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OBJECTIVE. This article discusses the basics of unenhanced MR angiography (MRA) and MR venography (MRV), time-resolved contrast-enhanced (CE) MRA and dynamic first-pass CE perfusion MRI, and unenhanced and CE MRV, in addition to assessing the clinical relevance of these techniques for evaluating patients with suspected pulmonary thromboembolism and deep venous thrombosis. CONCLUSION. Since the 1990s, the efficacy of MRA or MRV and dynamic perfusion MRI for patients with suspected pulmonary thromboembolism and deep venous thrombosis has been evaluated. On the basis of the results of single-center trials, comprehensive MRI protocols, including pulmonary unenhanced and CE MRA, perfusion MRI, and MRV, promise to be safe and time effective for assessing patients with suspected pulmonary thromboembolism, although future multicenter trials are required to assess the real clinical value of MRI.

PURPOSE To evaluate the diagnostic performance of minimum apparent diffusion coefficient (ADCmin ) and lesion-to-spinal cord signal intensity ratio (LSR) in the differentiation of benign and malignant pulmonary lesions. MATERIALS AND METHODS Forty-seven patients (36 men, 11 women; range, 17-81 years) with 62 pulmonary lesions underwent magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) performed using a 1.5T scanner during free-breathing using b 600 s/mm2 . The ADCmin values and LSR were calculated. A receiver operating characteristic (ROC) curve analysis was performed to detect the threshold value of the ADCmin and LSR values for discrimination between benign and malignant pulmonary lesions. RESULTS There were 42 malignant (33 primary tumors, 9 metastases) and 20 benign lesions. The mean ADCmin ± standard deviations (×10-3 mm2 /s) were 1.45 ± 0.33 for malignant tumors, and 2.4 ± 0.69 for benign lesions (P < 0.001). The mean LSR ± standard deviations for lung cancer was 1.24 ± 0.78, and for benign lesions was 0.55 ± 0.57 (P < 0.001). The area under the ROC curve for ADCmin (0.931; 95% confidence interval [CI]: 0.868-0.993) was greater than that for LSR (0.801; 95% CI: 0.675-0.926) (P = 0.029). For benign/malignant discrimination, the ROC curve showed threshold value of ADCmin to be 1.78 × 10-3 mm2 /s and that of LSR to be 0.86. Using these cutoff values, accuracy of ADCmin and LSR were 89%, 74%, respectively (P = 0.383). CONCLUSION Being a contrast-free and radiation-free technique, DWI allows discrimination of benign and malignant lung lesions. The ADCmin value performed marginally better than LSR values in distinction of benign and malignant lesions. LEVEL OF EVIDENCE 1 J. Magn. Reson. Imaging 2017;45:845-854.

OBJECTIVE. The aim of this study is to investigate the frequency of incorrect citations and its effects on the impact factor of a specific biomedical journal: The American Journal of Roentgenology. MATERIALS AND METHODS. The Cited Reference Search function of Thomson Reuters' Web of Science database (formerly the Institute for Scientific Information's Web of Knowledge database) was used to identify erroneous citations. This was done by entering the journal name into the Cited Work field and entering "2011-2012" into the Cited Year(s) field. The errors in any part of the inaccurately cited references (e.g., author names, title, year, volume, issue, and page numbers) were recorded, and the types of errors (i.e., absent, deficient, or mistyped) were analyzed. Erroneous citations were corrected using the Suggest a Correction function of the Web of Science database. The effect of inaccurate citations on the impact factor of the AJR was calculated. RESULTS. Overall, 183 of 1055 citable articles published in 2011-2012 were inaccurately cited 423 times (mean [± SD], 2.31 ± 4.67 times; range, 1-44 times). Of these 183 articles, 110 (60.1%) were web-only articles and 44 (24.0%) were print articles. The most commonly identified errors were page number errors (44.8%) and misspelling of an author's name (20.2%). Incorrect citations adversely affected the impact factor of the AJR by 0.065 in 2012 and by 0.123 in 2013. CONCLUSION. Inaccurate citations are not infrequent in biomedical journals, yet they can be detected and corrected using the Web of Science database. Although the accuracy of references is primarily the responsibility of authors, the journal editorial office should also define a periodic inaccurate citation check task and correct erroneous citations to reclaim unnecessarily lost credit. © 2017 American Roentgen Ray Society.

