Editorial
Breast cancer-related lymphedema (BCRL): Should we be doing more or less for the axilla?
Breast cancer mortality has declined steadily over the years with breast cancer screening, and improvement in diagnostic and therapeutic regimens. Despite cancer survivors living longer, breast cancer-related lymphedema (BCRL) is a significant complication after major breast surgery that can impact quality of life adversely. The incidence of BCRL reported...
Original Article
Clinical utility of PET/MRI in multiple myeloma
Multiple myeloma (MM) is a haematological malignancy characterised by abnormal accumulation of malignant plasma cells and is associated with anaemia, renal impairment, hypercalcemia and bone lesions. A sensitive method to detect bone lesions is crucial as it could determine the decision to start treatment. In this era, the International...
Commentary
Transforming radiology to support population health
The recent launch of Healthier SG—a national initiative by Singapore’s Ministry of Health (MOH) focusing on preventive health—will have far-reaching effects on the delivery of health services in Singapore.1 Part of it involves a shift away from tertiary hospital-based to community-based care, to improve diagnostic imaging services in the...
Letter to the Editor
Managing and preventing severe hand injuries among sugarcane juicer operators
Dear Editor,
Of all hand injuries encountered at an emergency department, 54% are sustained in the workplace,1 in part contributed by occupational injuries among food and beverage operators that caused a loss of 16,197 man-hours in 2021 alone.2 Commonplace in Singapore and in parts of South and Southeast Asia is...
Original Article
Clinical outcomes and management of contrast hypersensitivity in patients requiring repeated computed tomography imaging
Allergic and non-allergic hypersensitivity reactions to iodinated contrast media (ICM) are increasingly recognised, particularly the latter where there is greater clarity on pathomechanisms.1 There is limited evidence for the use of corticosteroids as premedication to prevent the occurrence of contrast-related reactions. At our institution, a dose of 30mg oral...
Editorial
Preventing recurrent hypersensitivity reactions to iodinated contrast media
Iodinated contrast media (ICM) is one of the most commonly used drugs in the practice of modern medicine. ICM, as the name implies, is a contrast media that contains iodine. It is frequently used in computed tomography (CT) and angiographic procedures, to highlight important anatomical structures and for the...
Letter to the Editor
Erdheim-Chester disease: Imaging spectrum of multisystemic manifestations
Dear Editor,
Erdheim-Chester disease (ECD) is a rare non-Langerhans histiocytosis, usually affecting middle-aged to older adults. It is a multisystemic disease with protean clinical manifestations. It can involve single or multiple organs, and presentations range from asymptomatic lesions detected incidentally on imaging to severe organ dysfunction. Hence, accurate and timely...
Commentary
Low-dose computerised tomography screening for lung cancer in Singapore: Practical challenges of identifying participants
INTRODUCTION
In March 2022, the European Commission on cancer screening suggested the inclusion of low-dose computerised tomography (LDCT) for lung cancer, targeted at current and former smokers.1 The aim of LDCT screening is to increase early detection, decrease diagnoses at metastatic stage of the disease and improve overall 5-year...
Images in Medicine
TB or not TB? The axillary lump question
An 81-year-old woman of healthy weight presented with a 2-week history of a painless right axillary lump. Physical examination revealed a 2cm firm nodule with a central keratinous plug in the right axilla (Fig. 1). The surrounding skin was pigmented, non-tender and indurated. Sonography of the nodule demonstrated an...
Letter to the Editor
Safe time interval for screening estimated glomerular filtration rate prior to gadolinium-enhanced MRI scan
Dear Editor,
Magnetic resonance imaging (MRI) contrast media are commonly used in medical imaging and are usually gadolinium-based contrast agents (GBCAs). They can be divided into 3 groups. Group I consists of compounds with linear molecular structures. Group II consists of compounds with macrocyclic molecular structures. Group III currently includes...
Commentary
The Lancet Commission on diagnostics: What it means for Singapore
Effective healthcare systems depend on a functioning healthcare value chain—defined as a care cascade comprising screening, diagnosis, treatment and follow-up. The tremendous heterogeneity and global disparity regarding this healthcare value chain has been one of the fundamental problems with prioritised urgency since the United Nation’s Millennium Development Goals were...
Original Article
Reduction in Retake Rates and Radiation Dosage Through Computed Radiography
New computed radiography imaging systems are slowly gaining a foothold in radiological departments worldwide. By computed radiography we mean a digital imaging system which exposes a photostimulable phosphor image receptor plate to obtain a latent image using existing radiographic equipment.
This article is available only as a PDF. Please click...
Original Article
Computed Tomographic and Magnetic Resonance Imaging Findings in Paranasal Sinus Involvement in Nasopharyngeal Carcinoma
Nasopharyngeal carcinoma (NPC) is an aggressive infiltrative neoplasm. Spread into the paranasal sinuses is often seen but the frequency is documented in only a few series.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Others
Book Review
This book is a collection of 30 case studies, which were published in the Singapore Medical Journal from 1994 to 1997. They include interesting cases from all the major anatomical regions and organ systems.
This article is available only as a PDF. Please click on “Download PDF” on top to...
Original Article
Bone Mineral Density—Correlation between Quantitative Ultrasound Characteristics and Dual Energy X-ray Absorptiometry
Osteoporosis is well documented to be a significant determinant of the risk of fracture and its assessment in vivo has been based on various methods for measuring bone mineral density (BMD). Dual-energy X-ray absorptiometry (DXA) has proven so far to be reasonably precise (about 1% to 2%) and accurate...
Others
Verrucous Haemangioma—A Case Report
Verrucous haemangioma is an uncommon congenital vascular malformation which may grow to large sizes. It has a characteristic hyperkeratotic and verrucous surface which resembles angiokeratoma circumscriptum.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Review Article
A Review of the Role of Magnetic Resonance Imaging in the Evaluation of Shoulder Impingement Syndrome and Rotator Cuff Tendon Tears
In the evaluation of chronic shoulder pain and dysfunction clinically suspected to be due to shoulder impingement syndrome and rotator cuff tendon tears, magnetic resonance imaging (MRI) has virtually replaced double contrast shoulder arthrography. MRI has the advantage of demonstrating the shoulder joint in multiple anatomical planes with excellent...
