Temporal Bone Trauma: Typical CT and MRI Appearances and Important Points for Evaluation.

Temporal bone trauma is frequently encountered in the emergency department. Technologic advances have enabled timely acquisition of thin-section images and multiplanar reconstructions such that temporal bone anatomy can be evaluated in great detail, with excellent delineation of fractures. The temporal bone is composed of a myriad of tiny structures, including many fissures and canals, that must be distinguished from true fractures. In addition, injury to important structures may result in serious complications such as hearing loss, dizziness, imbalance, perilymphatic fistula, cerebrospinal fluid leakage, facial nerve paralysis, and vascular injury. Structures that should be examined include the tympanic cavity and tegmen, the ossicular chain, the bony labyrinth, the facial canal, the internal carotid artery, the jugular foramen and venous sinuses, and the intracranial contents. Radiologists should be familiar with the anatomy of the temporal bone and be able to describe any pathologic findings and make suggestions to referring clinicians to guide management and determine the prognosis. The authors describe the typical CT and MRI appearances of temporal bone trauma, entities that mimic this injury and thus must be differentiated, and compulsory points for evaluating clinically relevant associated complications. Instruction is provided for acquiring the diagnostic skills necessary to report suggested injury status, complications, and likely sequelae to clinicians.©RSNA, 2020.

Value of high-dose radiation therapy for isolated osseous metastasis in breast cancer in terms of oligo-recurrence.

BACKGROUND: For many years, patients with recurrent or distant metastatic cancer have been considered to be at the last stage of their lives because it was considered that the cancer had spread throughout the whole body. However, the development of methods for the early detection of recurrence or distant metastases allows the detection of limited site recurrence or single organ metastases, called oligometastases or oligo-recurrence. Additional local treatment for oligometastatic or oligo-recurrent lesions such as radiation therapy could be efficacious. The purpose of the current study was to evaluate radiation therapy for solitary osseous metastasis of breast cancer in terms of oligometastasis and oligo-recurrence. PATIENTS AND METHODS: One hundred and thirteen breast cancer patients were treated with radiation therapy for osseous metastases at Kitasato University Hospital, Japan between January 1998 and March 2003. Out of them, seven patients had solitary osseous metastases with primary and other sites controlled. These patients were registered in the current study, three had lumber spine metastases, three pelvic and one thoracic spine. The median time between the initial treatment of the primary lesions and diagnosis of the osseous metastases was 44 months (range: 10-95 months). The median total radiation dose was 46 Gy (30-50 Gy; BED: biological effective dose, 39-60 Gy10). RESULTS: The median follow-up time was 40 months (range: 11-80 months). All the patients were alive at the last follow-up. Only one patient relapsed in terms of pain from the osseous metastasis. This patient was treated with 30 Gy (BED 39 Gy10) irradiation, the lowest total dose among the seven patients. CONCLUSION: Radiation therapy for solitary osseous metastasis might be efficacious and moreover, high dose could be useful for long-term pain relief of osseous metastasis.

Abscopal effect of radiation on toruliform para-aortic lymph node metastases of advanced uterine cervical carcinoma--a case report.

The case of a 69-year-old woman with advanced uterine cervical carcinoma with toruliform para-aortic lymph node metastases that showed an abscopal effect of radiation therapy (effect out of irradiated field) is reported. The patient was admitted to our University Hospital in March 2005, and treated with radiation therapy only for the primary pelvic lesions without chemotherapy because of her severe economic status. After the treatment, not only did the cervical tumor in the irradiated field disappear, but the toruliform para-aortic lymph node swelling outside the irradiated field also spontaneously disappeared. The patient is still alive and well without relapse. This case is the first clinical demonstration of an abscopal effect in advanced uterine cervical carcinoma.

[Quantitative evaluation of deformity of the iliac artery during extension and flexion of the hip joint: three-dimensional evaluation using MDCT].

We performed CT-angiography twice, first hip joint extension, followed by second flexion. Using vessel analysis software, we placed several points of interest at equal intervals on the center line of the iliac artery, from the bifurcation to the femoral artery inguinal portion, and recorded the their three-dimensional coordinates. We also marked the circumference, which passes by three points that add the respective next point and prior point to each reference point. This curvature (the inverse number of the radius) was utilized as the index that displays crookedness. This method was able to estimate quantitatively the grade of crookedness, and, by comparing an equidistant point from the bifurcation, to show the changes in grade at flexion of the hip joint.