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Objectives: To report a rare case of moyamoya syndrome with primary antiphospholipid syndrome (APS). Clinical Presentation and Intervention: A 41-year-old woman was admitted with sudden onset of left-sided hemiparesis. Magnetic resonance imaging and magnetic resonance angiography of the brain showed characteristic features of moyamoya vessels. Laboratory investigations revealed raised levels of anticardiolipin antibody. She made a complete and uneventful recovery with aspirin and intensive physiotherapy over a period of 2 weeks. Conclusion: The association of APS and moyamoya disease may present a dilemma in management. While APS is often considered to be an indication for giving anticoagulation, a trial of antiplatelet agents is preferable to anticoagulation because of the risk of bleeding from the fragile moyamoya vessels.

AimTo assess the reliability of a standardized reporting system of acute appendicitis at low-dose 320-rows CT.Subjects and MethodsRetrospective analysis CT of 78 patients with pathologically proven acute appendicitis. The study was performed at a low-dose 320-rows CT. The image analysis was performed by 2 radiologists according to a standardized reporting system of acute appendicitis.ResultsThere was an excellent overall of the inter-observer agreement of both observers for the standardized reporting system of acute appendicitis (K = 0.89, 95 % CI = 0.87-0.92, P = 0.001). There was good inter-observer agreement for visualization of the appendix (K = 0.78, P = 0.001), the tip diameter (K = 0.75, P = 0.001), and a single wall thickness of appendix (K = 0.77, P = 0.001). There was excellent inter-observer agreement for outer to outer wall diameter (K = 0.82, P = 0.001), mucosal hyper-enhancement (K = 0.80, P = 0.001), appendicolith (K = 0.86, P = 0.001), gas in the appendix (K = 0.82, P = 0.001), surrounding fat stranding (K = 0.81, P = 0.001), focal cecal thickening (K = 0.85, P = 0.001), peri-appendiceal air (K = 0.87, P = 0.001), peri-appendicular fluid collection, phlegmon, or abscess (K = 0.82, P = 0.001), and right ovary cyst (K = 0.83, P = 0.001).Conclusionwe concluded that excellent reliability of a standardized reporting system of acute appendicitis in the adults using low-dose 320-rows CT.