Original Article
Soft Tissue Cover in Compound and Complicated Tibial Fractures Using Microvascular Flaps
Compound tibial fractures are high-energy traumatic injuries, which are frequently associated with high incidence of complications like infection and failure of bony union leading to amputation. The extent of injury is proportional to the magnitude of trauma.
This article is available only as a PDF. Please click on “Download PDF”...
Original Article
Portable Chest Radiography: Comparison of High-resolution Digital Displays with Laser Printed Digital Film
In most institutions, about 10% to 25% of imaging examinations are recorded digitally (e.g. digital subtraction angiography, computed tomography, magnetic resonance imaging and ultrasound). Conventional-projection radiographic studies are still displayed in an analog fashion (on film).
This article is available only as a PDF. Please click on “Download PDF” on...
Original Article
Percutaneous Needle Aspiration in the Treatment of Hepatic Abscess: Factors Influencing Patients’ Outcome
Liver abscess traditionally has been treated by open surgical drainage, mortality rates being as high as 80% to 100% if left untreated. However, with the advent of modern non-invasive imaging techniques, percutaneous techniques performed under imaging guidance have, over the recent years, become increasingly acceptable as a suitable alternative...
Original Article
Contrast-Enhanced Magnetic Resonance Imaging of the Internal Auditory Canals and Posterior Fossa
Contrast-enhanced magnetic resonance imaging (MRI) is now the gold-standard examination for the exclusion of acoustic schwannomas or other posterior fossa tumours. We retrospectively reviewed 314 cases done over a period of 2 years and 9 months, correlating presenting symptoms with scan findings.
This article is available only as a PDF....
Review Article
Imaging of Thoracic Manifestations of Scleroderma
Systemic sclerosis (SScl) is a generalised disease of the connective tissue characterised by fibrosis and vascular changes affecting the skin, lungs, gastrointestinal tract, kidneys, and heart. The American College of Rheumatology has proposed that for the purpose of clinical trials and surveys, the diagnosis is made if the patient...
Review Article
Overview of Imaging in Rheumatologic Diseases
Since the discovery of X-rays over a century ago, radiology has played a pivotal role in rheumatology and diseases of the joints. The innovations and advances in technology in imaging and interventional radiology today enable more precise and earlier detection, assessment and treatment.
This article is available only as a...
Others
New Treatment and Research Strategies for the Improvement of Care of Cleft Lip and Palate Patients in the New Millennium
I have chosen as the title of my keynote address “New Treatment and Research Strategies for the Improvement of the Care of Cleft Lip and Palate Patients”. The reason for this is that despite the tremendous strides we have made over the past 50 years in the management of...
Others
Midface Distraction Osteogenesis in Cleft Patients: A Case Report
The aetiology of midfacial hypoplasia in patients with cleft lip and palate has been attributed in the literature to the surgical procedures used for the primary correction of these deformities. Ross reported that approximately 25% of patients developed maxillary hypoplasia that was refractory to orthodontic management alone.
This article is...
Others
Selective Laser Sintering: Application of a Rapid Prototyping Method in Craniomaxillofacial Reconstructive Surgery
The value of computed tomography (CT) in craniofacial trauma is now well established with progress in imaging modalities. Three-dimensional (3-D) CT has changed the way craniofacial surgery is planned and its valuable contributions and limitations have been studied.
This article is available only as a PDF. Please click on “Download...
Review Article
The Role of Distraction Osteogenesis in the Management of Craniofacial Disorders
The concept of distraction osteogenesis was championed by Ilizarov, beginning as early as 1954, for the treatment of a variety of congenital and acquired deformities of enchondral bone. In 1973, Snyder and associates reported on gradual distraction of the mandible using an extraoral device in canines.
This article is available...
Review Article
The Role of Laser Surface Imaging in the Evaluation of Craniomaxillofacial Disorders: The Singapore General Hospital Experience
The management of craniomaxillofacial disorders is not complete without the proper documentation of clinical information and the storage of images. It is usually long-term and has many follow-up sessions.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Review Article
Repair of Complex Orbital Fractures: Technical Problems, State-of-the-art Solutions and Future Perspectives
Fractures involving the orbits are frequent among facial injuries, making up to nearly 40% of the total. Within the wide range of severity, the small group of complex fractures (20% of the total) is responsible for most of the sequelae.
This article is available only as a PDF. Please click...
Review Article
Lessons Learnt from the Management of 1500 Complex Facial Fractures
With the advent of regional trauma centres and rapid air transport systems, a larger number of patients with extremely complex craniomaxillofacial trauma are now being seen. The problem of high-velocity facial injuries with multiple facial fractures concerns the severity of the bony injury.
This article is available only as a...
Original Article
An Anatomic Evaluation of the Furlow Double Opposing Z-Plasty Technique of Cleft Palate Repair
The Furlow double opposing Z-plasty has gained considerable popularity since its introduction approximately a decade ago, and is currently a favoured method of both primary and secondary palatoplasty in many centres. Several theoretical advantages make this technique of cleft palate repair attractive.
This article is available only as a PDF....
Original Article
Epidemiology of Cleft Lip and Palate in Singapore—A 10-Year Hospital-based Study
With the control of most infectious diseases and malnutrition, congenital malformations are now one of the most important causes of morbidity and mortality among infants in Singapore. Children born with cleft deformities require specialised multidisciplinary care from infancy till adulthood.
This article is available only as a PDF. Please click...
Original Article
A Review of Mandibular Fractures in a Craniomaxillofacial Trauma Centre
The mandible occupies a unique position in the facial skeleton, being both the aesthetic and functional foundation of the lower third of the face. Its prominence makes it particularly susceptible to trauma, and it is one of the most commonly fractured facial bones.
This article is available only as a...
Original Article
Magnetic Resonance Imaging of Brain Metastases: Magnetisation Transfer or Triple Dose Gadolinium?
Accurate detection of brain metastases is an important part of tumour staging. Magnetic resonance (MR) imaging is well accepted as a sensitive tool in the detection of brain metastases.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Original Article
Radiological Placement of 211 Central Venous Catheters: Outcome and Complications
Long-term central venous access is an important part of modern medical practice, especially in the haematology and oncology units. Central venous (CV) catheters are used for the administration of anti-neoplastic agents, immunosuppressive drugs, antibiotics, blood components, hyperalimentation, for frequent blood sampling, and for acute and temporary haemodialysis prior to...
