Rotator Cuff Patolojilerinin Değerlendirilmesinde Ultrasonografi ve Manyetik Rezonans Görüntülemenin Karşılaştırılması

Objective: This study was conducted to determine the effectiveness of magnetic resonance imaging in comparison to ultrasonography in the diagnosis of rotator cuff tears. Material and Methods: Magnetic resonance imaging and ultrasonographic findings of 28 cases who admitted to our clinic with shoulder pain and dysfunction were analyzed retrospectively. Magnetic resonance imaging findings were accepted as gold standard. Results: From among 15 cases where complete tear was determined by magnetic resonance imaging, 11 cases were confirmed by ultrasonography and in the remaining 4 of them, thinning in the tendons which is a non-specific finding was seen. In 9 cases where there was thinning in the tendons, the classifications in magnetic resonance imaging was made as follows: 5 of them were classified as stage 2 (partial tear) and 4 of them were classified as stage 3 (complete tear). In 4 cases, tear and retraction were determined in supraspinatus tendon in magnetic resonance imaging; however, supraspinatus tendon could not be visualized by ultrasonography. In our study, in rotator cuff tears, the sensitivity and specificity of the shoulder ultrasonography were found as 73% and 93%, respectively. Conclusion: In the evaluation of rotator cuff, it was found that ultrasonography should be the first imaging method considering its low cost and easy accessiblity. Moreover ultrasonography could display a similar performance with magnetic resonance imaging if it is performed by experienced radiologist.Amaç: Rotator cuff yırtıklarının tanısında manyetik rezonans görüntüleme ile karşılaştırıldığında, ultrason etkinliğininin belirlenmesi. Gereç ve Yöntemler: Omuz ağrısı ve disfonksiyonu ile başvuran 28 olgunun manyetik rezonans görüntüleme ve ultrason bulguları retrospektif olarak incelendi. Manyetik rezonans görüntüleme bulguları standart olarak kabul edildi. Bulgular: Manyetik rezonans görüntülemede komplet yırtık saptanan 15 olgunun 11 tanesi ultrasonografide tespit edilmiş; 4’ünde ise nonspesifik bulgu olan tendonda incelme izlenmiştir. Ultrasonografide tendonda incelme görülen 9 olgunun 5’i manyetik rezonans görüntülemede evre II (parsiyel yırtık), 4’ü de evre III (komplet yırtık) olarak sınıflandırıldı. Manyetik rezonans görüntülemede supraspinatus tendonunda yırtık ve retraksiyon saptanan 4 olguda ultrasonografide supraspinatus tendonu vizualize edilememiştir. Rotator cuff yırtıklarında, bizim çalışmamızda omuz ultrasonografisinin duyarlılığı % 73, özgüllüğü % 91 olarak bulundu. Sonuç: Rotator cuff değerlendirmesinde, ultrasonografinin hem düşük maliyet, hem de kolay ulaşılabilirlik nedeniyle ilk görüntüleme yöntemi olması gerektiği, deneyimli radyolog tarafından yapıldığında, manyetik rezonans görüntüleme'ye yakın performans sergileyebileceği bulunmuştur

Evaluation of the Relationship between Biceps-Glenoid Angle and Subscapularis Tendon Pathologies in the Biceps Long Head Tendon Subluxation with MRI

Amaç: Manyetik rezonans görüntülemede (MRG) biseps uzun başı tendonunda (BUBT) subluksasyon tespit edilen olgularda biseps-glenoid açısındaki değişkenliklerin tespiti ve subskapularis tendon patolojileri ile ilişkisinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Ocak 2014-Mart 2018 tarihleri arasında Kırıkkale Üniversitesi Tıp Fakültesi Radyoloji Anabilim Dalı’nda çekilen omuz manyetik rezonans görüntüleri incelendi. BUBT’da subluksasyon olan 30 hasta ve subluksasyon olmayan 32 kontrol hastası karşılaştırıldı. T2 ağırlıklı oblik-koronal MRG görüntülerde, BUBT’un supraglenoid tuberküle yapışma düzeyinden geçen kesitte, biseps tendonuna çizilen paralel çizgi ile glenoid kemik çatıya çizilen teğet çizgi arasındaki biseps glenoid açısı ölçüldü. Ayrıca subskapularis tendon patolojileri normal, parsiyel ve tam kat yırtık açısından analiz edildi. Bulgular: BUBT’da subluksasyon olan grupta 12 erkek, 18 kadın olup yaş ortalaması 61.0±13.6 yıl idi. BUBT’da subluksasyon olmayan grupta 14 erkek, 18 kadın olup yaş ortalaması 55.9±14.0 yıl idi. Subluksasyon olan grupta bisepsglenoid açı ortalaması 84.1º±4.9º ve subluksasyon olmayan grupta 92.8º±4.7º idi (p<0.05). BUBT’da subluksasyon olan olguların da %80’inde subskapularis tendon patolojisi mevcuttu. Sonuç: BUBT’da subluksasyon olan hastalarda, bisepsglenoid açı değerleri, subluksasyon olmayanlara göre düşüktür. BUBT subluksasyonu tanısında arada kalınan olgularda biseps-glenoid açı ölçümü yardımcı olabilir. Ayrıca BUBT subluksasyonuna, subskapularis tendon patolojileri sıklıkla eşlik etmektedir.Objective: The aim of this study was to determine the variability of biceps-glenoid angle in patients with subluxation of the long head of the biceps tendon (LHBT) in magnetic resonance imaging (MRI) and to evaluate the relationship between subscapular tendon pathologies. Material and Method: Shoulder MRIs taken in Kirikkale University Medical School Radiology Department between January 2014 and March 2018 were reviewed. Thirty patients with subluxation in BUBT and 32 control patients without subluxation were compared. In the T2-weighted oblique-coronal MRI images, the biceps-glenoid angle between the parallel line drawn to the biceps tendon and the tangent line drawn on the glenoid bone roof was measured in the cross-section at the level of supraglenoid tubercle adhesion of BUBT. In addition, subcapularis tendon pathologies were analyzed for normal, partial and full-thickness tear. Results: There were 12 males and 18 females in the subluxation group in BUBT and the mean age was 61±13.6 years. There were 14 males and 18 females in the non-subluxation group in BUBT and the mean age was 55.9±14 years. The mean biceps-glenoid angle was 84.1º±4.9º in the subluxation group and 92.8º±4.7º in the non-subluxation group, showing a statistically significant difference (p<0.05). Subcapularis tendon pathology was present in 80%of patients with subluxation in BUBT. Conclusion: In patients with subluxation in BUBT, bicepsglenoid angle values are lower than those with non-subluxation. Biceps-glenoid angle measurement may be helpful in cases where diagnosis of BUBT subluxation is obscure. In addition, subcapularis tendon pathologies frequently accompany BUBT subluxation

