Makale Arama

With the rapid technological advances, ultrasonography (US) has become an important breast imaging procedure in the last decade. In addition to the complementary role to mammography and magnetic resonance imaging, today it has an important place in interventional situations such as guiding needle aspiration, core needle biopsy and presurgery needle localization. American College of Radiology has developed “The Breast Imaging Reporting and Data System” (BIRADS) lexicon to standardize the terminology in the US reports. This lexicon includes the descriptors from several feature categories, the assessment of findings and the recommendation of the action to be taken. Six morphologic features were described for solid breast masses: shape, orientation, margin, lesion boundary, internal echo pattern and posterior acoustic features. Despite the known overlap between benign and malignant features, typical signs of benignity were oval shape, gently lobulation, homogenous hyperechogenity, parallel orientation; typical signs of malignity were irregular shape, antiparallel orientation, noncircumscribed margin, echogenic halo, decreased sound transmission. The purpose of this article was to discuss reliability of these BIRADS US lexicon descriptors in the differentiation of benign from malignant solid masses of the breast.

Elastofibroma dorsi is a rare, benign tumor, characterized by fibroblastic proliferation and accumulation of abnormal elastic fibers. It is located in the subscapular region between the scapula and the thoracic wall. Especially, the suspicion of soft tissue sarcoma may produce anxiety. Magnetic resonance imaging and computed tomography findings are usually typical; and, positron emission tomography may also contribute to the diagnosis. Diagnosis can be made easily with typical localization and imaging findings. We present clinical and imaging findings in three cases of elastofibroma dorsi.

Purpose: In this study, contrubitions of computed tomography (CT) and magnetic resonance imaging (MRI) were researched in the diagnosis of benign paranasal sinüs (PNS) lesions. Materials and methods: According to the clinical findings, between January 2001 – February 2004, 30 cases have been studied who were thought to have benign lesions belonging to nasal cavity, PNS or neighboring structures. CT and MRI studies are made to the all case. Inner structure characteristics, locations and radiological apperarances coursing pathological diagnosis of lesions in CT and MRI have been assessed. Results: The histopathological diagnoses of lesions were mucocele (8), odontogenic cysts (4), fibrous dysplasia (3), inverted papilloma (2), hemangioma (2), menengioma (2), schwannoma, osteoma, osteochondroma, paget disease, ameloblastom, giant cell tumor, central giant cell granuloma. Whwn assessed according to pathological results, sensitivity of CT and MRI were found to be 86.6% and 83.3% respectively. In 3 cases showing radiological malign feature (1 giant cell tumor, 2 inverted papillomas) the correct diagnosis was made histopathologically. Canclusion: CT is an effective method to show bone expansion and destructions, tumors originated from bone and intratumoral calcifications. MRI offers better the inner structures of cystic lesions, intratumoral hemorhages and differentiation of tumor from inflammation. Therefore, CT and MRI should be used jointly in the evaluation of the PNS lesions.

Demonstrating the imaging findings of asymptomatic giant thymolipoma mimicking cardiomegaly is aimed. A paracardiac mass was detected with 32-year-old male patient afterwards demonstration of cardiomegaly on a posterior-anterior (PA) chest x-ray examination taken for a routine control. Computed tomography (CT) showed a mass, localized in the anterior mediastinum, with smooth margins, showing no significant invasion of adjacent structures, and including fat density with fibrous component. The diagnosis was reported as thymolipoma histopathologically after transthoracic biopsy. On a preoperative magnetic resonance (MR) examination, taken for detailing the limits of the lesion, the mass showed hyperintensity on both T1 and T2 weighted images, and suppression on fat saturated T2 weighted images. No invasion of adjacent structures was detected. A thymolipoma may reach a large size without symptoms due to its great pliability. It can mimic cardiomegaly on x-ray images. Adipose tissue on CT is helpful in the diagnosis. MRI gives valuable information in determining the exact boundaries of the lesion.

