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Resumen Objetivo Incorporar los parametros basados en la tomografia computarizada sin contraste (TCSC) a las caracteristicas de los calculos y de los pacientes comunmente asociadas con el exito de la litotricia por ondas de choque (LEOCH) para evaluar la efectividad de este nuevo modelo en la prediccion del exito de LEOCH en calculos ureterales unicos situados en diferentes localizaciones. Materiales y metodos Se revisaron retrospectivamente los datos de los pacientes tratados con LEOCH por un unico calculo ureteral entre enero de 2017 y enero de 2019. Los parametros basados en la TCSC se evaluaron junto con los parametros demograficos de los pacientes y las caracteristicas de los calculos. Los parametros basados en TCSC incluyeron la presencia o ausencia de hidronefrosis, trabeculacion de la grasa perirrenal, edema periureteral, diametro del ureter proximal, grosor de la pared ureteral (GPU) en el sitio del calculo ureteral. Se utilizo el metodo de regresion logistica para desarrollar un modelo predictivo util. Posteriormente, se utilizo la curva ROC para determinar los puntos de corte, y se desarrollo un sistema de puntuacion para la prediccion del exito de LEOCH. Resultados La tasa libre de calculos fue del 77,1% (267/346) en toda la cohorte. El analisis univariante revelo que la edad, el volumen de los calculos, la densidad, la trabeculacion perirrenal, el diametro del ureter proximal y el GPU se asociaron con el exito de la LEOCH. En el analisis multivariante, la localizacion del calculo ureteral proximal, el volumen del calculo, la densidad y el GPU fueron predictores independientes del exito de la LEOCH. La formula utilizada en el analisis de regresion logistica fue: 1/ [1 + exp {-8,856 + 0,008(volumen del calculo) + 0,002 (densidad del calculo) + 0,673 (GPU) + 1026 (calculo ureteral proximal)}]. Las puntuaciones de 0, 1, 2, 3 y 4 se asociaron con un 97,8%, 83,4%, 60,8%, 33,2% y 11,1% de exito, respectivamente, en el modelo de prediccion basado en estos parametros. Conclusion Concluimos que nuestro modelo puede ser util en la eleccion del tratamiento con LEOCH de los calculos ureterales en diferentes localizaciones.

Objective: To evaluate the association of body composition parameters with outcomes in Covid-19. Methods: 173 patients hospitalized for Covid-19 infection in 6 European centers were included in this retrospective study. Measurements were performed at L3-level and comprised skeletal muscle index (SMI), muscle density (MD), and adipose tissue measurements [visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intramuscular adipose tissue (IMAT), visceral-to-subcutaneous-adipose-tissue-area-ratio (VSR)]. The association with mortality, the need for intubation (MV), and the need for admission to ICU within 30 days were evaluated. Results: Higher SAT density was associated with a greater risk of MV (OR = 1.071, 95%CI=(1.034;1.110), p < 0.001). Higher VAT density was associated with admission to ICU (OR = 1.068, 95%CI=(1.029;1.109), p < 0.001). Higher MD was a protective factor for MV and ICU admission (OR = 0.914, 95%CI=(0.870;0.960), p < 0.001; OR = 0.882, 95%CI=(0.832;0.934), p = 0.028). Higher VSR was associated with mortality (OR = 2.147, 95%CI=(1.022;4.512), p = 0.044). Male sex showed the strongest influence on the risk of ICU admission and MV. SMI was not associated with either parameter. Conclusion: In patients hospitalized for Covid-19 infection, higher VSR seems to be a strong prognostic factor of short-term mortality. Weak associations with clinical course were found for MD and adipose tissue measurements. Male sex was the strongest prognostic factor of adverse clinical course. Advances in knowledge: VSR is a prognostic biomarker for 30-day mortality in patients hospitalized for Covid-19 disease.

The aim of this study was to differentiate pancreatobiliary and intestinal type periampullary carcinomas using dynamic contrast MRI and MRCP (Magnetic Resonance Cholangiopancreatography) with diffusion-weighted imaging (DWI) MATERIALS AND METHODS: MRI and MRCP images of 70 patients with pathologically proven periampullary adenocarcinoma were included. MRCP image features, extra-ampullary features, enhancement patterns, and apparent diffusion coefficient (ADC) values derived from b-values of 1000 s/mm² were evaluated by two radiologists independently. The interclass correlation coefficient (ICC) or Cohen's kappa statistic was used to evaluate the interobserver agreement.51 patients were diagnosed with pancreatobiliary type carcinomas, and 19 with intestinal type. In the pancreatobiliary subtype, the distal wall of the common bile duct was usually irregular (p = 0.047). Although the progressive enhancement pattern was evident in the pancreatobiliary type, an oval filling defect in the distal common bile duct was found to be more common in the intestinal type (p0.001). The pancreatic duct cut-off sign (p0.001), gastroduodenal artery involvement (p0,001), and lymphadenopathy (p0.05) were mostly observed in pancreatobiliary carcinomas. The ADCmin, ADCmean, and ADCmax values of the pancreatobiliary type carcinomas were all lower compared to the intestinal type carcinomas (p0.05).The oval filling defect seen in MRI and MRCP examinations suggests intestinal type, whereas the progressive contrasting pattern of the masses with irregular narrowing in the distal margin of the common bile duct, the pancreatic duct cut-off sign, gastroduodenal artery involvement, lymphadenopathy, and low ADC values indicate pancreatobiliary type carcinomas.

