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Aim: We aimed to assess the incidence, mean size, patterns, and types of accessory and sesamoid bones of the foot using computed tomography. Material and Methods: A total of 814 non-contrast-enhanced computed tomography images of the foot obtained from 717 patients between October 2015 and January 2018 were investigated retrospectively. Images acquired in the original axial plane were used to perform multiplanar reconstruction in the coronal or sagittal planes. Incidence, mean size, patterns, and types of accessory and sesamoid bones were evaluated in all images. Results: Accessory bones were detected in 387 (47.5%) non-contrast-enhanced computed tomography scans from 326 patients (45.4%). Sixty-seven patients (9.3%) showed accessory bones on both sides; 133 patients (18.5%), only on the right side; and 126 patients (17.5%), only on the left side. The most common accessory bones of the foot were the os naviculare accessorium (24.8%), os trigonum, (20.3%), os peroneum (14.6%), os intermetatarseum (10.6%), os supranaviculare (3.1%), os supratalare (1.9%), and os vesalianum (1.5%). The hallucal sesamoid bone was observed in all patients, while the interphalangeal sesamoid bone was observed in 34.6% of the patients. Conclusions: The computed tomography scans provided a detailed overview of the characteristics of accessory and sesamoid bones, and the incidence of these bones in our patients was higher than those reported in previous radiographic studies. Our findings can facilitate the diagnosis and management of disorders involving these bones. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to reveal the frequency and impact of perforating venous insufficiency (PVI) in chronic venous insufficiency (CVI) of lower extremity (LE). Materials and Methods: Between 2012 and 2017, a total of 1154 patients [781 females (67.68%) and 373 males (32.32%), 228 (19.76%) unilateral and 926 (80.24%) bilateral LE] were examined using Doppler ultrasound (US). A total of 2080 venous systems of LEs [31.4% male (n=653) and 68.6% female (n=1427); 1056 left LEs (50.77%) and 1024 right LEs (49.23%)] were examined. All patients had symptoms of venous insufficiency (VI). Results: PVI was revealed in 27.5% (n=571) of LEs. Varicose veins (VVs) related with perforating vein (PV) were revealed in 44.7% of LEs (n=929). PVI was observed in 50.91% of patients with chronic deep venous thrombosis (DVT), 64.41% with deep venous insufficiency (DVI), 59.81% with great saphenous vein (GSV) insufficiency, 68.49% with small saphenous vein (SSV) insufficiency, 58.65% with accessory GSV insufficiency, and 58.77% with PV associated with VVs. There was a statistically significant relationship between PVI and chronic DVT, DVI, GSV, SSV, and accessory GSV insufficiency (p<0.001). A significant relationship was observed between the increase in PV diameter and the presence of PVI (p<0.001). Conclusion: PVI is quite common in combined VI, and PV evaluation should be a part of LE venous system examination. [ABSTRACT FROM AUTHOR]

Background: Peripheral arterial disease is an atherosclerotic disease characterized by an increase in morbidity and mortality. For these reasons early diagnosis of peripheral arterial disease is important. Ankle-brachial systolic pressure index measurement is frequently used in screening studies. Evaluating waveforms of distal lower extremities with Doppler ultrasound can be used as a screening program and provides more accurate information on peripheral arterial disease. Aim: We investigate the prevalence of peripheral arterial disease, compare the efficacy of Doppler ultrasound evaluation of distal lower extremity waveforms and ankle-brachial systolic pressure index measurement in screening programs, and discuss the importance of early diagnosis of asymptomatic cases. Material and methods: A total of 457 patients over the age of 65 (between 65 and 94, mean age: 71.4) including 270 males and 187 females were examined with Doppler ultrasound, had ankle-brachial systolic pressure index measurement taken and were screened for peripheral arterial disease. The correlation between Doppler ultrasound findings and ankle-brachial systolic pressure index was examined. Results: According to the Doppler ultrasound findings, in the aortoiliac (r = 0.648) and femoropopliteal (r = 0.564) area, there is a medium level of correlation between severe stenosis and occlusions and a low ankle-brachial systolic pressure index value, and a low level of correlation between such abnormalities in the tibioperoneal region (r = 0.116) and a low ankle-brachial systolic pressure index value. Therefore, while the sensitivity of ankle-brachial systolic pressure index increases in proximal stenosis, it decreases in distal stenosis. Conclusion: Despite the fact that ankle-brachial systolic pressure index is a diagnostic test commonly used in screening studies, evaluation of distal arteries by means of Doppler ultrasound provides more accurate information in terms of the identification of peripheral arterial disease. [ABSTRACT FROM AUTHOR]

