Murat Beyhan

MRI in the diagnosis of Mayer-Rokitansky-Kuster-Hauser syndrome.

PURPOSE The aim of this study was to establish the role of magnetic resonance imaging (MRI) in patients with Mayer-Rokitansky-Kuster-Hauser syndrome (MRKHS). MATERIALS AND METHODS Sixteen female MRKHS patients (mean age, 19.4 years; range, 11-39 years) were studied using MRI. Two experienced radiologists evaluated all the images in consensus to assess the presence or absence of the ovaries, uterus, and vagina. Additional urogenital or vertebral pathologies were also noted. RESULTS Of the 16 patients, complete aplasia of uterus was seen in five patients (31.3%). Uterine hypoplasia or remnant uterus was detected in 11 patients (68.8%). Ovaries were clearly seen in 10 patients (62.5%), and in two of the 10 patients, no descent of ovaries was detected. In five patients, ovaries could not be detected on MRI. In one patient, agenesis of right ovary was seen, and the left ovary was in normal shape. Of the 16 cases, 11 (68.8%) had no other extragenital abnormalities. Additional abnormalities were detected in six patients (37.5%). Two of the six had renal agenesis, and one patient had horseshoe kidney; renal ectopy was detected in two patients, and one patient had urachal remnant. Vertebral abnormalities were detected in two patients; one had L5 posterior fusion defect, bilateral hemisacralization, and rotoscoliosis, and the other had coccygeal vertebral fusion. CONCLUSION MRI is a useful and noninvasive imaging method in the diagnosis and evaluation of patients with MRKHS.

Insulin resistance and cardiovascular risk factors in women with PCOS who have normal glucose tolerance test

Introduction: We aimed to determine the insulin resistance in women with PCOS patients who have normal oral glucose tolerance test (OGTT) and to evaluate cardiovascular risk by measuring C-reactive protein (CRP) and carotid intimae-media thickness (CIMT). Methods: A total of 34 patients and age and body mass matched 20 healthy control subjects were included to this prospective study. Both of patients and control groups were consisted of normal oral glucose tolerance test. Insulin resistance (IR) was estimated using HOMA-IR method. CRP, lipid and hormone levels were measured. CIMT was measured by Carotid Artery B-Mode ultrasonography. Results: There was no significant difference between patients and controls in BMI, and waist circumference, lipid, TSH, LH, FSH, estradiol, and prolactin levels. Serum insulin, testosterone, DHEAS, ferritin levels and HOMA values were significantly higher in patient group. We found that 64.7% (n = 22/34) patients with PCOS had insulin resistance. Both of CIMT and CRP levels were significantly higher in the PCOS patients had BMI over 25 kg/m2. CRP levels was significantly higher in the PCOS patients had waist circumference greater than 80 cm. Conclusion: We found insulin resistance in the women with PCOS even if OGTT was normal. Our data were similar to literature, the women with PCOS have increased risk of premature atherosclerosis and metabolic syndrome.

Multidetector computed tomography angiography findings of chronic-contained thoracoabdominal aortic aneurysm rupture with severe thoracal vertebral body erosion.

Chronic-contained aortic aneurysm rupture with vertebral erosion is a rare entity with fatal complications. Multidetector computed tomography (CT) angiography is an important diagnostic method for the evaluation of the aortic aneurysms, their complications, and also the relationship between aneurysm and branching vessels and adjacent structures. We present the multidetector CT angiography findings of a 62-year-old patient with chronic-contained thoracoabdominal aortic aneurysm rupture causing severe vertebral body erosion.

