Browsing by Author "Yokus, Adem"

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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.
Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings
(Galenos Yayincilik, 2022) Toprak, Nursen; Aras, Ibrahim; Toktas, Osman; Yokus, Adem; Gunduz, Ali Mahir
Objective: The stiffness of a breast lesion provides information on the likelihood of malignancy. The most important factor affecting this stiffness is the composition of the extracellular matrix (ECM). The aim of this study was to assess the elastin fiber contents of malignant breast lesions and fibroadenomas and investigate any relationship between the shear wave velocity (SWV) measured by ultrasonography, and the elastin fiber content of lesions. Materials and Methods: Consecutive patients with breast lesions were enrolled. The SWV values of the lesions were analyzed. Histopathological analysis of elastin in excised lesions was performed by the method of Shivas and Douglas. Breast cancer patients were reviewed according to their lymph node status and tumor diameter. The relationship between SWV value and tissue elastin fiber score was analyzed. The correlation between breast cancer grade and elastin fiber score in malignant lesions was investigated. Results: A total of 167 consecutive breast lesions in 167 patients were included in this study (75 invasive cancer, 92 fibroadenomas). High elastic fiber score was significantly more common (p = 0.001) in malignant lesions (n = 61; 81.3%) than fibroadenomas (n = 13; 14.1%). There was a negative correlation between the mean SWV and the elastin fiber score of fibroadenomas (p = 0.001). A low grade in breast cancer was associated with high elastin fiber score (p = 0.01). Conclusion: Malignant lesions tend to have higher elastin fiber scores than fibroadenomas. Elastin fiber assessment may provide additional prognostic information in malignant lesions. Changes in elastin fiber content may account for the variation in elasticity in fibroadenomas.
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.
Comparison of Microwave Ablation and Lobectomy in the Treatment of Benign Thyroid Nodules
(Wiley, 2025) Turkoglu, Saim; Yilmaz, Abdullah Hilmi; Yokus, Adem; Ulutas, Mehmet Esref
Purpose: The purpose of this study is to evaluate the efficacy, safety, and advantages of microwave ablation (MWA) compared to lobectomy in the treatment of benign thyroid nodules. Methods: A total of 105 patients were included in the study, 49 in the MWA group and 56 in the surgical group. The mean age of the patients in the MWA group was 49.5 (+/- 12.8) and 40.2 (+/- 10.1) in the surgical group (p < 0.001). 81.6% of the patients in the MWA group were female and 18.4% were male. 83.9% of the patients in the surgical group were male and 16.1% were female (p = 0.75). Patients were followed for at least 12 months. The study was completed by comparing the two groups in terms of surgery-procedure times, complications, nodule sizes, thyroid function tests, symptoms, volume reduction rates (VRR), and cosmetic improvement scores. Results: The mean maximum nodule diameter in the patient group who underwent MWA was 3.5 (+/- 1) cm at the beginning and 2.3 (+/- 0.9) cm at the end of the 12th month (p < 0.001). VRR was 73.4% (+/- 14.8) at the end of the 12th month (p < 0.001). Cosmetic score was 2.5 (+/- 1) at the first month, 1.7 (+/- 1.1) at the third month, 1 (+/- 1) at the sixth month, and 0.6 (+/- 0.7) at the 12th month (p < 0.001). The procedure time was 15.4 (+/- 4.4) minutes in the patients in the MWA group, while it was 70.7 (+/- 17.2) minutes in the surgical group (p < 0.001). No complications developed in 48 patients (98%) in the MWA group and 38 patients (67.9%) in the surgical group (p = 0.005). Voice change occurred in three patients (5.4%) in the surgical group, hematoma in two (3.6%) patients and voice change in one (1.8%) patient in the MWA group. Hypothyroidism developed in eight patients in the surgical group, while hypothyroidism did not develop in the MWA group (p = 0.007). Conclusion: MWA is a safe and effective treatment method for benign thyroid nodules. It has many advantages over thyroidectomy, such as fewer complications, shorter procedure time, no need for hospitalization and general anesthesia, and good cosmetic results.
A Diagnostic Clue in Cerebellar-Type Multiple System Atrophy: the Hot Cross Bun Sign
(Ma Healthcare Ltd, 2023) Yokus, Adem
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.
