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Papers by eser bulut

A B S T R A C T Objective: To investigate the relationship between gastric wall fat halo sign and... more A B S T R A C T Objective: To investigate the relationship between gastric wall fat halo sign and potentially associated cardiovascular disease (CVD) in thoracic computed tomography (CT). Material and Methods: Between October 2018 and June 2019, 62 patients with gastric wall fat halo sign and 97 controls were prospectively evaluated. Patient height, weight, body mass index (BMI), sex, age, ascending aorta, descending aorta, main pulmonary artery, right and left pulmonary artery, long and short cardiac axis and maximum transverse thorax diameters; and ascending, arcus, descending aorta and coronary artery calcium scores were recorded for the two groups. Results: No significant differences were found in sex, age, height, body weight or BMI between the two groups (p > 0.125). Patients with gastric wall fat halo sign had significantly larger diameters of the ascending aorta, the descending aorta, the main pulmonary artery, the right and left pulmonary arteries, and the short and long...

Clinical Imaging, 2018

To investigate the relationship between gastric wall fat halo sign and visceral obesity with pote... more To investigate the relationship between gastric wall fat halo sign and visceral obesity with potentially associated diseases. Materials and methods: Between September 2015 and April 2017, 90 patients with gastric wall fat halo signs and 130 controls were prospectively evaluated. Patient height, weight, body mass index (BMI), sex, age, subcutaneous fat area (SFA), visceral fat area (VFA), total fat area (TFA), percentage of visceral fat (VF%) and the presence of colic or ileal fat halo signs, hepatic steatosis and aortic calcified plaques were recorded for the two groups. Cutoff values for the VFA, TFA, and VF% were determined and the diagnostic efficacy was calculated using receiver operating characteristic (ROC) curve analysis. Results: No significant differences were found in age, BMI and SFA, but the VFA, VF%, TFA and frequencies of colic or ileal fat halo signs, hepatic steatosis and aortic calcified plaques were significantly higher in the patient group. The areas under the ROC curve (AUCs) were 0.803, 0.770 and 0.596 for VFA, VF% and TFA, respectively. The diagnostic efficacies of VFA and VF% were significantly higher than those of the TFA. Conclusion: Gastric wall fat halo signs may be observed in overweight people, especially those with increased VFA and VF%. Additionally, these signs are usually observed along with fat halo signs of the colon or terminal ileum. However, extensive studies are needed to clarify the relationship between gastric wall fat halo signs and type 2 diabetes, cardiovascular diseases and metabolic syndrome.

Ortadoğu Tıp Dergisi, 2019

Kedi Tırmığı Hastalığı; daha çok çocuklarda ve genç erişkinlerde görülen, bölgesel lenfadenopati ... more Kedi Tırmığı Hastalığı; daha çok çocuklarda ve genç erişkinlerde görülen, bölgesel lenfadenopati ile karakterize yavaş seyirli bir enfeksiyon hastalığıdır. Hastalığın etkeni Bartonella henseleae'dır. Etken, sıklıkla kediler tarafından insanlara bulaştırılır. Hastalık; bölgesel lenfadenopati, ateş, halsizlik ve yorgunluk gibi yakınmalarla kendini gösterir. Sağ inguinal bölgede şişlik ve karın ağrısı şikayetiyle başvuran 25 yaşında bayan hastanın bilgisayarlı tomografi (BT) incelemesinde; sağ inguinal bölgede 5x4 cm boyutunda santrali nekrotik LAP izlendi. Abdominal Manyetik Rezonans Görüntüleme (MRG)'de; karaciğer ve dalakta multipl büyüğü 3 cm çapında T2 Ağırlıklı Görüntüleme (AG)'de hiperintens kontrastlı imajlarda periferal kontrastlanan difüzyon MR'de difüzyon kısıtlanması gösteren apse ile uyumlu lezyonlar izlendi. İnguinal lenf bezi eksizyonel biyopsisinin histopatolojik incelemesi; "Kedi Tırmığı Hastalığı ile uyumlu granülomatöz lenfadenit" olarak tanımlandı. Nedeni bilinmeyen ateşle gelen hastalarda LAP ve visseral organlarda apse birlikteliğinde KTH akılda bulundurulmalıdır.

Sakarya tıp dergisi, Sep 7, 2022

Objective Coronavirus disease-2019 (COVID-19) can particularly affect the respiratory and cardiov... more Objective Coronavirus disease-2019 (COVID-19) can particularly affect the respiratory and cardiovascular systems and cause serious mortality. Mitral annular calcification (MAC) is a mitral valve pathology associated with cardiac mortality. We aimed to evaluate the effect of MAC on myocardial injury (MI) and mortality, which can develop secondary to COVID-19 infection. Materials and Methods After applying the exclusion criteria, thorax computed tomography (CT) images of the remaining 1151 consecutive COVID-19 patients were evaluated. Calculation of MAC scores was done by two expert radiologists blinded to the study data. MI was defined as those with hs-TnI level (≥34 ng/dl). Patients included in the study were classified as having mortality and not occurring. Results Male gender, advanced age (>65), hypertension, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease (CKD), coronary artery disease, heart failure and atrial fibrillation rates were statistically higher in the mortality group (p<0.05). The presence of MAC was 34.1% in the mortality group, while it was 16% in the survival group (p<0.001). MI was observed 49.3% in the mortality group, while it was 16.2% in the survival group (p<0.001). Presence of MAC was associated with MI (14.8% vs 38.7%, p<0.001). Age (OR=1.976, 95% CI 1.166-3.346, p=0.011), male gender (OR=1.784, 95% CI 1.101-2.892, p=0.019), CKD (OR=2.293, 95% CI 1.085-4.485, p=0.030), MI (OR=2.893, 95% CI 1.735-4.823, p<0.001) and advanced lung involvement on CT (OR=2.231, 95% CI 1.084-4.594, p=0.029) were the independent predictors of mortality Conclusion In terms of MI and mortality risk in COVID-19 patients, it may be recommended to evaluate MAC from the CT images. Keywords Coronavirus; COVID-19 infection; mitral annular calcification; myocardial injury, computed tomography Öz Amaç Koronavirüs hastalığı-2019 (COVID-19) özellikle solunum ve kardiyovasküler sistemleri etkileyerek mortaliteye ve ciddi morbiditelere neden olabilir. Mitral halka şeklindeki kalsifikasyon (MAC), kardiyak mortalite ile ilişkili bir mitral kapak patolojisidir. Bu çalışmada, MAC'ın COVID-19 enfeksiyonuna sekonder gelişebilen miyokard hasarı (MI) ve mortalite üzerine etkisini değerlendirmeyi amaçladık. Gereç ve Yöntemle Dışlama kriterleri uygulandıktan sonra geriye kalan 1151 ardışık COVID-19 hastasının toraks bilgisayarlı tomografi (BT) görüntüleri değerlendirildi. MAC puanlarının hesaplanması, çalışma verilerine kör olan iki uzman radyolog tarafından yapıldı. MI, hs-TnI düzeyi (≥34 ng/dl) olanlar olarak tanımlandı. Çalışmaya dahil edilen hastalar mortalitesi olan ve olmayan olarak sınıflandırıldı. Bulgular Mortalite grubunda erkek cinsiyet, ileri yaş (>65), hipertansiyon, diabetes mellitus, kronik obstrüktif akciğer hastalığı, kronik böbrek hastalığı (KKD), koroner arter hastalığı, kalp yetmezliği ve atriyal fibrilasyon oranları istatistiksel olarak daha yüksekti (p<0.05). Mortalite grubunda MAC varlığı %34.1, sağkalım grubunda ise %16 idi (p<0.001). Miyokardiyal hasar mortalite grubunda %49.3, sağkalım grubunda ise %16.2 olarak saptandı (p<0.001).

