Evaluation of radiological images of cases operated for nasal polyp

Objective: In this study, we aimed to evaluate the differential diagnosis of nasal polyps and infected nasal polyps before the operation with density measurement in paranasal sinus computed tomography examination. Methods: The study included 129 patients (93 men and 36 women; mean age 41.00 years; range 13 to 82 years) diagnosed as nasal polyps (nasal polyps group) and 26 patients (17 men, 9 women; mean age 42.50 years; range 16 to 74 years) diagnosed as infected nasal polyps. In the preoperative paranasal computed tomography examination, the nasal polyps density of the patients was scored according to the Lund-Mackey system. To measure the volume of inflammatory opacification, the soft tissue density ratio (%) was measured. Neutrophil to lymphocyte ratio, mean platelet volume values, Lund-Mackey system, and soft tissue density ratio scores were statistically compared in all the groups. Results: The median mean platelet volume value was 9.40 (6.4-12.0) in the nasal polyps group and 10.20 (7.9-12.1) in the infected nasal polyps group with a statistically significant difference (P = .007). There was a significant positive correlation between infected nasal polyps and mean platelet volume (P = .006, r = 0.219**), Lund-Mackey system total, and soft tissue density ratio total (P = .000, r = 0.797**). According to the results of receiver operating curve analysis in patients with infected nasal polyps, sensitivity 61.5% and specificity 60.5% for mean platelet volume (P = .007, area under curve: 0.669 [0.574-0.763]) were found. The cut-off point for mean platelet volume value was > 9.95. Conclusion: If there is an infection in patients with nasal polyps, surgery should be considered after antibiotic therapy. The use of mean platelet volume as a marker of inflammation in these patients appears to be more reliable than the Lund-Mackey system and soft tissue density ratio scores

Diffusion-weighted MRI findings of caudate nucleus and putamen in patients with obsessive-compulsive disorder

Objective The purpose of this study was to establish the diffusion-weighted magnetic resonance imaging (DW-MRI) findings of the caudate nucleus and putamen in patients with obsessive-compulsive disorder (OCD) and to obtain new information on the etiopathogenesis of OCD, which is still unclear. Methods The study comprised 20 patients with OCDs and 20 healthy volunteers. In these cases, DW-MRI and diffusion-weighted echo-planar images (DW-EPI) at b600 and b1000 gradient values were taken and the measurements were made using the apparent diffusion coefficient (ADC) maps of each group at b600 and b1000 values from the caudate nucleus and putamen. Results When the DW-MRI examination in patients with OCD was compared with the control group, the mean ADC values in the caudate nucleus and putamen were not found to have statistically significantly changed. In addition, there were no significant differences regarding the right and left caudate nuclei and putamen ADC values at the b600 and b1000 in the patients with OCD or the control group. Conclusion There are still many unknowns about the neurobiology of OCD. When the DW-MRI examination of the patients with OCD was compared with the control group in our study, no significant difference was found between the ADC values of the caudate nucleus and putamen. Further studies are required for this present study on DW-MRI in patients with OCD to be meaningful

