In this study, the effectiveness of transthoracic ultrasound elastography in the benign and malign distinction of subpleural/pleural solid lesions was investigated.Between July 2015 and December 2016, 33 consecutive patients with subpleural solid lesions detected via computed tomography (CT) of the thorax were identified and prospectively included in this study. The average for each lesion's shear wave velocity (SWV) value was detected, and benign and malignant lesions' SWV values are statistically compared. The CT and pathology results were used as a reference to compare these values. A receiver operating characteristic analysis was used to determine the cutoff value for benign/malignant neoplasms.The 33 patients (10 female, 23 male) included in the study had a mean age of 56.2 ± 15.40 years (range, 17-84 years), and the mean SWV value of the lesions in 13 (39%) cases evaluated benign after a CT scan, histopathological examination, or both 2.18 ± 0.49 m/s. The mean SWV value of the lesions which were histopathologically diagnosed as malign in 23 (61%) cases was 3.50 ± 0.69 m/s. (P < 0.001). When the cutoff value was set as 2.47 m/s for the SVW value, sensitivity and specificity were determined to be 97.7%.The present study has shown that transthoracic ultrasound shear wave elastography can be an effective radiological examination method in the benign and malign differentiation of subpleural lesions and has the potential for use in the routine clinical application of transthoracic ultrasound elastography, a noninvasive method for evaluating the malignancy potentials of such lesions.

Objective The aim of this study was to evaluate the reproducibility of measurement of spleen stiffness at the time of the initial detection of splenomegaly, whether it is found incidentally or not, in determining the etiology of splenomegaly. Methods The pathologies that brought about the diffuse splenomegaly were evaluated in 3 main groups as follows: hepatoportal, myeloproliferative, and infectious causes. In addition, 17 healthy control patients were recruited. All patients were examined with acoustic radiation force impulse imaging with VTQ. Results The difference between the splenic parenchymal elasticity values in the hepatoportal group (3.27 ± 0.36 m/s), in the myeloproliferative disease group (2.98 ± 0.33 m/s), in the infectious disease group (2.44 ± 0.21 m/s), and in the control group (2.08 ± 0.19 m/s) was found to be statistically significant (P = 0.001). The intraclass correlation coefficient for shear wave velocity measurement between hepatoportal causes and myeloproliferative causes was 71.2% (95% confidence interval [CI], 54.9%–87.4%), between hepatoportal causes and infective causes was 99.7% (95% CI, 98.6%–100.0%), and between myeloproliferative causes and infective causes was 83.3% (95% CI, 68.8%–97.9%). In the same patient groups, spleen volumes were measured as 64.08 ± 9.66, 78.18 ± 18.52, and 51.57 ± 7.44 cm2, respectively; in the control group, it was 26.75 ± 6.57 cm2. The difference between spleen volumes was found to be statistically significant (P = 0.001). Conclusions Distinguishing the causes of splenomegaly is important because the disorders require different management strategies. In diseases that cause splenomegaly, tissue content may change according to pathogenesis. Such changes in the spleen are mechanical properties that can be quantified by elastography.

The aim of the study was to investigate the efficacy of shear-wave elastography (SWE) in the differentiation of transudative and exudative pleural effusions. This monocentric study comprised 60 cases (17 transudative, 43 exudative).Transthoracic SWE was performed in 60 cases for whom to use thoracentesis for the pleural fluid analysis was planned. The mean SWE values of each patient were recorded, and the correlation between the biochemical analysis results of pleural fluid after thoracentesis and SWE findings was evaluated. The effusion SWE values and biochemical analysis results were compared. Of the 60 patients who participated in this study, 32 (53.4) were male and 28 (46.6%) were female. The mean ± SD age was 59 ± 17.09 years (range = 21–89 years). Simultaneous serum biochemical analysis was performed for the patients with PE. The mean ± SD shear-wave velocity value of the transudative fluid was calculated 2.29 ± 0.41 (1.6–2.94), whereas the mean ± SD shear-wave velocity value of the exudative pleural fluid was calculated as 3.29 ± 0.63 (2.01–4.88) (P < 0.001). The receiver operating characteristic analysis showed that sensitivity and specificity were found as 91% and 76.5%, respectively, when the cutoff value was selected as 2.52 m/s in the differentiation of the transudative and exudative effusions. Shear-wave elastography may help in the differentiation of transudative and exudative of the pleural effusions.

It is important to know the age of clot formation to determine an appropriate treatment for deep vein thrombosis (DVT). The present study aims to differentiate between acute and subacute DVT using the shear wave elastography (SWE) technique. Patients with complaints no longer than 4 weeks and who were found to have early-stage (acutesubacute) thrombus on ultrasound (US) between January 2020 and May 2020 were included in the study. All of the patients underwent SWE using a Philips Healthcare EPIQ 5 Ultrasound System Inc. device with a high-resolution linear US probe (eL18-4, 22-2 MHz). Included in the study were 50 patients, including 23 with acute DVT and 27 with subacute DVT. Of the patients, 22 were women and 28 were men, and the mean age was 46.32 ± 11.33 years (range: 24-74 years). The mean SWE value was 2.63± 0.16 (2.39-2.96) in patients with acute DVT and 3.34± 0.31 (2.65-3.88) in patients with subacute DVT. The findings were statistically significant in the comparison of the 2 groups using an independent samples t test (P < 0.001). In the receiver operating characteristic analysis, the area under the curve was found to be 97.6%. When the cutoff value was taken as 2.85 according to the area under the curve, sensitivity was found to be 96.3%, and specificity was 91.3%. Thrombus stage plays a critical role in treatment decisions in DVT in the lower extremities. The present study reveals that the shear wave US elastography technique can be used to discriminate between acute and subacute DVT.

