A Comparison of Ultrasonography, Computerised Tomography, and Conventional MRI Findings for Splenic Nodules Associated with Type 1 Gaucher's Disease with Diffusion-Weighted MRI Findings.

A 26-year-old female patient with Type 1 Gaucher's disease (GD) was admitted to our clinic with complaints of stomachache and signs of anemia. The patient underwent ultrasonography (US), computerised tomography (CT), and magnetic resonance imaging (MRI) scan. Imaging studies revealed massive hepatosplenomegaly, choledocolithiasis, and six nodules in the spleen with a mean size of 14 mm. The nodules appeared hyperechoic, hypoechoic, and of mixed echogenicity on the US and hypodense on the CT. While the nodules were observed to be iso-hypointense in T1-weighted (T1WI) images, they appeared to be hyperintense in the T2-weighted (T2WI) images. There were no diffusion restrictions in these nodules that appeared on the diffusion-weighted magnetic resonance imaging (DWI). A nodule located at the lower pole was observed to be hypointense in the T2WI images. The nodule located at the lower pole, which appeared hypointense in T2WI series, had restricted diffusion upon DWI. In this study, we aimed to present the properties of splenic GD nodules using US, CT, and conventional MRI, together with DWI. This case report is the first to apply US, CT, and conventional MRI, together with DWI, to the splenic nodules associated with Gaucher's disease.

Is evaluation of placenta with real-time sonoelastography during the second trimester of pregnancy an effective method for the assessment of spontaneous preterm birth risk?

PURPOSE: The aim of this study is to investigate the effectiveness of placental strain ratio (SR) values measured by real-time sonoelastography (SE) in the second trimester in the prediction of spontaneous preterm birth (sPTB). METHODS: This study included 70 pregnant women who applied to our clinic for routine second-trimester screening. Placental SR measurements were performed with the SE method. Two different SR measurements were performed by taking two different tissues as references. The SR value measured when taking the rectus abdominis muscle as a reference was termed the muscle-to-placenta strain ratio (MPSR), while the SR value measured when taking subcutaneous tissue as a reference was termed the fat-to-placenta strain ratio (FPSR). Women whose gestational age at birth was less than 37 weeks 0 days were accepted as sPTB. The association between gestational age at birth and MPSR and FPSR was investigated. Receiver operating characteristics analysis was used to calculate the sensitivity and specificity of the elastographic outcomes. RESULTS: There was a low-level negative correlation between MPSR and gestational age at birth (r=-0.300, P=.012) and there was a moderate-level negative correlation between FPSR and gestational age at birth (r=-0.513, P<.001). The multivariate linear regression analysis showed that the FPSR (ß=0.609, P=.002) was the significant predictor for the sPTB. CONCLUSIONS: Our data indicate that the FPSR value measured with real-time SE in the second trimester of pregnancy may be effective in the prediction of sPTB.

Untreated Isolated Torsion of the Epididymis in an Adolescent.

Although torsion of epididymis is extremely rare, it should be kept in mind in the differential diagnosis of acute scrotal pain in adolescents. We report here a very rare cause of acute scrotum: torsion of the epididymis.

Venous flow volume measured by duplex ultrasound can be used as an indicator of impaired tissue perfusion in patients with peripheral arterial disease.

AIM: In this study, we aimed to investigate the arterial and venous flow volume rate (FV) in order to determine the tissue perfusion using duplex ultrasonography (DU). We hypothesized that FV provides reliable information regarding tissue perfusion in patients with peripheral arterial disease (PAD). MATERIAL AND METHODS: The study comprised 38 patients (72 legs) with PAD. In all patients, common femoral, popliteal, anterior tibial, posterior tibial arteries and veins were examined with DU. Measurements were obtained in the supine position with 15 cm elevation of the foot to neutralise central venous pressure. The diameter, blood flow velocity, and FV of arteries and veins were measured for each patient. RESULTS: The FV of the common femoral artery and vein (p = 0.001), popliteal artery and vein (p=0.003), and posterior tibial artery and vein (p = 0.008) had statistically significant differences. However, there was no statistically significant difference between the FV of the anterior tibial vein and artery (p = 0.408). The mean FV values of all veins were significantly lower than those of homonymous arteries in patients with PAD. CONCLUSIONS: Our study showed that venous FV measured by DU can be used as an indicator of impaired tissue perfusion in patients with PAD.

A giant subserosal uterine leiomyoma mimicking an abdominal mass: multimodal imaging data.

Giant uterine leiomyomas are extremely rare neoplasms and are challenging both diagnostically and therapeutically. A 49-year-old premenopausal female presented at our Department complaining of abdominal pain and distention for several years. Ultrasound (US), color Doppler US, abdominal computed tomography imaging after administration of contrast material, and abdominal magnetic resonance imaging were performed. Histopathologic examination revealed a pedunculated subserosal uterine leiomyoma. In this case report, we present abdominopelvic multimodal radiologic imaging findings of our patient with a giant subserosal uterine leiomyoma, in conjunction with histopathological findings.

