OBJECTIVE: To demonstrate that human visual illusion can contribute to sub-endocardial dark rim artifact in contrast-enhanced myocardial perfusion magnetic resonance images.MATERIALS AND METHODS: Numerical phantoms were generated to simulate the first-passage of contrast agent in the heart, and rendered in conventional gray scale as well as in color scale with reduced luminance variation. Cardiac perfusion images were acquired from two healthy volunteers, and were displayed by the same gray and color scales used in the numerical study. Before and after k-space windowing, the left ventricle (LV)-myocardium boarders were analyzed visually and quantitatively through intensity profiles perpendicular the boarders.RESULTS: k-space windowing yielded monotonically decreasing signal intensity near the LV-myocardium boarder in the phantom images, as confirmed by negative finite difference values near the board ranging −1.07 to −0.14. However, the dark band still appears, which is perceived by visual illusion. Dark rim is perceived in the in-vivo images after k-space windowing that removed the quantitative signal dip, suggesting that the perceived dark rim is a visual illusion. The perceived dark rim is stronger at peak LV enhancement than the peak myocardial enhancement, due to the larger intensity difference between LV and myocardium. In both numerical phantom and in-vivo images, the illusory dark band is not visible in the color map due to reduced luminance variation.CONCLUSION: Visual illusion is another potential cause of dark rim artifact in contrast-enhanced myocardial perfusion MRI as demonstrated by illusory rim perceived in the absence of quantitative intensity undershoot.

Traumatic orbital haemorrhage is an unfortunate complication with potential vision-threatening consequences.[1-3] The collection of blood can occur anywhere along the potential free orbital spaces,[4] but the subperiosteal collection of the blood is an important clinical variant where careful and timely intervention can give commendable rewards to the surgeon as well as to the patient.[1,2] Subperiosteal hematoma could be traumatic or non-traumatic, in turns, the non-traumatic cases may be due to bleeding tendency as in cases of leukaemia, blood dyscrasia and haemophilia or could be due to vascular malformation, venous congestion, infection, inflammation and neoplastic and non- neoplastic causes.[4] Here in this report, we elaborate the advantage of continuous ultrasound-guided needle drainage of the post-traumatic subperiosteal hematoma to enhance the clinical accuracy and to avoid the untoward complications.

No abstract available.
Colorectal Neoplasms*

Knowledge of communication between parietal abdominal veins, testicular vein and mesenteric veins is important for Surgeons, Urologists and Radiologists. These communications can result in varicocele or hemorrhoids and may lead to low success rate in hemorrhoid and varicocele surgeries. During routine dissection classes, we observed an unusual large venous plexus on the left psoas major muscle. The venous plexus was unilateral and was formed by many anastomotic venous channels on the psoas fascia and communicated with the left testicular and inferior mesenteric veins. The testicular and inferior mesenteric veins were significantly enlarged below the level of communication with the venous plexus.
Mesenteric Veins

Knowledge of anatomic variants of veins in the arm and axilla play a key role in planning of successful venous access. Possible anatomic variants of axillary vein, brachial vein and basilic vein and their clinical implications have been well described in the literature. We report a rare case of formation of a short axillary vein associated with complex venous communications between the basilic and brachial veins forming a venous ladder in the axilla, in formalin embalmed male cadaver. Axillary vein was formed in the upper part of the axilla by the fusion of basilic vein and unpaired brachial vein, and it was about 3cm in length. The higher-up confluence of basilic and brachial veins was also associated with presence of three communicating veins between the basilic and brachial veins in the axilla. Knowledge of reported venous variations is very useful during preoperative venous mapping and also for planning and execution of various surgical invasive procedures involving these veins.
Axillary Vein

Variant anatomy of muscles and veins of the neck is of importance to plastic surgeons, radiologists and general surgeons. We report the variations of sternocleidomastoid muscle and veins of the neck in the present article. Right sternocleidomastoid muscle had three heads of origin. The third head took its origin from the clavicle just lateral to the usual clavicular head. All the three heads were about 4 inches long and united with each other at the level of thyroid cartilage. There was no external jugular vein on the right side. The retromandibular vein united with facial vein to form common facial vein. Common facial vein joined with superior thyroid and lingual veins to form a thyrolinguo-facial trunk one inch below the angle of mandible. This trunk was about 2 inches long and terminated into the internal jugular vein. Knowledge of this case could be useful while raising a sternocleidomastoid flap, administering anesthesia to brachial plexus, neck surgeries and carotid endarterectomy.
Neck Muscles

