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Relationship between DXA measured systemic bone mineral density and subchondral bone cysts in postmenopausal female patients with knee osteoarthritis: a cross-sectional study : Osteoarthritis cysts and bone mineral density. BMC Musculoskelet Disord 2024; 25:50. [PMID: 38212780 PMCID: PMC10782551 DOI: 10.1186/s12891-023-07141-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 12/20/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Individuals with high systemic bone mineral density (BMD) may have an increased risk of incident knee osteoarthritis (OA). Besides that, radiographic osteophytes are strongly associated with BMD. Because of these reasons, the aim of the study was to investigate the possible association between radiological subchondral bone cyst (SBC) grade and systemic BMD and vitamin D status in the postmenopausal female patients with knee OA in a crosss-sectional study. METHODS This study included of 48 osteoporosis treatment-free postmenopausal patients diagnosed with symptomatic medial compartment knee OA. BMD analysis was performed using dual-energy X-ray absorptiometry (DXA) and serum vitamin D levels were measured after recording patients' findings. Each knee was scanned using computed tomography (CT), and categorical SBC scores were graded for the medial and lateral tibiofemoral (TF) and patellofemoral (PF) compartments and further calculated as compartmental total, total TF and grand total of both TF compartments. SBC scores were analysed with correlation analysis. RESULTS The patient population was characterized by radiographic joint space narrowing, obesity and low vitamin D status. Median medial total and grand total TF SBC scores were significantly different between the patient groups according to the Kellgren-Lawrence (KL) radiographic grading (p = 0.006 and p = 0.007, respectively). There were no correlations between femoral BMD values and SBC scores. However, positive correlations were detected significantly between L1 - 4 DXA values and TF SBC scores, but not with PF SBC scores (p = 0.005 for the correlation between L1 - 4 BMD and medial compartments total TF SBC score, p = 0.021 for the correlation between L1 - 4 BMD and grand total TF SBC score). No significant correlations were found with Vitamin D levels. CONCLUSIONS Development of TF OA high-grade SBCs may be linked to systemic bone mass as represented by trabecular bone-rich lumbar vertebrae. The relationship might point to the importance of bone stiffness as an acting factor in knee OA possibly with mechanical energy transfer to the joint.
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Evaluation of abdominal computed tomography findings in patients with COVID-19: a multicenter study. Diagn Interv Radiol 2023; 29:414-427. [PMID: 36960669 PMCID: PMC10679620 DOI: 10.4274/dir.2022.221575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 07/13/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE To evaluate the frequency of abdominal computed tomography (CT) findings in patients with coronavirus disease-2019 (COVID-19) and interrogate the relationship between abdominal CT findings and patient demographic features, clinical findings, and laboratory test results as well as the CT atherosclerosis score in the abdominal aorta. METHODS This study was designed as a multicenter retrospective study. The abdominal CT findings of 1.181 patients with positive abdominal symptoms from 26 tertiary medical centers with a positive polymerase chain-reaction test for severe acute respiratory syndrome coronavirus 2 were reviewed. The frequency of ischemic and non-ischemic CT findings as well as the association between CT findings, clinical features, and abdominal aortic calcific atherosclerosis score (AA-CAS) were recorded. RESULTS Ischemic and non-ischemic abdominal CT findings were detected in 240 (20.3%) and 328 (27.7%) patients, respectively. In 147 patients (12.4%), intra-abdominal malignancy was present. The most frequent ischemic abdominal CT findings were bowel wall thickening (n = 120; 10.2%) and perivascular infiltration (n = 40; 3.4%). As for non-ischemic findings, colitis (n = 91; 7.7%) and small bowel inflammation (n = 73; 6.2%) constituted the most frequent disease processes. The duration of hospital stay was found to be higher in patients with abdominal CT findings than in patients without any positive findings (13.8 ± 13 vs. 10.4 ± 12.8 days, P < 0.001). The frequency of abdominal CT findings was significantly higher in patients who did not survive the infection than in patients who were discharged after recovery (41.7% vs. 27.4%, P < 0.001). Increased AA-CAS was found to be associated with a higher risk of ischemic conditions in abdominal CT examinations. CONCLUSION Abdominal symptoms in patients with COVID-19 are usually associated with positive CT findings. The presence of ischemic findings on CT correlates with poor COVID-19 outcomes. A high AA-CAS is associated with abdominal ischemic findings in patients with COVID-19.
