Radiological Imaging Methods Research Articles

Radiological Imaging Diagnosis of Adult Renal Cystic Diseases and Management

Background: Renal cysts are a heterogonous group of cystic renal diseases that present in approximately 40% of the patients undergoing imaging. Objective: To describe the role of the radiological imaging methods for the diagnosis of adult renal cystic diseases and their management. Methods: A descriptive study carried out for 218 patients of renal cystic diseases in adults in two Private Hospitals in Aden Province during the period from February 2006 to December 2014, diagnosed by ultrasonography, contrasted urography and computerized tomography determined the age, gender, frequency, and complications and type of treatment. Results: Autosomal dominant polycystic kidney disease (ADPKD) presented in 96 patients (44%), simple renal cysts 90 (41%), medullary sponge kidney 25 (11%), localized cystic renal disease (LCRD) six (3%) and adult multilocular cystic nephroma one (1%). Ultrasound correctly interpreted 179 patients (82%), nonvisualized 25 (11%), and inconclusive 13 (7%) contrasted urography correctly interpreted 176 (76%), nonvisualized 13 (6%) and inconclusive 19 (9%) and computerized tomography (CT) scan 199 patients (91%), six (3%) and 13 (6%) respectively. Complications occurred in 65 patients (68%) of ADPKD, 23 (25%) of simple renal cysts, 15 (60%) of medullary sponge kidney (MSK) and three patients (50%) of LCRD. Conservative treatment performed in 171 (78%) and surgical intervention in 47 patients (22%). Conclusion: The commonest renal cystic disease is adult dominant polycystic kidney. Ultrasound is inconclusive for renal cystic masses. CT scan is the effective imaging study for localized and multifocal renal cystic diseases, complications and associated pathology. The frequent complications occur in adult dominant polycystic kidney disease and medullary sponge kidney. Keywords: Adults, renal cystic diseases, imaging, management Citation: Akares SA, Bahomil AA. Radiological imaging diagnosis of adult renal cystic diseases and management. Iraqi JMS. 2020; 18(1): 12-20. doi: 10.22578/IJMS.18.1.3

Understanding the Role of Gadoxetic Acid in MRI.

Radiological imaging methods used at a large scale in the assessment of hepatic lesions include: Ultrasound, computed tomography and magnetic resonance. To further characterize these lesions, specific contrast agents may be added, thus revealing the vascularity of the lesions. This review focuses on gadoxetic acid, which is a hepatospecific contrast agent used in MRI. The aim of the review is to briefly explain the mechanism of GA enhancement, describe the enhancement patterns of some benign and malignant hepatic lesions and discuss possible advantages of GA over standard contrast agents. The role of GA in functional MR cholangiography and the idea of accessing liver function by measuring parenchymal enhancement will also be explained.

Head and neck injuries after a bomb explosion: Diagnostic findings and treatment approaches.

To identify the types and severity of head, face and neck (HFN) injuries, which occurred as a result of a bomb explosion and reached serious life-threatening levels, using radiological imaging methods, and to discuss the options of treatment at the time of presentation. Of the 16 patients brought to the emergency department, 14 with HFN injuries were included in the study. Computed tomography (CT) and radiography scans were performed at the time of presentation in all patients, except for one. The injuries were divided into three groups according to their localization as head, face, and neck. A subgaleal hematoma was seen in 10 of 11 (78.5%) patients with head injuries. Eight (57.1%) of nine patients with facial injury had fractures and/or ocular injury in the orbital wall, and seven (50%) patients had maxillofacial bone fractures. Among ocular trauma cases, open-globe injuries were detected in three patients (21.4%), closed-globe in two (14.2%), and both types in three (21.4%). Of the five (35.7%) patients with secondary blast injuries in the neck, three (21.4%) had laryngeal trauma (Zone 2) due to shrapnel, localized in the false vocal cord, epiglottis, and thyrohyoid membrane, respectively. Emergency surgery was performed on a patient with a specific laryngeal injury. We consider that in patients presenting to the emergency department with blast HFN injuries, after providing airway patency and hemodynamic stability, CT and CT angiography should be performed because these modalities guide the treatment accurately and promptly.

