radiologically, and histopathologically.

A-43 year-old female with a painless mass within upper-lateral quadrant of her left breast complained of rapid and progressive growth during previous few days. No evidence of nipple discharge or sensation of pain was expressed. The mass was tender to palpation, but the size was too tiny to detect. The definitive diagnosis was established with sonography, which detected a hypoechogenic lesion, 10 mm in diameter. The excisional biopsy delivered a tissue composed of fusiform fibroblastic cells with bright ellipsoid-like nuclei and elevated nucleolus. Mitotic formations were also obvious. Low cellular and high cellular zones with hyaline fibrosis and erythrocyte accumulation existed, as well as a light lymphocytic infiltration. All of these features, in addition to adipocytic accumulation within the margins of this lesion, suggested a definitive diagnosis of Nodular fasciitis. The diagnosis of nodular fasciitis is difficult and often is indiscriminable from breast cancer, so paying close attention to this matter is critical.

Nodular fasciitis of the breast is a rare benign pathology of soft tissue that is a consequence of fibroblastic hyperplasia within breast. It can mimic breast cancer clinically, radiologically, and histopathologically.

A-43 year-old female with a painless mass within upper-lateral quadrant of her left breast complained of rapid and progressive growth during previous few days. No evidence of nipple discharge or sensation of pain was expressed. The mass was tender to palpation, but the size was too tiny to detect. The definitive diagnosis was established with sonography, which detected a hypoechogenic lesion, 10 mm in diameter. The excisional biopsy delivered a tissue composed of fusiform fibroblastic cells with bright ellipsoid-like nuclei and elevated nucleolus. Mitotic formations were also obvious. Low cellular and high cellular zones with hyaline fibrosis and erythrocyte accumulation existed, as well as a light lymphocytic infiltration. All of these features, in addition to adipocytic accumulation within the margins of this lesion, suggested a definitive diagnosis of Nodular fasciitis. The diagnosis of nodular fasciitis is difficult and often is indiscriminable from breast cancer, so paying close attention to this matter is critical.

Nodular Fasciitis;Ultrasonography;Pathology Nodular Fasciitis;Ultrasonography;Pathology http://www.Iranjradiol.com/index.php?page=article&article_id=18774 Mansour Moghimi Mansour Moghimi Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Pouria Yazdian Anari Pouria Yazdian Anari Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Tel: +98-3536230354; +98-9385101025, Fax: +98-3538113407 Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Tel: +98-3536230354; +98-9385101025, Fax: +98-3538113407 Marzie Vaghefi Marzie Vaghefi Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Abbas Meidany Abbas Meidany Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Heidar Salehi Heidar Salehi Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
en 27127583 10.5812/iranjradiol.9018 Comparison of Conventional Versus Spiral Computed Tomography with Three Dimensional Reconstruction in Chronic Otitis Media with Ossicular Chain Destruction Comparison of Conventional Versus Spiral Computed Tomography with Three Dimensional Reconstruction in Chronic Otitis Media with Ossicular Chain Destruction brief-report brief-report Conclusion

Spiral-CT scan is superior to conventional CT in the diagnosis of lesions in COM before operation. It can be used for detailed evaluation of ossicular chain in such patients.

Objectives

This study was performed to compare the findings of three-dimensional reconstructed spiral and conventional CT scan of ossicular chain study in patients with COM.

Patients and Methods

Fifty patients enrolled in the study underwent plane and three dimensional CT scan (PHILIPS-MX 8000). Ossicles changes, mastoid cavity, tympanic cavity, and presence of cholesteatoma were evaluated. Results of the two methods were then compared and interpreted by a radiologist, recorded in questionnaires, and analyzed. Logistic regression test and Kappa coefficient of agreement were used for statistical analyses.

Results

Sixty two ears with COM were found in physical examination. A significant difference was observed between the findings of the two methods in ossicle erosion (11.3% in conventional CT vs. 37.1% in spiral CT, P = 0.0001), decrease of mastoid air cells (82.3% in conventional CT vs. 93.5% in spiral CT, P = 0.001), and tympanic cavity opacity (12.9% in conventional CT vs. 40.3% in spiral CT, P=0.0001). No significant difference was observed between the findings of the two methods in ossicle destruction (6.5% conventional CT vs. 56.4% in spiral CT, P = 0.125), and presence of cholesteatoma (3.2% in conventional CT vs. 42% in spiral CT, P = 0.172). In this study, spiral CT scan demonstrated ossicle dislocation in 9.6%, decrease of mastoid air cells in 4.8%, and decrease of volume in the tympanic cavity in 1.6%; whereas, none of these findings were reported in the patients' conventional CT scans.

Background

Chronic otitis media (COM) can be treated with tympanoplasty with or without mastoidectomy. In patients who have undergone middle ear surgery, three-dimensional spiral computed tomography (CT) scan plays an important role in optimizing surgical planning.

Conclusion

Spiral-CT scan is superior to conventional CT in the diagnosis of lesions in COM before operation. It can be used for detailed evaluation of ossicular chain in such patients.

Objectives

This study was performed to compare the findings of three-dimensional reconstructed spiral and conventional CT scan of ossicular chain study in patients with COM.

Patients and Methods

Fifty patients enrolled in the study underwent plane and three dimensional CT scan (PHILIPS-MX 8000). Ossicles changes, mastoid cavity, tympanic cavity, and presence of cholesteatoma were evaluated. Results of the two methods were then compared and interpreted by a radiologist, recorded in questionnaires, and analyzed. Logistic regression test and Kappa coefficient of agreement were used for statistical analyses.

Results

Sixty two ears with COM were found in physical examination. A significant difference was observed between the findings of the two methods in ossicle erosion (11.3% in conventional CT vs. 37.1% in spiral CT, P = 0.0001), decrease of mastoid air cells (82.3% in conventional CT vs. 93.5% in spiral CT, P = 0.001), and tympanic cavity opacity (12.9% in conventional CT vs. 40.3% in spiral CT, P=0.0001). No significant difference was observed between the findings of the two methods in ossicle destruction (6.5% conventional CT vs. 56.4% in spiral CT, P = 0.125), and presence of cholesteatoma (3.2% in conventional CT vs. 42% in spiral CT, P = 0.172). In this study, spiral CT scan demonstrated ossicle dislocation in 9.6%, decrease of mastoid air cells in 4.8%, and decrease of volume in the tympanic cavity in 1.6%; whereas, none of these findings were reported in the patients' conventional CT scans.

Background

Chronic otitis media (COM) can be treated with tympanoplasty with or without mastoidectomy. In patients who have undergone middle ear surgery, three-dimensional spiral computed tomography (CT) scan plays an important role in optimizing surgical planning.

