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Iranian Journal of Radiology - Volume:7 Issue: 1, Spring 2010

Iranian Journal of Radiology
Volume:7 Issue: 1, Spring 2010

  • تاریخ انتشار: 1389/04/12
  • تعداد عناوین: 6
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  • M. Amoui, E. Pirayesh, Sh. Akhlaghpoor, M. Khorrami, Sh. Tolooee, H. Poorbeigi, Sh. Sheibani Page 1
    Background/
    Objective
    Radioembolization (RE) is a minimally invasive transcatheter therapy through which radioactive microspheres are infused into the hepatic arteries and selectively implanted within the tumor arterioles. Some therapeutic agents are particles incorporating pure β emitter elements (90Y, 32P) and do not have gamma radiation. Bremsstrahlung imaging of these radiotherapeutic agents confirms distribution of the radiotracer in hepatic tumors or probable extrahepatic deposition of radiopharmaceuticals and helps the physician to predict the patient''s response to RE therapy. The aim of this study was demonstration of 32P images and its correlation with CT/MRI findings.Patients and
    Methods
    Ten patients with variable types of hepatic tumors treated with intra-arterial injection of 32P were included in this study. 24-72 hours after radiotracer administration, bremsstahlung SPECT imaging was performed in all patients with a single head gamma camera equipped with a medium energy collimator. Energy window setting of 100 keV±25% was selected. Reconstructed images were evaluated by two nuclear medicine specialists and one radiologist, and based on compatibility of 32P images with CT/MRI, a grading scale from 1 to 4 was used to express their correlations.
    Results
    By selecting optimized parameters for bremsstrahlung SPECT images of 32P, we could obtain good quality images. In nine patients, 32P distribution in the liver was correlated with anatomical findings of CT/MRI.
    Conclusion
    RE is appropriate to deliver high radiation doses to liver tumors with minimal accumulation in the normal liver tissue. Bremsstrahlung imaging is a useful method to confirm proper distribution of the radiotherapeutic agent, which has good correlation with anatomical findings.
  • C. Yilmaz, A. Nart, A. Uslu, A. Aykas Page 7
    Splenic arteriovenous fistulas (AVFs) are rare lesions. Herein, we report a 40-year-old man with portal hypertension secondary to splenic AVF, which was primarily diagnosed by color Duplex sonography. Sonography revealed a non-pulsatile, cyst-like mass at the splenic hilum with an unusual comma-shaped extension. In color duplex sonography, complete color fill-in of the lesion with the characteristic reversed red and blue color flow (Yin-Yang pattern) was observed. Duplex Doppler interrogation of the AVF revealed high velocity low-impedance arterial flow and moderately pulsatile venous flow within the lateral and medial part of the lesion, respectively. The comma-like extension demonstrated a low-resistance arterial waveform with very high peak systolic velocity. Based on these findings, a diagnosis of splenic AVF was made which was confirmed at surgery. Special emphasis was made on sonographic findings enabling the correct diagnosis.
  • A. Mohammadi Page 23
    Despite advances in imaging techniques, the detection of retained wooden foreign bodies remains a difficult and challenging task. The detection of wood is especially important because it may serve as a nidus for superimposed infection. The initial examination may mimic malignancy. We report a rare case of retained wooden foreign body in the lung parenchyma, which was found on CXR and CT as a thick-walled cavity. Surgical resection was performed and the wooden particle was removed. Review of literature shows that wooden foreign bodies in the lung parenchyma are quite rare and they may present with a wide variety of density. We conclude that foreign body should be considered in the differential diagnosis of unusual lung opacity.
  • S. Nikzad, A. Azari, F. Hossein Khezri Page 27
    The lingual mandibular bone defect, which is also known as Stafne’s bone defect, is a rare entity commonly affecting the posterior lingual part of the mandible. Although this lesion usually contains normal connective tissue compartments, it may be misinterpreted as tumor like lesions. In this manuscript, based on the density analysis of the CT images and through use of a simplified quantification system, a novel approach has been introduced which attempts to differentiate the benign nature of the defect.
  • H. Mazaher, F. Farahmand, F. Khanali, S.M. Vaziri Bozorg, A.R. Ghasemi Esfe, F.E. Mahjoub, A. Roohi, M. Mehdizadeh Page 31
    Background/
    Objective
    There is no report about the relationship between the thickness of gastric wall layers measured with transabdominal ultrasonography and the presence of gastritis or Helicobacter pylori infection. The aim of this study was to assess the accuracy of sonography in diagnosis of gastritis and Helicobacter pylori infection.Patients and
    Methods
    One-hundred children aged 1 to 15 years who needed upper gastrointestinal endoscopy and biopsy because of suspected gastritis underwent transabdominal ultrasonography to measure thickness of different layers of the stomach antrum and duodenal bulb wall. The wall layer thickness was compared with the results of endoscopy for gastritis and the presence of Helicobacter pylori infection.
    Results
    The mean thickness of muscularis mucosa and the sum of muscularis mucosa and submucosa in both gastric antrum and duodenal bulb were significantly higher in patients with Helicobacter pylori infection than those without infection (mean thickness in gastric an-trum: 0.65±0.25mm vs. 0.53±0.19mm [p-value=0.03] and 1.21±0.35mm vs. 1.07±0.26mm [p-value=0.03], respectively; mean thickness in duodenal bulb: 0.69±0.32mm vs. 0.48±0.20mm [p-value=0.001] and 1.25±0.35mm vs. 0.99±0.28mm [p-value=0.002], respectively). The mean thickness of muscularis mucosa plus submucosa in the duodenal bulb was also more in patients with gastritis (1.09±0.35mm vs. 0.95±0.20mm [p-value=0.02]). Several cut points were determined to predict the results of endoscopy.
    Conclusion
    Transabdominal ultrasonography is a noninvasive and easily available method in evaluating children with suspected gastritis and predicting some findings of endoscopic evaluations.
  • H. Rokni Yazdi, M. Mirjalili, M.R. Noroozi Page 37
    Background/
    Objective
    To determine the usefulness of twinkling artifact in detecting urinary stones by sonography according to stone characteristics and sonographic features.Patients and
    Methods
    A prospective study was conducted on 60 urinary stones which had been detected by KUB, IVP or CT scan. First of all, gray scale sonography was performed using 3.5-5 MHz phased array and data including stone size, location and posterior shadow were registered. Then, presence or absence of twinkling artifact and its intensity with respect to different filters (0-3), pulse repetition frequencies (PRF) (244, 1563, and 4864 Hz), and focal zones (at the level of the stone, lower and higher) was assessed using color Doppler sonography. Finally and in the case of artifact presence, spectral Doppler sonographywas performed. For data analysis, χ2 and independent t test was used.
    Results
    The prevalence of twinkling artifact was 78.3%. Artifact presence in a PRF value of 1563 Hz was significantly related to the echo difference between stone and adjacent tissues (p= 0.001).
    Conclusion
    The above findings together with the fact that twinkling artifact was strongly present in more than half the cases, indicates the sufficiency in detecting urinary stones.