Kemal Ödev

Pulmonary embolism due to cardiac hydatid disease: imaging findings of unusual complication of hydatid cyst

Abstract. We report two cases of primary cardiac hydatid cyst in which hydatid materials caused recurrent embolizations in pulmonary arteries and pulmonary parenchyma. Cardiac hydatid cysts may stay asymptomatic for a long time, until they reveal themselves being perforated into cardiac chambers and/or pulmonary artery or systemic circulation. The role of imaging techniques in diagnosis is discussed and the importance of dynamic enhanced CT, MR imaging, and enhanced MR angiography (MRA) is reported. Imaging findings were confirmed by surgery and pathology. Early diagnosis is essential because delayed treatment increases the morbidity and mortality rates.

Differential diagnosis of dumbbell lesions associated with spinal neural foraminal widening: Imaging features

Computed tomography (CT) and magnetic resonance imaging (MRI) reliably demonstrate typical features of schwannomas or neurofibromas in the vast majority of dumbbell lesions responsible for neural foraminal widening. However, a large variety of unusual lesions which are causes of neural foraminal widening can also be encountered in the spinal neural foramen. Radiologic findings can be helpful in differential diagnosis of lesions of spinal neural foramen including neoplastic lesions such as benign/malign peripheral nerve sheath tumors (PNSTs), solitary bone plasmacytoma (SBP), chondroid chordoma, superior sulcus tumor, metastasis and non-neoplastic lesions such as infectious process (tuberculosis, hydatid cyst), aneurysmal bone cyst (ABC), synovial cyst, traumatic pseudomeningocele, arachnoid cyst, vertebral artery tortuosity. In this article, we discuss CT and MRI findings of dumbbell lesions which are causes of neural foraminal widening.

Multitechnique evaluation of renal hydatid disease.

OBJECTIVE Hydatid involvement of the kidney accounts for only 2-4% of all cases of hydatid disease. The purpose of this article is to review the imaging features of hydatid disease of the kidney and thus show the role of radiography, excretory urography, sonography, CT, and MRI in the diagnosis of hydatidosis. CONCLUSION The radiologist should be familiar with the imaging findings of hydatid disease because early diagnosis is important for more appropriate treatment.

Comparison of CT virtual cystoscopy of the contrast material-filled bladder with conventional cystoscopy in the diagnosis of bladder tumours

AIM To investigate the value of virtual cystoscopy using contrast material to fill the bladder during routine abdominopelvic computed tomography (CT) examinations for the detection of bladder tumours. MATERIALS AND METHODS Thirty-three consecutive patients (25 men and eight women; are range 51-82 years; mean age+/-SD, 65+/-7 years) who had painless macroscopic haematuria and were suspected to have bladder neoplasms were prospectively evaluated with virtual cystoscopy. After intravenous injection of contrast medium, the contrast material-filled bladders were examined with single-detector helical CT with 2-mm section thicknesses. Source CT data were transferred to a workstation for interactive navigation using surface rendering. All the patients also underwent conventional cystoscopy. RESULTS The results of virtual cystoscopy were compared with the findings from the conventional cystoscopy. Seventy-one of 78 bladder tumours detected with conventional cystoscopy in 28 patients were also shown on virtual images. The bladders of five patients appeared normal on both conventional cystoscopy and virtual cystoscopy. On virtual cystoscopy, seven of the 12 lesions that were < or =5 mm in diameter could be identified. The following statistical values for the identification of bladder lesions using virtual cystoscopy were calculated: sensitivity 94%, specificity 90%, positive predictive value 87%, negative predictive value 93%, and accuracy 93%. CONCLUSION CT virtual cystoscopy is a noninvasive technique that can be used successfully for detection of bladder tumours >5 mm in selected cases during daily routine abdominopelvic work.

Pulmonary and Cardiac Involvement in Behçet Disease: 3 Case Reports

Pulmonary and cardiac involvement in Behçet disease is rare but can cause life-threatening complications. This report presents computed tomography and magnetic resonance angiography findings in 3 patients with Behçet disease. Imaging findings were confirmed by surgery in 1 patient and by angiography in another. One patient had bilateral pulmonary artery aneurysms, 1 of which had already ruptured and had thrombosed. The other had unilateral pulmonary artery aneurysm and thrombosis accompanied with intracardiac thrombus formation. The third patient had unilateral pulmonary artery aneurysm, thrombus, and coronary artery aneurysm. As in our case, there have been rare reports of coronary artery disease and intracardiac thrombus formation associated with pulmonary vascular involvement. Noninvasive imaging modalities minimize any risk of endothelial damage and can be an alternative to angiography in assessment of pulmonary and cardiac involvement in Behçet disease.