Otitis Media;Cholesteatoma;Tomography;Spiral Computed Otitis Media;Cholesteatoma;Tomography;Spiral Computed http://www.Iranjradiol.com/index.php?page=article&article_id=9018 Saeed Naghibi Saeed Naghibi Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran; Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran. Tel: +98-9151158630, Fax: +98-5137613248 Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran; Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran. Tel: +98-9151158630, Fax: +98-5137613248 Sirous Seifirad Sirous Seifirad Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran Mahboobeh Adami Dehkordi Mahboobeh Adami Dehkordi Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran Sasan Einolghozati Sasan Einolghozati Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran Nafiseh Ghaffarian Eidgahi Moghadam Nafiseh Ghaffarian Eidgahi Moghadam Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran Amir Akhavan Rezayat Amir Akhavan Rezayat Department of Radiology, Mashhad University of Medical Sciences, Mashhad, Iran Department of Radiology, Mashhad University of Medical Sciences, Mashhad, Iran Soroush Seifirad Soroush Seifirad Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
en 27110328 10.5812/iranjradiol.12991 Follow-Up Imaging of Inflammatory Myofibroblastic Tumor of the Uterus and Its Spontaneous Regression Follow-Up Imaging of Inflammatory Myofibroblastic Tumor of the Uterus and Its Spontaneous Regression case-report case-report

Inflammatory myofibroblastic tumor (IMT) is an aggressive benign mass that may arise from various tissues and organs with a great variability of histological and clinical appearances. Due to variable and nonspecific imaging findings, diagnosis of IMT is not obtained before surgery. The aim of this paper is to present CT and MRI findings during four-year follow-up of complete, spontaneous regression of IMT of the uterus. The diagnosis was made by histology and immunohistochemistry analysis of the open excisional biopsy specimen. At that time, the organ of origin was not specified. After analysis of the follow-up imaging findings and the mode of tumor regression, the uterus was proclaimed as the probable site of origin. IMT of the uterus is extremely rare and has been reported in ten cases up to now. The gradual, complete regression of uterine IMT documented by CT and MRI may contribute to understanding of its nature.

Inflammatory myofibroblastic tumor (IMT) is an aggressive benign mass that may arise from various tissues and organs with a great variability of histological and clinical appearances. Due to variable and nonspecific imaging findings, diagnosis of IMT is not obtained before surgery. The aim of this paper is to present CT and MRI findings during four-year follow-up of complete, spontaneous regression of IMT of the uterus. The diagnosis was made by histology and immunohistochemistry analysis of the open excisional biopsy specimen. At that time, the organ of origin was not specified. After analysis of the follow-up imaging findings and the mode of tumor regression, the uterus was proclaimed as the probable site of origin. IMT of the uterus is extremely rare and has been reported in ten cases up to now. The gradual, complete regression of uterine IMT documented by CT and MRI may contribute to understanding of its nature.

Uterus;Inflammatory Pseudotumor;Neoplasm Regression;Spontaneous Uterus;Inflammatory Pseudotumor;Neoplasm Regression;Spontaneous http://www.Iranjradiol.com/index.php?page=article&article_id=12991 Biljana Markovic Vasiljkovic Biljana Markovic Vasiljkovic Center for Radiology and MRI, Clinical Center of Serbia, Medical Faculty, Belgrade University, Belgrade, Serbia; Center for Radiology and MRI, Clinical Center of Serbia, Medical Faculty, Belgrade University, Belgrade, Serbia. Tel: +38-163372956, Fax: +38-1112688553 Center for Radiology and MRI, Clinical Center of Serbia, Medical Faculty, Belgrade University, Belgrade, Serbia; Center for Radiology and MRI, Clinical Center of Serbia, Medical Faculty, Belgrade University, Belgrade, Serbia. Tel: +38-163372956, Fax: +38-1112688553 Vesna Plesinac Karapandzic Vesna Plesinac Karapandzic Institute of Oncology and Radiology, Medical Faculty, Belgrade University, Belgrade, Serbia Institute of Oncology and Radiology, Medical Faculty, Belgrade University, Belgrade, Serbia Tomislav Pejcic Tomislav Pejcic Urological Clinic, Clinical Center of Serbia, Belgrade, Serbia Urological Clinic, Clinical Center of Serbia, Belgrade, Serbia Aleksandra Djuric Stefanovic Aleksandra Djuric Stefanovic Center for Radiology and MRI, Clinical Center of Serbia, Medical Faculty, Belgrade University, Belgrade, Serbia Center for Radiology and MRI, Clinical Center of Serbia, Medical Faculty, Belgrade University, Belgrade, Serbia Zorica Milosevic Zorica Milosevic Institute of Oncology and Radiology, Medical Faculty, Belgrade University, Belgrade, Serbia Institute of Oncology and Radiology, Medical Faculty, Belgrade University, Belgrade, Serbia Snezana Plesinac Snezana Plesinac Gynecological Clinic, Clinical Center of Serbia, Medical Faculty, Belgrade University, Belgrade, Serbia Gynecological Clinic, Clinical Center of Serbia, Medical Faculty, Belgrade University, Belgrade, Serbia
en 27110335 10.5812/iranjradiol.21186 Role of 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Evaluation of Cytologically Indeterminate Thyroid Nodules Role of 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Evaluation of Cytologically Indeterminate Thyroid Nodules research-article research-article Conclusion

The FDG PET/CT showed a high sensitivity and a high negative predictive value for identifying malignancies in thyroid nodules with indeterminate FNAB results. Therefore, the FDG PET/CT may be a helpful tool in the clinical management of these nodules. When an FDG positive lesion is detected, further examination is recommended.

Background

Thyroid nodules with indeterminate fine-needle aspiration biopsy (FNAB) results remain a diagnostic dilemma, because 70 - 85% of these nodules have been found to be benign after thyroid surgery.

Objectives

The purpose of this study was to evaluate the usefulness of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the preoperative diagnosis of cytologically indeterminate nodules.

Patients and Methods

Forty-six patients were included in this study. These individuals had undergone FDG PET/CTs for the preoperative evaluation of thyroid nodules with indeterminate FNAB results. The results of the preoperative PET/CT scans were compared with the postoperative pathological results and statistically analyzed.

Results

Of the 46 patients included in our study, the histopathology of the surgical specimens revealed thyroid cancer in 17 individuals (37%, 17/46). The PET/CT scan showed a positive result in 27 patients. Of these, 16 patients (59.3%) were found to have thyroid carcinomas. In addition, the PET/CT scan was considered to be negative in 19 patients, 18 (94.7%) of whom had benign lesions. For the detection of malignant lesions, the values for the sensitivity and specificity, and the positive predictive and negative predictive values were 94%, 62%, 59%, and 95%, respectively.

Conclusion

The FDG PET/CT showed a high sensitivity and a high negative predictive value for identifying malignancies in thyroid nodules with indeterminate FNAB results. Therefore, the FDG PET/CT may be a helpful tool in the clinical management of these nodules. When an FDG positive lesion is detected, further examination is recommended.

Background

Thyroid nodules with indeterminate fine-needle aspiration biopsy (FNAB) results remain a diagnostic dilemma, because 70 - 85% of these nodules have been found to be benign after thyroid surgery.

Objectives

The purpose of this study was to evaluate the usefulness of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the preoperative diagnosis of cytologically indeterminate nodules.

Patients and Methods

Forty-six patients were included in this study. These individuals had undergone FDG PET/CTs for the preoperative evaluation of thyroid nodules with indeterminate FNAB results. The results of the preoperative PET/CT scans were compared with the postoperative pathological results and statistically analyzed.

Results

Of the 46 patients included in our study, the histopathology of the surgical specimens revealed thyroid cancer in 17 individuals (37%, 17/46). The PET/CT scan showed a positive result in 27 patients. Of these, 16 patients (59.3%) were found to have thyroid carcinomas. In addition, the PET/CT scan was considered to be negative in 19 patients, 18 (94.7%) of whom had benign lesions. For the detection of malignant lesions, the values for the sensitivity and specificity, and the positive predictive and negative predictive values were 94%, 62%, 59%, and 95%, respectively.

