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Endovascular treatment options have evolved in many ways and become an important alternative for open surgical repairs in various vascular territories. Herein, we present a case of an 18-year-old man with complex injury to the left subclavian artery and vein caused by a gunshot 4 months ago. After the gunshot, a high-flow fistula between the left subclavian artery and the vein occurred with pseudoaneurysm formation. This fistula led to a significant left subclavian steal phenomenon. A stent-graft was deployed along the injured left subclavian artery after embolization of the left vertebral artery by Amplatzer vascular plug 4 (AVP-4) in order to prevent subsequent endoleak due to the subclavian steal syndrome. [ABSTRACT FROM AUTHOR]

The authors evaluated transrectal sonographic (TRS) findings in 31 patients who had clinical and laboratory evidence compatible with chronic prostatitis. A comparative parallel study was also carried out in a group of 14 healthy volunteers who did not have any clinical or laboratory findings consistent with prostatitis. The TRS findings in these groups were statistically analyzed, and comparisons were made. There was statistical evidence that some of these TRS findings were consistent with, and almost pathognomonic for, chronic prostatitis. [ABSTRACT FROM AUTHOR]

Transcatheter aortic valve replacement (TAVR) has emerged as a well-established treatment option for eligible patients with severe aortic stenosis. This study aimed to investigate the correlation between abdominal fat tissue volumes, measured using computed tomography (CT), and all-cause mortality in patients undergoing TAVR. The study included 258 consecutive patients who underwent TAVR at a single center between September 2017 and November 2020. During the preoperative preparation, CT scans were used to perform a semi-quantitative measurement of abdominal fat components. Body mass index (BMI) for each participant was calculated. The relationship between fat parameters and overall survival was determined using multivariable Cox proportional hazards models. Participants had a mean age of 76.8 ± 7.8 years, of whom 32.9% were male. The median follow-up period was 12 months, during which 38 patients (14.7%) died. Both the survivor and non-survivor groups showed comparable risk factors. Regarding transabdominal fat volume parameters, deceased individuals exhibited significantly lower values. However, no significant differences were observed in BMI and transabdominal area measurements. Among transabdominal fat parameters, only subcutaneous fat volume [adjusted Hazard Ratio (aHR) = 0.83, p = 0.045] and total fat volume (TFV) [aHR = 0.82, p = 0.007] were identified as significant predictors of reduced all-cause mortality. Furthermore, TFV demonstrated the highest discriminative performance with a threshold of ≤ 9.1 L (AUC = 0.751, p < 0.001, sensitivity 71.1%, specificity 70.9%). Preoperative CT-based abdominal fat volume parameters, particularly TFV, can serve as potential predictors of survival in patients undergoing TAVR., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Background and Aims: The complete pathological response (pCR) following neoadjuvant chemotherapy (NAC) in breast cancer is essential for the accurate prediction of prognosis. We aimed to evaluate the efficacy of the presence and type of peritumoral edema detected by magnetic resonance imaging (MRI) in predicting pCR to NAC in breast cancer patients., Methods and Results: One hundred five patients with the diagnosis of invasive carcinoma were evaluated by MRI before NAC. Edema was evaluated in fat-suppressed T2-weighted images. The patients were categorized into three groups: patients with no peritumoral edema, patients with peritumoral edema, and patients demonstrating subcutaneous edema. The cases were categorized as being pCR and non-pCR. Molecular subtypes, lymphovascular invasion (LVI), tumor size, and apparent diffusion coefficient (ADC) were evaluated. A positive relationship was found between the presence of edema and tumor size. Subcutaneous edema was found to be statistically higher in non-pCR patients. While the number of pCR patients with subcutaneous edema was 17 (30.4%), the number of non-pCR patients with subcutaneous edema was 26 (53.1%) ( p   =  0.018). LVI was found to be statistically higher in patients with edema. The number of edema-negative and LVI (+) patients was 4 (15.4%), while the number of edema-positive and LVI (+) patients was 28 (35.4%) ( p  = 0.042). Intratumoral and peritumoral ADC values were significantly higher in tumors with edema., Conclusion: The presence of subcutaneous edema and LVI may be utilized for the prediction of pCR outcomes in breast cancer patients scheduled for NAC treatment.

