HAFİZE OTCU - Academia.edu (original) (raw)
Papers by HAFİZE OTCU
The Journal of Clinical Endocrinology & Metabolism, 2020
Aim The exact mechanisms that trigger the onset of puberty are not well known. Adipomyokines are ... more Aim The exact mechanisms that trigger the onset of puberty are not well known. Adipomyokines are postulated to stimulate the central neural network. In the present study, we investigated irisin levels in girls with central precocious puberty (CPP), slowly progressing precocious puberty (SPPP), or premature thelarche (PT); we also studied prepubertal girls and to determine if this adipomyokine could be used as a marker in this context. Methods A total of 94 girls including 33 with CPP, 31 with precocious puberty (PP) variants (SPPP or PT), and 30 healthy controls were enrolled to the study. The mean irisin levels were compared between groups. The bivariate correlations of irisin levels with clinical and laboratory parameters were assessed. Multivariate linear regression analysis was performed to determine independent predictive factors of irisin levels. Results Irisin levels were higher in the CPP group compared with the other groups (CPP group: 723.25 ± 62.35 ng/mL; PP variants grou...
The Heart Surgery Forum, 2015
Background: In this study, the relationship between patency of saphenous vein (SV) graft and diff... more Background: In this study, the relationship between patency of saphenous vein (SV) graft and different sizes of aorta wall punches was investigated during the follow-up period after coronary artery bypass graft surgery. We also evaluated the other possible factors affecting SV graft patency. Methods: This study consisted of 266 consecutive and symptomatic patients with postoperative angiography. The primary endpoint was at least one saphenous graft failure observed from coronary computed tomography angiography (cCTA) and/or invasive angiography after surgery. Groups were created as SV occluded and patent group. Survival curves of patients in groups were estimated using Kaplan-Meier method and compared by log-rank test. Multivariate analysis was performed using the Cox proportional hazard model. Results: Cox-regression analysis demonstrated influence of older age (P = .023) and Diabetes Mellitus (DM) (P = .002) on SV graft failure. However, increasing ejection fraction (P = .011) was a protective factor against SV graft failure. There was no significant difference between the two groups in terms of usage rate of the punches with different diameters (P = .296). Conclusion: The incidence of SV graft patency does not seem to increase in patients whose 4.8-mm aortic punch was used during proximal anastomosis compared to the reference group in which a punch of 4.0 mm was used. Also, the final proximal anastomosis graft size that was measured using cCTA was similar between patients with 4.8-mm punch and patients with 4-mm punch. Results from this study could help to determine which size for aortosaphenous anastomosis is clinically optimal.
Intra-articular ganglion cyst of the anterior cruciate ligament (ACL) is rarely seen, but concurr... more Intra-articular ganglion cyst of the anterior cruciate ligament (ACL) is rarely seen, but concurrently bilateral ganglion cyst of the ACL has not been reported in literature. In this report, we present an exceedingly rare case of a 31-year-old man with concurrently bilateral ACL ganglion cyst diagnosed with magnetic resonance imaging.
British Journal of Medicine and Medical Research, Jan 10, 2015
Aim: We reported a rare case of an anomalous origin of the left pulmonary artery (AOLPA) from the... more Aim: We reported a rare case of an anomalous origin of the left pulmonary artery (AOLPA) from the ascending aorta associated with pulmonary atresia and right sided aortic arch diagnosed at a relatively late age. Case: 13 year-old girl presented to our pulmonology clinic with complaints of cough and dyspnea. On chest X-ray cardio thoracic ratio was increased and shadow of the arch was not seen on the left. On her echocardiography pulmonary arteries couldn't be demonstrated. Computed tomography Case Study Selcuk et al.; BJMMR, 5(5): 719-723, 2015; Article no.BJMMR.2015.075 720 angiography was performed to the patient. Right sided arch aorta with pulmonary atresia associated with an anomalous origin of the left pulmonary artery from the ascending aorta with a well developed collateral blood supply to the right lung and coexisting pulmonary infection was detected. She was managed medically. She is on the first year of her follow up. Her medical status is stable. Conclusion: We presented a case of relatively rarely seen anomalous origin of the left pulmonary artery from the ascending aorta with a rarely seen association of pulmonary atresia and wanted to take attention to its presentation in a late childhood.