Thyroid Nodules;FDG PET/CT;Indeterminate;Fine Needle Aspiration Biopsy Thyroid Nodules;FDG PET/CT;Indeterminate;Fine Needle Aspiration Biopsy http://www.Iranjradiol.com/index.php?page=article&article_id=21186 Gulgun Buyukdereli Gulgun Buyukdereli Department of Nuclear Medicine, Faculty of Medicine, Cukurova University, Adana, Turkey; Department of Nuclear Medicine, Faculty of Medicine, Cukurova University, Ziyapasa bulvari, Kurtulus mah, Adana, Turkey. Tel: +90-5324305118, Fax: +90-3224590581 Department of Nuclear Medicine, Faculty of Medicine, Cukurova University, Adana, Turkey; Department of Nuclear Medicine, Faculty of Medicine, Cukurova University, Ziyapasa bulvari, Kurtulus mah, Adana, Turkey. Tel: +90-5324305118, Fax: +90-3224590581 Yasemin Aktar Yasemin Aktar Department of Nuclear Medicine, Faculty of Medicine, Cukurova University, Adana, Turkey Department of Nuclear Medicine, Faculty of Medicine, Cukurova University, Adana, Turkey Ertan Kara Ertan Kara Department of Public Health, Faculty of Medicine, Cukurova University, Adana, Turkey Department of Public Health, Faculty of Medicine, Cukurova University, Adana, Turkey Aysun Uguz Aysun Uguz Department of Pathology, Faculty of Medicine, Cukurova University, Adana, Turkey Department of Pathology, Faculty of Medicine, Cukurova University, Adana, Turkey Husnu Sonmez Husnu Sonmez Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey
en 27127576 10.5812/iranjradiol.28993 Transjugular Intrahepatic Portosystemic Shunt Occlusion Complicated with Biliary Fistula Successfully Treated with a Stent Graft: A Case Report Transjugular Intrahepatic Portosystemic Shunt Occlusion Complicated with Biliary Fistula Successfully Treated with a Stent Graft: A Case Report case-report case-report

A 43-year-old man with liver cirrhosis received transjugular intrahepatic portosystemic shunt (TIPS) for the treatment of recurrent variceal bleeding and F3 esophageal varices. During routine follow up liver ultrasound examination, six months after the implantation, TIPS occlusion was suspected and TIPS revision was performed. During the revision, moderate to severe stenosis at the hepatic venous segment of the tract and a total occlusion at the parenchymal segment of TIPS tract near the portal vein with biliary-TIPS fistula were identified with a clear visualization of the common bile duct. After the successful TIPS revision with the placement of an additional stent-graft, the biliary fistula and common bile duct were no more delineated. We herein report a rare case with an obvious visualization of biliary-TIPS fistula associated with obstruction of TIPS shunt on the tractogram and recanalization with an additional stent-graft.

A 43-year-old man with liver cirrhosis received transjugular intrahepatic portosystemic shunt (TIPS) for the treatment of recurrent variceal bleeding and F3 esophageal varices. During routine follow up liver ultrasound examination, six months after the implantation, TIPS occlusion was suspected and TIPS revision was performed. During the revision, moderate to severe stenosis at the hepatic venous segment of the tract and a total occlusion at the parenchymal segment of TIPS tract near the portal vein with biliary-TIPS fistula were identified with a clear visualization of the common bile duct. After the successful TIPS revision with the placement of an additional stent-graft, the biliary fistula and common bile duct were no more delineated. We herein report a rare case with an obvious visualization of biliary-TIPS fistula associated with obstruction of TIPS shunt on the tractogram and recanalization with an additional stent-graft.

Stenosis;Fistula;Portosystemic;Transjugular Intrahepatic Stenosis;Fistula;Portosystemic;Transjugular Intrahepatic http://www.Iranjradiol.com/index.php?page=article&article_id=28993 Eunyoung Kim Eunyoung Kim Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Sung Won Lee Sung Won Lee Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Tel: +82-222582075, Fax: +82-255865589 Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Tel: +82-222582075, Fax: +82-255865589 Woo Hyeon Kim Woo Hyeon Kim Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Si Hyun Bae Si Hyun Bae Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Nam Ik Han Nam Ik Han Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Jung Suk Oh Jung Suk Oh Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Ho Jong Chun Ho Jong Chun Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Hae Giu Lee Hae Giu Lee Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
en 27127579 10.5812/iranjradiol.30909 Significance of Additional Non-Mass Enhancement in Patients with Breast Cancer on Preoperative 3T Dynamic Contrast Enhanced MRI of the Breast Significance of Additional Non-Mass Enhancement in Patients with Breast Cancer on Preoperative 3T Dynamic Contrast Enhanced MRI of the Breast research-article research-article Conclusion

The possibility of malignancy is strongly indicated when additional NME lesions show linear or segmental enhancement on preoperative 3T DCE-MRI in patients with recently diagnosed breast cancer.

Results

On histopathologic analysis of the 88 NME lesions, 73 (83%) were malignant and 15 (17%) were benign. Lesion size did not differ significantly between malignant and benign lesions (P = 0.410). Malignancy was more frequent in linear (P = 0.005) and segmental (P = 0.011) distributions, and benignancy was more frequent in focal (P = 0.004) and regional (P < 0.001) NME lesions. The highest positive predictive value (PPV) for malignancy occurred in segmental (96.8%), linear (95.1%), clustered ring (100%), and clumped (92.0%) enhancement. Asymmetry demonstrated a high positive predictive value of 85.9%. The frequency of malignancy was higher for NME lesions located in the same quadrant with the index cancer (P = 0.006), and benignancy was higher in the contralateral breast (P = 0.015). On multivariate analysis, linear (P = 0.001) and segmental (P = 0.005) distributions were significant predictors of malignancy.

Background

In preoperative assessment of breast cancer, MRI has been shown to identify more additional breast lesions than are detectable using conventional imaging techniques. The characterization of additional lesions is more important than detection for optimal surgical treatment. Additional breast lesions can be included in focus, mass, and non-mass enhancement (NME) on MRI. According to the fifth edition of the breast imaging reporting and data system (BI-RADS®), which includes several changes in the NME descriptors, few studies to date have evaluated NME in preoperative assessment of breast cancer.

Objectives

We investigated the diagnostic accuracy of BI-RADS descriptors in predicting malignancy for additional NME lesions detected on preoperative 3T dynamic contrast enhanced MRI (DCE-MRI) in patients with newly diagnosed breast cancer.

Patients and Methods

Between January 2008 and December 2012, 88 patients were enrolled in our study, all with NME lesions other than the index cancer on preoperative 3T DCE-MRI and all with accompanying histopathologic examination. The MRI findings were analyzed according to the BI-RADS MRI lexicon. We evaluated the size, distribution, internal enhancement pattern, and location of NME lesions relative to the index cancer (i.e., same quadrant, different quadrant, or contralateral breast).

Conclusion

The possibility of malignancy is strongly indicated when additional NME lesions show linear or segmental enhancement on preoperative 3T DCE-MRI in patients with recently diagnosed breast cancer.

Results

On histopathologic analysis of the 88 NME lesions, 73 (83%) were malignant and 15 (17%) were benign. Lesion size did not differ significantly between malignant and benign lesions (P = 0.410). Malignancy was more frequent in linear (P = 0.005) and segmental (P = 0.011) distributions, and benignancy was more frequent in focal (P = 0.004) and regional (P < 0.001) NME lesions. The highest positive predictive value (PPV) for malignancy occurred in segmental (96.8%), linear (95.1%), clustered ring (100%), and clumped (92.0%) enhancement. Asymmetry demonstrated a high positive predictive value of 85.9%. The frequency of malignancy was higher for NME lesions located in the same quadrant with the index cancer (P = 0.006), and benignancy was higher in the contralateral breast (P = 0.015). On multivariate analysis, linear (P = 0.001) and segmental (P = 0.005) distributions were significant predictors of malignancy.

