Search

Because of the widespread use of breast screening mammography, the number of women diagnosed with ductal carcinoma in situ (DCIS) has increased dramatically in recent years. DCIS is a noninvasive form of breast cancer, accounting for up to 30% of breast cancers in screening populations and approximately 5% of breast carcinomas in symptomatic patients (1–3). DCIS has a variety of mammographic presentations, but the most common mammographic feature is microcalcification (4). Indeed 80%–90% of DCIS lesions present with microcalcifications only, without any accompanying mass lesions (4). Other findings such as masses, nodular abnormalities, dilated retroareolar ducts, architectural distortions, and developing densities have also been reported (5). Ultrasound-guided biopsy is often the method of choice for sonographically visible breast lesions as it provides easy access for biopsy. However, in cases when the abnormality seen on mammography is not visible on ultrasonography, stereotactic biopsy is the recommended sampling method. For microcalcification-only lesions with no accompanying mass, ultrasonography often fails to identify the site of the lesion; hence, stereotactic biopsy is used more frequently. In most breast units, stereotactic 14-gauge automated core biopsy has been replaced by stereotactic vacuum-assisted biopsy (SVAB) using 8- to 11-gauge needles (6). Large core SVAB allows larger samples to be obtained in a shorter period of time compared with samples obtained using automated core biopsy devices (7). Moreover, this technique has the advantage of a single insertion in the area of interest compared with automated core biopsy devices, which require repeated insertions. Several published articles have shown that SVAB decreased the rate of cancer underestimation and the rate of failure to retrieve breast microcalcifications (8). The management of noninvasive and invasive breast cancers is different and therefore, an accurate preoperative diagnosis is crucial for adequate surgical planning. Underestimation of DCIS lesions occurs when an invasive component is found after surgery, which had been missed at the initial preoperative sampling. The underestimation rate of stereotactic 14-gauge automated core biopsy in DCIS was reported as 16%–35% (9–11), while that of SVAB was 5%–29% (6, 9, 11–13). The purpose of this study was to determine the rate, causes, and predictive factors of underestimation of invasive carcinoma in patients diagnosed with DCIS following SVAB of microcalcification-only lesions.

To evaluate the relationship between varicocele and ankylosing spondylitis (AS) via color duplex sonography (CDS).Thirty male patients (age range 18-40 years, mean age 30.27 years) with AS and 30 male healthy controls (age range 20-36 years, mean age 27.23 years) were evaluated for varicocele using CDS.Vein diameter in right and left pampiniform plexus (PP) in the AS group was significantly higher than in the control group (p0.001 and p = 0.003, respectively). The incidence of varicocele was observed as 33.3 % in the AS group and 10 % in the control group. However, the difference was statistically significant (p = 0.028). The rate of right, left, and bilateral varicocele was 3.3 % (1 patient), 23.3 % (7 patients), and 6.6 % (2 patients), respectively, in the AS group, versus 0, 10, and 0 % in the control group (p = 1.000, p = 0.166, and p = 0.492, respectively).The incidence of varicocele in AS patients is higher than in control subjects, and the difference is statistically significant. Therefore, varicocele must be taken into consideration and investigated in patients with AS.

Cecal diverticulitis is an unusual condition that presents clinically similar to appendicitis. Although it is usually asymptomatic, it may cause inflammation, bleeding, or perforation. The diagnosis is not always easy and in the majority of cases, the diagnosis is usually made at laparotomy. There have been various controversies in the literature regarding the optimal management of cecal diverticulitis. The aim of this study is a detailed description of this rare cause of acute abdomen. A 40-year-old female patient presenting with acute onset pain in the right lower abdominal quadrant, nausea and fever had mild leukocytosis. Abdominal ultrasonography and computed tomography revealed findings suggestive of plastron appendicitis. The diagnosis of cecal diverticulitis was established during the surgery. The patient underwent diverticulectomy and appendectomy operations. Cecal diverticulitis is rare clinical entity that should be considered in the differential diagnosis of emergency patients admitted with the complaint of pain in the right lower abdominal quadrant., Çekal divertikülit klinik olarak apandisite benzeyen nadir bir durumdur. Genellikle asemptomatik olmasına rağmen, inflamasyon, kanama ve perforasyona sebep olabilir. Vakaların çoğunluğunda tanı zordur ve genellikle laparatomide tanı konulur. Literatürde çekal divertikülitin tedavisi ile ilgili çeşitli tartışmalar mevcuttur. Bu yazının amacı akut karının nadir bir nedeni olan çekal divertiküliti detaylı bir şekilde incelemektir. Akut sağ alt kadran ağrısı, bulantı ve ateşi olan 40 yaşında kadın hastanın hafif lökositozu vardı. Abdominal ultraonografi ve tomografide plastrone apendisiti düşündüren bulgular mevcuttu. Çekal divertikülit tanısı operasyon esnasında konuldu. Hastaya divertikülektomi ve apendektomi yapıldı. Çekal divertikülit, sağ alt kadran ağrısı olan acil vakalarda ayrıcı tanıda düşünülmesi gereken nadir görülen bir durumdur

