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Introduction:To investigate the relationship between morphometric variants of the cochlear nerve (CN) and the hearing level. To investigate the confounding effects of age, sex, and audiometric variables on the relationship between CN morphometrics and hearing loss, if present.Methods:Audiological data and magnetic resonance imaging findings of 127 patients with asymmetrical sensorineural hearing loss (ASNHL) were reviewed retrospectively. According to pure tone average (PTA) frequencies of each ear, difference above 25 dB were accepted as ASNHL. The vertical (Vd) and horizontal diameters (Hd) and the cross-sectional area (CSA) of the CN were measured.Results:The difference in CSA and Vd between ears showed a negative correlation with age. The mean CSA was 1.57 in AE and 1.60 in NE. Mean Hd was 1.00 in AE and 1.00 NE. Mean Vd was 1.40 in AE and 1.50 in NE. There was no correlation between the difference ratios of thresholds and CN diameter parameters. There was no significant correlation of CSA, Vd, and Hd with PTA thresholds at each frequency.Conclusion:Aging is associated with losses in Vd diameter and CSA. The degree of hearing loss was not correlated with the morphometric features of the CN. The morphometry of the CN should be interpreted together with the etiology of hearing loss.

Purpose: Shear wave elastography (SWE) is a relatively new technique for measuring tissue elasticity. Its implementation for assessing the tissue of the cervix is evolving, and SWE analyses of healthy, nonpregnant cervixes is the first step in understanding other SWE changes related to cervical pathologies; nevertheless, some challenges in the use of the technique still require investigation. We aimed to target the consistency of healthy cervix shear wave elastography measurements and examine the changes induced by patient-related factors. Material and methods: Elastograms were obtained at the internal and external os in the anterior (IA, EA) and posterior (IP, EP) portions of the cervix using a transvaginal approach in eight postmenopausal and 25 premenopausal women. Measurements with a standard deviation of over 20% and patients who presented with colour loss or heterogeneity were excluded from the study. Shear wave elastography assessments were performed using a Toshiba Aplio 500 version 6. Statistical significance was defined as a p value less than 0.10, due to the small number of patients. Results: The mean speeds obtained at the external os on the anterior and posterior aspects was 3.17 ± 0.85 m/s and 3.18 ± 0.84 m/s, respectively, and at the internal os, the results on the anterior and posterior aspects were 3.38 ± 0.73 m/s and 3.53 ± 0.81 m/s, respectively. The difference in speed among all regions was statistically significant (p < 0.05). Fifteen patients were also analysed by a second radiologist with a similar experience level as that of the first. Nine measurements for IP, 13 measurements for IA, 11 measurements for EP, and 15 measurements for EA were performed. The correlation coefficients between the two sets of measurements were 0.46, 0.30, 0.67, and 0.51, respectively. There was no difference in the SWE values with respect to age, parity, and gravidity for any of the regions. The SWE values at the IA, IP, and EA regions between the postmenopausal and premenopausal women were significantly different (p = 0.038, p = 0.059, p = 0.065). Conclusions: The posterior portion of the internal os is most likely to undergo inaccurate SWE measurement among the different anatomical positions. The correlation between radiologists was found to be different for different locations in the cervix. More studies are needed to determine the SWE values of the healthy cervix and the agreement levels between radiologists.

Objective: Literature related to the imaging of COVID-19 pneumonia, its findings and contribution to diagnosis and its differences from adults are limited in pediatric patients. The aim of this study was to evaluate chest X-ray and chest CT findings in children with COVID-19 pneumonia. Methods: Chest X-ray findings of 59 pediatric patients and chest CT findings of 22 patients with a confirmed diagnosis of COVID-19 pneumonia were evaluated retrospectively. Results: COVID-19 pneumonia was most commonly observed unilaterally and in lower zones of lungs in chest X-ray examinations. Bilateral and multifocal involvement (55%) was the most observed involvement in the CT examinations, as well as, single lesion and single lobe (27%) involvement were also detected. Pure ground-glass appearance was observed in 41%, ground-glass appearance and consolidation together was in 36%. While peripheral and central co-distribution of the lesions (55%) were frequently observed, the involvement of the lower lobes (69%) was significant. In four cases,the coexistence of multiple rounded multifocal ground-glass appearance and rounded consolidation were observed. Conclusion: COVID-19 pneumonia imaging findings may differ in the pediatric population from adults. In diagnosis, chest X-ray should be preferred, CT should be requested if there is a pathologic finding on radiography that merits further evaluation and if clinically indicated. Advances in knowledge: Radiological findings of COVID-19 observed in children may differ from adults. Chest X-ray should often be sufficient in children avoiding additional irradiation, chest CT needs only be done in cases of clinical necessity.

