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RADIOLOGY AND NUCLEAR MEDICINE (156 journals)                  1 2     

Abdominal Imaging     Hybrid Journal   (Followers: 11)
Academic Radiology     Hybrid Journal   (Followers: 17)
Acta Cytologica     Full-text available via subscription   (Followers: 3)
Acta Radiologica     Hybrid Journal   (Followers: 4)
Acta Radiologica Short Reports     Open Access   (Followers: 1)
Advances in Computed Tomography     Open Access   (Followers: 2)
AINS - Anasthesiologie - Intensivmedizin - Notfallmedizin - Schmerztherapie     Hybrid Journal   (Followers: 2)
Alasbimn Journal     Open Access  
American Journal of Neuroradiology     Full-text available via subscription   (Followers: 8)
American Journal of Roentgenology     Full-text available via subscription   (Followers: 11)
Annals of Nuclear Medicine     Hybrid Journal   (Followers: 3)
Annals of the ICRP     Hybrid Journal  
Applied Radiology     Full-text available via subscription   (Followers: 7)
Asia Oceania Journal of Nuclear Medicine & Biology     Open Access   (Followers: 1)
Biomedical Imaging and Intervention Journal     Open Access   (Followers: 5)
Biomedical Spectroscopy and Imaging     Hybrid Journal   (Followers: 2)
BMC Medical Imaging     Open Access   (Followers: 6)
BMC Nuclear Medicine     Open Access   (Followers: 5)
British Journal of Radiology     Full-text available via subscription   (Followers: 10)
Canadian Association of Radiologists Journal     Full-text available via subscription   (Followers: 3)
Cancer Biotherapy & Radiopharmaceuticals     Hybrid Journal   (Followers: 3)
Cancer Radiothérapie     Full-text available via subscription   (Followers: 1)
Case Reports in Radiology     Open Access   (Followers: 5)
Cellular Senescence and Therapy     Open Access  
Clinical and Translational Imaging     Hybrid Journal  
Clinical Imaging     Hybrid Journal   (Followers: 4)
Clinical Neuroradiology     Hybrid Journal   (Followers: 2)
Clinical Nuclear Medicine     Hybrid Journal   (Followers: 3)
Clinical Radiology     Hybrid Journal   (Followers: 7)
Computerized Medical Imaging and Graphics     Hybrid Journal   (Followers: 9)
Concepts in Magnetic Resonance Part A     Hybrid Journal  
Contemporary Diagnostic Radiology     Full-text available via subscription   (Followers: 2)
Contrast Media & Molecular Imaging     Hybrid Journal  
Critical Ultrasound Journal     Open Access   (Followers: 1)
Current Medical Imaging Reviews     Hybrid Journal   (Followers: 2)
Current Problems in Diagnostic Radiology     Hybrid Journal   (Followers: 4)
Current Radiology Reports     Hybrid Journal   (Followers: 1)
Der Nuklearmediziner     Hybrid Journal  
Der Radiologe     Hybrid Journal  
Diagnostic and Interventional Radiology     Free   (Followers: 3)
DNA and RNA Nanotechnology     Open Access  
Egyptian Journal of Radiology and Nuclear Medicine     Open Access   (Followers: 1)
Emergency Radiology     Hybrid Journal   (Followers: 4)
European Journal of Nanomedicine     Full-text available via subscription   (Followers: 3)
European Journal of Nuclear Medicine and Molecular Imaging     Hybrid Journal   (Followers: 8)
European Journal of Radiography     Full-text available via subscription   (Followers: 4)
European Journal of Radiology     Hybrid Journal   (Followers: 5)
European Radiology     Hybrid Journal   (Followers: 7)
European Radiology Supplements     Hybrid Journal   (Followers: 2)
Feuillets de Radiologie     Full-text available via subscription   (Followers: 1)
Frontiers in Neurogenesis     Open Access  
IEEE Transactions on Medical Imaging     Hybrid Journal   (Followers: 8)
Imagen Diagnóstica     Full-text available via subscription  
Imaging     Full-text available via subscription   (Followers: 2)
Imaging Decisions MRI     Hybrid Journal   (Followers: 2)
Imaging in Medicine     Full-text available via subscription   (Followers: 1)
Indian Journal of Nuclear Medicine     Open Access   (Followers: 3)
Indian Journal of Radiology and Imaging     Open Access   (Followers: 1)
Insights into Imaging     Open Access  
International Journal of Medical Physics, Clinical Engineering and Radiation Oncology     Open Access   (Followers: 4)
International Journal of Radiation Biology     Hybrid Journal   (Followers: 4)
International Journal of Tomography & Simulation     Full-text available via subscription   (Followers: 2)
Interventionelle Radiologie Scan     Hybrid Journal   (Followers: 1)
Investigative Radiology     Hybrid Journal   (Followers: 3)
Iranian Journal of Nuclear Medicine     Open Access   (Followers: 1)
Iranian Journal of Radiology     Open Access   (Followers: 2)
Japanese Journal of Radiology     Hybrid Journal   (Followers: 1)
Journal de Radiologie     Full-text available via subscription   (Followers: 1)
Journal de Radiologie Diagnostique et Interventionnelle     Full-text available via subscription   (Followers: 2)
Journal of Clinical Imaging Science     Open Access   (Followers: 1)
Journal of Computer Assisted Tomography     Hybrid Journal   (Followers: 2)
Journal of Diagnostic Medical Sonography     Hybrid Journal   (Followers: 1)
Journal of Diagnostic Radiography and Imaging     Hybrid Journal   (Followers: 3)
Journal of Forensic Radiology and Imaging     Full-text available via subscription  
Journal of Innovative Optical Health Sciences     Open Access  
Journal of Liver : Disease & Transplantation     Full-text available via subscription  
Journal of Magnetic Resonance Imaging     Hybrid Journal   (Followers: 7)
Journal of Medical Imaging and Radiation Oncology     Hybrid Journal   (Followers: 3)
Journal of Medical Imaging and Radiation Sciences     Hybrid Journal   (Followers: 5)
Journal of Medical Radiation Sciences     Open Access   (Followers: 2)
Journal of Neuroradiology     Full-text available via subscription   (Followers: 3)
Journal of Nuclear Medicine     Full-text available via subscription   (Followers: 10)
Journal of Nuclear Medicine & Radiation Therapy     Open Access   (Followers: 1)
Journal of Nucleic Acids Investigation     Open Access   (Followers: 2)
Journal of Pediatric Neuroradiology     Hybrid Journal   (Followers: 3)
Journal of Radiation Research     Open Access   (Followers: 3)
Journal of Radiation Research and Applied Sciences     Open Access   (Followers: 1)
Journal of Radiological Protection     Full-text available via subscription   (Followers: 4)
Journal of Radiology Case Reports     Open Access   (Followers: 1)
Journal of Radiology Nursing     Hybrid Journal   (Followers: 2)
Journal of Radiosurgery     Hybrid Journal   (Followers: 1)
Journal of Radiotherapy     Open Access  
Journal of Radiotherapy in Practice     Hybrid Journal   (Followers: 2)
Journal of Surgical Radiology     Open Access   (Followers: 2)
Journal of the American College of Radiology     Hybrid Journal   (Followers: 2)
Journal of Thoracic Imaging     Hybrid Journal   (Followers: 3)
Journal of Vascular and Interventional Radiology     Hybrid Journal   (Followers: 3)
La radiologia medica     Hybrid Journal  
Magnetic Resonance Imaging     Hybrid Journal   (Followers: 3)
Magnetic Resonance Imaging Clinics of North America     Full-text available via subscription   (Followers: 2)

        1 2     

Journal of Clinical Imaging Science
   [3 followers]  Follow    
  This is an Open Access Journal Open Access journal
     ISSN (Print) 2156-7514 - ISSN (Online) 2156-5597
     Published by Medknow Publishers Homepage  [177 journals]
  • Osteonecrosis Secondary to Paget's disease: Radiologic and
           Pathologic Features

    • Authors: Naveen Polisetti, Mahesh Neerupakam, Venkata Sarath Prathi, Jacob Prakash, D Vaishnavi, Swapna Sridevi Beeraka, Deepthi Bhavirisetty, Naveen Polisetti, Mahesh Neerupakam, Venkata Sarath Prathi, Jacob Prakash, D Vaishnavi, Swapna Sridevi Beeraka, Deepthi Bhavirisetty
      Pages: 1 - 1
      Abstract: Naveen Polisetti, Mahesh Neerupakam, Venkata Sarath Prathi, Jacob Prakash, D Vaishnavi, Swapna Sridevi Beeraka, Deepthi Bhavirisetty, Naveen Polisetti, Mahesh Neerupakam, Venkata Sarath Prathi, Jacob Prakash, D Vaishnavi, Swapna Sridevi Beeraka, Deepthi Bhavirisetty

      Journal of Clinical Imaging Science 2014 4(2):1-1

      Paget's disease (PD) is a chronic progressive disease of the bone characterized by abnormal bone metabolism affecting either a single bone (monostotic) or many bones (polyostotic) with uncertain etiology. We report a case of PD in a 70-year-old male, which was initially identified as osteonecrosis of the maxilla. Non-drug induced osteonecrosis in PD is rare and very few cases have been reported in the literature.
      Citation: Journal of Clinical Imaging Science 2014 4(2):1-1
      PubDate: Fri,21 Mar 2014
      DOI: 10.4103/2156-7514.129262
      Issue No: Vol. 4, No. 2 (2014)
       
  • Diagnostic Accuracy of CBCT for Aggressive Periodontitis

    • Authors: Ranjana Mohan, Ruhi Mark, Ipsa Sing, Ankita Jain
      Pages: 2 - 2
      Abstract: Ranjana Mohan, Ruhi Mark, Ipsa Sing, Ankita Jain

      Journal of Clinical Imaging Science 2014 4(2):2-2

      Cone beam computed tomography (CBCT) is an indispensable diagnostic imaging tool for dento-alveolar examination. CBCT scanning has become a valuable imaging modality in the field of Periodontology for the detection of very small osseous defects. A patient reported to the department of Periodontology with a complaint of loose teeth. Clinical and direct digital radiographic (DDR) examination revealed advanced periodontal destruction, but failed to diagnose the morphology of generalized osseous defects, around all the surfaces of each tooth. CBCT images were obtained for detailed examination of each and every osseous defect around all the teeth. Patient was then diagnosed with generalized aggressive periodontitis. Flap surgery was performed in order to eliminate the periodontal pockets, exposing and degranulating the osseous defects. Actual measurements of surgically exposed osseous defects were compared with that seen in CBCT images and found to be exactly identical. CBCT has proved to be as accurate in measuring osseous defects as direct measurements with a periodontal probe. Buccal and lingual periodontal defects that could not be diagnosed by conventional radiography can be identified with CBCT.
      Citation: Journal of Clinical Imaging Science 2014 4(2):2-2
      PubDate: Tue,27 May 2014
      DOI: 10.4103/2156-7514.133258
      Issue No: Vol. 4, No. 2 (2014)
       
  • Unusual Unilateral Fracture of the Condylar and Coronoid Processes of the
           Mandible

    • Authors: Timucin Baykul, M Asim Aydin, Muge Cina Aksoy, Yavuz Findik
      Pages: 3 - 3
      Abstract: Timucin Baykul, M Asim Aydin, Muge Cina Aksoy, Yavuz Findik

      Journal of Clinical Imaging Science 2014 4(2):3-3

      The incidence of condylar fracture is very high and most are not caused by direct trauma. On the other hand, fracture of the coronoid process is reported less often than fracture of other parts of the mandible. We report a case of right subcondylar and coronoid fractures without any evidence of direct trauma to the zygomatic area or an indirect trauma to the mandibular corpus or sypmheseal region. The possible cause was identified as acute reflex contraction of the temporalis muscles leading to coronoid and condylar stress fractures.
      Citation: Journal of Clinical Imaging Science 2014 4(2):3-3
      PubDate: Mon,29 Sep 2014
      DOI: 10.4103/2156-7514.141909
      Issue No: Vol. 4, No. 2 (2014)
       
  • Diagnostic Imaging for Dental Implant Therapy

    • Authors: Aishwarya Nagarajan, Rajapriya Perumalsamy, Ramakrishnan Thyagarajan, Ambalavanan Namasivayam
      Pages: 4 - 4
      Abstract: Aishwarya Nagarajan, Rajapriya Perumalsamy, Ramakrishnan Thyagarajan, Ambalavanan Namasivayam

      Journal of Clinical Imaging Science 2014 4(2):4-4

      Dental implant is a device made of alloplastic (foreign) material implanted into the jaw bone beneath the mucosal layer to support a fixed or removable dental prosthesis. Dental implants are gaining immense popularity and wide acceptance because they not only replace lost teeth but also provide permanent restorations that do not interfere with oral function or speech or compromise the self-esteem of a patient. Appropriate treatment planning for replacement of lost teeth is required and imaging plays a pivotal role to ensure a satisfactory outcome. The development of pre-surgical imaging techniques and surgical templates helps the dentist place the implants with relative ease. This article focuses on various types of imaging modalities that have a pivotal role in implant therapy.
      Citation: Journal of Clinical Imaging Science 2014 4(2):4-4
      PubDate: Mon,27 Oct 2014
      DOI: 10.4103/2156-7514.143440
      Issue No: Vol. 4, No. 2 (2014)
       
  • Management of Mucoepidermoid Carcinoma of the Palate Utilizing 18 F-FDG
           PET/CT

    • Authors: Sankaran Sudhakar, Raga Geethika Velugubantla, Swathi Erva, Sai kiran Chennoju
      Pages: 5 - 5
      Abstract: Sankaran Sudhakar, Raga Geethika Velugubantla, Swathi Erva, Sai kiran Chennoju

      Journal of Clinical Imaging Science 2014 4(2):5-5

      Salivary gland carcinomas are a clinically diverse group of neoplasms with histological patterns overlapping other tumors, thus complicating their diagnosis. Mucoepidermoid carcinoma (MEC), first described by Masson and Berger in 1924, is a well-recognized salivary gland neoplasm, accounting for 5-10% of all salivary gland tumors. MEC frequently involves the major salivary glands and is rarely seen involving the jaws. The biological behavior of MEC is usually more aggressive with higher nodal and metastatic status at the time of presentation, which notably reduces the survival rate. Hence, early and accurate diagnosis utilizing advanced imaging modalities can reduce its morbidity. The present case is a rare presentation of MEC involving the palate, where (18) F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) was utilized for diagnosis and treatment.
      Citation: Journal of Clinical Imaging Science 2014 4(2):5-5
      PubDate: Sat,29 Nov 2014
      DOI: 10.4103/2156-7514.145898
      Issue No: Vol. 4, No. 2 (2014)
       
  • Unintended Thermal Injuries from Radiofrequency Ablation: Organ Protection
           with an Angioplasty Balloon Catheter in an Animal Model

    • Authors: Martha-Grace Knuttinen, Thuong G Van Ha, Christopher Reilly, Anthony Montag, Christopher Straus
      Pages: 1 - 1
      Abstract: Martha-Grace Knuttinen, Thuong G Van Ha, Christopher Reilly, Anthony Montag, Christopher Straus

      Journal of Clinical Imaging Science 2014 4(1):1-1

      Objectives: The aim of this study was to investigate a novel approach of using a balloon catheter as a protective device to separate liver from the diaphragm or nearby bowel during radiofrequency ablation (RFA) of hepatic dome tumors in an animal model. Materials and Methods: All experimental procedures were approved by animal Institutional Review Board. Using a 3 cm RF needle electrode, 70 hepatic ablation zones were created using ultrasound in 7 pigs. 50 lesions were created using balloon interposition between liver and diaphragm; 20 lesions were created using the balloon device interposed posteriorly between liver and bowel. Additional 21 control lesions were performed. Animals were sacrificed immediately; diaphragm and bowel were then visually inspected and sectioned. Diaphragmatic and bowel injury was then classified according to the depth of thickness. Results: Control lesions caused full thickness injury, either to diaphragm or bowel. During ablation of lesions with balloon interposition, there was significantly less diaphragmatic injury, P < 0.001 and less bowel injury, P < 0.01. Conclusion: Using balloon interposition as a protective device has advantages over previous saline infusion or CO 2 insufflation, providing a safe way to expand percutaneous RFA of liver tumors located on the undersurface of the diaphragm. In addition, this method may be used in protection of other organs adjacent to areas being ablated.
      Citation: Journal of Clinical Imaging Science 2014 4(1):1-1
      PubDate: Thu,30 Jan 2014
      DOI: 10.4103/2156-7514.126018
      Issue No: Vol. 4, No. 1 (2014)
       
  • Non-resolving Findings in a Long-term Radiographic Follow-up of an Infant
           with Acute Paraffin Oil Aspiration

    • Authors: George Stathis, Konstantinos N Priftis, Maria Moustaki, Efthymia Alexopoulou
      Pages: 2 - 2
      Abstract: George Stathis, Konstantinos N Priftis, Maria Moustaki, Efthymia Alexopoulou

      Journal of Clinical Imaging Science 2014 4(1):2-2

      Acute lipoid pneumonia (LP) in children is a rare disorder caused by the aspiration of oil-based substances and is difficult to diagnose due to non-specific clinical symptoms and radiological findings. We report the case of a 5-month-old male infant with acute LP caused by accidental aspiration of a large amount of mineral oil. We present the imaging findings in the computed tomography scans performed during his hospitalization and focus on the residual abnormalities seen on a scan performed 7-years after the incident. This, to the best of our knowledge, is the longest follow-up report of an acute exogenous LP patient and the only case that demonstrates non-resolving abnormalities in a pediatric patient after a single acute episode of mineral oil aspiration.
      Citation: Journal of Clinical Imaging Science 2014 4(1):2-2
      PubDate: Thu,30 Jan 2014
      DOI: 10.4103/2156-7514.126028
      Issue No: Vol. 4, No. 1 (2014)
       
  • Nonfunctional Islet Cell Tumor of the Pancreas in a Patient with Tuberous
           Sclerosis: A Case Report with Literature Review

    • Authors: Aysegul Cansu, Ali Ahmetoglu, Sibel Kul, Dilek Uzman, Safak Ersoz
      Pages: 3 - 3
      Abstract: Aysegul Cansu, Ali Ahmetoglu, Sibel Kul, Dilek Uzman, Safak Ersoz

      Journal of Clinical Imaging Science 2014 4(1):3-3

      Islet cell tumors (ICTs) are rare tumors of the pancreas. Association of this type of tumor with tuberous sclerosis is extremely rare. Only 13 cases of pancreatic ICT with tuberous sclerosis have so far been documented in the literature. However, awareness of the association of tuberous sclerosis and ICT is important for early diagnosis and appropriate treatment of this condition. This article presents the case of a 63-year-old female with angiomyolipoma (AML) of the kidney and liver, calcified subependymal nodules and a large mass in the pancreas, which was proven to be an ICT on histopathological examination.
      Citation: Journal of Clinical Imaging Science 2014 4(1):3-3
      PubDate: Thu,30 Jan 2014
      DOI: 10.4103/2156-7514.126022
      Issue No: Vol. 4, No. 1 (2014)
       
  • Malignant Melanoma of the Rectum

    • Authors: Supreethi Kohli, Seema Narang, Anu Singhal, Vinod Kumar, Omkar Kaur, Raj Chandoke
      Pages: 4 - 4
      Abstract: Supreethi Kohli, Seema Narang, Anu Singhal, Vinod Kumar, Omkar Kaur, Raj Chandoke

      Journal of Clinical Imaging Science 2014 4(1):4-4

      Malignant melanoma of the rectum is an extremely rare disease. It typically presents in the fifth or sixth decade of life with nonspecific complaints such as rectal bleeding or anal pain. A timely diagnosis of anal melanoma is made even more difficult by the fact that most of the lesions lack obvious pigmentation and are even histologically amelanotic. Prognosis is very poor. Anorectal malignant melanomas spread along submucosal planes and are often beyond complete resection at the time of diagnosis. We present the radiological and pathological features seen in a 43-year-old woman diagnosed with melanoma of the rectum.
      Citation: Journal of Clinical Imaging Science 2014 4(1):4-4
      PubDate: Thu,30 Jan 2014
      DOI: 10.4103/2156-7514.126031
      Issue No: Vol. 4, No. 1 (2014)
       
  • Symmetrical Chorioretinal Colobomata with Craniovertebral Junction
           Anomalies in CHARGE Syndrome - A Case Report with Review of Literature

    • Authors: Tanie Natung, Amit Goyal, Akash Handique, Manish Kapoor
      Pages: 5 - 5
      Abstract: Tanie Natung, Amit Goyal, Akash Handique, Manish Kapoor

      Journal of Clinical Imaging Science 2014 4(1):5-5

      CHARGE syndrome is a common cause of congenital anomalies. Its rate of incidence is about 1:10,000. It is phenotypically heterogeneous, usually a sporadic or autosomal dominant disorder resulting from a mutation in the CHD7 (chromodomain helicase DNA-binding protein) gene. Since the time it was first described by Hall, [1] the knowledge of the clinical characteristics of CHARGE syndrome has increased over the years. Recently, basiocciput hypoplasia and basilar invagination in patients with CHARGE syndrome have been reported. We report here a case of CHARGE syndrome where there is involvement of symmetrical chorioretinal colobomata with craniovertebral junction anomalies. The patient had symmetrical chorioretinal colobomata, external and inner ear anomalies, sensorineural deafness, characteristic facial appearance, retarded growth and development, history of patent ductus arteriosus, and craniovertebral junction anomalies. Craniovertebral junction anomalies may be an under-diagnosed phenotypic expression of CHARGE syndrome. The diagnostic criteria of CHARGE syndrome may require further revision to include the addition of craniovertebral junction anomalies.
      Citation: Journal of Clinical Imaging Science 2014 4(1):5-5
      PubDate: Thu,30 Jan 2014
      DOI: 10.4103/2156-7514.126046
      Issue No: Vol. 4, No. 1 (2014)
       
  • Two Cases of Spinal, Extraosseous, Intradural Ewing's
           sarcoma/Peripheral Neuroectodermal Tumor: Radiologic, Pathologic, and
           Molecular Analysis

    • Authors: Stacey K Mardekian, Ashish Gandhe, Markku Miettinen, Svetlana Pack, Mark T Curtis, Ziedulla Abdullaev
      Pages: 6 - 6
      Abstract: Stacey K Mardekian, Ashish Gandhe, Markku Miettinen, Svetlana Pack, Mark T Curtis, Ziedulla Abdullaev

      Journal of Clinical Imaging Science 2014 4(1):6-6

      Extraosseous Ewing's sarcoma/peripheral neuroectodermal tumors (ES/PNETs) are rare neoplasms that account for approximately 10%-15% of soft tissue sarcomas in children and 5% of soft tissue sarcomas in adults. Primary spinal, extraosseous, intradural ES/PNETs are even less common. The diagnosis of ES/PNET is extremely challenging, because the tumor can have a nonspecific radiologic appearance, and the histologic features are shared by many other "small round cell tumors." Thus, ES/PNET should be included in the radiologic and pathologic differential diagnosis, even in older patients and in unusual tumor sites. We report two cases of spinal, extraosseous, intradural ES/PNETs in adults who presented with back pain. Magnetic resonance imaging revealed contrast enhancing, intradural lesions in the area of the conus medullaris. The tumor in Case 1 was partially intramedullary, while the tumor in Case 2 was exclusively extramedullary. In both cases, the radiologic and intraoperative surgical impression favored ependymoma. The diagnosis of ES/PNET was established in both cases by histopathologic, immunohistochemical, and molecular analysis.
      Citation: Journal of Clinical Imaging Science 2014 4(1):6-6
      PubDate: Thu,30 Jan 2014
      DOI: 10.4103/2156-7514.126050
      Issue No: Vol. 4, No. 1 (2014)
       
  • Hyperdense Endobronchial Mass - A Rare Manifestation of Metastatic
           Melanoma

    • Authors: Chul Y Chung, Gauruv S Likhari, Neda Zarrin-Khameh, Arun C Nachiappan
      Pages: 7 - 7
      Abstract: Chul Y Chung, Gauruv S Likhari, Neda Zarrin-Khameh, Arun C Nachiappan

      Journal of Clinical Imaging Science 2014 4(1):7-7

      Parenchymal lung metastases are common in malignant melanoma. However, endobronchial metastatic melanoma is uncommon. In this report, we describe a patient with a hyperdense endobronchial mass diagnosed as a melanoma metastasis. We review the imaging findings of pulmonary metastatic melanoma and discuss the differential diagnosis of an endobronchial mass in adults.
      Citation: Journal of Clinical Imaging Science 2014 4(1):7-7
      PubDate: Tue,25 Feb 2014
      DOI: 10.4103/2156-7514.127833
      Issue No: Vol. 4, No. 1 (2014)
       
  • Pulmonary Hyalinizing Granuloma Associated with Idiopathic
           Thrombocytopenic Purpura

    • Authors: Christopher Coleman, Aziza Nassar, Barbara McComb
      Pages: 8 - 8
      Abstract: Christopher Coleman, Aziza Nassar, Barbara McComb

      Journal of Clinical Imaging Science 2014 4(1):8-8

      Pulmonary hyalinizing granuloma (PHG) is a rare, benign lung disease of unknown etiology. It manifests as discrete, rounded nodules within the lung parenchyma. A 39-year-old woman presented for investigation after pulmonary nodules were found incidentally. Chest computed tomography showed multiple, discrete, non-enhancing pulmonary nodules bilaterally. Positron emission tomography (PET) was negative. Biopsy demonstrated a non-specific lymphoplasmacytic infiltrate. Open resection yielded two nodules consistent with hyalinizing granulomas. The differential for multiple pulmonary nodules is broad. PET scan can help rule out metastatic disease, although some cancers are not hypermetabolic on PET. Furthermore, some non-malignant conditions, including hyalinizing granuloma, can show increased activity on PET. PHG should be included in the differential of multiple pulmonary nodules, especially if nodule stability can be demonstrated and/or needle biopsies are non-diagnostic. Associated immune-mediated conditions, such as idiopathic thrombocytopenic purpura (ITP) in our patient, may also favor HG. In this case report we find an association between PHG and ITP.
      Citation: Journal of Clinical Imaging Science 2014 4(1):8-8
      PubDate: Tue,25 Feb 2014
      DOI: 10.4103/2156-7514.127835
      Issue No: Vol. 4, No. 1 (2014)
       
  • Initial Experience with Combination Digital Breast Tomosynthesis Plus Full
           Field Digital Mammography or Full Field Digital Mammography Alone in the
           Screening Environment

    • Authors: Stamatia Destounis, Andrea Arieno, Renee Morgan
      Pages: 9 - 9
      Abstract: Stamatia Destounis, Andrea Arieno, Renee Morgan

      Journal of Clinical Imaging Science 2014 4(1):9-9

      Objectives: Initial review of patients undergoing screening mammography imaged with a combination of digital breast tomosynthesis (DBT) plus full field digital mammography (FFDM) compared with FFDM alone. Materials and Methods: From June 2011 to December 2011, all patients presenting for routine screening mammography were offered a combination DBT plus FFDM exam. Under institutional review board approval, we reviewed 524 patients who opted for combination DBT plus FFDM and selected a sample group of 524 FFDM screening exams from the same time period for a comparative analysis. The &#967;2 (Chi-square) test was used to compare recall rates, breast density, personal history of breast cancer, and family history of breast cancer between the two groups. Results: Recall rate for FFDM, 11.45%, was significantly higher (P < 0001) than in the combination DBT plus FFDM group (4.20%). The biopsy rate in the FFDM group was 2.29% (12/524), with a cancer detection rate of 0.38% (2/524, or 3.8 per 1000) and positive predictive value (PPV) of 16.7% (2/12). The biopsy rate for the DBT plus FFDM group was 1.14% (n = 6/524), with a cancer detection rate 0.57% (n = 3/524, or 5.7 per 1000) and PPV of 50.0% (n = 3/6). Personal history of breast cancer in the FFDM group was significantly lower (P < 0.0001) than in the combination DBT plus FFDM group; 2.5% and 5.7%, respectively. A significant difference in family history of breast cancer (P < 0.0001) was found, with a higher rate in the combination DBT plus FFDM group (36.0% vs. 53.8%). There was a significant difference between the combination DBT plus FFDM group and FFDM alone group, when comparing breast density (P < 0.0147, 61.64% vs. 54.20% dense breasts, respectively) with a higher rate of dense breasts in the DBT plus FFDM group. In follow-up, one cancer was detected within one year of normal screening mammogram in the combination DBT plus FFDM group. Conclusion: Our initial experience found the recall rate in the combination DBT plus FFDM group was significantly lower than in the FFDM alone group, despite the fact that the combination DBT plus FFDM group had additional risk factors.
      Citation: Journal of Clinical Imaging Science 2014 4(1):9-9
      PubDate: Tue,25 Feb 2014
      DOI: 10.4103/2156-7514.127838
      Issue No: Vol. 4, No. 1 (2014)
       
  • Role of Perfusion CT Differentiating Hemangiomas from Malignant Hepatic
           Lesions

    • Authors: Jagjeet Singh, Sanjiv Sharma, Neeti Aggarwal, RG Sood, Shikha Sood, Ravinder Sidhu
      Pages: 10 - 10
      Abstract: Jagjeet Singh, Sanjiv Sharma, Neeti Aggarwal, RG Sood, Shikha Sood, Ravinder Sidhu

      Journal of Clinical Imaging Science 2014 4(1):10-10

      Objective: The purpose of the study was to determine the role of computed tomography (CT) perfusion in differentiating hemangiomas from malignant hepatic lesions. Materials and Methods: This study was approved by the institutional review board. All the patients provided informed consent. CT perfusion was performed with 64 multidetector CT (MDCT) scanner on 45 patients including 27 cases of metastasis, 9 cases of hepatocellular carcinoma (HCC), and 9 cases of hemangiomas. A 14 cm span of the liver was covered during the perfusion study. Data was analyzed to calculate blood flow (BF), blood volume (BV), permeability surface area product (PS), mean transit time (MTT), hepatic arterial fraction (HAF), and induced residue fraction time of onset (IRFTO). CT perfusion parameters at the periphery of lesions and background liver parenchyma were compared. Results: Significant changes were observed in the perfusion parameters at the periphery of different lesions. Of all the perfusion parameters BF, HAF, and IRFTO showed most significant changes. In our study we found: BF of more than 400 ml/100 g/min at the periphery of the hemangiomas showed sensitivity of 88.9%, specificity of 83.3%, positive predictive value (PPV) of 57.1%, and negative predictive value (NPV) of 96.7% in differentiating hemangiomas from hepatic malignancy; HAF of more than 60% at the periphery of hemangiomas showed sensitivity of 77.8%, specificity of 86.1%, PPV of 58.3% and NPV of 93.9% in differentiating hemangiomas from hepatic malignancy; IRFTO of more than 3 s at the periphery of hemangiomas showed sensitivity of 77.8%, specificity of 86.1%, PPV of 58.3%, and NPV of 93.9% in differentiating hemangiomas from hepatic malignancy. Conclusion: Perfusion CT is a helpful tool in differentiating hemangiomas from hepatic malignancy by its ability to determine changes in perfusion parameters of the lesions.
      Citation: Journal of Clinical Imaging Science 2014 4(1):10-10
      PubDate: Thu,27 Feb 2014
      DOI: 10.4103/2156-7514.127959
      Issue No: Vol. 4, No. 1 (2014)
       
  • Endovascular Coil Occlusion of Traumatic Intradural Aneurysm with
           Presentation as Carotid Cavernous Fistula

    • Authors: Lakshmi S P Karanam, Anand B Alurkar, M Natarajan, B Pugazhenthi
      Pages: 11 - 11
      Abstract: Lakshmi S P Karanam, Anand B Alurkar, M Natarajan, B Pugazhenthi

      Journal of Clinical Imaging Science 2014 4(1):11-11

      Carotid cavernous fistulae (CCF) are abnormal communication between cavernous segment of the internal carotid artery and cavernous sinus. These entities are usually encountered in 0.2-0.8% of patients with traumatic skull base fractures. Traumatic cerebral aneurysms are rare and account for less than 1% of intracranial aneurysms. CCF due to ruptured intradural traumatic aneurysm is very rare and difficult to treat by surgical methods. We present one such case of a 40-year-old man with post-traumatic CCF due to a ruptured intradural aneurysm successfully treated with endovascular embolization.
      Citation: Journal of Clinical Imaging Science 2014 4(1):11-11
      PubDate: Thu,27 Feb 2014
      DOI: 10.4103/2156-7514.127961
      Issue No: Vol. 4, No. 1 (2014)
       
  • Ultrasound and Doppler US in Evaluation of Superficial Soft-tissue Lesions

    • Authors: Huseyin Toprak, Erkan Kiliç, Asli Serter, Ercan Kocakoç, Salih Ozgocmen
      Pages: 12 - 12
      Abstract: Huseyin Toprak, Erkan Kiliç, Asli Serter, Ercan Kocakoç, Salih Ozgocmen

      Journal of Clinical Imaging Science 2014 4(1):12-12

      Improved developments in digital ultrasound technology and the use of high-frequency broadband transducers make ultrasound (US) imaging the first screening tool in investigating superficial tissue lesions. US is a safe (no ionizing radiation), portable, easily repeatable, and cheap form of imaging compared to other imaging modalities. US is an excellent imaging modality to determine the nature of a mass lesion (cystic or solid) and its anatomic relation to adjoining structures. Masses can be characterized in terms of their size, number, component, and vascularity with US and Doppler US especially with power Doppler US. US, however, is operator dependent and has a number of artifacts that can result in misinterpretation. In this review, we emphasize the role of ultrasound, particularly power Doppler, in superficial soft-tissue lesions.
      Citation: Journal of Clinical Imaging Science 2014 4(1):12-12
      PubDate: Thu,27 Feb 2014
      DOI: 10.4103/2156-7514.127965
      Issue No: Vol. 4, No. 1 (2014)
       
  • Momentum Continues

    • Authors: Vikram S Dogra
      Pages: 13 - 13
      Abstract: Vikram S Dogra

      Journal of Clinical Imaging Science 2014 4(1):13-13


      Citation: Journal of Clinical Imaging Science 2014 4(1):13-13
      PubDate: Fri,7 Mar 2014
      DOI: 10.4103/2156-7514.128459
      Issue No: Vol. 4, No. 1 (2014)
       
  • Difficulty in Clinical Evaluation of Radial Nerve Injury due to Multiple
           Trauma to the Humerus, Wrist, and Hand

    • Authors: Balik Mehmet Sabri, Güvercin Yilmaz, Erkut Adem, Keskin Davut, Bilir Özlem, Balik Mehmet Sabri, Güvercin Yilmaz, Erkut Adem, Keskin Davut, Bilir Özlem
      Pages: 16 - 16
      Abstract: Balik Mehmet Sabri, Güvercin Yilmaz, Erkut Adem, Keskin Davut, Bilir Özlem, Balik Mehmet Sabri, Güvercin Yilmaz, Erkut Adem, Keskin Davut, Bilir Özlem

      Journal of Clinical Imaging Science 2014 4(1):16-16

      Radial nerve damage is frequently encountered in humeral fractures. The radial nerve is primarily damaged when the humerus gets fractured, while secondary damage maybe due to post-traumatic manipulations and surgical exploration. High impact traumatic nerve injury, serious neuropathic pain, lack of response to therapeutic interventions, and indifference to the Tinel test are indications for surgical intervention. Since most humeral fracture-induced low impact radial nerve injuries resolve spontaneously, conservative therapy is preferred. We present a patient with humeral fracture-associated radial nerve injury, accompanied with digital amputation and flexor tendon avulsion on the same arm. These injuries required immediate surgery, thus rendering the clinical evaluation of the radial nerve impossible. We would like to highlight and discuss the inherent difficulties associated with multiple trauma of the upper arm.
      Citation: Journal of Clinical Imaging Science 2014 4(1):16-16
      PubDate: Fri,21 Mar 2014
      DOI: 10.4103/2156-7514.129263
      Issue No: Vol. 4, No. 1 (2014)
       
  • Establishing a Chest MRI Practice and its Clinical Applications: Our
           Insight and Protocols

    • Authors: Christine U Lee, Darin B White, Anne-Marie G Sykes, Christine U Lee, Darin B White, Anne-Marie G Sykes
      Pages: 17 - 17
      Abstract: Christine U Lee, Darin B White, Anne-Marie G Sykes, Christine U Lee, Darin B White, Anne-Marie G Sykes

      Journal of Clinical Imaging Science 2014 4(1):17-17

      Despite its nonionizing technique and exquisite soft tissue characterization, noncardiovascular, and nonmusculoskeletal magnetic resonance imaging (MRI) of the chest has been considered impractical due to various challenges such as respiratory motion, cardiac motion, vascular pulsatility, air susceptibility, and paucity of signal in the lung. With advances in MRI, it is now possible to perform diagnostically useful and good quality MRIs of the chest, but literature on subspecialized chest MRI practices is limited. The purpose of this manuscript is to describe the rationale, nuances, and logistics that went into developing such a practice in the Division of Thoracic Radiology at our institution. The topics addressed include technical and clinical considerations, support at administrative and clinical levels, protocol development, and economic considerations compared with conventional practices. Various MRI techniques are also specifically discussed to facilitate chest MRI at other sites. Although chest MRI is used in a relatively small number of patients at this point, in certain patients, chest MRI can provide additional information to optimize medical management. A few clinical cases illustrate the quality and clinical utility of chest MRI. Given recent advances in MRI techniques, it is now an opportune time to develop a chest MRI practice.
      Citation: Journal of Clinical Imaging Science 2014 4(1):17-17
      PubDate: Fri,21 Mar 2014
      DOI: 10.4103/2156-7514.129288
      Issue No: Vol. 4, No. 1 (2014)
       
  • Cancerogenesis Risks between 64 and 320 Row Detector CT for Coronary CTA
           Screening

    • Authors: Atif N Khan, Faisal Khosa, Boris Nikolic, Waqas Shuaib, Pei-Jan Paul Lin, Mohammad K Khan
      Pages: 18 - 18
      Abstract: Atif N Khan, Faisal Khosa, Boris Nikolic, Waqas Shuaib, Pei-Jan Paul Lin, Mohammad K Khan

      Journal of Clinical Imaging Science 2014 4(1):18-18

      Objectives: This study compares cancerogenesis risks posed by the 64 row detector and the 320 row detector computed tomography scanners used during coronary computed tomography angiography (CCTA) following decennial screening guidelines. Material and Methods: Data of the radiation absorbed after CCTA by lung, thyroid, and female breast in patients between 50 and 70 years of age obtained from prior published literature for the 64 row CT scanner were compared with data from our study using 320 row detector CT scanner. Data from the 64 row and the 320 row detector CT scanners was used to determine lifetime attributable risks (LAR) of cancer based on the biological effects of ionizing radiation (BEIR) VII report. Results: The relative reduction of LAR (%) for 50-, 60-, and 70-year-old patients undergoing scanning with the 320 row detector CT scanner was 30% lower for lung, and more than 50% lower for female breast when compared with results from 64 row detector CT scanner. The use of 320 row detector CT would result in a combined cumulative cancer incidence of less than 1/500 for breast in women and less than 1/1000 for lung in men; By comparison, this is much lower than other more common risk factors: 16-fold for lung cancer in persistent smokers, 2-fold for breast cancer with a first degree family member history of breast cancer, and 10-fold for thyroid cancer with a family member with thyroid cancer. Decennial screening would benefit at least 355,000 patients from sudden cardiac death each year, 94% of whom have significant coronary artery disease, with at least one stenosis >75%. LAR for thyroid cancer was negligible for both scanners. Conclusion: Lung and female breast LAR reductions with 320 row detector compared with 64 row detector CT are substantial, and the benefits would outweigh increased cancer risks with decennial screening in the age group of 50-70 years.
      Citation: Journal of Clinical Imaging Science 2014 4(1):18-18
      PubDate: Tue,29 Apr 2014
      DOI: 10.4103/2156-7514.131640
      Issue No: Vol. 4, No. 1 (2014)
       
  • Imaging Features of AlloDerm&#174; Used in Postmastectomy Breast
           Reconstructions

    • Authors: Christine U Lee, Allison J Clapp, Steven R Jacobson
      Pages: 19 - 19
      Abstract: Christine U Lee, Allison J Clapp, Steven R Jacobson

      Journal of Clinical Imaging Science 2014 4(1):19-19

      The purpose of this pictorial essay is to demonstrate the imaging features (ultrasound, mammogram, and magnetic resonance imaging (MRI)) of AlloDerm&#174; (LifeCell Corp.; Branchburg, NJ), an acellular dermal matrix sometimes used in both primary and reconstructive breast surgeries. AlloDerm&#174; is derived from cadaveric dermis and provides an immunologically inert scaffold in tissue reconstruction. Since there is little literature on the imaging of this substance, radiologists may be unfamiliar with its appearance in breast imaging. For this manuscript, ex vivo and in vivo images of AlloDerm&#174; in postmastectomy patients were evaluated using different imaging modalities. The appearance of AlloDerm&#174; can vary based on length of time postsurgery and incorporation into the host. AlloDerm&#174; appears as an isodense to glandular tissue on a mammogram and isoechoic to glandular tissue on ultrasound imaging. On MRI, in comparison with normal breast parenchyma, AlloDerm&#174; is hyperintense on T2-weighted imaging and isointense on T1-weighted imaging and demonstrates mild enhancement. To the best of the authors' knowledge, this is the first multimodality imaging description of AlloDerm&#174; used in postmastectomy patients. The conformation of AlloDerm&#174; at surgical placement and the degree of host cell migration and neoangiogenesis are factors to take into consideration when performing diagnostic evaluations; and, familiarity with the various imaging appearances of AlloDerm&#174; can be helpful to exclude residual or recurrent disease.
      Citation: Journal of Clinical Imaging Science 2014 4(1):19-19
      PubDate: Tue,29 Apr 2014
      DOI: 10.4103/2156-7514.131641
      Issue No: Vol. 4, No. 1 (2014)
       
  • Prenatal Diagnosis of Arthrogryposis as a Phenotype of Pena-Shokeir
           Syndrome using Two- and Three-dimensional Ultrasonography

    • Authors: Eduardo Felix Martins Santana, Priscila Nogueira Oliveira Serni, Liliam Cristine Rolo, Edward Araujo Júnior
      Pages: 20 - 20
      Abstract: Eduardo Felix Martins Santana, Priscila Nogueira Oliveira Serni, Liliam Cristine Rolo, Edward Araujo Júnior

      Journal of Clinical Imaging Science 2014 4(1):20-20

      Pena-Shokeir syndrome is a rare autosomal recessive disease, characterized by facial anomalies, arthrogryposis, polyhydramnios, fetal growth restriction, and pulmonary hypoplasia. This report describes the findings of this anomaly with two and three-dimensional ultrasound in a female in her 28 th week of pregnancy, who was referred to us because the fetus presented arthrogryposis of unknown cause. These imaging methods allowed adequate evaluation of the fetal malformations and also enabled appropriate counseling of the couple.
      Citation: Journal of Clinical Imaging Science 2014 4(1):20-20
      PubDate: Tue,29 Apr 2014
      DOI: 10.4103/2156-7514.131642
      Issue No: Vol. 4, No. 1 (2014)
       
  • Accuracy of Serial PET-CT Imaging in Systemic Sarcoidosis

    • Authors: Roberto G Carbone, Daniele Penna, Robert P Baughman, Elyse E Lower
      Pages: 21 - 21
      Abstract: Roberto G Carbone, Daniele Penna, Robert P Baughman, Elyse E Lower

      Journal of Clinical Imaging Science 2014 4(1):21-21

      Positron emission tomography (PET) in combination with computed tomography (PET-CT) is commonly used to identify malignant lesion in the lung. Despite there being only a few reports in literature, PET-CT imaging may have many advantages in the study of sarcoidosis, being useful in the diagnosis as well as in monitoring the response to treatment. The object of this case report is to highlight the clinical utility of integrated PET-CT imaging for evaluation of patients with systemic sarcoidosis and for comparing baseline findings to follow-up readings.
      Citation: Journal of Clinical Imaging Science 2014 4(1):21-21
      PubDate: Tue,29 Apr 2014
      DOI: 10.4103/2156-7514.131645
      Issue No: Vol. 4, No. 1 (2014)
       
  • MRI Findings of Coexistence of Ectopic Neurohypophysis, Corpus Callosum
           Dysgenesis, and Periventricular Neuronal Heterotopia

    • Authors: Harun Arslan, Metin Saylik, Hüseyin Akdeniz
      Pages: 22 - 22
      Abstract: Harun Arslan, Metin Saylik, Hüseyin Akdeniz

      Journal of Clinical Imaging Science 2014 4(1):22-22

      Ectopic neurohypophysis is a pituitary gland abnormality, which can accompany growth hormone deficiency associated with dwarfism. Here we present magnetic resonance imaging (MRI) findings of a rare case of ectopic neurohypophysis, corpus callosum dysgenesis, and periventricular neuronal heterotopia coexisting, with a review of the literature.
      Citation: Journal of Clinical Imaging Science 2014 4(1):22-22
      PubDate: Tue,29 Apr 2014
      DOI: 10.4103/2156-7514.131649
      Issue No: Vol. 4, No. 1 (2014)
       
  • Aggressive Angiomyxoma with Perineal Herniation

    • Authors: Seema Narang, Supreethi Kohli, Vinod Kumar, Raj Chandoke
      Pages: 23 - 23
      Abstract: Seema Narang, Supreethi Kohli, Vinod Kumar, Raj Chandoke

      Journal of Clinical Imaging Science 2014 4(1):23-23

      Aggressive angiomyxoma is a rare mesenchymal tumor involving the pelvic-perineal region. It occurs during the third and fourth decade of life and is predominantly seen in females. It presents clinically as a soft tissue mass in variable locations such as vulva, perianal region, buttock, or pelvis. Assessment of extent of the tumor by radiological evaluation is crucial for surgical planning; however, biopsy is essential to establish diagnosis. We present the radiological and pathological features seen in a 43-year-old female diagnosed with abdominal angiomyxoma with an unusual extension to the perineum.
      Citation: Journal of Clinical Imaging Science 2014 4(1):23-23
      PubDate: Wed,30 Apr 2014
      DOI: 10.4103/2156-7514.131740
      Issue No: Vol. 4, No. 1 (2014)
       
  • Thrombocytopenia in Patients with Gastric Varices and the Effect of
           Balloon-occluded Retrograde Transvenous Obliteration on the Platelet Count
           

    • Authors: WE Saad, W Bleibel, N Adenaw, CE Wagner, C Anderson, JF Angle, AM Al-Osaimi, MG Davies, S Caldwell
      Pages: 24 - 24
      Abstract: WE Saad, W Bleibel, N Adenaw, CE Wagner, C Anderson, JF Angle, AM Al-Osaimi, MG Davies, S Caldwell

      Journal of Clinical Imaging Science 2014 4(1):24-24

      Objectives: Gastric varices primarily occur in cirrhotic patients with portal hypertension and splenomegaly and thus are probably associated with thrombocytopenia. However, the prevalence and severity of thrombocytopenia are unknown in this clinical setting. Moreover, one-third of patients after balloon-occluded retrograde transvenous obliteration (BRTO) have aggravated splenomegaly, which potentially may cause worsening thrombocytopenia. The aim of the study is to determine the prevalence and degree of thrombocytopenia in patients with gastric varices associated with gastrorenal shunts undergoing BRTO, to determine the prognostic factors of survival after BRTO (platelet count included), and to assess the effect of BRTO on platelet count over a 1-year period. Materials and Methods: This is a retrospective review of 35 patients who underwent BRTO (March 2008-August 2011). Pre- and post-BRTO platelet counts were noted. Potential predictors of bleeding and survival (age, gender, liver disease etiology, platelet count, model for end stage liver disease [MELD]-score, presence of ascites or hepatocellular carcinoma) were analyzed (multivariate analysis). A total of 91% (n = 32/35) of patients had thrombocytopenia (
      Citation: Journal of Clinical Imaging Science 2014 4(1):24-24
      PubDate: Wed,30 Apr 2014
      DOI: 10.4103/2156-7514.131743
      Issue No: Vol. 4, No. 1 (2014)
       
  • Ultrasound Findings of the Painful Ankle and Foot

    • Authors: Suheil Artul, George Habib
      Pages: 25 - 25
      Abstract: Suheil Artul, George Habib

      Journal of Clinical Imaging Science 2014 4(1):25-25

      Objectives: To document the prevalence and spectrum of musculoskeletal ultrasound (MSKUS) findings at different parts of the foot. Materials and Methods: All MSKUS studies conducted on the foot during a 2-year period (2012-2013) at the Department of Radiology were reviewed. Demographic parameters including age, gender, and MSKUS findings were documented. Results: Three hundred and sixty-four studies had been conducted in the 2-year period. Ninety-three MSKUS evaluations were done for the ankle, 30 studies for the heel, and 241 for the rest of the foot. The most common MSKUS finding at the ankle was tenosynovitis, mostly in female patients; at the heel it was Achilles tendonitis, also mostly in female patients; and for the rest of the foot it was fluid collection and presence of foreign body, mainly in male patients. The number of different MSKUS abnormalities that were reported was 9 at the ankle, 9 at the heel, and 21 on the rest of the foot. Conclusions: MSKUS has the potential for revealing a huge spectrum of abnormalities. The most common finding was collection/hematoma and foreign bodies at the foot, tenosynovitis at the ankle, and Achilles tendinitis at the heel.
      Citation: Journal of Clinical Imaging Science 2014 4(1):25-25
      PubDate: Tue,27 May 2014
      DOI: 10.4103/2156-7514.133257
      Issue No: Vol. 4, No. 1 (2014)
       
  • Rare Presentation of Genitourinary Tuberculosis Masquerading as Renal Cell
           Carcinoma: A Histopathological Surprise

    • Authors: Santosh Kumar, Sriharsha Ajjoor Shankaregowda, Gautam Ram Choudhary, Karun Singla
      Pages: 26 - 26
      Abstract: Santosh Kumar, Sriharsha Ajjoor Shankaregowda, Gautam Ram Choudhary, Karun Singla

      Journal of Clinical Imaging Science 2014 4(1):26-26

      Genitourinary tuberculosis (GUTB) is a rare extrapulmonary manifestation of tuberculosis (TB). Various forms of presentation are described and in most cases the disease results in calcification, atrophy, or necrosis of the renal parenchyma. The kidney is not generally palpable except in cases of hydronephrosis due to an upper ureteric stricture. We present a case of GUTB presenting as inflammatory pseudotumor. This case was initially diagnosed as renal malignancy and managed accordingly. Histopathology confirmed the diagnosis of pseudotumoral renal TB.
      Citation: Journal of Clinical Imaging Science 2014 4(1):26-26
      PubDate: Tue,27 May 2014
      DOI: 10.4103/2156-7514.133259
      Issue No: Vol. 4, No. 1 (2014)
       
  • Ureterovesical Opaque Densities after Ureterovesical Reflux Injection
           Therapy: Diagnostic and Therapeutic Dilemma

    • Authors: Hamed Akhavizadegan
      Pages: 27 - 27
      Abstract: Hamed Akhavizadegan

      Journal of Clinical Imaging Science 2014 4(1):27-27

      Primary vesicoureteral reflux can be treated by injection of a bulking agent into the wall of the ureterovesical junction. Over time, the bulking agent can get calcified. Radiological images of the area show findings that mimic those seen in ureterovesical junction calculi. In this report, we present the imaging findings of this phenomenon and discuss its challenging aspects.
      Citation: Journal of Clinical Imaging Science 2014 4(1):27-27
      PubDate: Tue,27 May 2014
      DOI: 10.4103/2156-7514.133261
      Issue No: Vol. 4, No. 1 (2014)
       
  • First Report of Preoperative Imaging Diagnosis of a Surgically Confirmed
           Case of Valentino's Syndrome

    • Authors: Parag Suresh Mahajan, Mohammed Fahmy Abdalla, Nishan K. Purayil
      Pages: 28 - 28
      Abstract: Parag Suresh Mahajan, Mohammed Fahmy Abdalla, Nishan K. Purayil

      Journal of Clinical Imaging Science 2014 4(1):28-28

      Perforation of a duodenal ulcer (DU) into the retroperitoneal space presenting with clinical features of acute appendicitis is known as Valentino's syndrome. Post duodenal perforation, the gastric and duodenal fluids tend to settle in the right paracolic gutter causing peritonitis and clinically mimicking acute appendicitis. Only three cases of Valentino's syndrome have been reported till date in the published literature and there is only one previous report of its preoperative imaging diagnosis. To our knowledge, this is the first reported case of preoperative imaging diagnosis in a surgically confirmed case of Valentino's syndrome. In most cases, patients with undiagnosed Valentino's syndrome are operated for acute appendicitis, and on finding a normal appendix, search is made for the cause of peritonitis, which then leads to retroperitoneal perforation of duodenum. The diagnosis of Valentino's syndrome by computed tomography (CT) imaging is easy and can help in avoiding the surgery or directing the surgeon directly to the repair of the duodenal perforation. It is, therefore, essential for emergency physicians, surgeons, and radiologists to know about this entity and consider it in the differential diagnosis.
      Citation: Journal of Clinical Imaging Science 2014 4(1):28-28
      PubDate: Tue,27 May 2014
      DOI: 10.4103/2156-7514.133263
      Issue No: Vol. 4, No. 1 (2014)
       
  • Rare Case of Reversible Acute Symmetrical Lesions of the Bilateral Basal
           Ganglia Associated with Diabetic Nephropathy and Chronic Renal Failure

    • Authors: Parag Suresh Mahajan, Mohamed Amin El Esnawi, Sheik Akbar Hussein, Nasser Jassim Al Maslamani
      Pages: 29 - 29
      Abstract: Parag Suresh Mahajan, Mohamed Amin El Esnawi, Sheik Akbar Hussein, Nasser Jassim Al Maslamani

      Journal of Clinical Imaging Science 2014 4(1):29-29

      Reversible acute symmetrical basal ganglial lesion on magnetic resonance imaging and/or computed tomography in cases of diabetic nephropathy and chronic renal failure exhibiting acute onset of movement abnormalities like chorea is a very rare entity. It has characteristic clinical and imaging features. Only 29 cases are described in the literature, including the current one. These cases are predominantly Asian patients from the Far East and only one Asian Indian patient has been described. We report the second Asian Indian case of this condition and describe its various clinical and imaging features. Our aim is to educate the clinicians and radiologists about this condition, so that more such cases can be detected.
      Citation: Journal of Clinical Imaging Science 2014 4(1):29-29
      PubDate: Tue,27 May 2014
      DOI: 10.4103/2156-7514.133264
      Issue No: Vol. 4, No. 1 (2014)
       
  • Unusual Sclerosing Orbital Pseudotumor Infiltrating Orbits and
           Maxillofacial Regions

    • Authors: Huseyin Toprak, Ayse Aralasmak, Temel Fatih Yilmaz, Huseyin Ozdemir
      Pages: 30 - 30
      Abstract: Huseyin Toprak, Ayse Aralasmak, Temel Fatih Yilmaz, Huseyin Ozdemir

      Journal of Clinical Imaging Science 2014 4(1):30-30

      Idiopathic orbital pseudotumor (IOP) is a benign inflammatory condition of the orbit without identifiable local or systemic causes. Bilateral massive orbital involvement and extraorbital extension of the IOP is very rare. We present an unusual case of IOP with bilateral massive orbital infiltration extending into maxillofacial regions and discuss its distinctive magnetic resonance imaging (MRI) features that help to exclude other entities during differential diagnoses.
      Citation: Journal of Clinical Imaging Science 2014 4(1):30-30
      PubDate: Tue,27 May 2014
      DOI: 10.4103/2156-7514.133265
      Issue No: Vol. 4, No. 1 (2014)
       
  • Imaging Spectrum of Hemangioma and Vascular Malformations of the Head and
           Neck in Children and Adolescents

    • Authors: Venkatraman Bhat, Paul C Salins, Varun Bhat
      Pages: 31 - 31
      Abstract: Venkatraman Bhat, Paul C Salins, Varun Bhat

      Journal of Clinical Imaging Science 2014 4(1):31-31

      Vascular lesions of the head and neck region in children constitute an interesting group of lesions that benefit immensely from imaging techniques. Imaging is essential for identification, characterization, and delineation of the extent of lesion and subsequent follow-up. Infantile hemangiomas, which are vascular tumors with a specific evolution pattern, constitute a large majority of these lesions. On the other hand, there are vascular malformations, which are anomalies of the vascular system, consisting of a range of vascular tissues associated with various flow patterns. When diagnosis is clinically evident, imaging should utilize non-radiation techniques and address the issues necessary for management. Timing and interpretation of imaging methods employed in assessing childhood vascular lesion should also take into consideration the natural history so that imaging is performed to address a specific question. This review highlights the typical appearance of a hemangioma and a group of vascular malformations of the head and neck. For descriptive purpose, an attempt has been made to group lesions into specific subsites, with each one having specific clinical significance. Cases included illustrate the spectrum of the disease ranging from classical form in young children to slightly differing manifestations of the disease in adolescents and adults. The illustrations also provide a novel way of presenting image data using volume-rendering techniques of 3D data. Multi-modality team interaction and management strategies of these complex lesions are also emphasized.
      Citation: Journal of Clinical Imaging Science 2014 4(1):31-31
      PubDate: Tue,24 Jun 2014
      DOI: 10.4103/2156-7514.135179
      Issue No: Vol. 4, No. 1 (2014)
       
  • Multi-level Split Cord Malformation: Do We Need a New
           Classification?