SUMMARY: Brucellosis is an endemic disease in various regions of the world. Testicular abscess is a very rare complication of brucellosis which can be misdiagnosed as a testicular mass and may lead to unnecessary orchiectomy. To our knowledge there are only eight reported cases in the literature of a brucellar testicular abscess. We present a case of testicular abscess due to brucellosis diagnosed with serologic tests and color Doppler sonography, and treated with antibiotics and fine needle aspiration. Key words: Abscess, brucellosis, color Doppler sonography, testicular, ultrasonography

Background: Inflammatory myofibroblastic tumor (IMT), also known as inflammatory pseudotumor, is a benign disorder composed of fibrous tissues, myofibroblasts and inflammatory cell proliferation with obscure etiology. Although it is the most common lung tumor in children, it is seen rarely in adults constituting less than 1% of adult lung tumors., Case Reports: In this report, we present different and rare CT manifestations of three adult patients with lung IMT., Conclusions: In conclusion, IMT is a rare lung tumor in adults and may simulate malignancy. It should be considered in the differential diagnosis when a large mass with lobulated contour or harboring coarse calcification is observed.

Perfusion computed tomography (CT) has a great potential for determining hepatic and portal blood flow; it offers the advantages of quantitative determination of lesion hemodynamics, distinguishing malignant and benign processes, as well as providing morphological data. Many studies have reported the use of this method in the assessment of hepatic tumors, hepatic fibrosis associated with chronic liver disease, treatment response following radiotherapy and chemothera-p y, and hepatic perfusion changes after radiological or surgical interventions. The main goal of liver perfusion imaging is to improve the accuracy in the characterization of liver disorders. In this study, we reviewed the clinical application of perfusion CT in various hepatic diseases. © Turkish Society of Radiology 2014.

Background: The detection of renal scars is of paramount importance for optimal clinical management of patients with urinary tract infection (UTI) and vesicoureteral reflux (VUR). The aim of our study was to compare the efficacy of unenhanced magnetic resonance urography (MRU) and Tc-99m dimercaptosuccinic acid (Tc-DMSA) scintigraphy to dectect renal scars. Methods: Unenhanced MRU and Tc-DMSA scintigraphy were performed in 49 children (10 boys, 39 girls; mean age 7.4±4.2 years, range 1-15 years) with documented VUR. MR imaging scans were obtained within 7 days after voiding cystourethrogram (VCUG) and Tc-DMSA scintigraphy. The diagnostic performance of MRU in renal scar detection was calculated relative to that of the Tc-DMSA scan. Results: The renal scar detection rate of Tc-DMSA scintigraphy and unenhanced MRU in kidneys with VUR was 32.4 and 25.9%, respectively. The sensitivity and specificity of MRU in the detection of renal scars was 80 and 82.6% in kidneys with VUR, respectively. There was no statistically significant difference in lesion detection between MRU and Tc-DMSA scintigraphy (P >0.05).MRU and Tc-DMSA scintigraphy showed good agreement (κ = 0.60). Conclusions: Unenhanced MRU is a robust technique for the morphologic assessment of the urinary system and detection of renal scars. The lack of radiation and contrast material makes this technique a much safer alternative to scintigraphy in children with VUR, particularly in those who require follow-up scanning and, consequently, considerable radiation exposure. © IPNA 2014.