Evaluation of Common Carotid and Vertebral Arteries Flow Volumes in Patients With Ankylosing Spondylitis
(Bayrakol Medical Publisher, 2020) Orak, Suat; Bora, Aydin; Yokus, Adem; Ozkacmaz, Sercan; Senkoy, Emre
Aim: The aim of this study was to compare carotid intima-media thickness (IMT) and common carotid artery-vertebral artery flow volumes in ankylosing spondylitis patients with age and sex-matched healthy controls. Materials and Methods: Fifty patients with ankylosing spondylitis (study group) and 50 healthy volunteers (control group) were included in the study. At first, carotid intima-media thickness (IMT) measurements were performed in supine-neutral position by B-mode ultrasonography (US). Afterwards, common carotid and vertebral artery flow volumes were calculated by Doppler US in the neutral, right rotational, and left rotational positions. Results: Carotid IMT was significantly higher in the study group according to the control group (p=0.001). The common carotid artery (CCA) and vertebral artery (VA) flow volumes in the neutral position were similar between the two groups. There was no significant difference in CCA flow volumes between the groups in right and left rotational positions (p>0.05). Right vertebral artery and total vertebral artery flow volumes in the right rotational position were significantly lower in the study group (p=0.022 and p=0.005 respectively). In the left rotational position, left vertebral artery and total vertebral artery flow volumes were significantly lower in the study group when compared with the control group (p=0.001). Discussion: In our study, carotid IMT was significantly higher in patients with AS compared to healthy controls. Besides, significant volume decreases in vertebral artery flow volumes were detected in the study group in rotational positions.
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.
Examining Changes on Testicular Structure and Sperm Analysis of Covid-19 Patients
(Wiley, 2022) Ertas, Kasim; Eryilmaz, Recep; Yokus, Adem; Korpe, Kadir; Geduk, Nurullah; Ozkan, Mazlum; Aslan, Rahmi
This study aimed to examine the testicular functions with sperm analysis of patients with COVID-19. The study was carried out with male patients aged between 18 and 50 years with positive RT-PCR test and SARS-CoV-2 virus between December 2020 and April 2021. A total of 103 participants were included in the study. The mean age was 31.24 +/- 5.67 (19-45) years and the mean body mass index of the participants was 28.41 +/- 4.68 kg/m(2). The patients were divided into two groups, group-1 was patients who had COVID-19, group-2 was healthy men. A semen analysis of both groups was performed, and the serum total testosterone, FSH, LH, anti-mullerian hormone and Inhibin-B tests were analysed and recorded. The testicular dimensions and testicular densities were examined by ultrasound and elastography for both groups. Comparing the patient and control groups results, this study found that the sperm count per 1 cc (p = 0.01) and total motility (p = 0.01) in group-1 was lower than in the control group, the testicular dimensions decreased (for right testis group-2 was 15.39 +/- 4.78 ml versus group-1 was 12.11 +/- 4.62 cm(3) p < 0.01, for left testis group-2 was 16.01 +/- 5.12 versus group-1 was 11.92 +/- 4.78 cm(3); p < 0.01), and the shear wave velocities were significantly higher in group-1 patients. In conclusion, sperm parameters deteriorate in men who have symptomatic disease with SARS-CoV-2 infection. The fact that the cause of this deterioration is characterized by changes at the cellular level in the testis raises doubts about the persistence of this condition.
Insall-Salvati Index Is Associated With Anterior Cruciate Ligament Tears in Men: a Case-Controlled Study
(Sage Publications Ltd, 2022) Guven, Necip; Ozkan, Sezai; Turkozu, Tulin; Yokus, Adem; Adanas, Cihan; Gokalp, Mehmet Ata; Tokyay, Abbas
Purpose Many factors in the etiology of anterior cruciate ligament (ACL) tears, predisposing factors related to knee morphology have also been reported. This study aimed to determine whether the Insall-Salvati (IS) index, which measures patella height, is a predisposing risk factor for ACL tears. Methods The IS index, patellar length (PL), and patellar tendon length (PTL) values of patients (study group) that underwent arthroscopic reconstruction for ACL tears obtained by preoperative magnetic resonance imaging (MRI) were compared with the index values in the preoperative MRIs of patients that underwent knee arthroscopy for reasons besides ACL tears. In addition, the anterior tibial translation (ATT) of both groups was also measured and compared on MRI images. The MRI findings of the subjects included in both study groups were arthroscopically confirmed. Results The mean ages of the study group (n = 120) and control group (n = 90) were 29.1 +/- 8.2 years and 31.8 +/- 9.8 years, respectively. There was a statistically significant difference between the study and control groups in terms of the PL and PTL values (p = 0.016 and p = 0.001, respectively). The IS index was statistically significantly higher in the study group with ACL tears (p = 0.009). The ATT was 8.61 +/- 4.68 mm in the study group and 3.80 +/- 1.92 mm in the control group. The ATT results of both groups were evaluated, and it was found that the study group was significantly higher than the control group (p = 0.001) Conclusions As a result of our current study, we observed higher IS index values in patients with ACL tears than in patients without ACL tears. It should be kept in mind that patella alta, which is associated with a high IS index as one of the factors of knee morphology associated with ACL tears, may play a role in the etiology of ACL tears.
