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Introduction: We aimed to reveal the current status of high-resolution magnetic resonance imaging (HR-MRI) and its potential to identify different intracranial vessel wall pathologies. We also aimed to investigate the diagnostic performance of contrast-enhanced HR-MRI T1-SPACE sequence in determining vessel wall pathologies and to determine its contribution to conventional methods. Methods: We retrospectively reviewed HR-MRI images of 33 consecutive patients with 30% or above stenosis based on clinical, digital subtraction angiography (DSA), computed tomography angiography (CTA), and magnetic resonance angiography (MRA) evaluations. All patients had a history of stroke, and 33 stenotic vessel segments in anterior-posterior circulation were reviewed. On HR-MR images, plaque eccentricity, presence or absence of intraplaque hemorrhage, contrast enhancement pattern, and plaque length were evaluated. As causes of atherosclerosis, the presence of diabetes mellitus, hemoglobin A1c, total cholesterol, trigylicerid, and high-density lipoprotein levels, history of smoking, history of taking statin drugs, and hemoglobin levels were acquired, and the correlation between these variables and plaques labeled as stable or unstable in these patients was investigated. Results: Atherosclerosis was observed in 29 of the 33 cases included in our study, and stenosis in intracranial vascular structures due to moyamoya disease was observed in 4 cases. In patients with intracranial stenosis secondary to moyamoya disease, diffuse concentric homogeneous enhancement was observed within the vessel wall in the prestenotic artery segment. In patients with stenosis due to atherosclerosis, increased heterogeneous enhancement was observed within the atheroma plaque. A significant correlation was observed between eccentric-concentric plaque and atherosclerotic segment length. Conclusion: The vessel lumen can be evaluated using CTA, MRA, and DSA, but the vessel wall cannot be evaluated using these traditional techniques. Vessel wall imaging is helpful for identifying atheromas in intracranial and cervical carotid arteries, and for determining the morphologies of vessel walls and the surrounding structures. [ABSTRACT FROM AUTHOR]

Objectives: In this retrospective study, we evaluated the effectiveness of the tumor volume, grade invasion depth in the prediction of cervical lymph node metastasis. Identification of diagnostic parameters reliably predicting cervical lymph node involvement can be useful in improving the management of laryngeal cancer. Methods: One hundred and seven patients with squamous cell carcinoma of larynx and who underwent surgery were assessed retrospectively. Age, sex, Tumor-Node-Metastasis (TNM) stage, grade, invasion depth and computerised tomography (CT) volume of the tumors were analysed. The association between these parameters and cervical lymph node metastasis was determined. Results: Thirty two patients (29.91%) had positive cervical lymph nodes. Lymph node metastasis is detected in 13 (46.43%) poorly differentiated tumors, and in 19 (24.05%) moderate-well differentiated tumors. Mean volume was 2.15±0.14 cc in lymph node negative patients and 2.97±1.05 cc in lymph node positive patients. Mean invasion depth was 10.1±0.87 mm in lymph node negative patients and in 11.3±1.05 mm lymph node positive patients. The tumor grade and volume predicted successfully lymph node metastasis in patients with squamous cell carcinoma of the larynx, however invasion depth was not associated with nodal metastasis (p=0.047, p=0.0022, p=0.916, respectively). Conclusion: The tumor grade and volume could predict cervical lymph node metastasis in patients with squamous cell carcinoma of the larynx, whereas the depth of invasion did not. Calculation of the tumor volume radiologically can help predict lymph node metastasis by minimizing the variability in measurements such as the depth of invasion. [ABSTRACT FROM AUTHOR]

Aim: We examined the relationship between shear wave elastography (SWE) values and histopathological results in our study. Thus, we found the sensitivity of SWE in demonstrating early fibrosis. Materials and Methods: A total of consecutive 70 patients with chronic hepatitis B were prospectively evaluated. The patients included in fibrosis stages (F) 0, 1, 2, 3 and 4 according to Ishak scoring were examined with SWE. SWE measurements of F2, F3 and F4 patients who were found to have early stage fibrosis were compared with those of F0 and F1 patients. Results: The velocity+SD, and kPa+SD values in the group requiring treatment (F2, F3 and F4) were significantly higher than the group not requiring treatment (F0 and F1) (p < 0.05). The sensitivity rate of the 1.85 cut-off value for velocity+SD was 53.8%, the positive prediction rate was 80.8%, the specificity rate was 83.3%, and the negative prediction rate was 58.1%. For kPa+SD, the cutoff value of 10.8 had a sensitivity rate of 51.3%, a positive prediction rate of 95.2%, a specificity of 96.7%, and a negative predictive rate of 60.4%. A significant correlation was observed between the fibrosis score and the kPa+SD distribution. Conclusion: SWE can differentiate the patients requiring treatment (F2, F3 and F4) from the patients not requiring treatment. [ABSTRACT FROM AUTHOR]

