1,720,979 research outputs found
THE ROLE OF ULTRASOUND AND FINE NEEDLE ASPIRATION IN DIAGNOSING TUMOR FORMATIONS OF THE NECK REGION
No full textCilj: Utvrditi učestalost malignih lezija regije vrata detektiranih citološkom analizom nakon učinjene aspiracije tankom iglom pod kontrolom ultrazvuka. Potom analizirati lokalizaciju suspektnih lezija unutar regije vrata, te odrediti distribuciju učinjenih aspiracija tankom iglom obzirom na spol i dob pacijenata.
Ispitanici: U ovo retrospektivno istraživanje uključeni su pacijenti koji su u razdoblju od 1. siječnja 2022. do 31. prosinca 2022. bili podvrgnuti citološkoj aspiraciji tankom iglom pod kontrolom ultrazvuka lezija u regiji vrata, ingvinuma i aksile, u KBC-u Rijeka na Kliničkom zavodu za dijagnostičku i intervencijsku radiologiju. Iz elektroničkih medicinskih zapisa (dobivenih iz IBIS-a) zabilježili smo demografske podatke (dob, spol) te rezultate citoloških analiza učinjenih aspiracija tankom iglom.
Rezultati: U vremenskom periodu od godinu dana učinjeno je ukupno 180 aspiracija tankom iglom pod kontrolom ultrazvuka od čega njih 45 (25%) u muškaraca, te 135 (75%) u žena. Prosječna dob ispitanika bila je 61 ± 15 godina. Najmlađi ispitanik imao je 20 godina, a najstariji 86 godina. Najviše aspiracija tankom iglom učinjeno je u regiji vrata, njih 136 (75,56%). U najvećem broju učinjenih aspiracija citološki nalaz odgovarao je limfatičnom tkivu bez malignih elemenata (njih 45; 25%), dok je najrjeđi rezultat citološkog nalaza plazmacitom i pleomorfni adenom. Maligne lezije podjednako su zastupljene u muškaraca i žena (P=0,59). Značajno su učestalije aspiracije tankom iglom štitnjače u odnosu na druge aspiracije unutar regije vrata (P< 0,001).
Zaključak: Citološka aspiracija tankom iglom (FNA) pod kontrolom ultrazvuka je sigurna i učinkovita metoda pri detekciji i diferenciranju suspektnih lezija u regiji vrata, kao i regijama aksile i ingvinuma.Aim: To determine the frequency of malignant lesions of the neck region detected by cytological analysis after aspiration with a thin needle under ultrasound control. Then analyze the localization of suspicious lesions within the neck region, and determine the distribution of fine needle aspiration with regard to the gender and age of the patients.
Subjects: This retrospective study included patients who, in the period from January 1, 2022 to December 31, 2022, underwent fine-needle cytological aspiration under ultrasound control of lesions in the region of the neck, inguinum, and axilla, at KBC Rijeka at the Clinical Institute for diagnostic and interventional radiology. From the electronic medical records (obtained from IBIS), we recorded demographic data (age, sex) and the results of cytological analyzes of fine needle aspiration.
Results: In a period of one year, a total of 180 thin needle aspirations were performed under ultrasound control, of which 45 (25%) were performed in men and 135 (75%) in women. The average age of the subjects was 61 ± 15 years. The youngest respondent was 20 years old, and the oldest was 86 years old. Most fine needle aspiration was done in the neck region, 136 of them (75.56%). In the largest number of aspirates performed, the cytological findings corresponded to lymphatic tissue without malignant elements (45; 25%), while the rarest cytological findings were plasmacytoma and pleomorphic adenoma. Malignant lesions are equally represented in men and women (P=0.59). Aspirations with a fine needle of the thymus are significantly more frequent than other aspirations within the neck region (P< 0.001).
Conclusion: Cytological fine needle aspiration (FNA) under ultrasound control is a safe and effective method for detecting and differentiating suspicious lesions in the neck region, as well as in the axilla and inguinal regions
THE ROLE OF MAGNETIC RESONANCE IN DIAGNOSING RECURRENCE OF TUMORS OF THE HEAD AND NECK REGION
No full textUvod: Tumori regije glave i vrata sedmi su po učestalosti u općoj populaciji s više od 660 000 novih slučajeva i 325 000 smrtnih slučajeva godišnje diljem svijeta. Zloćudni tumori navedene regije u velikoj većini (90%) su karcinomi pločastih stanica koji nastaju u usnoj i nosnoj šupljini, paranazalnim sinusima, ždrijelu i grkljanu. Ovisno o karakteristikama tumora, liječe se kirurški, radioterapijom i kemoterapijom u različitim kombinacijama. Rano otkrivanje recidiva bolesti od iznimnog je značaja za učinkovito liječenje. Za detekciju recidiva korisnima su se pokazali različiti radiološki modaliteti uključujući: CT, MR, PET i ultrazvuk. Obzirom na nižu cijenu i dostupnost CT je preferirani modalitet, no MR je osjetljivija metoda koja nam daje odgovore na pitanja kao što su razlikovanje recidiva od promjena uzrokovanih liječenjem, opseg zahvaćanja sluznice, procjena intrakranijalne ekstenzije i ekstenzije u orbite, infiltracija koštane srži te perineuralno širenje tumora.
Cilj: Utvrditi učestalost recidiva tumora regije glave i vrata detektiranih u ispitanika podvrgnutih MR pregledu, potom analizirati pojavnost recidiva obzirom na spol i dob, kao i analizirati učestalost rizičnih faktora (konzumacija alkohola, pušenje) u ispitanika s dokazanim recidivom tumora regije glave i vrata.
Ispitanici i metode: U ovo retrospektivno istraživanje uključeni su svi pacijenti koji su u razdoblju od 1. siječnja 2020. do 31. prosinca 2022. bili podvrgnuti MR pregledu regije glave i vrata, u KBC-u Rijeka, s kliničkim pitanjem recidiva. Iz elektroničkih medicinskih zapisa (dobivenih iz IBIS-a) zabilježili smo demografske podatke (dob, spol), postojanje čimbenika rizika te patohistološki nalaz tkiva za koje se prema MR nalazu sumnjalo da je recidiv.
