Cytogenetic analysis of peripheral blood lymphocytes of hospital staff occupationally exposed to low doses of ionizing radiation.

Ionizing radiation is known to induce mutations and cell transformations, predominantly by causing single-strand and double-strand DNA breakage, thereby leading to chromosome instability and carcinogenesis. The aim of this study was to evaluate genotoxic effects in hospital staff exposed to low-dose ionizing radiation in comparison with a selected control group, by using the cytokinesis-blocked micronucleus (CBMN) and sister chromatid exchange (SCE) tests in peripheral blood lymphocytes. The study included 40 exposed radiology staff and 30 control subjects. The frequency of micronuclei (MN) was significantly increased in radiation-exposed groups compared with control persons (p < 0.05). The frequency of SCE did not show any significant difference in the exposed individuals in comparison to the controls. Our results showed that low-level chronic occupational exposure to ionizing radiation causes an increase of MN frequency in chromosomes, even though the absorbed doses were below the permissible limits. Our studies indicate that the CBMN assay is considered to be sensitive test in contrast to SCE analysis to evaluate chromosomal damage induced by ionizing radiation.

[Diagnosis of venous thromboembolism by single-detector row and multi-detector row CT angiography]. / Venöz tromboembolizm tanisinda tek detektör sirali ve çok detektör sirali BT anjiyografi.

Aim of this study is to determine the diagnostic value of pulmonary angiography performed by either single-detector row CT (SDCT) or multi-detector row CT (MDCT) in patients suspected of venous thromboembolism (VTE). SDCT was performed on 36 and MDCT on 18 of total of 54 patients on whom V/Q scintigraphy was obtained with a suspicion of VTE. Sixteen out of 54 cases got additional pulmonary DSA. Statistical analyses were based on final clinical diagnoses of the individual cases. Twenty-six out of 54 cases in the study got the final diagnoses of VTE and VTE was certainly excluded in the remaining 28. Sixteen out of true 26 VTE cases were in the SDCT group while the other 10 cases took place in the MDCT group, none of which was missed by either technique. There was one false positive result in the SDCT group and none in the MDCT group (96% and 100% specificity respectively, 100% sensitivity for both). Only 9% of all pulmonary emboli detected by SDCT assisted pulmonary angiography were located in subsegmental arterial branches, whereas 24% of emboli detected by MDCT angiography were subsegmental. Both SDCT and MDCT angiography are reliable tests in the detection of VTE. MDCT assisted pulmonary angiography is superior than SDCT assisted pulmonary angiography in subsegmental VTE detection.

Assessment of diagnostic accuracy of perfusion MR imaging in primary and metastatic solitary malignant brain tumors.

PURPOSE: The purpose of this study was to estimate the diagnostic accuracy of relative cerebral blood volume (rCBV) measurement in preoperative grading and differentiation of solitary intra-axial malignant brain tumors. METHODS: Thirty-six low-grade glial tumors (LGGTs), 22 high-grade glial tumors (HGGTs), and 17 metastases (METs) were prospectively evaluated by MR imaging and standard dynamic susceptibility contrast-enhanced gradient echo, echoplanar imaging during first pass of a bolus injection of contrast material. Normalized rCBV values from tumoral (rCBV(T)) and peritumoral (rCBV(P)) areas were calculated by standard software and statistically tested independently. RESULTS: The mean differences of rCBV(T) and rCBV(P) values between LGGT (2.30 +/- 1.12 and 1.18 +/- 0.24) and HGGT (5.42 +/- 1.52 and 2.17 +/- 0.82) (P < .001); HGGTs and METs (3.21 +/- 0.98 and 0.97 +/- 0.09) (P < .001); and LGGTs and METs (P < .05 and P < .001, respectively) were significant. No clear cutoff value was present. A clear rCBV(T) cutoff value of 2.6 was detected for differentiation of low- (1.75 +/- 0.38; LGA) versus high-grade (4.78 +/- 0.99; HGA) astrocytomas when nonastrocytic glial tumors were excluded. The rCBV(T) values were linearly correlated with degree of malignancy (r = 0.869; P < .001). Cutoff rCBV(P) values of 1.1 and 1.2 were quite effective in differentiation of METs from LGGTs and HGGTs, respectively. The overall efficacy of rCBV was higher in grading than in differentiation. CONCLUSION: The diagnostic accuracy of rCBV measurement is higher in grading of glial brain tumors than in differentiation of HGGTs from solitary intra-axial METs. The astrocytic and nonastrocytic glial tumors have to be evaluated separately for precise grading.

