Search

PURPOSE The formation of pterygoalar (Pa) and pterygospinous (Ps) bars are controversial whether they are secondary ossifications with aging or phylogenetic remnant. Therefore we aimed to evaluate the presence of Pa and Ps bars in children on routine cranial computed tomography images. METHODS We retrospectively analyzed the cranial computed tomography images of 500 children under the age of 18. Besides the 0.5 mm axial images, maximum intensity projection and 3D reconstructions were also used. The existence of incomplete or complete Pa and Ps bars were investigated. RESULTS Incomplete and complete Pa bar was detected in 4.6% and 2.2% of the cases, respectively. Incomplete Ps bar was seen in 13.6% of the cases and complete was in 6%. In total, per 1000 sides, 12 (2.4%) complete and 27 (5.4%) incomplete Pa bars were detected. In the same way, 35 (7%) complete and 88 (17.6%) incomplete Ps bars were seen. The smallest age ossification detected was 5 months old. Additionally, the prevalence of Pa and Ps bars between the under and over 10 years old age groups were statistically significant. Aging increased the prevalence. CONCLUSION Considering our results, it seems that the ossification of Pa and Ps ligaments may not be solely related with aging.

Introduction: The sudden emergence and rapid spread of the Coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 has dangered global health. For this reason, there has been an urgent need to develop strategies to control the spread of the virus. In this study, we aimed to evaluate the clinical, laboratory and chest computed tomography (CT) findings of COVID-19 cases with positive results of SARS-CoV-2 reverse transcription quantitative polymerase chain reaction (RT-qPCR). Materials and Methods: A total of 278 patients aged 18 years and over who had positive SARS-CoV-2 RT-qPCR results and had access to laboratory and chest CT examinations between 15 April 2020 and 31 August 2020 were included in the study. Clinical classification of patients was performed as asymptomatic, mild and severe. Demographic information, laboratory tests and chest CT results of the patients were created with the data obtained from the hospital system and the relevant branch physicians. The data were analyzed statistically. Results: In the study, 150 (54%) of the patients were males and 128 (46%) were females. Forty-two (15%) of these patients were classified as asymptomatic, 200 (72%) as mild and 36 (13%) as severe cases. Mean age of the patients was found to be 45.5 ± 17.5 years and 72 (25.9%) patients were found to have at least one comorbidity. Findings consistent with COVID-19 pneumonia were observed in the chest CT examinations of 42.4% (118/278) of the patients. The rate of findings in chest CT of severe patients (91.7%) was found higher than mild (38.5%) and asymptomatic cases (19%) (p< 0.05). When we examined the laboratory findings;59.4% of the patients had elevated CRP, 42.1% lymphopenia, 41.1% elevated LDH, 40.6% elevated creatinine, 36% elevated AST, 20.1% leukopenia, 8% elevated ALT, 7.2% elevated leukocyte, 5.4% elevated troponin I and 3.3% elevated CK-MB were detected. In severe patients, lymphopenia (83.3%), neutrophil elevation (41.7%), CRP elevation (97.2%), LDH elevation (91.3%), troponin I elevation (21.4%) and AST elevation (63.9%) findings were observed at a higher rate than asymptomatic and mild cases (p< 0.05). Conclusion: In our study, it was shown that the findings of high age, hypertension, diabetes mellitus, dyspnea, lymphopenia and the increase in neutrophil, CRP, LDH, troponin I and AST values were associated with severe clinical presentation. These findings are thought to be helpful in understanding the differences between clinical classes in COVID-19 patients.

