Browsing by Author "Arslan, Harun"

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Acoustic Radiation Force Impulse Elastosonography of Placenta in Maternal Red Blood Cell Alloimmunization: a Preliminary and Descriptive Study
(Soc Romana Ultrasonografe Medicina Biologie-srumb, 2017) Cetin, Orkun; Karaman, Erbil; Arslan, Harun; Akbudak, Ibrahim; Yildizhan, Recep; Kolusari, Ali
Aims: Maternal red blood cell alloimmunization is an important cause of fetal morbidity and mortality in the perinatal period, despite well-organized prophylaxis programs. The objective of the study was to evaluate placental elasticity by using Acoustic Radiation Force Impulse (ARFI) in Rhesus (Rh) alloimmunized pregnant women with hydropic and nonhydropic fetuses and to compare those with healthy pregnant women. Material and methods: This case-control and descriptive study comprised twenty-eight healthy pregnant women, 14 Rh alloimmunized pregnant women with nonhydropic fetuses, and 16 Rh alloimmunized pregnant women with hydropic fetuses in the third trimester of pregnancy. Placental elasticity measurements were performed by ARFI elastosonography at the day of delivery. The maternal characteristics and neonatal outcomes of the patients were also noted. Results: The highest mean placental ARFI scores were observed in Rh alloimmunized pregnant women with hydropic fetuses (1.13 m/s) (p= 0.001). Healthy controls and Rh alloimmunized pregnant women with nonhydropic fetuses had similar mean placenta ARFI scores (0.84 m/s, 0.88 m/s, respectively) (p< 0.05). Conclusions: Based on the present findings, the placenta becomes stiffer in Rh alloimmunized pregnancies complicated with hydrops fetalis. The increased placental ARFI scores may be a supplemental marker for adverse pregnancy outcomes, additional to Doppler evaluation of middle cerebral artery. This data should be confirmed with a large sample size and prospective studies by using serial measurements of ARFI elastosonography in maternal red blood cell alloimmunization.
Adenoid Hipertrofisi Çocukluk Çağı Afebril Konvüzyonu ile İlişkili Olabilir mi
(2024) Aycan, Nur; Arslan, Harun
Amaç: Afebril konvüzyonlar çocukluk çağında farklı etiyolojilerle ortaya çıkabilmekte, farklı etiyolojilerle tekrar edebilmektedir. Literatürde sıklıkla hipoksi ile hastalığın ilişkisi vurgulanmış olup amacımız hava yolu darlığı ve adenoid doku volümünün afebril konvüzyonların seyrinde etkili olup olmadığını, varsa bu ilişkinin nasıl bir ilişki gösterdiğini saptamaktır. Yöntem: Van Yüzüncü Yıl Üniversitesi Hastanesi Çocuk Acil Ünitesi’ne afebril konvüzyon ile başvuran 2-8 yaş arasındaki çocukların rutin kraniyal görüntülemesi için çekilen beyin manyetik rezonans görüntülerinden adenoid doku volümü ve nazofarengeal mesafesi ölçümleri yapıldı. Hastaların demografik özellikleri, antikonvülzan ilaç kullanımları, adenoid hipertrofisi semptomları ve konvülziv atak sayıları kaydedildi. Belirlenen değişkenler açısından istatistiksel analiz yapıldı. Bulgular: Çalışmada, belirlenen tarihler arasındaki hastanemiz çocuk acil ünitesine afebril konvüzyon ile başvuran, belirlenen yaş aralığındaki ve dahil edilme kriterlerine uygun 156 çocuk retrospektif olarak incelenmiştir. Doksan iki erkek ve 64 kız çocuğunun ortalama yaşı 3,94±0,139 olup cinsiyetler arasında yaş, afebril konvüzyon atak sayısı ve nazofaringeal mesafe açısından istatistiksel anlamlı farklılık saptanmamıştır (p>0,05). Hastaların 145'i (%92,9) sadece bir antikonvülsif ilaç kullanırken, 11’i (%7,1) iki antikonvülsif ilaç kullanmaktaydı. Adenoid doku volüm boyutları erkek çocuklarında (2,17±0,09) kız çocuklarından (1,87±0,12) istatistiksel olarak anlamlı şekilde yüksekti (p=0,023). Çocukların adenoid volümü ve afebril konvüzyon atak sayıları arasında ise istatistiksel olarak anlamlı şekilde pozitif yönde bir korelasyon mevcuttu (r=0,586, p=0,0001; n=156). Sonuç: Adenoid doku volümetrik boyutlarında artış çocukluk çağı ateşsiz konvüzyon ataklarında etkili faktörlerden biri olarak düşünülebilir.
