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AIM: To determine the role of preoperative MRI in the diagnosis and treatment of patients with granulosa cell tumors (GCTs) of the ovary. MATERIALS AND METHODS: Twenty-four patients who were operated on between 2018 and 2022 and who were pathologically diagnosed with GHT and met the inclusion criteria were retrospectively examined. The findings were compared with the patients' demographic data, symptoms, surgical findings (laterality, stage, lymph node involvement, endometrial pathology, tumor size), and CA-125 levels. RESULTS: The final cohort included 24 patients with a mean age of 54.71 ± 16.52. All the patients had the pathological diagnosis of adult type GCT. In the morphological evaluation, the most common finding was a solid-cystic mixed type (14 patients, 58.3%), while intratumoral hemorrhage signal was observed in 10 patients (41.7%). In the majority of cases (91.7%), the mass showed regular contours. The honeycomb/Swiss cheese sign was detected in 54.2% of the cases. When the T1 and T2 signal of the solid component of the mass were examined relative to the myometrium, the majority of GCTs appeared isointense on both sequences (83.3% and 62.5%, respectively). The mean ADC value of the solid component obtained from diffusion-weighted imaging was 0.78 ± 0.15 × 10-3. Pelvic fluid was observed in 41.7% of the cases. The average endometrial thickness was 9.74 ± 6.43 mm. Thickened endometrium more than 9 mm was observed in 9 out of the remaining 21 patients (42.9%). CONCLUSION: Understanding the key imaging features for GCTs plays an essential role in the diagnosis and guiding the treatment effectively.
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BACKGROUND: Obesity is known as a risk factor for endometrial cancer (EC). Only a few studies investigate the relationship between sarcopenia and sarcopenic obesity and EC. In this study, our aim was to investigate the relationship between the cross-sectional imaging-based body composition parameters and the disease prognosis in low-grade (LG) and high-grade (HG) EC. MATERIALS AND METHODS: We conducted a retrospective study in women diagnosed with low and high-grade EC between January 2014 and May 2022 who had abdominal MRI and thorax CT as a part of routine staging workup. We used the skeletal muscle index (SMI) at the level of the third lumbar vertebra to assess sarcopenia on CT. The T2-weighted sequence at the level of the L2-L3 intervertebral disc is used for visceral fat area (VFA), subcutaneous fat area (SFA), and total fat area (TFA). Two radiologists in consensus, calculated the parameters. RESULTS: A total of 250 EC patients (144 low-grade EC, 106 high-grade EC).Sarcopenia was observed in 122 (48.8%) patients, and sarcopenic obesity was found in 82 (32.8%) patients. Although there was an increase in VFA in cases with high-grade EC, there was no significant difference in terms of SFA. Additionally, the frequency of sarcopenia and sarcopenic obesity was higher in cases with high-grade EC. There was no association between sarcopenia and age, histological type, FIGO staging, or comorbidity in the univariate analysis. However, BMI was found to be associated with sarcopenia. CONCLUSIONS: Quantitative radiological measurement of sarcopenia, sarcopenic obesity, and body fat composition can be used as novel parameters in the prediction of disease prognosis in endometrial cancer.
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OBJECTIVE: Impaired arterial elastic features is one of the earliest manifestations of atherosclerosis in the vessel wall and is associated with the development of cardiovascular disease and increased mortality and morbidity. In this study, we aimed to investigate the mean values of aortic elasticity parameters in a normotensive population with transthoracic echocardiography and to evaluate these values in diï¬erent age groups and their relationship with other risk factors. METHODS: This retrospective study included 405 subjects who met the inclusion criteria among 2880 individuals screened between 2020 and 2022. The study population was divided into 5 groups according to their age. Aortic elasticity parameters (aortic strain, aortic stiï¬ness index, and aortic distensibility) were calculated from the associated formulas by measurements made from the ascending aorta in the parasternal long axis. RESULTS: In 405 subjects (mean age 42.18 ± 10.39, 54.3% female), the mean aortic strain value was 15.14 ± 3.56%, the mean aortic stiï¬ness index was 3.24 ± 1.05, and the mean aortic distensibility was 7.48 ± 2.36 cm2/dyn1/103. It was observed that aortic strain and distensibility values signiï¬cantly decreased with increasing age groups, while aortic stiï¬ness signiï¬cantly increased. All 3 aortic elasticity parameters were strongly correlated to age. In the multivariate linear regression analysis, age was found to be an independent factor for all aortic elasticity parameters. CONCLUSION: Aortic elasticity parameters can be evaluated with transthoracic echocardiography in daily practice. Comparing these measurements with normal values in similar age groups may help to detect patients with increased cardiovascular risk in the early period, regardless of the other risk factors.
