Browsing by Author "Kabaalioglu, Adnan"

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Advantages of Us in Percutaneous Dilatational Tracheostomy: Randomized Controlled Trial and Review of the Literature
(Radiological Soc North America, 2014) Yavuz, Alpaslan; Yilmaz, Murat; Goya, Cemil; Alimoglu, Emel; Kabaalioglu, Adnan
Purpose: To compare procedure times and complication rates of preincisional ultrasonographic (US) evaluation and perioperative US guidance in percutaneous dilatational tracheostomy (PDT) with those of the current standard of care, PDT performed without image guidance. Materials and Methods: Between December 2007 and January 2011, 341 patients were included in this institutional review board-approved study after informed consent was obtained from the patients or their relatives. The patients were divided randomly into two groups. In group A (n = 166), the possible causes of complications, such as aberrations of tracheal, thyroidal, and vascular structures, were determined with US, and tracheal measurements were performed by using US. The clinician's initial considerations at physical examination were compared with the US findings. PDT was subsequently performed with US guidance in suitable cases. In group B (n = 175), PDT was performed solely on the basis of physical landmarks. The procedure times and complication rates were compared across groups by using the Fisher exact test. Results: In group A, the puncture sites designated at the physical examination were reconsidered in 39 (23.8%) of 164 cases. The perioperative complication rates were slightly lower in group A (7.8% [12 of 154]) than in group B (15.0% [25 of 167]); however, the difference did not achieve statistical significance (P = .054). The mean procedure times for groups A and B were 24.09 minutes +/- 8.05 (standard deviation) (range, 14-68 minutes) and 18.62 minutes +/- 6.34 (range, 12-81 minutes), respectively (P = .001), and the numbers of patients in each group who required multiple puncture attempts were six (3.9%) of 154 and 23 (13.6%) of 169 (P = .003), respectively. Conclusion: The use of US guidance before and during PDT could render the procedure easier and safer, with fewer complications but a slightly longer procedure time. (C) RSNA, 2014
The Reliability of Color Doppler "twinkling" Artifact for Diagnosing Millimetrical Nephrolithiasis: Comparison With B-Mode Us and Ct Scanning Results
(Springer Japan Kk, 2015) Yavuz, Alpaslan; Ceken, Kagan; Alimoglu, Emel; Kabaalioglu, Adnan
To compare the effectiveness of B-Mode and color-Doppler ultrasound imaging features, including "twinkling-artifact" with unenhanced CT for detecting millimetrical nephrolithiasis. 397 patients were examined for suspected urolithiasis with US and CT were included. US findings such as echogenic focuses, posterior acoustic shadowing and twinkling artifact were examined for their ability to detect millimetricalcalculies (greatest diameter a parts per thousand currency sign5 mm) using CT findings as the gold-standard. The accuracy of US for measuring stone size was also investigated. 219 millimetriccalculies in 164 cases were detected by CT. The sensitivity and positive-predictive-values for the detection of microcalculies were 76.7 and 94.9 %, 85.8 and 88.3 %, 40.6 and 97.8 %, 68.9 and 94.4 %, and 38.4 and 97.7 % for the presence of B-Mode echogenity, twinkling-artifact, B-Mode echogenity with acoustic shadowing, B-Mode echogenity with twinkling-artifact, B-Mode echogenity with acoustic shadowing and twinkling-artifact, respectively. No significant difference between US and CT was observed in quantification of nephrolithiasis sizes (p = 913). Twinkling-artifact based color-Doppler US is preferable for the sensitive detection of millimetrical nephrolithiasis; however, the high false-positive value of this technique, which can lead to an overestimation of the stone number, has to be considered.