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Periacetabular vascular anatomy in high-riding dysplastic hips: a CT angiographic study. Hip Int 2022; 32:523-529. [PMID: 33131326 DOI: 10.1177/1120700020968157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Developmental hip dysplasia (DDH) is shown to have osseous and neural abnormalities but literature is sparse with investigation of vascular structures. Therefore, we aimed to evaluate periacetabular vascular structures. METHODS By computerised tomography angiography (CTA), 13 highly dislocated hips of 11 patients' iliac bone to external iliac and obturatory artery and vein proximities were measured and compared with the same measurements of 20 healthy hips of 12 patients. Numbering from superior to inferior, a total of 7 axial images were created on the 2D CTA coronal images with 1 cm apart, the 4th being at the level of acetabular dome. RESULTS The mean age of the patients was 53 (18-72) years. Dysplastic hips tended to have curved (53%) and healthy hips tended to have straight iliac arteries (p = 0.037). As compared to healthy hips, external iliac veins were significantly closer to the bone at all levels, but the external iliac arteries were closest at 1st to 4th levels (p < 0.001) in dysplastic hips. The course of the obturatory arteries was similar in both groups (p = 0.147). CONCLUSIONS The external iliac artery and vein is in close proximity to the iliac bone which dangers acetabular screw, acetabular reaming or retractor placement in highly dislocated hips. The surgeon should be aware of this proximity in operations of these hips to avoid vascular complications.
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Evaluation of the Prognostic Utility of Computed Tomography New Severity Score in COVID-19 Pneumonia Patients. HASEKI TIP BÜLTENI 2021. [DOI: 10.4274/haseki.galenos.2021.7100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Can we estimate cytokine storm from initial computed tomography images of Coronavirus disease-2019 patients? BRATISL MED J 2021; 122:405-412. [PMID: 34002614 DOI: 10.4149/10.4149/bll_2021_067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The present study aims to investigate whether elementary lesions detected at the time of the diagnosis, their distribution characteristics, and CT scoring can be predictive of a cytokine storm. BACKGROUND CT might have a prognostic predictive value beyond its diagnostic value. METHODS Sixty-eight patients, 32 with cytokine storm and 36 without cytokine storm, were included in the study. Four different scoring methods were created according to elementary lesions, distribution and involvement rate. CT scores and demographic findings of the cases were compared in the cytokine storm and non-cytokine storm groups. RESULTS The mean age of patients was 57.72 (SD: 13.5) and 40 (58.8 %) of them were male. The cytokine storm was significantly more common among male patients and patients of older age (p=0.04). The AUC values of CT score 1, CT score 2, CT score 3, and CT score 4 were as follows; 0.772 (95% CI; 0.651-0.892), 0.766 (95% CI; 0.647-0.885), 0.758 (95% CI; 0.639-8.78), and 0.760 (95% CI; 0.640-0.881), respectively. All CT scores had better predictive values in males. CONCLUSIONS CT scoring at the time of admission can be used to predict cases that may develop cytokine storm later (Tab. 4, Fig. 2, Ref. 15).
