Iranian Journal of Radiology
Volume:11 Issue: 3, Aug 2014

The effect of MRI on microleakage of amalgam restorations is an important health issue that should be considered. If MRI application causes increase of microleakage, amalgam fillings should be reassessed after MRI and replaced if necessary.. The aim of this study is to compare the effect of magnetic resonance imaging (MRI) on microleakage of class II bonded amalgam versus classical amalgam restorations.. Class II cavities (3 mm width × 1.5 mm depth) with gingival margins ending 1 mm below the cementoenamel junction (CEJ) were prepared in 40 permanent molar teeth. The teeth were randomly divided into four groups. Cavities in the first and second groups were restored with dentin adhesive and amalgam (bonded amalgam), and those in the third and fourth groups with amalgam only. MRI was performed with the teeth specimens from the first and third groups. All specimens were then thermocycled at 5° to 55° C with a 30-second dwell time for 1000 cycles. The samples were then immersed in 0.5% methylene blue dye for 24 hours and sectioned longitudinally. Dye penetration at the occlusal and gingival margins was quantified by 15× stereomicroscopy. IBM SPSS Statistics ver. 21.0 (IBM Corp., Released 2012., IBM SPSS Statistics for Windows, Armonk, NY: IBM Corp.) and MS-Excel 2007 programs were used for statistical analyses and calculations. “nparLD” module was used for F2_LD_F1 design analysis at R program. P<0.05 was considered statistically significant.. In teeth with amalgam filling, there were no significant differences of occlusal and gingival surface microleakage after MRI exposure. Occlusal and gingival surface microleakages were also similar with and without MRI in teeth with bonded amalgam filling.. The results of this study suggest that MRI does not increase microleakage of amalgam restorations..

Communication between subarachnoid and per lymphatic spaces can be due to a deficiency of lamina crib Rosa (stapes gusher). Recognition of the condition may alter the course of treatment that can avoid perilymph gushing. A five-year-old boy presented with a history of congenital hearing loss and recurrent meningitis. The computed tomography (CT) of the temporal bone showed severe bilateral dysplasia in the inner ears in favor of gusher disease..

Intestinal lipomatosis also known as lipohyperplasia is a rare disease. Diffuse infiltration of the fatty tissue mainly in the submucousal layer is characteristic. It is usually asymptomatic and found incidentally. We report a case of lipomatosis in the terminal ileum and ileocecal valve. Multidetector computed tomography (MDCT) with contrast enhancement showed fatty infiltration of the terminal ileum and ileocecal valve..

Accurate radiological assessment of the anatomical features of the temporal bone is crucial to prevent damage to vital elements in this area during surgery. Knowing the approximate location of specific temporal bone related landmarks in advance is very important for planning surgery. This study compared findings from computed tomography images with those observed directly during ear surgery.Patients and Patients with various pathologies of the ear who needed surgery were referred to an imaging center for a spiral CT scan of the temporal bone. The following parameters were measured by a radiologist and also later recorded by the surgeon during surgery: 1) The distance between the postero-superior border of the outer ear canal and the sigmoid sinus; 2) The distance between the dome of the lateral semicircular canal and the mastoid cortex; and 3) The distance between the external surface of the incus and the mastoid cortex. Twenty cases were included. In the three measurements performed in this study, only the first parameter (distance between the canal and the sigmoid sinus) was significantly different between the direct measurement made during surgery and that obtained from CT scans. There was no significant difference in the measurements of the distance between the dome of the lateral semicircular canal and the bone cortex, and the distance between the external surface of the incus and the surface of the bone cortex. Our study shows in terms of figures that measurements of features of the temporal bone made from spiral CT scan images and those directly obtained during surgery are similar to an adequate extent.

Fractures of the os sacrum can be the cause of severe pain and immobility. A common cause of insufficiency fractures is osteoporosis. In elderly and multimorbid patients, the complications of conservative therapy can sometimes be severe. In the meantime, good outcomes with regard to pain reduction and improved mobility are achieved with CT-assisted balloon sacroplasty. We report on the successful simultaneous treatment of a bilateral osteoporosis-related insufficiency fracture of the sacrum.

In head and neck cancer patients, diagnosis of metastatic cervical adenopathy is essential for treatment planning and prognosis assessment. Treatment of patients with head and neck cancer with clinically negative cervical lymph node (N0) remains controversial. While routine neck treatment would result in overtreatment in many patients, observation may delay the diagnosis and decrease the patients’ survival. To gain insights into the unclear questions regarding the value of diagnostic modalities in patients with N0 neck, this study was designed to compare the diagnostic efficacy of palpation, ultrasonography (US) and ultrasound-guided fine needle aspiration (USGFNA) in detecting cervical lymph node metastasis.Patients and Forty-two patients with head and neck cancer who underwent US and USGFNA prior to elective neck dissection were studied. Histopathologic findings of the neck specimens were compared with each diagnostic technique. Of the 53 neck dissection specimens, histopathology showed metastases in 16 cases. The overall accuracy of USGFNA, US and palpation was 96%, 68% and 70%, respectively. The specificity of USGFNA was superior to palpation and US alone. USGFNA had the highest sensitivity, predictive value and accuracy in detecting cervical metastases compared with other performed tests.. In our study, USGFNA was superior to palpation and US in detecting metastasis in clinically negative necks. This method can be recommended as a diagnostic tool in preoperative assessment of patients without palpable metastasis, but further investigations are needed before this modality could be considered as an alternative to elective neck dissection.

