Quantitative Diffusion-Weighted Magnetic Resonance Imaging of Normal and Diseased Uterine Zones

Background: Magnetic resonance (MR) imaging has been established as the best imaging modality for the detection, localization, and staging of uterine cancers. Recently, the usefulness of diffusion-weighted imaging (DWI) in the diagnosis of cancers has been reported in several studies. Purpose: To calculate the apparent diffusion coefficient (ADC) values of normal uterine zones as well as benign and malignant uterine diseases, and to determine a cut-off ADC value for the quantitative detection of uterine malignancies with DWI. Material and Methods: Eighty-seven patients (mean age 53 years) with 107 benign and malignant uterine pathologies and 50 healthy controls (mean age 38 years) were enrolled in the study. DWI was performed with b factors of 0, 500, and 1000 s/mm2. Results: The ADC values of benign and malignant lesions were compared using Student's t test. The mean and the standard deviation of the ADC values of the control group were as follows: myometrium 1.760.1910-3 mm2/s, junctional zone 0.990.1810-3 mm2/s, endometrium 1.650.3310-3 mm2/s, and cervix 1.710.1710-3 mm2/s. There was a statistically significant difference among the ADC values of normal myometrium and leiomyomas (1.470.3610-3 mm2/s; P0.009), endometrium and endometrial carcinomas (0.860.1310-3 mm2/s; P0.001), myometrium-junctional zone and adenomyosis (1.240.2010-3mm2/s; P0.001), and cervix and cervical carcinomas (0.910.1410-3 mm2/s; P0.001). The ADC values differed significantly between malignant (0.880.11) and benign lesions (1.550.33; P0.01). A cut-off value for malignant lesions of 1.0510-3 mm2/s yielded a sensitivity, specificity, and accuracy of 95.83%, 94.55%, and 94.94%, respectively. Conclusion: The present study shows that ADC measurements have the potential to quantitatively differentiate between normal and cancerous tissues of the uterine zones. We propose adding DWI as an adjunct sequence in the MR protocol for the assessment of uterine lesions

Churg-strauss sendromunun nadir radyolojik bulgusu: Kaviter nodüller]

Churg-Strauss syndrome is a very rare disease that occurs almost exclusively in patients with asthma. Thoracic radiological manifestations of Churg-Strauss syndrome are variable. The most common chest CT findings are parenchymal air-space consolidation and ground glass attenuation, as well as centrilobular nodules, bronchial dilatation or bronchial wall thickening, interlobular septal thickening. Multiple nodules may occur in Churg-Strauss syndrome but cavitating nodules are unusual and have been reported in only two cases in literature. Herein, we present a Churg-Strauss syndrome case with unusual cavitating nodules demonstrated by HRCT scans

Factors Associated With Multiple Falls Among Elderly Patients Admitted to Emergency Department

Background: Fall related injuries constitute a significant part of emergency department admissions of geriatric patients. Recurrent falls are also not uncommon. The aim of this study is to evaluate the factors that might be related with multiple falls among the elderly patients admitted to emergency department. Methods: The study was conducted between 1st May 2014 and 31 October 2014 at a tertiary education and research hospital in Istanbul, Turkey. All the patients over 65 years who admitted to emergency department due to falls were included. Patients and/or their relatives were asked to answer the questions searching for possible factors that may interfere with their multiple falls. Results: During the study period 308 patients over 65 years old admitted to emergency department. 51% were between 65 and 79 years old and 49% were >80 years old. The women constituted the 70.1% of the cases. The majority of the cases described the mechanism of injury as stumbling and fall (72.4%). Factors related with multiple falls were as follows: being between 65 and 79 ages, being physically active before the fall event, having chronic cardiovascular and neurologic diseases and being on benzodiazepine and SSRI medication. Conclusion: Physically active and relatively younger elderlies fall more frequently. As the most commonly described mechanism was stumbling and fall, the importance of environmental risk factors is emphasized. Patients with cardiovascular and neurological diseases should be further evaluated for increased fall risk and indications of benzodiazepines and SSRI's in elderly people should be well evaluated