With increased fluid intake and tolvaptan treatment, the growth rate of cysts can be theoretically decelerated in autosomal polycystic kidney disease. In this prospective study, it was planned to evaluate thirst sensation in these patients and the parameters affecting its intensity. Forty-one ADPKD patients on tolvaptan and 40 ADPKD patients not on tolvaptan as the control group were evaluated for thirst distress sensation and intensity. The feeling of thirst and the discomfort caused by excessive fluid intake was assessed with Thirst Distress Scale-HF 12 questions (60/12). Thirst intensity was evaluated with a 100 mm visual scale. Of the whole group, 35.8

Background/aim: Sacrococcygeal teratomas (SCT) are known as rare tumors, but they are the most common tumor in fetuses and newborns. This study aims to present fetal magnetic resonance imaging (MRI) findings of SCT diagnosed prenatally and compare them with that of the prenatal Ultrasound (US) findings. Materials and methods: Eleven patients diagnosed as SCT prenatally by US and further assessed by MRI are included. MRI was performed via a 1.5-T magnet with a body coil. The presence, size, content extension, and compressive effects of each mass were determined and correlated with US findings and with postnatal examinations, including surgery and pathology. As complications, the presence of ascites and skin edema or pleural or pericardial effusion was diagnosed as hydrops. The amniotic fluid index was calculated for the assessment of oligo- or polyhydramnios. Results: US findings are found strongly correlated with MRI findings. An agreement on the extent of each mass was observed in eight patients, disagreement in one fetus was an extension of the tumor within the spinal canal recognized only at MR and assessment of intrapelvic-abdominal extension was superior in MRI. There were n = 6 type I, n = 2 type II, n = 1 type III and, n = 2 type IV tumors. MRI was superior to US for detecting displacement of the colon (n = 3), intrapelvic-intraabdominal extension (n = 1), urinary tract complication (n = 2), and intraspinal extension (n = 1). Conclusion: MRI is found to be superior to US especially in the assessment of intrapelvic and intraspinal extension of the tumor, colonic displacement, and complications.

Aim: Our study aimed to report the normative values for optic nerve diameter in different age groups in MR imaging (MRI) in the pediatric population and to find a cut-off value for diagnosis in different age groups to be used for the diagnosis of optic glioma in patients with Neurofibromatosis 1(NF1). Materials-methods: Orbital MRI obtained from 2011 to 2021 for children with and without NF1 were reviewed. Patients were divided into three groups: NF1 with glioma (group 1, n = 38), NF1 without glioma (group 2, n = 57), and healthy controls (group 3, n = 295). Two radiologists assessed diameter and tortuosity using validated criteria. The optic nerve measurements were obtained by two radiologists in two plans (axial and coronal sections) at five locations; retroocular, midsegment, and prechiasmatic segment on axial plane and retroocular segment and chiasmatic on coronal plane. Results: Optic nerves were divided into 4 age groups: 0-2 years, 2-6 years, 6-12 years, and 12-18 years. It was observed that optic nerve diameters increased with age in healthy individuals. In subjects in groups 1 and 2, the mean diameter of the optic nerve was significantly greater at all locations compared with control individuals. Tortuosity scores were significantly associated in NF1 subjects with optic glioma than in NF1 subjects without optic glioma. Conclusion: We present the normative values obtained by measuring optic nerve diameters in pediatric populations (0-18 years) on MRI of our center. A rapid increase in optic nerve diameter was observed in the first 6 years of life, followed by a slower increase. Quantitative reference values for optic nerve diameter will benefit the development of objective diagnostic criteria for optic nerve gliomas (ONGs) secondary to NF1.

