Use of the Modified Visual Magnetic Resonance Rating Scale in alzheimer’s disease and ıts correlation with cognitive decline

Amaç: Alzheimer hastalığı (AH) araştırmaları için daha ileri nörogörüntüleme teknikleri geliştirilmiş olsa da, yapısal manyetik rezonans görüntüleme (MRG) AH’nin klinik tanısında önemini korumaktadır. Birçok parametreyi değerlendiren kapsamlı görsel MRG derecelendirme ölçeklerinin, hastalığın kognitif ve davranışsal görünümleriyle ilişkisi yeterince araştırılmamıştır. Bu çalışmada, Modifiye Görsel Manyetik Rezonans Derecelendirme Skalası’nın (MGMRDS) 7 alt bölümünün, AH tanısı almış hastaların demografik, kognitif ve davranışsal verileri ile korelasyonunu değerlendirmek amaçlanmıştır. Gereç ve Yöntemler: Retrospektif çalışmamıza beyin MRG ve nöropsikometrik test (NPT) verileri olan, Ruhsal Bozuklukların Tanısal ve Sayımsal Elkitabı (DSM-IV-TR) ölçütleri ile Ulusal Nörolojik ve İletişimsel Bozukluklar ve İnme Enstitüsü & Alzheimer Hastalığı ve İlişkili Bozukluklar Derneği (NINCDS–ADRDA) kriterleri temelinde AH tanısı almış, 50 yaş ve üzeri toplam 42 hasta dahil edildi. Beyin MRG verileri, hasta yaş, cinsiyet ve tanı verilerine kör bir nöroradyolog tarafından MGMRDS kullanılarak değerlendirildi. MGMRDS verilerinin kognitif ve davranışsal test sonuçlarıyla korelasyonu incelendi. Bulgular: Hastaların %61,9’u kadın, yaş ortalaması 75,19±9,26 (53–92) yıl idi. Ortalama eğitim süresi 5,02±4,84 (0–15) yıl, ortalama hastalık süresi 4,52±2,94 yıldı. Ortalama Mini Mental Durum Testi skoru 18,51±5,43 (4–30) iken, ortalama Klinik Demans Derecelendirmesi (KDD) skoru 1,07±0,42 (0,5–2,0) idi. Sulkal atrofi puanları uzun süreli hatırlama ve yüz tanıma ile negatif korele idi; ventriküler atrofi skorları ise öğrenme puanları, meyve–insan ve yüz tanıma değişkenleri ile ters korelasyon gösterdi. Anlık hatırlama, öğrenme puanı, kendiliğinden hatırlama, meyve–insan ve KDD değişkenleri ile mediyal temporal atrofi değişkeni arasında anlamlı ilişki gözlendi. Tartışma ve Sonuç: Beyin MRG’ye dayalı görsel derecelendirme skalaları kullanmak, demans değerlendirmelerinde tanıyı doğrulayıcı, ucuz ve pratik bir yaklaşımdır. MGMRDS, kognitif (yürütücü işlevler, bellek, dikkat, dil) verilerle de anlamlı korelasyon göstermektedir. Bu ölçeği daha geniş hasta gruplarında değişik kognitif bozukluklarda değerlendirecek çalışmalar klinik açıdan faydalı olacaktır.Aim: Although more advanced neuroimaging techniques have been developed for research on Alzheimer’s disease (AD), structural magnetic resonance imaging (MRI) remains important in the clinical diagnosis of AD. The relationship between comprehensive MRI visual rating scales evaluating many parameters and cognitive and behavioral appearances of the disease has not been adequately investigated. In this study, we aimed to evaluate the correlation of the 7 subsections of the Modified Visual Magnetic Resonance Rating Scale (MVMRRS) with demographic, cognitive, and behavioral characteristics of patients diagnosed with AD. Materials and Methods: The retrospective study included a total of 42 patients aged 50 years and older whose brain MRI and neuropsychometric test results were available and who were diagnosed with AD according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSMIV-TR) and of the National Institute of Neurological and Communicative Disorders and Stroke & the Alzheimer’s Disease and Related Disorders Association (NINCDS–ADRDA). By use of the Modified Visual Magnetic Resonance Rating Scale (MVMRRS), the brain MRI data were evaluated by a neuroradiologist blinded to the patient age, sex, and diagnosis data. Correlation of MVMRRS data with cognitive and behavioral test results was analyzed. Results: The mean patient age was 75.19±9.26 (53–92) years and 61.9% of all patients were female. The mean education level was 5.02±4.84 (0–15) years and the mean illness duration was 4.52±2.94 years. The mean Mini-Mental State Examination score was 18.51±5.43 (4–30) while the mean Clinical Dementia Rating (CDR) score was 1.07±0.42 (0.5–2.0). Sulcal atrophy scores were negatively correlated with longterm recall and facial recognition while ventricular atrophy scores were inversely correlated with the learning scores and fruit–human and facial recognition parameters. A significant relationship was observed between the immediate recall, learning score, spontaneous recall, fruit–human, and CDR variables and the medial temporal atrophy variable. Discussion and Conclusion: In dementia assessment, the use of MRI-based visual rating scales is an inexpensive and practical approach that also improves the diagnostic accuracy. Furthermore, the MVMRRS shows significant correlation with cognitive (executive functions, memory, attention, and language) data. Further studies to evaluate this scale in larger groups of patients with different patterns of cognitive impairment would be of clinical benefit