Ufuk, Furkan/0000-0002-8614-5387; Ufuk, Furkan/0000-0002-8614-5387 WOS:000459432000025 PubMed: 30629460 Objective: We aimed to determine the diagnostic performance of the contrast-enhanced and unenhanced combined pulmonary arterial MRI and magnetic resonance venography techniques in the diagnosis of venous thromboembolism (VTE). Methods: 44 patients who underwent CT pulmonary angiography (CTPA) for suspected PE constituted the study population. Patients underwent combined pulmonary and lower extremity MRI, and Doppler ultrasonography within 72 h after CTPA. Combined MRI included two sequences: unenhanced steady-state free precession (SSFP) and contrast-enhanced three-dimensional (3D) gradient echo (GRE). The presence of emboli in pulmonary arteries and thrombi in lower extremity veins on 3D-GRE and SSFP sequences was recorded. Results: CTPA showed a total of 244 emboli in 33 (75%) patients whereas contrast-enhanced 3D-GRE MRI showed deep vein thrombosis (DVT) in 34 (77%) subjects. Sensitivities for SSFP vs 3D-GRE MRI respectively in PE detection were 87.9 vs 100% on a per-patient basis, and 53.7 vs 73% on a per-embolus basis. Of 34 patients with established DVT, 31 (91%) were detected by Doppler ultrasound and 29 (85%) were detected by SSFP technique respectively. Conclusion: Both contrast-enhanced and unenhanced combined MRI of acute PE and DVT are feasible one-stop-shopping techniques in patients with suspected thromboembolism. Advances in knowledge: Pulmonary VTE is a common disease with high mortality. Non-invasive techniques withhigh accuracy are required for the assessment of VTE. CT-related radiation and contrast material risks cause concerns. MRI is a radiation-free technique evaluating the vessels with and without contrast. Combined contrast enhancedor unenhanced pulmonary and lower extremity MRI is feasible in patients with suspected thromboembolism.

Biliopleural fistula (BPF) is a very rare entity, characterised by a passage between the pleural cavity and biliary system. Our case, a 67-year-old female patient, had undergone a cholecystectomy 2 years previously and complained of a massive right pleural effusion. Pleural fluid samples of thoracentesis obtained was green and we suspected BPF. Pleural fluid/serum total bilirubin ratio was >1.0. Diagnosis of BPF was confirmed by Gadobenate dimeglumine (Gd-BOPTA) contrast-enhanced magnetic resonance cholangiography (MRC). Bile leak of the pleural cavity was blocked using the process of the papillotomiyby Endoscopic retrograde cholian giopancreotography. We present our case to emphasize that BPF is a very rare situation, with the finding of green pleural fluid, confirmation of the diagnosis with Gd-BOPTA contrast-enhanced MRC and treatment with ERCP.

WOS: 000360776900042 PubMed ID: 26144279 We read with great interest the recent study published inClinical Imaging that reported the utility of real-time elastography in plantar fasciitis and the comments on this article [1,2]. We would like to share our experience with sonoelastographic strain in early diagnosis of plantar fasciitis (PF). A 36-year-old female patient was admitted with left heel pain. She described a sharp, burning pain that exacerbated in the morning and after rest. She had no symptoms on the right heel. Physical examination revealed positive heel compression test on the left side. Left plantar fascia tenderness was detected on palpation. She had no foot deformities. Her calcaneal X-ray was in normal range without any signs of fascial thickening and calcaneal spur formation (Fig. 1a, b). B-mode ultrasonography (US) revealed normal findings for both right and left plantar fascia with a thickness of 0.8 mm and 2.2 mm, respectively (Fig. 2a, b). Given that her plantar fascia was normal according to B-mode US findings, stretching exercises and modification of daily living activities were recommended. On the follow-up visit 2 weeks later, she reported only 25% relief in her symptoms. Real-time sonoelastography (RTSE) was performed to detect early structural changes in the symptomatic plantar fascia with a high-resolution ultrasound device (Logiq E9; GE Healthcare, Milwaukee, WI, USA) equipped with an elastographycompatible 6–15-MHz matrix linear probe.