Background: Computed tomography (CT) gives an idea about the prognosis in patients with COVID-19 lung infiltration., Purpose: To evaluate the success rates of various scoring methods utilized in order to predict survival periods, on the basis of the imaging findings of COVID-19. Another purpose, on the other hand, was to evaluate the agreements among the evaluating radiologists., Material and Methods: A total of 100 cases of known COVID-19 pneumonia, of which 50 were deceased and 50 were living, were included in the study. Pre-existing scoring systems, which were the Total Severity Score (TSS), Chest Computed Tomography Severity Score (CT-SS), and Total CT Score, were utilized, together with the Early Decision Severity Score (ED-SS), which was developed by our team, to evaluate the initial lung CT scans of the patients obtained at their initial admission to the hospital. The scans were evaluated retrospectively by two radiologists. Area under the curve (AUC) values were acquired for each scoring system, according to their performances in predicting survival times., Results: The mean age of the patients was 61 ± 14.85 years (age range = 18-87 years). There was no difference in co-morbidities between the living and deceased patients. The survival predicted AUC values of ED-SS, CT-SS, TSS, and Total CT Score systems were 0.876, 0.823, 0.753, and 0.744, respectively., Conclusion: Algorithms based on lung infiltration patterns of COVID-19 may be utilized for both survival prediction and therapy planning.

Introduction: Systemic sclerosis (SSc) is a multisystemic disease. Thyroid involvement in systemic sclerosis is an overlooked issue. Our study aimed to evaluate the decreased thyroid volume in SSc. Also, we aimed to show the relationship between patients' thyroid volume and clinical and laboratory parameters., Method: This was a single-center, cross-sectional study. Eighty-six patients were included in the study. A radiologist evaluated patients' thyroid volumes by ultrasonography. Demographic and clinical characteristics of the patients were recorded. Skin thickness was evaluated by the modified Rodnan skin score (mRSS) and the disease severity by the Medsger severity score (MSS). Findings were analyzed statistically., Results: Thyroid volume was in the atrophic range in 53.5% of the patients. There was a significant negative correlation between thyroid volume and mRSS, MSS, and disease duration. Logistic regression analysis showed that mRSS and disease duration were risk factors for thyroid atrophy., Conclusions: Many studies point out that thyroid autoantibodies are a cause of thyroid dysfunction in patients with SSc. However, in most of these studies, thyroid volume was not evaluated. As a result of our study, we saw that the major cause of thyroid dysfunction in our SSc patients was thyroid atrophy. Also, we observed that thyroid atrophy was more common in patients with interstitial lung disease. We would like to draw attention to the fact that thyroid dysfunction and volume changes increase with the disease's duration and severity in systemic sclerosis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Badak et al.)

