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Purpose: We evaluate the appearances of the brain metastases (BMs) detected by brain magnetic resonance imaging (MRI) of small cell lung cancer (SCLC) on 18Fluor-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT). Patients and methods: SCLC patients who had an 18F-FDG PET/CT scan and a brain MRI within 30 days for initial staging were included. MRI was used to detect BMs. The imaging results of BMs on 18F-FDG PET/CT were assessed. On the 18F-FDG PET/CT study, the BMs were classified as undetectable, hypometabolic, hypermetabolic, or mixed patterns (lesions with both hypermetabolic and hypometabolic parts). Results: A total of 51 patients [48 (94.1%) of whom were male and 3 (5.9%) female, with an average age of 62.57 ± 9.64] were included in this study. Fifteen patients (29.4%) were in the limited stage, whereas 36 patients (69.6%) were in the extensive stage. In 11 individuals, MRI indicated 28 BMs. On 18F-FDG PET/CT, 13 of the 28 metastases were visible. The following were the BMs appearances on 18F-FDG PET/CT: hypometabolic (n: 4), hypermetabolic (n: 6), and mixed (n: 3). While the mean diameter of BMs detected in 18F-FDG PET/CT was 16mm; the mean diameter of undetected ones was 4.3 mm. Conclusion: On 18F-FDG PET/CT, BMs can have a variety of appearances, including hypometabolic, hypermetabolic, and mixed patterns. On the other hand, failure to detect millimetric size BMs in 18F-FDG PET/CT prevents proper staging.

Aim of the study: To determine the parenchymal vascularity of the thyroid gland with color superb microvascular imaging in patients with Graves’ disease, and compare the vascularization index values with healthy subjects. Materials and methods: The thyroid glands of 37 patients whose laboratory and clinical findings were consistent with Graves’ disease, and 40 asymptomatic subjects with normal laboratory values, were examined using color superb microvascular imaging. Measurements of the vascularization index were performed with a free region of interest which was drawn along the outer margin of the gland on the color superb microvascular imaging mode. The vascularization index values obtained in the Graves’ disease and control groups were compared. A correlation analysis was performed between the vascularization index values and laboratory and grayscale US parameters. Results: The median vascularization index value of the thyroid parenchyma in patients with Graves’ disease was significantly higher than in the asymptomatic group [median (min–max); 12 (2.3–32.1) vs 5.04 (1.1–10.8), p

Background Changes in optic nerve vascularity are observed in many diseases. Superb microvascular imaging (SMI) has the potential to become the method of choice for detecting microvasculature in the optic nerves. Purpose To evaluate optic nerve vascularity in healthy individuals through power Doppler sonography (PDUS) and SMI. Material and Methods Twenty-seven healthy patients with 54 eyes were prospectively evaluated. The duration of the examination for optic nerve vascularity lasted until the posterior ciliary artery blood supply was observed in PDUS and SMI. The visibility of vascularity, as well as the ratio of the vascular structures to the optic nerves (vascular index [VI]), was evaluated. Results Fifty-four eyes were evaluated from a total of 27 patients (mean age = 49.0 ± 19.42 years). The VI value for the right optic nerve was 29.58 ± 4.00 while for the left optic nerve, it was 31.21 ± 3.52. Vascularity was clearly observed in both eyes (n = 54) in all 27 cases in the evaluation performed with the SMI technique. However, with the power Doppler examination, vascular flow was not observed in 14 right eyes and in 10 left eyes within the specified timeframe. Conclusion The results indicate that imaging of vascular structures can be done faster and better with SMI than PDUS examination. The normal VI values may provide important information about the blood supply of the optic nerve, which is of relevance in orbital pathologies and many systemic conditions.

