Evaluating nail thickness and stiffness with shear-wave elastography in nail psoriasis: A preliminary study.

INTRODUCTION: Psoriasis is a chronic, relapsing skin disease affecting millions of people worldwide. Nail changes have been reported to occur in up to 40% of patients with mild psoriasis and 50%-70% with severe disease. Shear-wave elastography (SWE) is a new non-invasive ultrasonic technique that evaluates thickness and stiffness of tissues. AIMS: To evaluate nail plate thickness and stiffness of patients with psoriasis and determine whether there are differences among psoriatic patients with and without nail involvement, and to investigate the feasibility of using SWE in assessing this disease. MATERIALS AND METHODS: Nail plate thickness and stiffness were investigated in 54 patients with psoriasis and 58 healthy controls. SWE was performed with an Aplio 500 ultrasound system. RESULTS: Increased nail plate thickness was observed more often in the affected nails of psoriatic patients compared to non-affected nails of patients and controls. Stiffness was similar in both groups. CONCLUSIONS: Our study is the first report to evaluate the SWE scores in nail psoriasis. While it may not provide reliable information for diagnosis, it can be used for follow-up treatment.

Efficacy of Strain Elastography in Diagnosis and Staging of Acute Appendicitis in Pediatric Patients.

BACKGROUND In the present study, the role and efficiency of strain elastography (SE) were evaluated in diagnosis and staging of acute appendicitis in pediatric patients. MATERIAL AND METHODS We enrolled 225 pediatric patients with suspected clinical and laboratory findings of acute appendicitis. Gray-scale sonographic findings were recorded and staging was made by the colorization method of SE imaging. Appendectomy was performed in all patients and the results of the surgical pathology were compared with the imaging findings. The sensitivity, specificity, and accuracy of SE imaging were determined in terms of evaluating the "acute appendicitis". RESULTS Sonographic evaluation revealed acute appendicitis in 100 patients. Regarding the SE analysis, cases with appendicitis were classified into 3 groups as: mild (n=17), moderate (n=39), and severe (n=44). The pathological evaluation revealed 95 different stages of appendicitis and normal appendix in 5 cases: acute focal (n=10), acute suppurative (n=46), phlegmonous (n=27), and perforated (n=12), regarding the results of surgical pathology. Five patients with pathologically proven "normal" appendix were noted as "mild stage appendicitis" based on gray scale and SE analysis. In total, when gray-scale and SE results were compared with pathology results regardless of the stage of appendicitis, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates were 96%, 96%, 95%, 96.8%, and 96%, respectively. No statistically significant difference was detected between other groups (P<0.05). CONCLUSIONS In acute appendicitis, the use of SE imaging as a supportive method for the clinical approach can be useful in diagnosis, and its results are closely correlated with the histopathologic stage of appendix inflammation.

Color Doppler ultrasound characteristics after subinguinal microscopic varicocelectomy.

AIM: The present study evaluated the effect of differences in the peak systolic velocity (PSV) and resistive index (RI) in the testicular artery (TA), capsular artery (CA), and intratesticular artery (ITA) after microscopic subinguinal varicocelectomy (MSV) on postoperative pain and semen parameters. PATIENTS AND METHODS: Scrotal color Doppler ultrasound (CDUS) measurements were made in 33 patients (age 18-31 years) prior to MSV and 3 and 6 months after MSV. Pain was recorded using a visual analog scale and sperm concentration was determined to analyze the predictive value of the CDUS parameters regarding surgical outcome. RESULTS: A significant decrease in pain scores was observed in most patients at both follow-ups. The first postoperative CDUS revealed a significant increase in the TA-PSV (p<0.001) and a decrease in the TA-RI (p=0.002) and CARI (p=0.006). The second postoperative CDUS also revealed a significant increase in the TA-PSV and a decrease in the TA-RI, and the PSV in the ITA and CA and RI in the ITA and CA were significantly different from the values obtained pre-operatively and at the first follow-up. A negative correlation was found between the pain level and TA-PSV (r=-0.433, p=0.012), whereas sperm concentration positively correlated with both the TA-PSV and CA-PSV (r=0.534, p=0.001 and r=0.455, p=0.008, respectively). CONCLUSIONS: The PSV and RI are useful parameters for detecting changes in testicular microhemodynamics after MSV. In addition, the TA-PSV and CA-PSV can be used to predict improvements in pain and sperm concentration.

Role of dual-source dual-energy computed tomography versus X-ray crystallography in prediction of the stone composition: a retrospective non-randomized pilot study.

PURPOSE: We aimed to evaluate the accuracy of determining stone composition with dual-source (DS) dual-energy (DE) computed tomography (CT). METHODS: A total of 142 patients, diagnosed with urolithiasis and had complete medical records, were included in the study. The number, dimensions, location and CT density of the stones, and dose-length products and effective radiation dose were recorded for every patient. Stone compositions determined with DECT by two radiologists separately were compared with crystallography method. RESULTS: Among 138 stones with a crystallographic result out of 187 stones evaluated, 58 calcium oxalate, 42 hydroxyapatite, 24 uric acid and 10 cystine stones were detected. DECT showed a sensitivity and negative predictive value of 68.67 and 67.5 % for calcium oxalate. Moreover, DECT was found to be very useful in predicting hydroxyapatite and cystine stones with a 100 % sensitivity and negative predictive value. Cohen kappa correlation test showed a substantial agreement (κ = 0.682) between crystallographic analysis and prediction with DECT-analysis, which was statistically significant (p < 0.001). CONCLUSION: In this retrospective study, an unenhanced DECT was found to be accurate for in vivo determination of stone type, and thus it can be used easily without any extra burden to the patient or cost while providing additional information.

Synovial hemangioma in the knee: MRI findings.

Synovial hemangiomas are rare benign tumors of vascular origin. A 23-year-old boy presented with knee pain and swelling. The boy had developed symptoms 18-months earlier. He was diagnosed with synovial hemangioma based on magnetic resonnance imaging examination and histopathologic findings of the arthroscopic biopsy tissue. We present the magnetic resonance imaging and histopathologic findings of synovial hemangioma of the knee.