Evaluation of the contralateral hemisphere with DWI in pediatric patients with Dyke-Davidoff-Masson syndrome.

INTRODUCTION: Dyke-Davidoff-Masson Syndrome (DDMS) is a clinical syndrome that causes different clinical symptoms and is defined by volume decrement in one cerebral hemisphere. In this study, we aimed to evaluate the involvement of the normal-appearing contralateral hemisphere in 16 pediatric patients with DDMS using diffusion-weighted imaging (DWI). MATERIALS AND METHODS: Brain MRIs were retrospectively reviewed between January 2014 and January 2023. Sixteen pediatric patients radiologically compatible with DDMS were included in the study. Sixteen children who had undergone brain MRI, most commonly for headaches and whose MRI findings had been completely normal, were included as the control group. Apparent diffusion coefficient (ADC) values of the deep gray and white matter of the normal-appearing hemisphere in the patient group were calculated and compared with that of the control group. RESULTS: The ADC values of the gray and white matters of the patient and control groups were not statistically different. However, in the patient group, the ADC values of the gray and white matters in males were remarkably lower than in females (p = 0.038, p = 0.037, respectively). CONCLUSION: The difference in the ADC values of the contralateral hemisphere between females and males in the patient group suggests that the normal-appearing hemisphere may have been affected by DDMS. Although, the exact mechanism of this effect is not known. Therefore, in patients with DDMS, contralateral hemisphere involvement in cerebral hemiatrophy and hemispherectomy should be evaluated clinically and radiologically.

Comparison of Different Slice Thicknesses on Chest Computed Tomography for Evaluation of COVID-19- Associated Pneumonia.

OBJECTIVE: To compare the value of chest computed tomography at 1-mm and 5-mm slice thickness in terms of computed tomography severity score and computed tomography evaluation time in the diagnosis of COVID-19. MATERIAL AND METHODS: Sixty-five patients were included in the study group who are reverse-transcription polymerase chain reaction-positive for COVID-19 and had chest computed tomography. The 1 mm and 5 mm reconstructed images were evaluated in 2 different sessions with 4-week intervals by 2 certificated general radiologists. The presence of COVID-19-related findings, COVID-19 final category, and evaluation time were recorded. Thin and thick slices were compared for these variables and inter-reader reliability calculated with the Statistical Package for the Social Sciences (SPSS) for Windows. RESULTS: There was no significant difference between the COVID-19-related findings on thorax computed tomography between 1-mm and 5-mm slices except crazy paving appearance, microvascular enlargement, and septal thickening. The frequency of the final categories of computed tomography results was consistent between the thick and thin slices. The computed tomography assessment time was significantly lower in 5 mm slices. The inter-reader reproducibility analysis results demonstrated good and excellent reproducibility of measurements between readers for both slice thicknesses. CONCLUSION: It was found that 5-mm reconstruction thickness of chest computed tomography can be employed for the initial detection of COVID-19-related findings and the final diagnostic category-related COVID-19 rather than 1-mm slices with a faster availability of results which can be beneficial on pandemic hospitals.

Case Report: Isolated Renal Hydatid Cyst in a Boy

Hydatic cyst is a crucial and prevalent parasitic disease in the developing countries in the Mediterranean region. Its diagnosis is sometimes problematic because of non-specific complaints and unavailability of any positive results in a routine laboratory analysis. Isolated renal hydatid cysts are very rare. In this study, a primary left renal hydatid cyst which was found in a 12-year-old boy was presented. He was referred by another hospital to our department with a flank pain and cystic mass in left kidney. Indirect haemagglutination test (IHA) for Echinococcus was negative. Nephrectomy was performed with the diagnosis of renal cyst hydatic. Renal cyst hydatid may present with various clinical findings ranging from asymptomatic clinical course to total loss in renal function. It will be beneficial to consider a renal hydatid cyst in patients with blurred flank pain, even if IHA is negative.

Megacystis Microcolon Intestinal Hypoperistalsis Syndrome in Which a Different De Novo Actg2 Gene Mutation was Detected: A Case Report.

INTRODUCTION: Megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) is characterized by bladder distension without urinary tract obstruction, decreased or absent intestinal peristalsis and microcolon. Although the definitive cause remains unknown, changes in the ACTG2 gene are thought to be responsible for the intestinal and bladder hypoperistalsis. CASE REPORT: This female newborn with MMIHS had a c.532C>A /p.Arg178Ser heterozygous de novo mutation detected in the ACTG2 gene. Normal immature ganglion cells, normal calretinin punctate positivity, maintence of smooth muscle actin immunoreactivity, and decreased numbers of interstitial cells of Cajal(ICCs) were detected. CONCLUSION: This previously unreported c.532C>A /p.Arg178Ser heterozygous de novo mutation in the ACTG2 gene may lead to a severe form of MMIHS.

Beaver tail liver.

