Evaluation of patients with fibrotic interstitial lung disease: Preliminary results from the Turk-UIP study

OBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF. MATERIAL AND METHODS: The study included the patients with the usual interstitial pneumonia (UIP) pattern or possible UIP pattern on thorax high-resolution computed tomography, and/or UIP pattern, probable UIP or possible UIP pattern at lung biopsy according to the 2011 ATS/ERSARS/ALAT guidelines. Demographics and clinical and radiological data of the patients were recorded. All data recorded by researchers was evaluated by radiology and the clinical decision board. RESULTS: A total of 336 patients (253 men, 83 women, age 65.8 +/- 9.0 years) were evaluated. Of the patients with sufficient data for diag-nosis (n=300), the diagnosis was IPF in 121 (40.3%), unclassified idiopathic interstitial pneumonia in 50 (16.7%), combined pulmonary fibrosis and emphysema (CPFE) in 40 (13.3%), and lung involvement of connective tissue disease (CTD) in 16 (5.3%). When 29 patients with definite IPF features were added to the patients with CPFE, the total number of IPF patients reached 150 (50%). Rate of male sex (p<0.001), smoking history (p<0.001), and the presence of clubbing (p=0.001) were significantly high in patients with IPE None of the women <50 years and none of the men <50 years of age without a smoking history were diagnosed with IPE Presence of at least 1 of the symptoms suggestive of CTD, erythrocyte sedimentation rate (ESR), and antinuclear antibody (FANA) positivity rates were significantly higher in the non-IPF group (p<0.001, p=0.029, p=0.009, respectively). CONCLUSION: The rate of IPF among patients with fibrotic ILD was 50%. In the differential diagnosis of IPF, sex, smoking habits, and the presence of clubbing are important. The presence of symptoms related to CTD, ESR elevation, and EANA positivity reduce the likelihood of IPF

Diagnostic efficiency of multislice computed tomography colonography in the detection of colorectal tumors: Comparison with conventional colonography

AMAÇ Konvansiyonel kolonoskopi yapılan kolorektal kanser riski yüksek hastalarda, çok kesitli BT kolonografi tetkikinin kolorektal patolojilerin saptanmasındaki tanısal etkinliğini konvansiyonel kolonoskopi ile karşılaştırarak değerlendirmek. GEREÇ VE YÖNTEM Kolon kanseri şüphesiyle konvansiyonel kolonoskopi yapılan 37 hastaya 4 dedektörlü bir çok kesitli BT cihazı ile 4x1 mm’lik dedektör kolimasyonu, 120 kV, 0.5 sn’lik gantri rotasyonu ve 120 mAs’lik parametreler ile çekimler gerçekleştirildi. Her hastada yapılan multiplanar reformat imajlar, sanal kolonografi ve sanal kolonoskopi imajları konvansiyonel kolonoskopi ile karşılaştırıldış Sonuçlar %95 güvenilirlik alanı tekniği ile konvansiyonel kolonoskopi bulguları referans standart alınarak hesaplandı. BULGULAR Konvansiyonel kolonoskopide izlenen 23 polipin 17’si çok kesitli BT kolonografide doğru olarak saptandı. 10 mm ve daha büyük boyuttaki 11 lezyondan dokuz tanesi (%81), 6-9 mm boyutları arasındaki dört lezyondan üç tanesi (%75), 1-5 mm boyutları arasındaki sekiz lezyondan beş tanesi (%62)çok kesitli BT kolonografide doğru olarak saptandı. SONUÇ Sonuçlar çok kesitli BT kolonografi tetkikinin 10 mm’nin üzerindeki poliplerde duyarlılığının yüksek olması, rölatif olarak güvenilir ve minimal invazif olması nedeni ile varolan diğer kolorektal kanser tarama testlerine iyi bir alternatif olabileceğini göstermektedir.PURPOSE: To evaluate the diagnostic efficiency of multislice CT colonography in the detection of colorectal tumors by comparing it with conventional colonography in patients with high risk of colorectal cancer MATERIALS AND METHODS: Thirty-seven patients who had undergone conventional colonoscopy because of a suspicion of colorectal cancer were scanned with a fourdetector multislice CT scanner with 4x1 mm detector collimation, 120 kV, 0.5 sec gantry rotation and 120 mAs scan parameters. Multiplanar reformatted images, virtual colonography and virtual colonoscopy images were compared with conventional colonoscopy. With conventional colonoscopy taken as the reference standard, the results were calculated with 95% confidence interval technique. RESULTS: Seventeen of the 23 polyps detected in conventional colonoscopy were identified correctly with multislice CT. Nine of 11 lesions with a diameter of 10 mm or greater (81%), three of four lesions with a diameter of 6-9 mm (75%), and five of eight lesions with a diameter of 1-5 mm (62%) were correctly identified with multislice CT. CONCLUSION: Multislice CT colonography is a good alternative to other colorectal screening tests because it has high sensitivity for polyps 10 mm or larger in diameter, is relatively safe and minimally invasive