    • Authors: Gmaan A Alzhrani, Hosam M Al-Jehani, Denis Melan&#231;on
      Pages: 32 - 32
      Abstract: Gmaan A Alzhrani, Hosam M Al-Jehani, Denis Melan&#231;on

      Journal of Clinical Imaging Science 2014 4(1):32-32

      Split cord malformations (SCMs) are thought to be rare abnormalities representing 3.8-5% of all spinal cord anomalies. The prevalence is estimated to be 1 in 5499 live births (0.02%), with a slight female predominance (1.3:1). Although the estimates of prevalence vary, Type I SCM occurs more frequently than Type II SCM. In this paper, we are reporting the clinical presentation and imaging findings of multi-level SCM in a 27-year-old male. A literature review of the embryological background of SCM and pathological hypothesis for this entity is provided. A systematic review has been conducted to identify multi-level SCM cases reported in the literature, followed by proposing a new classification system to further our understanding and management of SCMs.
      Citation: Journal of Clinical Imaging Science 2014 4(1):32-32
      PubDate: Tue,24 Jun 2014
      DOI: 10.4103/2156-7514.135181
      Issue No: Vol. 4, No. 1 (2014)
       
  • Juxtaglomerular Cell Tumor: A Distinct Mesenchymal Tumor of Kidney

    • Authors: Hafsa Elouazzani, Ahmed Jahid, Zakiya Bernoussi, Najat Mahassini
      Pages: 33 - 33
      Abstract: Hafsa Elouazzani, Ahmed Jahid, Zakiya Bernoussi, Najat Mahassini

      Journal of Clinical Imaging Science 2014 4(1):33-33

      Juxtaglomerular cell tumor (JGCT) is an unusual mesenchymal entity of the kidney. It is a benign renin-secreting tumor causing hypertension and hypokalemia due to secondary hyperaldosteronism. It is curable if it is discovered early and surgically removed, but may cause a fatal outcome usually due to complications of associated hypertension.
      Citation: Journal of Clinical Imaging Science 2014 4(1):33-33
      PubDate: Mon,30 Jun 2014
      DOI: 10.4103/2156-7514.135482
      Issue No: Vol. 4, No. 1 (2014)
       
  • Retroperitoneal Extragastrointestinal Stromal Tumor: Radiologic Pathologic
           Correlation

    • Authors: Pankaj Watal, Swetang G Brahmbhatt, Prashant J Thoriya, Nandini U Bahri
      Pages: 34 - 34
      Abstract: Pankaj Watal, Swetang G Brahmbhatt, Prashant J Thoriya, Nandini U Bahri

      Journal of Clinical Imaging Science 2014 4(1):34-34

      Neoplasms with histology and immunohistochemistry similar to gastrointestinal stromal tumors may occur primarily outside the gastrointestinal tract, usually in the omentum and mesentery. These are referred to as extragastrointestinal stromal tumors (EGISTs). Retroperitoneum is a very rare site for such neoplasms. We report a patient with EGIST in the retroperitoneum, elaborating the cross-sectional imaging and histopathologic findings.
      Citation: Journal of Clinical Imaging Science 2014 4(1):34-34
      PubDate: Mon,30 Jun 2014
      DOI: 10.4103/2156-7514.135484
      Issue No: Vol. 4, No. 1 (2014)
       
  • Malignant Pleural and Peritoneal Mesothelioma Consequential to Brief
           Indirect Asbestos Exposure

    • Authors: Bharati Singhal, Supreethi Kohli, Anu Singhal, Vinod Kumar
      Pages: 35 - 35
      Abstract: Bharati Singhal, Supreethi Kohli, Anu Singhal, Vinod Kumar

      Journal of Clinical Imaging Science 2014 4(1):35-35

      This report highlights that pleural and peritoneal mesothelioma can occur without direct asbestos exposure as was seen in our young patient. The patient had indirect exposure for as short as 3 months as a child, 15 years earlier, when she was residing with her miner father in the district of Jharia, Jharkhand, which is an asbestos-rich mining area in eastern India. The patient presented with chest pain and breathlessness. Chest X-ray showed opaque right hemithorax. Typical contrast- computed tomography (CECT) enhanced radiological features included nodular, soft-tissue attenuation and homogenously enhancing rind-like mass causing scalloping of the underlying lung and liver. Similar lesions were also found involving the pelvis. Diagnosis of malignant mesothelioma was confirmed on lung biopsy. Under-reporting of exposure is usual because it is unrecognized by both patients and investigators.
      Citation: Journal of Clinical Imaging Science 2014 4(1):35-35
      PubDate: Mon,30 Jun 2014
      DOI: 10.4103/2156-7514.135662
      Issue No: Vol. 4, No. 1 (2014)
       
  • Transluminal Recanalization of Chronic Total Occlusion of Radial Artery
           Using Rendezvous Technique: A Case Report and Literature Review

    • Authors: Mohammad Arabi, Ishtiaq Ahmed, Nabeel Qattan
      Pages: 36 - 36
      Abstract: Mohammad Arabi, Ishtiaq Ahmed, Nabeel Qattan

      Journal of Clinical Imaging Science 2014 4(1):36-36

      Although endovascular management of lower extremity peripheral arterial disease (PAD) is well studied, little information exists regarding endovascular treatment of critical upper limb ischemia. We report a case of transluminal recanalization of right radial artery chronic total occlusion (CTO) using rendezvous technique in a patient with critical hand ischemia and dry gangrene of the right index finger.
      Citation: Journal of Clinical Imaging Science 2014 4(1):36-36
      PubDate: Mon,30 Jun 2014
      DOI: 10.4103/2156-7514.135663
      Issue No: Vol. 4, No. 1 (2014)
       
  • Revisiting Ectopic Pregnancy: A Pictorial Essay

    • Authors: Artemis Petrides, Cheryl Dinglas, Martin Chavez, Sharon Taylor, Sabrina Mahboob
      Pages: 37 - 37
      Abstract: Artemis Petrides, Cheryl Dinglas, Martin Chavez, Sharon Taylor, Sabrina Mahboob

      Journal of Clinical Imaging Science 2014 4(1):37-37

      Ectopic pregnancies occur in approximately 1.4% of all pregnancies and account for 15% of pregnancy-related deaths. Considering the high degree of mortality, recognizing an ectopic pregnancy is important. Signs and symptoms of an ectopic pregnancy are nonspecific and include pain, vaginal bleeding, and an adnexal mass. Therefore, imaging can play a critical role in diagnosis. There are different types of ectopic pregnancies, which are tubal, cornual, cesarean scar, cervical, heterotopic, abdominal, and ovarian. Initial imaging evaluation of pregnant patients with pelvic symptoms is by ultrasonography, transabdominal, transvaginal or both. We review the sonographic appearance of different types of ectopic pregnancies that will aid in accurate and prompt diagnosis.
      Citation: Journal of Clinical Imaging Science 2014 4(1):37-37
      PubDate: Thu,31 Jul 2014
      DOI: 10.4103/2156-7514.137817
      Issue No: Vol. 4, No. 1 (2014)
       
  • Feasible Dose Reduction in Routine Chest Computed Tomography Maintaining
           Constant Image Quality Using the Last Three Scanner Generations: From
           Filtered Back Projection to Sinogram-affirmed Iterative Reconstruction and
           Impact of the Novel Fully Integrated Detector Design Minimizing Electronic
           Noise

    • Authors: Lukas Ebner, Felix Knobloch, Adrian Huber, Julia Landau, Daniel Ott, Johannes T Heverhagen, Andreas Christe
      Pages: 38 - 38
      Abstract: Lukas Ebner, Felix Knobloch, Adrian Huber, Julia Landau, Daniel Ott, Johannes T Heverhagen, Andreas Christe

      Journal of Clinical Imaging Science 2014 4(1):38-38

      Objective:The aim of the present study was to evaluate a dose reduction in contrast-enhanced chest computed tomography (CT) by comparing the three latest generations of Siemens CT scanners used in clinical practice. We analyzed the amount of radiation used with filtered back projection (FBP) and an iterative reconstruction (IR) algorithm to yield the same image quality. Furthermore, the influence on the radiation dose of the most recent integrated circuit detector (ICD; Stellar detector, Siemens Healthcare, Erlangen, Germany) was investigated. Materials and Methods: 136 Patients were included. Scan parameters were set to a thorax routine: SOMATOM Sensation 64 (FBP), SOMATOM Definition Flash (IR), and SOMATOM Definition Edge (ICD and IR). Tube current was set constantly to the reference level of 100 mA automated tube current modulation using reference milliamperes. Care kV was used on the Flash and Edge scanner, while tube potential was individually selected between 100 and 140 kVp by the medical technologists at the SOMATOM Sensation. Quality assessment was performed on soft-tissue kernel reconstruction. Dose was represented by the dose length product. Results: Dose-length product (DLP) with FBP for the average chest CT was 308 mGy*cm &#177; 99.6. In contrast, the DLP for the chest CT with IR algorithm was 196.8 mGy*cm &#177; 68.8 (P = 0.0001). Further decline in dose can be noted with IR and the ICD: DLP: 166.4 mGy*cm &#177; 54.5 (P = 0.033). The dose reduction compared to FBP was 36.1% with IR and 45.6% with IR/ICD. Signal-to-noise ratio (SNR) was favorable in the aorta, bone, and soft tissue for IR/ICD in combination compared to FBP (the P values ranged from 0.003 to 0.048). Overall contrast-to-noise ratio (CNR) improved with declining DLP. Conclusion: The most recent technical developments, namely IR in combination with integrated circuit detectors, can significantly lower radiation dose in chest CT examinations.
      Citation: Journal of Clinical Imaging Science 2014 4(1):38-38
      PubDate: Thu,31 Jul 2014
      DOI: 10.4103/2156-7514.137826
      Issue No: Vol. 4, No. 1 (2014)
       
  • Implications of Ambient Glucose Variation on the Target-to-Background
           Ratio of Hepatic Tumors By 18 FDG-PET Imaging

    • Authors: Prashant Jolepalem, Lesley Flynt, John N Rydberg, Ching-Yee Oliver Wong
      Pages: 39 - 39
      Abstract: Prashant Jolepalem, Lesley Flynt, John N Rydberg, Ching-Yee Oliver Wong

      Journal of Clinical Imaging Science 2014 4(1):39-39

      Objectives: To investigate the effects of ambient glucose on quantitative analysis of hepatic tumors on 2-deoxy-2-(18 F)-fluoro-D-glucose (18 FDG) positron emission tomography (PET) and to establish a method for glucose correction. Patients and Methods: Eighty-six patients with hepatic lesions identified on 18 FDG PET/computed tomography (CT) were analyzed. The serum glucose level (Glc) was recorded prior to imaging, and the maximum standardized uptake value (SUV) in the hepatic tumors and the average SUV in normal liver were determined. The inverse relationship of SUV to glucose can be defined as d (SUV)/d (Glc) = g*SUV/(Glc), where g is the glucose sensitivity. Simulations using glucose level from 70 to 250 mg/dl were performed to evaluate the effects of Glc on the maximum SUV of malignant hepatic lesions and normal liver. Results: By logarithmic transformation and linear regression, g for metastasis was significantly higher than that for normal liver (&#8722;0.636 &#177; 0.144 vs. &#8722;0.0536 &#177; 0.0583; P = 0.00092). Simulation studies showed that the SUV in malignant lesions will decrease rapidly when Glc level is >120 mg/dl, while background liver remains relatively constant up to 250 mg/dl. Conclusion: The tumor FDG uptake is much more sensitive to ambient glucose level variation than the background liver. Therefore, correction by the glucose sensitivity factor will result in more accurate SUV measurements and make semi-quantitative analysis of 18 FDG PET scans more reliable.
      Citation: Journal of Clinical Imaging Science 2014 4(1):39-39
      PubDate: Thu,31 Jul 2014
      DOI: 10.4103/2156-7514.137832
      Issue No: Vol. 4, No. 1 (2014)
       
  • Imaging of Dual Ophthalmic Arteries: Identification of the Central Retinal
           Artery

    • Authors: Louise Louw, Johan Steyl, Eugene Loggenberg
      Pages: 40 - 40
      Abstract: Louise Louw, Johan Steyl, Eugene Loggenberg

      Journal of Clinical Imaging Science 2014 4(1):40-40

      Identification of the origin of the central retinal artery (CRA) is imperative in tailoring angiographic studies to resolve a given clinical problem. A case with dual ophthalmic arteries (OAs), characterized by different origins and distinct branching patterns, is documented for training purposes. Pre-clinical diagnosis of a 9-year-old child who presented with a sharp wire in the left-side eyeball was primarily corneal laceration. For imaging, a selected six-vessel angiographic study with the transfemoral approach was performed. Embolization was not required and the wire could be successfully removed. Right-side OA anatomy was normal, while left-side dual OAs with external carotid artery (ECA) and internal carotid artery (ICA) origins were seen. The case presented with a left-side meningo-ophthalmic artery (M-OA) anomaly via the ECA, marked by a middle meningeal artery (MMA) (origin: Maxillary artery; course: Through foramen spinosum) with normal branches (i.e. anterior and posterior branches), and an OA variant (course: Through superior orbital fissure) with a distinct orbital branching pattern. A smaller OA (origin: ICA; course: Through optic foramen) with a distinct ocular branching pattern presented with the central retinal artery (CRA). The presence of the dual OAs and the M-OA anomaly can be explained by disturbed evolutionary changes of the primitive OA and stapedial artery during development. The surgical interventionist must be aware of dual OAs and M-OA anomalies with branching pattern variations on retinal supply, because of dangerous extracranial-intracranial anastomotic connections. It is of clinical significance that the origin of the CRA from the ICA or ECA must be determined to avoid complications to the vision.
      Citation: Journal of Clinical Imaging Science 2014 4(1):40-40
      PubDate: Thu,31 Jul 2014
      DOI: 10.4103/2156-7514.137833
      Issue No: Vol. 4, No. 1 (2014)
       
  • Severe Aortic Coarctation in an Adult Patient with Normal Brachial Blood
           Pressure

    • Authors: Tina H Leetmaa, Bjarne L N&oslash;rgaard, Henning M&oslash;lgaard, Jesper M Jensen
      Pages: 41 - 41
      Abstract: Tina H Leetmaa, Bjarne L N&oslash;rgaard, Henning M&oslash;lgaard, Jesper M Jensen

      Journal of Clinical Imaging Science 2014 4(1):41-41

      The present case shows that a normal brachial blood pressure (BP) does not exclude severe coarctation and should be considered in normotensive patients presenting with a systolic murmur and/or unexplained severe left ventricular hypertrophy. Congenital coarctation of the aorta is a narrowing of the descending aorta, usually located distal to the origin of the subclavian artery, causing hypertension in the upper part of the body. This condition may be undiagnosed until adult life where the clinical presentation most often is high BP in the upper extremities. A 57-year-old patient with severe aortic coarctation and left ventricular hypertrophy presented with normal brachial BP. However, standard suprasternal view by echocardiography indicated coarctation. Multislice computed tomographic (CT) angiography revealed an uncommon location of the aortic narrowing with the right and left subclavian arteries originating below the area of coarctation, explaining the equally low BP in both upper extremities.
      Citation: Journal of Clinical Imaging Science 2014 4(1):41-41
      PubDate: Thu,31 Jul 2014
      DOI: 10.4103/2156-7514.137835
      Issue No: Vol. 4, No. 1 (2014)
       
  • Renal Vein Leiomyoma: A Rare Entity with Review of Literature

    • Authors: Santosh Kumar, Ankur Mittal, Sudheer Kumar Devana, Shrawan Kumar Singh
      Pages: 42 - 42
      Abstract: Santosh Kumar, Ankur Mittal, Sudheer Kumar Devana, Shrawan Kumar Singh

      Journal of Clinical Imaging Science 2014 4(1):42-42

      Tumors of vascular origin are unusual. These tumors are predominantly malignant and commonly arise from the inferior vena cava. Benign smooth muscle tumors arising from renal vein are very rare. We present a case of leiomyoma of renal vein in a post-menopausal woman that clinically resembled a retroperitoneal paraganglioma.
      Citation: Journal of Clinical Imaging Science 2014 4(1):42-42
      PubDate: Thu,31 Jul 2014
      DOI: 10.4103/2156-7514.137836
      Issue No: Vol. 4, No. 1 (2014)
       
  • Diffuse Hepatic Hemangiomatosis in the Adult without Extra-hepatic
           Involvement: An Extremely Rare Occurrence

    • Authors: Alexandre Batista, Antonio Pedro Matos, Jorge Oliveira e Neta, Miguel Ramalho
      Pages: 43 - 43
      Abstract: Alexandre Batista, Antonio Pedro Matos, Jorge Oliveira e Neta, Miguel Ramalho

      Journal of Clinical Imaging Science 2014 4(1):43-43

      We present a case of a pathologically proven multinodular diffuse hepatic hemangiomatosis (DHH) with no extra-hepatic involvement in a 68-year-old male. Cavernous hemangioma is the most common hepatic tumor. However, DHH, which is characterized by extensive replacement of liver parenchyma with hemangiomatous lesions, has been rarely reported in adults. The etiology and clinical course are not completely understood because of its rareness, although the diagnosis might be suggested by the magnetic resonance imaging findings.
      Citation: Journal of Clinical Imaging Science 2014 4(1):43-43
      PubDate: Sat,30 Aug 2014
      DOI: 10.4103/2156-7514.139733
      Issue No: Vol. 4, No. 1 (2014)
       
  • Arterial Tortuosity Syndrome: An Approach through Imaging Perspective

    • Authors: Venkatraman Bhat
      Pages: 44 - 44
      Abstract: Venkatraman Bhat

      Journal of Clinical Imaging Science 2014 4(1):44-44

      This pictorial illustration demonstrates various aspects of arterial tortuosity syndrome (ATS) obtained predominantly from a multiple detector computed tomography (MDCT) examination of a patient. In addition, a comprehensive review of typical multi-modality imaging observations in patients with ATS is presented along with a description of a few imaging signs. Non-invasively obtained, conclusive information is required in patients with ATS in view of the fragile vascular structures involved. An amazing wealth of information can be obtained by reviewing the volumetric data sets of MDCT examination. In the context of incomplete clinical information or remote reading of radiographic examination with inadequate clinical details, ability to "image data mine" the hidden, unexplored information may be vastly useful. The role of MDCT as a single modality of evaluation in ATS is highlighted.
      Citation: Journal of Clinical Imaging Science 2014 4(1):44-44
      PubDate: Sat,30 Aug 2014
      DOI: 10.4103/2156-7514.139734
      Issue No: Vol. 4, No. 1 (2014)
       
  • Ultrasonographic Findings in a Large Series of Patients with Knee Pain

    • Authors: Suheil Artul, Fadi Khazin, Jeries Hakim, George Habib
      Pages: 45 - 45
      Abstract: Suheil Artul, Fadi Khazin, Jeries Hakim, George Habib

      Journal of Clinical Imaging Science 2014 4(1):45-45

      Background: Musculoskeletal ultrasound (MSKUS) is becoming more and more popular in the evaluation of different musculoskeletal abnormalities. The aim of this retrospective study was to document the prevalence and spectrum of MSKUS findings at the painful knee. Materials and Methods: All the studies of MSKUS that were performed for the evaluation of knee pain during the previous 2 years at the Department of Radiology in Nazareth hospital were reviewed. Demographic and clinical parameters including age, gender, side, and MSKUS findings were documented. Results: Two hundred and seventy-six patients were included in the review. In 21 of them, both knees were evaluated at the same setting (total number of knees evaluated was 297). One hundred and forty-four knees were of the left side. Thirty-three pathologies were identified. 34% of the studies were negative. The most common MSKUS findings were medial meniscal tear (MMT) (20%), Baker's cyst (BC) (16%), and osteoarthritis (OA) (11%). Only one knee of all the knees evaluated in our study showed synovitis. Fifty-three knees (18% of all the knees evaluated) had more than one imaging finding, mosty two and while some had three findings. The most common combination of findings was MMT and BC (8 knees), MMT with OA (8 knees), and MMT with fluid (6 knee). In 67% of the patients who had simultaneous bilateral knee evaluation, at least one knee had no abnormal findings and in 43%, both knees were negative. Conclusions: MSKUS has the potential for revealing huge spectrum of abnormalities. In nearly 90% of the positive studies, degenerative/mechanical abnormalities were reported, with MMT, BC, and osteoarthritic changes being the most common.
      Citation: Journal of Clinical Imaging Science 2014 4(1):45-45
      PubDate: Sat,30 Aug 2014
      DOI: 10.4103/2156-7514.139735
      Issue No: Vol. 4, No. 1 (2014)
       
  • Importance of Presurgical Breast MRI in Patients 60 Years of Age and Older

    • Authors: Stamatia V Destounis, Andrea L Arieno, Renee C Morgan
      Pages: 46 - 46
      Abstract: Stamatia V Destounis, Andrea L Arieno, Renee C Morgan

      Journal of Clinical Imaging Science 2014 4(1):46-46

      Objective: To demonstrate the importance of presurgical bilateral breast Magnetic Resonance Imaging (MRI) in women 60 years of age and older. Materials and Methods: Institutional review board approval was obtained with waiver of informed consent for this retrospective review. From December 2003 to December 2011, all patients 60 years and older who had presurgical bilateral breast MRI were reviewed, revealing 1268 presurgical MRI examinations; 310 had a new lesion identified by MRI. Cases were excluded due to incomplete or missing data, resulting in 243 patients with 272 findings eligible for analysis. Data recorded included patient demographics, core biopsy method and pathology, type of surgery, and surgical pathology results. Results: Of 1268 exams performed in this population, 272 (21.5%) patients with suspicious MRI findings underwent needle biopsy. Malignancy was found in 114 (42%), benign findings in 127 (47%), and atypia in 31 (11%). Of the malignancies, 83 were in the ipsilateral breast and 31 in the contralateral breast to the original diagnosis. Of the ipsilateral findings, 47 were in the same quadrant as the primary diagnosis, 28 in a different quadrant, and 8 were metastatic lymph nodes. Of the 31 atypical findings, 14 were contralateral to the primary diagnosis and 17 were ipsilateral. Two hundred and thirty-three patients underwent surgical excision; 111 changed their surgical management as a lesion was seen on MRI and was diagnosed as cancer on needle biopsy. Conclusions: Among the patients aged 60 years and above who had presurgical bilateral breast MRI, we found additional cancers in 9.0% (n = 114/1268) and atypia in 2.4% (n = 31/1268). A change in management as a result of the MRI-detected lesion occurred in 8.8% (n = 111/1268). These results demonstrate that performing presurgical bilateral breast MRI is of value in women 60 years of age and above.
      Citation: Journal of Clinical Imaging Science 2014 4(1):46-46
      PubDate: Sat,30 Aug 2014
      DOI: 10.4103/2156-7514.139736
      Issue No: Vol. 4, No. 1 (2014)
       
  • A Rare Case of Primary Malignant Pericardial Mesothelioma

    • Authors: Rajoo Ramachandran, Prabhu Radhan, Roy Santosham, Swaminathan Rajendiran
      Pages: 47 - 47
      Abstract: Rajoo Ramachandran, Prabhu Radhan, Roy Santosham, Swaminathan Rajendiran

      Journal of Clinical Imaging Science 2014 4(1):47-47

      Primary malignant pericardial mesothelioma (PMPM) is a rare tumor of the pericardium. The cause of this tumor is unknown and it has a very poor prognosis. Exposure to asbestos is correlated with the onset of pleural and peritoneal mesothelioma; however, the role of asbestos in pericardial mesothelioma is unclear. Here we highlight the radiological features of this rare tumor and its correlative pathological confirmation with the help of new immunohistochemical (IHC) markers.
      Citation: Journal of Clinical Imaging Science 2014 4(1):47-47
      PubDate: Sat,30 Aug 2014
      DOI: 10.4103/2156-7514.139737
      Issue No: Vol. 4, No. 1 (2014)
       
  • An Infant with Splenohepatomegaly: A Rare Cause

    • Authors: Kathiravan Kalyanasundaram, Podhini Jegadeesan, Sibi Chakravarthy Mohan, Vinoth N Ponnurangam
      Pages: 48 - 48
      Abstract: Kathiravan Kalyanasundaram, Podhini Jegadeesan, Sibi Chakravarthy Mohan, Vinoth N Ponnurangam

      Journal of Clinical Imaging Science 2014 4(1):48-48

      Osteopetrosis is a rare congenital disorder of bone resorption, caused by failure of osteoclasts to reabsorb immature bone. Malignant infantile osteopetrosis presents in early life with generalized osteosclerosis and decreased bone marrow spaces, resulting in anemia, splenohepatomegaly due to extramedullary hematopoiesis, cranial nerve compression, and growth failure. It is a fatal condition with death occurring within the first year of life. Bone marrow transplant remains the only curative treatment. We present a report of an infant with splenohepatomegaly, who was diagnosed with malignant infantile osteopetrosis.
      Citation: Journal of Clinical Imaging Science 2014 4(1):48-48
      PubDate: Sat,30 Aug 2014
      DOI: 10.4103/2156-7514.139738
      Issue No: Vol. 4, No. 1 (2014)
       
  • Use of Cone Beam Computed Tomography in the Diagnosis of Superior
           Semicircular Canal Dehiscence

    • Authors: Ilson Sepulveda, Thomas Schmidt, Enrique Platin
      Pages: 49 - 49
      Abstract: Ilson Sepulveda, Thomas Schmidt, Enrique Platin

      Journal of Clinical Imaging Science 2014 4(1):49-49

      Superior semicircular canal dehiscence is a relatively new syndrome in the field of otology. It is of unknown etiology presenting with a variety of vestibular and auditory symptoms and radiologic findings play a crucial role in its diagnosis. Cone beam computed tomography has been shown to be a powerful tool in the field of otolaryngology. It is a three dimensional technique that uses lower radiation resulting in fewer artifacts and offers higher resolution when compared with multi-slice computed tomography. It is considered to be an excellent imaging modality for radiological exploration of the ear.
      Citation: Journal of Clinical Imaging Science 2014 4(1):49-49
      PubDate: Tue,23 Sep 2014
      DOI: 10.4103/2156-7514.141554
      Issue No: Vol. 4, No. 1 (2014)
       
  • Sequential Venoplasty for Treatment of Inferior Vena Cava Stenosis
           Following Liver Transplant

    • Authors: Ahmad Parvinian, Ron Charles Gaba
      Pages: 50 - 50
      Abstract: Ahmad Parvinian, Ron Charles Gaba

      Journal of Clinical Imaging Science 2014 4(1):50-50

      Obstruction of the inferior vena cava (IVC) is a rare complication of liver transplantation with significant consequences including intractable ascites and hepatic dysfunction. Although venoplasty and stenting are effective in many cases, patients who fail first-line treatment may require surgical intervention or re-transplantation. Scheduled sequential balloon dilation, an approach frequently used to treat fibrotic, benign biliary strictures, but less commonly vascular lesions, may avert the need for such high-risk alternatives while achieving favorable clinical and angiographic response. Herein, we report the case of a 36-year-old woman with transplant-related, initially angioplasty-resistant IVC stenosis that was successfully treated with sequential balloon dilation.
      Citation: Journal of Clinical Imaging Science 2014 4(1):50-50
      PubDate: Tue,23 Sep 2014
      DOI: 10.4103/2156-7514.141557
      Issue No: Vol. 4, No. 1 (2014)
       
  • Omental Nodular Deposits of Recurrent Chromophobe Renal Cell Carcinoma
           Seen on FDG-PET/CT

    • Authors: Aung Zaw Win, Carina Mari Aparici
      Pages: 51 - 51
      Abstract: Aung Zaw Win, Carina Mari Aparici

      Journal of Clinical Imaging Science 2014 4(1):51-51

      We present the case of a 69-year-old male with chromophobe renal cell carcinoma (RCC). Chromophobe RCC accounts for only 4% of renal cancers and it is the least aggressive type. Omental nodular deposits due to RCC metastasis are very rare and it is reported only in more aggressive forms of RCC. This is the first report that shows FluoroDeoxyGlucose - Positron Emission Tomography/Computed Tomgraphy (FDG-PET/CT) images of omental nodular deposits from chromophobe RCC. FDG-PET/CT is becoming very useful in restaging RCC with distant metastases.
      Citation: Journal of Clinical Imaging Science 2014 4(1):51-51
      PubDate: Tue,23 Sep 2014
      DOI: 10.4103/2156-7514.141560
      Issue No: Vol. 4, No. 1 (2014)
       
  • Malignant Phyllodes Tumor with Chondrosarcomatous Differentiation:
           Radiological-Pathological Correlation

    • Authors: Kathyayini Paidipati Gopalkishna Murthy, Ranjani Padmanabhan Chakravarthy
      Pages: 52 - 52
      Abstract: Kathyayini Paidipati Gopalkishna Murthy, Ranjani Padmanabhan Chakravarthy

      Journal of Clinical Imaging Science 2014 4(1):52-52

      We present a case of a 63-year-old woman with malignant phyllodes tumor in her left breast. On imaging, a large, dumbbell-shaped, predominantly cystic mass with thin peripheral enhancement was noted. The lesion was causing rib destruction, chest wall invasion, and intrathoracic extension. These aggressive imaging features were considered highly suspicious of a malignant chest wall tumor. Subsequent chest wall resection of the tumor showed breast tissue with a biphasic lesion composed of proliferated spindle cells in loose sheets with extensive islands of atypical cartilage and a scanty epithelial component, including compressed ducts in the periphery of the lesion. A diagnosis of a malignant phyllodes tumor with stromal overgrowth and chondrosarcomatous differentiation was made in view of the presence of a benign epithelial component and negative reaction of the stromal component with a pancytokeratin. To the best of our knowledge, a phyllodes tumor with the radiological features of chest wall invasion and intrathoracic extension has not been described in the literature until now. Malignant phyllodes should be included in the list of differentials along with sarcomas on encountering lesions with such aggressive imaging features.
      Citation: Journal of Clinical Imaging Science 2014 4(1):52-52
      PubDate: Mon,29 Sep 2014
      DOI: 10.4103/2156-7514.141910
      Issue No: Vol. 4, No. 1 (2014)
       
  • Neonatal Death Dwarfism in a Girl with Distinctive Bone Dysplasia
           Compatible with Grebe Chondrodysplasia: Analysis by CT Scan-based
           Phenotype

    • Authors: Ali Al Kaissi, Farid Ben Chehida, Rudolf Ganger, Franz Grill
      Pages: 53 - 53
      Abstract: Ali Al Kaissi, Farid Ben Chehida, Rudolf Ganger, Franz Grill

      Journal of Clinical Imaging Science 2014 4(1):53-53

      We report on a female fetus noted to have severe malformative type of skeletal dysplasia on ultrasonography done at 35 weeks gestation. The girl died shortly after birth. Clinical examination showed a fetus with severe dwarfism, extensive long and short bones, and bone deficiencies associated with multiple dislocations. Computed tomography (CT) scan-based phenotype showed a complex constellation of malformations consistent with the diagnosis of Grebe syndrome. Parents being first cousins (consanguineous marriage) strongly suggests autosomal recessive pattern of inheritance. To our knowledge, this is the first report of neonatal death dwarfism of Grebe syndrome analyzed by CT scan-based phenotype.
      Citation: Journal of Clinical Imaging Science 2014 4(1):53-53
      PubDate: Mon,29 Sep 2014
      DOI: 10.4103/2156-7514.141939
      Issue No: Vol. 4, No. 1 (2014)
       
  • Initial Experience of Utilizing Real-Time Intra-Procedural PET/CT Biopsy

    • Authors: Carina Mari Aparici, Rizwan Aslam, Aung Zaw Win
      Pages: 54 - 54
      Abstract: Carina Mari Aparici, Rizwan Aslam, Aung Zaw Win

      Journal of Clinical Imaging Science 2014 4(1):54-54

      Objectives: Nonreal-time Positron Emission Tomography/Computed Tomography (PET/CT) biopsies that use the image co-registration of a prior PET with an intra-procedural CT have been reported. The aim of this study was to report the initial experience of performing real-time intra-procedural PET/CT-guided biopsies. Materials and Methods: All patients (n = 4) had a prior PET/CT examination of the concerning lesion and no significant CT correlate. On the day of the biopsy, 5 mCi of 18F-fluorodeoxyglucose (FDG) or NaF18 was intravenously injected. After 60 min of biodistribution of the molecular probe, PET/CT images were obtained in a limited one bed position over the region of the concerning lesion to be biopsied. Results: One patient had a mesenteric mass and the other three had bone lesions, one located in the rib and two in the iliac bone. The pathology report revealed that two lesions (50%) were malignant and two lesions (50%) were benign. The results of the biopsy changed management in all cases. There was 0% complication rate. Conclusions: No additional software or hardware is required to perform real-time intra-procedural PET/CT-guided biopsies. It can optimize the yield, especially in cases where there are no anatomical abnormalities. Real-time intra-procedural PET/CT biopsy may have benefits over conventional biopsy techniques in terms of accuracy.
      Citation: Journal of Clinical Imaging Science 2014 4(1):54-54
      PubDate: Mon,29 Sep 2014
      DOI: 10.4103/2156-7514.141941
      Issue No: Vol. 4, No. 1 (2014)
       
  • The Rare Sprengel Deformity: Our Experience with Three Cases

    • Authors: Antonia Bindoudi, Eleni P Kariki, Konstantinos Vasiliadis, Ioannis Tsitouridis
      Pages: 55 - 55
      Abstract: Antonia Bindoudi, Eleni P Kariki, Konstantinos Vasiliadis, Ioannis Tsitouridis

      Journal of Clinical Imaging Science 2014 4(1):55-55

      Sprengel shoulder is a rare congenital deformity of one or both scapulae that is usually detected at birth. It occurs due to failure of the scapula to descend during intrauterine development and its cause is still unknown. Although the deformity appears randomly most of the time, familial cases have been reported. Sprengel shoulder is often associated with Klippel-Feil syndrome and other congenital skeletal deformities. Anteroposterior X-ray imaging can accurately diagnose Sprengel deformity. However, computed tomography and magnetic resonance scans with three-dimensional reconstruction are nowadays used in everyday practice in order to diagnose concomitant abnormalities, study in detail the anatomy of the affected shoulder(s), and plan appropriate management. We present here our imaging experience from three pediatric cases with Sprengel shoulder and take the opportunity to discuss this rare entity, which is, nevertheless, the commonest congenital defect of the scapula.
      Citation: Journal of Clinical Imaging Science 2014 4(1):55-55
      PubDate: Mon,27 Oct 2014
      DOI: 10.4103/2156-7514.143407
      Issue No: Vol. 4, No. 1 (2014)
       
  • Pelvic Pheochromocytoma Mimicking as Urinary Bladder Pheochromocytoma:
           Looking Beyond the Obvious

    • Authors: Santosh Kumar, Kalpesh Mahesh Parmar, Shivanshu Singh, Jyotsna Rani
      Pages: 56 - 56
      Abstract: Santosh Kumar, Kalpesh Mahesh Parmar, Shivanshu Singh, Jyotsna Rani

      Journal of Clinical Imaging Science 2014 4(1):56-56

      Pheochromocytomas located outside the adrenal glands are called paragangliomas. A pelvic location is rare, the most common location for a paraganglioma being the retroperitoneal space. Paragangliomas arise from neural crest cells. Pelvic pheochromocytomas may mimic urinary bladder pheochromocytomas on imaging studies. Patients may present with hypertensive crisis during micturition. We present a 26-year-old female who presented to us with accelerated hypertension with episodes of severe headache and palpitation during micturition. Based on imaging studies, she was diagnosed to have a urinary bladder pheochromocytoma. However, on exploration, the patient was found to have an extravesical pheochromocytoma arising from the left posterolateral pelvic wall, which was excised while preserving the bladder. We present this case report as pelvic pheochromocytomas can mimic bladder pheochromocytomas and are difficult to differentiate on radiological imaging and can lead to inadvertent cystectomy.
      Citation: Journal of Clinical Imaging Science 2014 4(1):56-56
      PubDate: Mon,27 Oct 2014
      DOI: 10.4103/2156-7514.143409
      Issue No: Vol. 4, No. 1 (2014)
       
  • Ewing's sarcoma of the Finger

    • Authors: Mehmet Ata Gokalp, Veysel Kaplanoglu, Seyyid Serif Unsal, Remzi Erten
      Pages: 57 - 57
      Abstract: Mehmet Ata Gokalp, Veysel Kaplanoglu, Seyyid Serif Unsal, Remzi Erten

      Journal of Clinical Imaging Science 2014 4(1):57-57

      Ewing's sarcoma is a mesenchymal cell tumor usually seen in long bones but very rarely seen in the bones of a finger. Swelling and pain are the most common complaints of the affected finger. In radiological imaging, it may be seen as permeative bone destruction accompanied by a soft tissue component or an expansile bone lesion. A 27-year-old right-hand dominant female patient presented with a swelling on the proximal phalanx of her right 3 rd finger that had existed for 3 years. However, the mass started to gradually increase in size and the pain worsened over a period of 5 weeks. The mass was excised under regional intravenous anesthesia and Ewing's sarcoma was confirmed following a histopathological evaluation. No local recurrence or metastasis was detected 1 year after surgery. Since Ewing's sarcoma is rarely seen in the finger, we present this case with its radiological and clinical findings.
      Citation: Journal of Clinical Imaging Science 2014 4(1):57-57
      PubDate: Mon,27 Oct 2014
      DOI: 10.4103/2156-7514.143420
      Issue No: Vol. 4, No. 1 (2014)
       
  • MDCT Venography Evaluation of a Rare Collateral Vein Draining from the
           Left Subclavian Vein to the Great Cardiac Vein

    • Authors: Antoine Abchee, Charbel Saade, Hussain Al-Mohiy, Fadi El-Merhi
      Pages: 58 - 58
      Abstract: Antoine Abchee, Charbel Saade, Hussain Al-Mohiy, Fadi El-Merhi

      Journal of Clinical Imaging Science 2014 4(1):58-58

      Congenital vascular anomalies of the venous drainage in the chest affect both cardiac and non-cardiac structures. Collateral venous drainage from the left subclavian vein to the great cardiac vein is a rare venous drainage pattern. These anomalies present a diagnostic challenge. Multi-detector computed tomography (MDCT) is useful in the diagnosis and treatment planning of these clinically complex disorders. We present a case report of an 18-year-old Caucasian male who came to our institute for evaluation of venous drainage patterns to the heart. We describe the contrast technique of bilateral dual injection MDCT venography and the imaging features of the venous drainage patterns to the heart.
      Citation: Journal of Clinical Imaging Science 2014 4(1):58-58
      PubDate: Mon,27 Oct 2014
      DOI: 10.4103/2156-7514.143425
      Issue No: Vol. 4, No. 1 (2014)
       
  • Hermansky-Pudlak syndrome Complicated by Pulmonary Fibrosis:
           Radiologic-Pathologic Correlation and Review of Pulmonary Complications

    • Authors: Tatiana Kelil, Jeanne Shen, Ailbhe C O'Neill, Stephanie A Howard
      Pages: 59 - 59
      Abstract: Tatiana Kelil, Jeanne Shen, Ailbhe C O'Neill, Stephanie A Howard

      Journal of Clinical Imaging Science 2014 4(1):59-59

      Hermansky-Pudlak syndrome (HPS) is a rare autosomal recessive disorder characterized by oculocutaneous hypopigmentation, platelet dysfunction, and in many cases, life-threatening pulmonary fibrosis. We report the clinical course, imaging, and postmortem findings of a 38-year-old female with HPS-related progressive pulmonary fibrosis, highlighting the role of imaging in assessment of disease severity and prognosis.
      Citation: Journal of Clinical Imaging Science 2014 4(1):59-59
      PubDate: Mon,27 Oct 2014
      DOI: 10.4103/2156-7514.143437
      Issue No: Vol. 4, No. 1 (2014)
       
  • Aneurysmal Bone Cyst of the Calcaneus

    • Authors: Veysel Kaplanoglu, Deniz Sozmen Ciliz, Hatice Kaplanoglu, Eda Elverici
      Pages: 60 - 60
      Abstract: Veysel Kaplanoglu, Deniz Sozmen Ciliz, Hatice Kaplanoglu, Eda Elverici

      Journal of Clinical Imaging Science 2014 4(1):60-60

      Aneurysmal bone cysts (ABCs) are benign, non-neoplastic, expansile, vascular, locally destructive lesions. The lesion may arise de novo (65%) or secondarily (35%) in pre-existing benign or malignant lesions (giant cell tumor, osteoblastoma, chondroblastoma, angioma, and others). The calcaneus is a rare localization for ABC, comprising only 1.6% of the cases. In this paper, we present a case of a female patient with a 3-month history of heel pain that got worse and was accompanied by swelling and difficulty in walking. The magnetic resonance images of the postero-lateral calcaneus showed a contrast-enhanced cystic lesion located in the medullary cavity; exophytic portion of the tumor extended into the soft tissue causing distinctive cortical thinning. Heterogeneous hyperintense septae formations and blood level components were also detected. After correlation with pathology results, the lesion was diagnosed as an ABC. Since an ABC of the calcaneus is a rarely seen phenomenon, we present the radiologic findings in this case and a review of the literature.
      Citation: Journal of Clinical Imaging Science 2014 4(1):60-60
      PubDate: Fri,31 Oct 2014
      DOI: 10.4103/2156-7514.143732
      Issue No: Vol. 4, No. 1 (2014)
       
  • Lesions of the Seminal Vesicles and their MRI Characteristics

    • Authors: Mahati N Reddy, Sadhna Verma
      Pages: 61 - 61
      Abstract: Mahati N Reddy, Sadhna Verma

      Journal of Clinical Imaging Science 2014 4(1):61-61

      Over the past few decades, MRI of the prostate has made great strides in improving cancer detection and is being embraced by more clinicians each day. This article aims to review the imaging characteristics of common and uncommon, but consequential lesions involving the seminal vesicles (SV), as seen predominantly on MRI. Many of these findings are seen incidentally during imaging of the prostate. Anatomy and embryology of the SV will be described which will help illustrate the associations of abnormalities seen. Congenital, infectious, neoplastic, and tumor mimics will be explored in detail, with discussion on clinical presentation and treatment strategies.
      Citation: Journal of Clinical Imaging Science 2014 4(1):61-61
      PubDate: Fri,31 Oct 2014
      DOI: 10.4103/2156-7514.143734
      Issue No: Vol. 4, No. 1 (2014)
       
  • Two Cases of Thyroid Metastasis from Head and Neck Squamous Cell Carcinoma
           Detected by FDG-PET/CT

    • Authors: Carina Mari Aparici, Aung Zaw Win
      Pages: 62 - 62
      Abstract: Carina Mari Aparici, Aung Zaw Win

      Journal of Clinical Imaging Science 2014 4(1):62-62

      We present two cases of head and neck squamous cell carcinoma (SCC) metastasizing to the thyroid gland. This is the first report that shows (18) F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) images of tonsillar and supraglottic SCCs invading the thyroid gland. Alcohol and tobacco use are the two most important risk factors for head and neck cancers, but recently human papilloma virus (HPV) infection has become a significant risk factor in the United States. FDG-PET/CT is very useful for SCC staging/restaging and follow-up.
      Citation: Journal of Clinical Imaging Science 2014 4(1):62-62
      PubDate: Sat,29 Nov 2014
      DOI: 10.4103/2156-7514.145850
      Issue No: Vol. 4, No. 1 (2014)
       
  • Blood Pool Contrast-enhanced Magnetic Resonance Angiography with
           Correlation to Digital Subtraction Angiography: A Pictorial Review

    • Authors: Martha-Grace Knuttinen, Jillian Karow, Winnie Mar, Margaret Golden, Karen L Xie
      Pages: 63 - 63
      Abstract: Martha-Grace Knuttinen, Jillian Karow, Winnie Mar, Margaret Golden, Karen L Xie

      Journal of Clinical Imaging Science 2014 4(1):63-63

      Magnetic resonance angiography (MRA) provides noninvasive visualization of the vascular supply of soft tissue masses and vascular pathology, without harmful radiation. This is important for planning an endovascular intervention, and helps to evaluate the efficiency and effectiveness of the treatment. MRA with conventional extracellular contrast agents relies on accurate contrast bolus timing, limiting the imaging window to first-pass arterial phase. The recently introduced blood pool contrast agent (BPCA), gadofosveset trisodium, reversibly binds to human serum albumin, resulting in increased T1 relaxivity and prolonged intravascular retention time, permitting both first-pass and steady-state phase high-resolution imaging. In our practice, high-quality MRA serves as a detailed "roadmap" for the needed endovascular intervention. Cases of aortoiliac occlusive disease, inferior vena cava thrombus, pelvic congestion syndrome, and lower extremity arteriovenous malformation are discussed in this article. MRA was acquired at 1.5 T with an 8-channel phased array coil after intravenous administration of gadofosveset (0.03 mmol/kg body weight), at the first-pass phase. In the steady-state, serial T1-weighted 3D spoiled gradient echo images were obtained with high resolution. All patients underwent digital subtraction angiography (DSA) and endovascular treatment. MRA and DSA findings of vascular anatomy and pathology are discussed and correlated. BPCA-enhanced MRA provides high-quality first-pass and steady-state vascular imaging. This could increase the diagnostic accuracy and create a detailed map for pre-intervention planning. Understanding the pharmacokinetics of BPCA and being familiar with the indications and technique of MRA are important for diagnosis and endovascular intervention.
      Citation: Journal of Clinical Imaging Science 2014 4(1):63-63
      PubDate: Sat,29 Nov 2014
      DOI: 10.4103/2156-7514.145860
      Issue No: Vol. 4, No. 1 (2014)
       
  • Dedicated Breast CT: Feasibility for Monitoring Neoadjuvant Chemotherapy
           Treatment

    • Authors: Srinivasan Vedantham, Avice M O'Connell, Linxi Shi, Andrew Karellas, Alissa J Huston, Kristin A Skinner
      Pages: 64 - 64
      Abstract: Srinivasan Vedantham, Avice M O'Connell, Linxi Shi, Andrew Karellas, Alissa J Huston, Kristin A Skinner

      Journal of Clinical Imaging Science 2014 4(1):64-64

      Objectives: In this prospective pilot study, the feasibility of non-contrast dedicated breast computed tomography (bCT) to determine primary tumor volume and monitor its changes during neoadjuvant chemotherapy (NAC) treatment was investigated. Materials and Methods: Eleven women who underwent NAC were imaged with a clinical prototype dedicated bCT system at three time points - pre-, mid-, and post-treatment. The study radiologist marked the boundary of the primary tumor from which the tumor volume was quantified. An automated algorithm was developed to quantify the primary tumor volume for comparison with radiologist's segmentation. The correlation between pre-treatment tumor volumes from bCT and MRI, and the correlation and concordance in tumor size between post-treatment bCT and pathology were determined. Results: Tumor volumes from automated and radiologist's segmentations were correlated (Pearson's r = 0.935, P < 0.001) and were not different over all time points [P = 0.808, repeated measures analysis of variance (ANOVA)]. Pre-treatment tumor volumes from MRI and bCT were correlated (r = 0.905, P < 0.001). Tumor size from post-treatment bCT was correlated with pathology (r = 0.987, P = 0.002) for invasive ductal carcinoma larger than 5 mm and the maximum difference in tumor size was 0.57 cm. The presence of biopsy clip (3 mm) limited the ability to accurately measure tumors smaller than 5 mm. All study participants were pathologically assessed to be responders, with three subjects experiencing complete pathologic response for invasive cancer and the reminder experiencing partial response. Compared to pre-treatment tumor volume, there was a statistically significant (P = 0.0003, paired t-test) reduction in tumor volume at mid-treatment observed with bCT, with an average tumor volume reduction of 47%. Conclusions: This pilot study suggests that dedicated non-contrast bCT has the potential to serve as an expedient imaging tool for monitoring tumor volume changes during NAC. Larger studies are needed in future.
      Citation: Journal of Clinical Imaging Science 2014 4(1):64-64
      PubDate: Sat,29 Nov 2014
      DOI: 10.4103/2156-7514.145867
      Issue No: Vol. 4, No. 1 (2014)
       
  • Imaging of Unilateral Meningo-ophthalmic Artery Anomaly in a Patient with
           Bilateral Nasopharyngeal Angiofibroma

    • Authors: Louise Louw, Johan Steyl, Eugene Loggenberg
      Pages: 65 - 65
      Abstract: Louise Louw, Johan Steyl, Eugene Loggenberg

      Journal of Clinical Imaging Science 2014 4(1):65-65

      A 12-year-old boy with epistaxis presented with a rare midline nasopharyngeal angiofibroma that extended lateral into the pterygoid and infratemporal fossae. Pre-operative angiography revealed bilateral prominent feeder arteries and two major anastomotic connections, and a rare left meningo-ophthalmic artery (M-OA) anomaly that was the sole path of supply to the eye. A literature search using Pubmed and Medline was conducted. For imaging, a six-vessel study (i.e. external and internal carotid and vertebral arteries on both sides) was selected. Embolization of prominent tumor feeder arteries was unsafe for tumor extirpation, but super-selective embolization of both sphenopalatine arteries was performed to control epistaxis. The M-OA anomaly that originated from the maxillary artery (MA) was marked by an ophthalmic artery (OA) variant with orbital and ocular divisions that coursed through the superior orbital fissure and optic foramen, respectively, each with distinct branching patterns, a middle meningeal artery (MMA) with normal branches (i.e. anterior and posterior branches), and two branch variations (i.e. lacrimal and meningeal branches) that originated from the anterior branch of the MMA. The lacrimal branch coursed through a cranio-orbital foramen, but the meningeal branch remained outside the orbit. The anatomy of the right OA was normal. The left M-OA anomaly was considered incidental and not tumor-related since the tumor was more prominent on the right side, and no intra-orbital infiltrations occurred. Of clinical significance is that proximal embolization of MA or MMA carries a high risk of visual impairment in cases where M-OA anomalies are the sole mode of supply to the eye.
      Citation: Journal of Clinical Imaging Science 2014 4(1):65-65
      PubDate: Sat,29 Nov 2014
      DOI: 10.4103/2156-7514.145889
      Issue No: Vol. 4, No. 1 (2014)
       
  • A Rare Case of Aneurysm of Arc of Riolan Artery and Gastroduodenal Artery

    • Authors: Athiyappan Kumaresh, Ramachandran Rajoo, Sellappan Rajamanickam Babu, Subramanian Ilanchezhian
      Pages: 66 - 66
      Abstract: Athiyappan Kumaresh, Ramachandran Rajoo, Sellappan Rajamanickam Babu, Subramanian Ilanchezhian