Analysis of Modic Degenerations Detected in Magnetic Resonance Imaging With Deep Learning Techniques
(2022) Yüksek, Mehmet; Arslan, Harun; Yokuş, Adem
Bu çalışmamızda, manyetik rezonans görüntülemede(MRG) saptanan modic dejenerasyon bulgularının derin öğrenme teknikleri kulllanılarak analiz edilmesi amaçlanmıştır. Gereç ve Yöntem: 2016-2021 yıllarında Lomber MRG tetkiki uygulanan, yaşları 19-86 arasında değişen 125'i kadın ve 182'si erkek toplam 307 hastada sagittal T1, sagittal ve aksiyel T2 ağırlıklı lomber MRG görüntüleri incelendi. Modic dejenerasyonlar(MD) sinyal değişikliklerine göre kategorize edilip işaretlendi. Çalışmamız sınıflandırma ve segmentasyon olmak üzere birbirinden bağımsız iki aşamadan oluşmaktadır. Kategorize edilen veriler ilk aşamada DenseNet-121, DenseNet-169, VGG-19 gibi ESA(evrişimli sinir ağı) mimarileri ile sınıflandırılmıştır. Daha sonraki aşamada ise işaretlenen resimler üzerinden resim işleme programlarıyla ESA mimarisi olan U-Net ile segmentasyon yapılarak maskeler çıkarılmıştır. Bulgular: Sınıflandırma aşamasında Modic-1, Modic-2, Modic-3 dejenerasyonlarda başarı oranı sırasıyla DenseNet-121'de %98, %96, %100 , DenseNet-169'da %100, %94, %100 , VGG-19'da %98, %92, %97 bulunmuştur. Segmentasyon aşamasında U-Net mimarisi ile başarı oranı %71 bulunmuştur. Sonuç: Bel ağrısı etiyolojisinde yer alan modic dejenerasyonların MRG bulgularının derin öğrenme mimarileriyle değerledirilmesi teşhis kolaylılığı sağlayarak radyoloji hekiminin iş yükünü önemli ölçüde azaltabilir.
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.
Bilateral Alt Ekstremite Ameli: Olgu Sunumu
(2021) Arslan, Harun; Akdemir, Zülküf; Ozen, Ozkan; Akdenız, Hüseyın
Ameli bir ekstremitenin tamamen olmaması anlamına gelir. Bu anomali izole olabileceği gibi multipl konjenital anomalilerin bir parçası olarak da bulunabilir. Ender görülen ve genellikle etyolojisi saptanamayan bir durumdur. Antenatal dönemde 24. gebelik haftasında bilateral alt ekstremite amelisi tespit edilen bir vakanın sunulması amaçlanmıştır.
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.
Castleman Hastalığı
(2020) Toprak, Nurşen; Yokuş, Adem; Arslan, Harun; Akdenız, Hüseyın; Gündüz, Ali Mahir
Castleman hastalığı ender görülen ve etiyolojisi tamolarak bilinmeyen benign bir lenfoprolifetif hastalıktır.En sık mediastinal lenf nodu tutulumu görülmekleberaber servikal, retroperitoneal, aksiller ve diğerbölgelerdeki lenf nodları da tutulabilir. Histopatolojikolarak hyalin vasküler, plazma hücreli ve miks tip olmaküzere üç tipi bulunmaktadır. Kliniğine göre de lokalizeve sistemik (multisentrik) formları bulunmaktadır.Lokalize tip genellikle asemptomatiktir ve kitle veyaşişlik ile kendini gösterir. Sistemik (multisentrik) tipteise ateş, anemi, yaygın lenfadenopati vehepatosplenomegali gibi nonspesifik semptomlargörülür. Lokalize tipin tedavisi kitlenin cerrahieksizyonudur. Sistemik tip tedavisinde genelliklesteroid, kemoterapi ve radyoterapi kullanılmasınarağmen kesin tedavisi yoktur. Bu çalışmada ses kısıklığışikâyeti ile gelen ve hyalin vasküler tip Castlemanhastalığı tanısı konulan bir olgu sunuldu.
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.