Rezultati: U vremenskom periodu od 3 godine učinjeno je 404 MR pregleda regije glave i vrata od čega njih 150 (89 pacijenata) s kliničkim pitanjem recidiva. Radiološki je postavljena sumnja na recidiv i potom patohistološki potvrđena u njih 21 (23,6%), od čega 11 žena te 10 muškaraca. Prosječna životna dob pacijenata s recidivom bila je 66 godina. U 14 pacijenata (66,7%) radilo se o karcinomu pločastih stanica. Zabilježena su 4 slučaja perineuralnog širenja. Anamnestički podatak o konzumacija alkohola i pušenju zabilježen je u 4, odnosno 7 pacijenata s dokazanim recidivom.
Zaključak: MR ima važnu ulogu u procjeni lokalne proširenosti bolesti te ulogu u diferenciranju recidiva tumora od postoperativnih promjena te predstavlja metodu izbora za detekciju i procjenu proširenosti perineuralnog širenja.Introduction: Tumors of the head and neck region are the seventh most common in the general population with more than 660,000 new cases and 325,000 deaths annually worldwide. The vast majority (90%) of malignant tumors in the mentioned region are squamous cell carcinomas that arise in the oral and nasal cavities, paranasal sinuses, pharynx and larynx. Depending on the characteristics of the tumor, they are treated with surgery, radiotherapy and chemotherapy in different combinations. Early detection of recurrence is extremely important for effective treatment. Various radiological modalities including: CT, MR, PET and ultrasound have proven to be useful for the detection of recurrence.Considering the lower price and availability, CT is the preferred modality, but MR is a more sensitive method that gives us answers to questions such as distinguishing recurrence from changes caused by treatment, the extent of mucosal involvement, assessment of intracranial extension and extension into the orbits, bone marrow infiltration and perineural tumor spread.
Aim: To determine the frequency of recurrence of tumors of the head and neck region detected in subjects who underwent MR examination, then to analyze the incidence of recurrence according to gender and age, as well as to analyze the frequency of risk factors (alcohol consumption, smoking) in subjects with proven recurrence of tumors of the head and neck region.
Subjects and methods: This retrospective study included all patients who, in the period from January 1, 2020 to December 31, 2022, underwent an MR examination of the head and neck region, at KBC Rijeka, with a clinical question of recurrence. From the electronic medical records (obtained from IBIS), we recorded demographic data (age, gender), the existence of risk factors, and the pathohistological findings of tissue suspected of recurrence according to the MR findings.
Results: In a period of 3 years, 404 MR examinations of the head and neck region were performed, of which 150 (89 patients) had a clinical issue of recurrence. Recurrence was suspected radiologically and then pathohistologically confirmed in 21 (23,6%)of them, of which 11 were women and 10 were men. The average age of patients with recurrence was 66 years. In 14 patients (66.7%), it was squamous cell carcinoma. 4 cases of perineural spread were recorded. Anamnesis data on alcohol consumption and smoking were recorded in 4 and 7 patients with proven recurrence.
Conclusion: MR has an important role in estimating the local extent of the disease and a role in differentiating tumor recurrence from postoperative changes, and is the method of choice for detecting and assessing the extent of perineural spread
The role of computed tomography in the diagnosis of normotensive hydrocephalus
No full textUvod: Hidrocefalus (ventrikulomegalija) je poremećaj uzrokovan prekomjernim nakupljanjem
cerebrospinalnog likvora (CSL) u moždanim komorama, što može povećati intrakranijalni tlak,
stoga se dijeli na normotenzivni i hipertenzivni hidrocefalus. Normotenzivni hidrocefalus (NTH)
često pogađa stariju populaciju i karakteriziraju ga apraksija hoda, urinarna inkontinencija i
demencija. Dijagnosticira se magnetskom rezonancijom (MR) ili kompjutoriziranom
tomografijom (CT). Liječenje uključuje uklanjanje uzroka opstrukcije ili simptomatsko liječenje
pomoću drenažnih sustava ili endoskopske ventrikulostomije.
Cilj: Ciljevi ovog istraživanja su utvrditi veličinu kaloznog kuta CT-om mozga kod bolesnika s
radiološki postavljenom sumnjom na iNTH-om, analizirati učestalost pojave iNTH-a s obzirom na
spolnu i dobnu distribuciju te odrediti povezanost između Evansovog indeksa i kaloznog kuta na
CT-u mozga kod pacijenata s radiološki postavljenom sumnjom na iNTH-om.
Ispitanici i metode: U ovo retrospektivno istraživanje uključeni su svi pacijenti koji su u
razdoblju od 1. siječnja 2020. do 31. prosinca 2023. bili podvrgnuti CT pregledu mozga u KBC-u
Rijeka, a kod kojih je radiološki postavljena sumnja na normotenzivni hidrocefalus. Iz
elektroničkih medicinskih zapisa (dobivenih iz IBIS-a) zabilježit ćemo demografske podatke (dob
i spol). Putem radiološkog informatičkog sustava – ISSA, na CT pregledima mozga (aksijalni,
koronarni i sagitalni presjeci) analizirat ćemo i izračunati mjere za procjenu veličine komornog
sustava (kalozni kut, cella media indeksa, Evans indeks te veličina temporalnog roga postranične
komore).
Rezultati: U 107 pacijenata radiološki je postavljena sumnja na iNTH, među kojima je značajno
više muškaraca (69 vs 38; P=0,003). Prosječna dob pacijenata bila je 75 ± 12 godina. Također, 98
(91,59%) pacijenata ima kalozni kut manji od 90 stupnjeva (P<0,01). Utvrđena je statistički
značajna korelacija između Evans indeksa i kaloznog kuta (ρ=-0,318, P<0,001). Srednja vrijednost
kaloznog kuta iznosi 69,4 ± 18,7 stupnjeva, potom srednja vrijednost Evans indeksa iznosi 0,39 ±
0,05 te cella media indeksa 51,4 ± 7,99.
