LETTERS

Letters to the Editor
No scientific or medical journal

would be complete without a section
for the publication of letters from its
readership. The importance of a 'let-
ters, section is that it promotes acade-
mic interaction, allowing readers to
voice an opinion, whether positive or
negative, to anything printed within
the Journal or other issues of relevance
to South African Radiology. This
issue therefore introduces a letters
forum into the SAjR and includes the
first of hopefully many more letters to
come.

Hepatic 'pseudo
lesions' - still an

unrecognised
pitfall

The interesting short report enti-
tled 'Hepatic "pseudo lesions" - still
an unrecognised pitfall', I in the
September 2002 edition of the SAJR
by Drs Ian Duncan and Pieter Fourie,
also illustrates a second helical CT
scan pitfall. On their image taken dur-
ing the early (arterial) phase of the
contrast-enhanced CT scan, demon-
strating unenhanced hepatic veins
(Fig. I), marked inhomogeneity of
splenic enhancement is also shown.
While most radiologists recognise this
as a normal phenomenon, many of

our non-radiological colleagues do
not. Clinical colleagues suspecting
malignant or inflammatory splenic
pathology have asked me on numer-
ous occasions about this appearance.

The authors of the article sum up
these pitfalls very aptly when they
state: 'Although helical scanning has
led to increased lesion detectability, it
has also produced some artifacts
unique to this technique:

As the custodians of imaging, our
role in defining what is normal must
always remain as important as detect-
ing what is abnormal.

DonEmby
Western Deep Levels Hospital
Western Levels

1. Duncan IC, Fourie PA. Hepatic 'pseudo lesions'
- still an unrecognised pitfall. South African
Journal of Radiology 2002; 6(3): 36.

In the article entitled 'Bronchiolitis
obliterans - an illustrative case fol-
lowing toxic fume exposure' by Sher
and Duncan (SA]R2002; 6(4): 43-45),
the legend for Figs 3a and 3b should
read as follows: 'The darker areas are
the ABNORMAL ones indicating
areas of air trapping.'

Erratum

Figs 3a and b. The same scan slices 8S in Fig. 2 taken at different wind'!w.settings that further accentuate
the mosaic attenuation pattern. The darker areas are the abnormal ones mdlcatmg areas of alf trappmg and
hypoperfusion.

63 SA JOURNAL OF RADIOLOGY. June 2003