Sevin Ayaz

The use of ultrasonography in infantile hypertrophic pyloric stenosis: do the patient’s age and weight affect pyloric size and pyloric ratio?

AIMS We aimed to obtain pyloric measurements of our patients with infantile hypertrophic pyloric stenosis (IHPS) using ultrasonography (US) and to evaluate the correlations between age, weight and pyloric size, pyloric ratio (PR). MATERIAL AND METHODS We designed a retrospective study including 20 term infants with surgically proven IHPS and studied the ultrasonographically obtained pyloric muscle thickness (PMT), pyloric diameter (width) (PD), pyloric length (PL) and PR (PMT/PD) to determine if there were statistically significant associations between patient age/weight and pyloric measurements. RESULTS The mean age of the infants was 38.7+/-17.3 days (range, 9-76 days) and their mean weight was 3688.5+/-772.7 g (range, 2810-6000 g), at referral. Mean PMT was 4.98+/-1.04 mm (range, 3.5-6.8 mm). Mean PD was 14.04+/-2.39 mm (range, 10-18 mm). Mean PL was 22.16+/-4.02 mm (range, 16-31.5 mm) and mean PR was 0.35+/-0.04 (range, 0.29-0.42). The correlation between age and PMT (r=0.654, p<0.05) and the correlation between age and PD (r=0.747, p <0.05) were significant. Age and weight were not significantly correlated with PR (p>0.05). CONCLUSIONS The PMT and PD are age dependent parameters. The PR is age and weight independent and therefore, when combined with PMT, PD and PL, it can be useful in the diagnosis of IHPS in infants with early onset disease and/or in those with a lower weight.

Ultrasonographic and Scintigraphic Findings of Thyroid Hemiagenesis in a Child: Report of a Rare Male Case

Thyroid hemiagenesis is a rare congenital anomaly in which one lobe of thyroid gland fails to develop. It is much rarer in males. There is a higher incidence of associated thyroid disorders in patients with thyroid hemiagenesis; therefore early and prompt diagnosis is important for children. We present the ultrasonographic and scintigraphic findings of thyroid hemiagenesis in an eight-year-old-boy. On ultrasonography (US), left lobe of the thyroid gland could not be demonstrated and the right lobe showed minimal hyperplasia. Its echogenicity was normal and no nodule was seen. On thyroid scintigraphy, left lobe of thyroid gland or any ectopic thyroid tissue could not be demonstrated, while the right lobe showed minimal hyperplasia. Without performing any invasive procedure, we enrolled the child in a follow-up program with the guidance of US and scintigraphy, which were effective both in making the final diagnosis of thyroid hemiagenesis and in evaluating the current status of the present thyroid tissue. In conclusion, if only one thyroid lobe is detected in a pediatric case initially with US or scintigraphy, the diagnosis of thyroid hemiagenesis should be suggested and, before any unnecessary or invasive attempt, the other complementary method (scintigraphy/US) should be performed.

Computed Tomography and Magnetic Resonance Imaging Findings in a Case with Biliary Microhamartomas

Biliary microhamartomas, also known as bile duct hamartomas and von Meyenburg complexes, are benign neoplasms containing cystic dilated bile ducts embedded in fibrous stroma. They develop in hepatobiliary system, do not generally give clinical outcomes, and are detected incidentally. However, they can rarely show malignant transformation. Our aim was to report the contribution of computed tomography, routine magnetic resonance imaging, and magnetic resonance cholangiopancreatography in the diagnosis of biliary microhamartomas in a 61-year-old woman.

Initial Fludeoxyglucose (18F) Positron Emission Tomography-Computed Tomography (FDG-PET/CT) Imaging of Breast Cancer – Correlations with the Primary Tumour and Locoregional Metastases

Summary Backround We aimed to evaluate initial PET/CT features of primary tumour and locoregional metastatic lymph nodes (LNs) in breast cancer and to look for potential relationships between several parameters from PET/CT. Material/Methods Twenty-three women (mean age; 48.66±12.23 years) with a diagnosis of primary invasive ductal carcinoma were included. They underwent PET/CT imaging for the initial tumour staging and had no evidence of distant metastates. Patients were divided into two groups. The LABC (locally advanced breast cancer) group included 17 patients with ipsilateral axillary lymph node (LN) metastases. The Non-LABC group consisted of six patients without LN metastases. PET/CT parameters including tumour size, axillary LN size, SUVmax of ipsilateral axillary LNs (SUVmax-LN), SUVmax of primary tumour (SUVmax-T) and NT ratios (SUVmax-LN/SUVmax-T) were compared between the groups. Correlations between the above-mentioned PET/CT parameters in the LABC group as well as the correlation between tumour size and SUVmax-T within each group were evaluated statistically. Results The mean values of the initial PET/CT parameters in the LABC group were significantly higher than those of the non-LABC group (p<0.05). The correlation between tumour size and SUVmax-T value within both LABC and non-LABC groups was statistically significant (p<0.05). In the LABC group, the correlations between the size and SUVmax-LN values of metastatic axillary LNs, between tumour size and metastatic axillary LN size, between SUVmax-T values and metastatic axillary LN size, between SUVmax-T and SUVmax-LN values, and between tumour size and SUVmax-LN values were all significant (p<0.05). Conclusions We found significant correlations between PET/CT parameters of the primary tumour and those of metastatic axillary LNs. Patients with LN metastases had relatively larger primary tumours and higher SUVmax values.