Turkiye Klinikleri Journal of Medical Sciences

In the period of the coronavirus disease-19 (COVID-19) pandemic, upper gastrointestinal endoscopy... more In the period of the coronavirus disease-19 (COVID-19) pandemic, upper gastrointestinal endoscopy was either postponed or canceled, except for emergencies, due to the high risk of transmission. Our study aimed to evaluate the effect of the COVID-19 pandemic on patients with upper gastrointestinal bleeding presenting to the emergency department and to compare it with the data before the pandemic. Material and Methods: In this single-center, retrospective study, patients were divided into 2 groups: pre-COVID-19 (pre-C) (March 2019-March 2020) and post-COVID-19 (post-C) (March 2020-March 2021). Patients who presented to the emergency department with upper gastrointestinal bleeding during these periods and underwent endoscopic examination were included in the study. Results: Endoscopy for upper gastrointestinal bleeding was urgently performed in 125 patients in the pre-C period and in 89 (29% decrease) patients in the post-C period. The Glasgow-Blatchford Score was higher in the pre-C period (p=0.02). Peptic ulcers were the most common cause of bleeding in both groups. High-risk peptic ulcer (forrest 1a/1b/2a/2b), and malignancy were observed more frequently in the post-C period (p=0.003, p=0.04; respectively). Endoscopic combined treatment rate was higher in the post-C group (p<0.001). Re-bleeding ratios were similar for both the groups (p=0.48). Conclusion: During the post-C period, the number of upper gastrointestinal bleeding cases admitted to the emergency department decreased significantly. However, the rate of high-risk peptic ulcer and malignancy in the etiology of upper gastrointestinal bleeding increased in the post-C period.

Turkish Journal of Medical Sciences

Background/aim: This study aims to investigate the relationship between gastric wall fat halo sig... more Background/aim: This study aims to investigate the relationship between gastric wall fat halo sign and potentially associated cardiovascular disease (CVD) in thoracic computed tomography (CT). Materials and methods: Between October 2020 and January 2021, 62 patients with gastric wall fat halo sign and 62 controls were evaluated with thorax CT. Patient's height, weight, body mass index (BMI), sex, age, comorbidities, laboratory parameters, diameters of cardiac axes, aorta and pulmonary artery; aorta and coronary artery calcium scores were recorded for the two groups. Results: No significant differences were found in sex, age, height, body weight or BMI between the two groups (p > 0.124). Patients with gastric wall fat halo sign had significantly larger diameters of the ascending aorta, the descending aorta, the main pulmonary artery, the right and left pulmonary arteries, and the short and long cardiac axes and a higher cardiothoracic ratio (CTR) than the control group (p < 0.001). Additionally, the calcium scores of the ascending, arcus, and descending aortas and the coronary arteries were significantly higher detected in patients group (p < 0.001). Patient group had significantly higher lipid profile, frequencies of diabetes mellitus (DM) and hypertension (HT) than control group (p<0.026). Conclusion: Patients with a gastric wall fat halo may show higher cardiovascular risk because of increased visceral fat tissue, vascular diameters, CTR, heart sizes, presence of DM, HT, increased lipid profile and calcium scores.

Diagnostic and Interventional Endoscopy

Acta neurologica Taiwanica, 2022

OBJECTIVE Although Coronavirus disease 2019 (COVID-19) is a respiratory virus different clinical ... more OBJECTIVE Although Coronavirus disease 2019 (COVID-19) is a respiratory virus different clinical presentations may appear by affecting other organs and systems. Along with vascular diseases in COVID-19 disease, other conditions involving the central nervous system (CNS) such as meningocephalitis, cerebral edema, and lesions on corpus callosum. Neuroimaging has an extremely important place in the diagnosis when central nervus system involvement is clinically suspected in people infected with COVID-19. METHODS The study was monocentric, retrospectively designed between March 2020 and May 2021 in a tertiary healthcare facility. Among the patients who underwent neurological evaluation, patients with anomaly in brain MRI and CT were included in the study. RESULTS Among 5,430 patients who have been admitted due to COVID-19 between the dates mentioned above, 51 patients including 27 (52.9%) females and 24 (47.1%) males presented abnormal findings in cerebral radiological tests. Vascular ab...

Acta Chirurgica Belgica, 2018

Figure 1. In the ultrasound scan, a cystic structure is seen in the right inguinal canal.

Bozok Tıp Dergisi, 2020

Bu çalışmanın amacı, meme kanserinin bilgisayarlı tomografi (BT)'de tanısal özelliklerini belirle... more Bu çalışmanın amacı, meme kanserinin bilgisayarlı tomografi (BT)'de tanısal özelliklerini belirlemek ve meme kanserinin tomografi görülebilirlik derecesini araştırmaktır. Gereç ve Yöntem: Mayıs 2010-Ocak 2016 tarihleri arasında histopatolojik tanısı bulunan 1000 meme lezyonu değerlendirildi. Bu lezyonların 604 (% 60,4)'ünde meme kanseri tanısı vardı. 604 meme kanseri olgusunun 161 (% 16.1)'inin mamografi ve toraks BT görüntüleri vardı. Çalışmaya dahil edilen bu 161 lezyonun BT ve mamografi (MG)'de lezyonların tanısal özellikleri, görülebilirlik oranları, malign ek odak ve patolojik LAP varlığı lezyonların tipi, boyutu ve lokalizasyonundan haberi olmayan iki radyolog tarafından değerlendirildi. Bulgular: Lezyon boyutları BT'de 7-110 (25.82) mm ve MG'de 6-92 (24.97) mm arasında değişmekteydi. BT ve MG'de kitle şekilleri ve kontürleri büyük oranda düzensiz idi. İki görüntüleme yöntemi arasında istatistiksel olarak anlamlı bir fark bulunmadı (p <0,001). Cerrahi patolojisi mevcut olan 133 hastanın 38'inde (% 28) tümörden ayrı malign ek odak saptanmış olup, MG'de lezyonların 18'i (% 47), BT'de ise 32'si (% 84) tespit edildi. Cerrahi patolojide 133 hastanın 55'inde (%41) patolojik lenfadenopati (LAP) tespit edilmiş olup MG'de 17 (% 30,1), BT'de ise 45 (% 81,9) patolojik LAP tespit edildi. Lezyonların yaklaşık % 70'inde hem BT hem de MG'de oldukça iyi görülebilirlik oranları vardı. İki gözlemci arasında, gözlemciler arası uyum anlamlıydı. Sonuç: Tomografi kullanımındaki artıştan dolayı, toraks BT'de meme dokusuna dikkat edilmesi ve meme kitlelerinin BT görüntüleme özellikleri bilinmesi meme kanserinin erken teşhisinde hayati öneme sahiptir.

