The Efficiency of Gray-Level Ultrasound Histogram Analysis in Patients with Supraspinatus Tendinopathy

BACKGROUND

Musculoskeletal ultrasonography is a viable substitute for magnetic resonance imaging (MRI) that offers advantages in terms of time efficiency and cost-effectiveness. The gray-level histogram is a tool used to depict the distribution of pixel gray levels that provide quantitative data.

AIM

The objective of our research was to establish a threshold value for ultrasonography-measured supraspinatus tendon gray-level values by comparing patients with tendinopathy to those without.

MATERIALS AND METHODS

This study comprised a cohort of 271 individuals, consisting of 124 patients diagnosed with supraspinatus tendinopathy and 147 cases without the aforementioned condition who underwent shoulder MRI and ultrasound examinations. Two radiologists independently conducted the gray-level histogram analyses. The histogram parameters were determined, including the mean, minimum, median, maximum, fifth, 10th, 25th, 50th, 75th, 90th, and 95th percentiles, as well as skewness, kurtosis, and variance. The interobserver agreement was evaluated using the interclass correlation coefficient.

RESULTS

The supraspinatus tendinopathy group's all gray-level values were lower than those of the control group, and the difference was statistically significant (P < .05). The supraspinatus tendinopathy group exhibited greater values of skewness and kurtosis in comparison to the control group (P < .05). The area under the curve of the 95th percentile of the gray-level value was the highest (area under the curve = 0.960; cut-off value = 82.5; sensitivity = 96.7%; specificity = 88.2%).

CONCLUSION

The analysis of the histogram of gray-level values has the potential to be a promising method for the monitoring of patients with supraspinatus tendinopathy. This approach could be considered a feasible alternative to MRI.

Assessment of Imaging Findings of Renal Carcinoma Subtypes with 3.0T MRI

BACKGROUND

The prevalence of renal masses has escalated as a result of the augmented utilization of cross-sectional imaging techniques. The approach to managing renal masses may exhibit variability contingent upon the subtype of renal cell carcinoma (RCC).

AIM

This research aimed to distinguish between clear cell and papillary RCCs, utilizing dynamic contrast magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI).

MATERIALS AND METHODS

The study assessed the MR images of 112 patients with RCC. Two radiologists independently analyzed tumor size, vascular involvement, signal characteristics in T1- and T2-weighted sequences, the presence of hemosiderin, both microscopic and macroscopic fat content, enhancement patterns, and apparent diffusion coefficient (ADC) values derived from b-values of 1000 s/mm².

RESULTS

Seventy patients had clear cell RCC, and 42 had papillary. In the clear cell RCC, microscopic fat content was significantly higher than the papillary RCC (P < 0.001). However, in papillary RCC, hemosiderin content was substantially greater (P = 0.001). On T2-weighted MR images, clear cell RCCs were usually hyperintense, while papillary RCCs were hypointense (P < 0.001). Even though the rapid enhancement pattern was observed in clear cell RCCs, the progressive enhancement pattern was more prevalent in papillary RCCs (P < 0.001).

CONCLUSION

Hyperintensity on T2-weighted images, microscopic fat content, and rapid enhancement pattern may be indicative of clear cell RCC, whereas hypointensity on T2-weighted images, hemosiderin content, and a progressive contrast pattern may be diagnostic for papillary RCC.

Diagnostic values of diffusion tensor parameters in 3 T breast magnetic resonance imaging: Differentiation of breast tumors from bilateral healthy breast parenchyma

Purpose

Our aim is to search diagnostic value of diffusion tensor parameters in the breast cancer.

Materials and Methods

We included 46 patients with contrast enhanced magnetic resonance imaging of the breast between the dates of July 2015 and December 2016. We measured fractional anisotropy (FA), apparent diffusion coefficient (ADC), relative anisotropy (RA) and volume ratio (VR) values of the malignant mass, ipsilateral and contralateral healthy breast parenchyma in each patient.

Results

ADC and VR values of the malignant lesions were significantly lower than normal parenchyma (P < 0.01). FA values were statistically higher in masses than normal breast parenchyma (P < 0.05). RA values were statistically higher in the mass than ipsilateral breast parenchyma (P < 0.01) but not significantly different from in contralateral breast parenchyma (P > 0.05). Only ADC values were statistically lower in contralateral side than ipsilateral breast parenchyma (P < 0.05) other parameters showed no statistical significance between parenchymas.

Conclusion

DTI findings, such as FA, ADC, RA and VR, provide significant contribution in differentiating cancer from healthy breast tissue.

