Pinar Kosar - Academia.edu (original) (raw)

Papers by Pinar Kosar

Research paper thumbnail of Coronary CT Angiography Findings with 64-Detector CT

Annals of Medical Research, 2021

Aim: This study aims to determine the coronary artery variations, anomalies, and pathologies that... more Aim: This study aims to determine the coronary artery variations, anomalies, and pathologies that could be detected in coronarycomputed tomography angiography (CCTA).Materials and Methods: Between March 2007 and December 2008, 1180 patients were referred to our clinic with CCTA requests.Coronary artery anatomy, the presence of variations and anomalies, coronary artery disease, proximal and distal anastomosis levels,stenosis and/or occlusion of by-pass grafts, stent patency, or stenosis were examined and recorded for all cases.Results: Total of 1118 cases included in the study. The left main coronary artery (LM) was not observed in 9 (0.80%) patients. In onecase (0.08%), the circumflex artery (LCx) artery was originated from the right sinus of Valsalva (RSV) with a retro-aortic course andthen reached its typical trace. The LM originated from the RSV in 2 patients (0.17%). The right coronary artery (RCA) originated fromthe left sinus of Valsalva (LSV) in 4 cases (0.35%). Coronary arte...

Research paper thumbnail of T2 MRI Mapping of Knee Cartilage in Professional Ballet Dancers

Medical Problems of Performing Artists

AIMS: Professional ballet dancers are at risk for degenerative knee cartilage changes. In the cur... more AIMS: Professional ballet dancers are at risk for degenerative knee cartilage changes. In the current study, we evaluated the knee cartilage with T2 mapping methods in professional ballet dancers and healthy controls and investigated possible differences of T2 values between these groups. METHODS: We included healthy dancers with 5−20 years of professional ballet dancing experience and sex-matched healthy controls without knee pathology. T2 values of the knee cartilage were measured from axial, coronal, and sagittal images. The values were measured by free hand region of interest (ROI). RESULTS: The study population consisted of 44 people (22 dancers, 22 controls), with mean age of 25.57 ± 5.53 yrs. We found no significant relationship between sex and T2 values. We detected a significant positive correlation between age and T2 values for patellofemoral joint cartilage. T2 values of patellofemoral and tibiofemoral joints of dancers were significantly higher. Mean T2 values of patello...

Research paper thumbnail of Variants of the popliteal artery terminal branches as detected by multidetector ct angiography

Open Medicine, 2015

Objective: To evaluate variants of the popliteal artery (PA) terminal branches with 64-multidetec... more Objective: To evaluate variants of the popliteal artery (PA) terminal branches with 64-multidetector computed tomographic angiography (64-MD CTA).Materials and Methods: A total of 495 extremities (251 right, 244 left) of 253 patients undergoing a 64-MD CTA examination were included in the study. Of these, 242 extremities were evaluated bilaterally, whereas 11 were evaluated unilaterally. The terminal branching pattern of the PA was classified according to the classification scheme proposed by Kim; the distance between the medial tibial plateau and the origin of the anterior tibial artery (A) and the length of the tibioperoneal trunk (B) have been measured and recorded.Results: In 459 cases (92.7%) branching of PA occurred distal to the knee joint (Type I); in 18 cases (2.8%) PA branching was superior to the knee joint (Type II); and hypoplasia of the PA branches was found in 27 cases (5.5%) (Type III). Among these types the most frequent branching patterns were Type IA (87.5%), Type...

Research paper thumbnail of Placental Elasticity and Histopathological Findings in Normal and Intra-uterine Growth Restriction Pregnancies Assessed with Strain Elastography in Ex Vivo Placenta

Ultrasound in Medicine & Biology, 2016

The aim of this study was to investigate the differences of placental elasticity between intra-ut... more The aim of this study was to investigate the differences of placental elasticity between intra-uterine growth restriction (IUGR) and normal pregnancies to show whether or not there is any association between histopathological changes and placental elasticity. Fifty-five human placentas were collected at delivery, including 25 with IUGR and 30 controls. Strain elastography (SE) was performed ex vivo and all placentas were examined histopathologically. Elasticity index (EI) and histopathological findings were compared between groups. The placental stiffness and presence of histopathological changes were higher in the IUGR group than in controls (p < 0.05). Also, histopathological findings were associated with decreased EI values, but no specific patterns of histologic abnormalities were identified except villitis and delayed villous maturity. Distinct reduced placental elasticity could be the result of the cumulative effects of all the histologic findings in IUGR.

Research paper thumbnail of X-ray Use in Chest Imaging in Emergency Department on the Basis of Cost and Effectiveness

Academic Radiology, 2016

The increasing use of imaging in the emergency department (ED) services has become an important p... more The increasing use of imaging in the emergency department (ED) services has become an important problem on the basis of cost and unnecessary exposure to radiation. Radiographic examination of the chest has been reported to be performed in 34.4% of ED visits, and chest computerized tomography (CCT) in 15.8%, whereas some patients receive both chest radiography and CCT in the same visit. In the current study, it was aimed to establish instances of medical waste and unnecessary radiation exposure and to show how the inclusion of radiologists in the ordering process would affect the amount of unnecessary imaging studies. This retrospective study included 1012 ED patients who had both chest radiography and CCT during the same visit at Ankara Training and Research Hospital between April 2015 and January 2016. The patients were divided into subgroups of trauma and nontrauma. To detect unnecessary imaging examinations, data were analyzed according to the presence of additional findings on CCT images and the recommendation of a radiologist for CCT imaging. In the trauma group, 77.1% (461/598) and in the nontrauma group, 80.4% (334/414) of patients could be treated without any need for CCT. In the trauma group, the radiologist recommendation only, and in the nontrauma group, both the radiologist recommendation and the age were determined to be able to predict the risk of having additional findings on CCT. Considering only the age of the patient before ordering CCT could decrease the rate of unnecessary imaging. Including radiologists into both the evaluation and the ordering processes may help to save resources and decrease exposure to ionizing radiation.