Medicine, 2020

The present study aimed to investigate the potential use of T2-weighted sequences with diffusion ... more The present study aimed to investigate the potential use of T2-weighted sequences with diffusion weighted imaging (DWI) in magnetic resonance (MR) enterography instead of conventional contrast-enhanced MR imaging (MRI) sequences for the evaluation of active inflammation in Crohn disease. Two-hundred thirteen intestinal segments of 43 patients, who underwent colonoscopy within 2 weeks before or after MR enterography were evaluated in this retrospective study. DWI sequences, T2-weighted sequences, and contrast-enhanced T1weighted sequences were acquired in the MR enterography scan after cleaning of the bowel and using an oral contrast agent. First, the intestinal segments that had active inflammation in MR enterography were qualitatively evaluated in T2-weighted and contrastenhanced T1-weighted sequences and then MR activity index (MRAI 1) and MRAI 2 were formed with and without contrastenhanced sequences in 2 separate sessions. The correlation coefficient between contrast enhanced and DWI MR enterography scores (MRAI 1 and MRAI 2) of intestinal inflammation was 0.97 for all segments. In addition, separate correlation coefficients were calculated for terminal ileum, right colon, transverse colon, left colon, and rectum, and there was a strong correlation between the MRAI 1 and MRAI 2 scores of each segment (r = 0.86-0.97, P < .001). On the other hand, MR enterography had 88.7% sensitivity, 97.9% specificity, 95.5% positive predictive value, 94.6% negative predictive value, and 94.8% accuracy for detection of active inflammation in all intestinal segments in Crohn disease. DWI and T2-weighted sequences acquired with cleaning of the bowel can be used instead of contrast-enhanced MRI sequences for the evaluation of active inflammation in Crohn disease. Abbreviations: ADC = apparent diffusion coefficient, CDEIS = Crohn disease endoscopic index of severity, CT = computed tomography, DWI = diffusion weighted imaging, FOV = Field of view, HASTE = half-fourier single-shot fast spin-echo sequence, MR = magnetic resonance, MRAI = magnetic resonance activity index, MRI = magnetic resonance imaging, T = Tesla, TRUFI = T2weighted steady-state gradient echo sequence.

TURKISH JOURNAL OF MEDICAL SCIENCES, 2019

is one of the most widely used flow diverter stents for the treatment of intracranial aneurysms. ... more is one of the most widely used flow diverter stents for the treatment of intracranial aneurysms. Its safety and efficacy have been reported by the "Pipeline for Uncoilable or failed aneurysms: results from a multicenter clinical trial" (PUFS trial) [1] and the "International Retrospective Study of the PED: a multicenter aneurysm treatment study" (IntrePED study) [2], with a high rate of occlusion of aneurysms in the internal carotid artery (ICA) and a low rate of major events. The device has been routinely employed in the treatment of all intracranial aneurysms, with increasing use in small and more distal intracranial aneurysms [3,4]. The PED received the European CE mark of approval in 2008 and US Food and Drug Administration (FDA) approval in 2011 and is now considered first-generation. The first-generation PED can be technically challenging, particularly in an anatomically tortuous parent vessel. Problems often encountered during PED placement include difficulty in freeing the distal end of the device from a constrained capture coil, limited pushability of the delivery wire, inconsistent deployment, misplacement, stent narrowing, and inability to resheath the PED after partial deployment [5]. The Pipeline Flex Embolization Device (PED Flex) received the European CE mark of approval in March 2014 and FDA approval in February 2015. The Pipeline Flex contains a completely redesigned delivery system, while the stent device remains unchanged. The new delivery system provides the following advantages: the proximal portion has a resheathing pad to allow for recapture and repositioning of the device after partial deployment, and the distal portion has two constraining protective sleeves that allow for increased convenience of the device opening and facilitation of stent resheathing by 180° rotation upon device recapture. The pusher is also larger, with a more robust laser-cut hypotube to enhance the pushability of the device during delivery [6]. All these changes in the PED delivery system should result in easier device deployment, potentially improving procedural outcomes. Background/aim: The Pipeline Flex Embolization Device (PED Flex) is a new updated version of the PED classic that incorporates a new delivery system to allow facilitation of stent deployment, resheathing, and removal of the capture coil. This study evaluated the PED Flex in terms of the technical aspects of the procedure and first-year follow-up results. Materials and methods: This retrospective study involved prospectively collected data from May 2015 to August 2017. The primary endpoint was technical aspects of the procedure, and the secondary endpoint was first-year follow-up results. Results: Forty-nine patients with 59 target intracranial aneurysms were enrolled. Patients' mean age was 52 years (range 21−71 years), and 31 (63.0%) were female. All aneurysms except for three were unruptured. The mean aneurysm diameter was 8 mm. Forty-seven patients with 56 aneurysms were successfully treated. Due to advancement, repositioning, and migration problems, 8 (13.1%) stents were not deployed and discharged. The total aneurysm occlusion rate was 77.0%. The mortality rate was 4.3%. Conclusion: Our experience shows that the applicability and safety of the renewed delivery system provided by PED Flex for improving device apposition and opening has been proven with one-year angiographic and clinical follow-up results.

Journal of Computer Assisted Tomography, 2019

Objective: This study aimed to evaluate the diagnostic efficacy of T2 dark spot, T2 dark rim, and... more Objective: This study aimed to evaluate the diagnostic efficacy of T2 dark spot, T2 dark rim, and T2 shading signs on magnetic resonance imaging in the differentiation of endometriomas from hemorrhagic cysts. Methods: Seventy-two hemorrhagic lesions were included in this retrospective study. The presence of T2 dark spot, T2 dark rim, and T2 shading signs in the lesions and the presence of complete or incomplete rim in lesions exhibiting T2 dark rim signs were evaluated. Results: Of 72 lesions, 50 were diagnosed with endometrioma and 22 were diagnosed with hemorrhagic cyst. Twenty-six of 50 endometriomas and none of the hemorrhagic cysts showed T2 dark spot sign. T2 shading was observed in 90% of endometriomas and 18% of hemorrhagic cysts. Incomplete T2 dark rim was detected in 67% of endometriomas and 21% of hemorrhagic cysts. Conclusions: T2 dark spot and T2 dark rim signs could be useful for distinguishing endometriomas from hemorrhagic cysts.

Turkish Journal of Surgery, 2019

Objective: The main purpose of the present study was to determine the effectivity of computerized... more Objective: The main purpose of the present study was to determine the effectivity of computerized tomography (CT) in detecting breast masses and discriminating masses as malignant or benign. Material and Methods: After having received the institutional local ethics committee approval, an experienced radiologist who did not participate in the study created a patient pool by searching our health center's Pathology department database between 2010 and 2018. The group created consisted of dense and non-dense breast types equally and included approximately similar percentages of benign and malignant breast mass sizes. Finally, 70 subjects were included: 30 females with definite malign, 20 with definite benign breast masses, and 20 without any breast pathology based on mammography and ultrasonography results, who were considered as the control group. Three experienced Radiologists (R1, R2, R3) who were not aware of the final diagnosis evaluated all images independently. Radiologist performance was assessed by calculating the area under the receiver operating characteristic curve (AUC) and interobserver reliability values were estimated by intraclass correlation coefficient (ICC) analysis. Results: The diagnostic accuracy suitability of CT according to BI-RADS scores for R1, R2 and R3 were found as p< 0.001, p< 0.001 and p< 0.001, respectively. There were significant interobserver reliability rates between all investigators (p= 0.0001). Conclusion: CT may be used as a valuable diagnostic tool in discriminating breast masses with further training in widely varying appearances of normal breast tissues leading to false positive findings.

TURKISH JOURNAL OF MEDICAL SCIENCES, 2019

Purpose: To investigate the relationship between the iodine concentration (IC) of perigastric fat... more Purpose: To investigate the relationship between the iodine concentration (IC) of perigastric fat tissue as assessed by dual-energy computed tomography (DECT) and serosal invasion of gastric cancer. Materials and methods: A total of 41 patients underwent preoperative staging evaluation for gastric cancer using DECT between July 2015 and March 2018. Patients were divided into two groups based on pathology results: serosal invasion (stage T4a) and intact serosa (stage T1?T3). Cut-off values, the diagnostic efficacy of IC in the perigastric fat tissue, and the perigastric fat tissue/tumor (P/T) ratio were determined. Results: Among the 41 patients, 22 had stage T4a gastric cancer, and 19 patients had gastric cancer with a stage lower than T4a. The mean IC of perigastric fat tissue and the P/T ratio were significantly higher in patients with serosal invasion than in those with intact serosa (p<0.001). During the arterial phase, the area under the curve (AUC) was 0.915 and 0.854 for t...

