SA Journal of Radiology - Volume 17, Issue 2, 2013
Volume 17, Issue 2, 2013
Author Razaan DavisSource: SA Journal of Radiology 17 (2013)More Less
The pattern and prevalence of vertebral artery injury in patients with cervical spine fractures : original articleSource: SA Journal of Radiology 17, pp 52 –55 (2013)More Less
Aim. It is not uncommon for vertebral artery injury to occur when there are fractures through the transverse foraminae of the first to the sixth vertebral bodies. Other important risk factors for vertebral artery injury include facet joint dislocations and fractures of the first to the third cervical vertebral bodies. The aim of this study was to determine the pattern and prevalence of vertebral artery injury on CT angiography (CTA) in patients with cervical spine fractures.
Method. A retrospective review of patients who had undergone CTA of the vertebral arteries was undertaken. Reports were reviewed to determine which patients met the inclusion criteria of having had both cervical spine fractures and CTA of the vertebral arteries. Images of patients who met the inclusion criteria were analysed by a radiologist.
Results. The prevalence of vertebral artery injury was 33%. Four out of the 11 patients who had vertebral artery injury had post-traumatic spasm of the artery, with associated thrombosis or occlusion of the vessel. In terms of blunt carotid vertebral injury (BCVI) grading, most of the patients sustained grade IV injuries. Four patients who had vertebral artery injury had fractures of the upper cervical vertebrae, i.e. C1 - C3. Fifteen transverse process fractures were associated with vertebral artery injury. No vertebral artery injury was detected in patients who had facet joint subluxations.
Conclusion. Patients with transverse process fractures of the cervical spine and upper cervical vertebral body fractures should undergo CTA to exclude vertebral artery injury.
Source: SA Journal of Radiology 17, pp 57 –58 (2013)More Less
Intrahepatic portosystemic venous shunts are rare vascular anomalies that may be detected in asymptomatic patients, given the recent advances in radiological imaging techniques. Accurate shunt evaluation and classification can be performed with ultrasound and multi-detector computed tomography. We report an unusual case of an intrahepatic portosystemic venous shunt with an incidental finding of neurofibromata.
Tracheal bronchus and pulmonary, hepatic and renal vascular congenital abnormalities - a case report : case reportSource: SA Journal of Radiology 17, pp 59 –61 (2013)More Less
Tracheal bronchus, also referred to as bronchus suis or pig's bronchus, is a rare tracheobronchial anomaly in which an ectopic bronchus arises from the lateral wall of the trachea above the carina and supplies the entire upper lobe or a segment of the upper lobe. It affects 0.5 - 2% of the population and may be detected incidentally, or in patients who present with bronchospasm, persistent cough, recurrent upper lobe infections and haemoptysis. Surgical resection is reserved for patients with severe or persistent symptoms that are resistant to treatment. We present a case of a symptomatic 5-month-old baby who had a type II right-sided tracheal bronchus on bronchography and CT.
Source: SA Journal of Radiology 17, pp 63 –64 (2013)More Less
Primary malignancy of the urachal remnant is a rare neoplasm that accounts for less than 0.01% of all adult cancers, with an estimated annual incidence of 1:5 million. The tumour carries a grave prognosis that attests to its highly aggressive nature. Owing to its extra-peritoneal location, the tumour runs a relatively silent clinical course until late presentation, when most patients display extensive local invasion and metastatic spread. In this report, we highlight a case of primary malignancy of the urachus that on initial clinical evaluation masqueraded as a Sister Mary Joseph's nodule. Characteristic imaging features, however, proved decisive in establishing the diagnosis of a urachal carcinoma.
Source: SA Journal of Radiology 17, pp 65 –67 (2013)More Less
Pseudoachondroplasia is an autosomal dominant skeletal dysplasia that results in disproportionately short stature, severe brachydactyly with strikingly lax small joints, malalignments of the lower limbs, and characteristic radiological features. Although named 'false achondroplasia', the entity is a distinct condition, in which affected individuals are born with normal length and have a normal facies, but is often only recognised after the age of 2 years, when the disproportion and waddling gait become evident. We report on an affected South African father and daughter, and highlight their clinical and radiographic features.
Source: SA Journal of Radiology 17, pp 68 –69 (2013)More Less
Chronic pulmonary tuberculosis may present as massive haemoptysis. Haemoptysis usually originates from the bronchial artery but the pulmonary artery might be the culprit vessel in recurrent haemoptysis. We present a case where bronchial artery embolisation had to be augmented by pulmonary artery coil embolisation for a Rasmussen's aneurysm after recurrent haemoptysis. In cases where recurrent haemorrhage occurs, sources other than the bronchial artery should be considered.
Source: SA Journal of Radiology 17, pp 70 –71 (2013)More Less
Author S.K. MisserSource: SA Journal of Radiology 17, pp 72 –73 (2013)More Less
We congratulate Professor Savvas Andronikou of the Department of Radiology, University of Pretoria, for his spot-on diagnosis, for which he receives the award of R1 000 from the RSSA. Dr Misser elaborates below on the images and findings. Please refer to page 45 of the March 2013 issue of the SAJR (http://dx.doi.org/10.7196/SAJR.843) for the investigative images.