Monday, January 31, 2005


Spot the diagnosis in this X-ray

There is evidence of generalized increase in bone density with evidence of ligmanetous calcification, diagnosis of flourosis.
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Wednesday, January 26, 2005


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Monday, January 24, 2005

Medical news

Ultrasound-based device can diagnose bone loss in space

A high-resolution ultrasound-based portable device will help physicians calculate bone loss in space travelers, according to researchers at NASA's National Space Biomedical Research Institute. While focused on space-related health issues, NSBRI findings may translate into help for earth-bound patients with similar conditions.
Studies of cosmonauts and astronauts who completed lengthy missions aboard the space station Mir showed that humans can sustain an average 2% loss of bone mass every month. The lower extremities and hips generally bear the brunt of bone loss and become particularly susceptible to fracture upon return to earth.
The technology, called Scanning Confocal Acoustic Diagnostic System (SCAD), will monitor bone density and strength outside the earth's gravitational pull. It will help physicians on the ground determine the rate of bone loss and severity of injuries sustained in space, as well as appropriate recovery planning, said Dr. Yi-Xian Qin, an associate team leader of NSBRI's development group.
"We are currently in the beginning phases of development, but eventually this technology can aid diagnosis for a number of skeletal disorders," Qin said.
Compared with FDA-approved quantitative ultrasound (QUS) technology clinically available for diagnosing osteoporosis, SCAD provides an image-based assessment of bone strength in a region of interest. The device, created by researchers at the Stony Brook University's department of biomedical engineering in New York, can increase ultrasound's accuracy and reduce noise from soft tissue by providing a real-time mapping of the bone.
In addition to its uses inflight, researchers anticipate SCAD could help physicians in several clinical fields improve the early diagnosis of conditions like osteopenia and osteoporosis, which are difficult to diagnose during their initial stages.
The SCAD project complements several other NSBRI studies looking into other space health concerns, including sleep and psychosocial disorders, muscle waste, cardiovascular changes, balance and orientation problems, and radiation exposure.

from www.dimag.com

Friday, January 21, 2005

Journal Club

Latest techniques in head and neck CT angiography.

Schuknecht B.Institute of Neuroradiology, University Hospital of Zurich, Klinik Bethanien, Toblerstr. 51, 8044, Zurich, Switzerland, image-solution@ggaweb.ch.

Continuous evolution of multi row CT is increasingly making CT angiography a viable imaging modality for assessment of the supraaortic and intracranial vessels as an anatomically and functionally coherent vascular system. Extended non-invasive examinations with reduced contrast volume have become feasible with the availability of 16 and 64 row MDCT scanners. Prerequisites to obtain high resolution CT angiographies of the head and neck vessels with superior detail include the administration of low contrast volume, high contrast density (400 mg I/ml) contrast media, adequate timing and data acquisition, optimal flow rate (4 ml/s) and saline flushing. Non-invasiveness, delineation of vessel calcification, virtual independence from hemodynamic conditions, and the ability to provide quantification without needing to correct for magnification are all attributes that favour CT angiography over digital subtraction angiography and to some extent even magnetic resonance angiography as an alternative non-invasive technique. CT angiography is established as a modality of choice for the assessment of patients with acute stroke and chronic steno-occlusive disease. CT angiography may indicate the presence of extra- or intracranial acute vessel occlusion and dissection, predisposing atherosclerotic steno-occlusive disease and thus indicate thrombo-embolism or local appositional thrombosis as the principle pathogenic factor. CT angiography is used to assess anatomy, and to depict the presence, location and extent of calcified and non-calcified plaque as a cause of high grade stenosis. Despite relatively limited sensitivity CT angiography is indicated for suspected or confirmed aneurysms that demand further verification of their presence, geometry, or relationship to parent artery branches and osseous anatomic landmarks. Low volume high density contrast media have substantially increased the ability of CT angiography to depict small aneurysms, small branches, and collateral vessels, and to recognize the residual lumen in vessels with high grade stenosis or conditions such as dissection or pseudo-occlusion. Superior detail high resolution CT angiography is thus a viable alternative to DSA, relegating the latter technique to endovascular treatment applications only.

Neuroradiology. 2004 Dec;46 Suppl 2:s208-13.

Monday, January 17, 2005


this is a classical ultrasound appearance of hydatid cyst!! multicystic appearance with peripherally arranged daughter cysts!!
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Tuesday, January 11, 2005


this is an US image of the pelvis of a patient who presented with a pelvic mass, can you spot the diagnosis........

its dermoid cyst, note the characteristic fat-fluid level (fat on US appears echogenic(brighter) and is lighter than fluid so floats on the top)
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Friday, January 07, 2005

King Tut: Team does CT scan to unravel why boy king died

Body scan to reveal how King Tut died

A team of researchers briefly removed King Tut's mummy from its tomb on Wednesday and laid bare his bones for a CT scan that could solve an enduring mystery: Was it murder or natural causes that killed Egypt's boy pharaoh 3,000 years ago?

Tut's toes and fingers and an eerie outline of his face could be seen as the mummy, resting in a box to protect it, was placed inside the machine in a specially equipped van, parked near his underground tomb in the famed Valley of the Kings.

The 1,700 images taken during the 15-minute CT scan could answer many of the mysteries that shroud King Tutankhamun's life and death _ including his royal lineage, his exact age now estimated at 17, and the cause of his death.