      Journal of Clinical Imaging Science 2014 4(1):66-66

      Arc of Riolan is a collateral channel that connects the proximal superior mesenteric artery (SMA) or its middle colic branch and the proximal inferior mesenteric artery or its left colic branch in case of stenosis of either of the arteries. A 65-year-old diabetic female presented with vague abdominal pain. Ultrasonography showed a large aneurysm within the abdomen in the left lumbar region. Computed tomography (CT) angiography done showed severe diffuse atherosclerotic calcification of the abdominal aorta with complete occlusion of the celiac trunk and mild stenosis of SMA origin. The arc of Riolan was seen between the middle colic artery and the ascending branch of the left colic artery, with a large saccular aneurysm in its mid section. No evidence of rupture or hematoma was visible. Another saccular aneurysm was also seen involving the gastro-duodenal and the pancreatico-duodenal collateral arcade. As far as we know, this is the first case of arc of Riolan artery aneurysm to be reported in English literature.
      Citation: Journal of Clinical Imaging Science 2014 4(1):66-66
      PubDate: Sat,29 Nov 2014
      DOI: 10.4103/2156-7514.145895
      Issue No: Vol. 4, No. 1 (2014)
       
  • Management of Bleeding Duodenal Varices with Combined TIPS Decompression
           and Trans-TIPS Transvenous Obliteration Utilizing 3% Sodium
           Tetradecyl Sulfate Foam Sclerosis

    • Authors: Wael E Saad, Allison Lippert, Sandra Schwaner, Abdullah Al-Osaimi, Saher Sabri, Nael Saad
      Pages: 67 - 67
      Abstract: Wael E Saad, Allison Lippert, Sandra Schwaner, Abdullah Al-Osaimi, Saher Sabri, Nael Saad

      Journal of Clinical Imaging Science 2014 4(1):67-67

      Objectives: Endoscopic experience in the management of duodenal varices (DVs) is limited and challenging given the anatomic constraints and limited experience. The endovascular management of DVs is not yet established and the controversy of whether to manage them by decompression with a transjugular intrahepatic portosystemic shunt (TIPS) or by transvenous obliteration is unresolved. In the literature, the 6-12 month rebleeding rate of DVs after TIPS is 21-37% and after transvenous obliteration is 13%. The purpose of the study is to evaluate the clinical outcome of combined TIPS decompression and transvenous obliteration/sclerosis. Materials and Methods: This is a retrospective study (case series) of two institutions, evaluating patients who underwent TIPS and/or transvenous obliteration/sclerosis for bleeding DVs (from January 2009 to June 2013). TIPS was performed according to a standard procedure using covered stents. Transvenous obliteration (variceal sclerosis) from the systemic and/or portal venous circulation was performed utilizing 3% sodium tetradecyl sulfate foam. Transvenous obliteration was commonly augmented with coils and/or vascular plugs. Technical (technical success of establishing TIPS and completely obliterating the DVs) and clinical outcomes (rebleeding rate and survival) were evaluated. Results: Five patients with liver cirrhosis presenting with bleeding DVs were included in the study with all eventually (and coincidentally) receiving TIPS and transvenous obliteration. Two of the five patients underwent concomitant TIPS and transvenous obliteration in the same procedural setting. However, three patients underwent transvenous obliteration due to bleeding despite a patent TIPS that had been previously placed. The average time from TIPS placement to transvenous obliteration was 125 days (range: 3-324 days). After having both procedures, there was no rebleeding in the patients during a mean follow-up period of 22 months (6-50 months). Coils and/or metallic vascular plugs were used to augment the sclerosant obliteration in four of five patients. Conclusion: The combination of TIPS decompression and foam sclerosant transvenous obliteration appears to be effective in preventing rebleeding in this limited case series and compares favorably with the existing evidence for either approach [TIPS or balloon-occluded retrograde transvenous obliteration (BRTO)] alone.
      Citation: Journal of Clinical Imaging Science 2014 4(1):67-67
      PubDate: Sat,29 Nov 2014
      DOI: 10.4103/2156-7514.145903
      Issue No: Vol. 4, No. 1 (2014)
       
  • Levoatriocardinal Vein: An Unusual Cause of Right-to-Left Shunting

    • Authors: Nilima Shet, Pierre Maldjian
      Pages: 68 - 68
      Abstract: Nilima Shet, Pierre Maldjian

      Journal of Clinical Imaging Science 2014 4(1):68-68

      We present a case demonstrating an anomalous vessel connecting the left brachiocephalic vein and the left superior pulmonary vein, found incidentally on computed tomography (CT) imaging. This pulmonary-systemic venous connection, known as a levoatriocardinal vein, is a rare anomaly. In previous descriptions, this vessel has typically been associated with left-to-right shunt. Here, we describe the magnetic resonance imaging (MRI) and CT findings in a case with right-to-left shunting through the anomalous vessel likely secondary to elevated right cardiac pressure.
      Citation: Journal of Clinical Imaging Science 2014 4(1):68-68
      PubDate: Sat,29 Nov 2014
      DOI: 10.4103/2156-7514.145907
      Issue No: Vol. 4, No. 1 (2014)
       
  • Imaging in the diagnosis of juvenile nasopharyngeal angiofibroma

    • Authors: Satyaranjan Mishra, NM Praveena, Rajat Golakh Panigrahi, Y Mogit Gupta
      Pages: 1 - 1
      Abstract: Satyaranjan Mishra, NM Praveena, Rajat Golakh Panigrahi, Y Mogit Gupta

      Journal of Clinical Imaging Science 2013 3(2):1-1

      Juvenile nasopharyngeal angiofibroma (JNA) is a rare, benign, highly vascular, and locally aggressive tumor that predominantly occurs in adolescent males. Usually, the presenting symptom is a painless nasal obstruction or epistaxis; however, other symptoms may develop depending on the size and extent of the tumor mass. Owing to the vascularity of the tumor, incisional biopsy is not attempted. The diagnosis is dependent on multiplanar imaging modalities like Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and Angiography. These imaging modalities help in assessing the tumor mass, pre-operative embolization of the feeder vessel, and treatment planning. Usually, patients with JNA are diagnosed by otorhinolaryngologists, but here, we present a rare case of JNA reporting to the dental hospital due to a tender palatal swelling.
      Citation: Journal of Clinical Imaging Science 2013 3(2):1-1
      PubDate: Fri,22 Mar 2013
      DOI: 10.4103/2156-7514.109469
      Issue No: Vol. 3, No. 2 (2013)
       
  • Non-syndromic non-familial agenesis of major salivary glands: A report of
           two cases with review of literature

    • Authors: Ravi Prakash Sasankoti Mohan, Sankalp Verma, Venkateswara Rao Chawa, Kuber Tyagi, Ravi Prakash Sasankoti Mohan, Sankalp Verma, Venkateswara Rao Chawa, Kuber Tyagi
      Pages: 2 - 2
      Abstract: Ravi Prakash Sasankoti Mohan, Sankalp Verma, Venkateswara Rao Chawa, Kuber Tyagi, Ravi Prakash Sasankoti Mohan, Sankalp Verma, Venkateswara Rao Chawa, Kuber Tyagi

      Journal of Clinical Imaging Science 2013 3(2):2-2

      Agenesis of the major salivary glands is a rare and unusual condition, with only a few cases documented in the literature. The anomaly can be total or partial, unilateral or bilateral, and involve the parotid, submandibular, and sublingual glands. The resultant xerostomia leads to extensive dental demineralization. The authors report two cases with decreased saliva volume, impaired dental condition with extensive loss of tooth structure, and an astonishing pattern of dental destruction most notable on the facial and lingual surfaces of incisors and canines that can be best described as "chipping." After detailed review of patient history, clinical examination, ultrasonography, contrast enhanced computed tomography, and magnetic resonance imaging a diagnosis of congenital absence of major salivary glands in both the patients was made. Dentists should be aware that salivary gland aplasia is an uncommon cause of dental deterioration. It may manifest itself not by extensive caries but as dental chipping effect. Early recognition and a therapeutic strategy can prevent further dental damage.
      Citation: Journal of Clinical Imaging Science 2013 3(2):2-2
      PubDate: Fri,22 Mar 2013
      DOI: 10.4103/2156-7514.109474
      Issue No: Vol. 3, No. 2 (2013)
       
  • Salivary Duct Cyst: Histo-pathologic Correlation

    • Authors: Divya Vinayachandran, Sathasivasubramanian Sankarapandian
      Pages: 3 - 3
      Abstract: Divya Vinayachandran, Sathasivasubramanian Sankarapandian

      Journal of Clinical Imaging Science 2013 3(2):3-3

      Non-neoplastic cysts of the salivary glands are uncommon and represent 2-5% of all salivary gland lesions. They are mainly mucoceles or salivary duct cysts. Unlike a mucocele, which is surrounded by granulation tissue, the salivary duct cyst is lined by epithelium. Salivary duct cysts are more common in the oral minor salivary glands and rarely occur in the major salivary glands, show a marked predilection for the superficial lobe of the parotid, and represent 10% of all salivary gland cysts. Neoplastic differentiation of the lining of the salivary duct cyst has been reported. We report a case of a salivary duct cyst of the left parotid gland, with a review of radiographic and histopathologic features.
      Citation: Journal of Clinical Imaging Science 2013 3(2):3-3
      PubDate: Tue,30 Apr 2013
      DOI: 10.4103/2156-7514.111236
      Issue No: Vol. 3, No. 2 (2013)
       
  • Basal Cell Adenocarcinoma of the Minor Salivary Glands Involving Palate
           and Maxillary Sinus

    • Authors: Prathi Venkata Sarath, N Kannan, Rajendra Patil, Rakesh Kumar Manne, Beeraka Swapna, KV Suneel Kumar
      Pages: 4 - 4
      Abstract: Prathi Venkata Sarath, N Kannan, Rajendra Patil, Rakesh Kumar Manne, Beeraka Swapna, KV Suneel Kumar

      Journal of Clinical Imaging Science 2013 3(2):4-4

      Basal cell adenocarcinoma (BCAC) is a rare neoplasm accounting for only 2.9% of all salivary gland neoplasms. BCAC involving palatal minor salivary glands are exceedingly rare, and only 10 cases have been reported in the literature. The treatment of choice is surgical excision. Here, we report a case of a 55-year-old male patient with massive BCAC of palatal minor salivary gland extending into the maxillary sinus. This is the first case of BCAC treated by radiotherapy followed by chemotherapy. A follow-up check conducted after 14-months showed good prognosis.
      Citation: Journal of Clinical Imaging Science 2013 3(2):4-4
      PubDate: Fri,31 May 2013
      DOI: 10.4103/2156-7514.112799
      Issue No: Vol. 3, No. 2 (2013)
       
  • Hemimandibular Hypertrophy - Hybrid Variants: Report of Two Cases

    • Authors: Ravi Prakash Sasankoti Mohan, Sankalp Verma, Udita Singh, Neha Agarwal
      Pages: 5 - 5
      Abstract: Ravi Prakash Sasankoti Mohan, Sankalp Verma, Udita Singh, Neha Agarwal

      Journal of Clinical Imaging Science 2013 3(2):5-5

      Hemimandibular hypertrophy and its variants result from unilateral excessive growth of the mandible and involve both the body and ramus of mandible. This causes facial asymmetry and in turn accompanying psychological problems. In this report we discuss use of imaging in diagnosis of these lesions and investigate the different variants.
      Citation: Journal of Clinical Imaging Science 2013 3(2):5-5
      PubDate: Sat,31 Aug 2013
      DOI: 10.4103/2156-7514.116199
      Issue No: Vol. 3, No. 2 (2013)
       
  • Multiple Osteolytic Lesions

    • Authors: Divya Vinayachandran, Sathasivasubramanian Sankarapandian
      Pages: 6 - 6
      Abstract: Divya Vinayachandran, Sathasivasubramanian Sankarapandian

      Journal of Clinical Imaging Science 2013 3(2):6-6

      Several systemic diseases initially present with various oral manifestations. Investigation of these oral symptoms may at times lead to the diagnosis of grave underlying life-threatening conditions. We present one such case, where the patient manifested with gross enlargement of the mandible, along with lesions in the lower limbs. These lesions were the initial manifestation and on further investigations the patient was diagnosed with multiple myeloma.
      Citation: Journal of Clinical Imaging Science 2013 3(2):6-6
      PubDate: Sat,31 Aug 2013
      DOI: 10.4103/2156-7514.117460
      Issue No: Vol. 3, No. 2 (2013)
       
  • Infected Dentigerous Cyst of Maxillary Sinus Arising from an Ectopic Third
           Molar

    • Authors: Yadavalli Guruprasad, Dinesh Singh Chauhan, Umashankar Kura
      Pages: 7 - 7
      Abstract: Yadavalli Guruprasad, Dinesh Singh Chauhan, Umashankar Kura

      Journal of Clinical Imaging Science 2013 3(2):7-7

      A dentigerous cyst or follicular cyst is a form of odontogenic cyst. It is believed that it forms during the development of the tooth and is associated with pressure exerted by the crown of an unerupted (or partially erupted) tooth on the fluid within the follicular space. Typically, dentigerous cysts are painless and discovered during routine radiographic examination. However, they may be large and result in a palpable mass. Additionally, as they grow they displace adjacent teeth. They almost exclusively occur in permanent dentition. The cyst is lined by stratified squamous non-keratinizing epithelium. About 70% of dentigerous cysts occur in the mandible and 30% in the maxilla. Dentigerous cysts associated with ectopic teeth within the maxillary sinus are very rare. We report radiologic and pathologic features in a rare case of infected dentigerous cyst of maxillary sinus arising from an ectopic third molar in a 21-year-old female patient.
      Citation: Journal of Clinical Imaging Science 2013 3(2):7-7
      PubDate: Sat,31 Aug 2013
      Issue No: Vol. 3, No. 2 (2013)
       
  • A Rare Presentation of Bilateral Maxillary Dens Invaginatus Diagnosed
           Using Cone Beam Computed Tomography

    • Authors: Sainath Dinapadu, Swathi Aravelli, Srikanth Pasari, Narender Reddy Marukala
      Pages: 8 - 8
      Abstract: Sainath Dinapadu, Swathi Aravelli, Srikanth Pasari, Narender Reddy Marukala

      Journal of Clinical Imaging Science 2013 3(2):8-8

      Dens invaginatus is a developmental variation in the formation of a tooth that causes changes in the internal anatomy of the tooth. The presence of double dens invaginatus is extremely rare. Understanding the type, extension, and complex morphology of dens invaginatus is essential. Diagnosis of this condition using conventional radiographic techniques is not easy. Advanced imaging techniques, such as cone beam computed tomography (CBCT) are very helpful in diagnosis of these complex anatomic variations. In the present case report, we demonstrate the use of CBCT in the evaluation and treatment planning of bilateral maxillary dens invaginatus, of which one presented as a case of double dens.
      Citation: Journal of Clinical Imaging Science 2013 3(2):8-8
      PubDate: Mon,30 Sep 2013
      DOI: 10.4103/2156-7514.119126
      Issue No: Vol. 3, No. 2 (2013)
       
  • Unicystic Ameloblastoma Masquerading as Huge Periapical Lesion, both
           Clinically and Histopathologically: Two Case Reports with Review of
           Literature

    • Authors: N. V. V. Satyabhusan, Samapika Routray, Lavanya Bendi, B Venkat Suresh, Sumit Majumdar, Neeta Mohanty
      Pages: 9 - 9
      Abstract: N. V. V. Satyabhusan, Samapika Routray, Lavanya Bendi, B Venkat Suresh, Sumit Majumdar, Neeta Mohanty

      Journal of Clinical Imaging Science 2013 3(2):9-9

      Unicystic ameloblastoma (UA) is one of the variants of ameloblastoma. It manifests as unilocular radiolucency in the mandible or maxilla on X-ray scans. In very rare cases, it can appear as a localized periradicular radiolucent area, imitating a periapical lesion. In this article, we present two cases of UA that were initially misdiagnosed as periapical lesions. Subsequently, surgical enucleation was performed and the diagnosis of UA was confirmed histopathologically.
      Citation: Journal of Clinical Imaging Science 2013 3(2):9-9
      PubDate: Mon,30 Sep 2013
      DOI: 10.4103/2156-7514.119156
      Issue No: Vol. 3, No. 2 (2013)
       
  • Adenoid Cystic Carcinoma of Sublingual Salivary Gland Obstructing the
           Submandibular Salivary Gland Duct

    • Authors: Venkata Suneel Kumar, Venkata Sarath Prathi, Rakesh Kumar Manne, Swapna Beeraka, Kannan Natarajan
      Pages: 10 - 10
      Abstract: Venkata Suneel Kumar, Venkata Sarath Prathi, Rakesh Kumar Manne, Swapna Beeraka, Kannan Natarajan

      Journal of Clinical Imaging Science 2013 3(2):10-10

      Sublingual salivary gland malignancies are extremely rare and account for only 0.3-1% of all epithelial salivary gland tumors. Here, we report a case of adenoid cystic carcinoma (ACC) of the sublingual salivary gland that presented as a swelling in the right anterior floor of the mouth obstructing the submandibular duct. Sublingual salivary gland ACC obstructing the submandibular duct is rare and only three cases have been reported in the literature until date. We discuss the different patterns of ACC seen during the pathologic investigations and its radiologic features.
      Citation: Journal of Clinical Imaging Science 2013 3(2):10-10
      PubDate: Tue,29 Oct 2013
      DOI: 10.4103/2156-7514.120793
      Issue No: Vol. 3, No. 2 (2013)
       
  • Giant Pindborg Tumor (Calcifying Epithelial Odontogenic Tumor): An Unusual
           Case Report with Radiologic-Pathologic Correlation

    • Authors: Satya Ranjan Misra, Sthitaprajna Lenka, Sujit Ranjan Sahoo, Sobhan Mishra
      Pages: 11 - 11
      Abstract: Satya Ranjan Misra, Sthitaprajna Lenka, Sujit Ranjan Sahoo, Sobhan Mishra

      Journal of Clinical Imaging Science 2013 3(2):11-11

      Odontogenic tumors develop in the jaws from odontogenic tissues such as enamel organ, Hertwig epithelial root sheath, dental lamina, and so on. A variety of tumors unique to the maxilla and mandible are therefore seen. Calcifying epithelial odontogenic tumor (CEOT) is a rare, aggressive, benign odontogenic tumor of epithelial origin accounting for only about 1% of all odontogenic tumors. It is eponymously called ''Pindborg tumor'', as it was first described by Pindborg in 1955. The origin of this locally invasive tumor remains unknown. It is thought to arise from stratum intermedium. It commonly affects the posterior mandible manifesting as a slow-growing asymptomatic swelling often associated with an impacted tooth. We report a case of CEOT, for which, owing to its huge size we have proposed the term ''giant'' Pindborg tumor (CEOT). This is probably the largest case of this tumor reported so far in the English literature. The present case also has the classic yet rare ''driven snow'' appearance of the tumor on radiographs.
      Citation: Journal of Clinical Imaging Science 2013 3(2):11-11
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124056
      Issue No: Vol. 3, No. 2 (2013)
       
  • Ultrasonographic Evaluation of Oral Submucous Fibrosis and Masseteric
           Hypertrophy

    • Authors: Jones Raja Devathambi, Nalini Aswath
      Pages: 12 - 12
      Abstract: Jones Raja Devathambi, Nalini Aswath

      Journal of Clinical Imaging Science 2013 3(2):12-12

      Objectives: To evaluate the efficacy of ultrasonography (USG) as a non-invasive tool in assessing the severity of oral submucous fibrosis (OSMF) and also to assess the relationship between OSMF and hypertrophy of the masseter muscle. Materials and Methods: The submucosal thickness in buccal mucosa and masseteric muscle hypertrophy were measured using ultrasound (10-15 MHz) in 60 patients comprising 30 OSMF patients and 30 controls. Results: Results were analyzed by one way analysis of variance, Chi-square test and t-test. As the stages of OSMF advanced there was an increase in submucosal thickness of the buccal mucosa as well as masseter muscle thickness in both relaxed and contracted state in the study group when compared with controls (P < 0.005). Conclusion: USG is an effective non-invasive zero radiation tool for assessing the progression of OSMF.
      Citation: Journal of Clinical Imaging Science 2013 3(2):12-12
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124057
      Issue No: Vol. 3, No. 2 (2013)
       
  • Multiple Venous Malformations with Phleboliths: Radiological-Pathological
           Correlation

    • Authors: Venkateswara Rao Chava, Ashwini Naveen Shankar, Naveen Shankar Vemanna, Sudheer Kumar Cholleti
      Pages: 13 - 13
      Abstract: Venkateswara Rao Chava, Ashwini Naveen Shankar, Naveen Shankar Vemanna, Sudheer Kumar Cholleti

      Journal of Clinical Imaging Science 2013 3(2):13-13

      Vascular malformations are congenital lesions that are present at birth and do not regress. However, they often present later in life. They are subdivided into two categories: (1) slow- or low-flow and (2) fast- or high-flow malformations. Low-flow malformations contain combinations of capillary, venous, and lymphatic components. Venous malformations can occur anywhere in the body, but are most frequently seen in the head and neck (40%). These lesions present in a variety of ways, from a vague blue patch to a soft blue mass, which may be single isolated or may occur in multiple areas. Treatment depends on the type of lesion, the location, degree of involvement, and the clinical symptoms. Here we are report the imaging and histopathologic findings in a patient with multiple venous malformations affecting the left side of the face and trunk.
      Citation: Journal of Clinical Imaging Science 2013 3(2):13-13
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124058
      Issue No: Vol. 3, No. 2 (2013)
       
  • Bilateral Multiple Level Lateral Meningocoele

    • Authors: BE Panil Kumar, Kishor V Hegde, G Lalitha Kumari, Amit Agrawal
      Pages: 1 - 1
      Abstract: BE Panil Kumar, Kishor V Hegde, G Lalitha Kumari, Amit Agrawal

      Journal of Clinical Imaging Science 2013 3(1):1-1

      Lateral meningocoele is a very rare disorder characterized by extensions of the dura and arachnoid through an enlarged neural foramen. We report a case of a 23-year-old female with deformity of spine who presented with low back pain and no neurological deficits. A whole spine magnetic resonance imaging showed multiple well-defined cystic masses involving dorsal, lumbar, and sacral spinal levels bilaterally, with dural ectasia and neural foraminal widening suggestive of bilateral multiple level lateral meningocoele. The patient is being managed conservatively and is on regular follow-up.
      Citation: Journal of Clinical Imaging Science 2013 3(1):1-1
      PubDate: Wed,30 Jan 2013
      DOI: 10.4103/2156-7514.106613
      Issue No: Vol. 3, No. 1 (2013)
       
  • Relationship Between Ultrasound Estimated Amniotic Fluid Index and Fetal
           Weight in Healthy Pregnant African Women

    • Authors: Ademola A Adeyekun, Gbolahan G Awosanya
      Pages: 2 - 2
      Abstract: Ademola A Adeyekun, Gbolahan G Awosanya

      Journal of Clinical Imaging Science 2013 3(1):2-2

      Introduction: Fetal weight (FW) estimation in late pregnancy is an important guide in obstetric care. Amniotic fluid protects the fetus against traumatic and infective insults. There possibly exists a relationship between FW and amniotic fluid index (AFI) that can be estimated by ultrasonography. Materials and Methods: Two hundred and fifty-eight low-risk pregnancies were prospectively studied by means of ultrasound over a 12-month period. FW was estimated using a combination of fetal parameters; bi-parietal diameter, fetal trunk cross sectional area, and femur length. AFI was assessed using the 4-quadrant method. Spearman's correlation was used to test possible relationship between amniotic fluid indices and estimated FW pairs. The level of statistical significance was set at P &#8804; 0.05. Results: The mean AF1 and estimated fetal weight (EFW) pairs were as follows: at 27-29 weeks the values were 172.1 mm and 1,250.2 g; at 30-32 weeks AF1 and EFW values were 170.3 mm and 1,648.0 g; at 33-35 weeks values were 162.3 mm and 2,273.5 g; at 36-38 weeks values were 144.09 mm and 2,906.1 g; at 39-40 weeks AF1 and EFW values were 125.0 mm and 3,222.6 g. Overall, there was no statistically significant relationship between AFI and EFW ( P > 0.05; r = 0.241). Conclusion: While FW calculations and amniotic index showed variations in value in late pregnancy, there does not appear to be a linear relationship between ultrasound estimate of FW and amniotic index. The implication of this is that fetal size need not be taken into cognizance when alterations in amniotic fluid values are noted.
      Citation: Journal of Clinical Imaging Science 2013 3(1):2-2
      PubDate: Wed,30 Jan 2013
      DOI: 10.4103/2156-7514.106614
      Issue No: Vol. 3, No. 1 (2013)
       
  • Are All Odontogenic Keratocysts Keratocystic Odontogenic Tumors?
           Correlation between Imaging Features and Epithelial Cell Proliferation

    • Authors: Harkanwal Preet Singh, Amit Nayar, Asha Raj, Prince Kumar
      Pages: 3 - 3
      Abstract: Harkanwal Preet Singh, Amit Nayar, Asha Raj, Prince Kumar

      Journal of Clinical Imaging Science 2013 3(1):3-3

      This study was to correlate and analyze the imaging features and epithelial cell proliferation pattern in different cases of keratocystic odontogenic tumors (KCOT) and study the role of inflammation using proliferative markers and different radiographic patterns of KCOT to determine its biological behavior. One hundred and eighty-six cases of KCOT were taken together and grouped based on radiographic patterns. Forty cases were randomly selected and stained using a proliferating cellular nuclear antigen marker. The correlation between imaging and epithelial proliferation with and without inflammation was determined. Unilocular variety is the most common type of KCOT, showing least epithelial proliferation of all the patterns. More than 50% of the multilocular KCOTs were associated with inflammation, showing an enhanced rate of epithelial proliferation. Results were subjected to statistical analysis. Different rates of epithelial proliferation of the different patterns suggested that all odontogenic keratocysts do not behave like tumors and that aggressive treatment should be reserved for selective cases only depending on radiographic and other histopathological parameters such as inflammation.
      Citation: Journal of Clinical Imaging Science 2013 3(1):3-3
      PubDate: Wed,30 Jan 2013
      DOI: 10.4103/2156-7514.106616
      Issue No: Vol. 3, No. 1 (2013)
       
  • Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery:
           Diagnosis with CT Angiography

    • Authors: Guray Oncel, Dilek Oncel
      Pages: 4 - 4
      Abstract: Guray Oncel, Dilek Oncel

      Journal of Clinical Imaging Science 2013 3(1):4-4

      Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. It is associated with early infant mortality and sudden death in adults. Traditionally, ALCAPA has been diagnosed by angiography or autopsy; however, the development of cardiac computed tomography (CT) and magnetic resonance imaging (MRI) has allowed noninvasive evaluation of the coronary anatomy by direct visualization of the origin of the left coronary artery (LCA) from the pulmonary artery. We report a case of 10-year-old girl who has been on follow up for dilated cardiomyopathy for 4 years. The definitive diagnosis of ALCAPA is reached by multislice computed tomography (MSCT). The MSCT scan showed an anomalous origin of LCA from the pulmonary trunk, with a tortuous and dilated right coronary artery and right-to-left collateralization. Consequently, the patient was successfully treated with surgery.
      Citation: Journal of Clinical Imaging Science 2013 3(1):4-4
      PubDate: Wed,30 Jan 2013
      DOI: 10.4103/2156-7514.106618
      Issue No: Vol. 3, No. 1 (2013)
       
  • Congenital Cystic Lung Diseases

    • Authors: Aditi Jain, K Anand, Saurabh Singla, Ashok Kumar
      Pages: 5 - 5
      Abstract: Aditi Jain, K Anand, Saurabh Singla, Ashok Kumar

      Journal of Clinical Imaging Science 2013 3(1):5-5

      Congenital cystic diseases of the lung are a rare but significant cause of morbidity in children and young adults presenting with respiratory distress and repeated chest infections. They consist of cystic adenomatoid malformation, bronchogenic cyst, pulmonary sequestration, and congenital lobar emphysema. Surgical treatment is a safe and an effective method of treatment. Chest X-ray and computed tomography are the key imaging modalities used for diagnosis.
      Citation: Journal of Clinical Imaging Science 2013 3(1):5-5
      PubDate: Wed,30 Jan 2013
      DOI: 10.4103/2156-7514.106620
      Issue No: Vol. 3, No. 1 (2013)
       
  • Non-Invasive Diagnosis of Abdomino-Pelvic Masses: Role of Multimodality
           Imaging

    • Authors: Vijayanadh Ojili, Sree Harsha Tirumani, Kedar N Chintapalli, Gowthaman Gunabushanam
      Pages: 6 - 6
      Abstract: Vijayanadh Ojili, Sree Harsha Tirumani, Kedar N Chintapalli, Gowthaman Gunabushanam

      Journal of Clinical Imaging Science 2013 3(1):6-6

      Recent advances in radiology have greatly increased the ability to make highly accurate diagnosis. Biopsy of many commonly seen lesions is no longer performed as the radiological findings are pathognomonic. This gives rise to the concept of 'virtual biopsy', a term coined on the lines of other imaging techniques such as virtual colonoscopy. Virtual biopsy is not a new imaging technique but a new concept which refers to the use of existing imaging modalities to evaluate the morphological features of tumors and arriving at a non-invasive diagnosis with a high degree of confidence obviating the need for true biopsy. Elements of virtual biopsy have already been incorporated into some evidence-based guidelines, and it is expected that with further technological advancements, an increasing number of tumors may be diagnosed and managed accordingly. A wider acceptance of virtual biopsy could further reduce the need for invasive biopsies and its attendant costs and risks. In this review article, we use index cases to further emphasize this concept.
      Citation: Journal of Clinical Imaging Science 2013 3(1):6-6
      PubDate: Wed,30 Jan 2013
      DOI: 10.4103/2156-7514.106621
      Issue No: Vol. 3, No. 1 (2013)
       
  • Role of secretin-enhanced magnetic resonance cholangiopancreatography in
           the evaluation of patients following pancreatojejunostomy

    • Authors: Munazza Anis, Koenraad Mortele
      Pages: 7 - 7
      Abstract: Munazza Anis, Koenraad Mortele

      Journal of Clinical Imaging Science 2013 3(1):7-7

      Objective: This study was conducted to assess the role of secretin-enhanced magnetic resonance cholangiopancreatography (S-MRCP) in the evaluation of patients following pancreatico-jejunal anatomosis. Materials and Methods: S-MRCP studies ( n = 83) performed at Brigham and Women's Hospital between 1/2005 and 7/2005 were retrospectively reviewed. Among these, there were 13 patients (10 females, 3 males; mean age = 45 years, range = 18-74 years) who were evaluated with S-MRCP following pancreatojejunal anatomosis. Single-shot fast spin-echo T2-weighted thick slab dynamic MRCP images obtained before and every minute (for 10 min) after IV injection of secretin (2 mcg/kg body weight of SecreFloTM IV over 1 min) were reviewed retrospectively and independently by 3 readers. Image analysis included measurement of the main pancreatic duct (MPD) diameter and subjective assessment of the grade of visualization of the MPD remnant. The amount of jejunal fluid and visualization of the pancreatico-jejunal anatomosis pre-and post-secretin were also documented. Direct correlation with endoscopic retrograde cholangiopancreatography (ERCP) finding was available in six of the 13 cases. Results: The MPD diameter and MPD remnant visualization improved post-secretin for 1/3 readers. The number of pancreatico-jejunal anastomoses and the amount of jejunal fillings pre-and post-secretin was seen to improve significantly for 1 of the 3 readers. For Reader 1, the mean MPD diameter in the body of the pancreas, on the pre-and post-secretin image, was 3.2 &#177; 1.3 mm and 3.8 &#177; 1.9 mm, respectively. There was no statistical difference in the values pre- and post-secretin in the MPD diameter ( P = 0.07), MPD visualization ( P = 0.16) and the number of pancreatico-jejunal anastomoses seen ( P = 0.125 5/13 pre- and 9/13 post-secretin). Statistical significance was seen in the amount of jejunal filling ( P = 0.01) after secretin. For Reader 2, the MPD diameter pre-and post-secretin was 4 &#177; 2 and 3.9 &#177; 2.1 mm, respectively ( P = 0.89). The MPD visualization ( P = 0.19) and degree of jejunal filling ( P = 0.7) did not improve significantly. There were 3/13 pancreatico-jejunostomy anastomoses seen pre- and 8/13 seen post-secretin ( P = 0.06). The values for Reader 3 reached a statistical significance for the measurement of MPD ( P = 0.032). In addition, MPD visualization ( P = 0.038), the number of anastomoses seen ( P = 0.016) and jejunal filling ( P = 0.006) were also significantly improved. Conclusion: The addition of intravenous secretin to an MRCP study in the evaluation of patients following pancreatojejunal anastomosis does not significantly impact the visualization of the pancreatic duct. However, secretin may improve the assessment of the pancreatico-jejunal anastomosis.
      Citation: Journal of Clinical Imaging Science 2013 3(1):7-7
      PubDate: Thu,28 Feb 2013
      Issue No: Vol. 3, No. 1 (2013)
       
  • Broad ligament fibroid mimicking as ovarian tumor on ultrasonography and
           computed tomography scan

    • Authors: Dayananda Kumar Rajanna, Vaibhav Pandey, Sujit Janardhan, Sujatha N Datti
      Pages: 8 - 8
      Abstract: Dayananda Kumar Rajanna, Vaibhav Pandey, Sujit Janardhan, Sujatha N Datti

      Journal of Clinical Imaging Science 2013 3(1):8-8

      Giant fibroids are known to arise from the uterus, and very rarely from the broad ligament. Large fibroids often undergo hyaline, cystic, and at times, red degeneration. In the present case, cystic degeneration with intervening septations in an adnexal mass raised the suspicion of ovarian neoplasm as the ovaries were not seen as separate from the lesion. The ultrasonographic and contrast-enhanced computed tomographic findings of this case were characteristic of ovarian neoplasm. The differential diagnosis included rare possibility of giant fibroid with cystic degeneration. The diagnosis was confirmed on histopathological examination. The patient underwent excision of the broad ligament fibroid, hysterectomy, and bilateral salpingo-oophorectomy. Magnetic resonance imaging has a role in the diagnosis of such lesions.
      Citation: Journal of Clinical Imaging Science 2013 3(1):8-8
      PubDate: Thu,28 Feb 2013
      Issue No: Vol. 3, No. 1 (2013)
       
  • Limited utility of plain abdominal radiographs in evaluating
           intussusceptions secondary to long indwelling feeding tubes

    • Authors: Albert Yang, Chandana Lall, Puneet Bhargava, David Imagawa
      Pages: 9 - 9
      Abstract: Albert Yang, Chandana Lall, Puneet Bhargava, David Imagawa

      Journal of Clinical Imaging Science 2013 3(1):9-9

      Adult intussusception (AI) is relatively rare and can be a difficult clinical diagnosis, often requiring cross-sectional imaging for confirmation. Unfortunately, intussusceptions in the setting of indwelling long enteral feeding tubes have been predominantly characterized in the pediatric population with minimal investigation in adults. We report three cases of AI in patients with long feeding catheters serving as anatomic lead points leading to intussusception diagnosed on cross-sectional imaging. We highlight the limited utility of the supine plain films for detection of AI, and it behooves the radiologist to hold a high index of suspicion if the patient has a long enteral catheter. Since the majority of these patients tend to be fairly ill and unable to stand for upright abdominal radiographs, in the setting of percutaneous feeding tubes, decubitus abdominal radiographs should always be obtained. These cases also highlight the importance of having a high clinical suspicion of intussusceptions in a patient presenting with abdominal pain in the setting of an enteral feeding tube. In post-operative patients, other factors can predispose the patient to intussusception, including adhesions. Another interesting feature in tube related AI is the reverse intussusception that may be seen with indwelling enteral tubes. Reverse intussusception is where the distal bowel telescopes into the proximal segment over the tube.
      Citation: Journal of Clinical Imaging Science 2013 3(1):9-9
      PubDate: Thu,28 Feb 2013
      DOI: 10.4103/2156-7514.107994
      Issue No: Vol. 3, No. 1 (2013)
       
  • Mixed adenoneuroendocrine carcinoma of cecum: A rare entity

    • Authors: Aditi Jain, Saurabh Singla, KS Jagdeesh, HY Vishnumurthy
      Pages: 10 - 10
      Abstract: Aditi Jain, Saurabh Singla, KS Jagdeesh, HY Vishnumurthy

      Journal of Clinical Imaging Science 2013 3(1):10-10

      Mixed adenoneuroendocrine carcinoma of cecum (MANEC) was first reported by Cardier in 1924. These tumors are thought to arise from multi-potential stem cells, which have differentiated bidirectionally. Location of the tumor influences the treatment and outcome. We report a rare case of MANEC where the patient presented with abdominal pain and distension. Imaging revealed an ileo colic intussusception with the lead point being a MANEC.
      Citation: Journal of Clinical Imaging Science 2013 3(1):10-10
      PubDate: Thu,28 Feb 2013
      DOI: 10.4103/2156-7514.107995
      Issue No: Vol. 3, No. 1 (2013)
       
  • Gossypiboma, varied presentations: A report of two cases

    • Authors: Supreethi Kohli, Anu Singhal, Bishwanath Tiwari, Sanjeev Singhal
      Pages: 11 - 11
      Abstract: Supreethi Kohli, Anu Singhal, Bishwanath Tiwari, Sanjeev Singhal

      Journal of Clinical Imaging Science 2013 3(1):11-11

      A mass formed around a cotton matrix left within the body is termed as textiloma or gossypiboma. It is a rare complication of surgery most commonly seen after abdominal operations. The time of presentation may range from early post-operative period to several decades later. A correct diagnosis can be made in only one-third of the cases. The most common differential diagnosis is a new-onset or recurrent tumor. This may lead to a lot of patient anxiety as well as several unnecessary attempts at biopsy or surgery. Gossypiboma may present as either of the following syndromes - pseudotumoral, occlusive, or septic entity and the risk of fistulization increases with time. We present two diverse cases, the first case being of a patient with gastro-cutaneous fistula due to retained sponge presenting within 2 months of open cholecystectomy, while the second case presented 13 years after a hysterectomy, with abdominal lump and obstruction caused by a retained sponge.
      Citation: Journal of Clinical Imaging Science 2013 3(1):11-11
      PubDate: Thu,28 Feb 2013
      DOI: 10.4103/2156-7514.107998
      Issue No: Vol. 3, No. 1 (2013)
       
  • Renal Cell Carcinoma in a Horseshoe Kidney: Radiology and Pathology
           Correlation

    • Authors: Ali Alamer
      Pages: 12 - 12
      Abstract: Ali Alamer

      Journal of Clinical Imaging Science 2013 3(1):12-12

      Renal cell carcinoma (RCC) is encountered in about 3% of all adult neoplasms. Presence of any kidney malformation can change the plan for surgical treatment of RCC with organ preserving surgery. We report a case of clear cell RCC in a horseshoe kidney. Computed tomography scan revealed a horseshoe kidney anomaly with a large mass in the left side. The diagnosis of RCC was confirmed by pathology and histology findings.
      Citation: Journal of Clinical Imaging Science 2013 3(1):12-12
      PubDate: Fri,29 Mar 2013
      DOI: 10.4103/2156-7514.109725
      Issue No: Vol. 3, No. 1 (2013)
       
  • Autosomal Recessive Polycystic Kidney Disease: Antenatal Diagnosis and
           Histopathological Correlation

    • Authors: Dayananda Kumar Rajanna, Anjani Reddy, Naren Satya Srinivas, Ankur Aneja
      Pages: 13 - 13
      Abstract: Dayananda Kumar Rajanna, Anjani Reddy, Naren Satya Srinivas, Ankur Aneja

      Journal of Clinical Imaging Science 2013 3(1):13-13

      Autosomal recessive polycystic kidney disease (ARPKD) is one of the most common inheritable disease manifesting in infancy and childhood with a frequency of 1:6,000 to 1:55,000 births. The patient in her second trimester presented with a history of amenorrhea. Ultrasound examination revealed bilateral, enlarged, hyperechogenic kidneys, placentomegaly, and severe oligohydramnios. The pregnancy was terminated. An autopsy was performed on the fetus. Both the kidneys were found to be enlarged and the cut surface showed numerous cysts. The liver sections showed changes due to fibrosis. The final diagnosis of autosomal recessive polycystic kidney disease was made based on these findings. In this article, we correlate the ante-natal ultrasound and histopathological findings in autosomal recessive polycystic kidney disease.
      Citation: Journal of Clinical Imaging Science 2013 3(1):13-13
      PubDate: Fri,29 Mar 2013
      DOI: 10.4103/2156-7514.109733
      Issue No: Vol. 3, No. 1 (2013)
       
  • Squamous Cell Carcinoma of the Renal Pelvis Associated with Kidney Stones:
           Radiologic Imaging Features with Gross and Histopathological Correlation

    • Authors: Ozlem Tugce Kalayci, Zehra Bozdag, Fitnet Sonmezgoz, Nurhan Sahin
      Pages: 14 - 14
      Abstract: Ozlem Tugce Kalayci, Zehra Bozdag, Fitnet Sonmezgoz, Nurhan Sahin

      Journal of Clinical Imaging Science 2013 3(1):14-14

      Squamous cell carcinoma (SCC) of the renal pelvis is a rare neoplasm and is usually associated with long standing renal stone disease. This tumor is aggressive in nature and usually has a poor prognosis. We report a case who presented with sudden significant weight loss. During the radiologic investigation, a renal mass and staghorn calculi were detected in the right kidney. The patient subsequently underwent right radical nephrectomy. Pathological diagnosis was SCC of renal pelvis with extensive infiltration in to the renal parenchyma. The radiologic imaging features and histopathologic findings of this rare tumor are discussed in this report.
      Citation: Journal of Clinical Imaging Science 2013 3(1):14-14
      PubDate: Fri,29 Mar 2013
      DOI: 10.4103/2156-7514.109741
      Issue No: Vol. 3, No. 1 (2013)
       
  • Losing Your Voice: Etiologies and Imaging Features of Vocal Fold Paralysis

    • Authors: Behroze Vachha, Mary Beth Cunnane, Pavan Mallur, Gul Moonis
      Pages: 15 - 15
      Abstract: Behroze Vachha, Mary Beth Cunnane, Pavan Mallur, Gul Moonis

      Journal of Clinical Imaging Science 2013 3(1):15-15

      Neurogenic compromise of vocal fold function exists along a continuum encompassing vocal cord hypomobility (paresis) to vocal fold immobility (paralysis) with varying degrees and patterns of reinnervation. Vocal fold paralysis (VFP) may result from injury to the vagus or the recurrent laryngeal nerves anywhere along their course from the brainstem to the larynx. In this article, we review the anatomy of the vagus and recurrent laryngeal nerves and examine the various etiologies of VFP. Selected cases are presented with discussion of key imaging features of VFP including radiologic findings specific to central vagal neuropathy and peripheral recurrent nerve paralysis.
      Citation: Journal of Clinical Imaging Science 2013 3(1):15-15
      PubDate: Fri,29 Mar 2013
      DOI: 10.4103/2156-7514.109751
      Issue No: Vol. 3, No. 1 (2013)
       
  • Magnetic Resonance Imaging as an Adjunct to Ultrasound in Evaluating
           Cesarean Scar Ectopic Pregnancy

    • Authors: Rebecca Wu, Michelle A Klein, Sabrina Mahboob, Mala Gupta, Douglas S Katz
      Pages: 16 - 16
      Abstract: Rebecca Wu, Michelle A Klein, Sabrina Mahboob, Mala Gupta, Douglas S Katz

      Journal of Clinical Imaging Science 2013 3(1):16-16

      Cesarean scar pregnancies (CSPs) are a relatively rare form of ectopic pregnancy in which the embryo is implanted within the fibrous scar of a previous cesarean section. A greater number of cases of CSPs are currently being reported as the rates of cesarean section are increasing globally and as detection of scar pregnancy has improved with use of transvaginal ultrasound (TVUS) with color Doppler imaging. Delayed diagnosis and management of this potentially life-threatening condition may result in complications, predominantly uterine rupture and hemorrhage with significant potential maternal morbidity. Diagnosis of a cesarean scar pregnancy (CSP) requires a high index of clinical suspicion, as up to 40% of patients may be asymptomatic. TVUS has a reported sensitivity of 84.6% and has become the imaging examination of choice for diagnosis of a CSP. Magnetic resonance imaging (MRI) has been used in a small number of patients as an adjunct to TVUS. In the present report, MRI is highlighted as a problem-solving tool capable of more precisely identifying the relationship of a CSP to adjacent structures, thereby providing additional information critical to directing appropriate patient management and therapy.
      Citation: Journal of Clinical Imaging Science 2013 3(1):16-16
      PubDate: Fri,29 Mar 2013
      DOI: 10.4103/2156-7514.109758
      Issue No: Vol. 3, No. 1 (2013)
       
  • Imaging of Tuberculosis of the Abdominal Viscera: Beyond the Intestines

    • Authors: Sree Harsha Tirumani, Vijayanadh Ojili, Alampady Krishna Prasad Shanbhogue, Arpit Nagar, Najla Fasih, Kedar N Chintapalli, Gowthaman Gunabushanam
      Pages: 17 - 17
      Abstract: Sree Harsha Tirumani, Vijayanadh Ojili, Alampady Krishna Prasad Shanbhogue, Arpit Nagar, Najla Fasih, Kedar N Chintapalli, Gowthaman Gunabushanam

      Journal of Clinical Imaging Science 2013 3(1):17-17

      There is an increasing incidence of both intra- and extra-thoracic manifestations of tuberculosis, in part due to the AIDS epidemic. Isolated tubercular involvement of the solid abdominal viscera is relatively unusual. Cross-sectional imaging with ultrasound, multidetector computed tomography (CT), and magnetic resonance imaging (MRI) plays an important role in the diagnosis and post treatment follow-up of tuberculosis. Specific imaging features of tuberculosis are frequently related to caseous necrosis, which is the hallmark of this disease. However, depending on the type of solid organ involvement, tubercular lesions can mimic a variety of neoplastic and nonneoplastic conditions. Often, cross-sectional imaging alone is insufficient in reaching a conclusive diagnosis, and image-guided tissue sampling is needed. In this article, we review the pathology and cross-sectional imaging features of tubercular involvement of solid abdominopelvic organs with a special emphasis on appropriate differential diagnoses.
      Citation: Journal of Clinical Imaging Science 2013 3(1):17-17
      PubDate: Tue,30 Apr 2013
      DOI: 10.4103/2156-7514.111234
      Issue No: Vol. 3, No. 1 (2013)
       
  • Occurrence of Polymelia in a Female Child

    • Authors: Satyajeet Verma, Manish Khanna, VN Tripathi, NC Yadav
      Pages: 18 - 18
      Abstract: Satyajeet Verma, Manish Khanna, VN Tripathi, NC Yadav

      Journal of Clinical Imaging Science 2013 3(1):18-18

      We report a rare case of polymelia in a 6-month-old female child who presented with developed lower limbs and an additional underdeveloped left lower limb.
      Citation: Journal of Clinical Imaging Science 2013 3(1):18-18
      PubDate: Tue,30 Apr 2013
      DOI: 10.4103/2156-7514.111235
      Issue No: Vol. 3, No. 1 (2013)
       
  • Angiographic Patterns of Transjugular Intrahepatic Portosystemic Shunt
           Dysfunction and Interventional Approaches to Shunt Revision

    • Authors: Ahmad Parvinian, Benedictta O Omene, James T Bui, Martha Grace Knuttinen, Jeet Minocha, Ron C Gaba
      Pages: 19 - 19
      Abstract: Ahmad Parvinian, Benedictta O Omene, James T Bui, Martha Grace Knuttinen, Jeet Minocha, Ron C Gaba

      Journal of Clinical Imaging Science 2013 3(1):19-19

      Transjugular intrahepatic portosystemic shunt (TIPS) is an established and effective treatment for the complications of portal hypertension. The non-trivial rates of shunt dysfunction inherent to TIPS mandate familiarity with the imaging diagnosis and endovascular management of this phenomenon. Herein, we present a pictorial review of the various angiographic patterns of TIPS dysfunction and illustrate traditional and innovative technical approaches to shunt revision.
      Citation: Journal of Clinical Imaging Science 2013 3(1):19-19
      PubDate: Tue,30 Apr 2013
      DOI: 10.4103/2156-7514.111237
      Issue No: Vol. 3, No. 1 (2013)
       
  • An Unusual Radiological Presentation of a Pulmonary Hydatid Cyst in a
           Child

    • Authors: Servet Kayhan, Unal Sahin, Hasan Turut, Cuneyt Yurdakul
      Pages: 20 - 20
      Abstract: Servet Kayhan, Unal Sahin, Hasan Turut, Cuneyt Yurdakul

      Journal of Clinical Imaging Science 2013 3(1):20-20

      Giant pulmonary hydatid cyst is usually encountered in adolescents and children who are older than 10 years. A relatively higher elasticity of the lung tissue allows rapid growth of cysts. We present a case of a 15-year-old male who was admitted with complaint of frequent and persistent dry cough for over a month. Computed tomographic scan revealed a giant cyst with thick enhancing rim and an "air bubble" sign. Diagnosis of giant hydatid cyst was confirmed by surgery and histopathological examination.
      Citation: Journal of Clinical Imaging Science 2013 3(1):20-20
      PubDate: Tue,30 Apr 2013
      DOI: 10.4103/2156-7514.111238
      Issue No: Vol. 3, No. 1 (2013)
       
  • An Uncommon Case of Neurofibromatosis Type 2: A Tribute to the
           Intracranial Calcifications

    • Authors: Anil Ozgür, Yasemin Karaman, Feramuz Demir Apaydin, Meltem Nass Duce
      Pages: 21 - 21
      Abstract: Anil Ozgür, Yasemin Karaman, Feramuz Demir Apaydin, Meltem Nass Duce

      Journal of Clinical Imaging Science 2013 3(1):21-21

      Neurofibromatosis Type 2 (NF2) is a genetic disorder associated with schwannomas, meningiomas, and ependymomas. Intracranial calcifications, either tumoral or non-tumoral, are relatively lesser known features of NF2. Here, we present a case of NF2, in which the diagnosis was suspected due to the presence of choroid plexus and subependymal calcifications, although no obvious schwannoma or meningioma was detected initially on standard computed tomography or magnetic resonance imaging. This case highlights the importance of further evaluation with appropriate imaging techniques.
      Citation: Journal of Clinical Imaging Science 2013 3(1):21-21
      PubDate: Fri,31 May 2013
      DOI: 10.4103/2156-7514.112802
      Issue No: Vol. 3, No. 1 (2013)
       
  • Appearances of von Meyenburg Complex on Cross Sectional Imaging

    • Authors: Phillip F.C Lung, Ounali S Jaffer, Nuzhat Akbar, Paul S Sidhu, Suzanne M Ryan
      Pages: 22 - 22
      Abstract: Phillip F.C Lung, Ounali S Jaffer, Nuzhat Akbar, Paul S Sidhu, Suzanne M Ryan

      Journal of Clinical Imaging Science 2013 3(1):22-22

      The von Meyenburg complex (VMC) is an uncommon congenital malformation and is characterized by benign bile duct hamartomas. These are usually discovered incidentally and may represent a diagnostic dilemma when liver metastases are suspected. MRI of VMC shows distinct imaging characteristics, but reporting of lesional contrast enhancement has been inconsistent, whilst microbubble contrast enhanced ultrasound provides 'real-time' evaluation of soft tissue vascularity. Given the diagnostic uncertainty over imaging in VMC, biopsy is often recommended as the definitive diagnosis. We report a biopsy proven case of VMC on a background of primary colonic malignancy investigated with ultrasound, contrast enhanced ultrasound, computed tomography CT, and magnetic resonance imaging MRI, and review the key imaging features.
      Citation: Journal of Clinical Imaging Science 2013 3(1):22-22
      PubDate: Fri,31 May 2013
      DOI: 10.4103/2156-7514.112804
      Issue No: Vol. 3, No. 1 (2013)
       
  • Diagnostic Efficacy of Panoramic Radiography in Detection of Osteoporosis
           in Post-Menopausal Women with Low Bone Mineral Density

    • Authors: Sunanda Bhatnagar, Vasavi Krishnamurthy, Sandeep S Pagare
      Pages: 23 - 23
      Abstract: Sunanda Bhatnagar, Vasavi Krishnamurthy, Sandeep S Pagare

      Journal of Clinical Imaging Science 2013 3(1):23-23

      Objective: The aim of the study was to evaluate panoramic radiograph, a commonly taken dental radiograph as a screening tool to detect early osseous changes (normal, mildly or severely eroded) of the mandibular inferior cortex and measure the mandibular cortical width (CW) in post-menopausal women and correlate it with the bone mineral density (BMD) measured by the ultrasound bone sonometer at the mid-shaft tibia region. Materials and Methods: The study included females between 45 years and 65 years of age in their post-menopausal stage (no menstruation for at least 6-12 months). Mandibular indices (mandibular CW and mandibular cortical shape) were evaluated from panoramic radiographs. The BMD assessment was carried out at the mid-shaft tibia region, exactly half-way between the heel and the knee joint perpendicular to the direction of the bone, using an ultrasound bone sonometer. It is a non-invasive device designed for quantitative measurement of the velocity of ultrasound waves as "speed of sound" in m/s, capable of measuring bone density at one or more skeletal sites. Using 1994 WHO criteria the study subjects were categorized as Group 1: Normal, Group 2: Osteopenia, Group 3: Osteoporosis. (WHO T score for tibia BMD can be used as a standard). Results: The diagnostic efficacy of the panoramic radiograph in detecting osseous changes in post-menopausal women with low BMD was shown to have 96% specificity and 60% sensitivity with mandibular cortical shape and 58% specificity and 73% sensitivity with mandibular CW measurement. Factorial ANOVA analysis carried out indicated a significant correlation of BMD classification with mandibular cortical shape (F = 29.0, P < 0.001, partial eta squared [&#951;2 ] =0.85), a non-significant correlation with mandibular CW, (F = 1.6, P = 0.23, &#951;2 = 0.86), and a more significant correlation with combined cortical shape and width (F = 3.3, P < 0.05, &#951;2 = 0.70). Conclusion: The study concludes that the combined mandibular cortical findings (P < 0.05) and mandibular cortical shape erosion alone (P < 0.001) on panoramic radiograph are effective indicators of osteoporosis in post-menopausal women.
      Citation: Journal of Clinical Imaging Science 2013 3(1):23-23
      PubDate: Thu,6 Jun 2013
      DOI: 10.4103/2156-7514.113140
      Issue No: Vol. 3, No. 1 (2013)
       