Ortadoğu Tıp Dergisi, 2019

Giriş ve Amaç: İntrakraniyal anevrizmaların tedavisinde cerrahi yolla klipleme altın standart ted... more Giriş ve Amaç: İntrakraniyal anevrizmaların tedavisinde cerrahi yolla klipleme altın standart tedavi metodu iken son 30 yıldır endovasküler tedavi cerrahi tedaviye alternatif hale gelmiştir. Endovasküler yol ile tedavi edilen anevrizmalarda, total oklüzyon sağlanmasına rağmen koillerin mekanik başarısızlığına bağlı nüks gelişebilir. Bu çalışmanın amacı; endovasküler yol ile tedavi edilmiş anevrizmaların takibi olarak planlanmıştır. Gereç ve Yöntem: Çalışmaya Ocak 2004-Aralık 2013 tarihleri arasında endovasküler yolla tedavi edilen ve kontrollerine uyan 130 hastaya ait 149 anevrizma dahil edildi. Hastaların 72'si kadın, 58'i erkektir. Hastaların yaşı 13 ile 81 yaş arasında olup ortalama yaş 50,9'dur. Hastalar 6-84 ay arasında manyetik rezonans anjiyografi ve dijital substraksiyon anjiyografi ile takip edildi. Morfolojik sonuçlar Raymond sınıflamasına göre değerlendirildi. Raymond 1 (total oklüzyon), Raymond 2 (anevrizma boynunda doluş var) ve Raymond 3 (rezidü anevrizma) şeklindedir. Bulgular: Endovasküler yolla tedavi edilmiş 116 anevrizmada (%77,9) Raymond sınıf 1, 16 anevrizmada (%10,9) Raymond sınıf 2, 17 anevrizmada (%11,4) Raymond sınıf 3 oklüzyon elde edilmiştir. Toplam rekanalizasyon oranı %22,1 bulunmuştur. Raymond sınıf 2 ve 3 olan 33 hastanın 17 tanesi 6.ay kontrollerinde tespit edilmiştir. Kalan 14 hasta 1.yıl kontrollerinde 2 hasta ise 2.yıl kontrollerinde tespit edilmiştir. Remnant-nüks tespit edilen 33 anevrizmanın 5 tanesi dev anevrizma (>25mm), 14 tanesi büyük anevrizma (10-25 mm), 14 tanesi ise küçük anevrizmlarda (<10mm) izlenmiştir. Sonuç: Endovasküler tedavi sonrası takipler tedavinin stabilitesini değerlendirmek ve oluşabilecek nüksü erken dönemde saptanmasında önemlidir. Birçok çalışmada endovasküler tedavi sonrasında ilk yıl içerisinde en az iki kontrol yapılması gerektiği bildirilmektedir. Uzun dönem takiplerin manyetik rezonans anjiyografi ile yapılması uygun bir seçenektir.

Pamukkale Medical Journal, 2019

Amac: Mamografi memenin baslica goruntuleme metodu olmasina ragmen, farkli patolojik bulgulari s... more Amac: Mamografi memenin baslica goruntuleme metodu olmasina ragmen, farkli patolojik bulgulari saptamak icin yapilan toraks bilgisayarli tomografilerde (BT) insidental benign ve malign meme lezyonlari saptanmasi giderek artmaktadir. Bu nedenle, bu lezyonlarin saptanmasi ve dogru olarak tanimlanmasi onemlidir. Bu calismada, meme disi patolojilerin saptanmasi icin yapilan BT'lerde meme lezyonlarinin morfolojik ozelliklerini degerlendirmeyi amacladik. Gerec ve Yontem: 2010-2018 tarihleri arasinda hastanemizin patoloji bolumu veritabani arastirilarak histopatolojik tanisi olan ve toraks BT cekimi yapilmis olan 20 malign ve 12 benign lezyon bulundu. Benign gruba ultrasonografi ya da mamografide en az 2 yillik takipte stabl lezyonu bulunan ve toraks BT'si bulunan 8 hasta eklendi. Toraks BT'de 20 malign, 20 benign lezyonu olan 40 hasta retrospektif olarak incelendi. Meme lezyonlarinin morfolojik ozellikleri, kontrastlanma paterni ve patolojik LAP varligi degerlendirildi. Sonuclar: Toraks BT'de 20 malign lezyonun 19 (%95)'u, 20 benign lezyonun 19 (%95)'u tespit edilmistir. Malign lezyonlarin 18'i duzensiz, 1'i oval sekildeydi. Kitle konturu ise 10'unda duzensiz, 8'inde spikule, 1'inde ise duzgun sinirliydi. Benign lezyonlarin 13'u oval, 4'u yuvarlak, 2'si ise duzensiz sekilliydi. Kitle konturu 14'unde keskin, 4'unde duzensiz, 1'inde ise spikule idi. Malign lezyonlarin tumunde, benign lezyonlarinda ise 6 (%31,6)'sinda kitle kontrastlanmasi mevcuttu. Malignite tanili 5 (%26,3) hastada ayni tarafta malign gorunumlu lenfadenopati tespit edildi. Benign tanili hastalarda eslik eden patolojik gorunumlu LAP saptanmadi. Sonuc: BT'de ortaya cikan ozellikler benign lezyonlari malignlerden ayirt etmeye yardimci olabilir. Toraks BT'de insidental kontrastlanan meme lezyonunun duzensiz kontur ve sekli, eslik eden patolojik LAP'inin olmasi maligniteyi, duzgun kontur ve seklinin olmasi kitlede kontrast tutulumunun olmamasi benigniteyi dusundurmelidir.

The Breast Journal, 2017

Pseudoaneurysms (PA) in the arterial supply of the breast are quite rare and mostly iatrogenic se... more Pseudoaneurysms (PA) in the arterial supply of the breast are quite rare and mostly iatrogenic secondary to biopsies. Breast PAs after blunt trauma is even rarer. In this paper, a case of breast PAs secondary to blunt trauma and its percutaneous treatment using human thrombin injection and after N-butyl cyanoacrylate is presented. n

SDÜ Tıp Fakültesi Dergisi, 2019

Giriş İniensefali, başın fikse ve belirgin retrofleksiyonu, ayrıca kısa ve hareketsiz ense ile ka... more Giriş İniensefali, başın fikse ve belirgin retrofleksiyonu, ayrıca kısa ve hareketsiz ense ile karakterize nadir bir kranio-servikal deformitedir. Oksipito-pariyetal kemikte defekt ve foramen magnumda genişleme, serviko-torakal vertebral kolonda kısalık ve füzyon defekti tanı koymaya yardımcı ana bulgulardır. Olgu Sunumu 38 yaşında ve 19. gebelik haftasındaki takipsiz olgumuzda, prenatal ultrasonografi ve manyetik rezonans görüntülemede kraniyumda oksipito-pariyetal bölgede geniş ensefalosel, servikal ve torasik vertebra posterior elemanlarında füzyon defekti ve kısa vertebral kolon izlendi. Fetus boynunda hiperekstansiyon mevcuttu. Terminasyon yapılan olguda bulgular postnatal olarak iniensefali olarak doğrulandı. Sonuç İninensefalide erken tanı ve terminasyon ile maternal riskler azaltılabilmektedir.

