Eda Albayrak

Is evaluation of placenta with real-time sonoelastography during the second trimester of pregnancy an effective method for the assessment of spontaneous preterm birth risk? ☆

PURPOSE The aim of this study is to investigate the effectiveness of placental strain ratio (SR) values measured by real-time sonoelastography (SE) in the second trimester in the prediction of spontaneous preterm birth (sPTB). METHODS This study included 70 pregnant women who applied to our clinic for routine second-trimester screening. Placental SR measurements were performed with the SE method. Two different SR measurements were performed by taking two different tissues as references. The SR value measured when taking the rectus abdominis muscle as a reference was termed the muscle-to-placenta strain ratio (MPSR), while the SR value measured when taking subcutaneous tissue as a reference was termed the fat-to-placenta strain ratio (FPSR). Women whose gestational age at birth was less than 37 weeks 0 days were accepted as sPTB. The association between gestational age at birth and MPSR and FPSR was investigated. Receiver operating characteristics analysis was used to calculate the sensitivity and specificity of the elastographic outcomes. RESULTS There was a low-level negative correlation between MPSR and gestational age at birth (r=-0.300, P=.012) and there was a moderate-level negative correlation between FPSR and gestational age at birth (r=-0.513, P<.001). The multivariate linear regression analysis showed that the FPSR (β=0.609, P=.002) was the significant predictor for the sPTB. CONCLUSIONS Our data indicate that the FPSR value measured with real-time SE in the second trimester of pregnancy may be effective in the prediction of sPTB.

Evaluation of Neonatal Brain Parenchyma Using 2-Dimensional Shear Wave Elastography

The aim of this study was to evaluate the stiffness of the neonatal brain using 2‐dimensional shear wave elastography in term and preterm neonates and to investigate possible stiffness differences between groups.

MRI findings of a postpartum patient with reversible splenial lesion syndrome (RESLES)

A 19-year-old female presented at the twentieth day postpartum with severe headache, nausea and vomiting. She had no history of hypertension. Ambulatory blood pressure measurement values were normal. Proteinuria was not detected. In blood analysis, D-dimer level was normal. In addition, MR venography for sinus vein thrombosis was normal. However, MR imaging of the brain showed a lesion measuring approximately 1.5 cm in diameter in the splenium of the corpus callosum (SCC) (Fig. 1a–c). The lesion was hyperintense on the T2A sequences and showed limitation of diffusion on the diffusion-weighted sequences. Although the patient’s complaints regressed within 1 week, there were no changes in the MRI findings at that time. The lesion was found to be completely healed on the control MRI examination 1 month later (Fig. 2a–c). Acquired lesions of the corpus callosum may be secondary to a wide variety of diseases. These include hydrocephalus, ischemia, disorders of the white matter, tumors and trauma. In recent years, the presence of specific reversible lesions involving the SCC has been associated with many different origins, such as infection, high-altitude cerebral edema, seizures, antiepileptic drugs and metabolic disorders [1]. This type of lesion is termed reversible splenial lesion syndrome (RESLES), which is a clinical radiological syndrome (Fig. 2). RESLES is a clinical condition that has recently been diagnosed with increasing frequency. There are currently no specific clinical diagnostic criteria; however, acute neurological disorders, mental-state changes, headache, nausea and radiological evidence of a splenial lesion support the diagnosis. The pathophysiology of splenial lesions is difficult to understand. Most studies on RESLES cases suggest cytotoxic edema in the SCC. This reversible pattern in the diffusion-weighted sequences is different from the subgroup of persistent ischemia that shows ADC reduction. A similar pattern is observed in hemiplegic migraines and venous sinus thrombosis [2]. A splenial lesion on MRI is the key radiological finding in this condition. On diffusion-weighted images, there is a typical limitation to the SCC. MRI findings are expected to regress spontaneously within a few weeks to months. Clinical conditions such as epilepsy, anticonvulsant withdrawal, acute disseminated encephalomyelitis, and causes of encephalomyelitis such as influenza A, mumps, varicella zoster, adenovirus and E. coli, have been considered as etiologies but could be identified in only a few patients [3]. Important etiological causes of splenial lesions in peripartum cases are sinus vein thrombosis, post-ictal state and preeclampsia–eclampsia. Curtis et al. reported a splenial lesion in a patient with visual symptoms for 6 weeks in the postpartum period [4]. Udaya et al. described a splenial lesion in a patient with postpartum psychosis [5]. Our patient did not have any symptoms other than headache, nausea and vomiting. In conclusion, clinicians should consider RESLES in patients presenting with peripartum headache, even in the absence of visual symptoms or psychosis. & Aysegul Altunkas aaltunkas@hotmail.com

The evaluation of abdominal findings in Crimean-Congo hemorrhagic fever

ObjectiveCrimean-Congo hemorrhagic fever (CCHF) is a widely seen, fatal disease and is endemic to some countries. It affects many organs in the abdomen. Comprehensive radiological study of CCHF is quite rare. This study will use multiple detector computed tomography (MDCT) to investigate if there is a relationship between clinical laboratory measurements and abdominal findings in CCHF and discuss our findings in the light of the literature.Materials and methodsWe retrospectively evaluated the medical records of 443 patients diagnosed with CCHF in our hospital between April 1, 2008 and September 30, 2014. Fifty-one patients had undergone abdominal MDCT examination.ResultsThe most common findings seen in abdominal MDCT were intra-abdominal free fluid and hepatomegaly. Gallbladder wall thickening, heterogeneity in mesenteric, omental fatty tissue, and splenomegaly were other common findings. Subcutaneous fat tissue edema, intramuscular hemorrhage, duodenal wall thickening, colon wall thickening, pancreatitis, and acute renal failure were among the rare findings seen in abdominal MDCT. Comparison of these findings to the clinical laboratory parameters showed a strong relationship between intra-abdominal free fluid and platelet count.ConclusionOur study is the first comprehensive study on abdominal MDCT findings of CCHF. We detected a strong relationship between patients’ platelet count and abdominal free liquid. Therefore, it should be kept in mind that abdominal free fluid can be among clinical manifestations in patients with platelet counts ≤50000 and that this manifestation can become aggravated.