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Aorta , Elasticidad , Femenino , Humanos , Masculino , Aorta/diagnóstico por imagen , Aorta/fisiología , Aterosclerosis/diagnóstico por imagen , Ecocardiografía , Elasticidad/fisiología , Estudios Retrospectivos , Adulto , Persona de Mediana Edad , Factores de Edad , Factores de Riesgo de Enfermedad Cardiaca , Valores de ReferenciaRESUMEN
PURPOSE: Olfactory dysfunction is a well-known complication in epilepsy. Studies have demonstrated that olfactory bulb volume (OBV), olfactory tract length (OTL), and olfactory sulcus depth (OSD) can be reliably evaluated using magnetic resonance imaging (MRI). In this study, we compared the OBV, OTL, and OSD values of children with epilepsy and those of healthy children (controls) of similar age. Our aim was to determine the presence of olfactory dysfunction in children with epilepsy and demonstrate the effects of the epilepsy type and treatment on olfactory function in these patients. METHODS: Cranial MRI images of 36 patients with epilepsy and 108 controls (3-17 years) were evaluated. The patients with epilepsy were divided into groups according to the type of disease and treatment method. Subsequently, OBV and OSD were measured from the coronal section and OTL from the sagittal section. The OBV, OTL, and OSD values were compared between the epilepsy group, subgroups, and controls. RESULTS: OBV was significantly reduced in the children with epilepsy compared with the control group (P < 0.001). No significant difference between the healthy children and those with epilepsy was determined in terms of OTL and OSD. Although OBV was moderately positively correlated with age in the control group (r = 0.561, P < 0.001), it was poorly correlated with age in children with epilepsy (r = 0.393, P = 0.018). CONCLUSION: The results of our study indicate that OBV decreases in children with epilepsy, but epilepsy type and treatment method do not affect OBV, OTL, or OSD (P > 0.05).
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Epilepsia , Trastornos del Olfato , Humanos , Niño , Imagen por Resonancia Magnética/métodos , Epilepsia/complicaciones , Epilepsia/diagnóstico por imagen , Bulbo Olfatorio/patología , Trastornos del Olfato/patologíaRESUMEN
Both suburothelial hemorrhage and intestinal mural hemorrhage are very rare causes of abdominal pain and gross hematuria. Com-puted tomography (CT) is very valuable in both diagnoses. We present left suburothelial hemorrhage and intestinal mural hemorrhage with CT findings, in a case of Coumadin use for mitral valve replacement.