PURPOSE Androgenetic alopecia (AGA) is the most common cause of hair loss in males. Physical examination and history are the most important examinations in diagnosis of the disease. As yet, there is no diagnostic method to be able to determine which individuals will develop AGA. Shear-wave elastography (SWE) is a novel diagnostic tool, which can evaluate tissue stiffness. Superb microvascular imaging (SMI) can determine low flow in microvessels. The aim of the current study was to determine whether or not AGA would develop in individuals with normal hair and a family history of AGA using B-mode US, SMI, and SWE. METHODS The study included 26 patients clinically diagnosed with AGA and a control group of 26 volunteers. RESULTS Thickness with the distance from the epidermis to the calvarium (ECD) on the hairline and cranial subcutaneous tissue thickness (CSTD) were determined to be statistically significantly thinner in the AGA group than in the control group (p

In the present study, we aimed to compare clinical and radiological findings between patients with and without pulmonary embolism (PE) and determine possible risk factors for PE development among patients with cancer. This was a retrospective study that examined the clinical features and tomographic findings of patients with cancer who underwent thoracic tomography for suspected PE. A total of 487 cases were included in the study. Of which, 45 (9.2%) patients were found to have PE. The effect of gender on PE was found to be significant (p = 0.018). Patients with PE compared to those without PE are 2.828 times more likely to be women than men. It was determined that the probability of not having a history of coronary artery disease (CAD) was 2.930 times (p = 0.036), probability of shortness of breath was 4.153 times (p

Constitutional mismatch repair deficiency (CMMRD) is an autosomal recessively inherited childhood cancer predisposition syndrome results from biallelic germline mutations affecting the key DNA mismatch repair gene: MLH1, MSH2, MSH6, or PMS2. CMMRD is associated with a high risk of developing early onset of central nervous system tumors, hematological, and intestinal tract tumors. Clinical manifestations, genetic screening, and cancer prevention strategies are limited. In this report we present a patient with metachronous Wilms tumor, glioblastoma, and acute T-cell lymphoblastic leukemia. He had cutaneous features of neurofibromatosis type 1 (NF1). Molecular testing revealed a novel homozygous mutation in MSH6 (c.2590G>T; p.G864) that has not been reported previously. CMMRD should be considered in patients with cutaneous features similar to NF1 if tumor is found other than expected tumors in NF, early onset cancer, and strong family history of cancer.

Erdheim-Chester disease (ECD) is a proliferative disorder of non-Langerhans histiocytes with a higher incidence in the fifth to seventh decades and rarer occurrence in the pediatric population. Although ECD typically involves bone, it can also affect the central nervous system, cardiovascular system, retro-orbital space, retroperitoneal space, and kidneys, lungs, and skin. A 13-year-old Syrian girl who presented with multisystemic involvement was diagnosed with ECD. The B-Raf proto-oncogene V600E mutation was not detected in ECD lesions. Response to the high-dose interferon-α therapy was excellent in this pediatric patient. In this article, pediatric ECD case reports are also reviewed.

The anatomical variations of renal artery related with number, branching pattern and origin level have been well described. The variations regarding the course of the artery are limited and mainly related with its relation of vena cava inferior. However, diaphragmatic crus is also on the pathway of renal artery and this relationship might also have variations. Different from its usual precrural position, there are a few cadaveric dissections reported as retrocrural or transcrural renal artery. This is the report of a rare variant of renal artery course, where it was crossing between the fibers of diaphragmatic crus detected on CT angiography.

SUMMARY: The objective of this study was to evaluate the role of the variations of carotid artery course on the relationship between styloid process (SP) and internal carotid artery (ICA). Carotid CT angiography scans of 170 patients were retrospectively evaluated. The variability of the course of ICA were classified. The length and medial angulation of the SP were measured on coronal 3D images. On axial images, the shortest distance between the bone edge of the SP and ICA were measured. The distance between SP and ICA among the course patterns of carotid artery were compared statistically. In the comparison of distances between SP and ICA with respect to the course of ICA, the difference between straight and curving (p

