The radiological findings of COVID-19

Background/aim: Available information on the radiological findings of the 2019 novel coronavirus disease (COVID-19) is constantly updated. Ground glass opacities (GGOs) and consolidation with bilateral and peripheral distribution have been reported as the most common CT findings, but less typical features can also be identified. According to the reported studies, SARS-CoV-2 infection is not limited to the respiratory system, and it can also affect other organs. Renal dysfunction, gastrointestinal complications, liver dysfunction, cardiac manifestations, and neurological abnormalities are among the reported extrapulmonary features. This review aims to provide updated information for radiologists and all clinicians to better understand the radiological manifestations of COVID-19. Materials and methods: Radiological findings observed in SARS-CoV-2 virus infections were explored in detail in PubMed and Google Scholar databases. Results: The typical pulmonary manifestations of COVID-19 pneumonia were determined as GGOs and accompanying consolidations that primarily involve the periphery of the bilateral lower lobes. The most common extrapulmonary findings were increased resistance to flow in the kidneys, thickening of vascular walls, fatty liver, pancreas, and heart inflammation findings. However, these findings were not specific and significantly overlapped those caused by other viral diseases, and therefore alternative diagnoses should be considered in patients with negative diagnostic tests. Conclusion: Radiological imaging plays a supportive role in the care of patients with COVID-19. Both clinicians and radiologists need to know associated pulmonary and extrapulmonary findings and imaging features to help diagnose and manage the possible complications of the disease at an early stage. They should also be familiar with CT findings in patients with COVID-19 since the disease can be incidentally detected during imaging performed with other indications.

Effects of glaucoma and central corneal thickness on optic nerve head biomechanics.

PURPOSE: To evaluate effects of glaucoma and central corneal thickness (CCT) on optic nerve head biomechanics. METHODS: Four groups were formed according to CCT measurements and the presence of glaucoma. Glaucomatous patients with thin (< 510 µ) and thick (> 570 µ) corneas composed groups 1 and 3, respectively. Nonglaucomatous patients with thin and thick corneas composed groups 2 and 4, respectively. Real-time elastography (RTE) was performed on all groups, and optic nerve strain rate (ONSR), orbital fat strain rate (OFSR), and strain ratio of orbital fat to the optic nerve and medial and lateral parts of the optic nerve (SROFON, SROFMON, SROFLON, respectively) were obtained and compared between groups. The correlations between CCT and these parameters were also investigated. RESULTS: Statistically significant difference was not found between groups in terms of strain rate of optic nerve and orbital fat, SRFON, SROFMON and SROFLON. There was a positive correlation between ONSR and OFSR and mean CCT in patients with CCT thinner than 510 µ (p: 0.03 r: 0.26, p: 0.01 r: 0.32 respectively). CONCLUSION: SROFON, SROFLON and SROFMON values did not differ between glaucomatous and nonglaucomatous patients with thin or thick CCTs. The correlations between CCT and OFSR and ONSR were found to be statistically significant in patients with thin CCT.

Relationship of salusin-alpha and salusin-beta levels with atherosclerosis in patients undergoing haemodialysis.

INTRODUCTION: In patients undergoing haemodialysis, cardiovascular mortality and morbidity, characterised by accelerated atherosclerosis and increased inflammation, are elevated. Salusins are newly defined molecules in the atherosclerotic processes, and while salusin-alpha (Sal-α) acts as an antiatherogenic factor, salusin-beta (Sal-ß) has a proatherogenic role. Their roles are as yet undefined in patients undergoing haemodialysis. METHODS: In this cross-sectional study, salusin levels, carotid intima-media thickness (CIMT) from the common carotid artery and pulse wave velocity (PWV) were measured for 180 patients undergoing haemodialysis and 90 healthy controls. RESULTS: Mean Sal-α and Sal-ß levels in patients undergoing haemodialysis (Sal-α: 726.4 ± 578.7 pg/mL; Sal-ß: 1,080.4 ± 757.1 pg/mL) and healthy controls (Sal-α: 325.8 ± 303.7 pg/mL; Sal-ß: 268.1 ± 409.0 pg/mL) were determined. Negative correlation was observed between Sal-α levels and CIMT (patients undergoing haemodialysis: r = -0.330, p < 0.0001; healthy controls: r = -0.223, p = 0.035) and PWV (patients undergoing haemodialysis: r = -0.210, p = 0.005; healthy controls: r = -0.378, p < 0.0001) in both groups. In patients undergoing haemodialysis, positive correlation was observed between Sal-ß/Sal-α ratio and CIMT (r = 0.190, p = 0.012) and PWV (r = 0.155, p = 0.041). On subgroup analysis, Sal-α levels were found to be low in patients with diabetes mellitus. CONCLUSION: Patients undergoing haemodialysis have higher Sal-ß and Sal-α levels, and their higher Sal-ß/Sal-α ratio, in comparison with healthy controls, might have cardiovascular risk implications.

The Karaman score: A new diagnostic score for acute appendicitis.

