The European Society of Head and Neck Radiology Mentoring Programme: development and feedback during the first phase of the initiative.

There is increasing awareness of the benefits of formal mentorship programmes in radiology. In the context of the COVID 19 pandemic which impacted on education, professional engagement and networking within the wider radiological community, the European Society of Head and Neck Radiology (ESHNR) decided to develop a formal mentoring programme. The ESHNR mentoring initiative is novel in its scope, whereby European and international members of a subspecialty radiology society are matched into mentor-mentee pairings to disseminate good practice, knowledge and ideas. The purpose of this report is to describe the motivations, planning, challenges and early experience of the ESHNR mentoring programme together with initial feedback from the scheme.The development of the programme and iterative modifications during the first phase of the scheme are described. The programme has enrolled 33 mentors and 27 mentees with international representation and 24 mentor-mentee pairs have participated in 2.6 (mean) meetings. The experience and benefits reported by the participating ESHNR members (mentees and mentors) were evaluated by a questionnaire at six months following the start of the programme. There were 80% of mentors and 88% of mentees who strongly agreed that the mentoring programme was rewarding rather than an obligation, and all participants reported that they would recommend the scheme to colleagues.A formal mentoring programme has been established for an international subspecialty radiology society. The early experience is encouraging and suggests that it is both useful and sustainable. Our experiences may be of benefit to other subspecialty societies considering a mentoring programme.

Diagnosis of temporomandibular dysfunction syndrome--image quality at 1.5 and 3.0 Tesla magnetic resonance imaging.

The purpose of this study was to examine the differences in expert ratings of quality of magnetic resonance images (MRI) of the temporomandibular joint in 24 patients with suspected anterior disc displacement examined in randomized order at 1.5 and 3.0 T. Parasagittal (closed and opened mouth) and paracoronal sections were performed with a surface coil. Two experienced examiners blinded to patient status and type of MRI diagnosed the images according to position of condyle, position and changes in the signal, and disc shape. In addition, perceptibility of position and disc shape were assessed. A highly significant difference in the perceptibility of disc shape (P < 0.001) and position (P < 0.001) was obtained. With comparable examination sequences and identical resolution, the 3.0 T MRI of the temporomandibular joint increases the perceptibility of joint structures.

Multidetector row computed tomography of the injured larynx after trauma.

Laryngeal trauma is rare and can occur as an isolated injury or as part of multitrauma. On the basis of airway patency, it is decided whether the patient needs rapid surgical intervention or whether the patient would profit from preoperative imaging done with multidetector row multislice thin section computed tomography with multiplanar reconstruction in the soft-tissue and bone window setting. Grading the fracture pattern from minor isolated to multiple dislocated fracture lines helps to plan individual treatment options and to prevent long-term voice complications.

Laryngeal fractures: clinical findings and considerations on suboptimal outcome.

CONCLUSION: We recommend early surgical exploration and fixation for patients with dislocated or comminuted laryngeal fractures to avoid long-term voice complications. One-third of 33 fracture patients rated their voice after the fracture had healed as fair but altered. OBJECTIVES: To examine the indications for and the outcome of surgical management in patients with laryngeal fractures. PATIENTS AND METHODS: The study was carried out in a tertiary care referral university hospital and was a retrospective study of case series. Thirty-three consecutive patients, aged 14-84 years, presented with various types of laryngeal fractures. Patients were staged according to the type of the fracture and surgical correction was performed when indicated. Voice outcome was documented and patients with subjectively suboptimal result were further evaluated by phoniatric specialist. RESULTS: In all, 32 of 33 laryngeal fracture patients had blunt trauma and the main causative factors were sport injuries (39%) and physical assault (33%). All of the 33 laryngeal fracture patients had a good airway outcome. The subjective voice outcome was good for 20 (61%) and fair for 13 (39%) patients. The mean follow-up time was 39.5 months (range 2-114 months). In phoniatric evaluation most (six of eight) patients with fair voice outcome could not produce high pitched voices because of inability to stretch the vocal folds.

Mu-CT.

While many radiologists are aware of the revolutionary development of computed tomography (CT)-scanners and their diagnostic implications, some researchers have focused on studying the potentials of mu-CT. The aim of this article is to give a brief overview of its physical properties and outline possible indications both for the real ex vivo and small animal mu-CT studies, as well as the modified mu-CT units used in dental practice.