Emphysematous aortitis is a form of septic aortitis. It is a rare disease with a high mortality rate, necessitating prompt diagnosis and aggressive treatment. We present the computed tomography features of emphysematous aortitis leading to esophageal rupture and esophageal-pleural fistula in a 76-year-old female with rheumatoid arthritis. © SAGE Publications.

Myomas are commonly seen benign tumors of the uterus; they may cause a great variety of symptoms depending on the location. Herein, we presented an unusual case of giant cervical myoma with associated actinomycosis resulting in bilateral hydronephrosis and uremia. A 42-year-old woman was admitted to emergency service with anuria and confusion. She had an intra-abdominal mass extending 4-5 cm above the level of umbilicus. The hemoglobin level was 5.1 g/dl and creatinine level was 5.2 mg/dl. Magnetic resonance imaging revealed enlarged uterus with intrauterine device which was displaced up above the level of umbilicus due to a large cervical mass measuring 16.5x11.5x12 cm, tortuous hydroureters on both sites and left tuba ovarian abscess. A huge cervical lobulated mass which was pressing both ureters and filling the lower abdomen, and left tuba ovarian abscess with dense adhesions which was created by actinomycotic infection were detected on explorative laparotomy. Uremia was normalized gradually following hysterectomy, and the patient was discharged with penicillin treatment. Although myomas are the benign tumors, they may mimic the genital malignancy, and may cause life-threatening complications such as renal failure and uremia.

Perirenal lymphoma is a rare disease and accounts for less than 10% of all malignant lymphomas. Mantle cell lymphoma (MCL) is the rarest but 1 of the most aggressive non-Hodgkin's lymphoma subtype. The perirenal involvement of MCL has not been reported previously. A 69-year-old male, who had been diagnosed as having MCL 1 year ago, presented with recent-onset right back pain. Herein we present the key imaging findings of perirenal soft tissue manifestation of MCL. © 2016 Elsevier Inc.

Background: Our aim was to compare the apparent diffusion coefficient (ADC) values of normal abdominal parenchymal organs and signal-to-noise ratio (SNR) measurements in the same patients with breath hold (BH) and free breathing (FB) diffusion weighted imaging (DWI). Material/Methods: Forty-eight patients underwent both BH and FB DWI. Spherical region of interest (ROI) was placed on the right hepatic lobe, spleen, pancreas, and renal cortices. ADC values were calculated for each organ on each sequence using an automated software. Image noise, defined as the standard deviation (SD) of the signal intensities in the most artifact-free area of the image background was measured by placing the largest possible ROI on either the left or the right side of the body outside the object in the recorded field of view. SNR was calculated using the formula: SNR=signal intensity (SI)(organ)/standard deviation (SD)(noise). Results: There were no statistically significant differences in ADC values of the abdominal organs between BH and FB DWI sequences (p>0.05). There were statistically significant differences between SNR values of organs on BH and FB DWIs. SNRs were found to be better on FB DWI than BH DWI (p

WOS: 000367808500012 PubMed ID: 26342298 The objective of this study was to investigate the role of real-time sonoelastography (RTSE) in patients with lateral epicondylitis (LE) and whether it is associated with clinical parameters. Seventeen patients with unilateral LE were enrolled in the study. The healthy elbows of the participants constituted the control group. Using B-mode ultrasound, color Doppler ultrasound, and RTSE, we prospectively examined 34 common extensor tendon elbows of 17 patients. Both color scales and strain ratio were used for evaluating RTSE images. Two radiologists evaluated the RTSE images separately. Elbow pain was scored on a 100-mm visual analog scale (VAS). Symptom duration and the presence of nocturnal pain were questioned. Quick disabilities of arm shoulder and hand (DASH) Questionnaire was applied to assess the pain, function, and disability. Nottingham health profile (NHP) was used to determine and quantify perceived health problems. Both color scales and strain ratios of the affected tendon portions were significantly different from that of healthy tendons (p < 0.001). There was no significant association between NHP, VAS, Quick DASH scores, and color scales and strain ratio. Strain ratio of the medial portion of the affected tendon was significantly correlated with symptom duration (rho = -0.61 p = 0.010) and nocturnal pain (rho = 0.522 p = 0.031). Interobserver agreement was substantial for color scales (kappa = 0.74, p = 0.001) and strain ratio (ICC = 0.61, p = 0.031). RTSE may facilitate differentiation between healthy and affected elbows as a feasible and practical supplementary method with substantial interobserver agreement. RTSE was superior to B-mode ultrasound and color Doppler ultrasound in discriminating tendons with LE. Strain ratio of the medial portion of the tendon is associated moderately with nocturnal pain and symptom duration. No other associations were present between RTSE findings and clinical or functional parameters.