Background

In preoperative assessment of breast cancer, MRI has been shown to identify more additional breast lesions than are detectable using conventional imaging techniques. The characterization of additional lesions is more important than detection for optimal surgical treatment. Additional breast lesions can be included in focus, mass, and non-mass enhancement (NME) on MRI. According to the fifth edition of the breast imaging reporting and data system (BI-RADS®), which includes several changes in the NME descriptors, few studies to date have evaluated NME in preoperative assessment of breast cancer.

Objectives

We investigated the diagnostic accuracy of BI-RADS descriptors in predicting malignancy for additional NME lesions detected on preoperative 3T dynamic contrast enhanced MRI (DCE-MRI) in patients with newly diagnosed breast cancer.

Patients and Methods

Between January 2008 and December 2012, 88 patients were enrolled in our study, all with NME lesions other than the index cancer on preoperative 3T DCE-MRI and all with accompanying histopathologic examination. The MRI findings were analyzed according to the BI-RADS MRI lexicon. We evaluated the size, distribution, internal enhancement pattern, and location of NME lesions relative to the index cancer (i.e., same quadrant, different quadrant, or contralateral breast).

Breast Neoplasms;Diagnosis;Non-Mass Enhancement;Preoperative Care;Magnetic Resonance Imaging Breast Neoplasms;Diagnosis;Non-Mass Enhancement;Preoperative Care;Magnetic Resonance Imaging http://www.Iranjradiol.com/index.php?page=article&article_id=30909 Yun Hee Cho Yun Hee Cho Department of Radiology, College of Medicine, Korea University, Seoul, Korea Department of Radiology, College of Medicine, Korea University, Seoul, Korea Kyu Ran Cho Kyu Ran Cho Department of Radiology, College of Medicine, Korea University, Seoul, Korea; Corresponding author: Kyu Ran Cho, Kyu Ran Cho, Department of Radiology, Anam Hospital, College of Medicine, Korea University, Inchon-ro, Seongbuk-gu, Seoul 136-705, Korea. Tel: +82-29205578, Fax: +82-29293796, E-mail: Department of Radiology, College of Medicine, Korea University, Seoul, Korea; Corresponding author: Kyu Ran Cho, Kyu Ran Cho, Department of Radiology, Anam Hospital, College of Medicine, Korea University, Inchon-ro, Seongbuk-gu, Seoul 136-705, Korea. Tel: +82-29205578, Fax: +82-29293796, E-mail: Eun Kyung Park Eun Kyung Park Department of Radiology, College of Medicine, Korea University, Seoul, Korea Department of Radiology, College of Medicine, Korea University, Seoul, Korea Bo Kyoung Seo Bo Kyoung Seo Department of Radiology, College of Medicine, Korea University, Seoul, Korea Department of Radiology, College of Medicine, Korea University, Seoul, Korea Ok Hee Woo Ok Hee Woo Department of Radiology, College of Medicine, Korea University, Seoul, Korea Department of Radiology, College of Medicine, Korea University, Seoul, Korea Sung Bum Cho Sung Bum Cho Department of Radiology, College of Medicine, Korea University, Seoul, Korea Department of Radiology, College of Medicine, Korea University, Seoul, Korea Jeoung Won Bae Jeoung Won Bae Department of Surgery, College of Medicine, Korea University, Seoul, Korea Department of Surgery, College of Medicine, Korea University, Seoul, Korea
en 27127581 10.5812/iranjradiol.32559 Predicting Factors for Successful Maturation of Autogenous Haemodialysis Fistulas After Salvage Percutaneous Transluminal Angioplasty in Diabetic Nephropathy: A Study on Follow-Up Doppler Ultrasonography Predicting Factors for Successful Maturation of Autogenous Haemodialysis Fistulas After Salvage Percutaneous Transluminal Angioplasty in Diabetic Nephropathy: A Study on Follow-Up Doppler Ultrasonography research-article research-article Conclusion

For more precise prediction of successful aAVF maturation after sPTA, short-term follow-up Doppler ultrasonography (< 2 weeks) was useful. If the ASR was < 0.7 or if residual stenosis was ≥ 30%, immediate repeat sPTA is recommended.

Results

The technical and clinical success rates were both 94.9% (56/59); the mean ASR was 0.84. An ASR of ≥ 0.7 and no significant residual stenosis (< 30%) (both P < 0.001) on two-week follow-up Doppler ultrasonography predicted successful aAVF maturation.

Objectives

The aim of this study was to identify factors predicting successful aAVF maturation and to determine positive technical aspects of sPTA.

Patients and Methods

We retrospectively reviewed medical records and radiological images of 59 patients who had undergone sPTA for non-maturing aAVFs. We analysed images from pre-surgical mapping Doppler ultrasonography, angiography, and angioplasty and follow-up Doppler ultrasonography performed within two weeks after sPTA. We assessed the following factors, for their ability to predict successful aAVF maturation: 1) patient factors (age; sex; co-morbidities; and aAVF age, side and type); 2) vessel factors (cephalic vein diameter and depth, presence of accessory veins, and pre- and postoperative radial artery disease); 3) lesion factors (stenosis number, location and severity); and 4) technical factors (presence of residual stenosis and anatomic success ratio (ASR) on follow-up Doppler ultrasonography).

Background

Maturation failure of autogenous arteriovenous fistula (aAVF) has been increasing after surgical procedures and the salvage percutaneous transluminal angioplasty (sPTA) for immature aAVF has been identified as an effective treatment modality.

Conclusion

For more precise prediction of successful aAVF maturation after sPTA, short-term follow-up Doppler ultrasonography (< 2 weeks) was useful. If the ASR was < 0.7 or if residual stenosis was ≥ 30%, immediate repeat sPTA is recommended.

Results

The technical and clinical success rates were both 94.9% (56/59); the mean ASR was 0.84. An ASR of ≥ 0.7 and no significant residual stenosis (< 30%) (both P < 0.001) on two-week follow-up Doppler ultrasonography predicted successful aAVF maturation.

Objectives

The aim of this study was to identify factors predicting successful aAVF maturation and to determine positive technical aspects of sPTA.

Patients and Methods

We retrospectively reviewed medical records and radiological images of 59 patients who had undergone sPTA for non-maturing aAVFs. We analysed images from pre-surgical mapping Doppler ultrasonography, angiography, and angioplasty and follow-up Doppler ultrasonography performed within two weeks after sPTA. We assessed the following factors, for their ability to predict successful aAVF maturation: 1) patient factors (age; sex; co-morbidities; and aAVF age, side and type); 2) vessel factors (cephalic vein diameter and depth, presence of accessory veins, and pre- and postoperative radial artery disease); 3) lesion factors (stenosis number, location and severity); and 4) technical factors (presence of residual stenosis and anatomic success ratio (ASR) on follow-up Doppler ultrasonography).

Background

Maturation failure of autogenous arteriovenous fistula (aAVF) has been increasing after surgical procedures and the salvage percutaneous transluminal angioplasty (sPTA) for immature aAVF has been identified as an effective treatment modality.