Amaç: Bu çalışmanın amacı meme kitlelerindeki vaskülariteyi değerlendirmek için, Renkli Doppler Görüntüleme (RDG), Power Doppler Görüntüleme (PDG) ve Süperb Mikrovasküler Görüntüleme (SMG) yaparak elde ettiğimiz bulguları, histopatolojik sonuçlar ile karşılaştırıp tanısal etkinliklerini değerlendirmektir. Yöntem: Belirtilen tarih aralığında, dahil etme kriterlerine uygun 46 hastaya gri skala USG, RDG, PDG ve SMG yapıldı. Her bir kitlenin vaskülarite özellikleri kaydedildi ve karşılaştırıldı. Bulgular: Kırk altı meme lezyonundan 26’sı benign ve 20’si maligndi. 26 benign lezyondan 19 tanesi fibroadenom, 5 tanesi granülomatöz mastit ve 2 tanesi sklerozan adenozis iken 20 malign lezyonun tamamı invaziv duktal karsinomdu. Benign lezyonlarda ortalama boyut 21,5± 9,6mm, malign lezyonlarda 12,4± 5,8mm idi. Renkli SMG (rSMG) ile malign lezyonlarda benign lezyonlardan daha fazla penetran damar (PV) tespit edilmiş olup malign lezyonlar için rSMG tarafınca tespit edilen PV sayısı, RDG ve PDG tarafınca tespit edilenden daha fazladır. Benign lezyonlarda rSMG ve RDG ile, PDG’ye kıyasla daha az PV tespit edildi. PV varlığı malignite tanısı için bir kriter olarak kullanıldığında, rSMG’nin duyarlılık, özgüllük, pozitif prediktif değer (PPD), negatif prediktif değer (NPD) ve tanısal doğruluğu, RDG ve PDG'ninkinden daha yüksekti. RDG ve PDG ile karşılaştırıldığında, rSMG ile daha fazla akım sinyali ve damar morfolojisi tespit edildi. Meme lezyonlarındaki vasküler paternlere göre farklı görüntüleme modalitelerinin tanısal etkinliğinde rSMG’nin duyarlılık, PPD, NPD ve tanısal doğruluğu, RDG ve PDG’ninkinden daha yüksekken, özgüllüğü daha düşüktü. Sonuç: rSMG, RDG ve PDG’den daha fazla vasküler dallanma detayı göstermekte olup benign-malign meme lezyonunun ayırt edilmesinde uygulanabilir bir yöntemdir.

Objective: The aim of our study is to investigate the distribution of lesions (focal, linear, segmental, regional, multiple regions, diffuse) and internal enhancement patterns (IEP) (homogeneous, heterogeneous, clumped, clustered ring) between benign and malignant type of non-mass enhancement (NME) and to evaluate the difference between Ki-67 and molecular subtypes (Luminal A, Luminal B, Basal-like, and HER2(+)) in malignant group. Methods: A total of 923 women who underwent routine breast MRI between January 2015 and May 2018 were retrospectively reviewed. 88 MR images were included in the study. Histopathological results were 46 benign and 35 malignant lesions. We compared the distribution and IEPs between benign and malignant type of NME. In the malignant group, distribution and IEPs of different molecular subtypes and Ki-67 values were compared. Results: Clustered ring internal enhancement were significantly associated with malignancy, while focal distribution and homogeneous enhancement pattern were associated with benignancy. A binomial logistic regression model explained 52.4% of the variance in benign-malignant status and correctly classified 77.3% of cases. Model sensitivity was 74.3%, specificity was 79.2%, positive predictive value was 70.2% and negative predictive value was 82.3%. There were not statistically significant differences in either distribution type of lesions or IEPs between molecular subtypes of malignant NME with different Ki-67 values. Conclusion: 3-T MRI findings of focal distribution and homogeneous enhancement pattern were found to be a significant predictor of benign NME. Clustered ring enhancement can predict the probability of malignancy for non-mass like enhancement lesions.

