Journal of Bionic Memory

Minimally invasive surgery in primary hyperparathyroidism

Adil Koyuncu — 2023-03-05

Aim: To describe the general and laboratory characteristics of patients with primary hyperparathyroidism (PHPT) who underwent surgery in our clinic, as well as surgery-related morbidity.

Methods: The study population were selected: Patients with clinical and radiological diagnosis of PHPT were included in the study. Minimal invasive parathyroid surgery, aimed only the affected gland, was chosen for the patients. Preoperative calcium (Ca), parathyroid hormone (PTH), and postoperative Ca and PTH levels were recorded. Preoperative sonography and scintigraphy studies to determine localization were obtained from the same database.

Results: 116 patients were undergone minimal invasive surgery for hyperparathyroidism, which is mainly focused on the pathological gland. The mean preoperative PHT was 397 ng/L and postoperative PTH was 53 ng/L. Preoperative and postoperative Ca levels were 11.7 mg/dL and 9.3 mg/dL, respectively. Histopathological evaluation revealed following results: 108 patients had adenoma. None of the subjects had malignancy. The mortality rate was 0% and the morbidity was 1.7%, related to this procedure.

Conclusion: According to the data in present study, we suggest that minimally invasive surgical techniques should be preferred in sake of higher success and lower postoperative morbidity in patients with a single gland disease.

The role of diffusion-weighted imaging and ADC value in head and neck lesions

Zeliha Cosgun — 2023-03-05

Aim: To evaluate the contrast enhanced magnetic resonance imaging (MRI), diffusion weighted MRI findings of head and neck lesions in combination with histopathological diagnosis.

Method: Forty-two patients referred to our university, department of Radiology between July 2008 and June 2011 with a prediagnosis of head-neck lesion. Patients whom underwent contrast enhanced MRI, diffusion weighted MRI, and incisional or excisional biopsy, were included in the study. Patients, whose MRI examinations were suboptimal due to any artefacts, were excluded. After determination of MRI parameters, such as signal intensity, enhancement pattern, apparent diffusion coefficient (ADC) value, and contrast enhanced MRI and diffusion weighted MRI examinations were evaluated by a radiologist who had ten years of experience. Histopathological evaluation was made by a pathologist who had no information about patients’ MRI findings.

Results: The mean ADC value of benign and malignant lesions were 0.128x10-3±0.053 mm²/sn and 0.100x10-3±0.026mm²/sn respectively. ADC value was found to be significantly higher in benign lesions compared to malignant ones (p=0.032). Conventional MRI criteria such as signal intensity, internal structure, presence of cystic space and enhancement were found to be insignificant in the differentiation of benign and malignant lesions.

Conclusion: Conventional MRI sequences are important in the diagnosis of head and neck lesions but not sufficient due to the overlapping findings. Diffusion weighted MRI, applied in addition to conventional MRI examination, is an efficient technique and has additional diagnostic value in determining nature of head and neck lesions in the preoperative period.

Assessment of the effectiveness of low-dose chest computed tomography in the diagnosis of COVID-19 pneumonia

Melike Elif Kalfaoglu — 2023-05-21

Aim: To determine whether low-dose chest computed tomography (CT) imaging protocol is appropriate in terms of technical success and radiation safety, by comparing it with standard protocols in terms of reaching diagnosis and X-ray exposure. Additionally, to investigate radiation dose criteria in patients undergoing CT scan for COVID-19.
Method: CT scans of 149 patients diagnosed with COVID-19 between January 2022 and March 2023 were analyzed. Patients were randomly assigned to either a standard protocol or a low-dose protocol. Factors such as technical success, diagnostic accuracy, exposure dose and side effects were analyzed.
Results: A statistically significant difference was found between low-dose and standard-dose CT scans for tube current-time product (p<0.001), CTDI (p<0.001), DLP (p<0.001), effective dose (p<0.001). , and cancer risk (p<0.001).
Conclusion: The low-dose CT protocol in COVID-19 patients yields similar results to standard protocols in terms of technical success and diagnostic accuracy, while significantly reducing exposure dose. Therefore, the use of low-dose protocol can be considered as an option to reduce the radiation dose that patients are exposed to.