SA Journal of Radiology - Volume 9, Issue 3, 2005
Volume 9, Issue 3, 2005
Author Peter CorrSource: SA Journal of Radiology 9 (2005)More Less
Extracted from text ... 2 SA JOURNAL OF RADIOLOGY ? October 2005 EDITORIAL MR breast imaging - does it have a place in your practice? Peter Corr FFRad (D) SA Department of Radiology University of KwaZulu-Natal and Inkosi Albert Luthuli Hospital Durban The incidence of breast cancer appears to be increasing worldwide, especially in Western countries, and also in South Africa. The demand among patients for breast cancer screening is increasing as they become better informed about the benefits of early detection. Radiologists have an important role to play in educating patients on the benefits of breast screening for cancer. MR breast imaging ..
Source: SA Journal of Radiology 9, pp 4 –6 (2005)More Less
Breast MR is a sensitive but nonspecific imaging investigation to detect breast cancer. MR imaging strengths lie in the accurate staging of the primary tumour, detecting recurrent cancer following lumpectomy and radiation therapy, problem solving in cases where there are equivocal mammographic findings, and screening for breast cancer in younger women with familial breast cancer. Interpretation of MR images requires a meticulous imaging technique including the use of contrast enhancement and fat suppression MR sequences using a good breast coil.
Source: SA Journal of Radiology 9, pp 7 –8 (2005)More Less
Breast MR imaging is the most accurate imaging investigation to detect breast prosthesis rupture. Rupture is common in older prostheses (> 10 years post implantation) and is often asymptomatic. The radiological signs of rupture are due to collapse of the elastomer shell which is eneveloped by silicone gel and when the silicone gel separates the elastomer shell from the surrounding fibrous breast capsule.
Pre-eclampsia, eclampsia and the thrombotic microangiopathic syndromes of pregnancy : review articleAuthor I.C. DuncanSource: SA Journal of Radiology 9, pp 9 –12 (2005)More Less
Extracted from text ... Introduction The pregnancy-related syndromes of pre-eclampsia, eclampsia, the Haemolysis, Elevated Liver enzymes and Low Platelets or HELLP syndrome, and the Thrombotic Thrombocytopenic Purpura/Haemolytic Uraemic Syndrome (TTP/HUS) are a group of disorders sharing various clinical and pathogenetic features, principally related to endothelial damage and development of thrombotic microangiopathy triggered by pregnancy. The clinical abnormalities of these disorders include neurological disturbances, acute renal failure, hypertension, haemolysis, deranged liver enzymes, and thrombocytopenia. This review looks at the similarities and differences between these various pregnancy-related syndromes as well as some of the relevant imaging features that may sometimes be encountered by radiologists. Definitions Gestational ..
Author G. BihlSource: SA Journal of Radiology 9, pp 14 –16 (2005)More Less
Extracted from text ... Kidney dysfunction is a serious complication that can occur following the administration of contrast media (CM). Although the incidence of contrast nephropathy (CN) is low in the general population (1 - 2%) it poses a serious risk to those with impaired kidney function. Other risks include diabetes, old age and dehydration. The first step in prevention is to identify patients at risk. In such patients a small dose of non-ionic iso-osmolar CM together with adequate hydration (preferably an intravenous infusion of 0.45% or 0.9% normal saline) and oral N-acetylcysteine (NAC) dramatically reduces CN. Although the disease occurs infrequently with normal ..
Source: SA Journal of Radiology 9, pp 17 –21 (2005)More Less
How contrast medium-induced nephropathy (CIN) comes about is poorly understood, although CIN is a common cause of acute renal failure. Hitherto, the various studies performed have led to different interpretations and partially contradictory conclusions. This article aimed to review the mechanisms underlying CIN and to outline existing data obtained with the newer iodinated agents in patients with pre-existing renal failure. Osmolality, which has received considerable attention, is but one of several physico-chemical properties of contrast media (CM). The more recently developed iso-osmolar CM are dimers, not monomers as the widely used non-ionic low osmolar CM. Thus, in spite of them being iso-osmolar, they have physicochemical features different from other CM, e.g. in terms of viscosity (> 5 fold greater than plasma viscosity), which may be of considerable pathophysiologic and clinical importance. Many experimental studies provide evidence for greater perturbation in renal function with iso-osmolar CM compared with non-ionic lowosmolar CM. Conversely, some clinical trials indicate an advantage of the iso-osmolar CM, although others do not. In this review, the possible causes of CIN are highlighted, including altered rheological properties, perturbation of renal haemodynamics, regional hypoxia, auto- and paracrine factors (adenosine, endothelin, reactive oxygen species) and direct cytotoxic effects. It is concluded that caution must be taken to avoid a false sense of security with the use of iso-osmolar CM.
Source: SA Journal of Radiology 9, pp 22 –24 (2005)More Less
Extracted from text ... Introduction Vertebral haemangioma is the most common benign tumour of the spine.1 The prevalence of spinal haemangiomas varies from 10% to 12% from postmortem and radiographic studies.1, 2 Sixty per cent of patients with haemangiomas are asymptomatic and are discovered as incidental findings on imaging.3 Twenty per cent of patients present with pain, which is usually not related to the spinal haemangioma.3 However approximately 20% of patients become symptomatic with increasing pain related to the haemangioma, or less commonly with progressive neurological signs with or without signs of spinal cord compression. 3, 4 We present 4 cases to demonstrate ..
Source: SA Journal of Radiology 9, pp 26 –28 (2005)More Less
Fibrous mastopathy is a condition seen mainly in premenopausal, insulin-dependent diabetics. The condition simulates breast cancer and is often poorly recognised. One of the main reasons for reporting this well-described entity is to make radiologists and surgeons more aware of this condition, thereby reducing unnecessary morbidity by establishing a correct diagnosis more efficiently, and differentiating it from breast carcinoma.
Source: SA Journal of Radiology 9, pp 29 –32 (2005)More Less
Neutropenic enterocolitis is a lethal, necrotising inflammation of the caecum and contiguous bowel, found in immunocompromised, neutropenic patients. A high index of clinical suspicion coupled with appropriate imaging modalities allows earlier diagnosis and can expedite the management of these severely ill patients. We describe the clinico-radiological features of this condition in the following case report, as well as a brief management approach to this rare, but increasingly recognised condition.
Source: SA Journal of Radiology 9, pp 34 –35 (2005)More Less
Hydatid disease is endemic to South Africa. Radiological findings may help establish the diagnosis and aid preoperative preparation. Unusual locations and atypical imaging appearances may complicate the differential diagnosis. A case of isolated hydatid disease mimicking choledochal cyst is presented. Primary hydatid disease of the pancreas in the paediatric population is rare and this is only the sixth case reported in the English literature. This article highlights the importance of always considering hydatid disease in our patient population whenever a cystic mass of the pancreas is identified.