Veli Süha Öztürk

Background/Objectives: To evaluate the clinical and MRI characteristics of benign solitary schwannomas of the extremities, compare pre- and postoperative neurological symptoms, and identify preoperative and intraoperative risk factors for postoperative complications. Methods: A retrospective review was conducted on 47 patients with histopathologically confirmed benign solitary schwannomas of the extremities who underwent surgical excision. Demographic data, MRI characteristics (tumor volume, perilesional edema, and degenerative changes such as cystic components or intratumoral hemorrhage), fascicular relationship, and use of tru-cut biopsy were recorded. Pre- and postoperative neurological symptoms were compared. Univariate logistic regression analysis was performed to identify factors associated with postoperative complications. Results: The mean age was 38.6 ± 15 years, and the mean follow-up period was 109.8 ± 65.1 months. Lesions were predominantly located in the upper extremity (65.9%), with a mean volume of 9.6 ± 4.8 cm³; perilesional edema and/or degenerative changes were present in 53.1% of cases. Postoperative complications occurred in 19.1% of patients, with intrafascicular involvement being a significant predictor (OR = 5.4, p = 0.037) and a positive preoperative Tinel’s sign showing a trend toward significance (OR = 4.2, p = 0.084). Tumor volume, perilesional edema, degenerative changes, tru-cut biopsy, and anatomical location were not significantly associated with complications. At final follow-up, pain remission was 82.1%, and paresthesia improvement was 63.6%. Conclusions: Intrafascicular involvement was associated with postoperative complications in univariate analysis, whereas preoperative MRI characteristics, biopsy, and Tinel’s sign showed no predictive value for postoperative risk.

Background: This study aimed to investigate the association between femoroacetabular impingement (FAI) morphology and femoral head bone marrow edema of unknown etiology on hip magnetic resonance imaging (MRI), and to assess the added value of computed tomography-based three-dimensional maximum intensity projection (CT-MIP) measurements in identifying a predisposition to acetabular overcoverage. Methods: Hip MRI examinations performed between January 2007 and 2025 were retrospectively reviewed. Cases with bone marrow edema attributable to identifiable etiologies were excluded. Twenty-six patients with available hip or pelvis computed tomography (CT) examinations obtained within one year were included, along with an age- and sex-matched control group imaged for indications unrelated to hip pain. A total of 104 hip joints were evaluated. Alpha angles were measured on axial oblique CT reformations. Virtual pelvic radiographs generated from CT-based three-dimensional reconstructions were used for lateral center-edge angle (LCEA) measurements, and acetabular coverage was quantified using the acetabular coverage index derived from CT-MIP images. Appropriate statistical analyses were performed, with p < 0.05 considered statistically significant. Results: FAI was identified in 82.7% of cases with bone marrow edema of unknown etiology on MRI (p < 0.001), with pincer-type morphology being the most prevalent subtype (55.8%). Bone marrow edema was significantly more common in pincer-type FAI compared with other subtypes (p < 0.001) and predominantly involved the posterolateral femoral head. Mean alpha angle, LCEA, and acetabular coverage index values were significantly higher in the case group than in controls (p < 0.001). For the detection of pincer-type FAI, CT-MIP-based acetabular coverage index demonstrated superior diagnostic performance compared with LCEA (AUC, 0.917 vs. 0.855; p = 0.017), with an optimal cutoff value of 0.93 yielding high specificity and accuracy. All measurements showed excellent intraobserver and interobserver reliability. Conclusions: Femoral head bone marrow edema of unknown etiology may serve as a radiologic clue to underlying pincer-type FAI, while CT-MIP-based analyses may provide incremental value beyond conventional angular measurements in characterizing acetabular overcoverage.

To investigate the potential diagnostic value of point shear wave elastography (pSWE) and the contribution of concurrent diffusion weighted magnetic resonance imaging (DW-MRI) to diagnostic performance in patients with cervical lymphadenopathy. This cross-sectional study included 116 cervical lymph nodes of 94 patients. All lymph nodes were evaluated before the treatment or histopathological sampling. Gray scale ultrasonographic features, elastographic stiffness and apparent diffusion coefficient (ADC) values were measured and recorded. Lymph nodes were divided into benign and malignant groups with histopathological findings. Short axis measurement, axis ratio, hilum morphology, vascularization patterns, pSWE, and ADC values were the most significant parameters in logistic regression tests. The median stiffness of malignant nodes was higher and the mean ADC values were lower than others. Also, lymphoproliferative disorders had the lowest ADC values (p < 0.001). Area under the curve values for pSWE and DW-MRI were 0.852 [95% confidence interval (CI), 0.779–0.925], 0.790 (95% CI, 0.695–0.885), respectively. The accuracy rate increased from 79.3% to 85.3% when the pSWE was combined with the ultrasonography (US). The use of pSWE combined with conventional US will reduce the number of biopsies and may be sufficient to differentiate the lymph nodes.

Objectives: The aim of this study was to investigate the relationship between pathological classification of parotid gland tumors and conventional MRI – diffusion-weighted imaging findings and also contribute the possible effect of apparent diffusion coefficient (ADC) to diagnosis. Methods: 60 patients with parotid masses diagnosed using histopathology and/or cytology were enrolled in this retrospective study. All patients were evaluated using a 1.5 T MRI. Demographic features, conventional MRI findings, and ADC values (mean, minimum, maximum, and relative) were recorded. MRI findings and ADC values were compared between benign–malignant groups and pleomorphic adenoma vs Warthin’s tumor groups. Results: 60 tumors (48 benign, 12 malignant) were evaluated in a total of 60 patients (39 males, 21 females). The mean age was 59 (±14, 18–86) years old; the mean lesion size was 26 (±10, 11–61) mm. On the texture of conventional MRI, T2 dominantly hyperintense/with hypointensity signal was seen in 87% of pleomorphic adenomas and T2 dominantly hypointense/with hyperintesity signal was encountered in 64% of all Warthin’s tumors. Seven (28%) Warthin’s tumors were misdiagnosed as pleomorphic adenomas and two others (8%) as malignant tumors. The commonly used mean ADC value was 1.6 ± 0.6 × 10^–3 mm² s⁻¹ for benign tumors, 0.8 ± 0.3 × 10^–3 mm² s⁻¹ for malign tumors, 1 (0.9–1.8) × 10^–3 mm² s⁻¹ for Warthin’s tumors, and 1.9 ± 0.3 × 10^–3 mm² s⁻¹ for pleomorphic adenomas. There was a statistically significant difference in ADC values between benign-malignant tumors and pleomorphic adenomas-Warthin’s tumors. Conclusions: Warthin’s tumor may occasionally be misdiagnosed as pleomorphic adenoma and malignant tumor because of variable morphologic features. In addition to benign–malignant differentiation, the added ADC measurement may also be useful for differentiating Warthin’s tumors from pleomorphic adenomas.

J Indian Prosthodont Soc, Official publication of Indian Prosthodontic Society

Diagnostic and Interventional Radiology

Dir Journal Diagnostic and Interventional Radiology