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1.
Eur Arch Otorhinolaryngol ; 281(7): 3649-3654, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38466422

ABSTRACT

INTRODUCTION: The lamina papyracea is the thin line between the ethmoid sinus and the medial orbital wall. Knowledge of the presence of the lamina papyracea dehiscence (LPD) bears critical importance to prevent misdiagnosis of fractures at this level and to define the anatomy before sinonasal surgery, including Functional Endoscopic Sinus Surgery (FESS). The present study is therefore intended to determine the incidence of LPD in paranasal computed tomography, to identify its imaging characteristics in CT, and to compare with the literature. MATERIALS AND METHODS: The current study included patients who underwent paranasal CT scanning for any reason in our clinic between January 2018 and January 2022. Patients were evaluated in terms of age, gender, and presence of LPD. Patients with dehiscence were evaluated in terms of age, gender, dehiscence localization (right, left), tissue at the level of dehiscence, dehiscence size, and dehiscence grade. RESULTS: 1000 patients with a mean age of 32. ± 16.3 (min = 18-max = 79) were included in the study. 20 patients (2%) were found to have LPD. Of those with LPD, 14 (70%) were grade 1, 4 (20%) were grade 2 and 2 (10%) were grade 3. Again of those with LPD, 14 (70%) had LPD localized on the right and 6 (30%) had LPD on the left. In 12 (60%) of the patients with LPD, herniated tissue was detected. Among these patients with herniation, fatty tissue herniation was observed in 10 (83.3%) and medial rectus muscle herniation was observed in 2 (16.7%). DISCUSSION AND CONCLUSION: Comprehensive evaluation for and identification of LPD are very important before possible sinus surgery.


Subject(s)
Ethmoid Sinus , Tomography, X-Ray Computed , Humans , Male , Female , Tomography, X-Ray Computed/methods , Adult , Middle Aged , Ethmoid Sinus/diagnostic imaging , Aged , Retrospective Studies , Adolescent , Young Adult , Paranasal Sinuses/diagnostic imaging , Endoscopy/methods
2.
Cureus ; 16(1): e51509, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38304650

ABSTRACT

Background and objective Gynecomastia is a benign proliferation of ductal epithelium in the retroareolar region in male patients. The aim of this study was to investigate the frequency of gynecomastia in male patients who underwent thoracic computed tomography (CT) imaging at our clinic, assess possible causes, highlight the imaging characteristics of gynecomastia, and compare our findings with the literature. Materials and methods Male patients over 18 years of age who underwent thoracic CT imaging in our clinic were included in the study. Patients were initially assessed based on age and the presence of gynecomastia. The patients with gynecomastia were evaluated in terms of age, gynecomastia localization (right, left, and bilateral), gynecomastia type (nodular, dentritic, and diffuse), and possible etiology. Results The study included 1500 patients with a mean age of 45.6±21.7 years, and 470 (31.3%) patients had gynecomastia. Gynecomastia was on the right side in 11.3%, on the left side in 11.1%, and bilateral in 77.7% of the patients. Gynecomastia was nodular in 52.1%, dendritic in 35.3%, and diffuse in 17.2% of the patients. The causative factor could not be identified in 44.3% of the patients with gynecomastia. Among cases where the etiology was identified (56.7%), the most common factors were cancer (23.4%), chronic kidney disease (CKD) (13.2%), and chronic hepatitis B (10.7%). Conclusion When evaluating thoracic CT, the breast area, in addition to the lungs, chest wall, and bone structures, should also be evaluated carefully. With the increased use of thoracic CT scans, incidentally detected gynecomastia in patients is also on the rise. Knowing the presence of gynecomastia is very important for the clinician to determine the etiology and treat the underlying disease. Therefore, detecting and reporting gynecomastia on thoracic CT can prevent unnecessary advanced breast imaging methods and play a very important role in treating the underlying etiology.

