donya farrokh

Chronic pulmonary thromboembolism (CTEPH) is an unusual complication of acute pulmonary embolism (PE), which is now considered to be treatable. In modern multi-detector scanners, a detailed evaluation of pulmonary artery geometry is currently possible. This study aimed to evaluate the changes in pulmonary artery bifurcation angle (PABA) in the follow-up computed tomography angiography (CTA) of patients with acute PE.  In this cross-sectional study, the records of two tertiary-level academic hospitals were gathered from 2012 to 2019. Pulmonary artery (PA) bifurcation angle and diameter were measured. Chi square test, independent samples t test, Mann-Whitney, and Pearson’s tests were employed to compare data. To evaluate the cut-off point, we utilized receiver operating characteristic (ROC) curve analysis. The accuracy, sensitivity, and specificity of pulmonary artery bifurcation angle changes were calculated. A P value <0.05 was considered to be significant.  Forty-six patients were included in the study. No significant differences were found between patients with and without CTEPH, and PABA in the dimeters of PA trunk, right PA, and left PA in the first CTA images (P values of 0.151, 0.142, 0.891, and 0.483, respectively), while in the secondary CTA, the mean PABA was significantly smaller in patients with CTEPH (P=0.011). In the receiver operating characteristic (ROC) analysis, delta angle revealed an area under the curve of 0.745 and an optimal cutoff of 0, leading to a sensitivity of 64%, specificity of 87%, and accuracy of 76% for diagnosing CTEPH. We showed a significant decrease in PABA in patients developing CTEPH. This parameter can be easily measured in lung CTA.

Rotator cuff disorders are a leading cause of shoulder symptoms. Accurate imaging, detecting the typeof the involved muscle, and severity of the injury have important effects on the choice of treatment. Accordingly, thecurrent study was conducted to evaluate the diagnostic accuracy of ultrasound for rotator cuff disorders in patientssuffering from shoulder pain and to explore the precision of ultrasound in determining the exact dimensions of a tear incomparison with magnetic resonance imaging (MRI). This prospective research was performed on patients clinically suspected of rotator cuff tendinopathy. Anultrasound of the shoulder was initially performed for the candidates. In this study, MRI was regarded as the modalityof choice for examining the images of shoulder disorders. The European Society of Musculoskeletal Radiology (ESSR)guidelines were used to design the protocols and implement imaging measures. Based on the reference standard ofMRI, the specificity and sensitivity as well as positive and negative predictive values of ultrasound in detection of rotatorcuff disorders were calculated. A total of48 patients (22 women, 23 dominant right hands) with an average age of 51.6±8.3 years wereenrolled in this study. Based on MRI findings, rotator cuff disorders were detected in 43 patients (89.5%). The mostcommonly observed disorders were partial-thickness rotator cuff tear (n=17, 35.4%), full-thickness rotator cuff tear(n=16, 33.3%), and tendinopathy (n=10, 20.8%). Among rotator cuff disorders, the highest sensitivity of ultrasound wasobserved in the detection of full-thickness tear (93.7%) and rotator cuff tendinopathy (90%). The highest specificity wasfound in the detection of full-thickness rotator cuff tear (100%) and partial-thickness rotator cuff tear (96.7%). Based on our findings, ultrasound could be considered as a high-quality diagnostic tool to rule in partialand full-thickness rotator cuff tears and rule out the rotator cuff pathologies.Level of evidence: I

Due to the fact that breast cancer has a high prevalence in the society and in a significant number of patients, its initial manifestation is only in the form of microcalcification on mammography, this study was performed with aim to  evaluate the pathologic results of stereotactic core needle  biopsy to determine the prevalence of malignant and benign lesion and subtype in each group in patients with  suspicious microcalcifications on mammography based on BIRADS classification.

