Adnan Okur

Detection of myocardial bridging with ECG-gated MDCT and multiplanar reconstruction.

OBJECTIVE The aim of this study was to evaluate the incidence of myocardial bridging in 626 patients examined with MDCT angiography of the coronary arteries. MATERIALS AND METHODS Six hundred twenty-six patients who were referred to Florence Nightingale and Atatürk University Hospitals were involved in this study. These patients had atypical chest pain, symptoms suggestive of coronary artery disease, or no significant cardiac complaint. Patients were in sinus rhythm and were premedicated with metoprolol tartrate (5 mg/mL IV bolus) to decrease the heart rate and nitroglycerin (5 mg sublingual 1 min before the examination) to dilate the coronary arteries. MDCT was performed on two different 16-MDCT scanners. RESULTS Among the 626 patients, 22 cases (3.5%) of myocardial bridging were detected. Fifteen cases of myocardial bridging (2.4%) were located at the middle third of the left anterior descending coronary artery (LAD), five (0.8%) were at the distal third of the LAD, and two (0.3%) were at the proximal third of the LAD. In these patients, the length of tunneled artery was between 6 and 22 mm, with a mean of 17 mm, and the depth of tunneled artery was between 1.2 and 3.3 mm, with a mean of 2.5 mm. CONCLUSION We found the incidence of myocardial bridging in this patient group to be 3.5%. This result is in agreement with some of the angiographic studies in the literature. Our study showed that MDCT is a reliable and noninvasive tool for diagnosing coronary myocardial bridging. After evaluating resource axial images, it is necessary to also evaluate the sagittal multiplanar reconstruction images for myocardial bridging.

Remarkable anatomic anomalies of coronary arteries and their clinical importance: a multidetector computed tomography angiographic study.

Objective: An anomalous origin and course of the coronary arteries can be benign or life threatening. Recently, because of new advances in computed tomography technology, radiologists have begun to interpret the diseases of coronary arteries. We aimed to demonstrate some remarkable anomalies of coronary arteries, some of which were not shown by multidetector computed tomography (MDCT) coronary angiography previously, and to discuss the clinical importance of these anomalies. Materials and Methods: Seven hundred twenty-five consequent patients referred to Florence Nightingale Hospital and Atatürk University Hospital for MDCT coronary angiography were included in this study. The patients were between the ages of 33 and 78 years (mean ± SD, 59 ± 13.86 years). Four hundred ninety-seven patients (68.6%) were men, and 228 (31.4%) were women. All the examinations were evaluated by both a radiologist and a cardiologist. Results: The incidence of anomalous anatomical origin and course of the coronaries found in our study group was 5.79% (n = 42). The anomalies found in our study are absence of the right coronary artery (RCA; n = 1, 0.13%), ectopic origin of RCA from the left anterior descending (LAD) artery (n = 1, 0.13%), absence of the left main coronary artery (n = 4, 0.52%), ectopic origin of the left main coronary artery from the right sinus of Valsalva (n = 1, 0.13%), double LAD and ectopic origin of LAD from RCA (n = 1, 0.13%), ectopic origin of the left circumflex artery from the right sinus of Valsalva (n = 3, 0.39%), ectopic origin of the left circumflex artery from RCA (n = 2, 0.26%), and myocardial bridging (n = 29, 4%). Conclusions: An anomalous origin of the coronary anatomy must be present in the interpretations because of its importance for patients, cardiologists, and surgeons. As a conclusion, our study showed that MDCT, especially volume rendering and maximum intensity projection techniques, may be useful for assessment of complex variations, when the conventional angiography may not be sufficient.

Angulation, Length, and Morphology of the Styloid Process of the Temporal Bone Analyzed by Multidetector Computed Tomography

Purpose: To investigate the angulation, length, and structural variations of the styloid process (SP) by multidetector computed tomography (MDCT). Material and Methods: MDCT scans were performed in 283 cases (127 M and 156 F, age range 18–77 years). The length of the SP and its angulation on the transverse and sagittal planes were measured. Structural variations of the SP were observed by means of three-dimensional (3D) and multiplanar reconstruction (MPR) images. Results: The length of the bony SP on both sides varied from 0 to 62 mm (mean 26.8±10.0 mm). Angulation ranged between 55° and 90.5° (7 2.7±6.6) in the transversal plane and between 76° and 110° (93.5±6.9) in the sagittal plane. Morphologically, the SP showed a considerable amount of variation. A solitary SP was present in 168 individuals (59.4%). In 9 individuals (3.1%), the SP was duplicated (4 unilateral and 5 bilateral). Sixty-one persons (21.6%) showed an incomplete ossified SP (42 unilateral and 19 bilateral), whereas in 7 individuals (2.5%) a bony SP was absent entirely (7 unilateral). In 38 individuals (13.4%), the stylohyoid ligament was ossified (16 entirely, 22 partial). In all individuals, 3D and MPR images showed the SP in its entire length. Conclusion: MDCT with 3D CT and MPR of SP may show further detailed information related to SP. Not only the length of the SP, but also its 3D orientation, should be in focus in anatomical and clinical studies.