Arteriovenous Fistula;Autologous Transplantation;Doppler Ultrasonography;Angioplasty Arteriovenous Fistula;Autologous Transplantation;Doppler Ultrasonography;Angioplasty http://www.Iranjradiol.com/index.php?page=article&article_id=32559 Eui-Yong Jeon Eui-Yong Jeon Department of Radiology, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates Department of Radiology, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates Young Kwon Cho Young Kwon Cho Department of Radiology, Kangdong Seong-Sim Hospital , Hallym University College of Medicine, Seoul, Republic of Korea; Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 150, Seongan-ro Gangdong-Gu, Seoul, 134701, Republic of Korea. Tel: +82-222242312, Fax: +82-222242481 Department of Radiology, Kangdong Seong-Sim Hospital , Hallym University College of Medicine, Seoul, Republic of Korea; Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 150, Seongan-ro Gangdong-Gu, Seoul, 134701, Republic of Korea. Tel: +82-222242312, Fax: +82-222242481 Sung Bum Cho Sung Bum Cho Department of Radiology, Korea University Anam Hospital , Korea University College of Medicine, Seoul, Republic of Korea Department of Radiology, Korea University Anam Hospital , Korea University College of Medicine, Seoul, Republic of Korea Dae Young Yoon Dae Young Yoon Department of Radiology, Kangdong Seong-Sim Hospital , Hallym University College of Medicine, Seoul, Republic of Korea Department of Radiology, Kangdong Seong-Sim Hospital , Hallym University College of Medicine, Seoul, Republic of Korea Seong O Suh Seong O Suh Department of Internal Medicine, National Police Hospital, Seoul, Republic of Korea Department of Internal Medicine, National Police Hospital, Seoul, Republic of Korea
en 27110342 10.5812/iranjradiol.29260 A long-Segmental Vascular Malformation in the Small Bowel Presenting With Gastrointestinal Bleeding in a Preschool-Aged Child A long-Segmental Vascular Malformation in the Small Bowel Presenting With Gastrointestinal Bleeding in a Preschool-Aged Child case-report case-report

Gastrointestinal (GI) bleeding in pediatric patients has several causes. Vascular malformation of the small bowel is a rare disease leading to pediatric GI bleeding. To our knowledge, few reports describe ultrasound and computed tomography findings of venous malformations involving the small bowel. We present a case of long-segmental and circumferential vascular malformation that led to GI bleeding in a pre-school aged child, focusing on the radiologic findings. Although vascular malformation including of the GI tract is rare in children, it should be considered when GI bleeding occurs in pediatric patients.

Gastrointestinal (GI) bleeding in pediatric patients has several causes. Vascular malformation of the small bowel is a rare disease leading to pediatric GI bleeding. To our knowledge, few reports describe ultrasound and computed tomography findings of venous malformations involving the small bowel. We present a case of long-segmental and circumferential vascular malformation that led to GI bleeding in a pre-school aged child, focusing on the radiologic findings. Although vascular malformation including of the GI tract is rare in children, it should be considered when GI bleeding occurs in pediatric patients.

Child, Preschool;Vascular Malformations;Intestine, Small;Gastrointestinal Hemorrhage;Radiology Child, Preschool;Vascular Malformations;Intestine, Small;Gastrointestinal Hemorrhage;Radiology http://www.Iranjradiol.com/index.php?page=article&article_id=29260 Yeoun Joo Lee Yeoun Joo Lee Department of Pediatrics, Pusan National University Children’s Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea Department of Pediatrics, Pusan National University Children’s Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea Jae-Yeon Hwang Jae-Yeon Hwang Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea; Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea. Tel: +82-553602778, Fax: +82-553601848 Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea; Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea. Tel: +82-553602778, Fax: +82-553601848 Yong Hoon Cho Yong Hoon Cho Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea Yong-Woo Kim Yong-Woo Kim Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea Tae Un Kim Tae Un Kim Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea Dong Hoon Shin Dong Hoon Shin Department of Pathology, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea Department of Pathology, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea
en 27127582 10.5812/iranjradiol.33133 Additional Value of Diffusion-Weighted Imaging to Evaluate Prognostic Factors of Breast Cancer: Correlation with the Apparent Diffusion Coefficient Additional Value of Diffusion-Weighted Imaging to Evaluate Prognostic Factors of Breast Cancer: Correlation with the Apparent Diffusion Coefficient research-article research-article Results

A low ADC value was associated with lymph node metastasis (P < 0.01) and with high Ki-67 protein levels (P = 0.03). There were no significant differences in the ADC values among the histological grade (P = 0.48), molecular subtype (P = 0.51), tumor size (P = 0.46), and p53 protein level (P = 0.62).

Conclusion

The pre-operative use of the 3.0 Tesla DWI could provide information about the lymph node status and tumor proliferation for breast cancer patients, and could help determine the optimal treatment plan.

Objectives

The goal of this study was to evaluate whether ADC measurements could provide information on the prognostic factors of breast cancer.

Patients and Methods

A total of 71 women with invasive breast cancer, treated consecutively, who underwent preoperative breast MRIs with DWI at 3.0 Tesla and subsequent surgery, were prospectively included in this study. Each DWI was acquired with b values of 0 and 1000 s/mm2. The mean ADC values of the lesions were measured, including the entire lesion on the three largest sections. We performed histopathological analyses for the tumor size, lymph node status, histological grade, hormone receptors, human epidermal growth factor receptor 2 (HER2), Ki-67, p53, and molecular subtypes. The associations with the ADC values and prognostic factors of breast cancer were evaluated using the independent-samples t test and the one-way analysis of variance (ANOVA).

Background

Breast cancer is a heterogeneous disease with diverse prognoses. The main prognostic determinants are lymph node status, tumor size, histological grade, and biological factors, such as hormone receptors, human epidermal growth factor receptor 2 (HER2), Ki-67 protein levels, and p53 expression. Diffusion-weighted imaging (DWI) can be used to measure the apparent diffusion coefficient (ADC) that provides information related to tumor cellularity and the integrity of the cell membranes.

Results

A low ADC value was associated with lymph node metastasis (P < 0.01) and with high Ki-67 protein levels (P = 0.03). There were no significant differences in the ADC values among the histological grade (P = 0.48), molecular subtype (P = 0.51), tumor size (P = 0.46), and p53 protein level (P = 0.62).

Conclusion

The pre-operative use of the 3.0 Tesla DWI could provide information about the lymph node status and tumor proliferation for breast cancer patients, and could help determine the optimal treatment plan.

Objectives

The goal of this study was to evaluate whether ADC measurements could provide information on the prognostic factors of breast cancer.

Patients and Methods

A total of 71 women with invasive breast cancer, treated consecutively, who underwent preoperative breast MRIs with DWI at 3.0 Tesla and subsequent surgery, were prospectively included in this study. Each DWI was acquired with b values of 0 and 1000 s/mm2. The mean ADC values of the lesions were measured, including the entire lesion on the three largest sections. We performed histopathological analyses for the tumor size, lymph node status, histological grade, hormone receptors, human epidermal growth factor receptor 2 (HER2), Ki-67, p53, and molecular subtypes. The associations with the ADC values and prognostic factors of breast cancer were evaluated using the independent-samples t test and the one-way analysis of variance (ANOVA).

Background

Breast cancer is a heterogeneous disease with diverse prognoses. The main prognostic determinants are lymph node status, tumor size, histological grade, and biological factors, such as hormone receptors, human epidermal growth factor receptor 2 (HER2), Ki-67 protein levels, and p53 expression. Diffusion-weighted imaging (DWI) can be used to measure the apparent diffusion coefficient (ADC) that provides information related to tumor cellularity and the integrity of the cell membranes.