A Comparative Evaluation of Cataract Classifications Based on Shear-Wave Elastography and B-Mode Ultrasound Findings
(Springer international Publishing Ag, 2019) Ozgokce, Mesut; Batur, Muhammed; Alpaslan, Muhammed; Yavuz, Alpaslan; Batur, Abdussamet; Seven, Erbil; Arslan, Harun
In this study, a comparison is made of the findings of B-mode ultrasound and ultrasound elastography with the Lens Opacities Classification (LOCS) grade in patients with senile cataracts. A total of 74 patients with cataracts and 32 age-matched healthy volunteers as the control group were evaluated in the departments of ophthalmology and radiology between 2016 and 2017. In the patient group, cataracts were graded according to LOCS, and B-mode sonographic appearance and elasticity measurements were recorded, after which the cataract grade and sonoelastography/B-mode ultrasound findings were compared using statistical methods. Among the 74 patients with cataracts, 38 were females (51.4%) and 36 were males (48.6%), and the mean age was 62.05 +/- 7.95 (43-78) years. A Chi-square test revealed a significant relationship between ultrasound echogenicity of cataract and grade of cataract (p < 0.005). The ultrasound elastography revealed a mean shear-wave velocity of 2.90 m/s +/- 0.371 (2.13-3.53) among patients with grade 3 cataracts, 3.1 m/s +/- 0.45 (2.26-3.98) among patients with grade 4, 3 m/s +/- 0.58 (2.35-4.60) among patients with grade 5 and 3 m/s +/- 0.528 (2.31-4.50) among patients with grade 6 cataracts, and 3 m/s +/- 0.258 (2.36-3.58) among the normal subjects. No statistically significant difference was noted in the analysis of variance (p > 0.005). While cataract grade and B mode echogenicity were directly proportional, there was no significant difference in lens elasticity.
Comparison of Computed Tomography Densitometry and Shear Wave Elastography Velocity Measurements for Evaluation of the Liver Volume in the Nonalcoholic Fatty Liver Disease
(E-century Publishing Corp, 2016) Bulut, Mehmet Deniz; Ozdemir, Hayrullah; Bora, Aydin; Yavuz, Alpaslan; Arslan, Harun; Batur, Abdussamet; Ozgokce, Mesut
Purpose: The aim of the present study is to evaluate and compare the values of velocities measured by the shear wave elastography (SWE), and those of the liver attenuation index (LAI) determined by the computerized tomography (CT) densitometry, in the nonalcoholic fatty liver disease (NAFLD). In other words, we aimed to compare the values of density measured by CT and the stiffness determined by elastography, in the liver steatosis. In addition, it is to investigate the effect of NAFLD on the liver volume. Materials and methods: Forty five cases with hepatosteatosis who had undergone abdominal CT and 50 individuals who did not exist with fatty liver clinically and radiologically, were investigated by ultrasonography (US) and SWE. The liver and spleen attenuation values were then measured in the images of non-contrast CT, and the LAI indices were calculated. Contrast images of abdomen were processed by the CT-Volume software and measurements of liver volume were performed using the interactive and automatic liver segmentation techniques together. Values of the liver volume, LAI, liver dimensions, and the shear wave velocities were determined and recorded in the patients with hepatosteatosis and controls; statistical comparisons were performed then. Results: In the nonalcoholic fatty liver, the mean value of velocity measured by SWE was found to be 1.08 (+/- 0.11) m/s, and that of LAI measured by CT densitometry was 13.68 (+/- 10.6). No correlation was observed between these two parameters (P>0.05). A high statistically significant difference between the patient and control groups in terms of the liver volume, LAI values and liver size has been observed (P<0.01). Direct correlations existed between the liver volume and LAI values, and the grades in US, and highly significant differences were determined (P<0.01). The mean values of the liver volume in the patient and control groups were determined to be 1917.4 (+/- 425.9) cm(3) and 1311.4 (+/- 241.4) cm(3), respectively. A high statistically significant difference between the groups in terms of liver volumes has been observed (P<0.01). Conclusion: In our study, we determined no correlation between the values of velocity measured by SWE, and the values of LAI measured by CT densitometry, in the NAFLD (P>0.05). This result indicates that there is no relation between the degree of stiffness evaluated by SWE, and the attenuation values measured by CT densitometry, in the non-alcoholic fatty liver. The liver volume was found to increase in NAFLD. We concluded that the CT densitometry can be used as an auxiliary technique associated with the US, in determining the degree of steatosis in NAFLD.
