Increased image quality and reduced radiation dose and contrast media volume: a holistic approach to intracranial CTA.

AIM: To investigate the dose-length product (DLP) during intracranial computed tomography angiography (CTA) using a patient-specific contrast formula. MATERIALS AND METHODS: Intracranial CTA was performed on 120 patients using 64-channel CT. Patients were subjected in equal numbers to one of two acquisitions/contrast medium protocols. Protocol A, consisted of 80 ml contrast medium and protocol B, involved a novel contrast medium formula. In each protocol, contrast medium and saline were injected at a flow rate of 4.5 ml/s. The DLP and contrast volume (CV) were measured between each protocol and the data obtained were compared using two-tailed independent t-test. RESULTS: Mean arterial vessel attenuation was up to 56% (p<0.01) higher using protocol B compared with A. In the venous system, the mean vessel attenuation was significantly lower in protocol B than A with a maximum reduction of 93% (p<0.001). The mean CV was significantly lower in protocol B (53±10 ml) compared to A (80±1 ml, p<0.001). The scan time was equal in each protocol (B, 4.22±1.2 seconds; A, 4.01±1.3 seconds). A significant reduction in mean DLP was demonstrated in protocol B (3.99±0.22 mSv) compared to A (4.74±0.22 mSv; p=0.02). CONCLUSION: A significant reduction in CV and DLP during intracranial CTA can be achieved when employing a patient-specific contrast medium formula.

Clinics in diagnostic imaging (68). Intradural extramedullary spinal paraganglioma.

Paragangliomas rarely present as spine tumours. The correct diagnosis is generally not suspected pre-operatively and initial imaging is often non-specific. A 36-year-old man with low back pain, and progressive leg numbness and weakness, was found to have an expansile intradural extramedullary spinal tumour on radiographs and magnetic resonance imaging. Surgery revealed a paraganglioma. The features of spinal paraganglioma and differential diagnosis of intradural extramedullary tumours are discussed.

Seroepidemiological study of Helicobacter pylori infection in South African children.

The seroepidemiology of Helicobacter pylori infection was studied in 681 randomly selected Black children from newborn to 13 years of age (333 boys, mean age 8.05 years, and 348 girls, mean age 7.76 years) in KwaZulu/Natal, South Africa. H. pylori infection was identified serologically using an enzyme-linked immunosorbent assay to detect the presence of immunoglobulin G against H. pylori. Demographic information collected included age, gender, family income, overcrowding, educational level, and possession of domestic pets. The seroprevalence of H. pylori infection was compared to a known faecal-orally transmitted infection, hepatitis A virus (HAV); 66% of the children were seropositive for H. pylori. There was an age-specific increase in H. pylori infection, with more than 80% of children being infected by the age of 10 years. There was no significant difference (P = 0.338) in the seropositivity of H. pylori infection between boys (68%) and girls (64%), nor was there any significant difference in H. pylori infection related to pets, level of parents' education, crowding, and income, by either univariate or multivariate analysis. However, there was a significant association (P < 0.00001) between the seroprevalence of H. pylori and HAV infections, suggesting similar modes of transmission.