MR cholangiopancreatography of a case with a biliary tract variation and postoperative biliary duct injury.

Because of the increasing frequency of surgical procedures such as hepatic resection, partial liver transplantation, and laparoscopic cholecystectomy, the number of patients requiring biliary imaging has increased. In this report, magnetic resonance cholangiopancreatography findings of a case with an aberrant right posterior hepatic duct draining directly into the gallbladder, which was overlooked prior to laparoscopic cholecystectomy, is presented and the importance of magnetic resonance cholangiopancreatography in the evaluation of congenital biliary anomalies and iatrogenic bile duct injury is discussed.

Testicular microlithiasis in pediatric age group: ultrasonography findings and literature review.

PURPOSE: To evaluate the occurrence of testicular microlithiasis in pediatric age group by means of ultrasonography (US) examinations and to review the literature for pediatric testicular microlithiasis cases accompanied by testicular and extratesticular tumors. MATERIALS AND METHODS: Nine children aged 3-16 years (mean age, 9.2 years) with testicular microlithiasis had been evaluated with US in a period ranging from 6 months to 6 years. In addition to the testicular ultrasonographic evaluation, liver US and abdominopelvic US were performed in all patients. RESULTS: Typical testicular microlithiasis findings were seen in a total of 17 testicles. In one patient, testis did not exist in either the scrotum or the inguinal canal or the abdomen unilaterally. None of the patients displayed a focal lesion during the evaluation. The abdominal ultrasonographic findings were normal in all patients. CONCLUSION: Although no tumoral lesion accompanying testicular microlithiasis or occurring in the course of evaluation was detected in this study, larger population and longer control periods are required, considering the co-existence of benign and malign lesions with testicular microlithiasis in the literature.

MR urography in pediatric uropathies with dilated urinary tracts.

PURPOSE: To determine the diagnostic value of magnetic resonance (MR) urography in children with urinary tract dilatation. MATERIALS AND METHODS: Twenty-five children between the ages of 4 months and 13 years (19 males and 6 females, mean age 6.5 years) were evaluated with T2 weighted and contrast-enhanced T1 weighted MR sequences. Results were compared with findings obtained with ultrasonography (n=25), intravenous urography (n=18), Tc99m- DTPA scintigraphy (n=16), and/or micturating cystouretrography (n=13). RESULTS: MR urography provided a superior imaging of urinary system dilatation, the site and the etiology of obstruction, and both regular and complicated kidney duplication than did conventional imaging methods. MR urography that used T2 weighted sequences was able to demonstrate 29 of 32 (90.6%) abnormal renal collecting systems. Fourteen of 21 (66.7%) normal systems were revealed by heavily T2 weighted images. Forty-six of 51 (90.2%) renal collecting systems could be shown by T1 weighted sequences. With this sequence, however, five collecting systems (9.8%) could not be shown secondary to poor renal function and/or dilution of contrast agent within the dilated urinary tract. CONCLUSION: In children, MR urography may replace conventional uroradiological methods.

Transrectal ultrasound-guided transperineal and transrectal management of seminal vesicle abscesses.

OBJECTIVE: The treatment of seminal vesicle abscesses (SVA) by transrectal ultrasound-guided transrectal and transperineal approaches were evaluated in this study. MATERIALS AND METHODS: Six SVA cases were diagnosed among 2350 patients admitted to our ultrasound unit with prostate and seminal vesicle symptoms during the last 6 years. Four out of six cases had bilateral, and two had unilateral SVA. Transperineal puncture and aspiration was done in four patients with bilateral abscesses and transrectal approach was preferred in two patients with unilateral abscesses. RESULTS: For both approaches, the aspiration was successfully done without any complication. The mean durations of intervention were 64 and 13 min, and the durations of hospitalization were 2 and 3 days for the transperineal and transrectal approaches, respectively. CONCLUSION: Transrectal ultrasound examination allows simultaneous evaluation of the gland and the guidance for a needle puncture and aspiration. Furthermore, rapid pain relief, regression of other symptoms, minimally invasive technique and shorter hospitalization seem to be important features as compared with conservative and surgical treatment modalities.