Radiological imaging in treatment planning and monitoring for patients with destructive pulmonary tuberculosis and the use of valvular bronchial blocking

In the Russian Federation, most cases of valvular bronchial blocking are associated with the treatment of destructive pulmonary tuberculosis. Bronchial blocking is indicated when there are cavities in various forms of pulmonary tu-berculosis that do not close for long (4 months or more). Bronchial blocking in these cases is meant to close cavi-ties, and bronchopleural fistulas, eliminate bleeding and spontaneous pneumothorax, and treat pleural empyema. Radiological diagnostic techniques are key elements in the planning and control of valvular bronchial blocking. At the planning stage, indications and contraindications for valve placement are assessed, as well as anatomical features that can predict ineffectiveness of the interven-tion, including, as the most important ones, signs of col-lateral ventilation. The most informative method of radio-logical imaging at this stage is computed tomography, which allows a detailed assessment of changes in the lung tissue of the zone of interest, including its surroun-ding, bronchial tree and pleura. When monitoring treat-Рис. 1. Эндобронхиальные клапаны российского производства [14]ment, depending on the clinical situation, it is possible to use both classical X-ray examination and computed tomo graphy. The article presents the tactics of radiologi-cal ima ging methods' application at the stage of selection and control of treatment for patients with destructive pul-monary tuberculosis. Various changes in the target lobe of the lungs after bronchial blocking are shown. Valvular bronchial blocking is an effective addition to the complex treatment of destructive pulmonary tuberculosis, includ-ing its complications, and contributes to the reduction of bacterial shedding. Computed tomography increases the efficiency of valvular bronchial blocking results' forecast, and also is an important monitoring technique after the valve placement

The effectiveness of piriformis injection under fluoroscopy and nerve stimulator guidance with local anaesthetic and steroid for management of piriformis syndrome among manual workers in Eastern India: A prospective interventional study

Background: Piriformis syndrome (PS) is a neuromuscular disorder characterized by compression or irritation of sciatic nerve by the piriformis muscle causing pain, tingling, and numbness in the buttocks and sometimes along the distribution of the sciatic nerve descending down to the leg. Pharmacotherapy and physical-therapy remain the first line of management. Local anesthetic (LA) with steroid injection in piriformis muscle is given if conservative management fails. Nerve stimulator, electromyography, radiological imaging, and various other methods have been used to increase the reliability of injections. In the present study, the efficacy of combined fluoroscopy and nerve stimulator guided piriformis injection with LA and steroid for the management of PS has been re-validated among the manual workers of Eastern India. Subjects and Methods: With ethical permission and informed consent from 35 patients of PS fulfilling the inclusion and exclusion criteria were given piriformis injection with 5 mL of 0.25% bupivacaine and 20 mg methyl prednisolone under guidance of a combination of fluoroscopy and nerve stimulator. Thirty-one patients completed the study. Pain in Numeric Rating Scale and Disability by Ronald Morris Disability Questionnaire were recorded for all patients before the procedure, 1 h, 1 week, 3 weeks, and 12 weeks after the procedure and were statistically analyzed. Results: Pain score and back disability score decreased significantly (P < 0.05) after the injection, and the effect was also sustained up to 12 weeks. Conclusions: Injection of LA along with steroid in piriformis muscle under fluoroscopy and nerve stimulator guidance, followed by physiotherapy, is an effective treatment for PS among manual workers.

Noninvasive Young's modulus visualization of fibrosis progression and delineation of pancreatic ductal adenocarcinoma (PDAC) tumors using Harmonic Motion Elastography (HME) in vivo.