Amaç: Çalışmamızda, difüzyon ağırlıklı manyetik rezonans görüntüleme (DAG)’nin tiroid nodüllerinin karakterizasyonundaki yeri araştırılacaktır. Yöntem: Ekim 2010–Nisan 2011 tarihleri arasında, tiroid nodülüne yönelik ultrasonografi, sintigrafisi yapılan ve ince iğne aspirasyon sitolojisi (İİAS) planlanan hastalara İİAS öncesinde DAG gerçekleştirildi. DAG üzerinden lezyonların ‘apparent diffusion coefficient’ (ADC) haritaları oluşturuldu. Dört ayrı b değeri (b=300sn/mm², b=500sn/mm², b=750sn/mm², b=1000sn/mm²) kullanılarak nodüllerin ADC değerleri sitopatoloji sonuçları bilinmeden ölçüldü. İİAS ve postoperatif histopatoloji sonuçlarına göre toplam iki malign, 24 benign nodül çalışmaya dahil edildi. Sintigrafi bulguları ADC değerleri ile karşılaştırıldı. ADC değerlerinden ROC (Reveiver Operating Characteric) eğrisi oluşturularak sınır değeri elde edilmeye çalışıldı. Bulgular: 24 benign tiroid nodülün ölçülen ortalama ADC değerleri b=300’de 3547 ± 556 x10-6mm2/sn, b=500’de 2221 ± 362 x10-6mm2/sn), b=750’de 1483 ± 242 x10-6mm2/sn, b=1000’de 1115 ± 182x10-6mm2/sn olarak hesaplandı. İki malign nodülün ortalama ADC değerleri b=300’de 2430±355 x10-6mm2/sn, b=500’de 1440±205 x10-6mm2/sn, b=750’de 998±144 x10-6mm2/sn, b=1000’de 715±118 x10-6mm2/sn olarak bulundu. Sonuç: Bizim çalışmamızda, benign-malign ayrımı için, farklı b değerlerinde sınır değerler oluşturulmaya çalışıldı. Olgu sayısının azlığı nedeniyle ROC eğrisi oluşturulup istatistiksel olarak anlamlı sınır değerleri bulunamadı. Ancak postoperatif histopatolojik incelemeye göre malign bir cm’den büyük nodül çalışmadaki tüm nodüller arasında en düşük ADC ölçümüne sahip iken bir cm’den küçük malign nodül ise b=750 değeri haricinde benign nodüllere göre düşük ADC değerlerine sahip idi. Her ne kadar olgu sayısının azlığı önemli bir kısıtlama oluştursa da çalışmamızdaki bulgular, literatürdeki diğer araştırma sonuçları ile birlikte ele alındığında DAG’nin tiroid nodüllerinin malign benign ayrımında faydalı olabileceğini göstermektedir.

Background: Flourodeoyglucose Positron Emission Tomography-Computed Tomography (FDG PET-CT) provides information about the anatomic structures and metabolic activities of tumors. The incidence of thyroid incidentaloma is rare on FDG PET-CT but it is related to malignancy when it is detected to be high. Although, patients who are already treated with another primary tumor can not be searched for second thyroid malignancy each time. The aim of this study was to evaluate TI RADS classification based on a score modified according to ultrasound (US) criteria for malignancy of thyroid nodules determined on FDG PET/CT imaging.

Neurofibromatosis type 1 (NF1) is an autosomal dominant neurocutaneous disease characterised by multisystemic involvement, including bone tissue. Deformities and reduced bone mass are the main bone manifestations in NF1. Quantitative computed tomography (QCT) provides true volumetric bone mineral density (BMD) measurement. This study aimed to evaluate bone metabolism parameters and BMD in children with NF1 using QCT.The data of 52 paediatric NF1 patients (23 female, 29 male) was evaluated retrospectively. We investigated anthropometric measurements, biochemical parameters like total calcium, phosphate, magnesium, alkaline phosphatase, 25-hydroxyvitamin D (25OHD), parathyroid hormone, calcitonin, urinary calcium/creatinine ratio, and QCT parameters like lumbar trabecular and cortical BMD, trabecular area and cortical thickness. Comparisons of gender and puberty status were performed.25% of patients had skeletal deformities and 42.3% had 25OHD inadequacy (lt;20 ng/mL). The frequency of 25OHD inadequacy was significantly higher in pubertal/postpubertal patients than prepubertal patients (61.9% vs. 29.0%, P = 0.019). Trabecular BMD Z-score waslt;-2.0 in 11.5% of patients; all with low BMD were at the pubertal/postpubertal stage. There was a significant negative correlation between age and trabecular Z-score (r = -0.41, P = 0.003). Mean cortical BMD was statistically similar between the genders and puberty groups. Puberty status, anthropometric Z-scores, and biochemical and QCT parameters were statistically similar between the genders (Pgt; 0.05).Paediatric NF1 patients may present with low BMD and 25OHD inadequacy, especially at puberty. QCT may be a useful tool to evaluate trabecular and cortical bone separately in NF1 patients.