Introduction:To investigate the relationship between morphometric variants of the cochlear nerve (CN) and the hearing level. To investigate the confounding effects of age, sex, and audiometric variables on the relationship between CN morphometrics and hearing loss, if present.Methods:Audiological data and magnetic resonance imaging findings of 127 patients with asymmetrical sensorineural hearing loss (ASNHL) were reviewed retrospectively. According to pure tone average (PTA) frequencies of each ear, difference above 25 dB were accepted as ASNHL. The vertical (Vd) and horizontal diameters (Hd) and the cross-sectional area (CSA) of the CN were measured.Results:The difference in CSA and Vd between ears showed a negative correlation with age. The mean CSA was 1.57 in AE and 1.60 in NE. Mean Hd was 1.00 in AE and 1.00 NE. Mean Vd was 1.40 in AE and 1.50 in NE. There was no correlation between the difference ratios of thresholds and CN diameter parameters. There was no significant correlation of CSA, Vd, and Hd with PTA thresholds at each frequency.Conclusion:Aging is associated with losses in Vd diameter and CSA. The degree of hearing loss was not correlated with the morphometric features of the CN. The morphometry of the CN should be interpreted together with the etiology of hearing loss.

Resumen Introduccion y objetivos La clasificacion de Bosniak para las lesiones renales quisticas se publico por primera vez en 1986 con base en los hallazgos de tomografia computarizada (TC). El objetivo de nuestro estudio fue investigar el rol de la resonancia magnetica (RM) y su impacto en la clasificacion de Bosniak para compararla con la TC, y determinar como la RM puede alterar el tipo de tratamiento de los quistes renales complejos. Material y metodos Se recogieron retrospectivamente los datos de 144 pacientes. Despues de aplicar los criterios de exclusion, 2 radiologos especialistas en ecografia abdominal evaluaron 102 lesiones quisticas renales con una categoria Bosniak de al menos IIF en TC o RM entre 2013 y 2016. Se registraron los datos demograficos, la categoria de Bosniak, la concordancia interobservador y las enfermedades de los pacientes tratados con cirugia. Resultados La concordancia entre la RM y la TC fue del 75,5%. La categoria Bosniak se vio incrementada tras la RM en 17 pacientes, y se cambio el tipo de tratamiento en 10 pacientes, que posteriormente fueron tratados quirurgicamente. Tras la RM, la categoria Bosniak paso de III a IIF en 6 pacientes de 8 y provoco un cambio en el tipo de tratamiento. Se realizo cirugia en un paciente de estos 6, y el informe de anatomia patologica se informo como benigno. Se detecto progresion durante el seguimiento al decimoctavo mes en un paciente de 5, y se practico cirugia en este caso. La enfermedad se informo como carcinoma de celulas renales (CCR). De los 51 pacientes tratados mediante cirugia, 35 (68,6%) recibieron informe anatomopatologico de CCR. Se detecto progresion en 7 pacientes de 51 que recibieron seguimiento (13,7%), y los resultados de la enfermedad se informaron como CCR. La mayoria de los tumores malignos eran de grado y estadio bajo. Conclusiones La RM se puede emplear con exito en la evaluacion de lesiones quisticas renales. En particular, el manejo de las lesiones Bosniak IIF y de todas aquellas clasificadas como Bosniak III debe incluir evaluacion mediante RM antes de optar por el tratamiento quirurgico. El incremento en la categoria de Bosniak es mas factible con RM que con TC, debido a su resolucion de alto contraste. Por lo tanto, se requieren mas estudios para identificar si esta fue la causa del sobretratamiento en pacientes con lesiones Bosniak III.

