In this study we reviewed the scans of 100 patients submitted to magnetic resonance angiography (MR angiography) of the brain for different clinical indications. The objectives of the study were to discuss the advantages and disadvantages of the 3D TOF in cerebral MR angiography, to review the main indications of MR angiography in the evaluation of intracranial vascular lesions, and to assess the frequency of the most important findings. The main indications for MR angiography were headache (n = 29), stroke (n = 14), transient ischemic attack (n = 11) and other causes (n = 35). In 11 patients the clinical indication could not be recovered from the patients records. Fifty two percent of the exams showed abnormalities. The main findings were vascular stenosis (n = 30), aneurysm (n = 10), anatomical variants (n = 6), vascular malformations (n = 4) and dural sinuses thrombosis (n = 2). The 3D TOF technique, the only technique applied in this study, proved to be efficient in most of the cases, requiring a relatively short acquisition time. One of the disadvantages was the lack of efficiency in covering large volume areas.

Keywords: Magnetic resonance angiography, Brain, Cerebrovascular diseases

OBJECTIVE: To review the abdominal ultrasound findings in patients with serologically proven dengue fever and to compare the results with data from the literature. MATERIALS AND METHODS: Thirty-eight patients with serologically proven dengue fever, 25 female and 13 male, mean age of 35 years, were submitted to abdominal ultrasound. The ultrasound findings were compared with data from the literature. RESULTS: The most relevant ultrasound findings were diffuse gallbladder wall thickening in 18 cases (47.4%), abdominal and/or pelvic free fluid in 12 (31.6%), splenomegaly in 11 (28.9%), hepatomegaly in 10 (26.3%) and perivesicular fluid in 10 (26.3%). Twenty-six percent of the patients had normal abdominal ultrasound. CONCLUSION: Abdominal sonography is a useful additional diagnostic tool for the confirmation of suspected cases of dengue hemorrhagic fever and for the evaluation of severity and progression of the disease. The knowledge of the ultrasound possible findings in patients with dengue fever is of extreme importance for the radiologist.

Keywords: Dengue, Ultrasound, Abdominal findings

Breast milk and cow's milk differ in multiple characteristics that account for a faster gastric emptying time after breast feeding. This faster gastric emptying may be associated with a faster gallbladder emptying. Our aim was to compare gallbladder contraction after breast milk meal and cow's milk meal using ultrasound examination. We studied 22 infants after a breast milk meal and 25 infants after a cow's milk meal. Gallbladder volume was measured after a 4-6 hours fasting and one hour after the meal (breast milk or cow's milk). Gallbladder contractility was calculated by determining the difference between gallbladder volume one hour after the meal and the fasting volume, and expressed as a percentage of the fasting volume. The gallbladder contractility medians for breast milk and cow's milk were 92.25% and 53.8%, respectively (p < 0.001). We concluded that gallbladder contraction after a breast milk meal is much faster than that after cow's milk meal.

Keywords: Gallbladder contraction, Ultrasonography, Milk

We evaluated the adrenals of individuals without tuberculosis (group 1 - G1) and with tuberculosis (group 2 - G2) using computed tomography. The antero-posterior length, the thickness, and the longitudinal length of the adrenals were compared in G1 and G2. The duration of the disease, the occurrence of morphologic abnormalities in G2, the distribution according to sex, age and skin color were also studied. There was difference in the antero-posterior length and thickness of right adrenal between G1 and G2. A higher prevalence of white skin male individuals was observed in G2. There was no association between duration of the disease and the occurrence of morphologic abnormalities in G2. A higher occurrence of adrenal enlargement was observed in G2. The main computed tomography findings in patients with tuberculosis were enlargement of the adrenal without calcification, enlargement of the adrenal with punctiform calcifications, and residual calcification of the adrenal.

Keywords: Adrenal, Tuberculosis, Computed tomography

OBJECTIVE: The objective of this paper was to establish a procedure for the determination of calibration factors and absorbed doses in electron beams. MATERIALS AND METHODS: An irradiator with a 60Co source and a linear accelerator Varian, Clinac 2100C, with photon and electron beams, were utilized. Thimble type and parallel-plane ionization chambers were tested. RESULTS: The measurement systems showed very good results in the preliminary tests (response stability and leakage current). The ionization chambers used for electron beam dosimetry were calibrated using four different methods. For the determination of absorbed dose, three methodologies recommended by the International Atomic Energy Agency were applied. Concordant results were obtained in almost all cases. CONCLUSION: The majority of the ionization chambers tested showed good results according to the established international limits.

Keywords: Absorbed dose, Ionization chambers, Electron beams, Calibration of instruments

OBJECTIVE: To review small bowel contrast examinations in order to identify the main findings and to determine the actual benefits to the patient. MATERIALS AND METHODS: This was a retrospective and descriptive study based on data of 60 examinations performed between January, 2001 and June, 2002 at the radiology department of the "Hospital Santa Cruz/Beneficência Portuguesa de Niterói", Rio de Janeiro, Brazil. RESULTS: A total of 60 examinations were reviewed: 24 (40.0%) showed abnormal radiological findings whereas 36 (60.0%) were normal. Thirty-six patients (60%) were between 35 and 65 years of age, only two (3.32%) were below 18 years and the oldest patient was 87 years. CONCLUSION: In spite of the new diagnostic imaging modalities such as endoscopy, small bowel contrast examinations are unlikely to fall into disuse and may remain the modality of choice for the investigation of this segment of the intestines. Therefore, we should keep in mind that small bowel contrast examinations and endoscopy are complementary rather than alternative methods when the advantages and disadvantages of each method are considered. Contrast examination of the small bowel is still an important and valuable method for the investigation of this segment of the intestines.

