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Purpose Baastrup’s disease is characterized by abnormal contact between adjacent spinous processes. Our study is the first to systematically incorporate the STIR sequence, recognized for its heightened sensitivity to fluid and edema, into the MRI protocol for diagnosing Baastrup’s disease in symptomatic individuals. The objective is to determine its prevalence and association with lumbar spinal degenerative changes. Materials and methods Lumbar spinal MRI examinations of 375 patients performed between January 2021 and 2022 were retrospectively reviewed by two radiologists. Baastrup’s disease was diagnosed based on meeting any of the following criteria: lumbar interspinous bursitis, hyperintense signal changes in adjacent spinous processes, and ligaments on the STIR sequence. The study also investigated the presence of degenerative changes and interreader agreement among radiologists. Results Baastrup’s disease was found in 141 of 375 individuals (37.8%). It correlated significantly with degenerative lumbar changes such as bulging ( P  = 0.0012), herniation ( P  = 0.0033), disc degeneration ( P  = 0.0013), Modic changes ( P  = 0.034), facet osteoarthritis ( P  = 0.0041), spinal stenosis ( P  = 0.005), and anterolisthesis ( P  = 0.0049). No significant associations were observed with gender ( P  = 0.468) or retrolisthesis ( P  = 0.167). Its occurrence increased gradually, peaking at 87.5% in individuals aged 80 and above. Radiologists showed complete agreement with Baastrup’s diagnoses. Conclusion Baastrup’s disease is more commonly observed than being considered rare, displaying an incremental occurrence with increasing age in symptomatic individuals notably discernible on the STIR sequence. Using the STIR sequence seems to promote a consensus among radiologists, irrespective of their experience levels.

etAmaç: Bu çalışmanın amacı prostat kanserinde transrektal gri skala ultrasonografi (US) bulguları ile tümörlerin malignite potansiyelleri arasındaki ilişkiyi incelemek ve transrektal renkli Doppler ultrasonografinin (RDUS) tanıya olan katkısını araştırmaktır.Gereç ve Yöntem: Çalışmamızda TRUS eşliğinde yapılan biyopsi sonrası prostat kanseri saptanan 63 olgu retrospektif olarak değerlendirilmiştir. Hastaların tümünde gri skala US, RDUS bulguları, serum PSA düzeyleri, patoloji sonuçları karşılaştırılmış ve aralarındaki ilişki araştırılmıştır.Bulgular: Orta diferansiye tümörler daha çok hipoekojenik iken (%69), kötü diferansiye tümörlerin mikst ekojenitede oldukları gözlenmiştir (%58). İzoekojenik tümörlerin tümü iyi ya da orta derece diferansiye grupta yer almışlardır. Toplam 65 kanser odağının 11’inde (%17) Doppler bakıda kanlanma saptanmazken (derece 0), 8’inde (%12) 1. derece ve 46’sında (%71) 2. derece kanlanma izlenmiştir. Lezyonların kanlanma derecesi arttıkça PSA değerlerinin belirgin olarak arttığı belirlenmiştir. Tümörlerin Gleason skorları ile kanlanma dereceleri arasında da önemli bağlantılar tespit edilmiştir. RDUS ile kanlanma saptanmayan lezyonların tamamı iyi ya da orta derece diferansiye kanser grubundadır. Buna karşın belirgin kanlanma saptanan kanserlerin büyük çoğunluğu (%98) orta ya da kötü diferansiye grupta yer almaktadır.Sonuç: Prostat kanseri saptanmasında RDUS’nin gri skala US’ye ilave katkısı bulunmamıştır. Ancak gri skala US ile kuşkulu lezyonların manifest hale gelmesine katkıda bulunduğu gözlenmiştir. Kanserlerin kanlanma dereceleri ile Gleason skorları arasında önemli bağlantılar dikkati çekmiştir. Buna göre RDUS ile belirgin kanlanma gösteren kanserlerin, kanlanmayan ya da minimal kanlanma izlenen kanserlere göre daha yüksek maligniteye sahip oldukları gözlenmiştir.

Non-thrombotic pulmonary embolism (NTPE) results from the embolization of non-thrombotic materials. It can often be a challenging diagnosis due to non-specific (similar to thrombotic pulmonary embolism) or uncommon clinical and imaging findings. Patients with NTPE often present to the emergency department with acute respiratory distress, and contrast-enhanced computed tomography (CT) of the chest and CT pulmonary angiography are the imaging modalities of choice for respiratory distress. Since the treatment of NTPE is entirely different from thromboembolism, its distinction is essential. Moreover, early diagnosis of NTPE is necessary. Radiologists must be familiar with the diagnostic findings of NTPE, and this article aims to review the imaging features of various causes of NTPE.