  • Camptodactyly-Arthropathy-Coxa Vara-Pericarditis Syndrome: Important
           Differential for Juvenile Idiopathic Arthritis

    • Authors: Ritu Manoj Kakkar, Sameer Soneji, Rashmi R Badhe, Shrinivas B Desai
      Pages: 24 - 24
      Abstract: Ritu Manoj Kakkar, Sameer Soneji, Rashmi R Badhe, Shrinivas B Desai

      Journal of Clinical Imaging Science 2013 3(1):24-24

      Camptodactyly-arthropathy-coxa vara-pericarditis (CACP) syndrome is an inherited disorder characterized by congenital or early-onset flexion camptodactyly, childhood-onset of non-inflammatory arthropathy, often associated with non-inflammatory pericarditis or pericardial effusion and progressive coxa vara. The causative gene is located on chromosome band 1q25-31. This gene encodes for "proteoglycan-4" (PRG-4), which is a surface lubricant for joints and tendons. This syndrome has distinct radiological and histological features, which are important to recognize since it may clinically mimic juvenile idiopathic arthritis and mutation studies may not be easily available. We describe a case of a 3-year 3-month-old female with features of CACP syndrome.
      Citation: Journal of Clinical Imaging Science 2013 3(1):24-24
      PubDate: Sat,29 Jun 2013
      DOI: 10.4103/2156-7514.114211
      Issue No: Vol. 3, No. 1 (2013)
       
  • Spontaneous Biliary Peritonitis in Children

    • Authors: Supreethi Kohli, Anu Singhal, Anita Arora, Sanjeev Singhal
      Pages: 25 - 25
      Abstract: Supreethi Kohli, Anu Singhal, Anita Arora, Sanjeev Singhal

      Journal of Clinical Imaging Science 2013 3(1):25-25

      Pediatric Spontaneous Bile duct perforation is a rare clinical condition with only around 150 cases reported worldwide. Early management gives excellent prognosis but the condition often presents a diagnostic dilemma. Hepato-biliary Technetium-99m-iminodiacetic acid scintiscan is the diagnostic investigation of choice but its availability in third world countries is limited. We present two cases of spontaneous biliary peritonitis in children, which were diagnosed without scintiscanning. The first case was a one-and -a half-year-old child, who was diagnosed with biliary peritonitis without pneumoperitoneum by a combination of Ultrasound (USG), Contrast enhanced computed tomography (CECT), and Magnetic Resonance Imaging (MRI). The child underwent USG-guided drainage and subsequent cholecystectomy with hepatico-jejunostomy. The second child also had biliary peritonitis without pneumoperitoneum, which was initially suspected on USG. CECT revealed dilated gall bladder and fluid collection in sub-hepatic space and pelvis. Abdominal paracentesis revealed presence of bile. The child responded to conservative therapy. Both are doing well on two-year follow-up. In a patient with jaundice, biliary tract abnormalities and/or free fluid, either generalized or localized to peri-cholecystic/sub-hepatic space on USG/CT/MRI, in the absence of pneumoperitoneum, suggest a diagnosis of biliary perforation even in the absence of scintiscanning.
      Citation: Journal of Clinical Imaging Science 2013 3(1):25-25
      PubDate: Sat,29 Jun 2013
      DOI: 10.4103/2156-7514.114213
      Issue No: Vol. 3, No. 1 (2013)
       
  • Clinico-radiologic Findings in Group II Caudal Regression Syndrome

    • Authors: Pankaj Sharma, Sheo Kumar, Awdesh Jaiswal
      Pages: 26 - 26
      Abstract: Pankaj Sharma, Sheo Kumar, Awdesh Jaiswal

      Journal of Clinical Imaging Science 2013 3(1):26-26

      Caudal regression syndrome (CRS) is a rare congenital abnormality in which a segment of the lumbo-sacral spine and spinal cord fails to develop. The severity of the morphologic derangement inversely correlates with residual spinal cord function. We present a case report of a 10-year-old girl with Group 2 CRS, to emphasize clinical and radiologic findings in this rare abnormality.
      Citation: Journal of Clinical Imaging Science 2013 3(1):26-26
      PubDate: Sat,29 Jun 2013
      DOI: 10.4103/2156-7514.114214
      Issue No: Vol. 3, No. 1 (2013)
       
  • Association of Progesterone, Pessary, and Antibiotic for Treating Pregnant
           Woman with Short Cervix Syndrome: Importance of Magnetic Resonance Imaging
           in the Assessment of Pessary Position

    • Authors: Edward Araujo Júnior, Eduardo Félix Martins Santana, Luciano Marcondes Machado Nardozza, Antonio Fernandes Moron
      Pages: 27 - 27
      Abstract: Edward Araujo Júnior, Eduardo Félix Martins Santana, Luciano Marcondes Machado Nardozza, Antonio Fernandes Moron

      Journal of Clinical Imaging Science 2013 3(1):27-27

      Preterm delivery (PD) is the most important cause of neonatal mortality, particularly before the 32 nd week of pregnancy. A short cervix is the most important quantitative marker for predicting PD. However, there are other qualitative markers such as cervical gland area, cervical funneling, and sludge. We present the case of a pregnant woman who was diagnosed with a short cervix at 14-weeks and demonstrate the use of triple therapy, which helped to achieve a good perinatal result. A 37-year-old pregnant woman (G3P0) was referred to our service at 14-weeks of pregnancy presenting with a short cervix (20 mm) and a positive sludge sign. She was hospitalized; a pessary was inserted, and started on antibiotic therapy (clindamycin and cefalotin for 10 days). At 20 weeks, she was again admitted to the hospital, and this time presented with a further shortened cervix (9 mm), cervical funneling, and a positive sludge sign, with the pessary in position. The following procedures were performed: Amniocentesis on the sludge (negative bacterioscopy), another cycle of antibiotics, administration of oral progesterone, and imaging to determine retention of pessary position. The patient was placed in the Trendelenburg position and remained hospitalized for 82 days. At 32 + 1 weeks, the fetus presented distress (tachycardia). C-section was performed, producing a live female newborn weighing 2,180 g and presenting Apgar indexes of 8/8. This case report demonstrates the importance of magnetic resonance imaging to assess the position of pessary in a pregnant woman with short cervix.
      Citation: Journal of Clinical Imaging Science 2013 3(1):27-27
      PubDate: Tue,9 Jul 2013
      DOI: 10.4103/2156-7514.114802
      Issue No: Vol. 3, No. 1 (2013)
       
  • Correlation of Ultrasonographic Parameters with Serum Creatinine in
           Chronic Kidney Disease

    • Authors: Jagdeesh K Siddappa, Saurabh Singla, Mohammed Al Ameen, SC Rakshith, Naveen Kumar
      Pages: 28 - 28
      Abstract: Jagdeesh K Siddappa, Saurabh Singla, Mohammed Al Ameen, SC Rakshith, Naveen Kumar

      Journal of Clinical Imaging Science 2013 3(1):28-28

      Objective: The purpose of our study is to correlate renal echogenicity with serum creatinine in order to determine the significance of renal echogenicity when it comes to identifying the progression of chronic kidney disease (CKD) and for the sonographic grading of CKD. Materials and Methods: Sixty patients above 30 years of age who had been diagnosed with CKD according to the guidelines of the National Kidney Foundation were included in the study. Patients on kidney replacement therapy or with fatty liver findings on ultrasonography were excluded. Ultrasounds of kidneys were performed by two radiologists who were blind to the patients' serum creatinine levels. Renal cortical echogenicity was compared with serum creatinine. Statistical analysis was performed using one-way ANOVA followed by Scheffe's test. The relationship between serum creatinine and sonographic features was assessed by correlation coefficient analysis. A P value less than 0.05 was considered statistically significant. Results: Mean serum creatinine was 2.80 mg/dl for Grade 1 (range: 0.9-9.2 mg/dl), 3.69 mg/dl for Grade 2 (range: 1.2-10.3 mg/dl), 3.86 mg/dl for Grade 3 (range: 1.1-6.5 mg/dl), and 7.90 mg/dl for Grade 4 (range: 3.1-11.4 mg/dl). The grades being determined by cortical echogenicity on imaging A statistically significant, positive correlation was observed between serum creatinine and grading based on cortical echogenicity (P = 0.004). Conclusion: Renal echogenicity and its grading correlates better with serum creatinine in CKD than other sonographic parameters such as longitudinal size, parenchymal thickness, and cortical thickness. Hence, renal echogenicity is a better parameter than serum creatinine for estimating renal function in CKD, and has the added advantage of irreversibility.
      Citation: Journal of Clinical Imaging Science 2013 3(1):28-28
      PubDate: Tue,9 Jul 2013
      DOI: 10.4103/2156-7514.114809
      Issue No: Vol. 3, No. 1 (2013)
       
  • Transjugular Intrahepatic Portosystemic Shunt for Maintenance of Portal
           Venous Patency in Liver Transplant Candidates

    • Authors: Ron Charles Gaba, Ahmad Parvinian
      Pages: 29 - 29
      Abstract: Ron Charles Gaba, Ahmad Parvinian

      Journal of Clinical Imaging Science 2013 3(1):29-29

      Maintenance of portal venous patency is vital to liver transplant candidates, as the presence of portal vein thrombosis (PVT) adversely impacts clinical outcomes by increasing surgical complexity and decreasing postoperative survival. By enhancing portal venous blood flow, transjugular intrahepatic portosystemic shunt (TIPS) creation may enable clearance of PVT and preservation of portal venous patency in cirrhotic patients. Herein, we describe four cases in which TIPS produced and sustained an open portal venous system in liver transplant candidates with partial PVT. All patients demonstrated rapid and effective flow-enabled clearance of clot and intermediate to long-term preservation of portal venous flow. On this basis, we propose that maintenance of portal venous patency in liver transplant candidates with partial PVT represents a developing indication for TIPS.
      Citation: Journal of Clinical Imaging Science 2013 3(1):29-29
      PubDate: Mon,29 Jul 2013
      DOI: 10.4103/2156-7514.115761
      Issue No: Vol. 3, No. 1 (2013)
       
  • A Rare Cause of Crazy-Paving and Mediastinal Lymphadenopathy: Congestive
           Heart Failure

    • Authors: Aysegul Senturk, Aysegul Karalezli, Ayse Nur Soyturk, H Canan Hasanoglu
      Pages: 30 - 30
      Abstract: Aysegul Senturk, Aysegul Karalezli, Ayse Nur Soyturk, H Canan Hasanoglu

      Journal of Clinical Imaging Science 2013 3(1):30-30

      Crazy-paving sign is a pattern seen on multislice computed tomography images of the lungs. It is characterized by a reticular pattern superimposed on ground-glass opacity. It was first described in the late 1980s in patients with pulmonary alveolar proteinosis, but has now been described in some other diseases of the lung. Enlarged mediastinal lymph nodes can be seen in infectious and specific inflammatory diseases and malignancies. The present report describes a case of a 44-year-old man in whom congestive heart failure presented with a crazy-paving appearance and enlarged lymph nodes of the lungs on the chest computed tomography scan.
      Citation: Journal of Clinical Imaging Science 2013 3(1):30-30
      PubDate: Mon,29 Jul 2013
      DOI: 10.4103/2156-7514.115762
      Issue No: Vol. 3, No. 1 (2013)
       
  • A Rare Cause of Acute Abdomen: Jejunal Diverticulosis with Perforation

    • Authors: Ibrahim Aydin, Ahmet Pergel, Ahmet Fikret Yucel, Dursun Ali Sahin
      Pages: 31 - 31
      Abstract: Ibrahim Aydin, Ahmet Pergel, Ahmet Fikret Yucel, Dursun Ali Sahin

      Journal of Clinical Imaging Science 2013 3(1):31-31

      Jejunal diverticulosis is generally asymptomatic and is associated with high morbidity and mortality secondary to complications, especially in elderly patients. We present a case report of a 74-year-old female patient with jejunal diverticulosis and perforation due to diverticulitis.
      Citation: Journal of Clinical Imaging Science 2013 3(1):31-31
      PubDate: Mon,29 Jul 2013
      DOI: 10.4103/2156-7514.115763
      Issue No: Vol. 3, No. 1 (2013)
       
  • Functioning Adrenocortical Carcinoma with Extension upto the Right Atrium
           Producing Cushing's Syndrome

    • Authors: Santosh Kumar, Gautam R Choudhary, Arawat Pushkarna
      Pages: 32 - 32
      Abstract: Santosh Kumar, Gautam R Choudhary, Arawat Pushkarna

      Journal of Clinical Imaging Science 2013 3(1):32-32

      Adrenocortical carcinoma (ACC) is a rare malignancy with poor prognosis. Surgery is the only curative therapy available and overall 5-year survival for patients who undergo a complete resection is 32% to 48%. They are known to produce intravascular invasion and into the inferior vena cava (IVC) and in rare cases they may reach the right atrium. We report a case of functioning ACC extending into the inferior vena cava and right atrium in a female with Cushing's syndrome.
      Citation: Journal of Clinical Imaging Science 2013 3(1):32-32
      PubDate: Sat,31 Aug 2013
      DOI: 10.4103/2156-7514.116186
      Issue No: Vol. 3, No. 1 (2013)
       
  • Localized Cystic Disease of the Kidney: A Rare Cause of Hypertension in a
           Young Adult

    • Authors: Aynur Solak, Mehmet Serkan Gür, Berhan Genç, Neslin Sahin
      Pages: 33 - 33
      Abstract: Aynur Solak, Mehmet Serkan Gür, Berhan Genç, Neslin Sahin

      Journal of Clinical Imaging Science 2013 3(1):33-33

      Localized cystic disease of kidney (LCDK) is a rare, non-familial, non-progressive renal disorder that is not associated with cysts or disorders in other organs. Only a few cases have been reported in the literature. While this condition is morphologically identical to the autosomal dominant form of polycystic kidney disease, it is not inherited and is not associated with significant deterioration of renal function. We present a case of a 16-year-old male patient who suffered from hypertension for over two years. On imaging we found several, variable-sized cysts in the upper half of the right kidney. The left kidney and lower segment of the right kidney were normal. Selective renal vein catheterization and sampling showed markedly elevated renin level in the right upper segmental vein (92 pg/ml, normal value: 11-33 pg/ml). The patient underwent a right upper heminephrectomy and histopathology was suggestive of LCDK. After surgery, the patient's blood pressure returned to normal levels without any need of antihypertensive medication and he is under follow-up on outpatient basis for the past two years.
      Citation: Journal of Clinical Imaging Science 2013 3(1):33-33
      PubDate: Sat,31 Aug 2013
      DOI: 10.4103/2156-7514.116191
      Issue No: Vol. 3, No. 1 (2013)
       
  • Magnetic Resonance Imaging of Benign Cardiac Masses: A Pictorial Essay

    • Authors: Thomas J Ward, Michael A Kadoch, Adam H Jacobi, Jacobi P Lopez, Javier Sanz Salvo, Matthew D Cham
      Pages: 34 - 34
      Abstract: Thomas J Ward, Michael A Kadoch, Adam H Jacobi, Jacobi P Lopez, Javier Sanz Salvo, Matthew D Cham

      Journal of Clinical Imaging Science 2013 3(1):34-34

      The differential diagnosis for a cardiac mass includes primary and metastatic neoplasms. While primary cardiac tumors are rare, metastatic disease to the heart is a common finding in cancer patients. Several "tumor-like" processes can mimic a true cardiac neoplasm with accurate diagnosis critical at guiding appropriate management. We present a pictorial essay of the most common benign cardiac masses and "mass-like" lesions with an emphasis on magnetic resonance imaging features.
      Citation: Journal of Clinical Imaging Science 2013 3(1):34-34
      PubDate: Sat,31 Aug 2013
      DOI: 10.4103/2156-7514.117458
      Issue No: Vol. 3, No. 1 (2013)
       
  • Semantic Dementia Diagnosed by F-18 FDG PET/MRI: Co-registered Images

    • Authors: Prashant Jolepalem, Dafang Wu
      Pages: 35 - 35
      Abstract: Prashant Jolepalem, Dafang Wu

      Journal of Clinical Imaging Science 2013 3(1):35-35

      We report a case of a 61-year-old male who presented with a sudden change in mental status. From a psychiatric standpoint, his symptoms were consistent with a bipolar disorder. A neurology consult raised suspicion for vascular dementia, given the sudden onset of symptoms; however, the magnetic resonance angiography (MRA) was unremarkable. The magnetic resonance imaging (MRI) had findings that were suggestive of both vascular and frontotemporal lobe dementia based on parenchymal atrophy and a lacunar infarct near the thalamus. However, by co-registering the magnetic resonance images with a subsequent fluorine-18 Fluorodeoxyglucose positron emission tomography (F-18 FDG PET), and combining the functional data with the anatomic appearance, the diagnosis was narrowed to semantic dementia, which is one of the lesser known subtypes of frontotemporal lobe dementia (FTD).
      Citation: Journal of Clinical Imaging Science 2013 3(1):35-35
      PubDate: Sat,31 Aug 2013
      DOI: 10.4103/2156-7514.117459
      Issue No: Vol. 3, No. 1 (2013)
       
  • Prevalence and Degree of Breast Arterial Calcifications on Mammography: A
           Cross-sectional Analysis

    • Authors: Norman Loberant, Vera Salamon, Nurit Carmi, Anna Chernihovsky
      Pages: 36 - 36
      Abstract: Norman Loberant, Vera Salamon, Nurit Carmi, Anna Chernihovsky

      Journal of Clinical Imaging Science 2013 3(1):36-36

      Objectives: The purpose of this study is to establish a database including prevalence and degree of breast arterial calcifications (BAC) in our population of women presenting for mammography. Materials and Methods: The mammograms of 1786 women over the age of 40 years were examined for the presence and degree of BAC. Statistical analysis was performed to correlate patient's age and ethnic origin with the presence and degree of BAC. Results: There was statistically significant and strong correlation between the patient's age and presence of BAC. There was also a less strong yet statistically significant correlation between patient age and degree of BAC. Regression analysis showed the likelihood of BAC at various ages. The prevalence of BAC is only 2% of women under 50 years of age; the prevalence of Grade 2-3 BAC is only 1% in women under 60 years of age. Conclusion: There is a predictable increase with age in both prevalence and degree of BAC in women. The presence of high degree BAC in women under 60 years of age or any BAC in women under 50 years of age is unusual.
      Citation: Journal of Clinical Imaging Science 2013 3(1):36-36
      PubDate: Fri,27 Sep 2013
      DOI: 10.4103/2156-7514.119013
      Issue No: Vol. 3, No. 1 (2013)
       
  • Isolated Tuberculous Tenosynovitis of the Anterior Tibial and Extensor
           Digitorum Longus Tendons

    • Authors: Berhan Genç, Aynur Solak, Aslan Mayda, Nazime &#350;en
      Pages: 37 - 37
      Abstract: Berhan Genç, Aynur Solak, Aslan Mayda, Nazime &#350;en

      Journal of Clinical Imaging Science 2013 3(1):37-37

      Musculoskeletal system is involved in 1-5% of extrapulmonary cases of tuberculosis. Tuberculous tenosynovitis is a rare form of musculoskeletal tuberculosis. Tuberculosis of the tendon sheath in the hand has been seen in a few cases. Involvement of the tendons of the leg is less common. Diagnosis is not easy as there are no specific clinical symptoms or signs. A 33-year-old male presented with painful swelling in the distal right lower limb that caused restriction of movement. Imaging studies showed inflammation and infection of the extensor digitorium longus and tibialis anterior tendons. Histopathological studies showed a necrotizing granulomatous inflammation in the synovial tissue. A diagnosis of tuberculosis was made and medical treatment was initiated that proved successful. Patient remained infection-free at 26-month follow-up examination.
      Citation: Journal of Clinical Imaging Science 2013 3(1):37-37
      PubDate: Fri,27 Sep 2013
      DOI: 10.4103/2156-7514.119015
      Issue No: Vol. 3, No. 1 (2013)
       
  • Acquired Arteriovenous Fistula of the Breast Following Ultrasound Guided
           Biopsy of Invasive Ductal Carcinoma

    • Authors: Adam Gregg, Rebecca Leddy, Madelene Lewis, Abid Irshad
      Pages: 38 - 38
      Abstract: Adam Gregg, Rebecca Leddy, Madelene Lewis, Abid Irshad

      Journal of Clinical Imaging Science 2013 3(1):38-38

      Image guided large-core breast biopsies are commonly performed procedures with relatively rare complications. The majority of these complications are minor, though at times more significant vascular injuries can occur with these biopsies as demonstrated by this case. Patient developed a pulsatile vascular breast mass after an ultrasound guided breast biopsy of invasive ductal carcinoma. Sonographic evaluation of this new breast mass demonstrated this mass to represent an arteriovenous fistula (AVF). Though multiple therapies are available for an iatrogenic fistula within the breast, the AVF was surgically excised in this case as it was immediately adjacent to a known cancer.
      Citation: Journal of Clinical Imaging Science 2013 3(1):38-38
      PubDate: Fri,27 Sep 2013
      DOI: 10.4103/2156-7514.119019
      Issue No: Vol. 3, No. 1 (2013)
       
  • Adenoid Cystic Carcinoma of the Upper Trachea: A Rare Neoplasm

    • Authors: Binoy Kumar Choudhury, Geetanjali Barman, Shobhit Singh, Kuddush Ahmed
      Pages: 39 - 39
      Abstract: Binoy Kumar Choudhury, Geetanjali Barman, Shobhit Singh, Kuddush Ahmed

      Journal of Clinical Imaging Science 2013 3(1):39-39

      Primary malignant tracheal tumors are not common and adenoid cystic carcinoma (ACC) of trachea is rare. We report an extremely rare case of ACC of proximal trachea, which was diagnosed in a 42-year-old male who presents with 6-month history of dyspnea. Lateral skiagram of neck, computed tomography, and magnetic resonance imaging revealed a broad-based polypoidal soft tissue mass arising from posterior wall of the proximal trachea. Biopsy confirmed the diagnosis of ACC. The patient was treated by surgical resection followed by radiotherapy and is on regular follow-up. Follow-up at 18 months post-treatment showed no local recurrence or distant metastases. The literature on tracheal ACC is reviewed. Image findings are briefly discussed.
      Citation: Journal of Clinical Imaging Science 2013 3(1):39-39
      PubDate: Fri,27 Sep 2013
      DOI: 10.4103/2156-7514.119021
      Issue No: Vol. 3, No. 1 (2013)
       
  • Nasal Lobular Capillary Hemangioma

    • Authors: Prashant Patil, Saurabh Singla, Ranoji Mane, KS Jagdeesh
      Pages: 40 - 40
      Abstract: Prashant Patil, Saurabh Singla, Ranoji Mane, KS Jagdeesh

      Journal of Clinical Imaging Science 2013 3(1):40-40

      Nasal lobular capillary hemangioma is a rare benign tumor of the paranasal sinuses. This lesion is believed to grow rapidly in size over time. The exact etiopathogenesis is still a dilemma. We discuss a case of nasal lobular capillary hemangioma presenting with a history of epistaxis. Contrast enhanced computed tomography of paranasal sinuses revealed an intensely enhancing soft-tissue mass in the left nasal cavity and left middle and inferior meati with no obvious bony remodeling or destruction. We present imaging and pathologic features of nasal lobular capillary hemangioma and differentiate it from other entities like nasal angiofibroma.
      Citation: Journal of Clinical Imaging Science 2013 3(1):40-40
      PubDate: Mon,30 Sep 2013
      DOI: 10.4103/2156-7514.119134
      Issue No: Vol. 3, No. 1 (2013)
       
  • Multispectral Photoacoustic Imaging of Prostate Cancer: Preliminary
           Ex-vivo Results

    • Authors: Vikram S Dogra, Bhargava K Chinni, Keerthi S Valluru, Jean V Joseph, Ahmed Ghazi, Jorge L Yao, Katie Evans, Edward M Messing, Navalgund A Rao
      Pages: 41 - 41
      Abstract: Vikram S Dogra, Bhargava K Chinni, Keerthi S Valluru, Jean V Joseph, Ahmed Ghazi, Jorge L Yao, Katie Evans, Edward M Messing, Navalgund A Rao

      Journal of Clinical Imaging Science 2013 3(1):41-41

      Objective: The objective of this study is to validate if ex-vivo multispectral photoacoustic (PA) imaging can differentiate between malignant prostate tissue, benign prostatic hyperplasia (BPH), and normal human prostate tissue. Materials and Methods: Institutional Review Board's approval was obtained for this study. A total of 30 patients undergoing prostatectomy for biopsy-confirmed prostate cancer were included in this study with informed consent. Multispectral PA imaging was performed on surgically excised prostate tissue and chromophore images that represent optical absorption of deoxyhemoglobin (dHb), oxyhemoglobin (HbO 2 ), lipid, and water were reconstructed. After the imaging procedure is completed, malignant prostate, BPH and normal prostate regions were marked by the genitourinary pathologist on histopathology slides and digital images of marked histopathology slides were obtained. The histopathology images were co-registered with chromophore images. Region of interest (ROI) corresponding to malignant prostate, BPH and normal prostate were defined on the chromophore images. Pixel values within each ROI were then averaged to determine mean intensities of dHb, HbO 2 , lipid, and water. Results: Our preliminary results show that there is statistically significant difference in mean intensity of dHb (P < 0.0001) and lipid (P = 0.0251) between malignant prostate and normal prostate tissue. There was difference in mean intensity of dHb (P < 0.0001) between malignant prostate and BPH. Sensitivity, specificity, positive predictive value, and negative predictive value of our imaging system were found to be 81.3%, 96.2%, 92.9% and 89.3% respectively. Conclusion: Our preliminary results of ex-vivo human prostate study suggest that multispectral PA imaging can differentiate between malignant prostate, BPH and normal prostate tissue.
      Citation: Journal of Clinical Imaging Science 2013 3(1):41-41
      PubDate: Mon,30 Sep 2013
      DOI: 10.4103/2156-7514.119139
      Issue No: Vol. 3, No. 1 (2013)
       
  • Imaging of Tuberculosis of the Abdominal Viscera: Beyond the Intestines

    • Authors: Saurabh Karmakar, Alok Nath, Hira Lal
      Pages: 42 - 42
      Abstract: Saurabh Karmakar, Alok Nath, Hira Lal

      Journal of Clinical Imaging Science 2013 3(1):42-42


      Citation: Journal of Clinical Imaging Science 2013 3(1):42-42
      PubDate: Mon,30 Sep 2013
      DOI: 10.4103/2156-7514.119149
      Issue No: Vol. 3, No. 1 (2013)
       
  • Benign Medullary Fibroma of the Kidney: A Rare Diagnostic Dilemma

    • Authors: Santosh Kumar, Gautam Ram Choudhary, Bhuvanesh Nanjappa, Amanjit Bal
      Pages: 43 - 43
      Abstract: Santosh Kumar, Gautam Ram Choudhary, Bhuvanesh Nanjappa, Amanjit Bal

      Journal of Clinical Imaging Science 2013 3(1):43-43

      Renomedullary interstitial cell tumor or medullary fibroma, is a small tumor that commonly presents as an incidental finding, but in rare cases maybe large and symptomatic. Although it is a benign tumor, it is difficult to differentiate this lesion from other malignancies of the kidney on radiological basis and hence many patients undergo radical nephrectomy. We present a case of renal medullary fibroma and various nuances associated with radiological identification of this lesion and its management related dilemmas.
      Citation: Journal of Clinical Imaging Science 2013 3(1):43-43
      PubDate: Tue,29 Oct 2013
      DOI: 10.4103/2156-7514.120776
      Issue No: Vol. 3, No. 1 (2013)
       
  • Lymphangioma Circumscriptum in an Adult: An Unusual Oral Presentation

    • Authors: C Ganesh, GS Sangeetha, Vivek Narayanan, TN Umamaheswari
      Pages: 44 - 44
      Abstract: C Ganesh, GS Sangeetha, Vivek Narayanan, TN Umamaheswari

      Journal of Clinical Imaging Science 2013 3(1):44-44

      Lymphangioma is a benign hamartomatous tumor of lymphatic vessels. This lymphatic malformation is characterized by an abnormal proliferation of lymphatic vessels. Extra-oral lymphangiomas occur more frequently in the neck region predominantly in the posterior triangle, while intra-oral lymphangiomas are commonly seen in the tongue mainly on the dorsum surface. Various imaging modalities such as ultrasound and color Doppler are very useful in viewing the extent of the lesion. In most of the cases, surgical excision is the treatment of choice. The prognosis is good for most patients, but recurrence has also been reported in some cases, presumably because the lesion is interwoven between muscle fibers, preventing complete removal. This case report discusses the clinical features, color Doppler imaging, histopathology, and treatment of lymphangioma.
      Citation: Journal of Clinical Imaging Science 2013 3(1):44-44
      PubDate: Tue,29 Oct 2013
      DOI: 10.4103/2156-7514.120779
      Issue No: Vol. 3, No. 1 (2013)
       
  • Giant Choledochal Cyst Mimicking Massive Gallbladder Hydrops in an Adult
           Patient: Multi Detector Computed Tomography and Magnetic Resonance Imaging
           Findings Correlated to Gross and Histopathological Findings

    • Authors: Joon-Il Choi, Chandana Lall, Puneet Bhargava, David K Imagawa
      Pages: 45 - 45
      Abstract: Joon-Il Choi, Chandana Lall, Puneet Bhargava, David K Imagawa

      Journal of Clinical Imaging Science 2013 3(1):45-45

      Choledochal cysts are uncommon congenital anomalies of the biliary tree, commonly presenting in infancy, generally in the 1 st year of life. Presentation in adult life is less common, accounting for 20% of cases. A 19-year-old female patient presented to the Emergency Department with severe abdominal distension, a palpable abdominal mass, mild jaundice and low grade fever. Ultrasound, computed tomography (CT) and magnetic resonance imaging of the abdomen showed a massive septated cystic lesion filling the entire abdomen with a significant mass effect on surrounding structures. Origin of the lesion was unclear and diagnosis included a giant mesenteric or duplication cyst, massive gallbladder with hydrops, biliary cystadenoma and giant choledochal cyst, among others. Final diagnosis was a Type IA choledochal cyst with massive asymmetric cystic dilatation of the extra-hepatic segments of the left hepatic duct with asymmetric dilatation of the right hepatic duct. Patient had an uneventful recovery after resection of the entire extrahepatic cyst and Roux-en-Y hepaticojejunostomy at the level of the hilum. In this article, we correlate CT and MRI findings to gross and histopathological findings of this giant Todani's Type IA choledochal cyst.
      Citation: Journal of Clinical Imaging Science 2013 3(1):45-45
      PubDate: Tue,29 Oct 2013
      DOI: 10.4103/2156-7514.120785
      Issue No: Vol. 3, No. 1 (2013)
       
  • Radiographically Occult Latent Radiogenic Osteosarcoma Uncovered on Tc-99m
           Methylene-diphosphonate Bone Scintigraphy

    • Authors: Prashant Jolepalem, Raymond Y Yeow, Diane Cosner, John P Seitz
      Pages: 46 - 46
      Abstract: Prashant Jolepalem, Raymond Y Yeow, Diane Cosner, John P Seitz

      Journal of Clinical Imaging Science 2013 3(1):46-46

      We present a case of a 70-year-old male who was referred for a technetium-99m methylene-diphosphonate bone scan for mild left hip pain and an elevated alkaline phosphatase level of 770 units/L. No additional information was provided and the patient's history was limited due to a language barrier. We were able to ascertain that the patient had a remote history of prostate cancer, which had been treated with radiation. Originally, we felt the bone scan was compatible with Paget's disease; however, further work-up revealed the presence of osteosarcoma, which was potentially radiation-induced.
      Citation: Journal of Clinical Imaging Science 2013 3(1):46-46
      PubDate: Tue,29 Oct 2013
      DOI: 10.4103/2156-7514.120786
      Issue No: Vol. 3, No. 1 (2013)
       
  • Truncus Arteriosus with Persistent Left Superior Vena Cava: Cardiac
           Computed Tomography Findings in an Unrepaired Adult Patient

    • Authors: Berhan Genç, Faik Fevzi Okur, Vedide Tavl&#305;, Aynur Solak
      Pages: 47 - 47
      Abstract: Berhan Genç, Faik Fevzi Okur, Vedide Tavl&#305;, Aynur Solak

      Journal of Clinical Imaging Science 2013 3(1):47-47

      Truncus arteriosus (TA), a rare complex congenital cardiac disease in which systemic pulmonary and coronary circulations originate from a common vessel, develops due to failure of separation of the common trunk during embryonic life. In this case report, we discuss a 24-year-old patient with TA in whom a computed tomography angiography was performed. To the best of our knowledge, no case has been reported so far where an adult had combined left superior vena cava and pulmonary vein anomaly.
      Citation: Journal of Clinical Imaging Science 2013 3(1):47-47
      PubDate: Tue,29 Oct 2013
      DOI: 10.4103/2156-7514.120787
      Issue No: Vol. 3, No. 1 (2013)
       
  • Concepts for Liver Segment Classification: Neither Old Ones nor New Ones,
           but a Comprehensive One

    • Authors: Jean H. D. Fasel, Andrea Schenk
      Pages: 48 - 48
      Abstract: Jean H. D. Fasel, Andrea Schenk

      Journal of Clinical Imaging Science 2013 3(1):48-48

      Concepts dealing with the subdivision of the human liver into independent vascular and biliary territories are applied routinely in radiological, surgical, and gastroenterological practice. Despite Couinaud's widely used eight-segments scheme, opinions on the issue differ considerably between authors. The aim of this article is to illustrate the scientific basis for understanding and harmonizing inconsistencies between seemingly contradictory observations. Possible clinical implications are addressed.
      Citation: Journal of Clinical Imaging Science 2013 3(1):48-48
      PubDate: Tue,29 Oct 2013
      DOI: 10.4103/2156-7514.120803
      Issue No: Vol. 3, No. 1 (2013)
       
  • Superior Gluteal Artery Pseudoaneurysm Presenting as a Gluteal Mass: Case
           Report and Review of Literature

    • Authors: Sawsan Taif, Asim Derweesh, Maali Talib
      Pages: 49 - 49
      Abstract: Sawsan Taif, Asim Derweesh, Maali Talib

      Journal of Clinical Imaging Science 2013 3(1):49-49

      Aneurysms of the gluteal arteries are very rare with the majority being post-trauma pseudoaneurysms. Generally, management of these aneurysms could be surgical or through endovascular techniques. We present a case of a superior gluteal artery pseudoaneurysm complicating a pelvic fracture that presented as a gluteal mass. It was successfully treated by transcatheter coil embolization. We review the presentation, imaging, and treatment options. Aneurysms have to be considered in the differential diagnosis of soft tissue masses, therefore lesion intervention by aspiration or needle biopsy should not be tried before ruling out a possible vascular nature which will easily be revealed by ultrasound Doppler or computed tomography scans.
      Citation: Journal of Clinical Imaging Science 2013 3(1):49-49
      PubDate: Tue,29 Oct 2013
      DOI: 10.4103/2156-7514.120805
      Issue No: Vol. 3, No. 1 (2013)
       
  • Intrauterine Volvulus of Terminal Ileum Without Malrotation

    • Authors: Suheil Artul, George Habib, Amin Adawi, Bishara Mansour, William Nseir
      Pages: 50 - 50
      Abstract: Suheil Artul, George Habib, Amin Adawi, Bishara Mansour, William Nseir

      Journal of Clinical Imaging Science 2013 3(1):50-50

      Neonatal terminal ileum volvulus in the absence of malrotation has never been reported before in English literature. However, another similar rare entity known as neonatal primary segmental volvulus without malrotation has been reported before. Volvulus, in general, is an extreme emergency and cases not diagnosed in time lead to death. The main diagnosis is based on radiological features seen on imaging. We present a case of volvulus of terminal ileum that was diagnosed and surgically treated at age of 15 h ensuring the newborn survived. The definitive diagnosis was based mainly on ultrasonographic findings.
      Citation: Journal of Clinical Imaging Science 2013 3(1):50-50
      PubDate: Thu,28 Nov 2013
      DOI: 10.4103/2156-7514.122317
      Issue No: Vol. 3, No. 1 (2013)
       
  • Vena Caval Anomalies

    • Authors: Ramyah Rajakulasingam, Rohin Francis, Ramanan Rajakulasingam
      Pages: 51 - 51
      Abstract: Ramyah Rajakulasingam, Rohin Francis, Ramanan Rajakulasingam

      Journal of Clinical Imaging Science 2013 3(1):51-51

      Anomalous vena cavae can have significant implications for procedures on the right side of the heart. We report a rare anatomical configuration in a 44-year-old female, which to the best of our knowledge, is the first report of such an association. She had a bicuspid aortic valve in conjunction with a persistent left superior vena cava (PLSVC) draining into the coronary sinus, and a left-sided inferior vena cava (IVC) draining into a left superior vena cava via the hemiazygos vein. Comprehensive assessment of these anomalies is crucial given the widespread use of invasive cardiac procedures.
      Citation: Journal of Clinical Imaging Science 2013 3(1):51-51
      PubDate: Thu,28 Nov 2013
      DOI: 10.4103/2156-7514.122319
      Issue No: Vol. 3, No. 1 (2013)
       
  • Malignant Mesenchymal Renal Tumor: A Rare Case of Primary Renal
           Fibrosarcoma

    • Authors: Madanmohan Gupta, Nandini U Bahri, Pankaj Watal, Shilpa L Chudasama, Swetang G Brahmbhatt, Harinder Yant
      Pages: 52 - 52
      Abstract: Madanmohan Gupta, Nandini U Bahri, Pankaj Watal, Shilpa L Chudasama, Swetang G Brahmbhatt, Harinder Yant

      Journal of Clinical Imaging Science 2013 3(1):52-52

      Malignant mesenchymal neoplasms of kidney constitute a rare group of tumors. Primary fibrosarcoma of kidney is an extremely rare subtype of primary malignant mesenchymal renal neoplasms. An elderly female presented with a gradually increasing abdominal lump and mild abdominal discomfort. On cross-sectional imaging, the lesion showed features suggestive of an atypical renal mass not conforming to either ball or bean type growth pattern. The mass was surgically removed and on histopathological and immunohistological investigations diagnosed to be primary renal fibrosarcoma.
      Citation: Journal of Clinical Imaging Science 2013 3(1):52-52
      PubDate: Thu,28 Nov 2013
      DOI: 10.4103/2156-7514.122322
      Issue No: Vol. 3, No. 1 (2013)
       
  • Diffusion Tensor Imaging of the Kidneys: Influence of b-Value and Number
           of Encoding Directions on Image Quality and Diffusion Tensor Parameters

    • Authors: Natalie C Chuck, Günther Steidle, Iris Blume, Michael A Fischer, Daniel Nanz, Andreas Boss
      Pages: 53 - 53
      Abstract: Natalie C Chuck, Günther Steidle, Iris Blume, Michael A Fischer, Daniel Nanz, Andreas Boss

      Journal of Clinical Imaging Science 2013 3(1):53-53

      Objectives: The purpose of this study was to evaluate to which degree investment of acquisition time in more encoding directions leads to better image quality (IQ) and what influence the number of encoding directions and the choice of b-values have on renal diffusion tensor imaging (DTI) parameters. Material and Methods: Eight healthy volunteers (32.3 y &#177; 5.1 y) consented to an examination in a 1.5T whole-body MR scanner. Coronal DTI data sets of the kidneys were acquired with systematic variation of b-values (50, 150, 300, 500, and 700 s/mm 2 ) and number of diffusion-encoding directions (6, 15, and 32) using a respiratory-triggered echo-planar sequence (TR/TE 1500 ms/67 ms, matrix size 128 &#215; 128). Additionally, two data sets with more than two b-values were acquired (0, 150, and 300 s/mm 2 and all six b-values). Parametrical maps were calculated on a pixel-by-pixel basis. Image quality was determined with a reader score. Results: Best IQ was visually assessed for images acquired with 15 and 32 encoding directions, whereas images acquired with six directions had significantly lower IQ ratings. Image quality, fractional anisotropy, and mean diffusivity only varied insignificantly for b-values between 300 and 500 s/mm 2 . In the renal medulla fractional anisotropy (FA) values between 0.43 and 0.46 and mean diffusivity (MD) values between 1.8-2.1 &#215; 10 -3 mm 2 /s were observed. In the renal cortex, the corresponding ranges were 0.24-0.25 (FA) and 2.2-2.8 &#215; 10 -3 mm 2 /s (MD). Including b-values below 300 s/mm 2 , notably higher MD values were observed, while FA remained constant. Susceptibility artifacts were more prominent in FA maps than in MD maps. Conclusion: In DTI of the kidneys at 1.5T, the best compromise between acquisition time and resulting image quality seems the application of 15 encoding directions with b-values between 300 and 500 s/mm 2 . Including lower b-values allows for assessment of fast diffusing spin components.
      Citation: Journal of Clinical Imaging Science 2013 3(1):53-53
      PubDate: Thu,28 Nov 2013
      DOI: 10.4103/2156-7514.122323
      Issue No: Vol. 3, No. 1 (2013)
       
  • Radiological Imaging Findings of a Case with Vertebral Osteoid Osteoma
           Leading to Brachial Neuralgia

    • Authors: Erkan Gokce, Erdogan Ayan, Fatih Çelikyay, Berat Acu
      Pages: 54 - 54
      Abstract: Erkan Gokce, Erdogan Ayan, Fatih Çelikyay, Berat Acu

      Journal of Clinical Imaging Science 2013 3(1):54-54

      Osteoid osteoma is a small, benign osteoblastic tumor consisting of a highly vascularized nidus of connective tissue surrounded by sclerotic bone. Three-quarters of osteoid osteomas are located in the long bones, and only 7-12% in the vertebral column. The classical clinical presentation of spinal osteoid osteoma is that of painful scoliosis. Other clinical features include nerve root irritation and night pain. Osteoid osteoma has characteristic computed tomography (CT) findings. Because magnetic resonance imaging (MRI) findings of the osteoid osteomas causing intense perinidal edema can be confusing, these patients should be evaluated with clinical findings and other imaging techniques. In this study, we present X-ray, CT, and MRI findings of a case with osteoid osteoma located in thoracic 1 vertebra left lamina and transverse process junction leading to brachial neuralgia symptoms.
      Citation: Journal of Clinical Imaging Science 2013 3(1):54-54
      PubDate: Thu,28 Nov 2013
      DOI: 10.4103/2156-7514.122324
      Issue No: Vol. 3, No. 1 (2013)
       
  • Computed Tomography Findings of an Unusual Maxillary Sinus Mass: Brown
           Tumor Due to Tertiary Hyperparathyroidism

    • Authors: Canan Altay, Nezahat Erdogan, Erdem Eren, Sedat Altay, Sebnem Karasu, Engin Uluç
      Pages: 55 - 55
      Abstract: Canan Altay, Nezahat Erdogan, Erdem Eren, Sedat Altay, Sebnem Karasu, Engin Uluç

      Journal of Clinical Imaging Science 2013 3(1):55-55

      Brown tumor is a non-neoplastic bone lesion that develops secondary to hyperparathyroidism and it is very rare in the maxillofacial region. We report the case of a 59-year-old man who presented with pain and a swelling in the left cheek. Computed tomography (CT) demonstrated an expansile and radioluscent lesion in the left maxillary sinus. Incisional biopsy was performed, and the diagnosis was Brown tumor. Brown tumor must be considered in the differential diagnosis of expansile lesions of maxillary sinus.
      Citation: Journal of Clinical Imaging Science 2013 3(1):55-55
      PubDate: Thu,28 Nov 2013
      DOI: 10.4103/2156-7514.122325
      Issue No: Vol. 3, No. 1 (2013)
       
  • Giant Renal Angiomyolipoma: Unusual Cause of Huge Abdominal Mass

    • Authors: Rajesh Taneja, Dig Vijay Singh
      Pages: 56 - 56
      Abstract: Rajesh Taneja, Dig Vijay Singh

      Journal of Clinical Imaging Science 2013 3(1):56-56

      We present the imaging and histopathological characteristics of a giant renal angiomyolipoma (AML) in a 49-year-old female patient, who presented with bloating sensation in the abdomen and a steadily increasing abdominal girth for about 3 years. Contrast enhanced computed tomography (CECT) scan films of abdomen revealed that a large fat containing tumor had replaced the left kidney while displacing the rest of the abdominal contents toward the other side of the midline. Intraoperatively the left kidney was completely replaced by a fat containing tumor. The recovered surgical specimen measured 39 cm &#215; 25 cm &#215; 9 cm and weighed 7500 g. Histopathological investigation with immuno-histochemical staining of the specimen with hydroxy beta-methylbutyric acid-45 confirmed this lesion as AML. CECT scan of the head did not show any lesion suggestive of tuberous sclerosis. The giant tumor of the present case is the heaviest AML in both syndromic and sporadic categories and largest by dimensions as sporadic AML ever reported in the literature.
      Citation: Journal of Clinical Imaging Science 2013 3(1):56-56
      PubDate: Thu,28 Nov 2013
      DOI: 10.4103/2156-7514.122326
      Issue No: Vol. 3, No. 1 (2013)
       
  • Endobronchial Ultrasound: A Useful Tool in the Diagnosis of Bronchogenic
           Cyst

    • Authors: Stamatis Katsenos, Jose Rojas-Solano, Heinrich D Becker
      Pages: 57 - 57
      Abstract: Stamatis Katsenos, Jose Rojas-Solano, Heinrich D Becker

      Journal of Clinical Imaging Science 2013 3(1):57-57

      Diagnosis of bronchogenic cysts is possible with computed tomography, where the cysts are seen usually as well-circumscribed lesions of water density. However, many of the cysts have a soft-tissue density thus rendering them indistinguishable from neoplasms. In this article, we describe a case of bronchogenic cyst presenting as soft-tissue mass that was evaluated and diagnosed by endobronchial ultrasound (EBUS). We discuss the ultrasound image characteristics of the cyst and its histopathology findings. EBUS seems to be a valuable tool in the diagnosis of bronchogenic cysts and also enables their complete aspiration.
      Citation: Journal of Clinical Imaging Science 2013 3(1):57-57
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124078
      Issue No: Vol. 3, No. 1 (2013)
       
  • Imaging Diagnosis of Neonatal Anemia: Report of Two Unusual Etiologies

    • Authors: Shabnam Bhandari Grover, G Rajalakshmi Preethi, Sumita Saluja, Ankit Bhargava
      Pages: 58 - 58
      Abstract: Shabnam Bhandari Grover, G Rajalakshmi Preethi, Sumita Saluja, Ankit Bhargava

      Journal of Clinical Imaging Science 2013 3(1):58-58

      Anemia in neonatal period is rare, with the common causes being Rh and ABO blood group incompatibility, hemorrhagic disease of newborn, congenital hemolytic anemia, hemoglobinopathies, and TORCH (toxoplasmosis, rubella, cytomegalovirus, herpes virus) infections. Congenital leukemia and infantile osteopetrosis (OP) are among the rare causes of neonatal anemia. A review of the literature shows approximately 200 reported cases of congenital leukemia. Articles describing the imaging features of congenital leukemia are still rarer. Infantile OP, another rare disorder with a reported incidence of 1 in 250,000 has characteristic imaging features, which are diagnostic of the disease. We report a case each, of two rare diseases: Congenital leukemia and infantile osteopetrosis. Additionally, our report highlights the radiological and imaging features of congenital leukemia and infantile OP and their crucial role in arriving at an early diagnosis.
      Citation: Journal of Clinical Imaging Science 2013 3(1):58-58
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124079
      Issue No: Vol. 3, No. 1 (2013)
       
  • Visualization of a Small Ventricular Septal Defect at First-pass
           Contrast-enhanced Cardiac Magnetic Resonance Imaging

    • Authors: Francesco Secchi, Antonello Giardino, Salvatore Fabiano, Vlasta Fesslova, Francesco Sardanelli
      Pages: 59 - 59
      Abstract: Francesco Secchi, Antonello Giardino, Salvatore Fabiano, Vlasta Fesslova, Francesco Sardanelli

      Journal of Clinical Imaging Science 2013 3(1):59-59

      Ventricular septal defect (VSD) is a congenital heart disease that accounts for up to 40% of all congenital cardiac malformations. VSD is a connection between right and left ventricle, through the ventricular septum. Echocardiography and magnetic resonance imaging (MRI) help identify this entity. This case presents a 12-year-old male diagnosed with a small muscular apical VSD of 3 mm in diameter, at echocardiography. Cardiac MRI using first-pass perfusion sequence, combining the right plane of acquisition with a short bolus of contrast material, clearly confirmed the presence of VSD.
      Citation: Journal of Clinical Imaging Science 2013 3(1):59-59
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124083
      Issue No: Vol. 3, No. 1 (2013)
       
  • Cystic and Cavitary Lung Lesions in Children: Radiologic Findings with
           Pathologic Correlation

    • Authors: Kemal Odev, Ibrahim Guler, Tamer Altinok, Sevgi Pekcan, Abdussamed Batur, Hüseyin Ozbiner
      Pages: 60 - 60
      Abstract: Kemal Odev, Ibrahim Guler, Tamer Altinok, Sevgi Pekcan, Abdussamed Batur, Hüseyin Ozbiner

      Journal of Clinical Imaging Science 2013 3(1):60-60

      A number of diseases produce focal or multiple thin-walled or thick-walled air- or fluid-containing cysts or cavitary lung lesions in both infants and children. In infants and children, there is a spectrum of focal or multifocal cystic and cavitary lung lesions including congenital lobar emphysema, congenital cystic adenomatoid malformation, pleuropulmonary blastoma, bronchogenic cyst, pulmonary sequestration, Langerhans cell histiocytosis, airway diseases, infectious diseases (bacterial infection, fungal infection, etc.), hydatid cysts, destroid lung, and traumatic pseudocyst. For the evaluation of cystic or cavitary lung lesion in infants and children, imaging plays an important role in accurate early diagnosis and optimal patient management. Therefore, a practical imaging approach based on the most sensitive and least invasive imaging modality in an efficient and cost-effective manner is paramount. We reviewed the conventional radiographs and computed tomography findings of the most common cystic and cavitary lung lesions in infants and children.
      Citation: Journal of Clinical Imaging Science 2013 3(1):60-60
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124087
      Issue No: Vol. 3, No. 1 (2013)
       
  • Adrenal Lesions: Spectrum of Imaging Findings with Emphasis on
           Multi-Detector Computed Tomography and Magnetic Resonance Imaging

    • Authors: Antonino Guerrisi, Daniele Marin, Mahbubeh Baski, Pietro Guerrisi, Federica Capozza, Carlo Catalano
      Pages: 61 - 61
      Abstract: Antonino Guerrisi, Daniele Marin, Mahbubeh Baski, Pietro Guerrisi, Federica Capozza, Carlo Catalano

      Journal of Clinical Imaging Science 2013 3(1):61-61

      The adrenal gland is a common site of a large spectrum of abnormalities like primary tumors, hemorrhage, metastases, and enlargement of the gland from external hormonal stimulation. Most of these lesions represent nonfunctioning adrenal adenomas and thus warrant a conservative management. Multi-detector computed tomography (CT) and magnetic resonance (MR) imaging are still considered highly specific and complementary techniques for the detection and characterization of adrenal abnormalities. Radiologist can establish a definitive diagnosis for most adrenal masses (i.e., carcinoma, hemorrhage) based on imaging alone. Imaging therefore can differentiate malignant lesions from those benign and avoid unnecessary aggressive management of benign lesions. The article gives an overview of the adrenal lesions and their imaging characteristics seen on CT and MR imaging.
      Citation: Journal of Clinical Imaging Science 2013 3(1):61-61
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124088
      Issue No: Vol. 3, No. 1 (2013)
       
  • Effect of Tube Voltage (100 vs. 120 kVp) on Radiation Dose and Image
           Quality using Prospective Gating 320 Row Multi-detector Computed
           Tomography Angiography

    • Authors: Atif N Khan, Faisal Khosa, Waqas Shuaib, Khurram Nasir, Ron Blankstein, Melvin Clouse
      Pages: 62 - 62
      Abstract: Atif N Khan, Faisal Khosa, Waqas Shuaib, Khurram Nasir, Ron Blankstein, Melvin Clouse

      Journal of Clinical Imaging Science 2013 3(1):62-62

      Objectives : The objective of the following study is to evaluate the effect of reducing tube voltage from 120 to 100 kVp using prospective gating 320 row multi-detector computed tomography angiography on image quality and reduction in radiation dose. Materials and Methods : A total of 78 sequential patients were scanned with prospective electrocardiogram gating. A total of 45 patients (Group 1) with mean body mass index (BMI) 29 &#177; 2 and heart rate (HR) 57 &#177; 7 beats per minute (BPM) were scanned at 120 kVp. 33 patients (Group 2) with mean BMI 23 &#177; 3 and HR 58 &#177; 6 bpm were scanned at 100 kVp. Effective dose was calculated using dose length product and factor (k = 0.014). Quantitative assessment of image quality was calculated by measuring signal to noise ratio (SNR) and contrast to noise ratio (CNR) in the left ventricle and left main coronary artery. Two experienced cardiac radiologists using a three-point ordinal scale assessed subjectively image quality. Results: In Group 1, the median radiation dose was 5.31 mSv (95% confidence interval [CI]: 4.86-6.09) and for Group 2 (P = 0.009) the mean radiation dose was 3.71 mSv (95% CI: 2.76-4.87), representing 30% decrease in radiation dose. In multivariate analyses, adjusting for age, gender, HR, BMI, tube current and scan length, an absolute median reduction of 2.21 mSv (1.13-3.29 mSv) was noted in patients scanned with 100 kVp (P < 0.0001). The quantitative image quality (SNR and CNR) was not statistically significant between the groups. Subjective image quality was rated as good or excellent in 99% of coronary segments for both groups (P value was considered as non-significant). Conclusion: Our study suggests that radiation dose may be lowered from 120 to 100 kVp with preservation of image quality in patient's whose BMI is &#8804;27.
      Citation: Journal of Clinical Imaging Science 2013 3(1):62-62
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124092
      Issue No: Vol. 3, No. 1 (2013)
       
