BACKGROUND The aim of this study was to define clinical evidence supporting that triple rule-out computed tomography angiography (TRO CTA) is a comprehensive and feasible diagnostic tool in patients with novel coronavirus disease 2019 (COVID-19) who were admitted to the emergency department (ED) for acute chest pain. Optimizing diagnostic imaging strategies in COVID-19 related thromboembolic events, will help for rapid and noninvasive diagnoses and results will be effective for patients and healthcare systems in all aspects. AIM To define clinical evidence supporting that TRO CTA is a comprehensive and feasible diagnostic tool in COVID-19 patients who were admitted to the ED for acute chest pain, and to assess outcomes of optimizing diagnostic imaging strategies, particularly TRO CTA use, in COVID-19 related thromboembolic events. METHODS TRO CTA images were evaluated for the presence of coronary artery disease, pulmonary thromboembolism (PTE), or acute aortic syndromes. Statistical analyses were used for evaluation of significant association between the variables. A two tailed P -value < 0.05 was considered statistically significant. RESULTS Fifty-three patients were included into the study. In 31 patients (65.9%), there was not any pathology, while PTE was diagnosed in 11 patients. There was no significant relationship between the rates of pathology on CTA and history of hypertension. On the other hand, the diabetes mellitus rate was much higher in the acute coronary syndrome group, particularly in the PTE group (8/31 = 25.8% vs 6/16 = 37.5%, P = 0.001). The rate of dyslipidemia was significantly higher in the group with pathology on CTA while compared to those without pathology apart from imaging findings of the pneumonia group (62.5% vs 38.7%, P < 0.001). Smoking history rates were similar in the groups. Platelets, D-dimer, fibrinogen, C-reactive protein, and erythrocyte sedimentation rate values were higher in COVID-19 cases with additional pathologies. CONCLUSION TRO CTA is an effective imaging method in evaluation of all thoracic vascular systems at once and gives accurate results in COVID-19 patients.

No abstract

BACKGROUND Chronic otitis media (COM) is an inflammatory disease that lasts for a long time. It is common in developing countries. Hearing loss can result from COM. The relationship between variations in middle ear anatomy and COM was investigated in our study. AIM To compare the prevalence of middle ear anatomic variations between the cases with COM and healthy individuals. METHODS This retrospective study included 500 patients with COM and 500 healthy controls. The presence of those variants was determined: Koerner’s septum, facial canal dehiscence, high jugular bulb, jugular bulb dehiscence, jugular bulb diverticulum, sigmoid sinus anterior location and deep tympanic recesses. RESULTS A total of 1000 temporal bones were examined. The incidences of these variants were respectively (15.4%-18.6%), (38.6%-41.2%), (18.2%-4.6%), (2.6%-1.2%), (1.2%-0%), (8.6%-0%), (0%-0%). It was observed that only high jugular bulb ( P < 0.001) and anteriorly located sigmoid sinus frequencies ( P = 0.002) in the case group were statistically significantly higher than the control groups. CONCLUSION COM is a multifactorial disease and variants of middle ear have always been important in terms of potential risk for complication during surgery but rarely associated with COM as an etiology or as a consequence of the disease. We didn't find a positive correlation between COM and Koerner’s septum and facial canal defect. We ended up with a significant conclusion with the variants of dural venous sinuses -high jugular bulb, dehiscence of jugular bulb, diverticulum of jugular bulb and anteriorly located sigmoid sinus- that have been studied less and frequently associated with inner ear illnesses.

No abstract

Aim: Morel-Lavallée syndrome (MLS) is a serious posttraumatic soft tissue injury in which the subcutaneous tissues are separated from the underlying fascia by glove-finger (closed type) peeling and replaced by a cavity filled with hematoma and fat. It is most commonly seen in the trochanter major, but it can also be found in the flank, hip, and lumbodorsal regions. The goal of this study is to define the typical findings of MLS in order to avoid misdiagnosis and delay in patient treatment. Material and Method: This retrospective study was approved by the Institutional Review Board. Informed consent was waived due to the retrospective nature of the study. Between 2015 and 2021, MR images and clinical follow-ups of 22 pediatric patients with clinical and radiological Morel-Lavallée lesions (MLL) were reviewed retrospectively. All patients were evaluated using 1.5T or 3T power MR devices (Siemens Healthineers, Erlangen, Germany). Results: Of 22 patients diagnosed with MLS, 77% (n=17) were male and 23% (n=5) were female. Patients ranged in age from 7 to 18 years, with a mean of 13.2 years (+/-2,3). The locations of MLL were knee (77%, n=17, 15 patients had anterior knee and 2 patients had posterior knee involvement), hip (14%, n=3) and thigh (9%, n=2) in order of frequency. These lesions all had a similar ovoid shape. The majority of patients (18/22) received solely conservative management but three patients underwent percutaneous drainage. Conclusion: In our study, the importance of differential diagnosis of MLL from traumatic collections and the importance of MRI findings in diagnosis and treatment were discussed. Accurate diagnosis and treatment of MLL are critical, as the lesion's size may increase as a result of delayed treatment, causing skin necrosis and denervation due to the mass effect.