A B S T R A C T Objective: To investigate the relationship between gastric wall fat halo sign and... more A B S T R A C T Objective: To investigate the relationship between gastric wall fat halo sign and potentially associated cardiovascular disease (CVD) in thoracic computed tomography (CT). Material and Methods: Between October 2018 and June 2019, 62 patients with gastric wall fat halo sign and 97 controls were prospectively evaluated. Patient height, weight, body mass index (BMI), sex, age, ascending aorta, descending aorta, main pulmonary artery, right and left pulmonary artery, long and short cardiac axis and maximum transverse thorax diameters; and ascending, arcus, descending aorta and coronary artery calcium scores were recorded for the two groups. Results: No significant differences were found in sex, age, height, body weight or BMI between the two groups (p > 0.125). Patients with gastric wall fat halo sign had significantly larger diameters of the ascending aorta, the descending aorta, the main pulmonary artery, the right and left pulmonary arteries, and the short and long...

Clinical Imaging, 2018

To investigate the relationship between gastric wall fat halo sign and visceral obesity with pote... more To investigate the relationship between gastric wall fat halo sign and visceral obesity with potentially associated diseases. Materials and methods: Between September 2015 and April 2017, 90 patients with gastric wall fat halo signs and 130 controls were prospectively evaluated. Patient height, weight, body mass index (BMI), sex, age, subcutaneous fat area (SFA), visceral fat area (VFA), total fat area (TFA), percentage of visceral fat (VF%) and the presence of colic or ileal fat halo signs, hepatic steatosis and aortic calcified plaques were recorded for the two groups. Cutoff values for the VFA, TFA, and VF% were determined and the diagnostic efficacy was calculated using receiver operating characteristic (ROC) curve analysis. Results: No significant differences were found in age, BMI and SFA, but the VFA, VF%, TFA and frequencies of colic or ileal fat halo signs, hepatic steatosis and aortic calcified plaques were significantly higher in the patient group. The areas under the ROC curve (AUCs) were 0.803, 0.770 and 0.596 for VFA, VF% and TFA, respectively. The diagnostic efficacies of VFA and VF% were significantly higher than those of the TFA. Conclusion: Gastric wall fat halo signs may be observed in overweight people, especially those with increased VFA and VF%. Additionally, these signs are usually observed along with fat halo signs of the colon or terminal ileum. However, extensive studies are needed to clarify the relationship between gastric wall fat halo signs and type 2 diabetes, cardiovascular diseases and metabolic syndrome.

Ortadoğu Tıp Dergisi, 2019

Kedi Tırmığı Hastalığı; daha çok çocuklarda ve genç erişkinlerde görülen, bölgesel lenfadenopati ... more Kedi Tırmığı Hastalığı; daha çok çocuklarda ve genç erişkinlerde görülen, bölgesel lenfadenopati ile karakterize yavaş seyirli bir enfeksiyon hastalığıdır. Hastalığın etkeni Bartonella henseleae'dır. Etken, sıklıkla kediler tarafından insanlara bulaştırılır. Hastalık; bölgesel lenfadenopati, ateş, halsizlik ve yorgunluk gibi yakınmalarla kendini gösterir. Sağ inguinal bölgede şişlik ve karın ağrısı şikayetiyle başvuran 25 yaşında bayan hastanın bilgisayarlı tomografi (BT) incelemesinde; sağ inguinal bölgede 5x4 cm boyutunda santrali nekrotik LAP izlendi. Abdominal Manyetik Rezonans Görüntüleme (MRG)'de; karaciğer ve dalakta multipl büyüğü 3 cm çapında T2 Ağırlıklı Görüntüleme (AG)'de hiperintens kontrastlı imajlarda periferal kontrastlanan difüzyon MR'de difüzyon kısıtlanması gösteren apse ile uyumlu lezyonlar izlendi. İnguinal lenf bezi eksizyonel biyopsisinin histopatolojik incelemesi; "Kedi Tırmığı Hastalığı ile uyumlu granülomatöz lenfadenit" olarak tanımlandı. Nedeni bilinmeyen ateşle gelen hastalarda LAP ve visseral organlarda apse birlikteliğinde KTH akılda bulundurulmalıdır.

Sakarya tıp dergisi, Sep 7, 2022

Objective Coronavirus disease-2019 (COVID-19) can particularly affect the respiratory and cardiov... more Objective Coronavirus disease-2019 (COVID-19) can particularly affect the respiratory and cardiovascular systems and cause serious mortality. Mitral annular calcification (MAC) is a mitral valve pathology associated with cardiac mortality. We aimed to evaluate the effect of MAC on myocardial injury (MI) and mortality, which can develop secondary to COVID-19 infection. Materials and Methods After applying the exclusion criteria, thorax computed tomography (CT) images of the remaining 1151 consecutive COVID-19 patients were evaluated. Calculation of MAC scores was done by two expert radiologists blinded to the study data. MI was defined as those with hs-TnI level (≥34 ng/dl). Patients included in the study were classified as having mortality and not occurring. Results Male gender, advanced age (>65), hypertension, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease (CKD), coronary artery disease, heart failure and atrial fibrillation rates were statistically higher in the mortality group (p<0.05). The presence of MAC was 34.1% in the mortality group, while it was 16% in the survival group (p<0.001). MI was observed 49.3% in the mortality group, while it was 16.2% in the survival group (p<0.001). Presence of MAC was associated with MI (14.8% vs 38.7%, p<0.001). Age (OR=1.976, 95% CI 1.166-3.346, p=0.011), male gender (OR=1.784, 95% CI 1.101-2.892, p=0.019), CKD (OR=2.293, 95% CI 1.085-4.485, p=0.030), MI (OR=2.893, 95% CI 1.735-4.823, p<0.001) and advanced lung involvement on CT (OR=2.231, 95% CI 1.084-4.594, p=0.029) were the independent predictors of mortality Conclusion In terms of MI and mortality risk in COVID-19 patients, it may be recommended to evaluate MAC from the CT images. Keywords Coronavirus; COVID-19 infection; mitral annular calcification; myocardial injury, computed tomography Öz Amaç Koronavirüs hastalığı-2019 (COVID-19) özellikle solunum ve kardiyovasküler sistemleri etkileyerek mortaliteye ve ciddi morbiditelere neden olabilir. Mitral halka şeklindeki kalsifikasyon (MAC), kardiyak mortalite ile ilişkili bir mitral kapak patolojisidir. Bu çalışmada, MAC'ın COVID-19 enfeksiyonuna sekonder gelişebilen miyokard hasarı (MI) ve mortalite üzerine etkisini değerlendirmeyi amaçladık. Gereç ve Yöntemle Dışlama kriterleri uygulandıktan sonra geriye kalan 1151 ardışık COVID-19 hastasının toraks bilgisayarlı tomografi (BT) görüntüleri değerlendirildi. MAC puanlarının hesaplanması, çalışma verilerine kör olan iki uzman radyolog tarafından yapıldı. MI, hs-TnI düzeyi (≥34 ng/dl) olanlar olarak tanımlandı. Çalışmaya dahil edilen hastalar mortalitesi olan ve olmayan olarak sınıflandırıldı. Bulgular Mortalite grubunda erkek cinsiyet, ileri yaş (>65), hipertansiyon, diabetes mellitus, kronik obstrüktif akciğer hastalığı, kronik böbrek hastalığı (KKD), koroner arter hastalığı, kalp yetmezliği ve atriyal fibrilasyon oranları istatistiksel olarak daha yüksekti (p<0.05). Mortalite grubunda MAC varlığı %34.1, sağkalım grubunda ise %16 idi (p<0.001). Miyokardiyal hasar mortalite grubunda %49.3, sağkalım grubunda ise %16.2 olarak saptandı (p<0.001).