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Plateletcrit as a Determinant of Diffusion-Restricted Lesion Volume in Diffusion-Weighted Imaging. CYPRUS JOURNAL OF MEDICAL SCIENCES 2021. [DOI: 10.5152/cjms.2021.2580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Relationship between Abdominal Aortic Calcification, Abdominal Adiposity, and Liver Density. JCPSP-JOURNAL OF THE COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN 2021; 30:1245-1250. [PMID: 33397047 DOI: 10.29271/jcpsp.2020.12.1245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/08/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To identify any relationship among visceral adipose tissue area (visceral FA), liver density (liver HU), psoas muscle area (psoas MA), waist circumference (WC) and the presence and severity of abdominal aortic calcific atherosclerosis (AAC). STUDY DESIGN Cross-sectional descriptive study. PLACE AND DURATION OF STUDY Ankara Kecioren Training and Research Hospital, Ankara, Turkey, from January to February 2019. METHODOLOGY This study included 316 patients, who had CT performed for urolithiasis investigation. For all patients, the presence and grade of AAC was recorded. Then, liver HU, spleen density (spleen HU), psoas MA, visceral FA, total abdominal fat area (total FA), subcutaneous fat area (subcutaneous FA), WC and hip circumference (HC) were measured on a workstation. RESULTS AAC was present in 127 patients (40.2%). The age, visceral FA, total FA, visceral FA/total FA ratio, WC and WC/HC ratio of patients with AAC were significantly higher than for patients without AAC (p <0.05). Psoas MA was significantly lower in patients with AAC (p <0.05). The cut-off value of visceral FA for the prediction of AAC was 131 cm2. The risk for AAC was 4.5 times higher in the group with visceral FA >131 cm2 (p <0.001). There were significant correlations between AAC grade and liver HU and spleen HU (p = 0.002 and p = 0.001, respectively). However, there was no significant correlation between AAC grade and liver HU/spleen HU ratio (p = 0.741). CONCLUSION Psoas muscle area, visceral adiposity and waist circumference can be used to predict abdominal aortic calcification. Key Words: Visceral adipose tissue, Subcutaneous adipose tissue, Fatty liver.
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Lumbar Ligamentum Flavum Cyst: Case Report. ISTANBUL MEDICAL JOURNAL 2019. [DOI: 10.4274/imj.galenos.2019.95375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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A novel deletion involving exon 13 of factor VIII gene in a newborn with splenic hematoma. Transfus Apher Sci 2019; 59:102562. [PMID: 31230948 DOI: 10.1016/j.transci.2019.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 06/03/2019] [Indexed: 11/29/2022]
Abstract
Splenic hematoma is an exceptionally rare event in newborn period that usually occurs in concomitant birth trauma and bleeding disorder. This report presents a newborn case with severe hemophilia A, who had a splenic hematoma presented on the second day of life with severe anemia, abdominal distention, abdominal and scrotal ecchymosis. The patient was successfully treated medically with factor VIII concentrates without splenectomy. Molecular analysis of the factor VIII gene revealed a hemizygous deletion in exon 13.
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An assessment of the relationship between thyroid nodule characteristics, insulin resistance and arterial stiffness in euthyroid nodular goiter. Endocrine 2018; 62:440-447. [PMID: 30084100 DOI: 10.1007/s12020-018-1701-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 07/26/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Publications suggesting that thyroid nodule might be associated with insulin resistance and metabolic syndrome are quite interesting. There is a need for studies assessing the relationship between nodule presence and cardiovascular risk in individuals with non-functioning nodular goiter. The purpose of the present study is to reveal whether or not insulin resistance, nodule presence, and nodule stiffness affect arterial stiffness, which is a reliable and valid cardiovascular risk indicator, in individuals with euthyroid nodular goiter using the pulse wave analysis (PWA). MATERIALS AND METHODS 50 patients with euthyroid nodular goiter and 50 healthy volunteers were included in the study. All participants were examined by B-mode thyroid ultrasound, and the participants in the nodular goiter group were also examined by strain elastography (SE). The strain index of nodules was calculated according to the Rago scoring. Also, fasting plasma glucose (FPG) and insulin levels were measured, and HOMA-IR. Arterial stiffness measurements of the participants were performed using a PWA device which employs a cuff-based oscillometric method from the brachial artery. RESULTS PWV was found to be significantly higher in the euthyroid nodular goiter group (p < 0.001). PWV was found to be positively correlated with FPG and waist circumference. Fasting plasma glucose was found to be higher in the group with nodular goiter (p = 0.03). However, no difference was found between the groups in terms of HOMA-IR and insulin level. HOMA-IR was not correlated with thyroid volume, nodule volume, and nodule count. Also, HOMA-IR was not correlated with strain index value and PWA data. CONCLUSION We found that PWV was significantly higher in patients with euthyroid nodular goiter. This result suggests that these patients may be at risk for cardiovascular disease.
