Bahar Yanik

Doppler sonography in renal artery stenosis. An evaluation of intrarenal and extrarenal imaging parameters

A prospective comparison of different direct and indirect Doppler parameters with angiography was performed to determine the most useful Doppler parameters and threshold values for the detection of significant (> or =60%) renal artery stenosis (RAS). The best combination of parameters was found to be the use of direct parameters of peak systolic velocity (PSV) greater than 180 or 200 cm/s and renal aortic ratio (RAR) greater than 3.0 with a sensitivity and specificity at 92% and 88%, respectively.

Continuous-type splenogonadal fusion associated with an ipsilateral testicular atrophy: Sonographic findings

Splenogonadal fusion is a rare congenital anomaly in which the spleen is abnormally connected to the gonad. Two types of splenogonadal fusion have been described: continuous and discontinuous. Splenogonadal fusion is frequently associated with cryptorchidism and/or congenital orofacial/limb anomalies. We describe the ultrasound findings in a case of continuous‐type splenogonadal fusion associated with ipsilateral testicular atrophy with correlation with MRI.

Sinus Pericranii Color Doppler Ultrasonographic Findings

Sinus pericranii is a rare abnormality that may appear as a midline nasofrontal mass. 1,2 This disorder consists of congenital or acquired anomalous connections between an extracranial blood-filled nodule and the intracranial dural sinuses through dilated diploic and emissary veins of the skull. 3 We report a case of sinus pericranii and present the findings on color Doppler ultrasonography (CDUS).

Superficial Dorsal Penile Vein Thrombosis (Mondor Disease of the Penis) Involving the Superficial External Pudendal Vein Color Doppler Sonographic Findings

Mondor disease of the penis is an uncommon condition characterized by thrombosis in the superficial dorsal penile vein (SDPV).Sonographic findings of SDPV thrombosis have been well documented in the literature. However, to our knowledge, the color Doppler sonographic findings of SDPV thrombosis involving the superficial external pudendal vein (SEPV) have not been reported before. We report the color Doppler sonographic findings of a case with SDPV thrombosis extending into the SEPV to its confluence with the long saphenous vein and discuss the importance of interruption in this venous drainage route as an etiologic factor of the disease.

Partial steal phenomenon in the ophthalmic artery due to a direct carotid-cavernous sinus fistula: orbital color Doppler ultrasonographic findings.

Received March 24, 2003, from the Department of Radiology, Social Security Ankara Hospital (B.Y., I.C., H.O., B.H.), and Social Security Eye Hospital (G.A.), Ankara, Turkey. Revision requested April 19, 2003. Revised manuscript accepted for publication May 13, 2003. Address correspondence and reprint requests to Bahar Yanik, MD, Olgunlar Sokak 45/13, TR-06660 Kucukesat, Ankara, Turkey. Abbreviations CCF, carotid–cavernous sinus fistula; CS, cavernous sinus; ECA, external carotid artery; ICA, internal carotid artery; OA, ophthalmic artery; RI, resistive index; SOV, superior ophthalmic vein carotid–cavernous sinus fistula (CCF) is an abnormal communication between the carotid arterial system and cavernous sinus (CS). This condition often results from a head trauma or spontaneous vascular rupture.1 Anatomically, these fistulas can be classified into 3 categories: direct, indirect, and mixed. The direct type is characterized by a fistula between the internal carotid artery (ICA) and the CS and is often a result of trauma. The indirect type, also known as a dural shunt, shows a communicating flow between the meningeal branches of either the ICA or external carotid artery (ECA) and the CS. This type arises spontaneously in elderly patients with systemic hypertension and atherosclerosis and possibly secondary to a previous sinus thrombosis or thrombophlebitis. The mixed type, with contributions from both the ICA and ECA, has also been reported.2 A CCF usually causes orbital signs and symptoms according to the size and location of the lesion. Anterior segment changes include chemosis and engorged episcleral and conjunctival blood vessels and signs of anterior segment ischemia. Posterior segment changes include vascular engorgement or central retinal vein occlusion, which eventually leads to permanent loss of visual acuity. Proptosis is typically pulsatile, associated with a bruit and a thrill.3 Orbital color Doppler imaging has been used in the investigation of various vascular orbital diseases, including CCF. Reversal of flow and pulsatility in the waveform pattern of the superior ophthalmic vein (SOV) have been reported previously.4 Although the relevant literature reveals limited information about a steal phenomenon in ophthalmic arteries (OAs) of patients with dural arteriovenous fistulas, to our knowledge, the partial steal phenomenon in the OA has not been described.5–7 In this report, we describe color Doppler imaging findings and give a physiologic explanation of the partial steal phenomenon in the OA of a patient with a direct CCF.

Sonographic findings in a case of polyneuropathy associated with POEMS syndrome.

Polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes (POEMS) syndrome is a rare multi‐system disease. We describe the ultrasonography (US) and color Doppler ultrasonography (CDUS) findings of peripheral neuropathy in a patient with POEMS syndrome. In US examination, peripheral nerves were found to be diffusely thickned in both upper limbs. CDUS imaging showed arterial blood flow with low systolic peaks on the nerves.

Carotid blowout syndrome with oronasal hemorrhage: magnetic resonance imaging findings.

Carotid blowout syndrome (CBS) is a rare but well-known complication of aggressive radiotherapy management of head and neck cancer. Reports on magnetic resonance imaging (MRI) findings of CBS are limited in the relevant literature, probably because of the angiography priority of this complication. We describe MRI findings in a patient with nasopharyngeal carcinoma complicated with CBS.

Trumpet maneuver in the sonographic diagnosis of an external laryngocele

Laryngocele is an uncommon disease defined as an abnormal dilatation or herniation of the laryngeal saccule, forming an air‐filled cavity. Radiologic evaluation of a suspected laryngocele generally includes plain radiographs, CT, and MRI. There are very few reports in the literature on sonographic findings of laryngocele. Trumpet maneuver has been reported in CT examination for the diagnosis of laryngocele. However, to the best of our knowledge, the use of trumpet maneuver in the sonographic diagnosis of laryngocele has not been previously described. This report presents the sonographic findings of an external laryngocele while performing the trumpet maneuver.

Eggshell Calcification of the Testis Ultrasonographic Findings

alcification of the tunica vaginalis and tunica albuginea testis is a very rare finding. In the literature, only a few cases have been reported in the adult age group. In the pediatric age group, a single-layer calcified rim at the periphery of the testicle was shown in 1 report.1 However, to our knowledge, double-layer peripheral calcification of the testis, possibly due to calcification of the tunica vaginalis and tunica albuginea, has not been described before. Here, the gray scale ultrasonographic and color Doppler ultrasonographic (CDUS) findings of eggshell calcification of the testis in a pediatric patient are presented.