Background and aims: Poor specificity and predictive values of current cross-sectional radiological imaging methods in evaluation of pancreatic adenocarcinoma (PDAC) limit the clinical capability to accurately stage the tumor pre-operatively and provide optimal surgical treatment and improve patient outcomes.Methods: In this study, we applied Harmonic Motion Elastography (HME), a quantitative ultrasound-based imaging method to calculate Young's modulus (YM) in PDAC mouse models (n = 30) and human pancreatic resection specimens of PDAC (n=32). We compared the YM to the collagen assessment by Picrosirius red (PSR) stain on corresponding histologic sections.Results: HME is capable of differentiating between different levels of fibrosis in transgenic mice. In mice without pancreatic fibrosis, the measured YM was 4.2 ± 1.3 kPa, in fibrotic murine pancreata, YM was 5.5 ± 2.0 kPa and in murine PDAC tumors, YM was 11.3 ± 1.7 kPa. The corresponding PSR values were 2.0 ± 0.8 %, 9.8 ± 3.4 %, and 13.2 ± 1.2%, respectively. In addition, three regions within each human surgical PDAC specimen were assessed: tumor, which had both the highest Young's modulus (YM > 40 kPa) and collagen density (PSR > 40 %); non-neoplastic adjacent pancreas, which had the lowest Young's modulus (YM < 15 kPa) and collagen density (PSR < 10%) and a transitional peri-lesional region between the tumor and non-neoplastic pancreas with an intermediate value of measured Young's modulus (15 kPa < YM < 40 kPa) and collagen density (15% < PSR < 35 %).Conclusion: In conclusion, a non-invasive, quantitative imaging tool for detecting, staging and delineating PDAC tumor margins based on the change in collagen density was developed.

An Anatomic Study of the Supratrochlear Foramen of the Humerus and Review of the Literature

Objective: The coronoid fossa and the olecranon fossa located on the distal end of the humerus are separated by a thin bone septum. This septum may be translucent or opaque. In some cases, this septum may become perforated, and it is called supratrochlear foramen. The aim of the present study was to describe the morphology of the supratrochlear foramen of the humerus. Methods: This study was conducted on 108 dry humeri (right (R): 56, left (L): 52) belonging to adults whose age, gender, and racial properties are unknown. They were examined to determine the presence of the supratrochlear foramen. The shapes of the supratrochlear foramen were determined, and their diameters were measured. Results: The supratrochlear foramen was observed in 11 cases on the right side and 11 cases on the left side. On the right side, 5 foramens were detected to be round-shaped, 3 oval-shaped, and 3 kidney-shaped, whereas on the left side, 6 foramens were detected to be oval-shaped and 5 round-shaped. Of the 86 dry humeri with no supratrochlear foramen, 57 (R: 30, L: 27) had a translucent septum, and 29 (R: 15, L: 14) had an opaque septum. Conclusion: It is apparent that the supratrochlear foramen has been evaluated on bones generally in the literature, and there are differences in incidence rates. Owing to the clinical significance of this formation, it is thought that studying on a wider population of living individuals using radiologic imaging methods will contribute to the literature. In addition, although there are different terms used to express this formation in the literature, it is thought that adopting the name, which is commonly used as supratrochlear foramen, is most appropriate.

Small Vessels Are a Big Problem in Neurodegeneration and Neuroprotection.

The cerebral microcirculation holds a critical position to match the high metabolic demand by neuronal activity. Functionally, microcirculation is virtually inseparable from other nervous system cells under both physiological and pathological conditions. For successful bench-to-bedside translation of neuroprotection research, the role of microcirculation in acute and chronic neurodegenerative disorders appears to be under-recognized, which may have contributed to clinical trial failures with some neuroprotectants. Increasing data over the last decade suggest that microcirculatory impairments such as endothelial or pericyte dysfunction, morphological irregularities in capillaries or frequent dynamic stalls in blood cell flux resulting in excessive heterogeneity in capillary transit may significantly compromise tissue oxygen availability. We now know that ischemia-induced persistent abnormalities in capillary flow negatively impact restoration of reperfusion after recanalization of occluded cerebral arteries. Similarly, microcirculatory impairments can accompany or even precede neural loss in animal models of several neurodegenerative disorders including Alzheimer's disease. Macrovessels are relatively easy to evaluate with radiological or experimental imaging methods but they cannot faithfully reflect the downstream microcirculatory disturbances, which may be quite heterogeneous across the tissue at microscopic scale and/or happen fast and transiently. The complexity and size of the elements of microcirculation, therefore, require utilization of cutting-edge imaging techniques with high spatiotemporal resolution as well as multidisciplinary team effort to disclose microvascular-neurodegenerative connection and to test treatment approaches to advance the field. Developments in two photon microscopy, ultrafast ultrasound, and optical coherence tomography provide valuable experimental tools to reveal those microscopic events with high resolution. Here, we review the up-to-date advances in understanding of the primary microcirculatory abnormalities that can result in neurodegenerative processes and the combined neurovascular protection approaches that can prevent acute as well as chronic neurodegeneration.