Srednja vrijednost veličine temporalnog roga desno iznosi 11,5 ± 4,14 mm, a lijevo 12,7 ± 6,91
mm.
Zaključak: U vremenskom periodu od četiri godine u 107 pacijenata radiološki je postavljena
sumnja na iNTH, statistički značajno učestalije u muškaraca (P<0,001). Od ukupnog broja
pacijenata njih 98 (91,59%) ima kalozni kut manji od 90 stupnjeva što ide u prilog dijagnozi iNTH.
Isto tako, utvrđena je statistički značajna povezanost između kaloznog kuka i Evans indeksa,
parametara koji ukazuju na ventrikulomegaliju.Introduction: Hydrocephalus (ventriculomegaly) is a disorder caused by the excessive
accumulation of cerebrospinal fluid (CSF) in the brain ventricles, which can increase intracranial
pressure. It is divided into normotensive and hypertensive hydrocephalus. Normotensive
hydrocephalus (NTH) often affects the elderly population and is characterized by gait apraxia,
urinary incontinence, and dementia. Diagnosis is made using magnetic resonance imaging (MRI)
or computed tomography (CT). Treatment includes removing the cause of obstruction or
symptomatic treatment using drainage systems or endoscopic ventriculostomy.
Aim: To determine the size of the callosal angle using CT brain scan in patients diagnosed with
iNPH, then analyze the frequency of iNPH occurrence with respect to gender and age distribution,
as well as determine the correlation between Evans' index and the callosal angle on brain CT in
patients diagnosed with iNPH.
Subjects and methods: In this retrospective study, all patients who underwent brain CT
examinations at KBC Rijeka from January 1, 2020, to December 31, 2023, and were radiologically
diagnosed with normotensive hydrocephalus, will be included. Demographic data (age and gender)
will be recorded from electronic medical records obtained from IBIS. Using the radiological
information system ISSA, brain CT scans (axial, coronal, and sagittal sections) will be analyzed
and measurements (callosal angle, cella media index, Evans' index, size of the temporal horn of
the lateral ventricle) will be calculated.
Results: In 107 patients, radiological suspicion of iNTH was established, with significantly more
men (69 vs. 38; P=0,003). The average age of the patients was 75 ± 12 years. Additionally, 98
(91,59%) patients had a callosal angle less than 90 degrees (P<0,01). A statistically significant
correlation was found between the Evans index and the callosal angle (ρ=-0,318, P<0,001). The
mean value of the callosal angle was 69,4 ± 18,7 degrees, the mean value of the Evans index was
0,39 ± 0,05, and the mean value of the Cella Media index was 51,4 ± 7,99.
Conclusion: Over a four-year period, radiological suspicion of iNTH was established in 107
patients, with a statistically significant higher prevalence in men (P<0,001). Of the total number
of patients, 98 (91,59%) had a callosal angle less than 90 degrees, supporting the diagnosis of
iNTH. A statistically significant correlation was found between the callosal angle and the Evans
index, parameters indicative of ventriculomegaly
Radiologic diagnostic of cerebral venous thrombosis
No full textUvod: Cerebralna venska tromboza (CVT) izrazito je rijetka bolest kraniovertebralnog venskog
sustava koja se odnosi na začepljenje, odnosno okluziju venskih struktura u šupljini kranijuma , a
obuhvaća duralnu vensku trombozu, trombozu kortikalnih vena i trombozu dubokih cerebralnih
vena. CVT je rijedak poremećaj koji se godišnje dijagnosticira u 3 do 4 slučaja na milijun
pacijenata. Dokazano je kako žene oboljevaju češće od muškaraca što se pripisuje rizičnim
čimbenicima vezanim za spol, kao što su korištenje oralnih kontracepcijskih sredstava, trudnoća
te primjena hormonalne nadomjesne terapije. CVT ima širok spektar kliničkih prezentacijskih
simptoma te se sama dijagnoza nerijetko vrlo teško postavlja. Vodeće dvije metode u
dijagnosticiranju cerebralne venske tromboze jesu CT venografija te MR venografija. Tijekom
praćenja stanja i razvoja bolesti kod pacijenata s dijagnosticiranim CVT-om, istovremeno se
primjenjuju obje tehnike snimanja.
Cilj: Ciljevi ovoga istraživanja su utvrditi spolnu distribuciju pacijenata kod kojih je radiološki
potvrđena cerebralna venska tromboza, potom utvrditi učestalost razvoja venskog infarkta u
pacijenata s dijagnosticiranom cerebralnom venskom trombozom te utvrditi učestalost glavobolje
kao simptoma kod pacijenata s dijagnosticiranom cerebralnom venskom trombozom.
Ispitanici i metode: U ovo retrospektivno istraživanje uključeni su svi pacijenti koji su bili
podvrgnuti CT ili MR venografiji u razdoblju od 1.1.2018. do 31.12.2023. godine. Iz elektroničkih
medicinskih zapisa (dobivenih iz IBIS-a) zabilježeni su demografski podaci (dob i spol) te podaci
o kliničkoj prezentaciji bolesti pri čemu je posebno obraćena pozornost na pojavu glavobolje kao
simptoma bolesti te na razvoj venskog infarkta nakon dijagnosticiranja CVT-a.
Rezultati: Od ukupnog broja pacijenata (134) u njih 21 (16%) je radiološki dijagnosticirana
cerebralna venska tromboza. Od pacijenata s potvrđenom CVT njih 12 (57.14%) je bilo ženskog
spola, a preostalih 9 (42.86%) muškog spola (P > 0,05). CVT je najčešće pogađala osobe između
20 i 50 godina, pri čemu je prosječna dob oboljelih pacijenata bila 46 ± 21 godina. Transverzalni
sinus bio je najčešće zahvaćen i to kod 8 (38.10%) pacijenata. Venski infarkt je bio prisutan kod 3
(14.29%) pacijenta s dijagnosticiranom cerebralnom venskom trombozom dok je glavobolja kao
simptom bila prisutna kod 10 (47.62%) pacijenata.
