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Conjoined twins are a rare and often catastrophic obstetrical event. Although ultrasonography is widely used in the diagnosis of conjoined twins, it may fail to demonstrate the details in fetuses with complex anomalies, especially during late pregnancy. We present an omphalopagus conjoined twins case evaluated by HASTE magnetic resonance imaging, which showed the conjunction site and cranial anomalies, and aided antenatal counseling and neonatal surgical planning.

Introduction: The purposes of this study were to describe and adapt the relevant methods of computed tomography (CT) and stereology to estimate parasitic volume in the liver, to compare the efficiency of benzimidazole treatment in hepatic alveolar echinococcosis (AE), and to determine whether the response rates measured by the stereological method are correlated with those measured by simple volumetric measurements (SVM)., Methods: Nine eligible patients with non-resectable AE were included in the study. By using their abdominal CT at the baseline and after a year of treatment, treatment responses of the cases were evaluated both by the stereological method via a software and by SVM, retrospectively. The volume estimation was performed in our study using a different approach that consisted of three separate stages combined with the Cavalieri method of modern design stereology., Results: The response rates were -17 +/- 55% and -12 +/- 37% by the Cavalieri method and SVM, respectively; however, they were not statistically significant (P = 0.59 and 0.21 for the Cavalieri method and SVM, respectively). Although some cases had comparable results, others had different response rates, and the two methods showed no significant correlation (r = -0.31, P = 0.41)., Conclusions: Because this modified method provides accurate results by reducing margin of errors, even in case of bizarre shape of AE, a correct, unbiased, and reliable management of the cases with AE via this method may be possible. Owing to lack of a correlation with SVM, it is suggested that a measurement via SVM may be wrong and its use in the evaluation of the treatment response in such cases will not be sufficient and completely true.

Objective: An anomalous origin and course of the coronary arteries can be benign or life threatening. Recently, because of new advances in computed tomography technology, radiologists have begun to interpret the diseases of coronary arteries. We aimed to demonstrate some remarkable anomalies of coronary arteries, some of which were not shown by multidetector computed tomography (MDCT) coronary angiography previously, and to discuss the clinical importance of these anomalies., Materials and Methods: Seven hundred twenty-five consequent patients referred to Florence Nightingale Hospital and Atatürk University Hospital for MDCT coronary angiography were included in this study. The patients were between the ages of 33 and 78 years (mean +/- SD, 59 +/- 13.86 years). Four hundred ninety-seven patients (68.6%) were men, and 228 (31.4%) were women. All the examinations were evaluated by both a radiologist and a cardiologist., Results: The incidence of anomalous anatomical origin and course of the coronaries found in our study group was 5.79% (n = 42). The anomalies found in our study are absence of the right coronary artery (RCA; n = 1, 0.13%), ectopic origin of RCA from the left anterior descending (LAD) artery (n = 1, 0.13%), absence of the left main coronary artery (n = 4, 0.52%), ectopic origin of the left main coronary artery from the right sinus of Valsalva (n = 1, 0.13%), double LAD and ectopic origin of LAD from RCA (n = 1, 0.13%), ectopic origin of the left circumflex artery from the right sinus of Valsalva (n = 3, 0.39%), ectopic origin of the left circumflex artery from RCA (n = 2, 0.26%), and myocardial bridging (n = 29, 4%)., Conclusions: An anomalous origin of the coronary anatomy must be present in the interpretations because of its importance for patients, cardiologists, and surgeons. As a conclusion, our study showed that MDCT, especially volume rendering and maximum intensity projection techniques, may be useful for assessment of complex variations, when the conventional angiography may not be sufficient.

