Iranian Journal of Radiology
Volume:8 Issue: 4, Dec 2011

Body packing is described as using the abdominal or pelvic cavity for concealing illegal drugs. Leakage from the packets may cause catastrophic effects on smugglers and medical history is not reliable in these patients. Moreover, new sophisticated smuggling techniques make it imperative that radiologists and emergency physicians understand and familiarize themselves with the different radiological manifestations of ingested drug packets. Currently, there is no gold standard for imaging patients suspected of body packing; nevertheless, computed tomography (CT) seems to be the best modality for packet detection and unenhanced CT without bowel preparation is a reliable technique for detection of ingested packets. On abdominal radiography, packets may be visualized as oval or round radiopaque foreign bodies surrounded by a gas halo. In the literature, sensitivity of abdominal radiography is reported from 74% to 100%. Visualization of the drug packets may be strikingly hampered by administration of oral or intravenous contrast medium in abdomino-pelvic CT; hence, contrast-enhanced CT does not seem to be a suitable modality for searching the ingested packets in suspicious smugglers.

Doppler ultrasound is the accepted gold standard for assessing direction of flow in the portal vein (PV). Moreover, it is non-invasive; therefore, it is well accepted by the patients and does not interfere with flow hemodynamics. The present study was aimed to evaluate the association between color Doppler findings and the severity of portal hypertension in patients with cirrhosis.Patients and The study group included 50 patients referred for ultrasound (US) evaluation over a period of six months from March to August, 2007. The patients were divided into three groups (Child’ A, B and C) based on Child Pugh classification. The direction of flow in the main portal vein (hepatopetal or nonhepatopetal) and peak venous velocity (PVV) in the main portal vein were measured and correlated with the presence or absence of ascites, splenomegaly, splenic and esophageal varices (assessed by Doppler US). These findings were correlated with clinical features and laboratory findings (using Child Pugh’s criteria). There was significant association between the decrease of peak portal venous velocity (PVV) and the increase in Child Pugh score. Hepatofugal flow was seen only in patients with more advanced disease. There was also significant association between PVV and splenic varices and ascites, while PVV was not affected by the presence or absence of esophageal varices or splenomegaly. Presence of a recanalized umbilical vein (UV) was associated with increased PVV even in advanced disease. Color Doppler is an excellent modality for detecting and characterizing the complex hemodynamics of portal hypertension in cirrhosis and they correlate with the clinical stage of disease.

Morphometric measurements of the corpus callosum (CC) are important to have normative values according to sex, age and race/ethnicity. This study was done to measure the size of CC and to identify its gender- and age-related differences in the North of Iran.Patients and The size of CC on midsagittal section was measured in 100 (45 males, 55 females) normal subjects using magnetic resonance imaging (MRI) admitted to the Kowsar MRI center in Gorgan–Northern Iran.Longitudinal and vertical dimensions of the CC, longitudinal and vertical lengths of the brain and the length of genu and splenium were measured. Data were analyzed by student’s unpaired t test, ANOVA and regression analysis. The anteroposterior length and vertical dimension of the CC, the length of genu and splenium were larger in males than in females, but these differences were not significant. The anteroposterior and vertical lengths of the brain were significantly larger in males than in females (P < 0.05). The length of CC increased with age and regression equations for predicting age were derived from the length of the CC. There was also a positive significant correlation between the anteroposterior length of the CC and the length of the brain and vertical dimension of the CC. This study showed that various CC parameters vary with the values documented in the Caucasian, Indian and Japanese population

The clivus is a bone region between dorsum cella and foramen magnum. It can be evaluated very clearly in routine brain magnetic resonance imaging (MRI) due to its central location. Quantitative and qualitative evaluation of the clivus and its changes according to age in a group of healthy people.Patients and The transition of clival bone marrow to fatty marrow by the increase in age is examined by MRI in 105 men and 105 women who had no clival and bone marrow pathology on MRI. The clivus/pons, clivus/CSF intensity values and clival bone marrow imaging patterns according to age groups were prospectively evaluated using a 1.5 Tesla MR device. When age groups were individually compared, there were meaningful statistical differences both in men and women in terms of clivus/CSF and clivus/pons intensity ratios (both Ps < 0.05). Clivus/pons and clivus/CSF intensity ratios were found to be increased with age in all cases. The distribution of age groups according to stages in all individuals was statistically meaningful (P < 0.05). When the appearance patterns of both genders in every ten-fold age were examined, stage III bone marrow was observed more in elder ages. As a result, besides the fact that standard ranges determined for clivus/CSF, clivus/pons intensity ratios according to age may be used in the assessment of potential pathological cases involving bone marrow; they can also be leading in the diagnosis of bone marrow diseases when taken into consideration together with clinical and laboratory data.