Comparison of Efficiencies Between Shear Wave Elastography, Fine-Needle Aspiration Biopsy and American College of Radiology Thyroid Imaging Reporting and Data System Scoring System in Determining the Malignity Potential of Solid Thyroid Nodules
(Lippincott Williams & Wilkins, 2021) Yavuz, Alpaslan; Akbudak, Ibrahim; Ucler, Rifki; Ozgokce, Mesut; Arslan, Harun; Batur, Abdussamed
We aimed to evaluate the efficiencies of quantitative shear-wave elastography, fine-needle aspiration (FNA) biopsy and American College of Radiology (ACR)-thyroid imaging reporting and data system (TIRADS) scoring system in determining the malignity potential of solid thyroid nodules. In period between September 2014 and January 2016, 191 solid thyroid nodules of 189 patients were enrolled in this study. The mean shear wave velocities of the nodules were recorded by acoustic radiation force impulse method. All nodules were classified according to ACR-TIRADS scoring system and underwent FNA procedure. The cytopathologic results (after FNA) were benign in nature, atypical-cytology/suspiciously malign and highly suspicious of malignity in 117, 28, and 21 nodules, respectively. The specimen from FNA was insufficient in 25 nodules. Thirty-four nodules of 33 enrolled patients were operated, and the efficiencies of shear wave elastography, FNA, and ACR-TIRADS procedures were statistically analyzed; relying on the histopathologic results, the shear-wave elastography had 83.3% sensitivity, 93.7% specificity (with a cutoff value of 2,74 m/s), the FNA had 94.4% sensitivity, 87.5% specificity, and ACR-TIRADS had 88.2% sensitivity, 94.1 specificity in determining malignant tyroid nodules (P < 0.005). Quantitative shear wave elastography is concluded to be an effective, noninvasive, and practical imaging modality with a lesser sensitivity and specificity values than TIRADS unless a lower sensitivity but a higher specificity values than FNA (93.7% vs 87.5%) in considering the malignity potential of solid thyroid nodules.
Comparison of Placental Elasticity in Normal and Pre-Eclamptic Pregnant Women by Acoustic Radiation Force Impulse Elastosonography
(Wiley-blackwell, 2016) Karaman, Erbil; Arslan, Harun; Cetin, Orkun; Sahin, Hanim Guler; Bora, Aydin; Yavuz, Alparslan; Akbudak, Ibrahim
AimThe aim of this research was to study and compare placental elasticity with acoustic radiation force impulse (ARFI) elastography in pre-eclamptic and normal pregnancies. MethodsA total of 107 singleton pregnancies in the third trimester (38 healthy control subjects, 34 patients with gestational hypertension, and 35 pre-eclampsia patients) were included in the study. ARFI elastography was used to determine the placental elasticity in the three predetermined regions of the placenta (the fetal edge, maternal edge, and central part of the placenta). The obstetrical data regarding grayscale and Doppler ultrasonography and perinatal outcomes were reviewed. A mean placental shear wave velocity cut-off value that predicts the presence of pre-eclampsia was determined. ResultsThe shear wave elasticity values in the pre-eclampsia group in all three regions were significantly higher than in the gestational hypertension and healthy control groups (P=0.001). The most significant difference was found in the peripheral edge of the placenta from the fetal surface in the pre-eclampsia group (P=0.001). ConclusionThe stiffness of the placenta determined by the ARFI technique is significantly higher in pre-eclampsia patients. ARFI elastography of the placenta might be used as a non-invasive and easy method in the diagnosis and evaluation of pre-eclampsia as a supplement to the already existing methods.
Contribution of Diffusion Weighted Mri To Diagnosis and Staging in Gastric Tumors and Comparison With Multi-Detector Computed Tomography
(Assoc Radiology & oncology, 2017) Arslan, Harun; Ozbay, Mehmet Fatih; Calli, Iskan; Dogan, Erkan; Celik, Sebahattin; Batur, Abdussamet; Kotan, Mehmet Cetin
Background. Diagnostic performance of Diffusion-Weighted magnetic resonance Imaging (DWI) and Multi-Detector Computed Tomography (MDCT) for TNM (Tumor, Lymph node, Metastasis) staging of gastric cancer was compared. Patients and methods. We used axial T2-weighted images and DWI (b-0,400 and b-800 s/mm(2)) protocol on 51 pre-operative patients who had been diagnosed with gastric cancer. We also conducted MDCT examinations on them. We looked for a signal increase in the series of DWI images. The depth of tumor invasion in the stomach wall (tumor (T) staging), the involvement of lymph nodes (nodal (N) staging), and the presence or absence of metastases (metastatic staging) in DWI and CT images according to the TNM staging system were evaluated. In each diagnosis of the tumors, sensitivity, specificity, positive and negative accuracy rates of DWI and MDCT examinations were found through a comparison with the results of the surgical pathology, which is the gold standard method. In addition to the compatibilities of each examination with surgical pathology, kappa statistics were used. Results. Sensitivity and specificity of DWI and MDCT in lymph node staging were as follows: N1: DWI: 75.0%, 84.6%; MDCT: 66.7%, 82%;N2: DWI: 79.3%, 77.3%; MDCT: 69.0%, 68.2%; N3: DWI: 60.0%, 97.6%; MDCT: 50.0%, 90.2%. The diagnostic tool DWI seemed more compatible with the gold standard method (surgical pathology), especially in the staging of lymph node, when compared to MDCT. On the other hand, in T staging, the results of DWI and MDCT were better than the gold standard when the T stage increased. However, DWI did not demonstrate superiority to MDCT. The sensitivity and specificity of both imaging techniques for detecting distant metastasis were 100%. Conclusions. The diagnostic accuracy of DWI for TNM staging in gastric cancer before surgery is at a comparable level with MDCT and adding DWI to routine protocol of evaluating lymph nodes metastasis might increase diagnostic accuracy.