To evaluate the impact of low skeletal muscle mass in patients with COVID-19 on relevant outcomes like 30-day mortality, need for intubation and need for intensive care unit admission.For this study, data from six centers were acquired. The acquired sample comprises 1138 patients. There were 547 women (48.1%) and 591 men (51.9%) with a mean age of 54.5 ± 18.8 years; median age, 55 years; range, 18-84 years). In every case, thoracic CT without intravenous application of contrast medium was performed. The following parameters of the pectoralis muscles were estimated: muscle area as a sum of the bilateral areas of the pectoralis major and minor muscles, muscle density, muscle index (PMI) (pectoralis muscle area divided by the patient's body height square) as a ratio pectoralis major and minor muscles divided by the patient's body heightOverall, 220 patients (19.33%) were admitted to the intensive care unit. In 171 patients (15.03%), mechanical lung ventilation was performed. Finally, 154 patients (13.53%) died within the observation time of 30-day. All investigated parameters of pectoralis muscle were lower in the patients with unfavorable courses of Covid-19. All pectoralis muscle parameters were associated with 30-day mortality in multivariate analyses adjusted for age and sex: pectoralis muscle area, HR = 0.93 CI 95% (0.91-0.95) p0.001; pectoralis muscle density, HR = 0.94 CI 95% (0.93-0.96) p0.001; pectoralis muscle index, HR = 0.79 CI 95% (0.75-0.85) p0.001, pectoralis muscle gauge, HR = 0.995 CI 95% (0.99-0.996) p0.001.in COVID-19, survivors have larger areas and higher index, gauge and density of the pectoralis muscles in comparison to nonsurvivors. However, the analyzed muscle parameters cannot be used for prediction of disease courses.

Background/Aim: Papillary neoplasia encompasses both malignant and benign lesions, and core needle biopsy (CNB) is crucial in their diagnosis. Histological findings determine their management. Here we compare volumetric apparent diffusion coefficient (ADC) histogram analysis of carcinomas and benign pathologies identified by histopathology from excisional biopsies. Methods: This retrospective study included 524 patients who underwent breast magnetic resonance imaging (MRI) for a suspicious breast mass from January 2018 to October 2022. Patients with benign lesions, incompatible ultrasound-guided CNB results with papillary neoplasia, and those with MRI exams insufficient for diagnosis due to motion artifacts were excluded. After applying the exclusion criteria, the study included 48 patients (average aged 61.5 (14.8) years; range, 31 to 72 years). After excisional biopsies, 30 benign lesions and 18 carcinomas were identified. MRI was acquired at 1.5 T (Verio; Siemens Medical Solutions, Erlangen, Germany), and the b-values for diffusion-weighted imaging were calculated at 1000 s/mm2. Histogram parameters were computed. Receiver operating characteristic (ROC) curve analysis was performed to investigate diagnostic accuracy, evaluate histogram analysis performance, and determine threshold values. Results: The ADCmin, ADCmean, ADCmax, and all ADC value percentiles were significantly lower in the carcinoma group than in the benign group (P

Sex estimation from skeletal remains is crucial for the estimation of the biological profile of an individual. Although the most commonly used bones for means of sex estimation are the pelvis and the skull, research has shown that acceptable accuracy rates might be achieved by using other skeletal elements such as vertebrae. This study aims to contribute to the development of sex estimation standards from a Turkish population through the examination of CT scans from the seven cervical vertebrae. A total of 294 individuals were included in this study. The CT scans were obtained from patients attending the Bakirkoy Training and Research Hospital (Turkey) and the data was collected retrospectively by virtually taking measurements from each cervical vertebrae. The full database was divided into a training set (N = 210) and a validation set (N = 84) to test the fit of the models. Observer error was assessed through technical error of measurement and sex differences were explored using parametric and non-parametric approaches. Logistic regression was applied in order to explore different combinations of vertebral parameters. The results showed low intra- and inter-observer errors. All parameters presented statistically significant differences between the sexes and a total of 15 univariate and multivariate models were generated producing accuracies ranging from a minimum of 83.30% to a maximum of 91.40% for a model including three parameters collected from four vertebrae. This study presents a virtual method using cervical vertebrae for sex estimation on the Turkish population providing error rates comparable to other metric studies conducted on the postcranial skeleton. The presented results contribute not only to the development of population-specific standards but also to the generation of virtual methods that can be tested, validated, and further examined in future forensic cases.