Objective This study intended to analyze alterations in ischiofemoral space (IFS) dimensions in normal children between the ages of 1 and 18 years for the ischiofemoral impingement. Materials and methods This study retrospectively focused on computed tomography images of 360 hips of 180 (90 boys and 90 girls) pediatric subjects (mean age: 9.50 +/- 5.20 years, range: 1-18 years) without any hip disorders to measure IFS, femoral neck angle (FNA), and ischial angle (IA). Results Mean IFS, FNA, and IA were measured as 14.64 +/- 7.24 mm, 34.61 +/- 11.47 degrees, and 131.52 +/- 4.22 degrees, respectively. IFS increased in children aged between 1 and 18 years, whereas FNA and IA decreased. IFS was similar in infancy and early childhood periods but then increased up to postpubescent period. FNA decreased proportionally from birth, whereas IA decreased in an irregular pattern. Linear functions were detected as y = 3.451 + 1.178 x years for IFS, as y = 48.555 - 1.468 x years for FNA, and as y = 132.535 - 0.107 x years for IA. Conclusion Our findings indicate that IFS tends to increase in size with age during childhood but decreases with further aging. Therefore, age-specific values for IFS, FNA, and IA may be beneficial for clinicians and radiologists for the diagnosis of ischiofemoral impingement.

Pulmonary fibrosis caused by bleomycin-induced pneumonia (BIP) is the most important side effect limiting the use of bleomycin and is mainly treated with corticosteroids. However, 1% to 4% of patients do not respond to corticosteroid therapy. Idiopathic pulmonary fibrosis and BIP develop by similar pathophysiological mechanisms. Nintedanib is a tyrosine kinase inhibitor used successfully in the treatment of idiopathic pulmonary fibrosis and there is no information about its use in BIP treatment. Here, we would like to present a 13-year-old boy with Hodgkin lymphoma who developed BIP after 2 cycles of ABVD (Adriamycin, bleomycin, vinblastine, and dacarbazine) and 4 cycles of BAECOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone), whose respiratory failure impaired despite corticosteroid therapy, but was successfully treated with nintedanib.

Background As deep nasolabial folds (NLF) are associated with facial aging, there is an increasing demand for esthetic correction with filler injections. Understanding the anatomy of the angular artery (AA) and facial artery (FA) around the NLF region is essential for ensuring the safety of dermal filler injections into the NLF. The purpose of this study was to provide detailed vascular anatomical information on the course and depth of AA and FA around NLF using Doppler ultrasound on live cases. Methods FA was observed from the origin level adjacent to the mandible corpus to the end of its terminal branch AA in 168 hemifaces of 84 cases with Doppler ultrasonography. Results We made a classification of the FA course based on the NLF. The minimum and maximum depths of the FA along its course were measured in 84 cases. The results showed that its course may be highly superficial (2.5 mm at the mandibular origin, 3.7 mm at the cheilion, 3.7 mm at the nasal ala) or it may follow a very deep course near the periosteum (15.0 mm at the mandibular origin, 18.7 mm at the cheilion, 23.5 mm at the nasal ala). FA depth was varied between 5.98 mm and 6.62 mm at the mandibular origin, between 8.36 mm and 9.20 mm at the cheilion, between 9.52 mm and 10.51 mm at the nasal ala at a 95% confidence interval. Conclusions This study suggests that there is no absolutely safe depth or region for nasolabial fold filler injections.

