Characterization of alar ligament on 3.0T MRI: a cross-sectional study in IIUM Medical Centre, Kuantan

INTRODUCTION: The main purpose of the study is to compare the normal anatomy of alar ligament on MRI between male and female. The specific objectives are to assess the prevalence of alar ligament visualized on MRI, to describe its characteristics in term of its course, shape and signal homogeneity and to find differences in alar ligament signal intensity between male and female. This study also aims to determine the association between the heights of respondents with alar ligament signal intensity and dimensions. MATERIALS & METHODS: 50 healthy volunteers were studied on 3.0T MR scanner Siemens Magnetom Spectra using 2-mm proton density, T2 and fat-suppression sequences. Alar ligament is depicted in 3 planes and the visualization and variability of the ligament courses, shapes and signal intensity characteristics were determined. The alar ligament dimensions were also measured. RESULTS: Alar ligament was best depicted in coronal plane, followed by sagittal and axial planes. The orientations were laterally ascending in most of the subjects (60%), predominantly oval in shaped (54%) and 67% showed inhomogenous signal. No significant difference of alar ligament signal intensity between male and female respondents. No significant association was found between the heights of the respondents with alar ligament signal intensity and dimensions. CONCLUSION: Employing a 3.0T MR scanner, the alar ligament is best portrayed on coronal plane, followed by sagittal and axial planes. However, tremendous variability of alar ligament as depicted in our data shows that caution needs to be exercised when evaluating alar ligament, especially during circumstances of injury

Case series of breast fillers and how things may go wrong: radiology point of view

INTRODUCTION: Breast augmentation is a procedure opted by women to overcome sagging breast due to breastfeeding or aging as well as small breast size. Recent years have shown the emergence of a variety of injectable materials on market as breast fillers. These injectable breast fillers have swiftly gained popularity among women, considering the minimal invasiveness of the procedure, nullifying the need for terrifying surgery. Little do they know that the procedure may pose detrimental complications, while visualization of breast parenchyma infiltrated by these fillers is also deemed substandard; posing diagnostic challenges. We present a case series of three patients with prior history of hyaluronic acid and collagen breast injections. REPORT: The first patient is a 37-year-old lady who presented to casualty with worsening shortness of breath, non-productive cough, central chest pain; associated with fever and chills for 2-weeks duration. The second patient is a 34-year-old lady who complained of cough, fever and haemoptysis; associated with shortness of breath for 1-week duration. CT in these cases revealed non thrombotic wedge-shaped peripheral air-space densities. The third patient is a 37‐year‐old female with right breast pain, swelling and redness for 2- weeks duration. Previous collagen breast injection performed 1 year ago had impeded sonographic visualization of the breast parenchyma. MRI breasts showed multiple non- enhancing round and oval shaped lesions exhibiting fat intensity. CONCLUSION: Radiologists should be familiar with the potential risks and hazards as well as limitations of imaging posed by breast fillers such that MRI is required as problem-solving tool

Impact of decentring patients for abdominal CT scan

Purpose: To evaluate the effect on skin dose and image quality when decentering in the y- and x-direction for abdominal CT scans.Methods: Patient centering data in CT were collected retrospectively from dose management software (DoseWatch, GE Healthcare) from a single university hospital (n=4 scanners) in 2017. Deviations from the isocentre were categorized for both vertical (±1.5cm, ±3.0cm, ±4.5cm) and horizontal (±1.5cm, ±3cm) planes on 498 patients. An anthropomorphic phantom (PBU-60) was subsequently scanned using each deviation on two scanners (Toshiba Prime, GE HD750) to allow dose and image quality (noise and visual grading assessment) comparisons. Results: Significant skin dose increases (4.3mSv/50%) were detected anteriorly for both scanners when centered above the isocenter and reductions (2.0mSv, 24%) when below the isocenter. For the HD750, dose decreased up to 8.3mSv in four locations at the -4.5 position with increases (2.0mSv) noted on the right side with horizontal deviation. With upward vertical deviation noise increased from 13HU (isocenter) to 15HU. No change in standard deviation (SD) was detected with the phantom below isocenter. With left horizontal deviation SD increased by 12HU while SD decreased by 12HU dextro-laterally. VGA-score was lowest at the largest vertical ISO-center deviation. Conclusion: Positioning above ISO-center may increase noise and skin dose. Similarly, horizontal deviation may increase dose. Subjective image quality is negatively affected by extreme vertical ISO-center deviation. <br/

Evolving radiographers' role in radiation protection

The system of radiological protection is build on science, experience and ethics reflected in the basic principles in ICRP103, i.e. optimisation of protection, dose limitation and justification. Radiographers are important stakeholders in the maintenance of the system, both legally, ethically and practically. The session reviews different aspects of radiation protection that may form the basis of further development of radiographers’ roles and responsibility.Session objectives:1. To understand radiographers' current legal responsibilities regarding radiation protection.2. To consider the role radiographers play in application of the justification principle.3. To review recent optimisation techniques for projection radiography.4. To appreciate how radiographers can best communicate risk-benefit information to patients.<br/

Aerospace Medicine and Biology. an Annotated Bibliography. 1958-1961 Literature, Volumes VII-X, Part 2

Abstracts on aerospace medicine and biology - bibliography on environmental factors, safety and survival, personnel, pharmacology, toxicology, and life support system