Diffuse large B cell lymphoma is the most common type of non-Hodgkin's lymphoma, representing nearly one-third of all cases. Any organ can be involved, making a diagnostic biopsy imperative. When the lungs are the involved organs, it is called primary pulmonary lymphoma (PPL). Hereby, we present a case of primary pulmonary lymphoma (PPL) that demonstrated a single large mass on chest CT and had metastatic skin lesions. The diagnosis of PPL was performed by histopathology and immunohistochemistry staining of the transthoracic lung biopsy and skin lesion specimens. This case highlighted an unusual and subtle clinical presentation, and the importance of new onset pulmonary symptoms and a large lung mass on chest X-ray. Review of the literature on the patient`s radiographic presentation revealed various findings, the most common of which were single or multiple nodular lesions in one or two lungs. It highlighted the fact that this diagnosis should be considered in all cases with a lung mass and skin lesions.

Lumbar paraspinal muscles play an important role in providing both mobility and stability during dynamic tasks. Among paraspinal muscles, transverse abdominis and lumbar multifidus have been of particular interest as active stabilizers of the lumbar spine. These muscles may become dysfunctional in chronic low back pain (CLBP). Low back injury can result in muscle inhibition and control loss that cannot recover spontaneously, and specific exercises are required to stimulate their recovery. The purpose of this study was to test the reliability of ultrasonography to measure muscle dimensions and to present a reliable method for measuring transverse abdominis and lumbar multifidus as stabilizing muscles of the lumbar spine.Patients and Fifteen healthy participants (18-55 year olds) were evaluated by a radiologist using Sono made in Canada. (ES500) with two probes (50mm linear 7.5 MHZ and 70 mm curvilinear 3.5 MHz). The muscle thickness of transverse abdominis and the anterior-posterior diameter and cross sectional area of the LMF were measured. To determine within and between days reliabilities, second and third measurements were repeated with half an hour and one week intervals, respectively. Intraclass correlation coefficient for left and right showed good to high reliability for the cross sectional area of lumbar multifidi (0.74 and 0.88, respectively) as well as the anterior-posterior dimensions of lumbar multifidi (0.89 and 0.91, respectively) and transverse abdomini thickness (0.73 and 0.85, respectively).. Rehabilitative ultrasonography is a reliable and non-invasive instrument to measure muscle thickness. The method used in this study is a reliable way to measure lumbar stabilizing muscles.

Carotid artery calcification may be related to cerebrovascular accident, which may result in death or physical and mental disabilities in survivors.. Our purpose is to study the association of carotid artery calcification (CAC) on dental panoramic radiographs and two risk factors of cerebrovascular accident (CVA) including hypertension and myocardial infarction (MI)..Patients and Panoramic images of 200 patients that were all women above 50 years of age (a population suffering from vascular diseases) were investigated. All panoramic images were provided under similar conditions in terms of the type of panoramic radiograph equipment, type of applied films and the automatic film processor. Then, the patients answered questions about MI history and taking antihypertensive drugs. We also measured the blood pressure of patients in two separate surveys. Data analysis was performed by SPSS statistical program. We used Exact Fisher test and Chi-Square test at a significant level of less than 0.05 to study the effect of these variables on the occurrence of carotid artery calcification.. Among 200 studied samples, 22 of the patients (11%) had carotid artery calcification on the dental panoramic radiograph. In total, 52 patients (26%) had hypertension and four people (2%) had a history of MI. Eleven individuals among patients suffering from hypertension (21.2%) and three individuals among patients with a history of MI (75%) demonstrated CAC on dental panoramic images. . The relationship between CAC found on dental panoramic radiographs and two CVA risk factors--hypertension and MI-- was significant. Therefore, it seems that detection of CAC on panoramic images of dental patients must be considered by dentists.

Paragangliomas in the head and neck are found typically in the region of the carotid body, jugular body, and along the 9th and 10th cranial nerves. They can occur in multicenteric forms, but generally, laryngeal paragangliomas are not found in these patients. Only two cases of laryngeal paraganglioma have been reported with a synchronous lesion elsewhere. We report an additional case of a 34-year-old female with multiple paragangliomas beginning with laryngeal involvement.