Veins of the head and neck exhibiting anatomical variations or malformations are clinically significant. Anatomical variation in the external jugular vein is very common. However, anatomical variation in the retromandibular vein is rare. In this paper, we report a rare case of complete absence of the retromandibular vein. In the absence of the retromandibular vein, the maxillary vein divided into anterior and posterior divisions. The posterior division joined the superficial temporal vein to form an atypical external jugular vein, and the anterior division joined the facial vein to form an anonymous vein. In clinical practice, radiologists and surgeons use the retromandibular vein as a guide to expose the branches of the facial nerve during superficial parotidectomy. Therefore, absence of the retromandibular vein is a hurdle during this procedure and may affect the venous drainage pattern from the head and neck.
Anonyms and Pseudonyms ; Drainage ; Facial Nerve ; Head ; Jugular Veins* ; Neck ; Parotid Region* ; Veins*

Veins of the head and neck exhibiting anatomical variations or malformations are clinically significant. Anatomical variation in the external jugular vein is very common. However, anatomical variation in the retromandibular vein is rare. In this paper, we report a rare case of complete absence of the retromandibular vein. In the absence of the retromandibular vein, the maxillary vein divided into anterior and posterior divisions. The posterior division joined the superficial temporal vein to form an atypical external jugular vein, and the anterior division joined the facial vein to form an anonymous vein. In clinical practice, radiologists and surgeons use the retromandibular vein as a guide to expose the branches of the facial nerve during superficial parotidectomy. Therefore, absence of the retromandibular vein is a hurdle during this procedure and may affect the venous drainage pattern from the head and neck.
Anonyms and Pseudonyms ; Drainage ; Facial Nerve ; Head ; Jugular Veins* ; Neck ; Parotid Region* ; Veins*

The extensor digitorum brevis muscle (EDB) is a practical option for use as an island flap or free flap when reconstructing soft tissue defects in the ankle as well as in the entire lower limb. It is frequently used to correct crossover toe deformity and other painful toe disorders. We evaluated the morphometry of the EDB in 44 formalin-fixed limbs. Length and width of the muscles were measured. Surface area was calculated as the product of length and width of the muscle. The length of each tendon was also measured from its origin to the point of distal attachment. Presence of any additional tendons was noted. Mean length, width, and surface area of the muscle were 7.39+/-0.71 cm, 4.1+/-0.37 cm, and 30.5+/-4.78 cm2 on the right side and 7.2+/-0.84 cm, 3.9+/-0.37 cm, and 28.4+/-5.35 cm2 on the left side, respectively. Morphometry of the tendons revealed that the tendon of the great toe had the highest mean length (9.5 cm) and the tendon of the fourth toe had the lowest mean length (6.3 cm). Four of the limbs studied (9.09%) had only three tendons. Three of the limbs studied (6.81%) had five tendons, and in one exceptional case (2.27%), six tendons were detected. These observations have significant value and are applicable to plastic and orthopedic surgery.
Animals ; Ankle ; Congenital Abnormalities ; Extremities ; Free Tissue Flaps ; Lower Extremity ; Muscles ; Orthopedics ; Plastics ; Tendon Transfer ; Tendons ; Toes

A peculiar liver was found in an adult male cadaver during a dissection class for undergraduate medical students. The quadrate lobe and fissure for the ligamentum teres were totally absent. Thus, the cystic notch on the inferior border was very broad and deep, and the fundus and body of the gall bladder popped out through this notch. The cystic duct terminated into the right hepatic duct at the porta hepatis instead of terminating into the common hepatic duct. Awareness of variations of the lobes and fissures may minimize a misdiagnosis of liver problems. The aim of the current study was to alert radiologists and surgeons about possible variations in the external appearance and anomalies of the lobes and fissures of the liver.
Adult ; Cadaver ; Cystic Duct ; Diagnostic Errors ; Hepatic Duct, Common ; Humans ; Liver ; Male ; Students, Medical ; Urinary Bladder