Iranian Journal of Radiology
Volume:8 Issue: 3, Sep 2011

Conventional angiography, generally referred to as intra-arterial digital subtraction angiography, still remains the gold standard reference method for the diagnosis of intracranial aneurysms, helical computed tomography angiography (CTA) is a new non-invasive volumetric imaging method. This study was conducted to screen patients presenting with subarachnoidhemorrhage by CTA before conventional digital subtraction angiography (DSA) and subsequently comparing the results for various aneurysm projections.Patients and In a prospective study, 99 consecutive patients with an initial diagnosis of subarachnoid hemorrhage were screened for aneurysms with CTA followed by conventional DSA. There were 17 cases with negative angiograms in whom repeat angiograms, three months later were negative for 15 cases, while two cases were found to bear aneurysm on the repeat examination. Eighty two patients had at least one proven aneurysm on initial DSA and two on the repeat angiogram. Out of 84 patients, five underwent endovascular treatment and 79 patients who underwent surgical clipping were considered for projection evaluation. Sensitivity of CTA was 98.78% (95% confidence interval [CI], 93.4-99.7%), while the specificity was 100% (95% CI, 81.57-100%) and the kappa coefficient of agreement between CTA and DSA was 96.5%. The most significant discrepancies with DSA findings were for visualizing the projection of inferior and posterior projecting proximal anterior circulation aneurysms. Helical CTA was in good concordance with DSA for screening of cerebral aneurysms; however, for exact visualization of the aneurysm neck and its projection, especially if it is inferior or posterior, DSA remains the gold standard..

Lung masses are often difficult to differentiate when their clinical symptoms and shapes or densities on computed tomography (CT) images are similar. However, with different pathological contents, they may appear differently on plain and enhanced CT. To determine the value of enhanced CT for the differential diagnosis of lung masses based on the differences in radiodensity with and without enhancement.Patients and Thirty-six patients with lung cancer, 36 with pulmonary tuberculosis (TB) and 10 with inflammatory lung pseudotumors diagnosed by CT and confirmed by pathology in our hospital were selected. The mean ± SD radiodensities of lung masses in the three groups of patients were calculated based on the results of plain and enhanced CT. There were no significant differences in the radiodensities of the masses detected by plain CT among patients with inflammatory lung pseudotumors, TB and lung cancer (P > 0.05). However, there were significant differences (P < 0.01) between all the groups in terms of radiodensities of masses detected by enhanced CT. The radiodensities of lung masses detected by enhanced CT could potentially be used to differentiate between lung cancer, pulmonary TB and inflammatory lung pseudotumors..

Uterine fibroids are common benign tumors of the female pelvis. Uterine artery embolization (UAE) is an effective treatment of symptomatic uterine fibroids by shrinkage of the size of these tumors. Segmentation of the uterine region is essential for an accurate treatment strategy. In this paper, we will introduce a new method for uterine segmentation in T1W and enhanced T1W magnetic resonance (MR) images in a group of fibroid patients candidated for UAE in order to make a reliable tool for uterine volumetry.Patients and Uterine was initially segmented using Fuzzy C-Mean (FCM) method in T1W-enhanced images and some morphological operations were then applied to refine the initial segmentation. Finally redundant parts were removed by masking the segmented region in T1W-enhanced image over the registered T1W image and using histogram thresholding. This method was evaluated using a dataset with ten patients’ images (sagittal, axial and coronal views). We compared manually segmented images with the output of our system and obtained a mean similarity of 80%, mean sensitivity of 75.32% and a mean specificity of 89.5%. The Pearson correlation coefficient between the areas measured by the manual method and the automated method was 0.99. The quantitative results illustrate good performance of this method. By uterine segmentation, fibroids in the uterine may be segmented and their properties may be analyzed.