In this descriptive study, 59 patients referred to mammographic clinic in Mashhad city between April2017-September2019, and underwent sterotactic core biopsy because of the presence of suspicious microcalcifications (including morphology and distribution) without mass or focal asymmetry on mammography. In all patients, calcification was identified in at least one core needle specimen after performing specimen mammography. The specimens were submitted and referred to pathologic laboratory and analyzed by two pathologists. The total prevalence of benign and malignant lesions and also the prevalence of subtype lesions in each group were evaluated. The results of different mammographic appearance of suspicious microcalcifications were also compared with pathologic diagnosis. Data were analyzed using SPSS statistical software (version 16) and descriptive statistics methods and frequency distribution of variables in the form of tables. P<0.05 was considered statistically significant.

Benign lesions were seen in 42 patients (71%) and malignant lesions in 17 patients (29%) in histopathologic examination. Total prevalence of benign lesions was more than malignant lesions and the prevalence of non-proliferative lesions more than proliferative lesions. Fibrocystic change was the most common lesion in non-proliferative group (54%). In malignant group, prevalence of Dcis Carcinoma and invasive ductal carcinoma was 74% and 26%, respectively. Prevalence of malignancy was more in pleomorphic type of microcalcifications than amorphous and coarse heterogeneous types.

According to the significant prevalence of malignancy especially the prevalence of DCIS, sterotactic biopsy can be used as a noninvasive biopsy method for Microcalcifications which have a suspicious morphology and distribution to detect early breast cancer.

 Hepatic lipomas are rare benign lesions of the liver with characteristic findings on imaging, which differentiate them from other more important tumors of the liver and prevent unessential invasive procedures.

 A 62-year-old man with intense acute dyspnea referred to our emergency department in Imam Reza Hospital, Mashhad city, Iran. We performed initial diagnostic tests, Chest X-Ray (CXR), and non-contrast lung CT scan for further evaluation. Laboratory tests were in the normal range, but two well-defined lobulated masses with typical features of lipomas were noted on abdominal sections of plain CT scan in the patient's liver. The aim of this report is to define the characteristic appearance of these benign neoplasms on imaging techniques and to help exclude some more prevalent hepatic tumors with similar appearances without invasive procedures.

 Although there are numerous fat-containing lesions in the liver and some have heterogeneous and atypical features, it is often possible to make a definitive diagnosis of hepatic lipomas based on their typical imaging features, including pure fat density on CT scan, well-defined margins, chemical shift artifact on MRI, etc.

Regarding to high prevalence of breast cancer, it is important to find strategies for early, rapid, convenient and accessible diagnosis. After screening and detecting a lesion in the breast, the type of lesion and the degree of malignancy should be determined.This study was performed with aim to evaluate the concordance between sonographic and histologic findings in breast lesions under core needle biopsy.

This cross-sectional prospective study was performed on 149 patients referred to Omid Hospital, Mashhad University of Medical Sciences who underwent core needle biopsy from breast lesions during 2015 to 2018. Patients who had BI-RADS 3, 4, and 5 and according to the surgeon's recommendation required biopsy of the lesion underwent ultrasonically guided biopsy. Also, the lesions which had a malignant sonographic view, but were placed in the benign lesions group after core needle biopsy and histologic examination, were evaluated with excision. Data were analyzed using SPSS software (version 22) and descriptive statistics (frequency distribution table and frequency percentage).

The histological findings of BI-RADS 3 lesions were completely benign (11 cases). The frequency of malignancy in lesions with BI-RADS 4 was 31% (39 cases). All cases with BI-RADS 5 were malignant according to histological finding. 8 (44%) of 18 cases with BI-RADS 4b lesions that were benign according to needle biopsy findings were malignant in excisional biopsy findings.

In cases that breast lesions are BI-RADS 4b in sonography and the results of core needle biopsy showed benign lesions, additional histological diagnostic evaluation is recommended to rule out malignancy. More studies with higher sample sizes are recommended to confirm the results of this study.