Correlation between disk morphology on MRI and time curves using electronic axiography.

This retrospective series was intended to determine whether morphological disk findings in open and closed mouth magnetic resonance imaging (MRI) may be correlated with the time curves in axiography. In this series, 45 temporomandibular joints of 33 patients were subjected to a retrospective evaluation. Magnetic resonance images obtained with closed and open mouth and joint movements assessed by electronic axiography were analyzed. Disk morphology in MRI was classified as normal, partly flattened, partly thickened, or completely thickened. For the axiographic tracings, time curves of the free movements of the respective joint were developed and evaluated. Data obtained were analyzed for any potential correlation using scatter plots and discriminance analysis. No correlation between these data was found suggesting that the axiographic time curves do not provide for any conclusions with regard to disk morphology. Apart from patient history and a thorough clinical evaluation, recording of jaw movements, but also using MRI continues to be of particular value in the diagnostic assessment of anterior disk displacement.

Dentomaxillofacial imaging with panoramic views and cone beam CT.

Panoramic and intraoral radiographs are the basic imaging modalities used in dentistry. Often they are the only imaging techniques required for delineation of dental anatomy or pathology. Panoramic radiography produces a single image of the maxilla, mandible, teeth, temporomandibular joints and maxillary sinuses. During the exposure the x-ray source and detector rotate synchronously around the patient producing a curved surface tomography. It can be supplemented with intraoral radiographs. However, these techniques give only a two-dimensional view of complicated three-dimensional (3D) structures. As in the other fields of imaging also dentomaxillofacial imaging has moved towards 3D imaging. Since the late 1990s cone beam computed tomography (CBCT) devices have been designed specifically for dentomaxillofacial imaging, allowing accurate 3D imaging of hard tissues with a lower radiation dose, lower cost and easier availability for dentists when compared with multislice CT. Panoramic and intraoral radiographies are still the basic imaging methods in dentistry. CBCT should be used in more demanding cases. In this review the anatomy with the panoramic view will be presented as well as the benefits of the CBCT technique in comparison to the panoramic technique with some examples. Also the basics as well as common errors and pitfalls of these techniques will be discussed. Teaching Points • Panoramic and intraoral radiographs are the basic imaging methods in dentomaxillofacial radiology.• CBCT imaging allows accurate 3D imaging of hard tissues.• CBCT offers lower costs and a smaller size and radiation dose compared with MSCT.• The disadvantages of CBCT imaging are poor soft tissue contrast and artefacts.• The Sedentexct project has developed evidence-based guidelines on the use of CBCT in dentistry.

Dental CT evaluation of mandibular first premolar root configurations and canal variations.

OBJECTIVES: Routine dental CT scans were used to describe mandibular first premolar root configurations and canal variations. STUDY DESIGN: One hundred twenty dental CT examinations were evaluated for mandibular first premolar root configurations and canal variations regarding shape of root and root canal, incidence of multiple canals, and level of bifurcation. RESULTS: A total of 17 teeth in 12 patients showed mesial invagination of the root of the mandibular first premolar. One root displayed 3 canals with 3 apical foramina. In 2 teeth, a single canal divided into 2 canals, but merged into 1 apical foramen. One root showing 2 root canals finally divided into 2 roots near the apex. Thirteen roots had 2 canals and 2 apical foramina. The distance from the cementoenamel junction to the level of bifurcation was between 4 and 13 mm (mean, 7.4 mm). CONCLUSION: The occurrence of incidentally found mandibular first premolar root variations should be an important component of dental CT reports.

Clinical significance of incidental magnetic resonance image abnormalities in mastoid cavity and middle ear in children.

