Purpose
There are many variations of the iliac vein, and it is aimed to evaluate these variations using multidetector computed tomography (MDCT).
Methods
Pelvic MDCT images of 1071 adult patients ...(576 males; 495 females; age range 18–94 years; mean age 50.3 years) were retrospectively evaluated. Reconstruction images of the pelvic region in sagittal and coronal planes were evaluated. Except for the usual iliac venous anatomy, all types of iliac vein connections were defined as “iliac venous variation”.
Results
Of the 1071 patients, 84.2% were considered as type 1 (usual). Different variations were observed in 15.8% of the patients, of whom, 63.9% of were male and 36.1% female, and this gender difference was statistically significant (
p
< 0.05). The rates of variations detected in the study were type 2 (49.7%), type 3 (29%), type 4 (4.7%), type 5 (6.5%), type 6 (4.8%), type 7 (1.8%) and type 8 (3.6%) respectively. New subtypes that we named as type 3c, type 6f, type 6 × and type 7b were first determined in our study.
Conclusion
Knowledge and evaluation of iliac venous variations before pelvic surgery or interventional procedures is of importance in preventing possible complications.
Background
It is important to know the renal vascular variations before renal surgeries and invasive procedures. The aim of this study is to evaluate the prevalence and types of variation of renal ...arteries and veins.
Methods
The abdominal CT images of 460 patients, taken between 2019 and 2021, were retrospectively analyzed in axial and coronal planes. The presence and number of accessory renal arteries and early branching in the main renal artery were evaluated. Then, bilateral renal vein variations were investigated. Finally, the compression of the left renal vein by different anatomical structures was evaluated.
Results
Of the 450 patients included in the study, the mean age was 53 years. No variations were detected in 378 renal arteries on the right side (84%) and 392 renal arteries on the left side (87.1%). The most common variation in renal arteries was an accessory inferior hilar artery in 7.5% and 6% rates on the right and left, respectively. An accessory inferior renal polar artery was observed at an overall rate of 1.3%. An accessory superior renal hilar artery was found at 3.3% and 2% rates on the left and the right, respectively. An accessory superior renal polar artery was found at an overall rate of 3.5%. Multiple variations in the renal arteries were observed at a rate of 6.4%. Early branching was observed at a rate of 4.9% on the right and 2.2% on the left. The presence of two and three right renal veins was observed at rates of 13.1% and 0.6%, respectively. Retroaortic and circumaortic left renal veins were found at 3.5% and 4.4% rates, respectively. The compression on the anterior and posterior left renal veins was observed at 4.6% and 0.9% rates, respectively.
Conclusion
Considering that variations in renal arteries and veins are too many and of different types to underestimate, a CT examination for the renal vascular anatomy before and at the planning phase of renal surgery or interventional procedures will be of great benefit to avoid potential complications.
Background
Vascular blow-out syndrome is a life-threatening bleeding condition that usually occurs in the carotid arteries as a result of invasion of head and neck malignant tumors. There are several ...case reports in the literature on peripheral vascular blow out. To our knowledge, there is no other case report in the literature on blow-out in the femoral artery secondary to skin malignancy.
Case presentation
A 66-year-old male patient, who was diagnosed with skin squamous cell carcinoma (SCC) as a result of tissue sampling due to redness and stiffness in the left inguinal region, underwent emergency surgery with severe bleeding. Since edema and deformations on the skin did not render the operation possible, the patient was taken to the interventional radiology unit by applying pressure compression onto the bleeding area for urgent endovascular treatment. The patient was treated with a stent-graft.
Conclusion
The femoral blow-out is an emergency condition that needs to be managed aggressively, and if left untreated, it can cause serious bleeding, limb ischemia, limb loss, or death. Endovascular stent-graft placement is the first method that should be considered, and this method provides fast and effective treatment.
We aimed to evaluate the success and complication rates of image-guided pelvic abscess drainage with emphasis on factors affecting the clinical success.
During a 7-year period, 185 pelvic abscesses ...were treated in 163 patients under ultrasonography and fluoroscopy (n=140) or computed tomography (n=45) guidance with transabdominal (n=107), transvaginal (n=39), transrectal (n=21) and transgluteal (n=18) approaches. Abscess characteristics (etiology, number, size, intrastructure, microbiological content, presence of fistula), patient demographics (age, sex, presence of malignancy, primary disease, antibiotic treatments), procedure-related factors (guidance method, access route, catheter size) and their effects on clinical success, complications, and duration of catheterization were statistically analyzed.
Technical and clinical success rates were 100% and 93.9%, respectively. Procedure-related mortality or major complications were not observed. Minor complications such as catheter dislodgement, obstruction, or kinking were detected in 6.7% of the patients. Clinical failure was observed in 10 patients (6.1%). Fistulization was observed in 14 abscesses. Fistulization extended the duration of catheter use (P < 0.001) and decreased the clinical success rate (P < 0.001). The presence of postoperative malignant, complex-multilocular abscesses, and fungus infection in the cavity extended catheter duration (P < 0.001, P = 0.018, and P = 0.007, respectively), whereas the presence of sterile abscess and endocavitary catheterization reduced the catheter duration (P = 0.009 and P = 0.011, respectively).
Image-guided pelvic abscess drainage has high clinical success and low complication rates. The only factor affecting the clinical success rate is the presence of fistula.