Ultrasound is a valuable diagnostic imaging modality in the clinical evaluation of breast masses. BIRADS (Breast Imaging Reporting and Data System) classification in ultrasound is an important and reliable method for assessment and estimation of the risk of malignancy in breast lesions. This study was performed with aim to evaluate the accuracy of the results of BIRADS classification (Grade 3 and 4) using sonography in evaluating the level of malignancy of breast masses and comparing it with pathology results. This study was performed on 139 patients referred to Imam Reza hospital, Omid Oncology hospital and some private clinics in Mashhad and evaluated the patients with palpable breast mass who were ultrasound candidates for further examination of the nature of mass in 2014-2016. Axilla breast ultrasound was performed by two radiology professors. Based on the classification of the American Radiology Society and BIRADS system, various degrees of breast masses malignancy were identified, and then the patients were referred for biopsy. The pathologic results were compared with ultrasound reports, and consistency of the results and accuracy of ultrasound were examined with statistical tests. Data were analyzed by SPSS software (version 16). Out of 37 biopsies of lesions with BIRADS-3 in ultrasound, two (5.4%) of the lesions resulted in malignant pathology. Out of 102 biopsies of lesions with BIRADS-4 in ultrasound, 65 (64%) resulted in benign pathology which indicates no consistency of pathology results with sonography in these cases. The sensitivity of the BIRADS-3 system for diagnosis of benign breast masses was 94% and its specificity was 64%. The sensitivity of the BIRADS-4 system for diagnosis of malignant breast cancers was 75% and its specificity was 79%. There was consistency between the results obtained from the classification by the BIRADS method and pathology; so regarding the relatively high accuracy of this method, radiologic-pathologic consistency can be used to determine how to follow the patients and choose the appropriate treatment method.

Background The first step in assessing thoracic lesions is chest X-ray, but the optional imaging procedure for the final diagnosis is controversial. We aimed to examine the diagnostic accuracy of imaging modalities in pediatric thoracic masses. Materials and Methods This prospective cross-sectional study was conducted from 2017 to 2018 in Dr. Sheikh hospital, Mashhad, Iran. A total of 130 patients with a confirmed pathology report of thoracic masses were recruited in this study. A pediatric radiologist independently evaluated the existing chest X-ray (CXR), ultrasound (US) and CT and reported the probable diagnosis. Imaging reports of CXR, US, and CT were compared with the pathology results. Results 83 (63.8%) of the patients were boys with the mean age of 72.15 + 46 months. The most prevalent site of the thoracic masses was the lung parenchyma with the frequency of 81 (62.3%), and the most frequent mass was hydatid cyst with the frequency of 57 (43.8%). Thoracic CT had the overall sensitivity of 100% for mass localization and 78.2% for nature determination; while US had the sensitivity of (95.4%) for mass localization and 90.9% for the diagnosis of mass nature. The sensitivity of CXR for thoracic mass localization was 89.4 and for mass nature determination was 35.5%. Conclusion Based on the results, CXR and US had a similar appropriate sensitivity in localization of thoracic masses. Although CT had the highest overall sensitivity for mass localization, in comparison with US, it was less diagnostic to define mass nature and US had the highest sensitivity for mass nature determination. Hence, US may potentially obviate further imaging such as CT in most of the cases.

A hydatid cyst of the breast is an extremely rare condition caused by Echinococcus granulosus, even in endemic countries, which accounts for 0.27% of all cases. Only a few reports have been published in the literature about breast hydatid cysts. Patients usually present with a palpable and painless lump in the breast. Clinically, it is difficult to differentiate breast hydatid cysts from more common breast lesions. However, imaging plays an important role, and often helps to distinguish this rare cystic disease of the breast from other breast masses.
Iran is an endemic area for Echinococcus granulosus, and we present six cases of primary breast hydatid cysts which were diagnosed over the course of 10 years in our institution. We aimed to present the mammographic and ultrasonographic findings for these patients.
Hydatid cysts should be considered in the diagnosis of cystic lesions of the breast, particularly in endemic areas.

Although tuberculosis has been a very common disease in endemic areas, isolated involvement of the breast was uncommon. The coexistences of breast carcinoma and tuberculosis mastitis was very rare but could create a dilemma in the diagnosis and treatment, as there were usually no pathognomonic features to differentiate malignancy from breast tuberculosis.

We have reported the case of a 40-year-old woman referred with a painful lump in her left breast and nipple retraction. Mammography has shown an irregular mass and pleomorphic micro calcifications. Breast ultrasound has revealed a hypo echoic irregular mass. The first diagnosis was breast carcinoma. Histological study confirms high grade ductal carcinoma in situ. There was also evidence of tuberculosis mastitis at histological examination of the breast specimen.

