Browsing by Author "Akdeniz, Huseyin"

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Anterior Cerebral Artery and Anterior Communicating Artery Variations: Assessment With Magnetic Resonance Angiography
(Elsevier Science inc, 2021) Yokus, Adem; Toprak, Nursen; Gunduz, Ali Mahir; Akdeniz, Huseyin; Akdemir, Zulkuf; Dundar, Ilyas; Arslan, Harun
BACKGROUND: Although anterior cerebral artery (ACA) and anterior communicating artery (AcomA) variations have been frequently investigated by contrast enhanced angiography, the number of studies performed with magnetic resonance angiography is quite low. Our aim in this study is to investigate ACA and AcomA variations with time of flight magnetic resonance angiography (TOF MRA). METHODS: Source and maximum intensity projection images of 581 adult patients (273 males, 308 females) who were scanned for intracranial arteries with the TOF MRA method were retrospectively analyzed. RESULTS: We found the typical configuration rate of the ACA and AcomA complex to be 40.6%. The most common structural anatomic variations out of typical configuration were AcomA aplasia (18.9%) and AcomA hypoplasia (17.9%), respectively. The least frequent variation that we found was duplicated AcomA (0.9%). When we examined gender comparatively, unilateral A1 segment aplasia was found to be higher in males and azygos ACA was found to be higher in females (P = 0.001 and P = 0.029, respectively). CONCLUSIONS: In this study, in which we used the TOF MRA technique, we detected high rates of anatomic variations of ACA and AcomA. This method, which is noninvasive, does not require contrast material and does not contain ionizing radiation, can be preferred especially in the evaluation of patients with kidney disease and contrast allergy.
A Case of Metastatic Esophageal Carcinoma in a Pregnant Woman With Radiologic Findings
(Premchand Shantidevi Research Foundation, 2016) Akdemir, Zulkuf; Karaman, Erbil; Arslan, Harun; Calli, Iskan; Akdeniz, Huseyin
The incidence of all malignant tumours during pregnancy is extremely rare and esophageal carcinoma ranges from 0.07 to 0.1% of all malignant neoplasms. The physiological changes during pregnancy frequently mask the complaints and symptoms related to the disease. The physical and physiological clinical conditions limit the diagnostic approaches. Therefore, the stage of cancer at the time of diagnosis is usually advanced. The management with cancer surgery and chemotherapy regimens must be modified in pregnant women in order to minimize fetal and maternal risks. Here, we report a very rare case of metastatic esophagus cancer in a 39-year-old woman with 28 weeks of pregnancy and aim to show the ultrasound (USG) and magnetic resonance imaging (MRI) findings with treatment and follow up management.
A Case of Primary Vertebral Osteosarcoma Metastasizing To Pancreas
(E S Burioni Ricerche Bibliografiche, 2009) Avcu, Serhat; Akdeniz, Huseyin; Arslan, Harun; Toprak, Nursen; Unal, Ozkan
Context Osteosarcoma is the most common malignant bone tumor in children and adolescents and possesses a high potential for metastasis. The most common sites of osteosarcomatous metastases are the lungs, pleurae, and bone; the pancreas being extremely rare. Case report We report the computed tomography findings of a rare case of pancreatic metastasis in a 14-year-old boy with primary vertebral osteosarcoma being followed-up for 6 years. On abdominal CT, a huge mass containing necrotic and calcified areas and causing bone destruction was seen between thoracic vertebra 7 and sacral vertebra 1 involving both the vertebrae and paravertebral soft-tissue. A large metastatic mass with an irregular contour was also visualized in the pancreatic head and peripancreatic region having tomographic findings similar to the vertebral mass. Tru-cut biopsy of the pancreatic mass confirmed the diagnosis of osteosarcoma metastasis. Conclusions Although extremely rare, osteosarcoma metastasis should be included in the differential diagnosis of pancreatic mass lesions, particularly in patients with a primary tumor.
