THE RELATIONSHIP BETWEEN THE SPINAL CANAL DIAMETER AND THE NEUROLOGICAL DEFICIT SEVERITY IN SPINAL INJURIES

Amaç: Torakolomber vertebra kırıklı hastalarda travmadan sonra (3 ay içinde) ve geç postoperatif (6 ay içinde) dönemde Bilgisayarlı Tomografi (BT) tetkiki ile spinal kanal daralma oranını ve aynı dönemlerde nörolojik bakı ile nörolojik yaralanma düzeylerini belirleyerek; aralarındaki korelasyonu ve BT'nin bu değerlendirmedeki yerini belirlemeyi amaçladık. Gereç ve yöntem: Torakolomber vertebra kırığı tanısı almış ve cerrahi tedavi görmüş 28 hasta preoperatif ve geç postoperatif dönemde BT ile incelendi. Ayrıca her hastanın Frankel Sınıflamasına göre nörolojik değerlendirmeleri yapıldı. Her hastada kanal işgal yüzdeleri tek tek belirlenip istatistiksel hesaplaması yapıldı. Bulgular: Olguların %61'i yüksekten düşme, %39'u trafik kazasıydı. Ortalama yaş 34,6 olup hastaların %57'si erkek, %43'ü kadındı. 28 hastanın 18'inde (%64,3) nörolojik yaralanma mevcuttu. Frankel A'dan Frankel E'ye kadar beş ayrı nörolojik derecede ortalama kanal işgal oranı sırasıyla %66, %51, %37, %21 ve %27 idi. Kanal darlığının artması ile nörolojik yaralanmanın ağırlaşması arasında doğru orantılı ve anlamlı bir ilişki bulundu. Geç dönemde kanal işgal oranı ile nörolojik durum arasında ise anlamlı bir ilişki bulunmadı. Yaralanmanın seviyesinin de nörolojik yaralanma derecesini etkilediği görüldü. Sonuç: Torakolomber vertebra kırıklarında nörolojik yaralanma primer olarak ilk travmanın ağırlığı ile belirlenmektedir. Yaralanmanın seviyesiyle birlikte ilk travma anında oluşan kanaldaki darlığın miktarı nörolojik yaralanmanın ağırlığını belirleyici unsurlardandır. Spinal kanalın görüntülenmesinde, kanal işgal oranının tesbitinde, tedavi planlanması ve postoperatif komplikasyonların değerlendirilmesinde BT üstün ve değerli bir görüntüleme yöntemidir. Objective: Patients with thoracolomber fractures were evaluated with c.t scan before and after operation in order to detect the degree of obliteration in the spinal canal. Also neurological evaluation was done. The relationship between spinal canal obliteration and the neurolojical deficit and the role of CT in this evaluation was investigated. Material and method: Pre and postoperative CT scans were performed in 28 cases with vertebra fractures. Also they were evaluated neurologically according to the Frankel Classification. Results: 61% of the patients fell from a high place, 39% had a traffic accident. Avarage age was 34.6. 57% was male, 43% was female. Spinal canal obliteration per-cent was measured for each patient. 64.3% of the patients had neurological deficit. Spinal canal obliteration was classified neurologically as Frankel A, B, C, D, E and the ratios were as follows in the same order 66%, 51%, 37%, 21%and 27%. The spinal canal narrowing and neurological deficit severity was correlated well. But there wasn't such a correlation at the late stage. Also the level of trauma affected the neurological deficit severity. Conclusion: In thoracolomber vertebra fractures neurological deficit is primerally correlated with the severity of trauma at first. The spinal narrowing and the level of trauma verrifies the severity of neurological deficit. CT examination is a good guide for planning surgery, finding out the spinal narrowing ratio and detecting the postoperative complications

