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Objective: Our aim was to evaluate the contribution of diffusion-weighted imaging to the differentiation of hydatid cysts (HCs) from the simple cysts and to the identification of the HC subtypes., Materials and Methods: A total of 37 patients were included in this retrospective study. Fifty of these patients had diagnosed liver cysts (28 HCs and 22 simple cysts) of at least 1 cm in size. All of the cysts were examined with sonography and magnetic resonance imaging, and the HCs were classified according to the World Health Organization criteria., Results: Twenty-eight of the total 50 cysts were HCs, and 22 were simple cysts. When the apparent diffusion coefficient (ADC) values of all HCs were compared with the ADC values of the simple cysts, a statistically significant relationship was found (P=.001). The optimal ADC threshold value was established as 2.5 s/mm(2). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rates were 60%, 95%, 94%, 65% and 76%, respectively., Conclusion: Diffusion-weighted imaging-magnetic resonance imaging is a considerably helpful technique for differentiating between HCs and simple cysts and for differentiating between HC subtypes., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objective: The purpose of the study was to differentiate between benign and malignant thyroid nodules using nodule-spinal cord signal intensity and nodule apparent diffusion coefficient (ADC) ratios on diffusion-weighted magnetic resonance imaging (DW-MRI)., Materials and Methods: Forty-four patients (27 females, 17 males; mean age, 49 years) with nodules who underwent DW-MRI were included in this study. The images were acquired with 0, 50, 400 and 1000 s/mm(2)b values. ADC maps were calculated afterwards. Fine needle aspiration biopsies (FNAB) were performed at the same day with DW-MRI acquisition. The diagnosis in patients where malignity was detected after FNAB was confirmed by histopathologic analysis of the operation material. The signal intensities of the spinal cord and the nodule were measured additionally, over b-1000 diffusion-weighted images. Nodule/cord signal intensity (SI) ratios were obtained and the digital values were calculated by dividing to ADC values estimated for each nodule. Statistical analysis was performed., Results: The (nodule SI-cord SI)/nodule ADC ratio is calculated in the DW images, and a statistically significant relationship was found between this ratio and the histopathology of the nodules (P<.001). The ratio was determined as 0.27 in benign and 0.86 in malignant lesions. The result of receiver operating characteristic (ROC) analysis was statistically significant, and the area under curve (100%) was considerably high. The threshold value was calculated as 0.56 according to the ROC analysis. According to this threshold value, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates for (nodule SI/cord SI)/ADC ratios in differentiating benign from malignant thyroid nodules are calculated as 100%, 97%, 83%, 100%, and 98%, respectively., Conclusion: We have found that (nodule/cord SI)/nodule ADC ratio has the highest values for sensitivity and specificity among the tests defined for characterization of nodules., (Copyright © 2012. Published by Elsevier Inc.)

It has recently been shown that ghrelin is a pleitropic modulator with effects on diverse biological functions, such as energy homeostasis and reproduction. In this study, ghrelin levels and its relationship between metabolic and biochemical parameters were investigated in male subjects with idiopathic hypogonadotropic hypogonadism (IHH). Patients in the study were composed of 33 men with IHH, and controls were composed of 36 healthy age-matched men. The patients' group had significantly higher waist/hip ratio (WHR), and lower testis volume, luteinizing hormone (LH), follicle stimuling hormone (FSH) and total testosterone (TT) levels when compared with controls. Plasma total ghrelin levels were significantly lower in patients than in controls (96.4 +/- 29.1 ng/ml vs. 146.1 +/- 28.9 ng/ml, P < 0.001, respectively). No correlation of ghrelin was found with body mass index, waist/hip ratio, homeostasis model assessment insulin resistance index, testis volume, LH, FSH and TT levels in both patients and controls. The present study showed that ghrelin levels were significantly lower in men with IHH than in controls. However, further studies are needed to better understand the relationships between ghrelin, and metabolic and reproductive systems.