Evaluation of the position variation of mandibular foramen

Berlinska Magdalena , Misiejuk Aleksandra , Komisarek Oskar . Evaluation of the position variation of mandibular foramen . Journal of Education, Health and Sport. 2019;9(7):1 85 -194 . eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.3269410 http://ojs.ukw.edu.pl/index.php/johs/article/view/71 20 https://pbn.nauka.gov.pl/sedno-webapp/works/917520 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26/01/2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2019; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 20.06.2019. Revised: 25.06.2019. Accepted: 04.07.2019. EVALUATION OF THE POSITION VARIATION OF MANDIBULAR FORAMEN Magdalena Berlinska 1 magdalena.berlinska@onet.pl ORCID: 0000-0002-1742-5481, Aleksandra Misiejuk 1 ale.misiejuk@gmail.com ORCID: 0000-0001-8224-4962, Oskar Komisarek 2 oskarkomisarek@gmail.com ORCID: 0000-0002-1037-3711 1 Students Scientific Society of Maxillofacial and Orthognathic surgery, Poznan University of Medical Sciences, Collegium Maius, ul. Fredry 10, 61-701 Poznan 2 Department of Maxillofacial Orthopaedics and Orthodontics, Poznan University of Medical Sciences, Collegium Maius, ul. Fredry 10, 61-701 Poznan ABSTRACT INTRODUCTION: Mandibular foramen is located on the internal surface of the ramus of the mandible. Through this opening mandibular nerve and vessels enter the mandibular canal. As there are no palpable landmarks that allow determining the position of the mandibular foramen precisely, it is helpful to use radiological imaging methods for this purpose. Mainly X-ray techniques are used, especially panoramic radiograph for its accessibility and wide range of diagnostic applications. Knowledge of the position of the mandibular foramen is essential for the correct and effective performance of the inferior alveolar nerve block, which is one of the most common anaesthesia in dental practice. AIMS: The purpose of the study was to examine and find possible correlations between sex, age, posterior teeth loss and relative localization of the mandibular foramen. SUBJECTS AND METHODS: Selected parameters were measured on 50 digital panoramic radiographic images of 50 patients, including 33 males and 17 females, hospitalized in the Maxillofacial Surgery Ward of the Heliodor Swiecicki Clinical Hospital in Poznan. RESULTS : Localization of the mandibular foramen does not correlate with age, nor the posterior teeth loss and sex has only a slight impact on its vertical location. CONCLUSIONS: Since none of the parameters proved to be particularly useful in predicting the location of the mandibular foramen. The operator should administer inferior alveolar nerve anaesthesia in accordance with standard rules. KEYWORDS: Mandibular foramen; panoramic radiography; anatomic variation; inferior alveolar nerve block