COMPARISON OF COMPUTERIZED TOMOGRAPHIC AND HISTOPATHOLOGICAL ,TUMOR (T) STAGING OF LARYNGEAL CANCERS

Amaç: Larenks kanserlerinde bilgisayarlı tomografi (BT) bulgularının ameliyat sonrası histopatolojik sonuçlarla karşılaştırılması. Gereç ve yöntem: Biopsi ile larenks kanseri tanısı almış yaş ortalaması 54,5 olan, 49'u erkek 52 hasta ameliyat öncesi BT tetkiki ile tümör lokalizasyonu (T) ve derin invazyon (preepiglottik ve paraglottik boşluk, subglottik alan ve kıkırdaklar) yönünden değerlendirildi. Sonuçlar patolojik (p) bakı sonuçları ile karşılaştırıldı. Bulgular: Doğruluk oranı glottik yerleşimli olanlarda %80, supraglottik yerleşimli olanlarda %64, transglottik olanlarda %76 olup, genel doğruluk oranı %73 olarak bulundu. Sonuç: T3 ve T4 evredeki tümörlerde BT evre doğruluk oranı, T1 ve T2 evre tümörlere göre yüksek bulundu. Bu doğruluk oranları literatürdekine paraleldir. Klinik muayeneyle birlikte BT değerlendirilmesi histopatolojik evrelemenin doğruluğunu arttırmaktadır. Objective: We compare the findings of computerized tomographic (CT) imaging with histopathologic results in larengeal cancer. Patients and method: Fifty-two patients (49 males, mean age 54,5) were evaluated preoperatively by CT with regard to localization (T) and deep involvement (preepiglottic space, laryngeal cartilages, paraglottic and subglottic areas). The results were correlated with histopathologic (p) findings. Results: The accuracy of CT were 80% for glottic; 64% for supraglottic, 76% for transglottic region tumors. Overall accuracy was 73%. Conclusion: Histopathologic and CT staging results are highly correlated in T3 and T4 stage tumors than T1 and T2 stage tumors, similar to those in the literature. The accuracy of histopathologic staging enhances by concomitant use of clinical and radiologic findings

Measure the Vascular Flow Volume rather than Vascular Stenosis and Pressure Gradient

We aimed to investigate the extent to which measurements of flow volume (FV) with colour flow duplex ultrasonography (CDU) could predict tissue perfusion. A 68 year-old male patient was admitted to our clinic complaining of intermittent claudication in the right leg. Digital subtraction angiography showed total occlusion of the right femoral artery. The right popliteal artery (PA) was filling by collaterals. CDU showed that the FV in the right PA was higher than in the left. Arterial-venous FV measurement with CDU should be performed rather than the detection of arterial stenosis to assess whether intervention is necessary

Diffusion-Weighted Magnetic Resonance Imaging Findings of Kidneys with Obstructive Uropathy: Differentiation between Benign and Malignant Etiology

Purpose. In this study, we aimed to evaluate the capability of diffusion-weighted magnetic resonance imaging (DWI) in differentiation between benign and malignant etiology of obstructive uropathy. Materials and Methods. DWI was performed in 41 patients with hydronephrotic kidneys and 26 healthy volunteers. MR imaging was performed using a 1.5 T whole-body superconducting MR scanner. The signal intensities of the renal parenchyma on DWI and apparent diffusion coefficient (ADC) maps were noted. DWI was performed with the following diffusion gradient b values: 100, 600, and 1000 s/mm2. A large circular region of interest was placed in the corticomedullary junction of the kidneys. For statistical analysis, the independent-samples t test was used. Results. The mean renal ADC values for b100, b600, and b1000 in hydronephrosis patients with benign and malignant etiology and the healthy volunteers of the control group were analysed. ADC measurements of renal parenchyma in all hydronephrotic kidneys with benign and malignant etiology were found to be statistically low compared to those of normal kidneys P<0.05. Conclusions. There were significant differences in the ADC values of obstructed kidneys compared to those of normal kidneys. Obstructed kidneys with malignant etiology had lower ADC values for b1000 compared to obstructed kidneys with benign etiology, but these alterations were statistically insignificant

Manganese-enhanced MRI to evaluate neurodegenerative changes in a rat model of kainic acid-induced excitotoxicity

WOS: 000323750100001PubMed ID: 23886936PURPOSE Manganese-enhanced magnetic resonance imaging (MEMRI) has been used to detect brain activity based on the ability of active neurons to take up manganese ions through calcium channels. Kainic acid (KA), an analog of excitotoxic glutamate, can elicit selective neuronal death in the brains of rodents, of which the pathological changes partially mimic neurodegeneration in the central nervous system. We used in vivo MEMRI to evaluate neurodegenerative changes in an excitotoxicity model induced by KA in rats. MATERIALS AND METHODS Adult Sprague-Dawley rats (220-250 g) were injected with either KA or saline into the right lateral ventricle. Precontrast and postcontrast MEMRI sessions were obtained. Region of interest (ROI) analyses were performed on both injected (saline and KA) and contralateral (normal) sites in the hippocampal area. All brains were evaluated histologically following MEMRI. RESULTS Analysis of percentage change in ROI intensities of T1-weighted fluid-attenuated inversion-recovery MR images in the hippocampal area revealed a significant difference between the KA-injected (ipsilateral) and contralateral sites (P = 0.008), whereas no significant difference was observed between the saline-injected and contralateral sites. Furthermore, there was a significant difference between ipsilateral sites of the saline-treated and KA-treated groups (P = 0.026). The histological results supported these findings. CONCLUSION MEMRI is a simple and useful in vivo method for detecting neurodegenerative changes due to excitotoxicity in the rat brain. The development of a manganese-based contrast agent that can be safely used in humans is warranted to investigate neurological disorders