Introduction Injuries that develop secondary to minor traumas and cannot be detected via direct examination methods, but are detected via advanced imaging methods, such as magnetic resonance (MR) imaging, are called occult bone injuries or bone bruises. In such injuries, diagnostic arthroscopy usually does not reveal any pathology. MR imaging methods are quite beneficial for the diagnosis of such clinical conditions, which cause acute pain and restriction of motion. The present study aimed to assess occult bone injuries via MR imaging in patients who presented with minor knee trauma. Patients and Methods Twelve patients who presented with minor knee trauma were included in the study. Etiological factors in these patients included walking a long distance, falls, and minor trauma. All patients underwent physical examinations, direct radiological imaging, MR imaging, and diagnostic arthroscopy. Results Direct radiographs of the patients showed no pathological fracture. Bone marrow changes detected on the MR images were classified according to Lynch’s classification as Type I lesions in nine patients and Type II lesions in three patients. Conclusion We suggest that MR imaging methods should be the gold standard for the diagnosis of minor traumatic bruise injuries of the knee.

The aim of this study was to determine the frequency of anatomical variations of the colon associated with the kidney.A retrospective analysis was performed on 1000 consecutive abdominal computed tomography (CT) scans performed between July 2010 and September 2011. A line parallel to the horizontal plane was drawn through the posterior edge of each kidney at three renal levels: upper, middle and lower pole. The bowel between the psoas muscle and the kidney was determined as the interposition of the colon. The amount of perinephric fat was estimated and graded.The total number of patients undergoing CT scans was 1000 (male/female = 510/490). The mean age of patients was 42.2 years. Seventeen patients (1.7%) had retrorenal colon, of which 12 (1.2%) were on the left side, three (0.3%) on the right side and two (0.2%) were bilateral. Of these 17 cases, 11 were found at the lower, two at the middle and four at the upper pole of the kidney. There was grade I perirenal fat tissue in 13 and grade II in four cases. Interposition of the colon was detected in 32 (3.2%) patients, 30 (3%) on the right and two (0.2%) on the left. The grade of perirenal fat tissue in patients with colon interposition was as follows: 25 patients grade I, six patients grade II and one patient grade III.In accessing the lower pole of the kidney, especially on the left side, the risk of colonic injury should be taken into consideration during percutaneous procedures, regardless of the patient's age and gender.

Aim To determine the need for a fine-needle or core biopsy in patients with clinically palpable breast abnormalities who have negative mammographic and sonographic findings. Method and materials Over a 12-year period, 251 patients with a palpable abnormality at presentation and who had a negative ultrasound and mammogram underwent clinically guided biopsy (CGB) by breast surgeons. This was 2.7% (251/9313) of all breast biopsies performed from January 1999 to December 2010. Physical findings were qualitatively categorized into five groups as clinically “normal”, “benign”, “probably benign”, “suspicious”, and “malignant” at the time of initial assessment. The number of biopsies for each category and biopsy results were analysed retrospectively. Results Three (1.2%) of the 251 CGBs were reported as malignant; two (0.8%) of which were invasive. Forty-six (18.3%) of the 251 cases were regarded as clinically suspicious or malignant while the remaining 215 examinations were categorized as benign or probably benign. All three malignancies were in the clinically suspicious or malignant group. Conclusion A negative ultrasound and mammogram in patients with a palpable abnormality does not exclude breast cancer; however, the likelihood is very low (1.2%). In this study, 81.7% of biopsies (205/251) could have been avoided if CGB was reserved for the clinically suspicious or malignant group only without missing any malignancies.