Primary intracranial Ewing sarcoma/primitive neuroectodermal tumor (ES/PNET) is an extremely uncommon tumor. Care should be taken as it can be mistaken for a meningioma radiologically.This paper reports a case of a 44-year-old male presenting with headache. A magnetic resonance imaging demonstrated a mass involving the tentorium, cerebrum and cerebellum with solid-cystic component. The solid component was hyperintense on T1-weighted images with significant enhancement. There was restriction in diffusion-weighted images and microhemorrhagic signal change in susceptibility weighted images. MR perfusion revealed increased relative cerebral blood volume and mean transit time values. Surgical pathology was reported as ES.Intracranial ES/pPNET is a rare tumor that generally arises from the meninges. It must be distinguished from meningioma since it can be mistaken radiologically, because the treatment and prognosis are quite different. Localization and conventional MR signal characteristics of both lesions are similar. Whereas, MR perfusion findings may be helpful in discrimination.

Aim: The purpose of this study was to investigate the effectiveness of the vascularization index (VI) obtained using color superb microvascular imaging (cSMI) technique in the assessment of thyroid surgical bed for remnant thyroid tissue (RTT). Material and methods: We evaluated the thyroid surgical bed of 65 patients who had underwent total thyroidectomy (TT) due to papillary carcinoma (PC) using thyroid scintigraphy and cSMI. Color SMI was also performed for the examination of the thyroid parenchyma of 39 healthy asymptomatic participants. VI measurements were performed by manually drawing the contours of the RTT in those with remnant thyroid, the thyroid surgical bed in the patients’ group without remnant thyroid, and normal thyroid parenchyma in the control group, using the free region of interest (ROI) with 2-dimensional color SMI VI (2DcSMIVI) mode. The volume of ROI was measured and echogenicity was evaluated. The quantitative 2DcSMIVI values of the surgical bed with RTT (Group A), the surgical bed without RTT (Group B) and normal thyroid of healthy asymptomatic participants (Group C) were compared. Results: The mean 2DcSMIVI values of Group A was significantly higher than Group B and C (p=0.001). The presence of RTT can be diagnosed with 89.1% sensitivity and 87.5% specificity when 1.75 2DcSMIVI is designated as the cut-off value. Conclusion: The 2DcSMIVI is an effective imaging technique that can be used for the diagnosis of RTT.

Background/aim To investigate the changes in the spleen size, parenchymal heterogeneity, and computed tomography (CT) texture analysis features of patients diagnosed with Coronavirus disease 2019 (COVID-19) Materials and methods The size and parenchymal structure of the spleen in 91 patients who underwent thoracic CT examination due to COVID-19 were evaluated. For the evaluation of parenchymal heterogeneity, CT texture analysis was performed using dedicated software (Olea Medical, France). The texture analysis of each case consisted of 15 first-order intensity-based features, 17 gray level co-occurrence matrix-based features, and 9 gray level run length matrix-based features. Results A total of 91 patients (45 males, 46 females) with a mean age of 54.31 ± 16.33 years (range: 18–81) were included in the study. A statistically significant decrease in spleen size was seen in the follow-up CT examinations (p < 0.001) whereas no statistically significant difference was found between the Hounsfield unit (HU) values. The radiomics consisted of first-order intensity-based features such as 90th percentile, maximum, interquartile range, range, mean absolute deviation, standard deviation, and variance, all of which showed statistically significant differences (p - values: < 0.001, < 0.001, 0.001, 0.003, 0.001, 0.001, and 0.004, respectively). “Correlation” as a gray level co-occurrence matrix-based feature and “gray level nonuniformity” as a gray level run length matrix-based feature showed statistically differences (p-values: 0.033 and < 0.001, respectively). Conclusions Although COVID-19 manifests with lung involvement in the early stage, it can also cause systemic involvement, and the spleen may be one of its target organs. A decrease in the spleen size and parenchymal microstructure changes can be observed in the short follow-up time. It is hoped that the changes in the parenchymal microstructure will be demonstrated by a noninvasive method: texture analysis.

