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Background/Aims: In the literature, the temporal variation of computed tomography severity score (CT-SS) values on consecutive CTs, which is an indicator of pneumonia severity, was not evaluated according to the presence of hepatosteatosis. We aimed to investigate the effect of hepatosteatosis on the temporal change of CT-SS in COVID-19 patients. Material and Methods: Our retrospective study included 472 RT-PCR positive COVID-19 patients (≥18 years old) admitted to our hospital between December 2021 and January 2022. Chest CT severity scores ranging from 0 to 5 were assigned to each lobe of the lung and total CT-SS was obtained. For quantitative analysis, if the hepatic/splenic attenuation ratio was <1, hepatosteatosis was defined in the first CT. Wilcoxon test was used to evaluate the temporal changes of CT-SS values relative to the presence of hepatosteatosis. Results: A total of 472 patients were included in the study and the mean age was 64.04±14.35 years. 255/472 (54%) of the patients were hepatosteatosis positive. There was no significant difference between hepatosteatosis groups and ICU admission and mortality (p=0.269; p=0.429). The median CT-SS values of the first CT scan of patients with hepatosteatosis were significantly higher than patients without hepatosteatosis (p<0.001). There was a significant increase between the 1st and the 2nd CT-SS in both patients with and without hepatosteatosis (both p<0.001). The increase in the second CT-SS was higher in patients with hepatosteatosis than in patients without hepatosteatosis. Conclusion: Hepatosteatosis is one of the important factors affecting the severity of pulmonary involvement, especially in the early period of COVID-19. Hepatosteatosis may be an indicator of poor prognosis in the temporal change of pneumonia severity in COVID-19 patients. [ABSTRACT FROM AUTHOR]

Objective: Our objective was to evaluate the performance of dual-energy computed tomography (DECT) in detecting post-traumatic bone marrow edema (BME) in distal extremities. Materials and Methods: We prospectively studied 31 consecutive patients (25 males) who presented within the first four weeks following distal extremity traumas (wrist, n=19; ankle, n=14) (protocol number: 2017/74). All patients underwent DECT and magnetic resonance imaging (MRI) within three days of presentation. Two independent radiologists analyzed DECT images for fractures and BME qualitatively. Computed tomography (CT) numbers on Virtual non-calcium (VNCa) images were obtained in both edematous and non-edematous areas for quantitative consensus assessment. We used MRI as a reference standard. Results: MRI identified BME in 56/71 bones (78.9%). The rates of BME detection on CT compared to MRI at the patient level were found to be statistically significantly lower, except for individuals over 40 years of age, women, those with 7-30 days between trauma and admission, and those with CT-detected fractures (p<0.05). The rates of BME detection on CT at the bone level, compared to MRI, were found to be statistically significantly lower (p<0.01), except for women and those with fractures detected on CT. The interobserver agreement for the qualitative analysis of BME was fair (?=0.407 and p<0.001). DECT's diagnostic accuracy rates in predicting BME were significantly higher in patients with fractures (p=0.028). CT numbers in edematous areas were significantly higher than in non-edematous areas (p<0.001). Conclusion: DECT may serve as an alternative for detecting post-traumatic BME in distal extremity bones. However, in our heterogeneous bone sample group, it exhibited low sensitivity and a low negative predictive value. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to investigate associations between hepatosteatosis (HS) with computed tomography severity score (CT-SS) and survival of coronavirus disease 2019 (COVID-19) patients attending the hospital. Methods: Our study was a retrospective analysis of 435 reverse transcription polymerase-chain reaction-positive COVID-19 patients (aged = 18 years) who attended our hospital between September and December 2021. The patient's chest CT parenchymal findings and CT-SSs were reported. For quantitative analysis, HS was defined if hepatic-to-splenic attenuation ratio (CTL/S)<1. In very fatty livers, we defined the hyperdense appearance of vascular structures compared to liver parenchyma as "pseudocontrast sign (PCS)." We divided patients into three groups based on the hepatic attenuation comparison of vascular attenuation. Group 1: no HS, Group 2: HS without PCS, and Group 3: HS with PCS. Results: 210/435 (48.3%) patients were included in Group 1, 184/435 (42.3%) in Group 2, and 41/435 (9.4%) in Group 3. The Mean CTL/S of Group 3 was 0.56±0.14, which was significantly lower than the other two groups (p<0.001). There was a very significant (p<0.001) negative correlation between CT-SS and CTL/S. There was no significant difference between HS groups with intensive care unit (ICU) admission (p=0.27) and mortality (p=0.64). In multivariate Cox regression analysis, HS with PCS was an 11-fold (p<0.001) risk factor for shortening the time from hospital admission to death and 3-fold (p=0.035) for shortening the time from ICU admission to death. Discussion and Conclusion: In our study, HS with the PCS was significantly associated with CT-SS but not with overall mortality. Consequently, this sign may be an independent indicator of shorter survival times among patients who died. However, multicenter studies are needed in a large patient population. [ABSTRACT FROM AUTHOR]