3.
Eur Arch Otorhinolaryngol ; 281(3): 1293-1299, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37870642

ABSTRACT

PURPOSE: The anterior ethmoidal artery (AEA) is an important risk area in endoscopic sinus surgery. This study aimed to evaluate the course of AEA according to the Keros classification and the presence of supraorbital ethmoid cell (SOEC) and to prevent possible complications by emphasizing the importance of preoperative paranasal computed tomography (CT) imaging. This approach will increase the effectiveness of endoscopic sinus surgery and improve patient safety. METHODS: The paranasal CT scan images of patients aged > 18 years between October 2020 and November 2021 from our center were retrospectively analyzed. The images were primarily evaluated in the coronal plane, and the sagittal and axial planes were utilized to evaluate variations in AEA regarding the skull base. Furthermore, the relation of AEA course with Keros classification and SOEC was evaluated. The study included 1000 patients aged 18-80 years (right and left, a total of 2000 samples). RESULTS: Grade 3 AEA was the most common regarding the skull base. Keros Type 2 was the most common classification. Overall, 48.7% patients had SOEC. The incidence of Grade 3 AEA was higher among patients with SOEC and a higher Keros classification compared with those without SOEC and a lower Keros classification. Furthermore, Keros Type 3 was the most associated with SOEC presence. CONCLUSION: Consistent with the literature, the probability of Grade 3 AEA in patients with high Keros classification and SOEC was significantly higher in our study. Therefore, we consider that preoperative imaging according to Keros classification and SOEC presence can predict AEA course and guide surgery.


Subject(s)
Ethmoid Sinus , Skull Base , Humans , Retrospective Studies , Ethmoid Sinus/diagnostic imaging , Ethmoid Sinus/surgery , Ethmoid Sinus/blood supply , Skull Base/diagnostic imaging , Skull Base/surgery , Ophthalmic Artery , Tomography, X-Ray Computed , Ethmoid Bone/diagnostic imaging , Ethmoid Bone/surgery
4.
Anatol J Cardiol ; 27(11): 628-638, 2023 11 01.
Article in English | MEDLINE | ID: mdl-37466024

ABSTRACT

BACKGROUND: Hypertrophic cardiomyopathy is a common genetic heart disease and up to 40%-60% of patients have mutations in cardiac sarcomere protein genes. This genetic diagnosis study aimed to detect pathogenic or likely pathogenic sarcomeric and non-sarcomeric gene mutations and to confirm a final molecular diagnosis in patients diagnosed with hypertrophic cardiomyopathy. METHODS: A total of 392 patients with hypertrophic cardiomyopathy were included in this nationwide multicenter study conducted at 23 centers across Türkiye. All samples were analyzed with a 17-gene hypertrophic cardiomyopathy panel using next-generation sequencing technology. The gene panel includes ACTC1, DES, FLNC, GLA, LAMP2, MYBPC3, MYH7, MYL2, MYL3, PLN, PRKAG2, PTPN11, TNNC1, TNNI3, TNNT2, TPM1, and TTR genes. RESULTS: The next-generation sequencing panel identified positive genetic variants (variants of unknown significance, likely pathogenic or pathogenic) in 12 genes for 121 of 392 samples, including sarcomeric gene mutations in 30.4% (119/392) of samples tested, galactosidase alpha variants in 0.5% (2/392) of samples and TTR variant in 0.025% (1/392). The likely pathogenic or pathogenic variants identified in 69 (57.0%) of 121 positive samples yielded a confirmed molecular diagnosis. The diagnostic yield was 17.1% (15.8% for hypertrophic cardiomyopathy variants) for hypertrophic cardiomyopathy and hypertrophic cardiomyopathy phenocopies and 0.5% for Fabry disease. CONCLUSIONS: Our study showed that the distribution of genetic mutations, the prevalence of Fabry disease, and TTR amyloidosis in the Turkish population diagnosed with hypertrophic cardiomyopathy were similar to the other populations, but the percentage of sarcomeric gene mutations was slightly lower.