This study aims to collect data by multidetector computed tomography (MDCT) on the diameter of the normal common bile duct (CBD) and the diameter of CBD after cholecystectomy. In this retrospective study, CBD measurements were performed on axial oblique images, perpendicular to the long axis of the distal CBD. The mean diameter of the normal CBD was measured in 604 patients without cholecystectomy. The patients were divided into 6 groups according to their age. Analysis of variance (ANOVA) was used to compare data obtained from the six age groups. The mean diameter of the CBD of 46 patients who had cholecystectomy was calculated. The results were compared with age matched control group by Student's t test. The largest diameter of CBD ranged from 1.8 to 11.8mm. The mean of the largest diameter of 604 subjects was 4.77 ± 1.81. The diameter of the CBD significantly increased with age. Mean largest CBD diameters of postcholecystectomy subjects (7.28 ± 2.37) were significantly greater than age matched control group. In conclusion the diameter of CBD shows a considerable increase with age. The largest diameter of the CBD is up to 6mm in most of the subjects. An upper limit of 8mm appears reasonable after the age of 50; and an upper limit of 10mm seems appropriate for cholescystectomized subjects.

Pulmonary Veins are one of the major structures of circulation. In the last decade, pulmonary veins have been known to play an important role as the triggering focus of the electrical activity in atrial fibrillation. Primary treatment method of AF is RF ablation of the focus. For the best ablation, the anatomy of PVs should be well established before the procedure. MATERIAL AND METHODS: In our radiology department, 783 patients underwent computed tomography angiography between January 2008 and May 2010. Patients were referred for coronary CTA because of known or suspected coronary artery disease or computed tomography pulmonary angiography (CTPA) because of known or suspect pulmonary embolism. All scanning was performed on Philips Brilliance 64 slice Multidetector CT. The group consisted of 402 male and 381 female patients with the average age of 48 (range 14–89). CT data of patients were retrospectively reviewed to identify the PV anatomy and to determine anatomic variants and anomalies. RESULTS: In the majority of cases, two pulmonary veins drain into the left atrium on each side. Eighteen and eight variations were found in the right and left sides, respectively. Most frequent combined variations were 2R-4L (32.3%) and 4L was the more frequent single variation type (76%). In addition to that one Situs inversus totalis (0.12%), two partial anomalous pulmonary venous returns (0.25%) and one scimitar syndrome (0.12%) were found. CONCLUSION: This study showed that multiple types of variations of PVs can be found with increasing patient number. Therefore, for the successful ablation and surgery without any complications, the anatomy of PVs should be known before the procedure. MDCT is a reliable imaging method for the detailed cross-sectional and 3D anatomy.

Background: Diffusion-weighted magnetic resonance imaging (DWI) is a widely-accepted diagnostic modality whose efficacy has been investigated by numerous past studies in the differentiation of malignant lesions from benign entities. Aims: The aim of this study was to evaluate the efficiency of diffusion-weighted magnetic resonance imaging in the characterization of renal lesions. Study Design: Diagnostic accuracy study. Methods: A total of 137 patients with renal lesions were included in this study. The median apparent diffusion coefficient (ADC) values as well as the b 800 and b 1600 signal intensities of normal kidneys, solid components of mixed renal masses, and total cystic lesions were evaluated. Results: There were significant differences between the ADC values of lesions and normal renal parenchyma, and between the ADC values of benign and malignant renal lesions on DWIs at b values of 800 and 1600 s/mm² (p

