ABSTRACT
OBJECTIVES: In this study, we presented neuroradiologic findings and diagnoses of neurologic complications in a series of heart transplant recipients. MATERIALS AND METHODS: A retrospective review was conducted at Baskent University Hospital. We searched the hospital and radiology databases and identified 109 heart transplant recipients. Thirty-one of these recipients had neuroradiologic evaluations secondary to presentation of neurologic symptoms after heart transplant, with 18 patients evaluated with computed tomography and 22 patients evaluated with magnetic resonance imaging (overlap of imaging-defined groups occurred in 9 recipients). Computed tomography and magnetic resonance imaging studies were retrieved from the Picture Archiving and Communication System, with each type of imaging retrospectively evaluated on consensus by 2 radiologists. RESULTS: Radiopathologic findings related to symptoms were detected in 12 of the 31 study patients. The most common abnormality was posterior reversible leukoencephalopathy syndrome (5 patients, 4.6%). The other abnormalities were ischemic stroke (3 patients, 2.8%), hemorrhagic stroke (1 patient, 0.9%), intracranial abscess (2 patients, 1.8%), and intracranial dissemination of sinusoidal fungal infection and related hemorrhagic infarct (1 patient, 0.9%). The other 19 heart transplant recipients who underwent computed tomography and/or magnetic resonance imaging for neurologic complaints showed no neuroradiologic findings related to neurologic symptoms. CONCLUSIONS: Posterior reversible leukoencephalopathy syndrome and ischemic stroke were the most common neurologic complications in our heart transplant recipients. The other complications were hemorrhagic stroke, intracranial abscess, and intracranial dissemination of sinusoidal fungal infection. Neurologic complications are common in heart transplant recipients and should be identified promptly for early treatment. For the recognition of these complications, computed tomography should be performed for initial evaluation to rule out edema or hemorrhage. However, in the presence of serious neurologic symptoms that cannot be explained by computed tomography, magnetic resonance imaging should be indicated.
Subject(s)
Central Nervous System Diseases/diagnostic imaging , Diffusion Magnetic Resonance Imaging , Heart Transplantation/adverse effects , Neuroimaging , Tomography, X-Ray Computed , Adolescent , Adult , Brain Abscess/diagnostic imaging , Brain Abscess/etiology , Central Nervous System Diseases/etiology , Central Nervous System Fungal Infections/diagnostic imaging , Central Nervous System Fungal Infections/etiology , Child , Databases, Factual , Female , Hemorrhagic Stroke/diagnostic imaging , Hemorrhagic Stroke/etiology , Humans , Ischemic Stroke/diagnostic imaging , Ischemic Stroke/etiology , Male , Middle Aged , Posterior Leukoencephalopathy Syndrome/diagnostic imaging , Posterior Leukoencephalopathy Syndrome/etiology , Predictive Value of Tests , Retrospective Studies , Treatment Outcome , Turkey , Young AdultABSTRACT
AIMS: The aim of this study is to assess the applicability of shear wave elastography (SWE) in the diagnosis of chronic autoimmune thyroiditis (CAT) patients. MATERIAL AND METHODS: The study group consisted of 50 patients with first-diagnosed CAT and 40 control subjects (CS). In all patients with CAT and CS, sonoelastographic measurements were made in both thyroid lobes. Optimal cut-off values were chosen to maximize the sum of sensitivity and specificity. Positive predictive value (PPV), negative predictive value (NPV), and accuracy values were also calculated. RESULTS: Quantitative elastographic analysis evaluated by SWE in CAT patients (2.56 +/- 0.30 m/s) was significantly higher compared with CS (1.63 +/- 0.12 m/s) (p<0.001). The optimal cut-off value was 2.42 m/s. SWE had 77% sensitivity, 71% specificity, 92% PPV, 81% NPV, and 87% accuracy for the presence of CAT. CONCLUSIONS: Our data indicate that SWE correctly defines the elasticity of thyroid parenchyma, and this technique may assist in the diagnosis and treatment monitoring of CAT.