Purpose To investigate the effects of patient-induced artifacts on the diagnostic performance of the COVID-19 Reporting and Data System (CO-RADS) and the computed tomography chest severity score (CT-SS). Methods A single-center retrospective analysis of patients aged 18 years and older who were admitted to the authors' hospital with laboratory-confirmed COVID-19 and underwent chest CT between July and November 2021 was conducted. Patients' chest CT scans were examined by 3 radiologists for CT-SS and CO-RADS classifications. Patient-based artifacts, including metal artifacts, incomplete projection artifacts, motion artifacts, and insufficient inspiration, were identified by 3 readers who were unaware of each other. For statistical analysis, interreader agreement was investigated using Fleiss kappa (k) agreement analysis. Results The study population included 549 patients with a median age of 66 years (IQR, 55-75 years), 321 (58.5%) of whom were men. According to the overall CO-RADS classification, the highest interreader agreement was in patients without CT artifacts (κ = 0.924), while the lowest interreader agreement was in patients with motion artifacts (κ = 0.613). For the CO-RADS 1 and 2 patient groups, insufficient inspiration decreased the interreader agreement most (κ = 0.712 and κ = 0.250, respectively). For the CO-RADS 3, 4, and 5 patient groups, motion artifacts reduced the interreader agreement most (κ = 0.464, κ = 0.453, and κ = 0.705, respectively). For total CT-SS, the highest kappa value was in patients without artifacts (κ = 0.574), while the lowest kappa value was in patients with motion artifacts (κ = 0.374). Discussion The CT technologist can avoid patient-induced artifacts by placing patients carefully on the CT table, giving patients necessary instructions before CT acquisition, and selecting optimal scanning parameters. The authors are not aware of another study in the literature investigating the effects of patient-based artifacts on interreader agreement of CO-RADS classification and CT-SS for COVID-19. Conclusion CT artifacts degrade image quality and might lead to interreader disagreement of CO-RADS classification and CT-SS for patients with COVID-19. [ABSTRACT FROM AUTHOR]

Aim: It has been reported that the increased neutrophil/lymphocyte ratio (NLR) is associated with a poor prognosis in Coronavirus disease-2019 (COVID-19) patients. We aimed to correlate three consecutive computed tomography severity score (CT-SS) values with simultaneous NLR and other laboratory parameters and investigate their temporal changes effects on the prognosis of COVID-19 patients. Methods: This single-center cross-sectional study included 99 (aged ≥18 years) COVID-19 patients hospitalized between March 1, 2021, and June 30, 2021. Demographic data, laboratory findings, and intensive care unit (ICU) admissions were obtained from electronic medical records. We divided patients into two groups: ICU and non-ICU patients A radiologist calculated three consecutive chest CT-SSs using a 25-point visually semiquantitative system. Spearman's rho correlation was used to evaluate correlations between CT-SSs and laboratory parameters in ICU and non-ICU patients. Results: The study population included 99 patients with a mean age of 61.17±14.36 years. Significant associations were found between the third-highest values of CRP (p=0.005), D-dimer (p=0.007), lactate dehydrogenase (p=0.027), and ICU admission. While there was no statistical significance between the first and second CT-SS and ICU admissions, there was a significant relationship between the third CT-SS and ICU admissions (p=0.013). Moderate positive correlations between the first NLR and CT-SS (p=0.025, r=0.488) and the second NLR and CT-SS (p=0.001, r=0.650) were found in ICU patients. Conclusion: Our results demonstrate the importance of late follow-up chest CT and laboratory parameters for the prognosis and ICU admissions of COVID-19 patients. [ABSTRACT FROM AUTHOR]