Purpose: Shear wave elastography (SWE) is a relatively new technique for measuring tissue elasticity. Its implementation for assessing the tissue of the cervix is evolving, and SWE analyses of healthy, nonpregnant cervixes is the first step in understanding other SWE changes related to cervical pathologies; nevertheless, some challenges in the use of the technique still require investigation. We aimed to target the consistency of healthy cervix shear wave elastography measurements and examine the changes induced by patient-related factors. Material and methods: Elastograms were obtained at the internal and external os in the anterior (IA, EA) and posterior (IP, EP) portions of the cervix using a transvaginal approach in eight postmenopausal and 25 premenopausal women. Measurements with a standard deviation of over 20% and patients who presented with colour loss or heterogeneity were excluded from the study. Shear wave elastography assessments were performed using a Toshiba Aplio 500 version 6. Statistical significance was defined as a p value less than 0.10, due to the small number of patients. Results: The mean speeds obtained at the external os on the anterior and posterior aspects was 3.17 ± 0.85 m/s and 3.18 ± 0.84 m/s, respectively, and at the internal os, the results on the anterior and posterior aspects were 3.38 ± 0.73 m/s and 3.53 ± 0.81 m/s, respectively. The difference in speed among all regions was statistically significant (p < 0.05). Fifteen patients were also analysed by a second radiologist with a similar experience level as that of the first. Nine measurements for IP, 13 measurements for IA, 11 measurements for EP, and 15 measurements for EA were performed. The correlation coefficients between the two sets of measurements were 0.46, 0.30, 0.67, and 0.51, respectively. There was no difference in the SWE values with respect to age, parity, and gravidity for any of the regions. The SWE values at the IA, IP, and EA regions between the postmenopausal and premenopausal women were significantly different (p = 0.038, p = 0.059, p = 0.065). Conclusions: The posterior portion of the internal os is most likely to undergo inaccurate SWE measurement among the different anatomical positions. The correlation between radiologists was found to be different for different locations in the cervix. More studies are needed to determine the SWE values of the healthy cervix and the agreement levels between radiologists.

Purpose: To investigate the relationship between lesion size determined using mpMRI and histopathological findings of specimens obtained after mpMRI fusion biopsy and radical prostatectomy. Material and Methods: We retrospectively analyzed 590 patients with PCa who underwent an MRI fusion biopsy between 2017-2019. We measured the diameter of suspicious tumor lesions on diffusion-weighted mpMRI and stratified the cohort into two groups. Group A included patients with a suspicious tumor lesion equal and smaller than 10 mm and Group B included those with a suspicious tumor lesion larger than 10 mm. RP was performed in 53 patients. The patients in Groups A and B were compared according to their pathological findings obtained with fusion biopsy and RP. Results: After applying the inclusion and exclusion criteria, Group A consisted of 144 patients and Group B comprised 146. In Group B, PI-RADS score determined in mpMRI was higher than Group A, and there was a statistically significant difference between the two groups in terms of clinical T-stage. The PCa detection rate and the number of positive cores were statistically significantly higher in Group B than in Group A. In addition, there was a statistically significant difference between the two groups in relation to the biopsy, the ISUP grades and the presence of clinically significant PCa. In Group B, pathological T-stage and extraprostatic extension (EPE) and surgical margin (SM) positivity were found to be higher among the patients who underwent RP. In the multivariate analysis, the mpMRI lesion size being >10 mm was found to be an independent predictive factor for SM and EPE positivity. Conclusion: The radiologists and clinicians should be awared of the possibility of presence of features that may affect local staging, such as EPE positivity, in the presence of lesions larger than 10 mm in which prostate cancer is detected.

Rationale and Objectives To retrospectively evaluate imaging findings in multisystem inflammatory disease in children associated with COVID-19 (MIS-C). Materials and Methods The radiological imaging findings of 45 pediatric patients aged between 52 days and 16 years, who were diagnosed with MIS-C according to the World Health Organization (WHO) criteria, were evaluated. All the patients underwent chest X-ray and echocardiography. The findings obtained from 25 abdominal radiographs, 24 abdominal US, 7 abdominal CT, 16 thorax CT, 21 cranial MRI and one spinal MRI, MR cholangiography (MRCP) and cardiac MRI examinations were categorized and evaluated according to the affected systems. Results While the most common findings in chest X-ray were perihilar opacity and peribronchial thickening, pleural effusion was the most finding in thorax CT. Echocardiography findings of myocarditis were observed in 31% of the cases. The most common findings in abdominal radiological evaluation were hepatomegaly and splenomegaly, edema in the gallbladder wall and periportal area, mesenteric lymph nodes in the right lower quadrant, thickening of the intestinal walls, and free fluid. Reversible splenial lesion syndrome (RESLES) was the most common neurological finding. Acute disseminated encephalomyelitis (ADEM)-like lesions, acute hemorrhagic necrotizing encephalomyelitis, and radiological findings consistent with Guillain-Barre syndrome were found in one case each. Conclusion Radiological findings seen in MIS-C in pediatric cases are correlated with the affected system. According to the system involved, there is no specific finding for this disease. Radiological findings are not the primary diagnostic tool but can assist in the evaluation of the affected systems and to guide treatment.

