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Aim: To determine the prevalence of occult hepatitis B (HBV) infection (OBI) in patients with nonviral liver disease. Materials & methods: This study included 83 HBsAg-negative patients followed up at a gastroenterohepatology clinic. The presence of HBV DNA was investigated by using an in-house nested-PCR method applied to liver parenchymal biopsy samples obtained from patients who underwent due nonviral chronic liver disease. Results: OBI was detected in 19 (22.9%) of the 83 cases, in 11 (44%) of 25 anti-HBc-positive patients, and 15 (31.9%) of 47 anti-HBc and/or anti-HBs antibodies-positive patients. Conclusion: There is a considerable prevalence of OBI among patients with nonviral chronic liver disease. Therefore, it is suggested that closely monitoring HBV can be useful to prevent or more effectively manage possible OBI-related complications among patients with nonviral chronic liver disease, especially those who are HBsAg seronegative or anti-HBV antibody seropositive.

Occult hepatitis B infection (OBI) is defined by the persistence of the hepatitis B virus (HBV) genome in the liver of individuals testing negative for hepatitis B surface antigen (HBsAg). Hepatitis B core antibody (anti-HBc) is the serological marker that indicates HBV exposure. The impact of anti-HBc and OBI on patients with chronic hepatitis C remains unclear. The aim of the present study was to determine the prevalence of anti-HBc and OBI and to evaluate their impact on the clinical and pathological outcomes of patients with chronic hepatitis C. The study included 59 HBsAg-negative chronic hepatitis C patients who underwent a liver parenchymal biopsy. The presence of HBV DNA was investigated using an in-house nested PCR method. OBI was detected in 16 (27.1%) of the 59 cases and also in 10 (62.5%) of 22 (37.3%) anti-HBc-positive patients. None of the patients had positive serum HBV DNA. OBI was associated with the presence of anti-HBV antibodies (P 0.05). There was also an association between anti-HBc positivity and the activity grades and fibrosis stages of the liver and also a prevalence of liver steatosis (P 0.05). Positive anti-HBc results may predict OBI and may also be associated with the progression of liver injury in HBsAg-negative patients with chronic hepatitis C. Therefore, it is suggested that patients with chronic hepatitis C should be screened for anti-HBc positivity, and anti-HBc-positive patients should be carefully evaluated for disease progression.

Background: Lymphocele is a common complication after kidney transplantation, which does not require treatment unless it is symptomatic. In this study, we aimed to evaluate the incidence, clinical symptoms, treatment choices, and success of different treatment methods of symptomatic lymphocele. Materials and Methods: We evaluated 168 patients who had kidney transplantation between January 2012 and January 2020. Patients with decreased kidney functions due to lymphocele formation during the clinical follow-up were included in the study. External drainage catheter was placed in all patients, except one. In case of treatment failure with external drainage, laparoscopic fenestration guided by intraperitoneal ultrasonography was performed. Clinical symptoms and success rates of treatments were evaluated. Results: Symptomatic lymphocele requiring interventional treatment was detected in 15 (8.9%) of 168 renal transplant patients. All of the symptomatic lymphocele cases had increased serum creatinine levels, whereas 10 had decreased urine volume, 4 had abdominal discomfort, and 2 had ipsilateral lower extremity edema. External drainage catheter was placed as the first-line treatment in 13 patients. In 6 cases, due to treatment failure with external drainage and in 2 patients as a first-choice treatment, laparoscopic fenestration was performed. No lymphocele recurrence was observed during follow-up. Conclusion: Among various methods defined in the treatment of lymphocele, use of laparoscopic fenestration is increasing because of its high success rate and advantages over other methods. Intraperitoneal ultrasound-guided laparoscopic fenestration is a useful and safe method that can be performed as a first-choice treatment since it eliminates the risk of organ injury or bleeding.