Cerebral Perfusion in Type 2 Diabetes Mellitus: a Preliminary Study With Mr Perfusion
(Elsevier, 2023) Ilik, Ibrahim; Arslan, Harun; Yokus, Adem; Batur, Muhammed; Ucler, Rifki; Akdeniz, Huseyin
Background: Type 2 diabetes mellitus (T2DM) is associated with altered cerebral vasoreactivity, cognitive impairment, and functional decline. Magnetic Resonance (MR) perfusion can be used to assess cerebral blood flow (CBF). The aim of this study is to analyze the association between diabetes mellitus and cerebral perfusion. Methods: The study included 52 patients diagnosed with T2DM and 39 healthy individuals. The diabetic patients were classified into three groups (PRP: proliferative retinopathy, NPRP: non-proliferative retinopathy, Non-RP: non-retinopathy DM). The rCBF measurements of cortical gray matter and thalami were carried out using the region of interest. Reference quantitative measurements were performed from ipsilateral white matter. Results: The comparison between the T2DM group and the control group revealed that rCBF values of bilateral frontal lobes, cingulate gyrus, medial temporal lobe, thalami and right occipital lobe were measured to be significantly lower in the T2DM group (p < 0.05). No significant difference was detected between the two groups in terms of rCBF values of the left occipital lobe and anterior aspect of the left temporal lobe (p > 0.05). The rCBF values were lower in the anterior aspect of the right temporal lobe and the difference showed borderline sta-tistical significance (p = 0.058). No significant difference was detected regarding mean rCBF values measured in the regions of cerebral hemispheres among the three patient groups with T2DM (p>0.05). Conclusion: Regional hypoperfusion was encountered in most of the lobes in the T2DM group when compared with the healthy group. However, in terms of rCBF values, there was no significant difference among the three groups with T2DM.
Coexistence of Neurofibromatosis Type-1, Left Internal Carotid Artery Hypoplasia and Left Phytisis Bulbi
(Galenos Publ House, 2011) Avcu, Serhat; Akdeniz, Huseyin; Unal, Ozkan; Arslan, Harun; Bora, Aydin
Congenital abnormalities of the internal carotid artery (ICA) are extremely rare and aplasia/hypoplasia of the ICA associated with other congenital malformations is uncommon. An 8-year-old male patient was admitted to our hospital for extreme nervousness, attention problems and hyperactivity. On MR examination, left phytisis bulbi, left frontal lobe atrophy, assymmetric dilataion in the left lateral ventricle and hamartomas in both globus pallidi, right thalamus, and bilateral cerebellar hemispheres posterior to the fourth ventricle were observed. Left ICA was observed as hypoplastic in the cervical and cranial MR-angiography. Left MCA and ACA could not be visualised. Left carotid canal hypoplasia and left sphenoidal bone dysplasia were detected on CT. As far as we know, only 4 cases with concomitancy of ICA hypoplasia-NF Type-1 have been reported up to the present. In our case, in addition, phytisis bulbi is accompanying this coexistence.
The Course of Cervical Spinal Cord Atrophy Rate and Its Relationship With Neda in Relapsing Remitting Multiple Sclerosis
(Springer Heidelberg, 2022) Cilingir, Vedat; Akdeniz, Huseyin
This study aimed to compare the annualized segmental cervical spinal cord atrophy rate (ASCAR) in the early and late stages of relapsing remitting multiple sclerosis (RRMS), and to investigate the relationship between ASCAR and no evidence of disease activity (NEDA) in RRMS. Participants in this study included early stage MS (EMSg) patients, late stage MS (LMSg) patients, and healthy controls. All of the included participants (n = 175 subjects) were followed up for 14 months, and an MRI was performed on each participant at the beginning and at the end of the study. Cervical spinal cord average segmental area (CSCA) was measured by a semi-automated method, and ASCAR (mm(2)/year) was calculated. Data from the EMSg (n = 81 subjects) and LMSg (n = 94 subjects) patient groups were compared with each other and with the control group (n = 43 subjects). Examination of the initial CSCA values revealed that the baseline CSCA of the control group was larger than that of the EMSg (p < 0.001), and the baseline CSCA of the EMSg was larger than that of the LMSg (p < 0.001). The ASCAR of the control group, LMSg, and EMSg were 0.48, 0.93, and 1.81 mm(2) (p < 0.001), respectively. Regression analysis revealed that disability increase was associated with ASCAR, while MRI activity and relapse presence were unrelated to ASCAR. In both patient groups, ASCAR was slower in those who fulfilled NEDA but this relationship was not significant. Cervical spinal cord atrophy progression over time occurs at a greater rate in the early stages of RRMS disease compared to the late stages. ASCAR was unrelated to MRI activity and relapse, which are clinical markers of acute inflammation.
