Evaluation of liver and spleen stiffness measurement with shear wave elastography in brucellosis.

BACKGROUND: Human brucellosis, which is endemic in the eastern region of Turkey, infects the reticulo-endothelial system. Acute brucellosis may cause hepatomegaly or splenomegaly. AIMS: The main purpose of this study was to investigate the effectiveness of the point shear wave elastography (pSWE) method in identifying and detecting liver and spleen stiffness in acute brucellosis. METHODS: This case-control study included 40 patients with acute brusellosis and 60 healthy individuals as a control group. The demographic data, abdominal ultrasonography (USG) and pSWE results of the patient and control groups were evaluated. Statistical and ROC analyses were performed. RESULTS: The liver pSWE value was 3.8395 ± 1.171 kPa in the patient group and 1.6619 ± 0.495 kPa in the control group. The spleen pSWE value was 3.2431 ± 1.803 kPa in the patient group and 1.3793 ± 0.622 kPa in the control group. The mean liver and spleen pSWE values were statistically significantly higher in the patient group than in the control group (p < 0.001). Cut-off values were determined as 2.524 for the liver pSWE and 1.62667 for the spleen pSWE. From the AUC values (0.959, 0.903), the diagnostic performance of liver and spleen pSWE values were seen to be excellent in distinguishing between patient and control groups. CONCLUSIONS: The study results showed that liver and spleen stiffness were high in acute brucellosis patients and had predictive significance above certain cut-off values. It can be considered that pSWE, which evaluates liver and spleen stiffness in acute brucellosis, may provide diagnostic benefit as a reliable, non-invasive technique.

Does B12 deficiency lead to change in brain metabolites in pediatric population? A MR spectroscopy study.

OBJECTIVES: The aim of this study is to examine metabolite changes in different brain regions of the children with vitamin B12 deficiency disease using MR spectroscopy. METHODS: Eighteen children with serum vit. B12 deficiency and 12 healthy volunteer children were included in the study. All children were examined with single-voxel spectroscopy examination via 1.5-Tesla MRI. The spectra were obtained from the left frontal periventricular white matter, left lentiform nucleus and left cerebellar hemisphere. The comparisons between patient group and control group were made with ratios calculated as NAA/Cr, Cho/Cr, mI/Cr, and Glx/Cr. All brain images were also examined in terms of brain atrophy, abnormal brain parenchyma intensity changes, or myelination status. RESULTS: The children were between 3 months and 16 years old in the patient group, and between 3 months and 15 years old in the control group. There were no statistical differences in terms of metabolite ratios in the three different brain regions between the patients and control group. In two patients, periventricular white matter hyperintensities were observed. In four patients, brain atrophy was detected. DISCUSSION: MR spectroscopy examination demonstrated that there were no statistical differences in terms of all metabolite ratios in left frontal periventricular white matter, left lentiform nucleus and left cerebellar hemisphere.

Brain metabolite alterations in Eisenmenger syndrome: Evaluation with MR proton spectroscopy.

OBJECTIVE: Eisenmenger syndrome (ES) is a life-threatening disease characterized by pulmonary hypertension and cyanosis in patients with congenital heart diseases. The aim of this study was to determine the brain metabolite changes in Eisenmenger syndrome compared with a control group using MR proton spectroscopy. METHODS AND MATERIALS: The study included 10 children (3 male, 7 female) with congenital heart diseases and a diagnosis of Eisenmenger syndrome. The control group consisted of 10 healthy volunteer children. All were examined with a 1.5T MRI scanner and single voxel spectroscopy was performed to obtain spectra from three different regions; left frontal subcortical white matter, left lentiform nucleus and left thalamus. Peak integral values obtained from the spectra were used as quantitative data. RESULTS: The ages of the children with ES were between 5 and 16 years, and between 5 and 15 years in the control group. Periventricular white matter hyperintensities were observed in 3 patients. On MR spectroscopy study, significantly lower levels of Choline metabolite (Cho) were detected in the frontal subcortical region and thalamus regions of the patients compared with the control group. There was no statistically significant difference between the levels of other metabolites (NAA, Cr, mI and Glx). In the lentiform nucleus, although the average value of Cho in ES patients was lower than that of the control group, it was not statistically significant. CONCLUSION: Cho metabolite was determined to have an important role in brain metabolism in Eisenmenger syndrome patients. Oral Cho treatment may help to extend survival.

Assessment of orbital blood flow velocities in retinopathy of prematurity.