  • Diffusion-weighted Magnetic Resonance Imaging in the Diagnosis of Bone
           Tumors: Preliminary Results

    • Authors: Yeliz Pekcevik, Mehmet Onur Kahya, Ahmet Kaya
      Pages: 63 - 63
      Abstract: Yeliz Pekcevik, Mehmet Onur Kahya, Ahmet Kaya

      Journal of Clinical Imaging Science 2013 3(1):63-63

      Objective: The study aims to determine whether apparent diffusion coefficient (ADC) can help differentiate benign and malignant bone tumors. Materials and Methods: From January 2012 to February 2013, we prospectively included 26 patients. Of these 15 patients were male and 11 were female; ranging in age from 8 to 76 years (mean age, 34.5 years). Diffusion-weighted magnetic resonance (MR) imaging was obtained with a single-shot echo-planar imaging sequence using a 1.5T MR scanner. We grouped malignant lesions as primary, secondary, and primary tumor with chondroid matrix. The minimum ADC was measured in the tumors and mean minimum ADC values were selected for statistical analysis. ADC values were compared between malignant and benign tumors using the Mann-Whitney U-test and receiver operating curve analysis were done to determine optimal cut-off values. Results: The mean ADC values from the area with lowest ADC values of benign and malignant tumors were 1.99 &#177; 0.57 &#215; 10&#8722;3 mm 2 /s and 1.02 &#177; 1.0 &#215; 10&#8722;3 mm 2 /s, respectively. The mean minimum ADC values of benign and malignant tumors were statistically different (P = 0.029). With cut-off value of 1.37 (10&#8722;3 mm 2 /s), sensitivity was 77.8% and specificity was 82.4%, for distinguishing benign and malignant lesion. Benign and secondary malignant tumors showed statistically significant difference (P = 0.002). There was some overlap in ADC values between benign and malignant tumors. The mean minimum ADC values of benign and malignant chondroid tumors were high. Giant cell tumor, non-ossifying fibroma and fibrous dysplasia showed lower ADC values. Conclusion: Although there is some overlap, ADC values of benign and malignant bone tumors seem to be different. Further studies with larger patient groups are needed to find an optimal cut-off ADC value.
      Citation: Journal of Clinical Imaging Science 2013 3(1):63-63
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124094
      Issue No: Vol. 3, No. 1 (2013)
       
  • Spectrum of High Resolution Computed Tomography Findings in Occupational
           Lung Disease: Experience in a Tertiary Care Institute

    • Authors: Satija Bhawna, UC Ojha, Sanyal Kumar, Rajiv Gupta, Dipti Gothi, RS Pal
      Pages: 64 - 64
      Abstract: Satija Bhawna, UC Ojha, Sanyal Kumar, Rajiv Gupta, Dipti Gothi, RS Pal

      Journal of Clinical Imaging Science 2013 3(1):64-64

      Objective: To study the spectrum of high resolution computed tomography (HRCT) findings in occupational lung disease in industrial workers and to assess the utility of International classification of HRCT for occupational and environmental respiratory diseases (ICHOERD). Materials and Methods: Retrospective analysis of radiological data (radiographs and computed tomography chest scans) gathered over a period of 3 years (January 2010- December 2012) of industrial workers in an organised sector who presented with respiratory complaints. The HRCT findings were evaluated using ICHOERD. Results: There were 5 females and 114 males in the study, with a mean age of 49 years. These workers were exposed to different harmful agents including silica, asbestos, cotton dust, metal dust, iron oxide, organic dust, rubber fumes, plastic fumes, acid fumes, and oil fumes. There were 10 smokers in the study. The radiograph of chest was normal in 53 patients. 46% of these normal patients (21.8% of total) demonstrated positive findings on HRCT. When the radiograph was abnormal, HRCT provided more accurate information and excluded the other diagnosis. The HRCT findings were appropriately described using the ICHOERD. Bronchiectasis was the most common finding (44.5%) with mild central cylindrical bronchiectasis as the most common pattern. Pleural thickening was seen in 41 patients (34.5%). Enlarged hilar or mediastinal lymphnodes were seen in 10 patients (8.4%) with egg-shell calcification in 1 patient exposed to silica. Bronchogenic carcinoma was seen in 1 patient exposed to asbestos. Conclusions: Occupational lung disease is a common work related condition in industrial workers even in the organized sector. Though chest radiograph is the primary diagnostic tool, HRCT is the undisputed Gold Standard for evaluation of these patients. Despite the disadvantage of radiation exposure, low dose CT may serve as an important tool for screening and surveillance. The ICHOERD is a powerful and reliable tool not only for diagnosis, but also for quantitative and analytical measurement of disease, thereby contributing to assessing the medical epidemiology of lung disease. It should always be used while evaluating HRCT of a patient with occupational lung disease.
      Citation: Journal of Clinical Imaging Science 2013 3(1):64-64
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124097
      Issue No: Vol. 3, No. 1 (2013)
       
  • Preliminary Clinical Experience with Digital Breast Tomosynthesis in the
           Visualization of Breast Microcalcifications

    • Authors: Stamatia V Destounis, Andrea L Arieno, Renee C Morgan
      Pages: 65 - 65
      Abstract: Stamatia V Destounis, Andrea L Arieno, Renee C Morgan

      Journal of Clinical Imaging Science 2013 3(1):65-65

      Objectives: To compare the visualization and image quality of microcalcifications imaged with digital breast tomosynthesis (DBT) versus conventional digital mammography. Materials and Methods: Patients with microcalcifications detected on full field digital mammography (FFDM) recommended for needle core biopsy were enrolled in the study after obtaining patient's consent and institutional review board approval (n = 177 patients, 179 lesions). All had a bilateral combination DBT exam, after undergoing routine digital mammography, prior to biopsy. The study radiologist reviewed the FFDM and DBT images in a non-blinded comparison and assessed the visibility of the microcalcifications with both methods, including image quality and clarity with which the calcifications were seen. Data recorded included patient demographics, lesion size on FFDM, DBT, and surgical excision (when applicable), biopsy, and surgical pathology, if any. Results: Average lesion size on DBT was 1.5 cm; average lesion size on FFDM was 1.4 cm. The image quality of DBT was assessed as equivalent or superior in 92.2% of cases. In 7.8% of the cases, the FFDM image quality was assessed as equivalent or superior. Conclusion: In our review, DBT image quality appears to be comparable to or better than conventional FFDM in terms of demonstrating microcalcifications, as shown in 92.2% of cases.
      Citation: Journal of Clinical Imaging Science 2013 3(1):65-65
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124099
      Issue No: Vol. 3, No. 1 (2013)
       
  • Contrast Enhanced Computed Tomography Characterization of
           Fluorodeoxygluocose-Avid Regional and Non-Regional Lymph Nodes in Patients
           with Suspicion of Metastatic Bladder Cancer

    • Authors: Muhammad A Chaudhry, Richard Wahl, Lujaien Al-Rubaiey Kadhim, Atif Zaheer
      Pages: 66 - 66
      Abstract: Muhammad A Chaudhry, Richard Wahl, Lujaien Al-Rubaiey Kadhim, Atif Zaheer

      Journal of Clinical Imaging Science 2013 3(1):66-66

      Objective: The objective of this study is to assess if size alone can predict the presence of metastatic disease within lymph nodes seen on contrast enhanced-computed tomography (CE-CT) in patients with suspicion of metastatic bladder cancer and also to evaluate the nodal distribution and morphological characteristics of fluorodeoxygluocose (FDG) avid lymph nodes on CE-CT. Materials and Methods: A retrospective analysis from 2002 to 2009 was performed on patients with suspicion of recurrent disease undergoing restaging FDG-positron emission tomography (PET)/CT. Standardized uptake value (SUVmax) adjusted for lean body mass was recorded in abnormal lymph nodes in the abdominopelvic region. Distribution, size, shape, presence of necrosis and clustering of the FDG-avid lymph nodes was assessed on CE-CT obtained within 4 weeks of the PET/CT. The abnormal nodes were then compared with non-FDG avid lymph nodes on the contralateral side serving as control. Results: A total of 103 lymph nodes were found to be FDG-avid in 14 patients on 17 PET/CT examinations. Overall, mean SULmax was 4.7 (range: 1.6-10.7), which is significantly higher than background of 1.5 (P < 0.05). Regional pelvic lymph nodes were FDG-avid in 93% of patients and metastatic extra-pelvic in 100% of patients. The overall average size of the FDG avid lymph nodes on CE-CT was 11 mm with a third of these measuring 3-8 mm. The average size of FDG-avid lymph nodes was 11 mm in the paraaortic region 13 mm in the common iliac 9 mm in the internal iliac and 13 mm in the external iliac regions. Nearly 88.4% of lymph nodes were round in shape, clustering was present in 68% and necrosis in 7% and average size of lymph nodes that served as controls was 6 mm with reniform morphology in 92% and absence of clustering and necrosis. Conclusion: Overlap in size exists between FDG-avid pathological and non-pathological lymph nodes seen on CE-CT in patients with metastatic bladder cancer. Other characteristic such as abnormal morphology and clustering are useful adjuncts in the evaluation of nodal metastatic disease.
      Citation: Journal of Clinical Imaging Science 2013 3(1):66-66
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124104
      Issue No: Vol. 3, No. 1 (2013)
       
  • Venous Intravasation as a Complication and Potential Pitfall During
           Hysterosalpingography: Re-Emerging Study with a Novel Classification

    • Authors: Abdurrahim Dusak, Hatice E Soydinc, Hakan Onder, Faysal Ekinci, Neval Y Görük, Cihat Hamidi, Aslan Bilici
      Pages: 67 - 67
      Abstract: Abdurrahim Dusak, Hatice E Soydinc, Hakan Onder, Faysal Ekinci, Neval Y Görük, Cihat Hamidi, Aslan Bilici

      Journal of Clinical Imaging Science 2013 3(1):67-67

      Objectives: Presently, hysterosalpingography (HSG) is used as a means to evaluate women with infertility and repetitive pregnancy loss. Venous intravasation is a complication and potential pitfall during HSG and analogous procedures including hysteroscopy. The aim of our study was to assess the venous intravasation and to obtain critical information for more secure and more accurate procedures. In particular, the primary goal of the present study was to compare HSG without and with intravasation to identify differences seen on HSG and to assess the predisposing factors of intravasation. The secondary goal was to describe clinical- and imaging-based novel classification of intravasation. Materials and Methods: This study included a patient cohort of 569 patients who underwent HSG between 2008 and 2011 at our center in the absence (control group) or presence (study group) of intravasation. Intravasation classified from level 0 (no intravasation) to level 3 (severe intravasation) was compared with preprocedural (demographic and clinical) and procedural (HSG) data. Data were analyzed using Statistical Package for Social Sciences (SPSS) statistical software. Results: Of the 569 patients undergoing HSG, 528 showed no intravasation and 41 (7.2%) patients showed intravasation when associated with preprocedural (leukocytes, menometrorrhagia, secondary infertility, ectopic pregnancy, abortus, polycystic ovaries, endometriosis, and interventions) and procedural (pain, scheduling, endometrial-uterine nature, and spillage) parameters. Moreover, intravasation was lower in women with smooth endometrium, triangular uterus, and homogeneous peritoneal spillage. No association was found between age, tubal patency, increased pressure, and intravasation. Conclusions: Using a novel classification method, intravasation can be observed in women during HSG and associates with preprocedural and procedural predisposing factors in subsumed conditions. This classification method will be useful for improving the efficiency and accuracy of HSG and related procedures by minimization of severe complications caused by intravasation.
      Citation: Journal of Clinical Imaging Science 2013 3(1):67-67
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124105
      Issue No: Vol. 3, No. 1 (2013)
       
  • Double Coronary Artery Anomaly in an Elderly Asymptomatic Patient with
           Positive Electrocardiogram Stress Test

    • Authors: Giuseppe Cannavale, Fabiana Trulli, Marco Colotto
      Pages: 68 - 68
      Abstract: Giuseppe Cannavale, Fabiana Trulli, Marco Colotto

      Journal of Clinical Imaging Science 2013 3(1):68-68

      Malignant coronary artery anomalies and myocardial bridging are more common findings in young patients with cardiac symptoms, but these two associated yet different types of anomalies in an elderly patient has been rarely described. The following case describes the diagnostic use of 128-slice coronary-computed tomography images of an 82-year-old male, former professional soccer player, who reached the age of 82 years without any symptoms of coronary heart disease. In this patient, an association of a malignant coronary artery anomaly of origin and course (left descending coronary artery originating from the right sinus of valsalva running between the aorta and the right ventricular outflow tract), together with a long myocardial bridging over the obtuse marginal branch was diagnosed by multi-slice computed tomography thanks to an initial positive electrocardiogram screening stress test.
      Citation: Journal of Clinical Imaging Science 2013 3(1):68-68
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124106
      Issue No: Vol. 3, No. 1 (2013)
       
  • A Rare Case of Pericallosal Lipoma Associated with Bilaterally Symmetrical
           Lateral Ventricular Choroid Plexus Lipomas without Corpus Callosal
           Anomalies

    • Authors: Parag Suresh Mahajan, Nawal M Al Moosawi, Islam Ali Hasan
      Pages: 69 - 69
      Abstract: Parag Suresh Mahajan, Nawal M Al Moosawi, Islam Ali Hasan

      Journal of Clinical Imaging Science 2013 3(1):69-69

      Lipomas constitute less than 5% of primary brain tumors. Pericallosal lipomas (PCLp) constitute almost half of all intracranial lipomas. Corpus callosal anomalies commonly occur in cases with PCLps. Although PCLp is often described as corpus callosal lipoma, it is most often pericallosal in location. PCLps may have calcification in the periphery and may continue into lateral ventricles, which is a very rare presentation. We observed a case of PCLp with peripheral calcifications associated with PCLp continuing as bilaterally symmetrical lateral ventricular choroid plexus lipomas (CPLp) without any corpus callosal or other central nervous system anomalies, and as this is not been previously reported, we are presenting it. The appearance of PCLp in this case does not correspond to the descriptions of any of the existing morphological types (anterior and posterior) of classification of PCLps; it is rather mixed, where PCLp occupies both anterior and posterior locations around the corpus callosum.
      Citation: Journal of Clinical Imaging Science 2013 3(1):69-69
      PubDate: Tue,31 Dec 2013
      DOI: 10.4103/2156-7514.124109
      Issue No: Vol. 3, No. 1 (2013)
       
  • Arachnoid Pit and Extensive Sinus Pnematization as the Cause of
           Spontaneous Lateral Intrasphenoidal Encephalocele

    • Authors: Ali AlMontasheri, Bandar Al-Qahtani, Nader Aldajani
      Pages: 1 - 1
      Abstract: Ali AlMontasheri, Bandar Al-Qahtani, Nader Aldajani

      Journal of Clinical Imaging Science 2012 2(1):1-1

      Lateral sphenoid encephalocele, especially within the lateral aspect of the sphenoid sinus, when the sphenoid sinus has pneumatized extensively into the pterygoid recess, are considered exceedingly rare. We report a rare case of lateral intrasphenoidal encephalocele with spontaneous cerebral spinal fluid (CSF) rhinorrhea. Computed tomography demonstrated bilateral arachnoid pit, extensive sphenoid sinus pneumatization, and a defect in the superior wall of the left lateral recess of the sphenoid sinus. Magnetic resonance imaging demonstrated anteromedial temporal lobe herniating through the bony defect.
      Citation: Journal of Clinical Imaging Science 2012 2(1):1-1
      PubDate: Fri,27 Jan 2012
      DOI: 10.4103/2156-7514.92363
      Issue No: Vol. 2, No. 1 (2012)
       
  • Radiological Imaging Features of Fasciola hepatica Infection
           &#8722; A Pictorial Review

    • Authors: Abdurrahim Dusak, Mehmet R Onur, Mutalip Cicek, Ugur Firat, Tianbo Ren, Vikram S Dogra
      Pages: 2 - 2
      Abstract: Abdurrahim Dusak, Mehmet R Onur, Mutalip Cicek, Ugur Firat, Tianbo Ren, Vikram S Dogra

      Journal of Clinical Imaging Science 2012 2(1):2-2

      Fascioliasis refers to a zoonosis caused by Fasciola hepatica, a trematode infecting herbivores, but also occurs in humans who ingest the metacercaria found in fresh water plants. Infection in humans is common in developing countries and is also not uncommon in Europe. Diagnosis of this infection is difficult, as the history and symptoms are nonspecific and stool analysis for eggs is negative until the disease is in an advanced state by when the parasite has reached the biliary system. The clinical course consists of two phases; first a hepatic parenchymal phase in which immature larvae invade the liver parenchyma, followed by a ductal phase characterized by the excretion of larvae into the bile ducts. Parenchymal Phase: Ultrasonography (US) findings are nonspecific in this early phase. Computerized tomography (CT) may demonstrate subcapsular low attenuation regions in the liver. Magnetic Resonance imaging (MRI) can also be utilized to establish liver parenchymal involvement, and is better than CT in characterizing hemorrhagic lesions, as well as identifying more lesions relative to CT. Ductal Phase: US examination is most useful at this stage, with its ability to demonstrate the live movement of the worms within the dilated ducts. A CT demonstrates dilated central biliary ducts with periportal tracking, whereas, mild ductal dilatation is poorly appreciated under MRI. Therefore, familiarity with the multimodality imaging features of fascioliasis, in combination with an available confirmatory enzyme-linked immunoassay, would be most helpful for early diagnosis.
      Citation: Journal of Clinical Imaging Science 2012 2(1):2-2
      PubDate: Fri,27 Jan 2012
      DOI: 10.4103/2156-7514.92372
      Issue No: Vol. 2, No. 1 (2012)
       
  • Acute Concomitant Anterior Cruciate Ligament and Patellar Tendon Tears in
           a Non-dislocated Knee

    • Authors: Robert D Wissman, Nathaniel Vonfischer, Kari Kempf
      Pages: 3 - 3
      Abstract: Robert D Wissman, Nathaniel Vonfischer, Kari Kempf

      Journal of Clinical Imaging Science 2012 2(1):3-3

      Anterior cruciate ligament (ACL) tears are common and may occur in isolation or with other internal derangements of the joint. Tears of the patellar tendon (PT) occur less frequently and are rarely associated with intra-articular pathology. Acute combined tears of both the ACL and PT are known complications of high-energy traumatic knee dislocations. We present a case of an acute concomitant ACL and PT tears in a low-energy non-dislocated knee. To our knowledge, this injury has only been described in a limited number of case reports in the orthopedic literature. We present the imaging findings of this combined injury and discuss the importance of magnetic resonance (MR) in diagnosis.
      Citation: Journal of Clinical Imaging Science 2012 2(1):3-3
      PubDate: Sat,18 Feb 2012
      DOI: 10.4103/2156-7514.93035
      Issue No: Vol. 2, No. 1 (2012)
       
  • An unusual case of extraosseous accumulation of bone scan tracer in a
           renal calculus - demonstration by SPECT-CT

    • Authors: Prathamesh Vijay Joshi, Vikram Lele, Rozil Gandhi
      Pages: 4 - 4
      Abstract: Prathamesh Vijay Joshi, Vikram Lele, Rozil Gandhi

      Journal of Clinical Imaging Science 2012 2(1):4-4

      Extraosseous localization of radioisotope, used in bone scan, in a variety of physiological and pathological conditions is a well-known phenomenon. The causes of extraosseous accumulation of bone-seeking radiotracers should be kept in mind when bone-imaging studies are reviewed to avoid incorrect interpretations. We report an extremely rare occurrence of extraosseous accumulation of bone scintigraphy tracer in a renal calculus, in a patient with adenocarcinoma of prostate, that was demonstrated by Single Photon Emission Computed Tomography and Computed Tomography (SPECT-CT) fusion imaging.
      Citation: Journal of Clinical Imaging Science 2012 2(1):4-4
      PubDate: Sat,18 Feb 2012
      DOI: 10.4103/2156-7514.93036
      Issue No: Vol. 2, No. 1 (2012)
       
  • Fibrochondrogenesis, an Antenatal and Postnatal Correlation

    • Authors: Nischal G Kundaragi, Kishor Taori, Chetan Jathar, Amit Disawal
      Pages: 5 - 5
      Abstract: Nischal G Kundaragi, Kishor Taori, Chetan Jathar, Amit Disawal

      Journal of Clinical Imaging Science 2012 2(1):5-5

      Fibrochondrogenesis is a rare, neonatally lethal osteochondrodysplasia, with autosomal recessive inheritance. It differs from other lethal dwarfisms in that it leads to broad, long-bone metaphyses (dumb-bell shaped) and pear-shaped vertebral bodies. We report a case of fibrochondrogenesis with severe pear-shaped platyspondyly, suspected antenatally, and give a comprehensive pictorial review of the antenatal ultrasound and postnatal radiographic findings. Only few cases of fibrochondrogenesis are diagnosed before the termination of pregnancy.
      Citation: Journal of Clinical Imaging Science 2012 2(1):5-5
      PubDate: Sat,18 Feb 2012
      DOI: 10.4103/2156-7514.93037
      Issue No: Vol. 2, No. 1 (2012)
       
  • Krukenberg Tumor: A Rare Cause of Ovarian Torsion

    • Authors: Sameer Sandhu, Omar Arafat, Harshad Patel, Chandana Lall
      Pages: 6 - 6
      Abstract: Sameer Sandhu, Omar Arafat, Harshad Patel, Chandana Lall

      Journal of Clinical Imaging Science 2012 2(1):6-6

      Ovarian torsion is the fifth most common gynecological surgical emergency. Ovarian torsion is usually associated with a cyst or a tumor, which is typically benign. The most common is mature cystic teratoma. We report the case of a 43-year-old woman who came to the Emergency Department with rare acute presentation of bilateral Krukenberg tumors, due to unilateral ovarian torsion. In this case report, we highlight the specific computed tomography (CT) features of ovarian torsion and demonstrate the unique radiological findings on CT imaging. Metastasis to the ovary is not rare and 5 to 10% of all ovarian malignancies are metastatic. The stomach is the common primary site in most Krukenberg tumors (70%); an acute presentation of metastatic Krukenberg tumors with ovarian torsion is rare and not previously reported in radiology literature.
      Citation: Journal of Clinical Imaging Science 2012 2(1):6-6
      PubDate: Sat,18 Feb 2012
      DOI: 10.4103/2156-7514.93038
      Issue No: Vol. 2, No. 1 (2012)
       
  • Dedicated Cone-beam Breast Computed Tomography and Diagnostic Mammography:
           Comparison of Radiation Dose, Patient Comfort, And Qualitative Review of
           Imaging Findings in BI-RADS 4 and 5 Lesions

    • Authors: Avice M O'Connell, Daniel Kawakyu-O'Connor
      Pages: 7 - 7
      Abstract: Avice M O'Connell, Daniel Kawakyu-O'Connor

      Journal of Clinical Imaging Science 2012 2(1):7-7

      Objective: This pilot study was undertaken to compare radiation dose, relative visibility/conspicuity of biopsy-proven lesions, and relative patient comfort in diagnostic mammography and dedicated cone-beam breast computed tomography (CBBCT) in Breast Imaging-Reporting and Data System (BI-RADS)&#174; 4 or 5 lesions. Materials and Methods: Thirty-six consecutive patients (37 breasts) with abnormal mammographic and/or ultrasound categorized as BI-RADS&#174; 4 or 5 lesions were evaluated with CBBCT prior to biopsy. Administered radiation dose was calculated for each modality. Mammograms and CBBCT images were compared side-by-side and lesion visibility/conspicuity was qualitatively scored. Histopathology of lesions was reviewed. Patients were administered a survey for qualitative evaluation of comfort between the two modalities. Results: CBBCT dose was similar to or less than diagnostic mammography, with a mean dose of 9.4 mGy (&#177;3.1 SD) for CBBCT vs. 16.9 mGy (&#177;6.9 SD) for diagnostic mammography in a total of 37 imaged breasts (P
      Citation: Journal of Clinical Imaging Science 2012 2(1):7-7
      PubDate: Sat,25 Feb 2012
      DOI: 10.4103/2156-7514.93274
      Issue No: Vol. 2, No. 1 (2012)
       
  • Aggressive Form of Cherubism

    • Authors: GV Reddy, G Siva Prasad Reddy, NVS Sekhar Reddy, Raj Kumar Badam
      Pages: 8 - 8
      Abstract: GV Reddy, G Siva Prasad Reddy, NVS Sekhar Reddy, Raj Kumar Badam

      Journal of Clinical Imaging Science 2012 2(1):8-8

      Cherubism is a rare non-neoplastic hereditary disease related to genetic mutations characterized by symmetrically swollen cheeks, particularly over the angles of the mandible, and an upward turning of the eyes. The affected mandible and maxilla begin to swell in early childhood, and gradually increase until the age of puberty. Apparently, surgical intervention is unnecessary unless significant functional, esthetic, or emotional disturbances develop. In the present paper, we report a case of cherubism, with classic features that was classified as grade 3, managed with surgery and followed up for 2-years after treatment.
      Citation: Journal of Clinical Imaging Science 2012 2(1):8-8
      PubDate: Sat,25 Feb 2012
      DOI: 10.4103/2156-7514.93275
      Issue No: Vol. 2, No. 1 (2012)
       
  • Asymptomatic Incidental Ductal Carcinoma in situ in a Male Breast
           Presenting with Contralateral Gynecomastia

    • Authors: Laura M Isley, Rebecca J Leddy, Tihana Rumboldt, Jacqueline M Bernard
      Pages: 9 - 9
      Abstract: Laura M Isley, Rebecca J Leddy, Tihana Rumboldt, Jacqueline M Bernard

      Journal of Clinical Imaging Science 2012 2(1):9-9

      Ductal carcinoma in situ (DCIS) in males is rare and usually presents with symptoms on the affected side, such as, palpable mass or bloody nipple discharge. Even as DCIS has been reported in conjunction with gynecomastia in the same breast, we report an unusual case of a 62-year-old Caucasian male, with no family history of breast cancer, who presented with symptomatic side gynecomastia, and was incidentally found to have DCIS in a completely asymptomatic left breast. To the best of our knowledge, this case is the first report in literature of asymptomatic, incidentally discovered DCIS in a male patient.
      Citation: Journal of Clinical Imaging Science 2012 2(1):9-9
      PubDate: Mon,19 Mar 2012
      DOI: 10.4103/2156-7514.94021
      Issue No: Vol. 2, No. 1 (2012)
       
  • Deep Circumflex Iliac Artery Pseudoaneurysm as a Complication of
           Paracentesis

    • Authors: Bhawna Satija, Sanyal Kumar, Ramnik K Duggal, Supreethi Kohli
      Pages: 10 - 10
      Abstract: Bhawna Satija, Sanyal Kumar, Ramnik K Duggal, Supreethi Kohli

      Journal of Clinical Imaging Science 2012 2(1):10-10

      We report a case of a pseudoaneurysm arising from the deep circumflex iliac artery, in an end-stage renal disease patient with gross ascitis, presenting with an anterior abdominal wall hematoma following paracentesis. Duplex Doppler sonography confirmed the presence of the pseudoaneurysm and multidetector computed tomography angiography delineated the detailed arterial anatomy.
      Citation: Journal of Clinical Imaging Science 2012 2(1):10-10
      PubDate: Mon,19 Mar 2012
      DOI: 10.4103/2156-7514.94022
      Issue No: Vol. 2, No. 1 (2012)
       
  • Asymptomatic Thymic Cyst Appearing in the Neck on Valsalva: Unusual
           Presentation of a Rare Disease

    • Authors: Kishor V Hegde, P Suneetha, PV Pradeep, Panil Kumar
      Pages: 11 - 11
      Abstract: Kishor V Hegde, P Suneetha, PV Pradeep, Panil Kumar

      Journal of Clinical Imaging Science 2012 2(1):11-11

      Thymic cysts are usually diagnosed accidentally during radiological evaluation of the chest for unrelated conditions. Symptoms appear late when the mass compresses on adjoining tissues. We report an unusual case of asymptomatic mediastinal thymic cyst which was seen in the neck whenever the patient was asked to perform Valsalva maneuver. This case is being reported for the unusual clinical presentation of a rare disease. The role of imaging in the diagnosis and common differential diagnoses are also discussed.
      Citation: Journal of Clinical Imaging Science 2012 2(1):11-11
      PubDate: Mon,19 Mar 2012
      DOI: 10.4103/2156-7514.94026
      Issue No: Vol. 2, No. 1 (2012)
       
  • Assessing the Performance of Imaging Health Systems in Five Selected
           Hospitals in Uganda

    • Authors: Michael G Kawooya, George Pariyo, Elsie Kiguli Malwadde, Rosemary Byanyima, Harriet Kisembo
      Pages: 12 - 12
      Abstract: Michael G Kawooya, George Pariyo, Elsie Kiguli Malwadde, Rosemary Byanyima, Harriet Kisembo

      Journal of Clinical Imaging Science 2012 2(1):12-12

      Objectives : The first objective of the study was to develop an index termed as the 'Imaging Coverage' (IC), for measuring the performance of the imaging health systems. This index together with the Hospital-Based Utilization (HBU) would then be calculated for five Ugandan hospitals. Second, was to relate the financial resources and existing health policy to the performance of the imaging systems. Materials and Methods: This was a cross-sectional survey employing the triangulation methodology, conducted in Mulago National Referral Hospital. The qualitative study used cluster sampling, in-depth interviews, focus group discussions, and self-administered questionnaires to explore the non-measurable aspects of the imaging systems' performances. Results: The IC developed and tested as an index for the imaging system's performance was 36%. General X-rays had the best IC followed by ultrasound. The Hospital-Based Utilization for the five selected hospitals was 186 per thousand and was the highest for general radiography followed by ultrasound. Conclusion: The IC for the five selected hospitals was 36% and the HBU was 186 per thousand, reflecting low performance levels, largely attributable to inadequate funding. There were shortfalls in imaging requisitions and inefficiencies in the imaging systems, financing, and health policy. Although the proportion of inappropriate imaging was small, reducing this inappropriateness even further would lead to a significant total saving, which could be channeled into investigating more patients. Financial resources stood out as the major limitation in attaining the desired performance and there is a need to increase budget funding so as to improve the performance of the imaging health systems.
      Citation: Journal of Clinical Imaging Science 2012 2(1):12-12
      PubDate: Thu,22 Mar 2012
      DOI: 10.4103/2156-7514.94225
      Issue No: Vol. 2, No. 1 (2012)
       
  • Imaging Techniques in Endodontics: An Overview

    • Authors: BS Deepak, TS Subash, VJ Narmatha, T Anamika, TK Snehil, DB Nandini
      Pages: 13 - 13
      Abstract: BS Deepak, TS Subash, VJ Narmatha, T Anamika, TK Snehil, DB Nandini

      Journal of Clinical Imaging Science 2012 2(1):13-13

      This review provides an overview of the relevance of imaging techniques such as, computed tomography, cone beam computed tomography, and ultrasound, to endodontic practice. Many limitations of the conventional radiographic techniques have been overcome by the newer methods. Advantages and disadvantages of various imaging techniques in endodontic practice are also discussed.
      Citation: Journal of Clinical Imaging Science 2012 2(1):13-13
      PubDate: Thu,22 Mar 2012
      DOI: 10.4103/2156-7514.94227
      Issue No: Vol. 2, No. 1 (2012)
       
  • Focal Lipoatrophy of Face: A Rare Esthetic Complaint

    • Authors: K Anbarasi, S Sathasivasubramanian, CL Krithika, PM VenkataSai
      Pages: 14 - 14
      Abstract: K Anbarasi, S Sathasivasubramanian, CL Krithika, PM VenkataSai

      Journal of Clinical Imaging Science 2012 2(1):14-14

      A well-proportioned face combines features that are balanced and symmetrical. Any structural alteration that leads to facial asymmetry causes esthetical and psychological disturbances. Lipoatrophy is one such condition, which results in loss of subcutaneous fat layer and manifests as a depression. Although many subtypes with varying clinical and etiological backgrounds exist, the idiopathic form is rare and facial involvement is the rarest. Computed tomography is one of the accepted diagnostic tools to determine the atrophic layer of facial anatomy. This report presents the clinical types, diagnosis, and management of a case of facial lipoatrophy.
      Citation: Journal of Clinical Imaging Science 2012 2(1):14-14
      PubDate: Thu,22 Mar 2012
      DOI: 10.4103/2156-7514.94229
      Issue No: Vol. 2, No. 1 (2012)
       
  • Post-traumatic Cavernosal Artery Pseudoaneurysm Presenting as Right Hip
           Pain: An Imaging Evaluation

    • Authors: Aarthi Govindarajan, PM Venkata Sai, C Anupama, S Santhosh Joseph
      Pages: 15 - 15
      Abstract: Aarthi Govindarajan, PM Venkata Sai, C Anupama, S Santhosh Joseph

      Journal of Clinical Imaging Science 2012 2(1):15-15

      Pseudoaneurysm of the cavernosal artery is quite rare. Herein, we describe color Doppler findings of post-traumatic pseudoaneurysm of the right cavernosal artery in a 19-year-old adolescent boy who presented with right hip pain. Doppler showed turbulence of flow with arterial inflow and outflow from the Pseudoaneurysm of the cavernosal artery is quite rare. Herein, we describe color Doppler findings of post-traumatic pseudoaneurysm of the right cavernosal artery in a 19-year-old adolescent boy who presented with right hip pain. Doppler showed turbulence of flow with arterial inflow and outflow from the aneurysm. Selective transarterial catheterization of the internal iliac and internal pudental artery with microcatheter and embolization of pseudoaneurysm using histocryl resulted in alleviation of symptoms.aneurysm. Selective transarterial catheterization of the internal iliac and internal pudental artery with microcatheter and embolization of pseudoaneurysm using histocryl resulted in alleviation of symptoms.
      Citation: Journal of Clinical Imaging Science 2012 2(1):15-15
      PubDate: Thu,22 Mar 2012
      Issue No: Vol. 2, No. 1 (2012)
       
  • An Unusual Case of Gallium Scan Mimicking a Bone Scan

    • Authors: Ameya Puranik, Karuna Luthra, RD Lele
      Pages: 16 - 16
      Abstract: Ameya Puranik, Karuna Luthra, RD Lele

      Journal of Clinical Imaging Science 2012 2(1):16-16

      Gallium-67 localization is based on the fact that it binds to plasma proteins like transferrin and lactoferrin, which have iron-binding sites. Abnormal biodistribution of gallium-67 citrate can occur in iron-overload states. We report one such case of gallium scan mimicking a bone scan due to skeletal uptake of gallium.
      Citation: Journal of Clinical Imaging Science 2012 2(1):16-16
      PubDate: Sat,28 Apr 2012
      DOI: 10.4103/2156-7514.95430
      Issue No: Vol. 2, No. 1 (2012)
       
  • Agenesis of the Gallbladder with the Presence of a Small Dysmorphic Cyst:
           Role of Magnetic Resonance Cholangiopancreatography

    • Authors: Antonio Pierro, Matia Martucci, Giuseppina Maselli, Alessandra Farchione
      Pages: 17 - 17
      Abstract: Antonio Pierro, Matia Martucci, Giuseppina Maselli, Alessandra Farchione

      Journal of Clinical Imaging Science 2012 2(1):17-17

      We report a case of agenesis of the gallbladder with the presence of a small dysmorphic cyst, along the bed of the gallbladder and cystic duct. The patient presented to us with a suspected diagnosis of atrophic and sclerotic gallbladder that was not seen on ultrasound examination, indicating the need for cholecystectomy. The patient's medical history report mentioned agenesis of the left kidney. The existence of a congenital abnormality led us to suspect the inability to visualize the gallbladder was probably due to a possible agenesis of the gallbladder. The patient was investigated with magnetic resonance cholangiopancreatography (MRCP), that confirmed the suspected diagnosis and avoided unnecessary surgery. The hypothesis of anomalous development or agenesis of the gallbladder should always be suspected when the gallbladder is not visible on ultrasound imaging, especially in patients with other congenital anomalies. We believe that in all these patients, MRCP must always be performed to help make decisions on the treatment protocol.
      Citation: Journal of Clinical Imaging Science 2012 2(1):17-17
      PubDate: Sat,28 Apr 2012
      DOI: 10.4103/2156-7514.95431
      Issue No: Vol. 2, No. 1 (2012)
       
  • Report of Two Siblings with Overlapping Features of Ellis-van Creveld and
           Weyers Acrodental Dysostosis

    • Authors: Devi C Shetty, Harkanwal P Singh, Prince Kumar, Chanchal Verma
      Pages: 18 - 18
      Abstract: Devi C Shetty, Harkanwal P Singh, Prince Kumar, Chanchal Verma

      Journal of Clinical Imaging Science 2012 2(1):18-18

      Skeletal dysplasias are a heterogenous group of disorders combining abnormalities in the skull and other skeletal bones. Weyers acrofacial dysostosis also known as Weyers acrodental dysostosis was first described in 1952, by Weyers, as a postaxial polydactyly, which had features distinct from, yet some in common with the Ellis-van Creveld Syndrome (EvC). Both the syndromes have been mapped to the same chromosome, 4p16. The cases reported here highlight the overlapping features of both syndromes, which are dissimilar in mode of inheritance and phenotypic severity, emphasizing the need for genetic analysis, to categorize these conditions.
      Citation: Journal of Clinical Imaging Science 2012 2(1):18-18
      PubDate: Sat,28 Apr 2012
      DOI: 10.4103/2156-7514.95432
      Issue No: Vol. 2, No. 1 (2012)
       
  • Rupture of Plantaris Muscle - A Mimic: MRI Findings

    • Authors: TN Gopinath, J Jagdish, K Krishnakiran, PC Shaji
      Pages: 19 - 19
      Abstract: TN Gopinath, J Jagdish, K Krishnakiran, PC Shaji

      Journal of Clinical Imaging Science 2012 2(1):19-19

      Calf muscle trauma commonly involves the gastrocnemius and soleus muscles. Plantaris muscle is a vestigial muscle coursing through the calf. Similar clinical features may be seen with injury to the plantaris muscle. It can also mimic other conditions like deep vein thrombosis, rupture of Baker's cyst, and tumors. MRI is helpful in identifying and characterizing it. We report two cases of ruptured plantaris muscle seen on MRI.
      Citation: Journal of Clinical Imaging Science 2012 2(1):19-19
      PubDate: Sat,28 Apr 2012
      DOI: 10.4103/2156-7514.95433
      Issue No: Vol. 2, No. 1 (2012)
       
  • Idiopathic Thrombus in the Common Carotid Artery on Digital Subtraction
           Angiography

    • Authors: Anand Alurkar, Lakshmi Sudha Prasanna Karanam, Suresh Nayak, Sagar Oak
      Pages: 20 - 20
      Abstract: Anand Alurkar, Lakshmi Sudha Prasanna Karanam, Suresh Nayak, Sagar Oak

      Journal of Clinical Imaging Science 2012 2(1):20-20

      In the present study, we discuss the accuracy of digital subtraction angiography (DSA) in diagnosis of thrombus in the common carotid artery and its role in the medical management of this disorder. Between 2006 and 2011, four patients (age group ranging from 26 to 48 years) presented to our institution with symptoms of stroke. DSA in all these patients showed cigar-shaped filling defect in the common carotid artery. All the patients were managed successfully with anticoagulation treatment. Follow-up Duplex scan was done in all the patients. DSA is the gold standard to diagnose free floating thrombus in the common carotid artery. Medical management can be effective in these patients but a multidisciplinary team approach is needed for appropriate management.
      Citation: Journal of Clinical Imaging Science 2012 2(1):20-20
      PubDate: Sat,28 Apr 2012
      DOI: 10.4103/2156-7514.95434
      Issue No: Vol. 2, No. 1 (2012)
       
  • Review of Metaplastic Carcinoma of the Breast: Imaging Findings and
           Pathologic Features

    • Authors: Rebecca Leddy, Abid Irshad, Tihana Rumboldt, Abbie Cluver, Amy Campbell, Susan Ackerman
      Pages: 21 - 21
      Abstract: Rebecca Leddy, Abid Irshad, Tihana Rumboldt, Abbie Cluver, Amy Campbell, Susan Ackerman

      Journal of Clinical Imaging Science 2012 2(1):21-21

      Metaplastic carcinoma (MPC), an uncommon but often aggressive breast cancer, can be challenging to differentiate from other types of breast cancer and even benign lesions based on the imaging appearance. It has a variable pathology classification system. These types of tumors are generally rapidly growing palpable masses. MPCs on imaging can present with imaging features similar to invasive ductal carcinoma and probably even benign lesions. The purpose of this article is to review MPC of the breast including the pathology subtypes, imaging features, and imaging pathology correlations. By understanding the clinical picture, pathology, and overlap in imaging characteristics of MPC with invasive ductal carcinoma and probably benign lesions can assist in diagnosing these difficult malignancies.
      Citation: Journal of Clinical Imaging Science 2012 2(1):21-21
      PubDate: Sat,28 Apr 2012
      DOI: 10.4103/2156-7514.95435
      Issue No: Vol. 2, No. 1 (2012)
       
  • Prenatal Diagnosis of Amniotic Band Syndrome in the Third Trimester of
           Pregnancy using 3D Ultrasound

    • Authors: Luciano Marcondes Machado Nardozza, Edward Araujo, Ana Carolina Rabachini Caetano, Antonio Fernandes Moron
      Pages: 22 - 22
      Abstract: Luciano Marcondes Machado Nardozza, Edward Araujo, Ana Carolina Rabachini Caetano, Antonio Fernandes Moron

      Journal of Clinical Imaging Science 2012 2(1):22-22

      Amniotic band syndrome is characterized by a build-up of bands and strings of fibrous tissue that adhere to the fetus and can compress parts of the fetus, thus causing malformations and even limb amputation while the fetus is still in the uterus. The clinical manifestations are extremely variable and their extent may range from a single abnormality, like a constriction ring, to multiple abnormalities. Such abnormalities are generally diagnosed at the end of the first or the beginning of the second trimester using two-dimensional ultrasonography (2DUS). Three-dimensional ultrasonography (3DUS) in rendering mode allows spatial analysis of the fetus and amniotic band, thus enabling better comprehension of this pathological condition and better counseling for the parents. There has not previously been any evidence to show that 3DUS would be useful in cases of late diagnosis (third trimester) of amniotic band syndrome. In the present case, a primigravid woman underwent her second obstetric ultrasound scan in the 34 th week, from which we observed two bands in contact with the right forearm, but with normal movement of this limb and its fingers. 3DUS made it possible to see the spatial relationship of these bands to the fetal body, thereby confirming their adherence to the limb. After the birth, the prenatal diagnosis of amniotic band syndrome without limb constriction was confirmed. A surgical procedure was carried out on the third day after birth to excise the bands, and the newborn was then discharged in a good general condition.
      Citation: Journal of Clinical Imaging Science 2012 2(1):22-22
      PubDate: Sat,28 Apr 2012
      DOI: 10.4103/2156-7514.95436
      Issue No: Vol. 2, No. 1 (2012)
       
  • Avoiding Unnecessary Fine-Needle Aspiration Cytology by Accuractely
           Predicting the Benign Nature of Thyroid Nodules Using Ultrasound

    • Authors: Sudhir Vinayak, Joyce A Sande
      Pages: 23 - 23
      Abstract: Sudhir Vinayak, Joyce A Sande

      Journal of Clinical Imaging Science 2012 2(1):23-23

      Objective: The objective of this study was to describe a reliable ultrasound based index scoring system based on ultraound characteristics to identify benign thyroid nodules and avoid unnecessary fine needle aspiration cytology. Materials and Methods: Patients undergoing ultrasound-guided fine-needle aspiration cytology (FNAC) for thyroid nodules were evaluated prospectively. A total of 284 patients were evaluated from November 2005 to November 2011. There were 284 nodules. Any solid or partly solid focal nodule in the thyroid gland was included in the study. Cysts with no solid component were excluded. We used LOGIQ 9 (GE Healthcare) scanner equipped with a 10--14 MHz linear matrix transducer with color and power Doppler capability. Four US characteristics were evaluated, i.e., nodule margins, echo texture, vascularity, and calcification. Fine needle aspiration (FNA) was performed on all nodules. The nodules were labeled benign or suspicious using an ultrasound index score and the results compared with FNAC. Follicular neoplasms on fine-needle aspiration cytology were further assessed by excision biopsy and histology. Cytology/histology was used as the final diagnosis. Results: In total 284 nodules were analyzed. All the 234 nodules in US labeled benign category were proven to be benign on cytology/histology. Therefore the specificity of ultrasound in labeling a nodule benign was 100%. Twenty of the 50 nodules that were suspicious on US were malignant. The most significant US differentiating characteristics were nodule margins, vascularity, and microcalcification. Conclusion: Our results show that US can accurately characterize benign thyroid nodules using an index scoring system and therefore preclude FNAC in these patients.
      Citation: Journal of Clinical Imaging Science 2012 2(1):23-23
      PubDate: Sat,28 Apr 2012
      DOI: 10.4103/2156-7514.95446
      Issue No: Vol. 2, No. 1 (2012)
       
  • Arthroscopic and Low-Field MRI (0.25 T) Evaluation of Meniscus and
           Ligaments of Painful Knee

    • Authors: Harish S Lokannavar, Xiaochun Yang, Harsha Guduru
      Pages: 24 - 24
      Abstract: Harish S Lokannavar, Xiaochun Yang, Harsha Guduru

      Journal of Clinical Imaging Science 2012 2(1):24-24

      Objective: Magnetic resonance imaging (MRI) is an accurate, non-invasive, cost-effective technique for examination of the soft tissue and osseous structures of the knee. The purpose of this study was to evaluate the accuracy of low-field MRI by comparing the results with subsequent arthroscopy. Materials and Methods: MR imaging study of 146 patients was done using 0.25 T ESTOATE G-SCAN and the sequence used were SE, FSE and GRE in all the three planes. The comparison was based on five parameters: accuracy, sensitivity, specificity, positive predictive value, and negative predictive value. Result: Our study showed high accuracy (98.08%) and negative predictive value (98.62%) for MRI in comparison with arthroscopy. Conclusion: Low-field MRI alleviates the need of arthroscopy for detection of meniscus tears and ligament tears.
      Citation: Journal of Clinical Imaging Science 2012 2(1):24-24
      PubDate: Wed,23 May 2012
      DOI: 10.4103/2156-7514.96539
      Issue No: Vol. 2, No. 1 (2012)
       
  • Routine Chest X-ray: Still Valuable for the Assessment of Left Ventricular
           Size and Function in the Era of Super Machines?