Amac: Okult Hepatit B Virus (HBV) enfeksiyonu (Occult HBV infection; OBI) mevcut serolojik testler ile HBV yuzey antijeni (Surface antigen; HBsAg) negatif tespit edilen bireylerin karacigerinde HBV genomunun uzun sureli persistan varligi ile karakterizedir. Bu calismada OBI tanili hastalardan elde edilen HBV’lerin genotip, subgenotip ve subtip profillerinin karakteristiginin irdelenmesi amaclanmistir. Gerec ve Yontem: Calismaya HBsAg negatif farkli klinik endikasyonlar nedeniyle karaciger parankim biyopsisi gerceklestirilen hastalarin karaciger biyopsi orneklerinde Nested PCR yontemiyle HBV DNA varligi tanimlanan 32 OBI tanili hasta ile 17 kronik hepatit B hastasi dahil edildi. HBV S gen MHR bolgesini hedefleyen DNA fragmanlari nested PCR kullanilarak amplifiye edildi. HBV’nin genotip, subgenotip ve subtip/serotiplerinin belirlemek icin Sanger sekans metodu kullanildi. Bulgular: Bu calismada OBI ve kronik hepatit B hastalarindan izo le edilen HBV’lerin tumununun genotipi D, subgenotipler sirasiyla HBV/D1 (%75,5), HBV/D2 (%6,1) ve HBV/D3 (%18,4) serotipler sirasiyla ayw2 (%73,5) ve ayw3 (%26,5) olarak belirlenmistir. OBI’li hastalarin %28,1’nin subgenotipi HBV/D3 olarak belirlenmesine karsin kronik hepatit B hastalarinin hic birinde HBV/D3 subgenotipi saptanmamistir. Sonuc: Subgenotip HBV/D3’un viral biyogenezin dinamigi uze rindeki potansiyel etkileri HBsAg negatifligi ve dusuk replikasyon yetkinligi ile karakterize OBI ile iliskili olabilir.

The purpose of this study was to evaluate the relationship of IL28B rs12979860 and rs8099917 polymorphisms with the clinical, histological, and virological outcomes of patients with chronic hepatitis B (CHB) also the treatment responses of patients who received Nucleos(t)ide analogs (NAs) therapy.This study included 152 CHB patients who were underwent liver parenchymal biopsy. The IL28B rs12979860 and rs8099917 polymorphism were genotyped using the TaqMan assay.The IL28B rs12979860 CC and IL28B rs8099917 TT were identified as the genotypes with the highest frequency in all patients. On the other hand, IL28B rs12979860 TT and IL28B rs8099917 GG were the genotypes with the lowest frequency. The frequency of IL28B rs8099917 TG genotype was significantly different between patients with hepatitis B, who has histologically defined liver cirrhosis and no-fibrosis (p=0.02). In addition, a statistically significant correlation was found between the presence of IL28B rs8099917 G allele and virological unresponsiveness to NAs treatments in CHB patients (p=0.028).The presence of the IL28B rs8099917 G allele in CHB patients might be associated with the risk of developing cirrhosis and virological unresponsiveness to NAs treatments.

This study aimed to observe the preventive effect of prophylactic treatment on joint health in people with hemophilia (PwH) and to investigate the importance of integration of ultrasonographic examination into clinical and radiological evaluation of the joints.This national, multicenter, prospective, observational study included male patients aged ≥6 years with the diagnosis of moderate or severe hemophilia A or B from 8 centers across Turkey between January 2017 and March 2019. Patients were followed for 1 year with 5 visits (baseline and 3Seventy-three PwH, of whom 62 had hemophilia A and 11 had hemophilia B, were included and 24.7% had target joints at baseline. The HJHS and HEAD-US scores were significantly increased at the 12The HEAD-US and HJHS scoring systems are valuable tools during follow-up examinations of PwH and they complement each other. We suggest that POC ultrasonographic evaluation and the HEAD-US scoring system may be integrated into differential diagnosis of bleeding and long-term monitoring for joint health as a routine procedure.Bu çalışmada hemofili hastalarında profilaksinin eklem sağlığı üzerindeki koruyucu etkisini gözlemlemek ve eklemlerin klinik ve ultrasonografik olarak değerlendirilmesinin öneminin araştırılması amaçlandı.Ulusal, çok merkezli, prospektif ve gözlemsel olan araştırma Ocak 2017 - Mart 2019 arasında 8 ayrı merkezde takip edilen erkek ve 6 yaşından büyük orta seviyede veya ağır hemofili-A ve hemofili-B hastalarını kapsıyordu. Hastalar 1 yıllık takip sırasında toplam 5 ayrı vizitte (başlangıç, 3. ay, 6. ay, 9. ay ve 12. ay) değerlendirildi. Hemofili Eklem Sağlığı Skoru (HJHS) eklemlerin fiziksel bakısında kullanılırken Petterson skorlama sistemi radyolojik bakı sırasında değerlendirildi. Ayrıca, hasta başı ultrasonografisiyle bilateral eklem incelemeleri yapılarak HEAD-US skorlama yöntemiyle eklem skorları belirlendi.Çalışmada 62’si hemofili A ve 11’I hemofili B olan 73 hastanın %24,7’sinde hedef eklem varlığı mevcuttu. HJHS ve HEAD-US skorlarının tüm hastalarda takibin 12. ayında anlamlı olarak arttığı gözlendi. Hemofili A hastalarında daha yüksek skorlar saptandı. Skor artımı alt gruplarda değerlendirildiğinde çocukluk yaş grubunda artışın anlamlı olmadığı gözlendi. Başlangıçta ve 12. ayda yapılan üçlü bakıda HJHS, HEAD-US ve Petterson skorlarının anlamlı olarak korele olduğu saptandı.HJHS eklem skoru ile HEAD-US radyolojik skorlamasının hemofili hastalarının eklem sağlığının takibinde çok değerli olup birbirlerini destekledikleri yakından gözlendi. Hasta başı US skorlama sistemlerinin günümüzde hemofilide eklem sağlığının rutin takip ve izlemi sürecinde hem kanama ayırıcı tanısı hem de uzun dönemli takip açısından oldukça değerli bir yeri olacağını düşünüyoruz.