Research paper thumbnail of Imaging Findings in Patients with Granulomatous Mastitis

Iranian Journal of Radiology, 2016

Background: Granulomatous mastitis (GM) is a rare inflammatory breast disease that may mimic the ... more Background: Granulomatous mastitis (GM) is a rare inflammatory breast disease that may mimic the clinical characteristics and radiologic imaging findings of breast carcinoma. Considering the importance of making a correct diagnosis, careful radiologic evaluations and recognition of imaging features are necessary. Objectives: The aim of this study was to review the radiological findings and diagnostic value of the imaging in GM. Patients and Methods: This retrospective study involved a total of 29 patients who were diagnosed with GM between 2009 and 2013 and who underwent mammography (MG) and/or ultrasound (US) examination in addition to magnetic resonance imaging (MRI) before diagnosis. Results: Among 14 patients over 35 years of age who underwent MG imaging, focal asymmetric, ill-defined nodular, or diffusely increased densities were detected in nine (64.3%), two (14.3%), and one (7.1%) subjects, respectively, while there were no pathological findings in two (14.3%) patients. In the overall group of 29 patients, US showed heterogeneous hypoechoic lesions with tubular extensions in 16 (55.2%), well-demarcated heterogeneous hypoechoic lesions in eight (27.6%), parenchymal heterogeneous appearance in three (10.3%), and a heterogeneous hypoechoic lesion with irregular margins in one (3.4%), with another (3.4%) patient having normal US findings. MRI findings included lesions consistent with solitary or multiple separate or confluent abscesses with marked peripheral ring enhancement in 25 (86.2%) patients, accompanied by intensity changes suggesting edematous inflammation in the peripheral parenchyma, as well as non-mass-like heterogeneous segmental and regional contrast enhancement. Four (13.8%) patients had non-mass-like segmental and regional contrast enhancement only. A histopathological diagnosis of GM was established in all patients with biopsy. Conclusion: GM presents with a wide range of conventional radiological findings, hampering the diagnosis. In patients with inconclusive conventional findings, MRI may assist in the differential diagnosis and assessment of the extent of disease. However, a definitive diagnosis and relevant treatment require histopathological confirmation.

Research paper thumbnail of Spontaneous Isolated Celiac Artery and Superior Mesenteric Artery Dissections: A Rare Case

Polish Journal of Radiology, 2015

Background: Arterial dissection is defined as the cleavage of the arterial wall by an intramural ... more Background: Arterial dissection is defined as the cleavage of the arterial wall by an intramural hematoma. Reports of dissection of the celiac and/or superior mesenteric artery are rare; as far as we know, only 24 cases of spontaneous isolated celiac trunk dissection, and 71 cases of spontaneous isolated superior mesenteric artery dissection have been reported.

Research paper thumbnail of Correlation of computed tomography, magnetic resonance imaging and clinical outcome in acute carbon monoxide poisoning

Brazilian Journal of Anesthesiology (English Edition), 2014

Background and objectives: carbon monoxide is a toxic gas for humans and is still a silent killer... more Background and objectives: carbon monoxide is a toxic gas for humans and is still a silent killer in both developed and developing countries. The aim of this case series was to evaluate early radiological images as a predictor of subsequent neuropsychological sequelae, following carbon monoxide poisoning. Case 1: after carbon monoxide exposure, early computed tomography scans and magnetic resonance imaging findings of a 52-year-old woman showed bilateral lesions in the globus pallidus. This patient was discharged and followed for 90 days. The patient recovered without any neurological sequela. Case 2: in a 58-year-old woman exposed to carbon monoxide, computed tomography showed lesions in bilateral globus pallidus and periventricular white matter. Early magnetic resonance imaging revealed changes similar to that like in early tomography images. The patient recovered and was discharged from hospital. On the 27th day of exposure, the patient developed disorientation and memory impairment. Late magnetic resonance imaging showed diffuse hyperintensity in the cerebral white matter. Conclusion: white matter lesions which progress to demyelination and end up in neuropsychological sequelae cannot always be diagnosed by early computed tomography and magnetic resonance imaging in carbon monoxide poisoning.

Research paper thumbnail of Nodular Sclerosing Adenosis Mimicking Malignancy in the Breast: Magnetic Resonance Imaging Findings

The Breast …, 2010

... Nodular Sclerosing Adenosis Mimicking Malignancy in the Breast: Magnetic Resonance Imaging Fi... more ... Nodular Sclerosing Adenosis Mimicking Malignancy in the Breast: Magnetic Resonance Imaging Findings. Pelin Seher Oztekin MD 1 ,; Isil Tuncbilek MD 1 ,; Pinar Kosar MD 1 ,; Serap Gültekin MD 2 ,; Fahriye Karataş Oztürk MD 3. Article first published online: 6 DEC 2010. ...

Research paper thumbnail of Sarkomu Taklit Eden Miyozitis Ossifikans

Turkiye Klinikleri Journal of Case Reports, 2014

Myositis ossificans (MO) is a benign lesion of muscle and soft tissue, characterized by well-deli... more Myositis ossificans (MO) is a benign lesion of muscle and soft tissue, characterized by well-delineated bone formation. Although its exact etiology is unknown, trauma plays role in 75% of cases. It is more common in males and rare during childhood. This report presents the radiological findings of a 12-years-old girl diagnosed with MO. Shortly after trauma, radiological examinations failed to differentiate a right pelvic floor lesion from sarcoma and biopsy findings were non-specific. However, a diagnosis of MO was made based on its typical radiological appearance during monthly follow-ups and a reduction in size was evident at two years. This case report aims to review radiological findings of MO, and to emphasize that MO may mimic sarcoma early in the course of the disease and that late typical appearance may be detectable even after years. Thus, MO should be borne in mind in the differential diagnosis of soft tissue lesions.