Breast tuberculosis has known as a rare disease even in endemic countries. Coexistence of breast carcinoma and tuberculosis mastitis is very rare but it could lead to many problems regarding diagnosis and treatment.

Magnetic resonance spectroscopy (MRS) is a sensitive and non-invasive imaging method that provides information about the metabolite variations due to pathological damages. In this study, we aimed to systematically review studies in which the MRS had been used for quantitative analysis of steatohepatitis.
PubMed and Scopus were methodically searched in June 2015 with following search method (((magnetic resonance spectroscopy OR MR spectroscopy OR MRS)) AND (hepatic steatosis OR steatohepatitis OR fatty liver)) AND Quantitative) to find relevant documents in which the diagnostic value of MRS had been investigated in patients with hepatic steatosis. Obtainable information were extracted and used for further evaluation based on the main purpose of this study.
Of 88 articles found in the PubMed and 328 found in the Scopus, only 10 relevant documents were selected and used for data extraction according to inclusion/exclusion criteria. Of total 2963 participants enrolled in the selected studies, 1428 were male and 1535 were female. The results of this review showed that MRS is reliable technique for quantitative assessment of steatohepatitis.
Findings showed that MRS as a non-invasive imaging method can quantitatively determine even small changes of metabolites due to pathological damages. As well, findings suggested that the results obtained by MR spectroscopy can be considered as reference standard in quantitative analysis. Based on the results of studied documents, MRS as a sensitive tool is helpful in the quantitative assessment of patients with fatty liver disease.

Renal angiomyolipoma (RAML), is a rare, benign tumor arising from renal mesenchymal cells. Frequently, it is asymptomatic and found incidentally. Spontaneous rupture with consequent retroperitoneal hemorrhage is an uncommon but catastrophic complication of RAML..
Herein, we report a case of a ruptured RAML with a massive retroperitoneal hemorrhage, seen at the emergency department following a minor trauma. A computed tomography (CT) scan showed a left RAML with retroperitoneal hemorrhage. An angiography was performed and then a transarterial embolization. Cessation of bleeding and clinical stabilization occurred without deterioration of renal function..
In hemodynamically stable patients with a ruptured RAML, early detection by CT followed by selective arterial embolization may be lifesaving..

Menstruation leads to bleeding and anemia; while endurance training causes erythropoiesis and stimulates hematopoiesis; therefore, this study was performed with aim to evaluate the effects of 6 weeks aerobic exercise training on blood hematological factors in adolescence girls.
This semi-experimental study was performed on 20 girls aged 11-12 years old in 2014. The subjects were randomly enrolled in two groups (Experimental and Control). Experimental group performed aerobic exercise for three sessions per week for six weeks. The control group continued the usual daily activities. Before and after the exercise programs, complete blood count (CBC; using the blood samples) and maximum oxygen uptake (VO2max; using 1600 meters running and walking) were measured. Data analysis was performed by SPSS software (version 16) and dependent and independent t-test, Kolmogorov Smironov, and Shapiro-Wilk tests. P
Increase of VO2max was significant after exercise in experimental group (P=0.018). The value of RBC, HGB, and HCT significantly increased after exercise in two groups (P0.05).
Six weeks of aerobic exercise are significantly effective in VO2max without significant changes in other hematological factors in adolescence girls.

Primary angiosarcoma of the breast is a rare malignant tumor. Diagnostic breast imaging includes mammography and ultrasound, which are usually nonspecific. A 42-year-old woman with angiosarcoma of the breast is presented. Physical findings showed a hard exophytic mass in the upper part of the left breast, with skin discoloration overlaying the mass. Mammography revealed a high density well defined mass in the left breast, without any micro-calcification and speculation. On ultrasound examination, a hypoechoic mass with a well-defined margin and heterogenous echogenicity was detected. A core needle biopsy and excisional biopsy were performed, and histological examination confirmed the diagnosis of angiosarcoma. The patient underwent simple mastectomy. We present the mammographic and ultrasonographic features of a case of primary breast angiosarcoma with exophytic growth.

