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A 20-year-old female patient was presented with a bilateral epiphora. She had no history of infection or trauma related to the sinus areas. On examination, her facial appearance was abnormal and fullness on the face was observed. The fluorescein dye disappearance test was positive in both eyes. The lacrimal system irrigation was patent nasolacrimal duct. However, the dacryoscintigraphy imaging scan demonstrated bilateral obstruction at the nasolacrimal duct-inferior meatus junction. Nasal endoscopy did not reveal any pathologic findings, and lateral nasal wall, septum, and nasal cavities were normal. The patient was referred to the radiology department for a computed tomography of the paranasal sinus as a preoperative diagnostic imaging for lacrimal intervention. Computed tomography revealed the absence of all paranasal sinuses on both sides as well as absence of the ostiomeatal complex and ethmoidal air cells. Both bony lacrimal canal was narrow. Epiphora may be initial sign of total paranasal sinus aplasia.

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Öz Purpose:The aim of this study was o assess the relationship between lung volume decrease and computed tomography (CT) findings in patients with COVID-19 pneumonia in early period. Materials and Methods: Fifty-four patients were included in the study. The lung volume (LV) was calculated separately for each lung by software-based quantitative CT (QCT). Patient demographics, comorbidity and smoking status, CT findings, visual semi-quantitative CT severity scoring (CT-SS), and decrease of LV were analyzed. Results: The rate of volume decrease was not statistically related to, age, gender, smoking, or hospitalization status. When the correlation between follow-up CT (FUCT) LV and CT-SS was examined there were good inverse correlation on the right lung (r = -0.583; p = 0.001) and left lung (r = -0.478; p = 0.001). The rate of decrease in the right LV was significantly higher in patients with comorbidities compared to other patients. There was a statistically moderate inverse correlation between decrease of LV and CT-SS in the right lung (r = -0.294; p = 0.031), and no significant correlation was found between the decrease of LV and CT-SS in the left lung (r = -0.096; p = 0.489). Conclusion:The rate of lung damage and associated volume decrease both increase with the amount of parenchymal involvement in patients with COVID-19 pneumonia. This change is more frequent in patients with multiple comorbidities. Accurate interpretation of CT findings with quantitative data can help physicians to manage the disease.Amaç: Bu çalışmanın amacı COVID-19 pnömonisi olan hastalarda erken dönemde akciğer hacim azalması ile bilgisayarlı tomografi (BT) bulguları arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntem: Çalışmaya inceleme kriterlerini karşılayan elli dört hasta dahil edildi. Hastaların her bir akciğeri için yazılım tabanlı kantitatif BT ile ölçüm yapılarak akciğer hacimleri hesaplandı. Hastalara ait demografik veriler, komorbidite ve sigara içme durumu, BT'deki inflamasyon bulguları, akciğer parankimindeki tutulum miktarını gösteren BT şiddet skorlaması ile ilk ve takip BT'lerindeki akciğer hacmindeki değişiklikler (azalma) arasındaki ilişki değerlendirildi. Bulgular: Hacim azalma oranı, yaş, cinsiyet, sigara içme veya hastanede yatış durumu ile istatistiksel olarak ilişkili değildi. Takip BT lerinde akciğer hacmi ve ciddiyet skorlaması arasındaki korelasyon incelendiğinde, sağ akciğerde (r = -0.583; p = 0.001) ve sol akciğerde (r = -0.478; p = 0.001) iyi derecede ters korelasyon vardı. Sağ akciğer hacmindeki azalma oranı komorbiditesi olan hastalarda diğer hastalara göre anlamlı derecede yüksekti. Sağ akciğerde hacim kaybı ile ciddiyet skoru arasında istatistiksel olarak orta derecede ters korelasyon varken (r = -0.294; p = 0.031) ve sol akciğerde anlamlı bir korelasyon bulunmadı (r = -0.096; p = 0.489). Sonuç: COVID-19 pnömonisi olan hastalarda parankimal tutulum miktarı ile birlikte akciğer hasarı oranı ve buna bağlı hacim azalması artar. Bu değişiklik komorbiditesi olanlarda daha sık görülmektedir. BT bulgularının ni...

Objectives:The purpose the study was to evaluate the role of diffusion weighted magnetic resonance imaging (DW-MRI) in diagnosis of benign and malignant breast lesions, to calculate a cut-off apparent diffusion coefficient (ADC) value and to explore use of relative ADC (r ADC) for improving sensitivity and specificity of MRI in diagnosis of breast cancer. Methods: This retrospective study based on a cohort of patients who underwent dynamic contrast enhanced (DCE)-MRI having suspicious breast mass by ultrasonography and mammography to whom DWI sequence was added to the routine diagnostic MRI. ADC and r ADC (lesion/normal breast tissue) values of breast masses were calculated. The threshold ADC values used to differentiate benign and malignant lesions were determined using receiver operating characteristic analysis, sensitivity, specificity, positive predictive value and negative predictive value were calculated. Results: Malignant masses had significantly lower ADC (mean: 1.03 ± 0.36 × 10 -3 mm 2 /s) and r ADC (mean: 0.66 ± 0.22 × 10 -3 mm 2 /s) values than those of benign masses with ADC (mean: 1.50 ± 0.56 × 10−3 mm 2 /s) and r ADC (mean: 0.97 ± 0.31 × 10 -3 mm 2 /s) values, respectively (p = 0.001 for both). The best cut-off value for the lesion ADC was 1.09 × 10 -3 mm 2 /s with a sensitivity of 72.73%, and specificity of 79.17%. The best cut-off value for r ADC was 0.83 with sensitivity of 78.79% and specificity of 70.83%. Conclusions: DWI has high diagnostic value with high sensitivity and specificity differentiating benign and malignant breast lesions. ADC and r ADC values can improve the diagnostic accuracy of differentiating benign and malignant breast lesions.