Intra-articular ganglion cyst of the anterior cruciate ligament (ACL) is rarely seen, but concurr... more Intra-articular ganglion cyst of the anterior cruciate ligament (ACL) is rarely seen, but concurrently bilateral ganglion cyst of the ACL has not been reported in literature. In this report, we present an exceedingly rare case of a 31-year-old man with concurrently bilateral ACL ganglion cyst diagnosed with magnetic resonance imaging.
Aim: We reported a rare case of an anomalous origin of the left pulmonary artery (AOLPA) from the... more Aim: We reported a rare case of an anomalous origin of the left pulmonary artery (AOLPA) from the ascending aorta associated with pulmonary atresia and right sided aortic arch diagnosed at a relatively late age. Case: 13 year-old girl presented to our pulmonology clinic with complaints of cough and dyspnea. On chest X-ray cardio thoracic ratio was increased and shadow of the arch was not seen on the left. On her echocardiography pulmonary arteries couldn't be demonstrated. Computed tomography
Current Medical Imaging Formerly Current Medical Imaging Reviews, 2019
Aim: The aim of our study was to determine whether the diffusion properties of the auditory pathw... more Aim: The aim of our study was to determine whether the diffusion properties of the auditory pathways alter between patients with Neurofibromatosis type 1 (NF1) and the healthy subjects. DTI can well demonstrate FA and ADC changes in auditory tracts and it may be a guide to identify the candidates for hearing loss among NF1 children. Methods: The study population consisted of 43 patients with NF1 and 21 healthy controls. Diffusion tensor imaging (DTI) was used to measure apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values from lemniscus lateralis, colliculus inferior, corpus geniculatum mediale and Heschl's gyrus. The results were compared with those of the control group. Results: The ADC values of lateral lemniscus, colliculus inferior and corpus geniculatum mediale were significantly higher in NF1 compared to those of the control group. On the other hand, decreased FA values were observed in lateral lemniscus and colliculus inferior in patients with NF1. ...
Annals of Hepatology, 2011
Focal nodular hyperplasia (FNH) and hemangioma are benign and generally asymptomatic hepatic tumo... more Focal nodular hyperplasia (FNH) and hemangioma are benign and generally asymptomatic hepatic tumors. With distinctive imaging findings on dynamic computed tomography (CT) and magnetic resonance imaging (MRI), differentiation of these benign hepatic tumors from metastases can be made. We described imaging findings of these hepatic lesions in a 57-year-old man who presented with rectal adenocarcinoma for staging.
Haseki Tıp Bülteni, 2015
To investigate the relationship of cartilage loss in tibiofemoral and patellofemoral joints with ... more To investigate the relationship of cartilage loss in tibiofemoral and patellofemoral joints with the number, size and location of loose bodies in secondary synovial chondromatosis (SC). Methods: Eighty-eight patients with secondary SC were evaluated retrospectively. The size and location of loose bodies were evaluated by both X-ray and magnetic resonance imaging. The relationship between cartilage lesions and the number, location and size of loose bodies were assessed by Chi-square test and Fisher's exact test. Results: When the relationship between the presence of loose body and cartilage damage was evaluated, it was observed that 83% of subjects (n=74) had cartilage loss at the tibiofemoral joint, 75% (n=66) on the medial and 9% (n=8) of patients had on the lateral side. It was determined that when the number of loose bodies was ≤5, the mean diameter was 7.3 mm (2-21 mm). It was 12.7 mm (2-30 mm) when the number was >5. The most frequently affected locations were the posterior compartment of the posterior cruciate ligament and the superior compartment of the popliteal fossa, regardless of the degree of cartilage loss. Conclusion:We concluded that the higher the cartilage damage, the higher the number and size of loose bodies. We assume that our study provides insight into further investigations to study new classification system for secondary SC in the knee joint.