BACKGROUND: The Karaman score is a novel diagnostic scoring system consisting of 6 parameters. The aim of the present study was to assess the diagnostic performance of the Karaman score in comparison with the Alvarado score. METHODS: A total of 200 patients who underwent an appendectomy were enrolled in the study (research registry number: 2290). RESULTS: The cutoff threshold of the Karaman score in distinguishing acute appendicitis from negative appendectomy was ≥9 with 84.3% sensitivity, 64.7% specificity, 92.1% positive predictive value (PPV), and 45.8% negative predictive value (NPV). The cutoff threshold of the Alvarado score in distinguishing acute appendicitis from negative appendectomy was ≥8 with 72.9% sensitivity, 70.6% specificity, 92.4% PPV, and 34.8% NPV. In multivariate logistic regression analysis, an Alvarado ≥8 score (Odds ratio [OR]:6.644, 95% confidence interval [CI]: 2.854-15.466; p<0.001) and a Karaman ≥9 score (OR:10.374, 95% CI: 4.383-24.558; p<0.001) were each individually predictive in distinguishing acute appendicitis from negative appendectomy when correction was made according to age and gender. However, when both scores were evaluated together, the Alvarado score ≥8 lost its efficacy (OR:1.838, 95% CI: 0.517-6.530; p=0.347), whereas the Karaman score ≥9 retained its predictive power (OR:6.586, 95% CI: 1.893-22.917; p=0.003). CONCLUSION: The Karaman score was more predictive than the Alvarado score in distinguishing acute appendicitis from a negative appendectomy.

Primary intraosseous meningioma mimicking osteosarcoma: case report.

With an incidence rate of 15-20%, meningiomas are one of the most common brain tumors among benign intracranial tumors. They are distributed as follows in intracranial localizations: parasagittal and falx (25%), convexity (18%), sphenoid wing (18%), parasellar (12%), posterior fossa (10%), intraventricular (2%), intraorbital (1%), and extracranial (1%). The most common extradural localizations are the paranasal sinuses, nasal cavity, skin, neck, glands, and intraosseous space. Intradiploic meningiomas are generally localized in the frontoparietal and orbital regions. Due to their low incidence and lack of adequate preoperative diagnostic testing, intradiploic meningiomas are generally mistaken for primary calvarial bone tumors and en plaque meningiomas. Our case was discussed here with literature findings since primary intradiploic meningioma is uncommon and poses diagnostic challenges.

Intraorbital Encephalocele Presenting with Exophthalmos and Orbital Dystopia : CT and MRI Findings.

A 15-year-old female patient with progressive pulsatile exophthalmos caused by intraorbital encephalocele was evaluated with computed tomography (CT) and magnetic resonance imaging (MRI) in our clinic. She had no history of trauma or reconstructive surgery. When she was a little girl, she had undergone surgery for congenital glaucoma on the right eye. On the three-dimensional image of CT, a hypoplasic bone defect was observed in the greater wing of the right sphenoid bone. MRI and CT scan showed herniation through this defect of the arachnoid membrane and protruded cerebral tissue into the right orbita. Intraorbital encephalocele is an important entity that can cause pulsatile exophthalmos and blindness.

Clinical and radiologic review of uncommon cause of profound iron deficiency anemia: median arcuate ligament syndrome.

Median arcuate ligament syndrome is an anatomic and clinical entity characterized by dynamic compression of the proximal celiac artery by the median arcuate ligament, which leads to postprandial epigastric pain, vomiting, and weight loss. These symptoms are usually nonspecific and are easily misdiagnosed as functional dyspepsia, peptic ulcer disease, or gastropathy. In this report, we presented a 72-year-old male patient with celiac artery compression syndrome causing recurrent abdominal pain associated with gastric ulcer and iron deficiency anemia. This association is relatively uncommon and therefore not well determined. In addition, we reported the CT angiography findings and three-dimensional reconstructions of this rare case.

Spontaneous rupture of intracranial dermoid tumor in a patient with vertigo. Computed tomography and magnetic resonance imaging findings.

BACKGROUND: Congenital dermoid cysts are very rare, constituting less than 1% of intracranial tumors. Spontaneous rupture of dermoid tumor is a potentially serious complication that can lead to meningitis, seizures, cerebral ischemia and hydrocephalus. Occasionally, dermoid tumors are incidentally discovered on computed tomography (CT) of the brain or magnetic resonance imaging (MRI) following unrelated clinical complaints. They are also discovered during radiologic investigations of unexplained headaches, seizures, and rarely olfactory delusions. CASE REPORT: In this report we describe a patient complaining of vertigo caused by spontaneous rupture of dermoid cyst, preoperatively diagnosed by CT and MRI. Cranial CT revealed a dense fatty lesion adjacent to the posterolateral parasellar region on the left with multiple small, dense fat droplets scattered in the subarachnoid space corresponding to a dermoid cyst rupture. Cranial MRI sections revealed a lesion with mixed-signal-intensity and multiple hyperintense droplets scattered through the cerebellar surface on the left. No enhancement was found on axial T1-weighted MRI after intravenous Gadolinium administration. Diffusion weighted image (DWI) and apparent diffusion coefficient map studies exhibited explicit restricted diffusion. DISCUSSION: Many studies and literature case reports concerning the rupture of dermoid cyst have been reported. However, multimodal imaging of this rare pathology in the same patient is uncommon. Although dermoid cysts are pathognomonic in appearance on a CT examination, the MRI is also of value in helping to understand the effect of extension and pressure of the mass. DWI is also important for support of the diagnosis and patient follow-up.