Evaluation of the position variation of mandibular foramen

Berlinska Magdalena , Misiejuk Aleksandra , Komisarek Oskar . Evaluation of the position variation of mandibular foramen . Journal of Education, Health and Sport. 2019;9(7):1 85 -194 . eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.3269410 http://ojs.ukw.edu.pl/index.php/johs/article/view/71 20 https://pbn.nauka.gov.pl/sedno-webapp/works/917520 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26/01/2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2019; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 20.06.2019. Revised: 25.06.2019. Accepted: 04.07.2019. EVALUATION OF THE POSITION VARIATION OF MANDIBULAR FORAMEN Magdalena Berlinska 1 magdalena.berlinska@onet.pl ORCID: 0000-0002-1742-5481, Aleksandra Misiejuk 1 ale.misiejuk@gmail.com ORCID: 0000-0001-8224-4962, Oskar Komisarek 2 oskarkomisarek@gmail.com ORCID: 0000-0002-1037-3711 1 Students Scientific Society of Maxillofacial and Orthognathic surgery, Poznan University of Medical Sciences, Collegium Maius, ul. Fredry 10, 61-701 Poznan 2 Department of Maxillofacial Orthopaedics and Orthodontics, Poznan University of Medical Sciences, Collegium Maius, ul. Fredry 10, 61-701 Poznan ABSTRACT INTRODUCTION: Mandibular foramen is located on the internal surface of the ramus of the mandible. Through this opening mandibular nerve and vessels enter the mandibular canal. As there are no palpable landmarks that allow determining the position of the mandibular foramen precisely, it is helpful to use radiological imaging methods for this purpose. Mainly X-ray techniques are used, especially panoramic radiograph for its accessibility and wide range of diagnostic applications. Knowledge of the position of the mandibular foramen is essential for the correct and effective performance of the inferior alveolar nerve block, which is one of the most common anaesthesia in dental practice. AIMS: The purpose of the study was to examine and find possible correlations between sex, age, posterior teeth loss and relative localization of the mandibular foramen. SUBJECTS AND METHODS: Selected parameters were measured on 50 digital panoramic radiographic images of 50 patients, including 33 males and 17 females, hospitalized in the Maxillofacial Surgery Ward of the Heliodor Swiecicki Clinical Hospital in Poznan. RESULTS : Localization of the mandibular foramen does not correlate with age, nor the posterior teeth loss and sex has only a slight impact on its vertical location. CONCLUSIONS: Since none of the parameters proved to be particularly useful in predicting the location of the mandibular foramen. The operator should administer inferior alveolar nerve anaesthesia in accordance with standard rules. KEYWORDS: Mandibular foramen; panoramic radiography; anatomic variation; inferior alveolar nerve block

Assessment of the Relationship Between the Femorotibial Angle and Meniscal Injury with Radiologic Imaging Methods

Assessment of the Relationship Between the Femorotibial Angle and Meniscal Injury with Radiologic Imaging Methods

Preoperative CA125 value predicts Glisson capsule involvement in patients with peritoneal carcinomatosis undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

Aim: The difficulty of detecting lesions smaller than 1cm in the preoperative period is still a continuing problem in peritoneal carcinomatosis. Methods: The prospective data of 106peritoneal carcinomatosis patients were included this study. Preoperative AFP, carcinoembryonic antigen, CA19.9, CA125, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, mean platelet value, platelet distribution width, red cell distribution width and radiological findings compared according to Glisson capsule tumor involvement. Results: Preoperative radiological imaging methods have low accuracy in demonstrating Glisson capsule involvement. Inflammatory and serum tumor markers, except CA125, have been shown to be ineffective at detecting preoperative Glisson capsule involvement. CA125 levels higher than 52.4 were found to be significant in indicating Glisson's capsule involvement. Conclusion: CA125 is more sensitive than radiological and nuclear imaging methods in detecting tumors smaller than 1cm.

Brain Death and Organ Donation in Paediatric Intensive Care Unit.

The purpose of the present study was to retrospectively analyse the brain death (BD) cases that were specified within the last 8 years in the paediatric intensive care unit of our hospital. Archive files and computer records of 23 paediatric cases were analysed. Data on age, gender, conditions that caused BD, paediatric risk of mortality (PRISM III) scores, time between suspicion of BD and issuing of BD report, confirmatory tests used, complications that occurred following the diagnosis of BD and time to cardiac arrest development after diagnosis of BD were recorded. The average age of the patients was 6.8±5.5 years. The most frequent cause of BD was intracranial haemorrhage (30.4%). The mean time to diagnosis after BD suspicion was 5.9±6.2 days. Electroencephalography was performed in 61% of the patients in addition to the apnoea test. Radiological imaging methods were used in 39% of the patients (n=9). Of the cases, 34.7% developed hypothermia, and 4.3% developed diabetes insipidus (DI). Among them, 43.4% had both DI and hypothermia. The mean PRISM score was calculated as 22±9.2. The donation rate of the families was 17%. The mean time to cardiac arrest development after diagnosis of BD was 6.9±7.4 days in non-donor cases where medical support had been reduced. Any patient with a neurologically poor prognosis in the intensive care unit should be considered to develop BD and diagnosed with BD without delay. The donation rate will increase if family interviews are done by an experienced and educated coordinator.