Balkan Medical Journal, 2016
Background: Early detection of coronary artery disease (CAD) is important because of the high mor... more Background: Early detection of coronary artery disease (CAD) is important because of the high morbidity and mortality rates. As invasive coronary angiography (ICA) is an invasive procedure, an alternative diagnostic method; coronary computed tomography angiography (CTA), has become more widely used by the improvements in detector technology. Aims: In this study, we aimed to examine the accuracy and image quality of high-pitch 128-slice dual-source CTA taking the ICA as reference technique. We also aimed to compare the accuracy and image quality between different heart rate groups of >70 beates per minute (bpm) and ≤70 bpm. Study Design: Retrospective cross-sectional study. Methods: Among 450 patients who underwent coronary CTA with the FLASH spiral technique, performed with a second generation dual-source computed tomography device with a pitch value of 3.2, 102 patients without stent and/or bypass surgery history and clinically suspected coronary artery disease who underwent ICA within 15 days were enrolled. Image quality was assessed by two independent radiologists using a 4-point scale (1=absence of any artifacts-4=non-evaluable). A stenosis >50% was considered significant on a per-segment, per-vessel, and per-patient basis and ICA was considered the reference method. Radiation doses were determined using dose length product (DLP) values detected by the computed tomography (CT) device. In addition, patients were classified into two groups according to their heart rates as ≤70 bpm (73 patients) and >70 bpm (29 patients). The relation between the diagnostic accuracy and heart rate groups were evaluated. Results: Overall, 1495 (98%) coronary segments were diagnostic in 102 patients (32 male, 70 female, mean heart rate: 65 bpm). There was a significant correlation between image quality and mean heart rate in the right coronary artery (RCA) segments. The effective radiation dose was 0.98±0.09 mili Sievert (mSv). On a per-patient basis, sensitivity, specificity, and positive and negative predictive values were 93.8%, 88.8%, 93.8% and 88.8%, respectively. These values were also similar in per-vessel and per-segment basis. Two different groups categorized by mean heart rate had almost similar results in terms of the diagnostic power of dual-source CTA. Conclusion: CTA with a high pitch value is a reliable, non-invasive diagnostic method that can CAD with low radiation doses not only in patients with a heart rate below 70 bpm, but also in patients with higher heart rates.
Diagnostic and Interventional Radiology
The aim of this study was to evaluate the prognostic quality of adjacent vessel sign (AVS) in mal... more The aim of this study was to evaluate the prognostic quality of adjacent vessel sign (AVS) in malignant breast tumors by comparing it with classical prognostic pathological biomarkers and magnetic resonance imaging (MRI) findings. METHODS A total of 124 patients with 133 malignant lesions were included. All the imaging was performed on a 1.5T Avanto scanner and the images were interpreted according to BI-RADS-MR® (fifth ed.) atlas. Maximum intensity projection (MIP) images were constructed from subtracted post-contrast images and were used to investigate AVS. Histopathological results and MRI findings were compared with AVS. RESULTS Interobserver agreement about AVS status was substantial (κ = 0.64). AVS positive lesions were significantly bigger in size (P < .001, AVS negative: median 12 mm, AVS positive: median 31 mm). AVS was significantly associated with increased Ki-67 index and axillary lymph node metastasis (P = .009 and P = .019, respectively). Between AVS and lymphovascular invasion (LVI), there was a trend toward positive relationship (P = .076). MRI findings of T2 hypointensity, peritumoral edema, irregular shape, non-homogeneous contrast enhancement, rapid early contrast enhancement, and skin infiltration showed significant positive relation with AVS (P < .001, P < .001, P < .001, P = .02, P = .021, and P = .021, respectively). AVS is found to be associated with increased Ki-67 index, axillary lymph node metastasis, and some MRI findings that point to malignancy or poor prognosis. CONCLUSION AVS indicates poor prognosis since it is related to axillary lymph node metastasis, increased Ki-67 index, LVI, peritumoral edema, rapid early contrast enhancement, increased background enhancement, skin extension, T2 hypointensity, non-homogeneous contrast enhancement, irregular lesion shape, and larger tumor size. AVS is an easy to use sign that shows substantial interobserver agreement. B reast cancer is the number one cause of cancer-related deaths in women. 