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Amaç: Çalışmamızın amacı kronik böbrek hastalığında (KBH), böbrek fonksiyonlarının tespitinde difüzyon ağırlıklı manyetik rezonans görüntülemenin (DAG) tanısal etkinliğini araştırmaktır.Gereç ve Yöntem: 74 kronik böbrek hastası ve 50 sağlıklı birey olmak üzere toplam 124 kişi çalışmaya dahil edildi. Hasta ve kontrol grubunda her iki böbrekten, DAG kullanılarak görünürdeki difüzyon katsayısı değerleri (GDK) ölçüldü. Ortalama GDK değerleri hasta ve sağlıklı grup arasında karşılaştırldı. Ayrıca KBH’nın evrelerine göre GDK değerlerinde meydana gelebilecek değişiklikler ve glomerüler filtrasyon hızı (GFH) ile GDK değerleri arasındaki ilişki değerlendirildi. KBH’nı belirlemede, farklı eşik GDK değerlerinin tanısal etkinliğini araştırmak için ROC eğrisi düzenlendi. Bulgular: GDK değerleri KBH’lı grupta, sağlıklı gruba göre belirgin oranda düşük bulundu ve KBH’nın evresi ilerledikçe GDK değerlerinde anlamlı bir düşüş tespit edildi. Ayrıca GDK ve GFH değerleri arasında kuvvetli pozitif korelasyon saptandı (r= 0.746, p < 0.001). ROC analizine göre, KBH’nı belirlemek için ortalama eşik GDK değeri

WOS:000417367100013 PubMed: 29386979 A 26-year-old female patient with Type 1 Gaucher's disease (GD) was admitted to our clinic with complaints of stomachache and signs of anemia. The patient underwent ultrasonography (US), computerised tomography (CT), and magnetic resonance imaging (MRI) scan. Imaging studies revealed massive hepatosplenomegaly, choledocolithiasis, and six nodules in the spleen with a mean size of 14 mm. The nodules appeared hyperechoic, hypoechoic, and of mixed echogenicity on the US and hypodense on the CT. While the nodules were observed to be iso-hypointense in T1-weighted (T1WI) images, they appeared to be hyperintense in the T2weighted (T2WI) images. There were no diffusion restrictions in these nodules that appeared on the diffusion-weighted magnetic resonance imaging (DWI). A nodule located at the lower pole was observed to be hypointense in the T2WI images. The nodule located at the lower pole, which appeared hypointense in T2WI series, had restricted diffusion upon DWI. In this study, we aimed to present the properties of splenic GD nodules using US, CT, and conventional MRI, together with DWI. This case report is the first to apply US, CT, and conventional MRI, together with DWI, to the splenic nodules associated with Gaucher's disease.

Background: Identifying the craniofacial abnormalities that cause snoring and the narrowest area of the upper airway creating obstructions can help determine the proper method of treatment.This study aims to identify the factors that can cause snoring and the areas of the airway that are the most likely to collapse with upper airway imaging. Materials and methods: Axial pharynx examinations with (compterized tomography) CT and magnetic resonance imaging (MRI) were performed to 38 patients admitted to hospital with the complaint of snoring and 12 patients who did not have complaint of snoring. The most narrow areas of nasopharynx, hypophranyx, oropharynx, bilateral parapharyngeal fat pad and parapharyngeal muscle thickness of airway were measured. All measurements were compared in snoring patient and control group in MRI and CT. Results: In patients with snoring, the most narrow part of upper airway was retropalatal region in oropharynx in both imaging methods and the other regions were found to be different when they were compared with control group in MRI and CT. When patients with snoring and control group were compared BMI, neck diameter was greater in patients with snoring and area of oropharynx was markedly narrow. We determined that in dynamic examinations when the parafaringeal muscle thickness increased, medial-lateral airway diameter and oropharynx area were decreased. Conclusions:. The narrowest section of the airway is the retropalatal region of the oropharynx in both CT and MRI. Therefore the most important zone affecting snoring is the retropalatal region

WOS:000423752200014 PubMed: 28853814 Purpose: Congenital and acquired pathologies of the seminal vesicles (SV) are rare diseases. The diagnosis of SV anomalies is frequently delayed or wrong due to the rarity of these diseases and the lack of adequate evaluation of SV pathology. For this reason, we aimed to comprehensively evaluate SV pathologies and accompanying genitourinary system abnormalities. Materials and Methods: Between March 2012 and December 2015, 1455 male patients with different provisional diagnosis underwent MRI. Congenital and acquired pathology of the SV was identified in 42 of these patients. The patients were categorized according to their SV pathologies. The patients were analyzed in terms of genitourinary system findings associated with SV pathologies. Results: SV pathologies were accompanied by other genitourinary system findings. Congenital SV pathologies were bilateral or predominantly in the left SV. Patients with bilateral SV hypoplasia were diagnosed at an earlier age compared to patients with unilateral SV agenesis. There was a significant association between abnormal signal intensity in the SV and benign prostate hypertrophy (BPH) and patient age. Conclusion: SV pathologies are rare diseases of the genitourinary system. The association between seminal vesicle pathology and other genitourinary system diseases requires complete genitourinary system evaluation that includes the seminal vesicles.