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Hemorragia Gastrointestinal , Warfarina , Hemorragia Gastrointestinal/inducido químicamente , Hemorragia Gastrointestinal/diagnóstico por imagen , Humanos , Tomografía Computarizada por Rayos X/métodosRESUMEN
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) can develop left ventricular (LV) systolic dysfunction and geometric changes due to several reasons. AIM: To investigate subclinical LV systolic dysfunction and structural features in patients with COPD, and its correlation with the severity of airway obstruction, identified by GOLD classification. METHODS: We studied 52 patients with COPD and 29 age and sex-matched controls, without any cardiac disease. In addition to conventional echocardiographic evaluation speckle tracking echocardiography (STE)-based strain imaging were performed to analyse sub-clinical LV systolic dysfunction. Also LV volumes were measured by using three-dimensional real time echocardiography (3DRTE). All patients underwent spirometry. RESULTS: Conventional echocardiographic parameters (LV wall thickness and diameters, LV EF) and LV volume measurements were similar between the groups. LV global longitudinal peak systolic strain (-14.76 ± 2.69% to -20.27 ± 1.41%, P < 0.001) and strain rate (0.75 ± 0.25 1/s to 1.31 ± 0.41 1/s, P < 0.001) were significantly impaired in patients, compared to controls demonstrating sub-clinical ventricular systolic dysfunction. Significant positive correlation was obtained between LV strain/strain rate and spirometry parameters (FEV1, FEV%, FEV1/FVC, PEF%) (r = 0.78/0.68, P < 0.001; r = 0.83/0.70, P < 0.001); r = 0.74/0.55, P < 0.001; r = 0.72/0.65, P < 0.001 respectively). In addition, there was significant negative correlation between LV strain/strain rate and GOLD classification (r = -0.80/ -0.69, P < 0.001 respectively). CONCLUSION: Subclinical LV systolic dysfunction can occur in COPD patients despite normal EF. STE is a technique that provides additional information for detailed evaluation of subtle changes in LV myocardial contractility, significantly associated with the severity of the disease in COPD patients.
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Enfermedad Pulmonar Obstructiva Crónica , Disfunción Ventricular Izquierda , Humanos , Disfunción Ventricular Izquierda/diagnóstico por imagen , Ecocardiografía/métodos , Sístole , Ventrículos Cardíacos/diagnóstico por imagen , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico por imagen , Función Ventricular IzquierdaRESUMEN
ABSTRACT: This study aimed to determine pain characteristics in patients with persistent headache after COVID-19 and to investigate the role of increased intracranial pressure (ICP) in the pathogenesis of this headache. This is a case-control study comparing the parameters and measurements indicating increased ICP based on magnetic resonance imaging between COVID-19-diagnosed patients with persistent headache and a control group. Optic nerve sheath diameter (ONSD) and eyeball transverse diameter (ETD) were performed on the left eye of each participant. Seventeen of the patients (53.12%) met the diagnostic criteria for new daily persistent headache. Seven patients (21.87%) had migraine, and eight (25%) had tension headache characteristics. No significant difference was observed between the patient and control groups in terms of the ONSD and ETD values. It is possible that the etiopathogenesis is multifactorial. We consider that future studies that will evaluate ICP measurements in large patient groups can present a different perspective for this subject.
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COVID-19/complicaciones , Cefalea/etiología , Hipertensión Intracraneal/patología , Hipertensión Intracraneal/virología , Presión Intracraneal , Adulto , Estudios de Casos y Controles , Ojo/patología , Femenino , Humanos , Hipertensión Intracraneal/diagnóstico por imagen , Hipertensión Intracraneal/fisiopatología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Nervio Óptico/patología , SARS-CoV-2 , Adulto JovenRESUMEN
The aim of this study was to describe the QTc prolongation and related adverse cardiac events during the administration of hydroxychloroquine (HCQ) and its combinations for the treatment of coronavirus disease 2019 (COVID-19). Hospitalized patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who received HCQ and had initial and follow-up electrocardiograms performed between March 10 and May 30, 2020 were included. Critical QTc prolongation was detected in 12% of the patients. On multivariate analysis, diabetes mellitus (odds ratio 5.8, 95% confidence interval 1.11-30.32, p = 0.037) and the use of oseltamivir (odds ratio 5.3, 95% confidence interval 1.02-28, p = 0.047) were found to be associated with critical QTc prolongation.