1 Tumor cells need neovascularization to stay alive, grow, invade, or spread. Studies show that contrast enhancement pattern in magnetic resonance imaging (MRI) is related to microvessel density, neovascularization, and prognostic parameters. 2-5 Also, tumor-bearing breast shows increased vascularity compared to the contralateral breast, and this is found to be related to prognostic indicators. 6-8 Asymmetrical increased vessels, first mentioned by Sievert in 1997, were later described by Sardanelli in 2005 as increased number of vessels 2 mm or thicker and 3 cm or longer, compared with the contralateral breast. 6,7,9,10 As one can easily appreciate, this method is laborious, timeconsuming, and impractical. On the other hand, an adjacent vessel sign (AVS) is more easily and rapidly applicable. AVS was first defined by Carriero et al. 11 as a vessel (either artery or vein) in contact with a lesion or entering it. Besides, AVS can be used in bilateral breast cancer or patients with mastectomy whereas asymmetrical increased vessels can be used only when a normal contralateral breast exists (Figure 1). Maximum intensity projection (MIP) series constructed from early postcontrast images are best to
Indian Journal of Surgery, 2022
To evaluate breast MRI and DWI and demographic features of pleomorphic invasive lobular carcinoma... more To evaluate breast MRI and DWI and demographic features of pleomorphic invasive lobular carcinoma (pILC) and classic invasive lobular carcinoma (cILC). Invasive lobular (ILC) is the second most common breast malignancy after invasive ductal carcinoma (IDC) and constitutes the 8–14% of all invasive breast cancers. ILC morphologically can be classified into the classic, alveolar, solid, tubulolobular, and pleomorphic subtypes according to WHO. This study was performed retrospectively. The MRI and demographic features of 18 patients with 23 pILC were compared with those 22 consecutive patients with 27 cILC. There was no significant difference in demographic features of patients, MR appearance, kinetics, and ADC values between two groups. pILC, an aggressive subtype of ILC, cannot be differentiated from cILC with breast MRI.
Archives of Medical Science - Civilization Diseases, 2016
Kardiologia Polska, 2017
Background and aim: Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot ... more Background and aim: Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot that plays an important role in the pathogenesis of coronary atherosclerosis. Due to its asymmetrical distribution, the relation between location-specific EAT measurements and coronary atherosclerosis remains unclear. Our study investigated the relationship between location-specific EAT volume and coronary atherosclerotic plaque burden that was detected by coronary computed tomography angiography (CCTA) in type 2 diabetic patients without coronary artery disease (CAD) history. Methods: A total of 157 consecutive diabetic patients who had undergone CCTA were included retrospectively. After evaluation of the CCTA images, the study population was divided into two groups according to the presence of coronary atherosclerosis. In both groups, total and left atrioventricular groove EAT volumes were measured. Results: Total and left atrioventricular groove EAT volumes were significantly associated with coronary atherosclerosis, but only left atrioventricular groove EAT volumes were an independent predictor for CAD. Also, total and left atrioventricular groove EAT volumes were positively correlated with C-reactive protein values (p = 0.0001/p = 0.0001) and the number of coronary atherosclerotic segments (p = 0.0001/p = 0.0001). Conclusions: Left atrioventricular groove EAT volume is an independent predictor of CAD in type 2 diabetic patients without CAD history. Left atrioventricular groove EAT volume may be used to identify type 2 diabetic patients who may require early CAD intervention because of the potential risk of coronary atherosclerosis.