Objective: The aim of our study is to investigate the distribution of lesions (focal, linear, segmental, regional, multiple regions, diffuse) and internal enhancement patterns (IEP) (homogeneous, heterogeneous, clumped, clustered ring) between benign and malignant type of NME and to evaluate the difference between Ki-67 and molecular subtypes (Luminal A, Luminal B, Basal-like, and HER2(+)) in malignant group. Methods: A total of 923 women who underwent routine breast MRI between January 2015 and May 2018 were retrospectively reviewed. 88 MR images were included in the study. Histopathological results were 46 benign and 35 malignant lesions. We compared the distribution and IEPs between benign and malignant type of NME. In the malignant group, distribution and IEPs of different molecular subtypes and Ki-67 values were compared. Results: Clustered ring internal enhancement were significantly associated with malignancy, while focal distribution and homogeneous enhancement pattern were associated with benignancy. A binomial logistic regression model explained 52.4% of the variance in benign-malignant status and correctly classified 77.3% of cases. Model sensitivity was 74.3%, specificity was 79.2%, positive predictive value was 70.2% and negative predictive value was 82.3%. There were not statistically significant differences in either distribution type of lesions or IEPs between molecular subtypes of malignant NME with different Ki-67 values. Conclusion: 3-T MRI findings of focal distribution and homogeneous enhancement pattern were found to be a significant predictor of benign NME. Clustered ring enhancement can predict the probability of malignancy for non-mass like enhancement lesions.

Although cervical lymph nodes have been a popular subject in previous studies, comparison of the diagnos-tic performance of SMI and SWE in axillary lymph nodes has been neglected. Therefore, our purpose here is to detect and compare the diagnostic performances of VI via SMI and SWE in axillary lymphadenitis and metastatic axillary LNs. Our results showed that combined grayscale ultrasonography evaluation of lymph nodes with SWE and SMI increase the diagnostic performance in distinguishing lymphadenitis-metastatic LAP. Purpose: The purpose of this study is to detect and compare the diagnostic performances of vascularity index (VI) via superb microvascular imaging (SMI) and shear wave elastography (SWE) in metastatic axillary lymphadenopathy and lymphadenitis. Materials and methods: The study is based on 45 female patients who were ultrasonographed due to swelling in the axilla and underwent SWE and SMI before tru-cut biopsy, between August 2019 and February 2021. The patients had a total of 53 lymph nodes (LNs), 38 of these were metastatic and 15 were lymphadenitis. Results: The results showed that mean volumes, value of cortex thickness, elasticity and velocity values, and mean VI values were significantly higher in metastatic LAP group compared to lymphadenitis group. Correlation analysis showed that both VI (r: 0.44) and elastography (r: 0.52) values were positively correlated with the cortex thickness, while elastography values were strongly correlated with volume (r: 0.42) and short diameter (r: 0.40). For differentiating lymphadenitis and metastatic LAP, the optimal cut-off VI value was 8.55 while the optimal cut-off elastography value was 31.8 kPa. Conclusion: In conclusion, combined grayscale ultrasonography evaluation of lymph nodes with SWE and SMI increase the diagnostic performance in distinguishing lymphadenitis-metastatic LAP.

Amaç: Bu çalışmada amacımız abdominal semptomları olan hastalarda abdominal Bilgisayarlı Tomografi (BT)’de koronavirüs hastalığı (COVID-19) ile ilgili bulguları bildirmektir. Yöntem: Bu retrospektif çalışmaya Mart-Haziran 2020'den itibaren batın BT çekilen 40 erişkin hasta (22-88 yaş) dahil edildi. Klinik bulgular, laboratuvar verileri ve görüntüleme bulguları analiz edildi. Tüm hastalar Revers-Transkriptaz Polimeraz Zincir Reaksiyonu (RT-PCR) ile doğrulandı. Bulgular: Bu çalışma, karın ağrısı, mide bulantısı, ishal ve anoreksiyası olan, ancak COVID-19 ile uyumlu solunum semptomları olmayan hastaları içermekte idi. Karın ağrısı, klinik COVID-19 şüphesi olmayan bu hastalarda (n = 31) en sık BT endikasyonuydu ve 32 hastada ekstrapulmoner bulgu yoktu. Sonuç: Abdominal semptomlar ile başvuran hastalarda batın BT incelemelerini değerlendirirken akciğer bazallerine dikkat edilmesi klinik olarak şüphelenilmeyen olgularda COVID-19 tanısını sağlayarak gerek erken tanı ve tedavide gerekse hastalığın yayılımını önlemede yarar sağlayabilir