Subject(s)
Cardiomyopathy, Hypertrophic , Fabry Disease , Humans , Sarcomeres/genetics , Sarcomeres/metabolism , Sarcomeres/pathology , Mutation , Cardiomyopathy, Hypertrophic/genetics , Phenotype
5.
Int J Cardiovasc Imaging ; 39(7): 1307-1312, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37145188

ABSTRACT

OBJECTIVE: There is a huge uncertainty in the medical community regarding the significance of non-dominant right coronary artery (RCA) in patients with inferior wall ischemia on myocardial perfusion single-photon emission computed tomography (SPECT). The purpose of this study is to determine the effect of non-dominant RCA on myocardial perfusion SPECT (MPS) with respect to the misleading detection of ischemia in the inferior wall of the myocardium. METHODS: This is a retrospective study of 155 patients, who had undergone elective coronary angiography owing to an indication of inferior wall ischemia by MPS between 2012 and 2017. Patients were divided into two groups based on the coronary dominance: group 1 (n = 107), if RCA is the dominant artery, and group 2 (n = 48), if there are dominance of left artery and codominance of both arteries. Obstructive CAD was diagnosed in the case of stenosis that had severity greater than 50%. The positive predictive value (PPV), which was calculated as per the correlation between the inferior wall ischemia in MPS and obstruction level in RCA, was compared in both groups. RESULTS: Majority of patients were male (109, 70%) and the mean age was 59.5 ± 10.2. There were 45 patients with obstructive RCA disease (PPV: 42%) among 107 patients in group 1, whereas there were only 8 patients with obstructive coronary artery disease (CAD) in RCA among 48 patients in group 2, (PPV: 16% and p = 0.004). CONCLUSIONS: The results demonstrated that non-dominant RCA is associated with false-positive detection of inferior wall ischemia via MPS.


Subject(s)
Coronary Artery Disease , Myocardial Perfusion Imaging , Humans , Male , Female , Middle Aged , Aged , Retrospective Studies , Predictive Value of Tests , Tomography, Emission-Computed, Single-Photon/methods , Coronary Angiography , Ischemia , Myocardial Perfusion Imaging/methods
6.
Turk Kardiyol Dern Ars ; 51(3): 221-225, 2023 04.
Article in English | MEDLINE | ID: mdl-36999326

ABSTRACT

Pulmonary arterial hypertension is still a fatal disease persisting with poor prognosis, despite all the advances in treatment (new agents and new combination strategies) in recent years. Patients present with different symptoms which are not specific to the disease (dyspnea, angina, palpitation, and syncope). Angina may occur secondary to myocardial ischemia due to increased right ventricular after load (oxygen supply and demand mismatch) or external compression on the left main coronary artery. Left main coronary artery compression is associated with post-exercise sudden cardiac death in pulmonary arterial hypertension patients. It should be kept in mind in the differential diagnosis of angina in patients with pulmonary arterial hypertension and should be treated immediately. Here, we report a pulmonary arterial hypertension patient associated with secundum-type atrial septal defect presented with ostial left main coronary artery compression caused by an enlarged pulmonary artery and treated with intravascular ultrasound-guided percutaneous coronary intervention.


Subject(s)
Heart Septal Defects, Atrial , Hypertension, Pulmonary , Pulmonary Arterial Hypertension , Humans , Coronary Vessels , Hypertension, Pulmonary/complications , Hypertension, Pulmonary/diagnosis , Pulmonary Artery , Angina Pectoris/etiology , Angina Pectoris/therapy , Heart Septal Defects, Atrial/complications , Heart Septal Defects, Atrial/diagnostic imaging , Heart Septal Defects, Atrial/surgery
7.
Omega (Westport) ; : 302228231163208, 2023 Mar 09.
Article in English | MEDLINE | ID: mdl-36892536

ABSTRACT

The aim of this research is to relationship between intolerance of uncertainty and spiritual well-being levels during Covid-19 among elderly. This study was conducted with cross-sectional and corrational design. The research was conducted between January and June 2021 in Turkey's Eastern Anatolia Region. Introductory Information Form, Intolerance of Uncertainty Scale-Short Form (IUS), and Spirituality Index of Well-Being (SIWB) were used to collect data. The research was completed with 302 volunteers who met the following inclusion criteria. All participants belong to the Muslims. A negative significant correlation was found between IUS and SIWB; that is as the spirituality of the elderly individuals increased, the levels of intolerance of uncertainty decreased. It is recommended to identify the fears and intolerances of elderly individuals. For uncertainty, it is necessary to refine their spirituality. For this, it is recommended to organize spiritual education programs.