The Journal of Clinical Endocrinology & Metabolism, 2020
Aim The exact mechanisms that trigger the onset of puberty are not well known. Adipomyokines are ... more Aim The exact mechanisms that trigger the onset of puberty are not well known. Adipomyokines are postulated to stimulate the central neural network. In the present study, we investigated irisin levels in girls with central precocious puberty (CPP), slowly progressing precocious puberty (SPPP), or premature thelarche (PT); we also studied prepubertal girls and to determine if this adipomyokine could be used as a marker in this context. Methods A total of 94 girls including 33 with CPP, 31 with precocious puberty (PP) variants (SPPP or PT), and 30 healthy controls were enrolled to the study. The mean irisin levels were compared between groups. The bivariate correlations of irisin levels with clinical and laboratory parameters were assessed. Multivariate linear regression analysis was performed to determine independent predictive factors of irisin levels. Results Irisin levels were higher in the CPP group compared with the other groups (CPP group: 723.25 ± 62.35 ng/mL; PP variants grou...
The Heart Surgery Forum, 2015
Background: In this study, the relationship between patency of saphenous vein (SV) graft and diff... more Background: In this study, the relationship between patency of saphenous vein (SV) graft and different sizes of aorta wall punches was investigated during the follow-up period after coronary artery bypass graft surgery. We also evaluated the other possible factors affecting SV graft patency. Methods: This study consisted of 266 consecutive and symptomatic patients with postoperative angiography. The primary endpoint was at least one saphenous graft failure observed from coronary computed tomography angiography (cCTA) and/or invasive angiography after surgery. Groups were created as SV occluded and patent group. Survival curves of patients in groups were estimated using Kaplan-Meier method and compared by log-rank test. Multivariate analysis was performed using the Cox proportional hazard model. Results: Cox-regression analysis demonstrated influence of older age (P = .023) and Diabetes Mellitus (DM) (P = .002) on SV graft failure. However, increasing ejection fraction (P = .011) was a protective factor against SV graft failure. There was no significant difference between the two groups in terms of usage rate of the punches with different diameters (P = .296). Conclusion: The incidence of SV graft patency does not seem to increase in patients whose 4.8-mm aortic punch was used during proximal anastomosis compared to the reference group in which a punch of 4.0 mm was used. Also, the final proximal anastomosis graft size that was measured using cCTA was similar between patients with 4.8-mm punch and patients with 4-mm punch. Results from this study could help to determine which size for aortosaphenous anastomosis is clinically optimal.
Intra-articular ganglion cyst of the anterior cruciate ligament (ACL) is rarely seen, but concurr... more Intra-articular ganglion cyst of the anterior cruciate ligament (ACL) is rarely seen, but concurrently bilateral ganglion cyst of the ACL has not been reported in literature. In this report, we present an exceedingly rare case of a 31-year-old man with concurrently bilateral ACL ganglion cyst diagnosed with magnetic resonance imaging.
British Journal of Medicine and Medical Research, Jan 10, 2015
Aim: We reported a rare case of an anomalous origin of the left pulmonary artery (AOLPA) from the... more Aim: We reported a rare case of an anomalous origin of the left pulmonary artery (AOLPA) from the ascending aorta associated with pulmonary atresia and right sided aortic arch diagnosed at a relatively late age. Case: 13 year-old girl presented to our pulmonology clinic with complaints of cough and dyspnea. On chest X-ray cardio thoracic ratio was increased and shadow of the arch was not seen on the left. On her echocardiography pulmonary arteries couldn't be demonstrated. Computed tomography Case Study Selcuk et al.; BJMMR, 5(5): 719-723, 2015; Article no.BJMMR.2015.075 720 angiography was performed to the patient. Right sided arch aorta with pulmonary atresia associated with an anomalous origin of the left pulmonary artery from the ascending aorta with a well developed collateral blood supply to the right lung and coexisting pulmonary infection was detected. She was managed medically. She is on the first year of her follow up. Her medical status is stable. Conclusion: We presented a case of relatively rarely seen anomalous origin of the left pulmonary artery from the ascending aorta with a rarely seen association of pulmonary atresia and wanted to take attention to its presentation in a late childhood.
