Ayşe Umul

Carotid and cerebral CT angiography using low volume of iodinated contrast material and low tube voltage

PURPOSE To evaluate image quality of carotid computed tomography angiography (CTA) using a low voltage (80kV) and low amount of iodinated contrast material. MATERIALS-METHODS A total of 101 patients referred for carotid CTA were randomly assigned to receive a specific protocol. In group A patients received intravenous administration of contrast material at a dose of 1mL/kg and CTA examinations were performed at 100kV. In group B, patients received intravenous administration of contrast material at a dose of 0.5mL/kg and CTA examinations were performed at 80kV. The same nonionic iodinated contrast material containing 370mg of iodine per mL was used in both groups. Attenuation values were measured from the center of specific arterial segments using regions of interest. Attenuation values above 300HU were accepted as significant. Institutional review board approval was obtained. RESULTS A total of 50 patients were included in group A (38 men, 12 women; mean age, 63.56 years±13.18 [SD]) and 51 patients in group B (33 men, 18 women; mean age, 59.60 years±16.63 [SD]). A total of 1615 arterial segments (1515 common carotid artery-middle cerebral artery and 101 aortic arches) were analyzed. Venous contamination was not observed in either group. The mean attenuation values of all arterial segments in both groups were greater than 300HU. Mean arterial attenuation value in group B (499.22HU±97.25 [SD]) was significantly greater than in group A (374.36HU±73.79 [SD]) (P<0.01). Hemodynamically significant stenosis (grade III stenosis or >70%) was detected in 2 segments in group A and in 3 segments in group B, while grade IV stenosis (occlusion) was detected in 2 segments in group B. Distal common carotid artery dissection was detected in 1 patient and aortic dissection was detected in 1 patient in group B. Total dose-length product (DLP) value was significantly greater in group A (225.74mGy·cm±21.80 [SD]) than in group B (116.60mGy·cm±21.22 [SD]) (P<0.01). The mean tube current was similar in group A (2013.11mAs±195.92 [SD]) and in group B (2096.64 mAs±309.03 [SD]) (P<0.05). CONCLUSION Carotid and cerebral CTA examinations using 128-section CT can be successfully obtained using an imaging protocol that combines low voltage and 50% reduction in the volume of iodinated contrast material. This provides good image quality with low radiation dose.

Aspergilloma Mimicking Metastasis in a Case with Laryngeal Carcinoma

Introduction: Aspergilloma is a fungal ball which is composed of hyphal structure fungus, fibrin, mucus and cellular debris and settled in a pre-existing pulmonary cavity or an ectatic bronchial. It may cause colonization in patients with an immunosuppressive and underlying lung disease. Although chest radiography provides valuable information, it can be scanned more effectively by computed tomography (CT). Monitoring fungal ball within the cavity in CT provides establishing the diagnosis. Case report: However, in this case report, we presented a case with operated laryngeal carcinoma whom we first had considered to have metastasis and who had received a diagnosis of aspergilloma in CT and Positron emission tomography (PET). Conclusion: Imaging findings may remain limited in definitive diagnosis of aspergilloma. Therefore, surgical resection will allow for both pathological diagnosis and treatment.

Relationship of rotator cuff tendon pathology with obesity, chronic diseases and steroid use -

