Iranian Journal of Radiology
Volume:9 Issue: 2, Jun 2012

Iodinated X-ray contrast media are the most commonly used contrast agents in the world with an annual application of 40-50 million. New non-ionic con- trast agents are subdivided into low osmolar agents such as iopromide and iso-osmolar agents such as iodixanol. Regarding different biochemical characteristics, these agents are different in the allergic reactions and contrast enhancement and final lesion conspicuity.. This study was carried out to compare allergic adverse effects and contrast enhancement between iodixanol and iopromide.Patients and One-hundred and twenty patients who were referred for abdominal CT scan to Besat Hospital were included in this study. Patients were randomly divided into two groups (A and B). Group A received 100 cc iodixanol (300 mgI/mL) and group B received 100 cc iopromide (300 mgI/ml) by power injector. CT examination was performed using Helical CT Scanner (Somatom, Siemens, Germany). Sixty seconds after injection, images were obtained and enhancement of port, liver and aorta were determined. Allergic adverse effects were recorded one hour and up to one week after injection. Iodixanol produced a significantly greater enhancement of the hepatic, aorta and portal vein than iopromide (P < 0.01). Sixty seconds after injection, associated pain and heat sensation were less frequent in iodixanol in comparison with iopromide (P = 0.03). Immediate reactions such as nausea and vomiting were less frequent in iodixanol (P = 0.01). Late skin reactions such as rash was more frequent in iodixanol (P < 0.01).. Iodixanol is safe and is better tolerated in the early phase of injection with better contrast enhancement and lesion conspicuity. Mild late skin rash is its disadvantage.

Infection after transrectal ultrasound (TRUS) guided biopsy of the prostate is a major and potentially life-threatening problem. Using antibiotic premedication can not completely eliminate infection after biopsy. We performed this study to determine the value of using povidone-iodine in prevention of post biopsy infection.Patients and Totally, 280 patients who were referred for TRUS guided biopsy of the prostate were divided randomly into two equal groups. The case group received an intrarectal mixture of povidone-iodine and lidocaine gel before performing biopsy, while the control group received only lidocaine gel. Patients were followed up for 30 days for possible signs of infection including fever, chills and dysuria. The mean age in the case group was 68.7 ± 7 years and 68.1 ± 7 years in the control group (P = 0.78). Overall, there were signs and symptoms of infection in 78 patients (27.9%), of which 27 (19.3%) were in the case group, while 51 (36.4%) were in the control group (P = 0.001, OR = 2.4, 95% CI = 1.4-4.1). Simple use of widely available povidone-iodine for cleaning the rectum before TRUS guided prostate biopsy can reduce the infection rate.

Many clinical and experimental studies have been done to analyze the anatomical and functional aspects of the internal auditory canal (IAC) in human beings since there are great inter-individual variability and structural variations that may occur regarding the other adjacent structures. The purpose of this study was to characterize the morphology of the internal auditory canal (IAC) during development using high resolution computed tomography (CT) and to analyze its dimensions, which will be determined by measuring the nearby areas and structures using a system of digital image processing.Patients and CT images of the IAC of 110 normal subjects aged 1 to 92 years (mean age, 46.5 years) of both genders were reviewed to determine the shape, area, opening width (OW), longitudinal length (LL), vertical diameter (VD) and distance from the vestibular aqueduct. The shapes observed in children and adults were funnel-shaped (74% and 58.3%, respectively), cylindrical (22% and 30.9%, respectively) and bud-shaped (4% and 10.8%, respectively). The measurements by CT in children were: area= 50.30 mm2, OW = 7.53 mm, length = 11.17 mm, VD = 4.82 mm and the distance between the IAC and the vestibular aqueduct (VA) = 12.63 mm. In adults, the measurements were: area = 44.64 mm2, OW = 7.10 mm, length = 9.84 mm, VD = 4.47 mm and the distance between IAC and VA = 11.17 mm. CT images showed that the IAC has different shapes and when the measurements obtained for children were compared with those of adults, the parameters that presented statistically significant differences in either gender were length and diameter.