Intra-articular ganglion cyst of the anterior cruciate ligament (ACL) is rarely seen, but concurr... more Intra-articular ganglion cyst of the anterior cruciate ligament (ACL) is rarely seen, but concurrently bilateral ganglion cyst of the ACL has not been reported in literature. In this report, we present an exceedingly rare case of a 31-year-old man with concurrently bilateral ACL ganglion cyst diagnosed with magnetic resonance imaging.
Aim: We reported a rare case of an anomalous origin of the left pulmonary artery (AOLPA) from the... more Aim: We reported a rare case of an anomalous origin of the left pulmonary artery (AOLPA) from the ascending aorta associated with pulmonary atresia and right sided aortic arch diagnosed at a relatively late age. Case: 13 year-old girl presented to our pulmonology clinic with complaints of cough and dyspnea. On chest X-ray cardio thoracic ratio was increased and shadow of the arch was not seen on the left. On her echocardiography pulmonary arteries couldn't be demonstrated. Computed tomography
Current Medical Imaging Formerly Current Medical Imaging Reviews, 2019
Aim: The aim of our study was to determine whether the diffusion properties of the auditory pathw... more Aim: The aim of our study was to determine whether the diffusion properties of the auditory pathways alter between patients with Neurofibromatosis type 1 (NF1) and the healthy subjects. DTI can well demonstrate FA and ADC changes in auditory tracts and it may be a guide to identify the candidates for hearing loss among NF1 children. Methods: The study population consisted of 43 patients with NF1 and 21 healthy controls. Diffusion tensor imaging (DTI) was used to measure apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values from lemniscus lateralis, colliculus inferior, corpus geniculatum mediale and Heschl's gyrus. The results were compared with those of the control group. Results: The ADC values of lateral lemniscus, colliculus inferior and corpus geniculatum mediale were significantly higher in NF1 compared to those of the control group. On the other hand, decreased FA values were observed in lateral lemniscus and colliculus inferior in patients with NF1. ...
Annals of Hepatology, 2011
Focal nodular hyperplasia (FNH) and hemangioma are benign and generally asymptomatic hepatic tumo... more Focal nodular hyperplasia (FNH) and hemangioma are benign and generally asymptomatic hepatic tumors. With distinctive imaging findings on dynamic computed tomography (CT) and magnetic resonance imaging (MRI), differentiation of these benign hepatic tumors from metastases can be made. We described imaging findings of these hepatic lesions in a 57-year-old man who presented with rectal adenocarcinoma for staging.
Haseki Tıp Bülteni, 2015
To investigate the relationship of cartilage loss in tibiofemoral and patellofemoral joints with ... more To investigate the relationship of cartilage loss in tibiofemoral and patellofemoral joints with the number, size and location of loose bodies in secondary synovial chondromatosis (SC). Methods: Eighty-eight patients with secondary SC were evaluated retrospectively. The size and location of loose bodies were evaluated by both X-ray and magnetic resonance imaging. The relationship between cartilage lesions and the number, location and size of loose bodies were assessed by Chi-square test and Fisher's exact test. Results: When the relationship between the presence of loose body and cartilage damage was evaluated, it was observed that 83% of subjects (n=74) had cartilage loss at the tibiofemoral joint, 75% (n=66) on the medial and 9% (n=8) of patients had on the lateral side. It was determined that when the number of loose bodies was ≤5, the mean diameter was 7.3 mm (2-21 mm). It was 12.7 mm (2-30 mm) when the number was >5. The most frequently affected locations were the posterior compartment of the posterior cruciate ligament and the superior compartment of the popliteal fossa, regardless of the degree of cartilage loss. Conclusion:We concluded that the higher the cartilage damage, the higher the number and size of loose bodies. We assume that our study provides insight into further investigations to study new classification system for secondary SC in the knee joint.