Lymphocytic adenohypophysitis is a rare disease associated with late pregnancy and early postpartum. Autoimmune mechanism is blamed as cause. İt is frequent in females, and may be misdiagnosed as pituitary adenoma. 29 years-old -female with 2 children presented with headache follovving cryptic tonsillitis. Recently she had problems vvith her Vision. Clinical and radiological work up including magnetic rezonance imaging revealed a mass in the sellar and suprasellar region. She undervvent surgical decompression follovving functional hormona! studies. Histopathologic evaluation of the specimen was reported as lymphocytic hypophysitis. Differential diagnosis of lymphocytic hypophysitis from that of adenoma is important in planning surgery. Relation to the pregnancy, a severe hypopituitarism, edematous anterior and posterior pituitary lobe are in favour of lymphocytic hypophysitis. But certain diagnosis is made via histopathologic diagnosis. İt is thought to be autoimmune in origin especially in pregnant or recently delivered vvomen. But in nonpregnant persons it may start or be aggravated after an infection as it is in our patient.

Aim: Nearly 30% of the patients with cleft palate need another surgery for velopharyngeal insufficiency. While
preoperative radiologic evaluation is necessary for planning, postoperative evaluation is also so important. In
this study, we plan to share our experience about evaluation of the velopharynx with dynamic MRI at patients
who were operated oving for velopharyngeal insuf ficiency.
Patients and Methods: The study included seventeen patients who were presented with velopharyngeal
insufficieny and we applied dynamic MRI for postoperative evaluation between April 2014 and May 2020.
Pharyngeal flap was applied for 7, posterior augmentation was performed for 7 (2 costal cartilaginous, 5 fat
graft) and myomucosal repair was done for 3 patients with submucosal cleft. Dynamic MRI were obtained
preoperatively and postoperatively at 3rd month. Postoperative results were evaluated with dynamic MRI.
Results: The study included seventeen patients, with an age range of 9-29 (mean 13± 2.5), 11 women (65%),
and 6 men (35%). Posterior wall located grafts were found at the second cervical vertebra and viable. While
there was no nasal air escape in superior pharyngeal flap applied patients at sagittal plane, in axial dynamic
images, gap was detected which is all essential for airway and must be obtained. The levator muscle direction
was observe normal postoperatively at patients with submucous clef. Nasal air escape area was decreased
in both methods significantly comparing with preoperative measu rement (p<0.05)
Conclusion: Because of the three-dimensional and dynamic structure of the velopharynx, it must be evaluated
in both planes and dynamic. Although there are many techniques for this purpose, none of them is ideal or
objective. Dynamic MRI can be used for postoperative follow-up as it is used for preoperative planning.
Evaluation of the pharyngeal flap atrophy , grafts and also gap size are provided with qualitative values .

Tumors arising from urinary bladder diverticula is a rare lesion. 76-year-old man who was presented with hematüria examined with radiologic methods. Tumoral lesions reaching into diverticula and bladder cavity were detected by ultrasonography, computed tomography and magnetic resonance imaging. Particularly, computed tomography and magnetic resonance imaging are confident to determine diverticular neoplasms.

Patients with temporomandibular joint (TMJ) dysfunction have symptoms such as pain in the jaw and surrounding tissues, limitation in jaw movements and/or clicks, crepitation, head, neck, ear, toothache. Although there are publications on PRP injections in the treatment of temporomandibular joint (TMJ) dysfunction, there is no study on the effect of the use of concentrated growth factor (CGF) in the literature. In this study, it was aimed to analyze the efficacy of concentrated growth factor (CGF) in patients with TMJ disc displacement, disc dislocation with/without reduction and joint degeneration. Patients who did not respond to conservative treatment during the period of 2015-2016 and were complaining of TMJ pain, knocking in the joints, decreased mouth opening were included to the study. Magnetic resonance imaging results of before and after injections, age, gender, previous therapies, pain, click on the joint, mouth openness were recorded. The pain felt in the jaw joint in patients was scored according to the visual analogue scale (VAS) numbered 0-10. Mouth openness was measured. Before and the six months after CGF injections, TME magnetic resonance imaging was performed on all patients. All measurements were repeated at 6 months and 1 year after CGF injection. The mean age of the 10 patients (3 males, 7 females) was 30 and the mouth openness was 2.1 cm before injection. In the first year after injection, mouth openness was measured as 3 cm on average. Before injections, there was a clicking sound in all patients. However, at the end of the 1st year, only 2 patients had clicking. The mean VAS before and after injection injection was 8 and 3, respectively. In this study, it was determined that one intraarticular injection of 1 cc CGF in the patients with joint degeneration and TMJ disc displacement with/without reduction resulted in decrease of VAS score and click sound and increase of mouth openness. CGF injection may achieve symptomatic improvement in patients with TMJ dysfunction.