This study aims to demonstrate the effect of gamma knife radiosurgery (GKRS) on symptoms, hemorrhage rates, and histopathological changes in patients with cavernous malformations (CMs), regardless of whether the symptomatic lesions are hemorrhagic. This single-center retrospective study evaluated symptomatic patients with single CMs treated with GKRS between 2016 and 2023. The patients’ demographic data, presenting symptoms, GKRS radiation dose, complications developed during follow-up (hemorrhage, radiotoxicity), the rate of symptom improvement, and histopathological changes of surgically removed CMs were recorded. Our study included 134 symptomatic patients, of whom 55 were male (41%) and 79 were female (59%). Among the patients, 80 (59.7%) had CMs in the lobar region, 23 (17.1%) in the cerebellum, 16 (12%) in the brainstem, and 15 (11.2%) in the basal nuclei/thalamus. The mean target volume was 0.64 ± 1.23 cm 3 , and the mean tumor margin dose was 14.89 ± 1.90 Gy. Symptoms were completely recovered in 95 patients (70.9%), while 18 (13.4%) experienced partial recovery. The annual hemorrhage rate (AHR) reduced from 6.26 to 1.01 following GKRS. Adverse radiation effects (ARE) were encountered in ten patients (7.46%) of cases, with only three patients (2.2%) being permanent. The mean follow-up period was 35.57 ± 23.54 months (2–83 months). Two patients without hemorrhage underwent surgical removal of CM due to symptomatic deterioration after GKRS. Histopathological examination demonstrated numerous vascular structures with luminal narrowing due to hyalinization and fibrinoid necrosis caused after GKRS. Our findings suggest that GKRS may help reduce hemorrhage rates and potentially relieve symptoms in patients with symptomatic CMs, although further long-term studies are necessary to confirm these observations and to fully assess potential risks. Since there is no radiological method to evaluate the impact of GKRS on CMs, our study examines the histopathological changes that occurred following the GKRS. The histopathological changes prove that GKRS alters the morphology of the CMs and thus can relieve symptoms and reduce hemorrhage rates associated with CMs.

Conclusion: EU-TIRADS is an easy tool to apply and it is reliable in prediction of malignancy risk of thyroid nodules. Results: FNAB was performed in 196 nodules. Twenty-seven (14%) nodules were histopathologically diagnosed as malignant. The risk of malignancy of TIRADS 2, 3, 4, and 5 was 0%, 2.2%, 5.1%, 59,5%, respectively. Considering TIRADS 2, 3, and 4 as probable benign and TIRADS 5 as probable malignant, the sensitivity, specificity, positive predictive value, and negative predictive value were found to be as 0.82, 0.91, 0.60, and 0.97, respectively. The overall accuracy of ultrasound was determined as 0.90. Materials and methods: In all, 156 patients who underwent ultrasound-guided FNAB of thyroid between May 2013 and May 2016 were included in this retrospective study. Ultrasound images were reviewed, and ultrasound-guided FNAB results were obtained. With the use of EU-TIRADS classification, each nodule was categorized as TIRADS from 1 to 5 according to its ultrasound features. Purpose: It is essential to predict the malignancy risk in thyroid nodules. For this purpose, thyroid imaging reporting and data system (TIRADS) classification system can be used to evaluate malignancy risk and plan the treatment strategy. The aim of this study is to evaluate the clinical feasibility and reliability of European-TIRADS (EU-TIRADS) classification.

Amaç: Ultrason elastografi tiroid nodüllerini değerlendirmeye yarayan non-invaziv ultrason tekniği olup dokunun sertlik ve elastikiyetini inceler ve baskı ile yumuşak dokuların sert dokulara göre daha kolay deforme olabilmesi prensibine dayanır. Dokunun deforme olabilme özelliği malign ve benign lezyonların ayırımında kullanılır. Bu çalışmanın amacı benign ve malign tiroid nodüllerini ayırmada elastografinin tanı değerini araştırmaktır.Gereç ve Yöntem: Yüzyetmişüç hastada 173 tiroid nodülü ince iğne aspirasyon biyopsisi öncesi gri skala ultrasonografi ve elastografi ile incelenmiştir. Elastografi sonuçları ince iğne aspirasyon biyopsisi sonuçları ile karşılaştırılarak, tiroid nodüllerine uygulanan elastografinin duyarlılık, özgüllük, pozitif ve negatif öngörü değerleri hesaplamıştır.Bulgular:Histopatoloji sonuçları 162 olguda (% 93,6) benign, 11 olguda(% 6,4) malign olan nodüller için elastografinin karsinom belirlemedeki duyarlılığı % 45,4, özgüllüğü % 55,5, pozitif öngörü değeri % 6, negatif öngörü değeri % 94 olarak bulundu. Bu değerlere göre elastografi benign ve malign tiroid nodüllerinin ayırımında istatistiksel olarak anlamlı bulunmamıştır (p>0,005).Sonuç: Bizim çalışmamızda tiroid nodüllerinin preoperatif tanısında elastografinin duyarlılık ve özgüllük değerleri önceki çalışmalara göre daha düşük bulunmuştur. Buna göre tiroid nodüllerinin değerlendirilmesinde biyopsi halen en güvenilir tanı yöntemi olarak geçerliliğini korumaktadır.

Introduction: Diaphragm thickness (DT) measurement in computed tomography (CT) has become popular in recent years. Our aim was to assess the intra- and inter-observer agreement of DT measurement and to investigate the best points for DT assessment in CT based on the most reliable measurement. Methods: Thoraco-abdominal CT angiography scans of 44 patients (23 males, mean age: 49.9±17.8 years) were retrospectively evaluated. All of the CT images were evaluated independently by four radiologists. Each observer evaluated images twice to assess intra-observer reproducibility. On both axial and coronal reconstructed CT images, the crura of 88 hemidiaphragms were measured at five different points. A p value less than 0.05 was considered to indicate statistical significance. Intra- and inter-observer agreement was evaluated by using intraclass correlation coefficient (ICC) scores with a 95% confidence interval. Results: In intra-observer analysis, ICC scores demonstrated substantial to almost perfect agreement for all measurements (ICC score range: 0.758-1). When we analyzed the inter-observer agreement, there was a moderate to almost perfect agreement for each measurement point (ICC score range: 0.523-0.895). All axial measurements showed the highest inter-observer agreement (ICC scores were 0.926 and 0.886 for first and second measurements, respectively). The maximum inter- and intra-observer agreement for single point DT measurements were found in maximum DT at the level of the origin of the celiac artery and in anterior DT at the level of the upper part of the L1 vertebral body. Conclusion: CT is a reliable tool DT measurement with excellent intra- and inter-observer agreement.