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Evaluation of the medial clavicular epiphysis according to the Schmeling and Kellinghaus method in living individuals: A retrospective CT study. Leg Med (Tokyo) 2017; 25:16-22. [DOI: 10.1016/j.legalmed.2016.12.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 12/27/2016] [Accepted: 12/29/2016] [Indexed: 11/27/2022]
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Effect of rheumatoid arthritis on strength, dexterity, coordination and functional status of the hand: the relationship with magnetic resonance imaging findings. ACTA REUMATOLOGICA PORTUGUESA 2016; 41:328-337. [PMID: 27926913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To evaluate the effect of rheumatoid arthritis (RA) on strength, dexterity, coordination and functional status of the hand and to determine the relation with magnetic resonance imaging (MRI) findings. MATERIALS AND METHODS Thirty eight patients with RA and thirty three controls were included in the study. There were five drop-outs in RA group. Pain was assessed by visual analog scale. Painful and swollen joints of the dominant hand were recorded. Hand deformities of the patients were noted. Hand grip strength and pinch strength of the dominant hand were evaluated. Hand disability was assessed by Duruoz hand index (DHI) and the Purdue pegboard test was used for assessment of coordination and dexterity. MRI of the dominant wrist and hand was performed in RA group. MRI scans were evaluated for synovitis, tenosynovitis, bone erosion and bone edema. RESULTS Demographic characteristics were similar between groups. While DHI scores were significantly higher (p=0.000), Purdue pegboard test scores were significantly lower in RA group in comparison to control group (p=0.000). Bone edema and synovitis scores were significantly higher in patients with longer disease duration (p=0.025, p=0,006 respectively). There were significant negative correlation between grip strength, pinch strength subgroups and tenosynovitis scores (p=0.001, p=0,001). When the Purdue pegboard scores were lower, tenosynovitis scores were significantly higher (p=0.019, p=0,013, p=0,043). There was a significant positive correlation between DHI score and tenosynovitis score (p=0.003). CONCLUSION This study showed that RA has significant negative impact on hand function and dexterity and the parameters used in the evaluation of hand function are mainly associated with tenosynovitis scores. Since tenosynovitis is a common pathology in RA, MRI can be used as a supportive method in early diagnosis of tenosynovitis and may be useful in identification of patients requiring aggressive treatment.
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Misdiagnosed epigastric mass: Ectopic liver. J Magn Reson Imaging 2016; 45:761-763. [PMID: 27564374 DOI: 10.1002/jmri.25449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 08/16/2016] [Indexed: 11/07/2022] Open
Abstract
We discuss an ectopic liver misdiagnosed as an abdominal mass and the importance of magnetic resonance imaging (MRI) in liver positional anomalies. A solid midline mass midline adjacent to the liver was found in a 45-year-old female at an external center during an ultrasound investigation conducted for occasional abdominal pain of many years. The patient was referred to us for MRI. MRI revealed a solid epigastric lesion adjacent to the liver but unrelated to the liver parenchyma. The mass was of similar intensity as the liver in all sequences and in postcontrast dynamic phases following hepatospecific contrast material administration. We also observed contrast material excretion into the solid lesion from the biliary ducts in the hepatobiliary phase. The lesion was diagnosed as ectopic liver tissue with these findings. LEVEL OF EVIDENCE 5 J. Magn. Reson. Imaging 2017;45:761-763.
