COMPUTED TOMOGRAPHY-GUIDED PERCUTANEOUS BIOPSY: CRITERIA FOR ACCURATE NEEDLE TIP IDENTIFICATION

Precise localization of the needle tip during CT-guided percutaneous biopsy is considered to be a key element of a successful procedure. To ensure accuracy, the true needle tip must be differentiated from a false or simulated tip which appears when the CT slice encompasses only the shaft of an angled needle. By obtaining images of an aspiration biopsy needle inserted vertically into a phantom and then incrementally tilting the gantry, the authors were able to compare the characteristic features of the true tip to the simulated tip. The true tip was abrupt and distinct and had an adjacent flame-like low density artifact. The simulated tip was indistinct and tapered, yet still produced the adjacent artifact. We concluded that the shape and distinctness of the end portion of the needle itself, rather than the attendant artifact, were the most reliable criteria for accurate needle tip identification.     

RELEVANCE OF SONOGRAPHIC ARTIFACTS OBSERVED DURING IN VITRO CHARACTERIZATION OF UROCYSTOLITH MINERAL COMPOSITION

Nine pure mineral type canine uroliths (bladder or urethral origin only) were imaged ultrasonographically using 3.5 MHz, 5.0 MHz, and 7.5 MHz fixed focus, mechanical sector transducers in a urinary bladder phantom. The uroliths studied were those composed of 100% magnesium ammonium phosphate, calcium oxalate monohydrate, calcium oxalate dihydrate, calcium phosphate appatite, and calcium hydrogen phosphate dihydrate (brushite), ammonium acid urate, sodium acid urate, cystine, and silica. The occurrence of both reverberation/streak and acoustic shadowing artifacts were compared to urocystolith mineral type (classified by effective atomic number), urocystolith width, urocystolith height (thickness), and ultrasonographic imaging frequency. No predictable relationship was found between either of the artifacts seen beyond the urocystolith (reverberation/streak or the acoustic shadowing) and urocystolith mineral type. There was no statistical relationship between the occurrence of reverberation/streak artifact and the size (width or height) of the urocystolith or the ultrasonographic frequency. There was, however, a statistically relevant relationship between ultrasonographic imaging frequency and the occurrence of acoustic shadowing and between urocystolith height (thickness) and the occurrence of acoustic shadowing. However, regardless of ultrasound frequency, acoustic shadowing was observed less than 35% of the time in any of the urocystolith mineral types examined. Based on the imaging of the bladder phantom supporting apparatus (7.0 mm bolts covered by plastic), the accurate characterization of a curved object surface directly facing the transducer was found to be directly related to the frequency of sound used for imaging and at best predictably limited to curved vs flat. Accurate measurement of the maximum transverse dimension of an echogenic curved object or accurate characterization of the lateral borders of such an object was considered unlikely with general ultrasonographic equipment of the frequencies studied. Therefore, detailed architectural characterization of urocystoliths suitable for mineral composition prediction is considered highly unlikely with general pulse-echo ultrasonographic techniques.     

PHYSIOLOGIC VARIANTS,BENIGN PROCESSES,AND ARTIFACTS FROM 106 CANINE AND FELINE FDG‐PET/COMPUTED TOMOGRAPHY SCANS

18F‐Fluoro‐deoxyglucose positron emission computed tomography (FDG‐PET/CT) is an emerging diagnostic imaging modality in veterinary medicine; however, little published information is available on physiologic variants, benign processes, and artifacts. The purpose of this retrospective study was to describe the number of occurrences of non‐neoplastic disease‐related FDG‐PET/CT lesions in a group of dogs and cats. Archived FDG‐PET/CT scans were retrieved and interpreted based on a consensus opinion of two board‐certified veterinary radiologists. Non‐neoplastic disease‐related lesions were categorized as physiologic variant, benign activity, or equipment/technology related artifact. If the exact cause of hypermetabolic areas could not be determined, lesions were put into an indeterminate category. A total of 106 canine and feline FDG‐PET/CT scans were included in the study. In 104 of the 106 scans, a total of 718 occurrences of physiologic variant, areas of incidental benign activity, and artifacts were identified. Twenty‐two of 23 feline scans and 82 of 83 canine scans had at least one artifact. Previously unreported areas of increased radiopharmaceutical uptake included foci associated with the canine gall bladder, linear uptake along the canine mandible, and focal uptake in the gastrointestinal tract. Benign activity was often seen and related to healing, inflammation, and indwelling implants. Artifacts were most often related to injection or misregistration. Further experience in recognizing the common veterinary FDG physiologic variation, incidental radiopharmaceutical uptake, and artifacts is important to avoid misinterpretation and false‐positive diagnoses.     

THE MACH PHENOMENON

Mach bands are optical illusions produced by an extensive lateral inhibition network within the retina. They are seen on every radiograph. Both positive and negative Mach bands can be seen at a boundary, but only one type is usually seen at boundaries created by biological structures because of their shape. Convex structures are associated with a negative Mach line and concave structures are associated with a positive Mach line. Using this principle, the shape of unknown structures can be deduced and structures of known shape can be more accurately identified. Sometimes, Mach lines can be very prominent and be perceived as real structures. Ways to make the distinction between Mach lines and real opacities are described. Understanding the Mach phenomenon improves accuracy of radiographic interpretation.     

