Quantitative diffusion-weighted magnetic resonance imaging in the evaluation of parotid gland masses: a study with histopathological correlation.

We evaluated the quantitative diffusion-weighted magnetic resonance imaging (DW-MRI) for parotid masses. Seventy-five patients with 81 focal parotid masses were included. Following DW-MRI, 73 masses underwent surgical biopsy/resection, 6 underwent ultrasonography-guided fine-needle aspiration, and 2 underwent both procedures. The mean apparent diffusion coefficient (ADC) of benign tumors (n=49, 1.72×10(-3) mm(2)/s) was higher than that of malignant tumors (n=32, 1.05×10(-3) mm(2)/s) (P<.001). ADC was 2.15×10(-3) mm(2)/s for pleomorphic adenomas, which was higher than that for other tumors (P<.001 for all). ADC cutoff was 1.315 for distinguishing between pleomorphic adenomas and others including malignant tumors. Therefore, DW-MRI may be useful for distinguishing between pleomorphic adenomas and other parotid masses.

Do open repair and different laparoscopic techniques in pediatric inguinal hernia repairs affect the vascularization of testes?

PURPOSE: The aim of this study was to evaluate, using Doppler ultrasonography, the effects of different hernia repair techniques on testicular perfusion in the pediatric age group. METHODS: This study was based on a prospective clinical trial of 72 pediatric patients over 2 years of age with unilateral inguinal hernia. They were operated on using 1 of 3 different techniques. Group 1 included 26 patients who were treated with a conventional open hernia repair technique. Group 2 included 22 patients who underwent Schier intracorporeal laparoscopic suture technique. Group 3 included 24 patients who underwent the laparoscopic partial excision and purse-string technique described by Montupet. In all cases, blood flow index of the centripetal and capsular arteries of the testes, including peak systolic velocity (PSV) and resistivity index (RI), were examined by using Doppler ultrasound preoperatively and early and late postoperatively. RESULT: The conventional open technique group (group 1) had transient temporary changes in PSV and RI values compared with preoperative findings; however, these changes were not statistically significant. No such changes were observed in the 2 laparoscopic groups. CONCLUSION: Neither conventional open nor laparoscopic hernia repair techniques impaired testes vascularization. Surgical manipulations performed using the conventional open repair technique caused transient, but not significant, changes in PSV and RI values.

Functional imaging of larynx via 256-Slice Multi-Detector Computed Tomography in patients with laryngeal tumors: a faster, better and more reliable pre-therapeutic evaluation.

OBJECTIVE: To determine the clinical utility of using dynamic maneuvers during imaging of larynx via 256-Slice Multi-Detector Computed Tomography in the pre-therapeutic evaluation of laryngeal tumors. MATERIALS AND METHODS: A total of 27 patients (7 women, 20 men; aged 53-76 years) diagnosed with laryngeal squamous cell carcinoma were evaluated pre-therapeutically via contrast enhanced axial CT scans during consecutive phases of phonation (PP), inspiration (IP) and Valsalva maneuver (VP). RESULTS: In 2 of 5 patients diagnosed with T1a glottic tumor, scans obtained during VP and PP were normal while the CT scans obtained during IP clearly showed a mass. In all patients (27/27) PP provided visualization of the ventricle, on coronal plane images and the pyriform sinus apices, on axial plane images. Involvement of the anterior commissure was best assessable on axial plane IP images (sensitivity 93%, specificity 92%). In cases of stage T1-T3 tumors use of dynamic maneuvers during laryngeal CT imaging showed the location and extension of the tumor better than the single phase CT scans did. We did not find a significant improvement in the pre-therapeutic evaluation in stage T4 tumors. CONCLUSION: Providing markedly clearer and more detailed evaluation of mucosal surfaces and deep structures of the larynx and mobility of the cords than do conventional scans, use of dynamic laryngeal maneuvers during laryngeal CT imaging seems to be an useful alternative in the pre-therapeutic assessment of laryngeal tumors.