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Öğe Diagnostic Performance of Superb Microvascular Imaging and Other Sonographic Modalities in the Assessment of Lateral Epicondylosis(Wiley, 2018) Arslan, Serdar; Karahan, Ali Yavuz; Oncu, Fatih; Bakdik, Suleyman; Durmaz, Mehmet Sedat; Tolu, IsmetObjectives-The aim of this study was to compare the diagnostic performance of different sonographic modalities for diagnosing lateral epicondylosis. Methods-A total of 50 symptomatic and 50 asymptomatic common extensor tendons in 44 patients with lateral epicondylosis, and 25 healthy participants were prospectively examined by B-mode sonography, color Doppler imaging, power Doppler imaging, Superb Microvascular Imaging (SMI; Toshiba Medical Systems Corporation, Tokyo, Japan), and strain elastography. We evaluated blood flow in common extensor tendons by using a grading system with color Doppler imaging, power Doppler imaging, and SMI. The diagnostic performance of the modalities was compared. Results-When a cutoff value of hypoechogenicity was used for the mean strain ratio, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy rates were 92.0%, 94%.0, 93.9%, 92.2%, and 93.0%, respectively. When a cutoff point of grade 1 was used, the sensitivity, specificity, PPV, NPV, and accuracy rates were 26.0%, 10.0%, 10.0%, 57.5%, and 63.0, for color Doppler imaging; 40.0%, 10.0%, 10.0%, 62.5%, and 70.0% for power Doppler imaging; and 84.0%, 94.0%, 93.0%, 85.5%, and 89.0% for SMI. When a cutoff value of 3.94 was used for the mean strain ratio, the sensitivity, specificity, PPV, NPV, and accuracy rates were 78.0%, 92.0%, 90.7%, 80.7%, and 85.0%, respectively. A statistically significant correlation was detected between SMI, strain elastography, and visual analog scale scores (P < .001). Conclusions-The combination of SMI and B-mode sonography was found to have excellent diagnostic performance for lateral epicondylosis. Neovascularzation in patients' tendons with lateral epicondylosis was identified much better with SMI compared to color or power Doppler imaging.Öğe Effectiveness of Superb Microvascular Imaging for the differentiation of intraductal breast lesions(Soc Romana Ultrasonografe Medicina Biologie-Srumb, 2018) Bakdik, Suleyman; Arslan, Serdar; Oncu, Fatih; Durmaz, Mehmet Sedat; Altunkeser, Aysegul; Eryilmaz, Mehmet Ali; Unlu, YasarAims: The aim of this study was to compare the diagnostic performance of superb microvascular imaging (SMI) and power Doppler imaging (PDI) for the differentiation of intraductal breast lesions. Materials and methods: A total of 54 intraductal breast lesions (39 benign, 10 atypical, and 5 malignant) in 53 patients were examined using B-mode ultrasonography, PDI, and SMI. Vascularity grading, distribution of microvessels, and penetrating vessels were evaluated using each Doppler technique. The diagnostic performances of both methods were compared. Results: SMI was more efficient in detecting flow signals than PDI (p=0.004). The highest diagnostic accuracy rates were achieved with SMI using vascular grading. When hypervascularity was used as a cut-off value to differentiate malignant and atypical lesions from benign lesions, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 66.6%, 80.7%, 66.6%, 80.7%, and 75.6% for PDI, and 86.6%, 76.9%, 68.4%, 90.9%, and 80.4% for SMI, respectively. Conclusions: SMI is more sensitive than PDI for detecting subtle blood flow in intraductal breast lesions with statistical significance. This novel and promising vascular imaging technique may be helpful in B-mode ultrasonography to distinguish intraductal breast lesions.Öğe Incidence and anatomical variability of accessory and sesamoid bones of the foot(2018) Bakdık, Süleyman; Çiçekcibaşı, Aynur Emine; Arslan, Serdar; Öncü, Fatih; Karahan, Ali Yavuz; Durmaz, Mehmet Sedat; Özen, Kemal EmreAim: We aimed to assess the incidence, mean size, patterns, and types of accessory and sesamoid bones of the foot using computed tomography.Material and Methods: A total of 814 non-contrast-enhanced computed tomography images of the foot obtained from 717 patients between October 2015 and January 2018 were investigated retrospectively. Images acquired in the original axial plane were used to perform multiplanar reconstruction in the coronal or sagittal planes. Incidence, mean size, patterns, and types of accessory and sesamoid bones were evaluated in all images.Results: Accessory bones were detected in 387 (47.5%) non-contrast-enhanced computed tomography scans from 326 patients (45.4%). Sixty-seven patients (9.3%) showed accessory bones on both sides; 133 patients (18.5%), only on the right side; and 126 patients (17.5%), only on the left side. The most common accessory bones of the foot were the os naviculare accessorium (24.8%), os trigonum, (20.3%), os peroneum (14.6%), os intermetatarseum (10.6%), os supranaviculare (3.1%), os supratalare (1.9%), and osvesalianum (1.5%). The hallucal sesamoid bone was observed in all patients, while the interphalangeal sesamoid bone was observed in 34.6% of the patients.Conclusions: The computed tomography scans provided a detailed overview of the characteristics of accessory and sesamoid bones, and the incidence of these bones in our patients was higher than those reported in previous radiographic studies. Our findings can facilitate the diagnosis and management of disorders involving these bones.