Purpose The purpose of this study was to evaluate magnetic resonance imaging (MRI)-pathology concordance of tumour size in patients with invasive breast carcinoma, with an emphasis on Breast Imaging Reporting and Data System (BI-RADS) descriptors of dynamic contrast-enhanced MRI (DCE-MRI). Material and methods Of patients who had preoperative DCE-MRI, 94 were enrolled. Concordance between MRI and the pathological findings was defined as a difference in tumour size of 5 mm or less. The greatest dimension was measured by two radiologists, and BI-RADS descriptives were described in accordance. The gold standard was chosen as the pathologic assessment. Results Tumour measurements determined by MRI and the pathological reports were not statistically different (2.64 ± 1.16 cm, Wilcaxon Z = -1.853, p = 0.064). Tumour sizes were concordant in 72/94 patients (76.6%). The mean difference between the pathological and MRI tumour sizes was -0.1 cm. MRI overestimated the size of 17/94 tumours (18.1%) and underestimated the size of 5/94 tumours (5.3%). Discordance was associated with larger tumour size. Histologic and molecular type of tumours, patient age, histologic grade, lymphovascular invasion or perineural invasion positivity, fibroglandular volume, background parenchymal enhancement, and being mass or non-mass were not associated with concordance. Irregular margin and heterogenous enhancement in DCE-MRI were associated with discordance in logistic regression analysis (p = 0.035, OR: 4.24; p = 0.021, OR: 4.96). Conclusions Two BI-RADS descriptors of irregular contour and heterogeneous contrast uptake were found to be associated with tumour size discrepancy. This might be attributed to the dynamic and morphologic specialities of tumours primarily rather than tumour biology.

Sacral insufficiency fracture (SIF) is an uncommon cause of hip and back pain. Sacroiliitis, often a feature of inflammatory conditions of spinal column, is inflammation of sacroiliac joints. Herein, we report a 41-year-old woman presenting with a SIF and sacroiliitis as a part of non-radiographic axial spondyloarthritis.

Objectives Elasticity measurements of tissues can be valuable in the diagnosis and management of various diseases. The aim of this study was to determine the elasticity values for normal liver, kidney, and spleen of healthy newborns and infants using shear wave elastography (SWE) imaging. Methods A total of 50 healthy term newborns and infants (19 girls and 31 boys; mean age 20.1 days, range 1 to 70 days) were examined by an experienced pediatric radiologist using SWE. None of them had any liver, kidney or spleen disease, or any other systemic disease that could affect these organs secondarily. All newborns and infants had a normal abdominal ultrasound scan. Results Age, sex, weight, height, and body mass index had no significant effects on shear wave velocity (SWV) values of liver and spleen. The SWV values of both kidneys decreased with age, weight, height, and body mass index. The mean SWV values were 1.70 m/s (range: 1.23–2.43 m/s) for the liver, 1.69 m/s (range: 0.8–2.40 m/s) for the right kidney, 1.70 m/s (range: 0.9–2.49 m/s) for the left kidney, and 2.03 m/s (range: 1.28–2.48 m/s) for the spleen. Conclusions Shear wave elastography can be used to measure liver, kidney, and spleen elasticity in newborns and infants. The standard values for abdominal organs allow differentiation of healthy versus pathological tissue. We measured the normal values of SWE in healthy newborns and infants as reference data.

