Age- and gender-related radiological changes of the cervical spine: A study with largest magnetic resonance imaging database of 5672 consecutive patients.

Background: The morphological features of the cervical spine are an essential issue. This retrospective study aimed to investigate the structural and radiological changes in the cervical spine. Materials and Methods: A total of 250 patients with neck pain but no apparent cervical pathology were selected from a database of 5672 consecutive patients undergoing magnetic resonance imaging (MRI). MRIs were directly examined for cervical disc degeneration. These include Pfirrmann grade (Pg/C), cervical lordosis angle (A/CL), Atlantodental distance (ADD), the thickness of transverse ligament (T/TL), and position of cerebellar tonsils (P/CT). The measurements were taken at the positions of T1- and T2-weighted sagittal and axial MRIs. To evaluate the results, patients were divided into seven age groups (10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70, and over). Results: In terms of ADD (mm), T/TL (mm), and P/CT (mm), there was no significant difference among age groups (P > 0.05). However, in terms of A/CL (degree) values, a statistically significant difference was observed among age groups (P < 0.05). Conclusions: Intervertebral disc degeneration was more severe in males than in females as age increased. For both genders, cervical lordosis, decreased significantly as age increased. T/TL, ADD, and P/CT did not significantly differ with age. The present study indicates that structural and radiological changes are possible reasons for cervical pain at advanced ages.

Fetal sex prediction measuring yolk sac size and yolk sac-fetal pole distance in the first trimester via ultrasound screening.

PURPOSE: The aim of the study was to determine the accuracy of fetal sex definition by measuring the yolk sac size and the yolk sac-fetal pole distance in the first trimester via ultrasound (US) screening. METHODS: We enrolled 92 gestational women in this prospective study. In the first trimester of US examination, the gestational sac, the gestational sac-fetal pole distance, and the yolk sac size were measured. When the fetal pole was in the longitudinal position, the distance between the fetal pole and the yolk sac was measured in millimeters (mm). The crown-rump length (CRL) was measured in the same position. US examination at 22 weeks was performed to determine whether the fetal gender was male or female. The genders of the fetuses were recorded. The sexes were also confirmed and recorded after birth. RESULTS: Fifty-five (59.8%) of the newborns were found to be male, while 37 (40.2%) of them were found to be female. We compared the yolk sac size and the yolk sac-fetal pole distance in both the female and male groups. We found that the genders showed a significant difference in terms of yolk sac-fetal pole distance, whereas the yolk sac size showed no significant difference between the genders. The optimal cutoff value of the yolk sac-fetal pole distance was 1.80 mm, with 70% sensitivity and 67% specificity for female gender prediction. The distance also showed an independent association with gender prediction in the first trimester. CONCLUSION: Yolk sac-fetal pole distance may have the potential to predict gender in the first trimester of pregnancy.

Association of trans-myocardial repolarisation parameters with size of the diffusion limitation area in acute ischaemic stroke.

OBJECTIVES: This study aimed to evaluate the relationship between transmyocardial repolarisation parameters and the size of the diffusion limitation area measured using diffusion weighted magnetic resonance imaging (DWMRI) in patients diagnosed with ischaemic stroke without known cardiac diseases. MATERIAL AND METHODS: The study was a prospective, observational clinical study. Patients without cardiac disease with acute ischaemic stroke were included in the study. Electrocardiography (ECG) was received from the patients. P, QT, QTc and Tp-e dispersions were calculated. All the patients had computerised brain tomography (CT) and then DWMRI carried out so as to calculate infarct areas. RESULTS: Seventy ischaemic stroke patients and 30 control patients were included in the study. All parameters except for QTc dispersion (p = 0.88) were higher in the stroke group than in the control group (p < 0.05 for all values). The infarct area calculated with DWMRI was divided into four groups according to quartiles, and QT, QTc, P, and Tp-e dispersions of patients were evaluated. Patients were found to have a prolonged dispersion as the infarct area expanded, and this difference was statistically significant (p < 0.05 for all values). CONCLUSIONS: When we compared the patients with ischaemic stroke who had no known cardiac disease to those in the control group we found an increase in transmyocardial repolarisation parameters. As diffusion limitation areas grew larger, QT, QTc, P, and Tp-e dispersions increased. Physicians should be aware of dysrhythmias and sudden cardiac death in acute stroke and should observe these patients, especially those with larger stroke lesions.

Evaluation of the medial clavicular epiphysis according to the Schmeling and Kellinghaus method in living individuals: A retrospective CT study.

The evaluation of the medial clavicular epiphysis via CT plays an important role in the determination of age, particularly the 19th and 22nd ages. Several authors have recommended the use of the Schmeling and Kellinghaus methods in conjunction in the evaluation of the medial clavicular epiphysis. The aim of this retrospective study was to evaluate thin section CT scan images of the medial clavicular epiphysis according to the Schmeling and Kellinghaus method, and to discuss the obtained data in the light of the literature. The thoracic CT scan images (0.6mm section thickness) of 601 patients (202 female and 399 male) aged between 10 and 35years obtained by 16-detector CT were evaluated by two examiners. The stage 2 was seen between 13 and 23years of age; stage 3 was seen between 16 and 27years of age. However, 100% of the female cases with stage 3c were ⩾18years of age, and 100% of the male cases with stage 3c were ⩾19years of age. Stage 4 was first observed at 20years of age in both sexes, and stage 5 was first observed at 25years of age in both sexes. We believe that stage 3c may be used, particularly in the determination 18-year age limit for both sexes. The outcomes of our study are consistent with those of our previous study and other studies in the literature, which is important for the confirmation of the reliability of the method.

