Browsing by Author "Durmaz, F."

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Can Computerized Tomography Hounsfield Unit Values Be Useful in the Differential Diagnosis of Pleural Effusion
(Tabriz University of Medical Sciences, 2020) Durmaz, F.; Ozgokce, M.; Ayyildiz, V.A.; Cilingir, B.M.; Goya, C.
Introduction: We aimed to investigate the efficacy of Hounsfield unit (HU) attenuation measured on computed tomography (CT) as a non-invasive method for pleural effusion characterization. Methods: Patients with pleural effusion who underwent thoracic CT imaging and thoracentesis within a maximum of three days were included in this retrospective study (15 transudate and 36 exudate). By drawing a circular region of interest (ROI) on the section with the thickest pleural effusion in terms of anteroposterior diameter in the upper-medial-lower zone on axial images, a total of three HU values, one from each level, were averaged. An independent t-test was applied to the CT attenuation (HU) values for the transudate-exudate differentiation. A receiver operating characteristic (ROC) analysis was then made. Results: The mean attenuation±standard deviation (minimum-maximum) value for the patients with transudate was 2.17±3.76 ((-7.5)-7.5) HU, whereas the mean HU value for the patients with exudate was 8.38±6.2 ((-6)-22). The independent t test made for the transudate-exudate differentiation revealed a statistically significant difference (P=0.001). In the ROC analysis carried out to determine the cut-off value of the attenuation value of pleural effusion in the transudate-exudate differentiation, the area under the curve was found to be 82.8%. When the cut-off value was taken as 2.75HU for the area under the curve, sensitivity was found to be 84%, and specificity was 60%. Conclusion: Although CT-HU values are statistically significant in the differential diagnosis of transudate-exudate, there is still a need to establish a correlation with other tomographic findings and clinical laboratory findings. © 2020 The Author(s).
The Comparison of Diffusion Weighted Imaging (Dwi) With Other Breast Mri Parameters in the Diagnosis of Breast Masses
(Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Özgökçe, M.; Havan, N.; Cuce, F.; Durmaz, F.; Sakci, Z.
The breast MRI parameters such as morphologic features, enhancement kinetics and diffusion restriction can be used for the differential diagnosis. We aimed to compare the Apperant Diffusion Coefficient (ADC) values of masses with other MRI parameters in diagnosis of breast masses. Between March 2014 and September 2017, 49 female patients in whom a breast mass was diagnosed, determined using ultrasound and mammography and who were further examined with MRI, were enrolled to this study. Total 51 lesions were detected. Routine breast MRI protocol was performed and images were evaluated. The ADC cut-off value was taken as 1,1×10-3mm2 /s according to the literature. Fifty-one lesions were diagnosed with biopsy. Of these lesions, 23 (45.1%) were malignant (20 invasive ductal carcinoma and others) and 28 (54.9%) were benign (20 fibroadenomas and others). The accuracy rate of DCE assessment of MRI was 90,9% for benign lesions in with a type 1 curved lesions, and 81,8% for malign lesions in with a type 3 curved lesions. The accuracy rate of ADC values was 93,1% for benign lesions and 95,5% for malign lesions. We believe that the ADC value can provide a higher diagnostic accuracy with the combination of morphological characteristics and contrast kinetics of the lesion and that ADC can be used alone because of its high diagnostic accuracy in some cases. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Computed Tomography Findings of Atypical Intralobar Pulmonary Sequestration: a Case Series
(Tabriz University of Medical Sciences, 2021) Özkaçmaz, S.; Özgökçe, M.; Akıncı, M.B.; Durmaz, F.; Dündar, İ.; Göya, C.; Sayır, F.
Introduction: Bronchopulmonary sequestration is a rare congenital abnormality of the lung that has two different types as intralobar and extralobar. In this study, we aimed to present six cases of intralobar sequestration with atypical findings in terms of feeding, drainage, and localization. Methods: Patients diagnosed with intralobar pulmonary sequestration in our clinic between 2015 and 2019 were evaluated retrospectively. Demographical features and atypical computed tomography (CT) findings of the patients were presented by literature. Results: Among 45 patients with intralobar sequestration, 6 (13.3%) (5 males and 1 female) with a mean age of 43.5±25.4(0-78) years old had atypical pulmonary findings on CT images. Atypical features regarding arterial supply was detected in 8.9%, venous drainage in 2.2%, location in 4.4%, radiological appearance in 4.4% and co-existing lesion in 2.2% of the patient with intralobar sequestration. Conclusion: Typical and atypical features of pulmonary sequestration must be well-known for differential diagnosis of solid or cystic pulmonary lesions. © 2021 The Author(s).
Detection of Incidental Findings on Chest Ct Scans in Patients With Suspected Covid-19 Pneumonia
(Yuzuncu Yil Universitesi Tip Fakultesi, 2021) Dündar, İ.; Özkaçmaz, S.; Durmaz, F.; Çoban, L.T.; Aygün, G.; Yıldız, R.; Türkoğlu, S.