8.
Echocardiography ; 39(10): 1367-1369, 2022 10.
Article in English | MEDLINE | ID: mdl-36100814

ABSTRACT

Unilateral absence of pulmonary artery (UAPA) resulting from a defect in the aortic arch's embryogenesis. Patients who survive into adulthood is rare. Herein, we presented a case of UAPA with pulmonary hypertension in a 49-year old female.


Subject(s)
Heart Defects, Congenital , Hypertension, Pulmonary , Lung Diseases , Vascular Malformations , Female , Humans , Adult , Middle Aged , Pulmonary Artery/diagnostic imaging , Pulmonary Artery/abnormalities , Hypertension, Pulmonary/complications , Lung/blood supply , Vascular Malformations/complications , Heart Defects, Congenital/complications , Lung Diseases/complications
9.
Surg Radiol Anat ; 44(6): 907-912, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35666298

ABSTRACT

PURPOSE: This study investigated the incidence of thyroid Zuckerkandl Tubercle (ZT) using a computed tomography (CT) scan of the neck with contrast to identify the typologies in ZT-positive CT scans, investigate the presence of nodules located in that area, and compare the results with the relevant literature. METHODS: We selected and retrospectively examined the CT scan images of patients who presented to our clinic with CT scans of the neck with contrast that clearly showed thyroid tissue and boundaries. Patients were evaluated based on age, gender, and presence of thyroid ZT. Patients with thyroid ZT were further investigated for localization and type of tubercles as well as for presence of nodules at the tubercle level. RESULTS: A total of 1000 patients (mean age: 48.4 ± 19.1) were included in the study. Out of the total 222 (22.2%) patients who had thyroid ZT, 134 (60.4%) patients had unilateral thyroid ZT on the right side and 29 (13.1%) patients had unilateral thyroid ZT on the left side; 59 (26.6%) patients had bilateral thyroid ZT. In addition, nodules at the ZT level were observed in 13 (1.3%) of the patients. A review of all cases with ZTs indicated that 63% were Type 1, 31% were Type 2, and 5% were Type 3. CONCLUSION: During the thyroid operations, ZT is essential for locating the recurrent laryngeal nerve. Reporting the presence of ZTs based on CT scans is crucial because it can prevent unnecessary interventional procedures, misdiagnoses, and likely complications in patients with planned thyroid operations.


Subject(s)
Recurrent Laryngeal Nerve , Thyroid Gland , Adult , Aged , Humans , Middle Aged , Parathyroid Glands , Retrospective Studies , Thyroid Gland/diagnostic imaging , Thyroid Gland/surgery , Thyroidectomy/methods , Tomography, X-Ray Computed
10.
Cureus ; 14(6): e26355, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35770182

ABSTRACT

Background and objective CT imaging is important in detecting the location and the structure of swallowed foreign bodies and assessing their complications, due to its features such as the ability to show the detailed anatomical structure and enable multiplanar examination. In this study, we aimed to analyze the CT findings of swallowed foreign bodies located in the gastrointestinal tract and compare them with the data in the existing literature. Materials and methods We conducted a retrospective archive study to achieve our goals. Patients who presented to our radiology department with the preliminary diagnosis of foreign body ingestion, abdominal pain, or acute abdomen and were found to have a foreign body in the gastrointestinal tract on CT between April 2018 and April 2021, especially those in whom the presence of a foreign body was confirmed by endoscopy or surgery, were included in our study. The patients were evaluated in terms of age, gender, foreign body type, foreign body localization, and complications. Results A total of 31 patients (15 males and 16 females) were included in the study. The patients' age ranged from 1 to 67 years, and the mean age was 28.5 ±5.4 years. The most common foreign bodies found were metallic toy parts (n=11, 35%), and most of the foreign bodies were located in the ileum (n=9, 29%) of the patients. Complications were observed in nine patients (29%). In patients with complications, the most common finding was perforation (n=3, 38%). Conclusion When a CT exam is performed on patients with abdominal pain, the gastrointestinal tract should be carefully evaluated to determine if a foreign body is involved and to analyze the complications caused by the foreign body.

