BACKGROUND AND PURPOSE: The recently introduced Pipeline Flex Embolization Device with Shield Technology (Pipeline Shield) is the third generation of Pipeline flow-diverter devices. It has a new stent-surface modification, which reduces thrombogenicity. We aimed to evaluate clinical and radiographic (safety and efficacy) outcomes of the Pipeline Shield. MATERIALS AND METHODS: The 30-day and 1-year mortality and morbidity rates and the 6-and 18-month radiographic aneurysm occlusion outcomesIndicates open access to non-subscribers at www.ajnr.org http://dx.

Background/aim: The presented study aimed to evaluate the utility of magnetic resonance angiography(MRA) in the pediatric population with nutcracker syndrome. Materials and methods:Patients with suggestive clinical symptoms and laboratory findings and got the diagnosis of nutcracker syndrome with Doppler ultrasonography between January 2011-2019 were included in the study. In addition, children who had renal MRA due to hypertension were evaluated as the control group. MRA images of all patients were examined retrospectively by three radiologists at different levels of experience, and the superior mesenteric artery angle, aorta-mesenteric distance, left renal vein diameter both in the regions of aorta-mesenteric and renal hilum were recorded.Results: Forty-five patients diagnosed with nutcracker syndrome were included in the study. The mean age of patients was 12 (4-16) and 30 (67%) were female. As the control group, 25 patients with hypertension who had MRA were included and they had a mean age of 12 (1-18) and 19 (76%) were male. The mean superior mesenteric artery angle was 26.5 ° (16-73 ± 12) in the patient group and 57.8 ° (25-139, ± 33) in the control group (p <0.001); the mean aorta-mesenteric distance was 3.3 mm (1.7-6.5, ± 1.1) in the patient group and 8 mm (3.4-32, ± 5.9) in the control group (p <0.001). MRA measurements of three radiologists were consistent with each other. Conclusion:MRA imaging can be applied as an alternative diagnostic method for Doppler ultrasonography and Multidetector CT examinations by radiologists with different experience levels in pediatric patients with nutcracker syndrome.

Objectives: The objective of this study was to determine the frequency of aspirin and clopidogrel resistance of patients undergoing neurovascular stenting procedure in the interventional radiology unit. Methods: The Multiplate® Analyzer (Roche Diagnostics, Germany) test data of 250 patients who underwent carotid or intracranial artery stenting due to atherosclerotic stenosis or treatment of intracranial aneurysms between 2013-2017 in the Interventional Radiology Unit of our hospital were evaluated retrospectively to detect the aspirin and clopidogrel resistance. Aspirin or clopidogrel resistance defined as the higher AUC value than 40U and 46U, respectively. The patients who did not have a result of the Multiplate® test; had anemia, known coagulation disorder or thrombocytopenia were excluded. Results: Among the 172 patients who met the inclusion criteria, 59 (34.3%) were those who had an intracranial stent during aneurysm treatment, and 113 (65.7%) had carotid stenting due to atherosclerotic stenosis. The prevalence of aspirin resistance was 9.4% (16/170) whereas that of clopidogrel resistance was 23.8% (41/172). Among the patients with atherosclerotic stenosis, aspirin resistance accounting for 3.6%, and clopidogrel resistance was 23.0%. Furthermore, the resistance in the patients with stent-assisted coiling for aneurysm treatment was 20.7% for aspirin and 25.4% for clopidogrel. Conclusions: In our study, the prevalence of aspirin resistance was found 9.4% and clopidogrel resistance 23.8% in patients who had neurovascular stenting. The effect of this condition on clinical outcomes in these patients should be investigated by randomized controlled trials.

, which has recently become a worldwide pandemic with high mortality, causes severe pneumonia. The major routes of transmission of this disease are direct inhalation of respiratory droplets or contact with surfaces contaminated with them. Its definitive diagnosis is made by a real-time PCR test. Radiological methods, especially computed tomography (CT), play an important role in supporting the diagnosis and determining disease stage and complications. In this paper, we report the CT findings of COVID-19 pneumonia at different disease stages in a patient diagnosed with the disease, and we provide a discussion of the relevant literature.

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Background/aim: This study aimed to evaluate the diagnostic efficacy of vertebral Hounsfield unit (HU) values on routine contrastenhanced abdominal computed tomography (CT) scans for the assessment of osteoporosis using dual-energy X-ray absorptiometry (DXA) T-scores as a reference standard. Materials and methods: A total of 111 consecutive patients who underwent contrast-enhanced abdominal CT examination for any indication and DXA within a 6-month period were retrospectively analyzed. The CT attenuation values of trabecular bone in HUs were measured in axial and sagittal planes from lumbar vertebrae 1-4 (L1-L4). The correlation between the DXA T-scores and HU values measured on the CT scans was evaluated by Pearson's correlation test. Areas under the curves (AUCs) were calculated by receiver operating characteristic analysis for diagnostic proficiency, and threshold values were determined. Paired t-test and Bland-Altman plot test were used to evaluate the correlation between axial and sagittal HU values. Results: There was a strong correlation between the DXA T-scores and HU values of all the lumbar vertebrae (P < 0.001). The highest correlation was for the L3 vertebra; L3 was thus chosen for additional analyses. The mean axial and sagittal L3 attenuations were 133.7 HU and 131.9 HU, respectively. The axial measurements were not significantly different from the sagittal measurements, with a mean difference of 1.8 HU (P > 0.05). The L3 axial CT attenuation threshold for 90% sensitivity was 170 HU and that for 90% specificity was 102 HU for distinguishing osteoporosis from osteopenia and normal bone mineral density (BMD). To distinguish the low BMD group from the normal group, the L3 axial CT attenuation threshold for approximately 90% sensitivity was 102 HU and for 90% specificity was 165 HU. Conclusion: The HUs derived from routine contrast-enhanced abdominal CT scans can be used for the evaluation of osteoporosis, without additional radiation exposure and cost.

Objectives: To investigate whether sarcopenia had an effect on in-hospital mortality independent from other demographic characteristics in patients with Coronavirus disease 2019 (COVID-19), and to determine a reliable cut-off value for sarcopenia if there is such a relationship. Methods: A total of 302 patients with COVID-19 were included in the study. Sarcopenia was assessed by indexed skeletal muscle mass at T12 vertebrae level (T12-SMI) on initial chest computed tomography (CT). A receiver operating characteristic (ROC) curve analysis was performed to detect a cut-off value of T12-SMI for mortality prediction. Then, sarcopenia was diagnosed by this value. Multivariable logistic regression analysis was used to detect independent variables for mortality. Results: Patients were separated into groups; 26 (8.6%) patients in the mortality group and 276 (91.4%) patients in the no-mortality group. In ROC analysis, cut-off values of 34.06 cm²/m² (sensitivity: 70%, specificity: 77%) in males and 29.36 cm²/m² (sensitivity: 67%, specificity: 69%) in females for T12-SMI were computed for mortality prediction. There were 110 (36.4%) patients with sarcopenia. Sarcopenia was more frequent in the mortality group than the no-mortality group (73.1% vs 33%, p &lt; 0.001). In multivariate analysis age, previous cardiovascular and respiratory disease, and sarcopenia were independently associated with mortality in COVID-19 patients. Conclusions: A cut-off value of 34.06 cm²/m² in males and 29.36 cm²/m² in females for T12-SMI can be used to diagnose sarcopenia in patients with COVID-19. Sarcopenia is clearly associated with mortality in these patients.

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