Is sarcopenia effective on survival in patients with metastatic gastric cancer?

BACKGROUND: Sarcopenia is a progressively diminishing state characterized by the reduction of muscle mass and density, which is frequently observed in malignancies of solid organs. AIM: To assess how sarcopenia affects the overall survival of individuals who have been diagnosed with metastatic gastric cancer. METHODS: The study retrospectively included individuals who had been diagnosed with metastatic gastric cancer between January 2008 and December 2020. Sarcopenia was identified through the calculation of the average Hounsfield units (HUAC) using computed tomography (CT) images taken at the time of diagnosis in patients. RESULTS: A total of 118 patients with metastatic gastric cancer were evaluated. Sarcopenia was detected in 29 patients (24.6%). The median survival of all patients was 8 (1-43) mo. The median survival of patients with sarcopenia was 2 mo, while it was 10 mo for those without sarcopenia (P < 0.001). A significant relationship was found between sarcopenia and survival. CONCLUSION: Sarcopenia has been observed to impact survival outcomes in various types of solid tumor cancers. Sarcopenic patients can be identified in a short time, easily and inexpensively, by HUAC measurements from CT images used for diagnosis, and survival could be promoted with nutritional support.

Benign incidental lesion of the calcaneus: the calcaneal vascular remnant.

BACKGROUND: The calcaneal vascular remnant, first described by Fleming et al. in 2005, is a benign intramedullary lesion of the calcaneus with a vascular origin. PURPOSE: To determine the prevalence and magnetic resonance imaging (MRI) characteristics of incidental calcaneal vascular remnant on routine ankle MRI. MATERIAL AND METHODS: We retrospectively reviewed 457 ankle MRI scans for the presence of calcaneal vascular remnant. MRI was considered positive when a focal cyst-like area was seen on a T2-weighted sequence, and a low signal intensity was identified on a T1-weighted image beneath the calcaneal sulcus. Patients with calcaneal vascular remnants were further evaluated for age, gender, right or left foot location, size, and lesion characteristics. RESULTS: The prevalence of incidental calcaneal vascular remnant was 21.7% on our consecutive ankle MR examinations. The average lesion size was 5.5 mm. No statistically significant difference was noted in the frequency of lesion detection between gender, age, and side of the lesions (P > 0.05). Multilobulated lesions were detected predominantly in women (P = 0.013) and classic type lesions were detected predominantly in men (P = 0.036). CONCLUSION: This report is the first to determine the prevalence and MRI characteristics of calcaneal vascular remnants. Detecting and reporting this lesion on routine MRI is essential to avoid confusion with other pathologic entities.

Evaluation of the frequency of tentorial hypoplasia and accompanying gyral herniation using MRI.

Purpose The cerebellar tentorium, the second-largest dural reflection in the brain, separates supratentorial and infratentorial structures. This study aimed to determine the frequency of tentorial hypoplasia (TH) and gyral herniation and their relationship with clinical findings. Methods The standard brain MRIs were examined retrospectively. The presence of TH and laterality were investigated. If hypoplasia was accompanied by a gyrus extending inferior to the line where the tentorium should be located, this was recorded as tentorial hypoplasia-herniated gyrus (TH-HG), while the cases with hypoplasia alone were noted as isolated TH. It was also determined which gyrus or gyri were herniated. The clinical findings of the patients were obtained, and the correlation between HG was explored. Results Standard brain MRIs of the 2051 patients were evaluated. Two hundred ten patients were excluded from the study due to different intracranial disorders, and 1841 patients, 739 (40.1%) males, and 1102 (59.9%) females, were included. Isolated TH or TH-HG was present in 56 patients, resulting in a prevalence of 3.04%. Of the patients with TH or TH-HG, 15 were men, and 41 were women. TH and TH-HG were significantly more common in women (p=0.038). TH-HG was unilateral in 22 (39.2%) patients and bilateral in 21 (37.5%). Left TH was found in 11 (19.6%) patients, left TH-HG in 29 (51.7%), right TH in eight (14.2%), and left TH-HG in 35 (62.5%). Conclusion Hypoplasia of the tentorium is a rare and unknown anomaly that can be easily diagnosed using MRI, and different gyral herniations may accompany TH.