In stable patients with blunt abdominal trauma, accurate diagnosis of visceral injuries is crucial.. To determine whether repeating ultrasound exam will increase the sensitivity of focused abdominal sonography for trauma (FAST) through revealing additional free intraperitoneal fluid in patients with blunt abdominal trauma..Patients and We performed a prospective observational study by performing primary and secondary ultrasound exams in blunt abdominal trauma patients. All ultrasound exams were performed by four radiology residents who had the experience of more than 400 FAST exams. Five routine intraperitoneal spaces as well as the interloop space were examined by ultrasound in order to find free fluid. All patients who expired or were transferred to the operating room before the second exam were excluded from the study. All positive ultrasound results were compared with intra-operative and computed tomography (CT) findings and/or the clinical status of the patients.. Primary ultrasound was performed in 372 patients; 61of them did not undergo secondary ultrasound exam; thus, were excluded from the study.Three hundred eleven patients underwent both primary and secondary ultrasound exams. One hundred and two of all patients were evaluated by contrast enhanced CT scan and 31 underwent laparotomy. The sensitivity of ultrasound exam in detecting intraperitoneal fluid significantly increased from 70.7% for the primary exam to 92.7% for the secondary exam. Examining the interloop space significantly improved the sensitivity of ultrasonography in both primary (from 36.6% to 70.7%) and secondary (from 65.9% to 92.7%) exams.. Performing a secondary ultrasound exam in stable blunt abdominal trauma patients and adding interloop space scan to the routine FAST exam significantly increases the sensitivity of ultrasound in detecting intraperitoneal free fluid.

A 52-year-old post-menopausal female was admitted to the emergency room due to acute onset of abdominal pain in the right lower quadrant. There was no history of trauma of the abdomen. Contrast-enhanced multi-detector computed tomography (MDCT) of the abdomen and pelvis revealed a massive right retroperitoneal hematoma and contrast extravasation from a right ovarian artery aneurysm. Digital subtraction angiography showed an active bleeding from a right ovarian artery aneurysm, which was embolized successfully, using n-butyl-cyanoacrylate.

Abdominopelvic fluid collections and abscesses management and their outcomes have improved in the recent years due to innovation of the image-guided drainage technique and improvement of surgical procedures. This study was undertaken to evaluate the efficacy of CT-guided percutaneous drainage in treating abdominopelvic abscesses..Patients and In this study, the data of 41 patients who had abdominal abscess or fluid collections, and underwent treatment by percutaneous CT-guided drainage were analyzed. Treatment was assessed by reduction of collection size, relief of symptoms and signs including abdominal pain and fever and imaging findings. Any morbidity such as wound infection, sepsis, hematoma formation or peritonitis was followed up to six months after the procedure. The average age of the patients was 54 years (range 12 to 79), including 21 (51%) men and 20 (49%) women. The common signs and symptoms were pain (83%) and fever (80.5%). The most prevalent abdominal abscess etiology was previous surgery in 31 cases (75.5%). Abscess diameter ranged between 5 and 12 cm (mean, 7.8 cm). The average hospital stay was 8 days (4-15). Thirty five cases (86%) were successfully treated. Only one case (2.5%) developed complication (peritonitis) after the procedure.. According to our findings, CT-guided percutaneous drainage is a safe and effective procedure in the treatment of abdominal abscess and fluid collection.

The management of retinoblastoma remains a challenge to the multidisciplinary team, particularly as treatment affects not only visual outcomes, but also ocular retention and morbidity. Management of retinoblastoma has evolved over the past two decades. To report the result of intra-ophthalmic artery chemotherapy (IAC) for the treatment of refractory and advanced retinoblastoma tumors.Patients and All patients who had failed to respond adequately to previous treatments and six naive patients with advanced retinoblastoma, receiving IAC between 2009 and 2012, were included in this institutional interventional case series. The patients received 1-2 treatments of IAC given 4-8 weeks apart. Complete response was defined as regressed tumor and complete disappearance of seeding clinically and partial response was defined as partial regression of the tumor with live parts of the tumor and/or lessening of seeds, but not complete disappearance of them clinically. A total of 24 eyes of 24 patients were treated with IAC during the study period. The mean age at the time of IAC was 38.9 months (14-120 months), and the mean follow-up was 16.8 months (3-36 months) after IAC. Tumor control was achieved in 14 eyes (58.3%). Type 3 (combined fleshy and calcified remnants) was the most common type of regression (37.5%). Complications included vitreous hemorrhage in nine eyes (37.5%), arterial occlusion in two (8.3%), cyclitic membrane possibly secondary to ischemia and tractional retinal detachment in one patient (4.2%), chorioretinal atrophy in three (12.5%) patients, and neovascular glaucoma in one eye (4.2%). In eight (33.3%) patients, no complication happened. Globe salvage was achieved in 62.5% of the cases. The success rate for naive patients was 84%. Sixty-seven percent of the cases received transpupillary thermotherapy and cryotherapy before IAC. Intra-ophthalmic artery melphalan is an effective treatment for advanced cases of retinoblastoma, with a reasonable level of success. In the short follow up period of this study, it appears that the primary cases showed better results in the control of tumor.