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    Determination of acute appendicitis histologic subtypes by MDCT findings
    (2020) Aslan, Serdar; Ozturk, Mesut
    Aim: Our aim was to investigate if histological subtypes of acute appendicitis (AA) can be predicted by multidetector computed tomography (MDCT) and laboratory findings.Material and Methods: A retrospective search of the hospital database to identify patients who underwent appendectomy and had an abdominal MDCT scan and laboratory tests including white blood cell (WBC) count and c-reactive protein (CRP) available before the operation revealed 123 patients (mean age: 25.69 ± 17.23 years). Histopathological results were classified as mucosal, gangrenous and suppurative AA. MDCT scans of the patients were evaluated for appendix diameter, appendix wall thickness, presence of pericecal fluid and extraluminal air. The relationship between MDCT and laboratory findings and histological subtypes of AA were assessed.Results: There were 24 (19.5%) mucosal, 47 (38.2%) suppurative and 52 (42.3%) gangrenous AA. WBC count, CRP level, appendix wall thickness and appendix diameter was significantly different between mucosal and gangrenous AA (p 0.05) and between suppurative and gangrenous AA (p 0.05). However, there was no significant difference between mucosal and suppurative AA in terms of all variables (p = 0.752, 0.551, 0.756, 0.250 and 0.051, respectively). Presence of pericecal fluid was 92.2% sensitive and 93.1% specific for gangrenous AA. Presence of extraluminal air was 94.7% sensitive and 97.3% specific for gangrenous AA.Conclusion: AA histologic subtypes can be predicted by especially MDCT findings.
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    The role of ARFI elastography to evaluate microstructrual changes of patients with testicular microlithiasis
    (Sage Publications Ltd, 2018) Aslan, Serdar; Bilgici, Meltem Ceyhan; Saglam, Dilek; Ozturk, Mesut
    Background: Testicular microlithiasis (TML) is thought to cause microstructural changes in the parenchyma of the testis, but it is difficult to demonstrate this by ultrasonography. It may be possible to evaluate microstructural changes in the testis by Acoustic Radiation Force Impulse (ARFI) elastography, which measures tissue stiffness. Purpose: To assess the tissue stiffness of testicles of children with TML and to compare them with the healthy control group. Material and Methods: Between November 2015 and May 2016, 25 pediatric patients with TML and 24 healthy children were enrolled in the study (mean age for TML and control group 6.7 +/- 3.17 and 7.9 +/- 4.18 years, respectively). Testicular volumes and mean shear wave velocity (SWV) values were calculated and compared with each other in both groups. Results: There was no significant difference in average testicular volumes between the TML group and the control group (1.14 cm(3), 1.21 cm(3), respectively; P = 0.986). Mean SWV of the testicles with TML and normal testicles with control group was 1.18 +/- 0.22 cm/s and 0.88 +/- 0.11 cm/s, respectively. The SWV of the testicles with TML was higher than the normal testicles and this was statistically significant (P < 0.001). Conclusion: This study has shown that tissue stiffness in patients with TML is increased compared to the normal population. ARFI elastography helps the early detection of microstructural changes in TML and can be used for screening and follow-up.