Diffusion-weighted magnetic resonance imaging findings of kidneys with obstructive uropathy: differentiation between benign and malignant etiology.

PURPOSE: In this study, we aimed to evaluate the capability of diffusion-weighted magnetic resonance imaging (DWI) in differentiation between benign and malignant etiology of obstructive uropathy. MATERIALS AND METHODS: DWI was performed in 41 patients with hydronephrotic kidneys and 26 healthy volunteers. MR imaging was performed using a 1.5 T whole-body superconducting MR scanner. The signal intensities of the renal parenchyma on DWI and apparent diffusion coefficient (ADC) maps were noted. DWI was performed with the following diffusion gradient b values: 100, 600, and 1000 s/mm(2). A large circular region of interest was placed in the corticomedullary junction of the kidneys. For statistical analysis, the independent-samples t test was used. RESULTS: The mean renal ADC values for b100, b600, and b1000 in hydronephrosis patients with benign and malignant etiology and the healthy volunteers of the control group were analysed. ADC measurements of renal parenchyma in all hydronephrotic kidneys with benign and malignant etiology were found to be statistically low compared to those of normal kidneys (P < 0.05). CONCLUSIONS: There were significant differences in the ADC values of obstructed kidneys compared to those of normal kidneys. Obstructed kidneys with malignant etiology had lower ADC values for b1000 compared to obstructed kidneys with benign etiology, but these alterations were statistically insignificant.

Squamous cell carcinoma of the renal pelvis associated with kidney stones: radiologic imaging features with gross and histopathological correlation.

Squamous cell carcinoma (SCC) of the renal pelvis is a rare neoplasm and is usually associated with long standing renal stone disease. This tumor is aggressive in nature and usually has a poor prognosis. We report a case who presented with sudden significant weight loss. During the radiologic investigation, a renal mass and staghorn calculi were detected in the right kidney. The patient subsequently underwent right radical nephrectomy. Pathological diagnosis was SCC of renal pelvis with extensive infiltration in to the renal parenchyma. The radiologic imaging features and histopathologic findings of this rare tumor are discussed in this report.

Deep vein thrombosis associated with protein C and protein S deficiency: an unusual cause of acute abdomen.

Deep venous thrombosis is an extremely rare cause of acute abdomen and is often difficult to diagnose. Protein C and protein S deficiencies are rare genetic abnormalities that predispose the patient to thrombophilia and lead to thrombosis. We report the case of a previously healthy 7-year-old boy with iliofemoral thrombosis due to protein C and protein S deficiencies mimicking acute abdomen.

Diffusion-weighted MR imaging findings of kidneys in patients with early phase of obstruction.

BACKGROUND: Diffusion-weighted (DW) magnetic resonance (MR) imaging is an MR technique used to show molecular diffusion. The apparent diffusion coefficient (ADC), as a quantitative parameter calculated from the DW MR images. The purpose of this study is to evaluate the ability of DW MR imaging in early phase of obstruction due to urolithiasis. MATERIALS AND METHODS: Twenty-six patients with acute dilatation of the pelvicalyceal system detected by intravenous urography were included in this study. MR imaging was performed using a 1.5 T whole-body superconducting MR scanner. DW imaging can be performed using single-shot spin-echo, echo-planar imaging (EPI) sequences with the following diffusion gradient b values: 100, 600, 1000 s/mm(2). Circular region of interest (ROI) was placed in the renal parenchyma for the measurement of ADC values in the normal and obstructed kidney. For statistical analyses, Paired t test were used. RESULTS: In spite of obstructed kidneys had the lower ADC values compared to normal kidneys, these alterations were statistically insignificant. CONCLUSION: We did not observe significantly different ADC values of early phase of obstructed kidneys compared to normal kidneys.

Clinical and MRI findings of brucellar spondylodiscitis.

OBJECTIVE: The aim of this retrospective study was to report the clinical features and MR imaging findings of patients with brucellar spondylodiscitis. MATERIALS AND METHODS: Twenty-two patients with spondylodiscitis, recruited among 152 patients with brucellosis referred from the Department of Infectious Diseases. Patients were diagnosed based on positive clinical findings, > or =1/160 titers of brucella agglutination tests and/or positive blood cultures. Magnetic resonance imaging (MRI) was performed to all of the patients with spondylodiscitis. Signal changes and enhancement of vertebral bodies, involvement of paravertebral soft tissues and epidural spaces, nerve root and cord compression and abscess formation were assessed. RESULTS: All of the patients (n=22; 7 F, 15 M) had > or =1/160 titers of brucella agglutination test and blood culture was positive in 9. A great majority of the patients had involvement at only one vertebrae level (n=21, 95.5%), whereas one patient (4.5%) had multilevel involvement. In MRI, eight patients had soft tissue involvement and three had abscess formation. All cases had vertebral and discal enhancement. Additionally epidural extension was detected in four cases, posterior longitudinal ligament (PLL) elevation in five cases and root compression in two cases. CONCLUSION: Brucella is still a public health problem in endemic areas. MRI is a highly sensitive and non-invasive imaging technique which should be first choice of imaging in the early diagnosis of spondylodiscitis.