Comparison of CT angiography and digital subtraction angiography in the diagnosis of aortic coarctation.

There are several methods for the diagnosis and evaluation of coarctation of the aorta. Digital Subtraction Angiography (DSA) is the standard detection method, though it entails complications and side-effects. The aim of the present study was to compare Computed Tomography (CT) angiography with DSA for diagnosing aortic coarctation. We performed a cross-sectional study of 15 patients (11 males and four females aged between two and 30 years) referred to Tabriz Shahid Madani Hospital and Imaging Center between August 2005 and February 2006 with suspected aortic coarctation. All patients were subjected to DSA and CT angiography for diagnosis of aortic coarctation. The mean age of the patients was 14.6 years; 11 were male (74.4%) and four (26.6%) were female. The DSA and CT angiography results were comparable in all patients in terms of diagnosis and the detection of complications, particularly cardiovascular complications. However, CT angiography was less time-consuming to perform than DSA (p < 0.0001). In conclusion, CT angiography, comparableto DSA, diagnosed coarctation of aorta in all the patients. However, CT angiography is a non-invasive, cost effective procedure that takes significantly less time to carry out than DSA. Therefore, CT angiography is recommended as an appropriate method for diagnosing the coarctation of aorta.

Metastatic brain tumors: a retrospective review in East Azarbyjan (Tabriz).

A set of one hundred and twenty nine patients with known primary malignancy and suspected brain metastasis was reviewed in present study. The patients were selected among patients presented to the MRI section of Imam Khomeini Hospital or a private MRI center in Tabriz (Iran). Primary tumor site, clinical manifestations, number and site of lesions were identified in this patient population. The primary tumor site was breast in 55 patients (42.6%), followed by lung (40.3%), kidney (7.7%), colorectal (4.6%), lymphoma (3.1%) and melanoma (1.5%). Most patients were presented with features of increased intracranial pressure (headaches and vomiting), seizures and focal neurologic signs. Single brain metastasis occurred in 16.3% of patients, while multiple lesions accounted for 83.7% of patients. Ninety seven patients had supratentorial metastases (75.2%). Twenty cases (15.5%) had metastases in both compartments. Infratentorial lesions were observed only in twelve patients (9.3%).

Anatomical distribution of central nervous system plaques in multiple sclerosis: an Iranian experience.

Multiple Sclerosis (MS) begins most commonly in young adults and is characterized by multiple areas of Central Nervous System (CNS) white matter inflammation, demyelination and glial scarring. The most valuable laboratory aid for diagnosing MS is Magnetic Resonance Imaging (MRI). An advanced type of MRI that exploits molecular diffusion can detect acute and active lesions. Early diagnosis and onset of treatment help to hinder disease progression. The aim of this study was to compare the findings of conventional and Diffusion-Weighted (DW) MRI in assessing the cerebral lesions of MS patients. Thirty patients with clinically definite MS (mean age 32.76 +/- 8.79 years) and an age- and sex-matched control group of 30 healthy volunteers (mean age 32.75 +/- 9.23 years) were enrolled in this 12 month descriptive-prospective survey. Both groups were subjected to conventional and DW MRI and were compared in respect of the total number, morphology, location and the mean size of the intra-cerebral MS plaques. The sensitivities and specificities of both imaging methods in detecting these plaques were determined. The conventional method revealed significantly more plaques within the brain (p < 0.05) and showed more ovoid lesions. More lesions were detected by the conventional method in the periventricular area, centrum semiovale and corpus callosum. The minimum plaque size was significantly lower in the conventional method group. The sensitivity of both methods was 100%. The specificities of conventional and DW MRI were 86.6 and 96.6%, respectively, so DW MRI may detect lesions that are not obvious by routine methods.

Intracranial displacement of the eye after blunt trauma.

A 67-year-old man fell from an agricultural vehicle and struck his right eye on a protruding element. Eight hours later, he was brought to the emergency unit of an ophthalmology hospital where examiners could not find the right eye and believed it to have been completely destroyed. However, CT disclosed that the eye, apparently still intact, had been displaced into the anterior cranial fossa through a fracture in the orbital roof. This is the first documentation of such a phenomenon.

Diagnosis of airway malacia by virtual bronchoscopy.

The study was aimed to identify the role of virtual bronchoscopy in detection of airway malacia in children. In a pre-experimental study over 3 years (from Nov. 2003 to Oct. 2006), 35 consecutive patients were presented to Tabriz Children's Hospital with clinical manifestations of airway malacia, examined by the technique of virtual bronchoscopy. Thirty five patients including 23 males and 12 females with the mean age of 3.7 +/- 1.6 months were studied. The presence of airway malacia and its location and severity were determined by virtual bronchoscopy in all studied cases; that revealed: laryngomalacia, bronchomalacia, tracheomalacia, laryngotracheomalacia and laryngobronchomalacia in 42.8, 25.7, 20, 8.6 and 2.9% of patients, respectively. Virtual bronchoscopy is a non-invasive, accurate and rapid imaging technique with an excellent validity for diagnosis of airway malacia and stenosis, therefore it can replace conventional bronchoscopy.

Delineation of lateral tentorial sinus with contrast-enhanced MR imaging and its surgical implications.

BACKGROUND AND PURPOSE: The lateral tentorial sinus (LTS) has not been well described in the imaging literature. The aim of this study was to investigate the value of MR imaging in assessing the LTS, which may provide guidance for preoperative planning. METHODS: Fifty-five adult patients underwent MR imaging of the brain. Four neuroradiologists evaluated the studies for delineation of the LTS and its branches. Presence of arachnoid granulation and dominance of the venous drainage also were reported. RESULTS: An LTS was detected in 104 of 110 lobes. The LTS in each lobe was classified as type I (candelabra) in 30 (28.8%), type II (independent veins) in 22 (21.1%), and type III (venous lakes) in 37 (35.5%); in 15 (14.4%) of the lobes, the LTS was indeterminate. LTS branches were inconsistently detected, with the exception of the vein of Labbé (VL). Five of eight branches were seen in approximately half of the cases. The VL was identified in 94 (85.4%) lobes. Among these, 53 (56.4%) were draining into the LTS and 22 (23.4%) into the transverse sinus; in 19 (20.2%) cases, the terminal portion was not visualized. The right transverse sinus was dominant in 19 (34.5%) patients and the left in 18 (32.7%); codomination was present in 18 (32.7%) cases. At least one arachnoid granulation was seen in the transverse sinus in 27 (49.1%) patients. CONCLUSION: In many instances, the LTS and VL drainage patterns were well delineated on routine MR images. For selected cases, this information may be crucial during lateral skull base surgery to avoid venous infarct.