Background Determining the nature of purely cystic hepatic lesions is essential because different kinds have different follow-ups, treatment options, and complications. Purpose To explore the potential of apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) for the differentiation of type I hydatid cysts (HC) and simple liver cysts (SLC), which have similar radiological appearances. Material and Methods This single-center prospective study was conducted during 2016–2019. Round, homogenous, anechoic liver cysts >1 cm were classified according to at least two years of imaging follow-up, radiological features, serology, as well as puncture aspiration injection reaspiration procedure and pathology results. ADC values of 95 cysts (50 type I HCs and 45 SLCs) were calculated on DWI. The differences in ADC values were analyzed by independent t-test. Results Of 51 patients, 28 were female, 23 were male (mean age 32.07 ± 22.95 years; age range 5–82 years). Mean diameter of 45 SLCs was 2.59 ± 1.23 cm (range 1.2–7.6 cm) and ADCmean value was 3.03 ± 0.47 (range 2.64–5.85) while mean diameter of 50 type I HCs was 7.49 ± 2.95 cm (range 2.8–14 cm) and ADCmean value was 2.99 ± 0.29 (range 2.36–3.83). There was no statistically significant difference in ADC values between type I HCs and SLCs Conclusion Some studies report that ADC values of type I HCs are statistically significantly lower than those of SLCs. Others suggest no significant difference. In our study with a higher number of cases, using ADC parameters similar to those in previous studies, we did not find any statistically significant difference.

This study was conducted to obtain the morphometric and volumetric measurements of bulbus oculi of Van cats, growing around the city of Van in Turkey and named after here, by using computed tomography (CT) and magnetic resonance imaging (MRI), and to reveal the biometric differences of these measurement values between the sexes. A total of 16 adult Van cats including 8 females and 8 males were used in the study.The animals were anesthetized with the combination of xylazine and ketamine. The anesthetized animals were scanned by using CT and MRI devices and their images were obtained. Then, the morphometric and volumetric measurements of bulbus oculi were calculated from these images using the software (Syngo CT Software) in the workstation and their statistical analysis was performed. Upon the examination of the morphometric and volumetric analysis results, it was determined that while W (bodyweight) and ACL (Left Anterior Chamber) values were higher in male cats, DVLL (Dorsoventral length of the left lens) value was higher in female cats. These differences between the sexes were statistically significant (P<0.05). The volumetric measurement values of bulbus oculi and lens were determined to be averagely 4.60 ± 0.27 cm 3 and 0.67 ± 0.09 cm 3 , respectively.In conclusion, the statistical differences of biometric values of bulbus oculi between male and female Van cats were determined by using CT and MRI. It is thought that the present study would contribute to the ophthalmological applications and the students receiving anatomy education.

Hydatid cyst (HC) is a parasitic disease that is endemic particularly to the sheep-breeding regions of the world, our country included. Given their propensity to materialize most commonly in the liver, our study evaluates the value of ultrasound elastography in the differential diagnosis of simple cyst and type I HCs of the liver. The study involved a total of 73 cysts (22 simple cysts, 51 type I HCs) that were removed using the puncture aspiration injection reaspiration technique between 2016 and 2018. All measurements were made using a Siemens ACUSON S2000 (Siemens Healthcare, Erlangen, Germany) device with a 4-MHZ 4C1 convex probe, an acoustic radiation force impulse elastography procedure, and a Virtual Touch IQ option. The difference between the mean shearwave elastography (SWE) values of both groups was analyzed with an independent t test. Of the 70 patients involved in the study, 29 were female and 41 were male, with a mean ± SD age of 38.85 ± 17.62 years (range, 5-82 years). Upon the examination of the 22 simple cysts and the 51 HCs, the mean ± SD SWE values were found to be 2.6 ± 0.96 (0.96-4.25) and 2.8 ± 1.69 (0.66-4.84), respectively. No statistically significant difference was identified between the SWE values of type I HCs and simple cysts (P > 0.005). Although HCs and simple cysts had similar radiological appearances, and a relative difference was noted in the differentiation of the elastographic measurements, this difference was not statistically significant. Accordingly, more comprehensive and various studies are needed.

The breast MRI parameters such as morphologic features, enhancement kinetics and diffusion restriction can be used for the differential diagnosis. We aimed to compare the Apperant Diffusion Coefficient (ADC) values of masses with other MRI parameters in diagnosis of breast masses. Between March 2014 and September 2017, 49 female patients in whom a breast mass was diagnosed, determined using ultrasound and mammography and who were further examined with MRI, were enrolled to this study. Total 51 lesions were detected. Routine breast MRI protocol was performed and images were evaluated. The ADC cutoff value was taken as 1,1×10-3 mm 2 /s according to the literature. Fifty-one lesions were diagnosed with biopsy. Of these lesions, 23 (45.1%) were malignant (20 invasive ductal carcinoma and others) and 28 (54.9%) were benign (20 fibroadenomas and others). The accuracy rate of DCE assessment of MRI was 90,9% for benign lesions in with a type 1 curved lesions, and 81,8% for malign lesions in with a type 3 curved lesions. The accuracy rate of ADC values was 93,1% for benign lesions and 95,5% for malign lesions. We believe that the ADC value can provide a higher diagnostic accuracy with the combination of morphological characteristics and contrast kinetics of the lesion and that ADC can be used alone because of its high diagnostic accuracy in some cases.