This study aimed to evaluate the chest Computed Tomography (CT) scans of COVID-19 suspected patients in the first period of the pandemic, to reveal the frequency of parenchymal-extraparenchymal incidental findings (IFs). Our single-center retrospective observational study was initiated with the approval of the ethics committee. Chest CT records taken during March-August 2020 due to the suspicion of COVID-19 pneumonia were scanned using the imaging archive of our center. The study was conducted with 1540 patients with non-contrast chest CT without prior CT imaging to detect IFs. Histopathological results and clinical-radiological follow-up data of the patients were scanned from medical records. Of the 1540 patients in our study, 902 (58.57%) were male and 638 (41.43%) were female, with a mean age of 41.96±17.08 (5-92) years. While 248 (16.1%) patients had a typical appearance for COVID-19 pneumonia on thorax CT, no findings were found in 1180 (76.6%) patients. Except for COVID-19 pneumonia, parenchymal IFs(primary malignant lung lesions, metastatic lesions, benign pathologies) were detected in 73 patients (4.74%) and extraparenchymal IFs(lymphadenopathy, breast lesions, thyroid nodule, bone, liver and kidney lesions…) in 280 patients (18.8%). Our study showed that the number of patients without any findings in terms of COVID-19 pneumonia on CT scans is high. It is understood that CT scans for pneumonia are unnecessary due to radiation exposure and should be used when clinically necessary. However, due to the ability of CT to detect incidental findings, it is also important to define IFs oth er than pneumonia in patients who underwent chest CT examination during the pandemic. © 2021, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
The Effectiveness of Hounsfield Unit Values in the Differentiation of Malign and Benign Thyroid Nodules
(Yuzuncu Yil Universitesi Tip Fakultesi, 2021) Durmaz, F.; Ozgokce, M.
Thyroid nodules are today encountered more frequently due to the advances in imaging methods. Here, we aimed to evaluate the efficacy of computed tomography Hounsfield Unit (HU) values in the differential diagnosis of benign or malign thyroid nodules. This retrospective study involved 51 patients with thyroid nodules who had thyroid fine needle aspiration biopsy (FNAB) result and chest computed tomography (CT) with or without contrast-enhanced, between January 2018 and September 2020. Circular ROIs (region of interest) were drawn on the section that best demonstrated the thyroid nodule on CT and obtained HU values were averaged. An independent t test was applied to the HU values for the malign-benign differentiation. Of the 40 patients who had contrast-enhanced CT, 25 were benign and 15 were malign. Of the 11 patients who had non-enhanced CT, 6 were benign and 5 were malign. In contrast-enhanced scans, nodule attenuation was statistically significantly higher in malign nodules (116.26±17.74 HU) when compared with benign nodules (93.84±24.33 HU) (p= 0.004). A receiver operating characteristic (ROC) analysis revealed an area under the curve of 78.8%. The sensitivity and specificity of the cut-off value of 104.5 for the area under the curve were found to be 80% each. In non-enhanced scans, nodule attenuations were not significantly different in malign (49±12.14 HU) and benign (67.5±16 HU) nodules (p= 0.72). Considering the possibility of malignancy in thyroid nodules, the thyroid gland should be evaluated carefully with thoracic CT. Sonographic correlation is recommended for nodules with a HU value of 104.5 and above detected on contrast-enhanced tomography images. © 2021, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Is There Correlation Between Flow Volume and Kt/V Ratio in Upper Arm Arteriovenous Fistula in Patients End Stage Renal Failure
(Tabriz University of Medical Sciences, 2023) Turko, E.; Gunduz, A.M.; Gurbuz, A.F.; Durmaz, F.; Dundar, I.; Goya, C.; Yokus, A.
Introduction: Chronic kidney disease is irreversible and may result in end-stage renal failure (ESRF). The kidney replacement program is determined by calculating Kt/V ratios, one of the dialysis efficiency indicators in treatment planning in routine dialysis applications in ESRF patients. We aimed to investigate whether there is a correlation between flow rate and Kt/V ratio. Methods: All patients were evaluated by B-mode ultrasonography (US) and color doppler ultrasonography (CDUS). The anastomosis line diameter was measured in the B-mode US. The fistula flow rate was calculated in a spectral examination at the anatomical location where the fistulized flow was best obtained at the anastomosis level. Patients with a fistula flow rate above 300 mL/min in CDUS examinations were considered reasonable flow rates. The fistula flow rate in these patients was compared with the Kt/V ratios. Spearman’s rank correlation coefficient was calculated since the normal distribution condition was not met to determine the relationship between variables. Results: The results of this study showed a high level (r=0.72, P=0.001) of positive and statistically significant correlation between flow rate and Kt/V ratio in upper arm arteriovenous fistula in patients with end stage renal failure. Conclusion: We found a highly positive and statistically significant correlation between fistula flow rate and Kt/V ratio. Low Kt/V ratios have different causes. Low fistula flow should be considered first in low Kt/V values. © 2023 The Author(s).