Objective: Natural course and clinical outcomes of chronic hepatitis B virus (HBV) infection is closely releated to immun responses of host and viral factors. Studies have suggested that there is strongly correlation between the level of IL-17 and especially of advanced liver damages associated with HBV. Role of IL-17 on natural course of chronic hepatitis B disease is yet to be fully clarified. This study aimed to evaluate the correlation between serum IL-17 levels with histological, virological, serological and biochemical data of chronic hepatitis B patients. Material and Method: Simultaneous liver biopsy and blood samples were obtained from 88 with chronic HBV enfection. Ishak modified histological activity index system was used for histological evaluation.The patients were divided into three groups taking into account by scoring as none/mild (F0-1), moderate / severe (F2-4) and cirrhosis (F5-6) according to the stages of fibrosis (F). It was analyzed using enzyme-linked immunosorbent assay (ELISA) to IL-17 levels in serum samples. Results: A total of 88 CHB patients were evaluated, with an average age of 41.77±13.39, 43 male and 45 female. Fibrosis stage of 64 (72.7%) of the patients included in the study was determined as F2-4. There were no statistically significant correlation between serum IL-17 levels with histological, virological, serological and biochemical data of patients. Conclusion: These data indicate that the immunopathological role of IL-17 on HBV-related especially low and moderate liver injuries are limited.

Graphical abstract, Highlights • Hemangiomas are the most common benign lesions of the liver. • They usually remain asymptomatic and it is sufficient to follow up with intermittent imaging methods. • Because of atypical location and pain, minimally invasive surgery was performed in this case. • Cavernous hemangiomas of the liver rarely require treatment. • Surgery can be the option in selected cases., Introduction Hemangiomas are the most common benign lesions of the liver. They usually remain asymptomatic and it is sufficient to follow up with intermittent imaging methods. The case presented herein featured with localization and atypical symptoms. Presentation of case A man aged 59 years was admitted with a three-month history of continuous and recently increased abdominal pain, and also early satiety. Computed Tomography (CT) showed a 9 × 6-cm mass that compressed the spleen on the left sub-diaphragmatic area, attached to the inferior part of the diaphragm. The mass was removed laparoscopically and pathology was cavernous hemangioma. Discussion Although surgical treatment of cavernous hemangioma of the liver (CHL) remains in the background, for symptomatic patients who have no clear diagnosis, when complications emerge, surgery can be preferable. Here in minimally invasive surgery was performed in this case suffering from atypical abdominal pain. Conclusion Cavernous hemangiomas of the liver rarely require treatment. Surgery is one of the options in selected cases and abdominal pain is one of the indications. In patients complaining from persistent abdominal pain, if intraabdominal atypical-localized mass was seen in examinations, hemangioma should be remembered in differential diagnosis.

Alveolar echinococcosis is a parasitic disease limited to the northern hemisphere. The disease occurs primarily in the liver and shows a profile mimicking slow-growing malignant tumors. Echinococcus multilocularis infection is fatal if left untreated. It can cause several complications by infiltrating the vascular structures, biliary tracts, and the hilum of the liver. As it can invade the adjacent organs or can spread to distant organs, alveolar echinococcosis can easily be confused with malignancies. We provide a brief review of epidemiologic and pathophysiologic profile of alveolar echinococcosis and clinical features of the disease. This article focuses primarily on the imaging features of alveolar echinococcosis on ultrasonogra-phy, computed tomography, magnetic resonance imaging, diffusion-weighted imaging and positron emission tomography-computed tomography. We also reviewed the role of radiology in diagnosis, management, and follow-up of the disease.