Karın ağrısının nadir bir sebebi: Primer epiploik apendajitis

Primary epiploic appendagitis (PEA) is a rare disease caused by torsion or spontaneous thrombosis of the central vein that drains epiploic appendages (EA). Primary Epiploic Appendagitis (PEA) is an ischemic infarction. Although PEA is a self-limiting disease and does not require surgical intervention in most cases, it may mimic diseases that require surgical intervention or aggressive medical therapy, such as appendicitis, diverticulitis, or cholecystitis. In order to avoid unnecessary surgical intervention, PEA should be kept in mind when patients present with acute abdominal pain. In this report, we present a PEA case admitted with abdominal pain.Primer epiploik appendajitis (PEA), epiploik apendiksleri drene eden santral venin torsiyon yada spontan trombozu sonucu gelişen nadir bir hastalıktır. Sıklıkla kendini sınırlar ve cerrahi tedavi gerektirmez, ancak cerrahi girişim yada agresif medikal tedavi gerektiren appandisit, divertikülit yada kolesistit gibi tabloları taklit edebilir. Akut karın ağrısıyla başvuran hastalarda gereksiz cerrahi girişimi önlemek adına PEA akılda bulundurulmalıdır. Biz de karın ağrısıyla başvuran ve PEA tanısı alan bir olgumuzu sunacağız

Morphometric evaluation of trigeminal nerve and meckel cave with 3.0 magnetic resonance imaging

Introduction: This study aimed to investigate morphometric features of the trigeminal nerve in healthy people on magnetic resonance images. The alterations in the size of the trigeminal nerve in the cisternal region along with aging and asymmetry between the right and left trigeminal nerves were also assessed. The knowledge of normal morphometric properties of the trigeminal nerve may be useful in evaluating patients having trigeminal neuralgia. Material and Methods: This retrospective study included 120 (62 males, 58 female) healthy individuals over 20 years old who had no previous or current cranial pathology. According to age ranges, individuals were evaluated in four groups as 20-29 years, 30-39 years, 40-49 years, and 50 years and older. Besides the long- and short-axis lengths of the trigeminal nerve, long- and short-axis lengths of Meckel cave, as well as the trigeminal-pons angle, were measured using three-dimensional balance fast-field echo sequence with 3T magnetic resonance imaging on the right and left sides.Results: It was observed that the lengths of trigeminal nerve were shorter on the right side in comparison to the left side (mean long axis 0,79 +/- 0,20 cm on the right, 0,86 +/- 0,28 cm on the left, P <0,05; and mean short-axis: 0,36 +/- 0,10 cm on the right and 0,41 +/- 0,17 cm on the left, P <0,05). Moreover, in males, the long-axis length of the Meckel cave was higher on both the right and left sides compared to females (P < 0.05). Discussion and Conclusion: This study shows that, both the width and length of the right trigeminal nerve are shorter compared to left in healthily population. In addition, long axis of Meckel Cave, that is posterolateral to anteromedial extend, was longer on both the right and left sides in males compared to females.Results: It was observed that the long axis (mean: 0.79 +/- 0.20 cm on the right, 0.86 +/- 0.28 cm on the left, P < 0.05) and short axis (mean: 0.36 +/- 0.10 cm on the right and 0.41 +/- 0.17 cm, P < 0.05). Moreover, in males, the long-axis length of the Meckel cave was higher on both the right and left sides compared to females (P < 0.05). Conclusion: This study shows that, both the width and length of the right trigeminal nerve are shorter compared to left in healthily population. In addition, long axis of Meckel Cave, that is posterolateral to anteromedial extend, was longer on both the right and left sides in males compared to females