İnternal derangement of temporomandibular joint (TMJ) has been described as abnormal relationship beetween the disc, articular eminence, fossa and condyl. İn this study it vvas compared to magnetic resonance imaging and clinical findings of internal derangement of TMJ. Hundered seventy nine joints of hundered patients, who vvere referred from Selçuk University Faculty of Dentistry with daim of internal derangement in their TMJ vvere examined by MRI. Examination vvas performed at closed and opened mouth position in T1, T2, proton vveighted oblique sagittal plane and closed mouth position in coronal plane. These joints vvere joints vvas divided into four groups as normal, reducted (RA), İrreducted (IRA) and with or vvithout degenerative joint changes according to MRI findings. Clinically they vvere classified as in early, intermediate and late stage. Most of the cases vvere in intermediate (%37) and late (%43) stages. İn early, intermediate, late stages the joints vvere determined normal: 66%, 42%, 10%; RA .26%, 44%, 23%; IRA: 8%, 14%, 67% by MRI respectively. İn RA and IRA joints pain 64%, 83%, limited mouth opening 23%, 66%, clicing 62%, 26%, crepition 11%, 39% vvere found by clinical examination, respectively. Degenerative change of osseos component at the joints vvere freçuently seen in the joints vvith IRA and crepitation. İn the clinical examination of TME vvere significant findings. Also the presence of osseos degenerative changes, vvhich could not be determined by clinical examination, are very important. Because they influence the treatment type and effctivity. We think that in determination of TME joint disfunction, clinical examination and MR findings should be evaluated together.

Intraventricular hemorrhage (IVH) is a common complication associated with delivery in preterm neonates. Germinal matrix, subependymal layer of lateral ventricle is the most occurring site of intraventricular hemorrhage. IVH is imaged as a hyperechogenic area and ventriculomegaly on ultrasonography, but it is detected easily by fetal magnetic resonance imaging (MRI). The present case was referred to our clinic due to ventriculomegaly on ultrasonography. Germinal matrix was determined on the fetal cranium with ultrasonography and intrauterine MRI at 30th weeks of gestation. The pregnancy was terminated by cesarean section due to severe preclampsia. Fetal MRI should be performed to confirm the diagnosis on the cases with suspect ventriculomegaly.

To determine the contribution of imaging techniques for diagnosis and therapy planning of patients with parotid masses. 16 patients (10 female, 6 male; between 13-75 age; mean age 41.12±16.97 years) were evaluated retrospectively. Age, gender, clinical characteristics of patients, imaging studies which were performed preoperatively, location and characteristics of masses and invasion to the surrounding tissue, histopathologic examination of surgery specimens were evaluated in the current study. Histopathologic examinations of specimens revealed that all cases were benign. Histopathologic findings revealed no malignancy. Histopathologically, lesion was diagnosed as pleomorphic adenoma in 11 patients (%68.75) and Warthin tumor in 5 patients (%31.25). The mass was located in left parotid gland in 8 (%50) patients and in right parotid gland in 8 (%50) patients. Preoperative, ultrasound (US) was performed in 7 patients; computed tomography (CT) was performed in 9 patients; magnetic resonance imaging (MRI) was performed in 5 patients. US should be the initial investigation of choice for patients with parotid masses because of superficial location. US is effective, inexpensive, nonradiation, non-invasive, practical and does not require sedation in diagnosis parotid masses. Deeply located tumors and malign tumors should be evaluated with CT or MRI. CT or MRI alone is sufficient for evaluation.