Does Arfi Elastography Complement B-Mode Ultrasonography in the Radiological Diagnosis of Idiopathic Granulomatous Mastitis and Invasive Ductal Carcinoma
(Sage Publications Ltd, 2022) Toprak, Nursen; Toktas, Osman; Ince, Suat; Gunduz, Ali Mahir; Yokus, Adem; Akdeniz, Huseyin; Ozkacmaz, Sercan
Background Idiopathic granulomatous mastitis (IGM) is a chronic, unpleasant autoimmune inflammatory condition and is clinically and radiologically often confused with breast malignancy. Purpose To investigate the contributions of qualitative and quantitative aspects of acoustic radiation force impulse (ARFI) elastography to the differential diagnosis between IGM and invasive ductal carcinoma (IDC) in the breast. Material and Methods Ninety-four women with IDC and 39 with IGM were included in the study. Shear wave velocity (SWV) was calculated for all lesions using quantitative elastography. Next, each lesion's correspondence on qualitative elastographic images to those on the B-mode images was evaluated: pattern 1, no findings on elastography images; pattern 2, lesions that were bright inside; pattern 3, lesions that contained both bright and dark areas; and pattern 4, lesions that were dark inside. Pattern 4 was subdivided into 4a (dark area same size as lesion) and 4b (dark area larger than lesion size). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated. Results The mean SWV based on ARFI elastography was 3.78 +/- 1.26 m/s for IGM and 5.34 +/- 1.43 m/s for IDC lesions (P < 0.05). Based on qualitative ARFI elastography, IDC lesions were mostly classified as pattern 4b, while IGM lesions were mostly classified as pattern 1 or 2 (P = 0.01). Evaluation of both the qualitative and quantitative aspects of ARFI elastography yielded a sensitivity of 89% and specificity of 84%. Conclusion ARFI elastography may facilitate the differential diagnosis between IGM and IDC.
The Effect of Computed Tomography on Oxidative Stress Level and Some Antioxidant Parameters
(Sage Publications Ltd, 2021) Gunduz, Ali Mahir; Demir, Halit; Toprak, Nursen; Akdeniz, Huseyin; Demir, Canan; Arslan, Ayse; Goya, Cemil
Background X-rays are defined as ionizing radiation and hydrolyze the water, causing free radical formation. Oxidative stress is the damage that occurs in cells due to the lack of antioxidants, which detoxifies them, with the increased production of free radicals that occur during normal cellular metabolism. Purpose To examine the acute effects of computed tomography (CT), i.e. ionizing radiation, on oxidative stress and antioxidant defense mechanisms. Material and Methods The study included a total of 53 patients that were selected among the patients that underwent non-contrast full-body CT. Malondialdehyde (MDA) and reduced glutathione (GSH) levels and superoxide dismutase (SOD) and catalase (CAT) activities were investigated in blood samples taken from patients. Results The post-scan levels of MDA increased significantly while the post-scan levels of GSH, SOD, and CAT decreased significantly compared to their pre-scan levels. Conclusion CT, which is a widely used X-ray imaging technique and has numerous known side effects, was found to increase the levels of MDA, which is an indicator of oxidative stress, and to decrease the levels of some antioxidants including GSH, SOD, and CAT.
Efficacy of Strain Elastography in Diagnosis and Staging of Acute Appendicitis in Pediatric Patients
(int Scientific Literature, inc, 2018) Arslan, Harun; Akdemir, Zulkuf; Yavuz, Alpaslan; Gokcal, Fahri; Parlakgumus, Cemal; Islamoglu, Necat; Akdeniz, Huseyin
Background: In the present study, the role and efficiency of strain elastography (SE) were evaluated in diagnosis and staging of acute appendicitis in pediatric patients. Material/Methods: We enrolled 225 pediatric patients with suspected clinical and laboratory findings of acute appendicitis. Gray-scale sonographic findings were recorded and staging was made by the colorization method of SE imaging. Appendectomy was performed in all patients and the results of the surgical pathology were compared with the imaging findings. The sensitivity, specificity, and accuracy of SE imaging were determined in terms of evaluating the "acute appendicitis". Results: Sonographic evaluation revealed acute appendicitis in 100 patients. Regarding the SE analysis, cases with appendicitis were classified into 3 groups as: mild (n=17), moderate (n=39), and severe (n=44). The pathological evaluation revealed 95 different stages of appendicitis and normal appendix in 5 cases: acute focal (n=10), acute suppurative (n=46), phlegmonous (n=27), and perforated (n=12), regarding the results of surgical pathology. Five patients with pathologically proven "normal" appendix were noted as " mild stage appendicitis" based on gray scale and SE analysis. In total, when gray-scale and SE results were compared with pathology results regardless of the stage of appendicitis, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates were 96%, 96%, 95%, 96.8%, and 96%, respectively. No statistically significant difference was detected between other groups (P<0.05). Conclusions: In acute appendicitis, the use of SE imaging as a supportive method for the clinical approach can be useful in diagnosis, and its results are closely correlated with the histopathologic stage of appendix inflammation.
