Ozlem Unal

Increased level of red blood cell distribution width is associated with deep venous thrombosis.

Previous studies have demonstrated a significant association between red blood cell distribution width (RDW) and acute pulmonary embolism. To the authors’ knowledge no study has been reported in patients with deep venous thrombosis (DVT). A total of 431 lower extremity venous duplex examinations were included in the study. Of these, 216 examinations with the diagnosis of DVT were compared to 215 examinations with normal duplex findings with respect to RDW. The two groups were well matched. DVT group had a higher median value and the interquartile range (25th and 75th) of RDW (%) level [14.9 (14.2–16.7)] compared to control group [14.4 (13.6–15.2); P <0.001], respectively. Patients were divided into tertiles based on RDW. DVT was detected in 42 patients (31.6%) in the lowest tertile, in 81 (53.3%) in the middle tertile, and in 93 (63.7%) in the highest tertile (P <0.001). In multivariate analysis after adjustment for confounding variables, RDW was the only parameter to predict the presence of DVT [odds ratio (OR) 1.37; 95% confidence interval (CI) 1.21–1.55; P <0.001]. After removing patients with chronic DVT, the interquartile range (25th and 75th) of the RDW (%) level was also higher in the DVT group [15.0 (14.2–16.7)] compared with the control group [14.4 (13.6–15.2); P < 0.001], respectively. In addition, in proximal DVT, the significant difference continued to be present, although this significance was lost in distal DVT [14.4% (13.6–15.2) vs. 16.1% (15.1–17.4), P <0.001 and 14.4% (13.6–15.2) vs. 14.3% (14.2–14.7), P = 0.959]. In multivariate analysis, RDW was an independent predictor of risk of proximal DVT (OR 1.60; 95% CI 1.39–1.84; P <0.001). RDW (%) level was significantly higher in patients with bilateral DVT than in patients with unilateral DVT [16.0 (14.8–17.1) vs. 14.4 (14.2–14.8), P <0.001, respectively]. In receiver operating characteristics curve analysis, RDW more than 14.9% had 85% sensitivity and 73% specificity in predicting proximal DVT. RDW, an inexpensive and easily measurable laboratory variable, was independently and significantly associated with the presence and severity of DVT, especially nonchronic proximal DVT. The mechanism of association requires, however, further study.

The utility of diffusion-weighted magnetic resonance imaging in differentiation of endometriomas from hemorrhagic ovarian cysts

The aim was to determine the utility of diffusion-weighted magnetic resonance imaging (DW MRI) and apparent diffusion coefficient (ADC) measurements in differentiation of endometrioma and hemorrhagic ovarian cyst. A total of 24 female patients who underwent pelvic MRI with an initial diagnosis of ovarian cyst were included in the study. The final diagnosis was endometrioma in 12 patients and hemorrhagic ovarian cyst in 12 patients. We observed significantly lower ADC values in endometriomas compared with hemorrhagic ovarian cysts in all b values. DW MRI with quantitative ADC measurements can be used for differentiation of endometrioma from hemorrhagic ovarian cysts.

Sonographic and sonoelastographic findings of a rarely seen soft tissue tumor: eccrine spiradenoma

Eccrine spiradenoma is a rare benign tumor originating from sweat glands. Its sonographic characteristics have been described in only a few reports, and there is no such report available that describes sonoelastographic findings of this tumor. In this case report, we aimed to define the sonographic and sonoelastographic findings of a benign eccrine spiradenoma.

Strain ratio measurement of femoral cartilage by real-time elastosonography: preliminary results

ObjectiveThe purpose of this study was to evaluate strain ratio measurement of femoral cartilage using real-time elastosonography.MethodsTwenty-five patients with femoral cartilage pathology on MRI (study group) were prospectively compared with 25 subjects with normal findings on MRI (control group) using real-time elastosonography. Strain ratio measurements of pathologic and normal cartilage were performed and compared, both within the study group and between the two groups.ResultsElastosonography colour-scale coding showed a colour change from blue to red in pathologic cartilage and only blue colour-coding in normal cartilage. In the study group, the median strain ratio was higher in pathologic cartilage areas compared to normal areas (median, 1.49 [interquartile range, 0.80–2.53] vs. median, 0.01 [interquartile range, 0.01–0.01], p < 0.001, respectively). The median strain ratio of the control group was 0.01 (interquartile range, 0.01–0.01), and there was no significant difference compared to normal areas of the study group. There was, however, a significant difference between the control group cartilage and pathologic cartilage of the study group (p < 0.001).ConclusionsElastosonography may be an effective, easily accessible, and relatively simple tool to demonstrate pathologic cartilage and to differentiate it from normal cartilage in the absence of advanced imaging facility such as MRI.Key Points• Elastosonography uses colour-maps and strain ratios for evaluating tissue deformability.• Colour change from blue to red and increased strain ratio represent softening.• Normal cartilage shows decreased compressibility, represented by blue colour and low strain ratio.• Pathologic cartilage shows increased compressibility, represented by red colour and high strain ratio.• Elastosonography may be used for differentiating pathologic cartilage from normal cartilage.

Is coracoacromial arch angle a predisposing factor for rotator cuff tears

PURPOSE The aim of the present study was to investigate whether coracoacromial arch angle is a predisposing factor for rotator cuff tears. METHODS Shoulder magnetic resonance imaging (MRI) examinations of 40 patients having shoulder arthroscopy due to rotator cuff tears and 28 patients with normal MRI findings were evaluated retrospectively. Acromio-humeral distance, coraco-humeral distance, the angle between the longitudinal axis of the coracoacromial ligament and longitudinal axis of the acromion (coracoacromial arch angle), and thickness of the coracoacromial ligament were measured. RESULTS In patients with rotator cuff pathology the mean coraco-humeral distance was 7.88±2.37 mm, the mean acromio-humeral distance was 7.89±2.09 mm, and the mean coracoacromial arch angle was 132.38°±6.52° compared to 11.67±1.86 mm, 11.15±1.84 mm, and 116.95°±7.66° in the control group, respectively (P < 0.001, for all). In regression analysis, all three parameters were found to be significant predictors of rotator cuff tears. The mean thickness of the coracoacromial ligament was not significantly different between the patient and control groups (0.95±0.30 mm vs. 1.00±0.33 mm, P > 0.05). CONCLUSION Acromio-humeral and coraco-humeral distances are narrower than normal limits in patients with rotator cuff tears. In addition, coracoacromial arch angle may be a predisposing factor for rotator cuff tears.

Transabdominal Sonographic Study of the Cavum Vergae Detection Rate in Healthy Third-Trimester Fetuses

We aimed to measure the thickness and volume of the cavum vergae by sonography in fetuses at gestational ages of 25 to 41 weeks to determine the relationship of cavum vergae thickness and volume with gestational age and biparietal diameter and to estimate the rate of cavum vergae closure in relation to gestational age.