M.Emin Sakarya

Evaluation of diaphragmatic movement with MR fluoroscopy in chronic obstructive pulmonary disease

The aim of this study was to show reduction of the diaphragmatic excursion with MR fluoroscopy in patients with chronic obstructive pulmonary disease (COPD) and to compare the results with pulmonary function test (PFT). The study included 13 men and 10 women (average age 56.2) with COPD, and 9 men and 6 women (average age 55.8) as a control group. MR fluoroscopy images with Spoiled Gradient-echo pulse sequence was obtained during deep inspiration and expiration. After examination, over cine-loop display, the highest and lowest positions of the diaphragm were identified and the distance of excursion was measured. Differences in the diaphragmatic excursion between patient and healthy subjects were compared. We have also compared MR fluoroscopy results with PFT. In each person of both groups, excursion of the diaphragm was demonstrated clearly in cine-loop display. Differences of excursion between deepest and highest point of diaphragm were on average 26 and 20 mm, respectively, in the right and left side in patients and 69 and 56 mm in healthy group. Significant correlation was found between expiratory volume in 1 s and MR fluoroscopy results. MR fluoroscopy study showed that there were significant statistical differences in diaphragmatic excursion between patients with COPD and healthy subjects. Expiratory volume in 1 s is closely associated with the diaphragmatic excursion. MR fluoroscopy would seem to be a useful method for showing diaphragmatic excursion.

The role of power Doppler sonography in the evaluation of superficial soft tissue abscesses

OBJECTIVE To evaluate the efficacy of power doppler ultrasonography in depicting increased vasculature and hyperemia around the superficial soft tissue abscess. MATERIALS AND METHODS 21 patients with soft tissue abscess were evaluated with gray scale imaging, color doppler sonography, power doppler sonography and computed tomography. In each case attempts were made using power doppler sonography to demonstrate any areas of increased vascularity around the lesion. The results were compared with computed tomographic findings. RESULTS Peripheral hyperemia and increased vasculature were demonstrated with power doppler sonography in 19 of 21 patients with soft tissue abscess. The hyperemic area demonstrated around the wall of the abscess by power doppler sonography was similar to the enhanced area shown by computed tomography performed after contrast administration. CONCLUSION Power doppler sonography shows increased vasculature and hyperemia in the wall of abscesses. Therefore, power doppler sonography can be used to assist with the diagnosis of superficial soft tissue abscess.

Demonstrating the effect of theophylline treatment on diaphragmatic movement in chronic obstructive pulmonary disease patients by MR-fluoroscopy

INTRODUCTION The purpose of this study was to determine the increase in diaphragmatic excursion of patients with chronic obstructive pulmonary disease (COPD) treated with theophylline by MR-fluoroscopy which is an innovative method to demonstrate effectiveness of this treatment. MATERIALS AND METHODS Investigations were performed on a 0.3 T open MR unit. MR-fluoroscopy images of 30 patients with COPD were obtained before and after theophylline treatment. Diaphragmatic movement values were recorded for evaluation. RESULTS The response of the diaphragmatic movement in COPD patients treated with theophylline was evaluated by MR-fluoroscopy and an increase of 48% in diaphragmatic contractility was determined after the treatment. The increase in contractility was found to be parallel with respiratory function tests and clinical status. CONCLUSION Diaphragmatic movement and response to the medical therapy in patients with COPD can be evaluated by MR-fluoroscopy method which can allow accurate measurements.

MR findings in cardiac hydatid cyst

We report a case of a 23-year-old man with a cardiac hydatid cyst involving the left ventricle wall. The diagnosis of the cyst was obtained by magnetic resonance (MR) imaging. He was operated on for cardiac hydatid cyst using enucleation and capitonnage procedure under extracorporeal circulation. Histopathologic study confirmed hydatid cyst diagnosis.

Hepatic cavernous hemangiomas: Patterns of contrast enhancement on MR fluoroscopy imaging

PURPOSE The purpose of this study was to assess the patterns of contrast enhancement of hepatic hemangiomas on gadolinium-enhanced MR fluoroscopy imaging prospectively. METHOD Investigation was performed on a 0.3-T open MR unit. Gadolinium-enhanced MR fluoroscopy images were obtained in 24 patients with 28 hepatic hemangiomas. Each MR fluoroscopy image was obtained in 2 s and MR fluoroscopy lasted for 10-25 min for each investigation. RESULTS Three patterns of contrast enhancement were observed in 24 patients on MR fluoroscopy images. Four small lesions were not detected on MR fluoroscopy images. Uniform enhancement was seen in nine lesions (29%), peripheral nodular enhancement progressing centripetally to uniform enhancement was seen in nine lesions (29%), and peripheral nodular enhancement with persistent central hypointensity was seen in six lesions (22%). CONCLUSION Enhanced MR fluoroscopy technique could obtain dynamic images of hepatic hemangiomas. It can be suggested as a useful technique for the showing of enhancement of hepatic hemangiomas, keeping in mind its low sensitivity in the diagnosis of small hemangiomas.

The role of power doppler sonography in the prenatal evaluation of fetal renal vasculature

Abstract This study was performed to determine whether power Doppler sonography is superior to color Doppler sonography in the depiction of the normal fetal intrarenal vasculature during pregnancy. Twenty-five fetal kidneys in 22 healthy fetuses between 22 and 40 weeks of gestation (mean 32.6 weeks) were studied with color and power Doppler sonography with a 3.75 MHz transducer. The efficacy of power and color Doppler sonography were compared in assessing fetal renal vasculature. Power Doppler sonography demonstrated diffuse “blush” in almost the entire cortex in 21 of 25 fetal kidneys, whereas it was demonstrated in half of the cortex in the other four kidneys. Color Doppler sonography failed to demonstrate a cortical blush in fetal kidneys. Power Doppler sonography has been shown to be superior to color Doppler sonography in the depiction of normal fetal intrarenal vasculature during pregnancy by demonstrating vascular blood flow better than color Doppler sonography.

Power doppler findings in nasopharingeal angiofibroma

Juvenile nasopharingeal angiofibroma (JNA) is a rare, histologically benign but clinically malign hypervascular tumor localized in the nasopharynx which occurs exclusively in adolescent boys. There is no definite attitude towards etiology of angiofibroma. In diagnostics, besides epypharyngoscopy, computed tomography and magnetic resonance imaging are the primary diagnostic tests. Angiography is used for preoperative embolization. In this case report, we aim to demonstrate the vascularity of JNA with power Doppler sonography (PDS) and advanced vasculature was observed into tumoral lesion with PDS.

Clinical value of preoperative intraoral ultrasonography in tonsillectomy

In this prospective study, 43 chronic tonsillitis patients underwent intraoral ultrasonography preoperatively and the width and thickness of tonsils and tonsillocarotid distances were measured. Positive correlation was obtained in postoperative measurements compared with ultrasonographic measurements of tonsils. The mean tonsillocarotid distances were 8.6 mm in the left and 8.25 mm in the right tonsillar fossa. This study showed that preoperative intraoral ultrasonography was to be help of tonsillectomy operations particularly in surgical anatomical orientation.