Purpose We aimed to determine the feasibility and effectiveness of agent emission imaging - high mechanical index (AEI-High MI) mode ultrasonography (US) compared with gray-scale and color Doppler US, alone or in combination, for the diagnosis of urolithiasis with reference to unenhanced computed tomography (CT). Methods This prospective study included 72 consecutive patients (40 males, 32 females; mean age, 45.9±14.7 years) referred by the department of urology for acute or elective symptoms of urolithiasis and confirmed to have urinary calculi on unenhanced abdominal CT, between January 2015 and June 2015. Gray-scale, color Doppler, and AEI-High MI US were performed by two radiologists to determine the effectiveness of these methods in the diagnosis of urinary stones and to compare them with the reference modality. Results A total of 189 calculi were detected on CT examination. Gray-scale US had a sensitivity of 66.1% and positive predictive value (PPV) of 88.7% for detecting calculi, while twinkling artifact of color Doppler had a sensitivity of 70.4% and PPV of 94.3%. The scintillation artifact of AEI-High MI mode had a sensitivity of 75.1% and PPV of 95.9%. When all ultrasound-based modalities were combined, the sensitivity and PPV rose to 83.1% and 88.2%, respectively. When calculi were grouped according to their size ( 10 mm), AEI-High MI mode had a higher sensitivity (60%) compared with gray-scale (32.5%) and color Doppler (41.3%) for calculi Conclusion AEI-High MI mode had a higher sensitivity compared with gray-scale and color Doppler for the detection of calculi smaller than 5 mm, but it did not make a significant contribution to detection of larger calculi. The combined use of gray-scale US with AEI-High MI mode could increase the detection rate of calculi smaller than 5 mm and provide a method for verification of suspected calculi on gray-scale US.

This study investigated the sonographic properties of drug packets containing narcotic drugs and the diagnostic role of ultrasonography in detecting body packing in comparison with CT. Forty-five suspects admitted to our hospital for diagnosis and management were routinely evaluated by non-contrast CT for the presence of drug packets. A single radiologist blind to CT data independently performed the abdominal ultrasonographic scans. Thirty-five of 45 suspects were carrying packets. In positive cases, two types of packets with different properties were noted. Twenty-eight cases had type 1 packets (solid form drug) and 7 had type 2 packets (liquid form cocaine). The sensitivity, specificity, positive, and negative predictive values of ultrasonography for detecting drug packets were 91%, 70%, 91%, and 70%, respectively. Ultrasonography accurately determined the presence or absence of packs in 39 of 45 suspects. Ultrasonography was found to have a high sensitivity but a low specificity in suspected cases. A negative ultrasonography cannot rule out the diagnosis of body packing. However, it may be preferred as the initial imaging method or for follow-up of suspected cases as a radiation-free, easy-to-use, and inexpensive technique.

Background: Reoperative neck surgery is technically more demanding because of the presence of scar tissue and distorted anatomy. We aimed to investigate the magnetic probe–guided excision of nonpalpable neck lesions in patients with previously operated neck compartments. Methods: This study included 9 patients with recurrent/persistent thyroid carcinoma, recurrent/persistent hyperparathyroidism with previously operated neck compartments. The pathologic lesions were localized by ultrasonography, and magnetic tracer (0.2 mL, iron oxide) was injected directly into the pathologic lesions. Careful dissection was carried out following the area of maximum magnetic activity until the nonpalpable lesions were identified and excised. Result: All neck lesions were removed in 9 patients. The median count from lesion was significantly higher than values from lesion bed (background activity; (9900/5 seconds vs 250/5 seconds, P < .001). During follow-up, all patients had negative ultrasonography. Conclusion: Magnetic probe–guided technique could provide access to nonpalpable lesion localization in centers without readily available access to nuclear medicine facilities.

OZET: Serebral derin venoz sistem trombozuna sekonder bilateral talamik enfarkt Bilateral talamik enfarkt nadir olup tum iskemik inmeler icinde kucuk bir kismi olusturur. En sik nedeni arteryel tikanmadir. Ancak daha nadir olarak venoz tromboza sekonder de gelisebilir. Nadir gorulmesi ve klinik semptomlarin spesifik olmamasi nedeniyle tani genellikle gecikir. Radyolojik goruntuleme yontemleri tanida degerli bilgiler saglar. Sunumda bas agrisi, bulanti ve kusma ile basvuran olguyu ele aliyoruz. Anahtar kelimeler: Bitalamik enfarkt, inme, serebral derin venoz sistem trombozu, kranial gorun- tuleme ABSTRACT: Bilateral thalamic infarction secondary to cerebral deep venous system thrombosis bithalamic infarction Bilateral thalamic infarction is a rare disorder that account a small fraction of ischemic strokes. The most common reason is the arterial occlusion. However in rare cases, it can be seen secondary to venous thrombosis. Because of the rarity and non-specific clinical symptoms diagnosis is delayed in most of the cases. Radiologic imaging methods are important in diagnosis. In this report, we describe

Alveolar hydatid disease or alveolar echinococcosis is a disease of the parasiteEchinococcus multilocularisthat is potentially fatal if left untreated. It primarily involves the liver but can be disseminated to other organs like the lungs and the brain by hematogenous route. Multiorgan involvement and the aggressive appearance of lesions make alveolar hydatid disease easy to confuse with a metastatic malignancy. For this reason, histopathological confirmation is essential for definite diagnosis. We present the imaging features of this disease in two patients in order to emphasize that these lesions can be easily misdiagnosed as malignancies.

