Imaging appearances of Buerger's disease complications in the upper and lower limbs.

Thromboangiitis obliterans (Buerger's disease) is a rare, non-atherosclerotic, segmental, inflammatory vasculitis that most commonly involves small and medium-sized arteries, veins and nerves of the extremities and affects tobacco smokers between the ages of 25 and 45 years. The manifestations of Buerger's disease can be extremely variable and, therefore, awareness of the condition is important for both general and musculoskeletal radiologists. This paper presents the radiological appearance of the sequelae of Buerger's disease involving the upper and lower limbs.

Fenestrated anterior cerebral artery with associated arterial anomalies. Case reports and literature review.

SUMMARY: Fenestration of the A2 segment is extremely rare. Cerebrovascular fenestration may be associated with an increased incidence of cerebral aneurysm and other vascular anomalies. Two case reports are presented which identify a fenestration of the A2 segment and other normal variations of the intra-cerebral circulation. A review of the literature has been undertaken to determine the prevalence and embryology of anterior cerebral artery fenestrations, their clinical significance and the association with aneurysm formation and other intracranial vascular anomalies.

Coaxial cutting needle biopsies: how important is it to rotate the cutting needle between passes?

AIM: To use an in-vitro model to measure the effect of turning the notch of the cutting needle between passes on the mass of core biopsy material obtained from a typical coaxial biopsy system when multiple passes are performed. METHODS: A coaxial guide needle was placed within tissue-equivalent agar cylinders and a cutting biopsy needle was used to take core biopsies. Two, three, or four sequential biopsies were performed on the same cylinder with the notch of the cutting needle either inserted facing in the same direction (no rotation) or placed in a sequence of different directions (rotation). The mass of the tissue core obtained at each biopsy pass was measured. A post hoc telephone questionnaire of radiologists across Australia was also undertaken to analyse current practice in the context of these results. RESULTS: There were statistically significant increases in the mass of tissue obtained using rotation compared with no rotation. Using rotation, the total mass of tissue obtained from three passes was increased by 32.8% (95% CI 23.9-41.7%) and from four passes was increased by 45% (95% CI 37.2-52.9%). The mass of the second pass cores was statistically significantly greater (p<0.001). Fifty-nine percent of Australian radiologists surveyed do not currently change the rotation of the biopsy needle between passes. CONCLUSION: This in-vitro model confirms that the notch of the cutting needle should be placed into different directions at each pass whenever a coaxial cutting biopsy system is being used to maximize the mass of tissue obtained.