Aim: To investigate the relationship between thrombus localization and the development of chronic thromboembolic pulmonary hypertension (CTEPH) in patients with acute pulmonary thromboembolism (PTE) and to determine the risk factors on the development of CTEPH and chronic thromboembolic disease (CTED). Methods: 91 patients who were diagnosed PTE with Computed Thorax Pulmonary Angiography (BTPA) between 2014-2018 and completed at least 3 months of anticoagulant treatment were evaluated. Medical histories, comorbidities, risk factors, symptoms, findings, thrombus localization, medical treatments, venous doppler and echocardiographic examinations, post-treatment symptoms and signs, Troponin-I, NT-proBNP, D-dimer and CRP values were recorded. These data were analyzed for development of CTEPH/CTED and survival. Results: Fifty six (61.5%) of the patients were female. 7 of 91 patients were diagnosed with CTEPH. Right/left ventricular diameter ratio>0.9, 3rd degree tricuspid insufficiency and pulmonary artery pressure (PAP)>36 mmHg has been statistically associated with development of CTEPH within the parameters evaluated at the time of diagnosis(p=0.011,p=0.007,p=0.0001). The thrombus localization in CTPA did not have any effect on survival and development of CTED. Tricuspid insufficiency, NT-proBNP elevation, abnormal findings on chest x-ray after treatment were found statistically significant development of CTED (p=0.009, p Conclusions: Patients with acute PTE should be closely monitored for development of CTEPH and CTED within the follow-up period after initial treatment.

Purpose To investigate the characteristics of the prechiasmatic sulcus in children aged between 1–20 years. Methods Patient files of 200 children admitted to the university hospital on 2019 were analyzed, retrospectively. The computed tomography images of patients were used to obtain anatomical knowledge containing prechiasmatic sulcus types and dimensions. Results The measurements related to the sulcal length (6.94 ± 1.25 mm) and sulcal angle (31.01 ± 18.13°) showed that the sulcal length did not alter in children between 1 and 20 years, whereas the sulcal angle did not vary from infancy to prepubescent period, but it was decreasing in postpubescent period. In 29 patients, the sulcal length was observed to divide into 2 parts with an evident angle. The interoptic distance and planum length were found as follows: 14.70 ± 2.85 mm and 14.84 ± 4.12 mm, respectively. The order of PS types was observed as type 4 (26.5%, 53 cases) > type 2 (26%, 52 cases) > type 1 (24%, 48 cases) > type 3 (23.5%, 47 cases). Conclusions The sulcal length did not vary in children, whereas the sulcal angle decreased with an irregular pattern. The sulcal angle decreased after prepubescent period, possibly due to the sphenoid sinus pneumatization and spheno-occipital synchondrosis. The sulcal length angle mostly in infants and young children may cause surgical orientation difficult during the resection of tumors using transcranial approaches.

The purpose of this study is to evaluate the relationship between right inferior phrenic artery diameter and portal hypertension in cirrhotic patients. CT examinations of 38 patients with chronic liver disease (patient group) and 40 patients without any liver disease (control group) were evaluated. The right inferior phrenic artery diameter of the patient and control group were measured. CT findings of portal hypertension, which were accepted as ascites, collaterals, splenomegaly and portal vein diameter greater than 13 mm, were determined and scored in the patient group. Patients obtained scores between one and four with respect to portal hypertension findings, and the scores were compared with phrenic artery diameters. Child-Pugh and MELD scores of the patients were also calculated. The mean diameter of the right inferior phrenic artery in the patient group was larger than that in the control group (p

This retrospective computed tomography (CT) study was aimed to assess the growth dynamic of the external aperture of the carotid canal (EACC) in children aged between 1 and 20 years. Two hundred patients (sex 100 females/100 males, average age 10.50 ± 5.77 years) with good head CT image quality were included in this study. CT images of the patients were used to obtain data related to the location, shape and dimension of EACC. EACC shapes were identified as oval shaped, round shaped, and tear-drop shaped in 58.3% (233 sides), 24% (96 sides) and 17.8% (71 sides), respectively. EACC length, disEACC–MSP (distance between EACC and midsagittal plane), and EACC width did not change from the prepubescence period; while, the disEACC–SC (distance between EACC and supramastoid crest) seemed to reach adult size in the postpubescence period. Linear functions for EACC length and width were calculated as: y = 5.453 + 0.091 × years, and y = 5.398 + 0.059 × years, respectively. The regression equations of the measured parameters representing the growth dynamic of EACC in children can be helpful to estimate its size, location and angulation, which suggest that the dimension and distances to certain anatomical landmarks seemed to reach adult size in different developmental periods. In this context, the findings of this study may seem to emphasize the importance of preoperative radiological evaluation on skull base, related to EACC, for multidisciplinary surgeon teams during childhood surgeries in terms of patients’ positioning, and the selection of appropriate surgical approach.

