Radiographic images
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* Richard N. Rankin

I was dismayed, again, to see in the *Canadian Journal of Surgery* misrepresentation of radiographic studies. I refer to Fig. 2 of the article by Baslaim and deVarennes on localized idiopathic fibrosing mediastinitis as a cause of superior vena cava (SVC) syndrome (*Can J Surg* 1998;41[1]:68–71). The legend for this figure reads: Computed tomography scan (top) and magnetic resonance image (bottom) . . . .” In fact, both images are from a magnetic resonance scan.

A further concern relates to the interpretation of the images. The arrow in the top image (a transverse slice, *T*1 weighted) seems not be pointing to the pathologic feature, which appears to be the doughnut-shaped structure immediately anterior to the tip of the arrow, with the residual superior vena cava lumen being the hole in the doughnut.

Both images are apparently *T*1 weighted; however, comparison of the 2 reveals apparent differences in tissue densities. This may be due to contrast injection for the lower image.

Yet a further concern relates to Fig. 1 from the same article. The radiographic quality of this image is questionable (or maybe it is the reproduction that is at fault). Certainly the image in the printed journal does not show the features that would indicate occlusion of the SVC by an apparent tumour. (It seems to me to show partial SVC obstruction by a filling defect — most likely a thrombus.)

These concerns lead me to ask: Does the journal have a regular review by a qualified person of the radiographic images it prints? Is there any requirement for authors using radiographic images to have asked for the guidance of the imager responsible for the images before submitting manuscripts?

Unfortunately this is not the first time I have noticed problems with the radiographic images in the *Canadian Journal of Surgery*. This is, however, the first time I have been moved to comment, and it is with some hesitancy that I do so, as I realize that the few images reproduced are not the primary thrust of the journal.