Iranian Journal of Radiology
Volume:3 Issue: 4, Summer 2006

Background/ Doppler sonography is a valuable noninvasive method for the diagno-sis of various liver diseases. However, there is scarce information on normal parameters of hepatic artery (HA) and portal vein (PV) in Iran. This study was conducted to assess normal Doppler indices of HA and PV in normal Iranian population. Patients and In this cross-sectional study, 37 (18 female, 19 male) healthy volun-teers aged 20-40 years underwent Doppler sonography after 8 hours of fasting. PV was as-sessed at crossing point with inferior vena cava in normal respiration and HA in the hepatic hilum. The meanSD PV diameter was 9.361.65 mm. The meanSD maximum, and mean velocity of PV were 35.2816.54 and 27.31713.139, respectively. The meanSD peak systolic velocity and resistance index of HA were 67.6433.48 and 0.760.07, respectively. Normal Doppler parameters of HA and PV depend on different factors like gender, respiratory phase and technique of measurement and there is no uniform standard technique for these measurements. These factors must be considered when using Doppler parameters for diagnosis of liver disease.

Hydatid disease is one of the commonest parasitic infections of the liver, rupture of which into the peritoneal cavity leads to secondary echinococcosis. Seventy percent of hydatid disease cases occur in the liver, although any organ may be involved. A case of omental and retroperitoneal hydatid disease along with the hydatid cyst of the liver is present.

Background/ Patients with concomitant coronary artery disease and carotid artery disease are at risk of developing serious neurologic events in pre- and post-coronary artery bypass graft (CABG) operation. The objective of this study was to determine the carotid Doppler ultrasonography findings in candidates for CABG. Patients and Between September 2004 and October 2005, we performed pre-operative Doppler study of carotid vessels in all candidates for CABG admitted to our hospital. We evaluated the level of stenosis, and the type, site and nature of the plaque for all patients according to the Nicoladis guideline. MeanSD age of patients studied was 67.58.6 (range: 29–84) years. Among 352 patients undergoing CABG, 143 (40.3%) had carotid disease. Stenosis 50% was observed in 10.5% of females and 5% of males (P=0.07). Significant stenosis (≥50%) was seen in 32 (9.1%) of patients, while 13 (3.8%) had critical stenosis (≥70%); 2 (0.6%) had complete occlusion of the left internal carotid artery. The prevalence of carotid stenosis and atherosclerotic plaques was higher in patients aged <60 years (P=0.002). The frequency of carotid stenosis in our patients is similar to other reports. Age is the important associated factor for carotid artery disease in candidates of CABG.

Objective/ CT scan of paranasal sinuses (PNS) has replaced the standard plain radiography in patients suspected of sinusitis. Since the standard CT scan (SCT) of PNS has high patient x-ray absorption dose, limited CT scan (LCT) of PNS is performed. The purpose of this study is to assess the diagnostic accuracy rate of PNS LCT in cases suspected of sinusitis. Patients and This cross-sectional study was performed on 120 patients with para-nasal sinuses SCT requested by clinicians to diagnose sinusitis. After interpretation of paranasal sinuses SCT, limited slices consisting of 5 noncontiguous slices of 5 mm thickness in both axial and coronal plains were selected to be interpreted by another radiologist. In this study paranasal sinuses LCT had a sensitivity of 95%, specificity of 92%, positive predictive value (PPV) of 96% and negative predictive value (NPV) of 90%. The limited CT scan in diagnosis of sinusitis has acceptable sensitivity and speci-ficity which indicates a suitable diagnostic value.

