Displaying publications 1 - 20 of 35 in total

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  1. Bicchierai G, Nori J, De Benedetto D, Boeri C, Vanzi E, Bianchi S, et al.
    Tumori, 2019 Oct;105(5):378-387.
    PMID: 30558495 DOI: 10.1177/0300891618816212
    PURPOSE: To evaluate the role of contrast-enhanced spectral mammography (CESM) in the post biopsy management of breast lesions classified as lesions of uncertain malignant potential (B3) by core needle biopsy and vacuum-assisted biopsy (VAB).

    METHODS: The local ethics committee approved this retrospective study and for this type of study formal consent is not required. A total of 42 B3 lesions in 40 women aged 41-77 years were included in our study. All patients underwent CESM 2-3 weeks after the biopsy procedure and surgical excision was subsequently performed within 60 days of the CESM procedure. Three radiologists reviewed the images independently. The results were then compared with histologic findings.

    RESULTS: The sensitivity, specificity, and positive and negative predictive values for confirmed demonstration of malignancy at CESM were 33.3%, 87.2%, 16.7%, and 94.4% for reader 1; 66.7%, 76.9%, 18.2%, and 96.7% for reader 2; 66.7%, 74.4%, 16.7%, and 96.7% for reader 3. Overall agreement on detection of malignant lesions using CESM among readers ranged from moderate to substantial (κ = .451-.696), for categorization of BPE from moderate to substantial (κ = .562-.711), and for evaluation of lesion intensity enhancement from fair to moderate (κ = .346-.459).

    CONCLUSION: In cases of Breast Imaging Reporting and Data System (BI-RADS) 1, BI-RADS 2, or BI-RADS 3 results at CESM, follow-up or VAB rather than surgical biopsy might be performed.

    Matched MeSH terms: Radiologists
  2. Radhiana H, Siti Kamariah CM, Mohd Nazli K, Azian AA
    Med J Malaysia, 2014 Feb;69(1):46-8.
    PMID: 24814633 MyJurnal
    The wide use of computed tomography (CT) scanning for patients with blunt abdominal trauma can reveal incidental findings that vary in their importance. We evaluated these findings, how it was reported by radiologists and its implication on the trauma care. In 30 out of 154 patients, 32 incidental findings were discovered (19.5%). Out of these 32 findings, only 3 cases (9.4%) were considered significant and required immediate attention from the managing team. In all these 3 cases, the findings were described in the body of the report and highlighted in the conclusion section at the end of the radiology report. However, similar reporting style was used in only 58.4% of cases with moderate clinical concern and 23.5% of cases with little clinical concern. In 41.2% of cases with little concern, the incidental findings were not mentioned in the radiology report. In conclusion, incidental findings in CT scan performed for blunt abdominal trauma were common but many were clinically insignificant. There is little consistency in radiology reporting of these findings especially those with moderate and little clinical concern.
    Matched MeSH terms: Radiologists
  3. Poh F, Sing WH, Mohan PC
    Med J Malaysia, 2015 Feb;70(1):38-41.
    PMID: 26032529
    We present a case of a 53-year-old woman who developed multifocal insufficiency fractures associated with adefovir dipivoxil (ADV) induced osteomalacia, including recurring metatarsal insufficiency fractures and a subtrochanteric femoral insufficiency fracture requiring surgical fixation. She had received low-dose ADV treatment for 59 months for chronic hepatitis B viral infection at the time of presentation with subtrochanteric fracture. Imaging evidence of multifocal insufficiency fractures and metabolic disease on background of hypophosphatemia is attributed to hypophosphatemic osteomalacia from adefovir-induced renal proximal tubular dysfunction. Radiologists and clinicians should be aware of the possibility of insufficiency fractures in patients receiving ADV therapy to avoid delayed diagnosis and progression of high-risk proximal femoral fractures.
    Matched MeSH terms: Radiologists
  4. Tan AP
    Med J Malaysia, 2015 Apr;70(2):100-1.
    PMID: 26162386
    Retained products of conception (POC) complicates nearly 1% of all pregnancies, occurring with greater frequency after termination of pregnancy than after vaginal or caesarean delivery. The presenting symptoms of retained products of conception are similar to those of gestational trophoblastic disease and hence accurate differentiation is difficult based on clinical history and physical examination alone. The distinction between these two entities is extremely important as the treatment differs dramatically. These patients often need to be further evaluated with either ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) of the pelvis. Hence, radiologists play a vital role in clinching the diagnosis although at times it may be challenging to differentiate between these two entities. Herein, we discuss a case of degenerated retained products of conception which was initially misdiagnosed as invasive trophoblastic disease in a 41-year-old woman whom last known pregnancy was 10 years ago.
    Matched MeSH terms: Radiologists
  5. Letchumanan M, Anour AA, Ganapathy SS, Harry S, Nik Lah NSH, Arsad N, et al.
    Med J Malaysia, 2021 03;76(2):131-137.
    PMID: 33742618
    OBJECTIVES: To recognize the radiographic patterns of coronavirus disease 2019 (COVID-19) in Malaysia.