Background Pylephlebitis, a rare complication of abdominal infections, is a septic thrombophlebitis of the portal venous system with high rates of morbidity and mortality. Case Report We present a case of pylephlebitis complicating acute appendicitis and report the utility of a computed tomography scan in the diagnosis. Why Should an Emergency Physician be Aware of This? The prompt diagnosis and appropriate treatment of pylephlebitis are crucial to reduce morbidity and mortality, but clinical presentation is often nonspecific. A computed tomography scan is instrumental in the early diagnosis of pylephlebitis because it readily reveals the thrombus in the mesenteric or portal vein in the setting of acute appendicitis. Early and aggressive treatment with broad-spectrum antibiotics is necessary, and anticoagulation therapy can also be used to prevent bowel ischemia. © 2016 Elsevier Inc.

We report magnetic resonance (MR), computed tomography (CT) and angiographic imaging of an unusual giant arachnoid granulation in the superior sagittal sinus in a man with headache and vertigo. Intrasinus pressure measurements revealed a significant pressure gradient across the lesion. MR imaging is useful to identify giant arachnoid granulation and dural sinus thrombosis, whereas dural sinus pressure measurement in certain cases of giant arachnoid granulations can be used to evaluate the lesion as the cause of the patient's symptoms. © European Society of Radiology 2008.

Laparoscopic cholecystectomy has rapidly become the preferred treatment for symptomatic cholecystolithiasis. However, the procedure is associated with a number of complications, one of which is the spillage of gallstones into the peritoneal cavity. Unretrieved gallstones may cause a wide variety of complications such as abscess, adhesion and small-bowel obstruction, or they may remain asymptomatic and harmless. In the latter case, spilled gallstones in the peritoneal spaces may cause diagnostic difficulty or mimic peritoneal metastasis. We present the computed tomography (CT) and magnetic resonance (MR) imaging features of intra-abdominal gallstone spillage in a case with head and neck neoplasm. Awareness of radiologic features of dropped intraperitoneal gallstones is necessary as they may be mistaken for peritoneal metastases. © Springer-Verlag 2007.

OBJECTIVE: To determine the visualization rate of the normal appendix on low- and standard-dose unenhanced computed tomography (CT) and to evaluate the variables that may influence the identification of the appendix. METHODS: The study population was derived from the previous study, approved by the internal review board, investigating the effectiveness of low-dose CT (LDCT) in diagnosis of urolithiasis. Sixty-eight patients presenting with acute flank pain underwent 2 unenhanced dual-slice CT examinations. Standard-dose CT (SDCT) scans were obtained using 2 × 5-mm collimation, 120 kVp, and 170 effective mAs and followed by LDCT using 30 or 50 effective mAs. Two independent board-certified radiologists retrospectively recorded the visualization, outer diameter, and the wall thickness of normal appendices. The diameters, circumference, and cross-sectional area of the abdomen were measured. RESULTS: The prevalence of appendectomy was 8.8% (6 of 68 patients). The means of the 2 reviewers' sensitivity, specificity, positive and negative predictive values, and accuracy for visualization of normal appendix at SDCT versus LDCT respectively were 78% versus 73%, 100% versus 92%, 100% versus 99%, 31% versus 24%, and 80% versus 74% (P = 0.39-0.75). The interobserver agreement was good at both SDCT (κ = 0.61) and LDCT (κ = 0.74). Overall 40% to 58% of appendices at LDCT and 33% to 47% at SDCT was larger than 6 mm. There was no significant correlation in the appendix visualization neither with abdominal dimensions nor with visceral or pericecal fat at both dose sets. The calculated mean effective radiation dose at LDCT was 70% to 82% less than SDCT. CONCLUSIONS: Low- and standard-dose nonenhanced helical CT can visualize a normal appendix with high accuracy and good interobserver agreement. The diameter of normal appendix overlaps with that of appendicitis at CT. A diameter of 10.0 mm should be considered as the upper limit of normal in the absence of any other CT signs of appendicitis. © 2007 Lippincott Williams & Wilkins, Inc.