Aim: We aimed to evaluate the effectiveness of combining 2-dimensional shear wave elastography (2D-SWE) with ultrasonography (US) in diagnosing acute appendicitis in patients with suspected acute appendicitis. Methods: Clinical and laboratory findings, gray-scale US and 2D-SWE imaging features, operation information, and pathology results of 48 patients diagnosed with acute appendicitis who presented with right lower quadrant pain were prospectively evaluated. We compared the findings to the US and SWE imaging features of 79 asymptomatic patients. Results: Mean Alvarado score and appendix diameter were statistically significantly higher for acute appendicitis (p < 0.001). In patients with acute appendicitis, mesenteric lymphadenopathy and fat stranding were also more frequent (p < 0.001). The mean velocity and kPa values for appendix and mesenteric fat were statistically significantly higher in acute appendicitis (p < 0.001). Conclusion: In the diagnosis of acute appendicitis, 2D-SWE increases the diagnostic performance of gray-scale US in the differentiation of inflamed and normal appendixes. [ABSTRACT FROM AUTHOR]

Objective: This retrospective study reveals whether a lesion is a benign pathological process or malignant by measuring apparent diffusion coefficient (ADC) values following prostate imaging reporting and diagnostic system version 2.1 (PI-RADSv2.1) guide on multiparametric magnetic resonance imaging (MpMRI) examinations. Furthermore, this study aims to determine the cut-off ADC values (ADCv) that may exist to help identify and distinguish between benign and the malignant lesions. Additionally, the paper evaluates whether there is a correlation between malignant lesions' International Society of Urological Pathology (ISUP) score and ADCv, and whether ADCv provide information about prostate cancer (PCa) aggressiveness without requiring invasive procedures. Materials and Methods: The study group consised of 243 patients. The lesions were diagnosed using transrectal ultrasound-guided cognitive MRI fusion. MpMRI images before the biopsy were evaluated according to PI-RADSv2.1 guideline by a radiologist. Three groups, benign prostatic tissue, prostatitis, and PCa were obtained according to the histopathological results. Results: When the cut-off value for ADC was 780x10-3, sensitivity was 80%. When the cut-off value was taken as 668x10-3, the sensitivity and specificity were 72% and 62%, respectively. When the cut-off ADCv was taken as 647x10-3, the sensitivity was 83% and the specificity was 48.5%. ADCv varied significantly depending on the ISUP groups (p=0.003). It was determined that the ISUP 1 group was significantly higher compared to other groups. ADC group mean values were not significantly different between groups 2, 3, 4, and 5. Conclusion: ADCv may be a suitable tool for estimating PCa aggressiveness, and it shows a significant potential to improve the diagnostic accuracy. [ABSTRACT FROM AUTHOR]

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Background: Insall-Salvati index (ISI) is widely used to evaluate patella position, the specific relationship between quadriceps patellar tendon angle (QPA) and patellofemoral measurements remains unclear. Understanding this relationship could provide valuable insights into diagnosing and treating knee pain, instability, and patellofemoral pathologies more effectively. In this study, we aimed to assess whether there was a significant difference between the patients with patella alta and baja in terms of many patellofemoral measurements and pathologies. Furthermore, we evaluated a newly described QPA., Methods: A retrospective cross-sectional study including 446 patients who underwent knee magnetic resonance imaging (MRI) between 2019 and 2021 in Basaksehir City Hospital was conducted. Two hundred and five patients were divided into two groups according to their ISI (ISI >1.3 and ISI <0.8). The patellar tendon length, patellar height, patella angle, lateral patellar tilt angle (LPTA), patella-patellar tendon angle (PPTA), QPA, medial and lateral trochlear inclination, patella angle, trochlear sulcus angle (TSA), trochlear groove depth (TGD), medial and lateral trochlea length (LT), medial trochlea length (MT) and LT ratio and tibial tubercle-trochlear groove distance, fat-pad edema, chondromalacia and effusion were evaluated. Whether the measurement or presence of pathology differed significantly according to ISI were investigated. The difference between two arithmetic means were analyzed with T -test. The Mann-Whitney U test were used for assessing the difference between two independent groups and to determine difference or equality between groups., Results: When the groups with ISI >1.3 and <0.8 were compared with each other in terms of measurements, patellar tendon length, tibial tubercle-trochlear groove distance, LPTA, PPTA, QPA were found to be significantly higher in the group with ISI >1.3 (P<0.05). Patellar height and TGD were significantly greater in the group with ISI <0.8 (P<0.001, P=0.007). Patellar tendon length, patellar tendon height, tibial tubercle-trochlear groove distance, patella angle, TGD, MT and LT, PPTA, QPA, medial trochlear inclination values and frequency of fat-pad edema were significantly higher in men (P<0.001). The ISI, TSA and frequency of chondromalacia was found to be significantly higher in women (P<0.001)., Conclusions: Major angles such as LPTA, PPTA, patellar tendon length, tibial tubercle-trochlear groove distance and QPA were increased in the group with patella alta. The patients with patella baja have higher patellar height and TGD., Competing Interests: Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-1722/coif). The authors have no conflicts of interest to declare., (2024 AME Publishing Company. All rights reserved.)