Inflammatory gastrointestinal diseases in children : Radiological diagnosis

Inflammatory bowel diseases are frequently seen in the clinical routine of apediatric radiologist. The timely diagnosis of inflammatory bowel diseases in children is particularly important in acute cases. This nonsystematic article intends to give an overview of the radiologic imaging methods for the diagnosis and work-up of pediatric patients with inflammatory bowel diseases. Ultrasound imaging is an important basis tool in pediatric clinical practice. However, sensitivity and specificity depends on the experience of the operator. Cross-sectional imaging modalities in pediatric patients with inflammatory bowel disease are performed only in exceptional cases when clinically justified. Dedicated computed tomography (CT) protocols for children are indispensable to lower radiation dose. Knowledge about particularities in inflammatory bowel diseases in pediatric patients and a rational approach to the use of radiological investigations in order to prevent the harmful effects of ionizing radiation are indispensable in dedicated pediatric imaging departments. From aradiation-hygiene point of view, the clinical application of ultrasound imaging should be favored in the work-up of pediatric patients with inflammatory bowel diseases. Knowledge about advanced imaging procedures is essential particularly in imaging departments specialized in pediatric radiology.

Age assessment in orthodontics and general dentistry.

In dentistry, methods for determining age and the degree of dental and skeletal development play an important role, in particular in the assessment of developmental disorders of the dentition as well as in the planning of orthodontic interventions. Dentistry is also important in the field of forensics due to the possibility of age determination based on the dentition. In addition to anthropometric and morphologic methods, numerous biochemical, histologic, radiologic, and radiation-free imaging methods exist to determine the chronologic, but also dental and skeletal age of a person or a patient. This article aims to provide an overview of the currently available methods for age determination in dentistry, both for forensic and diagnostic-therapeutic purposes, and to critically assess their indication and value based on the available evidence.

Evaluation of Clinical and Imaging Findings in Children with Diagnosis of Acute Appendicitis

Objectives: This study is an evaluation of the accuracy of ultrasonography (USG), computed tomography (CT), and Alvarado score (AS) in the diagnosis and management of acute appendicitis in children. Methods: Records of pediatric patients admitted to the pediatric emergency department (ED) between 2008 and 2012 were evaluated retrospectively. Patient data from the national electronic health information system was screened and those with complete clinical and imaging findings (AS, preoperative USG and/or CT images) and postoperative pathological diagnosis were included in the study. Results: Study group consisted of 449 children with diagnosis of suspected acute appendicitis aged between 3 and 15 years (mean age: 9.20 ± 2.73 years). Of the total, 428 (95.3%) patients underwent appendectomy and 21 (4.7%) cases were treated conservatively. Mean duration of symptoms was 4.94 ± 1.84 hours. Pathological evaluation results were negative (i.e., removal of normal appendix) in 36 (8.4%) patients; histopathological diagnosis was acute appendicitis in 392 (91.6%) patients. Perforated appendix was found in 38 (8.5%) patients. In patients with histopathologically confirmed appendicitis, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT in diagnosis of acute appendicitis were 96.3%, 55.6%, 92.8%, and 71.4%, respectively. Sensitivity, specificity, PPV, and NPV of USG were 73.5%, 22.2%, 91.1%, and 69.2%, respectively. Negative appendectomy rate was 6.4% (n = 8) in patients who had preoperative CT scan, and 6.5% (n = 28) in patients who had USG examination. Conclusions: CT has higher sensitivity than USG in diagnosis of acute appendicitis. USG, on the other hand, is widely accessible method and does not use ionizing radiation. Therefore, it may be used as initial radiological imaging method in acute appendicitis. Thin-filter, contrast-unenhanced CT scans may be preferred in cases where clinical signs and USG findings are unclear or controversial.

Imaging Parkinson\u2019s disease below the neck

Parkinson’s disease is a systemic disorder with widespread and early α-synuclein pathology in the autonomic and enteric nervous systems, which is present throughout the gastrointestinal canal prior to diagnosis. Gastrointestinal and genitourinary autonomic symptoms often predate clinical diagnosis by several years. It has been hypothesized that progressive α-synuclein aggregation is initiated in hyperbranched, non-myelinated neuron terminals, and may subsequently spread via retrograde axonal transport. This would explain why autonomic nerves are so prone to formation of α-synuclein pathology. However, the hypothesis remains unproven and in vivo imaging methods of peripheral organs may be essential to study this important research field. The loss of sympathetic and parasympathetic nerve terminal function in Parkinson’s disease has been demonstrated using radiotracers such as 123I-meta-iodobenzylguanidin, 18F-dopamine, and 11C-donepezil. Other radiotracer and radiological imaging methods have shown highly prevalent dysfunction of pharyngeal and esophageal motility, gastric emptying, colonic transit time, and anorectal function. Here, we summarize the methodology and main findings of radio-isotope and radiological modalities for imaging peripheral pathology in Parkinson’s disease.