    MATERIALS AND METHODS: Chest radiographs of patients confirmed with COVID-19 in Hospital Tawau, Sabah, Malaysia were retrospectively analyzed by two radiologists. The radiographic pattern, distribution among subgroups and evolution of the disease over time were determined.

    RESULTS: Among the 82 patients studied, 65 (79.3%) were males. Mean age of our cohorts was 37 ± 15 years. Baseline chest radiographs were abnormal in 37 patients (45.1%). Over half (52.9%) of the symptomatic patients had abnormal baseline radiograph. Among the children, patients with comorbidities, and patients 60 years of age and above, the abnormal radiographs were 14.3%, 71.4% and 69.3% respectively. Ground glass opacities were the commonest abnormal radiographic feature (35.4%), were peripherally located (35.4%) with predilection for the lower zones (29.3%). Most radiographic abnormalities were multifocal (20.7%) and frequently located in the left lung (19.5%). Radiographic recovery was observed in 15 of 18 patients (83%). Computed tomography (CT) scan demonstrated greater extent of the disease than observed in radiographs of the same patient.

    CONCLUSIONS: COVID-19 pneumonia presented with a specific radiographic pattern in our cohort of patients, comprising of ground glass opacities in peripheral and basilar distribution, affecting a single lung field and was observed in both symptomatic and asymptomatic patients. Chest radiograph is a useful adjunct screening tool, and in combination with clinical and epidemiological assessment may facilitate in early diagnosis of COVID-19 pneumonia.