Reoperative neck surgery is technically more demanding because of the presence of scar tissue and distorted anatomy. We aimed to investigate the magnetic probe-guided excision of nonpalpable neck lesions in patients with previously operated neck compartments.This study included 9 patients with recurrent/persistent thyroid carcinoma, recurrent/persistent hyperparathyroidism with previously operated neck compartments. The pathologic lesions were localized by ultrasonography, and magnetic tracer (0.2 mL, iron oxide) was injected directly into the pathologic lesions. Careful dissection was carried out following the area of maximum magnetic activity until the nonpalpable lesions were identified and excised.All neck lesions were removed in 9 patients. The median count from lesion was significantly higher than values from lesion bed (background activity; (9900/5 seconds vs 250/5 seconds, P.001). During follow-up, all patients had negative ultrasonography.Magnetic probe-guided technique could provide access to nonpalpable lesion localization in centers without readily available access to nuclear medicine facilities.

Objective Radiologists and other clinicians are facing an increasing number of illegal drug-related medical conditions. We aimed to draw attention to this growing global problem and to highlight some of the important points related to diagnosis and follow-up of body packing. We compare the diagnostic performance of unenhanced multidetector CT (MDCT) and abdomen X-ray for the detection of drug-filled packets. Materials and methods Sixty-seven suspects, who underwent both CT and X-ray examinations, have been included in the study. All MDCT and X-ray images were independently and retrospectively reviewed by two observers with different degrees of experience in abdomen imaging. Fifty-two of them were identified as body packers finally. Interobserver agreement, sensitivity, specificity, positive and negative predictive value were calculated. Results Two types of packets with different characteristics were identified in all body packers. Type 1 packets (solid-state drug) were found in 41 patients and type 2 packets (liquid cocaine) in 11 patients. All statistical analyses concern the detection of any packets. That is, the whole evaluation has been performed per patient. Sensitivity/specificity values of type 1 and type 2 packets for MDCT were 100–98%/100–100% and 100–100%/100–100%, respectively. Besides, sensitivity/specificity values of type 1 and type 2 packets for X-ray were 93–90%/100–91% and 64–45%/73–71%, respectively. In addition, interobserver agreements for detection of any packets were excellent ( κ = 0.96) and good ( κ = 0.75) for interpretation of MDCT and X-ray, respectively. Conclusion Unenhanced MDCT is a fast, accurate and easily used diagnostic tool with high sensitivity and specificity for the exact diagnosis of body packing.

