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    Evaluation of distal tibial epiphysis and calcaneal epiphysis according to the Vieth method in 3.0 T magnetic resonance images: a pilot study
    (Springer, 2023) Gurses, Murat Serdar; Has, Busra; Altinsoy, Hasan Baki; Suzen, Halit Sinan
    In forensic medicine practice, age estimation-both in living and deceased individuals-can be requested due to legal requirements. Radiologic methods, such as X-rays, for the estimation of bone age have been discussed, and ethical concerns have been raised. Given these factors, radiologic methods that reduce radiation exposure have gained importance and have become one of the research topics in forensic medicine. In this study, the MR images of the ankles of patients aged between 8 and 25 years, obtained with a 3.0 T MR scanner, were evaluated retrospectively according to the staging method defined by Vieth et al. In the study, the ankle MR images of 201 cases (83 females and 118 males) with sagittal T1-weighted turbo spin echo and T2-weighted short tau inversion recovery sequences were evaluated independently by two observers. According to the results of our study, the intra- and inter-observer agreements are at a very good level for both the distal tibial and calcaneal epiphyses. All the cases detected as stages 2, 3, and 4 in both sexes for both the distal tibial and the calcaneal epiphyses have been determined to be under the age of 18 years. According to the data obtained from our study, we consider that stage 5 for males and stage 6 for both sexes in the distal tibial epiphysis and stage 6 for males in the calcaneal epiphysis can be used to estimate the age of 15 years. As far as we know, our study is the first to evaluate ankle MR images with the method defined by Vieth et al. Further studies should be conducted to evaluate the validity of the procedure.
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    Solitary Metastasis Mimicking Glioblastoma in a Patient with Fahr's Disease
    (Springer India, 2025) Taydas, Onur; Has, Busra; Sakci, Zakir; Ogul, Hayri; Kantarci, Mecit
    Fahr's disease is defined as the accumulation of bilateral idiopathic calcification in the basal ganglia, dentate nucleus, and centrum semiovale. The coexistence of Fahr's disease and intracranial tumors is extremely rare, with only five cases documented in the literature. This study aimed to present a rare case, discussing both similarities and differences with previously reported cases. A 70-year-old female patient presented to our hospital with a progressive headache over the past month. Brain magnetic resonance imaging (MRI) with intravenous contrast was performed for further evaluation. Bilateral basal ganglia, thalamus, and dentate nuclei showed calcifications consistent with Fahr's disease. After excluding toxic, infectious, and endocrine causes of calcification, the patient was diagnosed with Fahr's disease. Magnetic resonance imaging also revealed a midline localized, irregularly contoured, and heterogeneously intense mass with contrast enhancement at the centrum semiovale level, accompanied by peripheral edema. Radiologically, the mass resembled a high-grade glioma or metastasis, and the presence of a lipid peak further suggested metastasis. Based on radiological findings, the patient was diagnosed with brain metastasis of breast carcinoma. The patient received chemotherapy for metastasis, which resulted in substantial regression of the mass. In patients with known Fahr's disease, new-onset headaches and related symptoms should warrant evaluation for possible brain tumors. In these cases, imaging findings should be assessed along with physical examination findings and the patient's medical history to support the diagnostic process.