Research paper thumbnail of Use of fibrin glue in preventing pseudorecurrence after laparoscopic total extraperitoneal repair of large indirect inguinal hernia

Annals of Surgical Treatment and Research, 2016

Purpose: Seroma is among the most common complications of laparoscopic total extraperitoneal (TEP... more Purpose: Seroma is among the most common complications of laparoscopic total extraperitoneal (TEP) for especially large indirect inguinal hernia, and may be regarded as a recurrence by some patients. A potential area localized behind the mesh and extending from the inguinal cord into the scrotum may be one of the major etiological factors of this complication. Our aim is to describe a novel tech nique in preventing pseudorecurrence by using fibrin sealant to close that potential dead space. Methods: Forty male patients who underwent laparoscopic TEP for indirect inguinal hernia with at least 100-mL volume were included in this prospective clinical study. While fibrin sealant was used to close the potential dead space in the study group, nothing was used in the control group. The volume of postoperative fluid collection on ultrasound was compared between the groups. Results: Patient characteristics and the volumes of hernia sac were similar between the 2 groups. The mean volume of postoperative fluid collection was found as 120.2 mL in the control group and 53.7 mL in the study group, indicating a sta tistical significance (P < 0.001). Conclusion: Minimizing the potential dead space with a fibrin sealant can reduce the amount of postoperative fluid collection, namely the incidence of pseudorecurrence.

Research paper thumbnail of Tiroid Bezinin Otoimmün Hastalıklarında Difüzyon Ağırlıklı Ekoplanar Manyetik Rezonans Görüntüleme

dergiler.ankara.edu.tr

Otoimmün tiroid patolojilerinin büyük bir grubunu oluşturan Graves ve Hashimoto hastalıklarında ,... more Otoimmün tiroid patolojilerinin büyük bir grubunu oluşturan Graves ve Hashimoto hastalıklarında , tanı ve aktivasyonunun değerlendirilmesinde, difüzyon ağırlıklı echoplanar manyetik rezonans (MR) incelemenin klinik olarak kullanılabilirliğinin belirlenmesidir. Gereç ve Yöntem : Mayıs 2007 ve Şubat 2008 arasında yapılan çalışmaya, otoimmün tiroidit tanısı alan 51 hasta (29 Hashimoto hastalığı ve 22 Graves hastalığı) ile 14 sağlıklı kontrol grubu dahil edildi. MR incelemede, T1 ağırlıklı, T2 ağırlıklı ve difüzyon ağırlıklı görüntüler single shot ekoplanar spin eko sekansı ile elde edildi. Çalışmada 200 ve 400 sn/mm² olmak üzere iki farklı b değeri kullanıldı ve "Apparent Diffusion Coefficent" (ADC) değerleri hesaplandı. Bulgular: Graves olgularında b-200 ile elde edilen ortalama ADC ölçümlerinin Hashimoto olguları ile karşılaştırıldığında daha yüksek olduğu bulundu (p < 0,05). b=400 sn/mm2 ile elde edilen ortalama ADC ölçümleri, hem kontrol grubu hem de Graves olgularında, Hashimato olgularına göre daha yüksek bulundu (p < 0,01). Graves olgularında hem b=200 sn/mm2 hem de b=400 sn/mm2 değerlerinde elde edilen ortalama ADC ölçümlerinde, hipertiroidi ve ötiroid gruplar arasında anlamlı fark saptanmadı(p değerleri sırası ile 0,259 ve 0,880). Hashimoto olgularında hem b=200 sn/mm2 hem de b=400 sn/mm2 değerlerinde elde edilen ortalama ADC ölçümlerinde, hipertiroidi, hipotiroidi ve ötiroid gruplar arasında anlamlı fark saptanmadı(p değerleri sırası ile 0,076 ve 0,075). Sonuç: Otoimmün tiroid hastalıklarında , difüzyon ağırlıklı görüntülerden elde edilen ADC değerleri , Graves ve Hashimoto hastalığının ayırıcı tanısında faydalı bir yöntemdir.

Research paper thumbnail of Does mesh/perimesh fibrosis have an effect on testicular arterial flow in patients with repaired inguinal hernia?

Ultraschall in der Medizin - European Journal of Ultrasound, 2007

Research paper thumbnail of Comparison of morphologic and dynamic US methods in examination of newborn hip

Diagn Interv Radiol, 2009

Comparison of morphologic and dynamic methods of hip ultrasonography (US) to differentiate normal... more Comparison of morphologic and dynamic methods of hip ultrasonography (US) to differentiate normal from abnormal findings in the diagnosis of developmental dysplasia of the hip (DDH). A total of 6,800 hips in 3,400 infants were examined with US, using the morphological method of Graf, and the dynamic method of Harcke. According to the Graf classification 81.47% of infants had Type 1 (normal hip), 10% Type 2a (physiologic immaturity), 2.44% Type 2b (acetabular dysplasia), 1.05% Type 2c (critical zone hip), 2.89% Type 3 (mildly dislocated), and 2.10% had Type 4 (dislocated) hips. Study in the transverse/neutral plane showed a normal relationship between the femoral head and the acetabulum in the 6,460 hips that were classified as Type 1-2c, that the hip was subluxated in 197 hips of Type 3, and was luxated in 143 hips of Type 4. Dynamic study with stress maneuver of the Type 1-2a hips showed that while 91.48% of the Type 1 hips (n = 5540) were stable and 8.52% were unstable, 92.37% of the Type 2a hips (n = 682) were stable and 7.63% were unstable. Dynamic study was not performed in cases that were diagnosed as Type 2b or worse. Follow-up US showed progression from Type 2a to Type 2b in 2.63% of Type 2a cases. Of the cases, 1.7% that were morphologically normal (Type 1) but unstable in their initial US examination, were revealed to be Type 3 later in the repeat US examination. We believe that overtreatment and delayed treatment rates of DDH will be minimized by the use of both morphological and dynamic US methods in the evaluation of the newborn hip.

Research paper thumbnail of Diagnostic Value of 64-slice CTA in Detection of Intracranial Aneurysm in Patients with SAH and Comparison of the CTA Results with 2D-DSA and Intraoperative Findings

Balkan Medical Journal, 2011

Page 1. 26 Diagnostic Value of 64-slice CTA in Detection of Intracranial Aneurysm in Patients wit... more Page 1. 26 Diagnostic Value of 64-slice CTA in Detection of Intracranial Aneurysm in Patients with SAH and Comparison of the CTA Results with 2D-DSA and Intraoperative Findings 1Department of Radiology, Ankara Training ...

