Respiratory-motion artefacts in liver MRI following injection of gadoxetate disodium and gadobenate dimeglumine: an intra-individual comparative study in cirrhotic patients.

AIM: To perform an intra-individual comparison of the frequency of respiratory-motion artefacts on magnetic resonance imaging (MRI) in cirrhotic patients following injection of gadoxetate disodium and gadobenate dimeglumine. MATERIALS AND METHODS: Ninety-five cirrhotic patients (61 men and 34 women, mean age 58 years) underwent liver MRI with intravenous administration of gadoxetate disodium and gadobenate dimeglumine at different times (interval between studies, 189±83 days). Three readers scored the severity of respiratory-motion artefacts on the three-dimensional (3D) gradient-echo (GRE) images acquired before and after contrast medium injection. McNemar's test was used to assess the difference in frequency of new respiratory-motion artefacts and transient severe motion (TSM) artefacts between gadoxetate disodium and gadobenate dimeglumine MRI studies. The association between clinical and technical features and the occurrence of TSM on gadoxetate disodium MRI studies was investigated. RESULTS: On arterial phase images, new respiratory-motion artefacts were present in 32/95 (34%) cases after injection of gadoxetate disodium, while only seen in 2/95 (2%) cases after injection of gadobenate dimeglumine (p<0.0001). TSM was present in 6/95 (6%) cases after injection of gadoxetate disodium, and in 0/95 (0%) case after injection of gadobenate dimeglumine. No clinical or technical features were associated with the occurrence of TSM. CONCLUSIONS: In cirrhotic patients, respiratory-motion artefacts on arterial phase 3D GRE images are more frequently seen after injection of gadoxetate disodium than after injection of gadobenate dimeglumine.

Anomalous left brachiocephalic vein: important vascular anomaly concomitant with congenital anomalies and heart diseases.

BACKGROUND: Anomalous left brachiocephalic vein (ALBCV) is a rare and less known systemic venous anomaly. Infrequently, this vein takes an abnormal course and passes to the right behind or beneath the aortic arch to create the superior vena cava (SVC). Its incidence was reported much higher in patients with congenital heart disease especially in conotruncal and aortic arch anomalies. It could be misdiagnosed with normal or abnormal mediastinal structures. It also could make complication during surgeries or invasive strategies. Previously, this anatomical finding has been reported in case reports and there are just few studies evaluating these patients as a group to find other abnormalities MATERIALS AND METHODS: We conducted a retrospective, multicentre study between 2008 and 2014 at three institutions. We reviewed thoracic computed tomography angiography of 1372 patients referred to these centres. The diagnosis of ALBCV was confirmed by an expert radiologist and the imagings were reassessed to identify new cases and concomitant anomalies. We analysed the imagings' details and measured the prevalence of each anomaly. RESULTS: Among the 22 cases of ALBCV, 12 (54.5%) and 10 (45.4%) patients were males and females, respectively, with median age of 12.5 years. Tetralogy of Fallot (TOF) was considered as a most concomitant anomaly with ALBCV (54.5%). Two patients had associated atrial septal defect (ASD) and defined as pentalogy of Fallot. Right-sided aortic arc (RSAA) was detected in 12 (54.5%) patients; mirror image was found in 5 of them. Pure ventricular septal defect or pulmonary stenosis without TOF was recognised in 4 patients. Three cases had isolated overriding aorta (13.6%). In 3 patients, we could find patent ductus arteriosus (13.6%). In 2 (9%) patients, abdominal haemangioma was incidentally diagnosed. Aberrant left retrotracheal subclavian artery was detected in 1 (4.5%) patient. One patient only had isolated ALBCV (4.5%). CONCLUSIONS: In our study, ALBCV was frequently seen in association with other congenital anomalies. mostly TOF and RSAA. In patients with pulmonary hypoplasia or aplasia, some parts of lung's blood supply were provided by abnormal aorto-pulmonary connections. For a radiologist, it is important to differentiate this anomaly in cross-sectional imaging from persistent left SVC, partial anomalous pulmonary veins return and an enlarged lymph node. Detection of ALBCV could draw the attention to the more serious heart disease and in isolated forms prevented further evaluations.

