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Objective: To investigate the frequency of previously defined neuroimaging signs of normal pressure hydrocephalus in our NPH patient group with positive cerebrospinal fluid (CSF) tap test response. Methods: Twenty-two patients with probable NPH and 33 healthy control individuals were enrolled in this study. Previously defined 9 parameters including Evan’s index, narrow high convexity sulci, dilation of the Sylvian fissures, focally enlarged sulci, enlargement of the temporal horns, callosal angle, periventricular hyperintensities, bulging of the lateral ventricular roof, and disproportionately enlarged subarachnoid space hydrocephalus were evaluated on conventional magnetic resonance imaging. A total radiological score was formed in both groups. The total radiological score, scores, and frequency of each radiological parameters were compared between patient and healthy control groups. Results: The mean age of the patient group was 67.31 ± 7.27 (F/M ratio was 7/15), whereas it was 69.09 ± 4.89 (F/M ratio was 11/22) in healthy control group. The result of these analyses revealed that scores of all the radiological parameters, except callosal angle score, were found to be higher in NPH patient group. The parameters with the highest positive predictive values were narrow high convexity sulci, narrowing of callosal angle, and DESH (100%, 100%, and 100%, respectively). On the other hand, enlargement of temporal horns had the highest negative predictive value among all parameters (96%). Conclusion: The results of our study support the use of neuroimaging parameters as an alternative method for CSF tap test. We suggest that in the presence of narrow high convexity sulci and/or narrowing of callosal angle, the decision of shunt surgery may be made in patients with suspicion of NPH, without performing CSF tap test. Confirmation of these results, in the future, large-scale studies may certainly provide critical perspectives to be used in the clinical practice.

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Akut rinosinüziti kronik rinosinüzitten klinik olarak ayırt etmek zordur ve bugüne kadar her iki durumda da benzer görünen hava-sıvı seviyesi veya opaklaşma ile radyolojik olarak değerlendirilebilirler. Amacımız, klasik radyolojik yaklaşımlarla birlikte hava dansitesinin analizinin, akut ve kronik rinosinüzit arasında ayrım yapmak için yeni bir araç olarak kullanılıp kullanılamayacağını incelemekti. Yöntem: Bu retrospektif çalışma paranazal sinüs çok kesitli bilgisayarlı tomografi (ÇKBT) yapılan 550 hastada toplam 2419 sinüs içermekteydi. Hastalar sinüs durumlarının klinik tanısına göre üç gruba ayrıldı: grup 1 (n = 176) akut enfeksiyonlu, grup 2 (s = 191) kronik rinosinüzitli hastaların oluşturduğu ve grup 3 (s = 181) sağlıklı sinüslerin oluşturduğu gruptur. Herbir gruptaki paranazal sinüsler içerisindeki ortalama hava yoğunluğu ve standart sapma, hava ile dolu sinüsün merkezindeki 0.5 cm2 lik ilgili alan (ROI) sinüs duvarı hariç olmak üzere hesaplandı ve ölçüm takip eden 4-6 BT kesitinde tekrarlandı. Bulgular: Ortalama hava dansitesi grup 1'de grup 2 ve 3 ile karşılaştırıldığında anlamlı olarak yüksekti (sırasıyla -810 HU, -973 HU ve -1010 HU; p <0.05) ve SD (89.3 HU, 21.1 HU ve 20.9 HU sırasıyla; p <0.05). Sonuç: Paranazal sinüslerde artmış hava yoğunluğu akut rinosinüzitin kronik rinosinüzitten ayrılmasında yardımcı olabilir.

Background: To evaluate the perfusion status of patients with acute stroke, different imaging tools are used depending on condition. CT-CT Angiography and MRI are indispensable imaging tools to diagnose and manage stroke patients. Susceptibility-weighted imaging (SWI) also has been used lately to evaluate vascular structures and consequences of stroke in brain. We aimed to compare CE-MRI, SWI, and CTA with DSC-MRP in terms of perfusion. Methods: Ipsilateral leptomeningeal-pial collateralization (LPC) on CE-MRI was correlated with increased CBV (p<0,001), decreased CBF (p=0,026), prolonged MTT and TTP (p=0,001 and p=0,003). LPC was observed more often in cases with infarct zones with penumbra compared to those without penumbra (p=0,024). Parenchymal enhancement (PE) was positively correlated with prolonged MTT and TTP (p=0,015 and p=0,031). Moreover, there was a positive relationship between PE and increased penumbra ratio over the infarct core (p=0,037). Results: Ipsilateral prominent vessel sign (PVS) was associated with increased CBV (p=0,004) and decreased CBF (p=0,002). No relationship was found between collateralization grading on CTA and perfusion metrics or penumbra ratio. Conclusion: ipsilateral PVS can be a measure of CBV and CBF. LPC on CE-MRI can be a sign of an increase in CBV. PE can show larger penumbra. It is the first in the literature showing the relationship of PE with perfusion deficit. In the light of these findings, we can suggest in case of unavailability of MRP, CE-MRI with SWI can be used to evaluate perfusion status.