Sonographic diagnosis of the ruptured hydatid cyst of the kidney

Abstract. The clinical and radiological features of one case of renal hydatid disease communicating with collecting system are described. Introduction of hydatid elements into the renal pelvis due to rupture was accompanied by six episodes of renal colic. Although the sonographic features of renal hydatid disease have been described extensively, direct demonstration by ultrasonography of hydatid cyst ruptured into the renal pelvis has not, to our knowledge, been previously reported. The diagnosis has also been confirmed at surgery.

Partial priapism secondary to tamsulosin: a case report and review of the literature.

Partial priapism is also called partial segmental thrombosis of the corpus cavernosum. It is a rare pathology, and its aetiology, physiopathology and treatment are still not completely understood. To our knowledge, partial priapism due to alpha blockers has not been reported previously in the literature. In this study, a successfully treated case of partial priapism occurring after the usage of alpha blocker is presented and discussed in light of the related literature.

Percutaneous Sonographically Guided Treatment of Hydatid Cysts in Sheep Direct Injection of Mebendazole and Albendazole

Objective. The purpose of this study was to investigate the scolicidal effect of intracystic injection of benzimidazolic solutions in naturally infected sheep with hydatid disease. Methods. Twenty‐four sheep with 37 hydatid cysts were included in this study for percutaneous treatment with benzimidazolic solutions. The animals were divided into 3 groups: group I, treatment group with mebendazole; group II, treatment group with albendazole; and group III, control group with distilled water. All solutions were given percutaneously under sonographic guidance. Cyst contents were aspirated with a needle, and then scolicidal solutions were injected into the cysts; reaspiration was not done. Routine follow‐up sonographic images were taken on the 15th day after treatment, then once per month for 3 months, and then at 3‐month intervals thereafter. At the 1‐month follow‐up, the percutaneous aspirate yielded orange juice–like material containing necrotic debris without living scolices. Results. Sonography showed a reduction in cyst size in the benzimidazolic groups (groups I and II) and progressive changes in echo patterns. An anaphylactic reaction was observed during the procedure in 1 animal. After 12 months of sonographic follow‐up, the animals in all groups were killed, and macroscopic and microscopic changes in tissue samples were evaluated. At autopsy, no cysts with living scolices were found in the benzimidazolic groups, and the appearance of the treated cysts was different from that of those in the control group. Microscopic examination showed the degeneration, necrosis, and thickening of the cyst walls in the treatment groups. Conclusions. Intracystic injection of benzimidazolic solutions as scolicidal agents may be used for percutaneous treatment of hepatic hydatid cysts in sheep.

Imaging of cystic and cyst like lesions of the mediastinum with pathologic correlation.

Cystic masses of the mediastinum are a heterogenous group of asymptomatic or symptomatic, congenital, infectious, or neoplastic lesions. For early and correct diagnosis, evaluation, and optimal patient management of cystic mediastinal masses in infants, children, or adults imaging plays an important role. A non-invasive and sensitive imaging modality is an efficient and cost-effective tool. Multidetector computed tomography (MDTC) with volumetric acquisition provides fast acquisition of high resolution images and multiplanar reconstruction. Both 2D and 3D imaging in mediastinal imaging help in surgical planning and assessing resectability of mediastinal lesions. MR imaging has many advantages over other modalities for detecting and identifying cystic, or fluid-filled mediastinal masses, because of its intrinsic high soft tissue contrast and direct multiplanar imaging capabilities. However, histological tissue analysis may be required to differentiate a cystic lesion from other cyst-like or low-attenuation lesions.

Cystic and Cavitary Lung Lesions in Children: Radiologic Findings with Pathologic Correlation

A number of diseases produce focal or multiple thin-walled or thick-walled air- or fluid-containing cysts or cavitary lung lesions in both infants and children. In infants and children, there is a spectrum of focal or multifocal cystic and cavitary lung lesions including congenital lobar emphysema, congenital cystic adenomatoid malformation, pleuropulmonary blastoma, bronchogenic cyst, pulmonary sequestration, Langerhans cell histiocytosis, airway diseases, infectious diseases (bacterial infection, fungal infection, etc.), hydatid cysts, destroid lung, and traumatic pseudocyst. For the evaluation of cystic or cavitary lung lesion in infants and children, imaging plays an important role in accurate early diagnosis and optimal patient management. Therefore, a practical imaging approach based on the most sensitive and least invasive imaging modality in an efficient and cost-effective manner is paramount. We reviewed the conventional radiographs and computed tomography findings of the most common cystic and cavitary lung lesions in infants and children.