Research paper thumbnail of Anatomical variations and anomalies of the coronary arteries:64-slice CT coronary angiographic appearance

Diagn Interv Radiol, 2009

To retrospectively review the 64-slice computed tomography (CT) appearance of coronary artery ana... more To retrospectively review the 64-slice computed tomography (CT) appearance of coronary artery anatomic variants and anomalies and determine their incidence in 700 patients. CT data of 700 patients who underwent 64-slice CT angiography (CTA) because of known or suspected coronary artery disease were retrospectively reviewed by two radiologists experienced in cardiovascular radiology. In each study, anatomic variants and anomalies were investigated. The coronary artery system was right dominant in 76%, left dominant in 9.1% and co-dominant in 14.8% of the cases. Ramus intermedius was present in 31%. Conus artery with a separate ostium in the right sinus Valsalva was observed in 22%, and in 0.2% two conus arteries originating with separate ostia were visualized. The sinus node artery (SNA) originated from the right coronary artery (RCA) in 79%, from the circumflex artery (Cx) in 20%, and from the left main coronary artery (LMCA) in 0.4%. In 0.4% of the cases SNA originating from the right sinus Valsalva with a separate ostium was seen. LMCA was absent in 0.4%. Cx was absent in 0.1%, and diagonals were absent in 0.1%. High takeoff of LMCA and RCA were observed in 0.7% and 0.1%, respectively. Myocardial bridging was observed in 37%. Anomalous origin of the coronary artery from the opposite sinus was observed in 1% of the cases. Complex anatomy of the coronary artery system can accurately be depicted by 64-slice CTA. This modality is useful in detecting coronary artery variants and anomalies and is a valid alternative to conventional coronary angiography in their diagnosis.

Research paper thumbnail of Transcutaneous Cervical and Transabdominal Ultrasonography as a Diagnostic Tool in Gastroesophageal Reflux in Childhood

Orl J Oto Rhino Laryngol, 2010

The aim of this study is to investigate if there is a diagnostic expressive difference in the ang... more The aim of this study is to investigate if there is a diagnostic expressive difference in the angle of His, upper and lower esophageal diameter (UED and LED), wall thickness of cervical esophagus (WTCE) measured by cervical and transabdominal ultrasonography (USG) between children with (+) and without gastroesophageal reflux (GER-). 50 children were separated into 2 groups. Group 1 was the control group (n = 30) consisting of children who had no symptoms of GER and had no GER detected in USG. Group 2 was the study group (n = 20) consisting of children with complaints related to GER, and who were GER+ by USG and esophageal pH monitoring. The USG examinations were completed after having observed 3 episodes of reflux or after 30 min if no reflux was detected. The angle of His, UED, LED and WTCE were measured. In 24-hour esophageal pH monitoring, acid contact to the proximal or distal probe greater than 5.0% of the total time below pH 4 was accepted as pathologic reflux. The age range of the 50 children (30 boys) was 4-13 years. Between the 2 groups there were no differences with regard to age and gender. Values of UED, LED and WTCE were statistically higher in group 2 compared with group 1. The angle of His was higher in the control group, but this was not statistically significant. Our study is the first in the literature that shows that measuring UED, LED and WTCE by USG, which is a noninvasive, readily available repeatable, cheap and fast technique, has a high diagnostic value in children with suspected GER.

Research paper thumbnail of Interobserver and Intraobserver Variability in the Sonographic Measurement of the Size of the Thyroid Gland by Extended Field-of-View Sonography

Journal of Diagnostic Medical Sonography, Mar 14, 2008

Research paper thumbnail of Preoperative Ultrasonographic Evaluation of Testicular Volume and Blood Flow in Patients With Inguinal Hernias

Journal of Ultrasound in Medicine Official Journal of the American Institute of Ultrasound in Medicine, Dec 1, 2007

The purpose of this study was to investigate whether an inguinal hernia would have an impact on t... more The purpose of this study was to investigate whether an inguinal hernia would have an impact on the testicular volume and blood flow by scrotal ultrasonography. Twenty-six male patients with unilateral inguinal hernias with a mean age of 48.1 years were included in the study. Testicular volumes were calculated, and spectral parameters such as the pulsatility index and resistive index of the testicular artery at supratesticular, subcapsular, and intratesticular levels on both the side with the inguinal hernia and the contralateral side were measured by a preoperative ultrasonographic examination. Comparisons between the dependent groups were performed by a Wilcoxon or paired samples t test where appropriate. The mean +/- SD testicular volume on the side with the inguinal hernia was significantly higher than that on the contralateral testis (15.46+/-4.49 versus 14.54+/-3.65 mL, respectively; P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.05, Student t test). In addition, the mean resistive index of the intratesticular arteries was significantly higher on the side with the hernia compared with the contralateral side (0.66+/-0.06 versus 0.63+/-0.05; P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.05, Student t test). These data indicate that an inguinal hernia may impair testicular blood flow, which may be attributable to an intermittent mechanical compression effect on the funiculus spermaticus in the inguinal canal.

Research paper thumbnail of The stylohyoid chain: CT imaging

European Journal of Radiology, May 1, 2010

We aimed in this report to discuss the embryology, anatomy, theories of ossification and symptoms... more We aimed in this report to discuss the embryology, anatomy, theories of ossification and symptoms, clinical presentation, and diagnosis of the stylohyoid chain (SHC) variations, together with the role of radiographs, computed tomography (CT) and three-dimensional (3D)-CT in showing these variations. Because CT/3D-CT additionally facilitates visualization of the entire SHC with different axes, it is the most valuable method for establishing the relationship between the SHC and the surrounding tissue. SHC variation can be discovered during CT performed for indications other than ossified SHC. It is important to diagnose whether or not the SHC is ossified, since one of the treatment procedures in ossified SHC is total excision. If the clinician and radiologist are aware of these variations observed in the SHC, patients with vague symptoms may be spared unnecessary investigations and may be properly diagnosed earlier.

