Kaya Saraç

Doppler sonography of the inferior and superior mesenteric arteries in ulcerative colitis

The purpose of this study was to evaluate the Doppler sonographic blood‐flow parameters and spectral patterns in the inferior mesenteric artery (IMA) and superior mesenteric artery (SMA) in patients with active and inactive (remission‐phase) ulcerative colitis (UC).

Intraventricular solitary fibrous tumor: an unusual tumor with radiological, ultrastructural, and immunohistochemical evaluation: case report.

OBJECTIVE AND IMPORTANCEIntracranial solitary fibrous tumors have been described previously, but intraventricular solitary fibrous tumors are extremely rare. We present what is, to our knowledge, the first reported case of solitary fibrous tumor in the third ventricle. CLINICAL PRESENTATIONA 63-year-old man presented with weakness of his lower extremities and headaches. Computed tomography and magnetic resonance imaging of the brain revealed an enhancing mass in the posterior part of the third ventricle. INTERVENTIONThe tumor originated from the wall of the left internal cerebral vein and extended to the posterior part of the third ventricle. Nearly total excision was performed via an infratentorial-supracerebellar approach. CONCLUSIONThe differential diagnosis of intracranial solitary fibrous tumors includes fibroblastic meningioma, meningeal hemangiopericytoma, neurofibroma, and schwannoma. The differential diagnosis in the present case was greatly helped by the immunohistochemical and ultrastructural findings, along with a disease-free 3.5-year follow-up. These findings are presented with reference to previous reports.

Cervical myositis ossificans traumatica: a rare location

Abstract. An unusual case of myositis ossificans traumatica lesion located in the paraspinal region is reported. Despite the contiguity of the lesion with the cervical vertebrae and ominous appearance of the biopsy material, the history of antecedent trauma and computed tomography findings allowed preoperative accurate diagnosis. To our knowledge, myositis ossificans traumatica located in the cervical paraspinal region is very rare.

Delayed myelination in a rhizomelic chondrodysplasia punctata case: MR spectroscopy findings

Rhizomelic chondrodysplasia punctata is a member of genetic peroxisomal disorders. Delayed myelination, which is probably related to the inadequacy of plasmalogens biosynthesis, is an important feature of this disorder. Direct assessment of neuropathologic aspects of RCDP syndrome such as neuronal degeneration and delayed myelination is possible with MR spectroscopy. In this report, MR spectroscopy findings (decreased Cho/Cr and increased Ins-Gly/Cr ratios and increased levels of mobile lipids) of a rhizomelic chondrodysplasia punctata case supporting delayed myelination are presented. This is the second report of MR spectroscopy examination of the specific brain metabolic changes associated with rhizomelic chondrodysplasia punctata.

Isolated posterior spinal artery aneurysm

Isolated aneurysms of the posterior spinal artery (not associated with arteriovenous malformations) are exceptionally rare. Three cases have been reported in the literature to date. We report a case of an isolated posterior spinal artery aneurysm causing acute subarachnoidal haemorrhage. Spinal artery aneurysms are contrasted with the more common intracranial aneurysms in terms of presentation and pathogenesis.

Metabolic Changes in Pelvic Lesions: Findings at Proton MR Spectroscopic Imaging

Objective: The purpose of this study is to investigate the in vivo magnetic resonance spectroscopic (MRS) features of pelvic lesions using long echo time and to characterize the spectral patterns of various pathological entities. Materials and Methods: 17patients with surgically and histopathologically confirmed pelvic lesions underwent long echo-time MRS, and the results obtained were analyzed. Before laparotomy, choline (Cho), lactate, lipid and creatine (Cr) levels of all lesions were measured by single voxel MRS (point-resolved spectroscopy technique, TE 136 ms). Voxels were placed in the center of the lesions. The MRS results of lesions were compared with the final histopathological diagnoses. Results: Spectroscopy analysis of serous, mucinous and undifferentiated carcinoma of the ovary revealed Cho, lactate and lipid signals, but granulosa-theca cell tumor showed only a lipid signal. The Cho signal was obtained from only 3 patients with mature cystic teratoma but none of the other benign ovarian tumors and pelvic abscesses. A lipid signal was detected in 3 patients diagnosed with pelvic abscess and all benign ovarian tumors. In addition to the lipid signal, a lactate signal was detected in the spectra of two pelvic abscesses. One case of endometrioma and 1 case of teratoma did not show any signal. Conclusion: MRS demonstrates significant differences in metabolite concentration between benign and malignant ovarian tumors and pelvic abscesses. MRS may therefore be helpful in the differential diagnosis of adnexal lesions.