Coronary Computed Tomography Angiography (CTA) is a diagnostic tool used in the current consisted of image test that combines X-rays via computerized technology. As the procedures are conducted, the X-ray beams that rotate around the human body are conditioned to sense the amount of X-rays, which pass through the body to control the radiation exposure. Conversely, the Dual Source Computed Tomography (CT) technology uses powerful CT scanners that have the capacity to image coronary arteries. Thus, the Dual-Source scanners use combined 64-slice scanners, incorporating 2 X-rays and detectors, hence enabling the operation of 2 X-rays at two dissimilar energy point modes. The sophisticated technology provides for performance of the test faster with improved resolution, favoring around 50% less radiation exposure. The high-tech scanners aided by the Dual Source technology freeze-frames almost each heart rate augments diagnostic competencies. Thus, it enables radiologists to check the afflicted patients with either speedy or unbalanced heartbeats devoid of the administration of beta-blockers. A timely diagnosis with coronary artery disease (CAD) is imperative in light of the morbidity and mortality of that concerns the disease (1). Invasive coronary angiography (ICA) is the gold standard for identifying coronary artery stenosis; however, it is an invasive process with very high radiation exposure (2). A configured high-tech (CT) technology has led to an increased use of coronary CTA, which is a somewhat expedient method with little radiation exposure of less than 50%, and high image quality and resolution (3,4). Different surveys have investigated the diagnostic properties of CTA with various devices (5,6). Long breath-hold times, motion artifacts, and excessive coronary artery wall calcifications were determined to be the major limitations of these studies. The results showed that 12% were non-assessable segments (6,7). Motion artifacts usually occur at increased heartbeats; intravenous (IV), and/or oral B-blockers are recommended to reduce these artifacts (8). Consequently, there were more limitations in sequential and spatial image quality for analysis; the data sets obtained were of frequent inadequate resolution for analysis. Hence, approximately 30% of the arteries tested were categorized as valuable (9,10). In the following years, hasty upgrading has taken place in CT technology, which has led to improved sequential and unique image quality and efficiency because of condensed attainment time (11). In 2002 and 2004, there followed the introduction of 16-slice and 64-slice scanners, which allowed a rotation time of about 330–420 ms (12). This was believed to be an excellent apparatus for CT visualization in the examination of coronary arteries. The first of the second-generation, 128-slice dual-source CT systems, sought to resolve the major problems related to coronary CTA; namely high radiation dose, motion artifacts, and poor imaging resolution. The system incorporates 2 sets of X-ray and detector sources arranged at 90°offset. Hence, data are obtained from more than 180° and restructure a cross-sectional image. Therefore, a little more data is a requisite for peripheral regions. Here, a one-quarter rotation is sufficient for collecting data required for a single image whenever two tubes and detectors of Dual Source Computed Tomography (DSCT) mounted on a similar gantry are made to function concurrently (13). The temporary resolution of DSCT is twice as high compared with a conventional single-source CT system since temporal resolution is the same as a quarter of scaffold rotation (14). Furthermore, the temporal resolution in DSCT is improved to about 83 ms; thus, it decreases the impact of motion artifacts on the resolution and image clarity. A current survey has shown an enhanced evaluation of moving pitches in the heart without the use of B blockers or Ivabradine (15). The Flash spiral technique scan utilizes data prospectively in a synchronized manner with electrocardiography (ECG) pulsing that modulates responses instantly to variations in the heart charge. A pitch is modified through the active automatic protocols that monitors the patients’ pulses and adapts it before a scan is completed. The method allows the use of the projected dosage, which is utilizable within the cardiac cycle for the most favorable results. Normally, the pulsing window should be set between mid and late diastolic stage; at this point, the dosage is condensed in line with the systolic heart’s cycle. Therefore, the creation of the tube should be reduced to 4% or lower within its titular value; hence, it saturates the maximized growth for the ECG spiral CT examination (16). The objective of the research was to examine how, during scanning, the heart rate changed, and the image quality when using dual-source CT. The final aim is to detect coronary artery undulation, together with the assessment of coronary stenosis, which depends on the temporal resolution and heart rate.

Background: This study retrospectively analyzed the clinical data, laboratory results, imaging findings, and histopathological features of 28 patients who underwent ultrasound-guided core-needle biopsy from a hepatic lesion and were diagnosed with alveolar echinococcosis. Results: Among 28 patients included in the study, 16 were females and 12 were males. The mean age of the studied population was 53 ± 16 years, and the age range was 18–79 years. The most common presenting symptom was abdominal pain, which was observed in 14 patients. A total of 36 lesions were detected in the patients’ livers, out of which 7 had a cystic appearance. Hepatic vascular involvement, bile duct involvement, and other organ involvement were depicted in 14, 5, and 7 patients, respectively. The average number of cores taken from the lesions was 2.7, ranging between 2 and 5. In histopathological evaluation, PAS+ parasitic membrane structures were visualized on a necrotic background in all cases. Regarding seven patients, who were operated, the pathological findings of preoperative percutaneous biopsies were in perfect agreement with the pathological examinations after surgical resections. None of the patients developed major complications after biopsy. Conclusion: Ultrasound-guided core-needle biopsy is a minimally invasive, reliable, and effective diagnostic tool for the definitive diagnosis of hepatic alveolar echinococcosis.

To investigate the role of density value in computed tomography (CT) and twinkling artifact observed in color Doppler analysis for the prediction of the mineral composition of urinary stones.A total of 42 patients who were operated via percutaneous or endoscopic means and had undergone abdominal non-contrast CT and color Doppler ultrasonography examinations were included in the study. X-ray diffraction method was utilized to analyze a total of 86 stones, and the correlations between calculated density values and twinkling intensities with stone types were investigated for each stone.Analyses of extracted stones revealed the presence of 40 calcium oxalate monohydrate, 12 calcium oxalate dihydrate, 9 uric acid, 11 calcium phosphate, and 14 cystine stones. The density values were calculated as 1499±269 Hounsfield Units (HU) for calcium oxalate monohydrate, 1505±221 HU for calcium oxalate dihydrate, 348±67 HU for uric acid, 1106±219 HU for calcium phosphate, and 563±115 HU for cystine stones. The artifact intensities were determined as grade 0 in 15, grade 1 in 32, grade 2 in 24, and grade 3 in 15 stones.In case the density value of the stone is measured below 780 HU and grade 3 artifact intensity is determined, it can be inferred that the mineral composition of the stone tends to be cystine.

