Superb Microvascular Imaging Doppler Technique In The Evaluation Of Ovarian Stromal Vascularity In Women With Polycystic Ovary Syndrome.

OBJECTIVE: To compare the assessment of intra-ovarian stromal vascularity through transabdominal ultrasonography with colour Doppler imaging, power Doppler imaging, colour superb microvascular imaging and monochrome superb microvascular imaging in polycystic ovary syndrome cases. METHODS: The retrospective cross-sectional study was conducted at the Obstetrics and Gynaecology outpatient department of the Usak Training and Research Hospital, Turkey, from April 11 to June 18, 2018, and comprised grayscale colour Doppler imaging, power Doppler imaging, colour superb microvascular imaging and monochrome superb microvascular imaging of women with polycystic ovary syndrome. The recorded video images were evaluated by three radiologists and rated through consensus decision. Mean values for age, body mass index, follicle stimulating hormone and luteinizing hormone levels, luteinizing hormone-follicle stimulating hormone ratio, Ferriman Gallwey score, and mean ovarian volume of the subjects were evaluated. Data was analysed using Number Cruncher Statistical System. RESULTS: Of the 54 women evaluated, data of 42(77.8%) was included. There were a total of 83 ovaries, as the left ovary of 1(1.2%) patient was not visible. The mean age and body mass index were 24.02±5.8 years and 25.08±4.5kg/m2. Mean follicle stimulating hormone and luteinizing hormone levels were 5.51±1.91 and 7.91±6.13m IU/mL. Luteinizing hormone/follicle stimulating hormone ratio and Ferriman Gallwey score were 1.4±0.8 and 8.67 ±6.94, respectively. The mean ovarian volume was 12.2±3.43 cm3. The detection of vascularity was colour Doppler imaging 0.72±0.97, power Doppler imaging 0.96±1.08, colour superb microvascular imaging 2.47±1.25, and monochrome superb microvascular imaging 2.75±1.31. The techniques were significant for superb microvascular imaging Doppler than conventional Doppler (p<0.001). Hyper- ovarian stromal vascularity, like a 'stellate' sign, was detected in 17(20.5%) of the total 83 ovaries analysed. CONCLUSIONS: Transabdominal ultrasonography-colour superb microvascular imaging was found to be more effective in detecting ovarian vascularity than conventional Doppler technique in women with polycystic ovary syndrome.

Diffusion-weighted imaging for the differentiation of Ewing sarcoma from osteosarcoma.

OBJECTIVE: The purpose of this study is to assess the ability of apparent diffusion coefficient (ADC) values in differentiating Ewing sarcoma and osteosarcoma. MATERIALS AND METHODS: This retrospective cross-sectional observational study included a total of 35 patients with a recent diagnosis of Ewing sarcoma (n = 13) and osteosarcoma (n = 22) who underwent conventional MRI and diffusion-weighted imaging (DWI). Three ADC measurements from the areas of the lowest diffusivity in ADC maps (ADCmin), and other areas with low diffusivity (ADCother), were made independently by two observers on pre-treatment MRI, and the means of these measurements were compared using independent samples t-test. Intraclass correlation coefficient was calculated for inter-observer agreement. RESULTS: There was a significant difference between the ADCmin (P < 0.001) and ADCother (P < 0.001) in Ewing sarcoma and osteosarcoma for both observers. For Ewing sarcoma and osteosarcoma, mean ADCmin was 0.566 ± 0.07 and 1.193 ± 0.33 × 10-3 mm2/s; 0.551 ± 0.08 and 1.182 ± 0.33 × 10-3 mm2/s; and mean ADCother was 0.813 ± 0.11 and 1.510 ± 0.35 × 10-3 mm2/s; 0811 ± 0.12 and 1.501 ± 0.33 × 10-3 mm2/s for observers 1 and 2, respectively. Inter-observer correlation coefficient for mean ADCmin was 0.994 and for mean ADCother was 0.995. CONCLUSION: Diffusion-weighted imaging and ADC values could be used in the differentiation of Ewing sarcoma and osteosarcoma in borderline cases.

Assessment of intravertebral pneumatocysts, degenerative joint disease, and ponticulus posticus in the cervical spine through cone beam computed tomography examination.

OBJECTIVE: To identify the prevalence rates and radiologic characteristics of intravertebral pneumatocysts (IVP), degenerative joint disease (DJD), and ponticulus posticus (PP) in the cervical spine by using cone beam computed tomography (CBCT) images. The correlations of the lesions with patient age and sex, as well as the correlations among the lesions, were also evaluated. STUDY DESIGN: CBCT images obtained from 440 patients were assessed retrospectively. Correlations between patient demographic characteristics and IVP, DJD, and PP in the cervical vertebrae were analyzed by using χ2 tests and logistic regression analysis. A difference of P < .05 was considered statistically significant. RESULTS: IVP occurred in 22 of 1792 vertebrae (1.2%) and in 17 of 440 patients (3.9%). DJD findings were observed in the cervical vertebrae of 260 patients (59.1%). PPs were found in 245 patients (55.7%). The prevalence rate of DJD varied significantly by age group (P = .002), whereas the prevalence rates of IVP and PP did not. There was a significant correlation between both DJD and PP with demographic characteristics (P < .001) and between DJD and PP in patients without IVPs (P = .038). CONCLUSIONS: Although DJD is common, radiologists should carefully examine CBCT scans of vertebrae for IVP and PP. Patients with DJD should be evaluated for the presence of PP.