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Low 25-hydroxyvitamin D level is not an independent risk factor for hepatosteatosis in obese children. J Pediatr Endocrinol Metab 2016; 29:783-8. [PMID: 27089408 DOI: 10.1515/jpem-2015-0426] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 02/22/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Obesity is an important risk factor for non-alcoholic fatty liver disease. Few studies have evaluated the association between vitamin D and non-alcoholic fatty liver disease in obese children. Therefore, we conducted a study to examine the relationship of vitamin D levels and hepatosteatosis in obese children. METHODS One hundred and eleven children with obesity participated in this study. Hepatosteatosis was diagnosed and graded using ultrasonography in all patients. Study participants were divided based on the presence of hepatosteatosis into two subgroups (hepatosteatosis and non-hepatosteatosis). Serum levels of 25-hydroxyvitamin D, calcium, phosphate, alkaline phosphatase, parathormone, and lipids were measured and compared. RESULTS Hepatosteatosis existed in 52% of obese children without chronic diseases. There was no statistically significant difference in the vitamin D level between the hepatosteatosis and non-hepatosteatosis groups. Alanine aminotransferase levels and the triglycerides-to-high density lipoprotein ratio were significantly higher, and the high density lipoprotein levels were significantly lower in the hepatosteatosis group compared to the non-hepatosteatosis group. CONCLUSIONS Vitamin D deficiency is not directly related with hepatosteatosis. A high ALT level and a high triglycerides-to-HDL ratio and low HDL levels are more significant in hepatic steatosis in obese children.
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Evaluation of the mastoid triangle for determining sexual dimorphism: A Saudi population based study. Forensic Sci Int 2015; 254:244.e1-4. [PMID: 26165493 DOI: 10.1016/j.forsciint.2015.06.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 05/15/2015] [Accepted: 06/21/2015] [Indexed: 10/23/2022]
Abstract
Demographic assessment of skeletal remains in forensic investigations includes identification of sex. The present study aimed to develop population-specific, sex-discriminating anthropometric standards for the mastoid triangle of a documented Saudi population using computed tomographic (CT) images of the lateral aspect of the skull. The present study was performed on 206 CT images of a documented Saudi population of known sex and age. The clinical CT images of subjects visiting the Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (KSA) were evaluated to know the validity of the metric assessment of the mastoid triangle for identification of sex in a Saudi population. The distance between asterion to porion (AP), asterion to mastoidale (AM), porion to mastoidale (PM) were measured and the area of the mastoid triangle (AMT) was calculated using these measurements. Discriminant function procedure was used to analyze the data for sexual dimorphism. In conclusion, the results of the present study indicate that all the 3 sides of the mastoid triangle and AMT were sexually dimorphic in the sampled Saudi population with PM being the best individual parameter in discriminating sex with an accuracy of 69.4%. Whereas, all the parameters combined showed the highest accuracy (71.4%).
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Crohn's disease masked by median arcuate ligament syndrome. Chin Med J (Engl) 2013; 126:2798. [PMID: 23876920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
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Diagnosis and follow-up in constipated children: should we use ultrasound? J Pediatr Surg 2010; 45:1849-55. [PMID: 20850631 DOI: 10.1016/j.jpedsurg.2010.05.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Revised: 04/19/2010] [Accepted: 05/04/2010] [Indexed: 11/29/2022]
Abstract
PURPOSE We investigated the efficacy of ultrasound in determining megarectum and fecal load and the response to treatment in constipation and tried to specify objective criteria in this study. METHODS A total of 66 cases were queried and divided into 2 groups as constipated (n = 35; mean age, 6.8 ± 2.9 years) and control (n = 31; mean age, 8.4 ± 3.8 years) according to Rome III criteria. After the clinical evaluation, pelvic ultrasonography (US) was performed by 2 separate radiologists. The bladder capacity and the transverse rectal diameter were measured with a full bladder. Then the rectal diameter and rectal anterior wall thickness were measured, and the presence of fecal load in the rectum and sigmoid colon was recorded with an empty bladder. The examination and ultrasound were repeated after treatment for a month in these patients. RESULTS Comparison of the US measurements of the 2 radiologists performing the US tests did not show any interobserver difference (r = 0.981; P < .001). We therefore believe our results are objective and reproducible. We found a positive correlation between the rectal diameters and the age, height, weight, and bladder capacity. The posturination mean rectal diameter was thicker in the constipated group (3.02 ± 1.04 cm) than in the control group (1.98 ± 0.64 cm) (P < .001). The cutoff point of rectal diameter for a diagnosis of constipation was determined as 2.44 cm (71% sensitive; 76% specific; area under curve, 0.825; P < .001). The rectal anterior wall thickness and fecal load were higher in the constipated patients (P < .001). There was a significant decrease in the constipation score and fecal load after treatment for a month (P < .001), but the rectal diameter had not reached normal limits yet despite the decrease (2.71 ± 0.77 cm) (P > .05). CONCLUSION The use of US helps in making a correct diagnosis and in the follow-up with objective criteria and also convinces the patient and the family that the treatment needs to be continued.
