Objective. The purpose of this study was to investigate the efficacy of sonography in the detection of plantar fasciitis (PF) compared with magnetic resonance imaging (MRI) findings in subjects with inferior heel pain. Methods. Seventy-seven patients with unilateral (n = 9) and bilateral (n = 68) heel pain were studied. Seventy-seven age-and sex-matched asymptomatic subjects served as a control group. Magnetic resonance imaging was used to establish a diagnosis of PF with sagittal T1-weighted, T2-weighted, and short tau inversion recovery sequences. The sonographic appearances of PF were compared with MRI findings. Plantar fascia and heel pad thickness were also measured on both imaging modalities. Results. Compared with MRI, sonography showed 80% sensitivity and 88.5% specificity in assessing PF. A strong correlation was found between plantar fascia and fat pad thickness measurements done by sonography (P < .001; r = 0.854) and MRI (P < .001; r = 0.798). Compared with the asymptomatic volunteers, patients with PF had significant increases in plantar fascia and heel pad thicknesses, weight, and body mass index (P = .0001). Heel pad thickness was also significantly increased with pain duration (P = .021). Conclusions. Although MRI is the modality of choice in the morphologic assessment of different plantar fascia lesions, sonography can also serve as an effective tool and may substitute MRI in the diagnosis of PF.

Alveolar echinococcosis is a rare parasitic disease caused by the fox tapeworm Echinococcus multilocularis, which is endemic in many parts of the world. Without timely diagnosis and therapy, the prognosis is dismal, with death the eventual outcome in most cases. Diagnosis is usually based on findings at radiologic imaging and in serologic analyses. Because echinococcal lesions can occur almost anywhere in the body, familiarity with the spectrum of cross-sectional imaging appearances is advantageous. Echinococcal lesions may produce widely varied imaging appearances depending on the parasite's growth stage, the tissues or organs affected, and the presence of associated complications. Although the liver is the initial site of mass infestation by E multilocularis, the parasite may disseminate from there to other organs and tissues, such as the lung, heart, brain, bones, and ligaments. In severe infestations, the walls of the bile ducts and blood vessels may be invaded. Disseminated parasitic lesions in unusual locations with atypical imaging appearances may make it difficult to narrow the differential diagnosis. Ultrasonography, computed tomography (CT), magnetic resonance (MR) imaging with standard and diffusion-weighted sequences, and MR cholangiopancreatography all provide useful information and play complementary roles in detecting and characterizing echinococcal lesions. Cross-sectional imaging is crucial for differentiating echinococcosis from malignant processes: CT is most useful for depicting the peripheral calcifications surrounding established echinococcal cysts, and MR imaging is most helpful for identifying echinococcosis of the central nervous system.

The objective is to investigate the effect of obesity and hepatosteatosis on the Doppler waveform pattern of the hepatic veins. B-mode and duplex Doppler sonography of the liver and the right hepatic vein was performed in 102 obese subjects and 84 healthy volunteers. The severity of fatty infiltration was graded as mild, moderate and severe. The flow pattern of the right hepatic vein was classified as triphasic, biphasic and monophasic. The Doppler flow pattern in the right hepatic vein was triphasic in 56 (55%), biphasic in 27 (26%) and monophasic in 19 (19%) obese patients, whereas it was triphasic in 83 (99%) and biphasic in 1 (1%) control subject, achieving a statistical significance (Mann-Whitney U-test, P<0.001). There was an inverse correlation between the sonographic grade of the hepatosteatosis and the phasicity of hepatic venous flow (r=-0.67, P<0.001). The hepatic vein pulsatility is significantly dampened in obese patients correlating with the grade of hepatosteatosis. The body habitus itself does not have an independent effect on hepatic venous waveform. The alteration in hepatic vein Doppler flow pattern in an obese population may suggest reduced vascular compliance in the liver because of fatty infiltration.

The aim of this study was to investigate the effect of body habitus, dimensions of the thoracic cavity, location of the carina within the mediastinum, and left atrial size on tracheal carinal angle using CT scan. The study population was drawn from the patients referred to CT scan for various indications. A total of 120 patients (65 men and 55 women; age range 17-85 years; mean age 56 years) who denied a history of prior thoracic surgery, and in whom CT scan excluded pulmonary fibrosis, moderate or severe emphysema, atelectasis, intrathoracic mass or adenopathy, pericardial or pleural effusion were prospectively enrolled. The interbronchial (IBA) and subcarinal (SCA) angles were measured on coronal reformatted images. The presternal and retrovertebral fat thickness, the anteroposterior and transverse diameters of the thorax, the distances from carina to the sternum and to the vertebral column were obtained at the level of carina. Three orthogonal dimensions and the volume of the left atrium were also assessed. The mean interbronchial angle was 77 degrees +/-13 degrees (range 49-109 degrees ) and subcarinal angle was 73 degrees +/-16 degrees (range 34-107 degrees ). IBA positively correlated with the female gender (r=0.25, p=0.007), body mass index (r=0.28, p=0.002), presternal (r=0.40, p=0.001) and retrovertebral fat thickness (r=0.31, p=0.001). The interbronchial angle was significantly greater in obese patients compared with lean patients (p=0.02). Both IBA and SCA were positively correlated with the left atrial volume (r=0.40, p=0.001 and r=0.34, p=0.001, respectively), and its transverse and craniocaudal dimensions. The carina-vertebral column distance inversely correlated with IBA (r=-0.42, p=0.001) and SCA (r=-0.41, p=0.001). The size of the thoracic cavity did not show significant relation to tracheal bifurcation angle. Tracheal bifurcation angle ranges widely in normal subjects, and absolute measurements of the carinal angle is of little diagnostic value. In addition to left atrial enlargement, female gender, obesity and close situs of carina relative to vertebral column are associated with greater tracheal bifurcation angle.

Computed tomography (CT) is very sensitive for detection and localization of intracranial calcifications. We reviewed in this pictorial essay the diseases associated with intracranial calcifications and emphasized the utility of CT for the differential diagnosis.