    Matched MeSH terms: Radiologists
  6. Che Jalil NA, Rama Chandran P, Samsudin AHZ, Yahya MM, Wan Abdul Rahman WF
    Malays J Pathol, 2021 Apr;43(1):69-73.
    PMID: 33903308
    Cancer metastasis to the thyroid gland from non-thyroid sites is a rare presentation in clinical practice. The most frequent primary cancers that metastasise to the thyroid are renal cell carcinoma, followed by colorectal, lung and breast. We report a case of a 64-year-old Malay lady who presented with anterior neck swelling 4 years after an initial diagnosis of uterine leiomyosarcoma. She had undergone a hysterectomy procedure four years ago. Fine needle aspiration cytology of the thyroid mass suggested undifferentiated thyroid carcinoma. After multi-disciplinary discussion, the patient underwent thyroidectomy and the final histopathological diagnosis was metastatic leiomyosarcoma of the thyroid. The diagnosis was aided by an immunohistochemistry panel of positive myogenic markers, negative epithelial markers as well as the previous medical history of uterine leiomyosarcoma. Metastatic leiomyosarcoma of the thyroid may mimic primary undifferentiated (anaplastic) thyroid carcinoma (UTC) with a sarcomatoid pattern, medullary thyroid carcinoma (MTC) with spindle cells morphology and spindle cell tumour with thymus-like differentiation (SETTLE). Hence, a multidisciplinary approach must be practised by pathologists, surgeons and radiologists to consider metastatic lesions of the thyroid gland, especially when a previous history of cancer exists or is suspected.
    Matched MeSH terms: Radiologists
  7. Hashim H, Muda AS, Abdul Aziz A, Abdul Hamid Z
    Malays J Med Sci, 2016 Jul;23(4):59-64.
    PMID: 27660546 MyJurnal DOI: 10.21315/mjms2016.23.4.8
    Embolisation has long been used as an adjunct to surgical resection in the treatment of brain arteriovenous malformation (bAVM). The most commonly used embolic material, n-butylcyanoacrylate glue, requires experience and skill to handle its quick and unpredictable flow and polymerisation. A new liquid embolic agent, ethylene vinyl alcohol copolymer (Onyx), is less adhesive and polymerises slowly, which provides better control for radiologists performing embolisation.
    Matched MeSH terms: Radiologists
  8. Che Mohamed SK, Abd Aziz A
    Malays J Med Sci, 2009 Oct;16(4):69-72.
    PMID: 22135515 MyJurnal
    When performing a radiological assessment for a trauma case with associated head injury, a fragment of dense tissue detected near the craniovertebral junction would rapidly be assessed as a fractured bone fragment. However, if further imaging and evaluation of the cervical spine with computerised tomography (CT) did not demonstrate an obvious fracture, then the possibility of ligament calcification would be considered. We present a case involving a previously healthy 44-yearold man who was admitted following a severe head injury from a road traffic accident. CT scans of the head showed multiple intracranial haemorrhages, while scans of the cervical spine revealed a small, well-defined, ovoid calcification in the right alar ligament. This was initially thought to be a fracture fragment. Although such calcification is uncommon, accident and emergency physicians and radiologists may find this useful as a differential diagnosis in patients presenting with neck pain or traumatic head injury.
    Matched MeSH terms: Radiologists
  9. Md Ralib AR, Han NT, Hin HS, Muda AS
    Malays J Med Sci, 2010 Jul;17(3):55-60.
    PMID: 22135550 MyJurnal
    Massive haemoptysis is the most dreaded of all respiratory emergencies. Bronchial artery embolisation is known to be a safe and effective procedure in massive haemoptysis. Bronchial artery of anomalous origin presents a diagnostic challenge to interventional radiologists searching for the source of haemorrhage. Here, we report a case of massive haemoptysis secondary to a lung carcinoma with the bronchial artery originating directly from the right subclavian artery. This artery was not evident during the initial flush thoracic aortogram. The anomalous-origin bronchial artery was then embolised using 15% diluted glue with good results. An anomalous-origin bronchial artery should be suspected if the source of haemorrhage is not visualised in the normally expected bronchial artery location.
    Matched MeSH terms: Radiologists
  10. Hassan R, Abd Aziz A
    Malays J Med Sci, 2010 Apr;17(2):29-39.
    PMID: 22135535 MyJurnal
    Blunt abdominal trauma can cause multiple internal injuries. However, these injuries are often difficult to accurately evaluate, particularly in the presence of more obvious external injuries. Computed tomography (CT) imaging is currently used to assess clinically stable patients with blunt abdominal trauma. CT can provide a rapid and accurate appraisal of the abdominal viscera, retroperitoneum and abdominal wall, as well as a limited assessment of the lower thoracic region and bony pelvis. This paper presents examples of various injuries in trauma patients depicted in abdominal CT images. We hope these images provide a resource for radiologists, surgeons and medical officers, as well as a learning tool for medical students.
    Matched MeSH terms: Radiologists
  11. Hassan R, Abd Aziz A, Md Ralib AR, Saat A
    Malays J Med Sci, 2011 Jan;18(1):60-7.
    PMID: 22135575 MyJurnal
    The spleen is one of the organs most frequently injured in blunt abdominal trauma. Computed tomography (CT) scanning can accurately detect splenic injury and is currently the imaging modality of choice in assessing clinically stable patients with blunt abdominal trauma. The CT features of spleen injury include lacerations, subcapsular or parenchymal haematomas, active haemorrhage, and vascular injuries. We present a pictorial review of the spectrum of CT findings for blunt splenic injuries. This article will be a useful reference for radiologists and surgeons as CT scan is widely used for the assessment of splenic injuries and contributes to the current trend towards nonsurgical management of this injury.
    Matched MeSH terms: Radiologists
  12. Hassan R, Aziz AA, Mohamed SK
    Malays J Med Sci, 2011 Oct;18(4):84-7.
    PMID: 22589677
    Retrocaval ureter is a rare cause of hydronephrosis. Its rarity and non-specific presentation pose a challenge to surgeons and radiologists in making the correct diagnosis. Differentiation from other causes of urinary tract obstruction, especially the more common urolithiasis, is important for successful surgical management. Current practice has seen multislice computed tomography (MSCT) rapidly replaces intravenous urography (IVU) in the assessment of patients with hydronephrosis due to suspected urolithiasis, especially ureterolithiasis. However, MSCT, without adequate opacification of the entire ureter, may allow the physician to overlook a retrocaval ureter as the cause of hydronephrosis. High-resolution IVU images can demonstrate the typical appearance that leads to the accurate diagnosis of a retrocaval ureter. We reported a case that illustrates this scenario and highlights the importance of IVU in the assessment of a complex congenital disorder involving the urinary tract.
    Matched MeSH terms: Radiologists
  13. Yaacob Y, Nguyen DV, Mohamed Z, Ralib AR, Zakaria R, Muda S
    Indian J Radiol Imaging, 2013 Apr;23(2):121-5.
    PMID: 24082475 DOI: 10.4103/0971-3026.116543
    To report our early experience in image-guided chemoport insertions by interventional radiologists.
    Matched MeSH terms: Radiologists
  14. Hussain IZ, Mohd Zaki F, Mukari SA, Md Pauzi SH, Loh CK, Alias H
    Indian J Radiol Imaging, 2020 03 30;30(1):46-51.
    PMID: 32476749 DOI: 10.4103/ijri.IJRI_209_19
    Objectives: The objective of this study is to describe the imaging features of medulloblastoma (MB) and correlate the MR characteristics with the different histological subtype of MB with 2-year survival.