Introduction Pleural plaques have the possibility of bearing malignancy thus investigation of this entity is important and the most important indicator of malignancy in general is fluorodeoxyglucose (FDG) accumulation in radiological appearance. However there is discrepancy between results of previous studies in the literature about this subject. The aim of this study is to analyze the standardized uptake value of pleural plaques and the cut off levels for malignancy in comparison with computed tomography (CT). Materials and methods Seventy one patients were included in the study (27F, 44M; mean: 59.9 ± 13.1 years). Oncologic F-18 FDG positron emission tomography/computed tomography (PET/CT) was performed to all the subjects for a different primary tumor. Pleural plaques were identified in all patients in CT component of PET/CT examination. Contrast enhanced and nonenhanced CT images were evaluated by a Radiology Physician independently according to the gold standard pathology. Result The diagnostic sensitivity, specificity of CT was; 39%, 79% respectively and if the cut-off SUVmax level was accepted "4.8" the diagnostic sensitivity and specificity of PET was 71%, and 63% respectively. Conclusions According to the results and ROC curves determined in the study the cut-off level for evaluation of pleural plaques in PET examination was "4.8". The sensitivity and accuracy of PET was higher compared to CT with this cut-off value.

Cardiac angiosarcomas are extremely rare in childhood, they are rapidly progressive tumours that often present themselves as diagnostic dilemmas, resulting in delayed diagnosis. Also, extracardiac manifestations, including abdominal pain, are extremely rare in patients with intracardiac tumors. We herein present the case of a 15-year-old girl who presented with abdominal pain. Echocardiography and thoracic computed tomography showed right atrial mass. The patient underwent surgery, chemotherapy, and radiotherapy. Eight months after treatment, abdominal recurrence was detected. The abdominal mass was resected, and radiotherapy and new chemotherapy protocol were given. The present case illustrates a rare case of primary cardiac angiosarcoma posing a diagnostic dilemma in an adolescent girl.

Axial mesodermal dysplasia complex (AMDC) is a combination of multiple congenital malformations arising due to the mesodermal cell migration, neural tube fusion, and rhombencephalon segmentation. Here, we present the imaging findings of a 15-year-old boy with AMDC who has bilateral inner ear malformations associated with a vestibulocochlear nerve extending to Meckel cave, cystic lesion in prepontine cisterna, cervical vertebral segmentation anomalies, and maxillar bone anomalies.

Pulmonary Langerhans cell histiocytosis (PLCH) is a well known entity in adults but is exceedingly rare in children. It is better described in adults than in children. Smoking is a major etiological factor in adulthood. We report a case of a previously healthy 16-year-old male with a history of cigarette smoking, who presented with cough with sputum, breathlessness, easy fatigability and loss of appetite for two weeks. He was first diagnosed with bronchiectasis according to the cystic pulmonary changes demonstrated by computed tomography. After appropriate treatment, there was no sign of clinical improvement. A lung biopsy confirmed Langerhans cell histiocytosis (LCH). The definitive diagnosis was isolated pulmonary LCH. PLCH should be considered in the etiology of cystic lung diseases. Isolated pulmonary LCH is rare so such cases are needed to be reported and followed-up to understand the treatment response and course of this illness.

