New method for estimating the volume and volume fractions of the nasal structures in the goose (Anser anser domesticus) using computed tomography images.

1. The conchae within the nasal cavity of poultry are important for water and energy conservation, but have not been experimentally evaluated. The aim of the present study was to determine the accuracy of volume and volume fraction estimates of the conchae, nasal septum and nasal cavity. 2. The nasal cavities of 7 adult goose heads were scanned using computed tomography (CT), with images sampled randomly at a 1/5 sampling fraction. Physical sections were obtained from the same samples, using an electric saw that had an adjustable section range, and provided 14 to 15 sections with a thickness of 2.5 mm. The section surface areas of the nasal cavity, nasal septum and conchae were estimated using the Cavalieri principle. Results obtained using the CT and physical section images were compared. Volumes and volume fractions obtained from the physical sections were accepted as the gold standard and differences in the CT images were determined. 3. Multiplication of the data obtained on the CT images with the deviation percentage of the physical sections produced normalised values. No differences were observed between the gold standard data and the CT images. While it was possible to normalise the obtained data using the gold standard values, the raw data could also be used for comparative studies because the deviations from normal would be similar for all groups. 4. Our study showed that the nasal structures could be estimated in vivo using CT images.

Contrast-enhanced power Doppler US in the diagnosis of acute appendicitis.

INTRODUCTION/OBJECTIVE: To determine the value of power Doppler (PD) ultrasonography (US) and contrast-enhanced power Doppler (CEPD) US in the diagnosis of acute appendicitis and the prediction of histopathologic stages. METHODS AND MATERIAL: 50 patients with suspected acute appendicitis were evaluated by the same radiologist with PD US and CEPD US. Air micro bubbles stabilized by a granulate of "galactose and palmitic acid" were used as a contrast medium for sonography with the concentration of 400 mg/ml. PD US and CEPD US results were later correlated with the surgical and histopathologic findings. PD US and CEPD US findings were considered positive for appendicitis; if there was depiction of hyperemia in the wall of the appendix or if there was depiction of prominent peripheral vascularity when compared with normal soft tissues; and negative if both hyperemia and peripheral hyperemia were not prominent. RESULTS AND DISCUSSIONS: Of the 50 patients, 35 patients had histopathologically proven acute appendicitis. CEPD US showed prominent hyperemia in the appendiceal vessels or feeding vessels of the inflamed appendix, and resistance index (RI) calculations were easier. There was statistically significant difference between mean RI values of the normal appendix, suppurative appendicitis and gangrenous appendicitis. PD US has accuracy of 80%, sensitivity of 74% and CEPD US has 98%, and 100% in the diagnosis of acute appendicitis. CEPD US identified 100% of suppurative appendicitis and gangrenous appendicitis. CONCLUSION: CEPD US is a promising method in the diagnosis of acute appendicitis and determination of the inflammation stage.

Tracheomegaly in association with rheumatoid arthritis.

Herein we present a case of tracheomegaly seen in a patient with rheumatoid arthritis. To the authors' knowledge, and from a review of the literature, this combination has not been previously described.

Power Doppler sonographic diagnosis of torsion in a wandering spleen.

A wandering spleen is a rare clinical entity resulting from congenital maldevelopment or acquired laxity of the spleen's suspensory ligaments; it may result in torsion of the spleen. We report the gray-scale sonographic, power Doppler sonographic, and CT findings in a case of wandering spleen torsion. The gray-scale sonograms showed a displaced spleen that appeared as a homogeneous, hypoechoic mass suggestive of an enlarged, ectopic spleen in the central abdomen. Power Doppler sonograms showed no blood flow in the parenchyma or hilum of the spleen and were consistent with torsion and infarction in the spleen. Contrast-enhanced CT scans showed a homogeneous, unenhanced mass that was diagnosed as a torsioned wandering spleen. The hilar vessels of the spleen were also unenhanced.

The prevalence of seminal vesicle cysts in autosomal dominant polycystic kidney disease.

BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is a systemic hereditary disorder characterized by bilateral diffuse renal cysts. Extrarenal involvement is a well known manifestation of ADPKD. Data relating to the association between seminal vesicle cysts and ADPKD are limited. The aims of this study are to evaluate the frequency of seminal vesicle cysts in ADPKD and to assess the relationship between seminal vesicle cysts, with cysts in the liver and prostate, and creatininaemia. METHODS: Forty five male patients (mean age 40 years, range 13-67) were included in the study. Each subject underwent a formal interview, physical examination; and abdominal and transrectal ultrasonography. Three patients were infertile, but one of the patients also had varicocele. RESULTS: Seminal vesicle cysts were present in 27 (60%) patients. Liver and prostate cysts were present in 19 (42%) and five (11%) patients, respectively. There was a positive correlation between seminal vesicle cysts, cysts in the liver, and serum creatinine concentrations. CONCLUSION: Our conclusions are: (i) seminal vesicle cysts are not uncommon in ADPKD; (ii) ADPKD should be looked for in patients with seminal vesicle cysts, and (iii) the clinical significance of seminal vesicle cysts in ADPKD remains to be defined.

Carpenter syndrome: report of two siblings.

