The evaluation of the effects of steroid treatment on the tumor and peritumoral edema by DWI and MR spectroscopy in brain tumors

Objective To investigate the effects of dexamethasone on brain tumor and peritumoral edema by different sequences of magnetic resonance imaging (MRI). Materials and methods MRI was performed in 28 patients with brain tumor. Patients were divided into the 3 groups based on the histological diagnosis; Group I: high-grade glial tumor, Group II: low-grade glial tumor, and Group III: brain metastasis. The measurements of peritumoral edema volume and apparent diffusion coefficient (ADC) values were performed while the peak areas of cerebral metabolites were measured by spectroscopy in groups I and II. The changes in edema volumes, ADC values and cholin/creatine peak areas were compared. Results The volume of peritumoral edema was decreased in groups I and II, but increased in group III after dexamethasone treatment. These changes were not statistically significant for 3 groups. ADC value was decreased in group I and increased in groups II and III. Changes in ADC values were statistically significant. Cholin/creatine peak areas were decreased after dexamethasone in groups I and II, but these changes were also not significant. Conclusion Dexamethasone has no significant effect on the volume of peritumoral edema in glial tumor and metastasis. Moreover, dexamethasone increases the fluid movements in low grade gliomas and metastases, decreases in high grade gliomas. However, more comprehensive clinical studies are needed to show the effects of dexamethasone on brain tumors and peritumoral edema

Diaphragmatic thickness in chronic obstructive lung disease and relationship with clinical severity parameters

Conclusion: Diaphragmatic dysfunction in COPD is related to mobility restriction rather than muscle thickness

An extremely rare coexistence : acute appendicitis and multiple intussusceptions in an adult

BACKGROUND: Adult intussusception is a rare phenomenon, acute appendicitis accompanying multiple transient intussusceptions are much more uncommon. Satisfaction and quiting imaging studies after finding an intussusception on ultrasound, may lead diagnostic errors. Radiologists should raise their awareness of imaging findings in intussusception and keep in their mind coexistent troubles in the belly. This unique case presents unusual imaging findings of a rare dual abdominal emergency condition, particularly highlighting the value of abdominal computed tomography. CASE REPORT: 32-year-old female was admitted to Emergency Department with complaints of epigastric abdominal pain and vomiting. US identified 'target' appereance on left paramedian location at umbilical level. Contrast enhanced abdominal CT not only confirmed the enteric intussusception that was demonstrated on previos US, but also showed additional concomitant intussusceptions and inflamed appendix. CONCLUSIONS: Adult intussusception is a rare phenomenon, multiple transient intussusceptions are even more uncommon. This unique report adds, precious clinical and imaging findings of acute appendicitis coexisting with multiple spontaneously resolving intussusceptions, to the literature. Physicians should be alerted for accompanying multiple abdominal pathologies and use justification essentials to make their decisions about the selection of the appropriate imaging modality

Multi-Regional Adaptive Image Compression (AIC) for Hip Fractures in Pelvis Radiography

High resolution digital medical images are stored in DICOM (Digital Imaging and Communications in Medicine) format that requires high storage space in database. Therefore reducing the image size while maintaining diagnostic quality can increase the memory usage efficiency in PACS. In this study, diagnostic regions of interest (ROI) of pelvis radiographs marked by the radiologist are segmented and adaptively compressed by using image processing algorithms There are three ROIs marked by red, blue and green in every image. ROI contoured by red is defined as the most significant region in the image and compressed by lossless JPEG algorithm. Blue and green regions have less importance than the red region but still contain diagnostic data compared to the rest of the image. Therefore, these regions are compressed by lossy JPEG algorithm with higher quality factor than rest of the image. Non-contoured region is compressed by low quality factor which does not have any diagnostic information about the patient. Several compression ratios are used to determine sufficient quality and appropriate compression level. Compression ratio (CR), peak signal to noise ratio (PSNR), bits per pixel (BPP) and signal to noise ratio (SNR) values are calculated for objective evaluation of image quality. Experimental results show that original images can approximately be compressed six times without losing any diagnostic data. In pelvis radiographs marking multiple regions of interest and adaptive compression of more than one ROI is a new approach. It is believed that this method will improve database management efficiency of PACS while preserving diagnostic image content

Ileocaecal Intussusception with a Lead Point: Unusual MDCT Findings of Active Crohn’s Disease Involving the Appendix

Adult intussusception is a rare entity accounting for 1% of all bowel obstructions. Unlike intussusceptions in children, which are idiopathic in 90% of cases, adult intussusceptions have an identifiable cause (lead point) in the majority of cases. Crohn’s disease (CD) may affect any part of the gastrointestinal tract, including the appendix. It was shown to be a predisposing factor for intussusception. Here, we report a rare case of adult intussusception with a lead point, emphasizing diagnostic input of multidetector computed tomography (MDCT) in a patient with active CD that involves the appendix

Correlation between physical measurements and observer evaluations of image quality in digital chest radiography