Normative Measurements and Apparent Diffusion Coefficient Values of Parotid Lymph Nodes on Magnetic Resonance Imaging.

OBJECTIVE: To determine the morphological features and apparent diffusion coefficient (ADC) values of normal intraparotid lymph nodes (IPLNs) obtained from the MRI examination. STUDY DESIGN: Cross-sectional descriptive study. PLACE AND DURATION OF STUDY: Health Sciences University, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Radiology, Ankara, Turkey, from January 2018 to December 2021. METHODOLOGY: The study included 232 patients who underwent neck MRI examination. The long axis diameter (LAD) was measured as the largest diameter of the IPLN, and the short axis diameter (SAD) was measured perpendicular to the LAD. ADC measurements were undertaken by placing the largest region of interest suitable for the size of the IPLNs. RESULTS: A total of 394 lymph nodes were evaluated. The median LAD and SAD of the lymph nodes were 5.50 (2.50) mm and 3.50 (2.00) mm, respectively. The LAD was 9 mm or lower in 95.7% of the lymph nodes; the SAD was 6 mm or lower in 94.7%. The ADC map was evaluated in 275 IPLNs, with the median ADC value being calculated as 0.77(0.18)x10-3 mm2/s. The ADC value was 1.05x10-3 mm2/s or lower in 96.3% of the lymph nodes. CONCLUSION: A SAD of 6 mm; and a LAD of 9 mm could be used as normalcy criteria in IPLNs. Normal IPLNs may have an ADC of 1.05x10-3 mm2/s or lower. Considering that benign IPLNs may have low ADC values, those can prevent false-positive results in terms of malignancy. KEY WORDS: Parotid glands, Lymph nodes, Magnetic resonance imaging, Apparent diffusion coefficient.

de Quervain's Tenosynovitis and Radial Styloid Osseous Changes.

Objectives: This study aimed to determine the radial styloid osseous changes observed on posteroanterior wrist radiographs of patients with de Quervain's tenosynovitis who required surgery or conservative treatment. Materials and Methods: The surgically treated group included 24 patients with de Quervain's tenosynovitis. The conservative treatment group and the healthy control group each comprised 24 age- and sex-matched subjects. We evaluated the presence of bone apposition, periosteal reaction, sclerosis, osteopenia, erosion, and contour bulge in the epiphyseal remnant at the radial styloid. The incidences of abnormal radiographic findings were compared between these three groups. The correlation of radial styloid bony changes with the duration of symptoms was also analyzed. Results: No significant differences were found between the three groups in terms of periosteal reaction, erosion, and contour bulge at the epiphysial remnant. Significant differences were found between the three groups in the incidence of bone apposition, sclerosis, and osteopenia (p < 0.001). Bone apposition incidence in the surgically and conservatively treated groups was significantly higher than that in the control group (p < 0.001). Sclerosis and osteopenia significantly differed between the surgically and conservatively treated groups (p < 0.001, p = 0.002, respectively). No significant association was observed between the duration of symptoms and the radial styloid osseous changes (p > 0.05). Conclusion: We found a variable incidence of abnormal radiographic findings on the radial styloid in patients with de Quervain's tenosynovitis and asymptomatic individuals. The presence of sclerosis and osteopenia may be potential risk factors for patients who do not respond to conservative treatment and need surgical intervention.

Traumatic lung herniation due to Cow's kick.

Lung herniation, where the lung and its visceral and parietal components protrude outwards from a defect in the chest wall, is not common. It is most commonly secondary to blunt or penetrating trauma. The diagnosis is difficult, as the presentation differs according to aetiology. Ultrasound or CT scanning help in diagnosis and treatment planning. We present a 70-year-old female patient with lung herniation following a cow's kick on the thorax.

Absence of CSF flow within the cerebral aqueduct in spontaneous intracranial hypotension: a report of two cases.

Spontaneous intracranial hypotension (SIH) is a potentially debilitating condition resulting from a low cerebrospinal fluid (CSF) volume secondary to spinal CSF leakage. Characteristic clinical and radiological imaging findings are helpful in diagnosis. Herein, we present and discuss the magnetic resonance imaging (MRI) and CSF flow study of two patients with SIH and no CSF flow within the cerebral aqueduct, which is extremely rare in the literature.