Objective: To present the magnetic resonance imaging (MRI) appearances of spinal split-cord malformation (SCM) and to investigate the various types of congenital spinal disorders associated with SCM., Materials and Methods: MR examinations of 23 patients with SCM were carried out in our hospital between June 2002 and May 2007 and retrospectively analysed., Results: Nineteen (82.6%) patients were diagnosed as type I SCM, while four (17.4%) were diagnosed as type II SCM. The most commonly involved site of SCM was the dorsolumbar area (47.8%) while cervical involvement was the least common (4.3%). No accompanying congenital spinal disorders were detected in four patients (17.4%). In 19 patients (82.6%), congenital spinal disorders accompanying SCM were detected, the most common of which was a low-lying cord, found in 14 patients (60.9%). Other anomalies included hydromyelia in seven patients (30.4%), lipoma in six (26%), meningomyelocele in four (17.4%), thick filum in three (13%) and dermoid cyst in three (13%)., Conclusion: In preoperative planning for SCM, its characteristics and those of the accompanying anomalies should be determined. MRI is a valuable tool for making such determinations.

Purpose: To investigate the sonographic characteristics of the normal ulnar nerve in the cubital tunnel, as well as any differences related to age, sex, and dominant arm., Method: Two hundred twelve elbows in healthy volunteers were evaluated sonographically. The cross-sectional area (CSA) of the ulnar nerve within the cubital tunnel was measured with the elbow in extension and in flexion. The presence and number of fascicles was determined. The displacement of the ulnar nerve out of the cubital tunnel in full elbow flexion was also investigated., Results: The mean +/- SD CSA of the ulnar nerve was 6.6 +/- 1.7 mm(2) (6.7 +/- 1.8 mm(2) in men and 6.5 +/- 1.7 mm(2) in women). The mean CSA of the ulnar nerve was highest for subjects aged 50-59 years, and lowest for subjects aged 30-39 years. Forty-two of 212 (19.8%) ulnar nerves had 2 fascicles, and 5 (2.4%) had 3 fascicles. The remaining 165 (77.8%) nerves had 1 fascicle. During elbow flexion, 49 of 212 (23.1%) ulnar nerves showed subluxation, and 18 (8.5%) were dislocated., Conclusion: There were differences in the CSA of the ulnar nerve between some age groups, but there was no variation with sex or handedness. Sonography can evaluate the morphologic changes of the nerve during flexion of the elbow., ((c) 2008 Wiley Periodicals, Inc.)

Purpose: Tuberculosis involvement of the central nervous system continues to represent a serious problem, particularly in developing countries. The aim of this study was to characterize the magnetic resonance imaging (MRI) findings of intracranial tuberculoma, a form of neurotuberculosis., Methods: We retrospectively reviewed the data of 27 patients with intracranial tuberculomas. These consisted of 17 women and 10 men with a mean age of 26 years (14-51). MRI was performed on all patients., Results: A total of 64 tuberculomas were found in these patients, of which 41 were distributed in the cerebral hemispheres, 17 in the cerebellar hemispheres, and 6 in the brainstem. Accompanied meningitis was detected in three patients, hydrocephalus in five patients, and hydrocephalus with meningitis in one patient., Conclusion: MRI makes a significant contribution to diagnosis of intracranial tuberculomas and can objectively determine accompanying abnormalities.

Poland syndrome is characterized by partial or complete absence of pectoralis muscles, ipsilateral syndactyly, and occasionally other malformations of the anterior chest wall and breast. Other associated anomalies, including dextrocardia, renal malformations, and vertebral anomalies, have been reported in rare cases. The condition is more frequent among males, and usually occurs on the right hemithorax in the unilateral form. The syndrome is believed to be caused by a genetic disorder that reduces the embryonal circulation in the subclavian and vertebral arteries. We report a 20-year-old man with Poland syndrome on the left hemithorax, which is rarely associated with dextroposition.