Original Article
Role of Ultrasonography in Screening for Urological Malignancies in Patients Presenting With Painless Haematuria
Haematuria of any degree should never be ignored and, in adults, it should be regarded as a symptom of urological malignancy until proven otherwise. Mariani et al, in their evaluation of 1000 consecutive patients, revealed life-threatening lesions in 9.1% of cases.
This article is available only as a PDF. Please...
Commentary
A Practical Technique of Colour Image Analysis: Applications in Experimental Research
Colour image analysers have been extensively used in medical research since 1970 for histomorphometric studies. Image analysis gives more information and a better understanding of relative morphological changes in histological tissue sections. This is especially pertinent when different morphological areas are immunohistologically stained and present in contrasting colours or...
Commentary
Effect of Antiangiogenic Agents on Experimental Animal Models of Hepatocellular Carcinoma
Metastatic spread is the principal reason of treatment failure in solid tumours. Surgery, radiation therapy and chemotherapy have not manifestly altered the prognosis for metastatic tumours.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Review Article
Gut Barrier Dysfunction in Experimental Acute Pancreatitis
Bacterial infections are devastating and potentially lethal complications of acute pancreatitis, responsible for up to 80% of deaths in the condition. Pathogenetic studies of acute pancreatitis imply that the disease is initially a non-bacterial insult and that secondary sepsis frequently occurs during the progression of pancreatitis, concomitant with the...
Review Article
Experimental Models of Pancreatitis
From a historical perspective, the first experimental pancreatitis was induced by Claude Bernard in 1856 by the injection of bile and olive oil into the canine pancreatic duct, thus producing an acute necrotising pancreatitis. Since that time, acute experimental pancreatitis has attracted thousands of researchers, who employ animal models...
Review Article
Immunological Consequences of Trauma and Shock
Despite intensive research and intervention, trauma continues to be the leading cause of death during the first three decades of life in the USA, and currently ranks as the fourth leading cause of mortality with over 160,000 deaths each year. Mortality following trauma occurs in three distinct periods.
This article...
Review Article
Murine Metastatic Tumour Models for Cancer Gene Therapy Research
In the evaluation of any new cancer treatment, the use of appropriate experimental animal tumour models to bridge the gap between in vitro discovery and its eventual clinical testing is an important step. In vitro experimentation does not take into consideration the complex biological interplay among the host tissues,...
Review Article
Experimental Models of Hepatic Fibrosis in the Rat
Hepatic fibrosis and cirrhosis of the liver are complex diseases which, in man, may be caused by such varied factors as alcohol, hepatitis, schistosomiasis, biliary atresia, malnutrition and exposure to carcinogens and hepatotoxins. Although hepatic fibrosis is characterised by the massive deposition of extracellular matrix components in the liver...
Review Article
Development of the Human Intrahepatic Biliary System
The development of the human biliary system has been studied extensively. This knowledge is essential to the understanding of the pathogenesis of a spectrum of diseases termed “ductal plate malformation” (DPM).
This article is available only as a PDF. Please click on “Download PDF” on top to view the full...
Review Article
Regulation of Insulin Secretion by Nerves and Neuropeptides
The pancreatic islets of Langerhans were described by Paul Langerhans in 1869. They are distributed throughout the entire pancreas forming in adults approximately 1% of the pancreatic mass.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Original Article
An Animal Model for the Study of Hepatic Stellate Cell and Hepatocellular Carcinoma Interaction
Hepatic stellate cells (HSC) are mesenchymal cells that are prominent in various forms of liver injury, in particular with cirrhosis or carbon tetrachloride-induced fibrosis. HSC are also being increasingly reported around and within hepatocellular cancers (HCC), and have been thought to be responsible for the capsule formation in these...
Original Article
Establishment of Animal Models Using Experimental Rats for Allogeneic Tissue Transplantation and Quantitative Flow Cytometric Detection of Immunochimera
Allogeneic tissue and organ transplantation has long been an important medical issue, as it provides an effective treatment alternative for a broad spectrum of medical problems. It is essential to establish the animal models used for a specific type of allogeneic tissue or organ transplantation prior to its clinical...
Original Article
Experimental Study of Hypovolaemic Shock-Induced Gastric Mucosal Lesions in the Rat
Hypoxic tissue injury is not only caused by lack of oxygen as was previously believed. Now it is clear that tissue injury associated with hypoxia occurs to a large extent in the post-hypoxic reoxygenation period.
This article is available only as a PDF. Please click on “Download PDF” on top...
Original Article
The Role of Mast Cell Degranulation in Ischaemia-reperfusion-induced Mucosal Injury in the Small Intestine
Although a number of data support the notion that mast cell (MC) degranulation Is an important component of the tissue response elicited by ischaemia-reperfusion, the role of the gastrointestinal MC system in the pathophysiology of postischaemic mucosal barrier lesions is still poorly understood. The mucosal MCs (MMCs) of the...
Original Article
Efficacy of Contraction Uncoupling by 2,3-Butanedione Monoxime during Initial Reperfusion versus Cardioplegic Arrest for Protection of Isolated Hearts
Despite the recent developments of minimally invasive surgery, most cardiac surgery procedures still include ischaemic cardioplegic arrest and cardiopulmonary bypass. For decades the efforts of many researchers aimed at improvement of cardioplegic solutions to minimise ischaemic injury of the myocardium.
This article is available only as a PDF. Please click...
Original Article
Synergistic Effect of Hepatitis B Virus and Aflatoxin B1 in Hepatocarcinogenesis in Tree Shrews
Primary hepatocellular carcinoma (HCC) is one of the commonest cancers in some parts of the world including several areas in China. The geographically distinct distribution of HCC indicates there are some special factors which play key roles in hepatocarcinogenesis.
This article is available only as a PDF. Please click on...
Original Article
The Expression of Insulin-like Growth Factor II, Hepatitis B Virus X Antigen and p21 in Experimental Hepatocarcinogenesis in Tree Shrews
Hepatocarcinogenesis is a multistage and multifunctional process. Epidemiological studies indicate that contamination of food with aflatoxin B, (AFB,) and chronic infection with hepatitis B virus (HBV) are the major risk factors for human primary liver cancer.
