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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.

Introduction To discuss the accuracy of the whole-body diffusion-weighted imaging with background body signal suppression (WB-DWIBS) technique performed in the 3.0-T system. Methods We studied 17 patients who underwent positron emission tomography (PET)/CT and WB-DWIBS examinations for staging their diseases. The DWIBS pulse and echo-planar imaging-short T1 inversion recovery single-shot pulse sequences were performed for WB-DWIBS. A PET/CT scan was performed with 18-fluorodeoxyglucose. The lesions were localised and counted in both of the examinations, and WB-DWIBS was evaluated for the neoplastic tissue detection rate, while PET/CT was accepted as the reference standard modality. Results The WB-DWIBS scan had a room occupation time of 32–35 min. All of the metastasis positive patients (n = 12) detected with PET/CT were also detected with WB-DWIBS (100%). In our patient group, there were a total of 109 bone metastases on PET/CT scans, and 93 of them (85.3%) were demonstrated with WB-DWIBS. We detected 128 metastatic lymph nodes on PET/CT, and 123 of them (96.3%) were demonstrated with WB-DWIBS. There were a total of 17 liver metastases on PET/CT, and 15 of them (88.2%) were detected with WB-DWIBS. There was no statistically significant difference between the two imaging modalities in detecting bone, lymph node and liver metastases (P > 0.05). Conclusions WB-DWIBS is a non-invasive technique that may successfully detect the spreading of the tumoural tissue in cancer patients when compared with PET/CT.

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 aim of this study was to evaluate the number, course, width and location of nutrient artery canals of the femur by using multidetector computed tomography (MDCT). Sixty-six adult (35 right and 31 left) dry femurs were included in this study and scanned by MDCT. Nutrient artery canals were evaluated on the multi-planar reformatted and volume rendered images which were reproduced on the basis of axial images. The median value of nutrient artery canals was two (minimum 1 and maximum 6). We determined that there was a negative correlation between the number of nutrient canals and the canal diameters. The outer ostia of the nutrient artery canals were most frequently located at the middle third segment of femoral diaphysis (65%). While the vast majority of the canals were showing upward courses (95%), only a few canals were having transverse (3%) or downward (2%) courses. Most encountered location of outer ostia of the canals according to linea aspera was the medial lip of the linea aspera (44%). Various variations were demonstrated in the number, course, and location of nutrient artery canals using MDCT. In conclusion, the knowledge of the topographic features of the nutrient artery canals may be useful in various clinical implications such as bone grafting or radiologic evaluation for the fracture lines.

Objective: While developed countries do age estimation for the purpose of identifica - tion, in countries such as Turkey, it is used to determine the real age of a person with an already known identity because of inaccurate birth records. The aim of this article was to investigate whether the calcification degree of the first costal cartilage could be a marker for age determina - tion. Material and Methods: We retrospectively analyzed the postero-anterior chest x-rays of 471 patients (270 males, 201 females; mean age ± standard deviation 42.38±20.69 years) who presented to the radiology department for various reasons. The calcification degree of the right first costal cartilage was classified in four stages based on criteria used by Barchilon and Garamendi, and the patients were classified in seven groups regarding their ages. The correlation between the calcifi - cation stage of the right first costal cartilages and age group was analyzed by Spearman's rho. Re- sults: According to the first costal cartilage calcification stage, the mean ages were 5.56, 25.49, 45.39 and 66.02 at stage 0, 1, 2 and 3, respectively. The calcification degree of the right first costal carti - lage and age correlated significantly in males and females (Spearman's rho=0.904, p

Poster: "ECR 2011 / C-0036 / Feasibility of MR urography in patients with urinary diversion " by: " B. Battal , M. Kocaoglu, E. Aydur, M. Dayanc, A. T. Ilica; Ankara/TR"

Cerebrospinal fluid (CSF) spaces include ventricles and cerebral and spinal subarachnoid spaces. CSF motion is a combined effect of CSF production rate and superimposed cardiac pulsations. Knowledge of CSF dynamics has benefited considerably from the development of phase-contrast (PC) MRI. There are several disorders such as communicating and non-communicating hydrocephalus, Chiari malformation, syringomyelic cyst and arachnoid cyst that can change the CSF dynamics. The aims of this pictorial review are to outline the PC MRI technique, CSF physiology and cerebrospinal space anatomy, to describe a group of congenital and acquired disorders that can alter the CSF dynamics, and to assess the use of PC MRI in the assessment of various central nervous system abnormalities.

Various types of lesions can occur within the corpus callosum (CC) which is a white matter tract communicating corresponding regions of the cerebral hemispheres. Magnetic resonance imaging is the modality of choice for the evaluation of the CC. In addition, diffusion weighted imaging and diffusion tensor imaging can provide additional information about the CC. The aim of this study is to illustrate the imaging features of the corpus callosum and its pathologies.

We describe a patient with Burkitt lymphoma who developed carotidynia. MRI showed thickening of the walls of both common carotid arteries and PET CT showed increased radiotracer uptake in the same regions. MRI was essential in establishing the diagnosis of this rare clinical presentation.