    • Authors: Maria-Aurora Morales, Renato Prediletto, Giuseppe Rossi, Giosuè Catapano, Massimo Lombardi, Daniele Rovai
      Pages: 25 - 25
      Abstract: Maria-Aurora Morales, Renato Prediletto, Giuseppe Rossi, Giosuè Catapano, Massimo Lombardi, Daniele Rovai

      Journal of Clinical Imaging Science 2012 2(1):25-25

      Objectives: The development of technologically advanced, expensive techniques has progressively reduced the value of chest X-ray in clinical practice for the assessment of left ventricular (LV) dilatation and dysfunction. Although controversial data are reported on the role of this widely available technique in cardiac assessment, it is known that the cardio-thoracic ratio is predictive of risk of progression in the NYHA Class, hospitalization, and outcome in patients with LV dysfunction. This study aimed to evaluate the reliability of the transverse diameter of heart shadow [TDH] by chest X-ray for detecting LV dilatation and dysfunction as compared to Magnetic Resonance Imaging (MRI) performed for different clinical reasons. Materials and Methods: In 101 patients, TDH was measured in digital chest X-ray and LV volumes and ejection fraction (EF) by MRI, both exams performed within 2 days. Results: A direct correlation between TDH and end-diastolic volumes (r = .75, P150 mL (sensitivity: 82%, specificity: 69%); in males a cut-off value of 15.5 mm identified LV end-diastolic volumes >210 mL (sensitivity: 84%; specificity: 72%). A negative relation was found between TDH and LVEF (r = -.54, P
      Citation: Journal of Clinical Imaging Science 2012 2(1):25-25
      PubDate: Wed,23 May 2012
      DOI: 10.4103/2156-7514.96540
      Issue No: Vol. 2, No. 1 (2012)
       
  • CT Manifestations of Osler-Weber-Rendu Syndrome in Liver: Report of Three
           Cases

    • Authors: Qu Chuan-Qiang, Guo Shou-Gang, He Yan, Chen Yu-Xin
      Pages: 26 - 26
      Abstract: Qu Chuan-Qiang, Guo Shou-Gang, He Yan, Chen Yu-Xin

      Journal of Clinical Imaging Science 2012 2(1):26-26

      Osler-Weber-Rendu syndrome is characterized by widespread telangiectasias. Its clinical manifestations depend on position and scope of the abnormal vessels. The clinical and CT data of 3 patients with Osler-Weber-Rendu syndrome were retrospectively analyzed. CT features reviewed include the change of volume and configuration of liver, presence of tortuous and irregular vessels, opacified vessel mass, arteriovenous shunt, and splenomegaly. CT is helpful for diagnosis, treatment, and follow-up of Osler-Weber-Rendu syndrome.
      Citation: Journal of Clinical Imaging Science 2012 2(1):26-26
      PubDate: Wed,23 May 2012
      DOI: 10.4103/2156-7514.96541
      Issue No: Vol. 2, No. 1 (2012)
       
  • Fahr's disease Presenting with Aneurysmal Subarachnoid Hemorrhage

    • Authors: Hosam Al-Jehani, Abdulrazag Ajlan, David Sinclair
      Pages: 27 - 27
      Abstract: Hosam Al-Jehani, Abdulrazag Ajlan, David Sinclair

      Journal of Clinical Imaging Science 2012 2(1):27-27

      Fahr's disease is a rare disorder of slowly progressive cognitive, psychiatric, and motor decline associated with idiopathic basal ganglia calcification (IBGC) and widespread calcification in the brain and cerebellum. Acute presentation of IBGC is most often as a seizure disorder; however, we present a case of an acute IBCG presentation in which the cause of the deterioration was an aneurysmal subarachnoid hemorrhage.
      Citation: Journal of Clinical Imaging Science 2012 2(1):27-27
      PubDate: Wed,23 May 2012
      DOI: 10.4103/2156-7514.96542
      Issue No: Vol. 2, No. 1 (2012)
       
  • Surgical Management of Aggressive Central Giant Cell Granuloma of Maxilla
           through Le Fort I Access Osteotomy

    • Authors: GV Reddy, G Siva Prasad Reddy, N. V. S. Sekhar Reddy, Aswin Kumar
      Pages: 28 - 28
      Abstract: GV Reddy, G Siva Prasad Reddy, N. V. S. Sekhar Reddy, Aswin Kumar

      Journal of Clinical Imaging Science 2012 2(1):28-28

      Giant cell granuloma (GCG) is an uncommon bony lesion in the head and neck region, most commonly affecting the maxilla and mandible and has a female predilection. The clinical behavior of central GCG ranges from a slowly growing asymptomatic swelling to an aggressive lesion. The clinical, radiological, histological features and management of an aggressive GCG of maxilla in an 18-year-old female patient are described and discussed. It is emphasized that surgery is the traditional and still the most accepted treatment for GCG. Le Fort I osteotomy has been advocated as one of the access osteotomy for the surgical management of aggressive and extensive GCG involving the maxilla. The postoperative morbidity and recurrence have been discussed.
      Citation: Journal of Clinical Imaging Science 2012 2(1):28-28
      PubDate: Wed,23 May 2012
      DOI: 10.4103/2156-7514.96543
      Issue No: Vol. 2, No. 1 (2012)
       
  • Honda Sign On 18-FDG PET/CT in a Case of Lymphoma Leading to Incidental
           Detection of Sacral Insufficiency Fracture

    • Authors: Prathamesh Joshi, Vikram Lele, Rozil Gandhi, Anil Parab
      Pages: 29 - 29
      Abstract: Prathamesh Joshi, Vikram Lele, Rozil Gandhi, Anil Parab

      Journal of Clinical Imaging Science 2012 2(1):29-29

      Sacral insufficiency fracture (SIF) is an important and treatable cause of low back pain in at-risk groups and the elderly. We report rare demonstration of 'Honda sign' in fluoro-deoxy-glucose positron emission tomography-computed tomography (FDG PET-CT) in a case of lymphoma, which led to incidental diagnosis of SIF. Honda sign, which is classically described in bone scans in cases of SIF, was found in FDG PET-CT in our case. This suggests SIF should be suspected when similar FDG uptake pattern is encountered and may help in early detection and management of SIF.
      Citation: Journal of Clinical Imaging Science 2012 2(1):29-29
      PubDate: Wed,23 May 2012
      DOI: 10.4103/2156-7514.96544
      Issue No: Vol. 2, No. 1 (2012)
       
  • Prenatal and Postnatal Schizencephaly Findings by 2D and 3D Ultrasound:
           Pictorial Essay

    • Authors: Lívia Teresa Moreira Rios, Edward Araujo, Luciano Marcondes Machado Nardozza, Ana Carolina Rabachini Caetano, Antonio Fernandes Moron, Marília da Glória Martins
      Pages: 30 - 30
      Abstract: Lívia Teresa Moreira Rios, Edward Araujo, Luciano Marcondes Machado Nardozza, Ana Carolina Rabachini Caetano, Antonio Fernandes Moron, Marília da Glória Martins

      Journal of Clinical Imaging Science 2012 2(1):30-30

      Schizencephaly is a brain-destructive lesion relating to clefts in the fetal brain that usually communicate with the ventricular system, subarachnoid space, or both. It presents as two types: Type I (closed) and Type II (open). During pregnancy, it may be suspected in the course of ultrasonography, which highlights ventricular dilatation and brain abnormalities. Usually, the diagnosis is confirmed postnatally using trans-fontanel ultrasonography. The etiology of schizencephaly is still unknown, but it may be derived from a primary disorder of brain development or from bilateral middle cerebral artery occlusion. Many causative agents including vascular insult, infections, toxins, and medications have been associated with this malformation. We present a pictorial essay of six cases of schizencephaly that were suspected on prenatal ultrasound scans and confirmed postnatally by trans-fontanel, two-dimensional and three-dimensional ultrasonography.
      Citation: Journal of Clinical Imaging Science 2012 2(1):30-30
      PubDate: Wed,23 May 2012
      DOI: 10.4103/2156-7514.96546
      Issue No: Vol. 2, No. 1 (2012)
       
  • Echo Planar Diffusion-Weighted Imaging: Possibilities and Considerations
           with 12- and 32-Channel Head Coils

    • Authors: John N Morelli, Megan R Saettele, Rajesh A Rangaswamy, Lan Vu, Clint M Gerdes, Wei Zhang, Fei Ai
      Pages: 31 - 31
      Abstract: John N Morelli, Megan R Saettele, Rajesh A Rangaswamy, Lan Vu, Clint M Gerdes, Wei Zhang, Fei Ai

      Journal of Clinical Imaging Science 2012 2(1):31-31

      Interest in clinical brain magnetic resonance imaging using 32-channel head coils for signal reception continues to increase. The present investigation assesses possibilities for improving diffusion-weighted image quality using a 32-channel in comparison to a conventional 12-channel coil. The utility of single-shot (ss) and an approach to readout-segmented (rs) echo planar imaging (EPI) are examined using both head coils. Substantial image quality improvements are found with rs-EPI. Imaging with a 32-channel head coil allows for implementation of greater parallel imaging acceleration factors or acquisition of scans at a higher resolution. Specifically, higher resolution imaging with rs-EPI can be achieved by increasing the number of readout segments without increasing echo-spacing or echo time to the degree necessary with ss-EPI - a factor resulting in increased susceptibility artifact and reduced signal-to-noise with the latter.
      Citation: Journal of Clinical Imaging Science 2012 2(1):31-31
      PubDate: Wed,23 May 2012
      DOI: 10.4103/2156-7514.96548
      Issue No: Vol. 2, No. 1 (2012)
       
  • Seizure Mimicking Stroke: Role of CT Perfusion

    • Authors: Vishnumurthy Shushrutha Hedna, Prerak P Shukla, Michael F Waters
      Pages: 32 - 32
      Abstract: Vishnumurthy Shushrutha Hedna, Prerak P Shukla, Michael F Waters

      Journal of Clinical Imaging Science 2012 2(1):32-32

      Stroke mimics constitute 15--20% of all cases presenting to the emergency department, prominent among them being seizures, hypoglycemia, tumors, migraines, and posterior reversible leucoencephalopathy. They have also abnormal computerized tomography perfusion (CTP) findings. We report a case where CTP helped us to diagnose and treat a seizure when initial presentation was that of a stroke.
      Citation: Journal of Clinical Imaging Science 2012 2(1):32-32
      PubDate: Fri,29 Jun 2012
      DOI: 10.4103/2156-7514.97728
      Issue No: Vol. 2, No. 1 (2012)
       
  • Imaging of Cystic and Cyst-like Lesions of the Mediastinum with Pathologic
           Correlation

    • Authors: Kemal Odev, Bilgin K Aribas, Alaaddin Nayman, Olgun K Aribas, Tamer Altinok, Ahmet Küçükapan
      Pages: 33 - 33
      Abstract: Kemal Odev, Bilgin K Aribas, Alaaddin Nayman, Olgun K Aribas, Tamer Altinok, Ahmet Küçükapan

      Journal of Clinical Imaging Science 2012 2(1):33-33

      Cystic masses of the mediastinum are a heterogenous group of asymptomatic or symptomatic, congenital, infectious, or neoplastic lesions. For early and correct diagnosis, evaluation, and optimal patient management of cystic mediastinal masses in infants, children, or adults imaging plays an important role. A non-invasive and sensitive imaging modality is an efficient and cost-effective tool. Multidetector computed tomography (MDTC) with volumetric acquisition provides fast acquisition of high resolution images and muitiplanar reconstruction. Both 2D and 3D imaging in mediastinal imaging help in surgical planning and assessing resectability of mediastinal lesions. MR imaging has many advantages over other modalities for detecting and identifying cystic, or fluid-filled mediastinal masses, because of its intrinsic high soft tissue contrast and direct multiplanar imaging capabilities. However, histological tissue analysis may be required to differentiate a cystic lesion from other cyst-like or low-attenuation lesions.
      Citation: Journal of Clinical Imaging Science 2012 2(1):33-33
      PubDate: Fri,29 Jun 2012
      DOI: 10.4103/2156-7514.97750
      Issue No: Vol. 2, No. 1 (2012)
       
  • Radiographic Study of the Prevalence of Dens Invaginatus in a Sample Set
           of Turkish Dental Patients

    • Authors: Hakan Çolak, Enes Tan, Bahadir Ugur Aylikçi, Recep Uzgur, Mustafa Turkal, Mehmet Mustafa Hamidi
      Pages: 34 - 34
      Abstract: Hakan Çolak, Enes Tan, Bahadir Ugur Aylikçi, Recep Uzgur, Mustafa Turkal, Mehmet Mustafa Hamidi

      Journal of Clinical Imaging Science 2012 2(1):34-34

      Aim: The aim of this study was to determine the prevalence of dens invaginatus in a sample of Turkish dental patients. Materials and Methods: The sample included 6, 912 panoramic radiographs from different Turkish dental patients. The ages of the patients ranged from 18 to 50 years. A tooth was considered having dens invaginatus if an infolding of a radiopaque ribbon-like structure equal in density to enamel was seen extending from the cingulum into the root canal. Maxillary and mandibular teeth were evaluated on panoramic radiographs to determine the type of dens invaginatus using Oehlers' classification. Results: The overall incidence of patients with dens invaginatus was 0.17%. Dens invaginatus were detected in 15 teeth of a total of 192 150 teeth to give a tooth prevalence of 0.008%. Maxillary lateral incisors were most commonly affected teeth in the mouth (80% of cases), followed by maxillary canine teeth (20% of cases). The bilateral incidence of a symmetrical distribution was 25%. Conclusion: The occurrence of dens invaginatus among this Turkish population was rare. Attention should be paid to the presence of dens invaginatus and the treatment problems associated with it.
      Citation: Journal of Clinical Imaging Science 2012 2(1):34-34
      PubDate: Fri,29 Jun 2012
      DOI: 10.4103/2156-7514.97755
      Issue No: Vol. 2, No. 1 (2012)
       
  • Primary Endobronchial Leiomyosarcoma of the Lung: Clinical, Gross and
           Microscopic Findings of Two Cases

    • Authors: Hafsa Elouazzani, Fouad Zouaidia, Ahmed Jahid, Zakiya Bernoussi, Najat Mahassini
      Pages: 35 - 35
      Abstract: Hafsa Elouazzani, Fouad Zouaidia, Ahmed Jahid, Zakiya Bernoussi, Najat Mahassini

      Journal of Clinical Imaging Science 2012 2(1):35-35

      Primary leiomyosarcoma of the lung is an unusual malignant tumor. Among this entity, the endobronchial form is very rare and the preoperative diagnosis is extremely difficult. We present two different presentations and outcomes of primary endobronchial leiomyosarcoma of the lung. In both cases, the histological study and the immunohistochemical stain, of the surgical resection, provided the final diagnosis. Through those cases we present the diagnostic and therapeutic difficulties encountered.
      Citation: Journal of Clinical Imaging Science 2012 2(1):35-35
      PubDate: Fri,29 Jun 2012
      DOI: 10.4103/2156-7514.97757
      Issue No: Vol. 2, No. 1 (2012)
       
  • "Knot Stent": An Unusual Cause of Acute Renal Failure in
           Solitary Kidney

    • Authors: Kamal Moufid, Driss Touiti, Lezrek Mohamed
      Pages: 36 - 36
      Abstract: Kamal Moufid, Driss Touiti, Lezrek Mohamed

      Journal of Clinical Imaging Science 2012 2(1):36-36

      The insertion of indwelling ureteric stents is a routine procedure in urology practice. Complications secondary to the insertion of these stents have also increased, such as stent encrustation, stent fragmentation, stone formation, and recurrent urinary tract infections. Knot formation within the renal pelvis or in the coiled portion of the ureteral stent is an extremely rare condition, with less than 15 cases reported in literature. The authors report a rare case of knotted stent, complicated by an obstructive acute renal failure and urosepsis, in a patient with a solitary functioning kidney.
      Citation: Journal of Clinical Imaging Science 2012 2(1):36-36
      PubDate: Fri,29 Jun 2012
      DOI: 10.4103/2156-7514.97758
      Issue No: Vol. 2, No. 1 (2012)
       
  • Training for Rural Radiology and Imaging in Sub-Saharan Africa: Addressing
           the Mismatch Between Services and Population

    • Authors: Michael G Kawooya
      Pages: 37 - 37
      Abstract: Michael G Kawooya

      Journal of Clinical Imaging Science 2012 2(1):37-37

      The objectives of this review are to outline the needs, challenges, and training interventions for rural radiology (RR) training in Sub-Saharan Africa (SSA). Rural radiology may be defined as imaging requirements of the rural communities. In SSA, over 80% of the population is rural. The literature was reviewed to determine the need for imaging in rural Africa, the challenges, and training interventions. Up to 50% of the patients in the rural health facilities in Uganda may require imaging, largely ultrasound and plain radiography. In Uganda, imaging is performed, on an average, in 50% of the deserving patients in the urban areas, compared to 10-13 % in the rural areas. Imaging has been shown to increase the utilization of facility-based rural health services and to impact management decisions. The challenges in the rural areas are different from those in the urban areas. These are related to disease spectrum, human resource, and socio-economic, socio-cultural, infrastructural, and academic disparities. Countries in Sub-Saharan Africa, for which information on training intervention was available, included: Uganda, Kenya, Tanzania, Rwanda, Zambia, Ghana, Malawi, and Sudan. Favorable national policies had been instrumental in implementing these interventions. The interventions had been made by public, private-for-profit (PFP), private-not-for profit (PNFP), local, and international academic institutions, personal initiatives, and professional societies. Ultrasound and plain radiography were the main focus. Despite these efforts, there were still gross disparities in the RR services for SSA. In conclusion, there have been training interventions targeted toward RR in Africa. However, gross disparities in RR provision persist, requiring an effective policy, plus a more organized, focused, and sustainable approach, by the stakeholders.
      Citation: Journal of Clinical Imaging Science 2012 2(1):37-37
      PubDate: Fri,29 Jun 2012
      DOI: 10.4103/2156-7514.97747
      Issue No: Vol. 2, No. 1 (2012)
       
  • Shoulder Ultrasonography: Performance and Common Findings

    • Authors: Diana Gaitini
      Pages: 38 - 38
      Abstract: Diana Gaitini

      Journal of Clinical Imaging Science 2012 2(1):38-38

      Ultrasound (US) of the shoulder is the most commonly requested examination in musculoskeletal US diagnosis. Sports injuries and degenerative and inflammatory processes are the main sources of shoulder pain and functional limitations. Because of its availability, low cost, dynamic examination process, absence of radiation exposure, and ease of patient compliance, US is the preferred mode for shoulder imaging over other, more sophisticated, and expensive methods. Operator dependence is the main disadvantage of US examinations. Use of high range equipment with high resolution transducers, adhering to a strict examination protocol, good knowledge of normal anatomy and pathological processes and an awareness of common pitfalls are essential for the optimal performance and interpretation of shoulder US. This article addresses examination techniques, the normal sonographic appearance of tendons, bursae and joints, and the main pathological conditions found in shoulder ultrasonography.
      Citation: Journal of Clinical Imaging Science 2012 2(1):38-38
      PubDate: Sat,28 Jul 2012
      DOI: 10.4103/2156-7514.99146
      Issue No: Vol. 2, No. 1 (2012)
       
  • Musculoskeletal Disorders in the Elderly

    • Authors: Ramon Gheno, Juan M Cepparo, Cristina E Rosca, Anne Cotten
      Pages: 39 - 39
      Abstract: Ramon Gheno, Juan M Cepparo, Cristina E Rosca, Anne Cotten

      Journal of Clinical Imaging Science 2012 2(1):39-39

      Musculoskeletal disorders are among the most common problems affecting the elderly. The resulting loss of mobility and physical independence can be particularly devastating in this population. The aim of this article is to present some of the most frequent musculoskeletal disorders of the elderly, such as fractures, osteoporosis, osteoarthritis, microcrystal disorders, infections, and tumors.
      Citation: Journal of Clinical Imaging Science 2012 2(1):39-39
      PubDate: Sat,28 Jul 2012
      DOI: 10.4103/2156-7514.99151
      Issue No: Vol. 2, No. 1 (2012)
       
  • Prenatal Diagnosis of EEC Syndrome with "Lobster Claw" Anomaly
           by 3D Ultrasound

    • Authors: Livia T Rios, Edward Araujo, Ana C. R. Caetano, Luciano M Nardozza, Antonio F Moron, Marília G Martins
      Pages: 40 - 40
      Abstract: Livia T Rios, Edward Araujo, Ana C. R. Caetano, Luciano M Nardozza, Antonio F Moron, Marília G Martins

      Journal of Clinical Imaging Science 2012 2(1):40-40

      The EEC syndrome is a genetic anomaly characterized by the triad: ectodermal dysplasia (development of anomalies of the structures derived from the embryonic ectodermal layer), ectrodactyly (extremities, hands and feet malformations) and cleft lip and/or palate; these malformations can be seen together or in isolation. The prenatal diagnosis can be made by two-dimensional ultrasonography (2DUS) that identifies the facial and/or limb anomalies, most characteristic being the "lobster-claw" hands. The three-dimensional ultrasonography (3DUS) provides a better analysis of the malformations than the 2DUS. A 25-year-old primigravida, had her first transvaginal ultrasonography that showed an unique fetus with crow-rump length of 47 mm with poorly defined hands and feet,. She was suspected of having sporadic form of EEC syndrome. The 2DUS performed at 19 weeks confirmed the EEC syndrome, showing a fetus with lobster-claw hands (absence of the 2 nd and 3 rd fingers), left foot with the absence of the 3rd toe and the right foot with syndactyly, and presence of cleft lip/palate. The 3DUS defined the anomalies much better than 2DUS including the lobster-claw hands.
      Citation: Journal of Clinical Imaging Science 2012 2(1):40-40
      PubDate: Sat,28 Jul 2012
      DOI: 10.4103/2156-7514.99153
      Issue No: Vol. 2, No. 1 (2012)
       
  • Cerebral Blood and CSF Flow Patterns in Patients Diagnosed for Cerebral
           Venous Thrombosis - An Observational Study

    • Authors: Souraya ElSankari, Marek Czosnyka, Pierre Lehmann, Marc-Etienne Meyer, Hervé Deramond, Olivier Balédent
      Pages: 41 - 41
      Abstract: Souraya ElSankari, Marek Czosnyka, Pierre Lehmann, Marc-Etienne Meyer, Hervé Deramond, Olivier Balédent

      Journal of Clinical Imaging Science 2012 2(1):41-41

      Background and Purpose: Recent studies of the organization of the cerebral venous system in healthy subjects using phase contrast magnetic resonance imaging (PC-MRI) show its structural complexity and inter-individual variations. Our objective was to study the venous blood and CSF flows in cerebral venous thrombosis (CVT). Materials and Methods: PC-MRI sequences were added to brain MRI conventional protocol in 19 patients suspected of CVT, among whom 6 patients had CVT diagnosis confirmed by MR venography. Results were compared with 18 healthy age-matched volunteers (HV). Results: In patients without CVT (NoCVT) confirmed by venography, we found heterogeneous individual venous flows, and variable side dominance in paired veins and sinuses, comparable to those in healthy volunteers. In CVT patients, PC-MRI detected no venous flow in the veins and/or sinuses with thrombosis. Arterial flows were preserved. CSF aqueductal and cervical stroke volumes were increased in a patient with secondary cerebral infarction, and decreased in 4 patients with extended thrombosis in the superior sagittal and transverse sinuses. These results suggest the main role of the venous system in the regulation of the dynamic intracranial equilibrium. Conclusions: CVT produces highly individualized pattern of disturbance in venous blood drainage. Complementary to MRI venography, PC-MRI provides non-invasive data about venous blockage consequences on CSF flow disturbances.
      Citation: Journal of Clinical Imaging Science 2012 2(1):41-41
      PubDate: Sat,28 Jul 2012
      DOI: 10.4103/2156-7514.99158
      Issue No: Vol. 2, No. 1 (2012)
       
  • Uterine Cervical Malignancy: Diagnostic Accuracy of MRI with
           Histopathologic Correlation

    • Authors: Mohammed A Shweel, Enas A Abdel-Gawad, Ehab Ali Abdel-Gawad, Hosny S Abdelghany, Alshimaa M Abdel-Rahman, Emad M Ibrahim
      Pages: 42 - 42
      Abstract: Mohammed A Shweel, Enas A Abdel-Gawad, Ehab Ali Abdel-Gawad, Hosny S Abdelghany, Alshimaa M Abdel-Rahman, Emad M Ibrahim

      Journal of Clinical Imaging Science 2012 2(1):42-42

      Objective: Cervical cancer is the third most common malignancy in women worldwide. Accurate staging of the disease is crucial in planning the optimal treatment strategy. The aim of this study was to evaluate the role of magnetic resonance imaging (MRI) in the assessment of extension and staging of cervical malignancy in correlation with histopathologic examination. Materials and Methods: Thirty females with untreated pathologically proven uterine cervical carcinoma were included in this prospective study. The patients were 40 - 65 years of age and their average age was 45 years. All patients were subjected to routine clinical staging workup and underwent MRI for preoperative staging. Preoperative MRI findings were reviewed and compared with the final pathological staging that is the Gold Standard of reference. Results: Histopathologic examination established that of the 30 tumors, 22 (73.3%) were squamous cell carcinoma. According to the International Federation of Gynecology and Obstetrics (FIGO) staging criteria, 2/30 patients (6.6%) were stage IB, 12/30 (40.3%) were IIA, 8/30 were IIB (26.6%), and 8/30 (26.6%) were IVA. MRI had a sensitivity of 100% and specificity 85.7% in the detection of parametrial infiltration, and a sensitivity of 100% and specificity of 90% in the detection of vaginal infiltration. It was sensitive (100%) and specific (100%) in detecting tumor extension to the stroma, urinary bladder, and rectum. Pathological examination demonstrated stage IB cervical carcinoma in 2/30 patients (6.6%), stage IIA disease in 10/30 patients (33.3%), stage IIB in 6/30 patients (20%), and stage IV disease in 8/30 patients (26.6%). MRI features demonstrated stage IB in 2/30 patients (6.6%), stage IIA disease in 12/30 patients (40%), stage IIB in 8/30 patients (26.6%), and stage IV disease in 8/30 patients (26.6%). MRI staging of cervical carcinoma was in concordance with histopathologic staging in stages IB and IVA and over-staging in IIA and IIB stages. Conclusion: MRI is an optimal non-invasive modality for preoperative staging of uterine cervical malignancy, and crucial in subsequent more accurate treatment planning.
      Citation: Journal of Clinical Imaging Science 2012 2(1):42-42
      PubDate: Sat,28 Jul 2012
      DOI: 10.4103/2156-7514.99175
      Issue No: Vol. 2, No. 1 (2012)
       
  • Radiological Features of Metastatic Gastrointestinal Stromal Tumors

    • Authors: Sujata Patnaik, Yarlagadda Jyotsnarani, Susarla Rammurti
      Pages: 43 - 43
      Abstract: Sujata Patnaik, Yarlagadda Jyotsnarani, Susarla Rammurti

      Journal of Clinical Imaging Science 2012 2(1):43-43

      The imaging features of 42 histopathologically confirmed cases of Gastrointestinal Stromal Tumors (GIST) were analyzed, to observe the pattern of metastasis. At presentation 22 of 42 patients (52.3%) showed metastasis. During follow-up, three more cases developed metastasis, within one year of resection. Mesentery, omentum, and liver were the most frequent sites for metastasis. Other sites that were rarely reported to be involved were increasingly recognized to show metastasis due to longer survival. The metastasis often showed attenuation and enhancement characteristics, similar to primary GIST, and frequently showed necrosis, hemorrhage, and calcification.
      Citation: Journal of Clinical Imaging Science 2012 2(1):43-43
      PubDate: Sat,28 Jul 2012
      DOI: 10.4103/2156-7514.99177
      Issue No: Vol. 2, No. 1 (2012)
       
  • Penile Metastases of Recurrent Prostatic Adenocarcinoma without PSA Level
           Increase: A Case Report

    • Authors: Antonio Pierro, Savino Cilla, Cinzia Digesù, Alessio G Morganti
      Pages: 44 - 44
      Abstract: Antonio Pierro, Savino Cilla, Cinzia Digesù, Alessio G Morganti

      Journal of Clinical Imaging Science 2012 2(1):44-44

      We report a case of penile metastases from recurrent prostatic adenocarcinoma that was the first sign of a widespread metastatic disease in the absence of any increase in prostate-specific antigen (PSA) level. In April 2011, an 80-year-old man presented to our Radiotherapy Unit with multiple palpable hard nodules in the penis, dysuria, and moderate perineal pain, 7 years after he had received radiotherapy for prostate cancer. Nodules in the penis had appeared in February 2011. The ultrasound and magnetic resonance (MR) imaging suggested the diagnosis of multiple penile metastases. A total body computed tomography scan revealed a systemic spread of the disease, with multiple metastases in the liver, bones, and lungs. PSA level was 0.126 ng/ml. A fine needle aspiration biopsy of the liver lesion was undertaken, and the histopathologic examination revealed the prostatic origin of the metastases, so androgen deprivation therapy was started. The diagnosis of metastases should be considered in a patient with prior history of prostate malignancies presenting with solid nodules in the penis, even if the PSA level is low.
      Citation: Journal of Clinical Imaging Science 2012 2(1):44-44
      PubDate: Sat,28 Jul 2012
      DOI: 10.4103/2156-7514.99178
      Issue No: Vol. 2, No. 1 (2012)
       
  • CAD May Not be Necessary for Microcalcifications in the Digital era, CAD
           May Benefit Radiologists for Masses

    • Authors: Stamatia V Destounis, Andrea L Arieno, Renee C Morgan
      Pages: 45 - 45
      Abstract: Stamatia V Destounis, Andrea L Arieno, Renee C Morgan

      Journal of Clinical Imaging Science 2012 2(1):45-45

      Objective: The aim of this study was to evaluate the effectiveness of computer-aided detection (CAD) to mark the cancer on digital mammograms at the time of breast cancer diagnosis and also review retrospectively whether CAD marked the cancer if visible on any available prior mammograms, thus potentially identifying breast cancer at an earlier stage. We sought to determine why breast lesions may or may not be marked by CAD. In particular, we analyzed factors such as breast density, mammographic views, and lesion characteristics. Materials and Methods: Retrospective review from 2004 to 2008 revealed 3445 diagnosed breast cancers in both symptomatic and asymptomatic patients; 1293 of these were imaged with full field digital mammography (FFDM). After cancer diagnosis, in a retrospective review held by the radiologist staff, 43 of these cancers were found to be visible on prior-year mammograms (false-negative cases); these breast cancer cases are the basis of this analysis. All cases had CAD evaluation available at the time of cancer diagnosis and on prior mammography studies. Data collected included patient demographics, breast density, palpability, lesion type, mammographic size, CAD marks on current- and prior-year mammograms, needle biopsy method, pathology results (core needle and/or surgical), surgery type, and lesion size. Results: On retrospective review of the mammograms by the staff radiologists, 43 cancers were discovered to be visible on prior-year mammograms. All 43 cancers were masses (mass classification included mass, mass with calcification, and mass with architectural distortion); no pure microcalcifications were identified in this cohort. Mammograms with CAD applied at the time of breast cancer diagnosis were able to detect 79% (34/43) of the cases and 56% (24/43) from mammograms with CAD applied during prior year(s). In heterogeneously dense/extremely dense tissue, CAD marked 79% (27/34) on mammograms taken at the time of diagnosis and 56% (19/34) on mammograms with CAD applied during the prior year(s). At time of diagnosis, CAD marked lesions in 32% (11/34) on the craniocaudal (CC) view, 21% (7/34) on the mediolateral oblique (MLO) view. Lesion size of those marked by CAD or not marked were similar, the average being 15 and 12 mm, respectively. Conclusion: CAD marked cancers on mammograms at the time of diagnosis in 79% of the cases and in 56% of the cases from the mammograms with CAD applied in the prior year(s). Our review demonstrated that CAD can mark invasive breast carcinomas in even dense breast tissue. CAD marked a significant portion on the CC view only, which may be an indicator to radiologists to be especially vigilant when a lesion is marked on this view.
      Citation: Journal of Clinical Imaging Science 2012 2(1):45-45
      PubDate: Sat,28 Jul 2012
      DOI: 10.4103/2156-7514.99179
      Issue No: Vol. 2, No. 1 (2012)
       
  • Primary Sarcoid of the Breast with Incidental Malignancy

    • Authors: Laura M Isley, Abbie R Cluver, Rebecca J Leddy, Megan K Baker
      Pages: 46 - 46
      Abstract: Laura M Isley, Abbie R Cluver, Rebecca J Leddy, Megan K Baker

      Journal of Clinical Imaging Science 2012 2(1):46-46

      Breast sarcoidosis is rare and usually presents in patients with known sarcoid involving other organ systems. In the breast, sarcoidosis may mimic malignancy which must be excluded by core biopsy. We report a very unusual case of primary breast sarcoidosis with incidentally discovered breast carcinoma. The roles of mammography, ultrasound, and MRI in the diagnosis as well as other potential differential diagnosis are discussed.
      Citation: Journal of Clinical Imaging Science 2012 2(1):46-46
      PubDate: Sat,28 Jul 2012
      DOI: 10.4103/2156-7514.99180
      Issue No: Vol. 2, No. 1 (2012)
       
  • Endovascular Management of Fusiform Superior Cerebellar Artery Aneurysms:
           A Series of Three Cases with Review of Literature

    • Authors: Anand Alurkar, Lakshmi Sudha P Karanam, Suresh Nayak, Sagar Oak
      Pages: 47 - 47
      Abstract: Anand Alurkar, Lakshmi Sudha P Karanam, Suresh Nayak, Sagar Oak

      Journal of Clinical Imaging Science 2012 2(1):47-47

      Distal superior cerebellar artery (SCA) aneurysms are rare. Fusiform aneurysms of SCA are rarer and more challenging to treat. Parent artery occlusion by endovascular coiling is the treatment option for these cases. Presence of good collateral circulation and paucity of perforators from S1 and S2 segments makes this a feasible option. From 2007 to 2010, we treated three patients (two men and one woman between the ages of 42 to 64 years) with distal fusiform SCA aneurysms using endovascular coiling. All the patients presented with symptoms of rupture and were treated in the acute phase. Informed and written high-risk consent was given by all patients prior to the procedure. Successful angiographic and clinical outcome was achieved in all three patients. Endovascular treatment of fusiform SCA aneurysms with coils is a safe and feasible option in the management of this rare entity.
      Citation: Journal of Clinical Imaging Science 2012 2(1):47-47
      PubDate: Sat,28 Jul 2012
      DOI: 10.4103/2156-7514.99181
      Issue No: Vol. 2, No. 1 (2012)
       
  • Computed Tomographic Features of Congenital Left Ventricular Diverticulum

    • Authors: Amit N. D Dwivedi, Arun G Thangiah, Madhukar Rai, Suchi Tripathi
      Pages: 48 - 48
      Abstract: Amit N. D Dwivedi, Arun G Thangiah, Madhukar Rai, Suchi Tripathi

      Journal of Clinical Imaging Science 2012 2(1):48-48

      Congenital left ventricular diverticulum is a rare cardiac malformation characterized by a localized out-pouching from the cardiac chamber. They are most often found in the left ventricle (LV) but have been reported to occur in all chambers of the heart. The patient is usually asymptomatic. However, complications like embolism, infective endocarditis, arrhythmia and, rarely, rupture may be the initial presentation. Diagnosis can be established by echocardiography (EKG), computed tomographic (CT) angiography, and magnetic resonance imaging (MRI). We report a case of congenital left ventricular diverticulum in an adult with no valvular abnormality as an incidental finding in an uncommon location.
      Citation: Journal of Clinical Imaging Science 2012 2(1):48-48
      PubDate: Sat,28 Jul 2012
      DOI: 10.4103/2156-7514.99182
      Issue No: Vol. 2, No. 1 (2012)
       
  • Tension Gastrothorax Complicating Third Trimester of Pregnancy: Suspicion
           is the Key

    • Authors: Rakesh Sharma, Deepak Rosha, Sananta K Dash, Trilok Chand
      Pages: 49 - 49
      Abstract: Rakesh Sharma, Deepak Rosha, Sananta K Dash, Trilok Chand

      Journal of Clinical Imaging Science 2012 2(1):49-49

      Gastrothorax is characterized by herniation of the stomach and other abdominal contents into the thoracic cavity either through the oesophageal hiatus or ruptured diaphragm. When gastrothorax causes pulmonary and hemodynamic compromise, due to compression of lungs and mediastinal structures, it is named as tension gastrothorax. Diagnosis of tension gastrothorax is often complicated during late pregnancy, because of unusual presentation, altered physiology, absence of trauma, hesitation about radiation exposure, and rarity of the condition. We report a case of a patient, in her 32nd week of pregnancy, who presented with left tension gastrothorax. Lower segment caesarean section was planned after steroid therapy, with all the preparations for thoracotomy. Intra-operatively, stomach, spleen, and colon were found herniated in the left hemithorax, through a ruptured left hemidiaphragm. Thoracotomy was done immediately after caesarean section, with reduction of herniated contents and repair of the defect in the diaphragm. The patient and her baby were discharged in stable condition 2 weeks after thoracotomy.
      Citation: Journal of Clinical Imaging Science 2012 2(1):49-49
      PubDate: Thu,30 Aug 2012
      DOI: 10.4103/2156-7514.100367
      Issue No: Vol. 2, No. 1 (2012)
       
  • Use of CBCT in the Successful Management of Endodontic Cases

    • Authors: Dax Abraham, Nikhil Bahuguna, Rishi Manan
      Pages: 50 - 50
      Abstract: Dax Abraham, Nikhil Bahuguna, Rishi Manan

      Journal of Clinical Imaging Science 2012 2(1):50-50

      The purpose of this article is to emphasize the use of Cone Beam Computed Tomography (CBCT) for root canal treatment. Two case reports are presented where CBCT has been used to locate and eventually treat extra canals in maxillary first molars. Dental clinicians should be aware of the anatomical variations in maxillary molars. CBCT should be an essential part of the diagnosis prior to initiating root canal treatment.
      Citation: Journal of Clinical Imaging Science 2012 2(1):50-50
      PubDate: Thu,30 Aug 2012
      DOI: 10.4103/2156-7514.100370
      Issue No: Vol. 2, No. 1 (2012)
       
  • Conservative Management of Type III Dens in Dente Using Cone Beam Computed
           Tomography

    • Authors: K Pradeep, M Charlie, MA Kuttappa, Prasana Kumar Rao
      Pages: 51 - 51
      Abstract: K Pradeep, M Charlie, MA Kuttappa, Prasana Kumar Rao

      Journal of Clinical Imaging Science 2012 2(1):51-51

      Dens in dente, also known as dens invaginatus, dilated composite odontoma, or deep foramen caecum, is a developmental malformation that usually affects maxillary incisor teeth, particularly lateral incisors. It may occur in teeth anywhere within the jaws, other locations are comparatively rare. It can occur within both the crown and the root, although crown invaginations are more common. The use of cone beam computed tomography (CBCT) is very helpful in endodontic diagnosis of complex anatomic variations. In this case we demonstrate the use of CBCT in the evaluation and endodontic management of a Type III dens in dente (Oehler's Type III).
      Citation: Journal of Clinical Imaging Science 2012 2(1):51-51
      PubDate: Thu,30 Aug 2012
      DOI: 10.4103/2156-7514.100372
      Issue No: Vol. 2, No. 1 (2012)
       
  • Imaging in the Diagnosis of Cemento-Ossifying Fibroma: A Case Series

    • Authors: R Mithra, Pavitra Baskaran, M Sathyakumar
      Pages: 52 - 52
      Abstract: R Mithra, Pavitra Baskaran, M Sathyakumar

      Journal of Clinical Imaging Science 2012 2(1):52-52

      Cemento-ossifying fibroma is a benign fibro-osseous lesion belonging to the same category as fibrous dysplasia and cementifying dysplasia. These are slow-growing lesions that are seen in the third and fourth decades of life. Both the ossifying fibroma and cemento-ossifying fibroma represent two extremes of the same disease process since histologically both contain bone and cementum. However, the term cemento-ossifying fibroma is justified on the basis of clinical and radiological correlation. Radiographs have become an essential tool in the diagnosis of lesions in the jaw, where the anatomy is complex. Nowadays, CT provides information for diagnosis as well as treatment planning. In this case series, we report three cases of cemento-ossifying fibroma that were histologically confirmed and discuss the imaging findings.
      Citation: Journal of Clinical Imaging Science 2012 2(1):52-52
      PubDate: Thu,30 Aug 2012
      DOI: 10.4103/2156-7514.100373
      Issue No: Vol. 2, No. 1 (2012)
       
  • Breast Hemangioma: MR Appearance with Histopathological Correlation

    • Authors: Rasha Ameen, Uday Mandalia, Amanda (Anne) Marr, Paula Mckensie
      Pages: 53 - 53
      Abstract: Rasha Ameen, Uday Mandalia, Amanda (Anne) Marr, Paula Mckensie

      Journal of Clinical Imaging Science 2012 2(1):53-53

      Breast hemangioma is a rare tumor and when small, it may be difficult to diagnose using conventional imaging techniques. In this report the MR appearance is described with histopathological correlation.
      Citation: Journal of Clinical Imaging Science 2012 2(1):53-53
      PubDate: Thu,30 Aug 2012
      DOI: 10.4103/2156-7514.100376
      Issue No: Vol. 2, No. 1 (2012)
       
  • Portal Vein Aneurysm Presenting with Obstructive Jaundice

    • Authors: Chandana Lall, Sadhna Verma, Rajesh Gulati, Puneet Bhargava
      Pages: 54 - 54
      Abstract: Chandana Lall, Sadhna Verma, Rajesh Gulati, Puneet Bhargava

      Journal of Clinical Imaging Science 2012 2(1):54-54

      To the best of our knowledge, a portal vein aneurysm presenting with obstructive jaundice has not been reported in the literature. The preferred treatment for these aneurysms is surgical and a shunting procedure should be considered in cases with portal hypertension to preserve portal vein flow when portal hypertension is present or is secondary to the aneurysm itself. In our case, due to patient's advanced age and co-morbidities, an endoscopic biliary stent was placed which led to successful resolution of symptoms of obstructive jaundice.
      Citation: Journal of Clinical Imaging Science 2012 2(1):54-54
      PubDate: Thu,30 Aug 2012
      DOI: 10.4103/2156-7514.100377
      Issue No: Vol. 2, No. 1 (2012)
       
  • Large Multilocular Thymic Cyst: A Rare Finding in an HIV Positive Adult
           Female

    • Authors: Xiao Shi, Farbod Nasseri, David M Berger, Arun C Nachiappan
      Pages: 55 - 55
      Abstract: Xiao Shi, Farbod Nasseri, David M Berger, Arun C Nachiappan

      Journal of Clinical Imaging Science 2012 2(1):55-55

      Multilocular thymic cysts with follicular hyperplasia are uncommon masses that occur in Human Immunodeficiency Virus (HIV) positive individuals. These cysts mostly present in HIV positive children. Here we report a rare case of multilocular thymic cyst in an HIV positive adult female. In this case report, the radiologic findings of multilocular thymic cyst, management and prognosis are discussed.
      Citation: Journal of Clinical Imaging Science 2012 2(1):55-55
      PubDate: Thu,30 Aug 2012
      DOI: 10.4103/2156-7514.100379
      Issue No: Vol. 2, No. 1 (2012)
       
  • TRAP Sequence - An Interesting Entity in Twins

    • Authors: RH Srinivas Prasad, T Ramachandra Prasad, K Dayananda Kumar
      Pages: 56 - 56
      Abstract: RH Srinivas Prasad, T Ramachandra Prasad, K Dayananda Kumar

      Journal of Clinical Imaging Science 2012 2(1):56-56

      Twin reversed arterial perfusion (TRAP) sequence, is a rare malformation occurring in monozygotic multiple gestations. One well-developed normal (pump) twin and the other twin with absent cardiac structure (acardiac), who is hemodynamically dependent on the normal (pump) twin are characteristic of this syndrome. The acardiac twin develops multiple anomalies that make survival difficult. The prognosis of the pump twin is variable with mortality rate ranging from 50% to 70%. Complications that affect the prognosis of the pump twin include complications of congestive cardiac failure due to increased cardiac demand, prematurity secondary to preterm delivery, and polyhydramnios. Because of these complications prompt detection, follow-up, and treatment of this condition is very important. We report two cases of TRAP sequence that emphasizes the importance of gray-scale and color Doppler imaging in diagnosis, detection of poor prognostic features, follow-up, and management of TRAP sequence.
      Citation: Journal of Clinical Imaging Science 2012 2(1):56-56
      PubDate: Tue,25 Sep 2012
      DOI: 10.4103/2156-7514.100997
      Issue No: Vol. 2, No. 1 (2012)
       
  • Feasibility of Computed Tomography Pulmonary Angiography with Low Flow
           Rates

    • Authors: J Gossner
      Pages: 57 - 57
      Abstract: J Gossner

      Journal of Clinical Imaging Science 2012 2(1):57-57

      Computed tomography pulmonary angiography (CTPA) is the imaging test of choice in suspected pulmonary embolism. High flow rates for the administration of contrast medium are recommended, but these cannot be achieved in a number of patients due to poor peripheral venous access or when using certain central venous catheters. This small feasibility study has examined the CTPA data in a set of 22 patients in whom contrast medium was given at low flow rates (2.0 or 2.5 mL/s). Subjectively, all but one of the patients was judged to be diagnostic. Objectively, enhancement values &#8805;200 HU were reached in 92% of the examined central vessels (pulmonary trunk, main pulmonary arteries, and lobar arteries). In conclusion, even with a low injection rate CTPA is of diagnostic value in most patients.
      Citation: Journal of Clinical Imaging Science 2012 2(1):57-57
      PubDate: Tue,25 Sep 2012
      DOI: 10.4103/2156-7514.100999
      Issue No: Vol. 2, No. 1 (2012)
       
  • Accuracy of Routine Clinical Ultrasound for Staging of Liver Fibrosis

    • Authors: Chih-Ching Choong, Sudhakar K Venkatesh, Edwin P. Y. Siew
      Pages: 58 - 58
      Abstract: Chih-Ching Choong, Sudhakar K Venkatesh, Edwin P. Y. Siew

      Journal of Clinical Imaging Science 2012 2(1):58-58

      Objective: To determine the diagnostic accuracy of routine clinical ultrasound in the staging of liver fibrosis in chronic viral hepatitis. Materials and Methods: A retrospective evaluation of the ultrasound images of 156 patients with chronic viral hepatitis who underwent liver biopsy was performed. Two radiologists in consensus, blind to the biopsy results and clinical details, evaluated the ultrasound images for liver fibrosis. The readers specifically assessed three features - surface nodularity, liver edge, and parenchymal echotexture - with scores of 0 to 3 (0 = normal, 1 = mild, 2 = moderate, 3 = severe). Accuracies of each sonographic feature for the detection of mild fibrosis and above (&#8805;F1), significant fibrosis (&#8805;F2), severe fibrosis (&#8805;F3), and cirrhosis (F4) were determined with histopathology as the reference standard. Results: Fibrosis was present in 99 patients (F1=34, F2=20, F3=22, and F4=23) and absent in 57 patients. The sensitivities for the detection of significant fibrosis with surface nodularity, liver edge, and parenchymal echotexture were 57%, 15%, and 41%, respectively. The accuracies for the detection of &#8805;F1, &#8805;F2, &#8805;F3, and F4 stages were 50.5%, 59%, 59%, and 65% for liver surface, 51%, 53%, 54%, and 55% for liver edge, and 58%, 59%, 63%, and 63% for parenchyma echotexture, respectively. The combined scores from all three features had accuracies of 56%, 59%, 62%, and 66% for the detection of &#8805;F1, &#8805;F2, &#8805;F3, and F4, respectively. Conclusion: Routine clinical ultrasound is a not a sensitive predictor of early fibrosis in chronic viral hepatitis. Surface nodularity is the most sensitive sonographic feature for the detection of significant fibrosis and routine clinical ultrasound is the most useful technique for the detection of cirrhosis.
      Citation: Journal of Clinical Imaging Science 2012 2(1):58-58
      PubDate: Tue,25 Sep 2012
      DOI: 10.4103/2156-7514.101000
      Issue No: Vol. 2, No. 1 (2012)
       
  • Primary Hyperparathyroidism: Imaging to Pathology

    • Authors: Sara Piciucchi, Domenico Barone, Giampaolo Gavelli, Alessandra Dubini, Devil Oboldi, Federica Matteuci
      Pages: 59 - 59
      Abstract: Sara Piciucchi, Domenico Barone, Giampaolo Gavelli, Alessandra Dubini, Devil Oboldi, Federica Matteuci

      Journal of Clinical Imaging Science 2012 2(1):59-59

      The aim of this review is to describe the multimodal imaging (ultrasound, magnetic resonance, computed tomography, and nuclear medicine) of primary hyperparathyroidism and its correlation to the pathological findings. In the last decades, imaging science has progressed a great deal. Accurate preoperative localization of the involved glands is essential for surgical success.
      Citation: Journal of Clinical Imaging Science 2012 2(1):59-59
      PubDate: Sat,6 Oct 2012
      DOI: 10.4103/2156-7514.102053
      Issue No: Vol. 2, No. 1 (2012)
       
  • A Rare Case of Dysembryoplastic Neuroepithelial Tumor

    • Authors: Harsha Guduru, Jun K Shen, Harish S Lokannavar
      Pages: 60 - 60
      Abstract: Harsha Guduru, Jun K Shen, Harish S Lokannavar

      Journal of Clinical Imaging Science 2012 2(1):60-60

      We present a rare case of dysembryoplastic neuroepithelial tumor, a rare benign glioneuronal tumor of the central nervous system. It generally occurs in the supratentorial region and the temporal cerebral cortex in children and young adults. The most common presentation is epilepsy. The supratentorial tumor without any signs of mass effect or peritumoral edema is the conventionally accepted diagnostic criteria. In this case of a 19-year-old male with intractable epilepsy, atypical features such as the location of the tumor and the presence of mass effect and peritumoral edema made imaging diagnosis difficult. Diagnosis was confirmed through histopathology. Due to its recent discovery and relatively rare occurrence it is important for radiologists to recognize this disease entity.
      Citation: Journal of Clinical Imaging Science 2012 2(1):60-60
      PubDate: Sat,6 Oct 2012
      DOI: 10.4103/2156-7514.102057
      Issue No: Vol. 2, No. 1 (2012)
       
  • Assessing the Performance of Medical Personnel Involved in the Diagnostic
           Imaging Processes in Mulago Hospital, Kampala, Uganda

    • Authors: Michael G Kawooya, George Pariyo, Elsie Kiguli Malwadde, Rosemary Byanyima, Harrient Kisembo
      Pages: 61 - 61
      Abstract: Michael G Kawooya, George Pariyo, Elsie Kiguli Malwadde, Rosemary Byanyima, Harrient Kisembo

      Journal of Clinical Imaging Science 2012 2(1):61-61

      Objectives: Uganda, has limited health resources and improving performance of personnel involved in imaging is necessary for efficiency. The objectives of the study were to develop and pilot imaging user performance indices, document non-tangible aspects of performance, and propose ways of improving performance. Materials and Methods: This was a cross-sectional survey employing triangulation methodology, conducted in Mulago National Referral Hospital over a period of 3 years from 2005 to 2008. The qualitative study used in-depth interviews, focus group discussions, and self-administered questionnaires, to explore clinicians' and radiologists' performancerelated views. Results: The study came up with following indices: appropriate service utilization (ASU), appropriateness of clinician's nonimaging decisions (ANID), and clinical utilization of imaging results (CUI). The ASU, ANID, and CUI were: 94%, 80%, and 97%, respectively. The clinician's requisitioning validity was high (positive likelihood ratio of 10.6) contrasting with a poor validity for detecting those patients not needing imaging (negative likelihood ratio of 0.16). Some requisitions were inappropriate and some requisition and reports lacked detail, clarity, and precision. Conclusion: Clinicians perform well at imaging requisition-decisions but there are issues in imaging requisitioning and reporting that need to be addressed to improve performance.
      Citation: Journal of Clinical Imaging Science 2012 2(1):61-61
      PubDate: Sat,6 Oct 2012
      DOI: 10.4103/2156-7514.102060
      Issue No: Vol. 2, No. 1 (2012)
       
  • Autoimmune Polyglandular Syndrome Type 1

    • Authors: Vedeswari C Ponranjini, S Jayachandran, L Kayal, K Bakyalakshmi
      Pages: 62 - 62
      Abstract: Vedeswari C Ponranjini, S Jayachandran, L Kayal, K Bakyalakshmi

      Journal of Clinical Imaging Science 2012 2(1):62-62

      Autoimmune Polyglandular Syndrome (APS) Type 1 is a rare hereditary disorder that damages organs in the body. This disease entity is the result of a mutation in the AIRE gene. It is characterized by three classic clinical features - hypoparathyroidism, Addison's disease, and chronic mucocutaneous candidiasis. For a patient to be diagnosed as having APS Type 1 syndrome at least two of these features needs to be present. The third entity may develop as the disease progresses. We report a case of a 35-year-old female patient with a history of seizure from the age of 11 years, who was managed with anticonvulsant drugs. With worsening of the seizure episodes, patient was diagnosed to have hypoparathyroidism together with the manifestations of oral candidiasis, nails dystrophy, enamel hypoplasia, and hypogonadism. A diagnosis of APS-1 was considered. The facility for genetic analysis of the AIRE gene mutation was not accessible, as the test costs were prohibitive and not affordable for the patient. Patient management was directed to treating individual disease components. However, cerebral and dental changes were irreversible.
      Citation: Journal of Clinical Imaging Science 2012 2(1):62-62
      PubDate: Wed,31 Oct 2012
      DOI: 10.4103/2156-7514.103018
      Issue No: Vol. 2, No. 1 (2012)
       
  • US Imaging in Peyronie's Disease

    • Authors: Kiriaki Kalokairinou, Charalampos Konstantinidis, Marilena Domazou, Theodoros Kalogeropoulos, Prodromos Kosmidis, Aristomenis Gekas
      Pages: 63 - 63
      Abstract: Kiriaki Kalokairinou, Charalampos Konstantinidis, Marilena Domazou, Theodoros Kalogeropoulos, Prodromos Kosmidis, Aristomenis Gekas

      Journal of Clinical Imaging Science 2012 2(1):63-63

      The aim of this study is to assess the role of ultrasound (US) in Peyronie's Disease (PD). PD is a psychologically and physically devastating disorder that manifests in middle-aged men. Fibrous inelastic plaques in the tunica albuginea, result in palpable penile scar in the flaccid condition and cause painful erections and penile deformity, including penile curvature, hinging, narrowing, and shortening of penis. Penile deformity is the most common (52%) first symptom of PD and is present in 94% of affected men. US is the primary imaging modality of choice due to its easy availability, low risk, and ability to image and quantify both calcified and soft tissue elements of PD. US provides identification of smaller and non-palpable lesions and shows the extent of fibrosis. Detection of calcifications within the plaque suggests stabilization of the disease and provides information useful to select patients for appropriate treatment.
      Citation: Journal of Clinical Imaging Science 2012 2(1):63-63
      PubDate: Wed,31 Oct 2012
      DOI: 10.4103/2156-7514.103053
      Issue No: Vol. 2, No. 1 (2012)
       
  • Does Contrast-Enhanced Cervical Ultrasonography Improve Preoperative
           Localization Results in Patients With Sporadic Primary
           Hyperparathyroidism?