This article is available only as a PDF. Please click on “Download PDF” on...
Original Article
Nitric Oxide Synthase-Its Distribution and Alteration in the Intramural Ganglia of the Urinary Bladder in Normal and Urethra-obstructed Guinea Pigs
Nitric oxide (NO) has been recognised as a nonadrenergic noncholinergic (NANC) inhibitory neurotransmitter at various sites in the nervous system. Its function as a NANC inhibitory transmitter has been documented in muscular and sphincter relaxation in the cardiovascular, digestive and urogenital system.
This article is available only as a PDF....
Original Article
Radionuclide Studies of Articular Cartilage in the Early Diagnosis of Arthritis in the Rabbit
Osteoarthritis is a common joint disease that involves destruction of articular cartilage. Magnetic resonance imaging (MRI) provides a sensitive imaging modality for the diagnosis of osteoarthritis.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Original Article
The Effect of Storage at -70°C and -150°C on the Torsion Properties of the Canine Femur
Allograft transplantation of bone has been established as a viable and useful reconstructive procedure when limb salvage is the option of choice. For bone allografts, this is thought to be due to the relatively avascular structure and that low-freezing or freeze-drying for periods beyond three months reduces cellular immunogenicity.
This...
Original Article
Direct Mucosal Targeting of Colonic Receptors by Prokinetic Drugs in an Experimental Model
The direct intraluminal (IL) administration of drugs into the intestine may have an important regional action and therefore clinical implications in the effective management of functional bowel disorders. We have previously published findings in the anaesthetised in vivo pig, that cisapride and mebeverine when infused IL into the sigmoid...
Original Article
The Viability of Liver Graft for Transplantation After Prolonged Warm Ischaemia
Liver transplantation (LTx) is the treatment of choice for many patients with end stage liver disease. However liver allograft availability prevents its widespread application.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Original Article
Use of Titanium Prosthesis to Bridge a Vertebral Gap in the Spine—A Preliminary Experimental Study
Bridging a vertebral gap in the spine is one of the commonest problems facing the spine surgeon after dealing with a tumour, infection or a fracture. The gold standard today is still the autogenous graft, though other solutions are the allograft, bone cement fashioned as a block, ceramics and...
Original Article
A Simple Method of Blood Pressure Measurement in the Pig Using a Neonatal Cuff
Blood pressure is an important parameter commonly measured in experimental studies using animal models. Various non-invasive techniques to monitor blood pressure have been described in the literature but most of these are applicable only to small animal models like the rat.
This article is available only as a PDF. Please...
Original Article
The Results of Autogenous Tibial Periosteal Transplants for Full Thickness Cartilage Defects in the Knee Joints of Pigs
Articular cartilage injuries to the knee are commonly seen by team doctors, sports physicians and orthopaedic surgeons. Despite many clinical as well as experimental studies on the healing of such defects, the ability to regenerate mature hyaline cartilage capable of withstanding daily functional stresses in the knee remains a...
Original Article
Microvascular Lung Tissue Oxygenation—A Methodological Study in the Pig
Although the lung is mostly referred to as a respiratory organ it also exhibits a variety of metabolic functions, e.g. uptake, storage and/or synthesis and metabolism of compounds as different as biogenic amines, prostaglandins and angiotensin I. In spite of this vast metabolic capacity and the respiratory role of...
Editorial
The Philosophical Basis of the Experimental Method
The application of the experimental approach to Science and Medicine has its roots in the 16th century. William Harvey (1578-1657), who demonstrated the passage of blood through the veins unidirectionally towards the heart as evidence for circulation of blood, was generally credited as one of the earliest physicians who...
Others
Retroperitoneal Castleman’s Disease in the Perinephric Space—Imaging Appearance: A Case Report and a Review of the Literature
Castleman’s disease (CD) was first proposed by Castleman in 1954. It is usually found in the mediastinum, but other sites have been described.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Original Article
Evaluation of Technetium-99m Ciprofloxacin (Infecton) in the Imaging of Infection
Over the past 10 years we have used various radiopharmaceuticals (RPCs) for imaging of inflammation and infection. These include gallium-67 citrate and the technetium-99m labelled nanocolloids, immunoglobulin (IgG), antigranulocyte antibodies (AGAB) and HMPAO-labelled leukocytes.
This article is available only as a PDF. Please click on “Download PDF” on top to...
Others
Reduction Mammaplasty in the Surgical Management of a Giant Breast Hamartoma: Case Report
Large benign tumours of the breast cause gross enlargement with compression of normal breast tissue. Following removal of the tumour, the affected side has a large redundant skin envelope and the breast volume may be reduced or distorted compared with the normal side.
This article is available only as a...
Others
5th Yahya Cohen Lecture: Angiosomes and Extension of Skin Flaps—Anatomic Study and Clinical Implications
I would like to express my gratitude to the Chapter of Surgeons and the Academy of Medicine, Singapore for the honour of presenting this 5th Yahya Cohen Lecture.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Others
Magnetic Resonance Arthrography of the Labral-Ligamentous Complex of the Shoulder: An Update
Shoulder instability is a frequently encountered clinical problem in young active people following injury, particularly in athletes. The labral-ligamentous complex is increasingly recognised as being an important structural component that contributes to shoulder instability.
This article is available only as a PDF. Please click on “Download PDF” on top to...
Original Article
Limited Magnetic Resonance Imaging (MRI) and the Occult Hip Fracture
Worldwide, in the past decade, the application of magnetic resonance imaging (MRI) has increased tremendously in the management of musculoskeletal trauma. Not least is its application as a valuable diagnostic tool in occult hip fracture evaluation.
This article is available only as a PDF. Please click on “Download PDF” on...
Original Article
Technetium-99m Methoxyisobutylisonitrile Imaging in the Follow-up of Differentiated Thyroid Carcinoma
Differentiated thyroid carcinoma (DTC) is not an uncommon tumour in Thailand.1 A high percentage of 10-year survival results in long-term follow-up. I-131 total-body scan (I-131 TBS) is commonly used for monitoring the disease after surgery and radioiodine ablation in most centres.
This article is available only as a PDF. Please...
