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Öğe Application of first-pass contrast bolus tracking sequence for the assessment of morphology and flow dynamics in cardiac MRI(Aves, 2013) Paksoy, Yahya; Ozbek, Orhan; Gumus, Serter; Koc, Osman; Nayman, Alaaddin; Kerimoglu, UlkuPURPOSE There are two well-known indications for first-pass perfusion in the literature. First is the evaluation of Myocardial ischemia, and the other is the evaluation of tumor vascularity. Our aim was to assess the value of a first-pass Contrast bolus tracking sequence (FPCBTS) for cases unrelated to these pathologies. MATERIALS AND METHODS A total of 35 patients (age range, 1 day to 66 years; mean age, 10.4 +/- 19.2 years; median age, 4.5 months) with suspected congenital (n=31) and acquired (n=4) heart and great vessel disease Were included in the study. All the patients underwent cardiac magnetic resonance imaging (MRI) and FPCBTS, and 20 patients underwent contrast enhanced magnetic resonance angiography (CE-MRA). We used cardiac MRI and CE-MRA for anatomic evaluation and FPCBTS for dynamic flow evaluation. RESULTS Truncus arteriosus, double outlet right ventricle, tetralogy of Fallot; corrected transposition of great arteries, atrial and ventricular septal defect, aortic rupture, cardiac hydatid cyst, tricuspid atresia, anomalous pulmonary venous return; and interrupted aorta were detected using the technique described here. Septal defects in six patients arid atrial aneurysm in two patients were excluded. The shunt gap and flow direction of the septal defects, a ruptured Wall in a dissected aorta, a hydatid cyst, and the atrial relationship in two cases with paracardiac masses Were diagnosed easily using this dynamic evaluation technique. CONCLUSION FPCBTS Can be performed in addition to cardiac MRI and CE-MRA to reveal flow dynamics and morphology.Öğe Case 269: Sacroiliac Joint Hydatid Disease(Radiological Soc North America, 2019) Kaya, Hasan E.; Kerimoglu, UlkuA 20-year old woman living in Turkey presented with a 3-month history of lower back pain. She had no medical history of note and was taking no medications. Complete blood count, C-reactive protein level, sedimentation rate, and creatinine, alanine aminotransferase, and aspartate aminotransferase levels were within normal limits. Anteroposterior pelvic radiography and unenhanced pelvic CT were performed to rule out sacroiliitis. The imaging findings were abnormal, and the patient underwent contrast-enhanced sacroiliac MRI. A few days later, she underwent contrast-enhanced (100 mL iohexol, Omnipaque; GE Healthcare, Cork, Ireland) abdominal CT because of right upper quadrant pain.Öğe A case of pathologic complete response after neoadjuvant triplet chemotherapy for locally advanced colon cancer with mismatch repair enzyme proficiency(Via Medica, 2023) Kocak, Mehmet Zahid; Cakir, Murat; Kerimoglu, Ulku; Araz, Murat; Eryilmaz, Melek Karakurt; Yumuk, Perran Fulden; Artac, MehmetPatients with potentially resectable colon cancer and expected to have negative margins should undergo resection rather than neoadjuvant chemotherapy. Recent studies have suggested that neoadjuvant immunotherapy may be an option for tumors with mismatch repair enzyme deficiency (dMMR), but standard treatment for locally advanced colon cancer with mismatch repair enzyme proficiency (pMMR) is still unclear. A 37-year-old male patient was diagnosed with clinical stage IIIC (T4b N1a M0) transverse colon cancer. Mismatch repair proteins were proficient. After 3 cycles of oxaliplatin (85 mg/m(2), day 1), irinotecan (150 mg/m2, IV, day 1), leucovorin (200 mg/m(2), IV, day 1), and 5-fluorouracil (3000 mg/m(2), 46 hours of continuous infusion initiating from day 1), there was a remarkable reduction in the tumoral mass on the abdominal computed tomography. A right hemicolectomy was performed. A pathologic complete response was obtained. Although there is no consensus on which patients are suitable for neoadjuvant therapy in pMMR locally advanced colon cancer, triplet chemotherapy may be a reasonable option in selected patients.