Background: Previous studies reported axillary lymphadenopathy (LAP) as a side effect of the anti‐COVID‐19 vaccine. However, the effects of nonsteroidal anti‐inflammatory drug (NSAID)s on mRNA COVID‐19 vaccine‐related LAP have not been investigated. Purpose: We aimed to investigate the effects of NSAIDs on temporal changes in sonographic findings of COVID‐19 vaccine‐associated LAP. Methods: Our single‐center retrospective cohort study was conducted between October 2021 and April 2022. We included patients (aged ≥ 18 years) who applied with complaints of swelling in the ipsilateral axillary region after the COVID‐19 vaccine and had axillary region ultrasound (US) scans in electronic medical records within 30 days pre‐vaccination. The serial US was performed on the third, 10th, and 30th days post‐vaccination. Results: Our study included 38 patients with a median age of 36 (IQR, 32–43) years. In 18 (47.4%) patients used NSAIDs in the early post‐vaccination period. Measurements of LAPs on ultrasound scans increased at day 3 post‐vaccination compared with pre‐vaccination both in NSAID users and non‐users. On the 10th day, a statistically insignificant decrease in LAP diameters and cortical thickness was observed in NSAID users compared to non‐users. On the post‐vaccination 30th day, axillary LAPs regressed similarly in both groups. Conclusion: In our study, post‐vaccine NSAID use had no statistically significant effect on the course of axillary LAPs. [ABSTRACT FROM AUTHOR]

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Objectives: To investigate the relationship between the mammography-detected breast arterial calcification (BAC) and orbital color Doppler ultrasonography (CDUS) results., Methods: Our single-center study, included female patients who applied to our hospital between January and May 2022 and underwent mammography and orbital CDUS examinations. Two radiologists evaluated the mammograms, grouped the patients as BAC (+) and BAC (-), and performed orbital CDUS. Continuous variables obtained from CDUS were compared according to the presence of BAC. Also, receiver operating characteristics (ROC) analysis was used to determine the orbital CDUS threshold values for the presence of BAC., Results: A total of 119 women were included with a median age of 62 years, 57 (47.90%) had BAC. Orbital CDUS examination was performed on both eyes of 119 patients (238 eyes in total). Peak systolic velocity (PSV) and end-diastolic velocity (EDV) values of the ophthalmic artery (OA) (P < .001) and EDV of the central retinal artery (CRA) (P < .001) were significantly lower in patients with BAC. Pulsatile index (PI) and resistive index (RI) values of OA (P < .001) and CRA (P < .001) were higher in patients with BAC. In ROC analysis, the cut-off values for the presence of BAC were calculated as OA PI ≥1.415 and OA RI ≥0.755 (P < .001); CRA PI ≥1.135 and CRA RI ≥0.655 (P < .001)., Conclusions: Orbital perfusion disorders may be observed in patients with vascular calcification detected on routine mammography. Therefore, a more detailed evaluation of patients with BAC detected on mammography with orbital CDUS may enable early detection and treatment of ocular vascular problems., (© 2024 American Institute of Ultrasound in Medicine.)

Aim: To estimate the rupture risk of anterior communicating artery (AComA) and AComA-related aneurysms according to their localization, angiographic architecture, and morphological features., Material and Methods: In this study, 124 patients with AComA and AComA-related anterior system aneurysms were retrospectively evaluated. The aneurysms were classified according to their morphological appearance and angiographic architecture. The size, size ratio, angiographic architecture, and aneurysmal dome orientation of ruptured and non-ruptured aneurysms were compared using digital subtraction angiography (DSA) 3D images., Results: There was a significant relationship between rupture risk and the size ratio (p=0.043), morphological properties of the aneurysm (p < 0.001), aneurysm dome orientation (OR 1.29, 95% CI 1.32-6.818), and aneurysm type according to the angiographical architecture (p < 0.005)., Conclusion: In determining the rupture risk of AComA and AComA-related aneurysms, size alone is not a sufficient parameter with aneurysm morphology proving to be more efficacious. Grouping of aneurysms according to angioarchitecture, and its significant correlation with aneurysm rupture, may help to understand the underlying mechanisms in the formation and rupture of aneurysms. From this, more specific treatment protocols can be created, helping to improve the clinical evaluation of AComA aneurysms.