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.

Anomalous left coronary artery arising from the pulmonary artery (ALCAPA) is a rare but very serious congenital coronary artery anomaly. Multidetector computed tomography (MDCT) coronary angiography has recently become the gold standard for depicting anatomical variations and anomalies of the coronary arteries because the origin and course of anomalous arteries can be demonstrated very accurately by this technique. In this report, we present a case of 22-year-old female who was admitted to our emergency department with cardiac arrest. In the course of diagnosis, MDCT coronary angiography revealed a left coronary artery arising from the pulmonary artery as well as marked dilatation of the coronary arteries.

This study aimed to investigate the clinical outcome of nasal septal surgery at altitude of 2,200 m. The study is a retrospective medical record review. Medical records of 137 patients were investigated in this study; 105 of these patients received septoplasty procedure and 32 received septorhinoplasty procedure at altitude of 2,200 m. Improvement of nasal obstruction was found in 79.6% and no change was seen in 20.4% of the patients. Complications were seen in 30.7%. The most frequent complication was persistent nasal obstruction. Outcomes of nasal septal surgery at high altitude were similar with previous studies done at low altitudes. Although high-altitude environmental factors may result in a number of clinical conditions, high-altitude conditions does not make a significant difference in the outcome of nasal septal surgery.

Brain herniations into dural venous sinuses (DVS) are rare findings recently described and their etiology and clinical significance are controversial. We describe five patients with brain herniations into the DVS or calvarium identified on MRI, and discuss their imaging findings, possible causes, and relationship to the patient's symptoms. All patients were examined with MRI including high resolution pre- and post-contrast T1- and T2-weighted sequences. With respect to brain herniations we documented their locations, signal intensities in different sequences, and size. We then reviewed clinical records in an attempt to establish if any symptoms were related to the presence of these herniations. Three males and two females were examined (age range, 11–68 years). Three patients had unilateral temporal lobe herniations into transverse sinuses, one had a cerebellar herniation into the skull, and one had bilateral temporal lobe herniations into the transverse sinuses as well as a cerebellar herniation into the sigmoid sinus. In all, the herniated brain and surrounding cerebrospinal fluid (CSF) had normal signal intensity on all MRI sequences. When correlated with clinical symptoms, brain herniations were thought to be incidental and asymptomatic in three patients and two patients had histories of headaches. Brain herniations with surrounding CSF into the DVS/skull should be considered potential sources of filling defects in the DVS. We believe that they are probably incidental findings that may be more common than previously recognized and should be not confused with the more common arachnoid granulations, clots, or tumors. Two patients had headaches, but their relation to the presence of herniated brain was uncertain.

To the editors, We read with great interest the article titled “DiffusionWeighted Magnetic Resonance Imaging for the Evaluation of Prostate Cancer: Optimal B Value at 3T” by Ji Hyun Koo et al. (1), published in the Korean Journal of Radiology (DOI: 10.3348/kjr.2013.14.1.61). This article will be a useful diffusion weighted imaging (DWI) guide for radiologists in assessing prostatic cancer. In the paper, the authors compared 4 different b values and suggested them for predicting prostate cancer; the optimal b value for 3T DWI was found to be 1000 s/mm. However, even with high b values, the overlap of the apparent diffusion coefficient (ADC) limits the accuracy of DWI in cancer detection, particularly in the transitional zone tissue, due to its lower ADC compared to the peripheral zone tissue (2). Therefore, we aimed to mention that, with

A 22-year-old male had a meniscopathy operation using spinal anesthesia. After the operation, the patient reported a throbbing headache. His brain computed tomography (CT) showed subarachnoid hemorrhage (SAH) and hyperdense dural venous sinuses suspicious for thrombosis. Filling defects were observed in the superior sagittal and right transverse sinuses on the contrast-enhanced magnetic resonance images. The patient was diagnosed with cerebral venous sinus thrombosis (CVST). On the tenth day of his admission, his clinical findings progressed and heparin therapy was initiated after resorption of hemorrhage was observed in a second non-contrast CT scan. The patient developed decreased consciousness the day after heparin administration. A subsequent brain CT revealed intraparenchymal hemorrhage in the right anteroinferior frontal region. Heparin therapy was discontinued, and anti-edema therapy was started. The presentation of CVST with SAH is a rare condition. Furthermore, development of CVST after spinal anesthesia is very rare. In this case, CVST developed after spinal anesthesia, and its first clinical presentation was SAH. To our knowledge, this is the first case CVST presenting with SAH after spinal anesthesia.