WOS: 000493121400001, PubMed: 31969956, Purpose: To study the density of lesions in the lumens of extrahepatic bile ducts through computed tomography examinations, and to compare their characterisations with the results of pathology and/or endoscopic retrograde cholangiopancreatography (ERCP). Methods: The density of lesions along extrahepatic bile ducts were measured and compared with pathology and/or ERCP. The lesions were evaluated in two main groups: benign or malignant. The bile duct wall enhancement, intrahepatic bile ducts, and gallbladder were also evaluated. Results: The study was conducted with computed tomography scans of 197 cases (93 females, 104 males) who had optimal imaging. The results regarding density of extrahepatic intraductal lesions that were studied at BT were compared with pathology and magnetic resonance cholangiopancreatography results. Of 197 lesions, 125 (63.5%) were reported as benign and 72 (36.5%) were reported as malignant. The results for benign lesions showed an average density of 66.67 +/- 17.30 Hounsfield units (HU), and for malignant lesions the average density was 82.38 +/- 13. Conclusion: Lesion density level (HU) gives valuable information for the differentiation between benign and malign lesions in intraluminal extrahepatic bile ducts.

WOS: 000474131600010, PubMed: 30601437, Objective The aim of this study was to evaluate the reproducibility of measurement of spleen stiffness at the time of the initial detection of splenomegaly, whether it is found incidentally or not, in determining the etiology of splenomegaly. Methods The pathologies that brought about the diffuse splenomegaly were evaluated in 3 main groups as follows: hepatoportal, myeloproliferative, and infectious causes. In addition, 17 healthy control patients were recruited. All patients were examined with acoustic radiation force impulse imaging with VTQ. Results The difference between the splenic parenchymal elasticity values in the hepatoportal group (3.27 +/- 0.36 m/s), in the myeloproliferative disease group (2.98 +/- 0.33 m/s), in the infectious disease group (2.44 +/- 0.21 m/s), and in the control group (2.08 +/- 0.19 m/s) was found to be statistically significant (P = 0.001). The intraclass correlation coefficient for shear wave velocity measurement between hepatoportal causes and myeloproliferative causes was 71.2% (95% confidence interval [CI], 54.9%-87.4%), between hepatoportal causes and infective causes was 99.7% (95% CI, 98.6%-100.0%), and between myeloproliferative causes and infective causes was 83.3% (95% CI, 68.8%-97.9%). In the same patient groups, spleen volumes were measured as 64.08 +/- 9.66, 78.18 +/- 18.52, and 51.57 +/- 7.44 cm(2), respectively; in the control group, it was 26.75 +/- 6.57 cm(2). The difference between spleen volumes was found to be statistically significant (P = 0.001). Conclusions Distinguishing the causes of splenomegaly is important because the disorders require different management strategies. In diseases that cause splenomegaly, tissue content may change according to pathogenesis. Such changes in the spleen are mechanical properties that can be quantified by elastography.

In this study, the effectiveness of transthoracic ultrasound elastography in the benign and malign distinction of subpleural/pleural solid lesions was investigated.Between July 2015 and December 2016, 33 consecutive patients with subpleural solid lesions detected via computed tomography (CT) of the thorax were identified and prospectively included in this study. The average for each lesion's shear wave velocity (SWV) value was detected, and benign and malignant lesions' SWV values are statistically compared. The CT and pathology results were used as a reference to compare these values. A receiver operating characteristic analysis was used to determine the cutoff value for benign/malignant neoplasms.The 33 patients (10 female, 23 male) included in the study had a mean age of 56.2 +/- 15.40 years (range, 17-84 years), and the mean SWV value of the lesions in 13 (39%) cases evaluated benign after a CT scan, histopathological examination, or both 2.18 +/- 0.49 m/s. The mean SWV value of the lesions which were histopathologically diagnosed as malign in 23 (61%) cases was 3.50 +/- 0.69 m/s. (P < 0.001). When the cutoff value was set as 2.47 m/s for the SVW value, sensitivity and specificity were determined to be 97.7%.The present study has shown that transthoracic ultrasound shear wave elastography can be an effective radiological examination method in the benign and malign differentiation of subpleural lesions and has the potential for use in the routine clinical application of transthoracic ultrasound elastography, a noninvasive method for evaluating the malignancy potentials of such lesions.