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Can renal dimensions and the main renal artery diameter indicate the presence of an accessory renal artery? A 64-slice CT study. Diagn Interv Radiol 2010; 17:266-71. [PMID: 20698003 DOI: 10.4261/1305-3825.dir.3507-10.0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
PURPOSE To evaluate whether renal dimensions and the main renal artery (mRA) diameter can provide indirect evidence of the presence or absence of accessory renal arteries (aRA). MATERIALS AND METHODS The study group consisted of 167 patients (83 women, 84 men; mean age, 52.4±13.1 years) who presented to our radiology department for abdominal CT examinations with various indications. CT examination was performed on a 64-slice CT scanner in the arterial phase. The kidney diameters were recorded. The number of renal arteries supplying each kidney was evaluated, and their diameters were measured. We attempted to determine a formula that could be used to predict the presence or absence of aRAs. RESULTS One or multiple aRAs were found in 76 (22.8%) of the 334 kidneys. The mRA diameter was 5.51±0.96 mm. The mRA diameter was smaller in kidneys with aRAs than in those without (P < 0.001). A cut-off value of 4.15 mm for the diameter of mRA to predict the presence of aRAs led to negative and positive predictive values of 80% and 90%, respectively. A formula that can predict that an aRA is absent with 97% accuracy given the values of the mRA diameter and the kidney length was determined using logistic regression. CONCLUSION The mRA diameter (4.15 mm) alone and the results of the formula developed herein employing the mRA diameter and kidney length can respectively predict the presence or absence of an aRA with high accuracy.
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The stylohyoid chain: CT imaging. Eur J Radiol 2010; 75:346-51. [PMID: 20462718 DOI: 10.1016/j.ejrad.2010.04.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Revised: 04/09/2010] [Accepted: 04/14/2010] [Indexed: 12/01/2022]
Abstract
We aimed in this report to discuss the embryology, anatomy, theories of ossification and symptoms, clinical presentation, and diagnosis of the stylohyoid chain (SHC) variations, together with the role of radiographs, computed tomography (CT) and three-dimensional (3D)-CT in showing these variations. Because CT/3D-CT additionally facilitates visualization of the entire SHC with different axes, it is the most valuable method for establishing the relationship between the SHC and the surrounding tissue. SHC variation can be discovered during CT performed for indications other than ossified SHC. It is important to diagnose whether or not the SHC is ossified, since one of the treatment procedures in ossified SHC is total excision. If the clinician and radiologist are aware of these variations observed in the SHC, patients with vague symptoms may be spared unnecessary investigations and may be properly diagnosed earlier.
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Sex determination from measurements of the sternum and fourth rib using multislice computed tomography of the chest. Forensic Sci Int 2010; 197:120.e1-5. [DOI: 10.1016/j.forsciint.2009.12.049] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2008] [Revised: 05/09/2009] [Accepted: 12/16/2009] [Indexed: 10/20/2022]
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Abstract
PURPOSE The aim of this study was to analyze the presence and type of vascularity with color Doppler ultrasound (CDUS) in gynecomastia, to describe gray-scale ultrasound (US) and CDUS features in different stages of gynecomastia, and to compare these findings with the characteristic US appearances of Tanner stages. MATERIALS AND METHODS A total of 108 breasts of 54 males aged 11-27 years with complaint of gynecomastia and US verification of gynecomastia were evaluated. Each breast was then classified according to Tanner stages. The retroareolar thickness was measured. The breast was divided into three regions (medial, lateral, and retroareolar) and the arterial flow was scored according to the number of regions in which arterial flow was observed. Venous blood flow was scored according to the number of vessels in each breast. RESULTS Gynecomastia was present in 78 breasts with a retroareolar thickness of 5-31 mm and symptom duration of 1-300 weeks. Fifteen breasts with gynecomastia had no arterial or venous flow. Tanner stages were found to be strongly associated with arterial and venous flow scores, duration of symptoms, and retroareolar thickness (P < 0.001). CONCLUSION This study shows that vascular structures should be accepted as a component of gynecomastia. Vascularity in gynecomastia corresponds to progression of breast development, and as the process advances vascularity becomes more prominent.