preeclampsia is associated with various maternal and neonatal outcomes such as intra-uterine growth retardation, preterm labor and increased risk of fetal mortality. It seems that increased uterine vascular resistance is associated with higher risk of preeclampsia progression. This study was performed with aim to investigate uterine artery indexes in Doppler sonography for predicting neonatal outcome in preeclamptic pregnancies.
this prospective study was conducted on 46 pre-eclampsia and 74 normal pregnant women referred to Emam Reza and Omalbanin hospitals in 2014. Trans-abdominal Doppler sonography was conducted between 26-36 weeks of pregnancy at supine position and Doppler signals of uterine artery indexes were evaluated and after delivery, neonatal complications were added to the form of evaluation. Data was analyzed by SPSS software (version 16) and T-student, Chi-square and Mann-Whitney tests. P The highest sensitivity, specificity and positive predictive value for the mean Pulsatility index of uterine artery in women with preeclampsia in predicting of low birth weight infants were 51.7% and 90.9% and 93.7%, respectively. The highest sensitivity and positive predictive value of uterine artery resistance index in predicting of low birth weight infants were 62% and 94.7%, respectively. Also, mean uterine artery resistance index in prediction of all adverse pregnancy outcomes had high specificity.
Although uterine artery indexes in Doppler sonography has no high sensitivity to predict neonatal outcomes, but their abnormal range can predict low birth weight.

Systemic sclerosis (SS) is a collagen vascular disease of unknown etiology that is characterized by connective tissue abnormalities. This study aimed to evaluate the extra-pulmonary manifestations of SS on chest high resolution computed tomography (HRCT). The medical records of patients with SS who presented to our hospital in a 10-year period were retrospectively reviewed. Forty patients with SS were included in this study. The extra pulmonary manifestations of SS were evaluated in these patients, including esophageal involvement, pulmonary arterial dilatation, pleural abnormalities, pericardial disease and mediastinal lymph node involvement. The most common extra-pulmonary manifestation was esophageal dilatation, which was detected in 70% of the cases followed by pleural involvement. Pulmonary arterial dilatation was seen in 20%, pleural involvement in 40%, pericardial involvement in 40% and mediastinal lymphadenopathy in 30%. The most common pleural abnormality was diffuse pleural thickening and the most common pericardial abnormality was pericardial effusion. There was an association between the severity of lung fibrosis with the incidence of esophageal dilatation and pulmonary arterial hypertension (PAH) in our series. Patients with SS and interstitial lung disease (ILD) who had PAH, had more severe lung fibrosis than those without PAH. Patients with SS may have a variety of extra-pulmonary manifestations, which can be detected using HRCT. Our study evidenced that HRCT was useful for detecting extra-pulmonary findings of SS such as esophageal dysmotility and dilatation, enlargement of main pulmonary artery and PAH, pleuropericardial involvement and mediastinal lymphadenopathy

we aimed to determine the best differential diagnosis between Crohn''s disease and intestinal tuberculosis. Abdominal and pelvic ct exams with oral and IV contrast and small bowel barium study findings are selected to differentiate intestinal tuberculosis from crohn’s disease. This was a cross-sectional retrospective study between 2001 -2011. The data was gathered from the medical records of patients with peritoneal and intestinal tuberculosis and Crohn''s disease who were referred to Ghaem and Emam raza Hospitals. Twenty six patients with Crohn''s and 22 cases of intestinal tuberculosis were selected. The data was extracted from the bowel and mesentery imaging methods including abdominal and pelvis CT-scan with oral and IV contrast، CT enterography، and small intestinal transit. The frequency of ten visible radiographic findings of medical records of patients was assessed and diagnostic value of each variable was evaluated in differentiating the two diseases. There was a significant difference between the age of the patients with TB and Crohn''s (p=0. 013). Data of CT-scan showed there was a significant difference between the patients with and without thickening and multiple strictures (p=0. 01)، mural strification (p=0. 015)، mural calcification (0. 038)، mesentic hypervascularity or natural mesenteric vasculature، ascites، lymphadenopathy (all، p<0. 001)، fibrofatty proliferation (p=0. 015)، and necrosis (p=0. 001). The other data showed that there was a significant association between mural strification and mesentic hypervascularity (p<0. 001). our study showed CT-scan is effective in proper diagnosis of TB by imaging findings and could differentiate Crohn''s disease. The mural calcification was evaluated as distinguishing factor of TB from Crohn’s disease. Necrotic lymphadenopathy in CT-scan can be assessed as a tool for differentiated TB from Crohn''s disease.