Objective: Magnetic resonance imaging for the diagnosis of musculoskeletal diseases can reveal different anatomical variants. A rare variant is the presence of a persistent median artery with the bifid median nerve. We aimed to visualize these anatomical variants and emphasize their clinical aspect. Methods: Informed consent was obtained from the patients, and ethics committee approval is not required as it is a retrospective case study. Magnetic resonance imaging of the right wrist of a 25-year-old female patient, the right wrist of a 29-year-old male patient, and the left wrist of a 57-year-old female patient taken at the Selçuk University Faculty of Medicine hospital were examined. Results: In these patients, ganglion cyst, lipoma, and tenosynovitis were detected in different localizations, respectively. The bifid median nerve and persistent median artery were found incidentally, which did not cause carpal tunnel syndrome symptoms. Conclusion: Pathological conditions in the persistent median artery and the bifid median nerve could be considered an anatomical risk factor for carpal tunnel syndrome. In the presence of a persistent median artery, surgeons must be aware of the possibility of additional median nerve anomalies. In hand trauma cases or carpal tunnel release patients, these anatomical variations should be considered. Radiological imaging methods such as color Doppler ultrasonography or magnetic resonance imaging are important for diagnosis. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the role of magnetic resonance dacryocystography (MR-DCG) technique in patients with obstruction of lacrimal drainage system. Methods: A total of 40 patients who had presented to the ophthalmology clinic were suspected to have obstruction of lacrimal drainage system, were evaluated with MR-DCG after instillation of 0.5% Gd-DTPA conjunctival contrast medium. Dacryocystorhinostomy (DCR) was performed in patients who were found to have lacrimal drainage system obstruction on either side on MR-DCG. Results: Obstruction of lacrimal drainage system was successfully detected in a total of 49 eyes of 40 patients undergoing examination with MR-DCG. The MR-DCG findings of 29 nasolacrimal systems were compared with the intraoperative findings in 28 out of 40 patients who had undergone the DCR operation. The sensitivity of MRDCG was determined as 100% and specificity as 96.7% for identification of nasolacrimal system obstruction when compared with the intraoperative findings, and MR-DCG was found to detect obstruction with high accuracy. Conclusion: MR-DCG has a high success rate in detection of lacrimal drainage system obstructions and the level and cause of the obstruction. [ABSTRACT FROM AUTHOR]

Aims: To investigate the role of magnetic resonance imaging (MRI) texture analysis (TA) in the detection of metastatic lymph nodes in patients with nasopharyngeal carcinoma (NPC). Material and methods: Between January 2020 and October 2021, 15 NPC patients with 32 metastatic lymph nodes and 30 healthy subjects with benign lymph nodes were included in the study. The texture features compared between metastatic and benign lymph nodes. The independent predictor parameters of metastatic lymph nodes were determined using multivariate regression analysis. Receiver operator characteristics (ROC) analysis was used to evaluate the diagnostic performance of the regression models. Results: The first order texture features did not differ significantly between groups (p>0.05). Except for correlation in metastatic lymph nodes, all gray-level co-occurrence matrix (GLCM) and graylevel run length matrix (GLRLM) features were significantly different (p<0.05). The GLCM features of joint entropy, joint energy, and maximum probability; and the GLRLM features of gray level non uniformity and low gray level run emphasis were independent predictors of metastatic lymph nodes. The area under the curve (AUC) values for the GLCM regression model and GLRLM regression model were 0.975 and 0.928, respectively. Conclusion: MRI texture analysis may be useful to detect metastatic lymph nodes in patients with NPC by providing quantitative information on tissue heterogeneity and cellular composition. [ABSTRACT FROM AUTHOR]

Extensive fetal cystic lymphangioma is a rare congenital malformation of the lymphatic system. Their prognosis depends on the size and location of the lesions as well as other accompanying anomalies. Our case was 35 years, fetal BPD was 27 weeks . Herein, we present a case of extensive fetal cystic lymphangioma that began at the pelvic area and symmetrically spanned the bilateral proximal and distal lower extremities. Numerous extensive and sharply circumscribed, thin walled multilobular cystic lesions in different sizes were observed in the subcutaneous superficial and deep soft tissue beginning from the pelvic area and extending to both lower extremities to the distal in the fetüs. To our knowledge, a case involving both extremities has not yet been reported in the literature. [ABSTRACT FROM AUTHOR]