Almost 80% of the population in their lives are confronted with low back pain. One of the most important cause of low back pain is lumbar disc herniation. Treatment of lumbar disc herniation is primarily conservative but progressive neurologic deficits or cauda ekina syndrome constitutes an indication for definitive surgery. Extruded lumbar disc herniation in our case, spontaneous regression without surgical intervention are discussed in the literature. 27 years old female patient was admitted to our clinic with complaints of back pain. The patient has a a previous history of severe low back and right leg pain two years ago and surgery was recommended by an other neurosurgery clinic with the diagnosis of lumbar disc herniation L5-S1. The patient does not accept this surgery and the patient’s complaints were resolved with medical treatment and resting. At the patient’s neurological examination laseque test was bilateral negative and her motor and sensory examination was normal. Lumbar magnetic resonance imaging has shown spontaneously regression of the previous extruded disc herniation and the patient discharged with conservative treatment. Emergency surgical indications of extruded lumbar disk herniation should be treated outside the impatient. Spontaneous regression of extruded lumbar disc surgery procedures without surgical initiative have been shown by this case.

Ultrasonography, Doppler ultrasonography and magnetic resonance imaging findings of three cases with choroidal metastasis were evaluated. Two of the cases were women, and one was man. They had pancreas, breast and bronchoalveolar carcinomas, respectively. Two cases presented with blurred Vision. The case with bronchoalveolar carcinoma was detected during the magnetic resonance imaging procedure for cerebral metastasis. İn one of the three patients immediate hypoechogenic, in the remaining two patients hyperechogenic lesions vvhich were protrused to the posterior wall of the globe determined by ultrasography. Doppler ultranography demonstrated that the lesions were vascularised. The lesions were hyperintense in two, and isointense in one case; ali of them were hypointense on T2- vveighted images. İn cases of primary malignancy with eye complaints, radiologic evaluation can be helpful in the elimination of eye metastasis.

Magnetic resonance imaging provides high contrast, anatomic delineation of the neck and is useful for preoperative localization of abnormal parathyroid glands in patients with persistent or recurrent hyperparathyroidism. Magnetic resonance imaging findings of the parathyroid masses are reported in three patients with hyperparathyroidism.

We report a 27 year-old man with a history of one year of Progressive slowing of movements, speech and tremors in extremities. Neurological examination revealed cognitive impairment, bradykinesia, rigidity and tremor in the ali extremities. Routine biochemical tests, blood count, serum ceruloplasmine and copper values, liver biopsy were ali normal. BRain magnetic resonance imaginary (MRI) showed frontotemporal atrophy, hipointensities in globus pallidus and substania nigra in T2 weighted images. Electromyography (EMG) showed normal motor and senso- ry conduction velocities but widespread large motor unit potentials (MUP) in cervical and extremity muscles. These findings have been reviewed in the light of relevant literatüre.

Aim: Lipoma arborescens is a rare intra-articular disease whose etiopatogenesis remains unknown.It was the aim to describe the radiological findings and to discuss the differential diagnosis. Case Report: Lipoma arborescens is a lesion characterized by the replacement of the subsynovial tissue by fat cells giving rise to a villous proliferation. It commonly affects the knee. Accurate diagnosis is important for surgical treatment. A 34-year-old patient who was suffering from a pain in his knee joint was examined by convansional radiography, computerized tomography, and magnetic resonance imaging. The lesion was diagnosed as lipoma arborescens especially with magnetic resonance imaging. Conclusion: The characteristic MR features of lipoma arborescens which has nonspecific clinical findings allows an accurate diagnosis.

Absent pulmonary valve syndrome (APVS) is a rare congenital heart disease. It can be seen isolated or with other congenital heart diseases. Here, we presented a neonate with cyanosis and dyspnea because of APVS. A-female-newborn was referred to pediatric cardiology due to cyanosis, respiratory distress and prenatally diagnosed right ventricular dilatation. Rudimentary pulmonary valves and severe pulmonary and tricuspid regurgitations were determined postnatally with echocardiography and magnetic resonance imaging. Additionally, main pulmonary artery and its branches were seen dilated. Unfortunately she died on third day of her life, although supportive and medical treatments were administered intensively. Most of APVS cases are a variant of Tetralogy of Fallot. But clinical findings, prognosis and hemodynamic conditions can be different. Infants requiring mechanical ventilation shold be undergone operation as soon as possible. Our case could not be operated because of unstable vital functions. Absent pulmonary valve syndrome should be considered as a differential diagnosis in neonates with cyanosis and respiratory distress. If prenatal diagnosis is present, we suggest that parturition should happen in a medical center includes pediatric cardiology and cardiovascular surgery and also neonatal intensive care unit.