Carpenter syndrome consists of acrocephaly, soft tissue syndactyly, short fingers, preaxial polydactyly, congenital heart disease, hypogenitalism, cryptorchidism, obesity, umbilical hernia and mental retardation. Here we report two affected sibs (IQs were 80 and 93) presenting various cerebrospinal malformations, i.e. frontal lobe deformity, narrowed foramen magnum, hypoplastic posterior fossa, kinked spinal cord, and syrinx cavitation demonstrated by magnetic resonance imaging.

Acute appendicitis: MR imaging and sonographic correlation.

OBJECTIVE: Acute appendicitis is the most common indication for emergency abdominal surgery. To our knowledge, MR imaging has not been compared with sonography for revealing acute appendicitis. Our aim was to assess and compare the accuracy, advantages, and limitations of MR imaging and sonography in revealing appendicitis. SUBJECTS AND METHODS: The study included 60 consecutive patients suspected of having appendicitis who underwent abdominal sonography and MR imaging. Fat-suppressed T2-weighted fast spin-echo and gadolinium-enhanced fat-suppressed T1-weighted spin-echo axial and coronal images were obtained. The initial MR imaging and sonographic studies were later correlated with the surgical-pathologic findings, follow-up evaluations, and diagnosis at the time of discharge. RESULTS: Surgical, histopathologic, and follow-up results revealed that 34 patients had appendicitis. Of the 26 patients without appendicitis, 15 with symptoms of acute appendicitis had no pathologic diagnoses and the remaining 11 had another diagnosis. Comparison of the sensitivity, accuracy, and negative predictive values for MR imaging and sonography was found to be statistically significant (p < .05, chi-square test), indicating that MR imaging was superior to sonography in revealing appendicitis. We found no statistical difference in specificity and positive predictive value for MR imaging and sonography. CONCLUSION: Despite some disadvantages, we found MR imaging to be superior to sonography in revealing suspected acute appendicitis. MR imaging can be used after suboptimal or nondiagnostic sonography in cases of suspected acute appendicitis.

MRI of the intracerebral lesions at 0.5 Tesla: comparison of fast spin-echo and conventional spin-echo sequences.

Fast spin-echo sequences was compared with conventional spin-echo sequences at 0.5 Tesla, in 130 patients who attended for routine brain MRI. Artefacts and contrast behaviour of anatomical structures and lesions were assessed visually and quantitatively by contrast-to-noise ratios. The difference between conventional spin-echo and fast spin-echo in contrast in intracerebral tumors and infarcts was not found to be significant statistically. Small amounts of haemosiderin and calcifications could not be seen on fast spin-echo images especially in T2 weighted. Flow artefacts were considerably reduced on fast spin-echo images. Motion artefact was considerably increased on dual-echo fast spin-echo sequences. There were no statistical differences between the results of the visual findings and between those of CNR values except for contrast between CSF and white matter and between haemoatoma and background in T2 sequences. Our results suggest that by virtue of the shorter acquisition time, diagnostic reliability and reduced flow artefact single-echo FSE sequences should be preferred to dual-echo CSE sequences in routine brain MRI at 0.5 Tesla.

Intracystic application of mebendazole solution in the treatment of liver hydatid disease. Preliminary report of two cases.

Mebendazole, a derivate of benzimidazole, is commonly used for the treatment of hydatid disease in patients at high operative risk and/or to prevent secondary hydatidosis. In this study, 2 cases of liver hydatid disease, in which mebendazole was used both orally and for intracystic application are presented. These cases have been treated by percutaneous drainage and videolaparoscopic methods. Mebendazole solution at a concentration of 2.4 micrograms/ml was injected into the cyst. For a period of 6 months 50 mg/kg/day oral treatment was given. At the end of a 6- to 9-month period, the total recovery was observed. This is the first report of mebendazole pair-treatment in the literature.

The diagnostic value of cranial computed tomography in complicated eclampsia.

Cranial CT scanning was performed in twenty-two patients with severe neurological complications secondary to eclampsia. All patients had repetitive and/or prolonged convulsions. In addition, three patients were in prolonged coma, and three had cortical blindness. One of the patients had central facial paresis, and two had hemiparesis. In seventeen patients, abnormal CT findings were identified. Diffuse cerebral edema was determined in four patients. The most frequent finding was bilateral low-density areas in the parietal and/or occipital lobes (7 cases). In three patients, CT revealed bilateral low-density areas in the basal ganglia. All women but three recovered completely. Two of the three patients who died had intracranial massive hemorrhage. Follow-up CT examinations demonstrated complete resolution of the low-density areas and slight cortical atrophy in three of four patients. Complete recovery of the patients associated with complete resolution of the low-density lesions suggested that these lesions corresponded to edema. We concluded that CT is useful in patients with complicated eclampsia because it may orientate management.

Bilateral adrenal hemorrhage associated with bilateral renal vein and vena cava thrombosis.

Idiopathic bilateral adrenal hemorrhage with thrombosis of both renal veins and inferior vena cava are presented using US and CT in a newborn. To our knowledge such bilateral involvement of the adrenal glands and the renal veins have not been reported previously.

Computed tomography in agenesis of the right lobe of the liver.

Congenital agenesis of the right lobe of the liver is a rare anomaly. In a case report the diagnosis was made by computed tomography. A retro- or suprahepatic location of the gallbladder and compensatory hypertrophy of the left liver lobe and/or caudate lobe may give support to the diagnosis. Before diagnosing congenital agenesis of the lobe, lobar atrophy due to cirrhosis, cholangiocarcinoma or any other predisposing conditions should be eliminated.