To evaluate the variations of the sternum and provide the prevalence of sternal foramen and its anatomical relationships. In this retrospective study, 544 subjects ranging in age from 18 to 95 years were evaluated. Sternal variations, prevalence of sternal foramen and its anatomical relationships to mediastinal structures were examined with the axial, sagittal and coronal reformat images of the patients who underwent thoracic computerized tomography. In 500 subjects, following sternal variations were found: sternal sclerotic band in 120 (24%), sternal cleft in 3 (0.6%), sternal foramen in 26 (5.2%), focal cortical notch and defect in 44 (8.8%) patients. The manubriosternal fusion was partial in 65 (13%) patients and complete in 112 (22.4%) patients. The sternoxiphoid fusion was partial in 201 (40.2%) and complete in 153 (30.6%) patients. There was no xiphoid process in 9 patients (1.8%; 29–51 years; mean age 38 years). Xiphoidal ending types were as follows: single-ended 361 (72.2%), double-ended 125 (25%), and triple-ended xiphoid 5 (1%) patients. The sternal foramen was adjacent to the lung in 13 (2.6%), to the pericardium of heart in 3 (0.6%), and to mediastinal fat in 10 (2%) patients. The sternum is a very critical anatomic structure of the anterior chest wall with several variations that can be confused with pathologic conditions. Radiologists’ familiarity with these variations is important for better radiologic evaluation in making differential diagnosis.

There is no consensus about the measurement techniques to determine the tibial torsion by using MRI. The primary research question of this study was to find out which MRI-based tibial torsion measurement method is more reliable and reproducible. Secondly, we compared tibial torsion values measured by three measurement methods in T1- and T2-weighted images. We retrospectively analyzed voluntary children performed MRI for determination of the lower limb torsional alignment after the surgical treatment between January 2013 and December 2013. Thirty-four extremities of 17 patients were included in the present study. The mean age of patients was 7.3 years (range 3–12 years). The transmalleolar, posterior intermalleolar and anterior talus angles were used for the measurement of tibial torsion. All tibial torsion measurements were calculated by three blinded observers in T1- and T2-weighted images, and these measurements were repeated blindly after 2 months. All measured intra- and interobserver intra-class correlations were greater than 0.60. The best scores were achieved with the anterior talus angle. It was followed by the posterior malleolar angle and the intermalleolar angle, respectively. Furthermore, there were no statistically significant differences between tibial torsion values measured by each observer in T1- and T2-weighted images of each method. MRI-based tibial torsion measurements were reliable and reproducible for all three methods. But we think that the anterior talus angle and the posterior malleolar angle are easier and more successful in determination of the tibial torsion. Also, both T1- and T2-weighted images can be used successfully for this purpose.

The goal of our study was to determine the diagnostic value of diffusion-weighted magnetic resonance imaging in the identification of acute mild pancreatitis with low Ranson scores. The study group included 22 healthy subjects and 40 patients with mild acute pancreatitis. Patients with Ranson scores of 1-3 were included in the present study. There was a significant reduction in mean pancreatic apparent diffusion coefficient among the acute pancreatitis patients (1.46±2.80×10(-3)mm(2)/s) relative to the healthy subjects (1.69±2.26×10(-3)mm(2)/s). Diffusion-weighted imaging improves diagnosis of mild acute pancreatitis and enables the differentiation of acute pancreatitis from other diseases involving abdominal pain and other nonspecific findings.

In recent years, methods by which to decrease radiation exposure during age estimation have gained importance and become a main research area in the forensic sciences. Imaging tools such as X-ray and computed tomography (CT) are accepted as the main diagnostic methods for evaluation of the epiphysis in living individuals; however, radiation exposure and superimposition are the main disadvantages of these techniques. Magnetic resonance (MR) imaging provides an advantage in terms of preventing radiation exposure. In this study, we performed an MR analysis of the degree of fusion of the distal tibia and calcaneal epiphysis and investigated the utility of this technique in the Turkish population. Using the three-stage method described by Saint-Martin et al., we retrospectively evaluated 167 MR images (97 males, 70 females; mean age, 17.7 +/- 4.8 years for males and 17.6 +/- 4.9 years for females; age range of all subjects, 8-25 years). Intraobserver and interobserver evaluation showed good repeatability and consistency of this method. Stages 2 and 3 ossification of the distal tibial epiphysis first occurred at age 14 and 15 years in males and 12 and 14 years in females, respectively. Stages 2 and 3 ossification of the calcaneal epiphysis first occurred at age 14 and 16 years in males and 10 and 12 years in females, respectively. When performed alone, MR analysis of the distal tibial and calcaneal epiphysis offers limited information for forensic age estimation. However, we suggest that MR analysis can be used as a supportive method when it is necessary to avoid repeated radiation exposure.