Objective: This study aimed to investigate and compare the ultrasonography and contrast-enhanced magnetic resonance imaging characteristics of incidentally detected hyperechoic focal liver lesions., Methods: Seventy-four patients (29 males and 45 females) who had undergone a B-mode ultrasonography and contrast-enhanced magnetic resonance imaging examination were included in this study. A total of 91 hyperechoic lesions detected on ultrasonography were evaluated. The ultrasonography features of these hyperechoic lesions were recorded, and the results were compared with those acquired from contrast-enhanced magnetic resonance imaging. The results were compared statistically using the Shapiro-Wilk, McNemar, and Wilcoxon signed-rank tests., Results: A corresponding lesion was found on contrast-enhanced magnetic resonance imaging in 72 of the 91 (79.1%) hyperechoic lesions detected on ultrasonography. Forty-one (56.9%) of the magnetic resonance imaging-defined lesions were typical hemangiomas, while 10 (13.9%) were focal steatosis areas and 4 (5.6%) were diagnosed with hepatocellular carcinoma. In contrast, 6 lesions (8.3%) were diagnosed as simple hepatic cysts, 4 (5.6%) as sclerosing hemangioma, 2 (2.8%) as thrombosed hemangioma, 1 (1.4%) as focal nodular hyperplasia, 1 (1.4%) as hamartoma, 2 (2.8%) as hydatid cysts, and 1 (1.4%) as hepatic lipoma. No statistically significant differences were found between ultrasonography and magnetic resonance imaging in terms of the segmental classification of the true positive lesions based on contour structures and lesion area measurements (p=0.558, p=0.375, and p=0.636, respectively)., Conclusions: Incidentally detected hyperechoic zones may not necessarily be detected on magnetic resonance imaging. This may be secondary to focal hepatic steatosis or false interpretation of the radiologist. Lesions requiring therapy must be considered in the differential diagnosis.

Purpose: Pancreas contour variations can sometimes be misdiagnosed as mass lesions. This study aimed to evaluate normal pancreatic contour morphology, variations, frequency and the development of the uncinate process., Methods: Out of 1183 consecutive computed tomography images taken in our hospital for various reasons (e.g. malignity, donor), 899 suitable images were included in the study. The following variations were identified: globular, elongated or globular-elongated contours of the pancreas head, protrusions of the body-tail surfaces and globular, lobular, globular-lobular, tapered and bifid contours of the tail. Hypoplasia and aplasia of the uncinate process were identified. All images were evaluated retrospectively by two radiologists., Results: Of the 899 patients, 504 (56.1%) were males. The mean age of the patients was 53.9 ± 14.7 (range 18-89). Hypoplasia of the uncinate process was found in 72 (8%) patients; aplasia was seen in 11 (1.2%) patients. Thirty-one (3.5%) of the pancreatic head variations were globular, 49 (5.4%) elongated and three (0.3%) elongated-globular. In patients with pancreatic uncinate process developmental anomaly, contour variations were also detected in the head of the pancreas. The pancreatic body-tail showed protrusions anteriorly in 76 (8%) patients and posteriorly in 11 (1.2%) patients. Seventy-two (8%) of the pancreatic tail variations were globular, 39 (4.4%) were globular-lobular, 18 (2%) were tapered and 17 (1.8%) were bifid., Conclusion: Patients with pancreatic uncinate process developmental anomaly also have contour variations in the head of the pancreas. Pancreatic uncinate process developmental anomaly was seen in 9.2%. Pancreatic tail contour variation was 16.2%. The pancreatic body-tail showed protrusion in 9.2% of patients., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: We aimed to evaluate the use of the COVID-19 reporting and data system (CO-RADS) among radiologists and the diagnostic performance of this system., Methods: Four radiologists retrospectively evaluated the chest CT examinations of 178 patients. The study included 143 patients with positive reverse transcriptase-polymerase chain reaction (RT-PCR) test results and 35 patients whose RT-PCR tests were negative but whose clinical and/or radiological findings were consistent with COVID-19. Fleiss' kappa (κ) values were calculated, and individual observers' scores were compared. To investigate diagnostic efficiency, receiver operating characteristic (ROC) curves were calculated for each interpreter., Results: The interpreters were in full agreement on 574 of 712 (80.6%) evaluations. The common Fleiss' κ value of all the radiologists combined was 0.712 (95% confidence interval [CI] 0.692-0.769). A reliable prediction on the basis of RT-PCR and clinical findings indicated the mean area under the curve (AUC) of Fleiss' κ value as 0.89 (95% CI 0.708-0.990). General interpreter agreement was found to range from moderate to good., Conclusion: The interpreter agreement for CO-RADS categories 1 and 5 was reasonably good. We conclude that this scoring system will make a valuable contribution to efforts in COVID-19 diagnosis. CO-RADS can also be of significant value for the diagnosis and treatment of the disease in cases with false-negative PCR results.

