SA Journal of Radiology - Volume 10, Issue 1, 2006
Volume 10, Issue 1, 2006
Author Julian L. HollSource: SA Journal of Radiology 10 (2006)More Less
Extracted from text ... EDITORIAL Forensic radiology J L H?ll, MB ChB, FFRad (D)SA Department of Radiology, Pretoria Academic Hospital, and University of Pretoria The radiological fraternity has played a significant role in the new South Africa, but taking our previous history into account and living in an era of human rights and social change we must realise that far more will be expected of us, including in the field of forensic radiology. Forensic pathology was the first field of medicine to use the new Ray as described by Ro?ntgen on 8 November 1895. Long before any pathological diagnosis had been made, or ..
Air embolus revisited - a diagnostic and interventional radiological perspective (bubble trouble and the dynamic Mercedes Benz sign) : review articleSource: SA Journal of Radiology 10, pp 3 –7 (2006)More Less
Air embolus has always been a recognised hazard within the practice of diagnostic imaging. This is now, more than ever, the case with the advent of the widespread use of pump injectors for intravenous contrast delivery and the increasing use of percutaneous interventions in the lungs. <br>The different clinical syndromes associated with air embolus in the systemic venous (right heart) circulation and the systemic arterial (left heart) circulation need to be clearly understood in order to diagnose and treat these conditions in the clinical setting. <br>This article reviews the topic of air embolus, including diagnosis and treatment, as this specifically relates to the practice of diagnostic and interventional radiology. The article also includes images relating to the depiction of air embolus, with attention drawn to a commonly encountered imaging appearance or sign.
Source: SA Journal of Radiology 10, pp 8 –10 (2006)More Less
Mammography is the most widely used diagnostic imaging method for screening and diagnosing breast cancer. Nevertheless, this technique has some limitations in that not all breast cancers are evident on mammograms, especially in dense or dysplastic breasts, patients with breast prosthesis or if the patient has previously undergone radiation, surgery or biopsy. Scintimammography (SM) is the functional imaging study of the breast with radiopharmaceuticals, such as <sup>99m</sup>Tc-labelled methoxyisobutylisonitrile (<sup>99m</sup>Tc-MIBI). SM is currently used as a complementary test to mammography in patients with suspected breast cancers. This study was undertaken to evaluate the impact of SM on the management of patients with a suspicious lesion detected by palpation or mammography. <br><I>Methods.</I> We performed a prospective study of 53 patients with a suggestion of breast cancer, either on palpation or mammography. Planar imaging was performed after injection of <sup>99m</sup>Tc-MIBI. Results were compared with histopathological analysis in all cases. <br><I>Results.</I> Breast cancer was proven in 11 cases. SM had a sensitivity of 90.9% and a specificity of 97.6%. SM correctly evaluated multicentricity or bilaterality in 3 of 11 patients and detected axillary lymph node in 1 patient. SM made the diagnosis of benign lesions in 41 cases with doubtful diagnosis, thus potentially avoiding biopsy in 77% of cases. <br><I>Conclusion. </I>SM is a useful complementary tool for the diagnosis and evaluation of disease extent in patients with an inconclusive diagnosis and can decrease the number of negative breast biopsies.
Source: SA Journal of Radiology 10, pp 11 –13 (2006)More Less
Extracted from text ... Introduction Bilateral paramedian thalamic infarction is rare. The suggested mechanism is occlusion of a single central thalamic perforating artery - an anatomic variant described by Percheron in 1977.1 Bilateral paramedian thalamic infarctions may result in the classic triad of hypersomnolence (excessive sleepiness), ocular disturbances (supranuclear and vertical gaze palsy) and neuropsychological deficits (including an amnestic syndrome). 2 The paramedian thalamus is believed to play an important role in the regulation of sleep and disturbances in sleep regulation are known to occur in paramedian thalamic stroke (PTS). Because of the absence of lateralising signs in PTS ('inobvious stroke') disturbance of consciousness ..
Source: SA Journal of Radiology 10, pp 14 –15 (2006)More Less
Botryomycosis is a rare condition that involves the skin and viscera. It is multifactorial in its development, characterised by granulomatous bacterial infection. The organisms form granules composed of bacterial masses that are adhered to each other. We present a case of botryomycosis with calvarial destruction.
Author R.A. AhmedSource: SA Journal of Radiology 10, pp 16 –17 (2006)More Less
There are 2 reasons for sonar and mammography evaluation of augmented breasts, namely to rule out malignancy and to asses the integrity of the implant. Silicon implants have been used since 1962 by an estimated 2 million women. Reviewing the literature and our case, there is no increased risk of breast carcinoma. Neither is there an increased risk of diagnosing a more advanced stage of cancer at the time of diagnosis. The available data do not indicate any significant difference between the characteristics of breast cancer in women with breast implants and those of women in the control population.
Source: SA Journal of Radiology 10, pp 18 –20 (2006)More Less
Primitive neuroectodermal tumours (PNETs) are tumours from pluripotent neural crest cells and may occur in the central or peripheral nervous system. PNET must be distinguished from other small round cell tumours like Ewing's sarcoma (ES), extraosseous Ewing's sarcoma, neuroblastoma, lymphoma, rhabdomyosarcoma and small-cell carcinoma. Although it can occur at any age, PNET occurs more frequently in adolescents and young adults with a median age of 17 years.