Öz Purpose: To investigate the possible relationship between rotator cuff tendon pathologies detected with magnetic resonance imaging and obesity and chronic diseases. Materials and Methods: Two hundred and sixty seven patients, who underwent shoulder MRI between 2014 January and October 2014 for pain and limitation of motion in the shoulder, were reviewed retrospectively. Tendon pathology was detected in 153 patients and they were included in the study. Tendon pathologies were examined by two radiologists. Tendon pathologies were divided into 3 groups including tendinosis, partially rupture and full thickness rupture. Body mass index (BMI) values were calculated for all patients. The study group were divided into two groups as BMI <25 and ≥25. In addition, presence of diabetes mellitus and hypertension and possible steroid use was noted . Results: The average age of the patients were found to be 57±13 years. Statistically significant correlation was observed between age and all tendon pathology for all patients. A statistically significant positive correlation was observed between BMI and supraspinatus tendon tears ,wheras there was marginal relationship but no statistically significant correlation between BMI the infraspinatus tendon tears. Conclusion: In our study, statistically significant correlation was observed between the supraspinatus tendon pathology with increasing age and increasing BMI. Aging process can not be changed, however prevention of obesity may provide a positive contribution to the conservation of the rotator cuff tendon pathology. Amaç: Omuz manyetik rezonans görüntülemesinde, rotator cuff tendon patolojisi saptanan olgularda, bu patolojilerin obezite ve kronik hastalıklarla olası ilişkisini araştırmak Gereç ve Yöntem: Ocak 2014 ile Ekim 2014 tarihleri arasında ağrı ve hareket kısıtlılığı nedenleriyle omuz manyetik rezonans görüntüleme yapılmış 267 hastanın görüntüleri retrospektif olarak tarandı. Tendon patolojisi 153 hastada saptandı ve bunlar çalışmaya dahil edildi. Tendon patolojileri iki radyolog tarafından değerlendirildi. Tendon patolojileri; tendinozis, parsiyel yırtık, tam kat rüptür olarak 3 gruba ayrıldı. Tüm hastaların vücut kitle indeks (VKİ) değerleri hesaplandı. VKİ değeri < 25 ve ≥25 olacak şekilde hastalar iki gruba ayrıldı. Ayrıca diabetes mellitus ve hipertansiyon varlığı ile olası steroid kullanımı not edildi. Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 57±13 yıl olarak saptandı. Tüm hastalar içinde, yaş ile tendon patolojileri arasında istatiksel olarak anlamlı korelasyon izlendi. Supraspinatus tendon yırtıkları ile VKİ arasında istatiksel anlamlı pozitif korelasyon izlenirken; infraspinatus tendon yırtıkları ile VKİ arasında istatiksel anlamlı olmayan marjinal bir ilişki saptandı. Sonuç: Çalışmamızda ilerleyen yaş ve artan VKİ değeri ile supraspinatus tendon patolojileri arasında istatiksel anlamlı korelasyon izlendi. Yaşlanma, değiştirilemez bir süreç iken obezitenin önlenmesi rotator kılıf tendon patolojilerinden korunmada olumlu katkılar sağlayabilir.

Unusual case of spinal epidermoid cyst and a concomitant spinal arachnoid cyst

A 38-year-old woman presented with a 12-month history of subjective weakness and pain in her legs. Thoracolumbar MRI revealed two spinal intradural cystic lesions at T5–6 and T11 levels, respectively. The lesion located at the T5–6 level was heterogeneously hyperintense on T2-weighted images and heterogeneously hypointense on T1-weighted images. This lesion showed high signal intensity on diffusion weighted MRI (DWI) and low signal intensity on apparent diffusion coefficient images (ADC). According to the MRI findings, we reported this tumour as a spinal epidermoid cyst. The pathology result suggested that the lesion was an epidermoid cyst. The second intradural lesion, at the T11 level, showed a hypointense signal on T1 and hyperintense signal on T2 images. However, in contrast to the superior lesion, this lesion was hypointense on DWI and hyperintense on ADC. We evaluated the second lesion as an arachnoid cyst according to the MRI findings.

Radiological Findings of Michel Aplasia.

Introduction: Congenital abnormalities of the inner ear is the most common cause of neurosensory hearing loss. Michel inner ear deformity is a rare developmental anomaly refers to the total aplasia of the inner ear. It is caused by developmental arrest of otic placode early during the third week of gestational age. Case report: We have discussed here that three year old girl diagnosed Michel aplasia with temporal bone computed tomography (CT) and temporal magnetic resonance imaging (MRI) findings.