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Is Neutrophil/Lymphocyte Ratio Predict to Short-term Mortality in Acute Cerebral Infarct Independently from Infarct Volume?

BACKGROUNDnNeutrophil/lymphocyte ratio (NLR) is related with increased mortality in both myocardial infarction and acute ischemic stroke. It remains unclear whether NLR is a simple marker of ischemic infarct volume or an independent marker of stroke mortality. The aim of this study is to investigate the relationship of NLR with infarct volume and short-term mortality in acute ischemic stroke (AIS).nnnMETHODSnThis retrospective study included 151 patients with first AIS that occurred within 24 hours of symptom onset. Patients were screened from the hospitals electronic record system by using International Classification of Diseases code (G 46.8). NLR was calculated as the ratio of neutrophils to lymphocytes. Short-term mortality was defined as 30-day mortality.nnnRESULTSnA total 20 of 151 patients died during follow-up. Both NLR and infarct volume of nonsurvived group were significantly higher than survived group (P < .05). Infarct volume, NLR, and National Institutes of Health Stroke Scale (NIHSS) were independent predictors of the mortality in Cox regression analysis. The optimal cutoff value for NLR as a predictor for short-term mortality was determined as 4.81. NLR displayed a moderate correlation with both NIHSS and Glasgow Coma Scale (P < .01). NLR values were significantly higher in the highest infarct volume tertile than both in the lowest volume tertile and midtertile of infarct volume (P = .001).nnnCONCLUSIONSnNLR at the time of hospital admission maybe a predictor of short-term mortality independent from infarct volume in AIS patients. NLR should be investigated in future prospective trials investigating AIS.

Prognostic value of preoperative neutrophil- to-lymphocyte and platelet-to-lymphocyte ratios, and multiphasic renal tomography findings in histological subtypes of renal cell carcinoma

BackgroundTo determine the relationship between renal cell carcinoma subtypes and the associated mortality and biochemical parameters. An additional aim was to analyze multiphasic multidetector computed tomography findings.MethodsThis study is a hospital-based retrospective investigation, using 211 patients with a diagnosis of renal cell carcinoma upon computed tomography examination. The histological subtypes included clear cell in 119 patients, chromophobe cell in 30 patients, papillary cell in 25 patients, mixed cell in 32 patients, and sarcomatoid cell in 4 patients.ResultsThe mean age of the patients participating in this study was 61.18u2009±u200911.81xa0years, and the mortality rate was 10.4% (nu2009=u200922) through the 2-year follow-up. The ratios of both the neutrophil-to-lymphocyte upon admission to the hospital and platelet-to-lymphocyte of the non-surviving group were significantly higher than those of the surviving group (pu2009<u20090.05). When the analysis of the 2-year survival of the patients was examined according to the median platelet-to-lymphocyte ratio values, the Kaplan-Meier survival curves were significantly different between the surviving and non-surviving groups (pu2009=u20090.01). In two-way analysis of variance test, statistically significant results which were influenced by mortality (pu2009=u20090.028) and were found between renal cell carcinoma subtypes in the computed tomography density of corticomedullary phase (pu2009=u20090.001).ConclusionsThe neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio may represent widely available biomarkers in renal cell carcinoma, and the logistic regression model indicated that neutrophil-to-lymphocyte ratio was a significant predictor for mortality. According to the median platelet-to-lymphocyte ratio values, the Kaplan-Meier survival curves were significantly different between the surviving and non-surviving groups.

The use of axial diameters and CT obstruction scores for determining echocardiographic right ventricular dysfunction in patients with acute pulmonary embolism

PurposeTo evaluate the accuracy of cardiac computed tomography (CT) parameters and pulmonary artery (PA) obstruction (OS) scores in determining the echocardiographic right ventricular dysfunction (RVD) in hemodynamically stable patients with acute pulmonary embolism (PE).Materials and methodsA total of 120 patients with acute PE were included in the study. Right ventricle/left ventricle ratio (RV/LV); PA axial diameter; superior vena cava (SVC) axial diameter; and Ghanima, Miller, Qanadli, and Mastora obstruction scores were obtained using CT. RVD was assessed by echocardiography. The patients were divided into two groups based on the presence or absence of RVD.ResultsRV/LV ratio, SVC axial diameter, PA axial diameter, and Miller, Qanadli, and Mastora scores were significantly increased in the RVD group. Multivariate logistic regression analysis showed that RV/LV ratio [OR 6.36 (2.02–279.46 95xa0% CI), pxa0=xa00.01] and PA axial diameter [OR 5.02 (1.02–1.26 95xa0% CI), pxa0=xa00.03] were independent predictors of echocardiographic RVD. Predictive values of these parameters were improved when combined with other intragroup cutoff values. A cutoff value for the RV/LV ratio of >1.08 had 81.43xa0% sensitivity, 52.08xa0% specificity, 71.3 PPV, and 65.8 NPV for prediction of RVD.ConclusionTomographic axial diameters enable more accurate predictions of RVD than OS scores do.