Modified Visual Magnetic Resonance Scale and Neuropsychometric Corelations in Alzheimer's disease

Amaç: Alzheimer hastalığı (AH) araştırmaları için daha ileri nörogörüntüleme teknikleri geliştirilmiş olsa da, yapısal manyetik rezonans görüntüleme (MRG) AH’nin klinik tanısında önemini korumaktadır. Birçok parametreyi değerlendiren kapsamlı görsel MRG derecelendirme ölçeklerinin, hastalığın kognitif ve davranışsal görünümleriyle ilişkisi yeterince araştırılmamıştır. Bu çalışmada, Modifiye Görsel Manyetik Rezonans Derecelendirme Skalası’nın (MGMRDS) 7 alt bölümünün, AH tanısı almış hastaların demografik, kognitif ve davranışsal verileri ile korelasyonunu değerlendirmek amaçlanmıştır. Gereç ve Yöntemler: Retrospektif çalışmamıza beyin MRG ve nöropsikometrik test (NPT) verileri olan, Ruhsal Bozuklukların Tanısal ve Sayımsal Elkitabı (DSM-IV-TR) ölçütleri ile Ulusal Nörolojik ve İletişimsel Bozukluklar ve İnme Enstitüsü & Alzheimer Hastalığı ve İlişkili Bozukluklar Derneği (NINCDS–ADRDA) kriterleri temelinde AH tanısı almış, 50 yaş ve üzeri toplam 42 hasta dahil edildi. Beyin MRG verileri, hasta yaş, cinsiyet ve tanı verilerine kör bir nöroradyolog tarafından MGMRDS kullanılarak değerlendirildi. MGMRDS verilerinin kognitif ve davranışsal test sonuçlarıyla korelasyonu incelendi. Bulgular: Hastaların %61,9’u kadın, yaş ortalaması 75,19±9,26 (53–92) yıl idi. Ortalama eğitim süresi 5,02±4,84 (0–15) yıl, ortalama hastalık süresi 4,52±2,94 yıldı. Ortalama Mini Mental Durum Testi skoru 18,51±5,43 (4–30) iken, ortalama Klinik Demans Derecelendirmesi (KDD) skoru 1,07±0,42 (0,5–2,0) idi. Sulkal atrofi puanları uzun süreli hatırlama ve yüz tanıma ile negatif korele idi; ventriküler atrofi skorları ise öğrenme puanları, meyve–insan ve yüz tanıma değişkenleri ile ters korelasyon gösterdi. Anlık hatırlama, öğrenme puanı, kendiliğinden hatırlama, meyve–insan ve KDD değişkenleri ile mediyal temporal atrofi değişkeni arasında anlamlı ilişki gözlendi. Tartışma ve Sonuç: Beyin MRG’ye dayalı görsel derecelendirme skalaları kullanmak, demans değerlendirmelerinde tanıyı doğrulayıcı, ucuz ve pratik bir yaklaşımdır. MGMRDS, kognitif (yürütücü işlevler, bellek, dikkat, dil) verilerle de anlamlı korelasyon göstermektedir. Bu ölçeği daha geniş hasta gruplarında değişik kognitif bozukluklarda değerlendirecek çalışmalar klinik açıdan faydalı olacaktır.Aim: Although more advanced neuroimaging techniques have been developed for research on Alzheimer’s disease (AD), structural magnetic resonance imaging (MRI) remains important in the clinical diagnosis of AD. The relationship between comprehensive MRI visual rating scales evaluating many parameters and cognitive and behavioral appearances of the disease has not been adequately investigated. In this study, we aimed to evaluate the correlation of the 7 subsections of the Modified Visual Magnetic Resonance Rating Scale (MVMRRS) with demographic, cognitive, and behavioral characteristics of patients diagnosed with AD. Materials and Methods: The retrospective study included a total of 42 patients aged 50 years and older whose brain MRI and neuropsychometric test results were available and who were diagnosed with AD according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSMIV-TR) and of the National Institute of Neurological and Communicative Disorders and Stroke & the Alzheimer’s Disease and Related Disorders Association (NINCDS–ADRDA). By use of the Modified Visual Magnetic Resonance Rating Scale (MVMRRS), the brain MRI data were evaluated by a neuroradiologist blinded to the patient age, sex, and diagnosis data. Correlation of MVMRRS data with cognitive and behavioral test results was analyzed. Results: The mean patient age was 75.19±9.26 (53–92) years and 61.9% of all patients were female. The mean education level was 5.02±4.84 (0–15) years and the mean illness duration was 4.52±2.94 years. The mean Mini-Mental State Examination score was 18.51±5.43 (4–30) while the mean Clinical Dementia Rating (CDR) score was 1.07±0.42 (0.5–2.0). Sulcal atrophy scores were negatively correlated with longterm recall and facial recognition while ventricular atrophy scores were inversely correlated with the learning scores and fruit–human and facial recognition parameters. A significant relationship was observed between the immediate recall, learning score, spontaneous recall, fruit–human, and CDR variables and the medial temporal atrophy variable. Discussion and Conclusion: In dementia assessment, the use of MRI-based visual rating scales is an inexpensive and practical approach that also improves the diagnostic accuracy. Furthermore, the MVMRRS shows significant correlation with cognitive (executive functions, memory, attention, and language) data. Further studies to evaluate this scale in larger groups of patients with different patterns of cognitive impairment would be of clinical benefit