To present the results of our retrospective study on 49 totally implantable subcutaneous venous ports inserted in angiography unit under ultrasound and fluoroscopic guidance. Between January 2010 and November 2011, 49 subcutaneous venous chest ports were placed in 48 patients (mean age, 49.3±16.7 years). One patient underwent port implantation twice. All the ports had single lumen catheters. The procedures were performed under ultrasound and fluoroscopic guidance in angiography unit. All ports were placed on the anterior chest wall. The technical success rate was 100%. There was no procedure-related minor or major complication. Mean duration of catheter usage was 220 days (total, 100.180 catheter days; range, 15 to 420 catheter days). There was no early complication(in the first month). Late complications occurred at a rate of 8.3% (n=4). Among those four cases, two ports (4.1%) had to be removed due to thrombosis. One port was explanted due to treatment-resistant bacteremia and sepsis, the other due to catheter malposition. In patients with malignant diseases, radiological implantation of subcutaneous venous ports can be performed with similar or lower complication rates, as compared to the surgical literature, due to the obvious advantage of imaging guidance. Hence, port implantation with imaging guidance may become a more preferred implantation method in the future., Anjiyografi ünitesinde ultrason ve floroskopi altında 49 tamamen implante edilebilen subkutan venöz port retrospektif olarak incelendi. 49 subkutan venöz göğüs portu 48 hastada (ortalama yaş 49.3 ± 16.7 yıl ) yerleştirildi . Bir hastaya iki port implantasyonu uygulandı. Tüm portlar tek lümen kateterine sahipti. Prosedürler ultrason ve anjiyografi ünitesinde floroskopi altında yapıldı. Tüm portlar göğüs ön duvarına yerleştirildi. Teknik başarı oranı %100 idi . İşleme bağlı minör veya major komplikasyon gözlenmemiştir . Erken komplikasyon (birinci ay ) olmadı. Geç komplikasyonlar % 8.3 oranında oluştu (n: 4) . Cerrahi literatürde malign hastalıklarda, subkutan venöz portların radyolojik implantasyonu benzer veya daha düşük komplikasyon oranları ile tercihedilebilir. Bu nedenle, görüntüleme kılavuzluğunda port implantasyonu gelecekte daha çok tercih edilen implantasyon yöntemi olabilir

Background A wandering spleen, defined as a spleen without peritoneal attachments, is a rare entity characterized by splenic hypermobility due to laxity or maldevelopment of the supporting splenic ligaments. Patients with a wandering spleen may be asymptomatic, or may present with a palpable mass in the abdomen, or with acute, chronic, or intermittent symptoms due to torsion of the wandering spleen. Because early clinical diagnosis is difficult, imaging modalities play an important role in the diagnosis. Treatment should be planned according to the vitality of the spleen. Case report A 22-year-old woman presented with an acute abdomen that was found to be due to a wandering spleen with 720° anti-clockwise torsion around the pedicle. Conclusions Splenectomy is advocated in the presence of torsion, splenic vein thrombosis, or splenic infarction. Conversely, when a viable wandering spleen is found at laparotomy, detorsion with splenopexy is preferred.

To determine if the specimen without calcification, as depicted on specimen radiography, made any contribution to the final histopathological diagnosis in comparison to the specimen with calcification. The records of 1312 stereotactic vacuum-assisted biopsies for breast microcalcifications between February 2000 and December 2010 were reviewed retrospectively. Following specimen x-ray the biopsy tissues with and without microcalcifications were sent in two separate pots (pot 1 and pot 2 respectively). The number of cores in each pot and the number of calcium specks within the cores were recorded. In 1135 of the 1312 (86%) cases the histopathological findings were similar for pot 1 and pot 2. In 165 cases (13%) the diagnosis was made solely on pot 1 while cores in pot 2 did not reveal any additional pathology. In 12 biopsies (1%) the significant pathology was only present in the specimen without any calcification. For "microcalcification only" breast lesions the specimen containing calcium will yield a correct diagnosis in 99% of cases. Cores containing no calcification rarely contribute to the diagnosis on their own, but in 87% of cases an accurate diagnosis would still have been made even if the targeted calcification had been missed.