Aim: The aim of this study was to detect macrovascular findings in systemic sclerosis (SSc) by means of color Doppler ultrasonography (CDUS) and to evaluate the relationship between the laboratory and clinical findings in the setting of the disease., Methods: This was a cross-sectional study. Eighty-eight patients were included in the study. CDUS examinations of the bilateral carotid, vertebral, and peripheral arteries were performed. The presence of macrovascular involvement was investigated and recorded, and its relationships with the clinical, laboratory, and cardiovascular risk factors were evaluated., Results: An atheromatous plaque was found in 67.7% of the 1936 arteries examined by CDUS. Of these 1936 arteries, 37.4% demonstrated a narrowing of the intraluminal diameter. On the other hand, the carotid intima-media thickness (CIMT) was found to have increased in 55.7% of the patients. This increase was found to be statistically correlated with disease duration, the modified Rodnan Skin Thickness Score, and the Medsger Disease Activity Score. But no relation existed with the disease subtype, age, or cardiovascular risk factors. Arterial occlusion was detected in 10 patients. An association was found between the CIMT values and arterial occlusion., Conclusions: In this study, we examined the arteries by means of CDUS, and we detected structural alterations in the peripheral and carotid arteries. We witnessed that these macrovascular changes had a close association with certain features of SSc. We think there is a need for broader prospective studies in order to evaluate the contribution of these factors to the macrovascular changes stated in the article., (© 2021 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Purpose: This study was to investigate the effect of mesorectal fat tissue volume (MRV) on the pathological response to neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer., Methods: 88 patients who had been diagnosed with locally advanced rectal cancer between January 2017 and June 2020 were reviewed retrospectively. The total abdominal, subcutaneous, visceral, and mesorectal fatty tissue components were measured semiquantitatively by two radiologists using computed tomography (CT)-based findings. The patients were divided into two groups as those with and without a pathological response to nCRT. The relationship of MRV with the other fat tissue components of the body was also evaluated., Results: We performed a retrospective analysis of 88 patients (mean age 62.7 years [range, 33-90 years]; 31 males and 57 females). A positive response to nCRT was present in 47 patients. There were 59 patients with stage 3 disease. 46 patients demonstrated lymph node involvement. The mean MRV was 69.6 ± 31.0 ml in no-response group and 105.8 ± 47.5 ml in response-positive patients (p < 0.05). MRV showed the highest correlation with visceral fat volume (VFV). There was a negative correlation between the MRV and the N stage. A cut-off value of ≥ 69.4 for MRV predicted the repsonse to nCRT, with 82.9% sensitivity and 58.5% specificity [AUC: 0.757 (0.653-0.842), p < 0.001] in receiver operating characteristic (ROC) curve analysis CONCLUSIONS: MRV can be used as a novel parameter in predicting of pathological response to nCRT in locally advanced rectal cancer patients.

Purpose: In this study, we aimed to establish a quantitative threshold value in the diagnosis of subacromial impingement syndrome by measuring the thickness of the subacromial bursa during abduction and adduction., Materials and Methods: Forty-five patients with subacromial impingement syndrome and 54 healthy individuals underwent dynamic shoulder ultrasonography. The subacromial bursa, between the supraspinatus tendon margin and peribursal adipose tissue, was measured between the acromion and humeral head at its widest part. The subacromial impingement ratio was calculated by dividing the subacromial bursa thickness during abduction to the subacromial bursa thickness during adduction. Shapiro-Wilk test was used in the assessment of normal distribution of parameters., Results: The mean subacromial bursa thickness in the abduction position was 1.8 ± 1.1 mm in the study group and 0.9 ± 0.3 mm in the control group. The mean subacromial bursa thickness in the adduction position was 0.9 ± 0.5 mm in the study group and 0.8 ± 0.3 mm in the control group. The subacromial impingement ratio showed a statistically significant difference between groups (p < 0.0001), and the ratio being 2.0 ± 0.5 in the study group and 1.2 ± 0.1 in the control group. For measurements performed in the abduction position, the best cut-off value was calculated as 1.3 mm, and sensitivity and specificity were 70.6 and 85.2%, respectively. The best cut-off value was 1.4 for the subacromial impingement ratio, and sensitivity and specificity were 88.2 and 96.3%, respectively., Conclusion: Subacromial impingement ratio is a very practical and reliable method in subacromial impingement syndrome diagnosis.