The aim of the present study was to quantify the stiffness of the median nerve (MN) at the carpal tunnel inlet by acoustic radiation force impulse (ARFI) elastography and to evaluate whether ARFI can be used in diagnosis and staging of carpal tunnel syndrome (CTS). Sonographic examinations of 96 wrists in 50 patients were included in the study. The cross-sectional area and stiffness of the MN were quantitatively measured by B-mode ultrasonography (USG) and ARFI. The findings of CTS were assigned to four groups: (I) normal (n = 21), (II) mild (n = 39), (III) moderate (n = 38), and (IV) severe (n = 19). The differences between CTS patients and controls and the differences in electrodiagnostic tests among subgroups were statistically compared. ROC analysis was performed to determine the cut-off values between subgroups. Bilateral CTS was present in 46 patients (92 wrists) and unilateral CTS in four patients. Of the 96 nerves in the 50 symptomatic “idiopathic CTS” patients (48 women, 2 men; mean age 45.9 years, range 23–73 years), 39 (40.4%) were mild, 38 (39.8%) were moderate, and 19 (19.8%) were severely affected. When compared to controls, MN stiffness was significantly higher in the CTS group (P

The objective of this paper is to evaluate the association between physical disability in multiple sclerosis (MS) patients, the thickness of the retinal nerve fibre layer (RNFL) and corpus callosum volumes, as expressed by the corpus callosum index (CCI). This study was based on a cohort of 212 MS patients and 52 healthy control subjects, who were age and gender matched. The MS patients included 144 women and 177 relapsing-remitting MS (RRMS) patients. Peripapillary and volumetric optical coherence tomography (OCT) scans of the macula were performed using spectral-domain OCT technology. All magnetic resonance imaging (MRI) scans were performed using 1.5-T systems. CCI and RNFL were lower in MS than healthy control subjects (0.341 versus 0.386, p

Purpose: To compare maternal liver elasticity scores by Acoustic Radiation Force Impulse (ARFI) elastosonography in healthy and preeclamptic pregnancies and its association with the severity of the disease.Materials and methods: Forty-two healthy, 33 mild, 33 severe preeclamptic and 28 pregnant women with Hemolysis, Elevated Liver enzymes and Low Platelets (HELLP) syndrome were included into the study. Maternal liver elasticity was measured by ARFI elastosonography at the first day of puerperium. The maternal and neonatal outcomes of the patients were retrieved from the medical records.Results: The ARFI-Mean liver elastosonography scores of controls and mild preeclamptic women were lower than severe preeclamptic and HELLP syndrome women (p: 0.001). The mean ARFI elastosonography score >1.22 m/s indicated the effect of severe preeclampsia on maternal liver elasticity with 72.7% sensitivity and 74.7% specificity (Area under curve [AUC], 0.835, 95% confidence interval [CI], 0.757-0.913). The mean ARFI elastosonography score >1.31 m/s indicated the effect of HELLP syndrome on maternal liver elasticity with 78.6% sensitivity and 75.9% specificity (AUC, 0.794, 95% CI, 0.695-0.892).Conclusions: The maternal liver becomes stiffer in severe preeclampsia and HELLP syndrome measured by ARFI elastosonography. The increased maternal liver ARFI scores may alert the obstetrician about the possible maternal puerperal morbidity.

Summary Backgrund Hemolytic uremic syndrome is a disease characterized by hemolytic anemia, thrombocytopenia and acute renal failure with multiple organ involvement. Central nervous system involvement is detected in 20–50% of the patients and this leads to increased morbidity and mortality. Case Report We report the neuroimaging findings in a four-month-old male with hemolytic uremic syndrome. The cerebral cortex and white matter showed mild signal intensity on T2-weighted images. The diffusion weighted imaging demonstrated restricted diffusion in the cerebral cortex and white matter with corresponding low signal intensity on the apparent diffusion coefficient maps representing cytotoxic edema. These findings ended in multicystic leukoencephalomalacia. Conclusions In hemolytic uremic syndrome with brain involvement symptoms develop due to the different level of actions of factors and thus MRI protocol towards cerebral parenchyma should include DWI, especially in pediatric patients.

