Evaluation of simple blood counts as inflammation markers for brain tumor patients

Aims Hemogram parameters in routine blood panels have been proposed as inflammation markers. These parameters, especially the red cell distribution width (RDW) and mean platelet volume (MPV), were evaluated as surrogate inflammatory markers in brain tumor patients. We aimed to observe RDW and MPV values of tumor patients and compare to those in healthy population. Methods We recorded white blood cell count, neutrophil count, lymphocyte count, hemoglobin, hematocrit, RDW, platelet count, and MPV of the study group at the time of diagnosis and compared to those of the control subjects. Results The RDW was significantly elevated in study group compared to that of the control subjects (p=0.001). The MPV was significantly lower in study group than that of the control group (p=0.01). Conclusion Decreased MPV and increased RDW were both associated with brain tumor. However, prospective studies with larger sample sizes are needed to support the results and expose MPV and RDW variations between metastatic and primary brain tumors

Extraspinal findings on routine lumbar spinal MR imaging: Prevalence and etiologies in 4012 patients

Aim: To investigate the prevalence and reporting rates of incidental findings (IF) in the routine magnetic resonance imaging (MRI) of the lumbar spine, and to emphasize their clinical importance. Methods: A total of 4012 lumbar MRI taken between January 2014 and December 2016 were reevaluated. The low back pain and sciatalgia those suspected for lumbar spinal pathology were chosen for this study.  Extra-spinal abnormalities were classified according to a modified CT Colonography Reporting and Data System (C-RADS) and analyzed. Results The mean age of patients was 49, 83 (range 17-87) years. Of the cases, 2472 were women and 1540 were men. In 3834 cases, disk pathology was observed. In 1282 cases extraspinal pathology was detected. The largest group in the study consisted of C-RADS E2 with 1048 patients (82.5%). There were 195 patients (28.3%) in the C-RADS E3 group and 23 (1.8%) patients in the C-RADS E4 group, potentially important. Conclusion: Our results show that random extra-spinal abnormalities in the lumbar spine MRI, are very common and systematic evaluation and proper reporting of MRI are crucial

Efficacy of the greater occipital nerve block in recurrent migraine type headaches

Aims We aimed to evaluate six months of results following repeated GON blocks. Methods We evaluated the results from GON block performed on 60 patients. Briefly, we applied a standard 2mL of 0.5% Bupivacaine GON blockage once a week for 4 weeks. We recorded the Visual Analog Scale (VAS) scores, the number of migraine attacks and the Migraine Disability Assessment Questionnaire (MIDAS) scores. The study subjects were not allowed to use medication for prophylaxis, and Ibuprofen (400mg, 1200mg at maximum) was prescribed for any migraine attacks. Results The initial mean number of attacks per month before starting treatment was 8.33+2.31. After treatment, the initial MIDAS mean was found to be 2.82 per month; this declined to 1.47 in 3rd, and was 1.50 in the 6th month. The individual month values were found to be significant, and were listed respectively as, 1st month: 3.95+2.52, 2nd month: 3.23+1.82, 3rd month: 2.60+1.90, 4th month: 2.68+2.10, 5th month: 2.58+1.90 and 6th month: 2.58+1.90. The mean VAS scores were recorded as follows for each month: 6.28±1.24, 3.13±0.97, 2.55±1.19, 2.35±1.26, 2.38±1.20 and 2.48±1.30, respectively. This difference was noted to be statistically significant. No difference regarding the efficacy of the treatment was determined when the results were compared across age groups. Conclusion We assume that GON blockage with 2mL of 0.5% Bupivacaine can be a supportive treatment in migraine treatment, with no serious adverse effects reported

Assessment of the effectiveness of low-dose chest computed tomography in the diagnosis of COVID-19 pneumonia

Aim:  To determine whether low-dose chest computed tomography (CT) imaging protocol is appropriate in terms of technical success and radiation safety, by comparing it with standard protocols in terms of reaching diagnosis and X-ray exposure. Additionally, to investigate radiation dose criteria in patients undergoing CT scan for COVID-19.Method: CT scans of 149 patients diagnosed with COVID-19 between January 2022 and March 2023 were analyzed. Patients were randomly assigned to either a standard protocol or a low-dose protocol. Factors such as technical success, diagnostic accuracy, exposure dose and side effects were analyzed.Results: A statistically significant difference was found between low-dose and standard-dose CT scans for tube current-time product (p<0.001), CTDI (p<0.001), DLP (p<0.001), effective dose (p<0.001). , and cancer risk (p<0.001).Conclusion: The low-dose CT protocol in COVID-19 patients yields similar results to standard protocols in terms of technical success and diagnostic accuracy, while significantly reducing exposure dose. Therefore, the use of low-dose protocol can be considered as an option to reduce the radiation dose that patients are exposed to

Relationship between osteoarthritis findings in knee radiography and meniscus lesion in magnetic resonance imaging in symptomatic knee pain cases

