To determine the prevalence of different extracranial internal carotid artery (EICA) variations in CT angiography (CTA) of the neck and its predisposing factors. In this retrospective study from 2021 to 2023 conducted in the radiology department of Shafa Hospital, Kerman, Iran, all patients who had undergone neck CTA were included. Expert radiologists blindly examined each CTA image for the following: EICA variations—coiling, kinking, straight morphology, and tortuosity—and the distance between the internal carotid artery and the apex of the epiglottis and the C2 lower margin. Of the 106 patients, the mean age was 55.9 ± 16.9 years. 64.2

Background:Multiple sclerosis (MS) as a complex neurological abnormality is marked with loss of myelin and axons due to chronic inflammatory and autoimmune responses. The modulatory properties of the low dose radiation (LDR) on inflammatory and immune responses have well known.Objective:The current research aimed to assess the impacts of LDR on the disability in patients suffering from MS.Material and Methods:This experimental pilot study was done on 10 patients with secondary progressive multiple sclerosis (SPMS). After magnetic resonance imaging, the SPMS patients were treated by LDR at a daily dose of 2 Gray for 5 consecutive days (totally 10 Gray dose) using a linear accelerator. The extent of the disability was evaluated one week after the completion of radiotherapy using expanded disability status scale (EDSS).Results:After receiving radiotherapy, the patients had a feeling of wellbeing of some sort. The mean of EDSS was significantly reduced after radiotherapy compared with before irradiation (7.4±0.45 vs 6.35±1.18; P<0.017). EDSS more decreased in younger SPMS patients (P=0.0001), and in the women after LDR (P=0.027).Conclusion:Radiotherapy can reduce fatigue and EDSS in patients with SPMS. The age and gender of patients may influence the LDR efficacy.

Introduction:Intracranial hemorrhage (ICH) is divided into two traumatic and non-traumatic categories. The present study sought to investigate the anatomical properties of non-traumatic intracranial hemorrhage in Kerman, Iran. Method:A total of 305 non-traumatic ICH cases were chosen in Shafa medical center. Data from patients’ files and CT scan images, including demographic factors and type of malformation, aneurysm size and shape, as well as the invovled location and artery were gathered and statistically analyzed. Results:Most cases were 40-60 years old. SAH, ICH and SAH+IVH were 69.5%, 14.4 and 8.5% respectively. From all, 65.2% had arteriovenous malformation and following furthure assessment, aneurysm with 148 cases (74.4%) was the most frequent and 57.4% of aneurysm cases were located in the right hemisphere. In 14.9% of cases, multiple aneurysms were observed. Conclusions: According to the results of this study, non-traumatic intracranial hemorrhages caused by arteriovenous malformation were in the shape of an aneurysm; an increase in age may result in higher probability of aneurysm occurence.

Background: Renal transplantation (RT) is the transplantation of a kidney into a patient with end-stage renal disease and has become the treatment of choice for most patients with end-stage renal disease. The knowledge of renal vascular variations is of a great importance for the surgeons who approach the kidneys from the retroperitoneal or laparoscopic route for renal transplants. The aim of this study was to detect renal vascular variations of kidney donors in Kerman by using CT angiogram. Methods: This cross-sectional study examined the CT angiograms of all kidney donors referred to the Radiology Ward of Shafa Medical center affiliated to Kerman University of Medical Sciences from 2010 to 2012. Results: The results of CT angiograms of 344 kidney donors were as follow: Right Renal Arteries: 236 cases with one artery; 97 cases with two arteries; 9 cases with three arteries; and one case with four arteries Left Renal Arteries: 225 cases with one artery; 103 cases with two arteries; and 16 cases with three arteries Right Renal Veins: 277 cases with one vein and 12 cases with two veins Left Renal Veins: 279 cases with one vein and 10 cases with two veins. Conclusion: There is no significant difference between our results and those of previous studies. In more than 30% of cases, our findings were associated with other incidental findings.