The value of magnetic resonance imaging in the diagnosis of penile fracture

Purpose We studied the use of magnetic resonance imaging in the diagnosis of penile fracture. Materials and Methods Between 1997 and 2012, fifteen patients (age range 17-48 years, mean age 37 years) with suspected penile fracture underwent MRI examinations. Ten patients were injured during sexual intercourse, whereas four patients were traumatized by non-physiological bending of the penis during self manupilation, one patient was traumatized falling from the bed. Investigations were performed with 1.5T MR unit. With the patient in the supine position, the penis was taped against the abdominal wall and surface coil was placed on the penis. All patients were studied with axial, coronal, sagittal precontrast and postcontrast T1-weighted TSE(TR/TE:538/13 msn) and T2-weighted TSE(5290/110 msn) sequences. All patient underwent surgical exploration. The follow-up ranged from 3 months to 72 months. Clinically all patients showed normal healing process without complications. In 11 patients a shortening and thickening of tunica albuginea was observed. Three patients have post traumatic erectil disfunction. Results In all patient corpus cavernosum fractures were clearly depicted on a discontinuity of the low signal intensity of tunica albuginea. These findings were most evident on T1WI and also depicted on T2W sequences. Images obtained shortly after contrast medium administration showed considerable enhancement only in rupture site. Subcutaneous extratunical haematoma in all patients were also recognizable on T2 WI. MRI findings were confirmed at surgery. Conclusions Magnetic resonance imaging is of great value for the diagnosis of penile fracture. Furthermore this method is well suited for visualising the post-operative healing process

The Amyand’s Hernia: A Rare Clinical Entity Diagnosed by Computed Tomography

Amyands hernia, named for the first person to describe an inguinal hernia containing the vermiform appendix, is an uncommon variant of an inguinal hernia. Amyands hernia is an extremely rare condition and is often misdiagnosed. Traditionally, these hernias have been diagnosed at surgery but are increasingly diagnosed by abdominal computed tomography (CT) scans. CT of the abdomen may help in guiding the diagnosis.

Evaluation of effects of bronchiectasis on bronchial artery diameter with multidetector computed tomography.

Background: Among patients with increased bronchial artery diameter there is a significant association between hemoptysis and bronchiectasis score. The higher score of bronchiectasis, the higher risk of hemoptysis development. Purpose: To investigate the association of stages of bronchiectasis based on a computed tomography (CT) grading system, with bronchial artery diameter and hemoptysis in patients with bronchiectasis. Material and Methods: Patients with lung pathologies other than bronchiectasis, which may cause hemoptysis, were excluded from the study. One hundred and forty-five patients who underwent contrast-enhanced thorax CT by a 64-detector CT for various indications, and who were diagnosed with bronchiectasis, were evaluated retrospectively. CT examinations were carried out by two radiologists with 9 and 4 years of experience with chest radiology, respectively. The diameters of the right and left bronchial arteries were measured 1u2009cm from the aortic origin and perpendicular to the vessel axis. Cases were assessed based on the Bhalla CT scoring system. The hemoptysis history of every patient was taken. Results: The diameters of the right and left bronchial arteries were significantly greater in patients with scores of 2 and 3 bronchiectasis than in patients with a score of 1. This was significantly greater in patients with a score of 3 than in patients with a score of 2 (Pu2009<u20090.05). In patients with a score of 1, the right bronchial artery diameter was significantly greater than that of the left bronchial artery (Pu2009<u20090.05). Right bronchial artery diameters were significantly greater than left bronchial artery diameters in score 3 patients (Pu2009<u20090.05). A significant association was observed between hemoptysis and bronchiectasis in patients with increased bronchial artery diameter (Pu2009<u20090.05). Conclusion: In patients with bronchiectasis, as the stage of bronchiectasis increases, the bronchial artery diameters and the risk of hemoptysis increase. We think that in patients who are diagnosed with bronchiectasis via multidetector CT (MDCT), based on scoring with bronchial artery diameters, the risk of hemoptysis can be estimated, and early management plans can be implemented.