Aims: To evaluate the reliability of testicular stiffness quantification using shear wave elastography in predicting the fertility potential of males and for the pre-diagnosis of disorders based upon sperm quantification. Material and methods: One hundred males between the ages of 19-49 years (mean age of 28.77±6.11), ninety of whom with complaints of infertility, were enrolled in this prospective study. Scrotal grey-scale, Doppler ultrasound (US), and mean testicular shear wave velocity quantifications (SWVQs) were performed. The volumes of testes, as well as the grade of varicocele if present, were recorded. The mean shear wave velocity values (SWVVs) of each testis and a mean testicular SWVV for each patient were calculated. The semen-analyses of patients were consecutively performed. Results: There were significant negative correlations between the mean testicular SWVVs of patients and their sperm counts or the testis volumes (r=-0.399, r=-0.565; p

Sarcoidosis is a chronic, multisystem inflammatory disorder of unknown etiology that is characterized by noncaseating granulomas. Although lung involvement is common in sarcoidosis, pleural involvement is rare. Pleural involvement may manifest as a pleural effusion, pneumothorax, pleural thickening and nodules, hydropneumothorax, hemothorax, or chylothorax. Here, we describe a case of sarcoidosis with pleural nodular thickening.

To evaluate anterior hepatic grooves (AHGs) associated with hepato-diaphragmatic mesocolic indentations (Chilaiditi sign) and to delineate the incidence and potential clinical significance of this association. Between November 2011 and June 2014, abdominal computed tomography examinations of 2,314 patients with varied indications were retrospectively reviewed. Patients were surveyed consecutively for the Chilaiditi sign and syndrome, and cases with grooves at the antero-inferior hepatic surface enclosing the adjacent mesocolic indents were determined. The incidence of AHGs and their predominance by gender and age were determined. The potential clinical significance of AHGs associated with Chilaiditi syndrome and their possible effect on liver volume were assessed. The incidences of AHGs were similar between genders (p = .461 and p = .646) and age (p = .113 and .621, respectively) among total cohort and patients with Chilaiditi sign, respectively. There was no significant correlation between AHGs and Chilaiditi syndrome (p = .506); no efficacies of AHGs to liver volume were assessed (p = .413). The AHGs are rare adaptive changes in shape of the liver without a significant effect on liver volume. This overlooked phenomenon is likely derived from the Chilaiditi sign, but has no significant correlation with Chilaiditi syndrome. Future studies with extended series are encouraged to reveal the possible significance of this phenomenon based on concerned surgical interventions.

In this study, we aimed to investigate the impact of non-alcoholic hepatic steatosis on the liver volume. As investigating hepatic steatosis, we utilized computed tomography (CT) to determine the degree of steatosis and we utilized hepatobiliary ultrasonography (USG) for densitometry and correlation. As hepatosteatosis group, 35 patients over 18 years of age and whose abdominal CT scans were requested by several clinics and performed routinely were included in this study, and as control group, 40 healthy subjects without hepatosteatosis (clinically and radiologically) and correlated with hepatosteatosis group in terms of age and gender were included in this study. CT densitometry and liver attenuation index (LAI) of all individuals who participated in our study were calculated, and contrast images of patients were transferred to CT-Volume Software (Siemens Syngo Multimodality Workplace; Version VE52A). In this study, interactive and automated volume measurement techniques were used together. The volumes were measured separately in patient and control group. In this study for each stage in USG, there was found a direct correlation in terms of LAI and volume, and this correlation was statistically significant (p

© 2016 Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.Cantrell pentalogy is a rather rare syndrome characterised by complete or partial ectopia cordis; together with omphalocele, congenital heart diseases, and defects in the pericardium, lower sternum and anterior diaphragm. In this article, our aim is to present the ultrasonographic evidence of the concurrence of a short umbilical cord and the Cantrell syndrome, which we believe will contribute to the literature.

