Sonographic and Anatomical Evaluation of the Liver and Portal Vein Reference Values / Evaluación Ecográfica y Anatómica de los Valores de Referencia del Hígado y la Vena Porta

SUMMARY: This paper's aim is a morphometric evaluation of liver and portal vein morphometry using ultrasonography in healthy Turkish population. This study was carried out with 189 subjects (107 females, 82 males). The demographic data and the body surface area were calculated. The longitudinal axis of the liver for two lobes, diagonal axis or liver span, anteroposterior diameter of the liver and portal vein, portal vein transverse diameter, caudate lobe anteroposterior diameter, and portal vein internal diameters as well as longitudinal liver scans in an aortic plane, sagittal plane, transverse plane, and kidney axis were measured. All measurements were analyzed according to age, sex, body mass index, obesity and alcohol consumption. The mean values of the age, height, weight and body mass index were calculated as 44.39 years, 167.05 cm, 74.23 kg, and 27.06kg/m2 in females, respectively. The same values were 44.13 years, 167.70 cm, 75.93 kg and 26.71 kg/m2 in males, respectively. There was significant difference between demographic characteristics, gender, and alcohol consumption in terms of anteroposterior diameter of the liver, portal vein transverse diameter of the right side and liver transverse scan. Also, some measurements including portal vein transverse diameter, liver transverse scan and at kidney axis longitudinal scan of liver showed significant difference between the age groups. There was significant difference in diagonal axis and anteroposterior diameter of liver, portal vein internal diameter, and longitudinal liver scans of the aortic plane parameters between obesity situation. The findings obtained will provide important and useful reference values as it may determine some abnormalities related liver diseases. Also, age, sex, obesity and body mass index values can be effective in the liver and portal vein morphometry related parameters.

El objetivo de este artículo fue realizar una evaluación de la morfometría del hígado y la vena porta mediante ecografía en una población turca sana. Este estudio se llevó a cabo en 189 sujetos (107 mujeres, 82 hombres). Se calcularon los datos demográficos y la superficie corporal. Se midió eleje longitudinal del de dos lóbulos del hígado, el eje diagonal o la extensión del hígado, los diámetros anteroposterior del hígado y de la vena porta, el diámetro transversal de la vena porta, anteroposterior del lóbulo caudado y los diámetros internos de la vena porta, así como las exploraciones longitudinales del hígado en un plano aórtico. Se midieron el plano sagital, el plano transversal y el eje del riñón. Todas las mediciones se analizaron según edad, sexo, índice de masa corporal, obesidad y consumo de alcohol. Los valores medios de edad, talla, peso e índice de masa corporal se calcularon como 44,39 años, 167,05 cm, 74,23 kg y 27,06 kg/m2 en las mujeres, respectivamente. Las mismas variable fueron 44,13 años, 167,70 cm, 75,93 kg y 26,71 kg/m2. Hubo diferencias significativas entre las características demográficas, el sexo y el consumo de alcohol en términos de diámetro anteroposterior del hígado, diámetro transversal de la vena porta del lado derecho y exploración transversal del hígado. Además, algunas mediciones, incluido el diámetro transversal de la vena porta, la exploración transversal del hígado y la exploración longitudinal del hígado en el eje del riñón, mostraron diferencias significativas entre los grupos de edad. Hubo diferencias significativas en el eje diagonal y el diámetro anteroposterior del hígado, el diámetro interno de la vena porta y los parámetros de las exploraciones hepáticas longitudinales del plano aórtico entre situaciones de obesidad. Los hallazgos obtenidos proporcionarán valores de referencia importantes y útiles ya que pueden determinar algunas anomalías relacionadas con enfermedades hepáticas. Además, los valores de edad, sexo, obesidad e índice de masa corporal pueden ser eficaces en los parámetros relacionados con la morfometría del hígado y la vena porta.

A qualitative and quantitative assessment of simultaneous strain, shear wave, and point shear wave elastography to distinguish malignant and benign breast lesions.

BACKGROUND: Ultrasound (US) elastography has become a routine instrument in ultrasonographic diagnosis that measures the consistency and stiffness of tissues. PURPOSE: To distinguish benign and malignant breast masses using a single US system by comparing the diagnostic parameters of three kinds of breast elastography simultaneously added to B-mode ultrasonography. MATERIAL AND METHODS: A total of 163 breast lesions in 159 consecutive women who underwent US-guided core needle biopsy were included in this prospective study. Before the biopsy, the lesions were examined with B-mode ultrasonography and strain (SE), shear wave (SWE), and point shear wave (STQ) elastography. The strain ratio was computed and the Tsukuba score determined. The mean elasticity values using SWE and STQ were computed and converted to Young's modulus E (kPa). RESULTS: All SE, SWE, and STQ parameters showed similar diagnostic performance. The SE score, SE ratio, SWEmean, SWEmax, STQmean, and STQmax yielded higher specificity than B-mode US alone to differentiate benign and malignant masses. The sensitivity of B-mode US, SWE, and STQ was slightly higher than that of the SE score and SE ratio. The SE score, SE ratio, SWEmean, SWEmax, STQmean, and STQmax had significantly higher positive predictive value and diagnostic accuracy than B-mode US alone. The area under the curve for each of these elastography methods in differentiating benign and malignant breast lesions was 0.93, 0.93, 0.98, 0.97, 0.98, and 0.96, respectively; P<0.001 for all measurements. CONCLUSION: SE (ratio and score), SWE, and STQ had higher diagnostic performance individually than B-mode US alone in distinguishing between malignant and benign breast masses.