The impact of TI-RADS in detecting thyroid malignancies: a prospective study.

INTRODUCTION: Thyroid ultrasonography (US) is the first-step noninvasive and easily accessible diagnostic method widely used in the detection and characterization of nodular thyroid disease. We aimed to develop a TI-RADS, which is easy to apply and only relies on the counting of suspicious criteria. In order to measure the reliability of the system, we investigated its correlation with fine needle aspiration biopsy (FNAB) and post-surgery histological results. MATERIALS AND METHODS: In this prospective study, 242 patients who had undergone FNAB with simultaneous cytopathologist in the radiology department between April and August 2016 were analyzed. Before FNAB, the thyroid gland was re-evaluated with US, and TI-RADS classification was made. Demographic characteristics, family thyroid cancer history and radiotherapy history to the neck region were noted. RESULTS: Of the 242 patients, 17.3% were male (42 males/200 females). US-guided FNAB was applied to all patients. Mean age was 50 ± 13 years (min: 19, max: 82). Both FNAB and final post-surgery histology results showed that sex and age were not statistically significantly associated with malignancy (p = 0.193) TI-RADS criteria and FNAB results revealed a statistically significant association between irregular contours, the state of anteroposterior diameter being longer than transverse diameter, microcalcifications, marked hypoechogenicity, and malignancy (p < 0,05). Thirty patients were TI-RADS ≥ 4, 206 patients were TI-RADS ≤ 3 and there was a significant correlation between TI-RADS and Bethesda classification (p = 0.001). In addition, statistically significant associations were found between malignancy and family history of thyroid cancer (p = 0.035) and radiotherapy history to the neck region (p = 0.01). CONCLUSION: TI-RADS system after nodule identification is based only on the counting of suspicious criteria. It will be safe and effective to recommend follow-up with low score TI-RADS, benign characters and insufficient FNAB results, and thus, unnecessary thyroidectomy operations will be prevented. It will be easier for surgeons to recommend surgery and persuade the patients for it when patients have high TI-RADS scores. TI-RADS has high power in detecting malignancy by recommending biopsy of suspicious nodules.

A rare case of isolated congenital unilateral brachymetatarsia presenting in a young adult male.

Congenital brachymetatarsia is a rare skeletal anomaly which is characterized by the abnormal length reduction of one or more metatarsal bones. It occurs as the result of the early closure of the growth plate. While the majority of the reported cases are idiopathic, it can also be seen in association with various genetic conditions or syndromes. Brachymetatarsia most commonly involves the fourth metatarsal followed by the first metatarsal. This rare disorder is mostly bilateral and reported almost exclusively in females. Herein, we present a rare case of congenital unilateral brachymetatarsia which was incidentally detected in a young adult male.

Magnetic resonance imaging for diagnosis of bipartite patella: usefulness and relationship with symptoms.

PURPOSE: Bipartite patella is a rare developmental variation of the knee cap. We aimed to identify the magnetic resonance imaging (MRI) features of bipartite patella and evaluate the association with clinical symptoms. MATERIAL AND METHODS: MRI exams of 61 patients with bipartite variant were evaluated for types of bipartite patella, oedema around the synchondrosis, bipartite fragment height (FH), distance between the fragment and the patella (FPD), and signal characteristics within the synchondrosis. The study was designed with two observers in order to achieve intra- and interobserver compliance. Any other major knee pathologies that can cause pain were also recorded. RESULTS: Of the 61 participants the average age was 40.1 ± 14.3 years, 44 were males, and 17 were females. Fifty-nine of the bipartite fragments were located at the superolateral quadrant of the patella. There was oedema at the bipartite area in 35 patients. Ten of these patients had no major MRI diagnosis other than oedema, and they were classified as the symptomatic group. The age of the patients in the symptomatic group was statistically lower than in the asymptomatic group (p < 0.05). There was no statistically significant difference between the groups in terms of male and female distributions, signal types across the synchondrosis, and FH or FPD measurements (p > 0.05). High concordance correlation coefficients were observed on measurements. CONCLUSIONS: MRI of the knee is highly accurate in evaluation of bipartite patella. To our knowledge; a detailed MRI analysis, like in our study, has not previously been performed, and our report is unique in showing that the symptomatic occurrence of bipartite patella is statistically higher in young patients.