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Background Magnetic resonance myelography (MRM) with three-dimensional (3D) T2-weighted (T2W) turbo spin echo (TSE) sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) may be a guide to the etiology of low back pain. Purpose To research the efficiency of a 3D T2W TSE SPACE MRM sequence for visualization of anatomic details of spinal nerve root at the spinal canal and lateral recess levels in the patients with low back pain. Material and Methods Lumbar spinal MRM 3D T2W TSE SPACE was performed in a total of 70 patients (median age 46 years). Patients were imaged while lying in a supine position with straightened legs. According to the degree of facet arthropathy findings, patients were divided into four separate subgroups in our retrospective cross-sectional study. Spinal nerve root angle was measured within the spinal canal and at lateral recess level, and facet joint angle and lumbar lordosis measurements were measured by two radiologists, independently. Results Lumbar level was strongly negatively correlated with facet joint angle (r = −0.95) as well as nerve root angle within the spinal canal (NRASC) (r = –0.857) and at the lateral recess level (NRALR) (r = −0.947). Intracanal decline of the spinal root angle caused by spinal stenosis findings was also observed ( P SC and NRALR, inter-observer correlation was 0.85 and 0.82 for the spinal canal and at lateral recess level, respectively. Conclusion 3D T2W SPACE in NRASC and NRALR provided high resolution images for evaluation. Therefore, this method may be a qualitative guide for the clinician and the surgeon in terms of root anatomy before any intervention.

Objectives:To evaluate the effectiveness of ultrasound (US) guided percutaneous abscess drainage in the treatment of adult patients with perforated appendicitis and to estimate the success rate. Material and methods:Pre-interventional computed tomography examinations of patients (n=63) who had abscess formation due to perforated appendicitis were reviewed retrospectively. A total of 15 patients [6 (40%) women and 9 (60%) men] with a mean age of 42±21 (SD) years who underwent US-guided percutaneous abscess drainage were enrolled in this study. Abscess volume, location, catheter duration and follow-up results were recorded. The treatment effectiveness of US-guided percutaneous abscess drainage was investigated. Results:A total of 15 patients were included. Abscess formations were in right lower quadrant (n=10) and deep pelvic area (n=5). The mean abscess volume was 235 mm3(range: 20 - 1180). The mean catheter duration was 12.2 ± 7.8 days (range: 3 - 30). Five patients (5/15, 33%) were treated non-surgically with complete response. In remaining 10 patients (10/15, 67%), surgical management was required because of recurrent abscess (3/15, 20%) and progression in abscess volume (7/15, 47%). The technical success rate and the clinical success rate was 100%, and 33%, respectively. Conclusion:Because of our low clinical success rate with 33%, we recommended US-guided percutaneous abscess drainage inperforated appendicitisfor some selected patients with high risk surgery.

To investigate the effectiveness of gadoxetic acid-enhanced magnetic resonance cholangiopancreatography (CE-MRCP) and T2-weighted half-Fourier acquisition single-shot turbo spin-echo (T2W HASTE) sequences for diagnosis of cysto-biliary communication in hydatid cysts compared to surgical results. Preoperative abdominal magnetic resonance imaging examinations of patients who underwent surgery for hepatic hydatid cysts were reviewed by two radiologists retrospectively. A total of 45 patients with hydatid cysts were included. Of 45, 27 also had CE-MRCPs. T2W HASTE sequences and CE-MRCPs were investigated separately for cysto-biliary communication. The relationship between radiological and surgical results was analyzed. The interobserver agreement was evaluated. Of 45 hydatid cysts, there were surgically proven 21 cysts without biliary communications and 24 cysts with biliary communications. All cysts with biliary communications were shown on T2W HASTE sequences. There was no leakage of gadoxetic acid into these cysts (n = 24). Sensitivity, specificity, negative predictive value, positive predictive value (PPV), and accuracy of diagnosis of cyst with biliary communication on T2W HASTE sequences was 100%, 63.64%, 100%, 66.67%, and 78.95%, respectively. Specificity (77.78%), PPV (87.50%), and accuracy (91.30%) were increased in ≥ 10 cm cysts. There was almost perfect interobserver agreement (K = 0.81–1.00). Leakage of gadoxetic acid inside the cyst indicates biliary communication. However, the lack of leakage does not rule out cysto-biliary communication. When biliary communication is clearly shown on T2W HASTE sequences, it should be reported as cysto-biliary communication even if there is no leakage of gadoxetic acid into the cyst on CE-MRCP.