PURPOSE: The purpose of this study was to identify the factors that may have an impact on upgrading atypical ductal hyperplasia (ADH) lesions to malignancy. MATERIALS AND METHODS: Between February 1999 and December 2010, the records of 150 ADH lesions that had been biopsied were retrospectively reviewed. The biopsy types included 11-gauge stereotactic vacuum-assisted biopsy (SVAB) (n=102) and ultrasonography (US)-guided 14-gauge automated biopsy (n=48). The patients were divided into two groups: those who had cancer in the final pathology and those who did not. Variables associated with underestimation of ADH lesions were compared between the groups. RESULTS: The underestimation rates according to the biopsy types were 41.7% (20/48) for the US-guided 14-gauge automated biopsy and 20.6% (21/102) for the 11-gauge SVAB (P = 0.007). The rate of underestimation was significantly higher in lesions greater than 7 mm than it was in smaller lesions, with both US-guided 14-gauge automated biopsy and 11-gauge SVAB (P = 0.024 and P = 0.042, respectively). The rate of underestimation was significantly higher with the 11-gauge SVAB (P = 0.025) in lesions that were suspicious (R4) and highly suggestive of malignancy (R5) than in those that were probably benign (R3). CONCLUSION: The underestimation rate in ADH lesions was significantly higher with US-guided 14-gauge automated biopsy compared to the 11-gauge SVAB. The underestimation rate was also significantly higher in lesions greater than 7 mm regardless of the biopsy type, and in lesions biopsied using SVAB that were regarded as suspicious (R4) or highly suggestive of malignancy (R5) on imaging.

The aim of this study was to assess the cerebral variations and observe their frequency in the patients who have undergone angiographies with the state of the art 64-slice multidetector computed tomography (MDCT) angiography technique due to various reasons. 500 patients (253 women, 247 men) who had CT scan in the period of April 2008 to March 2010 at Dicle University Medicine Faculty Hospital Radiology Unit were surveyed in this study. Patients who had CT scan with brain CT angio protocol were evaluated using multiplanar, maximum intensity projection (MIP) and volume rendering (VR) images in work station. 773 variations were totally detected among 500 patients. Variations were categorized as Willis polygon, fenestration and other variations. Frequent variations were detected at Willis polygon and posterior communicating artery (PCOA) hypoplasia was detected as the prevalent variation. In the present study, we have demonstrated that cerebral vascular variations are frequent and that these variations can be detected in a non-invasive manner using the MDCT angiography. The results obtained from our study may serve as preoperative guidelines for the units performing surgical procedures.

The gallbladder and the biliary tract are structures in close connection with the adjacent organs and may show a number of variations and anomalies. It is therefore important for surgical purposes to know their anatomy and variations in detail. Various methods are used in the imaging of the variations of the biliary tract and its pathologies, including ultrasonography, computed tomography; direct cholangiographic methods like endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, intravenous cholangiography and T-tube cholangiography, as well as indirect methods like magnetic resonance cholangiopancreatography (MRCP) or cholescintigraphy. The aim of this study is to investigate the frequency of the anatomic variations of the biliary tract using 3-T MRCP and to compare the findings with the data in the literature. For the purposes of this study, patients who underwent MRCP at our hospital (Dicle University Hospital) between November 2009 and February 2012 were investigated retrospectively. A total of 590 patients (between 6 and 88 years of age; mean age: 51 ± 9 years) were included in the study. The MRCP imaging was carried out with an magnetic resonance imaging (MRI) device supplied with 3-T magnetic power and by obtaining T2-weighted images through the single-shot fast spin echo technique using the standard body coil. The axial and coronal source images and the reformatted images were evaluated together in terms of the possible anatomic variations. Among the 590 patients included in the study, of 233 (39.5 %) showed anatomic variations at different levels in the intra- and extrahepatic biliary tracts. Among these variations, a right posterior hepatic duct insertion to the left hepatic duct at the level of the bifurcation has been observed in 71 patients (12.1 %), trifurcation was observed in 30 patients (5.1 %) and insertion into the main hepatic duct at the proximal aspect of the cystic duct was observed in 18 patients (3.1 %). At the level of the cystic duct, medial insertion of the cystic duct was viewed in 58 patients (9.8 %), distal medial insertion was seen in 40 patients (6.8 %), a short cystic duct was detected in 10 patients (1.7 %), pancreatobiliary junction anomaly was viewed in two patients (0.4 %) and duplicate anatomic variations have been observed in 42 patients (7.2 %). MRCP studies conducted using 3-T MRI devices may reveal similar or greater numbers of variations when compared to the existing MRCP studies in the literature. 3-T MRI shows a couple of variations. Pointing out these anatomical variations before the surgical intervention may prevent possible iatrogenic traumas. Donors with unsuitable variations for liver transplant may be spotted out at an early phase through the MRCP and certain operations with a high morbidity rate may thus be avoided.