Zaključak: Retrospektivno istraživanje uključilo je sve pacijente podvrgnute CT ili MR
venografiji u vremenskog periodu od 2018. do 2023. godine te utvrdilo da je cerebralna venska
tromboza dijagnosticirana u njih 21 (16%). Iako su žene obolijevale češće, razlika nije bila
statistički značajna. Hipoteza da CVT često dovodi do razvoja venskog infarkta i hipoteza da
većina pacijenata ima glavobolju nisu potvrđene, što naglašava potrebu za daljnjim istraživanjima.Introduction: Cerebral venous thrombosis (CVT) is an extremely rare disease of the
craniovertebral venous system that refers to the obstruction or occlusion of venous structures
within the cranial cavity. It includes dural venous thrombosis, cortical vein thrombosis, and deep
cerebral vein thrombosis. CVT is a rare disorder, diagnosed annually in 3 to 4 cases per million
patients. It has been proven that women are more frequently affected than men, attributed to
gender-specific risk factors such as the use of oral contraceptives, pregnancy, and hormone
replacement therapy. CVT has a wide spectrum of clinical presentation symptoms, making the
diagnosis often very challenging. The leading two methods in diagnosing cerebral venous
thrombosis are CT venography and MR venography. During the monitoring of the condition and
disease progression in patients diagnosed with CVT, both imaging techniques are simultaneously
applied.
Aim: The aims of this study are to determine the gender distribution of patients with radiologically
confirmed cerebral venous thrombosis, to establish the frequency of venous infarction
development in patients diagnosed with cerebral venous thrombosis, and to determine the
prevalence of headache as a symptom in patients diagnosed with cerebral venous thrombosis.
Subjects and methods: This retrospective study includes all patients who underwent CT or MR
venography between January 1, 2018, and December 31, 2023. Demographic data (age and gender)
and clinical presentation details, with particular attention to the occurrence of headache as a
symptom and the development of venous infarction after the diagnosis of CVT, were recorded
from electronic medical records (obtained from IBIS).
Results: Out of the total number of patients (134), 21 (16%) were radiologically diagnosed with
cerebral venous thrombosis (CVT). Among the patients with confirmed CVT, 12 (57.14%) were
female, and the remaining 9 (42.86%) were male (P > 0.05). CVT most commonly affected
individuals between the ages of 20 and 50, with the average age of affected patients being 46 ± 21
years. The transverse sinus was the most frequently affected, occurring in 8 (38.10%) patients.
Venous infarction was present in 3 (14.29%) patients diagnosed with CVT, while headache as a
symptom was present in 10 (47.62%) patients.
Conclusion: The retrospective study included all patients who underwent CT or MR venography
from 2018 to 2023 and found that cerebral venous thrombosis (CVT) was diagnosed in 21 of them
(16%). Although women were more frequently affected, the difference was not statistically
significant. The hypotheses that CVT often leads to the development of venous infarction and that
the majority of patients experience headaches were not confirmed, highlighting the need for further
research
THE ROLE OF MAGNETIC RESONANCE IN DIAGNOSING RECURRENCE OF TUMORS OF THE HEAD AND NECK REGION
No full textUvod: Tumori regije glave i vrata sedmi su po učestalosti u općoj populaciji s više od 660 000 novih slučajeva i 325 000 smrtnih slučajeva godišnje diljem svijeta. Zloćudni tumori navedene regije u velikoj većini (90%) su karcinomi pločastih stanica koji nastaju u usnoj i nosnoj šupljini, paranazalnim sinusima, ždrijelu i grkljanu. Ovisno o karakteristikama tumora, liječe se kirurški, radioterapijom i kemoterapijom u različitim kombinacijama. Rano otkrivanje recidiva bolesti od iznimnog je značaja za učinkovito liječenje. Za detekciju recidiva korisnima su se pokazali različiti radiološki modaliteti uključujući: CT, MR, PET i ultrazvuk. Obzirom na nižu cijenu i dostupnost CT je preferirani modalitet, no MR je osjetljivija metoda koja nam daje odgovore na pitanja kao što su razlikovanje recidiva od promjena uzrokovanih liječenjem, opseg zahvaćanja sluznice, procjena intrakranijalne ekstenzije i ekstenzije u orbite, infiltracija koštane srži te perineuralno širenje tumora.
Cilj: Utvrditi učestalost recidiva tumora regije glave i vrata detektiranih u ispitanika podvrgnutih MR pregledu, potom analizirati pojavnost recidiva obzirom na spol i dob, kao i analizirati učestalost rizičnih faktora (konzumacija alkohola, pušenje) u ispitanika s dokazanim recidivom tumora regije glave i vrata.
Ispitanici i metode: U ovo retrospektivno istraživanje uključeni su svi pacijenti koji su u razdoblju od 1. siječnja 2020. do 31. prosinca 2022. bili podvrgnuti MR pregledu regije glave i vrata, u KBC-u Rijeka, s kliničkim pitanjem recidiva. Iz elektroničkih medicinskih zapisa (dobivenih iz IBIS-a) zabilježili smo demografske podatke (dob, spol), postojanje čimbenika rizika te patohistološki nalaz tkiva za koje se prema MR nalazu sumnjalo da je recidiv.
Rezultati: U vremenskom periodu od 3 godine učinjeno je 404 MR pregleda regije glave i vrata od čega njih 150 (89 pacijenata) s kliničkim pitanjem recidiva. Radiološki je postavljena sumnja na recidiv i potom patohistološki potvrđena u njih 21 (23,6%), od čega 11 žena te 10 muškaraca. Prosječna životna dob pacijenata s recidivom bila je 66 godina. U 14 pacijenata (66,7%) radilo se o karcinomu pločastih stanica. Zabilježena su 4 slučaja perineuralnog širenja. Anamnestički podatak o konzumacija alkohola i pušenju zabilježen je u 4, odnosno 7 pacijenata s dokazanim recidivom.
