The effects of radiotherapy on arterial diameters in patients with high-grade glial tumors who have undergone adjuvant radiotherapy.

Background and Aims: Our purpose was to evaluate the M2 branch of the middle cerebral artery (MCA) in high-grade glial tumor patients who undergo adjuvant radiotherapy (RT). For this purpose, the diameter of the M2 branch was measured and evaluated by means of contrast-enhanced magnetic resonance imaging (CE-MRI) before and after RT. Post-radiotherapeutical measurements were made 1, 3, 5, and 7 months after the procedure; and vascular diameter alterations were evaluated. Materials and Methods: CE-MRI examinations were performed on the 32 patients enrolled in the study, who had undergone radiotherapy of the temporoparietal region. MRI examinations were performed prior to RT (RT0) and 1 (RT1), 3 (RT2), 5 (RT3), and 7 (RT4) months after RT. The M2 branch of the MCA was evaluated on MRI images, and the vessel diameter was measured in millimeters (mm), and then comparisons were made. Results: Statistically significant results were obtained during RT0-RT1, RT0-RT2, RT0-RT3, RT0-RT4, RT1-RT2, RT2-RT4, and RT3-RT4, and comparisons of the diameters of the M2 branch of the right MCA were performed (P < 0.05). When the same measurements and comparisons were made for the M2 branch of the left MCA, statistically significant results were found for the RT1-RT2, RT1-RT3, and RT1-RT4 comparisons (P < 0.05). Conclusion: Our study showed that the MCA M2 branch diminished in size following RT. This was demonstrated by means of CE-MRI controls performed up to 7 months after the completion of the RT procedures.

The comparison of the efficacy of diffusion weighted imaging (DWI) sequences with 3 different T2-weighted sequences in the detection of focal liver lesions.

PURPOSE: In this study we aimed to compare and evaluate the efficacies of the low and high b value diffusion weighted imaging (DWI) sequences with three different T2-weighted (T2W) sequences. MATERIALS AND METHODS: 255 liver lesions of 147 patients who had undergone MR examinations of the upper abdomen were evaluated. A maximum number of 4 lesions was taken for consideration in patients with multiple lesions. Low and high b valued DWI and 3 different T2W sequences (SSFSE, FIESTA, and PROPELLER FSE) were utilized. The evaluations were done by 3 different radiologists, by utilizing the double blind principle. RESULTS: The lesion detection performances of the b 0 DWI, b 600 DWI, FIESTA T2W, SSFSE T2W, and PROPELLER FSE T2W sequences, were 95.7 %, 66.3 %, 94.4 %, 92.8 %, and 93.8 %, in sequence order. The high b value DWI sequence was able to detect malignant lesions with a higher accuracy rate than the T2W sequences. There was a moderate to high rate of agreement among the interpreters, and the lesion-detection rates of the interpreters were in line with their levels of expertise. CONCLUSION: Even though the higher lesion detection rates of the DWI sequences were not found to be statistically significant, it was concluded that making the evaluations with the addition of DWI to the imaging protocol would certainly decrease the lesion-missing rate, and it would be wise to utilize the DWI technique in routine liver MR imaging.

Doppler ultrasonography helps discriminate between cirrhotic and non-cirrhotic patients with viral B and C hepatitis.

OBJECTIVE: The aim of this study was to define the cutoff values between compensated cirrhosis and non-cirrhotic patients with viral hepatitis B and C, using the criteria of the Doppler parameters of liver vascularity. MATERIALS AND METHODS: Seventy non-cirrhotic patients with viral hepatitis B and C and 30 cirrhotic patients were included in this prospective study. The diagnostic decisiveness properties of the Doppler values in the pre-determination of liver cirrhosis were evaluated using receiver operating characteristics curve analysis. RESULTS: Taking the cutoff value for hepatic vein waveform index as 0.605, a sensitivity of 80% and a specificity of 77.1% were obtained. The sensitivity was 80%, and the specificity was 68.6% for a mean max portal velocity cutoff value of 18.25cm/s. When the hepatic artery resistivity index cutoff value was taken as 0.705 for the diagnosis of cirrhosis, the sensitivity was 82.5% and the specificity 72.1%. For a hepatic artery pulsatility index cutoff value of 1.295, a sensitivity of 82.5% and a specificity of 72.1% were found. CONCLUSION: It is not possible to diagnose cirrhosis with only hemodynamic changes. However, the cutoff values may be helpful in the selection of patients to undergo the procedure of liver biopsy.

Magnetic resonance imaging evaluation of shoulder joint in patients with early stage of ankylosing spondylitis: A case-control study.

PURPOSE: The goal of this prospective study was to determine the prevalence of shoulder abnormalities on magnetic resonance imaging (MRI) in patients with ankylosing spondylitis (AS) who have normal shoulder X-ray examinations and no clinical shoulder abnormalities using a case-control study. MATERIALS AND METHODS: Fifty-three patients with AS according to the SpondyloArthritis international Society (ASAS) criteria were enrolled in the study. Fifty-three patients with no AS served as control subjects. Shoulder MRI examinations of patients in the two groups were analyzed and results were compared. RESULTS: In the patient group, 26/53 patients (49.1%) demonstrated one or two of the defined pathological shoulder MRI findings, whereas 5/53 patients (9.4%) had similar findings in the control group. In the patient group, 11/53 patients (20.8%) had enthesal bone marrow edema, 19/53 patients (35.8%) had increased synovial fluid, 8/53 patients (15.1%) had tendinitis, and 2/53 patients (3.8%) had bursitis. There was statistically significant difference between the patient and control groups in terms of prevalence of enthesal bone marrow edema, increase in synovial fluid, and tendinitis. CONCLUSION: Shoulder involvement is often overlooked in AS. Knowledge of the early-stage findings of the shoulder involvement due to AS is important to establish an early diagnosis and select treatment options.

US and CT findings of rectal amebian abscess.

An interesting case of rectal amebic abscess is presented. Ultrasound and CT images provided the diagnosis of a cystic intramural mass at the rectal wall of a young man, who complained of pelvic pain, constipation, and fever. His clinical history of amebiasis and the finding of trophozoids and cysts at the stool swap confirmed the diagnosis. Intravenous metronidazole therapy cured the disease and led to total disappearance of the mass, and clinical well-being.