Aim: Knee osteoarthritis is a very common joint disease in the community. However, some meniscus lesions are asymptomatic. Studies show that a significant number of individuals with knee pain without radiographic osteoarthritis findings show meniscus injury on magnetic resonance imaging (MRI). Our study aimed to evaluate the relationship between meniscus lesions and the presence of radiographic knee osteoarthritis in individuals over 50 years of age with knee pain complaints. Methods: Radiographic and MRI results of two hundred and forty patients who applied to our hospital with the complaint of knee pain between August 2018 and January 2020 were analyzed. Radiographic grading for knee osteoarthritis was performed using the Kellgren Lawrence scale. Classification of meniscus lesions in MRI was made as per the criteria defined by the British Knee Meniscus Surgery Association. Intergroup results were evaluated statistically. Results: Osteoarthritis was detected in 110 (45.8%) of 240 knee radiographs. In 78.3% of all cases, meniscus lesions were detected in 96.4% of those with osteoarthritis and 63% of those without osteoarthritis. In patients with osteoarthritis, the prevalence of surgically targeted and possible target lesions was found to be significantly higher than those with no arthritis findings. Conclusions: According to our study results, meniscus lesions were found quite common in individuals with knee pain, especially those with osteoarthritis. Particularly in patients with radiographic osteoarthritis findings, surgical targets and possible target meniscus lesions were more common than those without osteoarthritis findings. Therefore, MRI, in addition to direct radiography, should not be overlooked when determining treatment

OCJENA MNOGOSTRUKIH PODRUČJA NA SREDNJESAGITALNIM SLIKAMA MAGNETSKE REZONANCIJE MOZGA U BOLESNIKA S MULTIPLOM SKLEROZOM

The aim of the study was to compare the first and last magnetic resonance images (MRIs) in patients diagnosed with multiple sclerosis (MS) with MRIs of normal subjects. We wanted to investigate the region initially involved in MS patients. In this retrospective study, midsagittal plane was explored on brain MRIs taken at the time when MS diagnosis was established and the last MRI was obtained following treatment for MS. Comparison was done between healthy subjects and patients diagnosed with MS. The measures included the area of corpus callosum, cerebrum, cerebellum, pons, bulbus, fourth ventricle and pituitary gland. As a result, while there was growth in the fourth ventricle area, there was shrinkage in the other areas in MS patients. In women, the tissues involved at the beginning of the disease were pituitary gland, cerebrum and bulbus, and in men corpus callosum and cerebrum. Atrophy was not time-dependent. Assessment of the correlation between the Expanded Disability Status Scale (EDDS) and atrophy revealed an increase in EDDS (disease progression) to be associated with a decrease in the area of cerebrum and corpus callosum in men, and an increase in the fourth ventricular area in women. In conclusion, we demonstrated that pituitary gland atrophy develops in the early stage of MS, especially in women. Additional studies are needed to investigate the phenomenon of early pituitary and bulbus atrophy in women versus late atrophy of these tissues in men.Cilj rada bio je usporediti prve i posljednje slike magnetske rezonancije (MR) u bolesnika s multiplom sklerozom (MS) sa slikama zdravih osoba. Kod bolesnika s MS htjeli smo ispitati najranije zahvaćeno područje. U ovoj studiji se srednjesagitalno područje kod bolesnika s postavljenom dijagnozom MS pregledalo na slikama MR mozga u vrijeme postavljanja dijagnoze i nakon liječenja. Uspoređivalo se zdrave osobe s bolesnicima kojima je dijagnosticirana MS. Mjerenje je uključilo područje korpusa kalozuma, mozga, malog mozga, ponsa, bulbusa, četvrtog ventrikula i hipofi ze. Kod bolesnika s MS došlo je do porasta na području četvrtog ventrikula, a do smanjenja u drugim područjima. Utvrđeno je da su zahvaćena tkiva u žena na početku bolesti bila hipofi za, mozak i bulbus, a kod muškaraca korpus kalozum i mozak. Otkriveno je da atrofi ja ne ovisi o vremenu. Kada se promatralo korelaciju između zbira na Expanded Disability Status Scale (EDDS) i atrofi je, vidjelo se da s povećanjem EDDS (kada bolest napreduje) dolazi do smanjenja područja malog mozga i korpusa kalozuma u muškaraca, a povećanja područja četvrtog ventrikula u žena. Pokazali smo da se atrofi ja hipofi ze razvija u ranoj fazi MS, osobito u žena. Pozornost privlači rana atrofi ja hipofi ze i bulbusa u žena te kasna atrofi ja ovih tkiva u muškaraca

The role of diffusion-weighted imaging and ADC value in head and neck lesions

Aim:  To evaluate the contrast enhanced magnetic resonance imaging (MRI), diffusion weighted MRI findings of head and neck lesions in combination with histopathological diagnosis. Method: Forty-two patients referred to our university, department of Radiology between July 2008 and June 2011 with a prediagnosis of head-neck lesion. Patients whom underwent contrast enhanced MRI, diffusion weighted MRI, and incisional or excisional biopsy, were included in the study. Patients, whose MRI examinations were suboptimal due to any artefacts, were excluded. After determination of MRI parameters, such as signal intensity, enhancement pattern, apparent diffusion coefficient (ADC) value, and contrast enhanced MRI and diffusion weighted MRI examinations were evaluated by a radiologist who had ten years of experience. Histopathological evaluation was made by a pathologist who had no information about patients’ MRI findings. Results: The mean ADC value of benign and malignant lesions were 0.128x10-3±0.053 mm²/sn and 0.100x10-3±0.026mm²/sn respectively. ADC value was found to be significantly higher in benign lesions compared to malignant ones (p=0.032). Conventional MRI criteria such as signal intensity, internal structure, presence of cystic space and enhancement were found to be insignificant in the differentiation of benign and malignant lesions. Conclusion: Conventional MRI sequences are important in the diagnosis of head and neck lesions but not sufficient due to the overlapping findings. Diffusion weighted MRI, applied in addition to conventional MRI examination, is an efficient technique and has additional diagnostic value in determining nature of head and neck lesions in the preoperative period