Computed tomography-guided percutaneous drainage of splenic abscesses.

OBJECTIVE: The aim of the study is to evaluate the role of computed tomography (CT)-guided percutaneous drainage in the management of solitary splenic abscesses. MATERIALS AND METHODS: Sonography and CT were used in the initial diagnosis of splenic abscess in patients with vague left upper quadrant pain and/or fever. Solitary splenic abscesses of nine male patients whose ages varied between 21 and 27 years (mean age: 24.7 years) were percutaneously drained under CT guidance. Puncture with 18-gauge Chiba needles and coaxial guidewire technique was used for insertion of six or eight French pigtail catheters. Antibiotics in accordance with the microbiological results were also given adjuvant to drainage. Follow-up examinations were performed by sonography, daily for the first week and weekly for the next 7 weeks, and by CT at the end of first, fourth and eighth weeks. RESULTS: All patients tolerated the intervention well, except for one complicating with splenic rupture and hemorrhage, who underwent emergency splenectomy. The remaining eight patients recovered within 4 weeks without any splenic sequela. A mean of 3.9 days was needed before removing the drainage catheter based on regression criteria. DISCUSSION AND CONCLUSION: CT-guided percutaneous drainage of splenic abscesses may be proven effective and is superior to splenectomy in selected cases, as it preserves host immunity.

Multiloculated prostate abscess: treatment with transrectal ultrasound guided transrectal needle aspiration and lavage with the saline and antibiotic.

Prostatic abscess is a rare but nevertheless serious disease. It should be diagnosed at an early stage by the combination of clinical examination and transrectal ultrasound, and drained. We treated a 79-year-old case with multiple prostate abscesses (PAs) by using lavage of the saline and antibiotic (cefoxitin) after transrectal ultrasound-guided transrectal puncture and aspiration. We are presenting the transrectal ultrasound images of pre- and postmedication, where we achieved complete success and no relapse was seen in follow-up of 1 year.

Induced antioxidant activity in hospital staff occupationally exposed to ionizing radiation.

PURPOSE: Occupational exposure to low levels of ionizing radiation (IR) in radiology department staff may affect their antioxidant status. The aim of this study was to evaluate the oxidative stress parameters in radiology staff that are occupationally exposed to IR in a hospital setting. MATERIALS AND METHODS: The study population included 40 exposed radiology staff and 30 control subjects. The radiation doses of exposed staff ranged between 0.10 and 3.8 milligray (mGy) per month. The subjects' antioxidant status was determined by measuring the activities of copper zinc-superoxide dismutase (CuZn-SOD), selenium dependent glutathione peroxidase (Se-GPx), catalase (CAT) enzymes, and the levels of malondialdehyde (MDA) in erythrocytes. RESULTS: Our results showed that the activities of erythrocyte CuZn-SOD and Se-GPx enzymes observed for the radiation exposed group were significantly higher than in the controls. The activity of CAT enzyme and MDA levels were significantly lower in the exposed group than in the controls. Moreover, we investigated the influence of confounding factors on antioxidant enzymes or lipid peroxidation (LP), but we could not find any associations between them. CONCLUSIONS: Our study indicates the presence of stimulant effect of chronic low-dose radiation in exposed individuals, resulting in enhanced resistance to oxidative stress.

Bronchopulmonary foregut malformations presenting as mass lesions in children: spectrum of imaging findings.

Bronchopulmonary foregut malformations are a heterogeneous but interrelated group of abnormalities that may contain more than one histologic feature. Familiarity with the presentation and imaging features of bronchopulmonary foregut malformations presenting as a congenital mass or mass-like lesion is important. Moreover, imaging plays a central role in the evaluation of these lesions since, when symptomatic, clinical features are usually nonspecific. With imaging, the presence of and features of the lesion can be determined, facilitating appropriate management to prevent the potential complications including infection, respiratory compromise and, very rarely, malignancy.

CT and MRI in the evaluation of craniospinal involvement with polyostotic fibrous dysplasia in McCune-Albright syndrome.