Interhemispheric Cyst Associated With Corpus Callosum Agenesis: a Case With Neuroimages
(Elsevier Science inc, 2023) Yokus, Adem
Interhemispheric cysts are rare lesions in children and infants. Sometimes it is accompanied by agenesis of the corpus callosum. Although patients may be asymptomatic, they may admit to physicians with symptoms related to the mass effect of the cystic lesion. An 11-month-old girl infant with increased head circumference is presented with magnetic resonance imaging findings.
Reliability of Testicular Stiffness Quantification Using Shear Wave Elastography in Predicting Male Fertility: a Preliminary Prospective Study
(Soc Romana Ultrasonografe Medicina Biologie-srumb, 2018) Yavuz, Alpaslan; Yokus, Adem; Taken, Kerem; Batur, Abdussamet; Ozgokce, Mesut; Arslan, Harun
Aims: To evaluate the reliability of testicular stiffness quantification using shear wave elastography in predicting the fertility potential of males and for the pre-diagnosis of disorders based upon sperm quantification. Material and methods: One hundred males between the ages of 19-49 years (mean age of 28.77 +/- 6.11), ninety of whom with complaints of infertility, were enrolled in this prospective study. Scrotal grey-scale, Doppler ultrasound (US), and mean testicular shear wave velocity quantifications (SWVQs) were performed. The volumes of testes, as well as the grade of varicocele if present, were recorded. The mean shear wave velocity values (SWVVs) of each testis and a mean testicular SWVV for each patient were calculated. The semen-analyses of patients were consecutively performed. Results: There were significant negative correlations between the mean testicular SWVVs of patients and their sperm counts or the testis volumes (r=-0.399, r=-0.565; p<0.01, respectively). A positive correlation was found between testicular volumes and sperm counts (r=0.491, p<0.01). The cut-off values regarding mean testicular SWVV to distinguish normal sperm count from azoospermia and oligozoospermia were 1.465 m/s (75.0% sensitivity and 75.0% specificity) and 1.328 m/s (64.3% sensitivity and 68.2% specificity), respectively, and the value to distinguish oligozoospermia from azoospermia was 1.528 m/s (66.7% sensitivity, 60.7% specificity). Conclusion: The mean testicular SWVQ using the ARFI shear wave technique was a reliable, non-invasive and acceptably stable method for predicting male infertility, especially related to sperm count issues.
The Role of Elastography in Reducing Unnecessary Biopsies in Bi-Rads 4a and 4b Breast Lesions
(Springer india, 2024) Toprak, Nursen; Yokus, Adem; Gunduz, Ali Mahir; Durmaz, Fatma; Ilik, Zehra Akman
Many benign breast lesions in the Breast Imaging Reporting and Data System (BI-RADS) 4 category defined by ultrasonography (US) undergo unnecessary biopsies. This study aims to investigate the efficiency of acoustic radiation for impulse elastography (ARFI) in diagnosing BI-RADS 4 breast lesions. The ARFI elastography technique was utilized to assess the lesions both qualitatively and quantitatively. By using quantitative elastography measurement, we found that the shear wave velocity (SWV) of BI-RADS 4a lesions was significantly lower compared to the SWV of BI-RADS 4b and 4c lesions (p = 0.00). In qualitative evaluation, pattern 1 only defined benign lesions, and a negative predictive value (NPV) of 100% was obtained. Using quantitative, qualitative and combined methods, the Likelihood ratios was determined to be 1.81, 2.8 and 4.7 respectively. In addition to the ultrasound examination of BI-RADS 4 lesions, the addition of combined elastography assessment increases the accuracy of BI-RADS. BI-RADS 4a lesions can be followed in a similar way as BI-RADS 3 lesions.