11.
Surg Radiol Anat ; 44(5): 715-720, 2022 May.
Article in English | MEDLINE | ID: mdl-35604462

ABSTRACT

PURPOSE: This study aimed to investigate the prevalence of persistent trigeminal arteries (PTAs) using computed tomography (CT) angiography, emphasize its major characteristics, and compare the findings with those reported in the relevant literature. METHODS: Patients who underwent cerebral CT angiography in our radiology clinic for any preliminary diagnosis between December 2013 and December 2020 were included in this retrospective study. The patients were reviewed in terms of their age, sex, and the presence of PTAs. The localization of the PTA, vascular connection, PTA type (according to Saltzman and Salas classification), and vascular pathology at the level of anastomoses were examined in the patients with PTAs. RESULTS: A total of 1150 patients, (632 [55%] males and 518 [45%] females) were included in this study. A total of seven (0.6%) patients had PTAs. PTAs were located on the right and left sides in three (43%) and four (57%) patients, respectively. A total of three (43%), two (28%), and two (28%) cases were classified as types I, II, and III PTA based on the Saltzman classification, respectively. Moreover, four (57%) and three (43%) cases were lateral and medial types based on the Salas classification, respectively. CONCLUSION: In conclusion, understanding the diagnosis and classification of PTAs is crucial for the diagnosis of possible vascular pathologies by neuroradiologists and physicians performing neurovascular interventional procedures or operations. If these vascular pathologies remain undetected, they may cause fatal bleeding or embolism during surgeries and endovascular procedures.


Subject(s)
Computed Tomography Angiography , Endovascular Procedures , Angiography , Basilar Artery , Female , Humans , Male , Retrospective Studies
12.
Curr Med Imaging ; 18(12): 1343-1345, 2022.
Article in English | MEDLINE | ID: mdl-35578856

ABSTRACT

INTRODUCTION AND BACKGROUND: In this article, we aimed to present a congenital sialocutaneous fistula originating from the parotid gland in a 4-year-old child with MR findings. CASE PRESENTATION: A 4-year-old male patient was admitted to our clinic with a small hole in the inferior right half of the neck and a sticky fluid coming out of this area. Neck ultrasonography (US) and contrast neck Magnetic Resonance Imaging (MRI) were performed on the patient. In the US, a millimeter linear, vaguely hypoechoic appearance was observed in the subcutaneous tissue at this level on the neck. In contrast-enhanced neck MRI imaging, at the level of the right parotid tail, a millimetric linear fistula tract was observed, which was thought to originate from the superficial parotid lobe and extended to the skin at the proximal level of the right sternocleidomastoid (SCM) muscle. After suppressing surrounding fatty tissues in fat-suppressed contrast-enhanced series, this tract area became slightly pronounced. CONCLUSION: In conclusion, sialocutaneous fistula should be considered among the differential diagnoses in cases of skin fistulization in children. In terms of differential diagnosis, MRI is a very effective imaging method due to its high soft-tissue resolution.