We present a case of malignant peripheral nerve sheath tumor of multicentric origin, an extremely rare condition. A 25-year-old man was admitted to hospital with presenting symptoms of cough, dyspnea and left lateral back pain. Computed tomography and magnetic resonance imaging revealed extrapleural masses in the left hemithorax in addition to synchronous left inguinal mass. After surgical resection of the masses from the thoracic and inguinal regions, histological examination confirmed the preoperative diagnosis of malignant peripheral nerve sheath tumor.

Objective: To determine the effect of oropharyngeal air column area, parapharyngeal fat pad thickness, pterygoid muscle thickness, and parapharyngeal wall thickness on snoring., Materials and Methods: Fifty-six individuals (35 men, 21 women) complaining of snoring in a questionnaire administered to patients attending the MR unit for cervical MR imaging were enrolled as the study group, and 39 (23 men, 16 women) individuals with no complaint of snoring were enrolled as the control group. Firstly, patients' body mass index (BMI) was determined. Then turbo spin echo T2-weighted MR imaging in the axial plane was performed, from the nasopharynx to the hyoid bone level, in both groups. From the MR images, oropharyngeal air column area, parapharyngeal fat pad thickness, pterygoid muscle thickness and parapharyngeal wall thickness measurements were made. Finally, the results were statistically analysed using SPSS (Statistical Package for Social Sciences) for Windows 10.0. Student's t-test was used as a complementary method in the analysis of the study data. The correlations between BMI and parapharyngeal wall thickness, and BMI and oropharyngeal air column area were determined by Pearson's correlation analysis., Results: No statistically significant difference was found between study and control groups in terms of mean age, pterygoid muscle thickness, or pharyngeal fat pad thickness (P>.05). Snorers' BMI levels (P<.01) and average parapharyngeal wall thicknesses (P<.05) were statistically significantly higher than those of the control subjects. Snorers' oropharyngeal air column area was significantly narrower than that of the control subjects, statistically (P<.01)., Conclusion: As a result of the study, it was concluded that only oropharyngeal air column area and parapharyngeal muscle thickness had an effect on snoring.

We report the MRI findings of a 22-year-old woman who complained of localized swelling in the left temporal region and right side of the face. MRI revealed left temporal and right masseter muscle hypertrophy, which to our knowledge has not been reported previously. The diagnosis of benign masticatory muscle hypertrophy was confirmed by biopsy.

Glutaric aciduria or glutaric acidemia type I, an autosomal recessive disease, usually presents with an acute encephalopathic crisis in young children. We report the magnetic resonance (MR) and proton MR spectroscopy (MRS) imaging findings of a previously healthy 20-year-old man who presented with recurrent headaches. Organic acids from the patient's urine contained large amounts of adipate, glutarate, and 3-hydroxyglutarate consistent with glutaric aciduria type I.

Objective: The goal of our study was to compare the accuracy of computed tomography enteroclysis (CTE) to that of biopsy in detecting bowel wall alterations of the terminal ileum in Crohn's disease (CD)., Subjects and Methods: A total of 43 patients with either diagnosed or suspected CD (16 females, 28 males) underwent CTE and ileoscopy. Ileoscopy diagnosed 35 patients with CD of the ileum, while 8 patients served as the control group., Results: Computed tomography enteroclysis detected CD in 31 patients (88%) and in none of the control group. According to the criteria used for evaluation of small bowel loop distension, 31 cases were (72%) with optimal distension, nine cases (%21) with good distension, and three cases (7%) with poor distension. Computed tomography enteroclysis showed that mean ileal wall thickness in patients with CD was 6.8 mm (range, 9.5-4.1 mm) and 1.79 mm in patients in the control group (range, 2.20-1.38 mm). Mean postcontrast wall density in patients with CD was 81.9 HU (range, 111.6-52.2 HU) and 41.1 HU (range, 49.8-22.4 HU) in the control group. Mean postcontrast wall density in 17 patients with active CD was 97 HU (range, 67-123 HU) and 62 HU (range, 46-87 HU) in 18 CD patients in remission. We calculated that the overall sensitivity and specificity of CTE in detecting the severity of CD were 89% and 100%, respectively. Positive predictive value was 100%; negative predictive value was 89%., Conclusion: Our results indicate that CTE can reveal CD involvement of small bowel accurately and allow assessment of the degree of disease activity.