    Materials and Methods: This is a retrospective descriptive study. A total of 29 patients diagnosed with MB from January 2005 to December 2015 were included in this study. The MRI brain and spine studies of these patients were retrieved and reviewed by a pediatric radiologist and a neuroradiologist independently, both blinded from the histological type of the MB. The HPE slides were also retrieved and reviewed by a pathologist.

    Results: 80% of desmoplastic MB showed the presence of intracranial leptomeningeal seeding and 57.1% of anaplastic MB showed the presence of necrosis. The presence of intracranial leptomeningeal seeding (P = 0.002) and necrosis (P = 0.019) was predictive of the histological subtypes. There is a significant correlation between the enhancement pattern and the 2-year outcome (P = 0.03) with 6 out of 8 patients whose tumors showed minimal enhancement having disease progression within 2 years. A significant correlation was also seen between the presence of necrosis with a poorer outcome (P = 0.03) and between the HPE subtype and 2-year outcome (P = 0.03) with anaplastic MB having the poorest prognosis.

    Conclusion: MR imaging features of intracranial leptomeningeal seeding and the presence of necrosis were correlated with a specific histologic subtype of MB. The enhancement pattern as well as necrosis correlated with 2-year poorer outcome of the disease.

    Matched MeSH terms: Radiologists
  15. Nayak SB, Soumya KV
    Surg Radiol Anat, 2019 Jun 18.
    PMID: 31214757 DOI: 10.1007/s00276-019-02268-x
    Vermiform appendix is considered as a vestigial organ, and it has minimal or no role to play in the digestion and absorption of food. It is an enigma to the clinicians due to its variable positions and symptoms caused by its inflammation. In the available literature, there are many reports on various positions, size and disease of appendix. However, there is no report on an anteriorly located appendicular attachment to the caecum. During dissection classes for medical undergraduates, an appendix with its base attached to the anterior wall of the caecum was noted. The entire appendix was attached to the ileum through a mesoappendix and was readily visible when the anterior abdominal wall was reflected. This position could be a boon to the clinicians and radiologists during diagnosis and surgery of the appendix.
    Matched MeSH terms: Radiologists
  16. Bohari A, Hashim S, Ghoshal SK, Mohd Mustafa SN
    Radiat Prot Dosimetry, 2019 Dec 31;186(4):462-468.
    PMID: 31329977 DOI: 10.1093/rpd/ncz051
    Long exposure to radiation from fluoroscopy-guided interventions (FGIs) can be detrimental to both patients and radiologists. The effective doses received by the interventional radiology staff after performing 230 FGIs in a year were assessed by using double dosimetry and five various algorithms. The Shapiro-Wilk test revealed normally-distributed data (p < 0.01), while the significant correlation coefficients between the effective doses ranged between 0.88 and 1.00. As for the Bland-Altman analysis, both Niklason and Boetticher algorithms strongly supported the absence of statistical significance between the estimated effective doses. This portrays that the occupational doses received by the interventional radiology staff during FGIs fall within the acceptable limit regardless of the varied algorithms applied. In short, the Niklason and Boetticher algorithms appeared to be the more interchangeable ones for effective evaluation of doses. This is in view of their strong mutual correlations and excellent agreement.
    Matched MeSH terms: Radiologists
  17. Sethu Thakachy Subha, Fathinul Fikri Ahmad Saad, Abdul Jalil Nordin, Saraiza Abu Bakar
    MyJurnal
    This study sought to prospectively evaluate the influence of contrasted fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDGPET/CT) in the staging of and impact on the management plan for treatment in patients with nasopharyngeal carcinoma (NPC). A total of 14 histologically proven NPC patients (mean age: 44.64±4.01years) were included in the study. These patients underwent contrasted Computed Tomography (CT) as well as 18F-FDGPET/CT imaging. Staging was based on the 7th edition of the American Joint Committee on Cancer Tumor Node Metastases (AJCCTNM) recommendations.The oncologist was asked to prospectively assign a treatment plan for all patients being evaluated by CT and 18F-FDGPET/CT. The treatment plans were compared with the incremental information supplied by the FDG-PET/CT. The maximum standardised uptake value (SUVmax) and the widest dimension of the primary tumour, cervical lymph nodes size and the distant metastatic lesions were quantified on the co-registered PET/CT images by two experienced nuclear radiologists. The contrasted 18F-FDGPET/CT changed the management intent in nine patients (64.7%). A univariate analysis showed that there were significant correlations between SUVmax and the size of the metastatic