Others
Embolisation of a Renal Artery Pseudoaneurysm in a Patient with Renal Malrotation and Chronic Aortic Dissection
A 40-year-old Chinese male presented with severe right loin pain. He had a history of chronic abdominal aortic dissection of unknown aetiology. He was not hypertensive and there was no evidence of ankylosing spondylitis, Ehlers-Danlos syndrome or any connective tissue disorder.
This article is available only as a PDF. Please...
Original Article
Single Centre Review of Radiologically-guided Percutaneous Nephrostomies: A Report of 273 Procedures
Percutaneous nephrostomy (PCN) is a well-established technique in the armamentarium of an interventional radiologist when dealing with urinary obstruction. It provides temporary relief in obstructive uropathy and stabilises the patients for subsequent definitive treatment.
This article is available only as a PDF. Please click on “Download PDF” on top to...
Original Article
To Establish the Normal Bone Mineral Density Reference Database for the Singapore Male
Bone mineral densitometry was developed as a means to quantify the bone mineral content of the skeleton accurately and has been used in the diagnosis of osteopenia and osteoporosis. Dual-energy X-ray absorptiometry (DXA) of the axial skeleton is one such technique2 which is based on a subtraction method.
This article...
Original Article
Percutaneous Vertebroplasty in the Management of Osteoporotic Vertebral Compression Fractures: Initial Experience
With the general increase in life expectancy in the local population, the incidence of osteoporosis is anticipated to rise as well. Even with screening modalities such as bone mineral densitometry and preventive treatment such as hormone replacement therapy, many patients are asymptomatic and are diagnosed with osteoporosis only after...
Original Article
Differentiation of Malignant Vertebral Collapse from Osteoporotic and Other Benign Causes Using Magnetic Resonance Imaging
An elderly patient presenting with backache and vertebral collapse on plain X-ray is a common clinical scenario and a diagnostic challenge. It is difficult to differentiate between benign and malignant causes for the vertebral collapse.
This article is available only as a PDF. Please click on “Download PDF” on top...
Letter to the Editor
Letter to the Editor
We would like to draw the attention of your readers to the comments made in the editorial of the recent Imaging issue of your journal.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Others
Imaging-guided Bone Biopsy
Biopsy may be performed at surgery (open biopsy) or percutaneously (closed biopsy). Percutaneous bone biopsies are usually performed under imaging guidance using a variety of modalities, such as fluoroscopy1 and computed tomography (CT), and less commonly, ultrasonography (US) and magnetic resonance (MR) imaging.
This article is available only as a...
Others
Carcinoma of the Cervix: Role of MR Imaging
In females with cancer, cervical carcinoma is second to breast cancer in both incidence and mortality worldwide. About 465,000 new cases are diagnosed each year in both developing and industrialised nations, with a higher incidence in women of low socioeconomic status.
This article is available only as a PDF. Please...
Others
Intracerebral Schwannoma—A Rare Cause of Epilepsy
Schwannomas are extra-axial neoplasms derived from the nerve sheath of peripheral or cranial nerves. They represent approximately 8% of all intracranial tumours, arising predominantly from the vestibular nerve.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Others
Radiographic Features of a Case of Severe Acute Respiratory Syndrome with Fatal Outcome
Severe acute respiratory syndrome (SARS) is an atypical pneumonia that was first reported in early 2003. Reports of outbreaks of cases rapidly appeared in Hong Kong, Vietnam, China and Singapore.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Others
Clinical Applications of MR Cholangiopancreatography
Magnetic resonance cholangiopancreatography (MRCP) has attracted a lot of interest from clinicians because it is a non-invasive method of obtaining a cholangiographic image without the morbidity that is associated with endoscopic retrograde cholangiopancreatography (ERCP).
This article is available only as a PDF. Please click on “Download PDF” on top to...
Others
Imaging of Paediatric Mediastinal Masses
A review of mediastinal masses in children, emphasising imaging features, is important for several reasons. Firstly, the mediastinum is the most common location for thoracic masses in children.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Review Article
Clinical Positron Emission Tomography Imaging—Current Applications
Like other radionuclide techniques, positron emission tomography (PET) is based on the tracer principle – a small amount of labelled ligand is used to trace the metabolic pathway of an important chemical in the cell. PET complements anatomic imaging by its ability to map function or metabolism.
This article is...
Review Article
MR Imaging and MR Spectroscopy of Adenocarcinoma of the Prostate
Prostate cancer is usually suspected due to an abnormal digital rectal examination, elevated serum prostate specific antigen (PSA) level or both. The diagnosis of prostate cancer depends on histopathologic examination of tissue obtained from systematic sextant core needle biopsy under transrectal ultrasound guidance.
This article is available only as a...
Review Article
Imaging of Congenital Middle Ear Deafness
When a child or young adult with morphologically normal external ears and no previous history of ear discharge or trauma presents with conductive hearing deficit, a congenital middle ear anomaly should be sought. Although fenestral otosclerosis is a differential diagnosis, the early onset of symptoms and a lack of...
Review Article
MR Imaging of the Fetal Brain and Spine: A Maturing Technology
The introduction of a new diagnostic test into a clinical arena goes through a number of stages. The first stage is technical development.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Review Article
Imaging of Acquired Immunodeficiency Syndrome (AIDS)
The pandemic of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a global healthcare problem and HIV infection is the most common cause of death worldwide. There are now 60 million deaths recorded from the infection worldwide by the United Nations AIDS (UNAIDS) organisation, most of them in sub-Saharan...
Review Article
The Singapore National Breast Screening Programme: Principles and Implementation
In January 2002, the first population-based national mammographic breast screening programme in Asia, the Singapore National Breast Screening Programme (BreastScreen Singapore), was launched. The programme aims to achieve international standards of breast screening practice and breast cancer detection, as well as to reduce or stabilise the mortality from breast...
