Gallbladder polyps often have a benign nature. Current guidelines suggest surgical removal of polyps greater than 10 mm. However, the accuracy of the size criteria is limited because neoplasia can be found in gallbladder polyps less than 10 mm. The aim of this study was to evaluate the feasibility of real time elastography for gallbladder polyps and to demonstrate the elasticity properties of the polyps.Fifty-three polypoid lesions of the gallbladder were prospectively examined with real-time elastography. Of these patients, 52 had a diagnosis of benign gallbladder polyps and one patient was accepted as a gallbladder carcinoma due to its clinical and radiological findings. B-mode and real-time elastographic images were simultaneously presented as a two-panel image, and the elastogram was displayed in a color scale that ranged from red (greatest strain, softest component), to green (average strain, intermediate component), to blue (no strain, hardest component).The mean size for benign gallbladder polyps was 7.2 +/- 3 mm (range, 5-21 mm). All benign gallbladder polyps on consecutive real-time elastographic images appeared as having a high-strain elastographic pattern. Only one patient who was accepted with gallbladder carcinoma had a gallbladder polyp with low elasticity properties.Our study showed that real time elastography of gallbladder polyps is feasible. This novel approach may be useful for the characterization of polypoid lesions of the gallbladder.
Purpose . The objective is to compare lateralizing ability of three quantitative MR (qMRI) modalities to depict changes of hippocampal architecture with clinical entities in temporal lobe epilepsy. Methods . We evaluated 14 patients with clinical and EEG proven diagnosis of unilateral TLE and 15 healthy volunteers. T1-weighted 3D dataset for volumetry, single-voxel 1 H MR spectroscopy (MRS), and diffusion tensor imaging (DTI) were performed for bilateral hippocampi of all subjects. Results . Individual volumetric measurements provided accurate lateralization in 85% of the patients, spectroscopy in 57%, and DTI in 57%. Higher lateralization ratios were acquired combining volumetry-spectroscopy (85%), spectroscopy-DTI (85%), and volumetry-DTI (100%). Significantly decreased NAA/(Cho+Cr) ratios (p=0.002) and increased FA (p=0.001) values were obtained in ipsilateral to epileptogenic hippocampus. Duration of epilepsy and FA values showed a significant negative correlation (p=0.016,r=-0.847). The history of febrile convulsion associated with ipsilateral increased ADC values (p=0.015,r=0.851) and reduced NAA/(Cho+Cr) ratios (p=0.047,r=-761). Conclusion . Volumetry, MRS, and DTI studies provide complementary information of hippocampal pathology. For lateralization of epileptogenic focus and preoperative examination, volumetry-DTI combination may be indicative of diagnostic accuracy.
The objective of our study was to evaluate lactulose solution as a new oral contrast agent with the use of peroral CT enterography to determine the adequacy of luminal distention and conspicuity of the bowel wall.Peroral CT enterography performed with lactulose solution is a simple and noninvasive method of evaluating the small bowel by obtaining good distention. It can also be used at routine abdominal examinations as a negative contrast agent instead of iodinated oral contrast medium, especially for CT angiography.
Among patients with increased bronchial artery diameter there is a significant association between hemoptysis and bronchiectasis score. The higher score of bronchiectasis, the higher risk of hemoptysis development.To investigate the association of stages of bronchiectasis based on a computed tomography (CT) grading system, with bronchial artery diameter and hemoptysis in patients with bronchiectasis.Patients with lung pathologies other than bronchiectasis, which may cause hemoptysis, were excluded from the study. One hundred and forty-five patients who underwent contrast-enhanced thorax CT by a 64-detector CT for various indications, and who were diagnosed with bronchiectasis, were evaluated retrospectively. CT examinations were carried out by two radiologists with 9 and 4 years of experience with chest radiology, respectively. The diameters of the right and left bronchial arteries were measured 1 cm from the aortic origin and perpendicular to the vessel axis. Cases were assessed based on the Bhalla CT scoring system. The hemoptysis history of every patient was taken.The diameters of the right and left bronchial arteries were significantly greater in patients with scores of 2 and 3 bronchiectasis than in patients with a score of 1. This was significantly greater in patients with a score of 3 than in patients with a score of 2 (P < 0.05). In patients with a score of 1, the right bronchial artery diameter was significantly greater than that of the left bronchial artery (P < 0.05). Right bronchial artery diameters were significantly greater than left bronchial artery diameters in score 3 patients (P < 0.05). A significant association was observed between hemoptysis and bronchiectasis in patients with increased bronchial artery diameter (P < 0.05).In patients with bronchiectasis, as the stage of bronchiectasis increases, the bronchial artery diameters and the risk of hemoptysis increase. We think that in patients who are diagnosed with bronchiectasis via multidetector CT (MDCT), based on scoring with bronchial artery diameters, the risk of hemoptysis can be estimated, and early management plans can be implemented.
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