Subject(s)
Fistula , Magnetic Resonance Imaging , Child, Preschool , Diagnosis, Differential , Humans , Male
13.
Support Care Cancer ; 30(2): 1863-1872, 2022 Feb.
Article in English | MEDLINE | ID: mdl-34613473

ABSTRACT

OBJECTIVES: The COVID-19 pandemic has adversely affected the caregivers of people with all chronic diseases, including people with cancer (PWC). This study was conducted to determine the impact of anxiety and spiritual well-being on the care burden of caregivers of PWC during the COVID-19 pandemic. DESIGN: This cross-sectional descriptive study included 250 caregivers of hematology and oncology patients registered with a cancer support association. All participants completed the following self-report questionnaires: the Spiritual Well-Being Scale (SWBS), Generalized Anxiety Disorder 7-item scale (GAD-7), and the Zarit Caregiver Burden Interview (ZBI). RESULTS: Most (82.4%) of the caregivers expressed fear that their patient may contract COVID-19, and 42.0% stated that they had difficulty getting to the hospital. The caregivers' mean ZBI score was 21.06 ± 14.64, their mean GAD-7 score was 14.51 ± 6.02, and their mean SWBS score was 111.50 ± 16.84. According to the results of regression analysis, SWBS and GAD-7 scores had a significant effect on the ZBI score (p < 0.05). CONCLUSION: In this study, anxiety explained most of the care burden during COVID-19. Therefore, during the COVID-19 pandemic, it may be beneficial to implement practices to promote spirituality and reduce anxiety in caregivers of PWC.


Subject(s)
COVID-19 , Neoplasms , Anxiety/epidemiology , Anxiety Disorders , Caregiver Burden , Caregivers , Cost of Illness , Cross-Sectional Studies , Humans , Neoplasms/therapy , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
14.
Anesth Essays Res ; 15(1): 38-44, 2021.
Article in English | MEDLINE | ID: mdl-34667346

ABSTRACT

BACKGROUND AND AIM: The aim of this study is to investigate the magnetic resonance imaging (MRI) of patients with lumbar disc herniation (LDH) to identify the challenges associated with neuraxial anesthesia. MATERIALS AND METHODS: The MRI images in the supine position of 203 patients admitted to hospital with complaints of lower back pain were studied. Medial sagittal slices of the lumbar spine were imaged from L1 to S1. LDH is classified as either bulging, extrusion, or protrusion. RESULTS: For this study, 83 males and 120 females with a mean age of 43.18 ± 14.68 years were recruited. The highest herniation level was observed at L4-L5 in 145 (71.4%) patients: 76 instances of disc bulging (37.4%), 56 instances of extrusion (27.6%), and 13 instances of protrusion (6.4%). The longest distance between the skin and spinal cord was 60.06 ± 1.61 mm at L5-S1; the longest distance at width of the epidural space was 6.09 ± 1.95 mm at L3-L4. According to the disc herniation groups, no significant differences were found between the skin-to-dura distance, width of the epidural space, and depth of skin level to spinous process (P > 0.05). Moreover, the anterior dura to cord distances was significantly different from normal patients (P < 0.05). Indeed, there was a statistically weak and negative correlation between both the length and age of the lumbar spinal canal (P < 0.05, r = -0.295). CONCLUSIONS: Lumbar disc pathologies can cause anatomical derangements in the spinal canal, which may cause neurologic deficits by neuraxial blockade.