Breast Cancer;Diffusion-Weighted Imaging;Apparent Diffusion Coefficient;Breast Magnetic Resonance Breast Cancer;Diffusion-Weighted Imaging;Apparent Diffusion Coefficient;Breast Magnetic Resonance http://www.Iranjradiol.com/index.php?page=article&article_id=33133 Eun Kyung Park Eun Kyung Park Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Kyu Ran Cho Kyu Ran Cho Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea; Department of Radiology, Korea University College of Medicine 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea. Tel: +82-29205578, Fax: +82-29293796 Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea; Department of Radiology, Korea University College of Medicine 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea. Tel: +82-29205578, Fax: +82-29293796 Bo Kyoung Seo Bo Kyoung Seo Department of Radiology, Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Korea Department of Radiology, Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Korea Ok Hee Woo Ok Hee Woo Department of Radiology, Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology, Guro Hospital, Korea University College of Medicine, Seoul, Korea Sung Bum Cho Sung Bum Cho Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Jeoung Won Bae Jeoung Won Bae Department of Surgery, Anam Hospital, Korea University College of Medicine, Seoul, Korea Department of Surgery, Anam Hospital, Korea University College of Medicine, Seoul, Korea
en 27127578 10.5812/iranjradiol.30069 Diffusion Weighted Imaging, Diffusion Tensor Imaging, and T2* Mapping of Lumbar Intervertebral Disc in Young Healthy Adults Diffusion Weighted Imaging, Diffusion Tensor Imaging, and T2* Mapping of Lumbar Intervertebral Disc in Young Healthy Adults research-article research-article Conclusion

ADC, FA, and T2* values may quantitatively reflect the microstructural characteristics of NP, therefore they could be used to detect the minimal changes of early LDD.

Results

The ADC, FA, and T2* values were different (P < 0.05) among different ROIs within the same disc or among corresponding ROIs in different level discs. While the average values of ADC increased regularly with the lowering of the anatomical location (P < 0.05), the average FA and T2* values also associated with the anatomic locations, showed an increase in L4-L5 and L5-S1 discs (P < 0.05).

Patients and Methods

Apparent diffusion coefficient (ADC), fractional anisotropy (FA), and T2* images of the lumbar discs were obtained for 40 asymptomatic young subjects (19 males and 21 females; mean age of 24.3 years), using DWI, DTI and T2* mapping with a 1.5-T MRI scanner. ADC, FA, and T2* values were measured to compare five regions of interest (ROI) selected in each nucleus pulposus (NP) of the images.

Objectives

The aim of this study was to use diffusion weighted imaging (DWI), diffusion Tensor Imaging (DTI) and T2* mapping to detect lumbar discs in healthy young adults, to evaluate if they could depict the microstructural changes of early LDD.

Background

Although conventional magnetic resonance imaging (MRI) could provide excellent detection of morphological changes in the diagnosis of lumbar disc degeneration (LDD), it has some difficulties in discriminating minimal changes associated with early LDD before morphological or clinical alterations. Therefore, newer MRI techniques have emerged for investigation of early LDD.

Conclusion

ADC, FA, and T2* values may quantitatively reflect the microstructural characteristics of NP, therefore they could be used to detect the minimal changes of early LDD.

Results

The ADC, FA, and T2* values were different (P < 0.05) among different ROIs within the same disc or among corresponding ROIs in different level discs. While the average values of ADC increased regularly with the lowering of the anatomical location (P < 0.05), the average FA and T2* values also associated with the anatomic locations, showed an increase in L4-L5 and L5-S1 discs (P < 0.05).

Patients and Methods

Apparent diffusion coefficient (ADC), fractional anisotropy (FA), and T2* images of the lumbar discs were obtained for 40 asymptomatic young subjects (19 males and 21 females; mean age of 24.3 years), using DWI, DTI and T2* mapping with a 1.5-T MRI scanner. ADC, FA, and T2* values were measured to compare five regions of interest (ROI) selected in each nucleus pulposus (NP) of the images.

Objectives

The aim of this study was to use diffusion weighted imaging (DWI), diffusion Tensor Imaging (DTI) and T2* mapping to detect lumbar discs in healthy young adults, to evaluate if they could depict the microstructural changes of early LDD.

Background

Although conventional magnetic resonance imaging (MRI) could provide excellent detection of morphological changes in the diagnosis of lumbar disc degeneration (LDD), it has some difficulties in discriminating minimal changes associated with early LDD before morphological or clinical alterations. Therefore, newer MRI techniques have emerged for investigation of early LDD.

Magnetic Resonance Imaging;Diffusion Tensor Imaging;Diffusion Weighted Imaging;T2*;Intervertebral Disc Magnetic Resonance Imaging;Diffusion Tensor Imaging;Diffusion Weighted Imaging;T2*;Intervertebral Disc http://www.Iranjradiol.com/index.php?page=article&article_id=30069 Si Shen Si Shen Medical Imaging Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China Medical Imaging Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China Hao Wang Hao Wang Pain Clinic, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China; Pain Clinic, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China. Tel: +86-13430267880, Fax: +86-2038688416 Pain Clinic, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China; Pain Clinic, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China. Tel: +86-13430267880, Fax: +86-2038688416 Jing Zhang Jing Zhang Medical Imaging Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China Medical Imaging Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China Fei Wang Fei Wang Medical Imaging Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China Medical Imaging Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China Si-Run Liu Si-Run Liu Medical Imaging Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China Medical Imaging Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
en 27110339 10.5812/iranjradiol.22698 Can the Inversion Filter Improve the Visibility of the Mandibular Incisive Canal? Can the Inversion Filter Improve the Visibility of the Mandibular Incisive Canal? research-article research-article Results

There was no significant differences between IF and conventional mode regarding visibility of MIC (P > 0.05).

Conclusion

Although using IF caused improved visibility of MIC, the difference with conventional mode was not statistically different.

Patients and Methods

In this cross-sectional study, 2580 digital panoramic images of 18 to 70-year-old patients were inspected for presence of MIC. Visibility of MIC and extension of the canal were registered separately on each side using IF and conventional mode. Data were analyzed by Kappa test using SPSS version 20 software. A probability value of P < 0.05 was considered statistically significant.

Objectives

The purpose of this study was to assess the effect of inversion filter (IF) on the visibility of mandibular incisive canal in panoramic radiographs.

Background

One of the anatomic structures in the mental interforaminal area is the mandibular incisive canal (MIC). Using various manipulation tools in the digital system may affect the visibility of MIC.

Results

There was no significant differences between IF and conventional mode regarding visibility of MIC (P > 0.05).

Conclusion

Although using IF caused improved visibility of MIC, the difference with conventional mode was not statistically different.

Patients and Methods

In this cross-sectional study, 2580 digital panoramic images of 18 to 70-year-old patients were inspected for presence of MIC. Visibility of MIC and extension of the canal were registered separately on each side using IF and conventional mode. Data were analyzed by Kappa test using SPSS version 20 software. A probability value of P < 0.05 was considered statistically significant.

Objectives

The purpose of this study was to assess the effect of inversion filter (IF) on the visibility of mandibular incisive canal in panoramic radiographs.

Background

One of the anatomic structures in the mental interforaminal area is the mandibular incisive canal (MIC). Using various manipulation tools in the digital system may affect the visibility of MIC.