The purpose of this study is to evaluate whether the presence of any stage retinopathy of prematurity (ROP) alters central retinal artery (CRA) and ophthalmic artery (OA) blood flow parameters in premature infants. The patients were divided into two groups according to the development of ROP; those who have ROP were defined as group I, those without ROP were defined as group II. Ninety eyes of 45 patients in group I and 40 eyes of 20 patients in group II were investigated. The blood flows in the CRA and OA were measured using ultrasound color doppler imaging (CDI) that allows to evaluate the peak systolic velocity (PSV), end diastolic velocity (EDV), and resistivity index (RI). The results were compared between two groups of subjects. There were no significant differences in the PSV, EDV, and RI of CRA between two groups (P = 0.09, P = 0.20 and P = 0.63, respectively). The mean PSV value of OA in group I was found to be significantly higher than the one in group II (P < 0.05), but there were no significant differences in the mean EDV and RI values of OA between two groups (P = 0.40, P = 0.17 respectively). The subgroup analysis revealed that the ocular blood dynamics were not found to be significant between eyes with stage I ROP and eyes with stage II ROP (P > 0.05), whereas the difference in the mean PSV values of OA were found to be significant among the eyes with stage 1 ROP, eyes with stage 2 ROP, and eyes without ROP (P = 0.03). This study demonstrated significant alterations in systolic flow velocities in the OA predicted by CDI in infants with ROP.

Brain diffusion changes in Eisenmenger syndrome.

OBJECTIVE: This preliminary study aimed to evaluate whether there are changes in the apparent diffusion coefficient (ADC) values of the brain in patients presenting with Eisenmenger syndrome (ES). METHODS: This cross-sectional study included 10 consecutively recruited patients with ES and 10 healthy control subjects. In the patients and controls, eight distinct neuroanatomical locations were selected for analysis. Quantitative measurements of ADC values of the frontal white matter (FWM), occipital white matter, lentiform nucleus (LN), thalamus, frontal cortex, anterior and posterior limbs of the internal capsule and caudate nucleus were measured. Statistical analysis was performed using SPSS® (IBM Corp., New York, NY; formerly SPSS Inc., Chicago, IL) for Windows v. 20. Data were presented as mean ± standard deviation values. The Kruskal-Wallis test was used to assess differences in the ADC values of each brain location between the ES group and the control group. Statistical significance was accepted at the level of p < 0.05. RESULTS: The ADC values of the FWM and LN were significantly higher in the ES group than that in the control group. The mean ADC levels of other brain regions were not significantly different between the groups. CONCLUSION: Chronic hypoxia in patients with ES may lead to diffusion changes in the brain tissue. There is a need for further studies to assess the clinical significance of cerebral ADC values in patients with ES. Advances in knowledge: The ratio of extracellular volume to intracellular volume in the FWM and LN can be considered to be increased in patients with ES.

Diffusion-weighted MRI in the differential diagnosis of uterine endometrial cavity tumors.

BACKGROUND: This study aimed to investigate the efficacy of quantitative apparent diffusion coefficient (ADC) measurement in the differential diagnosis of the uterine endometrial cavity tumors (UECT). METHODS: This study included consecutive 36 female patients with UECT. The groups were formed as follows: group 1, patients with endometrial carcinoma; group 2, patients with endometrial polyp; group 3, patients with submucosal leiomyoma; and additionally group A, patients with malignant lesion; group B patients with benign lesion. Tumoral and outer myometrial ADC values were measured and the tumor-myometrium ADC ratios were calculated in all patients. Kolmogorov-Smirnov tests were used to test the normality of the data distributions. The data were not normally distributed, and therefore, nonparametric tests were performed. The cut-off values, sensitivity, and specificity were determined by the receiver operating characteristic analysis. RESULTS: The mean ADC value and ratio of group 1 were lower than that of group 2 and 3, and the mean ADC value and ratio of group 3 were lower than that of group 2. The sensitivity and specificity for group 1, 2, and 3 were as follows: 90, 100, and 66.7 %; and 81.8, 88, and 58.8 %, respectively, in terms of the ADC values; 90, 100 and 67 %; and 77.3, 96, and 64.7 % in terms of the ADC ratios. Statistically significant differences were demonstrated between group A and B in terms of mean tumoral ADC values and ratios. Sensitivity and specificity were found to be 90 and 81.8 %, respectively, in terms of the ADC values. The sensitivity and specificity were found to be 90 and 77.3 %, respectively, in terms of the ADC ratios. CONCLUSIONS: ADC values and ratios represent a promising parameter in the determination of the tumoral lesions in patients with UECT.

A rare case of petrous apex osteoma.

Osteomas are the most common tumours of the cranial vault and facial skeleton. Temporal bone osteoma is a rare entity. An osteoma arising from the petrous apex is extremely rare. We present a case of osteoma arising from the petrous apex followed by a discussion of the etiology, presentation, and radiologic findings.