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Does the presence of a mesh have an effect on the testicular blood flow after surgical repair of indirect inguinal hernia? JOURNAL OF CLINICAL ULTRASOUND : JCU 2009; 37:78-81. [PMID: 18642364 DOI: 10.1002/jcu.20516] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE Modern treatment of inguinal hernias includes prosthetic mesh repairs. However, direct contact of the mesh to the vessels in the inguinal canal and perimesh fibrosis may have a negative impact on testicular flow. The aim of this prospective study was to evaluate the effect of mesh implantation/perimesh fibrosis on testicular flow after repair of indirect inguinal hernias (IIHs). METHOD Forty-eight male patients with unilateral IIH were included. Both testicular parenchyma were assessed using gray-scale sonography, and color/spectral Doppler sonography was performed to evaluate testicular arterial impedance, perfusion, and venous flow. Measurements were made bilaterally at the level of the inguinal canal 1 day before and at the end of the 2nd month after the operation. RESULTS There was no difference in testicular and echotexture perfusion between the hernia and the control sides pre- and postoperatively. No venous thrombosis was found. In all groups, resistance index and pulsatility index, measured at 4 levels, were highest in the proximal inguinal canal and lowest at the extratesticular-intrascrotal level (p < 0.05). For all Doppler parameters there was no significant difference between the pre- and postoperative measurements on both the hernia and the control sides. CONCLUSION Mesh implantation/perimesh fibrosis does not adversely affect ipsilateral testicular flow. Mesh application is still a safe procedure in male patients in whom testicular function is important.
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Diffuse stylohyoid chain ossification. Diagn Interv Radiol 2007; 13:176-178. [PMID: 18092286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Clinical symptoms of stylohyoid chain ossification vary from ear pain to dysphagia. It is usually diagnosed coincidentally. Localized ossification of the chain is common, whereas diffuse ossification is rare. Herein, a case with bilateral diffuse stylohyoid chain ossification diagnosed with computed tomography, which was performed in order to evaluate the patient's temporomandibular joint pain, a rare onset of this condition, is discussed.
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Abstract
BACKGROUND To assess the variations of stylohyoid chain (SHC) using 3D-CT. METHODS We evaluated a total of 200 SHC on the head/neck CT scans of 100 patients (44 females, 56 males, age range 18-73 years). All of the patients had been scanned for neck lesions other than those concerning the region of the SHC. The morphology of both SHCs was examined in the 3D-CT images and the following aspects were evaluated; 1. length, 2. thickness, 3. mediolateral angling (MLA), 4. anteroposterior angling (APA), and 5. bending of the SHC. RESULTS Absence of the styloid process (n: 5), double proximal origin (n: 2), segmentation (n: 49), and complete ossification (n: 2) were found. The length of the SHC was 27.9 +/- 11.3 mm, and 26.2 +/- 11.1 mm on the right and left, respectively. The mean thickness of the SHC was 5 mm, and it showed positive correlation with length (P < 0.05). MLA was 73.2 +/- 6.7 and 70.7 degrees +/- 8.0 degrees for the right and left, respectively. APA was 64.6 degrees +/- 10.1 degrees and 62.7 degrees +/- 10.2 degrees for the right and left, respectively. There was a negative correlation between the right and left MLA (P = 0.001), and a positive correlation between the right and left APA (P = 0.001). Nine SHCs had bending of the lower end. CONCLUSION Three-dimensional CT gives detailed and reliable information about the SHC. We propose that the bending and thickness, which are new parameters, should be taken into consideration in the CT evaluation and classification of SHC variations.
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