Purpose: To use sonography to determine changes that may arise in splenic volume in humans from regions of lower altitude who begin to live in regions of higher altitude., Materials and Methods: The study was conducted in the Turkish province of Ağri, at an altitude of 1750 m and included 108 healthy, nonsmoking, disease-free volunteers who had moved from regions at an altitude lower than 500 m. Length, width, and thickness of the spleen were measured using sonography. Splenic volume was calculated using the following standard ellipsoid formula: length x width x thickness x 0.523. Sonographic assessments were repeated at 3 and 6 months along with other blood tests, including hemoglobin, hematocrit, and platelet levels., Results: The mean +/- SD splenic volume was 299 +/- 97 cm(3) (range, 116-574 cm(3)). At 3 and 6 months, the splenic volumes decreased significantly compared to their initial values (p < 0.05). An increase in hemoglobin, hematocrit, and platelet count was observed in all subjects., Conclusion: Our data show that splenic volume in healthy individuals who begins to live at high altitudes decreases gradually.

Purpose: To evaluate the appearance, type, frequency, and clinical importance of retroaortic left renal vein (RLRV) in patients examined with multidetector computed tomography (MDCT) angiography., Materials and Methods: A total of 1856 patients who underwent CT with urological symptoms (hematuria, flank and abdominal pain, left gonadal vein varicocele) (n = 889) or with symptoms other than urological ones (n = 967) were prospectively evaluated for the presence of RLRV. CT was performed with 110 ml of iodinated contrast material through the antecubital vein at a rate of 3.5 ml/s. Late arterial and early venous phase volumetric data sets were acquired at 30 and 65 s, respectively, from the start of the intravenous injection of contrast medium. In addition to axial images, multiplanar reconstructions (MPR), maximum-intensity projection (MIP), and three-dimensional volume-rendering (3D VR) images were used to assess left renal vein anomalies. Left renal vein anomalies were classified into four types according to their appearance: I) RLRV joining the inferior vena cava (IVC) in the orthotopic position; II) RLRV joining the IVC at level L4-L5; III) circumaortic or collar left renal vein; IV) RLRV joining the left common iliac vein., Results: RLRV was detected in 68 (3.6%) of the 1856 patients, with 26, 22, 17, and three of types I, II, III, and IV, respectively. Forty-four of the 68 patients with RLRV (65%) were in the group with urological symptoms, while 24 patients (35%) were in the group without urological symptoms. Compression of the RLRV was found in 16 patients in the urological symptoms group, while compression was detected in only three patients in the other group. This difference was statistically significant (P<0.05). The most common urological symptom was hematuria. The frequency of urological symptoms was higher in groups II and IV compared to the other groups., Conclusion: MDCT angiography with axial, MPR, MIP, and 3D VR images is effective in the detection of vascular renal anomalies such as RLRV. Diagnosing RLRV and differentiating it from other pathologic conditions causing hematuria is important in order to avoid complications during retroperitoneal surgery or interventional procedures.

Objective: Our aim was to assess the effectiveness of imaging modalities in detecting the underlying pathologies in patients with pulsatile tinnitus., Materials and Methods: Seventy-four patients with pulsatile tinnitus were radiologically evaluated. All patients except two are evaluated on a thin-section bone algorithm computed tomography scan covering the temporal bone and skull base, 14 patients with or without contrast-enhanced brain computed tomography, 7 patients with magnetic resonance imaging and magnetic resonance angiography, 5 patients with digital subtraction angiography, and 12 patients with Doppler ultrasonography., Results: The underlying pathology of tinnitus was detected in 50 patients (67.6%), and 24 patients were normal with radiologic studies. The most common cause was high jugular bulbus (21%) followed by atherosclerosis, dehiscent jugular bulbus, aneurysm of internal carotid artery, dural arteriovenous fistula, aberrant internal carotid artery, jugular diverticulum, and glomus tumor., Conclusion: It was concluded that radiologic imaging methods are effective in detecting the underlying pathology of pulsatile tinnitus.