Turkiye Klinikleri Journal of Medical Sciences

In the period of the coronavirus disease-19 (COVID-19) pandemic, upper gastrointestinal endoscopy... more In the period of the coronavirus disease-19 (COVID-19) pandemic, upper gastrointestinal endoscopy was either postponed or canceled, except for emergencies, due to the high risk of transmission. Our study aimed to evaluate the effect of the COVID-19 pandemic on patients with upper gastrointestinal bleeding presenting to the emergency department and to compare it with the data before the pandemic. Material and Methods: In this single-center, retrospective study, patients were divided into 2 groups: pre-COVID-19 (pre-C) (March 2019-March 2020) and post-COVID-19 (post-C) (March 2020-March 2021). Patients who presented to the emergency department with upper gastrointestinal bleeding during these periods and underwent endoscopic examination were included in the study. Results: Endoscopy for upper gastrointestinal bleeding was urgently performed in 125 patients in the pre-C period and in 89 (29% decrease) patients in the post-C period. The Glasgow-Blatchford Score was higher in the pre-C period (p=0.02). Peptic ulcers were the most common cause of bleeding in both groups. High-risk peptic ulcer (forrest 1a/1b/2a/2b), and malignancy were observed more frequently in the post-C period (p=0.003, p=0.04; respectively). Endoscopic combined treatment rate was higher in the post-C group (p<0.001). Re-bleeding ratios were similar for both the groups (p=0.48). Conclusion: During the post-C period, the number of upper gastrointestinal bleeding cases admitted to the emergency department decreased significantly. However, the rate of high-risk peptic ulcer and malignancy in the etiology of upper gastrointestinal bleeding increased in the post-C period.

Turkish Journal of Medical Sciences

Background/aim: This study aims to investigate the relationship between gastric wall fat halo sig... more Background/aim: This study aims to investigate the relationship between gastric wall fat halo sign and potentially associated cardiovascular disease (CVD) in thoracic computed tomography (CT). Materials and methods: Between October 2020 and January 2021, 62 patients with gastric wall fat halo sign and 62 controls were evaluated with thorax CT. Patient's height, weight, body mass index (BMI), sex, age, comorbidities, laboratory parameters, diameters of cardiac axes, aorta and pulmonary artery; aorta and coronary artery calcium scores were recorded for the two groups. Results: No significant differences were found in sex, age, height, body weight or BMI between the two groups (p > 0.124). Patients with gastric wall fat halo sign had significantly larger diameters of the ascending aorta, the descending aorta, the main pulmonary artery, the right and left pulmonary arteries, and the short and long cardiac axes and a higher cardiothoracic ratio (CTR) than the control group (p < 0.001). Additionally, the calcium scores of the ascending, arcus, and descending aortas and the coronary arteries were significantly higher detected in patients group (p < 0.001). Patient group had significantly higher lipid profile, frequencies of diabetes mellitus (DM) and hypertension (HT) than control group (p<0.026). Conclusion: Patients with a gastric wall fat halo may show higher cardiovascular risk because of increased visceral fat tissue, vascular diameters, CTR, heart sizes, presence of DM, HT, increased lipid profile and calcium scores.

Diagnostic and Interventional Endoscopy

Acta neurologica Taiwanica, 2022

OBJECTIVE Although Coronavirus disease 2019 (COVID-19) is a respiratory virus different clinical ... more OBJECTIVE Although Coronavirus disease 2019 (COVID-19) is a respiratory virus different clinical presentations may appear by affecting other organs and systems. Along with vascular diseases in COVID-19 disease, other conditions involving the central nervous system (CNS) such as meningocephalitis, cerebral edema, and lesions on corpus callosum. Neuroimaging has an extremely important place in the diagnosis when central nervus system involvement is clinically suspected in people infected with COVID-19. METHODS The study was monocentric, retrospectively designed between March 2020 and May 2021 in a tertiary healthcare facility. Among the patients who underwent neurological evaluation, patients with anomaly in brain MRI and CT were included in the study. RESULTS Among 5,430 patients who have been admitted due to COVID-19 between the dates mentioned above, 51 patients including 27 (52.9%) females and 24 (47.1%) males presented abnormal findings in cerebral radiological tests. Vascular ab...

Acta Chirurgica Belgica, 2018

Figure 1. In the ultrasound scan, a cystic structure is seen in the right inguinal canal.

Bozok Tıp Dergisi, 2020

Bu çalışmanın amacı, meme kanserinin bilgisayarlı tomografi (BT)'de tanısal özelliklerini belirle... more Bu çalışmanın amacı, meme kanserinin bilgisayarlı tomografi (BT)'de tanısal özelliklerini belirlemek ve meme kanserinin tomografi görülebilirlik derecesini araştırmaktır. Gereç ve Yöntem: Mayıs 2010-Ocak 2016 tarihleri arasında histopatolojik tanısı bulunan 1000 meme lezyonu değerlendirildi. Bu lezyonların 604 (% 60,4)'ünde meme kanseri tanısı vardı. 604 meme kanseri olgusunun 161 (% 16.1)'inin mamografi ve toraks BT görüntüleri vardı. Çalışmaya dahil edilen bu 161 lezyonun BT ve mamografi (MG)'de lezyonların tanısal özellikleri, görülebilirlik oranları, malign ek odak ve patolojik LAP varlığı lezyonların tipi, boyutu ve lokalizasyonundan haberi olmayan iki radyolog tarafından değerlendirildi. Bulgular: Lezyon boyutları BT'de 7-110 (25.82) mm ve MG'de 6-92 (24.97) mm arasında değişmekteydi. BT ve MG'de kitle şekilleri ve kontürleri büyük oranda düzensiz idi. İki görüntüleme yöntemi arasında istatistiksel olarak anlamlı bir fark bulunmadı (p <0,001). Cerrahi patolojisi mevcut olan 133 hastanın 38'inde (% 28) tümörden ayrı malign ek odak saptanmış olup, MG'de lezyonların 18'i (% 47), BT'de ise 32'si (% 84) tespit edildi. Cerrahi patolojide 133 hastanın 55'inde (%41) patolojik lenfadenopati (LAP) tespit edilmiş olup MG'de 17 (% 30,1), BT'de ise 45 (% 81,9) patolojik LAP tespit edildi. Lezyonların yaklaşık % 70'inde hem BT hem de MG'de oldukça iyi görülebilirlik oranları vardı. İki gözlemci arasında, gözlemciler arası uyum anlamlıydı. Sonuç: Tomografi kullanımındaki artıştan dolayı, toraks BT'de meme dokusuna dikkat edilmesi ve meme kitlelerinin BT görüntüleme özellikleri bilinmesi meme kanserinin erken teşhisinde hayati öneme sahiptir.