Evaluation of proptosis using image processing and analysis

Amaç: Proptozisli hastaların orbita manyetik rezonans görüntüleri üzerinde görüntü işleme ve analizle elde edilen antropometrik ölçümleri değerlendirmek. Gereç ve Yöntem: Geriye dönük olan bu çalışmada hastane kayıt sisteminde değerlendirilen 1-18 yaş arası çocukların orbita manyetik rezonans görüntüleri üzerinde ekzoftalmometre yapıldı. Proptozis olduğu belirlenmiş 17 hasta (hasta grubu) ile proptozis olmayan 17 hastanın (kontrol grubu) T2 ağırlıklı manyetik rezonans görüntülerinden en net alınan aksiyel ve koronal kesitleri üzerinde 15 adet ant- ropometrik ölçüm yapıldı. Bu görüntüler Matlab yazılım programında analiz edildi. Her iki grubun analiz sonuçları birbirleri ile karşılaştırıldı. Analizlerde istatistiksel anlamlılık düzeyi p≤0,05 olarak belirlendi. Bulgular: Hasta grubu (9±5.65 yaş) (6 kız, 11 erkek) ve kontrol grubu (7.82±5.46 yaş) (7 kız, 10 erkek) arasında cinsiyet ve yaş açısından anlamlı farklılık gözlenmedi (sırasıyla p=0,360, p=0,734). Hastaların %82’sinde sağ gözde proptozis mevcuttu. Hasta grubunun ant - ropometrik ölçümleri ile kontrol grubunun antropometrik ölçümleri birbirleri ile istatistiksel olarak karşılaştırıldı. İstatistiksel analiz sonucuna göre hasta grupta göz küresinin arkası ile temporal kemik iç tabulası arasında ölçülen mesafenin her iki göz arasındaki farkı, her iki göz küresinin dış kenarının birbirlerine olan uzaklığı ve her iki göz küresi nazal sınırının frontal lob ve nazal septum anteriorunu birleştiren orta hatta olan uzak farkı anlamlı oranda daha yüksek; sağ göz lens kalınlık ölçümleri ise anlamlı oranda daha düşük saptandı (sırasıyla p=0,003, p=0,030, p=0,014 ve p=0,05). Sonuç: Orbital patolojileri olan hastaların orbita manyetik rezonans görüntülerinin görüntü işleme ve analizle yapılan antropometrik ölçümleri proptozisli hastalarda önemli farklılıklar göstermiştir. Bu çalışma, bu konuda ileride yapılacak çalışmalar için temel bir çalışma işlevi görebilirObjectives: Evaluating the anthropometric measurements of patients with proptosis obtained by image processing and analysis on orbital magnetic resonance images. Material and Method: In this retrospective study, an exophthalmometer was performed on orbital magnetic resonance images of children aged 1-18 years, evaluated in the hospital registry system. Anthropometric measurements were performed on the most clearly obtained axial and coronal sections from T2-weighted magnetic resonance images of 17 patients (patient group) with proptosis (patient group) and 17 patients without proptosis (control group). These images were processed and analyzed in the Matlab software program. Analysis results of both groups were compared with each other. The statistical significance level was determined as p≤0.05. Results: No significant difference was observed between the patient group (9±5.65 years) and the control group (7.82±5.46 years) in terms of gender and age (p=0.360, p=0.734, respectively). Proptosis was present in the right eye in 82% of the patients. The anthropometric measurements of the patient group and the anthropometric measurements of the control group were statistically compared with each other. According to statistical analysis, the difference between two distances measured from the back of both globs to the temporal bone inner tabula, the distance of the outer border of both globs to each other and the difference between the distances from the nasal border of the globs to the midline connecting the frontal lobe and anterior nasal septum were found to be significantly higher; whereas lenticular thickness of right eyes were measured significantly lower in the patient group. (p=0.003, p=0.030, p=0.014, p=0.05, respectively). Conclusion: Anthropometric measurements performed by image processing and analysis of orbital magnetic resonance images of patients with orbital pathologies showed significant differences in patients with proptosis. This study can serve as a basic study for future studies on this subject

Determination of systemic and local causes of orbital proptosis diagnosed by neuroradiological modalities

Purpose: To determine the demographic and etiological characteristics in patients with orbital proptosis diagnosed by neuroimaging studies. Materials and Methods: We retrospectively analyzed neuroradiological images taken in the obtained during 11-years period (between January, 2009 and July, 2020) by extracting from in the hospital information system. Record system were analyzed retrospectively. An exophthalmometer was performed on the orbital images. The patients diagnosed as orbital proptosis with available clinical and histological data were included in the study. Results: The study included 167 patients (including 30 pediatric patients). It was found that the most common cause of orbital proptosis was inflammatory diseases of orbit, namely orbital cellulitis in children and thyroid orbitopathy in adults; followed by the primary benign tumors of orbit. Among the malignant tumors, primary orbital tumors were more common in children whereas secondary orbital tumors extending from the systemic or local regions were more common in adults. Bilateral proptosis was found in 43.1% of all cases. It was observed that the numbers of systemic (69 cases, 50.3%) and local diseases causing proptosis (68 cases, 49.6%) were comparable in adults while the local diseases causing proptosis (28 cases, 93.3%) were more common than systemic diseases causing proptosis (2 cases, 6.6%) in children. Conclusion: It was found that there was both local and systemic causes of orbital proptosis including those can threaten vision and life. The knowledge of etiological reasons in this series will assist the clinician in assessment of orbital proptosis detected at presentation in patients living in the same geography, ensuring early diagnosis and treatment