Background: Methotrexate (MTX) and leflunomide (LEF) play fundamental roles in rheumatoid arthritis (RA) treatment and require proper monitoring of side effects. Concerns about MTX/LEF-related liver fibrosis (LF) in patients with RA remain unclear. This study investigated liver stiffness using two-dimensional shear wave elastography (2D-SWE) in RA patients undergoing disease-modifying antirheumatic drug (DMARD) therapy. Moreover, 2D-SWE was employed to evaluate the correlations between liver stiffness, cumulative MTX and LEF doses and risk factors for substantial LF., Methods: We recruited 222 participants from the Department of Rheumatology. The participants were divided into healthy controls (n = 78) and patients with RA (n = 144). Pearson's correlation analysis was performed to assess the correlations between liver stiffness and the cumulative dose of MTX/LEF and other clinical and laboratory variables., Results: The mean elasticity modulus was 4.79 ± 0.92 kPa, excluding the presence of significant fibrosis. Mean 2D-SWE values were significantly lower in healthy controls than in RA treated with MTX and LEF. The cut-off ≥3.8 kPa 2D-SWE values with the sensitivity of 86.1%, specifity of 83.3%. 2D-SWE values were not significantly different across the strata of the cumulative MTX subgroups., Conclusions: MTX and LEF increase liver stiffness but may be considered low risk for the development of LF., (© 2024 Wiley Periodicals LLC.)

Objectives: This study aims to evaluate the effect of quercetin on fracture healing in an open fracture model in rats., Materials and Methods: A total of 80 Wistar-Albino male rats were used in this study. The rats were divided into 10 groups. Daily oral treatment of 100 mg/kg of quercetin dissolved in corn oil were given to four groups, whereas the other four group of control rats were treated with corn oil only. Histopathological and radiological examinations of fracture healing were performed at the end of Weeks 2 and 4 in these rats, while biomechanical and biochemical examinations were performed at the end of Weeks 4 and 6, since harder callus was required. Among the rats in the last two group that were not subjected to the open fracture model, one group was given only quercetin for three weeks and the other for six weeks, and the biochemical markers in the blood were compared between these two groups. Computed tomography images were taken for radiological evaluation. The modified Lane and Sandhu scoring system was used for histological evaluation. The 3-point bending test was performed for biomechanical evaluation. For biochemical evaluation, plasma alkaline phosphatase (ALP), acid phosphatase (AP), total antioxidant status (TAS) and total oxidant status (TOS) levels were measured., Results: Radiologically, there was no significant difference between the early-stage results of quercetin and control groups (p=0.247), while quercetin caused a significant increase in callus tissue in terms of latestage results (p=0.012). Histopathologically, there was no significant difference in the early stage (p=0.584); however, in the late stage, a borderline significant increase was observed in the quercetin group compared to the control group (p=0.091). Biomechanical analysis showed that quercetin significantly increased the fracture strength in the healing bone both in the early period (p=0.036) and in the late period (p=0.027). Among biochemical markers, TOS and AP were found to be significantly decreased in the quercetin group. In the non-operated and quercetin given groups, TAS levels was significantly higher (p=0.001) and AP levels were borderline significantly lower at the end of Week 6 (p=0.063)., Conclusion: Quercetin did not have a significant effect on bone healing in the early period, but significantly promoted bone healing in the late period in rats. We recommend the use of quercetin, a strong antioxidant, in cases with high oxidative stress and conditions such as diabetes, smoking, and malnutrition which may inhibit fracture union, although further clinical studies are needed to confirm these findings.

Objective: The aim of the present study is to assess carpal tunnel syndrome's (CTS's) ultrasonography (US) and magnetic resonance imaging (MRI) findings in patients with psoriatic arthritis (PsA) and compare them with healthy controls., Methods: Thirty-nine PsA and twenty-eight healthy volunteers were examined in this study. Demographic and clinical features were recorded. CTS-6, a diagnostic algorithm, was used to estimate the probability of CTS. Electrodiagnostic study (EDS) was applied to all wrists included in the report, where the diagnosis of CTS was made by EDS. The cross-sectional area (CSA) of the median nerve was measured at pisiform bone level by US and MRI., Results: Regarding to the demographic characteristics, no statistically significant difference was found between the groups. Twelve of 39 (30.76%) PsA patients had CTS, whereas CTS was not detected in the control group (p=0.001). US and MRI showed increased median nerve CSA in PsA patients compared to healthy controls (p=0.005, p<0.001; respectively). Also, US and MRI showed increased median nerve CSA in CTS patients compared to others (p=0.002, p<0.001; respectively). The Pearson correlation coefficient between MRI and US measurements of the CSA was 0.85 (p<0.001)., Conclusion: CTS frequency in PsA patients is found higher than healthy controls. The relationship between CTS diagnosed by EDS and CSA measured by both US and MRI was observed in PsA patients., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported., (Copyright © 2023 by The Korean College of Rheumatology. All rights reserved.)