    • Authors: Elias Karakas, Susanne Kann, Helmut Höffken, Detlef Klaus Bartsch, Ilhan Celik, Christian Görg, Andreas Pfestroff
      Pages: 64 - 64
      Abstract: Elias Karakas, Susanne Kann, Helmut Höffken, Detlef Klaus Bartsch, Ilhan Celik, Christian Görg, Andreas Pfestroff

      Journal of Clinical Imaging Science 2012 2(1):64-64

      Objective: Pre-operative localization studies are inevitable in patients with primary hyperparathyroidism (pHPT), who are eligible for focused or minimally invasive parathyroidectomy (MIP). High-resolution ultrasonography (US) in combination with planar 99m Tc-Sestamibi-scintigraphy (MIBI) and additional single-photon emission computed tomography (SPECT) are the standard procedures to localize enlarged parathyroid glands. Our aim was to evaluate the practicability and significance of contrast-enhanced ultrasonography (CEUS) in patients with pHPT. Materials and Methods: All investigations were performed at the University Hospital Marburg. Totally, 25 patients with biochemical proven pHPT underwent preoperative US, MIBI/SPECT, and CEUS. For CEUS, a suspension of phospholipid-stabilized sulfur-hexafluoride (SF6) microbubbles in combination with a special 12 MHz linear US probe was used. All patients were investigated by two sonographers, who did not get to view the findings noted by the other. Finally, surgery was performed and histopathological results were obtained from 24 patients. Results: In 17 (68%) patients, US and MIBI/SPECT already raised suspicion of parathyroid lesions and all suspected lesions were reassessed by CEUS. However, no additional information was obtained using CEUS. Especially in eight patients with negative or inconsistent US and MIBI/SPECT results, CEUS did not provide additional information regarding the site of the suspected parathyroid adenoma. Overall, no side effects were observed using CEUS. Surgical cure was achieved in all patients. Conclusion: In this limited cohort of patients, no additional information could be obtained using the costly CEUS compared to results of US and MIBI/SPECT.
      Citation: Journal of Clinical Imaging Science 2012 2(1):64-64
      PubDate: Wed,31 Oct 2012
      DOI: 10.4103/2156-7514.103054
      Issue No: Vol. 2, No. 1 (2012)
       
  • Prenatal Diagnosis of Lethal Multiple Pterygium Syndrome Using Two-and
           Three- Dimensional Ultrasonography

    • Authors: Fernanda Silveira Barros, Edward Araujo, Liliam Cristine Rolo, Luciano Marcondes Machado Nardozza
      Pages: 65 - 65
      Abstract: Fernanda Silveira Barros, Edward Araujo, Liliam Cristine Rolo, Luciano Marcondes Machado Nardozza

      Journal of Clinical Imaging Science 2012 2(1):65-65

      Lethal multiple pterygium (LMP) is a series of disorders of fetal formation with a heterogeneous range of manifestations that generally include cystic hygroma, pulmonary hypoplasia, cleft palate, cryptorchidism, joint contractures, fetal akinesia, heart defects, growth restriction, and intestinal malrotation. The prenatal diagnosis of this syndrome is suspected when two-dimensional ultrasound (2DUS) scan shows several malformations.. The three-dimensional ultrasound (3DUS) in rendering mode permits the spatial visualization of these malformations, allowing better understanding of this anomaly by parents. We report a case of a fetus in the second trimester with multiple abnormalities suggestive of LMP that were identified using 2DUS, and emphasize the importance of 3DUS in counseling the parents.
      Citation: Journal of Clinical Imaging Science 2012 2(1):65-65
      PubDate: Wed,31 Oct 2012
      DOI: 10.4103/2156-7514.103055
      Issue No: Vol. 2, No. 1 (2012)
       
  • The "Dot in Circle" Sign on MRI in Maduramycosis: A
           Characteristic Finding

    • Authors: Vikash Jain, Gopee E Makwana, Nandini Bahri, Manish K Mathur
      Pages: 66 - 66
      Abstract: Vikash Jain, Gopee E Makwana, Nandini Bahri, Manish K Mathur

      Journal of Clinical Imaging Science 2012 2(1):66-66

      Mycetoma or Maduramycosis is a localized chronic suppurative infection characterized by exuberant granulation tissue, discharging sinuses, and bone involvement later in the course of the disease. Early clinical diagnosis before the appearance of sinuses and grains (aggregates of organism surrounded by granulation tissue, which are discharged from the draining sinuses) is difficult. Delay in diagnosis may lead to amputation of the affected part. Definitive diagnosis is through biopsy and microbiological examination. However, at times diagnosis may still be difficult. The recently described "dot in circle" sign on magnetic resonance imaging (MRI) is easy to recognize and highly specific. We present a case of mycetoma foot with characteristic MRI features.
      Citation: Journal of Clinical Imaging Science 2012 2(1):66-66
      PubDate: Wed,31 Oct 2012
      DOI: 10.4103/2156-7514.103056
      Issue No: Vol. 2, No. 1 (2012)
       
  • Unusual Mediastinal Dumbbell Tumor Mimicking an Aggressive Malignancy

    • Authors: Sanyal Kumar, Bhawna Satija, Mahesh K Mittal, Brij B Thukral
      Pages: 67 - 67
      Abstract: Sanyal Kumar, Bhawna Satija, Mahesh K Mittal, Brij B Thukral

      Journal of Clinical Imaging Science 2012 2(1):67-67

      Hydatid cyst is known to affect all possible anatomical locations of the human body. However, the mediastinal localization is extremely rare. This benign, commonly asymptomatic and incidentally detected disease, at times may simulate an aggressive malignancy by its potential to cause osseous destruction and intraspinal extension. A young female, farmer by occupation, presented with complaints of left chest pain and monoparesis of the left lower limb. Radiograph followed by computed tomography (CT) of the chest demonstrated a cystic mass within the posterior mediastinum, eroding and scalloping overlying ribs and extending into the spinal canal by causing destruction of adjoining vertebra, and assuming a dumbbell shape. The serology was positive for echinococcosis. The patient underwent surgery and the postoperative histopathology confirmed the diagnosis of hydatid cyst. The patient recovered with no complications or recurrence. Hydatid cyst should always be considered in the differential diagnosis of mediastinal cystic lesions, however aggressive the lessions may appear.
      Citation: Journal of Clinical Imaging Science 2012 2(1):67-67
      PubDate: Wed,31 Oct 2012
      DOI: 10.4103/2156-7514.103057
      Issue No: Vol. 2, No. 1 (2012)
       
  • A Case of Mitral Valve Tophus in a Patient with Severe Gout Tophaceous
           Arthritis

    • Authors: Atooshe Rohani, Soheila Chamanian, Peiman Hosseinzade, Javad Ramezani
      Pages: 68 - 68
      Abstract: Atooshe Rohani, Soheila Chamanian, Peiman Hosseinzade, Javad Ramezani

      Journal of Clinical Imaging Science 2012 2(1):68-68

      A few cases of cardiac valve tophi have been reported in literature. In this case report, the echocardiographic characteristics of the hyperechoic mass in the posterior leaflet mitral valve, intact mitral valve ring, and the occurrence of severe tophaceous gout arthritis suggested the diagnosis of a gout tophus on the mitral valve.
      Citation: Journal of Clinical Imaging Science 2012 2(1):68-68
      PubDate: Wed,31 Oct 2012
      DOI: 10.4103/2156-7514.103058
      Issue No: Vol. 2, No. 1 (2012)
       
  • Littoral Cell Angioma of Spleen: An Uncommon Presentation of a Rare
           Neoplasm

    • Authors: Pramod Gupta, Silanath Peungjesada, Soume Foshee, Robin H Amirkhan
      Pages: 69 - 69
      Abstract: Pramod Gupta, Silanath Peungjesada, Soume Foshee, Robin H Amirkhan

      Journal of Clinical Imaging Science 2012 2(1):69-69

      Littoral cell angioma (LCA) is a rare primary splenic tumor that is difficult to differentiate preoperatively from other benign and malignant splenic lesions. Most of the cases present as multiple nodules in the spleen. We report a case of large solitary LCA of the spleen, an uncommon presentation. LCA should be considered in the differential diagnosis of multiple and solitary splenic lesions.
      Citation: Journal of Clinical Imaging Science 2012 2(1):69-69
      PubDate: Fri,30 Nov 2012
      DOI: 10.4103/2156-7514.104302
      Issue No: Vol. 2, No. 1 (2012)
       
  • Crouzon Syndrome: Clinico-Radiological Illustration of a Case

    • Authors: Raviprakash Sasankoti Mohan, Naveen Shanker Vemanna, Sankalp Verma, Neha Agarwal
      Pages: 70 - 70
      Abstract: Raviprakash Sasankoti Mohan, Naveen Shanker Vemanna, Sankalp Verma, Neha Agarwal

      Journal of Clinical Imaging Science 2012 2(1):70-70

      Crouzon syndrome, also called craniofacial dysostosis, is an autosomal dominant disorder with complete penetrance and variable expressivity. Described by a French neurosurgeon in 1912, it is a rare genetic disorder characterized by premature closure of cranial sutures, midfacial hypoplasia, and orbital defects. Here, we report a case of this rare entity. The patient presented with brachycephaly, maxillary hypoplasia, exophthalmos, mandibular prognathism, along with dental and orbital abnormalities.
      Citation: Journal of Clinical Imaging Science 2012 2(1):70-70
      PubDate: Fri,30 Nov 2012
      DOI: 10.4103/2156-7514.104303
      Issue No: Vol. 2, No. 1 (2012)
       
  • Intralobar Pulmonary Sequestrat&#305;on as an Unusual Cause of
           Recurrent Hemoptysis

    • Authors: Servet Kayhan, Burçin Çelik, Umit Belet, Oguz Aydin
      Pages: 71 - 71
      Abstract: Servet Kayhan, Burçin Çelik, Umit Belet, Oguz Aydin

      Journal of Clinical Imaging Science 2012 2(1):71-71

      Pulmonary sequestration is an embryonic, cystic lung tissue that is supplied by systemic blood circulation. It is a nonfunctional lung parenchyma unconnected to normal tracheobronchial system. In cases of pulmonary sequestration, surgical interventions should be performed in order to prevent possible complications such as massive hemoptysis and infections. Preoperative imaging and treatment planning should be done carefully. We present an uncommon case of recurrent hemoptysis caused by intralobar pulmonary sequestration located in the left lower lobe.
      Citation: Journal of Clinical Imaging Science 2012 2(1):71-71
      PubDate: Fri,30 Nov 2012
      DOI: 10.4103/2156-7514.104304
      Issue No: Vol. 2, No. 1 (2012)
       
  • Simultaneous Bilateral Carotid Stenting in a Series of 9 Patients: A
           Single-Center Experience with Review of Literature

    • Authors: Anand Alurkar, Lakshmi Sudha Prasanna Karanam, Suresh Nayak, Sagar Oak
      Pages: 72 - 72
      Abstract: Anand Alurkar, Lakshmi Sudha Prasanna Karanam, Suresh Nayak, Sagar Oak

      Journal of Clinical Imaging Science 2012 2(1):72-72

      Objectives : Simultaneous bilateral carotid artery stenting (SBCAS) is a challenging procedure, and selection criteria play an important role in determining the final outcome. The aim of the present study was to determine the efficacy and safety of the SBCAS in a series of 9 patients with significant bilateral carotid artery disease (&#62;50% on the symptomatic side and &#62;60% on the asymptomatic side). Materials and Methods: The present study is a retrospective study of 9 patients from January 2005 to December 2012 in a tertiary care center. There were 8 males and 1 female in the age range 50 to 75 years and an average mean age of 63 years. Inclusion criteria of the present study were patients with bilateral internal carotid artery stenosis &#62;50% (50 - 99%) in the symptomatic side and &#62;60% in the asymptomatic side as seen on digital subtraction angiography (DSA). SBCAS with use of distal protection device (Spider device, ev3), to prevent intra-procedural embolic migration, was done in all the patients. Results: Technical success was achieved in all patients (100%). Post-procedural events in the form of hypotension and bradycardia occurred in 3 patients after the placement of stent on both the sides, in 2 patients after the placement of the first stent, and in 1 patient after the placement of the second stent. We did not encounter any cases of hyperperfusion, which was a concern in these patients. There were no deaths, major or minor strokes, or myocardial infarction either in the post-procedural period (up to 1 month) or on clinical follow-up 3 and 6 months post-treatment. Conclusion: SBCAS was an effective and safe alternative treatment method in a select group of patients with bilateral carotid artery disease. It can be considered as a feasible treatment option with acceptable risks.
      Citation: Journal of Clinical Imaging Science 2012 2(1):72-72
      PubDate: Tue,4 Dec 2012
      DOI: 10.4103/2156-7514.104305
      Issue No: Vol. 2, No. 1 (2012)
       
  • Computed Tomography Mimics of Acute Appendicitis: Predictors of
           Appendiceal Disease Confirmed at Pathology

    • Authors: Jeremy B Duda, Miranda L Lynch, Shweta Bhatt, Vikram S Dogra
      Pages: 73 - 73
      Abstract: Jeremy B Duda, Miranda L Lynch, Shweta Bhatt, Vikram S Dogra

      Journal of Clinical Imaging Science 2012 2(1):73-73

      Purpose: Imaging and pathology findings are used to analyze the capability of computed tomography (CT) to distinguish between acute appendicitis and radiological mimickers. Materials and Methods: A retrospective review of 5861 patients undergoing abdominopelvic CT from 2000 to 2008 for suspicion of acute appendicitis was performed. Appendix diameter, surrounding inflammation, appendicolith, and location were assessed. Only those cases were included where patients underwent surgery for acute appendicitis on CT findings. Pathology specimens were examined and those indicative of acute appendicitis were identified. Statistical analysis was performed to correlate pathology and CT signs. Results: A total of 969 of the 5681 patients were included in the study. Acute appendicitis was verified in 870/969 (89%) cases, while 99/969 (11%) demonstrated either chronic findings (i.e., fibrosis [32%], granulomatous disease [16%], lymphoid hyperplasia [11%]) or no abnormality. In regression models, appendiceal diameter &#62;7 mm (odds ratio [OR] = 3.98, P < 0.0001) and mesenteric fat stranding (OR = 6.04, P < 0.0001) were associated with acute appendicitis. Nearly 87% (754/870) of acute appendicitis cases showed both signs on CT, compared with 53% (52/99) of those with other pathologic finding (P < 0.0001). In cases with non-appendicitis findings, 39% (39/99) had only one of these signs compared with 13% (112/870) of those with acute appendicitis (P < 0.0001). Conclusion: Diseases of the appendix other than acute appendicitis may manifest with isolated radiological findings and should be considered as part of the differential diagnosis in cases of borderline acute appendicitis.
      Citation: Journal of Clinical Imaging Science 2012 2(1):73-73
      PubDate: Tue,4 Dec 2012
      DOI: 10.4103/2156-7514.104306
      Issue No: Vol. 2, No. 1 (2012)
       
  • Magnetic Resonance-guided Focused Ultrasound Treatment for Uterine
           Fibroids: First Study in Indian Women

    • Authors: Shrinivas B Desai, Abhijit A Patil, Rahul Nikam, Ajinkya S Desai, Vrushali Bachhav
      Pages: 74 - 74
      Abstract: Shrinivas B Desai, Abhijit A Patil, Rahul Nikam, Ajinkya S Desai, Vrushali Bachhav

      Journal of Clinical Imaging Science 2012 2(1):74-74

      Objectives: To study the results of magnetic resonance-guided focused ultrasound surgery (MRgFUS) treatment carried out on Indian patients in our Hospital. Materials and Methods: Fifty Indian women (mean age = 36.2 &#177; 8.3 years) were treated for fibroids as outpatients using the ExAblate MRgFUS system (InSightec). Non-perfused volumes (NPVs) were measured immediately after treatment to calculate the treatment outcomes. A validated symptom-specific questionnaire to record their symptoms prior to treatment and six months following treatment was completed by patients. The size of the fibroids was measured on the day of the treatment and during the 6-month checkup to calculate shrinkage. Adverse events during and following treatment were recorded and monitored. Results: The average NPV ratio measured after the treatment was 88% &#177; 6%, indicative of high ablated fibroid tissue. Prior to treatment, the mean Symptoms Severity Score was 56.9 &#177; 4.8 (n = 50), which is indicative of highly symptomatic patients. Six months following treatment, there was an average fibroid shrinkage of 30% &#177; 11%, and a significant decrease in the mean score to 28.6 &#177; 6.0 (n = 50) (P < 0.001). There were no reports of serious or unexpected adverse events at any point during treatment or during the follow-up period from any of the 50 women treated in the current study. Conclusions: The current results obtained after 6 months of treatment corroborated previous data on the safety and efficacy of MRgFUS for treating uterine fibroids. This is the first publication that provides such data for a large cohort of Indian women.
      Citation: Journal of Clinical Imaging Science 2012 2(1):74-74
      PubDate: Tue,4 Dec 2012
      DOI: 10.4103/2156-7514.104307
      Issue No: Vol. 2, No. 1 (2012)
       
  • Role of Endovascular Treatment in Pediatric Cerebral Aneurysms: A Series
           of Two Case Reports

    • Authors: Anand Alurkar, Lakshmi Sudha Prasanna Karanamm, Sagar Oak
      Pages: 75 - 75
      Abstract: Anand Alurkar, Lakshmi Sudha Prasanna Karanamm, Sagar Oak

      Journal of Clinical Imaging Science 2012 2(1):75-75

      Aneurysms in the pediatric age group are rare and have preponderance for the posterior circulation. These aneurysms are more commonly large, giant, and complex. We present two case reports of saccular aneurysms in pediatric patients who were treated successfully by endovascular technique.
      Citation: Journal of Clinical Imaging Science 2012 2(1):75-75
      PubDate: Tue,4 Dec 2012
      DOI: 10.4103/2156-7514.104308
      Issue No: Vol. 2, No. 1 (2012)
       
  • Virilizing Adrenal Oncocytoma

    • Authors: Dinesh Sharma, Sanjiv Sharma, Anupam Jhobta, RG Sood
      Pages: 76 - 76
      Abstract: Dinesh Sharma, Sanjiv Sharma, Anupam Jhobta, RG Sood

      Journal of Clinical Imaging Science 2012 2(1):76-76

      Adrenal oncocytoma is a rare adrenal neoplasm with only 57 cases reported in literature. Adrenal oncocytomas can achieve large sizes and are usually nonfunctioning. They are detected accidentally during abdominal scans. Most of these adrenal neoplasms are benign. A functioning adrenal oncocytoma manifested with virilization in a 16-year-old female child. There seems to be little benefit in biopsying these tumors and surgery remains the optimum management.
      Citation: Journal of Clinical Imaging Science 2012 2(1):76-76
      PubDate: Tue,4 Dec 2012
      DOI: 10.4103/2156-7514.104309
      Issue No: Vol. 2, No. 1 (2012)
       
  • Bohler's and Gissane Angles in the Indian Population

    • Authors: Vetrivel C Sengodan, KH Amruth, Karthikeyan
      Pages: 77 - 77
      Abstract: Vetrivel C Sengodan, KH Amruth, Karthikeyan

      Journal of Clinical Imaging Science 2012 2(1):77-77

      Objective: The aim of our study is to determine the normal ranges of the calcaneal parameters in the Indian population, and to compare the results with the data in the literature. Materials and Methods: The study was conducted at Coimbatore Medical College Hospital, Coimbatore on the feet (324 in number) of male and female Indian adults. Lateral view of the ankle was taken using a digital X-ray machine. Two parameters namely Bohler`s and Gissane angles were measured, independently by two radiologists to prevent inter-observer variation. Results: The Bohler`s and Gissane angles for the Indian population are statistically different from those seen in the published data for other population groups, as evidenced by the P value ( P < 0.05). Conclusion: Calcaneal parameters specific to the Indian population have to be taken into consideration by the orthopedic surgeon to improve the standard of calcaneal fracture treatment in India.
      Citation: Journal of Clinical Imaging Science 2012 2(1):77-77
      PubDate: Tue,4 Dec 2012
      DOI: 10.4103/2156-7514.104310
      Issue No: Vol. 2, No. 1 (2012)
       
  • Intestinal Obstruction from Congenital Bands at the Proximal Jejunum: A
           Case Report and Literature Review

    • Authors: Debkumar Sarkar, Preetam Gongidi, Thomas Presenza, Emily Scattergood
      Pages: 78 - 78
      Abstract: Debkumar Sarkar, Preetam Gongidi, Thomas Presenza, Emily Scattergood

      Journal of Clinical Imaging Science 2012 2(1):78-78

      Congenital anomalous bands at the proximal jejunum resulting in obstruction have been described sporadically in the literature and are otherwise rare. We present a case of an 8 year-old girl with a nine-month history of intermittent vomiting and no history of prior surgery. The imaging workup includes an abdominal ultrasound, a single contrast upper gastrointestinal series, and a dual contrast computed tomography of the abdomen and pelvis. Surgical intervention revealed the presence of dense bands at the proximal jejunum without evidence of malrotation. Our report reviews the embryology and radiologic findings of this entity using different imaging modalities.
      Citation: Journal of Clinical Imaging Science 2012 2(1):78-78
      PubDate: Thu,27 Dec 2012
      DOI: 10.4103/2156-7514.105130
      Issue No: Vol. 2, No. 1 (2012)
       
  • Non&#8209;Azygos Accessory Fissure in Right Upper Lobe Associated
           with Superior and Inferior Accessory Fissures in Right Lower Lobe

    • Authors: Thomas Jose Eluvathingal Muttikkal, Chunli Deng
      Pages: 79 - 79
      Abstract: Thomas Jose Eluvathingal Muttikkal, Chunli Deng

      Journal of Clinical Imaging Science 2012 2(1):79-79

      Accessory fissures in the lungs are common congenital variations, usually detected as incidental findings in radiographs or CT scan. Accessory fissures can act as an anatomic barrier to the spread of inflammatory or neoplastic disease, as well as due to the variant anatomy, mimic lesions. It is important to recognize the presence of accessory fissures, as they affect surgical planning of pulmonary lobectomy and segmentectomy. Accessory fissure in the right upper lobe other than due to the anomalous course of azygos vein is very rare. We report a case of non-azygos accessory fissure, between the apical and the anterior segments of right upper lobe, along with superior and inferior accessory fissures in the right lower lobe.
      Citation: Journal of Clinical Imaging Science 2012 2(1):79-79
      PubDate: Thu,27 Dec 2012
      DOI: 10.4103/2156-7514.105133
      Issue No: Vol. 2, No. 1 (2012)
       
  • Isolated Humeral Metastasis in Uterine Cervical Cancer: A Rare Entity

    • Authors: Mahrooz Malek, Alireza Rajabzadeh Kanafi, Ramin Pourghorbeh, Reza Nafisi-Moghadam
      Pages: 80 - 80
      Abstract: Mahrooz Malek, Alireza Rajabzadeh Kanafi, Ramin Pourghorbeh, Reza Nafisi-Moghadam

      Journal of Clinical Imaging Science 2012 2(1):80-80

      Bone metastasis in cancer of uterine cervix, especially in the form of isolated bone involvement is a rare manifestation. Herein, we report the first case of isolated humeral metastasis in a known case of locally advanced cervical cancer. A fifty-six-year old female presented with International Federation of Gynecology and Obstetrics (FIGO) Stage IV A squamous cell carcinoma of uterine cervix. She was treated with a combination of radiation and chemotherapy and then total abdominal hysterectomy with bilateral salpingo-oophorectomy. Seven months later, she developed an isolated lytic lesion in the left humerus, which turned out to be a bone metastatic lesion.
      Citation: Journal of Clinical Imaging Science 2012 2(1):80-80
      PubDate: Thu,27 Dec 2012
      DOI: 10.4103/2156-7514.105137
      Issue No: Vol. 2, No. 1 (2012)
       
  • Complete Right Lung Agenesis with Dextrocardia: An Unusual Cause of
           Respiratory Distress

    • Authors: Devki Nandan, Girish Chandra Bhatt, Vivek Dewan, Imkongkumzuk Pongener
      Pages: 81 - 81
      Abstract: Devki Nandan, Girish Chandra Bhatt, Vivek Dewan, Imkongkumzuk Pongener

      Journal of Clinical Imaging Science 2012 2(1):81-81

      Pulmonary agenesis, defined as complete absence of bronchus, parenchyma, and vessels is a very rare condition. Herein, we report a 4-month-old infant who presented with fever, cough, and respiratory distress and was misdiagnosed in a peripheral hospital as a case of pneumonia. The child was, later diagnosed as having right lung agenesis with dextrocardia.
      Citation: Journal of Clinical Imaging Science 2012 2(1):81-81
      PubDate: Thu,27 Dec 2012
      DOI: 10.4103/2156-7514.105140
      Issue No: Vol. 2, No. 1 (2012)
       
  • A Rare Case of Primary osteosarcoma of urinary bladder

    • Authors: Jagdeesh Kenthanahalli Siddappa, Saurabh Singla, Aditi Jain, Ashok Kumar
      Pages: 82 - 82
      Abstract: Jagdeesh Kenthanahalli Siddappa, Saurabh Singla, Aditi Jain, Ashok Kumar

      Journal of Clinical Imaging Science 2012 2(1):82-82

      Extraskeletal osteosarcoma is a malignant mesenchymal soft tissue tumor without attachment to the bone, and is able to produce osteoid or cartilaginous matrix. This entity accounts for 1% of all soft tissue sarcomas. Thus far, less than 35 cases of bladder osteosarcomas have been reported in the literature. These tumors are associated with very poor prognosis. We report a case of primary osteosarcoma of the urinary bladder presenting with intermittent hematuria, dysuria, and right flank pain. Contrast-enhanced computed tomography scan of the abdomen, pelvis, and chest revealed a bladder mass and pulmonary metastases with specks of calcification.
      Citation: Journal of Clinical Imaging Science 2012 2(1):82-82
      PubDate: Thu,27 Dec 2012
      DOI: 10.4103/2156-7514.105145
      Issue No: Vol. 2, No. 1 (2012)
       
  • A Rare Coronary Artery Anomaly: Double Left Anterior Descending Artery

    • Authors: Guray Oncel, Dilek Oncel
      Pages: 83 - 83
      Abstract: Guray Oncel, Dilek Oncel

      Journal of Clinical Imaging Science 2012 2(1):83-83

      Double left anterior descending coronary artery arising from the left and right coronary arteries is one of the rarest of coronary anomalies. In this report, we present a case of double left anterior descending coronary artery with one originating from the left main stem and the second one originating from the same ostium with the right coronary artery, passing to the left side following an inter-arterial course between aorta and right ventricular outflow tract and spreading to the anterior wall of the left ventricle. The diagnosis was made with multislice computed tomography angiography. To our knowledge, only a few such cases have been published in the literature so far.
      Citation: Journal of Clinical Imaging Science 2012 2(1):83-83
      PubDate: Thu,27 Dec 2012
      DOI: 10.4103/2156-7514.105150
      Issue No: Vol. 2, No. 1 (2012)
       
  • Additional Merits of Two-dimensional Single Thick-slice Magnetic Resonance
           Myelography in Spinal Imaging

    • Authors: Abhishek Aggarwal, Rajiv Azad, Armeen Ahmad, Pankaj Arora, Puneet Gupta
      Pages: 84 - 84
      Abstract: Abhishek Aggarwal, Rajiv Azad, Armeen Ahmad, Pankaj Arora, Puneet Gupta

      Journal of Clinical Imaging Science 2012 2(1):84-84

      Objective: To validate the additional merits of two-dimensional (2D) single thick-slice Magnetic Resonance Myelography (MRM) in spinal imaging. Materials and Methods: 2D single thick-slice MRM was performed using T2 half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequence in addition to routine Magnetic resonance (MR) sequences for spine in 220 patients. The images were evaluated for additional diagnostic information in spinal and extra-spinal regions. A three-point grading system was adopted depending upon the utility of MRM in contributing to the detection of spinal or extra-spinal findings. Grade 1 represented no contribution of MRM while grade 3 would indicate that it was essential to detection of findings. Results: Utility of MRM in spine was categorized as grade 3 in 10.9% cases (24/220), grade 2 in 21.8% (48/220) cases and grade 1 in 67.3% cases (148/220). Thus, the overall additional merit of MRM in spine was seen in 32.7% (72/220) of cases. Besides in 14.1% cases (31/220) extra-spinal pathologies were identified. Conclusion: 2D single thick-slice MRM could have additional merits in spinal imaging when used as an adjunct to routine MR sequences.
      Citation: Journal of Clinical Imaging Science 2012 2(1):84-84
      PubDate: Mon,31 Dec 2012
      DOI: 10.4103/2156-7514.105268
      Issue No: Vol. 2, No. 1 (2012)
       
  • Effect of Magnesium Sulfate on Doppler Parameters of Fetal Umbilical and
           Middle Cerebral Arteries in Women with Severe Preeclampsia

    • Authors: Nazanin Farshchian, Negin Rezavand, Saeed Mohammadi
      Pages: 85 - 85
      Abstract: Nazanin Farshchian, Negin Rezavand, Saeed Mohammadi

      Journal of Clinical Imaging Science 2012 2(1):85-85

      Objective: To assess the effect of injecting magnesium sulfate on Doppler parameters of fetal umbilical and middle cerebral arteries (MCA) in women with severe preeclampsia. Materials and Methods: A total of 21 patients with severe preeclampsia admitted to Imam Reza Hospital, Kermanshah (Iran), were evaluated. Before and after administration of magnesium sulfate, Doppler ultrasound scan was carried out to measure fetal middle cerebral artery and umbilical artery blood flow. Paired t-test was used for statistical analysis. Results: After injection of magnesium sulfate, the mean resistivity index (RI)-umbilical, and pulsatility index (PI)-cerebral showed a statistically significant reduction ( P < 0.001). The cerebroumbilical C/U ratio increased after the intervention ( P < 0.001). The PI-umbilical ( P = 0.1) and pre- and post-RI-cerebral ( P = 0.96) did not have statistically significant changes. Conclusions: Infusion of magnesium sulfate significantly decreases the flow in the fetus RI-umbilical and PI-MCA, and it increases C/U ratio indices in color Doppler ultrasound.
      Citation: Journal of Clinical Imaging Science 2012 2(1):85-85
      PubDate: Mon,31 Dec 2012
      DOI: 10.4103/2156-7514.105269
      Issue No: Vol. 2, No. 1 (2012)
       
  • Mesenteric Air Embolism Following Enteroscopic Small Bowel Tattooing
           Procedure

    • Authors: Natalie Chen, Ramit Lamba, John Lee, Chandana Lall
      Pages: 86 - 86
      Abstract: Natalie Chen, Ramit Lamba, John Lee, Chandana Lall

      Journal of Clinical Imaging Science 2012 2(1):86-86

      Double balloon enteroscopy (DBE) is a revolutionary procedure in which the entire small bowel can be visualized endoscopically. DBE has the advantage of both diagnostic and therapeutic capabilities in the setting of small bowel neoplasms and vascular malformations. We present a unique case of a 76-year-old female who underwent small bowel DBE tattoo marking of a distal small bowel tumor complicated by development of severe abdominal pain postprocedure secondary to bowel air embolism into the mesenteric veins. Mesenteric air can be seen after other endoscopic procedures such as biopsy, mucosal clip placement and polypectomy, or following a colonoscopy. Mesenteric air embolism following small bowel tattooing procedure has not been previously reported in the literature. Mesenteric air when present may be attributed to mesenteric ischemia and can subject the patient to unnecessary surgical intervention if misdiagnosed. Thus, this report holds significance for the radiologist as computed tomography (CT) findings of mesenteric air embolism must be evaluated in the context of appropriate clinical history before treatment decisions are made.
      Citation: Journal of Clinical Imaging Science 2012 2(1):86-86
      PubDate: Mon,31 Dec 2012
      DOI: 10.4103/2156-7514.105270
      Issue No: Vol. 2, No. 1 (2012)
       
  • Coming of Age

    • Authors: Vikram Dogra
      Pages: 87 - 87
      Abstract: Vikram Dogra

      Journal of Clinical Imaging Science 2012 2(1):87-87


      Citation: Journal of Clinical Imaging Science 2012 2(1):87-87
      PubDate: Mon,31 Dec 2012
      DOI: 10.4103/2156-7514.105272
      Issue No: Vol. 2, No. 1 (2012)
       
  • Complications of Denver Shunt

    • Authors: Eranga Perera, Shweta Bhatt, Vikram S Dogra
      Pages: 6 - 6
      Abstract: Eranga Perera, Shweta Bhatt, Vikram S Dogra

      Journal of Clinical Imaging Science 2011 1(1):6-6

      Hepatic hydrothorax secondary to transdiaphragmatic spread of peritoneal fluid can cause respiratory discomfort to the patient. Draining of hydrothorax helps relieve these symptoms. Pleurovenous shunt (Denver shunt) is a relatively non-invasive method of shunting the pleural fluid to the central venous system. Reported complications of pleurovenous shunts are shunt failure, pulmonary edema, post shunt coagulopathy, deep vein thrombosis, and infection. We report a rare case of a leak at the venous end of the catheter that was placed within the right internal jugular vein, resulting in a large collection in the neck.
      Citation: Journal of Clinical Imaging Science 2011 1(1):6-6
      PubDate: Sat,8 Jan 2011
      DOI: 10.4103/2156-7514.75247
      Issue No: Vol. 1, No. 1 (2011)
       
  • Inflammatory Pseudotumor of the Kidney

    • Authors: Mehmet Ruhi Onur, Fatih Firdolas, Ercan Kocakoç, Irfan Orhan
      Pages: 7 - 7
      Abstract: Mehmet Ruhi Onur, Fatih Firdolas, Ercan Kocakoç, Irfan Orhan

      Journal of Clinical Imaging Science 2011 1(1):7-7

      Inflammatory pseudotumor of the kidney is a rare benign condition with unknown etiology that can mimic malignancy. We report a case of inflammatory pseudotumor of the kidney. A 59-year-old male patient was admitted with a complaint of right flank pain and hematuria. Ultrasonography and magnetic resonance imaging of the patient revealed a 9 cm &#215; 10 cm mass originating from the renal parenchyma with posterior extension. Operative findings revealed a mass adhering to the psoas muscle. Histopathologic examination demonstrated spindle-shaped fibroblast cells accompanying inflammatory cells. The pathological diagnosis was renal inflammatory pseudotumor. Repeated US and computed tomography revealed complete remission.
      Citation: Journal of Clinical Imaging Science 2011 1(1):7-7
      PubDate: Sat,8 Jan 2011
      DOI: 10.4103/2156-7514.75252
      Issue No: Vol. 1, No. 1 (2011)
       
  • Median Arcuate Ligament Compression of the Celiomesenteric Trunk

    • Authors: Victor Lee, Mauricio Daniel Alvarez, Shweta Bhatt, Vikram S Dogra
      Pages: 8 - 8
      Abstract: Victor Lee, Mauricio Daniel Alvarez, Shweta Bhatt, Vikram S Dogra

      Journal of Clinical Imaging Science 2011 1(1):8-8

      Median arcuate ligament (MAL) syndrome is a controversial condition characterized by compression of the celiac trunk and symptoms of intestinal angina. We present a case of MAL compressing the celiomesenteric trunk, a rare variation. We report computed tomography (CT) angiography and three-dimensional reconstructions of this rare phenomenon.
      Citation: Journal of Clinical Imaging Science 2011 1(1):8-8
      PubDate: Sat,8 Jan 2011
      DOI: 10.4103/2156-7514.75260
      Issue No: Vol. 1, No. 1 (2011)
       
  • Renal Collision Tumor in Association with Xanthogranulomatous
           Pyelonephritis

    • Authors: Jennifer Rothschild, Shweta Bhatt, Vikram S Dogra
      Pages: 9 - 9
      Abstract: Jennifer Rothschild, Shweta Bhatt, Vikram S Dogra

      Journal of Clinical Imaging Science 2011 1(1):9-9

      Collision tumor is a rare condition in which two neoplasms (usually benign and malignant), both growing in the same general area, collide with each other and become intermingled. We present histopathology and imaging correlation of xanthogranulomatous pyelonephritis coexistent with squamous cell carcinoma and osteogenic sarcoma of the kidney.
      Citation: Journal of Clinical Imaging Science 2011 1(1):9-9
      PubDate: Sat,8 Jan 2011
      DOI: 10.4103/2156-7514.75263
      Issue No: Vol. 1, No. 1 (2011)
       
  • Fibro-osseous Lesions of the Jaw: A Report of Two Cases

    • Authors: Guruprasad Yadavalli
      Pages: 10 - 10
      Abstract: Guruprasad Yadavalli

      Journal of Clinical Imaging Science 2011 1(1):10-10

      Fibro-osseous lesions of the maxillofacial bones comprise a diverse group of pathologic conditions that include developmental lesions, reactive or dysplastic diseases, and neoplasms. The concept of fibro-osseous lesions has evolved over the last several decades and now includes two major entities: fibrous dysplasia and ossifying fibroma. The less common lesions include florid osseous dysplasia, periapical dysplasia, focal sclerosing osteomyelitis, proliferative periostitis of Garre, and osteitis deformans. We report two cases, the first, a craniofacial polyostotic fibrous dysplasia, and the second, a juvenile ossifying fibroma of maxilla.
      Citation: Journal of Clinical Imaging Science 2011 1(1):10-10
      PubDate: Fri,11 Feb 2011
      DOI: 10.4103/2156-7514.76688
      Issue No: Vol. 1, No. 1 (2011)
       
  • Acute Renal Artery Occlusion with Prolonged Renal Ischemia: A Case of
           Successful Treatment with Stent Placement and Catheter-directed
           Thrombolysis

    • Authors: Mohammad Arabi, Ranjith Vellody, Kyung Cho
      Pages: 11 - 11
      Abstract: Mohammad Arabi, Ranjith Vellody, Kyung Cho

      Journal of Clinical Imaging Science 2011 1(1):11-11

      We present a case of acute renal artery occlusion caused by a high-grade stenosis associated with in-situ thrombosis. Endovascular renal artery stent placement combined with catheter-directed thrombolysis reversed the renal ischemia with restoration of renal function despite the prolonged ischemia.
      Citation: Journal of Clinical Imaging Science 2011 1(1):11-11
      PubDate: Fri,11 Feb 2011
      DOI: 10.4103/2156-7514.76689
      Issue No: Vol. 1, No. 1 (2011)
       
  • Pilomatrixoma of the Adult Male Breast: A Rare Tumor with Typical
           Ultrasound Features

    • Authors: Charles M Hubeny, Jeremy B Sykes, Avice O'Connell, Vikram S Dogra
      Pages: 12 - 12
      Abstract: Charles M Hubeny, Jeremy B Sykes, Avice O'Connell, Vikram S Dogra

      Journal of Clinical Imaging Science 2011 1(1):12-12

      Pilomatrixomas are uncommon benign skin neoplasms arising from the hair follicle matrix. They occur more commonly in children than adults. Most originate on the head, neck, or upper extremities, less commonly on the trunk or lower extremities, and very infrequently in the breast. We present a rare case of pilomatrixoma of the breast in an adult male. As the patient had a strong family history of breast cancer, a full work-up of the breast mass was performed. Ultimately, an excisional biopsy was carried out for patient reassurance.
      Citation: Journal of Clinical Imaging Science 2011 1(1):12-12
      PubDate: Fri,11 Feb 2011
      DOI: 10.4103/2156-7514.76690
      Issue No: Vol. 1, No. 1 (2011)
       
  • Sprengel Deformity: Magnetic Resonance Imaging Findings in Two Pediatric
           Cases

    • Authors: Alper Dilli, Umit Yasar Ayaz, Çagri Damar, Önder Ersan, Baki Hekimoglu
      Pages: 13 - 13
      Abstract: Alper Dilli, Umit Yasar Ayaz, Çagri Damar, Önder Ersan, Baki Hekimoglu

      Journal of Clinical Imaging Science 2011 1(1):13-13

      The characteristics of Sprengel deformity, which is also called congenital high scapula, are malposition and dysplasia of the affected scapula, with possible omovertebral connection. The aim of the present study was mainly to present the magnetic resonance imaging (MRI) findings of two pediatric cases of Sprengel deformity. A 7-year-old girl and a 9-year-old boy with deformities in their right shoulder were studied. Plain radiographs were obtained. MRI was performed for both children. The fibrous omovertebral connection is depicted in its longest form in one plane. Omovertebral band is best screened in coronal and axial cross sections. We are introducing a new MRI sign which we named as "Ra's eye" to define the appearance of omovertebral band within the surrounding fat tissue.
      Citation: Journal of Clinical Imaging Science 2011 1(1):13-13
      PubDate: Fri,11 Feb 2011
      DOI: 10.4103/2156-7514.76691
      Issue No: Vol. 1, No. 1 (2011)
       
  • Pseudoaneurysm of Uterine Artery: A Rare Cause of Secondary Postpartum
           Hemorrhage, Managed with Uterine Artery Embolisation

    • Authors: Pramya Nanjundan, Meenakshi Rohilla, Ainharan Raveendran, Vanita Jain, Niranjan Khandelwal
      Pages: 14 - 14
      Abstract: Pramya Nanjundan, Meenakshi Rohilla, Ainharan Raveendran, Vanita Jain, Niranjan Khandelwal

      Journal of Clinical Imaging Science 2011 1(1):14-14

      Uterine artery pseudoaneurysm is a rare cause of secondary postpartum hemorrhage but is potentially life-threatening and can occur after caesarean section (c-section) or a hysterectomy. A 28-year-old woman who developed secondary postpartum hemorrhage after c-section was diagnosed to have pseudoaneurysm from the left uterine artery on ultrasound (US) and computed tomography (CT) scan. She was treated with coiling of the pseudoaneurysm with stainless steel coil via selective catheterization of the uterine artery. The procedure was uneventful and the pseudoaneurysm was successfully obliterated. Angiographic embolization is a safe and effective method for treating postpartum hemorrhage due to pseudoaneurysm in hemodynamically stable patients. Therefore, it should be considered as a treatment option before resorting to surgery, in appropriately selected cases.
      Citation: Journal of Clinical Imaging Science 2011 1(1):14-14
      PubDate: Fri,11 Feb 2011
      DOI: 10.4103/2156-7514.76692
      Issue No: Vol. 1, No. 1 (2011)
       
  • Magnetic Resonance Imaging of Neurosarcoidosis

    • Authors: Daniel T Ginat, Gurpreet Dhillon, Jeevak Almast
      Pages: 15 - 15
      Abstract: Daniel T Ginat, Gurpreet Dhillon, Jeevak Almast

      Journal of Clinical Imaging Science 2011 1(1):15-15

      Neurosarcoidosis is an uncommon condition with protean manifestations. Magnetic resonance imaging (MRI) is often used in the diagnostic evaluation and follow-up of patients with neurosarcoidosis. Therefore, familiarity with the variety of MRI appearances is important. In this pictorial essay, the range of possible patterns of involvement in neurosarcoidosis are depicted and discussed. These include intracranial and spine leptomeningeal involvement, cortical and cerebral white matter lesions, corpus callosum involvement, sellar and suprasellar involvement, periventricular involvement, cranial nerve involvement, cavernous sinus involvement, hydrocephalus, dural involvement, ischemic lesions, perivascular involvement, orbit lesions, osseous involvement, nerve root involvement, and spinal cord intramedullary involvement. Differential diagnoses for each pattern of involvement of neurosarcoidosis are also provided.
      Citation: Journal of Clinical Imaging Science 2011 1(1):15-15
      PubDate: Fri,11 Feb 2011
      DOI: 10.4103/2156-7514.76693
      Issue No: Vol. 1, No. 1 (2011)
       
  • X-ray Digital Linear Tomosynthesis Imaging for Artificial Pulmonary Nodule
           Detection

    • Authors: Tsutomu Gomi
      Pages: 16 - 16
      Abstract: Tsutomu Gomi

      Journal of Clinical Imaging Science 2011 1(1):16-16

      The purpose of this paper is to identify indications for volumetric X-ray digital linear tomosynthesis (DLT) with single- and dual-energy subtraction techniques for artificial pulmonary nodule detection and compare X-ray DLT, X-ray digital radiography, and computed tomography.
      Citation: Journal of Clinical Imaging Science 2011 1(1):16-16
      PubDate: Fri,11 Feb 2011
      DOI: 10.4103/2156-7514.76694
      Issue No: Vol. 1, No. 1 (2011)
       
  • Traumatic Ectopic Dislocation of Testis

    • Authors: Eranga Perera, Shweta Bhatt, Vikram S Dogra
      Pages: 17 - 17
      Abstract: Eranga Perera, Shweta Bhatt, Vikram S Dogra

      Journal of Clinical Imaging Science 2011 1(1):17-17

      Traumatic ectopic dislocation of testis is a rare occurrence and usually occurs following a motorcycle collision, in what is referred to as "fuel tank injury". Early identification and subsequent surgical management is of utmost importance to maintain normal spermatogenesis in the dislocated testis. In appropriate clinical setting, scrotal ultrasound examination with gray-scale and color flow Doppler imaging is the method of choice for diagnosis. Computed tomography of the abdomen is a useful adjunct procedure. We report a case of traumatic testicular dislocation with partial testicular torsion following a motorcycle collision, diagnosed with imaging, and subsequently confirmed on surgery.
      Citation: Journal of Clinical Imaging Science 2011 1(1):17-17
      PubDate: Thu,24 Feb 2011
      DOI: 10.4103/2156-7514.77124
      Issue No: Vol. 1, No. 1 (2011)
       
  • Macrodystrophia Lipomatosa: Radiologic-Pathologic Correlation

    • Authors: Deepika Upadhyay, Umesh C Parashari, Sachin Khanduri, Samarjit Bhadury
      Pages: 18 - 18
      Abstract: Deepika Upadhyay, Umesh C Parashari, Sachin Khanduri, Samarjit Bhadury

      Journal of Clinical Imaging Science 2011 1(1):18-18

      Macrodystrophia lipomatosa (MDL) is a rare cause of congenital macrodactyly, characterised by progressive proliferation of all mesenchymal elements, with disproportionate increase in fibro-adipose tissue. It occurs most frequently in lower limbs along the distribution of the medial plantar nerve. MDL presents as localised gigantism of the hand or foot and comes to clinical attention for cosmetic reasons, mechanical problems secondary to degenerative joint disease, or development of neurovascular compression. Here, we report a case of MDL, with altered soft tissue growth due to an earlier surgery, making clinical diagnosis difficult. However, with a complete radio-clinical work-up and review of the history, a provisional diagnosis of MDL was made, which was confirmed by histopathology and during surgery.
      Citation: Journal of Clinical Imaging Science 2011 1(1):18-18
      PubDate: Tue,22 Mar 2011
      DOI: 10.4103/2156-7514.78264
      Issue No: Vol. 1, No. 1 (2011)
       
  • Sonographic Upper Gastrointestinal Series in the Vomiting Infant: How We
           Do It

    • Authors: Thaddeus W Herliczek, Deepak Raghavan, Kathleen McCarten, Michael Wallach
      Pages: 19 - 19
      Abstract: Thaddeus W Herliczek, Deepak Raghavan, Kathleen McCarten, Michael Wallach

      Journal of Clinical Imaging Science 2011 1(1):19-19

      Sonography (ultrasound) is used routinely to assess an infant with nonbilious projectile emesis. Fluoroscopic upper gastrointestinal (UGI) series has been the standard method to evaluate infants with bilious emesis. We use sonographic UGI routinely to assess infants with nonbilious emesis as well as infants with bilious emesis. This essay illustrates our technique, the results obtained using this technique for normal anatomy, and the commonly encountered pathology.
      Citation: Journal of Clinical Imaging Science 2011 1(1):19-19
      PubDate: Thu,31 Mar 2011
      DOI: 10.4103/2156-7514.78528
      Issue No: Vol. 1, No. 1 (2011)
       
  • Diffusion-weighted Magnetic Resonance Imaging in the Early Diagnosis of
           Neonatal Adrenoleukodystrophy

    • Authors: R Nuri Sener, Mehmet H Atalar
      Pages: 20 - 20
      Abstract: R Nuri Sener, Mehmet H Atalar

      Journal of Clinical Imaging Science 2011 1(1):20-20

      A newborn baby girl developed seizures right after birth. On the fourth day, the baby was examined using diffusion sequence magnetic resonance imaging (MRI) and diagnosed to have neonatal adrenoleukodystrophy. Laboratory findings confirmed the diagnosis. This is the first case of neonatal adrenoleukodystrophy (NALD) where diffusion MRI sequence helped in the diagnosis. We find association of NALD with seizures at birth is an extremely rare occurrence, and so far, only one case has been mentioned in the literature.
      Citation: Journal of Clinical Imaging Science 2011 1(1):20-20
      PubDate: Thu,31 Mar 2011
      DOI: 10.4103/2156-7514.78530
      Issue No: Vol. 1, No. 1 (2011)
       
  • Imaging of Mechanical Cardiac Assist Devices

    • Authors: Daniel Ginat, Howard Todd Massey, Shweta Bhatt, Vikram S Dogra
      Pages: 21 - 21
      Abstract: Daniel Ginat, Howard Todd Massey, Shweta Bhatt, Vikram S Dogra

      Journal of Clinical Imaging Science 2011 1(1):21-21

      Diagnostic imaging plays an important role in the assessment of patients with mechanical cardiac assist devices. Therefore, it is important for radiologists to be familiar with the basic components, function, and radiographic appearances of these devices in order to appropriately diagnose complications. The purpose of this pictorial essay is to review indications, components, normal imaging appearances, and complications of surgically and percutaneously implanted ventricular assist devices, intra-aortic balloon pumps, and cardiac meshes.
      Citation: Journal of Clinical Imaging Science 2011 1(1):21-21
      PubDate: Sat,30 Apr 2011
      DOI: 10.4103/2156-7514.80373
      Issue No: Vol. 1, No. 1 (2011)
       
  • Imaging of the Bursae

    • Authors: Zameer Hirji, Jaspal S Hunjun, Hema N Choudur
      Pages: 22 - 22
      Abstract: Zameer Hirji, Jaspal S Hunjun, Hema N Choudur

      Journal of Clinical Imaging Science 2011 1(1):22-22

      When assessing joints with various imaging modalities, it is important to focus on the extraarticular soft tissues that may clinically mimic joint pathology. One such extraarticular structure is the bursa. Bursitis can clinically be misdiagnosed as joint-, tendon- or muscle-related pain. Pathological processes are often a result of inflammation that is secondary to excessive local friction, infection, arthritides or direct trauma. It is therefore important to understand the anatomy and pathology of the common bursae in the appendicular skeleton. The purpose of this pictorial essay is to characterize the clinically relevant bursae in the appendicular skeleton using diagrams and corresponding multimodality images, focusing on normal anatomy and common pathological processes that affect them. The aim is to familiarize radiologists with the radiological features of bursitis.
      Citation: Journal of Clinical Imaging Science 2011 1(1):22-22
      PubDate: Sat,30 Apr 2011
      DOI: 10.4103/2156-7514.80374
      Issue No: Vol. 1, No. 1 (2011)
       
  • Ureteritis Cystica: A Radiologic Pathologic Correlation

    • Authors: Jennifer G Rothschild, Guan Wu
      Pages: 23 - 23
      Abstract: Jennifer G Rothschild, Guan Wu

      Journal of Clinical Imaging Science 2011 1(1):23-23

      Ureteritis cystica (UC) is a benign condition that commonly affects the ureter and can mimic other conditions such as transitional cell carcinoma, blood clots, air bubbles, radiolucent stones, fibroepithelial polyps, and sloughed renal papillae. Radiographically, UC is characterized by multiple small, round, lucent defects, which cause scalloping of the ureteral margins when seen in profile. The scalloping is produced by the projection of the submucosal cysts into the lumen and represents an important differential feature of this disease. We present a case of UC with a radiological pathological correlation.
      Citation: Journal of Clinical Imaging Science 2011 1(1):23-23
      PubDate: Sat,30 Apr 2011
      DOI: 10.4103/2156-7514.80375
      Issue No: Vol. 1, No. 1 (2011)
       
  • Photoacoustic Imaging: Opening New Frontiers in Medical Imaging

    • Authors: Keerthi S Valluru, Bhargava K Chinni, Navalgund A Rao
      Pages: 24 - 24
      Abstract: Keerthi S Valluru, Bhargava K Chinni, Navalgund A Rao

      Journal of Clinical Imaging Science 2011 1(1):24-24

      In today's world, technology is advancing at an exponential rate and medical imaging is no exception. During the last hundred years, the field of medical imaging has seen a tremendous technological growth with the invention of imaging modalities including but not limited to X-ray, ultrasound, computed tomography, magnetic resonance imaging, positron emission tomography, and single-photon emission computed tomography. These tools have led to better diagnosis and improved patient care. However, each of these modalities has its advantages as well as disadvantages and none of them can reveal all the information a physician would like to have. In the last decade, a new diagnostic technology called photoacoustic imaging has evolved which is moving rapidly from the research phase to the clinical trial phase. This article outlines the basics of photoacoustic imaging and describes our hands-on experience in developing a comprehensive photoacoustic imaging system to detect tissue abnormalities.
      Citation: Journal of Clinical Imaging Science 2011 1(1):24-24
      PubDate: Fri,6 May 2011
      DOI: 10.4103/2156-7514.80522
      Issue No: Vol. 1, No. 1 (2011)
       
  • The Beginning

    • Authors: Vikram Dogra
      Pages: 25 - 25
      Abstract: Vikram Dogra

      Journal of Clinical Imaging Science 2011 1(1):25-25


      Citation: Journal of Clinical Imaging Science 2011 1(1):25-25
      PubDate: Fri,6 May 2011
      DOI: 10.4103/2156-7514.80523
      Issue No: Vol. 1, No. 1 (2011)
       
  • Bronchial Artery Aneurysm due to Pulmonary Tuberculosis: Detection with
           Multidetector Computed Tomographic Angiography

    • Authors: Saurabh Karmakar, Alok Nath, Zafar Neyaz, Hira Lal, Rajendra V Phadke
      Pages: 26 - 26
      Abstract: Saurabh Karmakar, Alok Nath, Zafar Neyaz, Hira Lal, Rajendra V Phadke

      Journal of Clinical Imaging Science 2011 1(1):26-26

      A case of bronchial artery aneurysm due to pulmonary tuberculosis is reported. The patient presented with massive hemoptysis and the diagnosis was made using multidetector computed tomographic (MDCT) angiography. Selective bronchial arteriogram confirmed the MDCT findings and bronchial artery embolization was successfully performed with cessation of hemoptysis. Our article emphasizes the value of MDCT angiography in the diagnosis and management of such cases.
      Citation: Journal of Clinical Imaging Science 2011 1(1):26-26
      PubDate: Thu,19 May 2011
      DOI: 10.4103/2156-7514.81293
      Issue No: Vol. 1, No. 1 (2011)
       
  • Diffusion-weighted Magnetic Resonance Imaging: What Makes Water Run Fast
           or Slow?

