Imaging Features of Thoracic Manifestations of Behçet's Disease: Beyond Pulmonary Artery Involvement.

BACKGROUND: Behçet's disease is a chronic multisystemic vasculitis affecting vessels of different sizes in various organs. Thoracic manifestations of the disease show a wide spectrum involving a variety of anatomic structures within the chest. However, pulmonary artery involvement is a typical manifestation of the disease that contributes significantly to mortality in patients. The study aimed to analyze CT features of thoracic manifestations, particularly pulmonary artery involvement, and to quantitatively assess bronchial arteries in Behçet's disease. METHODS: Patients with Behçet's disease who underwent CT scans for suspected thoracic involvement between 2010 and 2018 were included. CT findings of 52 patients were retrospectively analyzed for thoracic manifestations of the disease. Bronchial arteries were assessed regarding diameter in patients with/without pulmonary artery involvement. The pulmonary symptoms were noted. RESULTS: Of the 52 patients, 67% had thoracic manifestations including pulmonary artery involvement, parenchymal changes, superior vena cava thrombosis, and intracardiac thrombus. Pulmonary artery involvement was observed in 50% of the cohort. Peripheral pulmonary arteries (77%) were the most commonly affected branches, followed by lobar (42%) and central (35%) pulmonary arteries. Other thoracic findings were significantly correlated with pulmonary artery involvement (p<0.05). Compared to patients without pulmonary artery involvement, those with pulmonary artery involvement had a higher bronchial artery diameter (p<0.05) and occurrence rate of dilated bronchial arteries. CONCLUSION: Involvement of peripheral pulmonary arteries is frequently encountered in Behçet's disease and it can resemble pulmonary nodules. Dilated bronchial arteries, which can be observed in cases of pulmonary artery involvement, should be considered in patients with hemoptysis.

Unusual cause of filling defect in pulmonary artery: pulmonary artery sarcoma.

Pulmonary artery (PA) sarcoma is an extremely rare malignant tumor of pulmonary artery. It is often misdiagnosed as pulmonary thromboembolism (PTE) because of its clinical and imaging features which are quite similar to PTE. Multimodality diagnostic imaging and recognition of specific imaging characteristics with appropriate clinical suspicion are required to make correct diagnosis. In this report, we present a case of PA sarcoma with imaging and clinical features as well as emphasize significance of using multimodality imaging.

Unusual cause of small bowel obstruction: mesodiverticular band of Meckel's diverticulum demonstrated by CT.

Small bowel obstruction resulting from the mesodiverticular band is a rare complication of Meckel's diverticulum and usually presents a diagnostic challenge. We present a case of small bowel obstruction due to the mesodiverticular band of Meckel's diverticulum with CT scan findings.

Imaging features of blast injuries: experience from 2015 Ankara bombing in Turkey.

OBJECTIVE: To present the radiological features of blast-related injuries in the victims of the 10 October 2015 Ankara bombing and emphasize the importance of imaging. METHODS: This retrospective descriptive study included a total of 28 patients who underwent CT scan or radiographic imaging within 6 h after the bombing on 10 October 2015. CT scans and plain radiographs were evaluated regarding mechanisms of injuries. Injuries were categorized as primary, secondary, tertiary and quaternary. The number of shrapnel and distribution of injuries were noted. Injury Severity Score (ISS) was used to rank the severity of the injury. RESULTS: Primary blast injuries consisted of only tympanic membrane rupture. A high rate of patients (21/28 patients) in the study group suffered from secondary blast injuries. Tertiary injuries were detected in only three patients. Of the severely injured patients, five had abdominal injuries, three had thoracic injuries and six had extremity injuries. ISS was significantly higher in patients with thoracic and abdominal injuries. CONCLUSION: Our results after the suicide bomb attacks showed that the most common injury pattern was secondary blast injury. The torso was the most commonly injured body region, followed by the extremities. This specific injury pattern requires the use of immense radiological imaging. Hence, radiologists should be aware of the mechanisms and spectrums of blast-related injuries. ADVANCES IN KNOWLEDGE: Both the unique injury pattern and the following chaos make blast-related injuries a challenge in terms of triage, diagnosis and management. Radiologists should be familiar with the wide spectrum of these unique injuries.

Precision imaging of focal liver lesions: comparison with conventional sonography in terms of image quality.