Keywords: Small bowel diseases, Contrast examinations, Differential diagnosis

The evaluation of film processing using the STEP test (sensitometric test for the evaluation of processing) is based on the identification of significant deviations in the processor-chemicals-film system. Ideal processing conditions are established for this type of evaluation. A standard film is processed according to the manufacturer's recommendations, i.e. standard processing at 100. The film is exposed to the light of a calibrated sensitometer and the sensitometric steps are read with the use of a densitometer. A standard curve (OD × STEP) is therefore obtained. The percentual deviation should be lower than 20% compared to the standard curve. This method is useful to identify processing problems. We tested processors from several public/university hospitals and found that approximately 33% of the equipments had inadequate processing conditions.

Keywords: Automatic processors, Radiographic films, Sensitometry, STEP test

OBJECTIVE: The aim of this study was to evaluate work-related musculoskeletal symptoms, and personal and professional activities of ultrasonographist physicians. MATERIALS AND METHODS: Forty-one physicians answered a questionnaire and were interviewed regarding personal and professional activities and the occurrence of musculoskeletal symptoms. Data were analyzed using variation coefficient, Spearman R and Student t tests. A nonlinear logistic regression equation based on the probability of discomfort was applied to evaluate the interaction among significant variables. RESULTS: The results indicated a high prevalence rate (85%) of symptoms among physicians. Pain on the upper limbs and back pain were observed in 50% and 39% of the cases, respectively. Several risks were identified such as high daily working load influencing the presence of pain, high cognitive demand, and frequent stress in the routine activity of ultrasonographist physicians. The regression analysis showed high probability of occurrence of injuries when all variables occurred together (r = 0,97). CONCLUSION: Overall, the results suggest that ultrasonography working activity is a risk to the musculoskeletal system.

Keywords: Ultrasonographer, Work-related musculoskeletal symptoms, Work-related musculoskeletal disorders

Laser-induced thermoablation has been used as a reliable method for producing coagulation necrosis in hepatic tumors in patients who are not suitable for surgical treatment. The procedure can be performed percutaneously, using image-guiding methods, by open laparotomy or laparoscopy. We review the current literature and discuss the principles, indications, complications and clinical results as well as the potential limitations and contraindications of this novel technique.

Keywords: Laser, Thermoablation, Liver, Liver tumors, Metastases

The distribution of fibroglandular tissue in the breast is often symmetrical. Changes in that symmetry may indicate a hidden lesion in the parenchyma. The evaluation of asymmetric densities in the breast is one of the main day-to-day challenges for radiologists, i.e., differentiating normal superimposed structures from true parenchymal lesions. The knowledge of different techniques and resources used to investigate asymmetric densities as well as evaluation protocols are essential to establish the nature of the lesions. Asymmetric densities may be the only sign of breast cancer otherwise clinically and radiologically concealed.

Keywords: Asymmetric density, Mammography, Invasive lobular carcinoma

The thymus is a small gland which is responsible for the production of T-lymphocytes. This organ is larger during the gestation period and can extend into the neck and present different anatomic variants. Ultrasound can identify the thymus via suprasternal, parasternal and sternal approaches, and through the neck when its position is atypical. During adolescence, ultrasound evaluation of the thymus is more difficult due to its involution and reduction in size, and interposition of the lung. The appearance of normal thymus is typical on the ultrasound and produces a unique echo pattern that is less echogenic than the normal thyroid gland with multiple echogenic lines and foci, representing a cross section of either a connective-tissue septum or a blood vessel within a septum. Recognition of normal thymic tissue can be very important in order to avoid unnecessary investigations or surgery of a normal thymus mimicking an abnormal mass.

Keywords: Thymus, Ultrasound, Neck ultrasound

Cherubim is a non-neoplastic hereditary bone disease characterized by bilateral, painless enlargements of the mandible and maxilla in children, producing the cherubic appearance. Cherubism may appear as an isolated case or in members of the same family. We report the case of a girl without familial history of cherubism who presented expansile osteolytic lesions in the mandible and maxilla, demonstrated by radiological exams.

Keywords: Cherubism, Mandibular diseases, Radiology, Computed tomography

We report a case of spontaneous healing of bucket-handle tear of the medial meniscus in a 32-year-old man. The patient twisted his left knee during a soccer game. At clinical examination, there was pain at mobilization and lock of extension at 45°. Magnetic resonance imaging showed a bucket-handle tear of medial meniscus and a detached fragment in the intercondylar notch. After conservative treatment there was spontaneous healing of the injury, seen on magnetic resonance imaging.

Keywords: Magnetic resonance imaging, Bucket-handle tear, Meniscal tear, Knee

Occult insulinomas are tumors which are not identified by conventional tests. Selective arterial calcium stimulation and hepatic venous sampling (ASVS) can be used to identify the pancreatic segment where the tumor is located. We report the case of a patient with clinically proven insulinoma detected only by ASVS. The details of the procedure are also discussed.

Keywords: Insulinoma, Pancreas, Arterial stimulation and venous sampling (ASVS)

The authors present the cases of three patients with total aganglionosis of the colon and review the literature. The main diagnostic features are reviewed to justify a separate analysis of the typical form of Hirschsprung's disease. There are no pathognomonic radiological findings and definitive diagnosis can only be established by histological examination. Considering the high incidence of complications and the mortality of patients with total aganglionosis of the colon, this disease should be suspected in any infant or young child with evidence of bowel obstruction seen on plain films, regardless of the contrast enema findings.

Keywords: Aganglionosis, Hirschsprung's disease, Intestinal obstruction