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Aim: The aim of this study was to investigate the pulmonary magnetic resonance angiography (MRA) imaging findings in Swyer- James syndrome (SJS) as a alternative imaging modalities. Methods: Thirteen patients had posteroanterior inspiratory/expiratory chest X-ray films and pulmonary MRA with SJS (6 males, 7 females) were retrospectively studied. Gradient-echo pulmonary MRA was performed in all patients with a 1.5 T MR unit. MRA imaging was performed in a single breath-hold during the injection of contrast media. Image analysis of the patients was performed. The results of pulmonary artery diameters and pulmonary peripheral vasculature were compared between normal sides versus the affected sides. Statistical analysis was performed with the Student t test. Results: The smaller pulmonary artery on the affected side with poor peripheral vasculature was observed with gadolinium-enhanced gradient-echo MRA in all patients. There was a significant difference between the diameters of the pulmonary arteries of the normal versus the disease sides (p< 0.0005). Conclusion: MRA successfully depicted the small pulmonary artery with diminished peripheral vasculature in patients with SJS. This study showed the pulmonary MRA imaging could be used as a alternative imaging modalities in the evaluation of patient with SJS. [ABSTRACT FROM AUTHOR]

Objectives and Background: This study was designed to compare the usefulness of the breast electrical conductivity measures performed in a surgical examination room against conventional breast screening modalities for identifying the symptomatic lesions of the breast tissue., Methods: A group of 181 patients were examined with Ultrasonography (USG), Mammography (MG), Electrical Impedance Scanning (EIS) modalities and were followed-up 24 months to clarify in terms of the lesion tumour progression relationship. Tumour biopsy was determined as an endpoint of the study., Results: According to USG, 13 (7.2 %) lesion were suspicious, where as EIS was reported 22 (12.2 %). 2 of these 9 patients were presented as BI-RADS 4 and histopathologic result was proven as malignant disease during 6 months short-interval follow-up. EIS exhibited compatible sensitivity (81.2 %), accuracy (84.6 %) and PPV (81.8 %) rates with USG in BI-RADS 4 subgroup, combination of these modalities raised sensitivity rates to 92.31 %, accuracy and PPV to 100 %. EIS results in BI-RADS 3 subgroup were pointed out 77.8 % specificity and 87.5 % NPV rates., Conclusion: Breast electrical impedance measures should be useful to reduce the number of the unnecessary follow-up and biopsy rates in the clinical setting (Tab. 2, Fig. 2, Ref. 39).

Hepatocellular adenomas are a benign, focal, hepatic neoplasm that have been divided into four subtypes according to the genetic and pathological features. The β-catenin activated subtype accounts for 10-15% of all hepatocellular adenomas and specific magnetic resonance imaging features have been defined for different hepatocellular adenomas subtypes. The current study aimed to report the magnetic resonance imaging features of a well differentiated hepatocellular carcinoma that developed on the basis of β-catenin activated hepatocellular adenomas in a child. In this case, atypical diffuse steatosis was determined in the lesion. In the literature, diffuse steatosis, which is defined as a feature of the hepatocyte nuclear factor-1α-inactivated hepatocellular adenomas subtype, has not been previously reported in any β-catenin activated hepatocellular adenomas case. Interlacing magnetic resonance imaging findings between subtypes show that there are still many mysteries about this topic and larger studies are warranted.

Aims: Tendons are crucial for optimal muscle force transfer and subject to changes with aging which may impair functional ability of elderly individuals. Achilles is the largest and the strongest tendon in the body; therefore it is an excellent site for the radiologic investigation of aging of tendons. Sonoelastography (SE) is a new ultrasound-based imaging technique that provides information on elastic properties and stiffness of tissues. The aim of our study was to investigate the age-related alterations in Achilles tendons using SE., Material and Methods: Forty five geriatric (age ≥ 65 years) and 42 young (age 18-40 years) healthy consecutive subjects were enrolled. Subjects with known history of metabolic or endocrine diseases, sports or traumatic injuries, peripheral vascular disorders were excluded. Both Achilles tendons were scanned with a real-time SE probe at a frequency of 6-15 MHz. Strains of Achilles tendons' proximal, middle and distal parts were assessed semi-quantitatively with comparing a reference tissue., Results: Both SE methods -color coded evaluation and strain measurement- showed a remarkably stiffer tendon in the elderly subjects compared to young subjects in all thirds of Achilles tendons. In young subjects 84.9 % tendon thirds were blue, and 15.1% were green whereas, in elders 93.7% were blue and 6.3% were green (p=0.024). There was a significant correlation between age and stiffness of tendons assessed with strain indices., Conclusion: Our result showed increased tendon stiffness in elderly subjects which might be responsible for the high prevalence of Achilles tendinopathies observed in elderly subjects.