Balkan Medical Journal, 2016
Background: Early detection of coronary artery disease (CAD) is important because of the high mor... more Background: Early detection of coronary artery disease (CAD) is important because of the high morbidity and mortality rates. As invasive coronary angiography (ICA) is an invasive procedure, an alternative diagnostic method; coronary computed tomography angiography (CTA), has become more widely used by the improvements in detector technology. Aims: In this study, we aimed to examine the accuracy and image quality of high-pitch 128-slice dual-source CTA taking the ICA as reference technique. We also aimed to compare the accuracy and image quality between different heart rate groups of >70 beates per minute (bpm) and ≤70 bpm. Study Design: Retrospective cross-sectional study. Methods: Among 450 patients who underwent coronary CTA with the FLASH spiral technique, performed with a second generation dual-source computed tomography device with a pitch value of 3.2, 102 patients without stent and/or bypass surgery history and clinically suspected coronary artery disease who underwent ICA within 15 days were enrolled. Image quality was assessed by two independent radiologists using a 4-point scale (1=absence of any artifacts-4=non-evaluable). A stenosis >50% was considered significant on a per-segment, per-vessel, and per-patient basis and ICA was considered the reference method. Radiation doses were determined using dose length product (DLP) values detected by the computed tomography (CT) device. In addition, patients were classified into two groups according to their heart rates as ≤70 bpm (73 patients) and >70 bpm (29 patients). The relation between the diagnostic accuracy and heart rate groups were evaluated. Results: Overall, 1495 (98%) coronary segments were diagnostic in 102 patients (32 male, 70 female, mean heart rate: 65 bpm). There was a significant correlation between image quality and mean heart rate in the right coronary artery (RCA) segments. The effective radiation dose was 0.98±0.09 mili Sievert (mSv). On a per-patient basis, sensitivity, specificity, and positive and negative predictive values were 93.8%, 88.8%, 93.8% and 88.8%, respectively. These values were also similar in per-vessel and per-segment basis. Two different groups categorized by mean heart rate had almost similar results in terms of the diagnostic power of dual-source CTA. Conclusion: CTA with a high pitch value is a reliable, non-invasive diagnostic method that can CAD with low radiation doses not only in patients with a heart rate below 70 bpm, but also in patients with higher heart rates.
Diagnostic and Interventional Radiology
The aim of this study was to evaluate the prognostic quality of adjacent vessel sign (AVS) in mal... more The aim of this study was to evaluate the prognostic quality of adjacent vessel sign (AVS) in malignant breast tumors by comparing it with classical prognostic pathological biomarkers and magnetic resonance imaging (MRI) findings. METHODS A total of 124 patients with 133 malignant lesions were included. All the imaging was performed on a 1.5T Avanto scanner and the images were interpreted according to BI-RADS-MR® (fifth ed.) atlas. Maximum intensity projection (MIP) images were constructed from subtracted post-contrast images and were used to investigate AVS. Histopathological results and MRI findings were compared with AVS. RESULTS Interobserver agreement about AVS status was substantial (κ = 0.64). AVS positive lesions were significantly bigger in size (P < .001, AVS negative: median 12 mm, AVS positive: median 31 mm). AVS was significantly associated with increased Ki-67 index and axillary lymph node metastasis (P = .009 and P = .019, respectively). Between AVS and lymphovascular invasion (LVI), there was a trend toward positive relationship (P = .076). MRI findings of T2 hypointensity, peritumoral edema, irregular shape, non-homogeneous contrast enhancement, rapid early contrast enhancement, and skin infiltration showed significant positive relation with AVS (P < .001, P < .001, P < .001, P = .02, P = .021, and P = .021, respectively). AVS is found to be associated with increased Ki-67 index, axillary lymph node metastasis, and some MRI findings that point to malignancy or poor prognosis. CONCLUSION AVS indicates poor prognosis since it is related to axillary lymph node metastasis, increased Ki-67 index, LVI, peritumoral edema, rapid early contrast enhancement, increased background enhancement, skin extension, T2 hypointensity, non-homogeneous contrast enhancement, irregular lesion shape, and larger tumor size. AVS is an easy to use sign that shows substantial interobserver agreement. B reast cancer is the number one cause of cancer-related deaths in women. 