Purpose: The purpose of this study was to evaluate the diagnostic efficacies of CT fistulography and MRI, in the diagnostic work-up of perianal fistula patients., Materials and Methods: All 41 patients who were included in the study (36 males and 5 females, with an average age of 41 years) underwent CT fistulography and MRI examinations prior to surgery. The fistula characteristics obtained from these examinations were compared with the surgical findings. The comparative results were evaluated by means of the Kappa analysis method., Results: CT fistulography predicted the correct perianal fistula classification in 30 (73.1%) of the 41 patients, whereas MRI correctly defined fistula classification in 38 (92.7%) of these patients (the K values were 0.621 and 0.896, respectively; with p < 0.001). CT fistulography depicted 29 secondary extensions in 16 patients, whereas MR imaging revealed 28 secondary extensions in 15 patients. A substantial agreement was found between surgical findings and two modalities (K value was 0.789 and 0.793 for CT fistulography and MRI, respectively, with a p value < 0.001). In terms of locations of internal openings, CT fistulography was able to detect the locations in 28 patients (68.2%), whereas MRI was more successful in this aspect, with a number of 35 patients (85.3%). Granulation tissues, inflammation and edema around the fistula, abscesses, and fistular wall fibrosis were also evaluated., Conclusion: CT fistulography and MRI have different advantages in the diagnosis of perianal fistulas. A good command of knowledge concerning the issue may be a key factor in modality decision.

Innominate artery steno-occlusive disease is a relatively rare clinical entity and may cause cerebrovascular symptoms. Herein, we report a 50-year-old male patient who presented with recurrent syncopal episodes and cerebrovascular ischemia. Color Doppler sonography revealed a distinctive flow pattern with partial and total flow reversal in the right internal carotid artery and vertebral artery, respectively. Further angiographic evaluation revealed complete occlusion of the innominate artery. Endovascular stenting was successful and enabled normal antegrade flow in the right common carotid and vertebral artery.

Purpose: The purpose of this study was to investigate the efficacy and safety of intraarterial transcatheter administration of polidocanol as an alternative treatment for peripheral arteriovenous malformations (AVMs)., Methods: The study comprised 10 patients (six males and four females) with a mean age of 28.8 years (range 8-52 years). All patients had trunk or extremity AVMs. Following the administration of general anesthesia or intravenous (IV) sedation, the patients underwent staged intraarterial polidocanol sclerotherapy with or without additional embolizations for their AVMs. The administration of polidocanol was executed by intraarterial infusion through a microcatheter or by direct percutaneous entry into the nidus under ultrasound guidance., Results: A total of 19 sessions were accomplished in 10 patients. Polidocanol was used alone in six of the 19 sessions. In 13 sessions, polidocanol was used in combination with another agent (including n-butyl cyanoacrylate (NBCA), lipiodol, and ethanol) and/or coils. In two sessions, polidocanol was administered percutaneously under ultrasound guidance directly into the nidus documented by arteriography. No major complications occurred., Conclusion: Intraarterial transcatheter administration of polidocanol alone or in combination with other agents is a safe and effective alternative treatment for peripheral AVMs.