Zaključak: MR ima važnu ulogu u procjeni lokalne proširenosti bolesti te ulogu u diferenciranju recidiva tumora od postoperativnih promjena te predstavlja metodu izbora za detekciju i procjenu proširenosti perineuralnog širenja.Introduction: Tumors of the head and neck region are the seventh most common in the general population with more than 660,000 new cases and 325,000 deaths annually worldwide. The vast majority (90%) of malignant tumors in the mentioned region are squamous cell carcinomas that arise in the oral and nasal cavities, paranasal sinuses, pharynx and larynx. Depending on the characteristics of the tumor, they are treated with surgery, radiotherapy and chemotherapy in different combinations. Early detection of recurrence is extremely important for effective treatment. Various radiological modalities including: CT, MR, PET and ultrasound have proven to be useful for the detection of recurrence.Considering the lower price and availability, CT is the preferred modality, but MR is a more sensitive method that gives us answers to questions such as distinguishing recurrence from changes caused by treatment, the extent of mucosal involvement, assessment of intracranial extension and extension into the orbits, bone marrow infiltration and perineural tumor spread.
Aim: To determine the frequency of recurrence of tumors of the head and neck region detected in subjects who underwent MR examination, then to analyze the incidence of recurrence according to gender and age, as well as to analyze the frequency of risk factors (alcohol consumption, smoking) in subjects with proven recurrence of tumors of the head and neck region.
Subjects and methods: This retrospective study included all patients who, in the period from January 1, 2020 to December 31, 2022, underwent an MR examination of the head and neck region, at KBC Rijeka, with a clinical question of recurrence. From the electronic medical records (obtained from IBIS), we recorded demographic data (age, gender), the existence of risk factors, and the pathohistological findings of tissue suspected of recurrence according to the MR findings.
Results: In a period of 3 years, 404 MR examinations of the head and neck region were performed, of which 150 (89 patients) had a clinical issue of recurrence. Recurrence was suspected radiologically and then pathohistologically confirmed in 21 (23,6%)of them, of which 11 were women and 10 were men. The average age of patients with recurrence was 66 years. In 14 patients (66.7%), it was squamous cell carcinoma. 4 cases of perineural spread were recorded. Anamnesis data on alcohol consumption and smoking were recorded in 4 and 7 patients with proven recurrence.
Conclusion: MR has an important role in estimating the local extent of the disease and a role in differentiating tumor recurrence from postoperative changes, and is the method of choice for detecting and assessing the extent of perineural spread
THE ROLE OF ULTRASOUND AND FINE NEEDLE ASPIRATION IN DIAGNOSING TUMOR FORMATIONS OF THE NECK REGION
No full textCilj: Utvrditi učestalost malignih lezija regije vrata detektiranih citološkom analizom nakon učinjene aspiracije tankom iglom pod kontrolom ultrazvuka. Potom analizirati lokalizaciju suspektnih lezija unutar regije vrata, te odrediti distribuciju učinjenih aspiracija tankom iglom obzirom na spol i dob pacijenata.
Ispitanici: U ovo retrospektivno istraživanje uključeni su pacijenti koji su u razdoblju od 1. siječnja 2022. do 31. prosinca 2022. bili podvrgnuti citološkoj aspiraciji tankom iglom pod kontrolom ultrazvuka lezija u regiji vrata, ingvinuma i aksile, u KBC-u Rijeka na Kliničkom zavodu za dijagnostičku i intervencijsku radiologiju. Iz elektroničkih medicinskih zapisa (dobivenih iz IBIS-a) zabilježili smo demografske podatke (dob, spol) te rezultate citoloških analiza učinjenih aspiracija tankom iglom.
Rezultati: U vremenskom periodu od godinu dana učinjeno je ukupno 180 aspiracija tankom iglom pod kontrolom ultrazvuka od čega njih 45 (25%) u muškaraca, te 135 (75%) u žena. Prosječna dob ispitanika bila je 61 ± 15 godina. Najmlađi ispitanik imao je 20 godina, a najstariji 86 godina. Najviše aspiracija tankom iglom učinjeno je u regiji vrata, njih 136 (75,56%). U najvećem broju učinjenih aspiracija citološki nalaz odgovarao je limfatičnom tkivu bez malignih elemenata (njih 45; 25%), dok je najrjeđi rezultat citološkog nalaza plazmacitom i pleomorfni adenom. Maligne lezije podjednako su zastupljene u muškaraca i žena (P=0,59). Značajno su učestalije aspiracije tankom iglom štitnjače u odnosu na druge aspiracije unutar regije vrata (P< 0,001).
Zaključak: Citološka aspiracija tankom iglom (FNA) pod kontrolom ultrazvuka je sigurna i učinkovita metoda pri detekciji i diferenciranju suspektnih lezija u regiji vrata, kao i regijama aksile i ingvinuma.Aim: To determine the frequency of malignant lesions of the neck region detected by cytological analysis after aspiration with a thin needle under ultrasound control. Then analyze the localization of suspicious lesions within the neck region, and determine the distribution of fine needle aspiration with regard to the gender and age of the patients.
Subjects: This retrospective study included patients who, in the period from January 1, 2022 to December 31, 2022, underwent fine-needle cytological aspiration under ultrasound control of lesions in the region of the neck, inguinum, and axilla, at KBC Rijeka at the Clinical Institute for diagnostic and interventional radiology. From the electronic medical records (obtained from IBIS), we recorded demographic data (age, sex) and the results of cytological analyzes of fine needle aspiration.
