ORIGINAL ARTICLE PURPOSE We aimed to evaluate ultrasonography (US) findings for Breast Imaging Reporting and Data System (BI-RADS) category 4 lesions using BI-RADS US lexicon and determine the positive and negative predictive values (PPV and NPV) of US with respect to biopsy results. METHODSSonograms of 186 BI-RADS 4 nonpalpable breast lesions with a known diagnosis were reviewed retrospectively. The morphologic features of all lesions were described using BI-RADS lexicon and the lesions were subcategorized into 4A, 4B, and 4C on the basis of the physician's level of suspicion. Lesion descriptors and biopsy results were correlated. Pathologic results were compared with US features. PPVs of BI-RADS subcategories 4A, 4B, and 4C were calculated. RESULTSOf 186 lesions, 38.7% were malignant and 61.2% were benign. PPVs according to subcategories 4A, 4B, and 4C were 19.5%, 41.5%, and 74.3%, respectively. Microlobulated, indistinct, and angular margins, posterior acoustic features, and echo pattern were nonspecific signs for nonpalpable BI-RADS 4 lesions. Typical signs of malignancy were irregular shape (PPV, 66%), spiculated margin (PPV, 80%) and nonparallel orientation (PPV, 58.9%). Typical signs of benign lesions were oval shape (NPV, 77.1%), circumscribed margin (NPV, 67.5%), parallel orientation (NPV, 70%), and abrupt interface (NPV, 67.6%). CONCLUSION BI-RADS criteria are not sufficient for discriminating between malignant and benign lesions, and biopsy is required. Subcategories 4A, 4B, and 4C are useful in predicting the likelihood of malignancy. However, objective and clear subclassification rules are needed.A dvancements in ultrasonography (US) equipment has significantly increased the value of US in breast imaging (1). Especially in women under the age of 50, detection of mammographically occult masses by US has increased up to 27% (1, 2). With the increasing use of US in routine breast imaging, in 2003 the American College of Radiology developed the first version of Breast Imaging Reporting and Data System (BI-RADS) US lexicon in order to standardize breast lesion characterization with US, as with mammography (3). In 2013, the second version of BI-RADS US lexicon was published in the fifth edition of BI-RADS atlas (4). The first version of BI-RADS US lexicon included shape, orientation, margins, lesion boundary, echo pattern, posterior acoustic features, and surrounding tissue alterations as descriptors (1-3, 5-8). The changes were minimal in the second version of BI-RADS US lexicon, with no changes in shape, orientation, margin, and feature descriptors; however, lesion boundary was removed. There were some differences in the nomenclature such as "posterior features" instead of "posterior acoustic features," and "associated features" instead of "surrounding tissue alterations." In the second version, "elasticity assessment" was added among the associated features and heterogeneous term was added to its echo pattern. Macrocalcification was removed from calcifications terminology, but intraductal was added (4)...

ABSTRACT.Purpose: To study the effect of three prostaglandin F 2 -a (PG) analogues on retrobulbar blood flow velocity in previously untreated patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT), using colour Doppler ultrasound. Methods: Sixty newly diagnosed patients with POAG or OHT were randomly assigned to travoprost 0.004% (n ¼ 12 with POAG, n ¼ 8 with OHT), latanoprost 0.005% (n ¼ 11 with POAG, n ¼ 9 with OHT) and bimatoprost 0.03% (n ¼ 13 with POAG, n ¼ 7 with OHT) treatment groups in a double-masked fashion. At baseline examination, blood pressure, heart rate and intraocular pressure (IOP) were recorded. Peak-systolic and end-diastolic velocities were measured in the ophthalmic (OA), central retinal (CRA) and temporal short posterior ciliary arteries (PCA). The resistive index (RI) and ocular perfusion pressure (OPP) were determined for each treatment group. After a treatment period of 6-months, all procedures were repeated. Results: There were no significant differences in age (53 ± 14 years in the travoprost group, 51 ± 14 years in the latanoprost group, 53 ± 11 years in the bimatoprost group), gender (11 men, nine women; 11 men, nine women; 13 men, seven women, by group, respectively), or clinical diagnosis (POAG or OHT) among treatment groups (p > 0.05). A significant decrease in IOP (baseline: 26.4 ± 3.3 mmHg, 26.8 ± 1.3 mmHg, 25.8 ± 1.8 mmHg, respectively; month 6: 20.9 ± 1.9 mmHg, 20.8 ± 2.4 mmHg, 18.3 ± 1.2 mmHg, respectively; p < 0.0001) and an increase in OPP (baseline: 33.7 ± 3.8 mmHg, 33.5 ± 3.2 mmHg, 33.9 ± 2.6 mmHg, respectively; month 6: 40.2 ± 3.5 mmHg, 39.9 ± 3.1 mmHg, 41.7 ± 2.6 mmHg, respectively; p < 0.0001) were verified in all three groups during the study period. Mean baseline RI values for the CRA in the travoprost group and the OA in the latanoprost group were both 0.7 ± 0.1 mmHg and both values were statistically significantly lower at 6 months (0.6 ± 0.1 mmHg in both groups; p ¼ 0.002, p < 0.0001, respectively). In the bimatoprost group there was no statistically significant difference in haemodynamic parameters over the study period (p > 0.05). Conclusions: Our results suggest that the three PG analogues significantly reduce IOP and increase OPP in patients with POAG or OHT. Topical travoprost and latanoprost significantly reduce the RI of the CRA and OA, respectively. We were unable to determine any effect of topical bimatoprost on ocular haemodynamics.

The unique bony architecture of the proximal ulna presents particular difficulties for the implants used in fracture fixation and arthroplasty of the elbow. Knowing the detailed anatomy of the variations of proximal ulna will guide the surgeon to obtain a more reliable length of the olecranon and to offer a safe place for Kirschner wire replacement concerning humero-ulnar joint functionality. In this study, PUTA was also defined. The angle determines the rotation of the proximal ulna and it has a great importance for the movements of the joint. The measured angulations will help the surgeon to design the proper prosthesis for the maintenance of the functions of the elbow joint.

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DWI has a significant added value compared to T2-weighted imaging alone in the diagnosis of perianal fistula.