Diabetes mellitus is a widespread disease. Its vascular complications can be characterized by arteriosclerosis formation in carotid arteries. Due to its delayed diagnosis resulting in more complications in Iran, it seems that screening diabetic patients is mandatory. The aim of this study was to compare the intima-media thickness (IMT) of carotid artery in diabetic and non-diabetic patients.Patients and This is a cross-sectional study, which included 80 participants (40 diabetics and 40 non-diabetics). By using ultrasound, bilateral IMTs of the distal carotid were measured and the data were analyzed using ANOVA and multivariate regression tests in SPSS 14. The mean IMT was 0.97 in diabetic patients and 0.63 in non-diabetics (P < 0.001). Age and gender had significant positive effects on the increase of IMT (P < 0.05 and P < 0.005, respectively for age and gender). Past medical history of coronary heart disease (CHD) and cerebrovascular accident (CVA) in diabetes is associated significantly with an increase in IMT (P =0.019 and 0.027 respectively). Other confounding variables such as smoking, history of hypertension (HTN) and hyperlipoproteinemia (HLP) in diabetic patients showed no significant relationship with the increase of IMT. Although measuring the IMT of the carotid artery by sonography is a useful tool for screening diabetic patients, more studies are needed for determining how to use these measurements in promoting the patients outcomes.

Diagnosis and accuracy in determining the exact location, extent and configuration of bony defects of the jaw are of utmost importance to determine prognosis, treatment planning and long-term preservation of teeth. If relatively accurate diagnosis can be established by radiography, proper treatment planning prior to treatment procedures will be possible. The aim of the present study was to assess the correlation between indirect digital radiographic measurements and clinical measurements in determining the topography of interproximal bony defects.Patients and Twenty interproximal bony defects, preferably in the mandibular and maxillary 5↔5 area were selected and radiographed using the parallel periapical technique. The radiographs were corrected and digitized on a computer using “Linear Measurement” software; then the three parameters of the base of defect (BD), alveolar crest (AC) and cementoenamel junction (CEJ) were determined using a software. Subsequent to radiographic measurements, clinical measurements were carried out meticulously during flap procedures. Then linear measurements were carried out using a periodontal probe to determine the defect depth and its mesiodistal width. Then the amount of correlation between these two measurements was assessed by Pearson's correlation coefficient. The correlation between clinical and radiographic measurements in defect depth determination, in the evaluation of defect angle and in determination of defect width were 88%, 98% and 90%, respectively. Indirect digital radiographic technique can be used to diagnose intra-osseous defects, providing a better opportunity to treat bony defects.

Primary non-Hodgkin’s lymphoma of the cranial vault is extremely rare. This case report presents a 42-year-old man with a painless subcutaneous scalp mass which extended intracranially associated with recent mild headache. Initial computed tomography and magnetic resonance imaging revealed two lesions emanating from the skull. Biopsy revealed a diagnosis of diffuse large B cell lymphoma (DLBCL). A thorough work-up revealed no other point of involvement. This case is concerned about considering lymphoma in the differential diagnosis of calvarial lesions with both intra- and extra cranial extensions but without obvious intervening bony destruction.

Pulmonary adenocarcinoma is one of the major types of lung cancers in which metastasis is not uncommon. Hereby, we report a case of pulmonary adenocarcinoma with multiple muscular, cutaneous, pancreatic and peritoneal metastases. Actually, all these features occurring in one patient makes it an extraordinary case. A rare anatomic variation, double inferior vena cava (IVCs), was another rare manifestation in this case.

Horseshoe lung is a congenital pulmonary malformation that is usually associated with scimitar syndrome. This malformation consists of fusion of both pulmonary lobes from the posterobasal segments. The fusion appears in the retrocardiac area, in front of the esophagus and thoracic aorta. Pleural separation of pulmonary lobes distinguishes pseudohorseshoe appearance from a true horseshoe lung. Scimitar syndrome known as hypogenetic lung syndrome is a part of the congenital pulmonary venolobar syndrome. It is a partial anomalous pulmonary venous return with pulmonary hypoplasia. Scimitar vein is an anomalous drainage vessel between the right pulmonary lobe vessels and the inferior vena cava. The appearance of the vessel resembles Turkish scimitar; therefore, the syndrome is called scimitar syndrome. We hereby report a 61-year-old woman with adult form congenital scimitar syndrome and will describe the imaging findings of pseudohorseshoe lung appearance.

Variation of the branches of the external carotid artery (ECA) is well known, but it is extremely rare for the occipital artery (OA) to arise from the internal carotid artery (ICA). A 87-year-old man was found to have this anatomical variation on the right side by threedimensional computed tomography angiography for vascular mapping of the carotid arteries before superselective intra-arterial catheterization for advanced tongue cancer. Imaging showed the OA arose from the anterior aspect of the right ICA with the origin located 8.8 mm distal from the carotid bifurcation. The inner diameter of the origin of the OA was 2.1 mm and the angle between the OA and the ICA was 62 degrees. It is important to recognize this anatomic variation of the branches of the ECA before head and neck microsurgical reconstruction or superselective intra-arterial chemotherapy for oral cancer.