Background/objective: Behçet disease (BD) is not a single unique entity but a syndrome with different clinical phenotypes that can involve arterial and venous vessels of all sizes. To date, there has been no specific test or serum marker to measure and determine the severity of BD, and diagnosis remains based on clinical findings. This study aimed to assess lower extremity venous wall thickness (VWT) measured by ultrasound and laboratory findings and diagnostic performance in patients with BD., Methods: A total of 106 participants were recruited from the rheumatology department in this single-center, case-control study. Participants meeting the eligibility criteria were divided into healthy controls (n = 52) and BD (n = 54). The VWT values of the common femoral vein, great saphenous vein, and popliteal vein were measured using ultrasonography. Laboratory data were obtained from the electronic registration database. Venous wall thicknesses and laboratory findings in patients with BD and healthy subjects were compared., Results: Venous wall thickness of the lower extremity veins was higher in the BD group and higher in those with a history of deep vein thrombosis than in those without. The mean leukocyte, monocyte, erythrocyte sedimentation rate (ESR), C-reactive protein, plateletcrit (PCT), red cell distribution width (RDW), mean platelet volume (MPV) values, and monocyte-to-lymphocyte ratio (MLR) were higher in BD patients than in the control group. There was a correlation among increased VWT, ESR, PCT, MPV, RDW, and MLR., Conclusions: C-reactive protein, ESR, MPV, PCT, MLR, RDW, and VWT can be used to assist in the diagnosis of BD., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: The aim of this study was to investigate the wholeness, thickness, and elastography measurements of the iliopsoas tendon using shear wave elastography who underwent open reduction surgery for unilateral developmental dysplasia of the hip., Patients and Methods: Between January 2011 and December 2016, a total of 15 patients (2 males, 13 females; mean age: 24.6±26.3 months; range, 3 to 98 months) who underwent surgical treatment for unilateral DDH were retrospectively analyzed. In addition to demographic data, clinical findings such as muscle strength, range of motion, and the presence of limping were recorded. Ultrasound elastography was used to examine the thickness, shear wave velocity and elasticity of the iliopsoas tendons., Results: The mean follow-up was 92.6±30.2 (range, 44 to 120) months. Full range of motion of the hips was observed in all patients. Hip flexor muscles' strength was 5/5 in bilateral. No hip dislocation or limping was not detected in any of the patients. Ultrasound examinations revealed that tenotomized iliopsoas tendons were intact in all patients. The mean muscle thickness was lower in operated sides, indicating no statistically significant difference. The mean velocity and elasticity were statistically significantly higher in the operated sides., Conclusion: This is the first study using shear wave ultrasonography for iliopsoas tenotomy of the patients underwent open reduction for developmental hip dysplasia. Re-adhesion of the iliopsoas tendons provided wholeness while healing as a more rigid and thinner structure compared to the intact sides.