The objective of this study was to investigate the optic nerve’s elastic properties and optic nerve sheath diameter (ONSD) using shear-wave elastography (SWE) in patients with idiopathic intracranial hypertension (IIH) compared to healthy individuals. The study included 22 IIH patients and 15 healthy subjects. SWEs were performed on the optic nerve and ONSD, and optic nerve stiffness were measured. The patients with IIH demonstrated higher stiffness of the optic nerve compared with that of healthy volunteers (P < 0.001). The optic nerve sheath diameter of the optic nerve in the IIH group was significantly larger than that in the control group (P < 0.001). There was no correlation between the disease duration and SWE values in the Spearman correlation test. These findings suggest that ONSD can be used as a follow-up method in the treatment of IIH. However, there was not any correlation between the disease duration and SWE-based stiffness measurement of the optic nerve.

The aim of our study is to compare 2 prostate fusion biopsy models in terms of accurate target sampling. One hundred patients who had Prostate Imaging-Reporting and Data System score 3, 4, or 5 lesions (lesion diameter, >5 mm in long axis) in multiparametric-magnetic resonance imaging and prostate-specific antigen levels between 3 and 10 ng/mL were enrolled in the study. All patients were biopsy naive. Two groups were composed with 50 patients each. Group 1 patients had cognitive fusion (CF) biopsy, and group 2 had magnetic resonance-ultrasound fusion platform biopsy. After fusion biopsy, standard biopsy was also performed. Outcomes of histopathologic and demographic data were evaluated statistically. There were no statistical differences between the 2 groups in terms of age, prostate-specific antigen levels, prostate volume, and lesion length (P > 0.05). There was no statistically significant difference in sampling targeted lesions (P > 0.05). Also, no difference was found between the 2 groups in terms of random biopsy cancer detection rates (P > 0.05). There was no statistically significant difference between CF and magnetic resonance-ultrasound fusion in terms of cancer detection rates. For the experienced operators, we recommend lesions that are longer than 5 mm can be sampled using CF, an inexpensive and faster technique.

RATIONALE AND OBJECTIVES: The aim of our study was to evaluate whether there is any correlation between a histogram analysis of the pectoralis muscle derived from chest computed tomography (CT) and the mortality rate for COVID-19 pneumonia in the adult population. METHOD: Chest CT derived measurements were evaluated retrospectively for 217 patients with a diagnosis of COVID-19 pneumonia. Using a CT histogram analysis, we measured pectoralis muscle volume (PV) and pectoralis muscle density (PD). Patients were divided into groups first according to gender and then subgroups, which are age and outcome. RESULTS: The COVID-19 diagnoses were confirmed by RT-PCR testing, chest CT and clinical findings in 217 patients (108 men, 109 women), aged 21-92 years (mean 61 years). PD measurements were lower in the exitus group (p = 0.001) and in patients aged ≥65 than in those aged

Objective: Literature related to the imaging of COVID-19 pneumonia, its findings and contribution to diagnosis and its differences from adults are limited in pediatric patients. The aim of this study was to evaluate chest X-ray and chest CT findings in children with COVID-19 pneumonia. Methods: Chest X-ray findings of 59 pediatric patients and chest CT findings of 22 patients with a confirmed diagnosis of COVID-19 pneumonia were evaluated retrospectively. Results: COVID-19 pneumonia was most commonly observed unilaterally and in lower zones of lungs in chest X-ray examinations. Bilateral and multifocal involvement (55%) was the most observed involvement in the CT examinations, as well as, single lesion and single lobe (27%) involvement were also detected. Pure ground-glass appearance was observed in 41%, ground-glass appearance and consolidation together was in 36%. While peripheral and central co-distribution of the lesions (55%) were frequently observed, the involvement of the lower lobes (69%) was significant. In four cases,the coexistence of multiple rounded multifocal ground-glass appearance and rounded consolidation were observed. Conclusion: COVID-19 pneumonia imaging findings may differ in the pediatric population from adults. In diagnosis, chest X-ray should be preferred, CT should be requested if there is a pathologic finding on radiography that merits further evaluation and if clinically indicated. Advances in knowledge: Radiological findings of COVID-19 observed in children may differ from adults. Chest X-ray should often be sufficient in children avoiding additional irradiation, chest CT needs only be done in cases of clinical necessity.