Also known as the sliver of liver, beaver tail liver is an anatomic variation of the liver where its left lobe extends laterally to contact and enclose the spleen. Hepatic parenchyma is normal. It may be difficult to distinguish the two organs from each other when both have equal echogenicity or density in ultrasonography and computed tomography. Therefore, it may mimic a splenic trauma or a perisplenic hemorrhage or subcapsular hematoma within the splenic parenchyma.

Assessment of sphenoid sinus related anatomic variations with computed tomography.

INTRODUCTION: Frequent and broad application of endoscopic sinus surgery (ESS) in parallel with experience makes it imperative to know the anatomy and the existing pathology very well before surgery. This study examines the association between anomalies in the sphenoid sinus area in paranasal sinuses computed tomography (PNS-CT) and pathological findings and determines variations of sphenoid sinus. METHODS: A total of 200 cases (100 women, 100 men) who had PNS-CT in the emergency and radiology polyclinics within the period of one year were included in this study. Bone tissue anomalies and soft tissue pathologies were assessed in the CT. RESULTS: Pterygoid process was found in 36.75% of our cases, anterior clinoid pneumatization was found in 21.25%; vidian canal in 34.25%, foramen rotundum in 17.5% and ICA in 12.75% had protrusion into the sphenoid sinus; 8.25% were found to have onodi cell, 11.25% were found to have multiple septation, 16.75% were found to have mucosal thickening and 2.5% were found to have retention cyst. CONCLUSION: The importance of PNS-CT in terms of determining anatomic variations before ESC and predicting possible complications during surgery has been emphasized once more. In our study, as sphenoid sinus pneumatization increased, the projection of neighbouring vein and nerve structures into the sinus was found to increase as well.

A Rare Case of Vesicourachal Diverticulum with Calculus in a 24-Year-Old Man.

BACKGROUND: During embryonal period, complete obliteration of the urachus at the umbilicus and incomplete closure at the bladder level are the cause of vesicourachal diverticulum. This abnormality is a rare finding that is usually discovered incidentally during radiological evaluation. Occasionally, stones have been detected within the diverticulum. CASE REPORT: We present a case of a vesicourachal diverticulum with calculus diagnosed by multidetector computed tomography and confirmed surgically and histopathologically in a 24-year-old man. CONCLUSIONS: During the radiological differential diagnosis of abnormalities of abdominal wall and urinary system, consideration of urachal abnormalities is important especially in symptomatic patients.

Diagnosis of High Bifurcation of the Abdominal Aorta with Associated Vascular Variations: Case Report with Multidedector Computed Tomography.

BACKGROUND: Variations of the branches and bifurcation of the abdominal aorta and their relations with other abdominal structures and organs are important concerning abdominal and spinal surgery. CASE REPORT: In this report, authors present a high -positioned bifurcation of the abdominal aorta at the level of the L3 vertebral body and its associations with multiple variations of other abdominal arteries during contrast-enhanced multi-detector computed tomography (MDCT) examination of the abdomen. CONCLUSIONS: We reported on a unique clinically and surgically significant case of variations of the abdominal aorta as related to the location and type of bifurcation. The awareness of the variations of the abdominal aorta is of great importance for surgeons in order to reduce complications during abdominal and spinal interventions, as well as for radiologists for precise interpretation of angiograms.

CT and MR Imaging in a Large Series of Patients with Craniofacial Fibrous Dysplasia.

BACKGROUND: In this retrospective review of patients with craniofacial fibrous dysplasia (FD), the clinical and radiological findings of CT and MR scan were analyzed. MATERIAL/METHODS: The study material included 32 patients, at 9 to 68 years of age that were directed for differential diagnostics of several disorders in the head. We recorded CT and MRI data related to the lesion number, location, sidedness, appearance, and sex of the cases with craniofacial FD. RESULTS: Of 32 patients involved in this study, 17 had monostotic and 15 had polyostotic involvement pattern. Bones most commonly involved by monostotic involvement in females were, in descending order, mandibular, maxillary, and sphenoid bones, while the sphenoid bone was involved the most in males. Leontiasis ossea was observed in 2 patients. Sclerotic and mixed lesion types were more common in both females and males. In T1- and T2-weighted MRI sequences, hypointensity was more common compared to hyperintensity or heterogeneous intensity. The type of enhancement of lesions was found similar after contrast medium administration. CONCLUSIONS: In the presence of craniofacial FD during CT or MRI imaging of the head, a detailed description of FD lesions may provide an important clinical benefit by increasing radiological experience during the diagnostics of this rare disorder.

Classical signs and appearances in pediatric neuroradiology: a pictorial review.

Radiological practice includes classification of illnesses with similar characteristics through recognizable signs. In this report, twenty-eight important and frequently seen neuroradiological signs in childhood are presented and described using X-rays, computed tomography (CT), magnetic resonance (MR) images, illustrations and photographs.

Confirming the brain death diagnosis using brain CT angiography: experience in Tokat State Hospital.