Amac: Bu calismada amacimiz abdominal semptomlari olan hastalarda abdominal Bilgisayarli Tomografi (BT)’de koronavirus hastaligi (COVID-19) ile ilgili bulgulari bildirmektir. Yontem: Bu retrospektif calismaya Mart-Haziran 2020'den itibaren batin BT cekilen 40 eriskin hasta (22-88 yas) dahil edildi. Klinik bulgular, laboratuvar verileri ve goruntuleme bulgulari analiz edildi. Tum hastalar Revers-Transkriptaz Polimeraz Zincir Reaksiyonu (RT-PCR) ile dogrulandi. Bulgular: Bu calisma, karin agrisi, mide bulantisi, ishal ve anoreksiyasi olan, ancak COVID-19 ile uyumlu solunum semptomlari olmayan hastalari icermekte idi. Karin agrisi, klinik COVID-19 suphesi olmayan bu hastalarda (n = 31) en sik BT endikasyonuydu ve 32 hastada ekstrapulmoner bulgu yoktu. Sonuc: Abdominal semptomlar ile basvuran hastalarda batin BT incelemelerini degerlendirirken akciger bazallerine dikkat edilmesi klinik olarak suphelenilmeyen olgularda COVID-19 tanisini saglayarak gerek erken tani ve tedavide gerekse hastaligin yayilimini onlemede yarar saglayabilir

Objective: Liver fibrosis is a dynamic, reversible process that can result in liver failure. There has been considerable interest in developing noninvasive methods for diagnosis and staging. To investigate the diffusion and perfusion changes of the fibrotic liver parenchyma with conventional diffusion-weighted imaging (CDI), diffusion tensor imaging (DTI), and T2*weighted dynamic susceptibility contrast-magnetic resonance perfusion imaging (DSC-MRPI) at 3Tesla MR scanner. Methods: Twenty-seven patients with chronic viral hepatitis and 24 volunteers were evaluated, prospectively. The standard MRI protocols of the abdomen, CDI, and DTI were performed. Apparent diffusion coefficient (ADC) maps were obtained, D and FA values were calculated for DTI. Signal Intensity(SI)-time curves were obtained and “blood volume”(BV), “blood flow” (BF), “time to peak”(TTP), “mean transit time”(MTT) were measured. All patients with hepatitis underwent liver biopsy. The efficacy of diffusion and perfusion parameters used in the diagnosis of fibrosis was analyzed with the receiver operating characteristic curve (ROC). Results: Patients had significantly lower liver ADC when compared to the control group, either with CDI and DTI. D values obtained from DTI were lower in patients than those of the normal volunteers, and the difference was statistically significant. On DSC-MRPI; BF, BV, MTT, and TTP of the liver were lower than those of the control group but only BV and MTT values showed statistical significance. Liver ADC, D, and BV values had a negative correlation with fibrosis. Conclusion: The results showed that the D values obtained from DTI, BV, and MTT values obtained from DSC-MRPI can be an efficient diagnostic tool for liver fibrosis in patients with chronic hepatitis.