Evaluation of fetal nasofrontal angle in the second trimester in normal pregnancies

The nasal bone is one of the important fetal structures to be radiologically evaluated in the first and second trimesters. In this study, we aimed to evaluate the nasal root and to determine the normal range of the naso‐frontal angle, which may potentially be used as a predictive or diagnostic parameter in the diagnosis of the above‐mentioned syndromes or other congenital abnormalities with associated nasal features using obstetric ultrasonography in normal fetuses.

Effective radiation exposure evaluation during a one year follow-up of urolithiasis patients after extracorporeal shock wave lithotripsy.

Introduction To determine and evaluate the effective radiation exposure during a one year follow-up of urolithiasis patients following the SWL (extracorporeal shock wave lithotripsy) treatment. Material and methods Total Effective Radiation Exposure (ERE) doses for each of the 129 patients: 44 kidney stone patients, 41 ureter stone patients, and 44 multiple stone location patients were calculated by adding up the radiation doses of each ionizing radiation session including images (IVU, KUB, CT) throughout a one year follow-up period following the SWL. Results Total mean ERE values for the kidney stone group was calculated as 15, 91 mSv (5.10-27.60), for the ureter group as 13.32 mSv (5.10-24.70), and in the multiple stone location group as 27.02 mSv (9.41-54.85). There was no statistically significant differences between the kidney and ureter groups in terms of the ERE dose values (p = 0.221) (p >0.05). In the comparison of the kidney and ureter stone groups with the multiple stone location group; however, there was a statistically significant difference (p = 0.000) (p <0.05). Conclusions ERE doses should be a factor to be considered right at the initiation of any diagnostic and/or therapeutic procedure. Especially in the case of multiple stone locations, due to the high exposure to ionized radiation, different imaging modalities with low dose and/or totally without a dose should be employed in the diagnosis, treatment, and follow-up bearing the aim to optimize diagnosis while minimizing the radiation dose as much as possible.

Incidental Breast Lesions Detected on Computed Thorax Tomography

OBJECTIVEnAlthough mammography is the primary imaging method of the breast, incidental benign and malignant breast lesions are increasingly being detected on computed tomographies (CTs) performed to detect different pathologies. Therefore, the detection and accurate identification of these lesions is important. In this study, we aimed to evaluate the frequency, morphological features, and results of incidental breast lesions on CTs performed for the detection of extramammarian pathologies.nnnMATERIALS AND METHODSnIncidental breast lesions on CTs performed in our department between 2011 and 2013 were evaluated. Patients who had previously diagnosed breast lesions were excluded from the study. The inclusion criteria were histopathologic diagnose and being followed-up for at least 2 years.nnnRESULTSnThe study population consisted of 33 women whose mean age was 55±1.38 (37-78) years. Of the 33 women, 12 (36%) had malignant and 21 (64%) had benign or normal findings. The most common malignant lesion was invasive ductal carcinoma, and the most common benign lesion was fibroadenoma. Ill-defined contour and lymphadenopathy in malignant lesions and well-defined contour in benign lesions were the most important CT findings.nnnCONCLUSIONnBreast must be carefully evaluated if it is included in the scans. An accurate report of breast lesions gives an opportunity for early diagnosis and treatment.

Bilateral supernumerary kidney: a very rare presentation.

To our knowledge, bilateral supernumerary kidney is a very rare renal abnormality and there are five cases presented in the literature. It is difficult to diagnose supernumerary kidney and clinicians have not detected most cases preoperatively. Laboratory and imaging studies were acquired and carefully examined. The normal laboratory tests were found. Emergency ultrasonography was performed and they revealed no signs of parenchymal abnormality in both kidneys. Serial imaging study including enhanced computed tomography (CT) was performed. An imaging study identified bilateral supernumerary kidney with expanded collecting systems. On each side, significant rotation anomaly was found. In addition, there were two different renal arteries originating from the aorta. This report presents radiological determinations of supernumerary kidney bilaterally in a young man. We think that CT commonly appears to be enough for the diagnosis of supernumerary kidneys.