Research paper thumbnail of Coronary CT Angiography Findings with 64-Detector CT

Annals of Medical Research, 2021

Aim: This study aims to determine the coronary artery variations, anomalies, and pathologies that... more Aim: This study aims to determine the coronary artery variations, anomalies, and pathologies that could be detected in coronarycomputed tomography angiography (CCTA).Materials and Methods: Between March 2007 and December 2008, 1180 patients were referred to our clinic with CCTA requests.Coronary artery anatomy, the presence of variations and anomalies, coronary artery disease, proximal and distal anastomosis levels,stenosis and/or occlusion of by-pass grafts, stent patency, or stenosis were examined and recorded for all cases.Results: Total of 1118 cases included in the study. The left main coronary artery (LM) was not observed in 9 (0.80%) patients. In onecase (0.08%), the circumflex artery (LCx) artery was originated from the right sinus of Valsalva (RSV) with a retro-aortic course andthen reached its typical trace. The LM originated from the RSV in 2 patients (0.17%). The right coronary artery (RCA) originated fromthe left sinus of Valsalva (LSV) in 4 cases (0.35%). Coronary arte...

Research paper thumbnail of T2 MRI Mapping of Knee Cartilage in Professional Ballet Dancers

Medical Problems of Performing Artists

AIMS: Professional ballet dancers are at risk for degenerative knee cartilage changes. In the cur... more AIMS: Professional ballet dancers are at risk for degenerative knee cartilage changes. In the current study, we evaluated the knee cartilage with T2 mapping methods in professional ballet dancers and healthy controls and investigated possible differences of T2 values between these groups. METHODS: We included healthy dancers with 5−20 years of professional ballet dancing experience and sex-matched healthy controls without knee pathology. T2 values of the knee cartilage were measured from axial, coronal, and sagittal images. The values were measured by free hand region of interest (ROI). RESULTS: The study population consisted of 44 people (22 dancers, 22 controls), with mean age of 25.57 ± 5.53 yrs. We found no significant relationship between sex and T2 values. We detected a significant positive correlation between age and T2 values for patellofemoral joint cartilage. T2 values of patellofemoral and tibiofemoral joints of dancers were significantly higher. Mean T2 values of patello...

Research paper thumbnail of Variants of the popliteal artery terminal branches as detected by multidetector ct angiography

Open Medicine, 2015

Objective: To evaluate variants of the popliteal artery (PA) terminal branches with 64-multidetec... more Objective: To evaluate variants of the popliteal artery (PA) terminal branches with 64-multidetector computed tomographic angiography (64-MD CTA).Materials and Methods: A total of 495 extremities (251 right, 244 left) of 253 patients undergoing a 64-MD CTA examination were included in the study. Of these, 242 extremities were evaluated bilaterally, whereas 11 were evaluated unilaterally. The terminal branching pattern of the PA was classified according to the classification scheme proposed by Kim; the distance between the medial tibial plateau and the origin of the anterior tibial artery (A) and the length of the tibioperoneal trunk (B) have been measured and recorded.Results: In 459 cases (92.7%) branching of PA occurred distal to the knee joint (Type I); in 18 cases (2.8%) PA branching was superior to the knee joint (Type II); and hypoplasia of the PA branches was found in 27 cases (5.5%) (Type III). Among these types the most frequent branching patterns were Type IA (87.5%), Type...

Research paper thumbnail of Placental Elasticity and Histopathological Findings in Normal and Intra-uterine Growth Restriction Pregnancies Assessed with Strain Elastography in Ex Vivo Placenta

Ultrasound in Medicine & Biology, 2016

The aim of this study was to investigate the differences of placental elasticity between intra-ut... more The aim of this study was to investigate the differences of placental elasticity between intra-uterine growth restriction (IUGR) and normal pregnancies to show whether or not there is any association between histopathological changes and placental elasticity. Fifty-five human placentas were collected at delivery, including 25 with IUGR and 30 controls. Strain elastography (SE) was performed ex vivo and all placentas were examined histopathologically. Elasticity index (EI) and histopathological findings were compared between groups. The placental stiffness and presence of histopathological changes were higher in the IUGR group than in controls (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Also, histopathological findings were associated with decreased EI values, but no specific patterns of histologic abnormalities were identified except villitis and delayed villous maturity. Distinct reduced placental elasticity could be the result of the cumulative effects of all the histologic findings in IUGR.

Research paper thumbnail of X-ray Use in Chest Imaging in Emergency Department on the Basis of Cost and Effectiveness

Academic Radiology, 2016

The increasing use of imaging in the emergency department (ED) services has become an important p... more The increasing use of imaging in the emergency department (ED) services has become an important problem on the basis of cost and unnecessary exposure to radiation. Radiographic examination of the chest has been reported to be performed in 34.4% of ED visits, and chest computerized tomography (CCT) in 15.8%, whereas some patients receive both chest radiography and CCT in the same visit. In the current study, it was aimed to establish instances of medical waste and unnecessary radiation exposure and to show how the inclusion of radiologists in the ordering process would affect the amount of unnecessary imaging studies. This retrospective study included 1012 ED patients who had both chest radiography and CCT during the same visit at Ankara Training and Research Hospital between April 2015 and January 2016. The patients were divided into subgroups of trauma and nontrauma. To detect unnecessary imaging examinations, data were analyzed according to the presence of additional findings on CCT images and the recommendation of a radiologist for CCT imaging. In the trauma group, 77.1% (461/598) and in the nontrauma group, 80.4% (334/414) of patients could be treated without any need for CCT. In the trauma group, the radiologist recommendation only, and in the nontrauma group, both the radiologist recommendation and the age were determined to be able to predict the risk of having additional findings on CCT. Considering only the age of the patient before ordering CCT could decrease the rate of unnecessary imaging. Including radiologists into both the evaluation and the ordering processes may help to save resources and decrease exposure to ionizing radiation.