Purpose The present study investigated the effectiveness and applicability of superb microvascular imaging (SMI) in determining the degree of liver fibrosis noninvasively in comparison with shear wave elastography (SWE). Methods Ninety-eight consecutive patients with chronic hepatitis B who underwent ultrasound (US)-guided needle biopsy were examined using US combined with SMI and SWE. The predictive performance of the two US techniques in staging liver fibrosis and inflammation was compared with reference to the histological findings obtained from liver biopsy. The intraobserver and interobserver reproducibility of SMI in vascularity scores were evaluated. Results SWE values and SMI vascular scores were statistically significantly different among fibrosis stages (χ2(3)=76.3, χ2(3)=81.5, P<0.001). The SWE and SMI models significantly predicted fibrosis stages separately, and SMI scores alone predicted fibrosis stages better than SWE values (50.1% for SWE, 63.5% for SMI, P<0.001). A model with both SMI scores and SWE values together explained 73.2% of variance in fibrosis stages. When other clinical and laboratory predictors were added to the model (81.5%, P<0.001), SWE values and SMI scores remained the main predictors of fibrosis stages. SWE and SMI were also applicable in predicting inflammatory grades, explaining 31% and 34% of variance, respectively, and 37.7% when used together (P<0.001). Conclusion Both SWE and SMI had good diagnostic performance in determining the degree of liver fibrosis in chronic hepatitis B patients. The efficacy of SMI was better than that of SWE. SMI can improve diagnostic performance for staging liver fibrosis and shows potential for estimating necroinflammation of the liver.

Purpose: To investigate the diagnostic performance of Prostate Imaging-Reporting and Data System version 2.0 (PI-RADSv2.0) for differentiating clinically significant prostate cancer (csPCa) from benign prostate disease on prebiopsy multiparametric MRI stratified by total prostate specific antigen (PSA) concentration. Materials and methods: 150 patients who had prebiopsy mpMRI, serum PSA concentration and subsequent biopsy were retrospectively analyzed. Patients were stratified by PSA concentration (Group1 > 10 ng/mL; Group2 4.0-<10 ng/mL). MRI findings were assessed using PI-RADSv2.0 by two blinded radiologists. Lesions were graded histopathologically using the International Society of Urological Pathology (ISUP) score. Diagnostic performance of PI-RADSv2.0 was evaluated and compared to PSA and PSA Density (PSAD). The performance of the radiologists was compared including inter-observer agreement for PI-RADSv2.0. The correlation between imaging and histopathological biopsy results was analyzed. Results: The differences in total PSA, free/total PSA ratio and PSAD between benign (n = 78) and malignant (n = 72) groups were significant (p < 0.05). The PI-RADSv2.0 scores of the radiologists were strongly correlated (r = 0.912, p < 0.001) with excellent agreement, Kappa = 0.97 (95%CI: 0.90-1.03; p < 0.005). Receiver operating characteristics curve analysis showed significantly high predictive power for PI-RADSv2.0, total PSA and PSAD alone. Comparison of age, prostate volume, PSAD, free/total PSA ratio and total PSA values between ISUP1 and ISUP > 2 cases revealed significantly increased PSAD (p < 0.001) and total PSA (p = 0.001) in the ISUP > 2 group. Conclusion: PI-RADSv2.0 had high diagnostic accuracy in both PSA groups. PI-RADSv2.0, PSAD and total PSA alone had significant high predictive power to detect csPCa. However, the combination of PI-RADSv2.0 and PSAD or total PSA for each reader showed no statistically significant improvement when compared to PIRADSv2.0 alone.

PURPOSE:The purpose of this paper is to investigate whether the IVIM parameters (D, D *, f) helps to determine the molecular subtypes and histological grades of breast cancer. METHODS:Fifty-one patients with breast cancer were included in the study. All subjects were examined by 3 T Magnetic Resonance Imaging (MRI). Diffusion-weighted imaging (DWI) was undertaken with 16 b-values. IVIM parameters [D (true diffusion coefficient), D* (pseudo-diffusion coefficient), f (perfusion fraction)] were calculated. Histopathological reports were reviewed to histological grade, histological type, and immunohistochemistry. IVIM parameters of tumors with different histological grades and molecular subtypes were compared. RESULTS:D* and f were significantly different between molecular subtypes (p = 0.019, p = 0.03 respectively). D* and f were higher in the HER-2 group and lower in Triple negative (-) group (D*:36.8 × 10-3 ± 5.3 × 10-3 mm2/s, f:29.5%, D*:29.8 × 10-3 ± 5.6 × 10-3 mm2/s, f:21.5% respectively). There was a significant difference in D* and f between HER-2 and Triple (-) subgroups (p = 0,028, p = 0.024, respectively). D* was also significantly different between the HER-2 group and the Luminal group (p = 0,041). While histological grades increase, D and f values tend to decrease, and D* tends to increase. While the Ki-67 index increases, D* and f values tend to increase, and D tend to decrease. CONCLUSION:D* and f values measured with IVIM imaging were useful for assessing breast cancer molecular subtyping. IVIM imaging may be an alternative to breast biopsy for sub-typing of breast cancer with further research.