This study investigated the prevalence and features of hepatic pseudolesions around the falciform ligament in 320 children undergoing contrast-enhanced abdominal multidetector computed tomography. Aberrant venous drainage was investigated using thin-section computed tomography images. Pseudolesions around the falciform ligament were detected in 63 patients (20%). The longest diameter was in the craniocaudal direction in 41 (65%) patients (lesions). An inferior vein of Sappey supplying the pseudolesions was seen in 11 patients (17%). Thirteen patients of the 63 patients (21%) with pseudolesions who had a history of extrahepatic malignancy were also examined by ultrasound; in two of the 13 patients the lesions were isoechoic and, in the remainding 11 patients, they were hyperechoic. It was concluded that hepatic pseudolesions around the falciform ligament occur frequently in the paediatric population on CT images. Detection of the longest diameter in the craniocaudal direction and the presence of an inferior vein of Sappey and fatty infiltration should be sufficient to exclude true lesions and make further evaluations unnecessary.

We present the mammographic and sonographic findings in a case of fibroadenomatosis involving both breasts and axillae in a renal transplant patient after 16 years of treatment with cyclosporin A. Awareness of the fact that cyclosporin A may induce the formation of fibroadenomas, including in accessory breast tissue, is important for correct diagnosis and preventing unnecessary intervention.

Background: Renal aspergillosis is a rare infection that usually occurs in persons with a predisposition for this condition. Its differential diagnosis includes primary and metastatic renal malignancies, pyelonephritis and secondary abscess formation, granulomatous disorders, and renal infarction. We aim to stress the role of multimodality imaging and percutaneous biopsy in the diagnosis of this condition. Case Report: We present diffusion weighted imaging (DWI) and positron emission tomography-computed tomography (PET-CT) findings in addition to conventional imaging modalities in a 55-year-old man with secondary renal aspergilloma. Conclusion: Radiological imaging methods are an integral part of diagnostic workup for renal aspergillosis. A definitive diagnosis is made by histopathological and/or microbiological examination of the material obtained via percutaneous biopsy under guidance of imaging methods.

Background This study was designed to investigate the diagnostic efficacy of computed tomography (CT) for the detection diaphragmatic injury in cases undergoing diagnostic and therapeutic laparoscopy in left thoracoabdominal penetrating injuries. Methods Demographic properties, stabbed body region, additional injuries, hemodynamic parameters, time to admission, diagnostic examinations, and type of treatment were retrospectively reviewed in one hundred and eight patients presenting with left thoracoabdominal injury after penetrating sharp object injury between April 2010 and December 2014. Preoperative CT scans of all patients were reviewed blind to the results of surgical evaluation. The relationship between diaphragmatic injury and hemothorax, pneumothorax, abdominal free fluid, and solid organ injuries were analyzed. All patients underwent physical examination, complete blood count monitoring, and hemodynamic assessment prior to surgery. Results The most common finding on physical examination was anterior left thoracoabdominal injury. The injury was detected surgically in 36% of twenty-five cases with lateral injury. Diaphragmatic injury was present in twenty-five (23.1%) of all cases, all of whom were treated with laparoscopic repair. An analysis of all CT findings in relation to surgical results revealed that CT had a sensitivity of 80%, a specificity of 95%, a PPV of 83%, and a NPV of 94% for the detection of diaphragmatic injuries. Mean duration of hospital stay was 5.4 days (range, 1-16 days) in the entire study population. Conclusion CT is still associated with diagnostic challenges in penetrating diaphragmatic injuries. Nevertheless, CT showed a high specificity and a negative predictive value in our study. Detection of a diaphragmatic defect and fatty tissue herniation makes the definitive diagnosis of diaphragmatic injury in penetrating thoracoabdominal injuries. Prospective studies with a larger sample size are necessary to further clarify the role of CT in detection of diaphragmatic injuries in thoracoabdominal sharp penetrating object injuries.

The aim of the study is to report a case of a rare congenital anomaly of the venous system and to emphasize its clinical importance. We describe a case of aplasia of the right common and external iliac veins in a healthy seven-year-old boy who was referred for Doppler ultrasound examination for further evaluation of an abnormal varicosity in the suprapubic region. Colour Doppler ultrasound revealed a dilated, arch-shaped vein. Contrast-enhanced magnetic resonance angiography showed the absence of the right common iliac vein and external iliac vein. It also clearly demonstrated the aberrant venous structure, originating from the right common femoral vein and draining to the left common femoral vein. In conclusion, in our case, the patient's life was threatened because the aberrant venous connection crossing within subcutaneous fatty tissue was not protected from external trauma and possible abdominal surgical interventions. Additional attention should be given to avoid such injuries, which can cause significant haemorrhage.