Chrono-toposequences of soils on the river terraces in Transylvania (Romania)

A sequence of surface soil profiles and buried soils described on the 4th, 3rd, 2nd and 1st terraces of different rivers in Transylvania is presented as part of an attempt to perform a paleopedologic interpretation of the dominant soil types of this area. Excepting the first terrace, the described soils were formed from Pleistocene slopewash deposits of Würm, or possibly of Riss age, which overlay alluvial terrace deposits. On the basis of fossil animal remains, periglacial cryostructures, prehistoric artifacts (Coţofeni culture of the transition period from the Neolithic to the Bronze Age) and Scythian graves an approximate age of different soil horizons, as well as the polycyclic nature of soils was established. There is no essential difference between a Würmian buried soil horizon and the argic Bt horizon of the surface soils; moreover, in some cases, the buried paleosols become the Bt horizon itself of the surface soils, through the thinning of the overlying deposits. Even if the possibility of formation of the argic Bt horizons during the postglacial until the end of Neolithic, cannot be excluded, from the presented situations it seems that these horizons in the Transylvanian Basin are Würmian relics, formed in the periglacial interstadials. In most of the cases Bt horizon has nothing in common genetically with the topsoil.     

LYMPH NODE UPTAKE OF 99MTc-MDP DURING BONE SCINTIGRAPHY IN DOGS

Localization of ^99mTc-MDP in lymph nodes was apparent on the three-hour bone-scan image in seven dogs. In six dogs injection or leakage of the radiopharmaceutical into the perivascular tissues was associated with subsequent uptake in an ipsilateral lymph node. In the remaining dog, ^99mTc-MDP localized in a lymph node infiltrated by metastatic osteosarcoma. This aided staging of the tumor. Possible mechanisms of ^99mTc-MDP localization in soft tissues are briefly reviewed.     

Effects of surgical implants on high-field magnetic resonance images of the normal canine stifle

To determine the effect of surgical implants on the depiction of canine stifle anatomy in magnetic resonance (MR) images, three canine cadaver limbs were imaged at 1.5 T before and after tibial plateau leveling osteotomy (TPLO), tibial tuberosity advancement (TTA), and extra-capsular stabilization (ECS), respectively. Susceptibility artifacts associated with implants were identified in MR images as a signal void and/or signal misregistration, which obscured or distorted the anatomy. Using the preoperative images as a reference, articular structures of the stifle in postoperative images were graded using an ordinal scale to describe to what degree each anatomic structure could be evaluated for clinical purposes. The TPLO implant, which contains ferromagnetic stainless steel, produced marked susceptibility artifacts that obscured or distorted most stifle anatomy. The titanium alloy TTA implants and the stainless steel crimps used for ECS produced susceptibility artifacts that mainly affected the lateral aspect of the stifle, but allowed the cruciate ligaments and medial meniscus to be evaluated satisfactorily. Susceptibility artifact was significantly less marked in images obtained using turbo spin-echo (TSE) sequences than in sequences employing spectral fat saturation. Clinical MR imaging of canine stifles containing certain metallic implants is feasible using TSE sequences without fat saturation.     

IMAGING ARTIFACTS IN DIAGNOSTIC ULTRASOUND—A REVIEW

Imaging artifacts commonly occur during routine ultrasonographic evaluation of patients and contribute to image inaccuracies. These artifacts are classified into artifacts arising from factors controllable prior to imaging or from sound beam interactions within the patient which may result in clinically useful or confusing artifacts. Artifact formation, and how this influences the anatomical image location, echogenicity, size and shape, is described. The clinical interpretation of artifacts is explained in order to gain maximum diagnostic information from an ultrasonographic image.     

NON-SKELETAL DISTRIBUTION OF BONE-SEEKING RADIOPHARMACEUTICALS

A variety of factors may change the normal distribution of bone-seeking radiopharmaceuticals. This paper presents a classification of non-skeletal bone tracer distribution according to physiologic, pathologic, and artifactual causes. The mechanisms thought to account for non-skeletal distribution are reviewed. Examples of non-skeletal bone tracer distribution include calcinosis cutis and pulmonary mineralization in hyperadrenocorticism, renal infarct, acute rhabdomyolysis, urine contamination, lymph node uptake following extravasation of the radiopharmaceutical, thyroid uptake due to free pertechnetate in the injectate, and intramuscular uptake following injection of butorphanol.     

Thick-section reformatting of thinly collimated computed tomography for reduction of skull-base-related artifacts in dogs and horses

Computed tomography (CT) of the caudal fossa of 10 canine and nine equine cadaver heads was performed with conventional slice widths of 5 and 10 mm, respectively, and with thin collimations of 1 and 2 mm, respectively. Reformatting of thinly collimated slices was done by addition of thinly collimated slices to section thicknesses of 5 and 10 mm, respectively. Seventy-six pairs of conventional and reformatted images of identical anatomic locations were evaluated for magnitude of skull-base-related artifacts and image noise. A film-based subjective evaluation of artifact and noise was performed by four radiologists on a five-point score system. There was a statistically significant reduction of artifacts of canine and equine heads by 33% and 50%, respectively, on reformatted images compared with conventional ones but no difference in image noise. On objective artifact assessment based on the magnitude of standard deviation of attenuation values in the interpetrosal region, there was a statistically significant reduction of artifacts of canine and equine heads by 23% and 39%, respectively, on reformatted images. Thick-section reformatting significantly improves image quality of CT scans of the caudal fossa in dogs and horses.