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Primer Sinovial Osteokondramotoziste Manyetik Rezonans Görüntüleme Bulguları

Şahin, Burcu | Aktaş, Elif | Arıkan, Murat | Toğral, Güray | Çiledağ, Nazan | Çağlar, Emrah | Arıbaş, Bilgin Kadri

Article | 2017 | ACTA ONCOLOGICA TURCICA50 ( 3 ) , pp.238 - 241

Giriş ve Amaç: Sinoviyal osteokondramatozis sinovial dokunun mezenkimal kalıntılarının kartilajinöz metaplazisi sonucu gelişir. Genellikle eklem aralıklarında ve tenosinoviyumda kalsifiye kartilajinöz oluşumlar ile karakterizedir. Tek eklem tutulumu yapar ve sıklıkla diz, kalça ve el bileği tutulur. Nadir de olsa kondrosarkoma malign dejenerasyon gösterebilmektedir. Patolojik olarak ispatlanmış farklı anatomik lokalizasyonlardaki sinoviyal osteokondromatozisli on olgumuza ait MR bulgularını sunmayı amaçladık. Yöntem ve Gereçler: Sinoviyal osteokondromatozis tanısı almış on olgunun MR incelemeleri retrospektif olarak iki farklı radyo . . .log tarafından birlikte tekrar değerlendirildi. Hastaların demografik ve klinik özellikleri ve lezyonların yerleşimi, şekli, uzanımı ve MR sinyal özellikleri değerlendirildi. Bulgular: Tanı alan 10 olgunun 6'sı erkek,4'ü kadın olup yaş ortalaması 50 bulunmuştur.(14-70 yaş) Hastaların geliş yakınmaları eklem ağrısı (n: 5), şişlik (n: 5) olarak belirtilmiştir. İki lezyon ayak bileğinde, 4 lezyon diz ekleminde, 2 lezyon omuz ekleminde ve 1 lezyon kalça ekleminde ve 1 lezyon dirsek ekleminde tespit edilmiştir. Röntgenografide tüm olguların ilgili eklem aralığında milimetrik noduler kalsikasyonlar izlenmiştir. Sadece 1 olguda kemik tutulumu da izlenmiştir. Omuz eklemi tutulumu olan olgularda ekstraartikülerbursal ve tenosinovial tutulum da izlenmiştir. Kalça eklemi tutulan olguda iliopsoas ve eksternalobturatuar bursalar da tutulmuştur. Tartışma ve Sonuç: Sinoviyal osteokondromatozisin direkt grafi ve MR bulguları genellikle tipiktir. Sinoviyal osteokondromatoziste MR intraartiküler lezyonun bursalara uzanımını ve kemik erozyonlarını göstermekte de oldukça başarılıdır. Introduction: Primary synovial chondromatosis is an uncommon benign monoarticular disorder. It is characterized by proliferation and metaplastic transformation of the synovium. It is generally characterized by calcified cartilagenous structures in the joint space or in the tenosynovium. It involves one joint and knee, hip, wrist are commonly affected joints. Malignant degeneration into chondrosarcoma has been reported but is rare. Here, we aimed to present MR images of 10 patients with primary synovial osteochondromatosis. Material and Methods: We retrospectively reviewed 10 pathologically confirmed cases of synovial chondromatosis. Patients' demographics and clinical presentations were reviewed. Imaging was evaluated by two musculoskeletal radiologists with agreement by consensus. Images were evaluated for lesion location, shape, extent and signal characteristics on MR. Results: Among the ten patients, 6 were male, 4 were female with a mean age of 50. (14-70 years) Lesion locations included knee (n=4), ankle (n = 2), shoulder (n = 2), elbow (n = 1), hip (n = 1). Radiographs commonly showed milimetric nodular calcifications. Only one lesion involved adjacent bone. The two patients with shoulder involvement also involved extraarticular bursa and tenosynovium. The case with the hip involvement also involved iliopsoas and external obturator bursa. Discussion and Conclusion: The radiographic and magnetic resonance imaging findings of synovial osteochondromatosis is typical. MRI is successful in determining the bone erosions and bursal extent of the intraarticular lesion Daha fazlası Daha az

Preoperative Evaluation of Lymph Node Metastases in Patients with Gastric Cancer: An Analysis of Imaging Methods

Günay, Yusuf | Çağlar, Emrah | Korkmaz, Esin | Erdemir, Rabiye Uslu | Taşdöven, İlhan | Kozan, Ramazan

Article | 2018 | ACTA ONCOLOGICA TURCICA51 ( 3 ) , pp.276 - 282

INTRODUCTION: Preoperative evaluation is necessary for the surgical treatment of gastric cancer (GC). Nonetheless, there is no single best diagnostic modality to predict lymph node metastases prior to surgery. The aim of this study was to analyze of the diagnostic utility of positron emission tomography-computed tomography (PET-CT) and CT for the preoperative evaluation of lymph node (LN) metastases in GC. METHODS: Eighty seven patients with a history of GC, who underwent gastrectomy and D2 LN dissection were investigated. Imaging test results and pathology reports were collected from the patients’ charts. RESULTS: There was no stat . . .istical differences between PET/CT and CT scans in regard to predicting LN metastases in GC patients (p>0.05). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT scans in predicting LN metastases were 55.56%, 54.55%, 55.26%, 75%, and 33.3%, respectively, versus 60.47%, 57.69%, 59.42%, 70.27%, and 46.88% for CT scans, respectively. However, combined PET/CT and CT showed better outcomes and specificity with a PPV of 80% and 88.9%, respectively. No patients or tumor factors were found to increase the accuracy of LN metastasis prediction using either PET/CT or CT scans. DISCUSSION AND CONCLUSION: The combination of CT and PET/CT scans increases the specificity and PPV. This increases the prediction accuracy of LN metastasis in GC patients compared to the use of each type of imaging modality alone. INTRODUCTION: Preoperative evaluation is necessary for the surgical treatment of gastric cancer (GC). Nonetheless, there is no single best diagnostic modality to predict lymph node metastases prior to surgery. The aim of this study was to analyze of the diagnostic utility of positron emission tomography-computed tomography (PET-CT) and CT for the preoperative evaluation of lymph node (LN) metastases in GC. METHODS: Eighty seven patients with a history of GC, who underwent gastrectomy and D2 LN dissection were investigated. Imaging test results and pathology reports were collected from the patients’ charts. RESULTS: There was no statistical differences between PET/CT and CT scans in regard to predicting LN metastases in GC patients (p>0.05). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT scans in predicting LN metastases were 55.56%, 54.55%, 55.26%, 75%, and 33.3%, respectively, versus 60.47%, 57.69%, 59.42%, 70.27%, and 46.88% for CT scans, respectively. However, combined PET/CT and CT showed better outcomes and specificity with a PPV of 80% and 88.9%, respectively. No patients or tumor factors were found to increase the accuracy of LN metastasis prediction using either PET/CT or CT scans. DISCUSSION AND CONCLUSION: The combination of CT and PET/CT scans increases the specificity and PPV. This increases the prediction accuracy of LN metastasis in GC patients compared to the use of each type of imaging modality alone Daha fazlası Daha az

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