To highlight the variation in imaging and clinical manifestations of four cases of isolated unilateral absence of pulmonary artery presented in varied ages. Four patients with unilateral pulmonary artery agenesis were referred to our institution They underwent a series of investigations, including chest radiography, computed tomography and magnetic resonance imaging. Two of the four patients had absence of the right main pulmonary artery, while the remaining two patients had absence of the left main pulmonary artery. All patients showed a restrictive defect on pulmonary function tests. Radiography, CT and MRI confirmed the anatomy and the presence of multiple collaterals. Isolated unilateral pulmonary artery agenesis has a non-specific presentation. Awareness of this condition can lead to earlier diagnosis, with cross-sectional imaging making an important contribution.

Neurofibromatosis type 2 mostly develops with multiple neoplasms of the central and peripheral nervous system and is associated with ocular abnormalities. The presented case is a 19-year-old female patient with bilateral vestibulocochlear schwannomas in both pontocerebellar corners, intradural intra-extramedullary masses, and multiple neurofibromas in the spinal canal. The clinical picture for NF-2, also called central neurofibromatosis, is completely different from von Recklinghausen disease. Untreated bilateral vestibulocochlear schwannoma may cause hydrocephalus in NF-2, and lead to death. Therefore, it is recommended to carefully monitor and treat bilateral vestibulocochlear schwannoma in accordance with its stage.

Highlights • Sigmoid cancer can be presented as sigmoid volvulus. • Volvulus can be seen at the proximal to the segment of colon cancer. • CT is advised for the preoperative evaluation of a suspected sigmoid volvulus or colon cancer., Introduction Sigmoid volvulus is the most prevalent type of colonic volvulus. Colon cancer is seen less where sigmoid volvulus is common, so it is rare to see that colon cancer is synchronous with sigmoid volvulus. Presentation of case We would like to present a case of sigmoid volvulus caused by colon cancer in a male patient aged 80 who was referred to the hospital with toxaemic shock presentation. Discussion Sigmoid cancer can be presented as sigmoid volvulus to the emergency department. In intestinal obstruction early diagnosis is of crucial importance. Computarized tomography is a diagnosis tool that should be preferred both in the diagnosis of obstruction and in detecting its cause, localisation, degree and complications. Conclusion When surgery is performed due to the urgent colonic obstruction in colonic volvulus diagnosed patients, a colon tumour should be considered in the same column loops or in the distal colon. We believe that CT is the method that should be preferred in large-bowel obstruction suspected patients.

Giris: Kunt abdominal travma sonrasi ust uriner sistemin izole yaralanmasi oldukca nadirdir. Fakat onceden varolan renal anomali durumunda meydana gelen travmalarda ruptur riski artar. Olgu Sunumu: Bu yazimizda daha once tesbit edilmemis asemptomatik ureteropelvik bileskede darligi olan bir cocukta, travma sonrasi ortaya cikan akut batin tablosunu sunuyoruz. Sonuc: Basit bir batin travmasi altta yatan bobrek anomalisi nedeniyle ciddi problemlere neden olabilir. BT uriner sistem travmalarinda primer goruntuleme yontemidir.

Background Diagnostic performance of Diffusion-Weighted magnetic resonance Imaging (DWI) and Multi-Detector Computed Tomography (MDCT) for TNM (Tumor, Lymph node, Metastasis) staging of gastric cancer was compared. Patients and methods We used axial T2-weighted images and DWI (b-0,400 and b-800 s/mm2) protocol on 51 pre-operative patients who had been diagnosed with gastric cancer. We also conducted MDCT examinations on them. We looked for a signal increase in the series of DWI images. The depth of tumor invasion in the stomach wall (tumor (T) staging), the involvement of lymph nodes (nodal (N) staging), and the presence or absence of metastases (metastatic staging) in DWI and CT images according to the TNM staging system were evaluated. In each diagnosis of the tumors, sensitivity, specificity, positive and negative accuracy rates of DWI and MDCT examinations were found through a comparison with the results of the surgical pathology, which is the gold standard method. In addition to the compatibilities of each examination with surgical pathology, kappa statistics were used. Results Sensitivity and specificity of DWI and MDCT in lymph node staging were as follows: N1: DWI: 75.0%, 84.6%; MDCT: 66.7%, 82%;N2: DWI: 79.3%, 77.3%; MDCT: 69.0%, 68.2%; N3: DWI: 60.0%, 97.6%; MDCT: 50.0%, 90.2%. The diagnostic tool DWI seemed more compatible with the gold standard method (surgical pathology), especially in the staging of lymph node, when compared to MDCT. On the other hand, in T staging, the results of DWI and MDCT were better than the gold standard when the T stage increased. However, DWI did not demonstrate superiority to MDCT. The sensitivity and specificity of both imaging techniques for detecting distant metastasis were 100%. Conclusions The diagnostic accuracy of DWI for TNM staging in gastric cancer before surgery is at a comparable level with MDCT and adding DWI to routine protocol of evaluating lymph nodes metastasis might increase diagnostic accuracy.