Contrast enhanced breast magnetic resonance imaging is a modality that is frequently used into the breast radiologist's daily clinical practice. MRI examination should have optimal technical proficiency in order to attain diagnostic quality avoiding false positive and negative diagnoses. Furthermore, due to increasing usage fields of the examinations uniting with high sensitivity phenomenon, excessive usage and excision/interventional procedures are inevitable. Therefore, we hope to highlight the appropriate usage of the MRI technique and it's clinical applications.Kontrast madde kullanılarak uygulanan meme manyetik rezonans görüntüleme, meme radyologlarının günlük klinik kullanımlarına artan sıklıkla giren bir yöntemdir. Manyetik rezonans görüntüleme (MRG), yanlış pozitif ve negatif teşhislerden kaçınacak tanısal kaliteye ulaşabilmesi için optimal teknik yeterliliğe sahip olmalıdır. Ayrıca artan kullanım alanları ile birleşen yüksek hassasiyet fenomeni nedeniyle, yöntemin ve eksizyonel/girişimsel prosedürlerin lüzumsuz kullanımı kaçınılmazdır. Bu nedenle, MRG tekniğinin uygun kullanım yöntemlerini ve klinik uygulama alanlarını vurgulamak istedik.

Renal artery variations are important for clinical reasons. The aim of this study is to determine the originating level and variations of renal arteries with 64-channel multidetector computed tomography (MDCT).In a university hospital, 820 patients who underwent MDCT angiography of the abdominal aorta were retrospectively evaluated. The number, early division (ED), and originating level of renal artery were evaluated retrospectively. Variations of the renal artery on both sides, the difference between the genders with variations of the renal artery, were compared with chi-square test.Renal artery originating from the level of L1-L2 intervertebral disc was found in 37.0% and 38.9% of patients on the right and left sides, respectively. Renal artery variations, including extrarenal artery (ERA), were found in 27% and ED in 26.7% of the patients. Significant differences were found in ED and ERA prevalence for genders (p = 0.006 and p = 0.043, respectively). The prevalence of both variations is higher in males.An awareness of renal vascular variations is very important for both surgeons and radiologists. In this series, renal arterial variations were found in approximately one-fourth of the study population.

The goal of our study was to measure the prevalence of anomalies in the extracranial segment of internal carotid artery (ICA), to measure the carotid-pharyngeal distance (CPD).Computed tomography (CT) angiography images of 607 patients were retrospectively examined. The course anomaly and CPD were obtained at different image plane. The patients were divided into four groups according to their age.The incidence of course anomaly in ICA was shown to be 60.3 %. Prevalence of course anomaly showed an increase with age (p0.001). Women had more ICAs with a course anomaly than men (p0.001). Mean CPD among all ICAs was found to be 11.13 mm. When CPD values were compared between the groups, group 1 and group 2 did not have a significant difference, however, there was a significant difference between other groups (p0.05). The CPD significantly decreased with age (p0.001). In ICAs that showed a straight course, the mean CPD was 13.0 mm, while in ICAs that showed course anomaly, the mean CPD was determined to be 9.49, showing a significant difference (p0.05).In conclusion, the number of ICAs that show a course anomaly increases with age, while the CPD decreases. The CPD is decreased in groups that show anomalies. The detection of a decreased CPD before surgery may lower the chance of a perioperative hemorrhage due to artery damage during pharyngeal procedures. Hence, while reporting neck CT angiographies, it may be valuable to also report the presence of ICA anomalies and CPD.

Objectives The present study aimed to present the clinical and multidetector computed tomography (MDCT) findings of patients who were diagnosed with the median arcuate ligament (MAL) syndrome on MDCT retrospectively. Methods Seven hundred forty-four patients in whom MDCT angiography was performed were retrospectively analyzed for investigating incidental MAL syndrome. Results Twenty-one patients were shown to have MAL syndrome. Of 21 patients, 18 with MAL syndrome were asymptomatic. Three patients had some symptoms. On MDCT angiography, proximal narrowing of the arteries was observed in 21 patients. Conclusions MDCT is a minimally invasive and useful tool for the diagnosis of MAL syndrome.