Genital tuberculosis (TB) is an important cause of infertility in the developing countries, where hysterosalpingography (HSG) remains an initial diagnostic procedure in the evaluation of tubal and peritoneal factors leading to infertility.

The aim of this study was to determine the HSG findings of genital TB in infertile women.

We retrospectively reviewed HSG findings in 20 women with genital tuberculosis. HSG was performed in these women as part of infertility work up over 5 years. The other diagnostic procedures used included endometrial curettage and biopsy, histological examination, culture, laparoscopy, hysteroscopy and polymerase chain reaction.

The mean age of the participants was 30.5±8 years. All women had clinical history of infertility for at least 4 years. Women presented with pelvic abdominal pain (30-35%) and menstrual disturbances (20-25%). Reviewing 20 cases of female genital TB were encountered various presentations on HSG.

HSG is an invaluable procedure in suggesting the diagnosis of genital TB in patients being investigated for infertility.

The aim of this study was to categorize abnormal mammographic findings in 1000 patients according to Breast Imaging-Reporting and Data System (BI-RADS) and to report most common age of abnormal mammographic findings, average age of incidence of malignancy and determination of suitable age to start the screening process in women. 1000 patients attending Radiology department for mammographic screening during 2007-2008 were asked to participate in this study. One radiologist evaluated the mammograms and categorized patients based on the BI-RADS. The average age of patients diagnosed with invasive ductal carcinoma and in situ ductal carcinoma was 48±6.51years. The average age of patients in category 5 (that translates into “probably malignant”) was (53±7.87) years. The average age of patients in other categories except for category 0 and category 1 that translates into “negative” was (52.07±7.81) years. There was also a significant relationship between patient’s age and BI-RADS categories according to findings of this study. Based on early incidence of irregular mammographies (52.07 years) and early incidence of malignant findings in such mammographies (48± 6.51 years), it is suggested to implement screening programs in a great scale for patients older than 35 years old. Based on high percentage of patients with increased breast density findings in mammograms (11.6%) and diagnosis of two cases with invasive ductal carcinoma in this group, we recommend sonography of patients with such findings to rule out the presence or absence of malignancy with a higher accuracy for which mammograms lack a diagnostic value.

Alveolar hydatid disease is a highly malignant form of echinococcosis caused by the larvae of the cestode echinococcus multilocularis. Alveolar hydatid disease always affects the liver and can metastasise to the lung and brain. Early diagnosis and precise evaluation of the localization as well as the extent of lesions are essential for treatment. In this report, we present ultrasound and computed tomography findings in a patient with hepatic alveolar echinococcosis. The patient, who was presented with hepatomegaly, jaundice, and an infiltrative solid tumor, diagnosed by ultrasound and computed tomography. In contrast to hydatid cyst caused by echinococcus granulosus, this is a rare disease in Iran.

Traumatic events are one of the major causes of arterial injuries. Physical examination is not a good predictor of the extent of injuries and arteriography is considered as the gold standard for this purpose. In the recent years, noninvasive modalities are increasingly replacing diagnostic arteriography. Color Doppler ultrasonography (USG) is an excellent method to investigate arterial diseases. The present study aimed to evaluate the diagnostic value of color Doppler USG compared to conventional angiography in traumatic arterial injuries of extremities.Patients and Seventy-five patients with extremity trauma suspicious for arterial injury were examined by color Doppler USG just before angiography. Doppler pattern and flow states were assessed, then angiography was performed. The results of duplex USG were compared with angiography. Color Doppler USG had a sensitivity of 95% and specificity of 98% in diagnosis of arterial injury. Positive and negative predictive values of Doppler USG were 92.5% and 94.2%, respectively. Color Doppler USG can be used as a reliable modality with acceptable sensitivity and specificity values to screen hemodynamically stable patients with limb trauma suspicious for arterial injury.