Purpose: The aim of this paper was to investigate the relationship between the physical and subjective (observer) image quality metrics in digital chest radiography. Methods: Five digital radiography systems, four with indirect flat panel detector and one with storage phosphor-based computed radiography system, were used in the study. The physical image quality assessments were carried out using effective detective quantum efficiency (eDQE) metric and subjective performance of the digital radiography systems was evaluated in terms of inverse image quality figure (IQFinv) derived from the contrast-detail (CD) diagrams using CDRAD 2.0 phantom and CDRAD phantom analyzer software. All measurements were performed for different tube voltages (70, 81, 90, 102, 110, and 125 kVp) and polymethyl methacrylate (PMMA) phantom thicknesses. An anthropomorphic chest phantom and visual grading analysis (VGA) technique based on European image quality criteria for chest radiography were used for clinical image quality evaluation. Results: The Spearman correlation coefficients were calculated for the investigation of the correlation between physical image quality and clinical image quality. The results showed strong positive correlation between the physical and clinical image quality findings. The minimum correlation coefficient was 0.91 (p < 0.011) for IQFinv vs VGA scores and 0.92 (p < 0.009) for IeDQE vs VGA scores. Conclusions: Our results confirm that clinical image quality can be predicted with both physical assessments and contrast-detail detectability studies

PROSTHETIC COMPLICATIONS IN IMPLANT SUPPORTED FIXED PROSTHESIS: A FOUR YEAR MULTI-CENTER RETROSPECTIVE ANALYSIS

There have been many materials and application methods developed in order to overcome the complications related with implant supported restorations. Prosthetic failures still could emerge in spite of all advanced applications. One of the most common reasons of a prosthetic failure was shown to be the excessive occlusal forces. Excessive occlusal forces may cause prosthetic complications or component fractures as well as with progressive crestal bone loss. The aim of this retrospective study was to evaluate the prosthetic complications of the implant supported fixed prosthesis followed up to four years. A Cox proportional hazard regression analysis was used to evaluate possible associations. Long bridges and single tooth crowns were associated with porcelain fracture (p<0.01, HR: 4.46) and cement loosening (p<0.05 HR: 3.22) respectively. Care must be given to occlusal alignment of the implant supported crowns/bridges to overcome long-term complications. Key Words: Implant prosthesis, prosthetic failures, retrospective analysis

Incidence of pulmonary embolism during COPD exacerbation

OBJECTIVE: Because pulmonary embolism (PE) and COPD exacerbation have similar presentations and symptoms, PE can be overlooked in COPD patients. Our objective was to determine the prevalence of PE during COPD exacerbation and to describe the clinical aspects in COPD patients diagnosed with PE. METHODS: This was a prospective study conducted at a university hospital in the city of Ankara, Turkey. We included all COPD patients who were hospitalized due to acute exacerbation of COPD between May of 2011 and May of 2013. All patients underwent clinical risk assessment, arterial blood gas analysis, chest CT angiography, and Doppler ultrasonography of the lower extremities. In addition, we measured D-dimer levels and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels. RESULTS: We included 172 patients with COPD. The prevalence of PE was 29.1%. The patients with pleuritic chest pain, lower limb asymmetry, and high NT-pro-BNP levels were more likely to develop PE, as were those who were obese or immobile. Obesity and lower limb asymmetry were independent predictors of PE during COPD exacerbation (OR = 4.97; 95% CI, 1.775-13.931 and OR = 2.329; 95% CI, 1.127-7.105, respectively). CONCLUSIONS: The prevalence of PE in patients with COPD exacerbation was higher than expected. The association between PE and COPD exacerbation should be considered, especially in patients who are immobile or obese

Quantative computerized tomography assessment of lung density as a predictor of postoperative pulmonary morbidity in patients with lung cancer

Cubuk, Sezai/0000-0003-4277-6360WOS: 000362069800031PubMed: 26380765Background: The aim of this study was to evaluate the pulmonary reserve of the patients via preoperative quantitative computerized tomography (CT) and to determine if these preoperative quantitative measurements could predict the postoperative pulmonary morbidity. Methods: Fifty patients with lung cancer who underwent lobectomy/segmentectomy were included in the study. Preoperative quantitative CT scans and pulmonary function tests data were evaluated retrospectively. We compare these measurements with postoperative morbidity. Results: There were 32 males and 18 females with a mean age of 54.4 +/- 13.9 years. Mean total density was -790.6 +/- 73.4 HU. The volume of emphysematous lung was ( 5.41% (P=0.014) and lung density <-787.5 HU (P=0.009) were independent prognostic factors associated with postoperative pulmonary morbidity. Conclusions: In this study, the patients with a lower lung density than -787.5 HU and a higher volume of emphysema than 5.41% were found to be at increased risk for developing postoperative pulmonary morbidity. More stringent precautions should be taken in those patients that were found to be at high risk to avoid pulmonary complications