Amaç: Bu çalışmanın amacı, Kocaeli Üniversitesi’nde Mart-Haziran 2020 tarihleri arasında gerçek zamanlı ters transkriptaz-polimeraz zincir reaksiyonu (RT-PCR) testi pozitif olan koronavirüs hastalığı 2019’un (COVID-19) toraks bilgisayarlı tomografi (BT) görüntüleme bulguları ve farklılıklarını değerlendirmektir. Yöntem: Belirtilen tarihlerde COVID-19 şüphesi ile başvuran 1875 hastadan RT-PCR testi pozitif olan 189 hasta değerlendirildi. Dahil etme kriterlerine uygun 114 hastanın sosyodemografik verileri, semptom başlangıcı ile BT çekimi arasındaki süre, BT’deki akciğer bulguları Microsoft Office Excel'e kaydedildi. BT bulguları Radiological Society of North America (RSNA)’nın önerdiği raporlama diline uygun kategorize edildi. Bulgular: Çalışmaya dahil olan 114 hastanın 52’si (%45,6) kadın, 62’si (%54,4) erkekti. Tüm hastaların yaş ortalaması 46,4 (±17,2) olup 41 hastada (%35,9) tipik görünüm, 3 hastada (%2,6) atipik görünüm, 18 hastada (%15,7) belirsiz görünüm, 52 hastada (%45,6) ise normal BT bulguları mevcuttu. BT bulguları olan 62 hastanın 42’sinde (%67,7) bilateral akciğer tutulumu, 20’sinde (%32,3) unilateral akciğer tutulumu mevcuttu.15 hastada (%24,2) tek akciğer lobu tutulumu, 47 hastada (%75,8) birden fazla lob tutulumu izlendi. Tutulan loblardan en sık alt loblarda tutulum mevcuttu (%77,4, n=48). Hastaların %3,2’sinde (n=2) santral buzlu cam opasiteleri mevcut iken %96,8’inde (n=60) periferal buzlu cam opasiteleri izlendi. COVID-19 BT duyarlılığı %42,7 idi. Sonuç: Çalışmamızda COVID-19’un BT bulguları literatürle benzer şekilde multiple, bilateral ve periferal yerleşimli buzlu cam opasiteleri şeklinde iken duyarlılığı yeterli düzeyde değildir. Bu nedenle özellikle hastalığın erken dönemlerinde BT bulgusunun olmaması hastalığı dışlatmamalıdır.

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease with pain, hypertension and kidney damage. Many studies have demonstrated that vasopressin V2 receptor antagonists slow down cyst growth and kidney damage during the course of the disease. In this study, the initiation and follow-up parameters of our patients who were treated with tolvaptan were presented.

Abstract A 64-year-old man with lung cancer underwent 18F-FDG PET/CT for restaging, which demonstrated intense 18F-FDG uptake in the right lobe of prostate gland and seminal vesicles, indicating a potential prostate cancer. In 68Ga-PSMA PET/CT, intense uptake in the right lobe of prostate gland and seminal vesicles was also observed but decreased in postmictional delayed images. Magnetic resonance imaging showed high signal intensity of urine in the same areas of uptakes. 18F-FDG and 68Ga-PSMA PET/CT findings in the prostate gland and seminal vesicles were considered to be a result of urinary reflux possibly because of the patient’s previous transurethral resection.