Medicine, 2020

The present study aimed to investigate the potential use of T2-weighted sequences with diffusion ... more The present study aimed to investigate the potential use of T2-weighted sequences with diffusion weighted imaging (DWI) in magnetic resonance (MR) enterography instead of conventional contrast-enhanced MR imaging (MRI) sequences for the evaluation of active inflammation in Crohn disease. Two-hundred thirteen intestinal segments of 43 patients, who underwent colonoscopy within 2 weeks before or after MR enterography were evaluated in this retrospective study. DWI sequences, T2-weighted sequences, and contrast-enhanced T1weighted sequences were acquired in the MR enterography scan after cleaning of the bowel and using an oral contrast agent. First, the intestinal segments that had active inflammation in MR enterography were qualitatively evaluated in T2-weighted and contrastenhanced T1-weighted sequences and then MR activity index (MRAI 1) and MRAI 2 were formed with and without contrastenhanced sequences in 2 separate sessions. The correlation coefficient between contrast enhanced and DWI MR enterography scores (MRAI 1 and MRAI 2) of intestinal inflammation was 0.97 for all segments. In addition, separate correlation coefficients were calculated for terminal ileum, right colon, transverse colon, left colon, and rectum, and there was a strong correlation between the MRAI 1 and MRAI 2 scores of each segment (r = 0.86-0.97, P < .001). On the other hand, MR enterography had 88.7% sensitivity, 97.9% specificity, 95.5% positive predictive value, 94.6% negative predictive value, and 94.8% accuracy for detection of active inflammation in all intestinal segments in Crohn disease. DWI and T2-weighted sequences acquired with cleaning of the bowel can be used instead of contrast-enhanced MRI sequences for the evaluation of active inflammation in Crohn disease. Abbreviations: ADC = apparent diffusion coefficient, CDEIS = Crohn disease endoscopic index of severity, CT = computed tomography, DWI = diffusion weighted imaging, FOV = Field of view, HASTE = half-fourier single-shot fast spin-echo sequence, MR = magnetic resonance, MRAI = magnetic resonance activity index, MRI = magnetic resonance imaging, T = Tesla, TRUFI = T2weighted steady-state gradient echo sequence.

TURKISH JOURNAL OF MEDICAL SCIENCES, 2019

is one of the most widely used flow diverter stents for the treatment of intracranial aneurysms. ... more is one of the most widely used flow diverter stents for the treatment of intracranial aneurysms. Its safety and efficacy have been reported by the "Pipeline for Uncoilable or failed aneurysms: results from a multicenter clinical trial" (PUFS trial) [1] and the "International Retrospective Study of the PED: a multicenter aneurysm treatment study" (IntrePED study) [2], with a high rate of occlusion of aneurysms in the internal carotid artery (ICA) and a low rate of major events. The device has been routinely employed in the treatment of all intracranial aneurysms, with increasing use in small and more distal intracranial aneurysms [3,4]. The PED received the European CE mark of approval in 2008 and US Food and Drug Administration (FDA) approval in 2011 and is now considered first-generation. The first-generation PED can be technically challenging, particularly in an anatomically tortuous parent vessel. Problems often encountered during PED placement include difficulty in freeing the distal end of the device from a constrained capture coil, limited pushability of the delivery wire, inconsistent deployment, misplacement, stent narrowing, and inability to resheath the PED after partial deployment [5]. The Pipeline Flex Embolization Device (PED Flex) received the European CE mark of approval in March 2014 and FDA approval in February 2015. The Pipeline Flex contains a completely redesigned delivery system, while the stent device remains unchanged. The new delivery system provides the following advantages: the proximal portion has a resheathing pad to allow for recapture and repositioning of the device after partial deployment, and the distal portion has two constraining protective sleeves that allow for increased convenience of the device opening and facilitation of stent resheathing by 180° rotation upon device recapture. The pusher is also larger, with a more robust laser-cut hypotube to enhance the pushability of the device during delivery [6]. All these changes in the PED delivery system should result in easier device deployment, potentially improving procedural outcomes. Background/aim: The Pipeline Flex Embolization Device (PED Flex) is a new updated version of the PED classic that incorporates a new delivery system to allow facilitation of stent deployment, resheathing, and removal of the capture coil. This study evaluated the PED Flex in terms of the technical aspects of the procedure and first-year follow-up results. Materials and methods: This retrospective study involved prospectively collected data from May 2015 to August 2017. The primary endpoint was technical aspects of the procedure, and the secondary endpoint was first-year follow-up results. Results: Forty-nine patients with 59 target intracranial aneurysms were enrolled. Patients' mean age was 52 years (range 21−71 years), and 31 (63.0%) were female. All aneurysms except for three were unruptured. The mean aneurysm diameter was 8 mm. Forty-seven patients with 56 aneurysms were successfully treated. Due to advancement, repositioning, and migration problems, 8 (13.1%) stents were not deployed and discharged. The total aneurysm occlusion rate was 77.0%. The mortality rate was 4.3%. Conclusion: Our experience shows that the applicability and safety of the renewed delivery system provided by PED Flex for improving device apposition and opening has been proven with one-year angiographic and clinical follow-up results.

Journal of Computer Assisted Tomography, 2019

Objective: This study aimed to evaluate the diagnostic efficacy of T2 dark spot, T2 dark rim, and... more Objective: This study aimed to evaluate the diagnostic efficacy of T2 dark spot, T2 dark rim, and T2 shading signs on magnetic resonance imaging in the differentiation of endometriomas from hemorrhagic cysts. Methods: Seventy-two hemorrhagic lesions were included in this retrospective study. The presence of T2 dark spot, T2 dark rim, and T2 shading signs in the lesions and the presence of complete or incomplete rim in lesions exhibiting T2 dark rim signs were evaluated. Results: Of 72 lesions, 50 were diagnosed with endometrioma and 22 were diagnosed with hemorrhagic cyst. Twenty-six of 50 endometriomas and none of the hemorrhagic cysts showed T2 dark spot sign. T2 shading was observed in 90% of endometriomas and 18% of hemorrhagic cysts. Incomplete T2 dark rim was detected in 67% of endometriomas and 21% of hemorrhagic cysts. Conclusions: T2 dark spot and T2 dark rim signs could be useful for distinguishing endometriomas from hemorrhagic cysts.

Turkish Journal of Surgery, 2019

Objective: The main purpose of the present study was to determine the effectivity of computerized... more Objective: The main purpose of the present study was to determine the effectivity of computerized tomography (CT) in detecting breast masses and discriminating masses as malignant or benign. Material and Methods: After having received the institutional local ethics committee approval, an experienced radiologist who did not participate in the study created a patient pool by searching our health center's Pathology department database between 2010 and 2018. The group created consisted of dense and non-dense breast types equally and included approximately similar percentages of benign and malignant breast mass sizes. Finally, 70 subjects were included: 30 females with definite malign, 20 with definite benign breast masses, and 20 without any breast pathology based on mammography and ultrasonography results, who were considered as the control group. Three experienced Radiologists (R1, R2, R3) who were not aware of the final diagnosis evaluated all images independently. Radiologist performance was assessed by calculating the area under the receiver operating characteristic curve (AUC) and interobserver reliability values were estimated by intraclass correlation coefficient (ICC) analysis. Results: The diagnostic accuracy suitability of CT according to BI-RADS scores for R1, R2 and R3 were found as p< 0.001, p< 0.001 and p< 0.001, respectively. There were significant interobserver reliability rates between all investigators (p= 0.0001). Conclusion: CT may be used as a valuable diagnostic tool in discriminating breast masses with further training in widely varying appearances of normal breast tissues leading to false positive findings.

TURKISH JOURNAL OF MEDICAL SCIENCES, 2019

Purpose: To investigate the relationship between the iodine concentration (IC) of perigastric fat... more Purpose: To investigate the relationship between the iodine concentration (IC) of perigastric fat tissue as assessed by dual-energy computed tomography (DECT) and serosal invasion of gastric cancer. Materials and methods: A total of 41 patients underwent preoperative staging evaluation for gastric cancer using DECT between July 2015 and March 2018. Patients were divided into two groups based on pathology results: serosal invasion (stage T4a) and intact serosa (stage T1?T3). Cut-off values, the diagnostic efficacy of IC in the perigastric fat tissue, and the perigastric fat tissue/tumor (P/T) ratio were determined. Results: Among the 41 patients, 22 had stage T4a gastric cancer, and 19 patients had gastric cancer with a stage lower than T4a. The mean IC of perigastric fat tissue and the P/T ratio were significantly higher in patients with serosal invasion than in those with intact serosa (p<0.001). During the arterial phase, the area under the curve (AUC) was 0.915 and 0.854 for t...