Hydatid cyst (HC) is a parasitic disease that may involve many organs, especially the lung and the liver. Pulmonary artery location of the hydatid cyst is extremely rare, but it may cause life-threatening complications. We report a case of a hydatid cyst that completely filled the left main pulmonary artery and its distal part without cardiac involvement. Thoracic computed tomography showed filling defects in the pulmonary arteries. Endobronchial ultrasound was performed for differential diagnosis and it showed a cystic lesion. Hydatid cyst-specific IgE and hem agglutination test results were positive. In the literature, cases like this in which the diagnosis of pulmonary hydatid cyst is made by endobronchial ultrasound are not usually seen. Although many imaging modalities such as plain chest radiography, cross-sectional imaging (MDCT and MRI), echocardiography and conventional pulmonary angiography have been used in the diagnostic approach, we recommend endobronchial ultrasound for the differential diagnosis of cases with cystic formation.

Purpose: Both chronic obstructive pulmonary disease (COPD) and asthma are important causes of morbidity and mortality worldwide. They primarily affect the lungs, but they have various extrapulmonary manifestations. The aim of our study was to evaluate the hemodynamic changes in orbital vessels of the patients with COPD and asthma using color Doppler ultrasonography and compare the results with healthy control subjects., Methods: Thirty-seven patients with COPD, 37 patients with asthma, and 41 healthy control subjects were included in this study. All patients with COPD were in moderate to severe group according to GOLD (Global Initiative for Chronic Obstructive Lung Disease), and similarly, all patients with asthma were in moderate to severe persistent group according to GINA (Global Initiative for Asthma) 2006 guidelines. End-tidal carbon dioxide, peripheral oxygen saturation, pulse rate, and respiratory rate were measured by using pulse oximeter in all patients. Measurements were performed in only 1 randomly selected eye of each participant. The peak systolic velocity, end diastolic velocity, and resistance index were measured in the central retinal artery, temporal posterior ciliary artery, and nasal posterior ciliary artery using the color Doppler ultrasonography technique., Results: The peak systolic velocity, end diastolic velocity, and resistance index values of temporal posterior ciliary artery and nasal posterior ciliary artery were significantly higher in COPD and asthma than in the control subjects. There was no difference between asthma and COPD., Conclusions: We concluded that retrobulbar hemodynamics change in COPD and asthma is showing 1 of the systemic effects in these diseases.

Objective: To evaluate the median nerve (MN) in pregnant women with carpal tunnel syndrome (CTS) by using ultrasound elastography., Patients and Methods: 30 wrists of 20 pregnant women with CTS and 25 wrists of 14 healthy control pregnant women were evaluated by ultrasound and ultrasound elastography (UE). The MN in the patients' wrist was imaged to measure the cross-sectional area and longitudinally to calculate the elasticity value (EV) at four different locations (proximal carpal tunnel (CT) at the level of the pisiform, distal CT at the level of the hamate, middle of the CT and forearm at one centimeter above the CT). Clinical classification was performed according to a historic and objective scale of CTS. In the healthy pregnant women and pregnant women with CTS, MN area and EV were analyzed statistically by comparing with parity and clinical grade., Results: There was a statistically significant difference for MN area between the patient and control groups (p = 0.001). A positive relationship was found between parity in pregnancy and clinical grade of the CTS (p = 0.035, Pearson's correlation coefficient = 0.386). Although MN elasticity for both groups was nearly the same in the proximal region of the CT, these values were decreased in the middle of the CT. MN elasticity values were smaller in the distal region of CT, and it was statistically significant in pregnant women with CTS (p = 0.02)., Conclusions: Ultrasound elastography, which is a non-invasive, inexpensive and a favorable diagnosis technique, may be useful in the diagnosis of CTS, especially in conditions in which an invasive procedure would be problem, as in pregnancy.