This case report documents one of the more unusual causes of a facial swelling in the preauricular and buccal region, post-traumatic parotid sialocele. Facial lacerations are common injuries; however, parotid gland involvement and, in particular, ductal transection is relatively uncommon and only 0.2% of such patients have a parotid gland injury. A sialocele typically develops 8 to 14 days after the injury but in our case, the presentation was delayed (8 months after trauma). Sialography can play a significatnt role in the diagnosis of sialocele by indicating the extent of parotid duct injury. We describe a 17–year– old girl with progressive marked facial swelling in the left parotid and buccal area with past history of penetrating facial injury. Using text and images, we detail our diagnostic management. This case report illustrates the relationship of trauma to sialocele formation, while suggesting that sialography shoud be done in oral, neck and face masses suspected to be related to salivary ducts. Post-traumatic parotid sialocele should be considered in the differential diagnosis for any post-traumatic facial or high neck swelling.

Background/ Because of the inherent danger and associated discomfort of invasive procedures such as colonoscopy or double contrast barium enema involving exposure to ra-diation, we studied the value of hydrocolonic sonography in the diagnosis of colorectal polyps in children with rectal bleeding. Patients and From March 2005 to January 2006, 46 children from 2.5-11 years of age presented with hematochezia were examined by means of hydrocolonic sonography and colonoscopy. On colonoscopy, 21 patients had normal results, 19 had polyps, 3 had proctitis, 2 had lymphonodular hyperplasia and 1 had anal fissure. Only 7 of 19 colorectal polyps were diagnosed by conventional abdominal sonography (37%), whereas hydrocolonic sonography permitted the diagnosis of 17 (89.5%) with a specificity equal to 92.5%. In comparison with colonoscopy, positive predictive value of hydrocolonic sonography was 89.4% and negative predictive value was 92.5%. Hydrocolonic sonography is a accurate and safe approach to evaluating children with rectal bleeding. Thus, it can be regarded as an appropriate replacement of barium enema.

Mandibuloacral dysplasia (MAD) is a rare autosomal recessive syndrome. Less than 25 families have been reported, most of which are Italian. Here, we describe a new patient of Iranian origin, born to consanguineous parents.

Background/ The brain response to temporal frequencies (TF) has been already reported. However, there is no study on different TF with respect to various spatial frequencies (SF). Functional magnetic resonance imaging (fMRI) was done by a 1.5 T General Electric system for 14 volunteers (9 males and 5 females, aged 19–26 years) during square-wave reversal checkerboard visual stimulation with different temporal frequencies of 4, 6, 8 and 10 Hz in 2 states of low SF of 0.4 and high SF of 8 cycles/degree (cpd). All subjects had normal visual acuity of 20/20 based on Snellen’s fraction in each eye with good binocular vision and normal visual field based on confrontation test. The mean luminance of the entire checkerboard was 161.4 cd/m2 and the black and white check contrast was 96%. The activation map was created using the data obtained from the block designed fMRI study. Pixels with a Z score above a threshold of 2.3, at a statistical significance level of 0.05, were considered activated. The average percentage blood oxygenation level dependent (BOLD) signal change for all activated pixels within the occipital lobe, multiplied by the total number of activated pixels within the occipital lobe, was used as an index for the magnitude of the fMRI signal at each state of TF&SF. The magnitude of the fMRI signal in response to different TF’s was maximum at 6 Hz for a high SF value of 8 cpd; it was however, maximum at a TF of 8 Hz for a low SF of 0.4 cpd. The results of this study agree with those of animal invasive neurophysiologic studies showing SF and TF selectivity of neurons in visual cortex. These results can be useful for vision therapy and selecting visual tasks in fMRI studies.

Although patients with systemic lupus erythematosus (SLE) have a high incidence of arterial and venous thrombotic manifestations, intrarenal microaneurysms have been quite rarely reported in these patients, and are probably unrecognized. We report a case of SLE which was complicated with huge retroperitoneal hemorrhage due to rupture of pseudoaneurysm following renal biopsy, associated with multiple microaneurysms. On angiography, multiple microaneu-rysms of the intralobular arteries and bleeding from the lower pole renal pseudoaneurysm were seen, which was embolized with gel foam. This case represents an unusual presentation of SLE.