Traumatic intractable epistaxis following fractures of the facial and base of skull rarely may be life-threatening. Common sites of injury are the internal carotid and maxillary artery. When conventional methods of arresting haemorrhage fail, the choices are then an open arterial ligation or superselective embolisation. This paper presents a patient with life-threatening epistaxis from a Le Fort type II fracture. Angiography revealed a maxillary artery injury in which superselective embolisation was performed and the haemorrhage was successfully arrested. A literature review of this technique is discussed, including its advantages and the relationship of the internal maxillary artery to facial fractures.
To compare echocontrast cystosonography (ECS) using in-vivo agitated saline with fluoroscopic micturating cystourethrography (MCU) in the detection and grading of vesicoureteric reflux (VUR).
This is a retrospective study to evaluate the results of our early experience of using doxorubicin eluting beads (DEB) to treat patients with early and intermediate hepatocellular carcinoma (HCC).
Leigh syndrome is a progressive neurodegenerative disorder of childhood. The symmetrical necrotic lesions in the basal ganglia and/or brainstem which appear as hyperintense lesions on T2-weighted MRI is characteristic and one of the essential diagnostic criteria. Recognising this MR imaging pattern in a child with neurological problems should prompt the clinician to investigate for Leigh syndrome. We present here two cases of Leigh syndrome due to different biochemical/genetic defects, and discuss the subtle differences in their MR neuroimaging features.
Computed tomography (CT) fluoroscopy is able to give real time images to a physician undertaking minimally invasive procedures such as biopsies, percutaneous drainage, and radio frequency ablation (RFA). Both operators executing the procedure and patients too, are thus at risk of radiation exposure during a CT fluoroscopy.This study focuses on the radiation exposure present during a series of radio frequency ablation (RFA) procedures, and used Gafchromic film (Type XR-QA; International Specialty Products, USA) and thermoluminescent dosimeters (TLD-100H; Bicron, USA) to measure the radiation received by patients undergoing treatment, and also operators subject to scatter radiation.The voltage was held constant at 120 kVp and the current 70mA, with 5mm thickness. The duration of irradiation was between 150-638 seconds.Ultimately, from a sample of 30 liver that have undergone RFA, the study revealed that the operator received the highest dose at the hands, which was followed by the eyes and thyroid, while secondary staff dosage was moderately uniform across all parts of the body that were measured.
Medullary carcinoma is a rare breast carcinoma with a syncytial growth pattern and high-grade cytology. It can be difficult to diagnose and may be missed on conventional imaging as the findings may overlap with benign lesions i.e. fibroadenomas. The authors report a case of a 25-year-old female who presented with multifocal breast lumps diagnosed with medullary carcinoma and fibroadenomas. Imaging and pathological correlation with contrast-enhanced MRI are presented in the diagnosis of these lesions.
By applying a hexagon-diamond search (HDS) method to an ultrasound image, the path of an object is able to be monitored by extracting images into macro-blocks, thereby achieving image redundancy is reduced from one frame to another, and also ascertaining the motion vector within the parameters searched. The HDS algorithm uses six search points to form the six sides of the hexagon pattern, a centre point, and a further four search points to create diamond pattern within the hexagon that clarifies the focus of the subject area.
Presence of air in the kidney can be problematic as the location of the air in different parts of the kidney greatly affects the subsequent management and outcome of the patient. We present here a case of a patient who had emphysematous pyelitis, in which CT scan was able to display presence of air only in the collecting system, thus differentiating this condition from the more fulminant emphysematous pyelonephritis. This leads to a more favourable prognosis and outcome to the patient.