Tibialis anterior kası herniasyonu alt ekstremitede en sık rastlanan kas herniasyonudur. Bu çalışmada tibialis anterior kası herniasyonu olan bir olgunun MRG bulgularını literatürü gözden geçirerek sunmayı amaçladık. 49 yaşında erkek hasta sağ bacakta iki yıldır devam eden ağrı ve ele gelen kitle şikayetleriyle başvuran hastaya sağ kruris MRG tetkiki yapıldı. Yapılan kruris MRG’de sağ tibialis anterior kası herniasyonu saptandı. Kas herniasyonu asemptomatik olabileceği gibi subkutanöz nodül, ilgili bölgede deri renginde değişim ya da ağrı şikayetiyle gelebilir. Anterior tibialis kası herniasyonu, lipom, anjiyolipom, fibrom, ya da varis gibi yumuşak doku patolojilerinden ayırt edilmelidir.

Ankarali, Handan Camdeviren/0000-0002-3613-0523 WOS: 000338109400014 PubMed: 24818628 Objective: In this study, we aimed to research the relation between breast arterial calcifications (BACs) detected on mammography and two well-known markers of cardiovascular diseases-carotid artery intima-media thickness (C-IMT) and haemodynamics parameters like carotid peak-systolic velocity (PSV), end-diastolic velocity (EDV) and resistive index (RI). Methods: The study group consisted of 50 consecutive BAC (+) women and the control group consisted of 55 BAC (-) women. In all participants, BAC was diagnosed using mammography and C-IMT was measured using B-mode and Doppler ultrasonography. BAC was defined as two linear calcification depositions in a conical periphery or as calcific rings at the mammographic evaluation. Doppler spectrum samples were obtained from 2 cm proximal to the main carotid artery bifurcation. Results: Postmenopausal female patients ranging in age from 40 to 86 included in this study. When the groups were adjusted for age, a statistically significant difference was found between mean C-IMT of BAC (+) and BAC (-) groups (0.81 +/- 0.2 vs. 0.69 +/- 0.2 mm; p

Several cases of appendicitis after blunt abdominal trauma have been reported in the literature. Whether there is a causative relationship between these two entities has long been a subject of debate. In the diagnosis of acute appendicitis, a well-received history and a good physical examination is very important. However, history and physical examination findings on cases of after blunt abdominal trauma may be misleading. Therefore, in these cases the symptoms associated with trauma may delay the diagnosis of acute appendicitis. We report a case of posttraumatic appendicitis and discuss possible pathogenetic mechanisms., Literatürde travma sonrası tanımlanmış, akut apandisit vakaları mevcuttur. Bununla birlikte travmanın akut apandisitin nedenlerinden biri olup olmadığı hala tartışma konusudur. Akut apandisit tanısında, iyi alınan bir anamnez ile yapılacak dikkatli ve iyi bir fizik muayene oldukça önemlidir. Ancak posttravmatik bir olguda anamnez ve fizik muayene bulguları yanıltıcı olabilmektedir. Bu nedenle bu olgularda semptomların travma ile ilişkilendirilmesi akut apandisit tanısını geciktirebilir. Biz künt batın travması sonrası akut apandisit tanısı konulan bir olguyu ve olası patolojik mekanizmalarını sunmayı amaçladık.

The aim of this study is to investigate the effectiveness of placental strain ratio (SR) values measured by real-time sonoelastography (SE) in the second trimester in the prediction of spontaneous preterm birth (sPTB).This study included 70 pregnant women who applied to our clinic for routine second-trimester screening. Placental SR measurements were performed with the SE method. Two different SR measurements were performed by taking two different tissues as references. The SR value measured when taking the rectus abdominis muscle as a reference was termed the muscle-to-placenta strain ratio (MPSR), while the SR value measured when taking subcutaneous tissue as a reference was termed the fat-to-placenta strain ratio (FPSR). Women whose gestational age at birth was less than 37 weeks 0 days were accepted as sPTB. The association between gestational age at birth and MPSR and FPSR was investigated. Receiver operating characteristics analysis was used to calculate the sensitivity and specificity of the elastographic outcomes.There was a low-level negative correlation between MPSR and gestational age at birth (r=-0.300, P=.012) and there was a moderate-level negative correlation between FPSR and gestational age at birth (r=-0.513, P.001). The multivariate linear regression analysis showed that the FPSR (β=0.609, P=.002) was the significant predictor for the sPTB.Our data indicate that the FPSR value measured with real-time SE in the second trimester of pregnancy may be effective in the prediction of sPTB.