Radiological Appearance of Hiatal Hernias on Computed Tomography
(Yuzuncu Yil Universitesi Tip Fakultesi, 2022) Ayyildiz, V.A.; Özgökçe, M.; Türkoğlu, S.; Dündar, I.; Durmaz, F.; Özkaçmaz, S.; Türko, E.
A hiatal hernia is the herniation of organs and structures in the abdominal cavity through the esophageal opening of the diaphragm. We aimed to present the tomographic findings of hiatal hernia types. The computed tomography (CT) images and demographic characteristics of the patients diagnosed with hiatal hernias based on contrast-enhanced and/or non-contrast thorax-abdominal CT scan between January 2016 and December 2019 were retrospectively reviewed (Material & Method shortened in abstract.). Oral contrast material wasn’t given to the patients. (Added) 210 patients with hiatal hernias, 126 (60%) were female and 84 (40%) were male. Among these patients, 124 (59 %) had type 1, 76 (36 %) had type 2, nine (4.2 %) had type 3, and one (0.4 %) had type 4 hiatal hernia. The most common complaints were cough (64%) and mild shortness of breath (34%). The most common clinical signs seen in the majority of patients were weight loss (73%) and loss of appetite (41%). All of the cases were mainly diagnosed based on radiological (CT) findings. With the increase in the use of CT for thoracic and abdominal diseases, there has been an increase in the frequency of incidental detection of hiatal hernias. Hernia diagnosis is important for preoperative surgical planning. Radiologists should be aware that complications of hiatal hernia can cause morbidity and mortality. The best diagnosis method is considered as CT, which is also useful in determining the type of hiatal hernias. © 2022, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Radiological Imaging Findings of Avalanche Victims With Traumatic Lesions in Van Eastern Province of Turkey
(Yuzuncu Yil Universitesi Tip Fakultesi, 2021) Özkaçmaz, S.; Dündar, İ.; Çoban, L.T.; İlik, İ.; Durmaz, F.; Çallı, İ.
This study aimed to present the radiological findings of survivors from two avalanches within two days in the same valley. This retrospective descriptive study was carried out in two centers after ethics committee approval. The radiological and demographical findings of 47 survivors were screened from two hospital databases. Patients were classified regarding the type of traumatic lesion as well as the lesion sites. A total of 39 traumatic lesions in 22 patients were detected via radiological imaging modalities. The female/male ratio was 4.8% (1/21) and the mean age was 42.6±17.1 years (24-86 years). Among the 39 traumatic lesions, 13 (33.3%) were detected in the extremities (4 in the muscles/ligaments, 9 in the bones), 9 (23.1%) in the spine (5 transverse, 2 spinous process, and 2 corpus fractures), 9 (23.1%) in the thorax (5 pulmonary contusion, 1 pneumomediastinum, 1 hemothorax, and 2 rib fractures), and 8 (20.5%) in the head (1 subdural hematoma, 5 maxillofacial fractures, and 2 subcutaneous hematomas). There were no abdominal or pelvic lesions detected in this study. Traumatic lesions can be seen in all systems and organs. Results of this study revealed that spinal and extremity fractures and pulmonary contusions were the most commonly reported traumatic lesions in the included av alanche victims. Muscular injuries were also detected. The use of MRI increases the success of lesion detection in intracranial structures and muscular-ligamentous tissues. © 2021, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Radiological Tips on Safe Tract Selection in Computed Tomography-Guided Transthoracic Biopsy: Single-Center Results
(Tabriz University of Medical Sciences, 2024) Koca, H.; Özgökçe, M.; Akinci, M.B.; Durmaz, F.; Ayyildiz, V.A.; Özkaçmaz, S.; Göya, C.
Introduction: The vast majority of lung masses are malignant. Benign lung masses include granulomatous inflammation and pneumonia consolidations. Malignant lung masses include lung cancers, lymphoma, and thymic neoplasms. Differentiating benign-malignant lung masses and treatment planning are essential for the prognosis of patients. Computed tomography (CT) guided transthoracic lung biopsy is a reliable diagnostic method with high accuracy and relatively few complications when an appropriate trace is selected. In this study, we aimed to present our experience and the results of lung mass cases that we biopsied with the guidance of CT. Methods: A total of 57 patients who were referred to us for clinicoradiological transthoracic biopsy (TTB) were studied with CT-guided histopathological sampling. The study did not include patients with no pathology results and ultrasound-guided biopsy. Results: A total of 57 patients, 42 male (73.6%) and 15 female (26.4%) with a mean age of 59.05 ± 17.04 (1-85), were evaluated. Thirteen of the lesions were reported as benign (22.8%), and 44 as malignant (77.2%). Conclusion: When an appropriate trace is selected, CT-guided transthoracic lung biopsy is a reliable diagnostic method with high accuracy and relatively few complications. © 2024 The Author(s).