With increases in migration across borders, age estimation in living individuals of not (reliably) documented identity becomes all the more important. Unfortunately, there are not many age indicators that can be used for this purpose, and human variation requires specific methodical approaches. In this paper, a recently proposed age marker to assess the age around the critical age limit of 18 completed years is tested. The method uses apophyseal development of cervical vertebrae 2, 3 and 4. Here CT scans of a large sample of Turkish individuals (n = 1276) were assessed, and likelihoods of being 18 years at a given stage were calculated. The likelihood of being at least 18 years for stages 0, 1 and 2 were zero or close to zero in both males and females. By the time that stage 4 was reached, the likelihood to be 18 years were between 65 and 70% (depending on the vertebra) in females and 81 and 90% in males. In comparison to South Africans, the Turkish individuals developed earlier, but the likelihoods of being 18 years were lower at stage 4 as some individuals were still judged to be in stage 3 well into their twenties. Although fairly variable, this method is a valuable new addition to the modalities that can be used for age assessment in the living. CT scans seemed to provide good visualization of the structures in question, although in actual forensic cases the high radiation dose may be problematic.

Objective: To compare intact and diseased ears for Eustachian tube (ET) length and width in patients with unilateral chronic otitis media (COM), and to assess the relationship between cholesteatoma spread, stapes erosion, lateral semicircular canal (LSCC) fistula and ET width and length retrospectively.Methods: Subjects with unilateral COM (122 subjects with 244 ears) who underwent surgery for cholesteatoma were evaluated retrospectively for this study. The width of the distal orifice of the bony segment and the length of the bony segment of the ET for both the diseased and healthy ear were measured. Subjects’ healthy and diseased ears were compared for ET length and width. The diseased sides were compared to assess the relationship between ET dimensions and cholesteatoma spread, stapes erosion and LSCC fistula.Results: The mean ET length and width in healthy and diseased ears was 11.38±1.7 and 1.43±0.37 mm, and 10.99±1.6 and 1.27±0.35 mm, respectively; the difference was statistically significant (p

Purpose The purpose of this study was to evaluate magnetic resonance imaging (MRI)-pathology concordance of tumour size in patients with invasive breast carcinoma, with an emphasis on Breast Imaging Reporting and Data System (BI-RADS) descriptors of dynamic contrast-enhanced MRI (DCE-MRI). Material and methods Of patients who had preoperative DCE-MRI, 94 were enrolled. Concordance between MRI and the pathological findings was defined as a difference in tumour size of 5 mm or less. The greatest dimension was measured by two radiologists, and BI-RADS descriptives were described in accordance. The gold standard was chosen as the pathologic assessment. Results Tumour measurements determined by MRI and the pathological reports were not statistically different (2.64 ± 1.16 cm, Wilcaxon Z = -1.853, p = 0.064). Tumour sizes were concordant in 72/94 patients (76.6%). The mean difference between the pathological and MRI tumour sizes was -0.1 cm. MRI overestimated the size of 17/94 tumours (18.1%) and underestimated the size of 5/94 tumours (5.3%). Discordance was associated with larger tumour size. Histologic and molecular type of tumours, patient age, histologic grade, lymphovascular invasion or perineural invasion positivity, fibroglandular volume, background parenchymal enhancement, and being mass or non-mass were not associated with concordance. Irregular margin and heterogenous enhancement in DCE-MRI were associated with discordance in logistic regression analysis (p = 0.035, OR: 4.24; p = 0.021, OR: 4.96). Conclusions Two BI-RADS descriptors of irregular contour and heterogeneous contrast uptake were found to be associated with tumour size discrepancy. This might be attributed to the dynamic and morphologic specialities of tumours primarily rather than tumour biology.

Objective: Wire-guided localization (WGL) is the preoperative localization method most commonly used before the surgical excision of non-palpable breast lesions (NPBLs). Recently, radioguided occult lesion localization (ROLL) has emerged as an alternative to WGL. We sought to compare the efficacy of ROLL with that of WGL for the preoperative localization of NPBLs and to assess our experience encountered as ROLL is implemented at our institution.

Background:Extracorporeal shockwave therapy (ESWT) has recently been used as a new treatment modality for plantar fasciitis. We aimed to determine the efficacy of ESWT by magnetic resonance imaging (MRI) findings.Methods:Thirty patients with plantar fasciitis who had received no treatment for 6 months were included. Extracorporeal shockwave therapy was applied once a week for a total of three sessions (frequency of 12–15 Hz, 2–3 bars, and 2,500 pulses). All of the patients were assessed with the visual analog scale, a 6-point evaluation scale, the Foot and Ankle Outcome Score (FAOS), and MRI findings before and 3 months after ESWT. Visual analog scale scores were used in determining the pain level of patients in the morning, during activity, and at rest. Foot and ankle–related problems were evaluated with the FAOS.Results:The duration of painless walking according to the 6-point rating scale, the FAOS, and pain showed significant improvements after ESWT (P < .05). Significant decreases in MRI findings, including thickening of the plantar fascia, soft-tissue edema, and bone marrow edema, were observed after treatment (P < .05).Conclusions:Extracorporeal shockwave therapy is a safe and effective treatment that yields favorable results in improvement of pain and function for plantar fasciitis. An MRI is useful for determining response to ESWT for these patients.