Hip ultrasonography in classification of proximal focal femoral deficiency: Two case reports

DOI: 10.4328/JCAM.4842 Received: 20.10.2016 Accepted: 17.11.2016 Printed: 01.06.2017 J Clin Anal Med 2017;8(suppl 3): 187-91 Corresponding Author: Ümit Yaşar Ayaz, Mersin Women’s and Children’s Hospital, Department of Radiology, Mersin, Turkey. T.: +90 3242230701 GSM: +905377639442 F.: +90 3242230722 E-Mail: umityasarayaz@gmail.com Özet Proksimal fokal femur yetmezliği (PFFY) bulunan iki infantta femur başlarını sonografik olarak göstermeyi ve ultrasonografi (US) katkısı ile PFFY sınıflaması yapmayı amaçladık. Sağ uyluğunda kısalık bulunan yedi aylık erkek olgunun (Olgu 1) radyografisinde sağ femurun proksimal yarısında belirgin hipoplazi saptandı. Aynı taraf asetabulum displazikti. US’de femur başı hipoplazikti. Sağ uyluğunda kısalık bulunan 16 günlük erkek olgunun (Olgu 2) radyografisinde sağ femurun sola kıyasla daha kısa ve ince olduğu görüldü. Aynı taraf asetabulumun gelişimi yeterliydi. US’de femur başı normaldi. US, PFFY’li infantlarda kıkırdak femur başlarının durumunu göstererek Olgu 1 ve Olgu 2’nin, sırasıyla Aitken sınıf C ve A olarak sınıflandırılmasına yardımcı olmuştur. US, radyografi ile birlikte PFFY sınıflamasında ve diğer kalça eklemini değerlendirmede kullanılabilir.

The Role of Radiologic and Scintigraphic Imaging in Differentiating Thoracic Pyogenic Spondylodiscitis from Metastasis

Background: Physical examination, basic laboratory tests and plain radiographs can give important data in diagnosis of the patients presenting with complaints of back pain. However, advanced imaging tools may be necessary for further evaluation of complicated processes in geriatric patients. Case presentation: We presented plain radiography, magnetic resonance imaging (MRI) and bone scintigraphy (BS) findings of thoracic pyogenic spondylodiscitis in a 72-year-old male patient which resembles metastatic disease. Conclusion: Multimodal imaging, particularly MRI and BS can provide useful data in the initial diagnosis and follow-up of geriatric patients with a complicated vertebral pathology. Spondylodiscitis can mimic metastatic disease.

Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (FDG PET/CT) Findings in an Unusual Case of Multiple Myeloma Presenting with a Large Extra-Axial Intracranial Mass.

Summary Background We aimed to present unusual cranial FDG PET/CT findings of a 56-year-old female with multiple myeloma (MM). Case Report Plain CT images revealed a lytic lesion in the right parietal bone, filled with an oval-shaped, large, extra-axial, extradural, intracranial mass which measured 75×75×40 mm and had smooth borders. The right parietal lobe was compressed by the mass. The maximum standardized uptake value (SUVmax) of the mass lesion was 8.94 on FDG PET/CT images. Multiple lytic lesions with an increased uptake were also detected in other calvarial bones, in several vertebras and in the proximal left femur. After seven months, a control FDG PET/CT following radiotherapy and chemotherapy revealed almost complete regression of the right parietal extra-axial mass lesion. The number, size and metabolism of lytic lesions in other bones also decreased. Conclusions FDG PET/CT was useful for an initial evaluation of MM lesions and was effective in monitoring the response of these lesions to therapy.

Pancake Kidney In A Geriatric Patient: Radiologic And Scintigraphic Findings

Our aim was to present a case of incidentally detected pelvic pancake kidney anomaly with imaging findings in a 65-years-old male patient and to discuss its clinical significance. Pancake kidney, also called pelvic fused kidney, lump or cake kidney, is a rare type of congenital renal fusion anomaly. It is characterized by the presence of a lobulated pelvic renal mass which has a dual parenchymatous system without an intervening septum. Radiologic and scintigraphic findings of the patient having symptoms of urgency were consistent with a pelvic pancake kidney. Although urinary system anomalies often coexist with malformations of other organs and systems, no associated anomalies could be detected in our case.