Öğe Frequency of potential causes of lower back pain and incidental findings in patients with suspected sacroiliitis: retrospective analysis of 886 patients with negative sacroiliac MRI examination for sacroiliitis(Sage Publications Ltd, 2021) Kaya, Hasan Emin; Kerimoglu, UlkuBackground In a majority of patients with suspected sacroiliitis (SI) who underwent sacroiliac magnetic resonance imaging (MRI), imaging studies may be normal, may depict other causes for pain, or may show clinically irrelevant incidental findings. Purpose To determine the prevalence of possible etiologies other than SI and frequency of incidental findings demonstrated on sacroiliac MRI examinations in a cohort of patients with lower back pain and suspected SI. Material and Methods Sacroiliac MRI examinations of 1421 patients with suspected SI were retrospectively reviewed. In patients without SI findings, other potential causes for lower back pain and incidental findings were documented. Results SI was present in 535 of 1421 patients (37.6%). In 886 of the patients whose MRI studies were negative for SI, other possible causes for lower back pain or incidental findings were seen in 386 (43.5%). The most common musculoskeletal (MSK) finding was lumbosacral transitional vertebra (8.6%) followed by findings suggesting piriformis syndrome (4.2%), spondylosis (3.7%), and sacral insufficiency fractures (1.8%). The most common non-MSK findings were follicular cysts (15.3%) and uterine fibroids (4.9%). Conclusion In patients with suspected SI but negative MRI examinations for SI, some other possible causes for lower back pain and several incidental findings can be seen on imaging. The presence of these findings may explain the patient's symptoms, and awareness of these conditions may be helpful in patient management and individualizing treatment.Öğe An important cause of pes planus: the posterior tibial tendon dysfunction(Pagepress Publ, 2015) Erol, Kemal; Karahan, Ali Yavuz; Kerimoglu, Ulku; Ordahan, Banu; Tekin, Levent; Sahin, Muhammed; Kaydok, ErcanPosterior tibial tendon dysfunction (PTTD) is an important cause of acquired pes planus that frequently observed in adults. Factors that play a role in the development of PTTD such as age-related tendon degeneration, inflammatory arthritis, hypertension, diabetes mellitus, obesity, peritendinous injections and more rarely acute traumatic rupture of the tendon. PTT is the primary dynamic stabilizer of medial arch of the foot. Plantar flexion and inversion of the foot occurs with contraction of tibialis posterior tendon, and arch of the foot becomes elaveted while midtarsal joints are locked and midfoot-hindfoot sets as rigid. Thus, during the walk gastrocnemius muscle works more efficiently. If the PTT does not work in the order, other foot ligaments and joint capsule would be increasingly weak and than pes planus occurs. We present a 10-yearold female patient diagnosed as PTTD and conservative treatment with review of the current literature.Öğe Irinotecan-induced NASH and liver failure(Elsevier Masson, Corp Off, 2021) Araz, Murat; Kilinc, Fahriye; Kerimoglu, Ulku; Keskin, Muharrem; Kucukkartallar, Tevfik[Abstract Not Availabe]Öğe Small bowel wall edema induced by regorafenib is associated with regorafenib intolerance and shorter survival in patients with metastatic colorectal cancer: A retrospective study(Sage Publications Ltd, 2021) Eryilmaz, Melek Karakurt; Kerimoglu, Ulku; Karaagac, Mustafa; Musri, Fatma Yalcin; Araz, Murat; Artac, MehmetIntroduction Regorafenib, a receptor tyrosine kinase inhibitor, is a routinely used targeted agent in the current treatment of patients with refractory metastatic colorectal carcinoma (mCRC). The aims of this study were to detect the presence of bowel wall edema during regorafenib treatment via computed tomography (CT) and to assess the relationship between survival and regorafenib-induced bowel wall edema in patients with mCRC receiving regorafenib. Patients and methods We retrospectively evaluated the presence of bowel wall edema on CT of 25 mCRC patients who received regorafenib and analyzed its relationship with progression free survival (PFS) and overall survival (OS). Results Among the 25 patients, 25 had small bowel wall edema (SBWE) and 14 had large bowel wall edema (LBWE) on at least one CT examination. The median SBWE value was 4.85 milimeters (mm). Of the 25 patients, 14 had SBWE <= 4.85 mm and 11 had SBWE >4.85 mm. Regorafenib intolerance was significantly higher at SBWE >4.85 mm patients (p = 0.03). The median PFS was 4.6 months (95% CI: 2.4-6.8) and median OS was 9.3 months (95% CI: 3.1-15.4). Median PFS and OS were shorter in patients with SBWE > 4.85 mm than in those with <= 4.85 mm, but not statistically significant (median PFS: 3.9 vs 4.6 months, p: 0.523; median OS: 5.6 vs 9.3 months, p: 0.977). Conclusions Regorafenib caused SBWE in patients with mCRC. Patients who developed more SBWE had a higher regorafenib intolerance and a shorter survival. Further studies are needed to confirm the predictor value of SBWE on the survival outcomes of patients with mCRC receiving regorafenib.