Sacral insufficiency fracture (SIF) is an uncommon cause of hip and back pain. Sacroiliitis, often a feature of inflammatory conditions of spinal column, is inflammation of sacroiliac joints. Herein, we report a 41-year-old woman presenting with a SIF and sacroiliitis as a part of non-radiographic axial spondyloarthritis.

Objectives Extracorporeal shock wave lithotripsy (ESWL) is a method used frequently for the treatment of renal stone disease. Although its safety is proven, there are still concerns about its unwanted effects on kidneys. In this prospective study, we aimed to evaluate renal tissue alterations with shear wave elastography (SWE) after ESWL. We also studied the correlation between SWE and resistive index (RI) changes. Methods The study included 59 patients who underwent ESWL treatment for renal stone disease. We performed SWE and color Doppler ultrasonography to calculate SWE and RI values before, 1 hour after, and 1 week after lithotripsy treatment. A binary comparison was performed by the Bonferroni test. The correlation between SWE and RI values was evaluated by a Pearson correlation analysis. Results The patients included 26 women (44.1%) and 33 men (55.9%). Their ages ranged from 20 to 65 years (mean ± SD, 45.0 ± 1.1 years). Stone diameters ranged from 7 to 19 mm (mean, 13.0 ± 0.5 mm). There was a significant difference in SWE values before and 1 hour after lithotripsy treatment (P = .001; P .99; P > .05). Resistive index values increased significantly 1 hour after lithotripsy treatment and returned to prelithotripsy values 1 week after treatment. In the correlation analysis, SWE and RI values were not correlated. Conclusions Measurements of alterations in SWE values after ESWL can provide useful information about renal tissue injury.

Our aim was to evaluate the feasibility of using shear wave elastography (SWE) to assess first extensor compartment tendons rigidity and its alterations with tenosynovitis.We performed B-mode ultrasound and SWE to total number of 80 participants. All participants were evaluated clinically to call the diagnosis of de Quervain tenosynovitis or to rule out the diagnosis. We composed 2 groups. Group 1 included 40 healthy volunteers (33 females and 7 male participants with ages ranging from 24 to 60 years, median age was 37.5 years) and group 2 had 40 de Quervain patients (32 females and 8 male patients with ages ranging from 25 to 51 years, median age was 34 years). SWE measurements were repeated 3 times and arithmetic average was used for the final SWE value.The median SWE value of healthy group (group 1) was 72kPa and the de Quervain patient group (group 2) was 29kPa. Two groups demonstrated statistically significant difference (p0.001). The ROC curve analysis was performed and the SWE value of 40.5kPA was calculated as a cut-off value for the diagnosis of de Quervain tenosynovitis with 95% specificity and 85% sensitivity.SWE modality can provide useful data regarding de Quervain tenosynovitis.

Our goal was to evaluate the role of ultrasound (US) imaging in an experimental 2-hit steatofibrosis rat model. Nineteen female Sprague-Dawley rats were divided into 2 groups: control group (n = 6) and high-fat diet carbontetrachloride (HFD-CCl4) group (n = 13) that was fed with HFD for 14 weeks. Ultrasound was performed to evaluate liver steatosis. The HFD-CCl4 group rats were divided further into 2 subgroups: HFD rats with liver steatosis [US (+) group; n = 6] and without steatosis [US (-) group; n = 7]. All rats in the subgroups were administered with CCl4. In both US (+) and US (-) subgroups, steatosis score, fibrosis score, triglyceride, and hydroxyproline contents were markedly higher compared with the control group. When compared with the US (-) group, triglyceride and hydroxyproline contents were significantly higher in the US (+) group, whereas steatosis and fibrosis scores were not different. Ultrasound imaging may be useful to assess the success of a 2-hit experimental steatofibrosis model.

Objectives Elasticity measurements of tissues can be valuable in the diagnosis and management of various diseases. The aim of this study was to determine the elasticity values for normal liver, kidney, and spleen of healthy newborns and infants using shear wave elastography (SWE) imaging. Methods A total of 50 healthy term newborns and infants (19 girls and 31 boys; mean age 20.1 days, range 1 to 70 days) were examined by an experienced pediatric radiologist using SWE. None of them had any liver, kidney or spleen disease, or any other systemic disease that could affect these organs secondarily. All newborns and infants had a normal abdominal ultrasound scan. Results Age, sex, weight, height, and body mass index had no significant effects on shear wave velocity (SWV) values of liver and spleen. The SWV values of both kidneys decreased with age, weight, height, and body mass index. The mean SWV values were 1.70 m/s (range: 1.23–2.43 m/s) for the liver, 1.69 m/s (range: 0.8–2.40 m/s) for the right kidney, 1.70 m/s (range: 0.9–2.49 m/s) for the left kidney, and 2.03 m/s (range: 1.28–2.48 m/s) for the spleen. Conclusions Shear wave elastography can be used to measure liver, kidney, and spleen elasticity in newborns and infants. The standard values for abdominal organs allow differentiation of healthy versus pathological tissue. We measured the normal values of SWE in healthy newborns and infants as reference data.