Intraspinal synovial cysts are uncommon lesions. İn this article a 72 year-old woman who developed a spinal synovial cyst at the left side of L4-5 disk space is reported. Beside her clinical signs and symptoms, magnetic resonance imaging, operative andpathological findings are presented. Treatment options, clinical, radiological and pathological aspects of intraspinal synovial cysts are discussed.

Aim: Spinal arteriovenous malformation is a rare pathology located in the dura along the spinal canal. Multi-detector computed tomographic (MDCT) angiography is a recently developed imaging technique. We present findings of magnetic resonance (MR) imaging and multi-detector computed tomographic angiography in 16-year-old patient with spinal arteriovenous malformations. Case report: MR images showed signal voids dilated vessels at the surface of the spinal cord at C1-2 level. Also, multi-detector computed tomographic angiography demontrated dilated varix-like vessels. The patient was diagnosed as having a spinal arteriovenous malformation. Result: Multi-detector computed tomographic angiography can be a non-invasive usefulness technique in detect the spinal arteriovenous malformatios.

Aim: Investigate the role of Magnetic Resonance Imaging (MRI) in the evaluation of response of the locally
advanced rectal cancer to the chemoradiotheraphy (CR T).
Patients and Methods: T2-weighted and Diffusion Weighted Imaging (DWI) of 24 cases with locally advanced
rectal cancer who have undergone total mesorectal excision 6-8 weeks following the CRT between 2015 and
2020 were evaluated retrospectively. The evaluated radiological parameters were as follows; Tumor morphology,
localization, length, mrT/mrN stages, and extramural vascular invasion (EMVI). Post-CRT MRI residue scoring
was performed (0: No residual tumor, 1: No significant residual tumor, fibrotic wall thickening, 2: Residual tumor
present). Regression grading was as follows; 1: No tumor, 2: Good response, mostly fibrosis, 3: Fibrosis and
mucin more than 50%, 4: Slight response, 5: No response.
Results: There was a significant decrease in the craniocaudal length of tumor and a significant increase
in the mean ADC of tumor after CRT (p=0.001). A significant and high correlation was observed between
histopathological T (pT) and post-CRT mrT (r=0.54, p=0.006). There was a significant correlation between pre-
CRT EMVI and perineural invasion (PNI) (r=0.53, p=0.008). A significant correlation was found between residue
scoring and regression grading (r=0.6; p=0.001), pT (r=0.48; p=0.02), and tumor length (r:0.51; p=0.01). There
was a significant correlation between regression grading and EMVI (r=0.43, p=0.036), PNI (r=0.46, p=0.02), pT
(r=0.41; p=0.048), pN (r=0.55; p=0.006), and metastatic/total lymph node ratio (r=0.46; p=0.02).
Conclusion: Post-CRT MRI is highly correlated with postoperative pathological evaluation of the locally
advanced rectal cancer. MRI is highly successful in re-staging as well as primary staging. The evaluation of
treatment response by MRI regression grading may contribute to the surgical planning.

Neonatal hemochromatosis is a rare disease clinically defined as severe neonatal liver disease in association with extrahepatic siderozis. The etiology of neonatal hemochromatosis is not understood exactly. However, according to a theory neonatal hemochromatosis is accepted to be an alloimmune disorder causing liver injury in fetus. After an effected one in the pregnancy the recurrence rate of neonatal hemochromatosis is ~80%. Hepatocellular failure which occurs in the first days of life with coagulopathy, hypoglycemia, hypoalbuminemia, hypofibrinogenemia, thrombocytopenia, anemia, and direct and indirect hyperbilirubinemia characterizes neonatal hemochromatosis. In order to diagnose neonatal hemochromatosis there are some certain criteria that sould be taken into account such as a positive family history, high serum ferritin levels, high serum alpha-fetoprotein levels and siderozis demonstrated with histology or with magnetic resonance. Since an affective medical treatment has not been found yet, liver transplantation is almost always required. The prognosis of neonatal hemochromatosis is generally poor. This review will discuss neonatal hemochromatosis that leads to liver failure in the fetus or newborn.