Original Article
Brachiocephalic-Superior Vena Cava Metallic Stenting in Malignant Superior Vena Cava Obstruction
A large majority of superior vena cava (SVC) syndrome is caused by malignancy (74% to 95%). This can either be due to direct SVC invasion or secondary to extrinsic compression.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Original Article
Pilot Study Using Technetium-99m Pertechnetate Sequential Radionuclide-Sialography to Assess Salivary Gland Function in Nasopharyngeal Cancer Patients on Radiation Therapy
Nasopharyngeal carcinoma (NPC) is an epithelial malignancy occurring worldwide with particularly high frequencies in the Far East. The incidence is highest in Hong Kong followed by Singaporean Chinese.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Original Article
Breath-hold Fast Recovery Fast Spin Echo versus Conventional Non-Breath-hold Fast Spin Echo T2-Weighted MR Imaging of Focal Liver Lesions
T2-weighted magnetic resonance (MR) imaging is an important sequence for characterisation of focal liver lesion. Accurate characterisation of benign lesions, such as haemangioma or cyst, is important to prevent unnecessary procedure or surgery.
This article is available only as a PDF. Please click on “Download PDF” on top to view...
Original Article
Diffusion-weighted MR Imaging in Intracranial Infections
Diffusion-weighted magnetic resonance (MR) imaging (DWMRI) is becoming essential to the assessment of acute cerebral infarction and has also been applied to distinguish cerebral abscess from necrotic intracranial neoplasm. There have also been a few case reports on DWMRI of encephalitis.
This article is available only as a PDF. Please...
Original Article
Preoperative High Resolution CT and MR Imaging in Cochlear Implantation
Candidates for cochlear implantation undergo a thorough audiological and medical assessment. The audiological assessment is done to ensure that these candidates who have bilateral profound or severe hearing loss have been given adequate hearing amplification, but show no significant benefit.
This article is available only as a PDF. Please click...
Original Article
Non-consensual Double Reading in the Singapore Breast Screening Project: Benefits and Limitations
Double reading of mammogram is not the standard practice in the United Kingdom National Health Service Breast Screening Programme (NHSBSP). Rather, single reading of the mammogram remains the basic policy, as was recommended in the Forrest report.
This article is available only as a PDF. Please click on “Download PDF”...
Original Article
Breast Cancer in Women Under 40 Years: Preoperative Detection by Mammography
The incidence of breast cancer peaks between the ages of 45 and 55 years. Approximately 7% of breast cancers occur below 40 years of age.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Editorial
The Past Decade of Diagnostic Radiology in Singapore: How Much Progress Have We Really Made?
It has been 10 years since the first ever issue of Annals dedicated to “Radiology” was published in Volume 22 No. 5 September 1993. Keeping in mind the tremendous growth in the development and applications of Imaging for both Diagnosis and Intervention, this second theme issue is long overdue.
This...
Review Article
Colorectal Hepatic Metastases: Role of Radiofrequency Ablation
Colorectal cancer is the second most common cancer in Singapore, accounting for 15.9% of all cancers registered with the Singapore Cancer Registry in the years between 1993 and 1997. Despite recent advances in surgery, radiotherapy and chemotherapy, more than half of those afflicted will die from their cancer.
This article...
Original Article
Computed Tomographic Appearance of Colorectal Hepatic Metastases
It is important to recognise the computed tomography (CT) appearance of hepatic metastases from colorectal primaries, as resection in a selected group may offer a 20% to 40% rate of five-year survival compared to 5% to 10% with non-surgical management.
This article is available only as a PDF. Please click...
Review Article
Current Status in Imaging of Colorectal Liver Metastases
Colorectal cancer is a common primary that metastasizes to the liver. About 20% of patients with colorectal cancer will have detectable metastases at the time of clinical presentation, with an additional 30% developing clinical evidence of hepatic disease within 24 months.
This article is available only as a PDF. Please...
Others
Routine Abdominal and Pelvic Ultrasound Examinations: An Audit Comparing Radiographers and Radiologists
Since its introduction into clinical practice in the early 1970s, ultrasound (US) has become firmly established as an extremely valuable imaging modality and widely used to the extent that abdominal US is the second most commonly performed imaging study (after chest radiography). Our department has also experienced a steady...
Original Article
Clinical Utility of Selective Intra-arterial Calcium-stimulated Hepatic Venous Sampling in Regionalisation of Insulinomas—The Singapore Experience
Insulinomas are small tumours with dimensions that seldom exceed 2.0 cm in diameter. Preoperative non-invasive localisation using trans-abdominal ultrasound and conventional computed tomography (CT) detect only between 25% and 60% of insulinomas.
This article is available only as a PDF. Please click on “Download PDF” on top to view the...
Others
Reflections of a Septuagenarian – Radiology: Past, Present and Future
Before I commence, I would like to thank the Singapore Radiological Society and the Chapter of Radiologists of the Academy of Medicine for inviting me to speak today on the occasion of the inauguration of the FY Khoo Lectureship. I was initially hesitant.
This article is available only as a...
Others
Flap Prefabrication – The Bridge Between Conventional Flaps and Tissue-engineered Flaps
Flap prefabrication is one of the most exciting areas in Plastic Surgery because of its bridging role between conventional reconstructive surgery and tissue engineering. Using this technique, tissues such as bone, cartilage, skin and muscle can be pre-assembled to form precise composites that will fit any defect.
This article is...
Others
Imaging Findings in Acute Neck Infection due to Pyriform Sinus Fistula
Pyriform sinus fistula is a developmental abnormality of the 3rd or 4th branchial pouch. It usually presents in childhood as acute inflammatory swelling of the neck and frequently involves the thyroid gland.
This article is available only as a PDF. Please click on “Download PDF” on top to view the...
Original Article
Audit of Diagnostic and Interventional Craniocervical Catheter Angiographic Procedures at the Singapore General Hospital
Catheter angiography has long been considered the diagnostic standard by which the accuracy of other vascular imaging modalities are compared, given its superior contrast and spatial resolution, as well its high selectivity and ability to show the full extent of vascular disease, presence of contralateral disease, patterns of collateral...
Original Article
Breast Ultrasound in Women With Familial Risk of Breast Cancer
Mammography is the modality of choice to screen for breast cancer in asymptomatic women. However, it is known that about 10% to 12% of breast cancers are mammographically occult.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Review Article
Coronary Artery Disease: Comprehensive Evaluation by Cardiovascular Magnetic Resonance Imaging
Coronary artery disease (CAD) is a major health problem worldwide. With advances in CAD intervention and improvements in treatment and management of CAD, there has been a dramatic increase in the survival rate of patients.
This article is available only as a PDF. Please click on “Download PDF” on top...