Öğe Spontaneously Thrombosed Polar Renal Artery Aneurysm: Multidetector Computed Tomography Findings(Lippincott Williams & Wilkins, 2013) Kerimoglu, Ulku; Guler, Ibrahim; Ozbek, Orhan[Abstract Not Availabe]Öğe Strain elastography in the characterization of renal cell carcinoma and angiomyolipoma(Canadian Urological Association, 2015) Keskin, Suat; Guven, Selcuk; Keskin, Zeynep; Ozbiner, Huseyin; Kerimoglu, Ulku; Yesildag, AhmetIntroduction: We evaluate the diagnostic performance of strain elastography to differentiate renal cell carcinoma (RCC) from angiomyolipoma (AML). Methods: Strain elastography was performed in 65 patients (mean age 55.5 years; range: 32-81) who had renal lesions (24 AMLs and 41 RCCs) prospectively. Lesions were classified according to lesion size and histological subtypes. The strain ratios of the RCCs and AMLs were evaluated by a radiologist. The area under the curve and the cut-off point were used to assess diagnostic performance. Sensitivity, specificity, and positive and negative predictive values were obtained. Results: In assessing the mean strain ratio, we divided the groups in 3 according to size: (1) <20-mm lesions; (2) 20- to 40-mm lesions; and (3) >40-mm lesions; the respective mean strain ratios were: 1.5 +/- 0.5 (range: 0.06-5.92), 2.8 +/- 0.4 (range: 0.17-9.92), 2.7 +/- 0.3 (range: 0.08-6.15). When RCCs and AMLs were compared, there was a statistically significant difference in the strain ratio among the 3 groups divided per lesion size (p < 0.01). For the strain ratio, the mean +/- standard deviation was 1.1 +/- 0.1 for AMLs and 3.4 +/- 0.3 for RCCs (p < 0.01). When lesion subtypes were compared, there was a statistically significant difference in the strain ratio between the AML and clear cell RCC (p < 0.01). Conclusions: For assessing renal lesions, strain elastography and strain ratio values may be useful in differentiating RCCs from AMLs.Öğe Sunitinib-induced small bowel wall edema as a prognostic marker in metastatic renal cell carcinoma(Wolters Kluwer Medknow Publications, 2023) Korkmaz, Mustafa; Eryilmaz, Melek Karakurt; Kerimoglu, Ulku; Karaagac, Mustafa; Kocak, Mehmet Zahid; Demirkiran, Aykut; Araz, MuratAim: The aim of this study was to evaluate the presence of small bowel wall edema (SBWE) on computed tomography (CT) images in patients with metastatic renal cell carcinoma (mRCC) treated with sunitinib and to investigate the relationship between the presence of SBWE and survival. Materials and Methods: We retrospectively evaluated the presence of SBWE on CT images of 27 mRCC patients who received at least one cycle of sunitinib. Then, we analyzed the relationship between the presence of SBWE and progression-free survival (PFS) and overall survival (OS). Results: All 27 patients had SBWE on at least one CT scan. The median value of SBWE thickness was 2.5 mm. SBWE thickness was <= 2.5 mm in 13 patients (group A) and >2.5 mm in 14 patients (group B). The median OS was significantly higher in group B (55 vs. 18 months, respectively, P = 0.02). Although it was not statistically significant (13 vs. 8 months, respectively, P = 0.69), the median PFS was longer in group B than in group A. Conclusions: This study showed that sunitinib treatment caused SBWE in all patients with mRCC who received the drug. Also, this study demonstrated an association between higher SBWE thickness and better survival outcomes.Öğe Vaginal metastasis in solid tumours: our four cases and review of the literature(Springer, 2021) Korkmaz, Mustafa; Eryilmaz, Melek Karakurt; Kerimoglu, Ulku; Karaagac, Mustafa; Demirkiran, Aykut; Demir, Emine Turen; Artac, MehmetBackground: Vaginal metastasis should be kept in mind when evaluating the staging tests of all cancers, especially endometrial cancer. Case presentation: We present four patients with vaginal recurrence who recently applied to our clinic. Three cases were of endometrial cancer and one case of rectal cancer. All patients presented with vaginal bleeding. Conclusion: Standard treatment for vaginal metastasis has not yet been established. Therapeutic options for vaginal metastasis-separately or in combination-are surgical resection, radiotherapy, and chemotherapy.Öğe Vaginal metastasis in solid tumours: our four cases and review of the literature(Springer, 2021) Korkmaz, Mustafa; Eryilmaz, Melek Karakurt; Kerimoglu, Ulku; Karaagac, Mustafa; Demirkiran, Aykut; Demir, Emine Turen; Artac, MehmetBackground: Vaginal metastasis should be kept in mind when evaluating the staging tests of all cancers, especially endometrial cancer. Case presentation: We present four patients with vaginal recurrence who recently applied to our clinic. Three cases were of endometrial cancer and one case of rectal cancer. All patients presented with vaginal bleeding. Conclusion: Standard treatment for vaginal metastasis has not yet been established. Therapeutic options for vaginal metastasis-separately or in combination-are surgical resection, radiotherapy, and chemotherapy.Öğe