Background: Several studies indicate contribution of hypothalamus-pituitary-adrenal (HPA) axis in multiple sclerosis (MS) disease. This study was designed to determine whether there is an effective difference in pituitary height, shape, and anterior-posterior diameter (APD) between patients with MS and the control group. Methods: In this study, sagittal pituitary height and APD of 134 men and women (64 patients with MS and 70 healthy subjects as control group) were measured by T1 sequence magnetic resonance imaging (MRI). All the subjects were free of sellar or parasellar pathology without a history of surgical intervention or prolactin affecting drugs like bromocriptine and cabergoline or corticosteroid consumption. Results: Mean height of pituitary gland was 6.62 ± 1.43 and 5.78 ± 1.15 mm for patients and the control group, respectively, and the difference between the two groups was statistically significant (P = 0.001). Mean APD was 10.40 ± 1.29 mm for the group of patients and 10.25 ± 1.41 mm for the control group, respectively, without significant differences. 46.9%, 37.5%, and 15.6% of patients had flat, convex, and concave hypophyseal surfaces, respectively. This rate was 50%, 30%, and 20% among the control group, respectively. There was no significant difference between our measurements among patients on whom imaging study was performed at time of disease onset with others. Conclusion: Mean height of pituitary gland among patients with MS was significantly greater than the control group (P = 0.001). So can we consider the same etiology for pituitary hypertrophy among patients with MS as a hypothesis?

BACKGROUND The races show different cerebrovascular involvements, for example, the involvement of intracranial arteries are higher among Asians than Caucasians. The aim of this study was to investigate the cerebrovascular stenosis pattern by computed tomography angiography (CTA), which is unprecedented in Iran. METHODS In this study, patients with brain stroke (thrombosis), confirmed by CT scanning and cardiac assessments, who referred to Shafa Hospital in Kerman, Iran, underwent brain and cervical arteries CT angiography to assess involved cerebrovascular territories and also its risk factors from June 2012 to June 2013. RESULTS We did CTA for 100 patients. Eighty-four cases had cerebral artery stenosis. Intracranial vessel involvement alone was observed in 47.6% of patients, simultaneous intracranial and extracranial artery stenosis in 26.2%, and extracranial artery stenosis in 26.2%. Posterior cerebral artery territory showed the highest degree of vascular stenosis. Posterior cerebral artery stenosis alone was observed in 51.3% of the cases; 27.4% of the cases suffered from anterior artery stenosis, and 21.6% had simultaneous anterior and posterior cerebral artery stenosis. Smokers showed higher extracranial artery involvement compared to non-smokers; 44% of smokers and 14% of non-smokers had extracranial vertebral involvement. CONCLUSION Our findings showed that intracranial artery involvement was the most prevalent finding in patients with thrombotic stroke in Kerman. Also posterior cerebral artery stenosis was more prevalent than anterior artery stenosis. Hypertension was the most common risk factor. Furthermore, smoking was considered as an important risk factor for extracranial artery stenosis, especially in the posterior cerebral artery.

Background & Aims: Low back pain is one of the most common problems and a symptom-related reason for visits to a physician, and one of the important causes of disability. It may also impose great costs on the individual and the health system. Most patients with back pain will recover within 4 to 6 weeks. One of the best paraclinical diagnostic methods is magnetic resonance imaging (MRI), which may result in incidental findings of great importance to the patient. Methods: In this cross-sectional study, all cases in which lumbosacral MRI was performed due to back pain were investigated in terms of incidental findings. Results: The MR images of 854 patients in 2012 were studied. Among these patients, 40.3% (344) were male and 59.7% (510) were female. Mean age of patients was 43.05 years with median of 42 years. The incidental findings were observed in 29.7% (254) of cases who had no clinical symptoms and were not investigated by the physician. Abnormal incidental findings were observed in 9.5% (81) of male and 20.2% (173) of female patients; this difference was significant (P = 0.001). The prevalence of incidental findings was significantly higher in men of above 42 years of age (P = 0.001), but this difference was not significant in female patients (P = 0.513). In total, the prevalence of incidental findings was higher in ages above 42 (P = 0.004). The most prevalent incidental findings were, respectively, renal cysts (11.5%), retroflection of uterus (5.7%), and ovarian cyst (4.3%). Life threatening findings were aortic disorders (n=11, 11.3 %) and important lesions (n=28, 3.3%) requiring investigation. Conclusion: Incidental findings in MRI are important and since they might be the origin of pain or health threatening, require further evaluation.