Results: In a period of one year, a total of 180 thin needle aspirations were performed under ultrasound control, of which 45 (25%) were performed in men and 135 (75%) in women. The average age of the subjects was 61 ± 15 years. The youngest respondent was 20 years old, and the oldest was 86 years old. Most fine needle aspiration was done in the neck region, 136 of them (75.56%). In the largest number of aspirates performed, the cytological findings corresponded to lymphatic tissue without malignant elements (45; 25%), while the rarest cytological findings were plasmacytoma and pleomorphic adenoma. Malignant lesions are equally represented in men and women (P=0.59). Aspirations with a fine needle of the thymus are significantly more frequent than other aspirations within the neck region (P< 0.001).
Conclusion: Cytological fine needle aspiration (FNA) under ultrasound control is a safe and effective method for detecting and differentiating suspicious lesions in the neck region, as well as in the axilla and inguinal regions
The role of computed tomography in the diagnosis of normotensive hydrocephalus
No full textUvod: Hidrocefalus (ventrikulomegalija) je poremećaj uzrokovan prekomjernim nakupljanjem
cerebrospinalnog likvora (CSL) u moždanim komorama, što može povećati intrakranijalni tlak,
stoga se dijeli na normotenzivni i hipertenzivni hidrocefalus. Normotenzivni hidrocefalus (NTH)
često pogađa stariju populaciju i karakteriziraju ga apraksija hoda, urinarna inkontinencija i
demencija. Dijagnosticira se magnetskom rezonancijom (MR) ili kompjutoriziranom
tomografijom (CT). Liječenje uključuje uklanjanje uzroka opstrukcije ili simptomatsko liječenje
pomoću drenažnih sustava ili endoskopske ventrikulostomije.
Cilj: Ciljevi ovog istraživanja su utvrditi veličinu kaloznog kuta CT-om mozga kod bolesnika s
radiološki postavljenom sumnjom na iNTH-om, analizirati učestalost pojave iNTH-a s obzirom na
spolnu i dobnu distribuciju te odrediti povezanost između Evansovog indeksa i kaloznog kuta na
CT-u mozga kod pacijenata s radiološki postavljenom sumnjom na iNTH-om.
Ispitanici i metode: U ovo retrospektivno istraživanje uključeni su svi pacijenti koji su u
razdoblju od 1. siječnja 2020. do 31. prosinca 2023. bili podvrgnuti CT pregledu mozga u KBC-u
Rijeka, a kod kojih je radiološki postavljena sumnja na normotenzivni hidrocefalus. Iz
elektroničkih medicinskih zapisa (dobivenih iz IBIS-a) zabilježit ćemo demografske podatke (dob
i spol). Putem radiološkog informatičkog sustava – ISSA, na CT pregledima mozga (aksijalni,
koronarni i sagitalni presjeci) analizirat ćemo i izračunati mjere za procjenu veličine komornog
sustava (kalozni kut, cella media indeksa, Evans indeks te veličina temporalnog roga postranične
komore).
Rezultati: U 107 pacijenata radiološki je postavljena sumnja na iNTH, među kojima je značajno
više muškaraca (69 vs 38; P=0,003). Prosječna dob pacijenata bila je 75 ± 12 godina. Također, 98
(91,59%) pacijenata ima kalozni kut manji od 90 stupnjeva (P<0,01). Utvrđena je statistički
značajna korelacija između Evans indeksa i kaloznog kuta (ρ=-0,318, P<0,001). Srednja vrijednost
kaloznog kuta iznosi 69,4 ± 18,7 stupnjeva, potom srednja vrijednost Evans indeksa iznosi 0,39 ±
0,05 te cella media indeksa 51,4 ± 7,99.
Srednja vrijednost veličine temporalnog roga desno iznosi 11,5 ± 4,14 mm, a lijevo 12,7 ± 6,91
mm.
Zaključak: U vremenskom periodu od četiri godine u 107 pacijenata radiološki je postavljena
sumnja na iNTH, statistički značajno učestalije u muškaraca (P<0,001). Od ukupnog broja
pacijenata njih 98 (91,59%) ima kalozni kut manji od 90 stupnjeva što ide u prilog dijagnozi iNTH.
Isto tako, utvrđena je statistički značajna povezanost između kaloznog kuka i Evans indeksa,
parametara koji ukazuju na ventrikulomegaliju.Introduction: Hydrocephalus (ventriculomegaly) is a disorder caused by the excessive
accumulation of cerebrospinal fluid (CSF) in the brain ventricles, which can increase intracranial
pressure. It is divided into normotensive and hypertensive hydrocephalus. Normotensive
hydrocephalus (NTH) often affects the elderly population and is characterized by gait apraxia,
urinary incontinence, and dementia. Diagnosis is made using magnetic resonance imaging (MRI)
or computed tomography (CT). Treatment includes removing the cause of obstruction or
symptomatic treatment using drainage systems or endoscopic ventriculostomy.
Aim: To determine the size of the callosal angle using CT brain scan in patients diagnosed with
iNPH, then analyze the frequency of iNPH occurrence with respect to gender and age distribution,
as well as determine the correlation between Evans' index and the callosal angle on brain CT in
patients diagnosed with iNPH.
Subjects and methods: In this retrospective study, all patients who underwent brain CT
examinations at KBC Rijeka from January 1, 2020, to December 31, 2023, and were radiologically
diagnosed with normotensive hydrocephalus, will be included. Demographic data (age and gender)
will be recorded from electronic medical records obtained from IBIS. Using the radiological
information system ISSA, brain CT scans (axial, coronal, and sagittal sections) will be analyzed
and measurements (callosal angle, cella media index, Evans' index, size of the temporal horn of
the lateral ventricle) will be calculated.
Results: In 107 patients, radiological suspicion of iNTH was established, with significantly more
men (69 vs. 38; P=0,003). The average age of the patients was 75 ± 12 years. Additionally, 98
(91,59%) patients had a callosal angle less than 90 degrees (P<0,01). A statistically significant
correlation was found between the Evans index and the callosal angle (ρ=-0,318, P<0,001). The
mean value of the callosal angle was 69,4 ± 18,7 degrees, the mean value of the Evans index was
0,39 ± 0,05, and the mean value of the Cella Media index was 51,4 ± 7,99.