tiple small cysts, type 3 (46%) lesions have a solid-tissue component associated with irregular large cysts, type 4 (4%) lesions include solid tissue without cysts, and type 5 (6%) lesions have a large cyst without solid tissue [2, 3]. Therefore, cyst-containing types (types 1–3 and type 5) should be included in the differential diagnosis of hepatic cysts. Different from hepatic mucinous cystic neoplasms (also called biliary cystadenoma and biliary cystadenocarcinoma) that usually have no communication with the bile ducts [4], intraductal papillary mucinous tumor of the bile ducts is a low-grade malignancy, generally limited to the biliary mucosa and characterized by innumerable frondlike papillary projections [5]. It can manifest as a biliary cystic lesion when a tumor arises from an intrahepatic bile duct and leads to focal aneurysmal dilatation because of an impediment of biliary flow by the tumor or abundant viscous mucin secretion [5]. If visualized, the solid components may appear as flat or fun gating papillary projections within dilated ducts. Hepatobiliary contrast agents are useful to show the biliary origin of the cystic lesion. Dilated peripheral intrahepatic bile ducts may rupture resulting in pseudomyxoma peritonei.

Background/aim: To investigate the age- and sex-associated carotid intima media thickness (cIMT) changes in healthy children to determine the age- and sex-specific normal range of values for childhood. Materials and methods: This study examined 91 healthy school-age children aged 7 15 years prospectively. Standardized sonographic cIMT measurements and analyses were performed. Body mass index and blood pressure were obtained, and atherosclerotic risk factors were investigated. Age- and sex-specific cIMT measurements for different age groups were calculated and the relation with sex was investigated. Results: Regarding the total study group, mean cIMT measurements for age groups 7 9, 10 12, and 13 15 years were 4.1 ± 0.5 mm, 4.4 ± 0.6 mm, and 4.6 ± 0.4 mm, respectively. cIMT did not differ between boys and girls in the same age group. Age related analyses showed significant variations among the age groups with positive correlation between cIMT and age. Conclusion: Our results suggest that age-related physiologic thickening of the carotid artery intima-media occurs not only in adults but also in children and that sex is not a factor for cIMT differences in childhood.

Müllerian adenosarkom daha çok postmenapozal dönemdeki kadınları etkileyen nadir bir tümördür. Patolojik olarak düşük gradeli endometrial stromal sarkom ve çoğunlukla benign, ama bazen de atipik glandüler epitelden oluşur. Hastalar çoğunlukla karın ağrısı, huzursuzluk ve uterin kanama şikayetiyle başvururlar. Bu yazıda abse formasyonuyla komplike olan ve postoperatif dönemde sepsis gelişen bir Müllerian adenosarkom olgusunu sunmayı amaçladık. Müllerian adenosarkomlar rölatif olarak iyi prognoza sahip nadir görülen tümörler olmakla birlikte klinik tablo nekroza sekonder gelişen enfeksiyon, abse gelişimi ve postoperatif sepsisle komplike olabilmektedir