A Comparison of Ultrasonography, Computerised Tomography, and Conventional MRI Findings for Splenic Nodules Associated with Type 1 Gaucher’s Disease with Diffusion-Weighted MRI Findings

A 26-year-old female patient with Type 1 Gauchers disease (GD) was admitted to our clinic with complaints of stomachache and signs of anemia. The patient underwent ultrasonography (US), computerised tomography (CT), and magnetic resonance imaging (MRI) scan. Imaging studies revealed massive hepatosplenomegaly, choledocolithiasis, and six nodules in the spleen with a mean size of 14 mm. The nodules appeared hyperechoic, hypoechoic, and of mixed echogenicity on the US and hypodense on the CT. While the nodules were observed to be iso-hypointense in T1-weighted (T1WI) images, they appeared to be hyperintense in the T2-weighted (T2WI) images. There were no diffusion restrictions in these nodules that appeared on the diffusion-weighted magnetic resonance imaging (DWI). A nodule located at the lower pole was observed to be hypointense in the T2WI images. The nodule located at the lower pole, which appeared hypointense in T2WI series, had restricted diffusion upon DWI. In this study, we aimed to present the properties of splenic GD nodules using US, CT, and conventional MRI, together with DWI. This case report is the first to apply US, CT, and conventional MRI, together with DWI, to the splenic nodules associated with Gauchers disease.

Is hemorrhage the reason in crimean-congo hemorrhagic fever patients with neurological signs and symptomsa

Purpose: Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease can result in mortality varying from 3.0% to 50.0%. In this study, we wished to discuss computed tomography (CT) findings together with clinical and laboratory findings in patients who had disease-related neurological signs. Materials and Methods: The study included patients who were diagnosed with CCHF. Seventeen patients that had neurological signs were enrolled as the patient group. As a control group, 40 patients diagnosed with CCHF and did not have neurological signs were enrolled. Patients who had neurological signs were examined with brain CT. Radiological and clinical findings of both groups were compared. Results: There were pathological findings in three patients while brain CTs of 14 patients were evaluated as normal. Blood urea nitrogen, lactate dehydrogenase, creatine kinase, total bilirubin, neutrophil, activated partial thromboplastin time, and C-reactive protein levels were significantly higher in the group with neurological signs whereas platelet count and calcium levels were significantly lower in this group. Six of 57 patients died during the follow-up period. Six patients who died were in the group, in which central nervous system (CNS) imaging study was performed. Conclusion: As the presence of CNS signs is a bad prognostic indicator in CCHF, they should be investigated carefully.

Sentetik Kannabinoid İntoksikasyonunun Abdominal Bilgisayarlı Tomografi Bulguları: Vaka Sunumu

Bu vaka sunumunun amaci akut sentetik kannabinoid (SK) intoksikasyonu ile acil servise basvuran genc bir hastada, kendi kendini sinirlayan ve geri donusumlu abdominal cok dedektorlu bilgisayarli tomografi (CDBT) bulgularinin literature esliginde sunulmasidir. SK intoksikasyonu, CDBT’de periportal halo isareti, pankreasin diffuz buyumesi, intra ve peripankreatik sivi, uzun segment devam eden ince barsak duvar kalinlasmalari ve barsak anslari arasinda serbest sivi seklinde bulgular sergilemektedir. Kanimiza gore calismamiz, SK intoksikasyonun batin CDBT bulgularini gosteren ilk calisma olma ozelligi tasimaktadir.

ASSESSMENT OF THE RELATIONSHIP BETWEEN INTRAABDOMINAL FAT THICKNESS AND THE AORTOMESENTERIC ANGLE AND DISTANCE USING COMPUTED TOMOGRAPHY

Eda Albayrak, Osman Demir 1 Gaziosmanpasa University, Faculty of Medicine, Department of Radiology Tokat, Turkey 2 Gaziosmanpasa University, Faculty of Medicine, Department of Biostatistics, Tokat, Turkey Corresponding author: Eda Albayrak, Gaziosmanpasa University, Faculty of Medicine, Department of Radiology Tokat, Turkey E-mail: edalbayrak1@hotmail.com Received/Accepted: September 23, 2017 / December 04, 2017 Conflict of interest: There is not a conflict of interest.

Untreated Isolated Torsion of the Epididymis in an Adolescent

Although torsion of epididymis is extremely rare, it should be kept in mind in the differential diagnosis of acute scrotal pain in adolescents. We report here a very rare cause of acute scrotum: torsion of the epididymis.

Can myometrial elasticity, as determined by elastography at 18–22 weeks of gestation, predict preterm delivery?

The aim of this study was to determine whether elastographic evaluation of uterine myometrium can predict preterm delivery.