Background: There is an increasing trend for administration of invasive radiological interventions, laparoscopic surgery, and transplantation procedures in recent years, and determining the vascular variations prior to these procedures is crucially important. Coeliacomesenteric trunk (CMT) is among these variations. This study aimed to retrospectively evaluate this rare anomaly by computed tomography (CT). Materials and methods: A total of 1000 CT angiography images were analysed retrospectively, and the patients with mesenteric and coeliac arteries arising from the abdominal aorta with a single root were identified. The level that CMT arose, and its branching patterns were determined individually for all patients. Results: Ten patients (6 males and 4 females) with a mean age of 50.2 years (17–87 years) had CMT in CT images. Conclusions: The knowledge of variations in the CMT prior to vascular or laparoscopic interventions will contribute to early intervention in case of a complication, or to avoid from a potential damage.

OBJECTIVES The aim of this study was to detect the level of stiffness of parathyroid adenomas and to distinguish them from benign and malignant thyroid nodules using ultrasound elastography with acoustic radiation force impulse imaging. METHODS Twenty-one patients with parathyroid adenomas and 71 patients with thyroid nodules were evaluated by acoustic radiation force impulse imaging in this study. Acoustic radiation force impulse elastograms were obtained after evaluation of the thyroid nodules, which were predicted to undergo fine-needle aspiration biopsy, and patients with a diagnosis of hyperparathyroidism, which was identified by sonography at the same time. RESULTS An analysis of mean shear wave velocity (SWV) values for parathyroid adenomas and thyroid nodules showed that parathyroid adenomas had significantly higher stiffness levels compared to benign thyroid nodules (mean SWV ± SD, 3.09 ± 0.75 versus 2.20 ± 0.39 m/s; P < .001) and lower stiffness levels compared to malignant thyroid nodules (mean SWV, 3.09 ± 0.75 versus 3.59 ± 0.43 m/s; P < .001). CONCLUSIONS Acoustic radiation force impulse imaging has high sensitivity and specificity for differentiating parathyroid adenomas from benign and malignant thyroid nodules. As an adjunctive tool, it can help distinguish parathyroid adenomas from thyroid nodules, including posteriorly located nodules.

In patients with chronic liver diseases, the identification of significant fibrosis is of special interest, because the presence of fibro sis is an important parameter for the estimation prognosis, for survelliance and for treatment decisions in patients with Chronic Liver Diseases. Although percutaneous liver biopsy is the gold standart method for assessing liver fibrosis, it has some limitations including its invasive nature, inconvenience, sampling errors, inadequate specimen size and interobserver variability in pathology interpretation. Therefore many studies have focused on the evaluation of noninvasive methods for the assessment of liver fibrosis stage. One of these methods is real time elastography which measures tissue elasticity. In the present study, we assessed intercostal and subcostal measurement methods to discriminate between normal and fibrotic liver .

Rekürren piyojenik kolanjit, sosyoekonomik düzeyi düşük toplumlarda daha sık görülen, etyolojisi tam bilinmeyen fakat düşük protein içerikli beslenme, paraziter enfestasyonlar gibi faktörlerin suçlandığı, safra yolu destrüksiyonu, striktürler, tekrarlayan taş oluşumu ve kolanjit atakları ile seyreden ve bazen maligniteler ile karışabilen bir hastalıktır. Bu olgu sunumunda kolanjiyokarsinom ön tanısı ile takip edilen ve rekürren piyojenik kolanjit olduğunu tespit ettiğimiz nadir rastlanan bir olguyu sunmayı amaçladık.