Sonographic determination of normal spleen size in Turkish adults / Determinación ecográfica del tamaño normal del bazo en adultos turcos

The current study was undertaken to determine normal spleen dimensions and anthropometric evaluation by ultrasonography from females and males in our population. These measurements were taken using an ultrasonography. The mean values of the age, height, weight and body mass index (BMI) of subjects, spleen width (SW), spleen length (SL), spleen thickness (ST) and spleen volume calculated with elipsoid formula; length x width x thickness x 0.524 were taken. These measurements were found to be 36.37±10.83 years, 164.22±4.72 cm, 60.26±7.11 kg, 22.30±2.09 kg/m2, 7.58±1.56 cm, 9.87±1.28 cm, 3.34±0.79 cm and 136.05±61.14 cm3 in females respectively. Additionally, in males same dimensions were 40.50±12.77 years, 174.41±6.57 cm, 76.33±8.54 kg, 25.06±2.10 kg/m2, 8.75±1.84 cm, 11.01±1.186 cm, 4.12±1.09 cm and 220.70±115.35 cm3 respectively. The observations presented in this report have defined anatomic parameters about spleen size that need to be taken into consideration for reference data to determine population discrepancies and helpful for radiologists and clinicians.

El objetivo fue determinar las dimensiones normales del bazo y realizar una evaluación antropométrica mediante ecografía en mujeres y hombres turcos. Fueron calculados los valores medios de edad, altura, peso, índice de masa corporal (IMC), ancho del bazo (AB), longitud del bazo (LB) y grosor del bazo (GB), junto al volumen del bazo mediante la fórmula elipsoide (largo x ancho x grosor x 0,524). Las mujeres presentaron una edad de 36,37±10,83 años, altura de 164,22±4,72 cm, peso de 60,26±7,11 kg, IMC de 22,30±2,09 kg/m2, AB de 7,58±1,56 cm, LB de 9,87±1,28 cm, GB de 3,34±0,79 cm y volumen del bazo de 136,05±61,14 cm3. Los hombres presentaron una edad de 40,50±12,77 años, altura de 174,41±6,57 cm, peso de 76,33±8,54 kg, IMC de 25,06±2,10 kg/m2, AB de 8,75±1,84 cm, LB de 11,01±1,186 cm, GB de 4,12±1,09 cm y volumen del bazo de 220,70±115,35 cm3. Nuestras observaciones han definido parámetros anatómicos sobre el tamaño del bazo, los cuales deben ser considerados como datos de referencia para determinar las discrepancias en la población, de utilidad para radiólogos y clínicos.

Portal venous diameter in children: normal limits according to age, weight and height.

PURPOSE: To establish the normal limits of portal vein diameter according to age, height and weight. MATERIALS AND METHODS: One hundred and sixty-eight healthy children, ages ranging from 1 month to 15 years were examined by ultrasound. Portal vein diameters at hepatic port, weight and height were recorded. RESULTS: A range of normal limits for portal veneous diameter according to age, weight and height are obtained and presented in tables. CONCLUSION: Knowing the normals for portal venous diameter in every age group in children is mandatory in differentiating disease. The tables according to age, weight and height will definitely be helpful in the work-up process.

The effect of retroperitoneal fat tissue thickness on testicular venous drainage.

INTRODUCTION: We evaluated a possible effect of the amount of retroperitoneal fat tissue on testicular venous drainage to shed light on the mechanism of varicocele occurrence. PATIENTS AND METHODS: A total of 132 patients with no fertility complaints were included in this study. Retroperitoneal fat thickness (RPFT) was measured during abdominal computed tomography examinations. According to the calculated body mass index (BMI), patients were categorized as normal, overweight or obese using National Institutes of Health criteria. Relationships were sought between RPFT, BMI and testicular vein-pampiniform plexus diameters measured with ultrasonography on both sides. RESULTS: Left and right testicular vein maximum diameters were significantly larger in obese patients compared with normal and overweight men (p = 0.01 and p = 0.003, respectively). In accordance with this, the left and right pampiniform plexus diameters were larger in the obese group than in the normal and overweight groups (p = 0.004 and p = 0.006, respectively). There was a moderate but significant correlation between the right testicular vein maximum diameter and mean RPFT (p = 0.003). The relationship between bilateral pampiniform plexus diameters and retroperitoneal fat distribution was stronger and significant (p = 0.0001). Correlation analysis revealed a significant relationship between BMI and retroperitoneal fat distribution (R = 0.53, p = 0.0001). CONCLUSIONS: The amount of retroperitoneal fat, which is related to BMI, could be a contributing factor in the etiology of right varicocele.

