Sonographic assessment of acute changes in plaque size and echogenicity and in intima-media thickness of carotid arteries after neck radiation therapy.

BACKGROUND: Ultrasonic assessment of acute changes in carotid artery walls before and after neck radiation therapy (RT). METHODS: Fifty cancer patients scheduled for curative neck irradiation were included and underwent sonographic examination of carotid arteries, with assessment of intima-media thickness (IMT) and plaque size and echogenicity before and immediately after completion of RT. RESULTS: IMT was linearly correlated with age and before RT (r = 0.267, p = 0.007) and increased after RT (0.68 ± 0.11 versus 0.87 ± 0.16, p < 0.001), without correlation with total RT dose and protocol. New plaques (six hypoechoic, one hyperechoic, and one calcified) were found in eight patients after RT, while 17 of the 44 plaques that were present before RT increased in size, and 8 soft and 1 dense plaques in nine patients became calcified. CONCLUSIONS: Radiation in the acute phase not only increases the IMT but also causes new plaque formation and changes in plaque size and echogenicity.

Preoperative evaluation of renal anatomy and renal masses with helical CT, 3D-CT and 3D-CT angiography.

PURPOSE: The aim of this prospective study was to determine the efficacy of three-dimensional computed tomography (3D-CT) and three-dimensional computed tomographic angiography (3D-CTA) that were reconstructed by using the axial images of the multiphasic helical CT in the preoperative evaluation of renal masses and demonstration of renal anatomy. MATERIALS AND METHODS: Twenty patients that were suspected of having renal masses upon initial physical examination and ultrasonographic evaluation were examined through multiphasic helical CT. Two authors executed CT evaluations. Axial images were first examined and then used to reconstruct 3D-CT and 3D- CTA images. Number, location and size of the renal masses and other findings were noted. Renal vascularization and relationships of the renal masses with the neighboring renal structures were further investigated with 3D-CT and 3D-CTA images. RESULTS: Out of 20 patients, 13 had histopathologically proven renal cell carcinoma. The diagnoses of the remaining seven patients were xanthogranulomatous pyelonephritis, abscess, simple cyst, infected cyst, angiomyolipoma, oncocytoma and arteriovenous fistula. In the renal cell carcinoma group, 3 patients had stage I, 7 patients had stage II, and 3 patients had stage III disease. Sizes of renal cell carcinoma masses were between 23 mm to 60 mm (mean, 36 mm). Vascular invasion was shown in 2 renal cell carcinoma patients. Collecting system invasion was identified in 11 of 13 renal cell patients. These radiologic findings were confirmed with surgical specimens. CONCLUSION: Three-dimensional CT and 3D-CTA are non-invasive, effective imaging techniques for the preoperative evaluation of renal masses.

[Evaluation of rhinorrhea by computed tomography cisternography]. / Rinorenin BT sisternografi ile degerlendirilmesi.

PURPOSE: We aimed to emphasize the indication for and importance of CT cisternography in the diagnosis of rhinorrhea patients by reviewing the literature with the support of unenhanced cranial CT findings. MATERIALS AND METHODS: Unenhanced cranial CT with axial sections and CT cisternography with coronal sections were performed in 14 patients who had spontaneous (n = 3) and posttraumatic (n = 11), intermittent or continuous CSF rhinorrhea. The slice thickness of infratentorial planes was 5 mm and supratentorial planes 10 mm. CT cisternography was performed from nasion to dorsum sella with a 3 mm slice thickness and 3 mm intervals. Bony and/or dural defects with entry of contrast into the ipsilateral paranasal sinuses were accepted as positive results. RESULTS: A CSF fistula was determined in nine of eleven posttraumatic patients. Three of them had accompanying cerebral herniation while on had a pseudomeningocele. The etiology of two spontaneous rhinorrhea patients was shown to be empty sella and meningocele pouch respectively. Eleven patients (nine posttraumatic, two spontaneous) whose CSF fistula had been shown on CT cisternography were operated on and our findings were confirmed. CSF fistula or bony defect was not observed in the CT cisternography of 3 biochemically proven rhinorrhea patients (2 posttraumatic, 1 spontaneous). These 3 patients were clinically observed and their rhinorrhea ended spontaneously. One posttraumatic patient who had had 2 operations had recurrence of rhinorrhea with an infected extradural collection six months after the operation. Another posttraumatic patient developed meningitis before CT cisternography. CONCLUSION: CT cisternography should be the preferred examination method in rhinorrhea patients, since it is cheaper than MR cisternography, is a widely used scanning technique and reduces the risks of surgical recurrences by showing the exact location of the fistula.