Browsing by Author "Vojinovic, Radisa (11640450400)"

Background and Objectives: Primary adrenal tumors (AT) are a heterogeneous group of neoplasms due to their functional heterogeneity, which results in the diverse clinical presentation of these tumors. The purpose of this study was to examine cross-sectional imaging characteristics using multi-detector computed tomography (MDCT) to provide insight into the lesion characterization and functional status of these tumors. The radionuclide imaging using Technetium-99m radiolabeled hydrazinonicotinylacid-d-phenylalanyl1-tyrosine3-octreotide (99mTc-HYNIC-TOC), was also used in the diagnostic evaluation of these tumors. Materials and Methods: This cross-sectional study included 50 patients with confirmed diagnoses of AT (21 hormone-secreting and 29 non-functional) at the University Clinical Center, Kragujevac, Serbia, during the 2019–2022 year period. The morphological and dynamic characteristics using MDCT were performed, using qualitative, semi-quantitative, and quantitative analysis. Absolute washout (APW) and relative washout (RPW) values were also calculated. A semi-quantitative analysis of all visual findings with 99mTc-HYNIC-TOC was performed to compare the tumor to non-tumor tracer uptake. Results: A statistically significant difference was found in the MDCT values in the native phase (p < 0.05), the venous phase (p < 0.05), and the delayed phase (p < 0.001) to detect the existence of adrenal tumors. Most of these functional adrenocortical lesions (n = 44) can be differentiated using the delayed phase (p < 0.05), absolute percentage washout (APW) (p < 0.05), and relative percentage washout (RPW) (p < 0.001). Furthermore, 99mTc-HYNIC-TOC could have a high diagnostic yield to detect adrenal tumor existence (p < 0.001). There is a positive correlation between radionuclide imaging scan and APW to detect all AT (p < 0.01) and adrenocortical adenomas as well (p < 0.01). Conclusions: The results can be very helpful in a diagnostic algorithm to quickly and precisely diagnose the expansive processes of the adrenal glands, as well as to learn about the advantages and limitations of the mentioned imaging modalities. © 2023 by the authors.

Objective. Increasing use of magnetic resonance imaging (MRI) in acute knee trauma has led to increased awareness of bone bruises (BB). Post-traumatic BB is the only predictor of early osteoarthritis. The aim of our research is to determine the way in which it is possible to observe and precisely determine the localization, size, and number of BBs, by the correct selection of MR imaging sequences. Methods. MR examinations of the knees performed during 2012-2013 in 100 subjects with an acute knee injury sustained during sports were retrospectively analyzed from the personal archive. All examinations were done in the first month after the trauma. Examinations were performed on an open-type MRI with a power of 0.3T. A standard protocol was used with sequences of spin echo T1-weighted in the sagittal plane, fat suppression T2-weighted in the sagittal, coronal, and axial planes, and Short Tau Inversion Recovery (STIR) in the coronal plane. The presence and arrangement of BB were analyzed. The difference in the frequency of BB findings in STIR compared to the T1W sequence and the assessment of the visibility of BB in both sequences were analyzed. Results. BB findings were observed in 51% of subjects. BB is, after effusion, the second, most frequent pathological finding on MR examination in acute knee trauma. A significant statistical difference was determined by the Wilcoxon test (Z=-5.067, p=0.000) between the T1W and STIR sequence, which indicates that the STIR sequence is convincingly more sensitive than the T1W sequence for the diagnosis of BB. Conclusion. It was concluded that STIR sequence provides better visibility of BB compared to T1W sequence. © 2023, Serbian Medical Society. All rights reserved.

Introduction: Antiphospholipid syndrome (APS) is an autoimmune disease characterised by arterious and venous thrombosis, miscarriage, and the presence of antiphospholipid antibodies (aPL) in the blood. As we know, APS is also characterised by accelerated atherosclerotic degeneration with an increased risk of thrombosis in all blood vessels, including the carotid arteries. Carotid artery stenosis can manifest in many different ways. The aim of this study is to present the results of our multidetector computerised tomography angiography (MDCTA) analysis of the carotid arteries in patients with primary and secondary APS compared with a control group. Materials and Methods: This study examined 50 patients with primary antiphospholipid syndrome (PAPS) and 50 patients with secondary antiphospholipid syndrome (SAPS). The results were compared with a control group also comprising 50 patients. The groups were analysed with respect to age, sex and the presence of well-established risk factors for vascular disease. The study was conducted using MDCTA, where we analysed the quantitative and qualitative (morphologic) characteristics of carotid artery lesions. Results: Patients from the control group had significantly elevated levels of cholesterol and triglycerides in comparison with patients with PAPS and SAPS (p < 0.001 and p < 0.05). The results show that carotid artery lesions were significantly more common in patients with APS (PAPS, n = 40, CI95: 0.50–0.75, p = 0.0322 and SAFS, n = 54, CI95: 0.59–0.80, p = 0.0004) than within the control group (n = 23). There was a statistically significant difference between patients with APS and the control group with respect to lesions in the distal segments (n = 27, CI95: 0.67–0.95, p = 0.0001), bulbi and proximal segments (n = 21, CI95: 0.84–1.00, p = 0.000005). The number of patients with one lesion (L) (n = 27) was significantly greater than the number of those with three (n = 10, CI95: 0.56–0.86, p = 0.0051) or four (n = 3, CI95: 0.73–0.98, p = 0.00001) lesions. There were also more patients with two lesions (n = 24) than those with four (n = 3) (CI95: 0.71–0.97, p = 0.00005). Carotid artery stenosis was shown as a percentage of the carotid artery lumen diameter (%DS). Stenosis of up to 30%, was more common in patients in the PAPS group (n = 12) than in the control group (n = 3) (CI95: 0.52–0.96, p = 0.0201), while the SAPS group (n = 17) had an even larger disparity (CI95: 0.62–0.97, p = 0.0017). We observed a highly significant difference in the frequency of stenoses between 30% and 50% DS between the PAPS group (n = 24) and the control group (n = 7) (CI95: 0.59–0.90, p = 0.0023), as well as the SAPS group (n = 30) (CI95: 0.65–0.92, p = 0.0002). A qualitative analysis of plaque morphology revealed that patients with PAPS had significantly more soft tissue lesions (n = 23) compared with calcified lesions (n = 2) (CI95: 0.74–0.99, p = 0.00003), as well as more mixed plaques (n = 9) and calcified plaques (n = 2) (CI95: 0.48–0.98, p = 0.0348). Patients within the SAPS group had significantly more soft tissue (n = 35) than calcified lesions (n = 3) (CI95: 0.79–0.98, p = 0.00000021), as well as more mixed lesions (n = 21) compared with calcified (n = 3) (CI95: 0.68–0.97, p = 0.0002). Conclusions: Our study shows that subclinical manifestations of carotid artery lesions were more common in patients with APS. We came to the conclusion that MDCTA is an accurate diagnostic method because it is a safe method that provides us with a great quantity of accurate information about the characteristics of atheromatous plaques, which aids us in the further planning of treatment for patients with APS. © 2023 by the authors.

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Up to this date, more than 180 million people worldwide have been affected with COVID-19 and more than 3.9 million people have died. The effect of COVID-19 on thrombosis is well known, and due to this, anticoagulant agents are prescribed. However, the use of anticoagulants is associated with the bleeding trend and occasionally major complications and death outcomes. In this paper, we present the case of a COVID-19 patient treated with anticoagulant therapy who developed Wunderlich’s syndrome. Up to our knowledge, this is the first case of this syndrome in a patient with COVID-19. © Experimental and Applied Biomedical Research.All rights reserved.

Up to this date, more than 180 million people worldwide have been affected with COVID-19 and more than 3.9 million people have died. The effect of COVID-19 on thrombosis is well known, and due to this, anticoagulant agents are prescribed. However, the use of anticoagulants is associated with the bleeding trend and occasionally major complications and death outcomes. In this paper, we present the case of a COVID-19 patient treated with anticoagulant therapy who developed Wunderlich’s syndrome. Up to our knowledge, this is the first case of this syndrome in a patient with COVID-19. © Experimental and Applied Biomedical Research.All rights reserved.