The effectiveness of Power Doppler vocal fremitus imaging in the diagnosis of breast hamartoma

Digital Photography X -- 3 February 2014 through 5 February 2014 -- 105377Objectives: To evaluate the usefulness of power Doppler vocal fremitus (PDVF) breast sonography for differentiation of hamartomas from other breast (malign or benign) masses. Material and methods: Two hundred and six breast masses in 180 women were evaluated. The breast lesions were scanned first by mammography (MG), then by ultrasonography (US) with PDVF imaging. Finally, biopsy was performed on lesions suspicious for malignancy (n=172). We used PDVF imaging to evaluate whether the Power acoustic Doppler artifact existed in all breast lesions. Results: Pathology results of 172 biopsied lesions showed that 83 were malign and 89 masses were benign. Totally 39 breast hamartomas were diagnosed radiologically (n=25) or histopathologically (n=14). All hamartomas (n=39) produced the power acoustic Doppler artifact as the surrounding tissue at the same depth in PDVF imaging. On the other hand, none of the malign or benign lesions, apart from hamartomas, evidenced a similar vibrational artifact as the surrounding tissue at the same depth in the PDVF imaging. Conclusion: PDVF imaging during breast sonography is an invaluable technique in the identification of breast hamartomas from other benign or malign breast masses

Diffusion tensor imaging can discriminate the primary cell type of intracranial metastases for patients with lung cancer