Background. The primary objective of the study was to evaluate the association between the minimum apparent diffusion coefficient (ADCmin) and Ki-67, an index for cellular proliferation, in non-small cell lung cancers. Also, we aimed to assess whether ADCmin values differ between tumour subtypes and tissue sampling method. Methods. The patients who had diffusion weighted magnetic resonance imaging (DW-MRI) were enrolled retrospectively. The correlation between ADCmin and the Ki-67 index was evaluated. Results. Ninety three patients, with a mean age 65 ± 11 years, with histopathologically proven adenocarcinoma and squamous cell carcinoma of the lungs and had technically successful DW-MRI were included in the study. The numbers of tumour subtypes were 47 for adenocarcinoma and 46 for squamous cell carcinoma. There was a good negative correlation between ADCmin values and the Ki-67 proliferation index (r = −0.837, p < 0.001). The mean ADCmin value was higher and the mean Ki-67 index was lower in adenocarcinomas compared to squamous cell carcinoma (p < 0.0001). There was no statistical difference between tissue sampling methods. Conclusions. Because ADCmin shows a good but negative correlation with Ki-67 index, it provides an opportunity to evaluate tumours and their aggressiveness and may be helpful in the differentiation of subtypes non-invasively.

Sclerosing stromal tumour (SST) of the ovary is a rare benign tumour of the ovarian stroma, first described in 1973 (Chalvardjian and Scully 1973). Although it is classified within the sex cord str...

WOS: 000351769600004, PubMed ID: 25512071, Sarcoidosis is a multisystem inflammatory disease of unknown etiology. The lungs and the lymphoid system are the most commonly involved organs. Extrapulmonary involvement is reported in 30% of patients, and the abdomen is the most common extrapulmonary site with a frequency of 50%-70%. Although intra-abdominal sarcoidosis is usually asymptomatic, its presence may affect the prognosis and treatment options. The lesions are less characteristic and may mimick neoplastic or infectious diseases such as lymphoma, diffuse metastasis, and granulomatous inflammation. The liver and spleen are the most common abdominal sites of involvement. Sarcoidosis of the gastrointestinal system, pancreas, and kidneys are extremely rare. Adenopathy which is most commonly found in the porta hepatis, exudative ascites, and multiple granulomatous nodules studding the peritoneum are the reported manifestations of abdominal sarcoidosis. Since abdominal sarcoidosis is less common and long-standing, unrecognized disease can result in significant morbidity and mortality. Imaging contributes to diagnosis and management of intra-abdominal sarcoidosis. In this report we reviewed the cross-sectional imaging findings of hepatobiliary, gastrointestinal, and genitourinary sarcoidosis.

Objective: To detect any significant alteration of basal and TRH stimulated circulating prolactin levels in those with an extremely dense breast composition as compared to ones with a fatty pattern in mammography in climacteric patients with a low risk probability for developing invasive breast cancer within five years according to a validated risk model. Materials and method: In this matched pairs case-control trial a total of 67 climacteric patients with an extremely dense breast composition were compared to a control group of 71 climacteric patients with an almost entirely fat pattern composition in terms of basal and TRH stimulated circulating prolactin levels. All participants in the study had an estimated 5 years breast cancer risk less than 1.67% according to the validated model of Gail. Subgroup analysis was done according to menopausal status (premenopausal versus postmenopausal) and according to the hormone replacement therapy (HRT) in postmenopausal patients (current users of HRT versus never used HRT). Results: We did not detect any statistically relevant differences between groups or subgroups in terms of basal, stimulated and ? levels (stimulated-basal) of prolactin (ng/ml). The differences between groups of extremely dense composition versus almost fatty pattern in terms of ?PRL (ng/ml) (±S.D.) were not statistically significant (68.1 ± 34.5 versus 69.1 ± 43.0; unpaired t test, Welch corrected p = 0.88, 95% CI -12.1 to 14.0). Conclusion: Our results do not suggest a contribution of circulating prolactin to increased mammographic density in climacteric patients with low risk probability to develop breast cancer. A study of similar kind is warranted in high risk patients. © 2005 Elsevier Ireland Ltd. All rights reserved.

