C. Cinar Basekim

Sonographic appearances of the normal ulnar nerve in the cubital tunnel

To investigate the sonographic characteristics of the normal ulnar nerve in the cubital tunnel, as well as any differences related to age, sex, and dominant arm.

MRI findings of intracranial tuberculomas

PURPOSE Tuberculosis involvement of the central nervous system continues to represent a serious problem, particularly in developing countries. The aim of this study was to characterize the magnetic resonance imaging (MRI) findings of intracranial tuberculoma, a form of neurotuberculosis. METHODS We retrospectively reviewed the data of 27 patients with intracranial tuberculomas. These consisted of 17 women and 10 men with a mean age of 26 years (14-51). MRI was performed on all patients. RESULTS A total of 64 tuberculomas were found in these patients, of which 41 were distributed in the cerebral hemispheres, 17 in the cerebellar hemispheres, and 6 in the brainstem. Accompanied meningitis was detected in three patients, hydrocephalus in five patients, and hydrocephalus with meningitis in one patient. CONCLUSION MRI makes a significant contribution to diagnosis of intracranial tuberculomas and can objectively determine accompanying abnormalities.

Untreated growing cranial fractures detected in late stage.

OBJECTIVE Because the great majority of published cases of treated growing cranial fractures (GCFs) involved infants and children, the natural evolution of untreated GCFs is not well known. The question of whether untreated GCFs may cause progressive neurological deficits is controversial. METHODS This retrospective study is of GCFs treated between 1989 and 1997. Nine patients (eight male patients and one female patient; median age, 20.5 yr) with GCFs who underwent surgical intervention during the late stage are presented. The dural and cranial defects were repaired, and additional decompressive surgical procedures (cyst fenestration, n = 6; cyst excision, n = 1; cyst excision with cystoperitoneal shunting, n = 2) were performed for all patients. This is the largest of the published series. RESULTS All of the patients had histories of severe head trauma that occurred during childhood. The average age at the time of the onset of symptoms was approximately 13.1 years, and the interval between head injury and first symptom ranged from 8 to 13 years. All of the patients had lytic lesions in the cranium. Headache was the most common symptom, and of eight patients, seven improved completely and one improved partially. One of four epileptic patients was seizure-free postoperatively. None of the paresis improved, except in one patient. CONCLUSION We conclude that untreated GCFs may cause delayed onset neurological manifestations in addition to cranial growth asymmetry. GCFs, discovered incidentally in adolescence or adulthood without any neurological deficits, should be operated on as soon as feasible to prevent further brain destruction. Cranioplasty with dural repair, in addition to cyst fenestration, should be considered as the essential procedure for the treatment of these lesions.

Multiple rice body formation in the subacromial-subdeltoid bursa and knee joint.

Multiple rice body formation is an uncommon disorder which resembles synovial chondromatosis both radiologically and clinically. The clinical symptoms are usually non-specific. We report on a pathologically proven multiple rice body formation in both the left subacromial-subdeltoid bursa and knee joint in a 4-year-old girl.

Synovial hemangioma of the knee invading the femur.

Synovial hemangiomas of the knee joint are rare. We report on a pathologically proven synovial hemangioma of the knee that invaded the femur.

CT fluoroscopy-guided percutaneous needle biopsies in thoracic mass lesions

OBJECTIVE We aimed to evaluate the usefulness of computed tomographic (CT) fluoroscopy guidance for transthoracic needle biopsies. METHODS AND MATERIAL CT fluoroscopy-guided biopsies were performed in 81 patients with thoracic mass lesions. Interrupted CT fluoroscopy technique was used with 50-130 mA at 120 kV exposure parameters and slice thickness of 10 mm. We used aspirating needle in 41 patients, cutting needle in 28 patients, and both in 12 patients. We obtained adequate biopsy material in 69 patients at first attempt. Mean fluoroscopy time was 15.17 s and maximum procedure time was 18 min. RESULTS Adequate samples for pathological diagnosis were obtained in all lesions. Pathological diagnoses were malignant in 41 patients, benign in 27 patients, and suspiciously malignant in 13 patients. There was no significant difference between diagnostic accuracy of the needles in malignant and benign lesions. Complications were observed in 11 patients (13.5%). DISCUSSION AND CONCLUSION CT fluoroscopy-guided technique provides effective real-time needle biopsy in patients with small tumor size and with tumor located near blood vessels, and in non-compliant patients for diagnosing thoracic lesions.

Radiologic findings in primary pulmonary leiomyosarcoma.

Leiomyosarcomas are uncommon smooth muscle tumors most commonly encountered in the female genital organs, gastrointestinal tract, and soft tissues. They are rarely encountered as primary pulmonary neoplasms. Herein we describe the conventional radiographic and computed tomographic findings in a patient with a pulmonary leiomyosarcoma.

Intrahepatic splenosis: a case report

Abstract. Splenosis is heterotopic autotransplantation and seeding of splenic tissue. In the literature, only a few cases of splenosis involving the liver and the radiologic characteristics of these lesions have been reported. We report a case of intrahepatic splenosis diagnosed by ultrasound, computed tomography, magnetic resonance imaging and scintigraphic features. To our knowledge, our patient is the first case diagnosed only by radiologic and radionuclide examination without any intervention.

Asymmetry of the height of the ethmoid roof in relationship to handedness

The aim of this work was to study the handedness differences in the height of the right and left ethmoid roofs. Hand preference was assessed using the Edinburgh Handedness Inventory. The height of the right and left ethmoid roofs was measured with computerised tomography (CT). The incidence of persons who had a lower ethmoid roof on the right side was significantly greater among right-handers than among left-handers; the incidence of persons who had a lower ethmoid roof on the left side was significantly greater among left-handers than among right-handers; and right and left ethmoid roofs were equal in all ambidextrous subjects. The relationship between the asymmetric ethmoid roofs and handedness may result from the right or left embryonic craniofacial region being smaller in the right- or left-handed subjects. This is particularly important in the light of the high degree of variability in the ethmoid roof, and even between the right and left sides in a given individual. Preoperative awareness of a patients unique sinus anatomy may help prevent iatrogenic injury to the surrounding vital structures during ethmoid sinus surgery (ESS).

Is it possible to differentiate between hydatid and simple cysts in the liver by means of diffusion-weighted magnetic resonance imaging?

OBJECTIVE Our aim was to evaluate the contribution of diffusion-weighted imaging to the differentiation of hydatid cysts (HCs) from the simple cysts and to the identification of the HC subtypes. MATERIALS AND METHODS A total of 37 patients were included in this retrospective study. Fifty of these patients had diagnosed liver cysts (28 HCs and 22 simple cysts) of at least 1 cm in size. All of the cysts were examined with sonography and magnetic resonance imaging, and the HCs were classified according to the World Health Organization criteria. RESULTS Twenty-eight of the total 50 cysts were HCs, and 22 were simple cysts. When the apparent diffusion coefficient (ADC) values of all HCs were compared with the ADC values of the simple cysts, a statistically significant relationship was found (P=.001). The optimal ADC threshold value was established as 2.5 s/mm(2). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rates were 60%, 95%, 94%, 65% and 76%, respectively. CONCLUSION Diffusion-weighted imaging-magnetic resonance imaging is a considerably helpful technique for differentiating between HCs and simple cysts and for differentiating between HC subtypes.