摘要:

Aspergilloma is a saprophytic infection that colonizes pre-existing lung cavities. Typically, aspergilloma develops in cavities formed as a result of diseases such as tuberculosis, sarcoidosis, bronchiectasis, lung abscess and cavitatory neoplasia. Coexistence of fungi with a pulmonary echinococcal (hydatid) cyst is seen more commonly in immunocompromised patients. Although aspergilloma has occasionally been described in operated hydatid cyst cavities, only one case has been reported previously in an unoperated case. We report on the case of a 40-year-old man with normal immune status and histologically proven concurrent infection of aspergillus in a previously unoperated pulmonary hydatid cyst.

DOI:10.1259/bjr/23110281

出版商:British Institute of Radiology    

年代:2008

数据来源: WILEY

摘要:

Solitary fibrous tumour of the liver is an extremely rare neoplasm, the reported imaging features of which are largely non-specific. We present a case in which dynamic contrast-enhanced CT, MRI and diffusion-weighted MRI findings suggested a diagnosis of solitary fibrous tumour of the liver that was subsequently confirmed by immunohistochemical evaluation.

DOI:10.1259/bjr/98393711

出版商:British Institute of Radiology    

年代:2008

数据来源: WILEY

摘要:

We report the case of an anomalous left anterior descending (LAD) artery with myocardial bridging, which originated from the proximal right coronary artery in a patient with a true LAD artery.

DOI:10.1259/bjr/62748086

出版商:British Institute of Radiology    

年代:2008

数据来源: WILEY

摘要:

We present a rare case of advanced basal cell carcinoma where multiple large lesions, located on the anterior chest wall and back, were treated simultaneously using tomotherapy (TomoTherapy HiArt; TomoTherapy Inc, Madison, WI). A 74-year-old man presented with seven to eight separate extensive lesions on his body, some with a duration of 7 years or more. The image-guidance component of tomotherapy allowed daily verification of the position of the target and critical structures, enabling accurate targeting in the vicinity of sensitive critical structures. Intensity-modulated radiotherapy on a conventional linear accelerator would have required junctioning of multiple complex plans, owing to the large treatment area, and most likely sequential treatment strategies to target anterior and posterior lesions. Helical tomotherapy allowed the three largest lesions to be treated simultaneously and thus eliminated the need for multiple courses of treatment.

DOI:10.1259/bjr/57705821

出版商:British Institute of Radiology    

年代:2008

数据来源: WILEY

摘要:

Unusual sites for recurrent ovarian metastases include extrahepatic solid organs (except the spleen), bone and the abdominal wall. We report a rare renal recurrence of ovarian malignancy and its imaging features.

DOI:10.1259/bjr/15263739

出版商:British Institute of Radiology    

年代:2008

数据来源: WILEY

摘要:

Idiopathic pulmonary haemosiderosis (IPH) is characterized by recurrent episodes of pulmonary haemorrhage. The disease predominates in childhood, with approximately 20% of patients presenting in adulthood. Most patients present with dyspnoea, fatigue and recurrent haemoptysis, resulting in iron deficiency anaemia. High-resolution CT manifestations of IPH include patchy or diffuse ground glass opacity and consolidation resulting from alveolar haemorrhage. We describe a new high-resolution CT finding in two adults with IPH — multiple honeycomb cysts, which were characteristically focal and localized predominantly to the posterior and lateral basal segments. We suggest that the development of honeycombing in patients with IPH is a traction phenomenon resulting from recurrent haemosiderin deposition in the interstitium, which is known to lead to progressive fibrosis. These honeycomb cysts may indicate the sites of the most severe and recurrent alveolar haemorrhage in adults with IPH.

DOI:10.1259/bjr/66050546

出版商:British Institute of Radiology    

年代:2008

数据来源: WILEY

摘要:

Distal oesophageal and Type I–II oesophagogastric junctional adenocarcinomas have a poor prognosis. In radical chemoradiotherapy, consensus is lacking on radiotherapy margins. Here, we review the effect of common imaging modalities on the extent of the gross tumour volume (GTV) and the evidence for margins. To do this, papers were identified from PubMed, and geometric uncertainties were combined using the British Institute of Radiology formula. CT and endoscopic ultrasound were best for GTV delineation, but the role of positron emission tomography is uncertain. Evidence suggests 3 cm proximal and 5 cm distal GTV–CTV (clinical target volume) margins (along the mucosa) for advanced tumours, but is lacking for early tumours and radial margins. Nodal spread, present in most pT2 tumours, is strongly prognostic and is initially to regional nodes (not wholly covered by typical radiotherapy). Calculated CTV–PTV (planning target volume) margins for three-dimensional conformal radiotherapy using literature estimates of tumour motion and set-up errors with bony online set-up correction, ignoring delineation errors, are 2.2 cm superiorly (sup) and inferiorly (inf) and 1.2–1.3 cm radially (1.3 cm sup–inf; 0.8 cm radially if the tumour's mid-position is known). As these margins may risk excessive toxicity, we propose treating microscopic disease for potentially curable tumours (cT2N0, some cT3N0), but gross disease only for advanced tumours. Recommended GTV–CTV margins are a maximum of 3 cm proximally and 5 cm distally up to cT2N0; 3 cm proximally and 5 cm distally for cT3N0 if anticipated toxicity allows; and 0 cm for cT4 and most node-positive tumours. The CTV–PTV margins above must be added to this for all stages. Methods of including elective nodal areas close to the GTV should be researched,e.g.nodal maps and intensity-modulated radiotherapy.