Conclusion: Over a four-year period, radiological suspicion of iNTH was established in 107
patients, with a statistically significant higher prevalence in men (P<0,001). Of the total number
of patients, 98 (91,59%) had a callosal angle less than 90 degrees, supporting the diagnosis of
iNTH. A statistically significant correlation was found between the callosal angle and the Evans
index, parameters indicative of ventriculomegaly
THE ROLE OF MAGNETIC RESONANCE IN DIAGNOSING RECURRENCE OF TUMORS OF THE HEAD AND NECK REGION
No full textUvod: Tumori regije glave i vrata sedmi su po učestalosti u općoj populaciji s više od 660 000 novih slučajeva i 325 000 smrtnih slučajeva godišnje diljem svijeta. Zloćudni tumori navedene regije u velikoj većini (90%) su karcinomi pločastih stanica koji nastaju u usnoj i nosnoj šupljini, paranazalnim sinusima, ždrijelu i grkljanu. Ovisno o karakteristikama tumora, liječe se kirurški, radioterapijom i kemoterapijom u različitim kombinacijama. Rano otkrivanje recidiva bolesti od iznimnog je značaja za učinkovito liječenje. Za detekciju recidiva korisnima su se pokazali različiti radiološki modaliteti uključujući: CT, MR, PET i ultrazvuk. Obzirom na nižu cijenu i dostupnost CT je preferirani modalitet, no MR je osjetljivija metoda koja nam daje odgovore na pitanja kao što su razlikovanje recidiva od promjena uzrokovanih liječenjem, opseg zahvaćanja sluznice, procjena intrakranijalne ekstenzije i ekstenzije u orbite, infiltracija koštane srži te perineuralno širenje tumora.
Cilj: Utvrditi učestalost recidiva tumora regije glave i vrata detektiranih u ispitanika podvrgnutih MR pregledu, potom analizirati pojavnost recidiva obzirom na spol i dob, kao i analizirati učestalost rizičnih faktora (konzumacija alkohola, pušenje) u ispitanika s dokazanim recidivom tumora regije glave i vrata.
Ispitanici i metode: U ovo retrospektivno istraživanje uključeni su svi pacijenti koji su u razdoblju od 1. siječnja 2020. do 31. prosinca 2022. bili podvrgnuti MR pregledu regije glave i vrata, u KBC-u Rijeka, s kliničkim pitanjem recidiva. Iz elektroničkih medicinskih zapisa (dobivenih iz IBIS-a) zabilježili smo demografske podatke (dob, spol), postojanje čimbenika rizika te patohistološki nalaz tkiva za koje se prema MR nalazu sumnjalo da je recidiv.
Rezultati: U vremenskom periodu od 3 godine učinjeno je 404 MR pregleda regije glave i vrata od čega njih 150 (89 pacijenata) s kliničkim pitanjem recidiva. Radiološki je postavljena sumnja na recidiv i potom patohistološki potvrđena u njih 21 (23,6%), od čega 11 žena te 10 muškaraca. Prosječna životna dob pacijenata s recidivom bila je 66 godina. U 14 pacijenata (66,7%) radilo se o karcinomu pločastih stanica. Zabilježena su 4 slučaja perineuralnog širenja. Anamnestički podatak o konzumacija alkohola i pušenju zabilježen je u 4, odnosno 7 pacijenata s dokazanim recidivom.
Zaključak: MR ima važnu ulogu u procjeni lokalne proširenosti bolesti te ulogu u diferenciranju recidiva tumora od postoperativnih promjena te predstavlja metodu izbora za detekciju i procjenu proširenosti perineuralnog širenja.Introduction: Tumors of the head and neck region are the seventh most common in the general population with more than 660,000 new cases and 325,000 deaths annually worldwide. The vast majority (90%) of malignant tumors in the mentioned region are squamous cell carcinomas that arise in the oral and nasal cavities, paranasal sinuses, pharynx and larynx. Depending on the characteristics of the tumor, they are treated with surgery, radiotherapy and chemotherapy in different combinations. Early detection of recurrence is extremely important for effective treatment. Various radiological modalities including: CT, MR, PET and ultrasound have proven to be useful for the detection of recurrence.Considering the lower price and availability, CT is the preferred modality, but MR is a more sensitive method that gives us answers to questions such as distinguishing recurrence from changes caused by treatment, the extent of mucosal involvement, assessment of intracranial extension and extension into the orbits, bone marrow infiltration and perineural tumor spread.
Aim: To determine the frequency of recurrence of tumors of the head and neck region detected in subjects who underwent MR examination, then to analyze the incidence of recurrence according to gender and age, as well as to analyze the frequency of risk factors (alcohol consumption, smoking) in subjects with proven recurrence of tumors of the head and neck region.
Subjects and methods: This retrospective study included all patients who, in the period from January 1, 2020 to December 31, 2022, underwent an MR examination of the head and neck region, at KBC Rijeka, with a clinical question of recurrence. From the electronic medical records (obtained from IBIS), we recorded demographic data (age, gender), the existence of risk factors, and the pathohistological findings of tissue suspected of recurrence according to the MR findings.
Results: In a period of 3 years, 404 MR examinations of the head and neck region were performed, of which 150 (89 patients) had a clinical issue of recurrence. Recurrence was suspected radiologically and then pathohistologically confirmed in 21 (23,6%)of them, of which 11 were women and 10 were men. The average age of patients with recurrence was 66 years. In 14 patients (66.7%), it was squamous cell carcinoma. 4 cases of perineural spread were recorded. Anamnesis data on alcohol consumption and smoking were recorded in 4 and 7 patients with proven recurrence.