The Efficiency of Acoustic Radiation Force Impulse (Arfi) Elastography in the Diagnosis and Staging of Carpal Tunnel Syndrome
(Springer Japan Kk, 2018) Arslan, Harun; Yavuz, Alpaslan; Ilgen, Ferda; Aycan, Abdurrahman; Ozgokce, Mesut; Akdeniz, Huseyin; Batur, Abdussamet
The aim of the present study was to quantify the stiffness of the median nerve (MN) at the carpal tunnel inlet by acoustic radiation force impulse (ARFI) elastography and to evaluate whether ARFI can be used in diagnosis and staging of carpal tunnel syndrome (CTS). Sonographic examinations of 96 wrists in 50 patients were included in the study. The cross-sectional area and stiffness of the MN were quantitatively measured by B-mode ultrasonography (USG) and ARFI. The findings of CTS were assigned to four groups: (I) normal (n = 21), (II) mild (n = 39), (III) moderate (n = 38), and (IV) severe (n = 19). The differences between CTS patients and controls and the differences in electrodiagnostic tests among subgroups were statistically compared. ROC analysis was performed to determine the cut-off values between subgroups. Bilateral CTS was present in 46 patients (92 wrists) and unilateral CTS in four patients. Of the 96 nerves in the 50 symptomatic "idiopathic CTS" patients (48 women, 2 men; mean age 45.9 years, range 23-73 years), 39 (40.4%) were mild, 38 (39.8%) were moderate, and 19 (19.8%) were severely affected. When compared to controls, MN stiffness was significantly higher in the CTS group (P < 0.001); furthermore, it was higher in the severe or extreme severity group than the mild or moderate severity group (P < 0.001). A 3.250 m/s cut-off value on ARFI revealed sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 81, 82, 95.1, 50, and 82%, respectively. The MN stiffness measured by ARFI elastography is significantly higher in patients with CTS then in controls. ARFI elastography appears to be a highly efficient imaging modality for the diagnosis and staging of these patients.
Endobronchial Tumors Presenting as Asthma
(Daedalus Enterprises inc, 2014) Arisoy, Ahmet; Ekin, Selami; Gunbatar, Hulya; Sertogullarindan, Bunyamin; Akdeniz, Huseyin; Bulut, Gulay; Demirkiran, Hilmi
Evaluation of Distal Femoral Cartilage by B-Mode Ultrasonography and Shear Wave Elastography in Patients With Knee Osteoarthritis: a Preliminary Study
(Sage Publications Ltd, 2021) Yokus, Adem; Toprak, Murat; Arslan, Harun; Toprak, Nursen; Akdeniz, Huseyin; Gunduz, Ali Mahir
Background Degenerative change in articular cartilage is one of the most important factors in the development of osteoarthritis. Shear wave elastography can be used to identify pathologic cartilage. Purpose To evaluate distal femoral cartilage by shear wave elastography in patients with symptomatic knee osteoarthritis. Material and methods Twenty patients with bilateral knee osteoarthritis (study group) and 20 volunteers with the same demographic characteristics but without symptomatic knee pain (control group) were included in the study. A total of 80 knee joints of 40 individuals were evaluated. At the medial, intercondylar, and lateral condylar levels distal femoral cartilage thickness was measured by B-mode ultrasonography and stiffness was measured by shear wave elastography. Results The medial, intercondylar, and lateral cartilage thickness measurements were similar between the two groups and no statistically significant difference was observed (P = 0.711,P = 0.766, andP = 0.575, respectively). The shear wave velocity values in the medial and intercondylar cartilage were significantly higher in the study group (P = 0.002). Shear wave velocity values measured from lateral cartilage were higher in the study group and the difference between the groups had a borderline statistical significance (P = 0.053). Conclusion Shear wave elastography seems to be a reliable, non-invasive, and acceptable method for the assessment of pathologic cartilage.
Goldston Syndrome in a Fetus: Case Report and Literature Review
(Taylor & Francis inc, 2010) Avcu, Serhat; Akdeniz, Huseyin; Unal, Ozkan; Kurdoglu, Mertihan
We present a case of the Goldston syndrome which is the association of polycystic kidneys with Dandy-Walker malformation. The diagnosis was made by ultrasound in twenty second week of gestation. Obstetric ultrasound and fetal MRI studies showed hydrocephalus, agenesis of the cerebellar hemispheres, vermian hypoplasia, cystic dilatation of the 4(th) ventricle, enlargement of the posterior fossa, abdominal distension, and oligohydramnios.. The kidneys were symmetrically enlarged and multicystic. To our knowledge this is the third reported case of Goldston syndrome which was diagnosed during intrauterine life.