The Role of Diffusion-Weighted Magnetic Resonance Imaging in the Differential Diagnosis of Simple and Hydatid Cysts of the Liver

Introduction

The present study indicates that simple and hydatid cysts in liver are a common health problem in Turkey. The aim of the study is to differentiate different types of hydatid cysts from simple cysts by using diffusion-weighted images.

Materials and Methods

In total, 37 hydatid cysts and 36 simple cysts in the liver were diagnosed. We retrospectively reviewed the medical records of the patients who had both ultrasonography and magnetic resonance imaging. We measured apparent diffusion coefficient (ADC) values of all the cysts and then compared the findings.

Results

There was no statistically meaningful difference between the ADC values of simple cysts and type 1 hydatid cysts. However, for the other types of hydatid cysts, it is possible to differentiate hydatid cysts from simple cysts using the ADC values.

Conclusion

Although in our study we cannot differentiate between type I hydatid cysts and simple cysts in the liver, diffusion-weighted images are very useful to differentiate different types of hydatid cysts from simple cysts using the ADC values.

The evaluation of the angles of Eustachian tubes in the patients with chronic otitis media on the temporal computerized tomography

INTRODUCTION

Chronic otitis media (COM), affecting all over the world and in a wide range of age groups in Turkey, is an important cause of ear discharge and hearing loss. The main clinical manifestations are tympanic membrane perforation, ear, nose and throat problems. On the tympanic membrane perforation becomes persistent and cholesteatoma development, there are a lot of opinions today. Especially in the pathology associated with otitis media with effusion eustachian tube, it is known that COM and cholesteatoma develop.

MATERIALS AND METHODS

In our study, we interpreted 210 patients' temporal computed tomography (CT). Seventy of these 210 patients had otitis media with cholesteatoma, 70 patients had only otitis media without cholesteatoma, and 70 patients had no otitis media. The eustachian tubes were evaluated using temporal CT multiplanar reconstruction method. Angles with the horizontal plane of the eustachian tube and Reid and tubotympanic angles were measured.

RESULTS

The angles between eustachian tube and horizontally oriented Reid plane of the patients with cholesteatoma were found to be significantly lower than the patients with otitis media without cholesteatoma and the patients with no history of otitis media. For the tubotympanic angle, no statistically significant differences were observed between the groups.

CONCLUSION

These results suggest that the decrease in the angle with the horizontal plane of Reid in the eustachian tube in adults may play a significant role in the etiology of cholesteatoma.

Comparison of elasticity values of the right lobe of the liver of normal weight and morbidly obese Turkish patients

INTRODUCTION

Shear wave elastography is a method for the measurement of tissue stiffness. The advantage of this method is that its outcome is not operator dependent. Our aim was to compare the elastiscity values of the right lobe of the liver of normal weighted and morbidly obese patients.

MATERIALS AND METHODS

The mean elastiscity values of the right lobe of the liver were calculated for 38 normal weighted and 37 morbidly obese patients. All the patients had no history of liver disease.

RESULTS

The mean elastiscity value was significantly higher in morbidly obese patients than (25,7 +3,30 kPascal) in normal weighted patients for the right lobe of liver (10,55 +2,20 kPascal).

CONCLUSION

Morbidly obese patients have a potential risk for liver fibrosis even in the absence of hepatosteatosis.

A case of sudden hearing loss associated with ANCA

A 46-year-old female patient presented to our clinic with complaints of aural fullness and hearing loss for two days. On audiometric examination, she had sensorineural hearing loss in the left ear. Mean pure tone audiometry (PTA) was 53dB. Her medical history was significant for oral medication-controlled diabetes mellitus and chronic thyroiditis. Laboratory studies showed an erythrocyte sedimentation rate (ESR) of 40 mm/h and an anti-neutrophil cytoplasmic antibody directed against myeloperoxidase (MPO-ANCA) level of 33.1 EU/ml. ANCA-associated vasculitis was considered. The patient was started on immunosuppressive treatment. Seven months after the initial episode, the patient suffered a relapse. At 17 month follow-up after the initial event, the patient is healthy with normal hearing. Serum MPO-ANCA is within normal limits.

Quantitative diffusion-weighted magnetic resonance imaging of normal and diseased uterine zones

BACKGROUND

Magnetic resonance (MR) imaging has been established as the best imaging modality for the detection, localization, and staging of uterine cancers. Recently, the usefulness of diffusion-weighted imaging (DWI) in the diagnosis of cancers has been reported in several studies.

PURPOSE

To calculate the apparent diffusion coefficient (ADC) values of normal uterine zones as well as benign and malignant uterine diseases, and to determine a cut-off ADC value for the quantitative detection of uterine malignancies with DWI.