The objective is to investigate the effect of obesity and hepatosteatosis on the Doppler waveform pattern of the hepatic veins. B-mode and duplex Doppler sonography of the liver and the right hepatic vein was performed in 102 obese subjects and 84 healthy volunteers. The severity of fatty infiltration was graded as mild, moderate and severe. The flow pattern of the right hepatic vein was classified as triphasic, biphasic and monophasic. The Doppler flow pattern in the right hepatic vein was triphasic in 56 (55%), biphasic in 27 (26%) and monophasic in 19 (19%) obese patients, whereas it was triphasic in 83 (99%) and biphasic in 1 (1%) control subject, achieving a statistical significance (Mann-Whitney U-test, P

Purpose To evaluate peripancreatic signal changes on fat-suppressed T1-weighted spoiled gradient echo images associated with acute pancreatitis and investigate potential utility in regards to relationship to clinical outcome. Materials and Methods The abdominal MR images in 31 patients with acute pancreatitis were reviewed, and evaluated for the presence of elevated signal intensity within the peripancreatic fat on fat-suppressed T1-weighted spoiled gradient echo images; the degree of signal changes was graded as mild, moderate, or severe. Results Ten of 31 patients demonstrated abnormal high signal intensity in the peripancreatic fat on fat-suppressed T1-weighted images. The degree of signal change was mild in three patients, moderate in one, and severe in six patients. All six patients with severe elevated peripancreatic soft tissue signal died within seven to 68 days (mean, 47 days) of their admission. All 21 patients without elevated peripancreatic fat signal survived without any complications. The correlation between the presence and severity of elevated peripancreatic MR signal and patient outcome was significant (P < 0.05). Conclusion Elevated peripancreatic signal on fat-suppressed T1-weighted images is associated progressively with poor outcome in patients with acute pancreatitis, and may represent a simplified method for prognostic cross-sectional imaging. J. Magn. Reson. Imaging 2003;18:49–58. © 2003 Wiley-Liss, Inc.

Birt-Hogg-Dubé syndrome is characterized by clinical manifestations such as hamartomas of the skin, renal tumors and lung cysts with spontaneous pneumothoraces. Patients with Birt-Hogg-Dubé syndrome may present with only multiple lung cysts. We report the chest computerized tomography (CT) features of three patients with Birt- Hogg-Dubé syndrome. Each patient had multiple lung cysts of various sizes according to chest CT evaluation, most of which were located in lower lobes and related to pleura. The identification of unique characteristics in the chest CT of patients with Birt-Hogg-Dubé syndrome may provide an efficient mechanism for diagnosis. © 2014 by the Atatürk University School of Medicine.

Direct communication of the right pulmonary artery and the left atrium is an extremely rare congenital malformation of the pulmonary vasculature. A 41-year-old woman with a history of cyanosis since childhood presented with mild exertional dyspnea. On physical examination, she had central cyanosis, clubbing of the fingers, and an upright position caused by orthodeoxia. Imaging studies showed a very large aneurysm in the distal right pulmonary artery with a direct communication to the left atrium. The patient underwent successful repair, with resolution of hypoxia and exertional symptoms. © 2014 by The Society of Thoracic Surgeons.

Erdheim-Chester disease is a rarely reported disease that can affect nearly every organ and chiefly infiltrates the connective, perivascular, and adipose tissue. The disease is a form of non-Langerhans-cell histiocytosis characterized by the proliferation of foamy his-tiocytes; its cardiovascular complications carry a severe prognosis. We present the case of a 29-year-old woman who was admitted for analysis of her angina. Our evaluation with use of cardiac multidetector computed tomographic angiography revealed large mediastinal soft tissue that compressed the patient's left anterior descending coronary artery. To our knowledge, this is the first report of the use of low-dose, dual-source, 256-slice multidetector computed tomography to characterize Erdheim-Chester disease that exclusively caused angina and stenosis of a coronary artery in a young adult. © 2014 by the Texas Heart® Institute, Houston.