15.
Turk J Med Sci ; 51(3): 1380-1387, 2021 06 28.
Article in English | MEDLINE | ID: mdl-33550765

ABSTRACT

Background/aim: Magnetic resonance (MR) images, signal intensity ratios calculated using region of interests (ROI) in T2W images by proportioning the dominant myoma to iliac muscle can aid patient selection and, thus, in achieving better outcomes with the uterine artery embolization (UAE) procedure. The present study investigates the association between the success of UAE treatment with signal intensity (SI) ratio of the dominant myoma to the iliac muscle in MR imaging performed prior to the procedure. Materials and methods: This is a retrospective study and included 30 patients who admitted to our clinic between February 2017 and July 2019 due to symptoms associated with myoma and who underwent MR imaging before and after UAE treatment. All patients, MR images obtained before UAE treatment and at the 12th month after the procedure were evaluated. In MRI, SI values were calculated by proportioning the dominant myoma to the iliac muscle using circular ROI in T1 weighted (W), T2W, and post-contrast T1W images. In the present study, 50% or more volumetric regression of the myoma with infarction of fibroids (loss of enhancement) at the 12-month follow-up MRI after the procedure was considered a successful procedure. Results: Myoma volumes calculated in MR images showed significant differences between the MRI performed before UAE procedure and the MRI performed at the 12th month after the procedure (p < 0.0001). SI ratio calculated from pre-procedure T2W MR images was found to be a significant determinant of 50% or more volumetric regression in the myoma after UAE procedure (p = 0.017), T1W, post-contrast T1W images were not statistically significant (p = 0.211). Conclusion: Our results indicate that SI ratio of the dominant myoma to the iliac muscle calculated using ROI in T2W images of MR studies performed before UAE procedure can predict the success of the procedure.


Subject(s)
Myoma , Uterine Artery Embolization , Uterine Neoplasms , Female , Humans , Magnetic Resonance Imaging , Retrospective Studies , Treatment Outcome , Uterine Neoplasms/diagnostic imaging , Uterine Neoplasms/therapy
16.
Cureus ; 13(1): e12877, 2021 Jan 23.
Article in English | MEDLINE | ID: mdl-33633906

ABSTRACT

Introduction Excess iron accumulation occurs mainly in organs such as reticuloendothelial cells, the pituitary gland, and the pancreas in beta-thalassemia because of blood transfusions. In the present study, it was aimed to investigate the relationship between T2* values on magnetic resonance imaging (MRI) and clinically diagnosed pituitary endocrinological disorders in children with thalassemia major. Methods This study enrolled patients diagnosed with beta-thalassemia at pediatric hematology outpatient clinics. In the study, in addition to the medical history of the patients, routinely performed tests, including hemoglobin electrophoresis, routine biochemical tests, and tests for pubertal development (follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, testosterone, etc.), as well as iron deposition measured by hepatic MRI T2* (STAR) sequence, were retrospectively assessed. A total of 29 patients were enrolled. Results Hypothyroidism was detected in 34.6% (9/26) of patients, short stature in 37% (10/27), and pubertal retardation in 50% (14/28) of the patients. There was no significant correlation between hypothyroidism and pituitary MRI T2* values. No significant correlation was found between laboratory parameters and pituitary MRI examination. Although the sensitivity of T2* levels could rise above 80%, their specificity remained low. This is one of the major limitations of the pituitary MR T2* study for the prediction of short stature. The best lower cut-off level of MR T2* to predict short stature was found 14.6 ms. Conclusion The diagnostic specificity pituitary MR examination levels for short stature were detected as low. Thus, the clinical standardization and validation of pituitary MR T2* values examination are needed before clinical follow-up and multifaceted studies are needed.

17.
Radiol Case Rep ; 13(2): 516-521, 2018 Apr.
Article in English | MEDLINE | ID: mdl-29904503

ABSTRACT

Arachnoid cysts are one of the most frequently encountered intracranial space-occupying lesions in daily neurosurgery and neuroradiology practice. Majority of arachnoid cysts, particularly those of smaller sizes, have a benign uneventful lifetime course. Certain symptoms may indicate serious complications related to underlying arachnoid cysts. Hemorrhage is one of the most fearsome complications of arachnoid cysts and almost all reported cases in the literature have undergone surgical correction. In this study, we aimed to present clinical and radiologic follow-up findings in two adult cases of intracranial arachnoid cyst with spontaneous intracystic hemorrhage and associated subdural hematoma, one of which was successfully treated conservatively. In addition, we broadly summarized and discussed pertinent studies in the English literature.

