Hounsfield unit density in the characterisation of bile duct lesions

Purpose: To study the density of lesions in the lumens of extrahepatic bile ducts through computed tomography examinations, and to compare their characterisations with the results of pathology and/or endoscopic retrograde cholangiopancreatography (ERCP). Methods: The density of lesions along extrahepatic bile ducts were measured and compared with pathology and/or ERCP. The lesions were evaluated in two main groups: benign or malignant. The bile duct wall enhancement, intrahepatic bile ducts, and gallbladder were also evaluated. Results: The study was conducted with computed tomography scans of 197 cases (93 females, 104 males) who had optimal imaging. The results regarding density of extrahepatic intraductal lesions that were studied at BT were compared with pathology and magnetic resonance cholangiopancreatography results. Of 197 lesions, 125 (63.5%) were reported as benign and 72 (36.5%) were reported as malignant. The results for benign lesions showed an average density of 66.67 ± 17.30 Hounsfield units (HU), and for malignant lesions the average density was 82.38 ± 13.67 HU. Conclusion: Lesion density level (HU) gives valuable information for the differentiation between benign and malign lesions in intraluminal extrahepatic bile ducts

Salmonella ovarian abscess in a patient with systemic lupus erythematosus presented as acute abdomen: A case report and review of the literature

A Salmonella ovarian abscess is a rare entity, and is similarly uncommon in cases with Systemic Lupus Erythematosus. To the best of our knowledge, thirty four cases of Salmonella ovarian abscess have been published in the literature, and only four of them were related to Systemic Lupus Eritematosus. Our aim is to review this clinical entity using information from our own experience as well as that from published cases. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved

The Appearances of Brain Metastases of Small Cell Lung Cancer on 18F-FDG PET/CT

Purpose: We evaluate the appearances of the brain metastases (BMs) detected by brain magnetic resonance imaging (MRI) of small cell lung cancer (SCLC) on 18Fluor-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT). Patients and methods: SCLC patients who had an 18F-FDG PET/CT scan and a brain MRI within 30 days for initial staging were included. MRI was used to detect BMs. The imaging results of BMs on 18F-FDG PET/CT were assessed. On the 18F-FDG PET/CT study, the BMs were classified as undetectable, hypometabolic, hypermetabolic, or mixed patterns (lesions with both hypermetabolic and hypometabolic parts). Results: A total of 51 patients [48 (94.1%) of whom were male and 3 (5.9%) female, with an average age of 62.57 ± 9.64] were included in this study. Fifteen patients (29.4%) were in the limited stage, whereas 36 patients (69.6%) were in the extensive stage. In 11 individuals, MRI indicated 28 BMs. On 18F-FDG PET/CT, 13 of the 28 metastases were visible. The following were the BMs appearances on 18F-FDG PET/CT: hypometabolic (n: 4), hypermetabolic (n: 6), and mixed (n: 3). While the mean diameter of BMs detected in 18F-FDG PET/CT was 16mm; the mean diameter of undetected ones was 4.3 mm. Conclusion: On 18F-FDG PET/CT, BMs can have a variety of appearances, including hypometabolic, hypermetabolic, and mixed patterns. On the other hand, failure to detect millimetric size BMs in 18F-FDG PET/CT prevents proper staging

Magnetic Resonance Imaging Texture Analysis in the Detection of Metastatic Lymph Nodes in Patients with Nasopharyngeal Carcinoma

Abstract Aims: To investigate the role of magnetic resonance imaging (MRI) texture analysis (TA) in the detection of metastatic lymph nodes in patients with nasopharyngeal carcinoma (NPC). Material and methods: Between January 2020 and October 2021, 15 NPC patients with 32 metastatic lymph nodes and 30 healthy subjects with benign lymph nodes were included in the study. The texture features compared between metastatic and benign lymph nodes. The independent predictor parameters of metastatic lymph nodes were determined using multivariate regression analysis. Receiver operator characteristics (ROC) analysis was used to evaluate the diagnostic performance of the regression models. Results: The first order texture features did not differ significantly between groups (p>0.05). Except for correlation in metastatic lymph nodes, all gray-level co-occurrence matrix (GLCM) and gray-level run length matrix (GLRLM) features were significantly different (p<0.05). The GLCM features of joint entropy, joint energy, and maximum probability; and the GLRLM features of gray level non uniformity and low gray level run emphasis were independent predictors of metastatic lymph nodes. The area under the curve (AUC) values for the GLCM regression model and GLRLM regression model were 0.975 and 0.928, respectively. Conclusion: MRI texture analysis may be useful to detect metastatic lymph nodes in patients with NPC by providing quantitative information on tissue heterogeneity and cellular composition

Retrospective Analysis of Lymphangitis Carcinomatosa Regarding Primer Tumor Spectrum and Computer Tomography Features