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Tratamiento Farmacológico de COVID-19 , Hidroxicloroquina/efectos adversos , Gripe Humana/tratamiento farmacológico , Síndrome de QT Prolongado/inducido químicamente , SARS-CoV-2 , Adulto , Anciano , Anciano de 80 o más Años , Azitromicina/administración & dosificación , Electrocardiografía/efectos de los fármacos , Femenino , Humanos , Hidroxicloroquina/administración & dosificación , Masculino , Persona de Mediana Edad , Oseltamivir/efectos adversos , Oseltamivir/uso terapéuticoRESUMEN
INTRODUCTION: Acute coronary syndromes (ACS) mostly occur in patients with traditional risk factors. Especially in young adults without major cardiovascular (CV) risk factors, one of the less common causes of ACS is myeloproliferative neoplasms (MPNs). METHODS: We retrospectively collected data on 11 consecutive patients (nine men, two women, mean age 40.18±8.4 years) with a diagnosis of MPN who presented with ACS. The demographic characteristics of the study population, type of MPN, clinical manifestations, location of myocardial infarction (MI), coronary angiography findings, complete blood count and other related findings, and treatment strategy before and after diagnosis were analyzed. RESULTS: Six patients were diagnosed with polycythemia vera, four with essential thrombocytosis and one with primary myelofibrosis. A JAK2 mutation was found in nine patients. Mean time to diagnosis of MPN was 2.81 years after presenting ACS and mean age at first MI was 32.9±6 years. Six patients had no major CV risk factors. Ten patients had anterior MI and one had inferior MI. After initiation of specific treatment for MPN, no recurrent thrombotic events were observed in a mean follow-up of 4±2.44 years. CONCLUSIONS: In young adults presenting with ACS, MPNs should be considered, especially in the absence of atherosclerotic coronary artery lesions. It is also important to pay attention to blood cell count abnormalities seen in intracoronary thrombotic events. Early diagnosis and treatment of MPNs is essential to prevent recurrence of thrombotic events and may reduce mortality and morbidity related to thrombotic complications.
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Síndrome Coronario Agudo , Trastornos Mieloproliferativos , Síndrome Coronario Agudo/diagnóstico , Síndrome Coronario Agudo/etiología , Adulto , Recuento de Células Sanguíneas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos Mieloproliferativos/complicaciones , Trastornos Mieloproliferativos/diagnóstico , Trastornos Mieloproliferativos/fisiopatología , Estudios RetrospectivosRESUMEN
OBJECTIVE: Silent myocardial involvement is associated with poor prognosis in patients with systemic sclerosis (SSc). Here we aimed to evaluate the subclinical left ventricular (LV) and right ventricular (RV) systolic dysfunction in patients with SSc without any cardiovascular diseases, by using both strain imaging methods, speckle tracking echocardiography (STE) and real-time 3D echocardiography (RT3DE). METHODS: A total of 47 patients with SSc and 20 age- and gender-matched healthy controls (HC) were studied. Conventional echocardiography, STE-based strain imaging, and real-time 3D echocardiography (Bothell, WA, USA) were performed to assess the biventricular deformation. Clinical and serological findings were sought. RESULTS: Conventional echocardiographic LV measurements were similar between SSc and HC. Both the LV and RV longitudinal peak systolic strain/strain rates were significantly impaired in SSc, demonstrating subclinical LV and RV systolic dysfunction (p≤0.001). Systolic pulmonary artery pressure (SPAP) was negatively correlated with both the LV and RV longitudinal peak systolic strain/strain rates (LV, r=-0.554 and r=-0.642, respectively, p<0.001; and RV, r=-0.554 and r=-0.642, respectively, p=0.001). There was a trend for decreasing LV strain and increasing LEVSV in a 1-year analysis of patients with SSc. CONCLUSION: SSc is associated with myocardial systolic dysfunction. A deformation scrutiny conducted by both the STE-based strain imaging and end-systolic LV volume analysis by real-time 3D echocardiography are promising modalities that allow us for non-invasive, comprehensive investigation of subtle deterioration in the biventricular systolic function of patients with SSc.