OBEZ ÇOCUKLARDA BEYNİN DİFÜZYON AĞIRLIKLI MANYETİK REZONANS GÖRÜNTÜLEME BULGULARI

Aim: To evaluate Diffusion Weighted Magnetic Resonance Imaging (DW MRI) findings in hunger and satiety related centers of the Brain in Obese Children. Material and Methods: 91 participants were enrolled in the study and 41 of them diagnosed as obese, 19 of them as overweight and 31 of them as non-obese volunteers and ages were ranged between 4-16. Diffusion weighted echo-plantar images of these cases taken in b100, b600, b1000 and b2000 gradient values and for each case b values determined for 14 regions of brain which are related with hunger and satiety. These regions are hypothalamus, hippocampal gyrus, middle temporal cortex, insula, corpus striatum, cingulate gyrus, orbitofrontal cortex, thalamus, midbrain, amygdala, occipital cortex, dorsomedial frontal cortex, dorsolateral frontal cortex and cerebellum. Measurements made with b600, b1000 and b2000values on 14 regions determined on Apparent Diffusion Coefficient (ADC) map for each group. Results: In ours study we have found a statistically significant difference between control and obese group,control and overweighed group and overweighed and obese group in ADC values in comparison of b600, b1000 and b2000 (

A Rare Complication of Frequent Sphenoid Sinusitis Is Subdural Empyema: Case Report

Subdural empyema is a fluid collection between dura and arachnoid layers and can develop secondary to states like meningitis, middle ear infection, paranasal sinus infection, trauma or cranial surgery. It can develop secondary to paranasal sinus infections which are rare observed and lead to a life-threatening situation. Early diagnosis and treatment cause a decrease in mortality and morbidity. As well as nonspecific symptoms and signs might cause, the most common symptom triad of fever, headaches and vomiting. Computerized tomography is the first choice for the diagnosis; however Magnetic Resonance İmaging is more efficient and useful. Broad spectrum antibiotherapy is chosen for the treatment, in most cases surgical drainage becomes necessary. In this paper, we aimed to present a rarely seen subdural empyema case secondary to frequently seen sphenoid sinusitis

Pregnancy with cabergoline treatment in a woman with bromocriptine resistant macroprolactinoma : case report

Bromokriptin ve kabergolin prolaktinoma tedavisinde kullanılan en yaygın dopamin agonistleridir. Dopamin agonistlerine direnç %10-15 civarında görülmektedir. Kliniğimize amenore ve baş ağrısı şikayeti ile başvuran 19 yaşında kadın hastaya yapılan tetkikler sonucu makroprolaktinoma tanısı konuldu. Başlangıç tedavisine kabergolin ile yanıt alınan hastanın takibinde gebelik istemi olması nedeniyle ilacı kesilip bromokriptin tedavisine geçildi. Bromokriptin 15 mg/gün yaklaşık 1 yıl kullanan hastada tedaviye cevapsızlık görüldüğü için bromokriptin direnci düşünülerek kabergolin tedavisine tekrar geçildi. Kabergolin tedavisi altında gebelik oluşan bu vakada, bromokriptin direncinin makroprolaktinoma takip ve tedavisini güçleştirebileceği ve direnç gelişen hastalarda alternatif ilaçlara geçilerek başarının sağlanabileceği vurgulanmak istenmiştir.Bromocriptine and cabergoline are the most preferred dopamine agonists in the therapy of prolactinomas. Primary resistance to dopamine agonists is usually seen in 10-15 % of the patients. Here, we described a case of a 19 year-old woman who was presented with amenorrhea and headache and then was diagnosed with macroprolactinoma. She was initially treated with cabergoline with a perfect response. We had switched cabergoline to bromocriptine because of the desire for pregnancy. After one year of 15 mg/day of bromocriptine treatment, the patient reported irregular menses with elevated prolactin levels. There with we changed bromocriptine to cabergoline because the cabergoline response was perfect at the beginning. We would like to emphasize that the resistance to bromocriptine therapy is not uncommon and may complicate the follow up of the patients with prolactinomas and in case of resistance, it is important to keep in mind to switch agents

SAFRA YOLLARI PATOLOJİLERİNDE ÇOK KESİTLİ BİLGİSAYARLI TOMOGRAFİ VE ENDOSKOPİK KOLANJİOPANKREATOGRAFİ BULGULARININ KARŞILAŞTIRILMASI

Aim: To investigate diagnostic value of multidedector computed tomography (MDCT) using multiplanar reformation (MPR) and minimum intensity projection (MinIP) techniques with comparison of MDCT findings and endoscopic retrograde findings known as the “gold standart” in patients cholangiopancreatograph