New imaging techniques and trends in radiology - Diagnostic and Interventional Radiology

Background: MRI is successful in showing the anatomy of probable pathologies of the central nervous system. Although it may not be sufficient to reveal physiological and metabolic changes, advanced MRI techniques, such as perfusion and permeability MRI, are the key to overcoming these limitations. The aim of this study was to detect the efficacy of permeability and perfusion MRI techniques. Results: The study included 38 patients with a pathology result of primary brain glioma. The permeability MRI (Ktrans, Ve), perfusion MRI values (CBV, CBF), and pathology results were evaluated. The high-grade group included 22 patients, and the low-grade group, 16 patients. Mean CBV and CBF, median Ktrans, and Ve values were higher in the high-grade group. All parameters tended to elevate with grade and had a positive correlation. CBV > 2.25, with sensitivity and specificity of 100%, CBF > 2.02, with sensitivity and specificity of 100%, Ktrans > 0.043, with sensitivity of 81.82% and specificity of 100%, and Ve > 0.255, with sensitivity and specificity of 100%, can predict high grade. Conclusion: Perfusion and permeability MRI can be used safely for the differentiation of high- and low-grade gliomas and for the prediction of glioma grades.

Purpose: Lymphoid hyperplasia can be an important mimicker of acute appendicitis by creating a non-compressible appendix more than 6 mm in diameter. The aim of this study was to evaluate methods of distinguishing lymphoid hyperplasia and appendicitis on the basis of sonography, lamina propria thickness, and Alvarado scoring.Methods: This retrospective study included 259 patients (142 appendicitis, 117 lymphoid hyperplasia). The US (ultrasound) reports of the patients were reviewed and the maximum diameter of the appendix, the presence or absence of increased echogenicity of the surrounding pericaecal fat, local fluid collection, the presence of reactive lymph nodes in the periappendiceal area, and mural hyperemia within the appendix were recorded.Results: The use of additional sonographic criteria, lamina propria thickness (≤1 mm is indicative for appendicitis), or Alvarado scoring (>6 mm is indicative for appendicitis) provided a true-positive diagnosis for acute appendicitis.Conclusion: The presence of local fluid collection in the periappendiceal area and a lamina propria thickness ≤ 1 mm are the most successful parameters for distinguishing appendicitis from lymphoid hyperplasia.

Introduction: Developmental dysplasia of the hip (DDH) is still a common and important disorder of childhood, with a prevalence of 0.1 to 2/1000 children. Using ultrasonography (US) in screening of DDH reduces the rates of open reductions and complications. In the current study, we aim to detect the optimal time for US examination for detecting DDH to prevent unnecessary repeating US examinations and treatments. Methods: Children referred to US examination for a healthy child screening program, according to the health policy of our country, are included in the current prospective study. Both hips of each child were sonographically examined by the same radiologist using Graf's method at 4th, 8th, 12th weeks of life. Results: A total of 2020 hips of 1010 children were examined. Fourth-week US results can predict 12th-week results (right hip: sensitivity 100%, specificity 75.7%; left hip: sensitivity 100%, specificity 78.3%). Eighth-week US results can predict 12th-week results (right hip: sensitivity 100%, specificity 87.5%; left hip: sensitivity 100%, specificity 83.9%). In predicting 12th-week US results, 8th-week results are found to be more successful than 4th-week results. Conclusions: Late diagnosis of DDH might cause serious public health problems. On the other hand, early US examinations can result in false-positive diagnosis. Unfortunately, there is still confusion about the optimal time for DDH screening with US, especially among radiologists who are not specialized in DDH sonography. A US scan performed at eighth week of life can predict any pathology presence safely and correctly.