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OBJECTIVE: In patients with aortic stenosis (AS), the left ventricular (LV) geometry changes due to the increased LV afterload. However, subclinical myocardial dysfunction can develop despite a normal LV ejection fraction (EF). This study was an investigation of subclinical LV systolic dysfunction in patients with severe AS with a normal LV EF using a strain imaging method, speckle-tracking echocardiography (STE), and an evaluation of its correlation with novel indices to assess the severity of AS. METHODS: A total of 45 asymptomatic patients with severe AS and 25 age- and sex-matched controls without any cardiac disease and with preserved LV EF (EF ≥60%) were studied. In addition to performing conventional echocardiography and STE-based strain imaging, novel indices (energy loss index [ELI], valvulo-arterial impedance, systemic arterial compliance) were also measured. RESULTS: The LV EF, and the LV end-diastolic and end-systolic diameters were similar in the 2 groups. The LV longitudinal peak systolic strain (10.66±1.15% to 19.66±2.62%; p=0.0001) and strain rate (0.32±0.07 s-1 to 1.85±0.32 s-1; p=0.0001) were significantly impaired in the study patients compared to the controls, demonstrating subclinical ventricular systolic dysfunction. A significant positive correlation was observed between the ELI and the LV strain/strain rate (r=0.45, p=0.002; r=0.55, p=0.0001, respectively). CONCLUSION: Patients with severe AS develop subclinical LV systolic dysfunction, despite a preserved EF. Novel strain imaging-based echocardiographic techniques may provide additional data that can detect early myocardial systolic deterioration in these patients.
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Estenosis de la Válvula Aórtica , Ecocardiografía , Disfunción Ventricular Izquierda , Anciano , Estenosis de la Válvula Aórtica/complicaciones , Estenosis de la Válvula Aórtica/diagnóstico por imagen , Estenosis de la Válvula Aórtica/epidemiología , Estudios de Casos y Controles , Diástole , Femenino , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Disfunción Ventricular Izquierda/complicaciones , Disfunción Ventricular Izquierda/diagnóstico por imagen , Disfunción Ventricular Izquierda/epidemiologíaAsunto(s)
Equinococosis/parasitología , Cardiopatías/parasitología , Tabiques Cardíacos/parasitología , Procedimientos Quirúrgicos Cardíacos , Diagnóstico Diferencial , Equinococosis/diagnóstico , Equinococosis/cirugía , Ecocardiografía , Cardiopatías/diagnóstico , Cardiopatías/cirugía , Tabiques Cardíacos/diagnóstico por imagen , Tabiques Cardíacos/cirugía , Humanos , Masculino , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
OBJECTIVE: Mitral annular calcification (MAC) is characterized by degenerative calcification of the mitral valve annulus. Atherosclerosis plays role in progression of MAC. Fetuin A is the inhibitor of pathological calcification. In the present study, we investigated the relationship between MAC and fetuin A with carotid intima media thickness (CIMT) and endothelial dysfunction. METHODS: In this observational cross-sectional study, 40 patients with documented MAC on transthoracic echocardiography and 40 without MAC were included. All patients had coronary artery disease (CAD). Endothelial functions were assessed by brachial artery Doppler ultrasound (USG) and carotid artery Doppler USG. Serum fetuin-A level was also measured. Linear regression analysis and receiver operator curve analysis were performed. RESULTS: Endothelial derived vasodilatory response (EDVR) was significantly decreased and CIMT value was increased in MAC group. There was a strong positive correlation between EDVR and serum fetuin-A value. There was a strong negative correlation between CIMT and EDVR, moderately negative correlation between CIMT and serum fetuin-A level. Simple linear regression analysis revealed that CIMT (ß=0.367, p=0.001) and serum fetuin-A level (ß=-0.291, p=0.009) were independent factors associated with MAC. The area under the curve (AUC) for serum fetuin-A level was 0.731 (95% 0.620-0.824) and AUC for CIMT was 0.724 (95% CI 0.613-0.818). CONCLUSION: We observed that MAC is closely related with CIMT and serum fetuin-A level. Serum fetuin-A and CIMT can be used as independent markers in the diagnosis of MAC. We suggest that MAC can be used as an early determinant of CAD.