DOI:10.1259/bjr/23903754

出版商:British Institute of Radiology    

年代:2008

数据来源: WILEY

摘要:

Craniofacial venous vascular malformations cause severe cosmetic problems and yet these lesions are not candidates for transcatheter embolisation owing to the lack of arterial feeders. The purpose of this study was to evaluate the effectiveness of pre-operative embolisation of these lesions withN-butyl 2-cyanoacrylate (NBCA) via direct puncture. Between September 2003 and April 2006, 13 patients (7 female; age range, 6–64 years; mean, 16.7 years) were embolised with direct puncture and injection of NBCA. All of the patients were referred from plastic surgery with an operational plan. Angiography performed in all patients showed no or little arterial staining. NBCA diluted with iodized oil at a ratio of 1:6 (18%) was injected via a percutaneously placed 21 gauge needle. Complete embolisation was achieved in 8 patients and partial embolisation in the remaining 5. A total of 18 sessions of embolisation were performed on 13 patients. Nine patients underwent only one embolisation session, three patients underwent two sessions and only one patient underwent three sessions. The mean volume of NBCA used per session was 5.8 ml, ranging from 1–12 ml. All patients underwent a successful surgical resection to improve cosmetic disfigurement within 10–15 days after the embolisation procedure. Mean follow-up time was 22 months. One patient experienced skin necrosis on her nose after embolisation. No other complications related to the procedure were observed. In conclusion, pre-operative NBCA embolisation with direct puncture is a safe and easy procedure. It can increase the success of the surgical treatment of these lesions.

DOI:10.1259/bjr/66893325

出版商:British Institute of Radiology    

年代:2008

数据来源: WILEY

摘要:

The purpose of the paper is to define predictors of the kerma–area product (KAP) in percutaneous coronary intervention (PCI). Two new digital X-ray interventional cardiology systems recently installed were included. A total of 398 PCI procedures were carried out by 6 board-certified senior interventional cardiologists with more than 15 years' experience and good knowledge of radiation protection measures. Clinical, radiation and procedural data were collected based on a detailed protocol developed by the SENTINEL cardiology subgroup. Correlation with clinical and procedure factors was then investigated. A significant correlation was found between fluoroscopy time and (i) lesion classification, (ii) the level of tortuosity and (iii) the number of vessels treated. No statistically significant differences were observed in the complexity of the case between operators. However, large differences were found in the KAP among operators, which were mostly attributed to the different number of frames taken by each operator. There was no statistically significant correlation between complexity and the total number of frames. The study showed that, in certain circumstances, the clinical need to successfully perform PCI takes precedence over radiation safety concerns.

DOI:10.1259/bjr/30604628

出版商:British Institute of Radiology    

年代:2008

数据来源: WILEY

摘要:

This study compared percutaneous sclerotherapy using 50% acetic acid with that using 99% ethanol for patients with simple renal cysts. The study included 72 simple renal cysts in 64 patients (male/female ratio  =  31/33; age range, 31–75 years). Under fluoroscopic guidance, the cyst fluid was aspirated completely. Sclerotherapy was then performed using 50% acetic acid for 32 cysts and 99% ethanol for 40 cysts. The volumes of each renal cyst before and after sclerotherapy were compared using ultrasonography or CT. Medical records were reviewed to analyse any complications. The mean follow-up period was 21.5 months (range, 3–75 months). The mean remnant volume of the cyst after sclerotherapy was 2.6% of the initial volume in the acetic acid group and 14.0% in the ethanol group. The rates of complete remission, partial remission and treatment failure were 90.6%, 9.4% and 0%, respectively, in the acetic acid group, and 60.0%, 30.0% and 10.0%, respectively, in the ethanol group. There were no complications related to sclerotherapy in either group. In conclusion, acetic acid is a safe and effective sclerosing agent, with clinical results superior to those of ethanol, and is an alternative to ethanol for sclerotherapy of renal cysts.

DOI:10.1259/bjr/41664864

出版商:British Institute of Radiology    

年代:2008

数据来源: WILEY