Search

Objective Primary aim is to compare the diagnostic value of contrast-enhanced 3D GRE T1-weighted sequences with unenhanced MR venography and conventional magnetic resonance imaging (MRI), in detection of dural venous sinus (DVS) and cortical venous thrombosis; secondary aim is to determine the relationship between DVS thrombosis/site and gender, age, infarction or hemorrhage. Methods We retrospectively reviewed conventional MR images, unenhanced MR venography and immediate post-contrast 3D GRE T1-weighted MR images in 30 patients (17 male and 13 female, 21–70 years old, mean age 40.1) with clinically suspected DVS thrombosis. MR examinations had been performed with 1.5T or 3T MR Scanners. DVSs were evaluated in 10 sub-segments, including cortical veins. Each set of MR images were examined separately, blinded to the final diagnosis. Associated findings were also noted and sensitivity, specificity and accuracy of each MRI technique were calculated. Results Final diagnosis of cortical venous and/or dural sinus thrombosis was established in 24 (80%) of 30 cases and 67 (22.3%) out of 300 segments. For detection of the thrombotic segment, sensitivity, specificity, and accuracy were 83.6%, 95.3%, and 92.7% by conventional MR sequences, 89.6%, 91.8%, and 91.3% by unenhanced MR venography, and 92.5%, 100%, and 98.3% by contrast-enhanced 3D GRE T1-weighted sequence, respectively. Infarction and hemorrhage were more frequent in cases with cortical venous thrombosis, while gender and age had no significant relation with DVS thrombosis or its site. Conventional MR sequences and unenhanced MR venography were helpful due to additional information they provided in some cases with isolated cortical venous thrombosis, with hyperintense thrombus material and with associated hemorrhage or infarction. Conclusion Contrast-enhanced 3D GRE T1-weighted MRI is the most accurate imaging method for the detection of DVS and/or cortical venous thrombosis. Infarction and hemorrhage were more frequent in cases with cortical venous thrombosis.

Transarterial chemoembolization (TACE) is a widely used treatment choice for hepatocellular cancer. DC Bead microspheres are a new embolic material for TACE that doxorubicin can be loaded to. The tumor response rate of this well-tolerated treatment was changed between 60% and 81.8%. We report a case of ischemic cholecystitis after TACE with drug-eluting beads (DEB) that required cholecystectomy. The possibility of cholecystitis is always remembered during TACE-DEB for tumors in segment IV and/or V. Although selective catheterization is related with a lower risk for ischemic cholecystitis, the anatomic and vascular variability in patients with malignancy may lead to some unexpected conditions.

Popliteal artery entrapment syndrome (PAES) is a rare congenital vascular pathology caused by the compression of the popliteal artery by adjacent muscle and tendinous structures. Popliteal artery aneurysm associated with this syndrome is extremely rare. A 45-year-old male suffering from pain at the right lower extremity during exercise was admitted to our hospital. Physical examination and Doppler imaging revealed a weak pulse at the posterior tibial artery and no pulse at dorsalis pedis and anterior tibial arteries. The patient was further evaluated with multidetector computed tomography angiography (MDCTA). MDCTA revealed PAES due to compression of the accessory fibers of the gastrocnemius muscle and related thrombosed popliteal aneurysm.

The anterior inferior cerebellar artery (AICA) arises from the lower side of the basilar artery and supplies blood to the rostral olfactory bulb, rostral pontine base, and cerebellar regions. The AICA syndrome was first defined by Adams in 1943. Here, we present a case of a patient with a left AICA occlusion who suddenly started experiencing dizziness and had abnormal gait; he was subsequently diagnosed with ischemia in the left cerebellar hemisphere. A 55-year-old man was admitted to the hospital with complaints of sudden onset of vertigo, speech disorder, and imbalance. The neurological examination revealed gait disturbance, and left-sided ataxia. In addition, dysarthric speech left peripheral facial paralysis, loss of pain and heat sensations in the left half of the face and right half of the body. Bilateral horizontal nystagmus was observed. Babinski and Hoffman signs were also observed on the left side. The patient was evaluated with diffusion weighted (DW) magnetic resonance (MR) imaging. On DW image and apparent diffusion coefficient (ADC) maps precisely determined diffusion restrictions in the antero-inferior part of the left cerebellar hemisphere and the left part of the inferior vermis. MR angiography revealed occlusions in the right internal carotid artery and left AICA; hence, he was administered antiagregan treatment. We have presented this case because infarctions in the AICA have different clinical features from those observed in other cerebellar arteries, and such cases are rarely observed in neurological practice.

To compare the development of temporal bone in normal and atretic ears and to assess some radiological landmarks that could be important in the hearing restoration interventions in such patients.Thirty-five patients with 40 atretic external ears were evaluated with temporal bone CT and compared to a control group of 40 normal ears retrospectively. Using comparable slice levels in all patients, the course and the caliper of the facial canal, the surface area of the incus and malleus, the level of mastoid aeration, the location and anteroposterior diameters of the jugular bulb and sigmoid sinus, the direction and the caliber of the tympanic bony part of the Eustachian tube, area of the middle ear cavity, distance from facial nerve to incudomalleolar joint, to the vestibule and to the jugular bulb were included in the assessment. Non-parametric and parametric statistical tests were used for comparison.In atretic ears middle ear sectional area was found to be smaller at the equivalent plane as compared to control subjects (mean area index: 19.3mm(2) versus 47.4mm(2)). Mastoid aeration was low in general and the ossicles in the atretic ears were hypoplastic (mean ossicular sectional area: 8.3mm(2) versus 11 mm(2)). The distance from the jugular bulb to the facial nerve was significantly lower (mean: 6.2mm versus 6.8mm) (p0.05) in the atretic ears. Facial canal caliber, distance from the facial canal to the incudomalleolar joint and distance from the facial canal to the vestibule in the atretic ears (means: 1.49, 2.93 and 1.82, respectively) did not show statistically significant difference from the control subjects (means: 1.44, 2.91 and 1.83, respectively) (p0.05 for all).External ear atresia is significantly associated with middle ear and mastoid abnormalities. The ossicles were underdeveloped which always have to be considered during reconstructive surgery. Radiologically, in the atretic ears anterior-posterior length of the temporal bone was more influenced as compared to superior-inferior portion, which justifies abnormal route of the facial nerve canal. However, there is no abnormality in the development of the facial nerve as the caliper is similar to the control subjects.