ABSTRACT
Background: In the study, we aimed to determine the sensitivity of the renal resistivity index (RI) in differentiating hypoplastic and atrophic kidneys in patients with small-sized kidneys, and to evaluate its capacity to predict the renal involvement confirmed by the DMSA scintigraphy.Material and methods: We retrospectively reviewed the ultrasonography (US) and DMSA findings, and medical records of pediatric patients with unilateral diminutive kidneys followed between January 2017 and June 2018. The RI measurements were performed twice, and the mean RI was calculated for each kidney of all patients.Results: Sixty-three (male/female, m/f = 28/35) pediatric patients aged 107.2 ± 49.4 months (range 14-206 months) were included in this study. The DMSA scintigraphy revealed abnormal changes to atrophic kidneys in 38 patients and hypoplastic kidneys in 25. There were no differences between the groups with atrophy and hypoplasia by age, gender, urine density, and creatinine. The patient group with atrophic kidneys had a mean RI of 0.55 ± 0.21, and patients with hypoplastic kidneys had a mean RI of 0.67 ± 0.03. The mean RI and systolic/diastolic rates of the patients with atrophy were significantly lower than of the patients with hypoplastic kidneys (p = 0.042 and p = 0.048, respectively). There was a positive correlation between RI and DFR in the group with atrophy (r = 0.461, p = 0.016), but this was not the case for the group with hypoplastic kidneys (r= -0.066, p = 0.889).Conclusions: The resistivity index might be very useful for differentiating atrophy and hypoplasia in patients with unilateral small kidneys and can be used instead of scintigraphic evaluation.
Subject(s)
Solitary Kidney/diagnostic imaging , Ultrasonography, Doppler, Color , Adolescent , Atrophy , Child , Child, Preschool , Female , Humans , Infant , Kidney/pathology , Male , ROC Curve , Radionuclide Imaging , Retrospective Studies , TurkeyABSTRACT
OBJECTIVE: The aim of this retrospective study is to evaluate the treatment outcomes in patients with toxic nodular goiter (TNG) that received radioiodine treatment (RAIT) and to determine the influence of age, gender, nodule size, I-131 dose, underlying etiology and antithyroid drugs on the outcomes of RAIT. METHODS: Two hundred thirty three patients (mean 64±10 years old) with TNG that received RAIT were included in the study. Treatment success was analyzed according to demographic (age and gender) and clinical data (thyroid function tests before and after RAIT, thyroid sonography and scintigraphy, I-131 dose, antithyroid drugs). A fixed dose of 555 MBq was administered to patients with nodules smaller than 2 cm in diameter and of 740 MBq to patients with nodules larger than 2 cm. Hyperthyroidism treatment success was defined as achieving hypothyroidism or euthyroidism six months after RAIT. RESULTS: In our study, the cure rate was 93.9% six months after RAIT. Hypothyroidism was observed in 74 (31.7%) patients, and euthyroidism was achieved in 145 (62.2%) patients while 14 (6%) patients remained in hyperthyroid state. Age and gender did not affect treatment outcomes. No correlation was found between underlying etiology or antithyroid drugs and therapeutic effectiveness. The effectiveness of RAIT was better in patients with nodules smaller than 2 cm. CONCLUSION: We observed that high cure rates were obtained in patients with TNG with 555 MBq and 740 MBq doses of I-131. While nodule diameter and RAI dose are important factors for treatment efficacy; age, gender, underlying etiology and antithyroid drugs do not affect the outcome of RAIT.
ABSTRACT
OBJECTIVE: The aim of this study is to investigate the presence of pyramidal lobe in thyroid scintigraphy and to compare the presence of pyramidal lobe in different thyroid pathologies between genders. METHODS: Images of 866 patients (663 female, 203 male) with ages ranging from 8 to 85 were evaluated retrospectively. Presence of pyramidal lobe and its location were established in images. Patients were divided into groups in terms of gender, presence of nodular/diffuse goiter, thyroid function test results and rate of the presence of pyramidal lobe and whether a significant difference existed between the groups were calculated. RESULTS: Of the 866 patients, 156 (18%) had pyramidal lobe observed in scintigraphy. Hundred and 26 (81%) of patients observed to have pyramidal lobe were female and 30 (19%) were male. Pyramidal lob stemmed from the left lobe in 76 (48%) patients, right lobe in 61 (40%) patients, and isthmus in 19 (12%) patients. Pyramidal lobe visualization rate was 18% for euthyroidism and hyperthyroidism, it was found as 15% for hypothyroidism. The rate of pyramidal lobe visualization was 13% in nodular goiter patients, 43% in diffuse goiter patients, and 20% in patients whose scintigraphy showed normal thyroid glands. In the statistical evaluation, rate of pyramidal lobe visualization in diffuse goiter patients was found to be significantly higher compared to other patients (p<0.001). CONCLUSION: Preoperative imaging of pyramidal lobe especially in patients requiring total thyroidectomy would decrease relapses that may occur later and thus facilitate the treatment and monitoring of patients. CONFLICT OF INTEREST: None declared.
ABSTRACT
Sarcoidosis is a systemic, granulomatous disorder that affects multiple organ systems, but most often the lungs and the skin. The incidence of radiographically evident osseous involvement is between 1% and 13%, with an average of 5% on conventional imaging. Sarcoidosis generally involves the peripheral skeleton with the phalanges, metacarpals, and metatarsals being most frequently affected. The majority of osseous lesions occur in the phalanges of the hands. Involvement of the axial skeleton is rather uncommon. Sarcoid bone lesions are usually asymptomatic. Nuclear medicine studies, in particular bone scintigraphy, gallium-67 (Ga-67) and F-18 fluoro-2-deoxyglucose positron emission tomography (F-18 FDG PET) have been used in staging of sarcoidosis, including assessment of extrapulmonary involvement. Here, we present a case of osseous sarcoidosis in a man whom the disease presented with multiple lesions in the axial skeleton and the long bones.
