This study compared the effectiveness of relative cerebral blood volume, apparent diffusion coefficient, and spectroscopic imaging in differentiating between primary high-grade gliomas and solitary metastases. A 3.0-T MR unit was used to perform proton MR spectroscopy, diffusion imaging, and conventional MR imaging on 26 patients who had solitary brain tumors (14 high-grade gliomas and 12 metastases). All diagnoses were confirmed by biopsy. Twelve perfusion MR studies (8 high-grade gliomas and 4 metastases) were also performed. The results showed that the choline to creatine ratio and relative cerebral blood volume in the peritumoral regions of high-grade gliomas were significantly higher than they were in the metastases. The apparent diffusion coefficient values in tumoral and peritumoral regions of metastases were significantly higher than they were in the primary gliomas. Although conventional MR imaging characteristics of solitary metastases and primary high-grade gliomas may sometimes be similar, the peritumoral perfusion-weighted and spectroscopic MR imaging enable distinction between the two. Diffusion-weighted imaging techniques were complementary techniques to make a differential diagnosis between the two malignant tumors.

Splenic abscess is an unusual and potentially life-threatening disease. Due to the nonspecific clinical picture, it remains a diagnostic challenge. Splenic abscess should be suspected in febrile patients with left upper quadrant tenderness and leukocytosis, and diagnosis confirmed based mostly on imaging studies, microbiologic and / or pathologic evidence, or by response to antibiotic or antifungal treatment. We present 29 cases of splenic abscess treated in our hospital from 1990 to 2001. There were 18 male patients (62%) and 11 female patients (38%). Ages ranged from 4 to 85 years, with a median of 44 years. There were five pediatric patients (17%) and 24 adults (83%). The most common associated condition was leukemia. Most patients were immunocompromised (72%). The more common signs and symptoms were fever (90%), chills (41%), abdominal pain (31%), and leukocytosis (38%). Ultrasonography of the abdominal cavity was positive in 27 cases (93%); computerized tomography or magnetic resonance imaging was used in 26 patients (90%) and was positive in all patients. The abscess was solitary in 21 cases (72%) and multiple in eight cases (28%). Positive blood cultures were found in only seven patients (24%). According to the literature, the treatment of choice is still splenectomy, but in our study, the success rate of 75% with antibiotics alone indicates that antibiotic therapy should be considered an important alternative treatment modality in patients not suitable for percutaneous drainage and splenectomy.

No abstract

Results of this study suggest that atherosclerosis represented by the carotid IMT contributes to the development of late-onset major depressive disorder. The findings support the vascular depression hypothesis.

Central neurocytoma (CNC), first described by Hassoun et al in 1982, is a rare neuronal tumor of the central nervous system, accounting for 0.25% to 0.5% of all central nervous system tumors. To our knowledge, there are only 5 published articles reporting the magnetic resonance spectroscopy (MRS) findings of neurocytomas. The 3-T proton MRS findings of 3 cases with CNC confirmed by immunohistochemical stains are reported here. Increased choline (Cho)/creatine (Cr) ratios with decreased N-acetylaspartate (NAA)/Cr ratios were observed in all 3 cases, but only 1 case had an increased peak at 3.55 ppm known as glycine (Gly). The other case with an increased alanine peak at 1.5 ppm had a poor prognosis. Therefore, we conclude that the presence of a Gly peak may suggest the diagnosis of CNC but that the absence of Gly does not exclude the diagnosis of CNC.

No abstract

No abstract

The aim of this study is to evaluate the anatomical details of the inner ear and middle ear, using multidetector row CT. Temporal bone CT scans were obtained using 16-detector row CT scanner (Lightspeed 16, General Electric Medical Systems, Milwaukee, WI) in 30 patients with dizziness, vertigo, or hearing loss. The three-dimensional (3D) images were reconstructed with volume rendering techniques. The 3D images were reviewed by two radiologists and scored by using a three-point quality rating for qualitative assessment of the 23 representative structures of the middle and inner ear. The malleus, incus, and facial nerve canal were identified in all patients. The incudomalleolar joint appeared fused in all patients. The stapes were seen clearly in 27 (90%) of 30 patients except in three patients. Among the three remaining patients, there was one who had effusions in the middle ear cavity. Another patient had left cholesteatoma. The third patient had normal middle ear cavity. The cochlea and the three semicircular canals (anterior, posterior, and lateral) were well demonstrated in 29 (97%) of 30 patients except for one old woman with osteoporosis. Sixteen-detector row CT imaging of temporal bone with advanced 3D reformation yields state-of-the-art anatomical details of the temporal region useful to address anatomical localization issues and ease conceptual structural learning.