"Reversed halo sign" on 3D CT in COVID-19

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Caesarean Scar Choriocarcinoma: Ultrasound and Magnetic Resonance Imaging Findings

Primary gestational choriocarcinoma in a uterine caesarean section scar (CSS) is an extremely rare entity, and its timely diagnosis and treatment is crucial in order to prevent related complications and metastatic disease. Herein, we report on a 33-year-old female who was referred to our department with an initial diagnosis of ectopic pregnancy. Transabdominal ultrasound and magnetic resonance imaging (MRI) demonstrated a nodular mass on CSS. The final histopathological diagnosis was CSS choriocarcinoma

Accuracy of Percutaneous CT-Guided Spine Biopsy and Determinants of Biopsy Success

Purpose: The purpose of this study was to investigate the accuracy of CT-guided spine biopsy as well as the factors that may influence its success. Methods and Materials: A total of 170 CT-guided biopsies performed on 156 patients with vertebral lesions were retrospectively analyzed. The accuracy of the biopsies was evaluated by comparing the final diagnosis with the biopsy results for patients who underwent surgery or with six-month clinical and radiological follow-up findings for patients who did not have surgery. The radiological features of each lesion, the features of the needles used, the needle approach, the pathology results, and the patient demographic data were statistically analyzed with Fisher exact test and ANOVA for their influence on the success of the biopsy. Results: The total success rate of percutaneous vertebral needle biopsies performed with CT guidance was 80 per cent (136/170). Age ('p' = 0.39), gender ('p' = 0.43), lesion location ('p' = 0.2), radiographic appearance ('p' = 0.8), needle type ('p' = 0.6), and approach (p = 0.1) had no effect on the adequacy of the obtained material or the success of the biopsy. There was a relationship between lesion histopathology and the rate of adequacy or success ('p' < 0.001). There was no relationship between the needle approach or the radiographic appearance of the lesion and the length of the specimen ('p' = 0.1). There were no major complications requiring treatment. Conclusion: The success rate of CT-guided percutaneous needle biopsy was close to that found in previous studies in the literature and independent of most patient parameters. Its complication rates are acceptable in experienced hands

"T2-hypointense dot sign": A novel and highly suggestive clue for the diagnosis of ovarian torsion

23rd Annual Meeting of the Turkish-Society-of-Magnetic-Resonance -- MAY 10-12, 2018 -- Ankara, TURKEYWOS: 000478106500012PubMed: 30933848Purpose: We aimed to describe "T2-hypointense dot sign" for the diagnosis of ovarian torsion and compare its diagnostic capability with whirlpool sign. Methods: Pelvic MRIs of 31 patients with surgically proven ovarian torsion were used for the analysis. The control group was comprised of 30 patients with adnexal neoplasm and 15 patients with tubo-ovarian abscess. The MRIs of all 76 patients were retrospectively evaluated by two independent radiologists for the presence of T2-hypointense dot sign and whirlpool sign using a three-point scale. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy values for the T2-hypointense dot sign for the diagnosis of ovarian torsion for observer 1 and observer 2 were 0.90, 1, 1, 0.93, and 0.96 and 0.87, 1, 1, 0.91, and 0.94, respectively. These same values for the whirlpool sign for observer 1 and observer 2 were 0.58, 1, 1, 0.77, and 0.82 and 0.42, 1, 1, 0.71, and 0.76, respectively. Both signs were definitely negative in patients with adnexal neoplasm and tubo-ovarian abscess. Interobserver agreement was excellent for the T2-hypointense dot sign (kappa = 0.83), but poor for the whirlpool sign (kappa = 0.31). Conclusions: The presence of T2-hypointense dot sign could be a valuable clue for the accurate and early diagnosis of ovarian torsion in non-contrast MRI scans.Turkish Soc Magnet Resonanc

Giant congenital pelvic AVM causing cardiac failure, diplegia, and neurogenic bladder

BACKGROUND: Pelvic arteriovenous malformations (AVMs) are uncommon lesions and only a rare number of male cases have been reported. Their clinical presentations are variable and imaging modalities have an important place in diagnosis and treatment planning. CASE REPORT: We present the imaging findings of a giant congenital pelvic AVM that was diagnosed in a 30-year-old male patient eight years ago and which progressed despite follow-up and treatment, causing cardiac failure, diplegia, and neurogenic bladder. CONCLUSIONS: Pelvic AVMs are uncommon lesions and they can present with various symptoms based on their locations and sizes. Delays in the diagnosis and treatment can cause local and systemic complications. Imaging is very important in the diagnosis of pelvic AVM

