Mine Aslan

A preliminary study of shear wave elastography for the evaluation of unilateral palpable undescended testes

OBJECTIVES We sought to compare unilateral palpable undescended testes and contralateral descended testes using shear wave elastography (SWE) to show potential quantitative differences in elasticity patterns, which might reflect the histologic features. METHODS Approval for this prospective study was obtained from the local ethics committee. A total of 29 patients (mean age, 7.52 years; range, 1-18 years) with unilateral palpable undescended testes and contralateral descended testes were examined by greyscale ultrasonography and SWE between February 2015 and April 2016. The volume and the elasticity of each testicle were the main factors evaluated. RESULTS There was no difference between undescended testes and contralateral descended testes in terms of volume. However, a significant difference was evident in SWE-derived quantitative data. CONCLUSIONS SWE seems to be a useful sonographic technique to predict histologic features of the undescended testicle, which might replace testicular biopsy in modern management of the undescended testis.

Diffusion-weighted MRI for differentiating Wilms tumor from neuroblastoma

PURPOSE Wilms tumor (WT) and neuroblastoma (NB) are the most common pediatric abdominal malignant neoplasms of the kidney and adrenal gland. Differentiating them from each other is essential since their treatments are different. Here, we aimed to show the diffusion characteristics of WT and NB for differentiation. METHODS Diffusion-weighted imaging (DWI) of 17 histopathologically diagnosed lesions (10 NB and 7 WT in 8 female and 9 male patients) was evaluated retrospectively. The apparent diffusion coefficient (ADC) value for each tumor was calculated using region-of-interest (ROI) measurements by two observers. The mean ADC values were compared, and receiver operating characteristics (ROC) curve analysis was performed. Intraclass correlation was evaluated for the reliability of ADC measurement. RESULTS The mean ADC values measured by two observers were 0.787±0.09 ×10-3 mm2/s and 0.768±0.08 ×10-3 mm2/s for WT, and 0.524±0.16 ×10-3 mm2/s and 0.529±0.16 ×10-3 mm2/s for NB, respectively (P = 0.006 and P = 0.011). Intraclass correlation coefficient was 0.955. Utilizing ROC curve analysis, a cutoff ADC value of ≤0.645 ×10-3 mm2/s was obtained to differentiate NB from WT. CONCLUSION ADC values of NBs were significantly lower than WT with a perfect interobserver agreement. We suggest that DWI may have a role in differentiating the two tumors.

In vivo assessment of placental elasticity in intrauterine growth restriction by shear-wave elastography

PURPOSE In this study, we evaluated the placental elasticity in vivo by shear-wave elastography in pregnant women under follow-up for intrauterine growth restriction (IUGR) and compared the elasticity values to normal pregnancies. MATERIAL AND METHODS This prospective study included 42 pregnant women with a possible diagnosis of intrauterine growth restriction based on obstetrical grayscale and Doppler ultrasonography and 42 women with a normal pregnancy during the 2nd and 3rd trimester. During follow-up examinations, seven fetuses showed an increased growth and were delivered with a birth-weight above the 10 percentile. However, for statistical purposes we included these seven patients in the IUGR group due to prospective nature of the study. All patients initially underwent obstetrical grayscale and Doppler ultrasonography with measurement of resistivity and pulsatility indices from uterine arteries. Subsequently, elasticity values of the peripheral and central part of the placentas from fetal and maternal surfaces were measured by shear-wave elastography. Following delivery, Apgar scores at 1st and 5th minute, birth weight were collected. For statistical analysis, Mann-Whitney U test was used. ROC curves were plotted and cut-off values for elasticity values were analyzed. RESULTS Median elasticity values of the central part of the placentas from maternal (28kPa vs 6kPa) and fetal sides (21.5kPa vs 5kPa) were significantly higher in IUGR pregnancies compared to the control group (p<0.001). Similarly, median elasticity values of peripheral part of placentas from maternal (22kPa vs 5.35kPa) and fetal sides (22.5kPa vs 5.3kPa) were significantly higher in IUGR pregnancies compared to the control group (p<0.001). CONCLUSION Placental stiffness values are significantly higher in patients with IUGR. Shear-wave elastography can be used as a non-invasive, complementary method to gray-scale and Doppler ultrasound for diagnosing IUGR.

Shear Wave and Strain Elastographic Features of the Brachial Plexus in Healthy Adults: Reliability of the Findings-a Pilot Study: Elastography of the Brachial Plexus in Healthy Adults

To determine the sonoelastographic findings for the normal brachial plexus via shear wave elastography (SWE) and strain elastography (SE) and the reliability of the measurements.

Bilateral Cystic Adrenal Neuroblastoma with Cystic Liver Metastasis

Bilateral congenital cystic adrenal neuroblastoma (NB) with cystic liver metastasis is a very rare condition and only few cases have been reported in the literature. Herein we report a case of a congenital bilateral cystic adrenal NB with cystic liver metastasis and briefly discuss characteristic imaging features of cystic NB.

Utility of diffusion-weighted magnetic resonance imaging in diagnosing hepatocellular carcinoma in cirrhotic liver

received: 18.06.2016 Accepted: 08.08.2016 1Department of Radiology, Ümraniye Training and Research Hospital, Istanbul, Turkey 2Department of Radiology, Göztepe Training and Research Hospital, Medical School of Istanbul Medeniyet University, Istanbul 3Department of Radiology, King Hamad University Hospital. Bahrain Yazışma adresi: Ahmet Aslan, Department of Radiology, Ümraniye Training and Research Hospital, Istanbul e-mail: aslahmet@gmail.com INtrodUctIoN

Multiple pericardial abscesses in a child with known chronic granulomatous disease

Sir, Chronic granulomatous disease (CGD) is a rare primary immunodeficiency that affects about 1 in 250,000 individuals.[1] It is known by a defective intracellular killing of phagocytized organisms. Pneumonia was noted in 79%, suppurative lymphadenitis in 53%, whereas subcutaneous abscesses in 52% in these patients.[1] Pericardial involvement is rarely seen in patients with CGD and mostly presented with pericardial effusion rather that abscess.[1] Herein, we present a case of a CGD with diffuse multiple pericardial abscesses, which is diagnosed by cardiac magnetic resonance imaging (MRI).

Pediatrik Yaş Grubunda Akciğer Grafisi Bulguları

Objective: To evaluate the normal postero-anterior (PA) chest radiographic findings and normal variations in the pediatric age group. Material and Methods: PA chest X-rays of healthy children, who had no respiratory and cardiovascular system disorder, taken for screening purposes, were retrospectively included in the study. These X-rays were evaluated for tracheal diameter, right and left main bronchus diameters, subcarinal angle, mediastinal witdh, cardiothoracic ratio, positions of diaphragms and normal variations (existence of cervical rib, presence of 11.th rib, existence of 13.th rib and azygos variation). Results: In 92,7 % of PA chest X-rays, inspiration was adequate. Patient position was not appropriate in 44,7 % of children. Trachea and main bronchus diameters were increasing proportional to age. Presence of 11.th rib was the most common anatomic variation. Conclusion: There are certain difficulties in the evaluation of chest x-rays in the pediatric age group. Knowledge about the normal size of anatomic structures and variations in chest x-rays can be useful for a correct diagnosis