Krukenberg tumour is a ovarian metastatic tumor. Its most frequently seen primary malignancy focus is stomach and breast, gallblader, colon and pancreas cancers can metastasize, too. Ovarian metastasis is seen very rarely. In patients whose primary malignancy focus is not known, it is not always possible to distinguish ovarian metastasis from ovarian masses. Magnetic resonance imaging (MRI) findings of the patient who had krukenberg tumor and for whom surgical intervention was planned due to the primary ovarian mass are presented in our case. It was seen in the result of the endoscopy applied after metastatic ovarian tumor diagnosis done by MRI that there was signet ring cell carcinoma in the stomach., Krukenberg tümörü overin metastatik tümörüdür. Primer malignite odağı en sık mide olmakla beraber meme, safra kesesi, kolon ve pankreas kanseri de overe metastaz yapabilmektedir. Over metastazı oldukça nadir olarak görülmektedir. Primer malignite odağı bilinmeyen hastalarda over metastazlarını primer over kitlelerinden ayırtedebilmek her zaman mümkün olamamaktadır. Bizim olgumuzda primer over kitlesi düşünülerek cerrahi planlanan, krukenberg tümörlü hastanın manyetik rezonans görüntüleme (MRG) bulguları sunulmuştur. Hastaya MRG ile konulan metastatik over tümörü tanısı sonrasında yapılan endoskopisinde midenin taşlı yüzük hücreli kanseri olduğu anlaşılmıştır.

Kontrast ilişkili nefropati (KİN) iyotlu kontrast ortama maruziyet sonrasında gelişebilen bir komplikasyondur. Genel popülasyonda KİN insidansının %2’den düşük olduğu tahmin edilmektedir, fakat yüksek riskli hastalarda KKn insidansınn %50 civarında olduğu bildirilmiştir. KİN’nin önlenmesinde ilk amaç yüksek riskli bireylerin tanımlanması ve ilişkili risk faktörlerinin kontrolüdür. Contrast-induced nephropathy (CIN) is a complication which may develop after exposure to iodinated contrast media. Incidence of CIN in the general population is estimated to be less than 2% but in high-risk patients CIN incidences have been reported approximately 50%. The first aim to prevent CIN is identifying high-risk subjects and controlling associate risk factors.

Tüm kolonik divertiküllerin yaklaşık %5 kadarı sağ kolon ve çekum yerleşimlidir. Sağ kolonda özellikle çekum yerleşimli divertiküller akut apendisitin preoperatif değerlendirilmesinde yanlış tanı konmasına neden olabilir. Bu iki antitenin tedavi modaliteleri tamamen farklı olduğundan ayırıcı tanı önemlidir

Imaging of the chronic type A aortic dissection by transthoracic and transesophageal echocardiogram

WOS:000408211500011 PubMed: 28765740 Background and Objectives: Systemic inflammation has an important role in the initiation of atherosclerosis, which is associated with arterial stiffness (AS). Aortic flow propagation velocity (APV) is a new echocardiographic parameter of aortic stiffness. The relationship between systemic inflammation and AS has not yet been described in patients with familial Mediterranean fever (FMF). We aimed to investigate the early markers of AS in patients with FMF by measuring APV and carotid intima-media thickness (CIMT). Subjects and Methods: Sixty-one FMF patients (43 women; mean age 27.3 +/- 6.7 years) in an attack-free period and 57 healthy individuals (36 women; mean age 28.8 +/- 7.1 years) were included in this study. The individuals with atherosclerotic risk factors were excluded from the study. The flow propagation velocity of the descending aorta and CIMT were measured to assess AS. Results: APV was significantly lower (60.2 +/- 16.5 vs. 89.5 +/- 11.6 cm/sec, p

Purpose Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease can result in mortality varying from 3.0% to 50.0%. In this study, we wished to discuss computed tomography (CT) findings together with clinical and laboratory findings in patients who had disease-related neurological signs. Materials and methods The study included patients who were diagnosed with CCHF. Seventeen patients that had neurological signs were enrolled as the patient group. As a control group, 40 patients diagnosed with CCHF and did not have neurological signs were enrolled. Patients who had neurological signs were examined with brain CT. Radiological and clinical findings of both groups were compared. Results There were pathological findings in three patients while brain CT's of 14 patients were evaluated as normal. Blood urea nitrogen, lactate dehydrogenase, creatine kinase, total bilirubin, neutrophil, activated partial thromboplastin time, and C-reactive protein levels were significantly higher in the group with neurological signs whereas platelet count and calcium levels were significantly lower in this group. Six of 57 patients died during the follow-up period. Six patients who died were in the group, in which central nervous system (CNS) imaging study was performed. Conclusion As the presence of CNS signs is a bad prognostic indicator in CCHF, they should be investigated carefully.