Acoustic Radiation Force Impulse Quantification in the Evaluation of Renal Parenchyma Elasticity in Pediatric Patients With Chronic Kidney Disease

WOS: 000406344700003PubMed: 28390141Objectives-To evaluate renal parenchymal elasticity with acoustic radiation force impulse imaging in pediatric patients with chronic kidney disease (CKD) and compare with healthy volunteers. Methods-Thirty-eight healthy volunteers and 30 pediatric CKD patients were enrolled in this prospective study. The shear wave velocity (SW) values of both kidneys in CKD patients and healthy volunteers were evaluated. Results-The mean SW in healthy volunteers was 2.2160.34 m/s, whereas the same value was 1.81 +/- 0.49, 1.72 +/- 0.63, 1.66 +/- 0.29, 1.48 +/- 0.37, and 1.23 +/- 0.27 for stages 1, 2, 3, 4, and 5 in CKD patients, respectively. The SW was significantly lower for each stage in the CKD patients compared with healthy volunteers. Acoustic radiation force impulse could not predict the different stages of CKD, with the exception of stage 5. The cut-off value for predicting CKD was 1.81 m/s; at this threshold, sensitivity was 76.5% and specificity was 92.1% (area under the curve = 0.870 [95% confidence interval: 0.750-0.990]; P < .001). Interobserver agreement expressed as intraclass coefficient correlation was 0.65 (95% confidence interval: 0.34 to 0.83; P < .001). Conclusions-Acoustic radiation force impulse may be a potentially useful tool in detecting CKD in pediatric patients

Epiploic Appendagitis as a Rare Cause of Acute Abdomen in the Pediatric Population: Report of Three Cases

WOS: 000426072300015PubMed: 29531496Epiploic appendagitis, caused by inflammation of small adipose tissue on the colon wall, is a rare cause of acute abdominal pain in the pediatric population. It is nearly impossible to establish a specific diagnosis merely on the basis of clinical findings; thus, radiological evaluation is always necessary. In this report, we present the cases of three children with abdominal pain who were diagnosed with epiploic appendagitis. All cases were successfully treated with conservative management

A rare cause of acute abdomen in the ED: Chemotherapy-induced pneumatosis intestinalis

WOS: 000424190600008PubMed: 29464220Pneumatosis intestinalis (PI) and portomesenteric venous gas (PVG) refers to the presence of air within the intestinal wall and portomesenteric vessels. Most of the time, it is associated with mesenteric ischemia that requires immediate surgical intervention as it has high mortality rate. It may also be seen secondary to various conditions, including infections, surgeries, and some chemotherapeutic drugs. A 61-year old-male was admitted to our emergency department complaining of abdominal pain after chemotherapy. Radiological evaluation of the patient demonstrated massive PVG and PI. Patient underwent urgent surgery due to the possibility of intestinal ischemia and infarction, but no necrosis was identified Chemotherapeutic drug-induced PI and PVG was the final diagnosis. Although PI and PVG are signs of mesenteric ischemia and intestinal necrosis most the of time, chemotherapeutic drugs may also cause PI and PVG rarely. Recent history of chemotheraphy and absence of any mesenteric vascular occlusion may be the diagnostic clue. Copyright (C) 2017 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner. This is an open access article under the CC BY-NC-ND license

Efficiency of inferior petrosal sinus sampling in the diagnosis of Cushing's disease and comparison with magnetic resonance imaging

WOS: 000460612600009PubMed: 31180374OBJECTIVE: The purpose of this study is to assess the efficiency of inferior petrosal sinus sampling (IPSS) in the diagnosis of adrenocorticotropic hormone-dependent Cushing's disease and to compare it with magnetic resonance imaging (MRI). METHODS: The diagnostic efficiency of IPSS in the differentiation of pituitary Cushing's disease from ectopic Cushing's disease was retrospectively evaluated in 37 patients who had IPSS in our clinic. Six patients were excluded from the study due to missing data. Hypophysis MRI examinations of 31 patients before IPSS were also evaluated. The contributions of MRI and IPSS to the detection of pituitary adenoma and the determination of lateralization were researched. RESULTS: Bilateral IPSS was successfully performed in 30 patients of the 31 patients in the study group. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of IPSS in differentiating between central and ectopic Cushing's syndrome before corticotrophin-releasing hormone (CRH) stimulation were 93.3%, 100%, 100%, 33.3%, and 93%, respectively, whereas after CRH stimulation were 100%, 100%, 100%, 100%, and 100%, respectively. The accuracy of both the rates was significantly higher compared with MRI. CONCLUSION: IPSS has the highest diagnostic efficiency in differentiating central Cushing's disease from ectopic Cushing's disease