Öğe Multidetector computed tomography and magnetic resonance imaging findings in pulmonary hydatid cysts(2019) Cebeci, Hakan; Özlü, Mustafa Yasir; Kılınçer, Abidin; Uysal, Emine; Durmaz, Mehmet Sedat; Uçar, Ramazan; Sunam, Güven SadiAim: Computed tomography (CT) and magnetic resonance imaging (MRI) are diagnostic modalities in pulmonary hydatid disease. We aimed to present CT and MRI findings in pulmonary hydatid disease. Material and Methods: CT and MRI findings of pulmonary hydatid cysts from January 2011 through June 2018 were evaluatedretrospectively. CT images of 112 patients and MRI images of 27 patients were evaluated. Patients’ gender and ages, lesion numberand distribution, concomitant organ involvement, complications, HU density of lesions on CT and signal characteristics of lesions onMRI were analyzed. T2 hypointense rim, T1 and T2 signal intensity, daughter vesicle and detached membranes were the evaluatedparameters on MRI. Results: 147 hydatid cyst lesions of 119 (66 female, 53 male) patients with a mean age of 39.4 19.6 years were included in the study 62 (52.1%) of patients had isolated lung involvement. 79 of 119 patients (66.4%) had solitary lung lesion. Mean CT density of cystswere 16 HU. 25 of 32 cysts showed T2 hypointense rim on MRI. Conclusion: Imaging plays important role in diagnosis and presurgical evaluation of pulmonary hydatid disease. CT is mostly usedin diagnosis; MRI should be a choice particularly in pediatric population.Öğe Sakrum’un multidedektör bilgisayarlı tomografi yöntemi ile morfometrik analizi(2018) Acar, Musa; Alkan, Şenay Burçin; Durmaz, Mehmet Sedat; Seçkin, Erdi; Öztemel, Kübra; Sezgin, Zeynep; Akbaba, AleynaAmaç: Antropometrik çalışmalar kimliklendirmenin cinsiyet tespiti aşamasında önemli bilgiler sunmaktadır. Multidedektör bilgisayarlı tomografi (MDBT) yöntemi vücut oluşumlarının hızlı ve yüksek çözünürlük ile ince kesitlerinin incelenmesini sağlar. Bu çalışmada Türk toplumuna ait her iki farklı cinsiyette referans aralıklar oluşturulmasına katkıda bulunmak amaçlandı. Gereç ve Yöntem: Çalışma MDBT ile sakrumları görüntülenen ve yaşları 20 ile 80 arasında değişen 100 birey (50 kadın-50 erkek) üzerinde yapıldı. Çalışmamızda ölçülerek kayıt altına alınan parametreler; sakrum genişliği, korpus vertebra genişliği, korpus vertebra çapı, kornular arası mesafe, sakral hiatus uzunluğu, sakral kanal uzunluğudur. Bulgular: Sakral vertebra’ya ait korpus genişlikleri erkeklerde kadınlardan anlamlı (p˂0.05) derecede yüksek tespit edildi. Benzer şekilde sakral hiatus uzunluğu erkeklerde anlamlı (p˂0.05) derecede daha yüksekti. Sonuç: Sonuç olarak çalışmamızda elde ettiğimiz ortalamaların genelde literatür bilgileri ile örtüştüğünü gördük. Bazı farklılıkların yaş, cinsiyet ve ırk gibi faktörlere bağlı olduğunu düşünmekteyiz. Elde ettiğimiz bu verilerin radyoloji, anatomi ve adli tıp gibi alanlarda bilim adamları ve klinisyenlere faydalı olacağı kanaatindeyiz.Öğe Two-Dimensional Shear Wave Elastography in the Assessment of Salivary Gland Involvement in Primary Sjogren's Syndrome(Wiley, 2020) Arslan, Serdar; Durmaz, Mehmet Sedat; Erdogan, Hasan; Esmen, Serpil Ergulu; Turgut, Bekir; Iyisoy, Mehmet SinanObjectives The aim of this study was to investigate the diagnostic performance of two-dimensional (2D) shear wave elastography (SWE) in the assessment of salivary gland involvement in primary Sjogren's syndrome (pSS). Methods Fifty-three patients with pSS and 30 healthy volunteers were included. The echogenicity of all submandibular and parotid glands was evaluated with B-mode ultrasound, and their elasticity was assessed with 2D SWE. The mean and standard deviation of the shear wave speed and elasticity modes on 2D SWE were calculated. Results The mean shear wave speed and elasticity mode values for the submandibular and parotid glands were significantly higher in the patients with pSS (P < .05). The mean elasticity of the shear wave speed mode was best able to differentiate the parotid glands of patients with pSS from those of healthy volunteers at a cutoff value of 2.48 m/s, whereas the mean elasticity of the elasticity mode was best able to differentiate the submandibular glands of patients with pSS from those of healthy volunteers at a cutoff value of 21 kPa. Conclusions Two-dimensional SWE is an effective technique for assessment of the parenchyma of the salivary glands in patients with pSS and predicts interstitial fibrosis and the severity of histologic damage.
