Duygu Herek

Congenital thoracic arterial anomalies in adults: a CT overview.

Congenital thoracic arterial anomalies can be incidentally detected in adults from imaging studies performed for other indications. Multidetector computed tomography plays a critical role in the noninvasive assessment of these anomalies and associated cardiac, mediastinal, or parencyhmal changes by providing volumetric data. Radiologists should be familiar with imaging findings of these anomalies to avoid misinterpretation and to establish accurate diagnosis. In this article, we review the imaging characteristics of congenital aortic, pulmonary, and aortopulmonary anomalies with an emphasis on multidetector computed tomography findings. We illustrate the CT findings of congenital arterial anomalies such as double aortic arch, right aortic arch, aortic coarctation, pseudocoarctation, interrupted aortic arch, interruption (absence) of the pulmonary artery, pulmonary artery sling, pulmonary artery stenosis, transposition of great vessels, truncus arteriosus, aortopulmonary window, and patent ductus arteriosus.

Feasibility of low-dose unenhanced multi-detector CT in patients with suspected acute appendicitis: comparison with sonography

OBJECTIVES To compare unenhanced low-dose computed tomography (LDCT) and ultrasound (US) in patients with suspected acute appendicitis. METHODS A total of 104 patients underwent US and LDCT examinations within an hour. RESULTS Thirty-nine of the 104 patients had surgically confirmed acute appendicitis. Sensitivity, specificity, and accuracy for US vs. LDCT were 82.5% vs. 92.5%, 83% vs. 89%, and 82.7% vs. 90.4%, respectively. The area under the curve (Az) was 0.85 for US and 0.92 for LDCT. The diagnostic performance of LDCT was better than US (P<.001). CONCLUSIONS Unenhanced LDCT is a feasible technique in the diagnosis of acute appendicitis.

CT features of intrathoracic gossypiboma (textiloma).

Here, we present chest radiography and computed tomography (CT) findings for three cases of mediastinal and pleural gossypiboma. Radiological manifestations varied according to the locations and chronicities of the gauze sponges and the types of reactions that they caused. CT analysis readily diagnosed gossypibomas in the early postoperative period by showing well-defined mediastinal- or pleural-based masses with hyperdense rims and central air bubbles. However, one patient presented in the late postoperative period, and a CT scan revealed a well-defined, solid pleural mass that was devoid of air bubbles; a correct diagnosis could not be established and the patient had to be reoperated on. Radiologists should be aware of different manifestations of this rare condition in cases of prior thoracic surgery and persistent respiratory symptoms.Here, we present chest radiography and computed tomography (CT) findings for three cases of mediastinal and pleural gossypiboma. Radiological manifestations varied according to the locations and chronicities of the gauze sponges and the types of reactions that they caused. CT analysis readily diagnosed gossypibomas in the early postoperative period by showing well-defined mediastinal- or pleural-based masses with hyperdense rims and central air bubbles. However, one patient presented in the late postoperative period, and a CT scan revealed a well-defined, solid pleural mass that was devoid of air bubbles; a correct diagnosis could not be established and the patient had to be reoperated on. Radiologists should be aware of different manifestations of this rare condition in cases of prior thoracic surgery and persistent respiratory symptoms.

Renal diffusion-weighted imaging in diabetic nephropathy: correlation with clinical stages of disease.

PURPOSE We aimed to assess the correlation between renal apparent diffusion coefficient (ADC) values measured by diffusion-weighted imaging (DWI) and the clinical stages of diabetic nephropathy. MATERIALS AND METHODS DWI (b value, 0 and 600 s/mm2) was performed in 78 patients with clinically confirmed diabetic nephropathy (study group) and 22 volunteers without diabetes mellitus or any renal disease (control group). The mean ADCs were calculated from multiple region-of-interest circles positioned in the renal cortex. Diabetic nephropathy was clinically categorized into five stages based on the values of urinary albumin excretion and glomerular filtration rate (GFR). RESULTS Mean renal ADC values of patients with stage 3 or 4 disease were significantly lower than those in patients with stage 1 or 2 disease and the control group (P < 0.001). ADC values of patients with stage 5 disease were significantly lower than those in patients with stage 4 (P = 0.003), stage 3 (P = 0.020), stages 2 and 1, and the control group (P < 0.001). Significant correlations were found between mean renal ADC values and clinical stages of diabetic nephropathy (r=-0.751, P < 0.001), between mean renal ADC values and estimated GFR values (r=0.642, P < 0.001), and between mean renal ADC values and urinary albumin excretion (r=-0.419, P < 0.001). CONCLUSION Renal ADC values show a significant correlation with clinical stages of diabetic nephropathy. As a relatively simple and noninvasive tool without contrast media administration, renal quantitative DWI may potentially play a role in making clinical decisions in the follow-up of diabetic patients.