Background Granulomatous mastitis is a rare and benign inflammatory breast disease that may clinically and radiologically mimic breast cancer. Objectives The aim of this study was to evaluate the features of idiopathic granulomatous mastitis (IGM) on breast magnetic resonance imaging (MRI) with mammographic and sonographic findings. Patients and methods A retrospective analysis was conducted on 20 patients with IGM who had been diagnosed by needle core or excisional biopsy at a single institution between 2006 and 2012. All of the patients underwent MRI for suspicious breast findings prior to biopsy. MRI examinations were performed on a 1.5 T scanner. The MRI findings were evaluated in accordance with the breast imaging-reporting and data system (BI-RADS) MRI lexicon established by the American College of Radiology. Results MRI detected a total of 29 lesions in the 20 patients. Fourteen of these lesions were seen as mass enhancements, with the remaining 15 identified as non-mass enhancements (NMEs). The median size of all lesions was 3.6 cm (range, 0.7 - 6.7 cm). The most frequently observed features were masses with a round shape (9 out of 14, 64%), smooth contour (11 out of 14, 78%), and a rim enhancement pattern (10 out of 14, 71%). The most common features of the 15 NME lesions were segmental distribution (6 out of 15, 40%) and heterogeneous enhancement patterns (8 out of 15, 53%). The time-intensity curves of the dynamic studies showed benign type one signal intensity (persistent enhancement pattern) in the majority of lesions (10 out of 20, 50%). Conclusion Our study suggests that breast MRI findings of IGM have a wide spectrum. Rim enhancement patterns are frequently seen on contrast enhanced images, but the imaging findings are nonspecific and cannot be used definitively to distinguish between benign and malignant lesions.

Although cervical degenerative changes is a common disorder, dysphagia induced by osteophyte formation is uncommon. We present a case of 54-year-old patient suffering dysphagia secondary to cricoidal osteophyte. Phsical examination showed no abnormality. A barium esophagography revealed anterior compression of the esophagus at the level of cricoid cartilage. A computed tomography (CT) showed a small spur originating from the cricoid. Magnetic resonance imaging (MRI) demonstrated the osteophyte-induced edema and allowed the differential diagnosis with the other causes of dysphagia. In this report, radiological features of cricoidal osteophyte is presented., Servikal kemik yapılarda dejeneratif değişiklikler sık görülmekle beraber, osteofitik oluşuma bağlı yutma güçlüğü oldukça nadir görülür. Krikoidten köken alan osteofit basısı nedeniyle yutma güçlüğü çeken 54 yaşındaki erkek hasta merkezimize başvurdu. Fizik muayenede anormallik saptanmadı. Baryumlu özofagus grafisinde, krikoid kıkırdak seviyesinde özofagusa anteriordan bası bulgusu izlendi. Etyolojiye yönelik çekilen bilgisayarlı tomografide, krikoidten köken alan spur saptandı. Yumuşak dokunun değerlendirilmesine yönelik elde edilen manyetik rezonans görüntülemede, osteofit etrafında ödem izlendi ve olası diğer yumuşak doku patolojileri ekarte edildi. Bu olguda, kridoid osteofitin radyolojik bulgularını sunmayı amaçladık

Primary hyperparathyroidism (pHPT) is a condition caused by excessive and uncontrolled secretion of parathyroid hormone. The classical presenting symptoms in primary hyperparathyroidism are renal stones, hypercalcemic crisis, soft tissue calcifications, and cystic bone disease. Although most cases of pHPT are detected early and before symptomatic lesions appear, some patients may present late in the course of their disease. In this report, we present a patient with extensive parenchymal calcifications forming a cast of the right kidney which is called as "putty kidney" with Brown tumor located in the pubic ramus.