In this study, the efficacy of computed tomography (CT) and magnetic resonance imaging (MRI) in the evaluation of craniospinal involvement with polyostotic fibrous dysplasia (PFD) in McCune-Albright syndrome (MAS) and related complications were reviewed. In CT, ground-glass appearance with well-defined borders was seen, with medullary widening and cortical thinning. More rarely, cystic/necrotic areas were observed within involved bone. These lesions were seen as hypointense in T1-weighted sequences and as hyperintense in T2-weighted sequences of MRI. There was no heterogeneous contrast enhancement. Cystic/necrotic areas were seen as hyperintense images on T2-weighted sequences. While bone marrow involvement was shown more clearly with MRI, compression of cranial and spinal nerves was determined most effectively by evaluation of CT and MRI together. CT and MRI should be employed together in order to demonstrate the extent of disease, and complications of craniospinal involvement of PFD in patients with MAS.

Impact of catheter arteriography on the serum level of asymmetric dimethylarginine, an endogenous inhibitor of nitric oxide synthase.

The purpose of this study was to investigate the instantaneous impact of catheter arteriography on blood asymmetric dimethylarginine (ADMA) levels in accordance with patient- and procedure-related variables. Sixty-eight patients (16 women, 52 men; mean age, 45.6 +/- 20.1 years; range, 20-79 years) referred for cerebral or peripheral catheter arteriography were recruited for the study. Pre- and postarteriography arterial blood ADMA levels were determined by high-performance liquid chromatographic technique. Type of nonionic iodinated contrast media used, duration of procedure, patient gender, and patient age were noted and evaluated as possible factors that could influence serum ADMA levels in arteriography procedures. Prearteriography ADMA levels decreased significantly after arteriography in general (pre, 1.16 +/- 0.96 micromol/L; post, 1.08 +/- 0.80 micromol/L; p = 0.002). Males tended to have lower postarteriography serum ADMA levels (p = 0.005). Serum ADMA levels tended to get lower after peripheral arteriography procedures (p = 0.005) and when iohexol, 350 mg I/ml, was used as the contrast agent (p = 0.017). In conclusion, ADMA level does not seem to be subject to acute elevation after catheter arteriography; on the contrary, its level may decrease in general. Moreover, a reduction in serum ADMA level may be expected, especially in male patients, in patients who undergo a peripheral arteriography procedure, or when iohexol, 350 mg I/ml, is used as the contrast agent.

Median arcuate ligament syndrome: multidetector computed tomography findings.

OBJECTIVE: We aimed to describe the clinical and multidetector computed tomography (MDCT) angiography findings of celiac, mesenteric, and renal artery entrapment by the median arcuate ligament. MATERIALS AND METHODS: Patients (n = 453) who underwent MDCT abdominal aorta angiography in a period of 3 years were retrospectively reviewed for vascular compression by median arcuate ligament known as median arcuate ligament syndrome. The MDCT examinations were performed with 16-slice (n = 292) and 64-slice scanners (n = 161). The median arcuate ligament itself and adjacent vascular branches of abdominal aorta were assessed for compression by 2 different radiologists who are experienced on MDCT angiography more than 3 years. Both axial, multiplanar reformatted images and 3-dimensional angiographies were used for interpretation. RESULTS: Twelve patients were found to have clinically significant vessel entrapments by median arcuate ligament; 6 of them with celiac artery, 4 of them with renal artery, and 2 of them with both celiac and mesenteric artery involvement. Patients with celiac and mesenteric vessel entrapments presented with epigastric pain. All patients with renal artery entrapment had resistant hypertension. The MDCT showed the proximal narrowing caused by compression of median arcuate ligament. The proximal portions of renal arteries pulled down and in toward the aorta, with mild to moderate narrowing. CONCLUSIONS: The MDCT exanimation with multiplanar images and 3-dimensional angiography is a noninvasive imaging technique that can be used with high accuracy in the diagnosis of median arcuate ligament syndrome.

Accessory cardiac bronchus and tracheal bronchus anomalies: CT-bronchoscopy and CT-bronchography findings.

Most common developmental anomalies of bronchial tree include accessory cardiac bronchus (ACB) and tracheal bronchus (TB). Minor bronchial anomalies include variants of TB, displaced segmental bronchi, and bronchial agenesis. We present CT-bronchoscopy and CT-bronchography findings of three cases with either ACB or TB. Recognition of these anomalies is important, as associated clinical complications, including recurrent episodes of infection, hemoptysis, and perhaps malignancies may be anticipated in a small percentage of patients.