The efficiency of bedside ultrasonography in patients with wrist injury and comparison with other radiological imaging methods: A prospective study

Study objectiveOur aim was to determine the efficiency of ultrasound (US) scanning in patients with wrist trauma admitted to the emergency department and to compare US diagnostic usage with other radiological imaging methods. MethodsPatients who presented to the emergency department with wrist injury and who met the inclusion criteria and exclusion criteria were eligible. For all patients, US evaluation of the whole wrist was performed by an emergency physician before other radiological imaging methods (radiographies, computed tomography (CT) and magnetic resonance (MR) imaging). All of the patients included in the study underwent US, radiography, CT, and MR. ResultsDuring the study, 122 patients were admitted with a wrist injury. After filtering for the exclusion criteria, 80 patients were included in the study. The sensitivity of US scanning in detecting fractures was 95.31% (95% confidence interval [CI]: 87.1–98.39), the specificity was 93.75% (95% CI: 71.67–98.89), and the positive predictive value was 98.39% (95% CI: 91.72–99.85), and the negative predictive value was 83.33% (95% CI: 72.98–90.41). The sensitivity of US scanning in detecting tendon and ligamentous structural injury was 66.67% (95% CI: 41.71–84.82), the specificity was 100% (95% CI: 94.42–100), the positive predictive value was 100% (95% CI: 94.29–99.89), and the negative predictive was 92.86% (95% CI: 84.25–97.14). ConclusionUS scanning is an effective method that can be applied in the emergency department to adult patients to diagnose distal forearm and carpal bones fractures. In soft tissue injuries, US and MR examinations produce similar results.

Predictive value of preoperative neutrophil-to-lymphocyte ratio while detecting bowel resection in hernia with intestinal incarceration.

The aim of this study was to evaluate the relationship between preoperative hematological inflammatory markers of the patients who underwent a surgery for incarcerated hernia and intestinal resection requirement. The data of 102 patients who underwent a surgery for incarcerated hernia were retrospectively evaluated. Whole blood cell counts were preoperatively measured, and operation types and pathology results were recorded. The patients with intestinal resections were compared with those without any resection in terms of leukocyte number, neutrophil rate, red cell distribution width (RDW), platelet distribution width, neutrophil-to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and mean platelet volume (MPV). Eighty-one patients were operated for incarcerated groin hernia, 17 for incarcerated umbilical hernia, and 4 for incarcerated incisional hernia. Twenty-six patients (25%) had intestinal resections; in 4 of them, intestinal perforation was detected. In patients with intestinal resections,the neutrophil rate, PDW, NLR, and PLR values were significantly higher than those in the patients without any resections. High NLR rates, certainly with clinical correlation, can be used as a biomarker to predict intestinal necrosis and the need for intestinal resection in patients who will undergo surgery for incarcerated hernia, particularlyin situations with lacking radiological imaging methods.

Multimodality Imaging Findings of a Renal Aspergilloma.

Renal aspergillosis is a rare infection that usually occurs in persons with a predisposition for this condition. Its differential diagnosis includes primary and metastatic renal malignancies, pyelonephritis and secondary abscess formation, granulomatous disorders, and renal infarction. We aim to stress the role of multimodality imaging and percutaneous biopsy in the diagnosis of this condition. We present diffusion weighted imaging (DWI) and positron emission tomography-computed tomography (PET-CT) findings in addition to conventional imaging modalities in a 55-year-old man with secondary renal aspergilloma. Radiological imaging methods are an integral part of diagnostic workup for renal aspergillosis. A definitive diagnosis is made by histopathological and/or microbiological examination of the material obtained via percutaneous biopsy under guidance of imaging methods.