Is the Prevalence of Estimated Pelvic Congestion Higher Than Examined? a Retrospective Study of Consecutive Abdominopelvic Computed Tomog-Raphy Analyses
(Bentham Science Publ Ltd, 2022) Akdeniz, Huseyin
Background: Chronic Pelvic Pain (CPP) is a common complaint in women, and is the key factor in the diagnosis of Pelvic Congestion Syndrome (PCS). Introduction: Consecutive abdominal and pelvic Computed Tomography (CT) scans in adult female patients not diagnosed with PCS and collected over a period of 3 years were evaluated retrospectively to determine the prevalence of underestimated Pelvic Congestion (PC). Methods: 500 consecutive abdominal and pelvic CT scans collected from female patients aged 18-80 years were retrospectively analyzed for the presence of PC. Results: 90 of the CT scans examined showed the presence of PC (18%). These patients were divided into two groups: Group I had 52 scans with unilateral PC, while Group II had 38 scans with the bilateral enlarged Ovarian Vein (OV). Left and right OV diameters were measured as 7.14 +/- 2.15 and 5.56 +/- 1.87 mm, respectively. Co-occurrence of additional vascular anomalies, such as nutcrack er-type compression of the left renal vein, and May Thurner, was significantly higher in Group I than Group II (p<0.001). The diameter of the OV remained wide irrespective of age in Group I, but showed a decrease with increasing age in Group II. The most common complaint was abdominal pain; these patients required an average of six referrals to two different clinics (primarily general surgery and internal medicine) before being diagnosed with PC. Conclusion: The diagnosis of PCS remains to be an important problem for patients because of insufficient perception of physicians. PCS should be considered in female patients with complaints of chronic abdominal and pelvic pain and CT may be a valuable examination tool for diagnosis.
Prevelance of Fabella: an Mri Study in the Eastern Anatolia Region of
(Bentham Science Publ Ltd, 2021) Akdeniz, Huseyin; Ozkan, Sezai; Adanas, Cihan
Background: The fabella, which is generally located in the lateral head of the gastrocne-mius muscle, is a sesamoid bone that articulates with the posterior face of the lateral femoral condyle. As traditional information, the prevalence of fabella is between 10-30% in the population and is usually present in both knees. Introduction: The objective of this study was to investigate the knee MRIs in the Eastern Anatolia Region of Turkey subjects in order to assess the prevalence of the fabella and analyse the differ-ences between gender, age and laterality and its symmetry pattern. Methods: This study was a retrospective study in patients older than 18 years whose knee MRIs were taken between February 2014 and February 2016. In this study, a total of 531 patients (290 fe -males and 241 males) were included. The radiographs were examined by two orthopedic surgeons and the fabella was located. Later, an expert radiologist made the final decision and confirmed the results. Results: The number of patients included in the study was 531. We detected os fabella in 59 (11.1%) patients. Of the 59 os fabella, 33 were in the right knee and 26 were in the left knee, 38 were female and 21 were male. Conclusion: In this study, we investigated the age and gender differences besides the prevalence and the symmetry pattern of the fabella in the Eastern Anatolia Region of Turkey's population. Pre-valence of the fabella was found to be 11.1% which is different than previously published studies.
Syndrome of Inappropriate Secretion of Antidiuretic Hormone Cholestasis and Pericardial Effusion Due To Brucellosis Infection: a Case Report
(Hindawi Ltd, 2010) Dulger, Ahmet Cumhur; Kemik, Ozgur; Sumer, Aziz; Akdeniz, Huseyin; Kucukoglu, Mehmet Emin; Canbaz, Esra Turan; Aytemiz, Enver
Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is an extremely rare complication of infectious diseases. A rare case of brucellosis complicated by syndrome of inappropriate secretion of antidiuretic hormone (SIADH) cholestasis and pericardial involvement is reported. A 27-year-old woman was admitted for fever, abdominal pain, and scleral icterus. Hermedical history revealed no recent use of diuretic agents. In addition to cholestasis and elevated liver enzymes, euvolemic hyponatremia, hypouricemia, low plasma osmolality, and high urinary osmolality were also detected. Surrenal and thyroid tests were also within normal range. Echocardiography revealed minimal pericardial effusion with normal cardiac functions. The final diagnosis was SIADH due to Brucellosis. Hyponatremia, cholestasis, and pericardial disease were resolved with effective antibrucellar treatment with streptomycine and doxycycline. After completing treatment of brucellosis, there was not any more evidence of cholestasis and pericardial fluid.