The purpose of our investigation was to determine the anatomical variations in the coeliac trunk-hepatic arterial system and the renal arteries in patients who underwent multidetector CT (MDCT) angiography of the abdominal aorta for various reasons. A total of 100 patients were analysed retrospectively. The coeliac trunk, hepatic arterial system and renal arteries were analysed individually and anatomical variations were recorded. Statistical analysis of the relationship between hepatocoeliac variations and renal artery variations was performed using a chi(2) test. There was a coeliac trunk trifurcation in 89% and bifurcation in 8% of the cases. Coeliac trunk was absent in 1%, a hepatosplenomesenteric trunk was seen in 1% and a splenomesenteric trunk was present in 1%. Hepatic artery variation was present in 48% of patients. Coeliac trunk and/or hepatic arterial variation was present in 23 (39.7%) of the 58 patients with normal renal arteries, and in 27 (64.3%) of the 42 patients with accessory renal arteries. There was a statistically significant correlation between renal artery variations and coeliac trunk-hepatic arterial system variations (p = 0.015). MDCT angiography permits a correct and detailed evaluation of hepatic and renal vascular anatomy. The prevalence of variations in the coeliac trunk and/or hepatic arteries is increased in people with accessory renal arteries. For that reason, when undertaking angiographic examinations directed towards any single organ, the possibility of variations in the vascular structure of other organs should be kept in mind.

The aim of this study was to determine the diagnostic value of ultrasonographic measurements in ulnar neuropathy at the elbow (UNE) and to assess the relationship between the measurements and the electrophysiological severity. The largest anteroposterior diameter (LAPD) and cross-sectional area (CSA) measurements of the ulnar nerve were noted at multiple levels along the arm, and the distal-to-proximal ratios were calculated. Almost all of the measurements and swelling ratios between patients and controls showed statistically significant differences. The largest CSA, distal/largest CSA ratio, CSA at the epicondyle, and proximal LAPD had larger areas under the curve than other measurements. The sensitivity and specificity in diagnosing UNE were 95% and 71% for the largest CSA, 83% and 85% for the distal/largest CSA ratio, 83% and 81% for the CSA at the epicondyle, and 93% and 43% for the proximal LAPD, respectively. There was a statistically significant correlation between the electrophysiological severity scale score (ESSS) and the largest CSA, the CSA at the epicondyle and 2 cm proximal to the epicondyle, and the LAPD at the level of the epicondyle (P < 0.05). None of the swelling ratios showed a significant correlation with the ESSS. The largest CSA measurement is the most valuable ultrasonographic measurement both for diagnosis and determining the severity of UNE.

The purpose of this study was to document the ultrasonographic measurement differences in median nerve size between patients with carpal tunnel syndrome (CTS) and controls, and to correlate these findings with electrophysiological stage and motor unit number estimation (MUNE), thereby allowing us to test the validity of ultrasound as a diagnostic modality for assessing the severity of CTS. High-resolution sonography and electrophysiological studies were performed on 41 wrists of 27 patients and compared with findings on 40 wrists of 20 healthy individuals. On ultrasonographic views, cross-sectional area and flattening ratio in proximal, middle, and distal tunnel segments of the median nerve were measured both by calculating ellipsoid area by large and small cross-sectional diameters and by automated ellipsoid area calculation. We compared electrophysiological stage and MUNE with proximal, middle, and distal cross-sectional area and other ultrasonographic findings. All correlations between electrophysiological stage and cross-sectional areas in these different segments of the median nerve were significant with both measurement methods. Negative correlations were seen between MUNE and cross-sectional area in the proximal and middle segments, whereas no significant correlation was detected in the distal segment. Our results indicate that there are close correlations between the ultrasonographic findings and electrophysiological stage. Ultrasound also reflects the reduction in the number of axons estimated by the MUNE method. Therefore, we suggest that the ultrasonographic findings reflect the severity of disease in patients with CTS.

This study found that the parameters useful for distinguishing HUPE and HSPE included CTPA obstruction score, RV and SVC diameters, RV/LV short-axis ratio, interventricular septum shape, and reflux into the IVC. RV dilatation may be a significant predictor for mortality.

Our aim was to assess the effects of initial ultrasonography (US) evaluation on the diagnosis and management of non-traumatic acute abdominal pain in the emergency department. Three hundred patients with the complaint of non-traumatic acute abdominal pain who were sent for US examination with an initial clinical impression were included in the study. Pre-US and post-US surveys were designed for the clinicians who requested US. The percentage concordance of US findings with the discharge diagnosis made by clinical follow-up, imaging modalities and surgery was determined by calculating the confidence interval. The concordance of the initial clinical impression and the US diagnosis with the discharge diagnosis were compared using the McNemar test. US could not detect any pathology in 102 (34%; 95%CI, 28.6-39.3%) of the patients. The US revealed a different diagnosis than the clinical impression in 69 (23%; 95%CI, 18.2-27.7%), and confirmed the diagnosis in 121 (40%; 95%CI, 34.4-45.5%) patients. The US changed the treatment plans in 47% (95%CI, 41.3-52.6%) of the patients. The clinicians stated US helped them "very much" or "moderately" in making a diagnosis in 83% (95%CI, 78.7-87.2%). When US results were compared with the discharge diagnosis, there was concordance in 238 (79.3%; 95%CI, 74.3-83.6%) patients but not in 62 (20.6%; 95%CI, 16-25.1%). Among 121 patients the initial clinical impression agreed with the US diagnosis and there was concordance with the discharge diagnosis in 105 (86.7%; 95%CI, 80-92.7%). The concordance of US findings with the discharge diagnosis was significantly higher than that of the initial clinical impression statistically. In the initial evaluation of the patients with acute abdominal pain, US is considerably helpful in making the correct diagnosis, and that the concordance with the discharge diagnosis is high. When whole abdominal scanning is not performed, targeted US study according to the initial clinical impression decreases the clinical benefit of US.

We report on a patient with Sedaghatian type spondylometaphyseal dysplasia (SSMD) who presented with metaphyseal dysplasia, congenital atrioventricular block, simplified gyral pattern, hypogenesis of corpus callosum, and severe cerebellar hypoplasia. We want to emphasize that in this rare congenital lethal skeletal dysplasia with unknown etiology, central nervous system malformations might be a major component of the disorder and should be evaluated in detail to possibly uncover the underlying pathophysiology.

pCT is a useful technology that can be helpful in overcoming the limitations of routine MDCT in diagnosing PDAC and characterization of isoattenuating lesions.

A 2 to 11% of the patients with acute cholecystitis that will develop gallbladder perforation and massive intraperitoneal hemorrhage as a result of perforation will rarely be seen. Massive intraperitoneal hemorrhage associated with the transhepatic perforation is very uncommon. By this article, we anticipate presenting clinical and radiological findings in a case that has acute cholecystitis with massive intraperitoneal hemorrhage associated with transhepatic perforation.