Others
A Case of Right Loin Pain: Septic Ovarian Vein Thrombosis Due to Campylobacter fetus Bacteraemia
Septic ovarian venous thrombosis is an uncommon entity. Classically, it occurs as a postpartum complication with reported frequency of 1 in 600 to 2000 deliveries.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Others
A Case of Ductal Carcinoma In situ of Breast with Poland Syndrome
We report a rare case of multi-focal ductal carcinoma in situ (DCIS) of the breast associated with Poland syndrome. A skin-sparing mastectomy of the left breast with immediate reconstruction using ipsilateral deep inferior epigastric perforator (DIEP) flap was performed.
This article is available only as a PDF. Please click on...
Others
Clinical Indications for Positron Emission Tomography (PET) Scanning
The purpose of these guidelines is to provide a broad framework for clinicians considering the use of positron emission tomography (PET) scanning for their patients. PET imaging is a rapidly evolving field, with ongoing developments in imaging technology, radiochemistry, isotope production, animal research and clinical applications.
This article is available...
Original Article
Semi-Quantitative Measurements of Normal Organs With Variable Metabolic Activity on FDG PET Imaging
Positron emission tomography (PET) has a proven clinical role in oncology, cardiology and neurology that primarily uses 2-deoxy-2--fluoro-deoxyglucose (FDG). FDG is an analogue of glucose that mimics the cellular uptake and initial metabolism of glucose, which enables cells utilising excess glucose to be visualised. Increased glucose metabolism is commonly...
Review Article
Clinical Applications of Positron Emission Tomography in Cardiology: A Review
Ischaemic heart disease associated with depressed left ventricular function is a common clinical management dilemma. There is overwhelming evidence that such patients have a poor prognosis when treated medically.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Review Article
The Role of FDG-PET in the Management of Non-small Cell Lung Carcinoma
Carcinoma of the lung is the leading cause of cancer death in both men and women and is the second most common malignancy in both men and women. In 2003, it is estimated that there will be 171,900 new cases of lung carcinoma diagnosed in the United States and...
Review Article
Clinical PET Imaging – An Asian Perspective
Positron emission tomography (PET) is distinct from other imaging modalities in its ability to probe the physiology and biochemistry of normal and abnormal tissues. It is based on the same principle of tracer kinetics used in conventional nuclear medicine.
This article is available only as a PDF. Please click on...
Review Article
PET Tracers and Radiochemistry
Positron emission tomography (PET) has become a powerful scientific and clinical tool for probing biochemical processes in the human body. This is due, in large part, to advances in instrumentation and synthetic chemistry.
This article is available only as a PDF. Please click on “Download PDF” on top to view...
Review Article
Physical Principles and Technology of Clinical PET Imaging
The past few years have seen the transition of positron emission tomography (PET) from the research domain into mainstream clinical applications for oncology. The emergence of PET as the functional imaging modality of choice for diagnosis, staging, therapy monitoring and assessment of recurrence in cancer has led to an...
Editorial
Positron Emission Tomography – A Vital Component of Molecular Imaging
Contemporary medical imaging is progressing towards quantification of tissue function in addition to merely providing anatomical information, as illustrated by the rising use of such modalities as functional magnetic resonance imaging (fMRI), magnetic resonance spectroscopy (MRS) and positron emission tomography (PET). As far back as 1951, positron-emitting radiotracers have...
Original Article
Benign Parotid Lesions: Is Near Total Parotidectomy Justified?
Benign lesions of the parotid gland constitute about 80% of parotid tumours. They include various lesions (Table 1), the commonest being pleomorphic adenoma, followed by adenolymphoma.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Original Article
Use of D-dimer and Lower Extremity Doppler Ultrasound Results to Obviate the Need for Computerised Tomographic Pulmonary Angiography
The diagnosis of pulmonary embolism (PE) can be a challenging problem. It depends on clinical suspicion and the interpretation of a combination of clinical and radiological presentations.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Original Article
Image-guided Radiofrequency Ablation of Liver Malignancies: Experience at Singapore General Hospital
Radiofrequency (RF) ablation for the treatment of focal liver malignancies is a relatively new image-guided procedure that is gaining increasing acceptance in the radiologic and surgical community, particularly as an alternative treatment option for patients who have inoperable tumours. The potential benefits of minimally invasive image-guided ablation, as compared...
Editorial
Building Collaboration in Cardiac Imaging
Publicity about new developments in medical technology is not at all unusual. But the degree with which multi-slice computed tomography (MSCT) for coronary artery disease (CAD) detection has captured the imagination of the public appears exceptional.
This article is available only as a PDF. Please click on “Download PDF” on...
Others
3rd FY Khoo Memorial Lecture – Education, Professionalism, Outsourcing and the Future of Radiology
Radiology is undergoing unprecedented changes. Not only is the technology evolving rapidly, providing images of breathtaking anatomical clarity, but functional information has also become a reality.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Review Article
Singapore National Medical Image Resource Centre (SN.MIRC): A World Wide Web Resource for Radiology Education
Radiological images are critical for diagnosis, teaching and research. In radiology education, learners must be exposed to large amounts of visual information, and assimilation of these medical images is essential in the training of diagnostic skills.
This article is available only as a PDF. Please click on “Download PDF” on...
Review Article
Teleradiology in Singapore – Taking Stock and Looking Ahead
Teleradiology is the electronic transmission of radiologic images from one location to another for the purposes of interpretation and/or consultation. The current interest in teleradiology is fuelled mainly by rapid technological advances, a worldwide shortage of radiologists, and cost considerations in developed countries.
This article is available only as a...
Original Article
Radiographic Features of SARS in Paediatric Patients: A Review of Cases in Singapore
Severe acute respiratory syndrome (SARS) is a newly emerged atypical pneumonia caused by the SARS-associated coronavirus (SARS-CoV). It is easily transmitted via droplet infection from close contact.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Others
A Case of Cystic Schwannoma of the Lesser Sac
Schwannoma or neurilemmoma (NL) is a well-defined, usually benign, tumour arising from the nerve sheath (Schwann cell). It may present as a solitary mass in any part of the body, but is more commonly seen in the head and neck, the extremities and on the trunk.
This article is available...