Rotator Cuff Patolojilerinin Değerlendirilmesinde Ultrasonografi ve Manyetik Rezonans Görüntülemenin Karşılaştırılması

Objective: This study was conducted to determine the effectiveness of magnetic resonance imaging in comparison to ultrasonography in the diagnosis of rotator cuff tears. Material and Methods: Magnetic resonance imaging and ultrasonographic findings of 28 cases who admitted to our clinic with shoulder pain and dysfunction were analyzed retrospectively. Magnetic resonance imaging findings were accepted as gold standard. Results: From among 15 cases where complete tear was determined by magnetic resonance imaging, 11 cases were confirmed by ultrasonography and in the remaining 4 of them, thinning in the tendons which is a non-specific finding was seen. In 9 cases where there was thinning in the tendons, the classifications in magnetic resonance imaging was made as follows: 5 of them were classified as stage 2 (partial tear) and 4 of them were classified as stage 3 (complete tear). In 4 cases, tear and retraction were determined in supraspinatus tendon in magnetic resonance imaging; however, supraspinatus tendon could not be visualized by ultrasonography. In our study, in rotator cuff tears, the sensitivity and specificity of the shoulder ultrasonography were found as 73% and 93%, respectively. Conclusion: In the evaluation of rotator cuff, it was found that ultrasonography should be the first imaging method considering its low cost and easy accessiblity. Moreover ultrasonography could display a similar performance with magnetic resonance imaging if it is performed by experienced radiologist.Amaç: Rotator cuff yırtıklarının tanısında manyetik rezonans görüntüleme ile karşılaştırıldığında, ultrason etkinliğininin belirlenmesi. Gereç ve Yöntemler: Omuz ağrısı ve disfonksiyonu ile başvuran 28 olgunun manyetik rezonans görüntüleme ve ultrason bulguları retrospektif olarak incelendi. Manyetik rezonans görüntüleme bulguları standart olarak kabul edildi. Bulgular: Manyetik rezonans görüntülemede komplet yırtık saptanan 15 olgunun 11 tanesi ultrasonografide tespit edilmiş; 4’ünde ise nonspesifik bulgu olan tendonda incelme izlenmiştir. Ultrasonografide tendonda incelme görülen 9 olgunun 5’i manyetik rezonans görüntülemede evre II (parsiyel yırtık), 4’ü de evre III (komplet yırtık) olarak sınıflandırıldı. Manyetik rezonans görüntülemede supraspinatus tendonunda yırtık ve retraksiyon saptanan 4 olguda ultrasonografide supraspinatus tendonu vizualize edilememiştir. Rotator cuff yırtıklarında, bizim çalışmamızda omuz ultrasonografisinin duyarlılığı % 73, özgüllüğü % 91 olarak bulundu. Sonuç: Rotator cuff değerlendirmesinde, ultrasonografinin hem düşük maliyet, hem de kolay ulaşılabilirlik nedeniyle ilk görüntüleme yöntemi olması gerektiği, deneyimli radyolog tarafından yapıldığında, manyetik rezonans görüntüleme'ye yakın performans sergileyebileceği bulunmuştur

Comparison of diffusion-weighed MRI findings of the testis in patients with the advanced stage unilateral testicular varicocele

The aim of this study was to compare the testicular apparent diffusion coefficient (ADC) values of the patients with unilateral advanced stage varicocele and healthy volunteers. Twenty-seven patients with unilateral advanced stage varicocele and twenty-seven healthy volunteers were included in the study. Those with a diagnosis of clinical varicocele and the healthy volunteers were examined clinical and color Doppler ultrasonography. Patients with a unilateral (left) varicocele clinically grade III, color Doppler ultrasound grade IV-V were included in the study. All the patients and healthy volunteers were obtained ADC values. Mean values were calculated and statistical comparison was performed. ADC values were analysed by using an independent t test for each participant. Pearson's correlation test was used for the comparison of left pampiniform venous diameter and both testicular parenchymal ADC values. Left testicular ADC values were observed to be significantly lower when a comparison of the testicular parenchymal with left advanced stage varicocele and healthy volunteers revealed significantly low left testicular ADC values in patients (p0.05) Furthermore, a negative correlation was detected between the increase in the left testicular venous diameter and parenchymal ADC values of the bilateral testis in patients with left advanced stage varicocele (left p -624, right p -0.382). Diffusion weighted magnetic resonance imaging may be beneficial in defining the testicular damage in patients with varicocel