Research paper thumbnail of Imaging Findings in Patients with Granulomatous Mastitis

Iranian Journal of Radiology, 2016

Background: Granulomatous mastitis (GM) is a rare inflammatory breast disease that may mimic the ... more Background: Granulomatous mastitis (GM) is a rare inflammatory breast disease that may mimic the clinical characteristics and radiologic imaging findings of breast carcinoma. Considering the importance of making a correct diagnosis, careful radiologic evaluations and recognition of imaging features are necessary. Objectives: The aim of this study was to review the radiological findings and diagnostic value of the imaging in GM. Patients and Methods: This retrospective study involved a total of 29 patients who were diagnosed with GM between 2009 and 2013 and who underwent mammography (MG) and/or ultrasound (US) examination in addition to magnetic resonance imaging (MRI) before diagnosis. Results: Among 14 patients over 35 years of age who underwent MG imaging, focal asymmetric, ill-defined nodular, or diffusely increased densities were detected in nine (64.3%), two (14.3%), and one (7.1%) subjects, respectively, while there were no pathological findings in two (14.3%) patients. In the overall group of 29 patients, US showed heterogeneous hypoechoic lesions with tubular extensions in 16 (55.2%), well-demarcated heterogeneous hypoechoic lesions in eight (27.6%), parenchymal heterogeneous appearance in three (10.3%), and a heterogeneous hypoechoic lesion with irregular margins in one (3.4%), with another (3.4%) patient having normal US findings. MRI findings included lesions consistent with solitary or multiple separate or confluent abscesses with marked peripheral ring enhancement in 25 (86.2%) patients, accompanied by intensity changes suggesting edematous inflammation in the peripheral parenchyma, as well as non-mass-like heterogeneous segmental and regional contrast enhancement. Four (13.8%) patients had non-mass-like segmental and regional contrast enhancement only. A histopathological diagnosis of GM was established in all patients with biopsy. Conclusion: GM presents with a wide range of conventional radiological findings, hampering the diagnosis. In patients with inconclusive conventional findings, MRI may assist in the differential diagnosis and assessment of the extent of disease. However, a definitive diagnosis and relevant treatment require histopathological confirmation.

Research paper thumbnail of Spontaneous Isolated Celiac Artery and Superior Mesenteric Artery Dissections: A Rare Case

Polish Journal of Radiology, 2015

Background: Arterial dissection is defined as the cleavage of the arterial wall by an intramural ... more Background: Arterial dissection is defined as the cleavage of the arterial wall by an intramural hematoma. Reports of dissection of the celiac and/or superior mesenteric artery are rare; as far as we know, only 24 cases of spontaneous isolated celiac trunk dissection, and 71 cases of spontaneous isolated superior mesenteric artery dissection have been reported.

Research paper thumbnail of Correlation of computed tomography, magnetic resonance imaging and clinical outcome in acute carbon monoxide poisoning

Brazilian Journal of Anesthesiology (English Edition), 2014

Background and objectives: carbon monoxide is a toxic gas for humans and is still a silent killer... more Background and objectives: carbon monoxide is a toxic gas for humans and is still a silent killer in both developed and developing countries. The aim of this case series was to evaluate early radiological images as a predictor of subsequent neuropsychological sequelae, following carbon monoxide poisoning. Case 1: after carbon monoxide exposure, early computed tomography scans and magnetic resonance imaging findings of a 52-year-old woman showed bilateral lesions in the globus pallidus. This patient was discharged and followed for 90 days. The patient recovered without any neurological sequela. Case 2: in a 58-year-old woman exposed to carbon monoxide, computed tomography showed lesions in bilateral globus pallidus and periventricular white matter. Early magnetic resonance imaging revealed changes similar to that like in early tomography images. The patient recovered and was discharged from hospital. On the 27th day of exposure, the patient developed disorientation and memory impairment. Late magnetic resonance imaging showed diffuse hyperintensity in the cerebral white matter. Conclusion: white matter lesions which progress to demyelination and end up in neuropsychological sequelae cannot always be diagnosed by early computed tomography and magnetic resonance imaging in carbon monoxide poisoning.

Research paper thumbnail of Nodular Sclerosing Adenosis Mimicking Malignancy in the Breast: Magnetic Resonance Imaging Findings

The Breast …, 2010

... Nodular Sclerosing Adenosis Mimicking Malignancy in the Breast: Magnetic Resonance Imaging Fi... more ... Nodular Sclerosing Adenosis Mimicking Malignancy in the Breast: Magnetic Resonance Imaging Findings. Pelin Seher Oztekin MD 1 ,; Isil Tuncbilek MD 1 ,; Pinar Kosar MD 1 ,; Serap Gültekin MD 2 ,; Fahriye Karataş Oztürk MD 3. Article first published online: 6 DEC 2010. ...

Research paper thumbnail of Sarkomu Taklit Eden Miyozitis Ossifikans

Turkiye Klinikleri Journal of Case Reports, 2014

Myositis ossificans (MO) is a benign lesion of muscle and soft tissue, characterized by well-deli... more Myositis ossificans (MO) is a benign lesion of muscle and soft tissue, characterized by well-delineated bone formation. Although its exact etiology is unknown, trauma plays role in 75% of cases. It is more common in males and rare during childhood. This report presents the radiological findings of a 12-years-old girl diagnosed with MO. Shortly after trauma, radiological examinations failed to differentiate a right pelvic floor lesion from sarcoma and biopsy findings were non-specific. However, a diagnosis of MO was made based on its typical radiological appearance during monthly follow-ups and a reduction in size was evident at two years. This case report aims to review radiological findings of MO, and to emphasize that MO may mimic sarcoma early in the course of the disease and that late typical appearance may be detectable even after years. Thus, MO should be borne in mind in the differential diagnosis of soft tissue lesions.