Radiological imaging findings of scheuermann disease

AIM To find accompanying anomalies of typical and atypical Scheuermann’s disease (SD) is reported in the present study. METHODS Study included 20 patients (16 men and 4 women) who had radiological imaging radiography, magnetic resonance imaging (MRI) and computed tomography, if available, due to back pain, curved back and low back pain in November 2011-February 2016 period. Patients were categorized into typical and atypical patterns based on the region involved. Thoracic kyphosis values were measured using real Cobb angle. Accompanying disc degeneration, herniations and spinal cord pathologies were studied using MRI. RESULTS Age of the patients ranged from 11.0 to 23.0 (mean 17.2 ± 3.0). Typical pattern of SD were detected in 15 patients while atypical pattern were detected in 5 patients. Cobb angle range was 40.2-67.2 (mean 55.5 ± 8.7) in typical Scheuermann’s patients and 24.7-49.9 (mean 36.7 ± 10.8) in atypical ones. Intervertebral level was affected and had the measures of 3-8 (mean 5.3 ± 1.6) and 7-9 (mean 8.2 ± 0.8) in typical and atypical Scheuermann’s patients, respectively. Level of degenerative disc disease in MRI was 1-7 discs (mean 4.1 ± 1.7) in typical patients and 5-10 discs (mean 7.6 ± 1.9) in atypical patients. CONCLUSION SD can be seen in typical and atypical patterns, typical being more frequent. Because degenerative disc diseases, herniations and cord pathologies such as syringomyelia can accompany SD (albeit more common in atypical pattern), it is necessary to evaluate these patients with plain radiography and MRI together.

Evaluation of pineal cysts with magnetic resonance imaging

AIM To evaluate radiological imaging findings of patients who had been found to have pineal cyst (PC) in brain magnetic resonance imaging (MRI). METHODS A total of 9546 patients who had brain MRI examination in March 2010-January 2018 period were studied. Fifty-six patients (44 female and 12 male) found to have PC were evaluated. Eighteen of the patients had had follow-up examinations of 2-94 mo (mean 30.50 ± 28.83). PC dimensions and volume, radiological imaging features (signal intensities, contours, internal septation-loculation and contrast-enhancement features) and natural history in cases who had been followed-up were evaluated by two radiologists. RESULTS Of 9546 patients, 5555 were female (58.2%) and 3991 male (41.8%). Age range was 1-99 (mean 43.18 ± 20.94). PC frequency was calculated to be 0.58%. Forty-four of the 56 patients (78.57%) with PC were female and 12 male (21.43%), and their age range was 5-61 (mean 31.26 ± 12.73). Thirty-five of the PCs were typical (62.50%) and 21 (37.50%) were atypical. No significant difference was found between initial and final imaging sizes of PCs which were monitored by follow-up examinations (P > 0.05). CONCLUSION PCs are cysts which do not show clear size and natural changes and are more frequently observed in females and in adult ages. Most of them are isointense with cerebrospinal fluid on T1 and T2A weighted images, hyperintense compared to cerebrospinal fluid on fluid-attenuated inversion recovery; sequence and smoothly contoured. Their typical forms have peripheral rim and multilocular ones may have septal contrast-enhancement.

Evaluating Ossifications of the Nuchal Ligament with Cervical Computed Tomography

Objective The nuchal ligament (NL) extends from the external occipital protuberance and median nuchal line to the spinous process of the 7th cervical vertebrae. In this study, we evaluated the incidence, location level, and size of ossifications of the NL (ONL) in patients who underwent cervical computed tomography (CT) for various reasons. Materials and Methods The present study included 481 patients (187 females and 294 males) who underwent cervical CT from February 2011 to November 2016 due to reasons such as trauma, cervical spondylosis, neck pain, and screening for metastasis. CT was performed using 2- or 8-slice scanners. Archive images of patients on picture archiving and communication system were retrospectively evaluated by two radiologists. The structures in bone density and form detected in NL were evaluated as nuchal ossification. ONL location levels, numbers, and dimensions were determined. The relationship between both sexes and age and the incidence of ONL was investigated. Results ONL was detected in 44 patients (9.14%). The mean ages of patients with ONL and without ONL were 62.27±13.92 (23-86) and 41.78±20.76 (4-101) years, respectively. There was a statistically significant relationship between ONL and age (p<0.001). Thirty-six patients had one ONL, seven patients had two, and one patient had three. The most common ONL location was the C5 spinous process level (n=12) followed by the C6 spinous process level (n=8). The longest ONL in craniocaudal direction was 20.9 mm, and the shortest one was 3.1 mm. Conclusion ONL is a smooth-contoured ovoid or round bone structure extending parallel to the longitudinal axis that can frequently be observed as one or multiple occurrences with different sizes on cervical CT images.