Spontaneous Rupture of the Middle Fossa Arachnoid Cyst Into the Subdural Space: Case Report
(int Scientific information inc, 2015) Bora, Aydin; Yokus, Adem; Batur, Abdussamet; Bulut, Mehmet Deniz; Yavuz, Alpaslan; Gulsen, Ismail; Arslan, Mehmet
Background: Arachnoid cysts are congenital, benign and intra-arachnoidal lesions. A great majority of arachnoid cysts are congenital. However, to a lesser extent, they are known to develop after head trauma and brain inflammatory diseases. Arachnoid cysts are mostly asymptomatic and they can develop anywhere in the brain along the arachnoid membrane. Case Report: Arachnoid cysts form 1% of the non-traumatic lesions which occupy a place and it is thought to be a congenital lesion developed as a result of meningeal development abnormalities or a lesion acquired after trauma and infection. There is a male dominance at a rate of 3/1 in arachnoid cysts which locate mostly in the middle fossa. Our patient was a 2-years-old boy. Conclusions: As a conclusion, spontaneous subdural hygroma is a rare complication of the arachnoid cysts. Surgical intervention could be required in acute cases.
The Success of Deep Learning Modalities in Evaluating Modic Changes
(Elsevier Science inc, 2024) Yuksek, Mehmet; Yokus, Adem; Arslan, Harun; Canayaz, Murat; Akdemir, Zulkuf
BACKGROUND: Modic changes are pathologies that are common in the population and cause low back pain. The aim of the study is to analyze the modic changes detected in magnetic resonance imaging (MRI) using deep learning modalities. METHODS: The sagittal T1, sagittal and axial T2 - weighted lumbar MRI images of 307 patients, of which 125 were female and 182 were male, aged 19 - 86 years, who underwent MRI examination between 2016 - 2021 were analyzed. Modic changes (MC) were categorized and marked according to signal changes. Our study consists of 2 independent stages: classification and segmentation. The categorized data were first classified using convolutional neural network (CNN) architectures such as DenseNet-121, DenseNet-169, and VGG-19. In the next stage, masks were removed by segmentation using U -Net, which is the CNN architecture, with image processing programs on the marked images. RESULTS: During the classification stage, the success rates for modic type 1, type 2, and type 3 changes were 98%, 96%, 100% in DenseNet-121, 100%, 94%, 100% in DenseNet-169, and 98%, 92%, 97% in VGG-19, respectively. At the segmentation phase, the success rate was 71% with the U -Net architecture. CONCLUSIONS: Evaluation of MRI findings of MC in the etiology of lower back pain with deep learning architec- tures can significantly reduce the workload of the radiol- ogist by providing ease of diagnosis.
Use of Virtual Touch Tissue Quantification Elastography Technique in Fetal Lung Maturation
(Lippincott Williams & Wilkins, 2023) Arslan, Harun; Kucukbas, Gokce Naz; Turkoglu, Saim; Akdemir, Zulkuf; Yokus, Adem; Gunduz, Ali Mahir; Sahin, Hanim Guler
This study is an analysis of fetal lung stiffness by virtual touch tissue quantification (VTTQ) elastography to predict fetal lung maturation. Evaluation of fetal lungs was first performed in B mode, and fetal lungs were analyzed at 3 different periods at third trimester in each pregnant woman, at 28 to 31, 32 to 36, and 37 to 41 weeks. Fetal lung elastography was performed at regions with the least acoustic shadow and far from ribs and heart. Each fetal lung assessment were done by taking mean lung stiffness obtained by measuring stiffness of both left and right fetal lungs. T test analysis showed no significant difference in fetal lung stiffness between male and female fetuses among 3 gestational periods. Analysis of variance was performed to evaluate fetal lung stiffness of the fetuses at 3 different gestational periods (28-31, 32-36, and 37-41 weeks). This analysis showed significant difference (P < 0.01). Duncan multiple comparison analysis did not show significant difference in fetal lung stiffness between 28 and 31 weeks and 32 and 36 weeks, whereas fetal lung stiffness of fetuses at 37 to 41 weeks were significantly greater (P < 0.01). This study is first step to analyze fetal lung maturation noninvasively using VTTQ elastography technique by measuring fetal lung stiffness.