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Background: Cancellations of surgeries for elective cases and late admissions of symptomatic cases during the pandemic period might have increased the number of cases of acute cholecystitis and its complications. Purpose: To compare the severity of acute cholecystitis and complication rates during the pandemic and pre-pandemic periods. Material and Methods: We evaluated the computed tomography (CT) findings observed for the diagnosis of complications for both acute simple and acute complicated cholecystitis during both the pandemic and pre-pandemic periods. Patients admitted to the hospital between March 2020 and December 2020 made up the study group and the corresponding appropriate patients from one year earlier were studied as the control group. In addition to the CT findings, clinical and laboratory findings, co-morbidities such as diabetes, as well as the admission time to hospital from the onset of the initial symptoms to hospital admission were also evaluated. Results: A total of 88 patients were evaluated (54 in the study group, 34 in the control group; mean age = 64.3 ± 16.3 years). The male-to-female ratio was 51/37. The number of patients diagnosed with complicated cholecystitis were significantly higher in the study group (P = 0.03). Murphy finding and diabetes status were similar between the two groups (P = 0.086 and P = 0.308, respectively). Admission time to the hospital was significantly different for study and control groups in simple cholecystitis patients (P = 0.045); with no significant difference in cases of complicated cholecystitis (P = 0.499). Conclusion: Our study reveals the course of acute cholecystitis during the pandemic period was much more serious with higher complications. [ABSTRACT FROM AUTHOR]

Objective: To determine the role of ultrasonography (US) and computed tomography (CT) in the evaluation of ascites etiology., Methods: From 2000-2006, patients admitted to the Radiology Department, Uludag University Medical School Hospital, Bursa, Turkey, were studied to determine the etiology of ascites, or those in whom ascites was determined during the course of other investigations were evaluated using US and CT. Existence of septa-debris, accompanying organ pathology, omental involvement, intestinal wall thickening, peritoneal implant, lymph node, diameter of portal vein, thickening of gall bladder wall, pleural effusion, collateral vascular structure, and cavernous transformation were also investigated., Results: A total of 30 cases were included. Causes were determined to be malignant in 15 (50%) cases and 15 (50%) benign. The US was significantly superior to CT in the evaluation of gall bladder thickening. Omental thickening, thickening of intestinal wall, and peritoneal implant development were seen significantly more frequently in malignant compared to benign cases, while thickening of the gall bladder wall was seen more frequently in benign cases. Ascites density of malignant cases detected in slices without contrast was higher than in benign cases. The probability of malignancy was 98% when omental thickening, thickening of intestinal wall, and peritoneal implant were present together in the same case., Conclusion: Although CT and US may help to evaluate ascites, however, the differential diagnosis of ascites etiology remains a challenge.

Objective: The purpose of this study was to assess the advantages of the image subtraction technique in chemical shift MRI for the differentiation of adrenal adenomas from nonadenomas., Subjects and Methods: Thirty-five patients with 42 adrenal masses (eight metastases and 34 nonfunctioning adenomas) underwent chemical shift MRI using a double-echo fast low-angle shot sequence. Subsequently, opposed-phase chemical shift MR images were subtracted from in-phase images. The subtraction images were assessed quantitatively and qualitatively. For quantitative assessment, the signal intensity values of the adrenal masses were measured by one investigator with manually defined regions of interest. Qualitative assessment of the subtraction images was performed independently by two investigators, who reported their confidence in diagnosing adenomas versus nonadenomas based on signal intensity of the adrenal masses on subtraction images., Results: The mean signal intensities were significantly different between adenomas and metastases on subtraction images (213 vs 18; p < 0.0001). There was no overlap in signal intensities between adenomas and metastatic tumors. The accuracy in distinguishing adenomas from metastatic tumors was 100% if the cutoff value of the signal intensity selected was 36-106. Quantitative results corresponding to 100% specificity were also observed, with similar sensitivity. No difference in interpretation between the two investigators occurred., Conclusion: Chemical shift subtraction MRI provides a high confidence level in distinguishing adrenal adenomas from adrenal metastases. The image subtraction technique also facilitates quantitative and qualitative evaluation of adrenal masses in chemical shift MRI.