The evaluation of prostate lesions with IVIM DWI and MR perfusion parameters at 3T MRI

PurposeThe purpose of our study was to analyze the difference between IVIM DWI and perfusion parameters of malignant lesions and benign lesions–normal prostate tissue.MethodsThis prospective study included 31 patients who had multiparametric prostate MRI with IVIM DWI due to elevated prostate-specific antigen level and clinical suspicion between February 2015 and September 2016.Results For peripheral zone, the mean values of Ktrans, Kep, iAUC, χ2 and f were significantly higher in malignant lesions, and the mean values of Dt were significantly lower in malignant lesions (p 0.00, p 0.02, p 0.00, p 0.02 and p 0.00, respectively). For transitional zone, the mean values of Ktrans, Ve, iAUC, χ2 and f were significantly higher in malignant lesions, and the mean values of Dp and Dt were significantly lower in malignant lesions (p 0.00, p 0.00, p 0.00, p 0.00, p 0.00, p 0.02 and p 0.00, respectively). For whole prostate gland, the mean values of Ktrans, Kep, Ve, iAUC, χ2 and f were significantly higher in malignant lesions, and the mean values of Dp and Dt were significantly lower in malignant lesions (p 0.00, p 0.03, p 0.00, p 0.00, p 0.00, p 0.01, p 0.04 and p 0.00, respectively).ConclusionsRestricted diffusion–pseudodiffusion and increased perfusion parameters are important to differentiate prostate cancer from benign pathologies. It is also important to keep in mind that transitional zone and peripheral zone tumors may have different perfusion and diffusion parameters. Future studies are needed to confirm our findings.

Duplex Doppler Sonographic Assessment of the Superior Mesenteric Artery in Patients With Mesenteric Panniculitis

We aimed to determine how the hemodynamic parameters of the superior mesenteric artery are affected in mesenteric panniculitis.

Antikoagülan ilişkili abdominal hematomlarin: Klinik ve BT bulgulari

Giris ve Amac: Antikoagulan iliskili abdominal hematomlarin klinik ozelliklerini ve bilgisayarli tomografi (BT) bulgularini degerlendirmeyi amacladik. Gerec ve Yontem: Bu sistematik retrospektif calismaya Mart 2008 ile Mayis 2016 tarihleri arasinda antikoagulan tedavi altinda abdominal hematom tanisi alan 55 hasta ( ortalama yas: 66±12 yil, aralik 29-84 ) dahil edildi. Hastalar demografik ozellikler, klinik belirtiler, tibbi oyku, iliskili faktorler, biyokimyasal testler, BT bulgulari, tedavi ve sonuclari acisindan degerlendirildi. Bulgular: En sik kullanilan antikoagulan ajan warfarin (%72.7) olmakla birlikte enoksaparin kullanimi %20 ve warfarinin enoksaparin ile birlikte kullanimi % 7.3 oranlarinda saptandi. Ana klinik semptomlar karin agrisi ve abdominal distansiyondu. Toplam 85 hematom alani saptandi ve en sik gorulen lokalizasyonlar rektus kas kilifi (%50.9) ve gastrointestinal sistem (% 30.9) olarak izlendi. Kontrol Antikoagulasyon Komitesinin kriterlerine gore 15 (%27.3) hastada major kanama saptandi. Sonuc: Antikoagulan iliskili abdominal hematomlarin sik gorulen klinik ve BT bulgularinin bilinmesi, hizli ve dogru tani koymayi olanak saglar. Ayni zamanda klinik hasta yonetiminde dogrudan bir etkiye sahiptir.

Şiddetli Semilobar Holoprozensefalili Bir Olguda Fetal MRG Bulguları

cephalon into telencephalon and diencephalone in different phases between 35-42 days of embryogenic life. The disease can be divided into three grades; alobar, semilobar and lobar based on the degree of severity. The prognosis