Misdiagnosed epigastric mass: Ectopic liver.

We discuss an ectopic liver misdiagnosed as an abdominal mass and the importance of magnetic resonance imaging (MRI) in liver positional anomalies. A solid midline mass midline adjacent to the liver was found in a 45-year-old female at an external center during an ultrasound investigation conducted for occasional abdominal pain of many years. The patient was referred to us for MRI. MRI revealed a solid epigastric lesion adjacent to the liver but unrelated to the liver parenchyma. The mass was of similar intensity as the liver in all sequences and in postcontrast dynamic phases following hepatospecific contrast material administration. We also observed contrast material excretion into the solid lesion from the biliary ducts in the hepatobiliary phase. The lesion was diagnosed as ectopic liver tissue with these findings. LEVEL OF EVIDENCE: 5 J. Magn. Reson. Imaging 2017;45:761-763.

Cerebral Venous Sinus Thrombosis with Internal Jugular Venous Thrombosis in a Male Patient with Nephrotic Syndrome.

Cerebral venous sinus thrombosis with internal jugular vein thrombosis is not reported as a complication in nephrotic syndrome. We report a 40-year-old male with nephrotic syndrome, who had headache during his hospitalization. Conventional diagnostic tests showed extensive thrombosis at the proximal part of superior sagittal sinus, left cortical vein, left sigmoid-transverse sinus and left internal jugular vein. The patient underwent medical treatment and was discharged in good health after 2 weeks. The aim of this study is to report a novel case of cerebral venous sinus thrombosis with internal jugular venous thrombosis in a male patient with nephrotic syndrome.

Which treatment method should be preferred for lumbar discal cysts? A case report and a review of the literature.

Discal cysts are extremely rare pathologies that occur most often in the lumbar region. The clinical symptoms of discal cysts are indistinguishable from those of a lumbar disc herniation. The aetiology and pathogenesis of discal cysts remain unknown. The optimal treatment of discal cysts also remains controversial. Most cases of lumbar discal cysts are treated surgically, while some cases regress spontaneously. In this article, we report a case of a lumbar discal cyst treated surgically by microdiscectomy. We discuss the treatment options for discal cysts in the context of the literature.

Identification of intervertebral disc regeneration with magnetic resonance imaging after a long-term follow-up in patients treated with percutaneous diode laser nucleoplasty: a retrospective clinical and radiological analysis of 14 patients.

PURPOSE: The aim of this study was to demonstrate regeneration of intervertebral discs undergoing laser therapy with sagittal relaxation time (T2) mapping after a long-term follow-up. MATERIALS AND METHODS: Fourteen patients (9 men, 5 women; age range 20-57 years; mean age 36.5 years) treated with percutaneous 908-nm wave-length diode laser nucleoplasty for lumbar disc prolapsus at our clinic between January 2006 and June 2009 were studied. For the application of laser nucleoplasty in the past, patients who did not have central canal stenosis and/or lateral stenosis, sequestered disc fragment, operation scars and bleeding disorders were selected. The intervertebral disc levels undergoing laser therapy were L3-L4 (n = 2) or L4-L5 (n = 12). Patients were called for follow-up visits after a maximum 6-years (n = 2) or a minimum 3 years (n = 3) with a mean of 4.4 years. The patients' clinical status for leg pain was evaluated according to the visual analog scale (VAS) and subsequently, a lumbar magnetic resonance imaging was performed. Sagittal T2 mapping was performed for the intervertebral discs undergoing laser nucleoplasty. We analyzed the relationship between T2 in the regions of interest (ROIs), which is known to correlate with changes in the composition of intervertebral discs, and the degree of degeneration determined using the Pfirrmann grading system and VAS of patients. RESULTS: On the basis of the evaluation of the results of intervertebral discs in all patients, there was a significant increase in T2 in the anterior NP (ROI 2, +10.3 ms; p < 0.05). A significant increase was noted in T2 in the middle NP (ROI 3, +24.6 ms; p < 0.001). The most significant increase was recorded for the posterior NP (ROI 4, +28.6 ms; p < 0.001). No significant decrease was found in T2 in the anterior and posterior AF (ROI 1, -1.5 ms; p = 0.925; ROI 5, -0.1 ms; p = 0.683). According to the Pfirrmann grading system, disc degeneration grades before laser therapy were recorded as grade III (n = 6) and grade IV (n = 8) whereas disc degeneration grades after laser therapy were found to be grade I (n = 6) and II (n = 8). A significant decrease was noted in Pfirrmann grades of disc degeneration after laser therapy (p < 0.0005). CONCLUSIONS: In this study, there was a prolongation of T2 indicating regeneration in the nucleus pulposus after laser therapy and these results were found to be consistent with VAS measurements after a long-term follow-up. This study, which demonstrates the quantitative efficacy of laser therapy, indicates that MRG can be more effectively used in the future.