Background and Purpose: Given their overlapping features, pituitary metastases frequently imitate pituitary neuroendocrine tumors in neuroimaging studies. This study aimed to distinguish pituitary metastases from pituitary neuroendocrine tumors on the basis of conventional MR imaging and clinical features as a practical approach., Materials and Methods: In this 2-center retrospective study, backward from January 2024, preoperative pituitary MR imaging examinations of 22 pituitary metastases and 74 pituitary neuroendocrine tumors were analyzed. Exclusion criteria were as follows: absence of a definitive histopathologic diagnosis, history of pituitary surgery or radiation therapy before MR imaging, and pituitary neuroendocrine tumors treated with medical therapy. Two radiologists systematically evaluated 13 conventional MR imaging features that have been reported more commonly as indicative of pituitary metastases and pituitary neuroendocrine tumors in the literature. Age, sex, history of cancer, and maximum tumor size constituted the clinical/epidemiologic features. The primary cancer origin for this study was also noted. Univariable and multivariable logistic regression was used for the selection of variables, determining independent predictors, and modeling. Interobserver agreement was evaluated for all imaging parameters using the Cohen κ statistic or intraclass correlation coefficient., Results: A total of 22 patients with pituitary metastases (8 women; mean age, 49.5 [SD, 13] years) and 74 patients with pituitary neuroendocrine tumors (36 women; mean age, 50.1 [SD, 11] years) were enrolled. There was no statistically significant distributional difference in age, sex, or maximum tumor size between the 2 groups. Lung cancer (9/22; 41%) was the most commonly reported primary tumor, followed by breast (3/22; 13.6%) and unknown cancer (3/22; 13.6%). Logistic regression revealed 3 independent predictors: rapid growth on control MR imaging, masslike or nodular expansion of the pituitary stalk, and a history of cancer. The model based on these 3 features achieved an area under the curve, accuracy, sensitivity, specificity, and Brier score of 0.987 (95% CI, 0.964-1), 97.9% (95% CI, 92.7%-99.8%), 95.5% (95% CI, 77.2%-99.9%), 98.6% (95% CI, 92.7%-100%), and 0.025, respectively., Conclusions: Two conventional features based on pituitary MR imaging with the clinical variable of history of cancer had satisfying predictive performance, making them potential discriminators between pituitary metastases and pituitary neuroendocrine tumors. In cases in which differentiation between pituitary metastases and pituitary neuroendocrine tumors poses a challenge, the results of this study may help with the diagnosis., (© 2024 by American Journal of Neuroradiology.)

Background: To evaluate the hysterosalpingography (HSG) findings of women with infertility in a tertiary center located in central Turkey., Methods: A total of 1,996 patients undergoing the HSG procedure for the investigation of infertility from April 2012 to 2017 were retrospectively evaluated using the archives of the reproductive endocrinology and radiology departments. Demographic and clinical characteristics of patients with normal HSG findings (n = 1,549) and patients with abnormal HSG findings (n = 447) were compared, and the distribution of pathologies on the HSG examinations was evaluated as well., Results: There were statistically significant differences between patients with normal and abnormal HSG findings in terms of age (25.68 ± 4.54 vs. 35.87 ± 2.65, p < 0.001), type (for secondary) and duration of infertility [43.1% vs. 50.6% (p = 0.006); 7 (1-22) vs. 2 (1-12) (p < 0.001), respectively], and baseline follicle stimulating hormone and estradiol levels [7.22 ± 1.38 vs. 7.55 ± 1.42 (p < 0.001); 45.54 ± 9.92 vs. 44.40 ± 9.99 (p < 0.001), respectively]. Among a total of 1,996 HSG examinations, 447 (22.39%) showed abnormalities, of which 237 (11.87%) were associated with tubal pathologies, 163 (8.17%) with uterine pathologies, and 47 (2.35%) with a combination of both. While the most common tubal pathology was one-sided distal tubal occlusion (2.91%), the most common uterine pathology was filling defects (4.16%)., Conclusion: HSG is the most commonly used, well-tolerated, low-cost, and safe radiological procedure to use for the investigation of the causes of female infertility., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)