Serdar Arslan

Diagnostic Performance of Superb Microvascular Imaging and Other Sonographic Modalities in the Assessment of Lateral Epicondylosis

The aim of this study was to compare the diagnostic performance of different sonographic modalities for diagnosing lateral epicondylosis.

Advantages of b-mode ultrasound combined with strain elastography in differentiation of idiopathic granulomatous mastitis from malignant breast lesions

Background/aim: To evaluate the diagnostic performance of strain elastography (SE) combined with B-mode ultrasound in distinguishing between idiopathic granulomatous mastitis (IGM) and malignant breast lesions. Materials and methods: Seventy-seven malignant breast lesions and 36 IGM were assessed using B-mode ultrasound and SE. Ultrasonographic findings for all the breast lesions were classified based on the 2013 American College of Radiology Breast Imaging Reporting and Data System (BI-RADS-US), and the SE findings were evaluated based on the strain ratio and a five-point scale. The diagnostic performances of B-mode ultrasonography, SE, and the combination of both methods were compared. Results: Significant differences in strain ratio and elastography scores were found between IGM and malignant breast lesions. When the lesions were assessed with B-mode ultrasound alone, in order to distinguish between IGM and malignant breast lesions, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 94.8%, 66.7%, 85.9%, 85.7%, and 85.8%, respectively. However, when assessed with a combination of B-mode ultrasonography and SE, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 96.1%, 100%, 100%, 92.3%, and 97.3%, respectively. Conclusion: The combination of SE and B-mode ultrasound has better diagnostic performance in the differentiation of IGM and malignant breast lesions than B-mode ultrasonography alone.

Percutaneous treatment of hepatic cystic echinococcosis: the success of alcohol as a single endocavitary agent in PAIR, catheterization, and modified catheterization techniques

ObjectivesThis retrospective study aims at demonstrating the success rate, effectiveness, and advantages of alcohol as a scolicidal and sclerosing agent for the percutaneous treatment of liver hydatid cysts.MethodsA total of 554 liver hydatid cysts obtained from 347 patients admitted between January 2008 and February 2016 were retrospectively investigated. Of these, 435 (78.5%), 91 (16.4%), and 28 (5%) were classified as Gharbi type 1, 2, and 3, respectively. Type 1 and 2 cysts were treated using PAIR (puncture, aspiration, injection, respiration) and single puncture catheterization methods; type 3 lesions were treated using a modified catheterization technique. Alcohol was used as a scolicidal and sclerosing agent in all procedures.ResultsAfter excluding three lesions (0.5%) because of lack of parenchymal support during catheterization, 274 (49.7%), 250 (45.3%), and 27 (4.9%) of 551 lesions were treated with PAIR, single puncture catheterization, and modified catheterization techniques, respectively. Therefore, a 99.5% of technical success rate was obtained. Major complications in 2 patients (0.5%) and minor complications were observed in 36 patients (10.3%). Mean hospital stay was 1.55±2.3 days (range: 0-23 days). Patients were followed-up for mean 19.6 months (range: 6-83 months), during which recurrences were detected in 19 patients (5.4%).ConclusionsThe use of alcohol as a scolicidal and sclerosing agent during the percutaneous treatment of liver hydatid cysts is associated with a high success rate and low rates of recurrence and complications, and should be considered an important alternative to surgical procedures.

Superb Microvascular Imaging of the Median Nerve in Carpal Tunnel Syndrome: An Electrodiagnostic and Ultrasonographic Study: SMI of Median Nerve in CTS

To evaluate intraneural blood flow of the median nerve using superb microvascular imaging (SMI) and power Doppler ultrasonography (PDUS), and to examine their correlation with electroneuromyography in patients with carpal tunnel syndrome (CTS).

Thoracolumbar intramedullary lipoma without dysraphism causing paraplegia in a pediatric patient

A 6-month-old infant was admitted to our hospital with absence of movement in his legs. During a physical examination, lower extremity muscle strength was found to be 1 out of 5 bilaterally. Also, there was no response to sensory testing. Spinal ultrasonography was performed and showed an intramedullary mass filling the spinal canal containing echogenic linear septations with subcutaneous fatty tissue (Fig. 1). Spinal magnetic resonance imaging (MRI) was performed to more clearly investigate spinal abnormalities. Lumbar MRI showed an intramedullary mass causing expansion of the cord between T10 and L4 and measuring 83 × 17 × 16 mm. The lesion was hyperintense in T1and T2weighted images. There was no enhancement after intravenous contrast administration. Additionally, suppression was seen in fat-suppressed images. Lipoma was diagnosed with typical imaging findings (Fig. 2). No other dysraphism finding was detected in the spinal MRI.