Research paper thumbnail of Use of fibrin glue in preventing pseudorecurrence after laparoscopic total extraperitoneal repair of large indirect inguinal hernia

Annals of Surgical Treatment and Research, 2016

Purpose: Seroma is among the most common complications of laparoscopic total extraperitoneal (TEP... more Purpose: Seroma is among the most common complications of laparoscopic total extraperitoneal (TEP) for especially large indirect inguinal hernia, and may be regarded as a recurrence by some patients. A potential area localized behind the mesh and extending from the inguinal cord into the scrotum may be one of the major etiological factors of this complication. Our aim is to describe a novel tech nique in preventing pseudorecurrence by using fibrin sealant to close that potential dead space. Methods: Forty male patients who underwent laparoscopic TEP for indirect inguinal hernia with at least 100-mL volume were included in this prospective clinical study. While fibrin sealant was used to close the potential dead space in the study group, nothing was used in the control group. The volume of postoperative fluid collection on ultrasound was compared between the groups. Results: Patient characteristics and the volumes of hernia sac were similar between the 2 groups. The mean volume of postoperative fluid collection was found as 120.2 mL in the control group and 53.7 mL in the study group, indicating a sta tistical significance (P < 0.001). Conclusion: Minimizing the potential dead space with a fibrin sealant can reduce the amount of postoperative fluid collection, namely the incidence of pseudorecurrence.

Research paper thumbnail of Tiroid Bezinin Otoimmün Hastalıklarında Difüzyon Ağırlıklı Ekoplanar Manyetik Rezonans Görüntüleme

dergiler.ankara.edu.tr

Otoimmün tiroid patolojilerinin büyük bir grubunu oluşturan Graves ve Hashimoto hastalıklarında ,... more Otoimmün tiroid patolojilerinin büyük bir grubunu oluşturan Graves ve Hashimoto hastalıklarında , tanı ve aktivasyonunun değerlendirilmesinde, difüzyon ağırlıklı echoplanar manyetik rezonans (MR) incelemenin klinik olarak kullanılabilirliğinin belirlenmesidir. Gereç ve Yöntem : Mayıs 2007 ve Şubat 2008 arasında yapılan çalışmaya, otoimmün tiroidit tanısı alan 51 hasta (29 Hashimoto hastalığı ve 22 Graves hastalığı) ile 14 sağlıklı kontrol grubu dahil edildi. MR incelemede, T1 ağırlıklı, T2 ağırlıklı ve difüzyon ağırlıklı görüntüler single shot ekoplanar spin eko sekansı ile elde edildi. Çalışmada 200 ve 400 sn/mm² olmak üzere iki farklı b değeri kullanıldı ve "Apparent Diffusion Coefficent" (ADC) değerleri hesaplandı. Bulgular: Graves olgularında b-200 ile elde edilen ortalama ADC ölçümlerinin Hashimoto olguları ile karşılaştırıldığında daha yüksek olduğu bulundu (p < 0,05). b=400 sn/mm2 ile elde edilen ortalama ADC ölçümleri, hem kontrol grubu hem de Graves olgularında, Hashimato olgularına göre daha yüksek bulundu (p < 0,01). Graves olgularında hem b=200 sn/mm2 hem de b=400 sn/mm2 değerlerinde elde edilen ortalama ADC ölçümlerinde, hipertiroidi ve ötiroid gruplar arasında anlamlı fark saptanmadı(p değerleri sırası ile 0,259 ve 0,880). Hashimoto olgularında hem b=200 sn/mm2 hem de b=400 sn/mm2 değerlerinde elde edilen ortalama ADC ölçümlerinde, hipertiroidi, hipotiroidi ve ötiroid gruplar arasında anlamlı fark saptanmadı(p değerleri sırası ile 0,076 ve 0,075). Sonuç: Otoimmün tiroid hastalıklarında , difüzyon ağırlıklı görüntülerden elde edilen ADC değerleri , Graves ve Hashimoto hastalığının ayırıcı tanısında faydalı bir yöntemdir.

Research paper thumbnail of Does mesh/perimesh fibrosis have an effect on testicular arterial flow in patients with repaired inguinal hernia?

Ultraschall in der Medizin - European Journal of Ultrasound, 2007

Research paper thumbnail of Comparison of morphologic and dynamic US methods in examination of newborn hip

Diagn Interv Radiol, 2009

Comparison of morphologic and dynamic methods of hip ultrasonography (US) to differentiate normal... more Comparison of morphologic and dynamic methods of hip ultrasonography (US) to differentiate normal from abnormal findings in the diagnosis of developmental dysplasia of the hip (DDH). A total of 6,800 hips in 3,400 infants were examined with US, using the morphological method of Graf, and the dynamic method of Harcke. According to the Graf classification 81.47% of infants had Type 1 (normal hip), 10% Type 2a (physiologic immaturity), 2.44% Type 2b (acetabular dysplasia), 1.05% Type 2c (critical zone hip), 2.89% Type 3 (mildly dislocated), and 2.10% had Type 4 (dislocated) hips. Study in the transverse/neutral plane showed a normal relationship between the femoral head and the acetabulum in the 6,460 hips that were classified as Type 1-2c, that the hip was subluxated in 197 hips of Type 3, and was luxated in 143 hips of Type 4. Dynamic study with stress maneuver of the Type 1-2a hips showed that while 91.48% of the Type 1 hips (n = 5540) were stable and 8.52% were unstable, 92.37% of the Type 2a hips (n = 682) were stable and 7.63% were unstable. Dynamic study was not performed in cases that were diagnosed as Type 2b or worse. Follow-up US showed progression from Type 2a to Type 2b in 2.63% of Type 2a cases. Of the cases, 1.7% that were morphologically normal (Type 1) but unstable in their initial US examination, were revealed to be Type 3 later in the repeat US examination. We believe that overtreatment and delayed treatment rates of DDH will be minimized by the use of both morphological and dynamic US methods in the evaluation of the newborn hip.

Research paper thumbnail of Diagnostic Value of 64-slice CTA in Detection of Intracranial Aneurysm in Patients with SAH and Comparison of the CTA Results with 2D-DSA and Intraoperative Findings

Balkan Medical Journal, 2011

Page 1. 26 Diagnostic Value of 64-slice CTA in Detection of Intracranial Aneurysm in Patients wit... more Page 1. 26 Diagnostic Value of 64-slice CTA in Detection of Intracranial Aneurysm in Patients with SAH and Comparison of the CTA Results with 2D-DSA and Intraoperative Findings 1Department of Radiology, Ankara Training ...

