The acute effects of different hamstring muscle stretching techniques on reducing muscle resistance to movement by ultrasound elastography.

OBJECTIVE: Many stretching methods are applied on the hamstring muscles for reducing muscle resistance on movement. The aim of our study to investigate the acute effects of static stretching and the Mulligan traction straight leg raise (TSLR) technique administered to the hamstring muscles on reducing its resistance to movement. METHODS: The study included 22 healthy male volunteers (19.5 ± 0.98 years). After the individuals were randomly divided into two groups, static stretching was administered to the hamstring muscles in the first group and the Mulligan TSLR technique was administered on the same muscle in the second group. Active knee extension angles of the individuals were evaluated by a digital goniometer and muscle strain was assessed by ultrasound elastography. RESULTS: While there was a significant difference in all parameters in both groups after the treatment, the changes in the active knee extension angle and the strain index value of the biceps femoris musculotendinous junction were higher in the Mulligan TSLR group compared to the static stretching group (p < 0.05). CONCLUSION: It was concluded that, static stretching and the Mulligan TSLR technique administered to the hamstring muscles are effective ways to increase the range of motion. The Mulligan TSLR technique, however, can be opted in healthy individuals and patients since it is painless and more effective in reducing muscle resistance to movement and range of motion.

Diagnostic Performance of Multiparametric MR Imaging at 3.0 Tesla in Discriminating Prostate Cancer from Prostatitis: A Histopathologic Correlation.

OBJECTIVE: To investigate the diagnostic performance of multiparametric magnetic resonance imaging (mpMRI) in differentiating prostate cancer (PCa) from prostatitis foci. MATERIALS AND METHODS: This retrospective analysis included 81 biopsy-proven lesions (44 prostatitis and 37 PCa). Normalized T2-signal intensity (nT2SI) and SI on diffusion-weighted imaging (b=1000 and 2000 mm2/s), apparent diffusion coefficient (ADC) values, peak SI, SI at the end of the dynamic curves, mean peak time, mean enhancement percentage, and washout percentage obtained from dynamic contrast-enhanced imaging (DCEI) were measured. RESULTS: nT2SI (3.8 vs. 3.2, p=0.003) and ADC values (0.685×10-3 mm2/s vs. 0.874×10-3 mm2/s, p<0.001) were significantly higher in the prostatitis group than in the PCa group. The washout percentage was the only DCEI parameter that was significantly different between the two groups (12% vs. 4%, respectively, p=0.003). The ADC values alone showed higher sensitivity (80.5%) and specificity (75%) than all of the single criteria and most of the combined criteria. The combination of nT2SI, ADC values, and washout percentage (at least two positive criteria were sufficient for a diagnosis of PCa) yielded the highest sensitivity (77.7%) and specificity (85.7%) among all combinations. CONCLUSION: PCa and prostatitis can be discriminated using mpMRI with high sensitivity and specificity.

Magnetic resonance elastography: basic principles, technique, and clinical applications in the liver.

Magnetic resonance elastography (MRE) is a constantly advancing technique for assessment of stiffness of tissues with newer technology and sequences. It is being increasingly used for the assessment of liver fibrosis. In this article, we discuss the advantages of MRE over biopsy and noninvasive methods such as US elastography in the assessment of liver fibrosis. Image acquisition and interpretation of liver MRE is also discussed.

MR Enterography in Crohn's disease complicated with enteroenteric fistula.

OBJECTIVE: In this retrospective study, we aimed to evaluate MR enterography (MRE) findings, MR index of activity (MaRIA) and laboratory markers in Crohn patients with enteroenteric fistula. METHODS: Institution's electronic medical records (laboratory, pathology, ileocolonoscopy results and discharge summary) were reviewed and MR images retrieved from the PACS were reanalyzed in Crohn patients assessed at Gastroenterology Clinic of our university between July 2011 and July 2016. MR enterography and clinic parameters of 38 Crohn patients with enteroenteric fistula and 48 Crohn patients without enteroenteric fistula were compared. RESULTS: Of the findings, perienteric inflammation was seen only in fistula group. The mean wall thickness was significantly greater; perienteric fluid, mural hyperenhancement, cecal contraction, thickening of ileocecal valve, and colonic involvement were significantly more common in fistula patients. There was no significant difference between groups with regards to MaRIA index and perianal disease. In patients with enteroenteric fistula, there was significant association between the presence of hypoalbuminemia and presence of ileitis at ileocolonoscopy. In the overall study population, there was a positive correlation between the MaRIA and CRP values at the time of the MRE. CONCLUSIONS: Perienteric mesenteric inflammation and fluid collection are common in enteroenteric fistulization. MaRIA indices and laboratory findings of patients with enteroenteric fistula are not significantly different from those without fistulas.