Inguinal hernias in the newborn age group are seldom encountered. In the affected female patient, the ovaries, fallopian tubes, and the intestines may settle in the hernia sac. The early diagnosis of torsion in cases in which the ovary is herniated into the inguinal canal is of utmost importance in order to give surgery the chance of reduction and correction. In this paper, a case of an ovarian herniation into the inguinal canal without the presence of torsion is being presented, and the place of US and CDUS in the differential diagnosis of the situation is being discussed.

A 42-year-old female patient, who had been diagnosed with an occlusion of her left internal carotid artery (ICA) following Doppler ultrasonographic (US) and digitally-subtracted angiographic (DSA) examinations performed in an outer healthcare center in order to eliminate the underlying cause of her complaint of amorosis fugax, later applied to our hospital with the same complaint. At Doppler US performed in our hospital's radiology department, her right common carotid artery (CCA) was normal, but her left CCA was hypoplastic. The right internal artery (ICA) was validated as normal. At the left side, however, the ICA was apparent only as a stump and it did not demonstrate a continuity. The diagnosis of ICA agenesis was confirmed by the utilization of Doppler US, CT, and DSA imaging, and it was concluded also that ipsilateral CCA hypoplasia could be evaluated as an important clue to the diagnosis of ICA agenesis.

The objective of this study was to investigate the reliability and validity of the Turkish version of the Bath Ankylosing Spondylitis (AS) Patient Global Score (BAS-G). Seventy-one consecutive patients with AS were enrolled into the study. Patients were requested to fill in the questionnaire on the day of admission (first visit), on a second occasion within 24 h after admission (second visit) for test-retest reliability analysis, and on a third occasion for assessing sensitivity to change. Construct validity was assessed by correlation analysis with the Bath AS Functional Index (BASFI), Dougados Functional Index (DFI), Dougados Articular Index (DAI), physical examination findings, and several other parameters. Test-retest reliability analysis of individual BAS-G scores at initial and second visits showed good intraclass correlations [n=46, intraclass correlation=0.928 (0.870-0.960) and intraclass correlation=0.853 (0.725-0.920), for 1-week and 6-month scores, respectively]. Both 1-week and 6-month scores showed moderate correlations with the BASFI (r=0.586 and r=0.503, respectively, P=0.000 for both). The 1-week score also showed moderate correlation with the DFI (r=0.530, P=0.000). The 1-week score showed weak correlations with finger-to-floor distance (r=0.263, P=0.027), chest expansion (r=-0.245, P=0.039), and DAI (r=0.271, P=0.036). Change in the 1-week score at the third visit showed good correlation with the BASFI score (r=0.670, P=0.000, n=36) and moderate correlation with the DFI (r=0.440, P=0.017, n=29). The Turkish version of the BAS-G has good reliability and validity. It is a good tool for assessing patients with AS or other rheumatic diseases in clinical practice and research.

Unlabelled: To investigate the reliability and validity of the Turkish version of the Dougados functional index (DFI) in patients with ankylosing spondylitis (AS). The Turkish version of DFI was obtained after a translation and back-translation process. Seventy consecutive patients with AS were enrolled. Patients were requested to complete the questionnaire on the day of admission (first visit), a second time within 24 h after admission (second visit), and on a third occasion. Reliability, validity and reproducibility of the Turkish version of the index were assessed. All the items showed significant correlations with the total index score with r-values ranging from 0.516 to 0.817. Cronbach alpha score was calculated as 0.908. Significant correlations were found between the total DFI score and Schober test (r=-0.293, P<0.05), occiput-wall distance (r=0.384; P<0.01) finger-to-floor distance (r=0.450, P<0.001), chest expansion (r=-0.331, P<0.01) and Dougados articular index (r=0.352, P<0.05). Good correlations were found between individual DFI items and the total score (r=between 0.533 and 0.882, p< 0.001) for the first and second visits, showing good reproducibility of the index., Conclusion: the Turkish version of DFI has good reliability, validity and reproducibility, confirming its utility for trials in Turkish AS patients.