1 Tumor cells need neovascularization to stay alive, grow, invade, or spread. Studies show that contrast enhancement pattern in magnetic resonance imaging (MRI) is related to microvessel density, neovascularization, and prognostic parameters. 2-5 Also, tumor-bearing breast shows increased vascularity compared to the contralateral breast, and this is found to be related to prognostic indicators. 6-8 Asymmetrical increased vessels, first mentioned by Sievert in 1997, were later described by Sardanelli in 2005 as increased number of vessels 2 mm or thicker and 3 cm or longer, compared with the contralateral breast. 6,7,9,10 As one can easily appreciate, this method is laborious, timeconsuming, and impractical. On the other hand, an adjacent vessel sign (AVS) is more easily and rapidly applicable. AVS was first defined by Carriero et al. 11 as a vessel (either artery or vein) in contact with a lesion or entering it. Besides, AVS can be used in bilateral breast cancer or patients with mastectomy whereas asymmetrical increased vessels can be used only when a normal contralateral breast exists (Figure 1). Maximum intensity projection (MIP) series constructed from early postcontrast images are best to
Indian Journal of Surgery, 2022
To evaluate breast MRI and DWI and demographic features of pleomorphic invasive lobular carcinoma... more To evaluate breast MRI and DWI and demographic features of pleomorphic invasive lobular carcinoma (pILC) and classic invasive lobular carcinoma (cILC). Invasive lobular (ILC) is the second most common breast malignancy after invasive ductal carcinoma (IDC) and constitutes the 8–14% of all invasive breast cancers. ILC morphologically can be classified into the classic, alveolar, solid, tubulolobular, and pleomorphic subtypes according to WHO. This study was performed retrospectively. The MRI and demographic features of 18 patients with 23 pILC were compared with those 22 consecutive patients with 27 cILC. There was no significant difference in demographic features of patients, MR appearance, kinetics, and ADC values between two groups. pILC, an aggressive subtype of ILC, cannot be differentiated from cILC with breast MRI.
Archives of Medical Science - Civilization Diseases, 2016
Kardiologia Polska, 2017
Background and aim: Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot ... more Background and aim: Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot that plays an important role in the pathogenesis of coronary atherosclerosis. Due to its asymmetrical distribution, the relation between location-specific EAT measurements and coronary atherosclerosis remains unclear. Our study investigated the relationship between location-specific EAT volume and coronary atherosclerotic plaque burden that was detected by coronary computed tomography angiography (CCTA) in type 2 diabetic patients without coronary artery disease (CAD) history. Methods: A total of 157 consecutive diabetic patients who had undergone CCTA were included retrospectively. After evaluation of the CCTA images, the study population was divided into two groups according to the presence of coronary atherosclerosis. In both groups, total and left atrioventricular groove EAT volumes were measured. Results: Total and left atrioventricular groove EAT volumes were significantly associated with coronary atherosclerosis, but only left atrioventricular groove EAT volumes were an independent predictor for CAD. Also, total and left atrioventricular groove EAT volumes were positively correlated with C-reactive protein values (p = 0.0001/p = 0.0001) and the number of coronary atherosclerotic segments (p = 0.0001/p = 0.0001). Conclusions: Left atrioventricular groove EAT volume is an independent predictor of CAD in type 2 diabetic patients without CAD history. Left atrioventricular groove EAT volume may be used to identify type 2 diabetic patients who may require early CAD intervention because of the potential risk of coronary atherosclerosis.