The U.S. Nuclear Regulatory Commission (USNRC) initiated a contract with Oak Ridge National Laboratory (ORNL) to calculate radiation dose rates to members of the public that may result from exposure to patients recently administered iodine-131 (131I) as part of medical therapy. The main purpose was to compare dose rate estimates based on a point source and target with values derived from more realistic simulations of a human source and target. The latter simulations considered the time-dependent distribution of 131I in the patient and attenuation of emitted photons by the patient's tissues. The external dose rate estimates were derived using Monte Carlo methods and two representations of the Phantom with Movable Arms and Legs (PIMAL), previously developed by ORNL and the USNRC, to model the patient and a nearby member of the public. Dose rates to tissues and effective dose rates were calculated for distances ranging from 10 cm to 300 cm between the phantoms. Dose rates estimated from these simulations are compared to estimates based on the point-source method, as well as to results of previous studies that estimated exposure from 131I patients. The point-source method overestimates dose rates to members of the public in very close proximity to an 131I patient but is a broadly accurate method of dose rate estimation at separation distances of 300 cm or more at times closer to administration.

Height, shape and anteroposterior diameter of normal pituitary gland in 15 to 40 years old population

An updated version of the skin dose computer code VARSKIN, namely VARSKIN 4, was examined to determine the accuracy of the photon model in calculating dose rates with different combinations of source geometry and radionuclides. The reference data for this validation were obtained by means of Monte Carlo transport calculations using MCNP5. The geometries tested included the zero volume sources point and disc, as well as the volume sources sphere and cylinder. Three geometries were tested using source directly on the skin, source off the skin with an absorber material between source and skin, and source off the skin with only an air gap between source and skin. The results of these calculations showed that the non-volume sources produced dose rates that were in very good agreement with the Monte Carlo calculations, but the volume sources resulted in overestimates of the dose rates compared with the Monte Carlo results by factors that ranged up to about 2.5. The results for the air gap showed poor agreement with Monte Carlo for all source geometries, with the dose rates overestimated in all cases. The conclusion was that, for situations where the beta dose is dominant, these results are of little significance because the photon dose in such cases is generally a very small fraction of the total dose. For situations in which the photon dose is dominant, use of the point or disc geometries should be adequate in most cases except those in which the dose approaches or exceeds an applicable limit. Such situations will often require a more accurate dose assessment and may require the use of methods such as Monte Carlo transport calculations.

Study Design. This study measured the frequency of lumbar intervertebral disc nucleus pulposus microscopic calcification and angiogenesis in adult patients undergoing discectomy compared to normal cadavers.Objective. The results were compared to determine the relationship between disc microscopic calcification with disc degeneration type, histopathological angiogenesis, patients' age, gender, and duration of symptoms.Summary of Background Data. True frequency of microscopic calcification in normal or degenerated lumbar discs have not been fully defined nor linked to disc degeneration type and angiogenesis. Some studies demonstrated that angiogenesis and calcification are related to each other in several another tissues.Methods. The frequency of microscopic calcification in specimens of disc nucleus pulpous obtained from 2 groups were measured: specimens were obtained during surgery from 90 consecutive patients of 15 to 50 years old suffering from disc herniation in single level of L4-L5 or L5-S1 between 2005 and 2006, 60 additional specimens of lumbar disc nucleus pulposus were obtained from normal cadavers of the same ages. Calcification was determined microscopically by Von Kossa staining and angiogenesis by H/E, and type of degeneration radiologically by Modic classification.Results. Frequency of microscopic calcification was significantly higher in degenerated disc than normal cadaveric (54.4% vs. 6.7%) and was higher in Modic type III than type I (III: 95.0%, II: 57.4%, I: 13.0%), also prevalence of angiogenesis was significantly higher in patients than cadaveric discs (41.0% vs. 6.7%) and in calcified than noncalcified discs (59.2% vs. 19.5%) (P < 0.001). There was no relationship between disc calcification and patients' gender and level of discectomy.Conclusion. Disc nucleus pulposus microscopic calcification is a common event occurring in adult patients suffering from lumbar disc herniation. Mechanisms that link disc degeneration, angiogenesis, and calcification remain a focus for further researches that may be useful in future medical treatments before surgical treatment of lumbar disc herniation.

The complete or partial spontaneous disappearance of a cerebral arteriovenous malformation is rare. Spontaneous thrombosis in large arteriovenous malformations has been reported in only two cases. We report the case of a large arteriovenous malformation in a 17-year-old man, that thrombosed spontaneously after minor surgical manipulation and review the literature and some possible mechanisms for spontaneous thrombosis of arterioveno us malformation.