18.
Surg Radiol Anat ; 40(9): 1085-1091, 2018 Sep.
Article in English | MEDLINE | ID: mdl-29860552

ABSTRACT

Ectopic intrathoracic liver tissue is extremely rare. Studies are mainly limited to case reports. In the vast majority of reported cases, a diagnosis of intrathoracic liver tissue was made either after a thoracic surgery or during a postmortem examination. However, once included in differential diagnosis, surgical intervention or biopsy procedures may be avoided with optimal diagnostic approach. In the present study, we conducted a literature review and proposed a new classification method for accessory liver within the thoracic cavity. This approach may provide a better understanding of underlying pathophysiology and aid in determination of optimal diagnostic modality and clinical management of such cases. According to our literature review, type II ectopic liver is the most common subtype followed by types I and III. All types can be definitively diagnosed with imaging modalities. On the other hand, it is important to prevent patients, particularly children, from unnecessary radiation exposure during performance of sophisticated diagnostic imaging modalities. Ultrasound is a safe, low-cost and accessible imaging modality that has not been previously reported in diagnosis of this entity. With addition of Color Doppler Imaging, ultrasound may allow for diagnosis with high precision in types I and II, as demonstrated in the present study. Based on long-term follow-up of a case reported here, this study also illustrates the natural course of this entity via non-operative management. This approach may prevent an unnecessary surgical intervention.


Subject(s)
Choristoma/diagnosis , Liver , Rare Diseases/diagnosis , Thoracic Diseases/diagnosis , Ultrasonography, Doppler, Color , Child , Choristoma/complications , Choristoma/epidemiology , Choristoma/therapy , Conservative Treatment , Contrast Media/administration & dosage , Cough/diagnosis , Cough/etiology , Diagnosis, Differential , Fever/diagnosis , Fever/etiology , Humans , Male , Pneumonia/diagnostic imaging , Rare Diseases/complications , Rare Diseases/epidemiology , Rare Diseases/therapy , Thoracic Cavity/diagnostic imaging , Thoracic Diseases/complications , Thoracic Diseases/epidemiology , Thoracic Diseases/therapy , Tomography, X-Ray Computed/methods , Treatment Outcome
19.
Clin Imaging ; 47: 65-73, 2018.
Article in English | MEDLINE | ID: mdl-28898729

ABSTRACT

PURPOSE: Traumatic diaphragmatic rupture is a diagnostic challenge for both surgeons and radiologists and generally occurs secondary to blunt and penetrating trauma of thoracoabdominal region. MATERIAL AND METHODS: 56 patients who underwent surgical procedure due to blunt or penetrating trauma were included to the study. RESULTS: There were 37 diaphragmatic ruptures in the left side and 19 patients in the right side. The most common radiological finding was "the direct monitoring of defect" (54,3%). CONCLUSION: Findings suggestive of diaphragmatic rupture must be carefully evaluated in patients with blunt or penetrating thoracoabdominal trauma.


Subject(s)
Abdominal Injuries , Diaphragm/injuries , Muscular Diseases/diagnosis , Rupture/diagnosis , Thoracic Injuries , Wounds, Nonpenetrating/complications , Wounds, Penetrating/complications , Female , Humans , Male , Muscular Diseases/etiology , Respiration Disorders/diagnosis , Respiration Disorders/etiology , Retrospective Studies , Rupture/etiology , Tomography, X-Ray Computed/methods
20.
Clin Imaging ; 41: 106-111, 2017.
Article in English | MEDLINE | ID: mdl-27840261

ABSTRACT

The aim of this study is to show the frequency of incidentally found (pulmonary thromboembolism) PTE in oncological patients and evaluate dispersion of incidents in terms of underlying primary tumor and seek risk factors associated with incidental PTE. Among one thousand oncology patients, 46 (4.6%) individuals found to have incidental PTE. Of positive patients, the highest proportion (24%) was belong to breast cancer group (n=11). The most common location for pulmonary emboli was the lower lobe branch of right pulmonary artery (n=33, 71.7%). Evident PTE had not been reported in final radiology reports of 21 cases.


Subject(s)
Incidental Findings , Neoplasms/complications , Pulmonary Embolism/complications , Pulmonary Embolism/diagnostic imaging , Tomography, X-Ray Computed/methods , Female , Humans , Male , Pulmonary Artery/diagnostic imaging , Risk Factors
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