INTRODUCTION: Lymphangitis carcinomatosis (LC) is used to describe the metastatic involvement of pulmonary lymphatic canals and perilymphatic connective tissue by primary tumor cells and commonly occurs secondary to primary tumors, mostly adenocarcinomas, originated from breast, lung, gastrointestinal system cancers. Common findings in lung computed tomography (CT) are interlobular septal thickening and increased reticular/reticulonodular density. In this study, we aim to present the primary tumor spectrum and most frequent computed tomography findings of patients with LC. METHODS: In this double-centered study 63 patients, who had lung CT examination due to prediagnosis of LC, were retrospectively investigated. 41 patients with final diagnosis of LC due to findings upon Positron emission tomography/Computed tomography (PET/CT), ultrasonography, CT scan, endoscopic, bronchoscopic and cytopathologic investigations and/or clinical manifestations are ultimately included RESULTS: In 41 patients with LC, lung in 11 cases, esophagus in 7 cases, colon in 6 cases, stomach in 4 cases, pancreas in 3 cases, breast in 2 cases, bladder in 2 cases, thyroid in 2 cases and singly larynx, kidney, prostate and bone marrow in 4 cases were respectively revealed as primary tumor origins. Most frequent lung CT findings were increased reticular/reticulonodular and nodular densities, thickenings of interlobular septa, mediastinal and hilar lymphadenopathies, pleural and/or pericardial effusions, atelectasis, ground-glass opacities. Extrapulmonary involvement was detected in 14 patients DISCUSSION AND CONCLUSION: LC occurs with metastatic involvement of pulmonary lymphatics in patients with primary malignancy, especially adenocarcinomas. In CT, the reticular, reticulonodular, and noduler pattern (most common pulmonary parenchymal changes) and mediastinal lymphadenopathies (LAP) are the most common findgs. Pulmonary CT examination is accepted as the most important radiological modality in diagnosis and follow up of LC

Primary hyperparathyroidism causing putty kidney with brown tumor located in the pubic ramus

Primary hyperparathyroidism (pHPT) is a condition caused by excessive and uncontrolled secretion of parathyroid hormone. The classical presenting symptoms in primary hyperparathyroidism are renal stones, hypercalcemic crisis, soft tissue calcifications, and cystic bone disease. Although most cases of pHPT are detected early and before symptomatic lesions appear, some patients may present late in the course of their disease. In this report, we present a patient with extensive parenchymal calcifications forming a cast of the right kidney which is called as "putty kidney" with Brown tumor located in the pubic ramus

Budd-chiari syndrome and renal arterial neurysms due to behcet disease: a rare association Case report Open Access

Abstract Behcet's disease is a multisystemic vasculitis of unknown etiology with a chronic relapsing course. Vasculitis in Behcet's disease with predominant vascular involvement is the only vasculitis that affects both arteries and veins of any size. Involvement of the renal artery and inferior vena cava is rare among the arteries and veins, respectively. When disease affect the veins, it is in the form of thrombosis. Arterial complications include aneurysms, stenosis and occlusions. Both rupture of arterial aneurysm and occlusion of suprahepatic veins, causing Budd-Chiari syndrome, are associated with a high mortality rate. Vascular involvement is more common in male patients than in female patients. Men and patients with a younger age of onset present with a more severe prognosis. In this case report, we describe a very rare cause of intrarenal arterial aneurysm's rupture with previous Budd-Chiari syndrome due to Behcet's disease and successful angiographic embolization of actively bleeding aneurysm

Safra kesesi duplikasyonu olgusunda görüntüleme bulguları

Amaç: Nadir görülen konjenital anomali olan çift safra kesesi olgusunun görüntüleme bulgularını sunmak. Bulgular: Tekrarlayan karın ağrısı nedeniyle merkezimize başvuran dört yaşındaki hastada yapılan ultrasonografide pankreas başı düzeyinden portal hilusa uzanım gösteren kistik lezyon izlendi. Ayırıcı tanıya yönelik elde edilen manyetik rezonans kolanjiopankreatografide koledokla bağlantısı olan çift safra kesesi izlendi. Sonuç: Cerrahiye bağlı olası komplikasyonların önlenmesi açısından operasyon öncesi safra kesesi varyasyonunun tam olarak gösterilmesi gerekmektedir. Radyolojik görüntüleme bulgularıyla safra kesesi ve safra yolları varyasyonları gösterilebilir.Aim: To present imaging findings of a case with gallbladder duplication, which is a rare congenital anomaly. Material and Method: A four-year-old girl was admitted to our hospital with a complaint of recurrent abdominal pain. Abdominal sonography revealed a fusiform cystic structure reaching from the head of pancreas to the hepatic hilum. Magnetic resonance cholangiopancreatography clearly showed the true duplication of the gallbladder, consisting of two vesicae and two separate cystic ducts entering the common duct, indicative of duplication. Result: To prevent biliary damage, preoperative diagnosis of gallbladder duplication is necessary. Radiologic imaging findings allow us to show variations of gallbladder and biliary tract

Left Renal Vein Anomalies in Routine Abdominal CT Scans

Amaç: Rutin abdomen BT incelemelerinde sol renal ven anomalilerinin görünümleri ve görülme sıklığının araştırılması. Yöntem: Toplam 1004 abdomen BT tetkiki retrospektif olarak sol renal ven anomalileri açısından incelendi. Sol renal venin seyri ardışık BT kesitleri ile takip edilerek anomalileri araştırıldı. Bulgular: Çalışma kapsamındaki 1004 olgunun 63ünde (%6.3) sol renal ven anomalisi saptandı. Bunlardan 43 (%4.3)' ü retroaortik, 20si (%2) sirkumaortik renal ven anomalisi idi. Sonuç: Sol renal ven anomalilerinin, retroperitoneal cerrahi ve girişimsel işlemlerden önce tanımlanması önemlidir. Bu anomaliler dikkatli incelemeler ile rutin abdomen BT tetkiklerinde saptanabilir.Aim: The purpose of this study was to investigate the incidence of left renal vein anomalies in routine abdominal computed tomography scans. Methods: One thousand and four patients (590 men, 414 women) were evaluated retrospectively with routine abdominal computed tomography scans. Results: Sixty three patients of 1004 were identified with renal vein variants (6.3%). Forty three (4.3%) patients exhibited retroaortic left renal vein and twenty (2%) patients had circumaortic renal veins. Conclusion: The incidence of renal vein variations observed in this study is discussed and compared with that reported in the literature. It is necessary to emphasize that the presence of these renal vein variations in particular must be acknowledged since they have significant clinical importance