Purpose: Histopathological differentiation of primary lung cancer is clinically important. We aimed to investigate whether diffusion tensor imaging (DTI) parameters of metastatic brain lesions could predict the histopathological types of the primary lung cancer. Methods: In total, 53 patients with 98 solid metastatic brain lesions of lung cancer were included. Lung tumors were subgrouped as non-small cell carcinoma (NSCLC) (n = 34) and small cell carcinoma (SCLC) (n = 19). Apparent diffusion coefficient (ADC) and Fractional anisotropy (FA) values were calculated from solid enhanced part of the brain metastases. The association between FA and ADC values and histopathological subtype of the primary tumor was investigated. Results: The mean ADC and FA values obtained from the solid part of the brain metastases of SCLC were significantly lower than the NSCLC metastases (P 0.909 × 10-3 mm2/s for mean ADC (Sensitivity = 80.3, Specificity = 83.8, PPV = 89.1, NPV = 72.1) and > 0.139 for FA values (Sensitivity = 80.3, Specificity = 54.1, PPV = 74.2, NPV= 62.5) revealed in differentiating NSCLC from NSCLC. Conclusion: DTI parameters of brain metastasis can discriminate SCLC and NSCLC. ADC and FA values of metastatic brain lesions due to the lung cancer may be an important tool to differentiate histopathological subgroups. DTI may guide clinicians for the management of intracranial metastatic lesions of lung cancer

Flow diverter stents in the treatment of cerebral aneurysms less than 5 mm

AIM: To evaluate the safety and efficacy of flow diverter (FD) stents in the treatment of intracranial aneurysms less than 5 mm. MATERIAL and METHODS: We treated 66 aneurysms in 43 patients with aneurysms less than 5 mm. Of the patients, 29 were females and 14 males (mean age: 50.2 years). Headache was the most frequent symptom. In 8 patients, the aneurysms were recanalized and these had been treated with coils or stent-assisted coiling. All aneurysms were in the anterior circulation. In the treatment, one of the SILK, Pipeline, Derivo or FRED FD stents was used for each patient. Neurointerventional stent medication (double antiplatelet) was used. All patients were investigated for new ischemic lesions with diffusion-weighted imaging one day later. The first follow-up angiogram was planned 3-6 months later. RESULTS: The treatment was technically successful in all patients. Minor complications occurred in 3 patients (7%). In one patient, thrombus inside the SILK was seen and was relieved with tirofiban. The second patient bled from the right common femoral artery entrance, which was operated on. In the third patient, the complication was technical. All patients were discharged without any neurological deficit. The mean follow-up period was 26 (6-52) months. Of the aneurysms, 64 (97.0%) were completely closed. CONCLUSION: The FD treatment of cerebral, anterior circulation small aneurysms less than 5 mm is effective and safe

The relationship between bronchoscopy, radiology and microbiology in non cystic fibrosis patients

28th International Congress of the European-Respiratory-Society (ERS) -- SEP 15-19, 2018 -- Paris, FRANCEWOS: 000455567107327...European Respiratory Societ

Relationships between bronchoscopy, microbiology, and radiology in noncystic fibrosis bronchiectasis

Background: Published data on the correlations of bronchoscopy findings with microbiological, radiological, and pulmonary function test results in children with noncystic fibrosis (CF) bronchiectasis (BE) are unavailable. The aims of this study were to evaluate relationships between Bronchoscopic appearance and secretion scoring, microbiological growth, radiological severity level, and pulmonary function tests in patients with non-CF BE. Methods: Children with non-CF BE were identified and collected over a 6-year period. Their medical charts and radiologic and bronchoscopic notes were retrospectively reviewed. Results: The study population consisted of 54 female and 49 male patients with a mean age of 11.7 ± 3.4 years. In the classification according to the bronchoscopic secretion score, Grade I was found in 2, Grade II in 4, Grade III in 9, Grade IV in 17, Grade V in 25, and Grade VI in 46 patients. When evaluated according to the Bhalla scoring system, 45 patients had mild BE, 37 had moderate BE, and 21 had severe BE. Microbial growth was detected in bronchoalveolar lavage fluid from 50 of the patients. Forced expiratory volume in 1 s (FEV1) and functional vital capacity decreased with increasing bronchoscopic secretion grade (P = 0.048 and P = 0.04), respectively. The degree of radiological severity increased in parallel with the bronchoscopic secretion score (P = 0.007). However, no relationship was detected between microbiological growth rate and radiological findings (P = 0.403). Conclusions: This study showed that bronchoscopic evaluation and especially scoring of secretions correlate with severe clinical condition, decrease in pulmonary function test, worsening in radiology scores, and increase in microbiological bacterial load in patients. Flexible endoscopic bronchoscopy should be kept in mind in the initial evaluation of non-CF BE patients