Purpose: The aim of this study was to investigate the efficacy of shear wave elastography (SWE) in the diagnosis of perforating vein insufficiency, and to determine the applicability of these measurements., Methods: A total of 140 symptomatic patients with a total of 280 lower extremities were investigated. All patients presented with venous insufficiency (VI) symptoms, and received Doppler ultrasound assessment to determine VI and SWE measurements. The SWE values were measured in the adjacent perivenous tissue of the largest Cockett's perforating vein (PV) of both lower extremities, at the level where they pass the fascia. The Cockett's PV diameter and the presence of reflux in Cockett's PV and the great saphenous vein were compared with SWE values in perivenous tissue of PVs., Results: The SWE values of the perforating vein insufficiency group were significantly higher than those of the normal PV without insufficiency group (P < 0.001). A significant and positive relation was seen between increased PV diameter and SWE values (P < 0.001) and there was a significant relationship between the presence of perforating vein insufficiency and increase in PV diameter. A statistically significant increase was detected in SWE values for the PV for those with reflux in the great saphenous vein (P < 0.001). The best cut-off values that can be used to detect perforating vein insufficiency were found 34.600 for kPa and 3.375 for m/s., Conclusion: SWE may be used effectively in addition to conventional Doppler ultrasound examination in diagnosing and following perforating vein insufficiency., (© 2020. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Objective: To assess coronary artery calcification (CAC) in patients with acute pulmonary embolism and determine whether this correlates with right ventricular dilation (RVD) and mortality., Methods: Computed tomography pulmonary angiography scans of 330 patients were used to perform retrospective assessment of the pulmonary artery computed tomography obstruction index (PACTOI), the right/left ventricle diameter ratio, the diameter of the pulmonary trunk, and the ordinal CAC score., Results: Age (P < 0.001), urea level (P < 0.001), D-dimer level (P = 0.006), diameter of the pulmonary trunk (P < 0.001), and PACTOI (P < 0.001) were significantly higher in the RVD-positive patient group. We found a significant relation between increased CAC score and increased mortality (P = 0.038). Left-sided CAC was detected much more often in RVD-positive patients (P = 0.008)., Conclusions: Coronary artery calcification is common in patients with acute pulmonary embolism, especially when those patients are also RVD-positive. A significant relation was found between RVD and left-sided CAC., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: To evaluate the diagnostic performance of the RSNA structured reporting language for chest CT findings in patients with COVID-19., Material and Methods: Patients with suspected COVID-19 who underwent chest CT and RT-PCR tests were enrolled consecutively in this retrospective study, regardless of symptoms. Imaging findings were categorized as "typical", "indeterminate", "atypical", or "negative" according to RSNA reporting language and compared to RT-PCR. "Single, round GGO" and "single, peripheral GGO," do not fit the reporting language, were also analyzed as "indeterminate" patterns., Results: Of the 1186 patients included in the analysis, the diagnosis of COVID-19 was confirmed in 388 patients. Of the 388 patients, CT findings were categorized as "typical" in 248, "indeterminate" in 77, and "negative" in 63. The sensitivity, specificity, and accuracy of "typical" findings were 63.9, 99.0, and 87.5% for COVID-19, respectively. In addition to the "typical" findings, the highest diagnostic accuracy of 92.2% was achieved when the "single, peripheral GGO" and "single, round GGO" were considered to be CT-positive., Conclusion: The RSNA reporting language has significant diagnostic performance for identifying COVID-19 pneumonia. CT findings that do not exactly fit the RSNA reporting language, such as "single, round GGO" and "single, peripheral GGO" improve diagnostic performance., (© 2021. Japan Radiological Society.)

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 <0.001]. When the cutoff value of the vascularization index is determined as 6.3, Graves' disease can be diagnosed with 83.8% sensitivity and 70% specificity., Conclusions: The vascularization index obtained with color superb microvascular imaging can be a quantitative indicator of parenchymal vascularity in the diagnosis of Graves' disease, and serve as a supportive tool., Competing Interests: Conflict of interest The authors do not report any financial or personal connections with other persons or organizations which might negatively affect the contents of this publication and/or claim authorship rights to this publication., (© Polish Ultrasound Society.)

Purpose: We aimed to investigate the use and effectiveness of Shear-Wave Elastography (SWE) in Hashimoto's Thyroiditis (HT) diagnosis and compare the SWE values in HT patients with asymptomatic volunteers., Methods: The thyroid gland parenchyma of 74 patients whose clinical and laboratory findings and ultrasonography (US) features were indicative of HT and 75 healthy, asymptomatic participants with normal laboratory values were examined using SWE. Their thyroid parenchymal echoes and thyroid gland volume were measured using B-mode US examination. Elastographic measurements were made by plotting the boundaries of thyroid gland by hand, using Free Region of Interest (ROI). The quantitative SWE values [meters/second (m/s) and kilopascal (kPa)] were compared betweent the patients and the controls. The correlation analyses between the SWE measurements and the autoantibodies [Anti-thyroid peroxidase antibody (TPOAbs) and anti-thyroglobulin antibodies (TgAbs)], thyroid-stimulating hormone (TSH), freetriiodothyronine (fT3), free-thyroxine (fT4), and thyroglobulin levels were performed., Results: The mean thyroid SWE measurement values of HT group were significantly higher than the asymptomatic group (p < 0.001). This study proposes 29.45 kPa or 2.77 m/s as a sensitive-spesific cut-off value for HT. We revealed significant positive association between SWE values and TgAb levels, gland volume, TgAb, TPOAb levels, and a significant negative association between SWE and echogenicity (p < 0.001)., Conclusion: In the assessment of HT, SWE is a highly sensitive imaging method to estimate the degree of fibrosis and to provide objective numerical values.