Others
Magnetic Resonance Imaging of Sports Injuries of the Knee
Sports-related knee injuries are common, with contact sports and sports involving twisting movements being the most frequent causes. Sports injuries may affect any of the knee structures, including ligaments, menisci, bones, cartilage and periarticular soft tissues.
This article is available only as a PDF. Please click on “Download PDF” on...
Original Article
Forty-one Cervicofacial Vascular Anomalies and Their Surgical Treatment – Retrospection and Review
Vascular anomalies of the head and neck can be categorised as either haemangiomas or vascular malformations.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Original Article
Local Experience of Endorectal Magnetic Resonance Imaging of Prostate with Correlation to Radical Prostatectomy Specimens
Prostate cancer ranks among the top 10 cancers in Singapore. The incidence of prostate cancer has risen by 5% to 118% in most Asian countries.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Letter to the Editor
Medical Misadventure: Barium Extravasation in Colorectal Cancer
Double contrast barium enema (DCBE) is a safe and accurate diagnostic procedure for colorectal cancer. It is often the next diagnostic test after incomplete colonoscopy, with an additional diagnostic yield of 3.2% for neoplastic lesions larger than 1 cm in the non-visualised portion of the colon.
This article is available...
Letter to the Editor
Durian Seed Masquerading as Gallstone Ileus on Computed Tomography
Bezoars and gallstones are unusual causes of small bowel obstruction, with well-described imaging features on CT. We present a case of intestinal obstruction caused by a laminated mass in the terminal ileum that resembled a gallstone on CT, but was surgically proven to be a durian seed phytobezoar.
This article...
Original Article
A Survey of Local Preclinical and Clinical Medical Students’ Attitudes towards Radiology
Radiology is not a popular specialty for undergraduate student electives or postgraduate training amongst students from a local undergraduate medical school which is based in Southeast Asia. During the last 2 years (2007 & 2008), none of our elective students came from the local undergraduate medical school. During the...
Original Article
The Deep Inferior Epigastric Perforator Flap for Breast Reconstruction: Is this the Ideal Flap for Asian Women?
Breast reconstruction is an integral part of breast cancer management. One of the aims of breast reconstruction is the creation of a new breast that is aesthetically appealing and symmetrical to the opposite breast.
This article is available only as a PDF. Please click on “Download PDF” on top to...
Letter to the Editor
Primary Epithelioid Angiosarcoma of the Lung Presenting as Left-sided Shoulder Pain
Primary angiosarcoma of the lung is a rare, often difficult to diagnose disorder with non-specific respiratory manifestations. Angiosarcoma involving the lung is usually a result of metastatic disease.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Letter to the Editor
Macronodular Tuberculosis: Imaging Resemblance of Cholangiocarcinoma
The ability of multiphasic computed tomography (CT) and magnetic resonance (MR) studies in the diagnosis of liver tumours such as hepatocellular carcinoma and cholangiocarcinoma is well established. Nevertheless, potential mimics of malignant tumours abound. Hepatic tuberculosis presenting as hepatic mass is rare and preoperative diagnosis is usually difficult without...
Original Article
Central Clot Score at Computed Tomography as a Predictor of 30-day Mortality after Acute Pulmonary Embolism
Multi-detector Computed Tomography (MDCT) pulmonary angiography is currently the method of choice for the detection of acute pulmonary embolism (PE), because of its convenience, speed, sensitivity, direct clot visualisation and ability to provide alternative diagnoses that mimic PE clinically.
This article is available only as a PDF. Please click on...
Images in Medicine
Periarticular FDG Uptake on PET/CT in Malignant Melanoma—Metastatic or Misleading?
A 74-year-old male with newly diagnosed melanoma of the right mastoid region, underwent resection of the lesion followed by F-18 fluoro-deoxyglucose (FDG) positron
emission tomography/computed tomography (PET/CT) for staging. Figure 1 demonstrates a whole body maximal intensity projection image while Figures 2 and 3 show cross-sectional images through the elbows...
Letter to the Editor
Ultrasound-Guided Thyroid Fine Needle Aspiration Biopsy—The Way Forward
I read with great interest the recent article published in the Annals of Academy of Medicine Singapore entitled, ‘Surgeon-Performed Ultrasound-Guided Fine Needle Aspiration Cytology (SP-US-FNAC) Shortens Time for Diagnosis of Thyroid Nodules, Ann Acad Med Singapore 2014;43:320-4’. Indeed, ultrasound-guided fine-needle aspiration (US-FNA) is an exceptionally valuable and simple approach...
Original Article
Relationships between Prostatic Volume and Intravesical Prostatic Protrusion on Transabdominal Ultrasound and Benign Prostatic Obstruction in Patients with Lower Urinary Tract Symptoms
Benign prostatic hyperplasia (BPH) is one of the commonest diseases of ageing men. It can be associated with bothersome lower urinary tract symptoms (LUTS) that affect quality of life and it causes structural and functional changes in the bladder. Previous clinical guidelines had emphasised on managing symptoms; however current...
Original Article
Are Pregnant Women Adequately Equipped for Autonomy in Pregnancy Screening?
The concept of first trimester screening (FTS) to evaluate the risk of fetal aneuploidies was first introduced in 1997 by Orlandi et al. The Fetal Medicine Foundation, London, has refined and populated this screening test that uses a combination of maternal age, nuchal translucency (NT) thickness and biochemical markers,...
Letter to the Editor
A Follow-up Longitudinal Survey on a Cohort of Undergraduate Medical Students’ Attitudes towards Radiology
As a follow-up to an earlier study comparing the attitudes of first year undergraduate medical students following the introduction of a new radiology curriculum in 2008 with their clinical seniors who did not have an early exposure to radiology; we again surveyed this same cohort of first year students...
Commentary
Transthyretin amyloid cardiomyopathy: The emerging role of cardiac amyloid imaging
Transthyretin amyloidosis (or ATTR amyloidosis) is an under-recognised multisystemic disorder, arising from misfolding of transthyretin proteins into insoluble amyloid fibrils. As amyloid fibrils deposit into various tissues and organs, the process invariably leads to organ dysfunction. Deposition of amyloid fibrils into the heart results in cardiac amyloidosis (CA). Manifestations...
Editorial
A Duty of Quality
The process of delivery of health care is complex and includes aspects which concern the clinician, the patient and the treatment process itself. Training imparts skill and knowledge to the clinician.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full...