Magnetic resonance imaging brain size/IQ relations in Turkish University students.

Abstract The relation of IQ (Cattells Culture Fair Intelligence Test) to brain size was studied in 103 right- and left-handed men and women at Ataturk University in eastern Turkey. Cerebral areas were measured on a midsagittal section of the brain using MRI. An overall correlation of 40 was found between MRI-measured total area and IQ thereby further supporting the IQ–brain size hypothesis. Additional analyses suggested that these results may need qualification. In men, only anterior cerebral area correlated with IQ. In women, total and posterior cerebral areas were correlated with IQ. Other results varied by handedness.

A rare cause of intestinal obstruction in the adult: Morgagni's hernia

Morgagnis hernia is a rare congenital diaphragmatic herniation and is usually diagnosed in childhood. It is quite rare in adults, and intestinal obstruction as a complication due to intrathoracic intestinal herniation rarely occurs. We present the plain radiography and computed tomography findings of an adult patient with acute abdomen symptoms due to Morgagnis hernia.

Anaphylaxis due to a rupture of hydatid cyst: Imaging findings of a 10-year-old boy

Anaphylactic shock as a result of trauma is very rare. We report the clinical and radiologic findings of a 10-year-old boy who developed systemic anaphylaxis due to traumatic rupture of hepatic hydatid cyst into a pericystic blood vessel. In regions where hydatid disease is endemic, rupture of a hydatid cyst might be taken into consideration in patients who have post-traumatic anaphylactic shock. Likewise, this pathology should be kept in mind when evaluating an immigrant from an endemic area in nonendemic regions.

Diagnostic performance of diffusion-weighted MR imaging in detecting acute appendicitis in children: Comparison with conventional MRI and surgical findings

To determine the value of diffusion‐weighted MRI for the diagnosis of acute appendicitis in children.

Spinal widespread intradural extramedullary hydatidosis.

Spinal hydatid cyst is an uncommon but serious condition. Intradural presentation is extremely rare. The case reported herein describes an unusual recurrent hydatidosis with progression of recurrence and spreading into intradural extramedullary field.

An investigation of the association between coronary artery dominance and coronary artery variations with coronary arterial disease by multidetector computed tomographic coronary angiography.

Purpose: Depending on the perfusing interventricular septum of the arteries, there are 3 types of circulation dominance: right, left, and balanced. In this study, coronary artery branches supplying the ventricular septum were investigated in vivo in a large group of patients by multidetector computed tomography (MDCT) coronary angiography. In addition, the association of coronary artery variations with coronary arterial disease was investigated. Materials and Methods: The study included 325 consecutive patients (214 men and 108 women, with a mean age of 59 ± 14 years) who underwent MDCT coronary angiography. Multidetector computed tomography was performed with a 16-detector-row computed tomographic scanner. The type of dominance, coronary arterial diseases, and coronary artery variations were recorded. Results: In our study, the types of coronary circulation were right, left, and balanced in 227 (70%), 40 (12.5%), and 58 (17.5%) patients, respectively. Dominance of right circulation was detected in 150 of 217 (69%) of men and in 77 of 108 (71%) of women; dominance of left circulation was found in 26 of 217(12%) of men and in 14 of 108 (13%) of women; balanced/codominance circulation was found in 41 of 217 (19%) of men and in 17 of 108 (16%) of women. However, no significant differences were detected between the sexes for the type of coronary circulation. Coronary artery disease was determined in 68 patients (20.9%) by MDCT, and coronary artery variations were also determined in 34 patients (10.4%). Both the number and the rate of coronary artery variations were significantly higher among the patients with left artery dominance. Conclusions: Knowledge of coronary artery variations and pathologies is important in planning the treatment and in interpretation of findings of cardiovascular diseases. Our study indicated that, although right dominance circulation is more common in general population, both the coronary diseases and coronary artery variations are more common in individuals with left dominance circulation.

CLINICAL IMPORTANCE OF ASYMMETRYAND HANDEDNESS DIFFERENCES IN COMMON CAROTID ARTERY INTIMA-MEDIA THICKNESS

Earlier publications have reported that common carotid artery intima-media thickness (CCA-IMT) was lower on the right side than on the left side and that left-handed patients have a lower risk of sudden death of brain infarction. This study aimed to determine whether there is an asymmetry and the handedness related difference in CCA-IMT. Ultrasonographic examinations were performed with the use of Aplio US system. In total sample, male and female left-handers, CCA-IMT was greater on left side than on right side. In men, both right and left CCA-IMTs, but in women only right IMT, were lower in the left-handers than in the right-handers. Both right and left CCA-IMTs was positively correlated with age in men and in women. Handedness was a significant factor influencing CCA-IMT with adjustment for sex and age. It was greater on left side than on right side, especially in the left-handers. CCA-IMTs were lower in the left-handers than in the right-handers. These results suggest that hemodynamic stress and intimal damage was larger in the left carotid artery, which was larger in the right-handers compared to the left-handers.