A case report of synchronous osteoblastoma and fibromatosis.

Osteoblastoma is a rare bone tumour that accounts for 1% of all primary bone tumours and 3% of all benign bone tumours. Osteoblastoma occurring in long bones has a predilection for the meta-diaphysis. It bears a close histological resemblance to osteoid osteoma, but it is not growth limited - usually 2 cm or greater at diagnosis. The term "fibromatosis" covers a broad spectrum of benign fibrous tissue proliferations. It is characterized by infiltrative growth and a tendency for recurrence; however, unlike sarcoma, it never metastasizes. To our knowledge, this is the first case report in the English literature of a patient with synchronous presentation of an osteoblastoma and fibromatosis.

Bouveret's syndrome: a rare complication of cholecystolithiasis.

Bouveret's syndrome is obstruction of the stomach or the duodenum from a gallstone that has migrated through a biliogastric or bilioduodenal fistula. This rare syndrome has been described in a number of case reports.

Accuracy of Voxel-Based and Algebraic Formula-Based Methods in Quantifying Cerebral Aneurysm Volume by 3D-Rotational Digital Subtraction Angiography. An In-Vitro and In-Vivo Study.

SUMMARY: Accurate knowledge of cerebral aneurysm volume would be valuable in guiding the volume of embolized material required for optimal filling of an aneurysm sac and recording percentage volume filling. Algebraic volumes are frequently estimated by algebraic volume formulae. 3D digital subtraction angiography (DSA) aids endovascular treatment planning and yields volumetric data. Our aim was to define the accuracy of 3D-DSA in quantifying aneurysm volume using an automated voxel-based volumetric method (voxel volume method) and compare results to volumes calculated by ellipsoid and cylindrical algebraic formulae (algebraic volume method). We constructed 13 latex aneurysm moulds and measured their true volumes using a micropipette in-vitro. 3D-DSA was performed on contrast filled moulds and experimental volume estimated by both voxel and algebraic methods. In our in-vivo study we quantified the voxel and algebraic volumes from the 3D data sets of 75 cerebral aneurysms. The linear regression test provided correction values between voxel and algebraic methods. The in-vitro study showed that the voxel volume method was the most accurate (mean percentage deviation from true volume 3.7 +/- 3.5%; p=0.9). The ellipsoid method significantly underestimated - 11.2 +/- 13.6%; p < 0.05) and the cylindrical method overestimated (42.6 +/- 35.7%; p < 0.05) true aneurysm volume. Similar results were obtained in-vivo. While algebraic measurements could be corrected by an equation, the clinical usefulness of this equation is questionable due to the large volume range to achieve a 95% confidence interval. The voxel volume method is accurate in quantifying aneurysm volume. Aneurysms in-vivo do not conform to simple algebraic geometry. Aneurysm volume on 3D-DSA should be calculated by the voxel-based method and not by algebraic formulae.

Informed consent for interventional radiology procedures: a survey detailing current European practice.

PURPOSE: Official recommendations for obtaining informed consent for interventional radiology procedures are that the patient gives their consent to the operator more than 24 hr prior to the procedure. This has significant implications for interventional radiology practice. The purpose of this study was to identify the proportion of European interventional radiologists who conform to these guidelines. METHODS: A questionnaire was designed consisting of 12 questions on current working practice and opinions regarding informed consent. These questions related to where, when and by whom consent was obtained from the patient. Questions also related to the use of formal consent forms and written patient information leaflets. Respondents were asked whether they felt patients received adequate explanation regarding indications for intervention, the procedure, alternative treatment options and complications. The questionnaire was distributed to 786 European interventional radiologists who were members of interventional societies. The anonymous replies were then entered into a database and analyzed. RESULTS: Two hundred and fifty-four (32.3%) questionnaires were returned. Institutions were classified as academic (56.7%), non-academic (40.5%) or private (2.8%). Depending on the procedure, in a significant proportion of patients consent was obtained in the outpatient department (22%), on the ward (65%) and in the radiology day case ward (25%), but in over half (56%) of patients consent or re-consent was obtained in the interventional suite. Fifty percent of respondents indicated that they obtain consent more than 24 hr before some procedures, in 42.9% consent is obtained on the morning of the procedure and 48.8% indicated that in some patients consent is obtained immediately before the procedure. We found that junior medical staff obtained consent in 58% of cases. Eighty-two percent of respondents do not use specific consent forms and 61% have patient information leaflets. The majority of respondents were satisfied with their level of explanation regarding indications for treatment (69.3%) and the procedure (78.7%). Fifty-nine percent felt patients understood alternative treatment options. Only 37.8% of radiologists document possible complications in the patient's chart. Comments from respondents indicated that there is insufficient time for radiologists to obtain consent in all patients. Suggestions to improve current local policies included developing the role of radiology nursing staff and the use of radiology outpatient clinics. CONCLUSIONS: More than 50% of respondents are unhappy with their policies for obtaining informed consent. Interventional societies have a role to play in advocating formal consent guidelines.