Ismail Okan Yildirim

Conventional and ZOOMit DWI for Evaluation of Testis in Patients With Ipsilateral Varicocele

OBJECTIVE The current study aimed to investigate the effects of varicocele on testis parenchyma by using ZOOMit DWI and conventional DWI and to compare both diffusion methods. SUBJECTS AND METHODS Forty-five patients with unilateral varicocele diagnosed by physical examination and color Doppler ultrasound between July 2015 and December 2015 and 32 healthy volunteers were included in the study. ZOOMit and conventional DWI were performed for all patients with a 3-T MRI scanner. RESULTS Apparent diffusion coefficient (ADC) values calculated using both conventional and ZOOMit DWI decreased in the patients with varicocele of the testis, when compared with the healthy volunteer control group. Furthermore, it was determined that conventional and ZOOMit ADC values for the contralateral side without varicocele also decreased when compared with the healthy volunteer control group (p < 0.05). However, there was no statistically significant difference between testes with or without varicocele in terms of conventional ADC values (p = 0.183), whereas ZOOMit ADC values for testes with varicocele were found to be statistically significantly lower than those for testes without varicocele (p < 0.05). A significant negative correlation was found between venous diameter measured both at rest and during the Valsalva maneuver and ZOOMit ADC values in testes with varicocele. CONCLUSION For patients with varicocele, conventional and ZOOMit DWI may be predictive of histopathologic changes in the testis, and ZOOMit DWI may be more effective in the diagnosis, treatment, and postoperative response in patients with varicocele when compared with conventional DWI.

Tumoral Calcinosis Around the Elbow: Case Report

Tumoral calcinosis is a rare ectopic calcification seen around large joints. Large joints are seen in the hip, shoulder and elbow, and less frequently in the foot and ankle. It is unclear why the first two decades of life are caused by familial predisposing aphakia, as well as being seen more frequently. We presented Magnetic Resonance Imaging findings of the patient who presented with tumoral calcinosis elbow pain clinic. Tumoral calcinosis should be kept in mind in differential diagnosis when a mass with soft tissue periarticular calcification is seen in the vicinity of large joints.

Letter to the Editor regarding recurrent sebaceous carcinoma of the eyelid: Outcome after postoperative reirradiation: Letter to the Editor

To the Editor: We read with great interest the case report titled “Recurrent sebaceous carcinoma of the eyelid: Outcome after postoperative reirradiation” authored by Puja Sahai published in the January 2016 issue of Head & Neck. In this case report, “(a) 38-year-old man . . . diagnosed with sebaceous carcinoma of the right lower eyelid” was described. Herein, we seek a correction, in case your readers may be misled by the 2 important technical problems. It is significant that the image that was presented in Figure 2A as a non–contrast-enhanced CT is indeed a contrastenhanced CT image. The hyperdense appearance of the basilar artery, extraocular muscle groups, and cavernous sinus are the evidence that this procedure is done by giving contrast material. In consideration of these data, the image presented as a non–contrast-enhanced CT in Figure 2A should be changed to a contrast-enhanced CT. Not having a radiologist among the researchers may have caused this mistake. Aside from this, there is another technical problem that should also be corrected. While examining a lesion to determine whether it is contrast-enhanced or non–contrastenhanced, the researchers have to examine the images of a contrast-enhanced CT and a non–contrast-enhanced CT together. The mass presented in Figure 2B is identified as a contrast-enhanced lesion, but the noncontrast images are not presented. We thought that this mistake is another wrong message given to the readers, most of whom are not radiologists. In order to examine whether a lesion is contrast enhanced or not, both contrast-enhanced CT images and non– contrast-enhanced CT images of the same location have to be presented together.

Regarding ''Dedifferentiated Chondrosarcoma of the Larynx''

We read with great interest the case report titled ‘‘Dedifferentiated Chondrosarcoma of the Larynx’’ authored by Fidai SS, published in the 2015 issue of Head and Neck Pathology. In this case report, a 55 year-old male with no significant past medical history with dedifferentiated chondrosarcoma of the larynx was described [1]. Herein we demanded a correction, in case your readers may be misled by the one important technical problem. The planes of CT images on Fig. 1b were falsely written as sagittal, as they were coronal. Accordingly, the word ‘coronal’ should be changed with ‘sagittal’ in the figure legend. To the best of our knowledge, the correction of above-mentioned technical points will prevent you from giving a wrong message to your readers that are not radiologists.

Letter to the Editor: regarding "Lipomatous ependymoma: report of a rare differentiation pattern with a comprehensive review of literature".

We read with great interest the case report titled ‘‘Lipomatous ependymoma: report of a rare differentiation pattern with a comprehensive review of literature’’ authored by Kavita Gaur published in the February 2016 issue of Brain Tumor Pathol [1]. In this case report, a ‘‘13-year-old girl presenting with left-sided hemiparesis altered sensorium and episodic headache with bouts of projectile vomiting’’ was described. The authors have expressed that a large heterogeneous intraventricular mass lesion displaying focal calcification and hyperintensity on T1and T2weighted fluid attenuated inversion recovery (FLAIR) magnetic resonance images suggested the presence of intratumoral fat. Herein, we demand a correction, in case your readers may be misled by a technical problem. The image which is presented in Fig. 1a as a T1-weighted image is a FLAIR magnetic resonance image, because vasogenic edema surrounding the mass effect in the parenchyma of the right lateral ventricle is hyperintense in Fig. 1a. In T1-weighted images, vasogenic edema is hypointense. Evaluating brain parenchyma and ventricular images together also shows that this is a FLAIR-weighted sequence instead of a T1-weighted sequence. We thought that this mistake is a wrong message given to the readers of your journal, most of whom are not radiologists.