Swine influenza (H1N1) is a very contagious respiratory infection and World Health Organization (WHO) has raised the alert level to phase 6 (pandemic). The study of clinical and laboratory manifestations as well as radiologic imaging findings helps in its early diagnosis. The aim of this study was to evaluate the imaging findings of patients with documented H1N1 infection referred to our center.Patients and Thirty-one patients (16 men) with documented H1N1 infection were included in our study. The initial radiography obtained from the patients was reviewed regarding pattern (consolidation, ground glass, nodules and reticulation), distribution (focal, multifocal, and diffuse) and the lung zones involved. Computed tomography (CT) scans were also reviewed for the same abnormalities. The patient files were studied for their possible underlying diseases. The mean age was 37.97 ± 13.9 years. Seventeen (54.8%) patients had co-existing condition (eight respiratory, five cardiovascular, two immunodeficiency, two cancer, four others). Twelve (38.7%) patients required intensive care unit (ICU) admission. Five (16.1%) patients died. (25.8%) had normal initial radiographs. The most common abnormality was consolidation (12/31; 38.7%) in the peripheral region (11/31; 35.5%) followed by peribronchovascular areas (10/31; 32.3%) which was most commonly observed in the lower zone. The patients admitted to the ICU were more likely to have two or more lung zones involved (P = 0.005). In patients with the novel swine flu infection, the most common radiographic abnormality observed was consolidation in the lower lung zones. Patients admitted to ICU were more likely to have two or more lung zones involved.

Renal artery stenosis (RAS) has been increasingly recognized in the recent years, especially in patients with coronary artery disease (CAD). RAS affects the patients with hypertension (HTN), but the exact prevalence is not known. This study was performed to determine the prevalence and to identify the predictors of RAS in hypertensive patients undergoing coronary artery angiography.Patients and In a cross-sectional study from August 2008 to August 2009, 481 patients with HTN and suspected CAD underwent selective coronary and renal angiography for screening and predicting RAS. RAS was defined as a higher than 50% stenosis in the renal artery lumen. Multivariate analysis of factors associated with the presence of RAS were examined using a logistic regression model. The mean ± standard deviation of age was 59.25 ± 10.81 years and 50.3% were men. According to angiographic data, 425 patients (88.4%) had CAD, while 56 (11.6%) had normal coronary arteries. RAS was seen in 94 (22%) patients with CAD. The multivariate logistic regression analysis identified only age (P < 0.001) and the number of significant coronary lesions (P < 0.001) as independent predictors of RAS. Gender, smoking, congestive heart failure, diabetes mellitus (DM), hyperlipidemia (HLP) and body mass index (BMI) were not independent predictors. This study suggests that in the management of patients with RAS, risk factors should most likely be considered as beneficial. In addition, the clinical and angiographic features are helpful in predicting its presence in elderly patients with CAD.

Focal orbital amyloidosis is a rare entity and little is known about its magnetic resonance imaging (MRI) features. In this case report, imaging features of a case of focal orbital amyloidosis presenting as a mass have been documented together with its histopathological findings. On MRI, a well-defined mass was seen as isointense with rectus muscle on T1-weighted images and heterogeneously hypointense on T2-weighted images. Punctuate calcifications were observed on the computerized tomography (CT) examination..

Abscess Osteomyelitis Magnetic Resonance Imaging This report presents the “penumbra sign” of a Brodie’s abscess in a 69-year-old male patient. The lesion was located in the proximal metaphysis of the left tibia. Histopathology confirmed the diagnosis of subacute osteomyelitis. The penumbra sign on magnetic resonance (MR) images is a helpful sign for the diagnosis of Brodie’s abscess.

Coexistence of a viable fetus with a hydatidiform mole is a rare condition and the diagnosis is very important because of the risk of developing severe complications in pregnancy.The management of these pregnancies is optional, although accurate and great care is required to find early signs of maternal or fetal complications. Hereby we report a case of dizygotic twin pregnancy with a complete mole and coexisting fetus that resulted in a live neonate.

Osteomas are benign osteogenic neoplasms or hamartomas with a very slow growth rate. Osteoma is the most common mesenchymal neoplasm of the paranasal sinuses. In the jaws, the mandible is more commonly involved than the maxilla. Osteomas may occur at any age, but most frequently are found in individuals older than 40 years. Although most osteomas are small, some may become large enough to cause severe damage, especially those that develop in the frontoethmoid region. Osteomas composed solely of compact bone are uniformly radiopaque and those containing cancellous bone show evidence of internal trabecular structure. To determine and evaluate the exact extension and internal structure of these lesions, computed tomography (CT) is a more useful imaging modality in comparison to conventional radiography. Hereby, we discuss clinical and imaging features of two osteomas (one in the ethmoid sinus and the other in the mandible) along with the main differential diagnoses and pathologic features.