To evaluate the variations of the sternum and provide the prevalence of sternal foramen and its anatomical relationships. In this retrospective study, 544 subjects ranging in age from 18 to 95 years were evaluated. Sternal variations, prevalence of sternal foramen and its anatomical relationships to mediastinal structures were examined with the axial, sagittal and coronal reformat images of the patients who underwent thoracic computerized tomography. In 500 subjects, following sternal variations were found: sternal sclerotic band in 120 (24%), sternal cleft in 3 (0.6%), sternal foramen in 26 (5.2%), focal cortical notch and defect in 44 (8.8%) patients. The manubriosternal fusion was partial in 65 (13%) patients and complete in 112 (22.4%) patients. The sternoxiphoid fusion was partial in 201 (40.2%) and complete in 153 (30.6%) patients. There was no xiphoid process in 9 patients (1.8%; 29–51 years; mean age 38 years). Xiphoidal ending types were as follows: single-ended 361 (72.2%), double-ended 125 (25%), and triple-ended xiphoid 5 (1%) patients. The sternal foramen was adjacent to the lung in 13 (2.6%), to the pericardium of heart in 3 (0.6%), and to mediastinal fat in 10 (2%) patients. The sternum is a very critical anatomic structure of the anterior chest wall with several variations that can be confused with pathologic conditions. Radiologists’ familiarity with these variations is important for better radiologic evaluation in making differential diagnosis.

Fat-infiltrated lymph nodes mostly seen on mammograms (MG) of the elderly and obese women. We analyzed the fat infiltration of lymph nodes for its potential use in estimating body mass index (BMI). 2D digital MG of 157 women assessed by one breast radiologist and one radiology resident. For each patient, the largest lymph node chosen as the index by analyzing the medial, lateral oblique (MLO) views. The width and length of the node and the hilum, the cortex, and the Hilo-cortical ratio (HCR) were measured. Breast density was categorized according to the ACR BI-RADS 4th edition and divided into two groups as dense and non-dense. Obesity was defined as BMI ≥ 30 kg/m2, overweight as BMI

Morphometric analysis of the mandibular ramus (MR) provides highly accurate data to discriminate sex. The objective of this study was to demonstrate the utility and accuracy of MR morphometric analysis for sex identification in a Turkish population.Four hundred fifteen Turkish patients (18-60 y; 201 male and 214 female) who had previously had multidetector computed tomography scans of the cranium were included in the study. Multidetector computed tomography images were obtained using three-dimensional reconstructions and a volume-rendering technique, and 8 linear and 3 angular values were measured. Univariate, bivariate, and multivariate discriminant analyses were performed, and the accuracy rates for determining sex were calculated.Mandibular ramus values produced high accuracy rates of 51% to 95.6%. Upper ramus vertical height had the highest rate at 95.6%, and bivariate analysis showed 89.7% to 98.6% accuracy rates with the highest ratios of mandibular flexure upper border and maximum ramus breadth. Stepwise discrimination analysis gave a 99% accuracy rate for all MR variables.Our study showed that the MR, in particular morphometric measures of the upper part of the ramus, can provide valuable data to determine sex in a Turkish population. The method combines both anthropological and radiologic studies.

De Quervain tenosynovitis affects the first extensor compartment of the wrist and occurs more frequently in females. This high prevalence could not be explained by soft tissue. As the osseous anatomy has been mostly neglected, we aimed to compare the distal radius between the sexes. We evaluated the presence of a bony ridge on the floor of the first extensor compartment on CT images with multiplanar imaging. We included 244 wrists (72 females, 172 males) in the study. A bony ridge was present in 58 (23.8 %) and absent in 186 (76.2 %) wrists. A ridge was present in 24 (33.3 %) wrists among females and 34 (19.8 %) wrists among males. A groove with a bony ridge was statistically associated with females. We observed two tendon groove morphologies for the first extensor compartment. A groove with a bony ridge occurs more frequently in females. Further research is needed to clarify the relationship between the high frequency of a bony ridge and increased prevalence of de Quervain tenosynovitis in females.