Costa Originated Giant Aneurysmal Bone Cyst
(Erciyes Univ Sch Medicine, 2010) Cobanoglu, Ufuk; Kosem, Mustafa; Altindal, Ebru; Arslan, Harun
A 56-years-old female patient who had a traffic accident 10 years ago applied to our outpatient clinic with complaints of dyspnea for 2 years, chest pain and an enlarging mass on her right chest side wall. There was a mass lesion sized 14 x 10 cm beginning from the 715 level with chest x-ray. Mass was resected totally to cover the relevant costas and thorax front wall muscular structure which was encompassed and diaphragm region. Aneurysmal Bone Cyst having solid and cystic components was reported at the pathologic examination.
Duodenal Lipom: Bilgisayarlı Tomografi Bulguları
(2019) Akdemir, Zülküf; Arslan, Harun; Toprak, Nurşen; Akdenız, Hüseyın
Duodenal lipomlar, gastrointestinal sistemin iyi huylutümörleri olup, literatürde sınırlı vaka bildirileri vardır.En sık yerleşim yeri kolondur (% 64), bunu incebağırsak (% 26), duodenum (% 4), mide (% 3) ve yemekborusu (% 2) izlemektedir. Duodenumda, lipomlarçoğunlukla ikinci kısımda görülme eğilimindedir ve ensık submukozal düzlemde bulunur, fakat aynı zamandasubserozal olabilir ve sapsız veya pedinküllü olabilir.Çoğunlukla asemptomatiktirler ancak daha büyükolanlar karın ağrısı, bağırsak tıkanması veya kanamayaneden olabilir. Endoskopi ve modern görüntülemetekniklerindeki son gelişmeler nedeniyle, daha fazlavaka teşhis ve tedavi edilmektedir. BilgisayarlıTomografi (BT) tanı için ilk tercihtir. Tedavi hastanındurumuna, tümörün büyüklüğüne ve lokalizasyonunabağlıdır. Bu çalışmada, son altı aydır yemek sonrasıdevam eden üst karın dolgunluğu ve mide ekşimesi ilebaşvuran ve duodenal lipom tanısı alan bir hastanın BTbulguları sunulmaktadır.
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.
Evaluation of Computed Tomography Angiography as an Ancillary Test To Reduce Confusion After Clinical Diagnosis of Brain Death
(Elsevier Science inc, 2021) Tekeli, Arzu Esen; Demirkiran, Hilmi; Arslan, Harun
Background. The diagnosis of brain death (BD) is mainly a clinical diagnosis. Ancillary tests may be used in confusing situations. Although computed tomography angiography (CTA) has high sensitivity and specificity, it can give false-positive results in cases with craniotomy. Objective. The aim of this study is to emphasize the importance of accurate and detailed clinical diagnosis and to reveal that there is organ loss as a result of prolonged supportive tests, especially in developing countries. Material and Methods. This retrospective study included patients who were diagnosed with BD in the intensive care unit of Van Y?z?nc? Y?l University, between September 2014 and August 2017 in Turkey. The study included 14 male and 8 female patients. Patients who did not show any spontaneous respiratory symptoms after the apnea test were diagnosed with clinical BD. Patients on neurodepressant medications who were hypothermic or hypoxic or had a severe endocrine or metabolic disorder were excluded from the study. CTA was used as an ancillary test in compliance with legal requirements. Age, sex, hospitalization days, day of clinical diagnosis of BD, first radiologic evaluation by CTA, clinical diagnosis, and radiologic evaluation were recorded for all patients. Results. Radiologic evaluation was not compatible with the clinical evaluation in 5 patients. Although 2 of these 5 patients had BD diagnosis clinically, blood flow could be expected during CTA because of cranial injury. Unlike in the literature, false positivity was found in 3 patients with hypoxic ischemic encephalopathy in the present study. Conclusions. Proper management of limited resources and the facilitation of cadaver organ donation in developing countries are important and humanitarian global responsibilities. Revision of the country?s legal regulations is important and is warranted in & nbsp;this regard.