Neurocutaneous melanosis (NCM) is a rare, congenital non-hereditary syndrome, characterized by multiple pigmented nevi. We report the radiologic findings of a newborn who had extensive cutaneous melanotic nevus with satellite lesions in the brain. Ultrasound showed multiple echogenic foci in the cerebral parenchyma. Subsequent MRI confirmed these lesions as characteristic deposits of melanin. The infant was asymptomatic, but presence of risk factors such as malign transformation or neurological manifestations makes early diagnosis very important. We present this case to emphasize on the radiological findings of this syndrome in order to reach an early diagnosis.

Fibular hemimelia (FH) is a congenital longitudinal limb deficiency characterized by complete or partial absence of the fibula. Typically, it has been diagnosed at birth, when the neonate is seen to have lower limb shortening and a foot with missing toes. Although it is the most frequent lower limb deficiency anomaly, there are few published reports of prenatally diagnosed cases. Most of these published cases have involved the complete absence of the fibula, which is relatively easy to diagnose with antenatal ultrasound. In our opinion, our case is the first case of unilateral partial absence of the fibula detected using prenatal ultrasound imaging. Herein, we report a FH case associated with foot equinovalgus, and absence of the fourth and fifth foot rays diagnosed at 24 weeks' gestation. The anomaly was confirmed after birth by X-ray, and conservative orthopedic management was chosen. Our case shows that partial limb defects can also be detected by prenatal ultrasound imaging.

Familial Mediterranean fever (FMF) is an autosomal recessive auto inflammatory disease, characterized by acute attacks of serositis, arthritis or skin rash. Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease characterized by multisystem inflammatory lesions affecting any organ systems in the body. Coexistence of FMF and SLE is rare in literature. In this report, we present three patients with FMF associated with SLE.

Purpose: To evaluate ocular blood flow dynamics by color Doppler ultrasonography (CDU) in patients with end-stage renal disease (ESRD). Additionally, to investigate the effect of dialysis type on ocular blood flow by comparing the findings of peritoneal dialysis (PD) subjects, hemodialysis (HD) subjects, and healthy controls., Material and Methods: Forty patients (21 HD and 19 PD) and 40 controls were included in the study. CDU and spectral analysis of temporal posterior ciliary artery (TPCA) and central retinal artery (CRA) were performed to evaluate peak systolic flow velocity (PSV), end diastolic flow velocity (EDV), and resistive indices (RIs). Ocular blood flows were examined before and after HD. Post-HD findings were compared with those in PD subjects and healthy controls., Results: PSV and EDV values in CRA and TPCA after HD sessions were found to be significantly decreased when compared with pre-dialysis values. There was no statistically significant difference between the pre-dialysis and post-dialysis RI values of both arteries. Systolic and diastolic blood flows in CRA and TPCA were higher and RI values were lower in PD subjects than in HD and controls. No significant difference was seen between HD subjects and controls., Conclusion: After a single HD session, ocular blood flows of patients with ESRD were normalized. But PD subjects show higher systolic and diastolic ocular blood flows than healthy controls, suggesting that HD is more effective than PD for achieving normal ocular blood flow.

Objective: To evaluate the role of the venous system in cyclical mastalgia., Materials and Methods: 25 healthy women and 39 women with cyclic mastalgia underwent venous Doppler examination in both pre- and postmenstrual period. Upper-outer quadrant veins of breast were evaluated. The impedance indices of both groups were compared in both the premenstrual and postmenstrual period., Results: During the premenstrual period, venous impedance indices were significantly higher in the patients with cyclic mastalgia (p=0.004) than in the control group. After the menstrual period, there was no difference in venous impedance indices between the groups., Conclusion: Excessive tissue oedema might be responsible for both a tension-mediated pain and a compression of the venous system thereby showing higher impedance than that in control group.

Pulmonary and cardiac involvement in Behçet disease is rare but can cause life-threatening complications. This report presents computed tomography and magnetic resonance angiography findings in 3 patients with Behçet disease. Imaging findings were confirmed by surgery in 1 patient and by angiography in another. One patient had bilateral pulmonary artery aneurysms, 1 of which had already ruptured and had thrombosed. The other had unilateral pulmonary artery aneurysm and thrombosis accompanied with intracardiac thrombus formation. The third patient had unilateral pulmonary artery aneurysm, thrombus, and coronary artery aneurysm. As in our case, there have been rare reports of coronary artery disease and intracardiac thrombus formation associated with pulmonary vascular involvement. Noninvasive imaging modalities minimize any risk of endothelial damage and can be an alternative to angiography in assessment of pulmonary and cardiac involvement in Behçet disease.