Purpose: The purpose of this study was to determine quantitative testicular tissue stiffness values in normal and infertile men using shear wave elastography (SWE), and to evaluate the relationship between infertility and testicular stiffness value., Methods: In total, 100 testes of 50 infertile patients with abnormal semen parameters were classified as group A, and 100 testes of 50 control subjects were classified as group B. These two groups were compared in terms of age, testicular volume, and SWE values. The group B testes were randomly chosen from patients who had applied for ultrasonography for any reason, and who had no testis disease and no history of infertility., Results: The mean age of the patients was 27.83 years, and no significant difference in age was found between the groups (P = 0.133). No significant difference in testicular volume was found between the groups (P = 0.672). The SWE values were significantly higher in group A than in group B (P = 0.000 for both m/s and kPa values). SWE values had a negative correlation with mean testicular volume in group A (for m/s values: P = 0.043; for kPa values: P = 0.024)., Conclusion: SWE can be a useful technique for assessing testicular stiffness in infertile patients to predict parenchymal damage in testicular tissue that leads to an abnormality in sperm quantity. In addition, decreased testicular volume, together with increased SWE values, can reflect the degree of parenchymal damage.

Aim of the study: This study aimed to examine the role of superb microvascular imaging and shear wave elastography for the pre-surgical evaluation of common parotid tumors. Material and methods: This single-center prospective study included 37 patients with parotid gland lesions. After institutional review board approval, grayscale, shear wave elastography and superb microvascular imaging ultrasound examinations were performed prior to biopsy or operation. The diagnosis of the lesions was based on cytological/pathological evaluation after the ultrasound examinations. Pleomorphic adenomas and Warthin tumors were compared using the Mann-Whitney U test. A receiver operating characteristic curve analysis was performed to obtain a cut-off value. A multivariate regression analysis was carried out. Results: The mean age of the patients (11 female, 26 male) was 48.2 ± 18. The shear wave elastography parameters of the lesions were not significantly different between pleomorphic adenomas and Warthin tumors, while the vascular index obtained by using superb microvascular imaging was significantly different ( p = 0.012). The mean vascular index was 2.9 ± 3.1 in pleomorphic adenomas, and 9.5 ± 9.5 in Warthin tumors. A cut-off value of 4.05 for the vascular index discriminated pleomorphic adenoma and Warthin tumors with 68% sensitivity and 72% specificity (the area under the curve was 0.768). Conclusion: Superb microvascular imaging is a novel ultrasound imaging technique which is useful for the discrimination of pleomorphic adenomas and Warthin tumors., (© Polish Ultrasound Society.)

Objective: Carbon monoxide (CO) poisoning is one of the most common poisonings worldwide. The affinity of hemoglobin for CO is significantly higher than that for oxygen, and the formation of carboxy-hemoglobin leads to a decrease in the capacity of blood to transport oxygen to tissues, tissue hypoxia, and early perfusion changes in the affected tissue. This study aimed to investigate the utility of arterial spin labeling perfusion imaging (ASL-PI) in revealing cerebral vascular hemodynamic changes in patients presenting to the emergency room with CO poisoning and to compare findings with those from diffusion-weighted imaging (DWI)., Method: This study was conducted between November 2016 and May 2019 and was approved by the local ethics committee. DWI and ASL-PI examinations were performed in 83 patients who presented to the emergency room with CO poisoning. Four regions-the cerebral cortex, basal ganglia, cerebral white matter, and cerebellum-were evaluated for alterations in perfusion and diffusion, and findings from DWI and ASL-PI were compared., Results: The study group included 39 (50.6%) females and 38 (49.4%) males, with a mean (±SD) age of 40.08 ± 20.41 years (range, 7-86 years). DWI revealed restricted diffusion in 10 regions in 6 (7.8%) patients, including the basal ganglia (n = 2), cerebral white matter (n = 2), cerebral cortex (n = 3), and the cerebellum (n = 3). ASL-PI revealed hypo-perfusion in 64 regions in 36 (46.8%) patients, including the basal ganglia (n = 21), cerebral white matter (n = 12), cerebral cortex (n = 23), and cerebellum (n = 7)., Conclusion: ASL-PI provided additional information when used to identify perfusion changes in the brains of individuals who experienced CO poisoning and was superior to DWI as it revealed early changes in the brain. Considering its limitations, ASL-PI can be routinely used with DWI in cases of CO poisoning., Competing Interests: Declaration of competing interest The authors declare that there are no financial or other relations that could lead to a conflict of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)