Pulmonary actinomycosis is a rare chronic pulmonary infection caused by actinomyces, a Gram–positive, microaerophilic bacterium. Pulmonary involvement other than cervicofacial or abdominopelvic actinomycosis is uncommon and often leads to a misdiagnosis of pulmonary tuberculosis or lung cancer. Endobronchial involvement is very rare in pulmonary actinomycosis. Here in, we describe the case of a 66–year–old male patient, referred with a history of massive hemoptysis since a few weeks ago. Plain chest radiograph and computerized tomographic scan revealed a dens consolidation in the right upper lobe; which was confirmed to be pulmonary actinomycosis with endobronchial involvement by transbronchial biopsy.

Carotid intima-media thickness (cIMT) has been known as a criterion of generalized atherosclerosis and a marker of cardiovascular disease progression in many studies which can be measured by ultrasound using high-resolution device. This is a case-control study. A total of 40 children (16 males and 24 females) with type1 diabetes mellitus and control group consisting of equal numbers (17 males and 23 females) who were otherwise healthy were included in the study from May 2007 to January 2008. The two groups were age matched, with the mean age of 10.56±3.21 years in control group and 10.67±4.18 years in diabetic patients. Left and right cIMT were measured by ultrasound. There was a significant difference between case and control subjects in terms of mean cIMT (P<0.001). cIMT was significantly higher in the diabetic group. Among variables including age, BMI and diabetes, diabetes was the only influential parameter in this respect. The mean time length of type 1 diabetes in our diabetic group was reported 4.24±3.02 years, with a minimum of four months and a maximum of ten years. There was a statistically significant difference between the two diabetic patients with below and above four years of disease duration (P=0.03 for right carotid artery and P=0.01 for left carotid artery). cIMT has been identified as an early indicator of atherosclerosis in many studies. It increases in patients with type 1 diabetes as the disease progresses and this can be followed by macro and microvascular atherosclerotic changes.

Hydatid disease is a parasitic infestation caused by the larval form of Echinococcus gronulosus and it remains a considerable public health problem in several Mediterranean countries such as Iran. Liver is the most common site of involvement. Lungs are the second most common sites of hematogeneous spread in adults and are probably the most common sites in children (15% - 25% of cases). Primary hydatid cyst of the spleen is a rare entity. Here, we describe a case of primary splenic hydatid cyst in a six-year-old boy who was presented with left upper quadrant pain and swelling. Abdominal ultrasonography revealed a large cystic mass in the spleen. Computed tomography (CT) confirmed the primary splenic hydatid cyst. No other organ or system involvement could be demonstrated. Total splenectomy was performed for the patient..

Lung disorders are important for prognosis of connective tissue disease (CTD). Thus, chest radiography, High Resolution Computed Tomography (HRCT) of the chest and ultrasonic echocardiogram are suggested after the diagnosis of these conditions. The purpose of this study was to evaluate chest HRCT findings in patients with CTD. In this descriptive cross-sectional study, we evaluated HRCT findings in patients with (CTD) hospitalized in Imam Reza Hospital in Mashhad from 2006- 2011. Patients’ age, sex, type of rheumatic disease andHRCT results were collected and analyzed by SPSS version 16.0 software. out of 75 patients (78.67% females, 21.33% males with a mean age of 41.6 years), 56% had respiratory symptoms. Scleroderma was the most common disease (38.6%) followed by rheumatoid arthritis (26.6%) and systemic lupus erythematosus (14.6%). Interstitial tissue involvement of the lung was the most frequent finding in patients with scleroderma, dermatomyositis, polymyositis and Sjogren's syndrome (48.3%, 57.1%, 60% and 66.7%, respectively). Pleural thickening was the most common finding in patients with rheumatoid arthritis (45%). Pleural effusion was the most frequent finding in patients with systemic lupus erythematosus (45.4%). Lymphadenopathy and bronchiectasis had the lowest prevalence (1.3%). Our data shows that interstitial tissue involvement, pleural thickening and pleural effusion are common in patients with rheumatic diseases which is consistent with some previous studies.