Objective: The aim of this study was to evaluate the incidence of myocardial bridging in 626 patients examined with MDCT angiography of the coronary arteries., Materials and Methods: Six hundred twenty-six patients who were referred to Florence Nightingale and Atatürk University Hospitals were involved in this study. These patients had atypical chest pain, symptoms suggestive of coronary artery disease, or no significant cardiac complaint. Patients were in sinus rhythm and were premedicated with metoprolol tartrate (5 mg/mL IV bolus) to decrease the heart rate and nitroglycerin (5 mg sublingual 1 min before the examination) to dilate the coronary arteries. MDCT was performed on two different 16-MDCT scanners., Results: Among the 626 patients, 22 cases (3.5%) of myocardial bridging were detected. Fifteen cases of myocardial bridging (2.4%) were located at the middle third of the left anterior descending coronary artery (LAD), five (0.8%) were at the distal third of the LAD, and two (0.3%) were at the proximal third of the LAD. In these patients, the length of tunneled artery was between 6 and 22 mm, with a mean of 17 mm, and the depth of tunneled artery was between 1.2 and 3.3 mm, with a mean of 2.5 mm., Conclusion: We found the incidence of myocardial bridging in this patient group to be 3.5%. This result is in agreement with some of the angiographic studies in the literature. Our study showed that MDCT is a reliable and noninvasive tool for diagnosing coronary myocardial bridging. After evaluating resource axial images, it is necessary to also evaluate the sagittal multiplanar reconstruction images for myocardial bridging.

Objective: To evaluate whether images obtained during the reconstruction window responding to the isovolumic relaxation period could be used for rapid and easy postprocessing., Methods: One hundred ten consecutive patients with suspected coronary artery disease who had previously had a multidetector computed tomography (MDCT) scan for imaging coronary arteries were enrolled in this study. The age of the patients was 59 +/- 13 years (range: 33-78 years), and 77 (70%) were male. Multidetector computed tomography was performed on a 16-detector-row computed tomography scanner during 1 breath hold (16-24 seconds). Seven different sets of images reconstructed at every 10% of the R-R interval from 30% to 90% for contrast-enhanced scans at levels containing the first several centimeters of the left and right coronary arteries were analyzed. The best of these reconstruction windows were then compared with the images reconstructed at the isovolumic relaxation period, which is the last portion of the T wave at the end of the systole, where there is not any change in ventricular volume, which causes stepladder artifacts. The step artifact was classified as excellent, good, or poor. Image quality was assessed by 2 radiologists who were not aware of each other's interpretation., Results: According to the routinely used reconstructions, there were 76 patients with excellent image quality, 28 with good image quality, and 6 with poor image quality. For the period of isovolumic relaxation, there were 74 patients with excellent image quality, 25 with good image quality, and 11 with poor image quality., Conclusion: If one begins image analysis with the isovolumic relaxation period reconstruction window, spending less time for postprocessing analyses, good image quality can be obtained such as with other good reconstruction windows.

This article compared the efficiency of the mass screening test with projected color slides in detecting color-blindness with the authentic classic method of Ishihara. The study was conducted in a randomly selected lecture room with 104 students aged between 19-25 years (median 21). Using Ishihara projected slides, performed mass screening test. Re-testing was done individually with printed Ishihara plates. Six male and one female with color-blindness were detected. The frequency of color-blindness was 13.6% among males, with a total incidence of 6.7%. The results of two testing methods were compared statistically. Sensitivities and specificities of both tests were 100%. Using projected slides of Ishihara plates instead of the authentic method is an effective and timesaving method for detecting color-blindness. This method can be suggested as a mass-screening test and might be beneficial in detecting color-blindness in large populations such as students, soldiers, and so on.

Time-of-flight (TOF) magnetic resonance venography (MRV) is often used to examine the intracranial dural sinuses, particularly in the evaluation of dural sinus thrombosis. The goal of the study was to evaluate the use of TOF MRV in assessing the normal anatomy of dural sinuses and their variations as sources of potential pitfalls in the diagnosis of venous sinus thrombosis. Cerebral TOF MRV obtained in 105 persons with normal MR studies were reviewed to determine the presence, aplasia and hypoplasia of the transverse sinuses. Twenty-one (20%) aplasias of the left sinus, 41 (39%) hypoplasia of the left sinus, 33 (31%) symmetric, 6 (6%) hypoplasia of the right sinus, and 4 (4%) aplasias of the right sinus cases were determined in the asymmetry in sizes of transverse sinuses. These results suggested that transverse sinus flow gaps or aplasias can be observed in approximately 24% of normal population on MR imaging. The rate of these gaps in normal subjects must be kept in mind because it can be a source of misdiagnosis in cases of suspected dural sinus thrombosis., (Copyright 2004 S. Karger AG, Basel)