Objective: To emphasize the contribution of superparamagnetic iron oxide (SPIO) contrast agent in the diagnosis of the splenic hamartoma. Clinical Presentation and Intervention: A 63-year-old female was admitted to our hospital with diffuse abdominal pain. An ultrasound examination revealed a 5 × 4 cm solid lesion in the spleen. Dynamic gadolinium-enhanced magnetic resonance imaging (MRI) of the abdominal findings was consistent with a splenic hamartoma. SPIO-enhanced MRI was then performed and it confirmed the diagnosis. The lesion showed a decrease of signal intensity on T2-weighted images. Conclusion: This case showed that SPIO-enhanced MRI was useful for establishing a noninvasive diagnosis of the splenic hamartomas.

Mediastinal lipomatosis (ML) is a benign condition characterized by the accumulation of mature adipose tissue within the mediastinum. ML is usually associated with Cushing syndrome and obesity. Most patients are asymptomatic, but some have thoracic pain, dyspnea, cough, dysphonia, dysphagia, and supraventricular tachycardia. We report a case of ML compressing the right ventricular outflow tract in a patient with Behçet disease.

We present the mammographic and sonographic findings in a case of fibroadenomatosis involving both breasts and axillae in a renal transplant patient after 16 years of treatment with cyclosporin A. Awareness of the fact that cyclosporin A may induce the formation of fibroadenomas, including in accessory breast tissue, is important for correct diagnosis and preventing unnecessary intervention.

In this study, we aimed to describe non-contrast abdominal MRI findings in body packers and emphasize the role of this imaging technique in diagnosis of body packing.Non-contrast abdominopelvic MRI was performed at the radiology department in 16 suspected body packers that were brought to our hospital, and 13 of them were diagnosed with body packing. We evaluated the presence, location, and shapes of packets as well as signal characteristics on T1- and T2-weighted images.We came across two types of packets: those containing solid substances (10 cases) and those filled with liquid cocaine (3 cases). Both types were accurately diagnosed with the help of MRI. Only 1 suspected body packer received a false positive diagnosis.Abdominopelvic MRI is a reliable and valuable method of diagnosing body packing.

Emergency physicians and radiologists have been increasingly encountering internal concealment of illegal drugs. The packages commonly contain powdered solid drugs such as cocaine, heroin, methamphetamine and hashish, but they may also contain cocaine in the liquid form. The second type of package has recently been more commonly encountered, and poses a greater diagnostic challenge. As clinical evaluation and laboratory tests frequently fail to make the correct diagnosis, imaging examination is typically required. Imaging methods assume a vital role in the diagnosis, follow-up and management. Abdominal X-ray, ultrasonography, CT and MRI are used for the imaging purposes. Among the aforementioned methods, low-dose CT is state-of-the-art in these cases. It is of paramount importance that radiologists have a full knowledge of the imaging characteristics of these packages and accurately guide physicians and security officials.

A sternal cleft is a rare congenital and developmental disorder. In general, this disorder is associated with skeletal and extraskeletal abnormalities (eg, Cantrell syndrome), but isolated sternal clefts have also been reported. A sternal cleft with pectus excavatum is a rare congenital abnormality. We present a complete sternal cleft with right-sided clavicular hypoplasia and pectus excavatum in a 31-year-old female patient.

Traumatic occlusion of the renal artery is a serious injury. Management differs according to the grade of injury. In most circumstances, emergency surgical revascularization or endovascular intervention is required. We describe the case of a child with multiorgan injuries and spasm of the main renal artery after blunt trauma simulating arterial occlusion or end-organ infarction.

Foreign body ingestion is a common problem in children, but it is also seen among adults. Most foreign bodies pass through the gastrointestinal tract without causing complications. Perforation of the gut by a foreign body, followed by migration of the foreign body to the liver is quite rare. Herein we report a case of inadvertent ingestion of a sewing needle that perforated the duodenum and migrated to the liver. The patient was monitored weekly with abdominal radiographs, but displacement of the needle could not be observed. At follow-up, right upper quadrant pain was noted. Two weeks later, computed tomography revealed that the needle was completely buried into the right lobe of the liver. Ultrasonographic examination successfully showed the extracapsular displacement of the needle. Eventually, laparoscopic removal of the needle was easily performed.

Mucosa associated lymphoid tissue MALT lymphoma is a low grade malignancy that arises most commonly from the gastric mucosa. Small intestinal involvement is very rare. The causative relationship between Helicobacter pylori and the gastric MALT lymphoma is a well known issue, but recently there are several data suggesting the role of hepatitis C virus (HCV) infection in the pathogenesis of lymphoma including MALT lymphoma. Herein we present a rare case of duodenal MALT lymphoma with multiple intra-abdominal thromboses together with HCV infection that was confirmed by real-time polymerase chain reaction detecting HCV-RNA within the peripheral blood mononuclear cells.