Intravenous contrast-enhanced dynamic MR urography: diagnosis of vesicoureteral reflux during bladder filling with time-signal intensity curves.

PURPOSE: To evaluate the time-signal intensity (SI) curves generated from intravenous (IV) gadodiamide-enhanced dynamic magnetic resonance (MR) urographic scans for identifying vesicoureteral reflux (VUR) during bladder filling. MATERIALS AND METHODS: MR urographic studies of children were retrospectively reviewed, and 52 ureterorenal units of 26 patients (15 females and 11 males, mean age = 5.5 years) who had also undergone voiding cystourethrographic (VCUG) examination were included in this study. The patients were examined on a 1.5T scanner. For functional MR urography and to generate time-SI curves, we used a post IV contrast-enhanced two-dimensional (2D) fast field echo (FFE) sequence (TR = 17 msec, TE = 3.2 msec, flip angle (FA) = 90 degrees ) in the coronal plane. MR urographic time-SI curves that demonstrated a prompt and concave fall of the initial third phase followed by intermittent or constantly increasing SI peaks above the baseline from which the second phase starts were considered to have VUR. We compared the differences in time-SI curves between the control group and patients with VUR during bladder filling. RESULTS: Twelve ureterorenal units of eight patients (four bilateral and four unilateral) had VUR during bladder filling on VCUG. The time-SI curves of these patients showed intermittent (N = 8 ureterorenal units), and constantly increasing (N = 4 ureterorenal units) SI peaks consistent with VUR. One patient also had bilateral abnormal time-SI curves suggesting VUR despite the normal VCUG study. In the control group, 25 units had normal triphase time-SI curves, six renal units had urinary dilatation with good washout after diuretic injection, and four renal units had upper urinary dilatation without contrast washout, while five renal units did not show any function. None of the patients in the control group revealed distortion in the time-SI curve. The differences in time-SI curves patterns between the control group and patients with VUR during bladder filling were statistically significant (P < 0.001). CONCLUSION: After a prompt and concave decrease of the initial third phase of the time-SI curve, intermittent spikes or a constant rise in SI above the baseline suggest the existence of VUR.

MRI findings of renal lymphangiectasia.

We present the case of a 20-year-old male with renal lymphangiectasia who presented with hypertension and hematuria. We discuss the role of magnetic resonance imaging (MRI) with gadolinium-enhanced MR urography in confirming the diagnosis, extensions of this rare benign entity, and associated conditions.

Obstructive uropathy caused by testicular vein compression: multidetector-row computed tomography findings.

Although the right testicular vein and ureter follow a close course at the level of the third lumbar vertebra, it is unusual for the right testicular vein to be a cause of ureteral obstruction. Previously, conventional computed tomography (CT) has been used for establishing this anatomic relation. A case of hydronephrosis in a man secondary to right testicular vein compression diagnosed with multidetector-row CT findings is described.

Giant seminal vesicle stones. Report of two cases.

Seminal vesicle stones are rare conditions and only a few cases have been reported in the literature. Here we present 2 cases with single and multiple seminal vesicle calculi.

Imaging findings in idiopathic granulomatous mastitis. A review with emphasis on magnetic resonance imaging.

OBJECTIVE: To describe magnetic resonance (MR) imaging features of patients with a histologic diagnosis of idiopathic granulomatous mastitis (IGM). METHODS: Dynamic contrast-enhanced MR imaging was performed with a 1.5-T MR unit. Postprocessing of images included subtraction and calculation of time-intensity curves of the enhancing regions at several points in all patients. RESULTS: In addition to granulomatous inflammation, biopsy slides of 5 patients demonstrated abscess formation without a specific organism (aseptic abscess). One patient had a fibrotic tissue component. Magnetic resonance imaging findings were heterogeneously enhancing areas with (n = 5) and without (n = 1) multiple ring-like enhanced abscesses and a circumscribed lesion with heterogeneous contrast enhancement (n = 1). Time-intensity curves showed a benign pattern in all but 1 patient. CONCLUSION: Idiopathic granulomatous mastitis has a number of appearances on MR imaging. Magnetic resonance imaging with measurement of time-signal intensity curves may support the findings of ultrasonography and mammography in distinguishing benign inflammatory breast disorders from malignant ones; however, biopsy still remains the only method of definite diagnosis.