Convention dictates that standards are a necessity rather than a luxury. Standards are supposed to improve the exchange of health and image data information resulting in improved quality and efficiency of patient care. True standardisation is some time away yet, as barriers exist with evolving equipment, storage formats and even the standards themselves. The explosive growth in the size and complexity of images such as those generated by multislice computed tomography have driven the need for digital image management, created problems of storage space and costs, and created a challenge for increasing or getting an adequate speed for transmitting, accessing and retrieving the image data. The search for a suitable and practical format for storing the data without loss of information and medico-legal implications has become a necessity and a matter of 'urgency'. Existing standards are either open or proprietary and must comply with local, regional or national laws. Currently there are the Picture Archiving and Communications System (PACS); Digital Imaging and Communications in Medicine (DICOM); Health Level 7 (HL7) and Integrating the Healthcare Enterprise (IHE). Issues in digital image management can be categorised as operational, procedural, technical and administrative. Standards must stay focussed on the ultimate goal - that is, improved patient care worldwide.
To date, the College of Radiology (CoR) does not see any clear benefit in performing whole body screening computed tomography (CT) examinations in healthy asymptomatic individuals. There are radiation risk issues in CT and principles of screening should be adhered to. There may be a role for targeted cardiac screening CT that derives calcium score, especially for asymptomatic medium-risk individuals and CT colonography when used as part of a strategic programme for colorectal cancer screening in those 50 years and older. However, population based screening CT examinations may become appropriate when evidence emerges regarding a clear benefit for the patient outweighing the associated radiation risks.
Atypical mycobacterium is rarely seen as a cause of chronic mastoiditis but has been increasingly recognized over the past few years. Mycobacterium abscessus is the most pathogenic and chemotherapy-resistant, rapid-growing mycobacterium of all the four groups. This paper presents a case of a 57-year-old woman who had chronic mastoiditis with recurrent exacerbations. The initial computed tomography (CT) findings showed the presence of an inflammatory process and she was treated with the appropriate antibiotics. The patient subsequently underwent a tissue biopsy when she presented with another exacerbation. At this time, the CT scan did not identify the ongoing exacerbation, but the Gallium-67 scintigraphy did.
Informal discussion started in 1996 and the South East Asian Federation of Organizations for Medical Physics (SEAFOMP) was officially accepted as a regional chapter of the IOMP at the Chicago World Congress in 2000 with five member countries, namely Indonesia, Malaysia, Philippines, Singapore and Thailand. Professor Kwan-Hoong Ng served as the founding president until 2006. Brunei (2002) and Vietnam (2005) joined subsequently. We are very grateful to the founding members of SEAFOMP: Anchali Krisanachinda, Kwan-Hoong Ng, Agnette Peralta, Ratana Pirabul, Djarwani S Soejoko and Toh-Jui Wong.The objectives of SEAFOMP are to promote (i) co-operation and communication between medical physics organizations in the region; (ii) medical physics and related activities in the region; (iii) the advancement in status and standard of practice of the medical physics profession; (iv) to organize and/or sponsor international and regional conferences, meetings or courses; (v) to collaborate or affiliate with other scientific organizations.SEAFOMP has been organizing a series of congresses to promote scientific exchange and mutual support. The South East Asian Congress of Medical Physics (SEACOMP) series was held respectively in Kuala Lumpur (2001), Bangkok (2003), Kuala Lumpur (2004) and Jakarta (2006). The respective congress themes indicated the emphasis and status of development. The number of participants (countries in parentheses) was encouraging: 110 (17), 150 (16), 220 (23) and 126 (7).In honour of the late Professor John Cameron, an eponymous lecture was established. The inaugural John Cameron Lecture was delivered by Professor Willi Kalender in 2004. His lecture was titled "Recent Developments in Volume CT Scanning".
MatLab(®) has often been considered an excellent environment for fast algorithm development but is generally perceived as slow and hence not fit for routine medical image processing, where large data sets are now available e.g., high-resolution CT image sets with typically hundreds of 512x512 slices. Yet, with proper programming practices - vectorization, pre-allocation and specialization - applications in MatLab(®) can run as fast as in C language. In this article, this point is illustrated with fast implementations of bilinear interpolation, watershed segmentation and volume rendering.