Objective The objective of this study was to calculate the mastoid cell volume of infants using computed tomography imaging. Methods We calculated the mastoid cell volumes of 87 infants younger than 1 year classified into 4 age groups. Results There were significant (P = 0.0001) differences in the ear mastoid cell volumes (cm(3)) among the 0- to 3-, 4- to 6-, 7- to 9-, and 10- to 12-month age groups. Generally, the mastoid cell volume increased with age. Conclusions Mastoid cell volume correlates with the age of infants up to 1 year. We plan to expand this study and determine cutoff values for the mastoid cell volumes of infants.

Background Penile fracture is a surgical emergency defined as rupture of the tunica albuginea. Although most cases can be diagnosed with clinical evaluation, it has been stated in the literature that diagnosis in as many as 15% of cases can be challenging. In uncertain cases, imaging can help determine diagnosis. Methods Present study included 20 cases where diagnosis could not be made with certainty and magnetic resonance imaging (MRI) was performed. MR images were examined for tunical rupture and accompanying pathologies. When rupture was observed, localization and length of rupture were noted. All patients underwent degloving surgery. All imaging findings were compared to surgical findings. Results MRI revealed 19 tunical ruptures. In 1 case, hematoma was seen with no sign of penile fracture. No urethral injuries were found. All MRI findings were confirmed during surgery. Conclusion Performing MRI in clinically equivocal cases can provide crucial data to make precise diagnosis and improve patient management.

Objectives We aimed to evaluate the electroencephalography (EEG) and diffusion weighted magnetic resonance (DWMR) findings obtained after a seizure in the acute period and to find out whether DWMR had any contribution to determine lateralization of epileptogenic activity. Methods Consecutive 43 patients with a seizure admitted to emergency department between July 2016 and February 2017 were evaluated, retrospectively. Patients whose seizures occurred in the last three days were included in the study. Demographic and clinical features, EEG and radiologic findings of the patients were evaluated. Results Mean age of total 43 patients was 48.12 ± 29.7 (18–80) years and 26 (60.5%) of them were female, 17 (39.5%) were male. Patients were divided into 3 groups regarding the classification of epileptic seizures; generalized (n = 17), partial (n = 23) and unclassified seizures (n = 3). Ten patients (23.3%) had the diagnosis of epilepsy previously. Abnormalities in EEG and DWMR were detected in 55.8% and 16.3% of the patients, respectively. In addition, 6 patients of the 7 with MR abnormalities were from partial seizures and 1 patient from generalised seizures groups. Areas of diffusion restriction were consistent with the localization of EEG abnormalities in 4 out of 7 patients. Discussion EEG is a valuable tool in supporting the diagnosis of epilepsy and classification of seizures. DWMR may be used in epilepsy patients to detect the areas that could be the cause of the epileptogenic activity in the post-ictal acute phase. Conclusions Further studies with higher number of patients may investigate the relationship between EEG and DWMR abnormalities. Significance This study may draw attention to relationship between neurophysiological and radiological findings in the acute period after a seizure.

The analysis of ossification points plays a considerable role in forensic age estimation. Although traditional methods are still in use, researchers are working on different age estimation procedures especially within the development of radiologic methods. One of these methods is to define spheno-occipital synchondrosis fusion degree. Spheno-occipital synchondrosis, an important growth point on cranial base, provides noteworthy information about age estimation through its late stage ossification nature. This study aimed to investigate spheno-occipital synchondrosis fusion degree for age estimation in the Turkish population. In our study, 1-mm-sectioned computed tomography images of 638 (399 men and 139 women) subjects within the age of 10 to 25 years were retrospectively examined. It is stated in our study that spheno-occipital syncondrosis fusion begins superiorly and progresses inferiorly until it is completed. Spheno-occipital syncondrosis is known to be totally open at the mean (SD) age of 11.5 (1.5) years in men and 10.7 (0.8) years in women. In addition, fusion degree is known to be increased with age. Fusion starts approximately 2 years earlier in women than in men, and the process of fusion completes at the age of 17 years in both sexes. An analysis of fusion degree between sex groups showed significance at the age of 11 to 15 years, and Spearman rank correlations indicate a significant positive relationship between age and degree of spheno-occipital fusion (P < 0.001; men, rho = 0.714; women, rho = 0.698). Consequently, 5-staged analysis of spheno-occipital synchondrosis fusion degree in use with 1-mm computed tomography images will be helpful for age estimation between 11 and 17 years.