To investigate the anatomical variations in the origins of the thyroid arteries on CT angiography images. The presence and the origins of the superior thyroid artery, the inferior thyroid artery, and the thyroidea ima artery were retrospectively evaluated based on carotid CT angiography examinations. The bifurcation level of the common carotid artery with respect to the cervical vertebrae and disc spaces was also determined. A total of 640 patients were included in the study. The right and left superior thyroid arteries arose from the external carotid artery in 413 (64.5%) and 254 (39.7%) patients, from the bifurcation of the common carotid artery in 131 (20.5%) and 148 (23.1%) patients, and from the common carotid artery in 90 (14.1%) and 226 (35.3%) patients, respectively. We could not observe the right and the left superior thyroid arteries in 6 (0.9%) and 12 (1.9%) of the patients, respectively. However, the right and left inferior thyroid arteries were not identified in 14 (2.2%) and 45 (7%) of the patients, respectively. The thyroidea ima artery was detected in 2.3% of the patients. The visualization of thyroid arteries on CT angiography images enables the anatomy of the arterial supply system of the thyroid gland to be explored in a noninvasive manner prior to surgery.

Amac: Dinamik bilgisayarli tomografi tetkikinde ovaryan venlerde izlenebilen reflu acisindan arteriyel ve erken portal venoz faz goruntuleri karsilastirilmistir. Yontem: Ocak 2010-Mart 2016 tarihleri arasinda klinigimizde yapilan dinamik bilgisayarli tomografi tetkikleri retrospektif olarak incelendi ve 125 hasta calismaya dahil edildi. Kontrast madde verilmeye baslanmasindan sonra 25. saniyede (arteriyel faz) ve 60. saniyede (erken portal venoz faz) elde edilen goruntuler incelendi. Ovaryan venlerdeki reflu varligi degerlendirildi. Sol ve sag ovaryan venlerin caplari olculdu. Bulgular: Yuz yirmi bes hastanin 29'unda (%23,2), hem arteriyel hem de erken portal venoz fazda sol ovaryan vende reflu saptandi. Otuz uc (%26,4) hastada sadece erken portal venoz fazda sol ovaryan ven reflusu tespit edildi. Kirk dokuz (%39,2) hastada erken portal venoz fazda sag ovaryan ven reflusu gozlendi. Sol ovaryan ven capi ortanca degerlerinin; sol ovaryan vende sadece erken portal venoz fazda reflusu olanlarda reflu olmayanlara gore daha yuksek (p=0,016), her iki fazda da reflusu olanlarda reflu olmayanlara gore cok daha yuksek (p

Patients with complete XY gonadal dysgenesis (GD) show a high predisposition to germ cell tumors (GCT). Patients with coexistence of GCT and GD have been reported previously. Here we present a 15-year-old girl with mixed GCT and GD who also developed an intra-abdominal synovial sarcoma one year after the treatment. This is the first report, to our knowledge, of synovial sarcoma associated with XY GD.

Background: The aim of this study is to investigate the effect of anatomic differences on the relationship between renal artery and diaphragmatic crus via the touch of two structures. Materials and methods: The study included dynamic computed tomography (CT) scans of 308 patients performed mainly for characterisation of liver and renal masses. Anatomic differences including the thickness of the diaphragmatic crus, the localisation of renal artery ostium at the wall of aorta, the level of renal artery origin with respect to superior mesenteric artery were evaluated. Statistical relationships between renal artery-diaphragmatic crus contact and the anatomic differences were assessed. Results: Thickness of the diaphragmatic crus at the level of renal artery origin exhibited a statistically significant relationship to renal artery-diaphragmatic crus contact at the left (p < 0.001) and right side (p < 0.001). There was a statistically significant relationship between high renal artery origin and renal artery- -diaphragmatic crus contact at the left (p < 0.001) and right side (p = 0.01). The localisation of renal artery ostium at the wall of aorta (right side, p = 0.436, left side, p = 0.681) did not demonstrate a relationship to renal artery-diaphragmatic crus contact. Conclusions: Thickness of the diaphragmatic crus and high renal artery origin with respect to superior mesenteric artery are crucial anatomic differences determining the relationship of renal artery and diaphragmatic crus. (Folia Morphol 2018; 77, 1: 22–28)

OBJECTIVE. abdominal cocoon is characterized by total or partial encasement of the small bowel by a thick fibrotic membrane, leading to mechanical obstruction. Here, we report two cases of abdominal cocoon; both patients presented with symptoms of intestinal obstruction.CONCLUSION. We describe the CT and sonographic features of this disease, emphasizing the role of MDCT, and discuss the preoperative diagnostic clues.