OBJECTIVE: Fourteen brain death cases diagnosed in Mart 2012-May 2013 period in Tokat State Hospital were studied retrospectively. CT angiography experience about those cases was shared, and use of CT angiography in confirmation of brain death was discussed. MATERIAL AND METHODS: All 14 cases were patients on mechanical ventilator, who did not respond to medical and surgical treatments at intensive care unit and were diagnosed clinically with brain death. All of these patients had CT angiography as a confirmatory test using a 4-slice CT scanner in Radiology department in Tokat State Hospital. FINDINGS: Six of the patients were female and eight were male. All of them were referred from intensive care unit and had clinical brain death diagnosis before CT angiography. In the evaluation of CTA, four-point scoring involving opacification loss in both ICVs and cortical segments of MCA was used. CTA examinations confirmed brain death diagnoses in all patients who had clinical brain death diagnoses, and no confliction between CTA findings and clinical diagnoses was observed. CONCLUSION: Demonstrating the lack of cerebral circulation is a necessity for confirmation of brain death diagnosis. While conventional angiography remains the standard method, CTA emerged as an alternative method. In parallel to increase in prevalence of organ implants, CTA, a fast and efficient method, has been increasingly used in confirmation of brain death diagnoses.

An MRI study of age-related changes in the dimensions related temporal lobe.

The aim of this study was to determine the effect age-related changes on the MRI-based parameters related to several measurement of temporal lobe in the lifespan of adult persons. MRI scans of head (n=236) were reviewed retrospectively to identify abnormalities of temporal lobe, third ventricle, and temporal horn of lateral ventricle. Patients were divided into 3 study groups according to their age. Using axial and coronal views of the cerebral hemispheres, interuncal distance, thickness of temporal lobe, Evans' ratio, and the width of third ventricle, height of hippocampus, width of choroid fissure, and width of the temporal horn were measured. The mean age of study group was 44.2±17.7 (18 to 86). The gender ratio (F/M) of study group was 129/107. There is mild-moderate significant correlation between age and Evans' ratio (r=0.35, p<0.05). There is mild significant correlation between age and interuncal distances (r=0.24, p<0.05). There was no correlation between age and third ventricle widths, temporal lobe widths, and temporal horn widths of left and right sides of brain (p>0.05). A mild and significant correlation was present between these variables (r=0.14 and r=0.17, respectively; p<0.05). There was a mild and significant correlation between these variables. (r=-0.14 and r=-0.19, respectively; p<0.05). Although several parameters including our measurements were developed for the assessment of size and structure of temporal lobe. It is not ease to determine MRI-based markers for the prediction, diagnosis, and follow-up of mild cognitive impairment and Alzheimer's disease in the elderly.

Carotid artery Doppler ultrasonography in patients with chronic kidney disease.

BACKGROUND: We investigated the changes in the values of carotid intima-media thickness (IMT) and Doppler index measurements in the autosomal dominant polycystic kidney disease (ADPKD), peritoneal dialysis (PD), and hemodialysis (HD) patients. MATERIAL AND METHODS: Twenty outpatients on HD (mean age 46.1 ± 16.4), 27 outpatients on PD (mean age 45 ± 12.4), and 26 normotensive outpatients with ADPKD (mean age 52.4 ± 16.7) as the case groups and 21 healthy subjects (mean age 48.4 ± 7.2), as the control group, were included. The participants underwent ultrasonography of the common, right, and left carotid arteries for the IMT and Doppler flow measurements. RESULTS: Overall, compared to the normal group, in the study groups, the IMT and peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI), and pulsatility index (PI) were significantly higher in common carotid arteries; however, their differences were not meaningful in internal carotid arteries (p<0.05). CONCLUSIONS: Overall, ADPKD, PD, and HD increase the IMT, PSV, EDV, RI, and PI values of CCA; however, their effect considerable less on the study parameters of ICA. There is no considerable difference among the effects of ADPKD, HD, and PD on the study parameters. Of CKD patients during the first diagnostic and follow-up workups, the measurements of carotid IMT and Doppler indices may provide valuable data for improving success of the clinical management.

Primary malignant melanoma of the nasal cavity.

Primary malignant melanoma of the nose and paranasal sinus mucosa is a rare disease and seen in less than 1% among all melanomas. Malignant melanomas have 2 origins: cutaneous and mucosal. The mucosal form has a worse prognosis because of its aggressiveness compared with that of the cutaneous form. Mucosal melanomas often occur at a rate of 2% to 3% among all melanomas and are typically found in the nasal cavity and paranasal sinuses. Generally, it is more common in males and in those older than 50 years. In this study, 4 patients were observed at the Cumhuriyet University Faculty of Medicine; 2 of them were a 64-year-old man and an 82-year-old woman who had a malignant melanoma originating from the nasal septal mucosa, 1 patient was a 72-year-old woman whose malignant melanoma originated from the inferior turbinate, and 1 patient was a 77-year-old woman with a sinonasally located melanoma. The conditions of these patients were discussed under the light of literature instructions.