Early MRI findings in stab wound of the cervical spine: two case reports

Abstract. MR imaging was found to be the most sensitive modality for the detection of spinal cord abnormalities in the acutely injured spine. Although it is reported that traumatic pneumomyelogram indicates a base-of-skull or middle cranial fossa fracture and is almost certainly associated with intracranial subarachnoid air, early MR imaging may demonstrate subarachnoid air in penetrating trauma of the spinal cord without head injury. We report two cervical-spine stab-wound cases, one of which had subarachnoid air on early MR findings.

Diffusion-weighted imaging in chronic Behçet patients with and without neurological findings

Our aim was to investigate whether neurological impairment in chronic Behçet’s disease (BD) patients with normal appearing brain can be assessed by means of diffusion-weighted imaging (DWI). The averaged apparent diffusion coefficient (ADC) values were calculated in 22 different radiologically normal appearing brain regions in 32 patients with and without neurological findings and 20 control subjects. The ADC values in bilateral frontal, temporal and occipital normal appearing white matter were significantly higher in the patient groups compared with the control subjects (p<0.05). In these brain regions, DWI revealed differences in the ADC values between patients with neurological findings (including symptomatic and neuro-Behçet patients) and the asymptomatic patient group. The similarity of the ADC values of patients without symptoms to those of the control group allowed clear discrimination between patients with and without neurological findings. DWI may serve to assess subclinical neurological involvement in BD, even when structural changes are absent.

Magnetic Resonance Spectroscopy Features of Uterine Leiomyomas

Objective: The purpose of this study is to investigate the in vivo magnetic resonance spectroscopy features of uterine leiomyomas using long echo time and to characterize the spectral patterns of these lesions. Methods: We calculated metabolites in 15 patients with uterine leiomyomas and myometrium of 20 healthy control subjects using single-voxel proton MR spectroscopy (point resolved spectroscopy technique, TE:136 ms). Voxels were placed at the center of the uterine leiomyomas. The peak areas of creatine, choline, lipid and lactate were determined. The MR spectroscopy results of uterine leiomyomas were compared with the spectroscopy results obtained from the myometrium of healthy control subjects. Results: The characteristically obtained signal was choline, which was detected not only in 14 of the 15 leiomyomas (93.3%) but also in 18 of the 20 myometrium of control subjects (90%). The lipid signals were determined in 9 of 15 patients with uterine leiomyomas (60%) and 8 of 20 control subjects (40%). The lactate signal was obtained from six of 15 patients with leiomyomas (40%) but only two of myometrium (10%). The creatine signal was obtained from 4 of 15 patients with leiomyomas (26.6%) and 5 of 20 myometrium (25%). Among the tested parameters only lactate peak was statistically significant (p < 0.05). Conclusion: Proton MR spectroscopic imaging may be helpful for the investigation of the underlying pathophysiology of uterine leiomyomas. The presence of lactate and lipid signals in the spectrum may be a useful indicator of metabolic pathway of uterine leiomyomas.

Proton MR spectroscopy features of normal appearing white matter in neurofibromatosis type 1

To determine whether differences exist between neurofibromatosis type 1 (NF1) patients with or without focal lesions and healthy normal volunteers in the metabolite ratios of normal appearing white matter, 27 patients with NF1 (with parenchymal lesion, MR positive, n: 17; without parenchymal lesions, MR negative, n: 10) and 20 healthy volunteers underwent MRI and short TE (31 ms) proton MR spectroscopy (MRS). In 17 patients with parenchymal lesions, 61 focal lesions were detected by MRI. MRS was performed from normal appearing frontal and posterior parietal white matter (FWM and PWM) in NF1 and from control groups. NAA/Cr, Cho/Cr and MI/Cr ratios were calculated. Significant increase in Cho/Cr and MI/Cr ratios were found in FWM and PWM in MR negative and positive groups when compared to control group. NAA/Cr ratio in MR positive group was significantly decreased in FWM compared to control group. There were no significant differences between FWM and PWM in all metabolite ratios of MR negative group. MI/Cr ratio in MR positive group was significantly elevated in PWM compared to FWM. Metabolite changes detected by MRS could indicate demyelination and gliosis in normal appearing white matter in all NF1 patients, and additionally neuroaxonal damage in the FWM of NF1 patients with focal lesions. For that reason, in the clinical evaluation and follow-up of these patients MRS features of normal appearing white matter should be considered in addition to focal lesions.