    • Authors: Francesca Fornasa
      Pages: 27 - 27
      Abstract: Francesca Fornasa

      Journal of Clinical Imaging Science 2011 1(1):27-27

      Diffusion-Weighted Magnetic Resonance Imaging (DWI) obtains information useful in diagnosing several diseases through the measurement of random, Brownian diffusion of water molecules in tissues. This pictorial essay illustrates the main factors, i.e., ratio between the volume occupied by cells and the extracellular space, composition of the extracellular space, and temperature, that determine the rate of the water diffusion. The mechanism through which these influencing factors affect water diffusion is explained. Clinical and experimental examples, derived both from physiology and from non-human models, are described.
      Citation: Journal of Clinical Imaging Science 2011 1(1):27-27
      PubDate: Thu,19 May 2011
      DOI: 10.4103/2156-7514.81294
      Issue No: Vol. 1, No. 1 (2011)
       
  • Enforcing Quality Metrics over Equipment Utilization Rates as Means to
           Reduce Centers for Medicare and Medicaid Services Imaging Costs and
           Improve Quality of Care

    • Authors: Amit Sura, Alexander Ho
      Pages: 28 - 28
      Abstract: Amit Sura, Alexander Ho

      Journal of Clinical Imaging Science 2011 1(1):28-28

      Radiology has been the focus of efforts to reduce inefficiencies while attempting to lower medical costs. The 2010 Medicare Physician Fee Schedule has reduced Centers for Medicare and Medicaid Services' (CMS) reimbursements related to the technical component of imaging services. By increasing the utilization rate, the cost of equipment spreads over more studies, thus lowering the payments per procedure. Is it beneficial for CMS to focus on equipment utilization as a cost-cutting measure? Can greater financial and quality of care rewards be made by improving metrics like appropriateness criteria and pre-authorization? On examining quality metrics, such as appropriateness criteria and pre-authorization, promising results have ensued. The development and enforcement of appropriateness criteria lowers overutilization of studies without requiring unattainable fixed rates. Pre-authorization educates ordering physicians as to when imaging is indicated.
      Citation: Journal of Clinical Imaging Science 2011 1(1):28-28
      PubDate: Tue,31 May 2011
      DOI: 10.4103/2156-7514.81771
      Issue No: Vol. 1, No. 1 (2011)
       
  • The Fetal Magnetic Resonance Imaging Experience in a Large Community
           Medical Center

    • Authors: Peter M Ghobrial, Rebecca A Levy, Stephen C O'Connor
      Pages: 29 - 29
      Abstract: Peter M Ghobrial, Rebecca A Levy, Stephen C O'Connor

      Journal of Clinical Imaging Science 2011 1(1):29-29

      Fetal magnetic resonance imaging (MRI) continues to prove a useful problem solving tool for diagnostic and management decision making issues encountered in the antenatal period. In this paper, we attempt to review basic fetal MRI protocol considerations and demonstrate key imaging findings through multiple modalities, with pathologic correlation in several cases. A study of five fetal MRI cases, from our institution, were selected in order to highlight both the indications for, and benefits obtained from this advanced imaging technique. Fetal MRI proved useful in each case in better defining fetal anomalies, especially where ultrasound (due to drawbacks such as shadowing by pelvic bones) was unable to be completely diagnostic. The more in-depth study made possible by MRI also helped with formulation of disease prognosis and estimation of survival chances of the fetus. Further, MRI as a diagnostic and prognostic tool has become more ubiquitous across the medical community. This imparts tangible benefit to patients, who are now able to find this service within arm's reach. Whereas previously these patients were obligatorily referred up to 90 miles away from our centre for further medical work-up, now a large percentage can obtain their prenatal imaging and perinatal care locally. In addition, medical education benefits as new types of cases, those with pathology of the antenatal period, are retained for work-up and management in these large community settings. Cases from our institution exemplify these types of pathologies, from fetal chest masses to a syndromic presentation of bilateral renal agenesis.
      Citation: Journal of Clinical Imaging Science 2011 1(1):29-29
      PubDate: Tue,31 May 2011
      DOI: 10.4103/2156-7514.81772
      Issue No: Vol. 1, No. 1 (2011)
       
  • Imaging-guided Parenchymal Liver Biopsy: How We Do It

    • Authors: Gopal R Vijayaraghavan, Sheehan David, Myriam Bermudez-Allende, Hussain Sarwat
      Pages: 30 - 30
      Abstract: Gopal R Vijayaraghavan, Sheehan David, Myriam Bermudez-Allende, Hussain Sarwat

      Journal of Clinical Imaging Science 2011 1(1):30-30

      Liver biopsies are performed for both focal and nonfocal lesions (parenchymal). In our center, majority of liver biopsies are performed for parenchymal liver disease. Parenchymal liver biopsy plays a key role in the diagnosis of various diffuse liver dysfunctions. Results of the biopsy help grade the disease, facilitating prognostication, which helps in planning specific treatment strategies. Imaging guidance is gaining wide acceptance as the standard procedure. Ultrasound (US) guidance is currently considered the most cost-effective and safe way to perform parenchymal liver biopsies. Radiologists worldwide and particularly in the United States are increasingly performing this procedure. Radiologists performing biopsies generally use the cutting needle. Different needle sizes, techniques and preference for biopsy of the right or left lobe have been described. We attribute these preferences to prior training and individual radiologist's comfort level. We describe the algorithm followed at our institution for performing percutaneous US-guided parenchymal liver biopsy. While clinical societies have recommended a minimum of 40 liver biopsies as a requirement for proficiency of clinicians, specific to radiology trainees/fellows interested in pursuing a career in intervention, we feel a total of 20 liver biopsies (includes assisted and independently performed biopsies under supervision) should be adequate training.
      Citation: Journal of Clinical Imaging Science 2011 1(1):30-30
      PubDate: Wed,15 Jun 2011
      DOI: 10.4103/2156-7514.82082
      Issue No: Vol. 1, No. 1 (2011)
       
  • Image-guided Percutaneous Drainage in the Pediatric Population: A Primer
           for Radiologists

    • Authors: Keerthi Arani, Kiran Nandalur, Christina M Tucker, David A Bloom
      Pages: 31 - 31
      Abstract: Keerthi Arani, Kiran Nandalur, Christina M Tucker, David A Bloom

      Journal of Clinical Imaging Science 2011 1(1):31-31

      Image-guided percutaneous drainage is an excellent minimally invasive method for dealing with infectious complications in the pediatric population. A thorough understanding of drainage procedures in children can often lead to improved patient outcomes. Indications for percutaneous drainage will be reviewed, including abscesses related to appendicitis, post-surgical abscess formation, and abscesses related to Crohn's disease. This pictorial essay will help the radiologist better understand the common etiologies of abscesses in children that may require percutaneous drainage, the special considerations for catheter placement, patient preparation, and anesthesia or sedation issues unique to the pediatric population.
      Citation: Journal of Clinical Imaging Science 2011 1(1):31-31
      PubDate: Tue,21 Jun 2011
      DOI: 10.4103/2156-7514.82243
      Issue No: Vol. 1, No. 1 (2011)
       
  • Imaging Features of the Pleuropulmonary Manifestations of Rheumatoid
           Arthritis: Pearls and Pitfalls

    • Authors: Harbir S Sidhu, Gauraang Bhatnagar, Pervinder Bhogal, Richard Riordan
      Pages: 32 - 32
      Abstract: Harbir S Sidhu, Gauraang Bhatnagar, Pervinder Bhogal, Richard Riordan

      Journal of Clinical Imaging Science 2011 1(1):32-32

      Rheumatoid arthritis (RA) is a common disorder that affects the joints. RA is a systemic disease associated with relatively frequent and variable pleuropulmonary manifestations. This article reviews the common and potentially serious thoracic sequelae in terms of pleural disease, pulmonary nodules, airways disorders, and interstitial disease, as well as pulmonary side effects of antirheumatic medication. An imaging-guided approach to classification of RA-associated lung disease is outlined and the comparative values of different imaging modalities are discussed. An appreciation of current knowledge of epidemiology, pathological correlation, and prognostic implications of different RA-associated lung disease is provided. We highlight importance of considering pertinent differential diagnoses to avoid misdiagnosis, and outline common pitfalls in dealing with pleuropulmonary rheumatoid disease.
      Citation: Journal of Clinical Imaging Science 2011 1(1):32-32
      PubDate: Tue,21 Jun 2011
      DOI: 10.4103/2156-7514.82244
      Issue No: Vol. 1, No. 1 (2011)
       
  • Communicating Tubular Duplication of Upper Esophagus-A Rare Occurrence

    • Authors: Jawahar Rathod, Amit Disawal, Kishor Taori, Meenakshi Agrawal, Prajwaleet P Gaur, Vijay Jadhav, Krishna Prasad, Kanchan Wankhede
      Pages: 33 - 33
      Abstract: Jawahar Rathod, Amit Disawal, Kishor Taori, Meenakshi Agrawal, Prajwaleet P Gaur, Vijay Jadhav, Krishna Prasad, Kanchan Wankhede

      Journal of Clinical Imaging Science 2011 1(1):33-33

      Duplications of esophagus are commonly classified into two types, tubular and cystic. Tubular duplication of esophagus is a rare occurrence and is much less common than cystic duplication of foregut. Most esophageal duplications are located in the lower third of the esophagus. A cervical esophageal duplication is extremely rare. Esophageal duplications have been reported twice as commonly on the right as on the left. We report a case of incidental finding identified on computed tomography of communicating tubular esophageal duplication involving the left side of the upper esophagus in a tuberculosis patient that was subsequently confirmed on barium swallow test.
      Citation: Journal of Clinical Imaging Science 2011 1(1):33-33
      PubDate: Tue,21 Jun 2011
      DOI: 10.4103/2156-7514.82245
      Issue No: Vol. 1, No. 1 (2011)
       
  • Sonographic Findings of Additional Malignant Lesions in Breast Carcinoma
           Seen by Second Look Ultrasound

    • Authors: Ana Delgado Laguna, S Jimenez Arranz, V Quintana Checa, S Alonso Roca, D Expósito Jiménez, J Oliver-Goldaracena
      Pages: 34 - 34
      Abstract: Ana Delgado Laguna, S Jimenez Arranz, V Quintana Checa, S Alonso Roca, D Expósito Jiménez, J Oliver-Goldaracena

      Journal of Clinical Imaging Science 2011 1(1):34-34

      Objective: The aim is to show ultrasound (US) findings of additional malignant lesions of breast carcinoma visualized on targeted second-look US that were not identified by mammography or US prior to the time of diagnosis. Materials and Methods: A double-blind retrospective review of the US results from January 2008 through August 2010 of 228 patients with known breast cancer was conducted by two expert radiologists. The focus of the review was on the second-look US characteristics (following BI-RADS criteria) of 26 documented additional malignant lesions of the 76 with successful sonographic correlation from the 123 lesions detected by magnetic resonance imaging (MRI). All of them, before the MRI, had an initial mammography and a US with a histopathological biopsy of the primary lesion. Results: Approximately 60 to 70% of the findings were classified as BI-RADS 2 and BI-RADS 3, while assessing the final US category. The review of the second-look US showed the size of the second malignant additional lesion ranged from 3 to 22 mm, of which 90% were smaller than 10 mm and 66% were smaller than 7 mm. Conclusions: Most additional malignant lesions, nonpalpable carcinomas, which were previously not detected by mammography and US at first-look diagnosis, were detected by a targeted second-look US examination. These lesions were of category BI-RADS 2 and BI-RADS 3 and smaller than 7 mm.
      Citation: Journal of Clinical Imaging Science 2011 1(1):34-34
      PubDate: Sat,25 Jun 2011
      DOI: 10.4103/2156-7514.82338
      Issue No: Vol. 1, No. 1 (2011)
       
  • Role of Magnetic Resonance Enterography in Differentiating between
           Fibrotic and Active Inflammatory Small Bowel Stenosis in Patients with
           Crohn's disease

    • Authors: Francesca Fornasa, Chiara Benassuti, Luca Benazzato
      Pages: 35 - 35
      Abstract: Francesca Fornasa, Chiara Benassuti, Luca Benazzato

      Journal of Clinical Imaging Science 2011 1(1):35-35

      Objective: To assess the diagnostic accuracy of magnetic resonance imaging (MRI) in prospectively differentiating between fibrotic and active inflammatory small bowel stenosis in patients with Crohn's disease (CD). Materials and Methods: A total of 111 patients with histologically proven CD presenting with clinical and plain radiographic signs of small bowel obstruction underwent coronal and axial MRI scans after oral administration of polyethylene glycol solution. A stenosis was judged present if a small bowel segment had >80% lumen reduction as compared to an adjacent normal loop and mural thickening of >3 mm. At the level of the stenosis, both T2 signal intensity and post-gadolinium T1 enhancement were quantified using a 5-point scale (0: very low; 1: low; 2: moderate; 3: high; and 4: very high). A stenosis was considered fibrotic if the sum of the two values (activity score: AS) did not exceed 1. Results: A small bowel stenosis was identified in 48 out of 111 patients. Fibrosis was confirmed at histology in all of the 23 patients with AS of 0 or 1, who underwent surgery within 3 days of the MRI examination. In the remaining 25 patients (AS: 2-8), an active inflammatory stenosis was suspected and remission of the obstructive symptoms was obtained by means of medical treatment. One of these patients (AS: 2), however, underwent surgery after 14 days, due to recurrence. MRI had 95.8% sensitivity, 100% specificity, and 97.9% accuracy in the diagnosis of fibrotic stenosis. Conclusion: MRI is reliable in differentiating fibrotic from inflammatory small bowel stenosis in CD.
      Citation: Journal of Clinical Imaging Science 2011 1(1):35-35
      PubDate: Sat,25 Jun 2011
      DOI: 10.4103/2156-7514.82339
      Issue No: Vol. 1, No. 1 (2011)
       
  • A Very Rapid Visual Recovery of Posterior Reversible Encephalopathy
           Syndrome

    • Authors: Harpreet S Walia, F Lawson Grumbine, Neal V Palejwala, Gagan K Sawhney, David S Risner, Sandeep S Walia
      Pages: 36 - 36
      Abstract: Harpreet S Walia, F Lawson Grumbine, Neal V Palejwala, Gagan K Sawhney, David S Risner, Sandeep S Walia

      Journal of Clinical Imaging Science 2011 1(1):36-36


      Citation: Journal of Clinical Imaging Science 2011 1(1):36-36
      PubDate: Sat,25 Jun 2011
      DOI: 10.4103/2156-7514.82341
      Issue No: Vol. 1, No. 1 (2011)
       
  • Crohn's disease: Multimodality Imaging of Surgical Indications,
           Operative Procedures, and Complications

    • Authors: B Kolar, J Speranza, S Bhatt, V Dogra
      Pages: 37 - 37
      Abstract: B Kolar, J Speranza, S Bhatt, V Dogra

      Journal of Clinical Imaging Science 2011 1(1):37-37

      Surgical management is considered for specific indications in Crohn's disease and a wide variety of surgeries is performed. The purpose of this pictorial essay is to depict manifestations of Crohn's disease that indicates surgery, various surgical procedures that are performed, and the complications arising from these surgical procedures. Surgical indications including obstruction due to strictures or adhesions, fistulae and abscesses, and surgeries for these conditions, such as, ileocecectomy, stricturoplasty, small bowel resection, fecal diversion, segmental colectomy, and lysis of adhesions and their complications will be discussed and their imaging will also be illustrated.
      Citation: Journal of Clinical Imaging Science 2011 1(1):37-37
      PubDate: Thu,14 Jul 2011
      DOI: 10.4103/2156-7514.82966
      Issue No: Vol. 1, No. 1 (2011)
       
  • Angiogenesis Imaging in Neoplasia

    • Authors: David J Bowden, Tristan Barrett
      Pages: 38 - 38
      Abstract: David J Bowden, Tristan Barrett

      Journal of Clinical Imaging Science 2011 1(1):38-38

      Angiogenesis plays a key role in physiological and pathophysiological processes and is recognized as being essential for tumor growth and metastases. The recent oncological development of anti-angiogenic drugs brings with it a need for angiogenesis quantification and monitoring of response. The nature of these agents means that traditional anatomical methods of assessing morphologic change are outmoded and functional imaging techniques and/or agents are necessary. Herein, we describe the various imaging techniques that can be employed to assess angiogenesis, along with their inherent advantages and disadvantages and discuss the current and future developments in the field.
      Citation: Journal of Clinical Imaging Science 2011 1(1):38-38
      PubDate: Wed,27 Jul 2011
      DOI: 10.4103/2156-7514.83229
      Issue No: Vol. 1, No. 1 (2011)
       
  • Clinically Relevant Imaging in Tuberous Sclerosis

    • Authors: Rupa Radhakrishnan, Sadhna Verma
      Pages: 39 - 39
      Abstract: Rupa Radhakrishnan, Sadhna Verma

      Journal of Clinical Imaging Science 2011 1(1):39-39

      Tuberous sclerosis (TS), also known as Bourneville disease or Bourneville-Pringle disease, is an autosomal dominant genetic disorder classically characterized by the presence of hamartomatous growths in multiple organs. TS and tuberous sclerosis complex (TSC) are different terms for the same genetic condition. Both terms describe clinical changes due to mutations involving either of the two genes named TSC1 and TSC2, which regulate cell growth. The diagnosis of TSC is established using diagnostic criteria based on clinical and imaging findings. Routine screening and surveillance of patients with TSC is needed to determine the presence and extent of organ involvement, especially the brain, kidneys, and lungs, and identify the development of associated complications. As the treatment is organ specific, imaging plays a crucial role in the management of patients with TSC.
      Citation: Journal of Clinical Imaging Science 2011 1(1):39-39
      PubDate: Wed,27 Jul 2011
      DOI: 10.4103/2156-7514.83230
      Issue No: Vol. 1, No. 1 (2011)
       
  • The Forgotten Guide Wire: A Rare Complication of Hemodialysis Catheter
           Insertion

    • Authors: Said Abuhasna, Dirar Abdallah, Masood ur Rahman
      Pages: 40 - 40
      Abstract: Said Abuhasna, Dirar Abdallah, Masood ur Rahman

      Journal of Clinical Imaging Science 2011 1(1):40-40

      A rare complication of a hemodialysis catheter insertion is the loss of the complete guide wire into the circulation. A complete guide wire in the circulation may not necessarily produce symptoms, and it may remain unnoticed for a significant period of time. We present a rare case where a complete guide wire was lost into the circulation during insertion of a hemodialysis catheter into the right femoral vein in a 19-year-old female with systemic lupus erythromatosis. The patient remained asymptomatic through two plasmapheresis treatments over a period of 2 days. The guide wire was eventually retrieved without complications. The factors leading to the wire being forgotten will be reviewed, and the measures initiated to prevent any future occurrence will be addressed.
      Citation: Journal of Clinical Imaging Science 2011 1(1):40-40
      PubDate: Sat,30 Jul 2011
      DOI: 10.4103/2156-7514.83397
      Issue No: Vol. 1, No. 1 (2011)
       
  • Magnetic Resonance Enterography Findings in Crohn's disease in the
           Pediatric Population and Correlation with Fluoroscopic and Multidetector
           Computed Tomographic Techniques

    • Authors: Parul Patel, Margaret Ormanoski, Kim M Hoadley
      Pages: 41 - 41
      Abstract: Parul Patel, Margaret Ormanoski, Kim M Hoadley

      Journal of Clinical Imaging Science 2011 1(1):41-41

      Traditionally, fluoroscopic examinations such as enteroclysis, upper GI studies, and small bowel follow through exams have been the procedures of choice in evaluating inflammatory bowel disease (IBD) in pediatric populations. With the advent of multidetector computed tomography (MDCT), it has subsequently become a complementary examination in imaging inflammatory bowel disease. A major advantage of MDCT over fluoroscopic examination is its ability to directly visualize bowel mucosa, as well as demonstrate extra-enteric complications of IBD such as abscesses, fistulae, and sinus tracts. The major disadvantage of CT however is exposure to ionizing radiation, especially in IBD patients of the pediatric age group who maybe repeatedly imaged due to exacerbations. As a result, magnetic resonance enterography (MRE) is becoming increasingly important in the evaluation and follow-up of pediatric patients with IBD. This pictorial essay will summarize the multi-modality imaging findings of IBD with emphasis on MRE including the imaging protocol and procedure. For the purposes of this article, patients less than 17 years of age have been considered to represent the pediatric population.
      Citation: Journal of Clinical Imaging Science 2011 1(1):41-41
      PubDate: Sat,30 Jul 2011
      DOI: 10.4103/2156-7514.83399
      Issue No: Vol. 1, No. 1 (2011)
       
  • Angiographic-CT-FDG-Pathologic Correlations of the Incidentally Discovered
           Adrenal Mass

    • Authors: Bi-Fang Lee, Nan-Tsing Chiu, Hong-Ming Tsai, Hung-Wen Tsai, Chung-Jye Hung
      Pages: 42 - 42
      Abstract: Bi-Fang Lee, Nan-Tsing Chiu, Hong-Ming Tsai, Hung-Wen Tsai, Chung-Jye Hung

      Journal of Clinical Imaging Science 2011 1(1):42-42

      During abdominal ultrasonography of a 37-year-old man a 3.2 cm hypoechoic mass in the right hepatic lobe was found incidentally. This prompted an abdominal CT, an FDG PET/CT, and an angiography to evaluate the nature of the mass. Laboratory data showed positive anti-HBs/anti-HBe, and negative HCV antibody. The alfa-fetoprotein and liver function tests were within normal limits. Contrast-enhanced CT found an enhanced hepatic tumor and primary hepatocellular carcinoma was suspected. PET/CT revealed no abnormal FDG accumulation in the right hepatic mass. The digital subtraction angiographies of the right inferior phrenic artery and right renal artery revealed a hypervascular tumor in the right adrenal gland. Therefore, a diagnosis of a right adrenal tumor was made. Serum aldosterone, serum cortisol, and urine vanillylmandelic acid, and catecholamine were all within normal limits. Laparoscopic right adrenalectomy was performed and adrenal cortical adenoma was diagnosed on a histological study.
      Citation: Journal of Clinical Imaging Science 2011 1(1):42-42
      PubDate: Wed,17 Aug 2011
      DOI: 10.4103/2156-7514.83928
      Issue No: Vol. 1, No. 1 (2011)
       
  • Temporal and Pontine Involvement in a Case of Herpes Simplex Encephalitis,
           Presenting as Kluver Bucy Syndrome - A Case Report

    • Authors: Suresh Thirunavukarasu
      Pages: 43 - 43
      Abstract: Suresh Thirunavukarasu

      Journal of Clinical Imaging Science 2011 1(1):43-43

      Bilateral temporal and frontal lobe involvement is a common characteristic of herpes simplex encephalitis (HSE). Clinical sequelae of herpes simplex encephalitis may manifest sometimes as Kluver Bucy syndrome (KBS). In herpes simplex encephalitis, apart from frontal lobe, extra temporal involvement is rare and uncommon. We report a case of HSE manifesting clinically as KBS with a rare radiological finding of temporal and extratemporal involvement of pons.
      Citation: Journal of Clinical Imaging Science 2011 1(1):43-43
      PubDate: Sat,27 Aug 2011
      DOI: 10.4103/2156-7514.84318
      Issue No: Vol. 1, No. 1 (2011)
       
  • Struma Ovarii with Papillary Thyroid Carcinoma

    • Authors: Daniel M Alvarez, Victor Lee, Shweta Bhatt, Vikram S Dogra
      Pages: 44 - 44
      Abstract: Daniel M Alvarez, Victor Lee, Shweta Bhatt, Vikram S Dogra

      Journal of Clinical Imaging Science 2011 1(1):44-44

      Struma ovarii is an uncommon condition, in which thyroid tissue is the predominant or exclusive element in an ovarian teratoma. Thyroid tissue may demonstrate the same spectrum of pathological features as in the normal thyroid including benign and malignant changes. We present a case of papillary thyroid carcinoma arising in a struma ovarii of the left ovary in a 21-year-old female.
      Citation: Journal of Clinical Imaging Science 2011 1(1):44-44
      PubDate: Sat,27 Aug 2011
      DOI: 10.4103/2156-7514.84322
      Issue No: Vol. 1, No. 1 (2011)
       
  • Computed Tomography Findings in Xanthogranulomatous Pyelonephritis

    • Authors: Arumugam Rajesh, George Jakanani, Nick Mayer, Kevin Mulcahy
      Pages: 45 - 45
      Abstract: Arumugam Rajesh, George Jakanani, Nick Mayer, Kevin Mulcahy

      Journal of Clinical Imaging Science 2011 1(1):45-45

      Background: Xanthogranulomatous pyelonephritis (XGN) is an uncommon condition characterized by chronic suppurative renal inflammation that leads to progressive parenchymal destruction. Purpose: To review the computed tomography (CT) findings of patients diagnosed with XGN. Materials and Methods: A retrospective review of CT findings in patients with histologically proven XGN was carried out. Results: Thirteen CT examinations of 11 patients were analyzed. Renal enlargement was demonstrable on the affected side in all patients. Nine patients (82%) had multiple dilated calyces and abnormal parenchyma. Six patients (55%) had a renal pelvis or upper ureteric calculus causing obstruction. Three patients (27%) had focal fat deposits identifiable within the inflamed renal parenchyma. Two patients had renal abscesses. Ten patients (91%) had extrarenal extension of the inflammatory changes. Three patients (27%) demonstrated extensive retroperitoneal inflammation. Conclusion: Unilateral renal enlargement and inflammation were the most consistent findings of XGN on CT. Perinephric inflammation and collections or abscess should also alert the radiologist to the possibility of this diagnosis.
      Citation: Journal of Clinical Imaging Science 2011 1(1):45-45
      PubDate: Sat,27 Aug 2011
      DOI: 10.4103/2156-7514.84323
      Issue No: Vol. 1, No. 1 (2011)
       
  • Imaging Findings in Chiari I Malformation with Syringomyelia in a Case of
           Charcot Shoulder

    • Authors: Shantanu Kumar, Vineet Sharma, Santosh Kumar, Sonal Jain
      Pages: 46 - 46
      Abstract: Shantanu Kumar, Vineet Sharma, Santosh Kumar, Sonal Jain

      Journal of Clinical Imaging Science 2011 1(1):46-46

      Neuropathic arthropathy of the shoulder is reported in only 5% of cases. Here, we report a rare case of neuropathic arthropathy of the shoulder, secondary to Chiari malformation Type I with associated syringomyelia, that remained undetected for four years. A 38-year-old female presented to our Department with a swelling over the right shoulder that had persisted for four years. X-ray of the joint showed destruction of the head of the right humerus, with typical blunt amputated appearance of the bone and increased joint space. Magnetic resonance imaging showed destruction and lateral dislocation of the head of the humerus. Large amount of fluid collection was seen in and around the right shoulder joint. Neuropathic osteoarthropathy can be defined as bone and joint changes that occurs secondary to loss of sensation. In our case, neuropathic shoulder joint was secondary to syringomyelia associated with Chiari I malformation.
      Citation: Journal of Clinical Imaging Science 2011 1(1):46-46
      PubDate: Wed,21 Sep 2011
      DOI: 10.4103/2156-7514.85173
      Issue No: Vol. 1, No. 1 (2011)
       
  • Congenital Agenesis of the Left Lung: A Rare Case

    • Authors: Tülin Durgun Yetim, Hanifi Bayarogullari, Hülya Polat Yalçin, Vefik Arica, Seçil Gunher Arica
      Pages: 47 - 47
      Abstract: Tülin Durgun Yetim, Hanifi Bayarogullari, Hülya Polat Yalçin, Vefik Arica, Seçil Gunher Arica

      Journal of Clinical Imaging Science 2011 1(1):47-47

      Pulmonary agenesis is a rare congenital anomaly, the etiology of which is not clearly known. Other systemic comorbidities such as cardiovascular, gastrointestinal, musculoskeletal, and urogenital system anomalies can be observed in more than half of the patients. It is usually diagnosed during childhood. Diagnosis in adulthood is very rare. We present a case of pulmonary agenesis diagnosed in an adult.
      Citation: Journal of Clinical Imaging Science 2011 1(1):47-47
      PubDate: Wed,21 Sep 2011
      DOI: 10.4103/2156-7514.85175
      Issue No: Vol. 1, No. 1 (2011)
       
  • Breast MR Imaging: What the Radiologist Needs to Know

    • Authors: Gurpreet S Dhillon, Nick Bell, Daniel T Ginat, Alena Levit, Stamatia Destounis, Avice O'Connell
      Pages: 48 - 48
      Abstract: Gurpreet S Dhillon, Nick Bell, Daniel T Ginat, Alena Levit, Stamatia Destounis, Avice O'Connell

      Journal of Clinical Imaging Science 2011 1(1):48-48

      Magnetic resonance imaging (MRI) of the breast is being performed more frequently to improve primary and recurrent tumor detection, characterization, and response to therapy. Sensitivity of this test approaches 90% and the specificity ranges from 37% to 100%. We present a concise tutorial for the general radiologist with a pictorial review of common lesions identified with breast MRI.
      Citation: Journal of Clinical Imaging Science 2011 1(1):48-48
      PubDate: Mon,3 Oct 2011
      DOI: 10.4103/2156-7514.85655
      Issue No: Vol. 1, No. 1 (2011)
       
  • Imaging Acute Appendicitis: State of the Art

    • Authors: Diana Gaitini
      Pages: 49 - 49
      Abstract: Diana Gaitini

      Journal of Clinical Imaging Science 2011 1(1):49-49

      The goal of this review is to present the state of the art in imaging tests for the diagnosis of acute appendicitis. Relevant publications regarding performance and advantages/disadvantages of imaging modalities for the diagnosis of appendicitis in different clinical situations were reviewed. Articles were extracted from a computerized database (MEDLINE) with the following activated limits: Humans, English, core clinical journals, and published in the last five years. Reference lists of relevant studies were checked manually to identify additional, related articles. Ultrasound (US) examination should be the first imaging test performed, particularly among the pediatric and young adult populations, who represent the main targets for appendicitis, as well as in pregnant patients. A positive US examination for appendicitis or an alternative diagnosis of possible gastrointestinal or urological origin, or a negative US, either showing a normal appendix or presenting low clinical suspicion of appendicitis, should lead to a final diagnosis. A negative or indeterminate examination with a strong clinical suspicion of appendicitis should be followed by a computed tomography (CT) scan or alternatively, a magnetic resonanace imaging (MRI) scan in a pregnant patient. A second US examination in a patient with persistent symptoms, especially if the first one was performed by a less experienced imaging professional, is a valid alternative to a CT.
      Citation: Journal of Clinical Imaging Science 2011 1(1):49-49
      PubDate: Fri,7 Oct 2011
      DOI: 10.4103/2156-7514.85778
      Issue No: Vol. 1, No. 1 (2011)
       
  • Multimodality Imaging of Normal Hepatic Transplant Vasculature and Graft
           Vascular Complications

    • Authors: Jeffrey H Roberts, Fernanda S Mazzariol, Susan J Frank, Sarah K Oh, Mordecai Koenigsberg, Marjorie W Stein
      Pages: 50 - 50
      Abstract: Jeffrey H Roberts, Fernanda S Mazzariol, Susan J Frank, Sarah K Oh, Mordecai Koenigsberg, Marjorie W Stein

      Journal of Clinical Imaging Science 2011 1(1):50-50

      Orthotopic liver transplantation is an important treatment option for patients with end-stage liver disease. Advances in surgical technique, along with improvements in organ preservation and immunosuppression have improved patient outcomes. Post-operative complications, however, can limit this success. Ultrasound is the primary imaging modality for evaluation of hepatic transplants, providing real-time information about vascular flow in the graft. Graft vascular complications are not uncommon, and their prompt recognition is crucial to allow for timely graft salvage. A multimodality approach including CT angiography, MRI, or conventional angiography may be necessary in cases of complex transplant vascular anatomy or when sonography and Doppler are inconclusive to diagnose the etiologies of these complications. The purpose of this article is to familiarize radiologists with the normal post-transplant vascular anatomy and the imaging appearances of the major vascular complications that may occur within the hepatic artery, portal vein, and venous outflow tract, with an emphasis on ultrasound.
      Citation: Journal of Clinical Imaging Science 2011 1(1):50-50
      PubDate: Tue,25 Oct 2011
      DOI: 10.4103/2156-7514.86665
      Issue No: Vol. 1, No. 1 (2011)
       
  • Non-Coronary Cardiac Findings and Pitfalls in Coronary Computed Tomography
           Angiography

    • Authors: Noriko Oyama-Manabe, Teppei Sugaya, Takayoshi Yamaguchi, Satoshi Terae
      Pages: 51 - 51
      Abstract: Noriko Oyama-Manabe, Teppei Sugaya, Takayoshi Yamaguchi, Satoshi Terae

      Journal of Clinical Imaging Science 2011 1(1):51-51

      Non-coronary incidental findings are not rare. Kirsch et al found 67% non-coronary abnormalities with coronary computed tomography angiography (CCTA). Radiologists are expected to identify the extracoronary, intra- and para-cardiac anatomical structures and distinguish them from pathologic processes in CCTA. We have reviewed 2000 CCTA studies done at our institution with 64-MDCT. This pictorial essay presents case studies of non-atherosclerotic cardiovascular findings to recognize cardiac anatomic structures and how to distinguish them from pathologic processes. Correct interpretation of benign, clinically insignificant findings is crucial to avoid unnecessary additional imaging tests.
      Citation: Journal of Clinical Imaging Science 2011 1(1):51-51
      PubDate: Tue,25 Oct 2011
      DOI: 10.4103/2156-7514.86666
      Issue No: Vol. 1, No. 1 (2011)
       
  • Paratesticular Solitary Plasmacytoma

    • Authors: Mehmet Ruhi Onur, Ben Wandtke, Jorge L Yao, Vikram S Dogra
      Pages: 52 - 52
      Abstract: Mehmet Ruhi Onur, Ben Wandtke, Jorge L Yao, Vikram S Dogra

      Journal of Clinical Imaging Science 2011 1(1):52-52

      Primary solid neoplasms of the extratesticular tissues are rare. The reported prevalence rate of paratesticular neoplasms is between 3% and 16% of all patients referred for scrotal ultrasonography. A plasmacytoma is a discrete, solitary mass of malignant monoclonal plasma cells that can arise in any part of the body. In this report, we present a case of a paratesticular solid mass detected in an 80-year-old patient that proved to be primary extraosseous plasmacytoma on surgery, and discuss its sonographic features.
      Citation: Journal of Clinical Imaging Science 2011 1(1):52-52
      PubDate: Tue,25 Oct 2011
      DOI: 10.4103/2156-7514.86667
      Issue No: Vol. 1, No. 1 (2011)
       
  • Assessing the Diagnostic Imaging needs for Five Selected Hospitals in
           Uganda

    • Authors: Michael G Kawooya, George Pariyo, Elsie Kiguli Malwadde, Rosemary Byanyima, Harrient Kisembo
      Pages: 53 - 53
      Abstract: Michael G Kawooya, George Pariyo, Elsie Kiguli Malwadde, Rosemary Byanyima, Harrient Kisembo

      Journal of Clinical Imaging Science 2011 1(1):53-53

      Introduction: Uganda has limited health resources. It is important to measure the need for imaging in order to set policy and plan for imaging services. Objectives: The first specific objective was to develop and apply four imaging needs indices on a case study basis, in five selected Ugandan hospitals. The indices were: Imaging Load (IL), Imaging Burden (IB), Type Specific Imaging Burden (TSIB), and Disease Specific Imaging Burden (DSIB). The second objective was to explore the perceptions of the patient, referring clinician, and radiologist regarding the values, meaning, and objective of imaging in patient care. Materials and Methods: This was a cross-sectional survey employing triangulation methodology, conducted in 5 Ugandan hospitals over a period of 3 years during 2005 - 2008. The subjects were divided into four clusters: Obstetrics and gynecology (obs/gynae), surgery, internal medicine, and pediatrics. For the quantitative component of the study, data from case notes was used to calculate the indices. The qualitative component explored the non-measurable aspects of imaging needs from the clinician's, radiologist's, and patient's perspective. Results: A total of 1961 patient case notes were studied. The IB was 460 per 1000 hospital patients per year. The highest TSIB was for ultrasound at 232 per 1000 hospital patients per year, followed by 191 patients for general X-ray. The majority of the patients interviewed had special desires, expectations, and misconceptions. Conclusions: There is a high IB of 460 per thousand patient populations per year, mainly due to ultrasound. The majority of the patients have perceptions, misconceptions, beliefs, and values which influence the need for imaging. There is a need to address the medical and non-tangible imaging needs of the patient and to counteract imaging-related misconceptions and over-expectations. Public awareness of the value, capabilities, limitations, and adverse effects of various imaging modalities need to be addressed to ensure that the patients make informed imaging choices and readily avail themselves of interventions in situations when imaging is crucial, for example in suspected high-risk pregnancy.
      Citation: Journal of Clinical Imaging Science 2011 1(1):53-53
      PubDate: Sat,19 Nov 2011
      DOI: 10.4103/2156-7514.90035
      Issue No: Vol. 1, No. 1 (2011)
       
  • Glandular Odontogenic Cyst of Maxilla

    • Authors: Yadavalli Guruprasad, Dinesh Singh Chauhan
      Pages: 54 - 54
      Abstract: Yadavalli Guruprasad, Dinesh Singh Chauhan

      Journal of Clinical Imaging Science 2011 1(1):54-54

      Glandular odontogenic cyst (GOC) is a rare developmental lesion that is considered a distinct entity because of its uncommon histopathological characteristics. It has morphological similarities to other lesions, which makes its diagnosis challenging for pathologists. It strikes distinct age groups, with an average patient age being 50 years. This lesion can involve either jaw, but the anterior region of the mandible is the most commonly affected area. It exhibits a tendency toward recurrence when conservative treatment is administered. It is believed that the low prevalence of GOC in the literature is due not only to its rarity, but also to the fact that its main characteristics are also found in other pathological entities. We report here radiologic-pathologic features of GOC of the maxilla in a 17-year-old female patient.
      Citation: Journal of Clinical Imaging Science 2011 1(1):54-54
      PubDate: Mon,21 Nov 2011
      DOI: 10.4103/2156-7514.90074
      Issue No: Vol. 1, No. 1 (2011)
       
  • Dermatofibrosarcoma Protuberans of the Scalp with Fibrosarcomatous
           Degeneration and Pulmonary Metastasis

    • Authors: Joseph L Gatlin, Richard Hosch, Majid Khan
      Pages: 55 - 55
      Abstract: Joseph L Gatlin, Richard Hosch, Majid Khan

      Journal of Clinical Imaging Science 2011 1(1):55-55

      Dermatofibrosarcoma protuberans is a rare locally aggressive cutaneous tumor of intermediate malignancy. It is a slow-growing neoplasm with a marked propensity to recur after resection. Head and neck involvement is unusual and distant metastases are quite rare but tend to be more frequent in tumors that undergo fibrosarcomatous degeneration. We present the imaging and corresponding histopathology in a case of dermatofibrosarcoma protuberans of the scalp demonstrating fibrosarcomatous degeneration and lung metastasis.
      Citation: Journal of Clinical Imaging Science 2011 1(1):55-55
      PubDate: Fri,2 Dec 2011
      DOI: 10.4103/2156-7514.90482
      Issue No: Vol. 1, No. 1 (2011)
       
  • Peripheral Osteoma of the Mandible

    • Authors: Hemant Shakya
      Pages: 56 - 56
      Abstract: Hemant Shakya

      Journal of Clinical Imaging Science 2011 1(1):56-56

      Osteomas of the facial bones are a rare entity and very few cases have been reported in the literature. Osteomas are benign neoplasms, often asymptomatic and consist of well-differentiated matured bone. There are three varieties of osteomas- the central type arising from the endosteum, the peripheral type arising from the periosteum, and the extra-skeletal soft tissue osteomas which usually develops within the muscle. In the facial bones, both central and peripheral osteomas have been described. Peripheral osteomas have been described to occur in the frontal, ethmoid, and maxillary sinuses, but are not common in jawbones. We describe a rare case of symptomatic peripheral osteoma of mandible in a middle-aged female patient.
      Citation: Journal of Clinical Imaging Science 2011 1(1):56-56
      PubDate: Fri,2 Dec 2011
      DOI: 10.4103/2156-7514.90483
      Issue No: Vol. 1, No. 1 (2011)
       
  • Paratesticular Liposarcoma: A Radiologic Pathologic Correlation

    • Authors: Ahmet Pergel, Ahmet Fikret Yucel, Ibrahim Aydin, Dursun Ali Sahin, Hasan Gucer, Ahmet Kocakusak
      Pages: 57 - 57
      Abstract: Ahmet Pergel, Ahmet Fikret Yucel, Ibrahim Aydin, Dursun Ali Sahin, Hasan Gucer, Ahmet Kocakusak

      Journal of Clinical Imaging Science 2011 1(1):57-57

      Spermatic cord liposarcoma is an uncommon paratesticular tumor. Patients usually present with a painless scrotal or inguinal mass, mimicking inguinal hernia. Clinical examination suggested an inguinal hernia. Computed tomography demonstrated a fat-containing mass in the right inguinal region. The mass was surgically removed, along with the right testis and spermatic cord. Histopathological examination revealed a well-differentiated liposarcoma. No evidence of recurrence or metastases has been noted during the two-year follow-up with postoperative adjuvant therapy.
      Citation: Journal of Clinical Imaging Science 2011 1(1):57-57
      PubDate: Sat,17 Dec 2011
      DOI: 10.4103/2156-7514.90952
      Issue No: Vol. 1, No. 1 (2011)
       
  • F-18 Fluorodeoxy Glucose Positron Emission Tomography/Computed Tomography
           Findings in a Rare Case of Penile Leiomyosarcoma

    • Authors: Kuruva Manohar, Bhagwant Rai Mittal, Raghava Kashyap, Anish Bhattacharya, Nandita Kakkar, Uttam Kumar Mete
      Pages: 58 - 58
      Abstract: Kuruva Manohar, Bhagwant Rai Mittal, Raghava Kashyap, Anish Bhattacharya, Nandita Kakkar, Uttam Kumar Mete

      Journal of Clinical Imaging Science 2011 1(1):58-58

      Penile cancer is a rare entity accounting for only 0.4% all male malignancies. Penile leiomyosarcomas are even rarer with only around 35 cases reported in literature. We report a rare case of penile leiomyosarcoma illustrating F-18 Fluorodeoxy glucose (FDG) positron emission tomography/computed tomography (PET/CT) features and histopathology correlation.
      Citation: Journal of Clinical Imaging Science 2011 1(1):58-58
      PubDate: Sat,17 Dec 2011
      DOI: 10.4103/2156-7514.90955
      Issue No: Vol. 1, No. 1 (2011)
       
  • Ellis Van Creveld Syndrome with Synpolydactyly, an Antenatal Diagnosis
           with Postnatal Correlation

    • Authors: Nischal G Kundaragi, Kishor Taori, Ritesh Kumawat, Jawahar Rathod, Atul E Sawant
      Pages: 59 - 59
      Abstract: Nischal G Kundaragi, Kishor Taori, Ritesh Kumawat, Jawahar Rathod, Atul E Sawant

      Journal of Clinical Imaging Science 2011 1(1):59-59

      Ellis Van Creveld syndrome (EVC), also known as chondroectodermal dysplasia, presents at birth with short limbs accompanied by postaxial polydactyly, nail dysplasia, and dental anomalies. Other manifestations of EVC include atrial septum defects and other congenital heart diseases. We report a case of the EVC syndrome with postaxial polydactyly (Synpolydactyly with seven fingers on the right side and hexadactyly on the left side) and a partial atrioventricular canal defect diagnosed antenatally. This variation of EVS has not been reported in English literature till date.
      Citation: Journal of Clinical Imaging Science 2011 1(1):59-59
      PubDate: Sat,24 Dec 2011
      DOI: 10.4103/2156-7514.91132
      Issue No: Vol. 1, No. 1 (2011)
       
  • Left Internal Carotid Artery Agenesis Associated with Basilar and Left
           Vertebral Artery Aneurysm

    • Authors: Lale Pasaoglu, Murat Vural, Ipek Ziraman, Sadik Ahmet Uyanik
      Pages: 60 - 60
      Abstract: Lale Pasaoglu, Murat Vural, Ipek Ziraman, Sadik Ahmet Uyanik

      Journal of Clinical Imaging Science 2011 1(1):60-60

      Agenesis of the internal carotid artery (ICA) is a rare congenital anomaly. Most of the patients are asymptomatic and it is usually discovered incidentally by computed tomography (CT) or magnetic resonance imaging (MRI). There is close association of the cranial aneurysms and subarachnoid hemorrhage with ICA agenesis. We present a case of a 61-year-old male with left ICA agenesis associated with basilar artery and left vertebral artery aneurysms. The patient complained of headaches and numbness on the right-side of the face. Physical examination showed high blood pressure (210/90 mmHg). Neurological examination revealed nystagmus and decreased sensation on the right-side of the face. Agenesis of left ICA, left carotid canal with basilar and left vertebral artery aneurysms were demonstrated incidentally using CT, MRI, and digital subtraction angiography, as a part of an evaluation for suspected cerebrovascular accident.
      Citation: Journal of Clinical Imaging Science 2011 1(1):60-60
      PubDate: Sat,24 Dec 2011
      DOI: 10.4103/2156-7514.91133
      Issue No: Vol. 1, No. 1 (2011)
       
  • Plexiform Ameloblastoma of the Mandible

    • Authors: Dinesh Singh Chauhan, Yadavalli Guruprasad
      Pages: 61 - 61
      Abstract: Dinesh Singh Chauhan, Yadavalli Guruprasad

      Journal of Clinical Imaging Science 2011 1(1):61-61

      Ameloblastoma is a common and aggressive odontogenic epithelial tumor. It has an aggressive behavior and recurrent course, and is rarely metastatic. Ameloblastoma represents 1% of all tumors and cysts that involve the maxillomandibular area and about 10% of the odontogenic tumors. It is primarily seen in adults in the third to fifth decade of life, with equal sex predilection. Radiographically, it appears as an expansile radiolucent, with thinned and perforated cortices, and is known to cause root resorption. As it shares common radiographic features with other lesions such as the giant cell tumor, aneurismal bone cyst, and renal cell carcinoma metastasis, a definitive diagnosis can only be made with histopathology. We present an extensive case of plexiform ameloblastoma of the mandible in a 42-year-old female patient.
      Citation: Journal of Clinical Imaging Science 2011 1(1):61-61
      PubDate: Sat,24 Dec 2011
      DOI: 10.4103/2156-7514.91134
      Issue No: Vol. 1, No. 1 (2011)
       
  • Bronchial Artery Arising from the Left Vertebral Artery: Case Report and
           Review of the Literature

    • Authors: Timothy J Amrhein, Charles Kim, Tony P Smith, L Washington
      Pages: 62 - 62
      Abstract: Timothy J Amrhein, Charles Kim, Tony P Smith, L Washington

      Journal of Clinical Imaging Science 2011 1(1):62-62

      Knowledge of bronchial artery anatomy, including the possible locations of anomalous origin, is essential for complete catheter directed embolization for massive hemoptysis. Undetected anomalous bronchial arteries can be a source of failed bronchial artery embolization. We report a case of a common trunk bronchial artery arising from the left vertebral artery and review standard and variant bronchial artery anatomy.
      Citation: Journal of Clinical Imaging Science 2011 1(1):62-62
      PubDate: Sat,24 Dec 2011
      DOI: 10.4103/2156-7514.91135
      Issue No: Vol. 1, No. 1 (2011)
       
  • New Aspirations

    • Authors: Vikram Dogra
      Pages: 63 - 63
      Abstract: Vikram Dogra

      Journal of Clinical Imaging Science 2011 1(1):63-63


      Citation: Journal of Clinical Imaging Science 2011 1(1):63-63
      PubDate: Sat,24 Dec 2011
      DOI: 10.4103/2156-7514.91136
      Issue No: Vol. 1, No. 1 (2011)
       
  • Adenomatoid Odontogenic Tumor &#8722; A Report of Two Cases with
           Histopathology Correlation

    • Authors: Pavitra Baskaran, Satyaranjan Misra, M Sathya Kumar, R Mithra
      Pages: 64 - 64
      Abstract: Pavitra Baskaran, Satyaranjan Misra, M Sathya Kumar, R Mithra

      Journal of Clinical Imaging Science 2011 1(1):64-64

      Adenomatoid odontogenic tumor (AOT) is an uncommon, hamartomatous, benign, epithelial lesion of odontogenic origin that was first described by Driebaldt in 1907, as a pseudo-adenoameloblastoma. The current World Health Organisation (WHO) classification of odontogenic tumors defines AOT as being composed of the odontogenic epithelium in a variety of histoarchitectural patterns, embedded in mature connective tissue stroma, and characterized by slow, but progressive growth. The current article reports two cases with different presentations; first in a young female patient and the second in a middle-aged male patient. The importance of biopsy, which is the gold standard for diagnosis, and its use in planning of the treatment is discussed.
      Citation: Journal of Clinical Imaging Science 2011 1(1):64-64
      PubDate: Sat,31 Dec 2011
      DOI: 10.4103/2156-7514.92186
      Issue No: Vol. 1, No. 1 (2011)
       
  • Gardner's Syndrome

    • Authors: Sapna Panjwani, Anjana Bagewadi, Vaishali Keluskar, Saurabh Arora
      Pages: 65 - 65
      Abstract: Sapna Panjwani, Anjana Bagewadi, Vaishali Keluskar, Saurabh Arora

      Journal of Clinical Imaging Science 2011 1(1):65-65

      Gardner's syndrome is an autosomal dominant disease and is a subtype of familial adenomatous polyposis. It is characterized by adenomatous intestinal polyps, multiple osteomas in the skull, maxillae, mandible, and multiple cutaneous and subcutaneous masses (epidermoids and desmoid). Intestinal polyps, if not treated, have 100% chance of becoming malignant. We report a case of a 25-year-old female patient with Gardner's syndrome, with clinical manifestations including impacted supernumerary teeth, odontomes, sebaceous cyst on the scalp, and osteomas. It is important for the general dental practitioners to be aware of the clinical and radiological characteristics of Gardner's syndrome.
      Citation: Journal of Clinical Imaging Science 2011 1(1):65-65
      PubDate: Sat,31 Dec 2011
      DOI: 10.4103/2156-7514.92187
      Issue No: Vol. 1, No. 1 (2011)
       
  • New Horizons

    • Authors: Vikram Dogra
      Pages: 1 - 1
      Abstract: Vikram Dogra

      Journal of Clinical Imaging Science 2011 1(1):1-1


      Citation: Journal of Clinical Imaging Science 2011 1(1):1-1
      PubDate: Fri,3 Dec 2010
      DOI: 10.4103/2156-7514.73499
      Issue No: Vol. 1, No. 1 (2010)
       
  • Cystic Duct Remnant Syndrome

    • Authors: Eranga Perera, Shweta Bhatt, Vikram S Dogra
      Pages: 2 - 2
      Abstract: Eranga Perera, Shweta Bhatt, Vikram S Dogra

      Journal of Clinical Imaging Science 2011 1(1):2-2

      Post-cholecystectomy syndrome (PCS) is a common manifestation in patients with cholecystectomy. The patients exhibit a heterogeneous group of symptoms, such as upper abdominal pain, vomiting, gastrointestinal disorders, jaundice, and dyspepsia. Choledocholithiasis, biliary dyskinesia, and dilation of cystic duct remnants are common causes of these symptoms. The symptoms can recur after a symptom-free period following cholecystectomy or they can persist after surgery. Ultrasonography, computed tomography (CT), and magnetic resonance imaging scan, which are non-invasive methods of imaging, have a high sensitivity in detecting the causes of PCS. We report a case of an 84-year-old lady who came to the Ultrasound Department with recurrent episodes of abdominal pain following cholecystectomy. The gray-scale sonography showed a dilated cystic structure, which was confirmed as the duct remnant in follow-up contrast-enhanced CT.
      Citation: Journal of Clinical Imaging Science 2011 1(1):2-2
      PubDate: Fri,3 Dec 2010
      DOI: 10.4103/2156-7514.73500
      Issue No: Vol. 1, No. 1 (2010)
       
  • Unusual Case of Gunshot Injury to the Face

    • Authors: Yadavalli Guruprasad, Girish Giraddi
      Pages: 3 - 3
      Abstract: Yadavalli Guruprasad, Girish Giraddi

      Journal of Clinical Imaging Science 2011 1(1):3-3

      An unusual case of facial gunshot injury with the missile lodged in the cervical spine region, but without any neurological impairment, is reported. The extent of tissue damage and missile track termination in a male patient who sustained gunshot trauma to the face was assessed by plain radiography and by computed tomography scans. The patient was treated conservatively and observed for clinical manifestations of neurological deficit for one year. We present a case of gunshot injury to the face with the missile lodged in the cervical spine region and atypical absence of clinical manifestation that may occur even when a bullet remains in the vicinity of the cervical spine.
      Citation: Journal of Clinical Imaging Science 2011 1(1):3-3
      PubDate: Fri,3 Dec 2010
      DOI: 10.4103/2156-7514.73501
      Issue No: Vol. 1, No. 1 (2010)
       
  • Bilateral Testicular Epidermoid Cysts

    • Authors: Norman Loberant, Shweta Bhatt, Edward Messing, Vikram S Dogra
      Pages: 4 - 4
      Abstract: Norman Loberant, Shweta Bhatt, Edward Messing, Vikram S Dogra

      Journal of Clinical Imaging Science 2011 1(1):4-4

      Testicular epidermoid cysts are the most common benign tumors of the testes, but account for only 1-2% of all testicular tumors. In a young man presenting with a testicular mass, a high index of suspicion must be maintained for the malignant testicular germ cell tumor, which is 50-times more common than testicular epidermoid cyst. Bilateral testicular epidermoid cysts are a very rare condition, with only a few reports in the literature. It is extremely important in this condition to make a correct pre-operative diagnosis on imaging to enable a testis-sparing surgery.
      Citation: Journal of Clinical Imaging Science 2011 1(1):4-4
      PubDate: Fri,3 Dec 2010
      DOI: 10.4103/2156-7514.73502
      Issue No: Vol. 1, No. 1 (2010)
       
  • Sonographic Spectrum of Tunica Albuginea Cyst

    • Authors: Daniel M Alvarez, Shweta Bhatt, Vikram S Dogra
      Pages: 5 - 5
      Abstract: Daniel M Alvarez, Shweta Bhatt, Vikram S Dogra

      Journal of Clinical Imaging Science 2011 1(1):5-5

      Tunica albuginea (TA) cyst is the most common extratesticular benign mass, which is usually palpable. Ultrasound examination is the imaging modality of choice to characterize palpable testicular lesions. This pictorial essay presents the spectrum of sonographic features of TA cysts in order to assist radiologists in making the correct diagnosis and avoid unnecessary surgeries.
      Citation: Journal of Clinical Imaging Science 2011 1(1):5-5
      PubDate: Fri,3 Dec 2010
      DOI: 10.4103/2156-7514.73503
      Issue No: Vol. 1, No. 1 (2010)
       
  • Sonography in the Diagnosis and Assessment of Dengue Fever

    • Authors: VR Santhosh, Prashanth G Patil, MG Srinath, Ashok Kumar, Aditi Jain, M Archana
      Pages: 14 - 14
      Abstract: VR Santhosh, Prashanth G Patil, MG Srinath, Ashok Kumar, Aditi Jain, M Archana

      Journal of Clinical Imaging Science 2014 4(1):14-14

      Objective: The objective of the following study is to determine the use of ultrasound as an important adjunct to clinical and laboratory profile in diagnosing dengue fever and in predicting the severity of the disease by correlating imaging features with platelet count. The variation in sonographic features seen in patients from different age groups was also studied. Materials and Methods: This is a retrospective study. 96 patients who were serologically diagnosed as having dengue fever between April and August 2012 were referred for ultrasound scanning of the abdomen and thorax and the imaging findings were analyzed. Results: Out of 96 sero-positive dengue cases, 64 (66.7%) patients showed edematous gallbladder (GB) wall thickening, 62 (64.5%) patients showed ascites, 48 (50%) patients had pleural effusion, 17 (17.7%) patients had hepatomegaly, 16 (16.7%) patients had splenomegaly and in 17 (17.7%) patients ultrasound findings were normal. Edematous GB wall thickening, ascites and pleural effusion were the most common combination of findings in all age groups. Edematous GB wall thickening was seen in 97.8% of patients with platelet count of less than 40,000 along with ascites (86.9%) and pleural effusion (58.6%). In patients with platelet count between 40,000 and 80,000 ascites was more common than edematous GB wall thickening. Significantly no abnormal sonographic finding was detected in patient with platelet count more than 150,000. Conclusion: Sonographic features of thickened GB wall, pleural effusion (bilateral or right side), ascites, hepatomegaly and splenomegaly should strongly favor the diagnosis of dengue fever in patients presenting with fever and associated symptoms, particularly during an epidemic. The degree of thrombocytopenia showed a significant direct relationship to abnormal ultrasound features.
      Citation: Journal of Clinical Imaging Science 2014 4(1):14-14
      PubDate: Mon,1 Jan 1900
      DOI: 10.4103/2156-7514.129260
      Issue No: Vol. 4, No. 1 (1900)
       
  • A Rare Case of Oropharyngeal Teratoma Diagnosed Antenatally with MRI

    • Authors: Murali Mohan Manchali, Chandrahasa Sharabu, Meher Latha, Leela Kumar
      Pages: 15 - 15
      Abstract: Murali Mohan Manchali, Chandrahasa Sharabu, Meher Latha, Leela Kumar

      Journal of Clinical Imaging Science 2014 4(1):15-15

      Oropharyngeal teratomas are extremely rare congenital tumors and have an incidence rate of one in 35,000-200,000 newborn babies/neonates. Oropharyngeal teratomas may cause life threatening airway obstruction to a newborn. Early diagnosis with ultrasound and magnetic resonance imaging (MRI) is essential to plan management. Here, we present a rare case of oropharyngeal true teratoma diagnosed with MRI antenatally in a fetus at 34 weeks of gestation in a 25-year-old female who was being evaluated for polyhydraminos. We found MRI to be more helpful for antenatal diagnosis, counseling, and management than ultrasonography and computed tomography (CT).
      Citation: Journal of Clinical Imaging Science 2014 4(1):15-15
      PubDate: Mon,1 Jan 1900
      DOI: 10.4103/2156-7514.129261
      Issue No: Vol. 4, No. 1 (1900)
       
 
 
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