A 23-year-old woman was transferred to our department with loss of consciousness 6 h after undergoing rod placement for thoracolumbar scoliosis. Both computed tomography and magnetic resonance imaging of the brain revealed diffuse pneumocephalus and infra- and supratentorial hemorrhages. The pedicular screw tracts were analyzed with computed tomography and misplacement of a screw was noticed. It was thought that inadvertent dural injury had occurred at the time of insertion. The patient was re-operated and the dural tear was repaired. To our knowledge, this is the first description of these uncommon complications in one patient after spine surgery.

The purpose of this study was to show the qualitative and quantitative MRI characteristics of soft-tissue masses in differentiation of benign and malignant lesions. A total of 90 soft-tissue lesions were reviewed in this study. The scoring system presents a more objective diagnostic performance in the prediction of benign or malignant masses. With the use of this scoring system, unnecessary biopsy can be precluded in benign lesions.

During color Doppler examination of a 41-year-old man who presented with vertigo, a right vertebral artery could not be found. Both MR angiography and digital subtraction angiography revealed a large anastomotic vessel between the right internal carotid and vertebral artery. It was thought to be type I proatlantal artery. Furthermore, the external carotid arteries were bilaterally absent. Although each vascular anomaly mentioned above is rare, it even more rare for these variations to occur simultaneously., (Copyright American Society of Neuroradiology)

Multiple rice body formation is an uncommon disorder which resembles synovial chondromatosis both radiologically and clinically. The clinical symptoms are usually non-specific. We report on a pathologically proven multiple rice body formation in both the left subacromial-subdeltoid bursa and knee joint in a 4-year-old girl.

We report the magnetic resonance (MR) angiographic findings of an asymptomatic case with abnormal branching of aortic arch and Kommerell's diverticulum, which to our knowledge has not been described previously.

We present the case of a patient who attempted suicide by ingesting matchstick heads (55% potassium chlorate). The patient presented to the emergency room with loss of consciousness, and MR imaging revealed symmetric hyperintense signal within the deep gray matter and medial temporal lobes. The patient improved after undergoing conventional treatment and hyperbaric oxygen.

Objective: There is a small number of studies in adult nonpalpable testes cases, and there is no published paper on the diagnostic value of their ultrasonographic examination. In this prospective study, we compared the sonographic and laparoscopic findings in adult cases with nonpalpable testes to assess the necessity and the profits of ultrasound., Materials and Methods: 50 cases, 38 unilateral and 12 bilateral, with nonpalpable testes were investigated. Patients' ages ranged from 20 to 25 years with a mean of 22. Sonographic examinations were performed with a high-resolution ultrasonography device., Results: Laparoscopic evaluation of the patients with unilateral nonpalpable testis yielded 27 testes out of a total 38. In one case, the testis was detected in the inguinal canal with inguinal exploration. The remaining 10 cases were regarded as vanishing testes. All 24 testes of 12 patients with bilateral nonpalpable testes were found. The pre-laparoscopic ultrasonographic examination detected 20 of 24 testes in bilateral cases (83% sensitivity), and 17 of 26 testes in unilateral cases (65% sensitivity)., Conclusion: Our results suggest that ultrasonography does not exclude the necessity for laparoscopy, and it is not superior to physical examination in detection of the inguinal atrophic testes or testicular nubbin.

Synovial hemangiomas of the knee joint are rare. We report on a pathologically proven synovial hemangioma of the knee that invaded the femur.