Focal herniation of cerebral parenchyma into transverse sinus.

Journal of Neuroradiology - In Press.Proof corrected by the author Available online since samedi 8 novembre 2014

Relationship of apelin, procalcitonin, and fetuin-A concentrations with carotid intima-media thickness in acromegaly

Background Acromegaly is characterized by excess growth hormone and insulin-like growth factor-1 concentrations. There is conflicting evidence as to whether acromegaly is associated with an increased risk of atherosclerosis. Apelin is an adipose tissue-derived peptide that may be associated with hyperinsulinemia. Fetuin-A is a hepatocyte produced plasma glycoprotein that has an important role as a calcification inhibitor. The aim of this study was to examine apelin, fetuin-A, and procalcitonin concentrations and to assess their relationship with carotid intima medial thickness (cIMT) in subjects with acromegaly. Methods Apelin, fetuin-A, and procalcitonin serum concentrations were measured in 37 (20 inactive and 17 active) subjects with acromegaly and 30 control subjects, along with carotid intima medial thickness. Results The concentrations of apelin, fetuin-A, and procalcitonin were increased in subjects with acromegaly. There were significant correlations between apelin, fetuin-A, and procalcitonin in subjects with acromegaly. Carotid intima medial thickness values were similar between control subjects and subjects with acromegaly. Conclusions Carotid intima medial thickness was not increased in subjects with acromegaly. It is possible that the increased apelin and fetuin-A concentrations observed play a protective role against the development of atherosclerosis in subjects with acromegaly.

CT demonstration of pulmonary embolism due to the rupture of a giant hepatic hydatid disease

Hydatid disease can be seen anywhere in the body and presents with a variety of clinical symptoms and imaging features according to its location. In this article, computed tomography features of a giant hepatic hydatid cyst extending into the right atrium and causing pulmonary embolism are presented.

Acute acalculous cholecystitis due to hepatitis A infection in a child: A rare cause of acute abdomen

The four cases presented are in agreement with other studies where GUDs in HIV-infected patients were found to be recurrent, chronic, aggressive and sometimes associated with systemic symptoms,[2,3] as was seen in case 3. In view of the principal role of high HIV viral load and immunosuppression in the pathogenesis of these manifestations,[4,5] HAART improves the recovery of GUD and prevents its recurrence, as demonstrated in our cases with genital herpes. In developing countries where sophisticated GUD diagnostic facilities are unavailable, the syndromic approach is simple, rapid and effective in the management of GUD, especially in HIV-infected patients who present atypically.[1]

Tracheobronchial Angle Measurements in Children: An Anthropometric Retrospective Study With Multislice Computed Tomography

Objectives The purpose of this study is to investigate if any change exists in the values of tracheal bifurcation angles (subcarinal angle [SCA] and interbronchial angle [IBA]), right and left bronchial angles (RBA and LBA) in different pediatric age groups. Methods Chest computed tomography (CT) images of children aged 18 years and younger were reviewed retrospectively by two radiologists who were blinded to each other’s measurements. One hundred and eighteen children were involved. RBA, LBA, SCA, and IBA were measured on coronal reformatted images. Subjects were classified into three groups according to their age. Measurement of IBA was done by measuring the angle between the lines drawn along the central axis of right and left main bronchi over their length. RBA and LBA were measured at the intersection points of the lines drawn along the inferior borders of the right and left main bronchi and the line passing through the longitudinal axis of trachea. Sums of RBA and LBA gave SCA. Interobserver agreement was also analyzed. Results SCA, IBA, and RBA values were statistically significant between children of ages less than 10 years and over 10 years P<0.01). Interobserver agreement was excellent with an intraclass correlation coefficient score of 0.87 (95% confidence interval) for RBA, SCA, and IBA measurements. Conclusion We concluded that tracheal bifurcation angles are wider in children of age 10 years and younger. As age increases values of SCA, IBA, and RBA decrease.

CT of Hepatic Sarcoidosis: Small Nodular Lesions Simulating Metastatic Disease

Summary Background Sarcoidosis is a multisystemic inflammatory disease of unknown origin. The lymphoid system and the lungs are the most commonly involved organs. The frequency of signs or symptoms of hepatic involvement is very low. Case Report We present a case of symptomatic granulomatous liver disease secondary to sarcoidosis, mimicking a metastatic disease on ultrasonography and CT. Conclusions Hepatic involvement in sarcoidosis might be a perplexing diagnostic problem. The decisive CT finding with respect to the differential diagnosis was the absence of a mass effect and intact vascular architecture around the lesions.