Detection of cytochrome P450-2A6, -3A5 and -4B1 with real-time polymerase chain reaction in prostate tissue.

Cytochrome P450 (CYP) is a heme-containing enzyme superfamily metabolizing a wide variety of xenobiotics, including drugs and carcinogens. The majority of CYP genes are expressed in the liver, however, some CYP isoforms are also reported for a number of extra hepatic tissues. We analyzed Cytochrome P450-2A6, -3A5 and -4B1 mRNAs using real-time reverse-transcriptase polymerase chain reaction (RT-PCR) in a total of 21 homogenized prostate tissues with or without malignancy. We detected a consistent expression of CYP2A6 and CYP3A5 in all, and of CYP4B1 in some (11/21) of the samples at mRNA level. Neither the histopathological status nor the smoking habit of the individuals affected CYP4B1 expression. Our results reflect possible roles for these particular CYPs in therapy and protection of prostate tissue.

The prevalence and variations of inferior right hepatic veins on contrast-enhanced helical CT scanning.

PURPOSE: To present the prevalence and variations of inferior right hepatic veins (IRHVs) on contrast-enhanced helical computed tomography (CEHCT) scans. MATERIALS AND METHODS: The routine abdominal CEHCT scans of 349 patients were reviewed. Three hundred and eight patients (88.2%) were included in the study. Of the 349 patients, 41 (11.8%) were excluded from the study because of improper opacification of hepatic veins and right hepatic lobe lesions which made difficult the optimal visualization and assessment of IRHVs. The mean age of 308 patients was 43 years (range 3-97 years). One hundred and forty-three patients (46.4%) were men and 165 (53.6%) women. Scans were examined whether the IRHVs were demonstrated or not and classified according to their numbers, levels, diameters, and joinings to inferior vena cava (IVC). RESULTS: Of the 308 patients, 65 (21.1%) had one or two IRHVs. Fifty-four patients (83.1%) had only one IRHV and 11 (16.9%) patients had two. More than two IRHVs were not seen in any patient. Eight (72.7%) of 11 double IRHVs joined the IVC at the same level and others (27.3%) did not. There was no truncal opening to the IVC. In five patients (7.7%) the IRHV were large (> or =0.5 cm). CONCLUSION: The presence of IRHVs is common and routine CEHCT scanning is efficacious in assessment of IRHVs.

[Unenhanced spiral CT in the diagnosis of acute appendicitis]. / Akut apandisit tanisinda kontrastsiz spiral BT'nin yeri.

PURPOSE: To evaluate the role of unenhanced spiral computed tomography (CT) in the work-up of patients with suspicious symptoms of acute appendicitis. MATERIALS AND METHODS: Sixty-five patients with suspected acute appendicitis (34 (52%) women and 31 (48%) men), were studied with spiral CT without administration of IV or oral contrast. From the upper L1 vertebral plate to the superior border of the iliac wings, slices of 10 mm collimation with 8 mm/sec table speed were taken, and from that level to the acetabular roof level, 5 mm thick slices were obtained with a table speed of 5 mm/sec and tube rotation time of 1.5 sec. The diagnosis of acute appendicitis was made by seeing a dilated appendix vermiformis greater than 6 mm in diameter and/or an appendicolith accompanied by periappendiceal inflammatory changes. The findings were compared with surgical and pathological results. Those patients who were not operated on were followed-up for 3 months. RESULTS: Acute appendicitis was diagnosed in 28 (43%) of the 65 patients. Of the 28 patients with a CT diagnosis of acute appendicitis, 25 (38%) had acute appendicitis proven by surgery and pathology. Twenty-one (32%) patients had a normal CT study and 16 (25%) patients had non-appendiceal pathologies. There were 25 true-positives, 35 true negatives, 3 false positives and 2 false negatives. Non-contrast helical CT had a sensitivity of 93%, specificity of 92%, accuracy of 95%, positive predictive value of 89% and negative predictive value of 95% in the diagnosis of acute appendicitis. CONCLUSION: Non-contrast CT is an accurate, reliable and efficacious method in the diagnosis of acute appendicitis. It also has the advantage of showing other pathologies mimicking the symptoms of acute appendicitis.