OBJECTIVES: The purpose of this study was to compare the Precision Imaging sonographic technique (Toshiba Medical Systems Corporation, Tokyo, Japan) with conventional sonography of liver lesions in terms of lesion conspicuity, margin sharpness, overall image quality, and posterior enhancement. METHODS: Sixty-nine focal liver lesions in 60 patients (age range, 14-76 years; mean age, 43 years) were prospectively evaluated. Each lesion was examined with Precision Imaging and conventional sonography. All images were reviewed and graded on a 3-point scale by 2 readers for lesion conspicuity, margin sharpness, and overall image quality. Posterior acoustic enhancement was also analyzed in cystic lesions. A Wilcoxon signed rank test was used for statistical comparisons of the techniques for all parameters. RESULTS: Statistical analysis showed that for margin sharpness, lesion conspicuity, and overall image quality, Precision Imaging was superior to conventional sonography (P< .05). In addition, according to lesion types and dimensions, Precision Imaging was significantly superior to conventional sonography for all parameters. For posterior enhancement, there was no significant difference between Precision Imaging and conventional sonography (P ≥ .05). CONCLUSIONS: In sonography of focal liver lesions, Precision Imaging provides better lesion conspicuity, better margin sharpness, and better overall image quality than conventional sonography. With respect to posterior enhancement of cystic lesions, Precision Imaging is not significantly different from conventional sonography. Precision Imaging may be used as a complementary method in the sonographic evaluation of focal liver lesions.

Evaluation of acute trismus by MRI: a case report. Bilateral peritonsillar cellulitis.

We describe a rare case of a bilateral peritonsillar cellulitis (PTC). The clinical presentation of fever, trismus and odynophagia was consistent with PTC, more evident on the right side; but the presence of bilateral tonsillar swelling and midline uvula confounded the diagnosis. In spite of the throat examination was performed with a great difficulty due to trismus, the T2 weighted fat saturated STIR magnetic resonance imaging (MRI) guided us to make the diagnosis and to start the intravenous antibiotic treatment immediately.

Sonographic findings in tuberculous epididymo-orchitis.

Genitourinary tuberculosis is the most common manifestation of extrapulmonary tuberculosis. The epididymides, the seminal vesicles, and the prostate are the most commonly infected sites. The testes are rarely involved. We describe the unusual sonographic findings in a case of tuberculous epididymo-orchitis that presented with multiple small, hypoechoic nodules within the testis.

Virtual cystoscopy in the evaluation of bladder tumors.

OBJECTIVE: The objective of this study was to investigate the value of contrast material-filled virtual cystoscopy in the detection of bladder tumors. MATERIALS AND METHODS: Thirty-nine patients who had recent diagnosis or were followed up due to priory history of bladder tumor underwent virtual cystoscopy. After the intravenous injection of contrast medium, the bladder was examined with helical computed tomography (CT) scan. The data were transferred to a workstation for interactive navigation using surface rendering. Two radiologists independently interpreted the axial and virtual images, and discrepancies were resolved by consensus. The results of virtual cystoscopy were compared with the findings of conventional cystoscopy. RESULTS: Forty-nine of 54 bladder lesions detected with conventional cystoscopy in 33 patients were also shown on virtual images. On virtual cystoscopy, three of the seven lesions 5 mm or smaller in diameter could be identified. There were no false-positive findings. The sensitivity of the technique was 96.2% for polypoid tumors and 88.9% for sessile lesions. When axial and virtual images were evaluated together, the sensitivity rate increased to 94.4%. CONCLUSION: Bladder tumors can be diagnosed noninvasively using contrast medium-filled virtual cystoscopy. Evaluation of both the axial and virtual images increases the sensitivity of the technique.

Clitoral metastasis from transitional cell carcinoma of the renal pelvis: CT and MRI findings.

Metastatic tumors of the clitoris are extremely rare. We report a case of clitoral metastasis in a 75-year-old woman who was treated for transitional cell carcinoma of renal pelvis 2 years ago. The computed tomography and magnetic resonance imaging findings are presented with a short review of the literature. To the best of our knowledge, clitoral metastasis originating from transitional cell carcinoma of the renal pelvis has not been reported in the English language literature.

[Case report: Cemento-ossifying fibroma of the ethmoidal sinus presenting with exophthalmos]. / Ekzoftalmusa yol açan etmoid sinüs semento-osifiye fibromu.

Cemento-ossifying fibroma is a benign fibro-osseous tumor which contains fibrous tissue and varying amounts of calcified tissue resembling bone, cementum or both. The tumor is frequently seen in the mandibula and maxilla, but it may rarely affect the ethmoidal sinus. In this report, CT findings of cemento-ossifying fibroma located in the ethmoidal sinus are presented.