Breast arterial calcifications and carotid intima-media thickness and haemodynamics: Is there any association?

OBJECTIVE

In this study, we aimed to research the relation between breast arterial calcifications (BACs) detected on mammography and two well-known markers of cardiovascular diseases-carotid artery intima-media thickness (C-IMT) and haemodynamics parameters like carotid peak-systolic velocity (PSV), end-diastolic velocity (EDV) and resistive index (RI).

METHODS

The study group consisted of 50 consecutive BAC (+) women and the control group consisted of 55 BAC (-) women. In all participants, BAC was diagnosed using mammography and C-IMT was measured using B-mode and Doppler ultrasonography. BAC was defined as two linear calcification depositions in a conical periphery or as calcific rings at the mammographic evaluation. Doppler spectrum samples were obtained from 2 cm proximal to the main carotid artery bifurcation.

RESULTS

Postmenopausal female patients ranging in age from 40 to 86 included in this study. When the groups were adjusted for age, a statistically significant difference was found between mean C-IMT of BAC (+) and BAC (-) groups (0.81 ± 0.2 vs. 0.69 ± 0.2 mm; p<0.001). No significant differences were observed between BAC (+) and BAC (-) groups in terms of PSV, EDV, RI.

CONCLUSION

The findings of the present study suggest that BAC, diagnosed by mammography, is independently associated with C-IMT. C-IMT measurement is suggested as a useful tool to detect early atherosclerotic changes. However, haemodynamic variables (PSV, EDV, RI) were not statistically different between the BAC (+) and BAC (-) groups. Prospective larger cohort studies are needed to further elucidate whether BAC is an independent risk factor for cardiovascular disease.

Role and importance of Doppler ultrasound in the diagnosis of pulmonary sequestration: report of two adolescent cases

Pulmonary sequestration is a rare pulmonary parenchymal anomaly. The localization of the aberrant artery and its relation with sequestration are of importance in the process of diagnosis in the preoperative period. The feeding artery can be identified by color Doppler ultrasonography. We report two cases of pulmonary sequestration in two adolescents, aged 11 and 13 years old, and this report documents the use of in which color Doppler ultrasound demonstrated the abnormal feeding artery. Color Doppler ultrasonography, a noninvasive and radiation-free imaging modality should be considered in the diagnostic algorithm of pulmonary sequestration.

Pituitary hyperplasia mimicking pituitary macroadenoma in two adolescent patients with long-standing primary hypothyroidism: case reports and review of literature

We report two cases with primary autoimmune hypothyroidism and an ectopic thyroid gland causing pituitary enlargement mimicking pituitary macroadenoma. One of the cases presented with complaints of headache and short stature and the other case with a complaint of menorrhagia. In both cases, the pituitary mass and symptoms resolved with levothyroxine replacement. Normal menses resumed. However, pituitary dynamic tests revealed persistent growth hormone and gonadotropin deficiency in one case and growth hormone deficiency in the other. To our knowledge, this is the first report in an adolescent of hypogonadotropic hypogonadism, growth hormone deficiency, and menorrhagia associated with pituitary hyperplasia secondary to primary hypothyroidism. The recognition of the association between reversible pituitary hyperplasia and primary hypothyroidism might eliminate unnecessary surgery.

Floating ball appearance in ovarian cystic teratoma

The presence of floating fat balls or globules in an ovarian cystic teratoma is an unusual finding. Herein, we present ultrasonographic and tomographic findings of a rarely reported case of cystic teratoma with a floating fat ball.

Cerebral blood flow measurements of the extracranial carotid and vertebral arteries with Doppler ultrasonography in healthy adults

PURPOSE

To establish normal cerebral blood flow volume by measuring flow volume of the extracranial carotid and vertebral arteries using Doppler ultrasonography in healthy adults.

MATERIALS AND METHODS

A prospective study was performed with a group of 96 healthy adults aged 20 to 80 years (48 women, 48 men; mean age of all patients, 49.8 +/- 17.1). The common, external, and internal carotid arteries and the vertebral arteries (CCA, ECA, ICA, and VA, respectively) were examined using Doppler ultrasonography. Peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI), and luminal diameters of the vessels were measured, and flow volumes were calculated in all the arteries. The influence of age on these parameters was also investigated.

RESULTS

In the CCA, ICA, and VA, all flow velocities and flow volumes decreased significantly with an increase in age. The luminal diameters of the carotid and vertebral arteries increased significantly with aging, while there was no significant alteration in the RI. The luminal diameters of the CCA, ICA, and ECA were significantly smaller in women than in men. PSV and EDV in the ICA, and EDV in the VA were significantly higher in men. There was no gender-linked difference in flow volumes of the brain-feeding arteries, however, in the ECA flow volumes were significantly higher in women.

CONCLUSION

Normal cerebral blood flow volume was established by measuring the flow volume of the ECA and VA with Doppler ultrasonography in healthy adults. We believe that these data can be useful in evaluating cases with cerebrovascular disease, which are related to altered cerebral blood flow volume.

[Diagnostic value of HASTE technique and excretory MR urography in urinary system obstructions]

PURPOSE

To compare the diagnostic value of static-liquid magnetic resonance urography (MRU) in T2-weighted HASTE (half-fourier acquisition single-shot turbo spinecho) sequences and T1-weighted excretory MRU with i.v. diuretic and contrast material injection.

MATERIALS AND METHODS

The study included 29 patients (15 men, 14 women). Thirty-one urinary obstructions were detected on intravenous urography (IVU) two of which were due to bilateral obstructions. The cases were evaluated by T2 HASTE sequences combined with T1-weighted FLASH 3D sequences after i.v. diuretics and gadolinium DTPA injection.

RESULTS

Thirty-one urinary obstructions were detected on IVU. Thirty of which were confirmed by T2-weighted MRU and all were confirmed by excretory MRU. In one nonobstructive case, unilateral grade 1 ureteropelvicaliectasis related to ureteral stone was falsely interpreted by both sequences. There were no statistical differences among IVU, T2-weighted MRU and excretory MRU in detecting the obstruction levels. In 22 cases with ureteral stones, 12 of which were confirmed by T2-weighted MRU and 18 cases were confirmed by excretory MRU. Sensitivity and specificity fo detecting the ureteral stones as a cause of obstruction with T2-weighted MRU were 50%and 89% and with excretory MRU were 77% and 89% respectively. In 9 obstructive cases due to causes other than the stones, 8 of which were detected by T2-weighted MRU and all of which were detected by excretory MRU. Sensitivity and specificity for detecting the causes other than the stones with T2-weighted MRU were 96% and 100% and with excretory MRU were 100% and 100% respectively.

CONCLUSION

MRU is a useful thechnique revealing high-quality images to determine the urinary system obstructions to obtain the causes of obstructions. MRU should be used as an alternative imaging technique in cases which IVU can not be applied. The existence and the causes of obstruction can be detected by HASTE MRU. Excretory MRU can supply additional information in cases with functional kidneys where the cause of obstruction can not be revealed by HASTE MRU.

[Simple and cost effective cannula for sialography: Technical note]

We developed a simple and cost-effective modified cannula for sialography. The cannulae were made from nineteen, twenty-one and twenty-three gauge winged infusion set which are generally used for injection of contrast material in radiological imaging. In this article, we intend to introduce this cannula and discuss its utility.