Conclusion: MR has an important role in estimating the local extent of the disease and a role in differentiating tumor recurrence from postoperative changes, and is the method of choice for detecting and assessing the extent of perineural spread
Radiologic diagnostic of cerebral venous thrombosis
No full textUvod: Cerebralna venska tromboza (CVT) izrazito je rijetka bolest kraniovertebralnog venskog
sustava koja se odnosi na začepljenje, odnosno okluziju venskih struktura u šupljini kranijuma , a
obuhvaća duralnu vensku trombozu, trombozu kortikalnih vena i trombozu dubokih cerebralnih
vena. CVT je rijedak poremećaj koji se godišnje dijagnosticira u 3 do 4 slučaja na milijun
pacijenata. Dokazano je kako žene oboljevaju češće od muškaraca što se pripisuje rizičnim
čimbenicima vezanim za spol, kao što su korištenje oralnih kontracepcijskih sredstava, trudnoća
te primjena hormonalne nadomjesne terapije. CVT ima širok spektar kliničkih prezentacijskih
simptoma te se sama dijagnoza nerijetko vrlo teško postavlja. Vodeće dvije metode u
dijagnosticiranju cerebralne venske tromboze jesu CT venografija te MR venografija. Tijekom
praćenja stanja i razvoja bolesti kod pacijenata s dijagnosticiranim CVT-om, istovremeno se
primjenjuju obje tehnike snimanja.
Cilj: Ciljevi ovoga istraživanja su utvrditi spolnu distribuciju pacijenata kod kojih je radiološki
potvrđena cerebralna venska tromboza, potom utvrditi učestalost razvoja venskog infarkta u
pacijenata s dijagnosticiranom cerebralnom venskom trombozom te utvrditi učestalost glavobolje
kao simptoma kod pacijenata s dijagnosticiranom cerebralnom venskom trombozom.
Ispitanici i metode: U ovo retrospektivno istraživanje uključeni su svi pacijenti koji su bili
podvrgnuti CT ili MR venografiji u razdoblju od 1.1.2018. do 31.12.2023. godine. Iz elektroničkih
medicinskih zapisa (dobivenih iz IBIS-a) zabilježeni su demografski podaci (dob i spol) te podaci
o kliničkoj prezentaciji bolesti pri čemu je posebno obraćena pozornost na pojavu glavobolje kao
simptoma bolesti te na razvoj venskog infarkta nakon dijagnosticiranja CVT-a.
Rezultati: Od ukupnog broja pacijenata (134) u njih 21 (16%) je radiološki dijagnosticirana
cerebralna venska tromboza. Od pacijenata s potvrđenom CVT njih 12 (57.14%) je bilo ženskog
spola, a preostalih 9 (42.86%) muškog spola (P > 0,05). CVT je najčešće pogađala osobe između
20 i 50 godina, pri čemu je prosječna dob oboljelih pacijenata bila 46 ± 21 godina. Transverzalni
sinus bio je najčešće zahvaćen i to kod 8 (38.10%) pacijenata. Venski infarkt je bio prisutan kod 3
(14.29%) pacijenta s dijagnosticiranom cerebralnom venskom trombozom dok je glavobolja kao
simptom bila prisutna kod 10 (47.62%) pacijenata.
Zaključak: Retrospektivno istraživanje uključilo je sve pacijente podvrgnute CT ili MR
venografiji u vremenskog periodu od 2018. do 2023. godine te utvrdilo da je cerebralna venska
tromboza dijagnosticirana u njih 21 (16%). Iako su žene obolijevale češće, razlika nije bila
statistički značajna. Hipoteza da CVT često dovodi do razvoja venskog infarkta i hipoteza da
većina pacijenata ima glavobolju nisu potvrđene, što naglašava potrebu za daljnjim istraživanjima.Introduction: Cerebral venous thrombosis (CVT) is an extremely rare disease of the
craniovertebral venous system that refers to the obstruction or occlusion of venous structures
within the cranial cavity. It includes dural venous thrombosis, cortical vein thrombosis, and deep
cerebral vein thrombosis. CVT is a rare disorder, diagnosed annually in 3 to 4 cases per million
patients. It has been proven that women are more frequently affected than men, attributed to
gender-specific risk factors such as the use of oral contraceptives, pregnancy, and hormone
replacement therapy. CVT has a wide spectrum of clinical presentation symptoms, making the
diagnosis often very challenging. The leading two methods in diagnosing cerebral venous
thrombosis are CT venography and MR venography. During the monitoring of the condition and
disease progression in patients diagnosed with CVT, both imaging techniques are simultaneously
applied.
Aim: The aims of this study are to determine the gender distribution of patients with radiologically
confirmed cerebral venous thrombosis, to establish the frequency of venous infarction
development in patients diagnosed with cerebral venous thrombosis, and to determine the
prevalence of headache as a symptom in patients diagnosed with cerebral venous thrombosis.
Subjects and methods: This retrospective study includes all patients who underwent CT or MR
venography between January 1, 2018, and December 31, 2023. Demographic data (age and gender)
and clinical presentation details, with particular attention to the occurrence of headache as a
symptom and the development of venous infarction after the diagnosis of CVT, were recorded
from electronic medical records (obtained from IBIS).
Results: Out of the total number of patients (134), 21 (16%) were radiologically diagnosed with
cerebral venous thrombosis (CVT). Among the patients with confirmed CVT, 12 (57.14%) were
female, and the remaining 9 (42.86%) were male (P > 0.05). CVT most commonly affected
individuals between the ages of 20 and 50, with the average age of affected patients being 46 ± 21
years. The transverse sinus was the most frequently affected, occurring in 8 (38.10%) patients.
Venous infarction was present in 3 (14.29%) patients diagnosed with CVT, while headache as a
symptom was present in 10 (47.62%) patients.
Conclusion: The retrospective study included all patients who underwent CT or MR venography
from 2018 to 2023 and found that cerebral venous thrombosis (CVT) was diagnosed in 21 of them
(16%). Although women were more frequently affected, the difference was not statistically
significant. The hypotheses that CVT often leads to the development of venous infarction and that
the majority of patients experience headaches were not confirmed, highlighting the need for further
research
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