The purpose of this study was to investigate the reliability and validity of the Turkish version of the Bath Ankylosing Spondylitis (AS) Functional Index (BASFI). The Turkish version of the BASFI was obtained after a process of translation and back-translation. Eighty-one consecutive patients meeting the 1984 New York criteria for AS were enrolled. Patients were evaluated and requested to complete the questionnaire at days 1 and 2 and on a third occasion between days 15-90. Reliability, reproducibility, validity and sensitivity to change of the Turkish version of the index were assessed. Each score correlated closely with the index score, with coefficients between 0.727 and 0.844. Reliability analysis showed a Cronbach's alpha score of 0.926. Correlations were found between all items of the BASFI and Schober's test (r=-0.258 to -0.531, p<0.001-0.05), occiput-to-wall distance (r=0.284 and 0.589, p<0.001-0.05), and finger-to-floor distance (r=0.334 to 0.613, p<0.001-0.01). The total index score was correlated with the number of nocturnal awakenings (r=0.515, p<0.001), Schober's test (r=-0.444, p<0.001), finger-to-floor distance (r=0.567, p<0.001), occiput-to-wall distance (r=0.535, p<0.001), chest expansion (r=-0.403, p<0.001), and the Dougados articular index (r=0.371, p<0.01). A good correlation was found between day 0 and 1 BASFI indices (r=0.765-0.917, p<0.001), showing good reproducibility of the index. The Turkish version of the BASFI showed reliability, reproducibility, and validity, confirming its utility in the research of AS in Turkey. However, sensitivity to changes due to drug therapy and/or rehabilitation remains to be determined.

An interesting case of a giant renal hydatid cyst is presented. The big cystic mass detected at ultrasonography (US) and computerized tomography (CT) in a ten-year-old girl looked like a simple cyst. No germinative membrane or any other radiological sign of a hydatid cyst was present. The operation was planned for a simple cyst; but was altered, after an intraoperative diagnostic needle sampling brought out the characteristic fluid of hydatid cyst. We came to the conclusion that hydatid cystic masses may not always present with their characteristic radiological findings; and that extreme caution should be practiced by the radiologist and the surgeon in order to prevent iatrogenic echinococcal dissemination.

Study Design: After determining the normal reference values for the length of the transverse processes of the seventh cervical vertebra, the association between the presence of cervical rib and sacralization was investigated., Objective: To determine the length of cervical rib and search for any association between cervical rib and sacralization., Summary of Background Data: Both cervical ribs and sacralization have been noted in some patients in the authors' clinical practice., Methods: The cervical rib is a supernumerary rib arising from a cervical vertebra, or it might be simply an elongation of the transverse process of the seventh cervical vertebra. However, there is no consensus about a specified length of this process. For reference values, anteroposterior cervical radiographs of 210 normal individuals (112 male, 98 female, mean age 33.9 +/- 10.1 years, range 19-61 years) were taken, and elongation of the transverse processes beyond 2 standard deviations (30 mm) was considered as cervical rib. In the guide of the reference values, 324 outpatients (165 male, 159 female, mean age 42.0 +/- 14.6 years, range 17-85 years), having cervical ribs or sacralization detected by plain radiographs, were taken as the study group. As control 729 volunteers (364 male, 365 female, mean age 41.7 +/- 14.3 years, range 15-76 years) were studied., Results: In 1053 patients, of 471 patients having cervical ribs, 345 (73.2%) had also sacralization; of 536 patients with sacralization, 345 (64.4%) also had cervical ribs. Significant associations were found between cervical rib with or without articulation and sacralization [chi2 = 52.284, P < 0.001, odds ratio 5.097 (3.156-8.234); chi2 = 139.473, P < 0.001, odds ratio 5.204 (3.922-6.905), respectively]., Conclusion: Presence of cervical rib might be a clue to the existence of sacralization or vice versa. In patients with cervical or lumbar pain, this association may be helpful for differential diagnosis before applying sophisticated diagnostic techniques.