Central nervous system (CNS) involvement has been observed in 14-80% of patients with systemic lupus erythematosus (SLE). Magnetic resonance imaging (MRI) is an appropriate method for evaluating CNS involvement in these patients. Clinical manifestations and MRI findings of CNS lupus should be differentiated from other mimicking diseases such as multiple sclerosis (MS). The aim of this study was to evaluate the prevalence and extent of brain and cervical cord MRI lesions of lupus patients. The relationship between neurological signs and symptoms and MRI findings were evaluated as well.Patients and Fifty SLE patients who had been referred to the rheumatology clinic of our hospital within 2009 were included in a cross sectional study. All patients fulfilled the revised 1981 American College of Rheumatology (ACR) criteria for SLE. We evaluated the neurological signs and symptoms and brain and cervical MRI findings in these patients. Forty-one patients (82%) were female and nine (18%) were male. The mean age was 30.1 ± 9.3 years. Twenty eight (56%) patients had an abnormal brain MRI. No one showed any abnormality in the cervical MRI. The lesions in 20 patients were similar to demyelinative plaques. Seventeen patients with abnormal brain MRI were neurologically asymptomatic. There was only a significant relationship between neurological motor manifestations and brain MRI abnormal findings. Unlike the brain, cervical MRI abnormality and especially asymptomatic cord involvement in MRI is quite rare in SLE patients. This finding may be helpful to differentiate SLE from other CNS disorders such as MS..

For determining the cervical column curvature, the curve fitting method is the most precise method, but using this method in clinic seems to be difficult if not possible. In this study, we used a modification of cervical column inclination angle that has been already mentioned The aim of this study was to evaluate the posture and curvature of the cervical column introducing a modified constructed angle in order to evaluate the cervical column curvature in a relax position in relation to the jaws sagittal position.Patients and The lateral cephalometries of patients with no anomaly were taken in the natural head position. The mean age of the patients was 13.49 years including 56 female and 44 male. Steiner and Wits analysis was used to evaluate the sagittal position of the jaws. Modified constructed CVT/HOR and OPT/HOR angles were used to evaluate the cervical column posture and curvature. Patients were classified into three groups according to the angle’s classification. The results showed a significant positive correlation between modified constructed angles and sagittal jaw relationships (P < 0.05). Besides, in class II patients, there was a significant correlation between OPT/HOR and parameters ANB and Wits (P < 0.05 and P < 0.01, respectively). Age could not affect the curvature and posture of the cervical column. According to the result of this study using modified constructed angles may be a simple method for evaluation of the relation between cervical column curvature and sagittal position of the jaws. There is significant correlation between cervical column posture angles and parameters ANB and Wits in Cl. II patients.

Omental lipomas are extremely rare tumors of childhood. We report a case of solitary giant lipoma of the omentum in a child, successfully managed by complete excision, without any recurrence on follow-up study..

Hydatid disease is a parasitic infection which occurs in specific geographical areas such as the Mediterranean region. We report a case of hydatid cyst of the knee in a 34-year-old man who was admitted with inability to walk and a painful knee. He had a past history of liver infection nine years ago. Laboratory findings were negative. According to the high prevalence of hydatid disease in Iran, it should be considered as a differential diagnosis of Baker’s cyst, synovial cyst and lipoma..

Polypoid cystitis is a benign exophytic mucosal lesion of the bladder. Differentiating it from papillary transitional cell carcinoma is difficult due to their similar characteristics. Although indwelling catheter is the main well-known cause of polypoid cystitis, some case reports unrelated to catheterization have been described. However, the radiological findings of polypoid cystitis have rarely been reported. We hereby describe polypoid cystitis in a 20-year-old man without a history of catheterization along with the computed tomographic findings..

Parapharyngeal tumors are less common in clinical practice and are often difficult to diagnose upon clinical examination due to the anatomic complexity of the region. We report a rare case of extracranial parapharyngeal space meningioma presenting as a cervical mass with encasement of cranial nerves giving tram track appearance and features on various imaging modalities [Radiographs, Ultrasound, Computed tomography (CT) scan and Magnetic resonance imaging (MRI)]..

Osteoid osteoma is a benign bone tumor of undetermined etiology, composed of a central zone named nidus which is an atypical bone completely enclosed within a wellvascularized stroma and a peripheral sclerotic reaction zone. There are three types of radiographic features: cortical, medullary and subperiosteal. Forty-four patients with osteoid osteoma were studied retrospectively. In plain films, 35 patients presented as the cortical type, six cases were located in the medullary zone and three had subperiosteal osteoid osteoma. In all the cases, the nidus was visualized on computed tomography (CT) scan. The nidus was visible in four out of five patients who had also undergone magnetic resonance imaging (MRI). Double-density sign, seen on radionuclide bone scans was positive in all patients. MRI is more sensitive in the diagnosis of bone marrow and soft tissue abnormalities adjacent to the lesion, and in the nidus that is located closer to the medullary zone. On the other hand, CT is more specific when it comes to detecting the lesion’s nidus