Research paper thumbnail of Anatomical variations and anomalies of the coronary arteries:64-slice CT coronary angiographic appearance

Diagn Interv Radiol, 2009

To retrospectively review the 64-slice computed tomography (CT) appearance of coronary artery ana... more To retrospectively review the 64-slice computed tomography (CT) appearance of coronary artery anatomic variants and anomalies and determine their incidence in 700 patients. CT data of 700 patients who underwent 64-slice CT angiography (CTA) because of known or suspected coronary artery disease were retrospectively reviewed by two radiologists experienced in cardiovascular radiology. In each study, anatomic variants and anomalies were investigated. The coronary artery system was right dominant in 76%, left dominant in 9.1% and co-dominant in 14.8% of the cases. Ramus intermedius was present in 31%. Conus artery with a separate ostium in the right sinus Valsalva was observed in 22%, and in 0.2% two conus arteries originating with separate ostia were visualized. The sinus node artery (SNA) originated from the right coronary artery (RCA) in 79%, from the circumflex artery (Cx) in 20%, and from the left main coronary artery (LMCA) in 0.4%. In 0.4% of the cases SNA originating from the right sinus Valsalva with a separate ostium was seen. LMCA was absent in 0.4%. Cx was absent in 0.1%, and diagonals were absent in 0.1%. High takeoff of LMCA and RCA were observed in 0.7% and 0.1%, respectively. Myocardial bridging was observed in 37%. Anomalous origin of the coronary artery from the opposite sinus was observed in 1% of the cases. Complex anatomy of the coronary artery system can accurately be depicted by 64-slice CTA. This modality is useful in detecting coronary artery variants and anomalies and is a valid alternative to conventional coronary angiography in their diagnosis.

Research paper thumbnail of Transcutaneous Cervical and Transabdominal Ultrasonography as a Diagnostic Tool in Gastroesophageal Reflux in Childhood

Orl J Oto Rhino Laryngol, 2010

The aim of this study is to investigate if there is a diagnostic expressive difference in the ang... more The aim of this study is to investigate if there is a diagnostic expressive difference in the angle of His, upper and lower esophageal diameter (UED and LED), wall thickness of cervical esophagus (WTCE) measured by cervical and transabdominal ultrasonography (USG) between children with (+) and without gastroesophageal reflux (GER-). 50 children were separated into 2 groups. Group 1 was the control group (n = 30) consisting of children who had no symptoms of GER and had no GER detected in USG. Group 2 was the study group (n = 20) consisting of children with complaints related to GER, and who were GER+ by USG and esophageal pH monitoring. The USG examinations were completed after having observed 3 episodes of reflux or after 30 min if no reflux was detected. The angle of His, UED, LED and WTCE were measured. In 24-hour esophageal pH monitoring, acid contact to the proximal or distal probe greater than 5.0% of the total time below pH 4 was accepted as pathologic reflux. The age range of the 50 children (30 boys) was 4-13 years. Between the 2 groups there were no differences with regard to age and gender. Values of UED, LED and WTCE were statistically higher in group 2 compared with group 1. The angle of His was higher in the control group, but this was not statistically significant. Our study is the first in the literature that shows that measuring UED, LED and WTCE by USG, which is a noninvasive, readily available repeatable, cheap and fast technique, has a high diagnostic value in children with suspected GER.

Research paper thumbnail of Interobserver and Intraobserver Variability in the Sonographic Measurement of the Size of the Thyroid Gland by Extended Field-of-View Sonography

Journal of Diagnostic Medical Sonography, Mar 14, 2008

Research paper thumbnail of Preoperative Ultrasonographic Evaluation of Testicular Volume and Blood Flow in Patients With Inguinal Hernias

Journal of Ultrasound in Medicine Official Journal of the American Institute of Ultrasound in Medicine, Dec 1, 2007

The purpose of this study was to investigate whether an inguinal hernia would have an impact on t... more The purpose of this study was to investigate whether an inguinal hernia would have an impact on the testicular volume and blood flow by scrotal ultrasonography. Twenty-six male patients with unilateral inguinal hernias with a mean age of 48.1 years were included in the study. Testicular volumes were calculated, and spectral parameters such as the pulsatility index and resistive index of the testicular artery at supratesticular, subcapsular, and intratesticular levels on both the side with the inguinal hernia and the contralateral side were measured by a preoperative ultrasonographic examination. Comparisons between the dependent groups were performed by a Wilcoxon or paired samples t test where appropriate. The mean +/- SD testicular volume on the side with the inguinal hernia was significantly higher than that on the contralateral testis (15.46+/-4.49 versus 14.54+/-3.65 mL, respectively; P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.05, Student t test). In addition, the mean resistive index of the intratesticular arteries was significantly higher on the side with the hernia compared with the contralateral side (0.66+/-0.06 versus 0.63+/-0.05; P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.05, Student t test). These data indicate that an inguinal hernia may impair testicular blood flow, which may be attributable to an intermittent mechanical compression effect on the funiculus spermaticus in the inguinal canal.

Research paper thumbnail of The stylohyoid chain: CT imaging

European Journal of Radiology, May 1, 2010

We aimed in this report to discuss the embryology, anatomy, theories of ossification and symptoms... more We aimed in this report to discuss the embryology, anatomy, theories of ossification and symptoms, clinical presentation, and diagnosis of the stylohyoid chain (SHC) variations, together with the role of radiographs, computed tomography (CT) and three-dimensional (3D)-CT in showing these variations. Because CT/3D-CT additionally facilitates visualization of the entire SHC with different axes, it is the most valuable method for establishing the relationship between the SHC and the surrounding tissue. SHC variation can be discovered during CT performed for indications other than ossified SHC. It is important to diagnose whether or not the SHC is ossified, since one of the treatment procedures in ossified SHC is total excision. If the clinician and radiologist are aware of these variations observed in the SHC, patients with vague symptoms may be spared unnecessary investigations and may be properly diagnosed earlier.