Digital;Panoramic Radiography;Software Digital;Panoramic Radiography;Software http://www.Iranjradiol.com/index.php?page=article&article_id=22698 Farida Abesi Farida Abesi Dental Materials Research Center, Department of Oral and Maxillofacial Radiology, Dental Faculty, Babol University of Medical Sciences, Babol, Iran Dental Materials Research Center, Department of Oral and Maxillofacial Radiology, Dental Faculty, Babol University of Medical Sciences, Babol, Iran Nima Nikafshar Nima Nikafshar Student Research Committee, Dental Faculty, Babol University of Medical Sciences, Babol, Iran Student Research Committee, Dental Faculty, Babol University of Medical Sciences, Babol, Iran Sina Haghanifar Sina Haghanifar Dental Materials Research Center, Department of Oral and Maxillofacial Radiology, Dental Faculty, Babol University of Medical Sciences, Babol, Iran; Dental Materials Research Center, Department of Oral and Maxillofacial Radiology, Dental Faculty, Babol University of Medical Sciences, Babol, Iran. Tel: +98-1132291408, Fax: +98-1132291093 Dental Materials Research Center, Department of Oral and Maxillofacial Radiology, Dental Faculty, Babol University of Medical Sciences, Babol, Iran; Dental Materials Research Center, Department of Oral and Maxillofacial Radiology, Dental Faculty, Babol University of Medical Sciences, Babol, Iran. Tel: +98-1132291408, Fax: +98-1132291093 Soraya Khafri Soraya Khafri Social Medical and Health Department, Babol University of Medical Sciences, Babol, Iran Social Medical and Health Department, Babol University of Medical Sciences, Babol, Iran Mahtab Hamzeh Mahtab Hamzeh Department of Pediatric Dentistry, Dental Faculty, Babol University of Medical Sciences, Babol, Iran Department of Pediatric Dentistry, Dental Faculty, Babol University of Medical Sciences, Babol, Iran
en 27110343 10.5812/iranjradiol.31208 Epistaxis as the First Manifestation of Silent Renal Cell Carcinoma: A Case Report with Relevant Literature Review Epistaxis as the First Manifestation of Silent Renal Cell Carcinoma: A Case Report with Relevant Literature Review case-report case-report

The paranasal sinuses are known to be a rare location for metastasis. Renal cell carcinoma (RCC) is the most frequent primary tumor to metastasize to the sinonasal region, followed by lung and breast cancer. In particular, clear cell type RCC, which represents approximately 85% of RCCs, is characterized by early metastasis, and it sometimes spreads to unusual sites (1, 2). Metastatic tumors in the paranasal sinuses are distributed in the maxillary, sphenoid, ethmoid, and frontal sinuses, in order of decreasing frequency. Symptoms are usually nonspecific, but epistaxis is the most common sign, due to the hypervascularity of the primary tumor. The prognosis is uncertain, but the 5-year survival rate fluctuates between 15% and 30%. The purpose of this case report is to document a rare case of silent RCC that first presented as epistaxis due to nasal cavity and ethmoid sinus metastasis.

The paranasal sinuses are known to be a rare location for metastasis. Renal cell carcinoma (RCC) is the most frequent primary tumor to metastasize to the sinonasal region, followed by lung and breast cancer. In particular, clear cell type RCC, which represents approximately 85% of RCCs, is characterized by early metastasis, and it sometimes spreads to unusual sites (1, 2). Metastatic tumors in the paranasal sinuses are distributed in the maxillary, sphenoid, ethmoid, and frontal sinuses, in order of decreasing frequency. Symptoms are usually nonspecific, but epistaxis is the most common sign, due to the hypervascularity of the primary tumor. The prognosis is uncertain, but the 5-year survival rate fluctuates between 15% and 30%. The purpose of this case report is to document a rare case of silent RCC that first presented as epistaxis due to nasal cavity and ethmoid sinus metastasis.

Metastatic Renal Cell Carcinoma;Sinonasal Metastasis;Epistaxis Metastatic Renal Cell Carcinoma;Sinonasal Metastasis;Epistaxis http://www.Iranjradiol.com/index.php?page=article&article_id=31208 Seung Min Lee Seung Min Lee Department of Radiology, Dankook University Hospital, Choenan, South Korea Department of Radiology, Dankook University Hospital, Choenan, South Korea You Me Kim You Me Kim Department of Radiology, Dankook University Hospital, Choenan, South Korea Department of Radiology, Dankook University Hospital, Choenan, South Korea Bong Man Kim Bong Man Kim Department of Radiology, Dankook University Hospital, Choenan, South Korea; Department of Radiology, Dankook University Hospital, Choenan, South Korea. Tel: +82-1056908768, Fax: +82-415509674 Department of Radiology, Dankook University Hospital, Choenan, South Korea; Department of Radiology, Dankook University Hospital, Choenan, South Korea. Tel: +82-1056908768, Fax: +82-415509674
en 27110341 10.5812/iranjradiol.27890 Sequential Sonographic Features of Primary Invasive Aspergillosis Involving Only the Thyroid Gland: A Case Report and Literature Review Sequential Sonographic Features of Primary Invasive Aspergillosis Involving Only the Thyroid Gland: A Case Report and Literature Review case-report case-report

A 29-year-old woman with systemic lupus erythematosus (SLE) presented with palpitation and neck swelling. Initial sonography showed an ill-defined hypoechoic lesion in the right thyroid gland, mentioning subacute thyroiditis. The patient received conservative care for one week. However, her neck swelling worsened and she complained of dyspnea. Follow up sonography showed marked enlargement of both thyroid glands. Irregular infiltration of hypoechoic lesions was detected along the subcapsular region of both thyroid glands. She underwent immediate intubation to secure the airway and total thyroidectomy. Histopathological staining revealed features of fungal thyroiditis with fungal hyphae characteristic of Aspergillus. There was no abnormality in the lung or paranasal sinuses. In this report, we describe the sequential sonographic findings of invasive aspergillosis in the thyroid gland presenting as progressive enlargement without other organ involvement.

A 29-year-old woman with systemic lupus erythematosus (SLE) presented with palpitation and neck swelling. Initial sonography showed an ill-defined hypoechoic lesion in the right thyroid gland, mentioning subacute thyroiditis. The patient received conservative care for one week. However, her neck swelling worsened and she complained of dyspnea. Follow up sonography showed marked enlargement of both thyroid glands. Irregular infiltration of hypoechoic lesions was detected along the subcapsular region of both thyroid glands. She underwent immediate intubation to secure the airway and total thyroidectomy. Histopathological staining revealed features of fungal thyroiditis with fungal hyphae characteristic of Aspergillus. There was no abnormality in the lung or paranasal sinuses. In this report, we describe the sequential sonographic findings of invasive aspergillosis in the thyroid gland presenting as progressive enlargement without other organ involvement.

