Furkan Ufuk

Diffusion-weighted MRI of pulmonary lesions: Comparison of apparent diffusion coefficient and lesion-to-spinal cord signal intensity ratio in lesion characterization: DWI of Pulmonary Lesions

To evaluate the diagnostic performance of minimum apparent diffusion coefficient (ADCmin) and lesion‐to‐spinal cord signal intensity ratio (LSR) in the differentiation of benign and malignant pulmonary lesions.

CT evaluation of medial clavicular epiphysis as a method of bone age determination in adolescents and young adults

PURPOSE We aimed to investigate the use of computed tomography (CT) staging of the medial clavicular epiphysis ossification in forensic bone age determination, and find a CT criterion to determine whether an individual is adult or not. METHODS Chest CT and pulmonary CT angiography exams of 354 patients between 10 and 30 years of age (mean, 21.4 years) were retrospectively evaluated for epiphyseal ossification phase of the bilateral medial clavicles (708 clavicles) and compared with the sex and chronologic age of the individuals. The ossification phase of the medial clavicular epiphyses was classified from stage I to stage V using a modified staging system. RESULTS Epiphyseal ossification center appeared from 11 to 21 years of age. Partial fusion occurred between 16 and 23 years of age. Complete fusion was first achieved at the ages of 18 and 19 years for male and female individuals, respectively. The probability of an individual being ≥18 years old was 70.8% in stage III A and 100% in stages III B, IV, and V in females and males. CONCLUSION CT evaluation of the medial clavicular epiphysis is helpful in forensic age determination and stage III B can be used as a criterion to make the prediction that an individual is older than 18 years.

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.

Role of Strain Elastography in the Evaluation of Testicular Torsion An Experimental Study

To evaluate the utility of real‐time strain elastography in experimentally induced testicular torsion at different degrees and torsion hours.

Inflammatory Myofibroblastic Tumor of the Lung: Unusual Imaging Findings of Three Cases

Summary Background Inflammatory myofibroblastic tumor (IMT), also known as inflammatory pseudotumor, is a benign disorder composed of fibrous tissues, myofibroblasts and inflammatory cell proliferation with obscure etiology. Although it is the most common lung tumor in children, it is seen rarely in adults constituting less than 1% of adult lung tumors. Case Reports In this report, we present different and rare CT manifestations of three adult patients with lung IMT. Conclusions In conclusion, IMT is a rare lung tumor in adults and may simulate malignancy. It should be considered in the differential diagnosis when a large mass with lobulated contour or harboring coarse calcification is observed.

Pylephlebitis Complicating Acute Appendicitis: Prompt Diagnosis with Contrast-Enhanced Computed Tomography.

BACKGROUND Pylephlebitis, a rare complication of abdominal infections, is a septic thrombophlebitis of the portal venous system with high rates of morbidity and mortality. CASE REPORT We present a case of pylephlebitis complicating acute appendicitis and report the utility of a computed tomography scan in the diagnosis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The prompt diagnosis and appropriate treatment of pylephlebitis are crucial to reduce morbidity and mortality, but clinical presentation is often nonspecific. A computed tomography scan is instrumental in the early diagnosis of pylephlebitis because it readily reveals the thrombus in the mesenteric or portal vein in the setting of acute appendicitis. Early and aggressive treatment with broad-spectrum antibiotics is necessary, and anticoagulation therapy can also be used to prevent bowel ischemia.

Life‐threatening spontaneous kidney rupture in a rare case with systemic lupus erythematosus: Prompt diagnosis with computed tomography

Nontraumatic, spontaneous parenchymal kidney rupture is a rare clinical entity that may cause extensive hemorrhage, hypovolemic shock, and death. Spontaneous nontraumatic kidney rupture is extremely rare in systemic lupus erythematosus (SLE) patients. Because of the high morbidity and mortality rates, an immediate establishment of the diagnosis and treatment are necessary. We present the case of a 30‐year‐old female with spontaneous parenchymal rupture of the right kidney who had renal failure due to SLE and presented with atraumatic sudden right flank pain during hemodialysis treatment. To our knowledge, this case is the second report of SLE manifesting as spontaneous kidney rupture in the literature.

Diffusion-Weighted Imaging and Color Doppler Ultrasound in Evaluation of Partial Testicular Torsion in Rat Model

Summary Background To evaluate the utility of histogram analysis of apparent diffusion coefficient (ADC) in the diagnosis of incomplete testicular torsion. Material/Methods Fourteen Wistar albino rats were randomly allocated into two groups. In group 1 (control), left testicles were kept outside for 45 seconds and then replaced, whereas left testicles were twisted by 360° in group 2. Four hours later, DWI was performed. After that, magnetic resonance imaging (MRI) and testicular color Doppler ultrasound (CDU) were performed by two radiologists who looked for the presence or absence of blood flow. ADC measurements were carried out by two radiologists who were blinded to each other’s measurements. After CDU, testes were surgically removed and a pathological examination was performed after four hours of torsion. Comparisons of minimum, mean, and maximum ADC values in testicles were performed with the Wilcoxon test. P value of 0.05 or less was considered as statistically significant. Inter-observer agreement was also analyzed. Results In the torsion group, minimum ADC values for left testicles were significantly lower than for the control group (p<0.05), regardless of the observer. Inter-observer agreement for measurements of ADCmin and ADCmax values was substantial, with an ICC score of 0.751 and 0.774, respectively (95% CI). Inter-observer agreement for the measurement of ADCmean value was excellent, with an ICC score of 0.844 (95% CI). The pathological examination revealed mild interstitial edema and closely packed seminiferous tubules in the left testes, indicating reversible damage in the torsion group. Conclusions On the pathological examination, all left testes in the torsion group were recoverable after four hours of torsion. Minimum ADC values can be used as an auxiliary method in the diagnosis of partial testicular torsion. Comparing minimum ADC values between the affected and non-affected testicles can be a useful tool in the early diagnosis of incomplete testicular torsion.

Perirenal Involvement of Mantle Cell Lymphoma: Imaging Features

Perirenal lymphoma is a rare disease and accounts for less than 10% of all malignant lymphomas. Mantle cell lymphoma (MCL) is the rarest but 1 of the most aggressive non-Hodgkins lymphoma subtype. The perirenal involvement of MCL has not been reported previously. A 69-year-old male, who had been diagnosed as having MCL 1 year ago, presented with recent-onset right back pain. Herein we present the key imaging findings of perirenal soft tissue manifestation of MCL.