Common and uncommon pitfalls in pancreatic imaging: it is not always cancer.

Despite advances in multimodality imaging of pancreas, there is still overlap between imaging findings of several pancreatic/peripancreatic disease processes. Pancreatic and peripancreatic non-neoplastic entities may mimic primary pancreatic neoplasms on ultrasound, CT, and MRI. On the other hand, primary pancreatic cancer may be overlooked on imaging because of technical and inherent factors. The purpose of this pictorial review is to describe and illustrate pancreatic imaging pitfalls and highlight the basic radiological features for proper differential diagnosis.

Non-visualisation of cavum septi pellucidi: implication in prenatal diagnosis?

OBJECTIVE: This manuscript reviews congenital anomalies and imaging findings associated with non-visualisation of the cavum septi pellucidi (CSP) found on prenatal sonogram. BACKGROUND: Observation of a normal cavum septi pellucidi (CSP) is an important landmark in the second and third trimester prenatal ultrasound evaluation of the fetal brain, and its visualisation provides reassurance of normal central forebrain development. Non-visualisation of the CSP is a prenatal sonographic finding, which in most cases is associated with neuroanatomical anomalies that include agenesis of the corpus callosum, schizencephaly, septo-optic dysplasia, holoprosencephaly, chronic hydrocephalus and acquired fetal brain injury. Isolated septal deficiency, a rare but controversial entity, is considered a variant of normal. Common pitfalls in the sonographic evaluation of CSP include columns of the fornix that mimic CSP, and prominent cavum vergae that can simulate non-visualisation of the CSP. When non-visualisation of the CSP is suspected, magnetic resonance imaging (MRI) of the fetal brain can confirm and evaluate associated anomalies. CONCLUSION: Visualisation of the CSP is an integral component of the prenatal ultrasound and its non-visualisation is associated with other malformations, diagnosis of which is aided by MRI. TEACHING POINTS: • Cavum septi pellucidi (CSP) is an important landmark in the prenatal ultrasound evaluation of the fetal brain, and is a marker for normal central forebrain development. • Non-visualisation of the CSP is most commonly associated with other neuroanatomical abnormalities. • Examination of the fetal brain by MRI can confirm the sonographic findings and evaluate for associated anomalies.

Interaction between root lesion nematode Pratylenchus vulnus and two species of Fusarium on growth and development of maple seedlings.

Producing healthy seedlings and distributing them to far areas, is one of the most important factor for developing forests. Because of easy planting, rapid growth and good wood quality, Acer velutinum is the most useful species, among the softwood and hardwood trees. Growth and development of the nurseries were effected by different pests and diseases, the nematodes are one of these agents. They are not actively surveyed in the forest nurseries in Iran. On a survey of maple seedling in the forest nurseries Pratylenchus vulnus, Fusarium solani and F. oxysporum were identified. The interaction between these two fungi and nematode were studied in randomized complete block design with four replications and six treatments. For mass production and multiplication of the nematodes, they were sterilized with Streptomycin Sulfate, they were reared on carrot disc culture. The nematodes were then added to each pot. The results showed a highly significant difference (p = 0.01) between different treatments. In the treatment with nematodes alone growth of seedlings was minimum and population density of nematodes in soil and root tissue was maximum. In this treatments 75% of seedlings were died and seedling average height were 2.25 cm. In the treatments with nematode and fungi together the population of nematodes were decreased and the growth of seedlings were increased, in comparison with nematode alone. F. oxysporum showed more antagonistic effect on nematodes than F. solani. In the nematode + F. oxysporum treatment, 25% of seedlings were died and seedling average height was 12.75 cm. In the nematode + F. solani treatment, 50% of seedlings were died and the seedling average height was 5.5 cm. This is the first report of pathogenecity of Pratylenchus vulnus and its interaction whit fungi on maple seedlings in Iran.