Bu çalışmada COVID-19 tanısı alan hastaların toraks bilgisayarlı tomografi (BT) sonuçlarını inceleyip, tipik ve atipik bulguları literatür eşliğinde sunmayı amaçladık.Araçlar ve Yöntem: Hastanemize mart ve nisan aylarında başvuran ve reverse transkriptaz-polimeraz zincir reaksiyonu (RT-PZR) ile COVID-19 tanısı alan hastaların toraks BT'leri retrospektif olarak değerlendirildi. Akciğer parankim bulgularından buzlu cam sahaları, konsolidasyon, vasküler genişleme, fibrozis, nodül, septal kalınlaşma (crazy paving), ters halo, plevral effüzyon ve mediastinal LAP bulguları araştırıldı. Parankimdeki tutulum yerine göre bilateral-unilateral, periferik-santral, üst-orta-alt loblardaki odak sayılarına göre lezyonların dağılımı değerlendirildi.Bulgular: PCR pozitif olan 53 hastanın (ortalama yaş 48,38±20,97) 14'ünde (% 26) toraks BT'de bulgu yoktu. BT'de bulgusu olan 39 hastada (%74), tipik bulgulardan buzlu cam sahası (%85), konsolidasyon (%56), buzlu cam ve konsolidasyon birlikteliği (%59), vasküler genişleme (%28) izlendi. Atipik bulgulardan nodül (%20), septal kalınlaşma (%30), fibrozis (%10), plevral efüzyon (%8), hava bronkogramı (%18), ters halo bulgusu (%5) saptandı. Hastalarımızda mediastinal LAP saptanmadı. Toraks BT'de bilateral, orta ve alt zonlarda periferik yerleşimli multifokal odaklar tipik tutulum şekliydi. 14 hastada toraks BT negatif olup herhangi bir bulguya rastlanmadı.Sonuç: Toraks BT, COVID-19 hastaları için tanıya yardımcı çok önemli bir yöntem olup parankim tutulumunun tipik ve atipik bulgular şeklinde kategorize edilerek değerlendirilmesi tanı sürecini kolaylaştırabilir.
Os calcaneus secundarius is one of several accessory ossicles of the foot that have been identified as normal variants of skeletal development. It may cause ankle pain and may mimic an avulsion fracture of the anterior calcaneal process. A twenty-year-old male was admitted to our institution with right ankle pain following an inversion injury. An axial CT image of the patient's right ankle revealed a shape with smooth and sharp margins, identified as a well-corticated bone fragment in the subtalar region. A diagnosis of an accessory ossicle, os calcaneus secundarius, was made based on radiographic findings. As a result of this case, it is recommended that potential locations of the accessory bones should be well understood in order to prevent misdiagnosis and inappropriate surgical procedures. Os calcaneus secundarius must be considered when an apparent bone fragment or a suspicious fracture line at the anterior region of os calcaneus is demonstrated.
Gradenigo syndrome is associated with middle ear infection that extends to the petrous apex, leading to pain at the innervation site of the ophthalmic and maxillary branches of the trigeminal nerve and the development of abducens nerve palsy. Cerebral venous sinus thrombosis is a serious neurological complication of otitis media and occurs secondary to spread of the infection to the underlying bone. We herein report a pediatric case of otitis media associated with Gradenigo syndrome and ipsilateral sigmoid–transverse sinus thrombosis with magnetic resonance imaging findings.
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.
Background Idiopathic granulomatous mastitis (IGM) is a chronic, unpleasant autoimmune inflammatory condition and is clinically and radiologically often confused with breast malignancy. Purpose To investigate the contributions of qualitative and quantitative aspects of acoustic radiation force impulse (ARFI) elastography to the differential diagnosis between IGM and invasive ductal carcinoma (IDC) in the breast. Material and Methods Ninety-four women with IDC and 39 with IGM were included in the study. Shear wave velocity (SWV) was calculated for all lesions using quantitative elastography. Next, each lesion’s correspondence on qualitative elastographic images to those on the B-mode images was evaluated: pattern 1, no findings on elastography images; pattern 2, lesions that were bright inside; pattern 3, lesions that contained both bright and dark areas; and pattern 4, lesions that were dark inside. Pattern 4 was subdivided into 4a (dark area same size as lesion) and 4b (dark area larger than lesion size). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated. Results The mean SWV based on ARFI elastography was 3.78 ± 1.26 m/s for IGM and 5.34 ± 1.43 m/s for IDC lesions ( P < 0.05). Based on qualitative ARFI elastography, IDC lesions were mostly classified as pattern 4b, while IGM lesions were mostly classified as pattern 1 or 2 ( P = 0.01). Evaluation of both the qualitative and quantitative aspects of ARFI elastography yielded a sensitivity of 89% and specificity of 84%. Conclusion ARFI elastography may facilitate the differential diagnosis between IGM and IDC.
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