MATERIAL AND METHODS

Eighty-seven patients (mean age 53 years) with 107 benign and malignant uterine pathologies and 50 healthy controls (mean age 38 years) were enrolled in the study. DWI was performed with b factors of 0, 500, and 1000 s/mm(2).

RESULTS

The ADC values of benign and malignant lesions were compared using Student's t test. The mean and the standard deviation of the ADC values of the control group were as follows: myometrium 1.76+/-0.19 x 10(-3) mm(2)/s, junctional zone 0.99+/-0.18 x 10(-3) mm(2)/s, endometrium 1.65+/-0.33 x 10(-3) mm(2)/s, and cervix 1.71+/-0.17 x 10(-3) mm(2)/s. There was a statistically significant difference among the ADC values of normal myometrium and leiomyomas (1.47+/-0.36 x 10(-3) mm(2)/s; P<0.009), endometrium and endometrial carcinomas (0.86+/-0.13 x 10(-3) mm(2)/s; P<0.001), myometrium-junctional zone and adenomyosis (1.24+/-0.20 x 10(-3) mm(2)/s; P<0.001), and cervix and cervical carcinomas (0.91+/-0.14 x 10(-3) mm(2)/s; P<0.001). The ADC values differed significantly between malignant (0.88+/-0.11) and benign lesions (1.55+/-0.33; P<0.01). A cut-off value for malignant lesions of 1.05 x 10(-3) mm(2)/s yielded a sensitivity, specificity, and accuracy of 95.83%, 94.55%, and 94.94%, respectively.

CONCLUSION

The present study shows that ADC measurements have the potential to quantitatively differentiate between normal and cancerous tissues of the uterine zones. We propose adding DWI as an adjunct sequence in the MR protocol for the assessment of uterine lesions.

Fine-needle aspiration as a diagnostic tool for recurrent tonsillitis

Acute tonsillitis is a common childhood disease, but repeated antibiotic treatment may fail, leading to tonsillectomy. Superficial swab cultures do not sufficiently represent the core bacteria present, but fine-needle aspiration may be a promising diagnostic method. We evaluated 58 patients undergoing tonsillectomy, and took superficial and core swabs, and fine-needle aspirations. Staphylococcus aureus was the most common bacterial pathogen identified, present in 26 out of 50 (52%) positive core cultures, followed by Haemophilus influenza in 13 positive core cultures (26%), and group A beta-haemolytic streptococci in 10 positive core cultures (20%). Fine-needle aspiration detected 33 out of 50 positive core cultures (66%), whereas superficial swab culture detected 18 of 50 (36%); the difference being statistically significant. All pathogens detected by superficial swabs and fine-needle aspiration were detected in core cultures. The sensitivity and specificity of fine-needle aspiration were 66% and 100%, respectively, compared with 36% and 100% for superficial swabs. Fine-needle aspiration is therefore a promising method for detecting core bacteria in patients with recurrent tonsillitis.

[Alveolar soft tissue sarcoma]

Alveolar soft part sarcoma is a malignant soft part tumor the etiology of which has not yet been clarified. Histopathological examinations show an alveolar or pseudoglandular pattern. PAS-positive, diastase resistant intraplasmic inclusion bodies are characteristic for this tumor which occurs in the head and neck region; mainly the tongue and the orbita. Primary therapy includes total resection which can later be combined with radiotherapy or chemotherapy. The present study involves a 17 year old patient. We totally removed the tumor and then used radiotherapy. The postoperative examinations over 3 years showed neither local recurrence nor distant metastases.

Evaluation of oxidative stress parameters in blood of patients with laryngeal carcinoma

OBJECTIVES

In this study, plasma lipid peroxidation as assessed by thiobarbituric acid reactive substances and erythrocyte antioxidant status markers namely CuZn superoxide dismutase, glutathione peroxidase, glutathione and plasma levels of vitamin C and E were investigated in 20 patients with larygneal carcinoma and 15 healthy controls.

DESIGN AND METHODS

Lipid peroxidation was observed to be significantly higher (0.01 > p > 0.001) in the larynx carcinoma group in comparison to the healthy controls. Both stage I + 11 and stage III carcinoma patients were observed to have significantly higher thiobarbituric acid reactive substances than the control group. A significant difference was found in plasma vitamin E level between the control group and stage I + 11 and stage III carcinoma patients (p < 0.01, 0.05 > p > 0.02, respectively).

RESULTS

Our findings reveal the presence of increased lipooxidative damage in laryngeal carcinoma patients, but no change with respect to the endogenous antioxidant components-GSH, GSH Px, and CuZn SOD.