Hanifi Yildirim

Evaluation of the fibular incisura of the tibia with magnetic resonance imaging.

Knowledge of the distal tibiofibular syndesmosis should be helpful in determining the normal position of the fibula in the incisural notch. The purpose of this study was to determine the anatomic characteristics of the fibular incisura of the tibia on MR imaging. One hundred fifty lower limbs (43 male, 32 female volunteers) were examined with MRI. The length of the anterior facet was 10.4 mm in males and 8.9 mm in females, and the length of the posterior facet was 10.4 mm in males and 8.9 mm in females. The angle between anterior and posterior facets was 138.6° in males and 139.9° in females. The depth of the fibular incisura of the tibia was 3.6 mm in males and 2.9 mm in females. The vertical distance of tibiofibular overlapping was 7.9 mm in males and 7.0 mm in females. The distance between anterior margin of the tibia and anterior margin of the fibula was 14.3 mm in males and 12.5 mm in females. All of these parameters of men (except the angle between anterior and posterior facets) were significantly higher than the parameters of women (p < .001, p < .001, p < .05, p < .05, p < .01, respectively).

CT and MRI findings of ameloblastoma in two cases

We report CT and MRI findings in two patients with ameloblastoma. One case had a multilocular mixed lesion and the other had a unilocular solid pattern. The second case is probably one of the youngest reported. CT and MRI can be used to delineate and show the extent of the tumour.

A magnetic resonance imaging study of the adhesio interthalamica in schizophrenia

Several recent studies have found a relationship between midline cerebral malformations (cavum septi pellucidum, absence of the adhesio interthalamica) and schizophrenia. In this study, we investigated whether the adhesio interthalamica is more often absent in patients with schizophrenia than healthy cases and whether the absence of the adhesio interthalamica may be related to the volume of the third ventricle. Twenty-six patients (11 male, 15 female) in the schizophrenia group and twenty-nine (11 male, 18 female) cases in the control group were examined by MRI. The adhesio interthalamica was found to be absent more often among patients with schizophrenia compared with control subjects and patients without adhesio interthalamica did not have significantly larger third ventricle volumes. The absence of the adhesio interthalamica may be important in explaining the association between the abnormalities of brain midline structures and schizophrenia.

Iatrogenic vertebral artery pseudoaneurysm: US, CT and MRI findings

Vertebral artery pseudoaneurysm (VAP) is the result of the penetrating neck trauma, chiropractic manipulation, vasculopathies and rarely iatrogenic due to internal jugular vein (IJV) catheterization. It should be identified and treated immediately because of its potential risk of rupture. We present a case of a right VAP resulting from jugular vein catheterization, with the Doppler ultrasonography (US), Computed tomography (CT) and magnetic resonance imaging (MRI) findings. Although angiography is a well known gold standard modality, Doppler US, CT and MRI findings can be sufficient to demonstrate VAP.

Bronchial atresia of the right lower lobe

Bronchial atresia (BA) is a rare congenital anomaly that is found incidentally in approximately 50% of cases. It predominantly affects young men and generally produces no symptoms. The other 50% of cases have pulmonary symptoms such as fever, cough, or shortness of breath due to recurrent pulmonary infection or overinflation of the involved lung parenchyma. The most common site is the left upper lobe, particularly of the apical-posterior segment. The right lower and middle lobes are affected in only 8% of cases. The radiographic features may be highly suggestive of the diagnosis. The mucus-filled bronchus is seen as a rounded, branching opacity emanating from the hilum and is surrounded by an area of increased hyper-translucency. We report an unusual presentation of BA in a 43-year-old woman with a history of recurrent pulmonary infection and dyspnea. The patient was found to have BA in all the basal segments of the lower lobe of the right lung.

Cortical Visual Impairment Secondary to Hypoglycemia

Cortical visual impairment (CVI) most commonly occurs in children after hypoxic insults but may also occur as a sequel of meningitis, encephalitis, head trauma, and hydrocephalus. CVI secondary to hypoglycemia is rarely encountered. A 4-year-old girl was admitted to hospital with a history of bilateral visual impairment. She had several severe hypoglycemic attacks lasting a week in the neonatal period. Bilateral occipital gliotic lesions were defined on magnetic resonance imaging (MR). [99mTc]-hexamethyl propylene amine oxime (HMPAO) brain single-photon emission computerized tomography (SPECT) was performed to determine the cerebral blood flow (CBF). SPECT images showed an extended hypoperfusion area in the right parieto-temporal region with marked non-perfusion areas in bilateral occipital cortices. It should be noted that hypoglycemia has devastating effects on cerebral tissues including optical areas and thus resulting in CVI. We would like to emphasize the importance of early diagnosis and prompt treatment.