SUMMARY OBJECTIVE: The aim of this study is to evaluate the myocardium structure in patients with chest pain who were determined to have moderate and/or high risk for cardiac ischemic heart disease (IHD) but who had normal findings on conventional coronary angiography by using native cardiac magnetic resonance imaging (CMRI) T1 mapping and comparing with healthy volunteers. METHODS: A total of 50 patients and 30 healthy volunteers who underwent CMRI were included in our prospective study. Patients whose clinical findings were compatible with stable angina pectoris, with moderate and/or high risk for IHD, but whose conventional coronary angiography was normal, were our patient group. Native T1 values were measured for 17 myocardial segments (segmented based on American Heart Association recommendations) by two radiologists independently. The data obtained were statistically compared with the sample t-test. RESULTS: Myocardial native T1 values were found to be significantly prolonged in the patient group compared with the control group (p

The purpose of this study was to describe the magnetic resonance imaging (MRI) findings including diffusion-weighted MRI of nonfunctional pancreatic neuroendocrine tumors (PanNETs) and their hepatic metastases, and investigate the relationships between MRI features and histopathological findings for each grade of PanNETs.A total of 30 patients were included. There were 14 men and 16 women with a mean age of 61.60±11 (SD) years (range: 31-81years). PanNET lesions were analyzed qualitatively (signal intensities, contrast enhancement, lesion margins, presence of metastasis and characteristics of metastases) and quantitatively (signal intensity ratios, contrast enhancement indices and normalized apparent diffusion coefficient [ADC]). The relationships between MRI findings and histopathological findings were evaluated.Among 30 nonfunctional PanNETs, 11 were high-grade tumors, 10 were intermediate and 9 were low-grade tumors. All high grade PanNETs showed low to intermediate signal on T2-weighted images and ill-defined borders. All intermediate grade PanNETs had intermediate and 6 low grade PanNETs have high signal on T2-weighted images. Patients with hepatic metastases from high grade PanNETs had cystic component in 8/10 (80%) and wash-out in 7/10 (70%) whereas intermediate grade PanNETs had none (P0.05). The normalized ADC values of high grade PanNETs was lower than those of intermediate and low grade PanNETs (P0.05).The presence of cystic component or contrast wash-out in hepatic metastases correlates with high grade PanNETs. The pre-operative MRI combined with DWI has an important role in grading and surgical planning of PanNETs.

Seminomas are the most common testicular tumors But frequency of bilateral testicular seminomas is about Seminomas can spread and metastasize in a very short time because of short doubling time For this reason early diagnosis and management is essential The tendency of multicentricity and bilateral location in lymphoma is higher than seminoma The first line treatment of testicular lymphoma is chemotherapy So management is different in lymphoma and seminoma The accurate preoperative diagnosis is important We report a case of a year old man with bilateral multicentric testicular lesions who had not yet fathered a child and had malignant findings on magnetic resonance imaging MRI and diffusion weighted imaging DWI After surgery histological examination revealed bilateral multicentric testicular seminomas This case underlines the role of MRI and DWI in the management of patient nbsp

The relationship of patellofemoral congruency with chondromalacia patellae (CP) was retrospectively evaluated. Lateral patellar tilt angle (LPTA), sulcus angle (SA), trochlear depth (TD), and patella angle (PA) were measured at 301 knee magnetic resonance images and compared between groups with and without CP. In the CP group, LPTA and TD were significantly low (P.01), SA was high (P.01), while PA showed no difference (P.05). The parameters were also compared between groups with mild and severe CP, and no significant difference was found (P.05). Our results demonstrate that patellar tilt and trochlear dysplasia are related to the presence but not the degree of CP.

Ovotesticular disorder of sex development (DSD) is a very rare chromosomal anomaly characterized by the presence of both ovarian and testicular tissues. We reported a case of delayed diagnosis in a 18-year-old man presenting with nonpalpable testes. Pre-operative magnetic resonance imaging (MRI) demonstrated associated anomalies (agenesis of seminal vesicle, configuration of urethra) and Mullerian duct remnants. The presence and location of both ovary and testis, and restricted diffusions of gonads were detected on MRI. On histopathology, malignancies were found in both gonads. Pre-operative MRI findings were helpful for surgical approach. We emphasized the importance of pre-operative MRI on treatment planning.

A case of aberrant left pulmonary artery originating from the right pulmonary artery resembling pulmonary artery sling malformation, but without true sling formation, is presented. Anomalous left pulmonary artery was accompanied with long-segment proximal tracheal stenosis and other congenital malformations typically associated with PAS complex. The anomalous pulmonary artery passed anterior to the trachea; therefore, no true sling was formed. Because no airway compression by the aberrant left pulmonary artery was detected, the proximal tracheal stenosis was thought to be primary.

Background Non-alcoholic fatty liver disease (NAFLD) is very common and serious disease. It begins as a simple hepatosteatosis but can progress to cirrhosis. The early detection of portal hypertension (HT) can be helpful in the management of these patients. Aims To evaluate radiologic findings of portal hypertension at computed tomography (CT) of patients with non-alcoholic fatty liver disease for early diagnosis. Methods and materials Images of 225 cases who underwent non-enhanced abdominal CT were reviewed. The patients with the difference between hepatic and splenic attenuation (CT L-S) > 10 were enrolled in hepatosteatosis group. The remainings formed control group. The relationship between two groups about diameters of portal and splenic veins, craniocaudal (CC) span of liver, splenic index, caudate lobe/right lobe (C/RL) ratio was analyzed statistically by Mann–Whitney U Test and Student’s t-test. Results Total 213 cases, as hepatosteatosis (n = 149) and control (n = 64) groups, were involved in this study. Liver CC span, splenic index and C/RL ratio between two groups were found to be statistically significant (p Conclusions The splenic index and C/RL ratio are important findings of portal HT and fibrosis. CT imaging can be beneficial for diagnosis and treatment of NAFLD patients.