Diffuse pulmonary lymphangiomatosis: imaging findings

Diffuse pulmonary lymphangiomatosis is a rare pulmonary disorder affecting the lymphatic channels from the mediastinum to the pleura. The disease usually occurs in children and young adults and frequently ends with death due to progressive course. Imaging findings of the disease are based on lymphatic involvement which appear as mediastinal soft tissue infiltration and thickening of pulmonary peribroncovascular bundles and interlobular septae. In this report, spiral and high-resolution computed tomography, and ultrasonography findings of severe form of this rare disease are presented. Furthermore, some lymphatic disorders, which are called with similar name but different appearances on imaging, are discussed

Sternal metastasis from uterine leiomyosarcoma

Uterus leiomyosarkomları zayıf metastaz eğilimi olan nadir yumuşak doku tümörleridir. En sık, akciğerler, karaciğer ve beyine metastaz yaparlar. Bu olgu sunumunda sternuma metastaz yapan nüks uterus leiomyosarkomunun manyetik rezonans görüntüleme bulguları sunulmakatadır.Uterine leiomyosarcoma is a rare soft tissue neoplasm having a tendency to the distant metastasis, most commonly to the lung, liver and brain. In this case, magnetic resonance imaging findings of recurrent uterine leiomyosarcoma metastasing to the sternum, which is unusual metastatic site for uterine leiomyosarcoma, are presented

MR-arthrography comparedto MRI in glenohumeral joint instability

Klinik olarak anterior, posterior ve çok yönlü tekrarlayan omuz instabilités! ön tanısı alan 47 olgu Magnetik Rezonans (MR) ve Magnetik Rezonans Artrografi (MRA) ile incelendi. Olgularda hem MR, hem de MRA inceleme ile humérus başı, eklem kapsülü, glenohumeral ligamanlar, glenoid lab-rum ve komşu kemik yapılar değerlendirildi. Olgulardan 15'inde yapılan artroskopik inceleme, 1 olguda uygulanan açık cerrahi sonuçları MR ve MRA sonuçları ile karşılaştırıldı. 10 olguda MRA ile Artroskopi bulguları ve 1 olguda MRA ve açık cerrahi sonuçlan uyumlu idi. MRA ile Bankart lezyon tanısı alan 20 olgunun 16'smda MR ile aynı tanı konabildi. MRA ile 17 olguda labral lezyon saptanabilirken MR ile ancak lezyonların 7'si tanınabildi. MRA ile rahatlıkla değerlendirilebilen kapsül tipleri MR ile değerlendirilemedi Hill-Sachs lezyon ve rotator cuf tendon patolojileri her iki yöntem ile de eşit oranda tanındı. Sonuç olarak MRA'nın gleno-humeral instabilité olgularında artroskopi ve açık cerrahi öncesi uygulanması gereken primer tanı yöntemi olduğu sonucuna varılmıştır.47 patients, who were suffering from anterior, posterior or multidirectional shoulder joint instability, were evaluated by MR and MR-Arthography. In all patients, humeral head, joint capsule, glenohumeral ligaments, glenoid labrum and neigboring bony structures were assessed. Fifteen subjects underwent arthroscopic and one .patient underwent surgical exploration. All the surgical and arthros-copical data were corraleted with MRI and MRA findings. In 10 subjects examined by arthroscopy and in the case operated surgically, all the findings were compatible with the data obtained by MRA. In 16 of the 20 cases with Bankard lesions proved by MRA, the same diagnosis could also be made by conventional MRI. MRA could detect labral lesions in 17 cases. But the same diagnosis could be made by MRI in only 7 patients. The joint capsule types, which can be easily evaluated by MRA, could not be visualised by MRI. The sensitivity of MRI and MRA for Hill-Sachs lesions and rotator cuff pathologies were the same. It is concluded that MRA is the primary imaging modality of choice in cases of glenohumeral joint instability before undergoing shoulder joint arthroscopy or open surgical exploration

Two cases of infantile myofibromatosis: Multiple visceral involvement and a solitary soft tissue mass

Infantile myofibromatosis is a rare myofibroblastic tumor in which soft tissue, bone and rarily visceral involvement can be seen. It is usually a solitary tumor, however, multicentric involvement may also be present. The cases with solitary or multiple lesions but no visceral involvement have good prognosis and spontaneous regression can often be seen. Nevertheless, multicentric visceral tumors are associated with high mortality. In this report, imaging findings of a case of infantile myofibromatosis with liver and both adrenal glands involvement; and another case with involvement of posterior thoracal and servical region muscles are presented