To investigate the feasibility of percutaneous removal of the entire sentinel lymph node (SLN) in an animal model using a breast lesion excision system after identifying these nodes using contrast-enhanced ultrasound (CEUS) and intradermal microbubbles. Animal studies approval was obtained. SLNs were identified using CEUS and intradermal injection of microbubbles in two young pigs. Microbubbles were mixed with blue dye and injected around the mammary papillae to access lymphatic drainage to the superficial inguinal lymph nodes. When enhancing nodes were identified, the breast lesion excision system (BLES) was used to remove these nodes percutaneously. Both animals then underwent surgical lymph node dissection. Histopathological examination of all the samples was performed. Removal of the entire SLN was successful in three groins in the pigs. All three nodes were stained with blue dye. No other stained nodes were observed in the node dissection specimens. The nodal architecture of removed lymph nodes was well preserved on microscopy. There were no signs of excess trauma within the biopsy bed. The results obtained from the swine model demonstrated that it is feasible to remove the entire SLN percutaneously under the guidance of CEUS and microbubbles. • Intradermal injection of microbubbles and CEUS can identify sentinel lymph nodes • Ultrasound could then guide percutaneous removal of intact and complete SLNs • We have shown this was feasible in pigs but not yet in humans • This technique may eventually have the potential to reduce futile SLN biopsies.

Osteopoikilosis (OPK) is an uncommon osteosclerotic dysplasia. There is no exact evidence of its etiology and pathogenesis. Usually, it is an asymptomatic disease, and the diagnosis is made incidentally from radiographs, which show multiple, small, well-defined, variably shaped and widely distributed sclerotic areas over the skeleton. In this study, we report a 54-year-old man who suffers from back and leg pain and was diagnosed OPK by radiologically and review literature.

PURPOSE The aim of this study was to determine the causes and rate of failure in removing calcification in microcalcification-only lesions using 11-gauge stereotactic vacuum-assisted breast biopsy. MATERIALS AND METHODS In total, 1365 microcalcification-only lesions were included in this study. The breast biopsy database was reviewed retrospectively. The biopsies were divided into two groups based on whether the specimen X-ray showed calcium within the cores. Breast composition, lesion size, calcification distribution, density on mammography, and the number of specimens were compared between the two groups. RESULTS In 11 (0.8%) biopsies, no calcium in the specimen radiography could be identified. Re-biopsy was performed in five cases. The initial biopsy result was unchanged at the second biopsy in three cases containing calcium, while in the other two cases, a benign biopsy result was upgraded to atypical ductal hyperplasia and ductal carcinoma in situ, respectively. In six cases, the biopsy was not repeated despite the absence of calcium in the specimen X-ray. In three of these cases, calcifications were reported histopathologically and deemed to be too small to be identified on specimen X-ray. In two of six patients, sufficient information was found in the cores without microcalcification to indicate the need for surgery. One patient refused re-biopsy. A statistically significant higher failure rate was observed in low-density calcification compared with intermediate or high-density calcification on mammography. CONCLUSION The failure to retrieve microcalcification is uncommon when an 11-gauge vacuum-assisted breast biopsy is used. Low-density calcifications have a higher rate of failure. In cases in which no calcium is observed in specimen radiography, repeated biopsy is recommended.

Background Stab wounds resulting spinal cord injury (SCI) are relatively rare and typically associated with immediate neurological damage. Objectives We report MDCT and MRI findings of spinal injury findings following an unusual penetrating stab wound of the neck. Case report A 31-year-old man had a stab wound in the cervical region. CT showed linear fracture in the corpus and left lamina of fourth cervical vertebra. MRI revealed left side oriented posteroanterior penetrating linear spinal cord lesion and broad T2W hyperintensity changes representing spinal cord contusion. Conclusion CT and MRI allow bony injuries, foreign bodies, spinal instability and the classification of different types of lesions, ranging from spinal cord edema to complete spinal cord transection. MR imaging should be performed after acquiring negative CT imaging findings in the case of high suspicion of spinal cord trauma as seen in our present case.