Ortadoğu Tıp Dergisi, 2019

Giriş ve Amaç: İntrakraniyal anevrizmaların tedavisinde cerrahi yolla klipleme altın standart ted... more Giriş ve Amaç: İntrakraniyal anevrizmaların tedavisinde cerrahi yolla klipleme altın standart tedavi metodu iken son 30 yıldır endovasküler tedavi cerrahi tedaviye alternatif hale gelmiştir. Endovasküler yol ile tedavi edilen anevrizmalarda, total oklüzyon sağlanmasına rağmen koillerin mekanik başarısızlığına bağlı nüks gelişebilir. Bu çalışmanın amacı; endovasküler yol ile tedavi edilmiş anevrizmaların takibi olarak planlanmıştır. Gereç ve Yöntem: Çalışmaya Ocak 2004-Aralık 2013 tarihleri arasında endovasküler yolla tedavi edilen ve kontrollerine uyan 130 hastaya ait 149 anevrizma dahil edildi. Hastaların 72'si kadın, 58'i erkektir. Hastaların yaşı 13 ile 81 yaş arasında olup ortalama yaş 50,9'dur. Hastalar 6-84 ay arasında manyetik rezonans anjiyografi ve dijital substraksiyon anjiyografi ile takip edildi. Morfolojik sonuçlar Raymond sınıflamasına göre değerlendirildi. Raymond 1 (total oklüzyon), Raymond 2 (anevrizma boynunda doluş var) ve Raymond 3 (rezidü anevrizma) şeklindedir. Bulgular: Endovasküler yolla tedavi edilmiş 116 anevrizmada (%77,9) Raymond sınıf 1, 16 anevrizmada (%10,9) Raymond sınıf 2, 17 anevrizmada (%11,4) Raymond sınıf 3 oklüzyon elde edilmiştir. Toplam rekanalizasyon oranı %22,1 bulunmuştur. Raymond sınıf 2 ve 3 olan 33 hastanın 17 tanesi 6.ay kontrollerinde tespit edilmiştir. Kalan 14 hasta 1.yıl kontrollerinde 2 hasta ise 2.yıl kontrollerinde tespit edilmiştir. Remnant-nüks tespit edilen 33 anevrizmanın 5 tanesi dev anevrizma (>25mm), 14 tanesi büyük anevrizma (10-25 mm), 14 tanesi ise küçük anevrizmlarda (<10mm) izlenmiştir. Sonuç: Endovasküler tedavi sonrası takipler tedavinin stabilitesini değerlendirmek ve oluşabilecek nüksü erken dönemde saptanmasında önemlidir. Birçok çalışmada endovasküler tedavi sonrasında ilk yıl içerisinde en az iki kontrol yapılması gerektiği bildirilmektedir. Uzun dönem takiplerin manyetik rezonans anjiyografi ile yapılması uygun bir seçenektir.

Pamukkale Medical Journal, 2019

Amac: Mamografi memenin baslica goruntuleme metodu olmasina ragmen, farkli patolojik bulgulari s... more Amac: Mamografi memenin baslica goruntuleme metodu olmasina ragmen, farkli patolojik bulgulari saptamak icin yapilan toraks bilgisayarli tomografilerde (BT) insidental benign ve malign meme lezyonlari saptanmasi giderek artmaktadir. Bu nedenle, bu lezyonlarin saptanmasi ve dogru olarak tanimlanmasi onemlidir. Bu calismada, meme disi patolojilerin saptanmasi icin yapilan BT'lerde meme lezyonlarinin morfolojik ozelliklerini degerlendirmeyi amacladik. Gerec ve Yontem: 2010-2018 tarihleri arasinda hastanemizin patoloji bolumu veritabani arastirilarak histopatolojik tanisi olan ve toraks BT cekimi yapilmis olan 20 malign ve 12 benign lezyon bulundu. Benign gruba ultrasonografi ya da mamografide en az 2 yillik takipte stabl lezyonu bulunan ve toraks BT'si bulunan 8 hasta eklendi. Toraks BT'de 20 malign, 20 benign lezyonu olan 40 hasta retrospektif olarak incelendi. Meme lezyonlarinin morfolojik ozellikleri, kontrastlanma paterni ve patolojik LAP varligi degerlendirildi. Sonuclar: Toraks BT'de 20 malign lezyonun 19 (%95)'u, 20 benign lezyonun 19 (%95)'u tespit edilmistir. Malign lezyonlarin 18'i duzensiz, 1'i oval sekildeydi. Kitle konturu ise 10'unda duzensiz, 8'inde spikule, 1'inde ise duzgun sinirliydi. Benign lezyonlarin 13'u oval, 4'u yuvarlak, 2'si ise duzensiz sekilliydi. Kitle konturu 14'unde keskin, 4'unde duzensiz, 1'inde ise spikule idi. Malign lezyonlarin tumunde, benign lezyonlarinda ise 6 (%31,6)'sinda kitle kontrastlanmasi mevcuttu. Malignite tanili 5 (%26,3) hastada ayni tarafta malign gorunumlu lenfadenopati tespit edildi. Benign tanili hastalarda eslik eden patolojik gorunumlu LAP saptanmadi. Sonuc: BT'de ortaya cikan ozellikler benign lezyonlari malignlerden ayirt etmeye yardimci olabilir. Toraks BT'de insidental kontrastlanan meme lezyonunun duzensiz kontur ve sekli, eslik eden patolojik LAP'inin olmasi maligniteyi, duzgun kontur ve seklinin olmasi kitlede kontrast tutulumunun olmamasi benigniteyi dusundurmelidir.

The Breast Journal, 2017

Pseudoaneurysms (PA) in the arterial supply of the breast are quite rare and mostly iatrogenic se... more Pseudoaneurysms (PA) in the arterial supply of the breast are quite rare and mostly iatrogenic secondary to biopsies. Breast PAs after blunt trauma is even rarer. In this paper, a case of breast PAs secondary to blunt trauma and its percutaneous treatment using human thrombin injection and after N-butyl cyanoacrylate is presented. n

SDÜ Tıp Fakültesi Dergisi, 2019

Giriş İniensefali, başın fikse ve belirgin retrofleksiyonu, ayrıca kısa ve hareketsiz ense ile ka... more Giriş İniensefali, başın fikse ve belirgin retrofleksiyonu, ayrıca kısa ve hareketsiz ense ile karakterize nadir bir kranio-servikal deformitedir. Oksipito-pariyetal kemikte defekt ve foramen magnumda genişleme, serviko-torakal vertebral kolonda kısalık ve füzyon defekti tanı koymaya yardımcı ana bulgulardır. Olgu Sunumu 38 yaşında ve 19. gebelik haftasındaki takipsiz olgumuzda, prenatal ultrasonografi ve manyetik rezonans görüntülemede kraniyumda oksipito-pariyetal bölgede geniş ensefalosel, servikal ve torasik vertebra posterior elemanlarında füzyon defekti ve kısa vertebral kolon izlendi. Fetus boynunda hiperekstansiyon mevcuttu. Terminasyon yapılan olguda bulgular postnatal olarak iniensefali olarak doğrulandı. Sonuç İninensefalide erken tanı ve terminasyon ile maternal riskler azaltılabilmektedir.