Aspergillosis;Thyroid;Ultrasound Aspergillosis;Thyroid;Ultrasound http://www.Iranjradiol.com/index.php?page=article&article_id=27890 Su Ho Kim Su Ho Kim Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Jee Young Kim Jee Young Kim Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10 63ro Yeongdeunpo-gu, Seoul 150-713, Korea. Tel: +82-237792017, Fax: +82-27835288 Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10 63ro Yeongdeunpo-gu, Seoul 150-713, Korea. Tel: +82-237792017, Fax: +82-27835288 Woo Chan Park Woo Chan Park Department of Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Mee Kyung Kim Mee Kyung Kim Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Tae Jung Kim Tae Jung Kim Department of Hospital Pathology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Hospital Pathology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
en 27127580 10.5812/iranjradiol.30941 Primary Nasopharyngeal Tuberculosis Combined with Tuberculous Otomastoiditis and Facial Nerve Palsy Primary Nasopharyngeal Tuberculosis Combined with Tuberculous Otomastoiditis and Facial Nerve Palsy case-report case-report

Primary nasopharyngeal tuberculosis (TB) without pulmonary involvement is rare, even in endemic areas. Herein, we present a rare complication of primary nasopharyngeal TB accompanied with tuberculous otomastoiditis (TOM) and ipsilateral facial nerve palsy, in a 24-year-old female patient, with computed tomography and magnetic resonance imagery findings.

Primary nasopharyngeal tuberculosis (TB) without pulmonary involvement is rare, even in endemic areas. Herein, we present a rare complication of primary nasopharyngeal TB accompanied with tuberculous otomastoiditis (TOM) and ipsilateral facial nerve palsy, in a 24-year-old female patient, with computed tomography and magnetic resonance imagery findings.

Facial Nerve;Mastoiditis;Nasopharyngeal Diseases;Paralysis;Tuberculosis Facial Nerve;Mastoiditis;Nasopharyngeal Diseases;Paralysis;Tuberculosis http://www.Iranjradiol.com/index.php?page=article&article_id=30941 Hee Young Choi Hee Young Choi Department of Radiology, Graduate School, Kyung Hee University, Seoul, Korea Department of Radiology, Graduate School, Kyung Hee University, Seoul, Korea Ji Hye Jang Ji Hye Jang Department of Radiology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea Department of Radiology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea Kyung Mi Lee Kyung Mi Lee Department of Radiology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea Department of Radiology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea Woo Suk Choi Woo Suk Choi Department of Radiology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea Department of Radiology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea Sang Hoon Kim Sang Hoon Kim Department of Otolaryngology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea Department of Otolaryngology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea Seung Geun Yeo Seung Geun Yeo Department of Otolaryngology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea Department of Otolaryngology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea Eui Jong Kim Eui Jong Kim Department of Radiology, Graduate School, Kyung Hee University, Seoul, Korea; Department of Radiology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea; Department of Radiology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, P. O. Box: 130-701, Seoul, Korea. Tel: +822-9588611, Fax: +822-9680787 Department of Radiology, Graduate School, Kyung Hee University, Seoul, Korea; Department of Radiology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea; Department of Radiology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, P. O. Box: 130-701, Seoul, Korea. Tel: +822-9588611, Fax: +822-9680787
en 27127575 10.5812/iranjradiol.25609 Correlating Whole-Body Bone Mineral Densitometry Measurements to Those From Local Anatomical Sites Correlating Whole-Body Bone Mineral Densitometry Measurements to Those From Local Anatomical Sites research-article research-article Patients and Methods

In this cross-sectional study, we evaluated all patients referred to a single rheumatology clinic for bone mineral density measurements from 2009 to 2010. All patients who had bone mineral density measurements taken from the hip, lumbar spine, forearm, and whole body were enrolled in the study. Standard bone mineral density measurements were performed using a dual energy X-ray absorptiometry device (Hologic Delphi A; Hologic, Bedford, MA, USA). Bone mineral density, Z-score, and T-score were measured for all patients and all body regions.

Conclusion

Using the same cutoff points for whole-body measurements as for site-specific measurements will result in overestimation or especially underestimation of osteopenia and osteoporosis diagnosis. Choosing new and appropriate cutoff points for whole-body densitometric measurements when we want to substitutes this assessment instead of site specific measurements seems mandatory and will decrease the rate of false diagnoses of densitometric deficiencies in these anatomical sites.

Results

The mean age of the 152 participating patients was 56.7 ± 12.6 years, and 97.4% were female. Pearson correlation coefficients of the whole-body bone mineral density values compared with site-specific values in patients over age 50 were 0.66 – 0.75. Using T-score cutoff points of -1 and -2.5 for osteopenia and osteoporosis, whole-body measurements underestimated the percentage of abnormal patients compared with the site-specific measurements (all P < 0.001). Using receiver operating characteristic (ROC) analysis, the whole-body bone mineral density showed respective areas under the curve of 0.96 and 0.84 for the diagnosis of abnormal hip bone mineral density and osteoporosis.

Background

Using the same cutoff points for whole-body measurements as for site-specific measurements will result in underestimation of osteoporosis.

Objectives

We assessed the correlation between densitometry measurements for the whole body with those for the femur, lumbar spine, and forearm to evaluate the possibility of replacing site-specific values with whole-body measurements.

Patients and Methods

In this cross-sectional study, we evaluated all patients referred to a single rheumatology clinic for bone mineral density measurements from 2009 to 2010. All patients who had bone mineral density measurements taken from the hip, lumbar spine, forearm, and whole body were enrolled in the study. Standard bone mineral density measurements were performed using a dual energy X-ray absorptiometry device (Hologic Delphi A; Hologic, Bedford, MA, USA). Bone mineral density, Z-score, and T-score were measured for all patients and all body regions.

Conclusion

Using the same cutoff points for whole-body measurements as for site-specific measurements will result in overestimation or especially underestimation of osteopenia and osteoporosis diagnosis. Choosing new and appropriate cutoff points for whole-body densitometric measurements when we want to substitutes this assessment instead of site specific measurements seems mandatory and will decrease the rate of false diagnoses of densitometric deficiencies in these anatomical sites.

Results

The mean age of the 152 participating patients was 56.7 ± 12.6 years, and 97.4% were female. Pearson correlation coefficients of the whole-body bone mineral density values compared with site-specific values in patients over age 50 were 0.66 – 0.75. Using T-score cutoff points of -1 and -2.5 for osteopenia and osteoporosis, whole-body measurements underestimated the percentage of abnormal patients compared with the site-specific measurements (all P < 0.001). Using receiver operating characteristic (ROC) analysis, the whole-body bone mineral density showed respective areas under the curve of 0.96 and 0.84 for the diagnosis of abnormal hip bone mineral density and osteoporosis.

Background

Using the same cutoff points for whole-body measurements as for site-specific measurements will result in underestimation of osteoporosis.

Objectives

We assessed the correlation between densitometry measurements for the whole body with those for the femur, lumbar spine, and forearm to evaluate the possibility of replacing site-specific values with whole-body measurements.

Bone;Osteopenia;Osteoporosis;Diagnostic Imaging;Densitometry Bone;Osteopenia;Osteoporosis;Diagnostic Imaging;Densitometry http://www.Iranjradiol.com/index.php?page=article&article_id=25609 Alireza Rajaei Alireza Rajaei Department of Rheumatology, Loghman e Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Rheumatology, Loghman e Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Pooneh Dehghan Pooneh Dehghan Department of Imaging, Research Development Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Imaging, Research Development Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: +98-9123130026 Department of Imaging, Research Development Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Imaging, Research Development Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: +98-9123130026 Saideh Ariannia Saideh Ariannia Department of Rheumatology, Loghman e Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Rheumatology, Loghman e Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Arman Ahmadzadeh Arman Ahmadzadeh Department of Rheumatology, Loghman e Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Rheumatology, Loghman e Hakim Hospital, Shahid Beheshti 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 Kourosh Sheibani Kourosh Sheibani Clinical Research and Development Center, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Clinical Research and Development Center, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran