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    Effect of fine needle aspiration biopsy on change in thyroid nodule elasticity
    (Societatea Romana de Ultrasonografie in Medicina si Biologie, 2026) Akçicek, Mehmet; Dağ, Nurullah; Keskin, Lezan; Petik, Bülent; Ünlü, Serkan
    Aims: This study aimed to investigate changes in the stiffness of thyroid nodules following fine needle aspiration biopsy (FNAB), using shear wave elastography (SWE), a non-invasive imaging technique utilized in thyroid nodule evaluation. Material and Methods: A total of 82 patients scheduled to undergo FNAB for the first time were included. Ultrasound and SWE examinations were performed before the procedure and again 8 to 10 weeks after FNAB. Nodule stiffness was measured in kilopascals (kPa) during both evaluations, and changes in elasticity were assessed. Results: The mean SWE stiffness of the nodules significantly decreased from 21.80 ±11.43 kPa before FNAB to 17.83 ±9.98 kPa after FNAB (p = 0.001). Smoking status and serum free T3 levels were significantly associated with changes in SWE stiffness (p < 0.05). However, no significant difference was observed between TIRADS 3 and TIRADS 4 categories regarding the change in stiffness (p = 0.223). Conclusion: This study demonstrates a significant reduction in thyroid nodule stiffness after FNAB as measured by SWE. These post-biopsy changes may lead to potential misinterpretations in subsequent elastographic evaluations, possibly affecting diagnostic accuracy and clinical decision-making. © 2026, Societatea Romana de Ultrasonografie in Medicina si Biologie, All rights reserved.
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    MRI Evaluation of Anterolateral Ligament and Associated Lesions of the Knee
    (2022) Petik, Bülent
    Aim: This study aimed to evaluate the anatomy of the anterolateral ligament (ALL), ALL injuries and the relationship between ALL injuries and other knee ligaments injuries, meniscal tears, bone injuries by retrospectively scanning patients’ knee magnetic resonance imaging (MRI). Material and Methods: Our study was designed as a retrospective, non-randomized, and single-center clinical study. We included knee MR images of 320 patients who applied to our tertiary care institution and underwent knee MRI between August 2021 and March 2022. Results: A total 320 knee MRI’s [female;163 (50.9%), mean age; 39.60±14.16 years, range; 21-77 years, left knee; 172 (53.7%)] were included study. At least one component of ALL was visualized in 319 (99.7%) cases [whole components: 276 (86.3%), meniscal: 311 (97.2%), femoral: 314 (98.1%), tibial: 280 (87.5%)]. Of the 182 ALL-injured knee, 182 (100%) had anterior cruciate ligament (ACL) injury, 116 (63.7%) had lateral meniscal injury, and 103 (56.6%) had bone injury. ACL (p=0.001), lateral meniscus (p=0.001), and bone injury (p=0.001) were more frequently in ALL-injured as compared with ALL-intact knee. Conclusion: There is a statistically significant relationship between acute ACL rupture, lateral meniscus, bone injury, and ALL injury. When evaluating MRI in patients with ACL, lateral meniscus, and bone injury, ALL evaluation should also be performed.
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    The Value of Diffusion Tensor Imaging in Evaluation of Patients with Bell’s Palsy
    (2022) Sarikaya, Yasin; Petik, Bülent; EKMEKCI, BURCU
    Background: The aim of this study is to evaluate whether there is any correlation among House–Brackmann scoring, electroneuronography, and diffusion tensor imaging values of the cisternal and internal auditory canal segment of facial nerve and to examine diagnostic, prognostic, and grading usefulness of diffusion tensor imaging in patients with Bell’s palsy. Methods: Thirty-seven patients over 18 years old finally diagnosed as having Bell’s palsy were enrolled in this study. House–Brackmann scoring, electroneuronography, and diffusion tensor imaging were performed at 3-5 and 21-24 days of Bell’s palsy onset. The data of diffusion tensor imaging were extracted from a line that starts from the cerebellopontine angle, extends to internal auditory canal, and covers the facial and vestibulocochlear nerve complex using manual or line tractography. Results: The apparent diffusion coefficient values of the affected nerve complexes measured in initial diffusion tensor imaging studies were significantly higher than those of contralateral nerve complexes (P < .05). The fractional anisotropy values of the affected nerve complexes were also significantly lower than those of contralateral nerve complexes (P < .05). The initial fractional anisotropy values were negatively correlated with initial House–Brackmann scoring (r=?0.35; P <.05) and degeneration indexes of orbicularis oculi and oris muscles (r=?0.36; P < .05, r=?0.35; P < .05, respectively). Conclusion: Diffusion tensor imaging is giving us beneficial data for understanding the pathophysiology of Bell’s palsy in the acute stage of the disease. House–Brackmann scale and electroneuronography are still the most reliable prognostic and diagnostic tools for patients with Bell’s palsy. Clinical improvement in facial paralysis of patients with Bell’s palsy does not mean radiologic amelioration in diffusion tensor imaging.