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Introduction: This study aimed to assess the correlation between nucleic acid amplification test (real-time reverse transcription-polymerase chain reaction, RT-PCR) positivity of patients presenting with suspected COVID-19 and pneumonic infiltration consistent with COVID-19-specific pneumonia diagnosis on thoracic computed tomography (CT), with symptoms, laboratory findings, and clinical progression. Methods: The study included 286 patients (female:male 131:155; mean age, 53.3 ± 17.9 years) who were divided into two groups according to their RT-PCR test results. The symptoms, laboratory examinations, clinical findings, and thoracic CT imaging of the patients were evaluated. Results: While the physical examination, comorbidities, and total CT scores were similar between the groups, taste/smell abnormalities were observed more frequently in the PCR-positive group. The use of moxifloxacin, lopinavir/ritonavir, and tocilizumab was higher in the PCR-positive group (p = 0.016, p < 0.001, and p = 0.002, respectively). The duration of hospitalization, intensive care requirement, and mortality rate of the studied groups did not differ between the groups. Conclusions: Among patients presenting with suspected COVID-19 and pneumonic infiltration consistent with COVID-19 on thoracic CT, the symptoms, physical examination, total CT scores, duration of hospitalization, intensive care requirement, and mortality rate were similar between RT-PCR-positive and RT-PCR-negative patients. However, PCR-positive patients appeared to require more specific treatments.

Background Ectopic thymus could be located intrathyroidal, therefore fine ultrasound details are useful for this differentiation. Aim To investigate differences in stiffness and vascularity properties among thyroid nodules and intrathyroidal ectopic thymus (IET) by obtaining quantitative data in children. Patients and methods Twenty-seven thyroid nodules and 20 IET in children were evaluated in terms of vascularity index (VI) via superb microvascular imaging (SMI) and stiffness by shear wave elastography (SWE). Differences in the volume, VI, and SWE parameters of the lesions were assessed by using the Mann-Whitney U test. Association of the age, lesion volume, SWE, and VI parameters was investigated by using Spearman's correlation analysis. The optimal cut-off values for stiffness and vascularity in the differentiation of nodules from IET were calculated with ROC analysis. Results The median (range) age of the participants with thyroid nodules and IET were 15.6 (10-18) years and 8.8 (3-14) years, respectively. The medians (range) VI of the IET and thyroid nodules were 4.7 (0.2-16) % and 23.8 (7.5-40)%, respectively. The median SWE values were 7.6 (4.4-9.5) kPa and 15.58 (8.5-23.4) kPa for IET and nodules, respectively. There have been highly significant differences among medians of volume, SWE, and VI values of the lesions. Significant positive correlations were found between VI and SWE parameters (p=0.001, r=0.64), and volume with VI (p=0.018, r=0.34) and SWE (p:0.001, r= 0.5). The diagnostic accuracies were 93%, 91% with the cut-off values as 9.2 kPa, 13% for the SWE and SMI, respectively. IETs were found to be less vascular and less stiff than thyroid nodules. Conclusions IETs could be easily and confidently differentiated from nodules using SWE and SMI quantifications. This discrimination prompts the reduction of unnecessary interventional procedures.

Purpose We aimed to determine the feasibility and effectiveness of agent emission imaging - high mechanical index (AEI-High MI) mode ultrasonography (US) compared with gray-scale and color Doppler US, alone or in combination, for the diagnosis of urolithiasis with reference to unenhanced computed tomography (CT). Methods This prospective study included 72 consecutive patients (40 males, 32 females; mean age, 45.9±14.7 years) referred by the department of urology for acute or elective symptoms of urolithiasis and confirmed to have urinary calculi on unenhanced abdominal CT, between January 2015 and June 2015. Gray-scale, color Doppler, and AEI-High MI US were performed by two radiologists to determine the effectiveness of these methods in the diagnosis of urinary stones and to compare them with the reference modality. Results A total of 189 calculi were detected on CT examination. Gray-scale US had a sensitivity of 66.1% and positive predictive value (PPV) of 88.7% for detecting calculi, while twinkling artifact of color Doppler had a sensitivity of 70.4% and PPV of 94.3%. The scintillation artifact of AEI-High MI mode had a sensitivity of 75.1% and PPV of 95.9%. When all ultrasound-based modalities were combined, the sensitivity and PPV rose to 83.1% and 88.2%, respectively. When calculi were grouped according to their size ( 10 mm), AEI-High MI mode had a higher sensitivity (60%) compared with gray-scale (32.5%) and color Doppler (41.3%) for calculi Conclusion AEI-High MI mode had a higher sensitivity compared with gray-scale and color Doppler for the detection of calculi smaller than 5 mm, but it did not make a significant contribution to detection of larger calculi. The combined use of gray-scale US with AEI-High MI mode could increase the detection rate of calculi smaller than 5 mm and provide a method for verification of suspected calculi on gray-scale US.

Erol OB, Sahin D, Bayramoglu Z, Yilmaz R, Akpinar YE, Unal OF, Yekeler E. Ectopic intrathyroidal thymus in children: Prevalence, imaging findings and evolution. Turk J Pediatr 2017; 59: 387-394. The aim of this study was to evaluate the ultrasound (US) features of intrathyroidal ectopic thymus (IET) and demonstrate the alterations after follow-up. This study included 36 lesions of 32 patients (mean age 95 ± 58 months) diagnosed with IET. The patients underwent follow-up US examination at least 22-months without a medication or surgical intervention. A total of 36 IETs with an incidence of 0.91% were detected among 3914 thyroid ultrasound (US) examinations. The mean of anteroposterior (ap), transverse (tr), and craniocaudal (cc) diameters in the initial US examinations were 3.1±1.19 mm, 4.89±1.86 mm, and 6.45±3.92 mm respectively. All of the lesions were well-demarcated, hypoechoic to the thyroid gland, and contained uniformly distributed punctate echogenic foci. Follow-up US examinations were performed after 684±85 days. The alterations between the initial and follow-up diameters for ap and cc direction were not statistically significant. However, a significant difference (p=0.007) was found for transverse diameters and the IETs were found to be smaller at follow-up US than in the initial US. Most of the IETs were located in the left lobe (64%), middle portion (83%), and extended to a border of thyroid gland (69%) and nonspherical in shape (89%). The descriptive findings of IETs are uniform distribution of punctate echogenic foci, absence of a rim, and the presence of vessels traversing through the lesion without parenchymal displacement. Given our findings, healthcare professionals should be aware of the diagnosis of IET. Patients with an IET could be safely managed with follow-up US and any surgical treatment would not be required.