    lymph nodes (R2 =0.0761, p
    Matched MeSH terms: Radiologists
  18. Tawfik EA, Cartwright MS, Grimm A, Boon AJ, Kerasnoudis A, Preston DC, et al.
    Muscle Nerve, 2019 10;60(4):361-366.
    PMID: 31335971 DOI: 10.1002/mus.26642
    Neuromuscular ultrasound has become an essential tool in the diagnostic evaluation of various neuromuscular disorders, and, as such, there is growing interest in neuromuscular ultrasound training. Effective training is critical in mastering this modality. Our aim was to develop consensus-based guidelines for neuromuscular ultrasound training courses. A total of 18 experts participated. Expert opinion was sought through the Delphi method using 4 consecutive electronic surveys. A high degree of consensus was achieved with regard to the general structure of neuromuscular ultrasound training; the categorization of training into basic, intermediate, and advanced levels; the learning objectives; and the curriculum for each level. In this study, a group of neuromuscular ultrasound experts established consensus-based guidelines for neuromuscular ultrasound training. These guidelines can be used in the development of the specialty and the standardization of neuromuscular ultrasound training courses and workshops.
    Matched MeSH terms: Radiologists/education
  19. Nayak SB, Shetty SD, Packirisamy V, Vasudeva SK
    Morphologie, 2021 May 05.
    PMID: 33965324 DOI: 10.1016/j.morpho.2021.04.003
    Jejunum is drained into superior mesenteric vein through a series of jejunal veins. The way in which the first jejunal vein terminates is of great importance in upper abdominal surgery and radiological procedures. Knowledge of its variations is particularly important in surgical procedures like orthotropic hepatic transplantation, hepatic vein reconstruction, pancreatic surgery and surgical procedures of duodenojejunal junction. We saw a first jejunal vein opening directly into the portal vein. Further, the inferior mesenteric vein drained into the first jejunal vein. This case could be useful to gastroenterologists, general surgeons and radiologists.
    Matched MeSH terms: Radiologists
  20. Gupta H, Batta NS, Kataria H, Batra V, Upadhyay AD, Jain V, et al.
    Malays Orthop J, 2020 Mar;14(1):34-41.
    PMID: 32296480 DOI: 10.5704/MOJ.2003.006
    Introduction: An increased tibial tuberosity-trochlear groove (TTTG) distance is used for deciding a treatment plan in patello-femoral instability (PFI). The centre of the patellar tendon and the chondral trochlear groove can be directly visualised on MRI, and measured, giving the patellar tendon-trochlear groove (PTTG) distance. A study was designed to compare the inter-rater and the test-retest reliabilities of PTTG and TTTG measurements in MRI of patients without PFI and in a group with PFI.

    Materials and Methods: This cross-sectional reliability study was done on archival MRI films of 50 patients without patellar instability and 20 patients with patellar instability. TTTG and PTTG distances were independently measured by two orthopaedic surgeons and two radiologists. A hybrid PTTG measurement with bony landmarks on the femoral side and the patellar tendon landmark on the tibial side, was used to estimate the influence of the differences in the femoral and tibial landmarks on the difference in reliabilities. The intra-class correlation coefficient (ICC) was calculated for all four raters, as well as separately for each rater.

    Results: The PTTG distance had a higher inter-rater reliability (ICC=0.86, 95% CI=0.79-0.92) compared to the TTTG distance (ICC=0.70, 95% CI=0.59-0.80) in patients without PFI. Similar trends were seen in patients with PFI (0.83 vs 0.66). The inter-rater reliability for the hybrid PTTG distance was found to lie in between the TTTG and PTTG.

    Conclusions: The MRI-based PTTG distance had better inter-rater reliability compared with the MRI-based TTTG distance.

    Matched MeSH terms: Radiologists
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