The purpose of this study was to investigate the optimum height that the sphenoid sinus ostium can be probed safely from the roof of choana in a large group of patients.The study was performed retrospectively. The 200 sphenoid ostia of the 100 patients whose thin-section computed tomography (CT) including the sphenoid sinus region, made for various reasons, were included in the study. The height of the sphenoid ostium and the skull base from the choana roof were measured on sagittal images of CT. Also, by calculating the ratio of first measurement to the second one, the location of the sphenoid ostium at the anterior wall of sphenoid sinus was determined proportionally.The mean height of the sphenoid ostium from the choana roof was 10.9 (SD, 2.3) mm (range, 5.7-21.5 mm), and the mean height of skull base along the anterior wall of sphenoid sinus from the choana roof was 21.3 (SD, 3.2) mm (range, 13.3-30.6 mm). The ratio of the first measurement to the second measurement was 0.5 (SD, 0.08) (range, 0.29-0.77).In conclusion, under endoscopic view, the sphenoid sinus ostium can be safely probed between 13.3 mm (the minimum skull base height) and 5.7 mm (the minimum sphenoid sinus ostium height) distance upward from the choana, but determining the height of the sphenoid sinus ostium preoperatively on CTs for each patient separately will increase the chance of success in probing the sphenoid sinus.

Ulnar nerve usually gets entrapped at cubital sulcus, but it may rarely occur at the wrist region and the most frequent reason is chronic pressure. Entrapment of the ulnar nerve at the arm region is very rare and only a few case reports have been published. Arcade of Struthers, which is found in the middle region of the arm, is an entrapment area for ulnar nerve. We aimed to underline the importance and presence of arcade of Struthers by presenting a 20 year old male patient with a clinical presentation of ulnar entrapment neuropathy and having electrophysiological findings of ulnar entrapment at the middle region of his arm.

Sternal cleft is a very rare midline defect. Incomplete forms are more common than complete ones. In this challenging anomaly, the underlying mediastinal structures (especially the heart and great vessels) can easily be injured by external trauma. In addition, the deformity is cosmetically unpleasant and quite alarming to the young patient and the patient's family. In this report, we describe the multidetector CT (MDCT) images that demonstrate the complete sternal cleft.

Dear Sir, We read the article entitled “Endovascular Revascularization for Patients with Critical Limb Ischemia: Impact on Wound Healing and Long Term Clinical Results in 189 Limbs” by Bae et al. (1), as published in Korean J Radiol (2013;14:430-438), with a great interest. This article may provide a useful guide for radiologists. In the paper, authors made a retrospective study on 189 limbs with critical limb ischemia, which were treated with endovascular revascularization between 2008 and 2010. Analysis was made using the Kaplan-Meier method. In our clinical

We have read the recent interesting article titled “Monosegmental Hepatobiliary Fibropolycystic Disease Mimicking a Mass: Report of Three Cases” by Kwon et al. (1), published in Korean Journal of Radiology. In this article, the authors briefly discussed the management of the biliary cystic lesions of the liver particularly fibropolycystic liver disease such as Caroli’s Disease. As mentioned by the authors in the article, these cystic lesions are formed by remodeling the ductal plate and communicating with the biliary tree. The authors stated that different types of fibropolycystic liver disease demonstrate characteristic findings at computed tomography (CT) and magnetic resonance (MR) imaging. Ultrasonography (US), CT, magnetic resonance cholangiopancreatography (MRCP), percutaneous transhepatic cholangiography, and endoscopic retrograde cholangiopancreatography can show the dilated

To the Editors: We have read the recent article by Lee et al. (1) with great interests. They reported multidetector computed tomography (MDCT), magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) findings of a unique case of a patient who presented incidentally-detected main pancreatic duct dilatation that was caused by the intrapancreatic-replaced common hepatic artery. In their report, they also emphasized that other organs such as esophagus, duodenum, common bile duct, or ureters can be compressed by aberrant origins or unusual course blood vessels, causing symptoms like dysphagia, jaundice, or hydronephrosis. Due to our special interest in the anatomical variation of the vessels and radiologic evaluation method of the unusual or aberrant vascular structures and its effects on the adjacent organs (2-6), we would like to contribute regarding the non-invasive and

Primary pancreatic hydatid cysts are rare and its percutaneous treatment and catheterization technique has, to the best of our knowledge, not been published in literature. A 33-year-old male patient who presented with abdominal pain was evaluated by ultrasonography (US) and computed tomography examinations. Both examinations revealed a cyst in the neck of the pancreas. After the administration of albendazole chemoprophylaxis, the patient underwent diagnostic puncture showing high pressure spring water which harbored the scoleces and was treated percutaneously by the catheterization technique. In this technique, first the cyst was punctured, the fluid content aspirated, the radiocontrast material injected to see possible fistulisation, and then re-aspirated. The 20% hypertonic saline solution was injected and re-aspiration was performed to the best of our abilities, followed by the insertion of a catheter for drainage of the remaining non-aspiratable fluid content. At follow-up examination, the cyst was not visible on US after 6 months. There was no evidence of cyst recurrence or dissemination after 18 months at serologic and imaging follow-up.

Bronchial carcinoid tumors are rarely seen in adults and may remain asymptomatic for many years. In this report, multidetector computed tomography angiography and virtual bronchoscopy findings of a large bronchial carcinoid tumor that has caused chest pain, dyspnea and diaphoresis in a 21-year-old male patient are presented.