OBJECTIVE: Magnetic resonance imaging of the head may reveal incidental findings in paranasal sinuses. The purpose of this study was to discover whether similar changes could be identified in the mastoid cavity and middle ear as well. METHODS: A group of 50 children undergoing magnetic resonance imaging of the head for suspected intracranial pathology were prospectively gathered. Their parents completed a questionnaire concerning each child's medical history connected with acute otitis media. Otoradiologists evaluated the pictures for mastoid cavity and middle ear and paranasal sinus abnormalities. RESULTS: In six (12%) children, magnetic resonance imaging detected abnormalities resembling acute inflammatory changes, although none had had acute otitis media during the preceding last 3 months. Abnormalities detected in the paranasal sinuses were not correlated with abnormalities in the mastoid cavity and middle ear. CONCLUSIONS: High signal intensity in magnetic resonance images from the mastoid cavity and middle ear may be incidental and without any clinical significance. These findings must be interpreted together with knowledge of the child's medical condition and clinical examination of the ears.

Cystic neck lesions: clinical, radiological and differential diagnostic considerations.

CONCLUSIONS: Metastatic disease should always be considered as a potential differential diagnosis in the adult patient with a cystic neck lesion. OBJECTIVES: The most common cause of a cystic neck lesion in young adults is a branchial cleft cyst (BCC). In older patients metastatic lymph nodes may be easily misdiagnosed as BCC. This study aimed to investigate the incidence of unsuspected carcinoma in routinely excised cervical cysts at a tertiary care teaching hospital and to determine the characteristics of benign BCC and cystic malignancy in preoperative imaging. PATIENTS AND METHODS: A total of 196 consecutive adult patients operated on with the initial diagnosis of benign lateral cervical cyst were identified and the hospital charts and imaging studies were reviewed. The mean age of the patients was 40 years (range 17-79 years). RESULTS: Metastatic squamous cell carcinoma was demonstrated histologically postoperatively in six (3.1%) patients and metastatic papillary thyroid carcinoma in one (0.5%) patient. Therefore, the incidence of unsuspected carcinoma in the cystic neck lesions initially diagnosed as BCC was 3.6%. The preoperative imaging appearances of these lesions had been considered identical to that of BCC.

Ameloblastic carcinoma of the mandible resembling odontogenic cyst in a panoramic radiograph.

Ameloblastic carcinoma is a rare odontogenic tumor exhibiting histologic evidence of malignancy in the primary or recurrent tumor, regardless of whether it has metastasized or not. Most ameloblastic carcinomas are presumed to have arisen de novo, with few cases of malignant transformation of ameloblastoma being apparent. A case is reported of a 21-year-old caucasian female with ameloblastic carcinoma in the left angulus area of the mandible resembling an odontogenic cyst in the panoramic radiograph. In addition to the panoramic radiograph, computerized tomography (CT) and magnetic resonance (MR) images were taken preoperatively. This report demonstrates that CT or MR examinations may be crucial in differentiating odontogenic tumors from cysts.

Localized pericochlear hypoattenuating foci at temporal-bone thin-section CT in pediatric patients: nonpathologic differential diagnostic entity?

PURPOSE: To evaluate the prevalence of localized hypoattenuating areas in the cochlear otic capsule at temporal-bone thin-section computed tomography (CT) in pediatric patients and correlate the findings with clinical information. MATERIALS AND METHODS: Temporal-bone thin-section CT images obtained in 73 patients aged 0-9 years (20 Austrian, 53 Finnish; 36 female and 37 male patients) were evaluated for the presence of localized hypoattenuating foci in the region of the fissula ante fenestram of the otic capsule. Clinical information collected for all patients was also evaluated. The data were analyzed with a logistic regression model. RESULTS: Hypoattenuating areas in the region of the fissula ante fenestram were observed in 23 of 73 patients (32%). Hypoattenuating foci were substantially more prevalent in patients younger than 3 years than in those 3 years or older (odds ratio, 0.14; 95% CI: 0.04, 0.52; P =.001). The prevalence did not differ between sexes or according to clinical diagnosis. Only three of the 23 patients with hypoattenuating foci had clinical findings suggestive of otosclerosis, and none had osteogenesis imperfecta. After adjustment for age and sex, the finding was more prevalent among the Finnish patients (odds ratio, 5.4; 95% CI: 1.19, 24.52; P =.02) than among the Austrian patients. CONCLUSION: Hypoattenuating areas in the region of the fissula ante fenestram in the otic capsule at thin-section CT are prevalent among children younger than 3 years in the absence of clinical evidence of otosclerosis or osteogenesis imperfecta and appear in children up to 9 years old.