Author N. AdroosSource: SA Journal of Radiology 10, pp 21 –22 (2006)More Less
Extracted from text ... A 1-year 5-month-old boy presented to the casualty department at Kalafong Hospital with diarrhoea, coughing, fever and weight loss. On examination he was found to be anaemic, peripherally cyanotic and had clubbing of his fingers. On auscultation there were crepitations in the right axilla and a pansystolic murmur over the entire chest. He had a pulse rate of 170/min, a respiratory rate of 44/min and the oxygen saturation at room air was 60 - 70% and on 100% oxygen, 60 - 80%. On the chest radiograph (CXR) a right middle and lower lobe consolidation was noted (Fig. 1). The diagnosis ..
Source: SA Journal of Radiology 10, pp 23 –24 (2006)More Less
Extracted from text ... Introduction Central pontine myelinolysis is a demyelinating disease of the pons characterised by loss of myelin and oligodendroglia with relative neuron sparing. This condition classically occurs in alcoholics, malnourished or chronically debilitated adults1 and usually occurs in the hospital setting, a few days following rapid correction of hyponatraemia.We report a case of central pontine myelinolysis in a chronic alcoholic, malnourished patient following rapid correction of hyponatraemia. Case report A 44-year-old man presented to the emergency department with generalised weakness and altered speech of 1 week's duration. There was a history of an accidental fall at home with scalp injury. The ..
Source: SA Journal of Radiology 10, pp 25 –27 (2006)More Less
Congenital bilateral perisylvian syndrome (CBPS) was traditionally associated with pseudobulbar palsy, cognitive deficits and epilepsy. However studies have found that the clinical spectrum of CBPS is much broader including patients without epilepsy, but with serious developmental language disorder. Magnetic resonance imaging (MRI) has been associated with either diffuse polymicrogyria around the entire extent of the sylvian fissure or in the posterior aspects of the parietal regions, in which case it is called posterior parietal polymicrogyria. <BR>This article discusses the possible embryological origin of these lesions, the MRI findings using specific protocols and the ability of thinslice MRI 1.5 Tesla units to make the diagnosis of bilateral posterior parietal polymicrogyria in a child with speech pathology.
Source: SA Journal of Radiology 10, pp 28 –29 (2006)More Less
Extracted from text ... CASE REPORT 28 SA JOURNAL OF RADIOLOGY ? March 2006 A variety of pips and chewed nuts can simulate disease by appearing as multiple filling defects on the double-contrast barium enema. The unwary and untrained eye might interpret these filling defects as multiple polyps, leading to the wrong diagnosis and unnecessary further investigations or treatment. A case of multiple linseeds mimicking polyposis coli on doublecontrast barium enema has been described by Petty and Mannion.1 The following similar cases were noted. Case 1. A 73-year-old woman presented with abdominal pain. A double-contrast barium enema showed multiple pointed oval-shaped filling defects (Fig. ..
Source: SA Journal of Radiology 10 (2006)More Less
Extracted from text ... CASE REPORT 30 SA JOURNAL OF RADIOLOGY ? March 2006 The 'twinkling sign' is described as a colour Doppler artifact in which a rapidly changing mixture of red and blue colours is displayed distal to a strongly, rough reflective structure (Figs 1 and 2).1 This probably results from complex back scatter of the ultrasound waves with prolonged pulse duration, interpreted by Doppler as movement.2 This sign is a fundamental artifact because it is well detected by the digital Doppler system which has a higher noise immunity. The focal depth minimally affects the shape of the artifact by narrowing its focal ..
Author G. RozendaalSource: SA Journal of Radiology 10, pp 31 –32 (2006)More Less
Extracted from text ... Parotid gland enlargement may be the presenting clinical manifestation of systemic HIV infection in children as well as adults.1 Comprehensive salivary gland evaluation is therefore mandatory in patients with uni- or bilateral parotid gland swelling. This article highlights the imaging techniques (ultrasound, computed tomography (CT), magnetic resonance imaging (MRI)) used in the investigation of salivary gland enlargement and identifies the specific radiological signs found in HIV infection. The presence of diffuse, multiple cysts in one or both enlarged parotid glands represents benign lymphoepithelial proliferation with cyst formation and is found in systemic HIV infection. Concurrent hyperplastic cervical and intraparotid lymphadenopathy ..
Source: SA Journal of Radiology 10, pp 33 –35 (2006)More Less
Extracted from text ... by Aadil Ahmed and Mala Modi Soboleski D, Therialt C, Acker A. Unnecessary irradiation to non - thoracic structures during pediatric chest radiography. Pediatr Radiol 2006; 36: 22 - 25. This article highlights the fact that our present positioning techniques for paediatric chest radiographs result in unnecessary radiation exposure to non-thoracic structures. Pearls: ? Infants and young children have a higher sensitivity than older children and adults to radiation exposure and the potential for harmful side-effects. ? The ratio of radiation exposure to nonthoracic structures increases as the age of the patient decreases. ? ? 43% of the length of ..