We were able to identify the vasa nervorum along the outer aspect of the studied nerves using contrast-enhanced ultrasound.

After-hours radiology is an increasingly frequent topic for discussion and debate within the medical community; in the academic community, this topic centers around the role of the ''on-call'' radiology resident. Academic and nonacademic centres have been experiencing ballooning workloads and have had to introduce new and creative work paradigms to accommodate this extra burden [1]. Results of one representative study reported an increase in after-hours utilisation of computed tomography (CT) by 59%, magnetic resonance imaging (MRI) by 51%, and ultrasound by 30% over a 4-year period [2]. Furthermore, the use of crosssectional imaging, particularly CT, is increasing at a rate that far exceeds emergency department (ED) volumes and acuity [3]. Not only is the volume and breadth of on-call imaging growing, there is increasing pressure for ''stat'' or contemporaneous reports. These realities place a significantly increasing and changing load on radiology residents, who typically manage the department after hours. Hence, to optimally prepare residents for on-call commitments as well as to allocate manpower and resources optimally, it is important to be aware of the trends and variations in the current after-hours radiology landscape. This information would be particularly useful to the University of Western Ontario's Diagnostic Radiology Residency program planners.The purpose of this study was to assess for any significant trends with regard to on-call radiology consultations in a Canadian academic health care setting (London Health Sciences Centre and St. Joseph's Health Care in London, Ontario) between 2005 and 2009. Specifically, the following questions were analysed:Has there been a significant increase in total number of after-hours radiology consultations? If so, by how much? Is there any variation based on modality? Is there any variation based on the month? Is there any variation based on day of the week? Is there any variation based on resident level of training? Materials and MethodsA retrospective review of on-call radiology consultations at the University of Western Ontario (UWO) from January 1, 2005, to December 31, 2009, was performed. This was achieved by using the ''UWO Radiology Preliminary Reports'' Web site and its associated search engine ( Figure 1). While on-call (5 PM to 8 AM on weeknights and 8 AM to 8 AM on weekends and statutory holidays) radiology residents at the UWO are required to enter certain demographic and contextual data into the Web site, along with a preliminary report for all consultations performed. Typically, a single entry is made for a consultation on a single patient, although the actual number of tests may be multiple for that patient.The radiology resident is responsible for all after-hours CT, ultrasound, MRI, fluoroscopy, as well as occasional plain film interpretation at the specified request of a clinician. The preliminary report includes date and time, patient initials, hospital identification number, type of study or studies (modality, body part), summary of findings, ...

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A 51-year-old man presented with a 5-day history of progressive facial swelling, sensation of head fullness, increasing shortness of breath and paroxysmal nocturnal dyspnea. He denied chest pain, syncope or presyncope. Past medical history included mechanical aortic valve replacement 7 years prior and atrial fibrillation treated with warfarin.