PURPOSE The aim of our study was to evaluate the availability of magnetic resonance spectroscopy (MRS) for the differentiation of benign or malignant pulmonary nodules and masses. METHODS A total of ...59 patients (45 male, 14 female) with pulmonary nodules and masses were included in this prospective study. MRS was applied to the pulmonary lesions of the patients and choline levels were determined. Afterwards CT-guided percutaneous needle biopsy was performed. According to the biopsy results, pulmonary lesions were benign in 25 patients and malignant in 34 patients. RESULTS Choline levels were significantly higher in malignant lesions compared with benign lesions (p < 0.001). When the other conditions were kept constant, the probability of malignancy significantly increased by 17.38-fold (95% CI, 3.78-79.93) in those with choline levels >1.65 micromol/g compared to those with choline levels less than or equal to1.65 micromol/g (p < 0.001). CONCLUSION MRS is a noninvasive method that can be used in the differential diagnosis of pulmonary nodules and masses.
Introduction
Thyroid ultrasonography (US) is the first-step noninvasive and easily accessible diagnostic method widely used in the detection and characterization of nodular thyroid disease. We aimed ...to develop a TI-RADS, which is easy to apply and only relies on the counting of suspicious criteria. In order to measure the reliability of the system, we investigated its correlation with fine needle aspiration biopsy (FNAB) and post-surgery histological results.
Materials and methods
In this prospective study, 242 patients who had undergone FNAB with simultaneous cytopathologist in the radiology department between April and August 2016 were analyzed. Before FNAB, the thyroid gland was re-evaluated with US, and TI-RADS classification was made. Demographic characteristics, family thyroid cancer history and radiotherapy history to the neck region were noted.
Results
Of the 242 patients, 17.3% were male (42 males/200 females). US-guided FNAB was applied to all patients. Mean age was 50 ± 13 years (min: 19, max: 82). Both FNAB and final post-surgery histology results showed that sex and age were not statistically significantly associated with malignancy (
p
= 0.193) TI-RADS criteria and FNAB results revealed a statistically significant association between irregular contours, the state of anteroposterior diameter being longer than transverse diameter, microcalcifications, marked hypoechogenicity, and malignancy (
p
< 0,05). Thirty patients were TI-RADS ≥ 4, 206 patients were TI-RADS ≤ 3 and there was a significant correlation between TI-RADS and Bethesda classification (
p
= 0.001). In addition, statistically significant associations were found between malignancy and family history of thyroid cancer (
p
= 0.035) and radiotherapy history to the neck region (
p
= 0.01).
Conclusion
TI-RADS system after nodule identification is based only on the counting of suspicious criteria. It will be safe and effective to recommend follow-up with low score TI-RADS, benign characters and insufficient FNAB results, and thus, unnecessary thyroidectomy operations will be prevented. It will be easier for surgeons to recommend surgery and persuade the patients for it when patients have high TI-RADS scores. TI-RADS has high power in detecting malignancy by recommending biopsy of suspicious nodules.
Abstract Purpose The aim of this study is to determine the correlation between AIFRS and underlying diseases, microorganisms, presenting symptoms, extent of disease, radiological findings, and ...outcomes and propose a new classification system. Material and methods The data of 19 AIFRS cases were analyzed retrospectively. MRI and CT were performed in all patients preoperatively. All patients underwent at least one surgical debridement. Results Hematologic diseases were the most common(52%) underlying disease. Patients with type-2 diabetes and those with multiple etiologies causing immunosuppression had the lowest survival. Both Aspergillus spp. and Mucoraceae spp. were isolated in 9 patients, but were not associated with poor prognosis. Headache and nasal discharge/crusting were the most common presenting symptoms. Premaxillary involvement was significantly correlated with poor prognosis(p=0.001). Unilateral involvement was correlated with poor prognosis although this finding was not significant(p=0.111). The overall mortality rate was 61.2%. Patients with neutropenia that was corrected had 80% survival(p=0.014). Cessation of corticosteroids and regulating the blood glucose level in patients with immunosuppression due to corticosteroid use resulted in 75% survival. Conclusion There is not a single curative treatment for acute invasive fungal rhinosinusitis (AIFRS). For a favorable prognosis, underlying conditions must be treated in addition to surgical debridement and antifungals.
Objective: The aim of this report is to share our experience and treatment outcomes with far-advanced otosclerosis (FAO) patients. Methods: Patients that underwent surgery from 2003 through 2014 at a ...tertiary referral center were retrospectively reviewed. Nineteen FAO patients were included in the study. Audiological results and the ability to communicate face to face and over telephone were considered as the main outcome measures. Results: Six FAO patients benefited well from stapedotomy with an average of 5.9-decibel (dB) air-bone gap and 86% median speech discrimination. Cochlear implantation (CI) was performed in 13 patients; two had disease progression after stapedotomy, five had failed stapes surgeries elsewhere, and six preferred CI as primary treatment. Median speech discrimination score of CI patients was 78.4%. Overall, all patients had satisfactory face-to-face communication and 90% could use telephone. Conclusion: Bilateral stapedotomy and wearing hearing aid is an effective and cost-effective solution for restoring natural binaural hearing and requires no specific training. Should stapedotomy fail, cochlear implantation is always a successful back-up option. Keywords: Cochlear implantation, otosclerosis, hearing loss, stapes surgery
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