PURPOSE: In this study, the pulmonary arterial computed tomography obstruction index ratio, which indicates the degree and extent of thrombotic arterial occlusion, was calculated in cases with pulmonary thromboembolism. Our objectives were to investigate the value of this index for the identification of cases with massive pulmonary thromboembolism and to search for correlations between this index and clinical parameters. MATERIALS AND METHODS: Data from 68 patients were evaluated retrospectively. For the clinical evaluation, the Wells scoring system was used. Pulmonary computed tomographic angiography examinations were acquired using an eight-channel multidetector computed tomography. The presence of arterial filling defects was recorded, and the clot burden was quantified based on the degree and extent of thrombotic arterial occlusion. RESULTS: According to the Wells scoring system, the patients were assigned to low (n = 14), moderate (n = 34), and high clinical (n = 20) possibility groups, and the difference among the mean pulmonary arterial computed tomography obstruction index ratios of the three groups was significant (P = 0.001). A positive correlation was observed between the pulmonary arterial computed tomography obstruction index ratio and the Wells score (r = 0.470, P < 0.001). The pulmonary arterial computed tomography obstruction index ratio cut-off point was determined to be 40% for the discrimination of massive and nonmassive cases (sensitivity, 72.7%; specificity, 91.4%). CONCLUSION: We found that in cases where the pulmonary arterial computed tomography obstruction index ratio was above 40%, a diagnosis of massive pulmonary thromboembolism was demonstrated. Furthermore, a positive correlation between the obstruction index and the Wells score suggested the use of a clinical evaluation as a means of developing a recommendation regarding the thrombotic load.

9-Biffi M, Boriani G, Frabetti L, Bronzetti G, Branzi A. Left superior vena cava persistence in patients undergoing pacemaker or cardioverter-defibrillator implantation: a 10- year experience. Chest, 2001; 120:139–44

Contrast-induced nephropathy (CIN) refers to an abrupt deterioration in renal function associated with the use of iodinated contrast media. Today, contrast media is commonly used in both diagnostic and therapeutic procedures; the use of contrast media will likely increase in the future. To prevent CIN, the at-risk patients and contrast agents must first be identified. Traditional risk factors are chronic kidney disease (CKD), diabetes mellitus, advanced age, congestive heart failure and anemia. Prominent risks factors are CKD and diabetes mellitus, particularly the combination of the two. Contrast agent dose should be as low as possible and iso-osmolar agents should be used for high-risk patients. Current intravenous periprocedural volume expansion has a strong consensus for prevention of CIN in at-risk patients.

WOS:000391810900003 PubMed: 27818861 Purpose: Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease with high mortality. The agent causing CCHF is a Nairovirus. The virus is typically transmitted to humans through tick bites. CCHF is a life-threatening disease observed endemically over a wide geographical regions in the world and a little known about pulmonary findings in CCHF patients. Methods: The patients that were admitted and diagnosed with CCHF between April 2010 and September 2015 were examined. Patients' medical records were then evaluated retrospectively. Patients who underwent thorax CT evaluation based on the clinical findings at the time of admission and/or during the hospital stay were included in the study. Patients' laboratory test results and thorax CT findings for respiratory assessment along with demographic characteristics. Results: Forty patients diagnosed with CCHF that underwent thorax CT based on their indications were included in the study. Twenty-seven patients (62.5 %) were male with a mean age of 55.22 +/- 19.84 years. According to these results, the three most common thorax CT findings were parenchymal infiltration [32 patients (80 %)], pleural effusion [31 patients (77.5 %)], and alveolar infiltration [28 patients (70 %)]. Moreover, we determined that the most frequently seen radiological findings often occurred bilaterally. Conclusions: There is still not enough information regarding this life-threatening disease. We also would like to emphasize that both direct radiography and thorax CT are highly successful in detecting frequently encountered radiological findings such as pleural effusion, alveolar hemorrhage, and parenchymal infiltration that indicate pulmonary involvement.