A simpler X-ray done 36 years ago showed bone fragments inside the skull of Tut _ who was buried in a "hurried'' fashion in a glitter of gold treasures, said Zahi Hawass, Egypt's chief archaeologist. But that previous test wasn't sophisticated enough to determine if the bone fragments signified a blow to the head.

The CT scan, in contrast, will provide a far more detailed, three-dimensional view of the scattered bones and coverings that make up Tut's mummy. CT imaging has been used for numerous Egyptian mummies in the past, including one of famed pharoah Ramses I. It also was used on the 5,200-year-old remains of a Copper Age man found frozen in 1991 in a glacier in the northern Italian Alps. In that case, CT imaging picked up what simpler X-rays had failed to _ identifying an arrowhead in the iceman's body that possibly killed him.

Hawass, part of the 10-man team that conducted Wednesday's tests, said the results of the Tut scan will be announced later this month in Cairo.

"There are so many stories about his death and his age,'' Hawass said. "Today we will determine what really happened.''

The removal of the mummy from its tomb _ the first time in 82 years _ also showed it is in bad condition and Egyptian officials will begin a "process of restoration to protect and preserve it,'' Hawass said. The mummy was returned to the tomb after the scan and all restoration will be done there, he said.

The short life of Tutankhamun has fascinated people since his tomb was discovered in 1922 by a British archaeologist, revealing a trove of fabulous treasures in gold and precious stones that showed the wealth and craftsmanship of the Pharaonic court.

A U.S. museum tour a quarter-century ago of Tut's treasures drew more than 8 million people. A smaller number of treasures _ minus Tut's famous gold mask _ will again go on display in the United States starting June 16 in Los Angeles, after touring Germany and Switzerland.

The decision to allow the exhibit marked the reversal of an Egyptian policy set in the 1980s that confined most of the objects to Egypt, after several pieces were damaged on international tour.

Archaeologists have long wondered if Tut was murdered. Hawass said one factor included the fact that the conditions of his burial in the tomb seemed "hurried.''

Tutankhamun ruled about 3,300 years ago and is believed to be the 12th ruler of ancient Egypt's 18th dynasty. He ascended to the throne at about the age of 8 and died around 1323 B.C. at approximately 17.

Tut's lineage also has long been in question. It's unclear if he is the son or a half-brother of Akhenaten, the "heretic'' pharaoh who introduced a revolutionary form of monotheism to ancient Egypt and who was the son of Amenhotep III.

The CT scan, conducted under rare cloudy skies in the valley on the Nile's west bank, began with the removal of the wooden box that holds Tut's mummy from underneath a stone sarcophagus in the underground tomb. Tourists to the tomb see only that stone covering.

The box holding the mummy was then carried up stone steps out of the vault. Coverings, which appeared to be insulation-like material, were then pulled back. The blackened mummy, still resting in the box to protect it, was then inserted into the CT machine.

The machine, brought from Germany, was donated by Siemens and National Geographic, Hawass said.

National Geographic executive vice president Terry Garcia said his organization would fund the project for about five years, during which many Egyptian mummies would be scanned to determine how best to preserve them and learn more about their health before they died. A documentary is also in the works.

"The most pressing purpose of this work is conservation, and through the imaging work we can determine what steps might be necessary to conserve them,'' Garcia said. "Then we will also be trying to get a better picture of health and disease in ancient Egypt.''

Egyptian officials had previously announced they were planning the tests, but did not give a date and did not inform most media ahead of time.

Hawass has given exclusive rights to film archaeological events to certain media in the past in return for financial assistance or research help.

The mummy had not left the tomb since the British archaeologist Howard Carter excavated the tomb 82 years ago. Hawass said Carter's team damaged the mummy as they used sharp tools to prize off the famous gold and blue mask.

The team of examiners included medical doctors who operated the machine, senior antiquities officials and restoration experts.

The examination had raised a row among archaeologists and officials in Egypt, who insisted the mummy not be taken from Luxor, and that the research be done by Egyptians. The researchers originally had planned to move the mummy to the Egyptian Museum in Cairo for examination, but altered that after the outcry.


Tuesday, January 04, 2005

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Journal Club

CT cystography and virtual cystoscopy in the assessment of new and recurrent bladder neoplasms.
Browne RF, Murphy SM, Grainger R, Hamilton S.
Departments of Radiology and Urology, The Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland.


Objective: To determine if CT cystography and virtual cystoscopy have a role in the assessment of neoplasms of the urinary bladder.
Material and Methods: Twenty five adults suspected of having bladder tumours underwent CT cystography. Twenty three had subsequent virtual cystoscopic reconstructions from the axial data. The examinations were reviewed by two radiologists and the findings were correlated with those at conventional cystoscopy.
Results: Seventeen masses larger than 0.5cm were identified by CT cystography in 16 patients. Two patients had normal CT cystography, but one had small recurrent neoplasms on conventional examination. Seven patients had nodular mucosal irregularities which were subsequently shown to be neoplastic in three. Accuracy for diagnosis of neoplasm in all patients was 88%.
Conclusion: CT cystography is very accurate at identifying masses larger than 0.5cm and can show mucosal abnormalities as small as 2mm. It is minimally invasive and can be diagnostic when conventional cystoscopy is inconclusive. It can indicate appropriate areas for assessment and biopsy at conventional examination. Virtual cystoscopy gave comparable views to conventional cystoscopy, but did not add diagnostic information. It is not likely to replace conventional cystoscopy, but may be helpful in occasional circumstances where the latter is inconclusive, or can not be performed.


Eur J Radiol. 2005 Jan;53(1):147-53

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