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Öğe 64 kesitli multidedektör BT ile pulmoner emboli tespit edilen hastalarda eş zamanlı yapılan BT venografi ile alt ekstremite venöz renkli doppler usg korelasyonu(Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, 2010) Nayman, Alaaddin; Ödev, KemalPulmoner tromboemboli (PTE) sık görülmekle birlikte tanısındaki gecikmenedeniyle mortalitesi yüksek bir hastalıktır. PTE ve alt ekstremite derin ven trombozu (DVT) aynı patolojik sürecin iki parçası olmakla birlikte PE'nin %90 nedenini alt DVT oluşturmaktadır.Çalışmamızın amacı klinik muayenesinde pulmoner emboli ön tanılı olgularda BTA' nın tanıya katkısını, alt ekstremite derin venlerinin indirekt BT venografi ve RDUS ile değerlendirilmesi ve son iki incelemenin DVT tanısındaki yerini araştırmaktır.GEREÇ VE YÖNTEM: Çalışmaya ön tanısında PE olan ve pulmoner BT anjiografide (BTA) PE tespit edilen 46 hasta dahil edildi. Hastaların iliak krestler ile femur başı arası ve popliteal bölgeleri (kesit aralığı 0.8 mm) toplam bir bölge için 17-18 kesit alınacak şekilde, ek kontrast madde verilmeden tarandı. Hastalara aynı gün içinde alt ekstremite venlerine yönelik RDUS yapıldı.BULGULAR: Çalışma dahilindeki 46 hastanın 4' ünde RDUS' de trombüs varken BTV normaldi. 2' sinde de doppler normal iken BTV' de trombüs görünümü vardı. RDUS altın standart kabul edildiğinde indirekt BTV'nin duyarlılığı: %81.8 seçiciliği: %91.6 olarak hesaplandı. İki tetkik arasında Kappa değeri: 0.738 olarak hesaplandı ve %87 tutarlılık olduğu saptandı. BTA çekimi için hastaya verilen ortalama doz miktarı 2.43 mSv, BTV için verilen doz 0.457 olarak hesaplandı.SONUÇ: Kombine BTA-indirekt BTV yöntemi olarak adlandırılan inceleme tekniğinde çok yüksek duyarlılıkta olmasa bile yüksek seçicilik oranında, düşük dozda ek kontrast madde verilerek DVT saptanabilmektedir.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 Epstein-Barr virus encephalitis: findings of MRI, MRS, diffusion and perfusion(Turkish J Pediatrics, 2011) Ozbek, Orhan; Koc, Osman; Paksoy, Yahya; Aydin, Kursad; Nayman, AlaaddinOzbek O, Koc O, Paksoy Y, Aydin K, Nayman A. Epstein-Barr virus encephalitis: findings of MRI, MRS, diffusion and perfusion. Turk j Pediatr 2011; 53: 680-683 Epstein-Barr virus is an infection that is known as infectious mononucleosis. Even though the central nervous system is not a primary region of involvement of this disease, neurological complications are reported rarely. In this case report, we evaluated a 15-month-old male who presented to the pediatric neurology clinic due to high fever and a neurologic attack. His serological tests and radiological examinations (magnetic resonance imaging (MRI), MR spectroscopy (MRS), diffusion-weighted imaging (DWI) and MR perfusion) were consistent with Epstein-Barr virus encephalitis, which is a very rare complication of infectious mononucleosis. Additionally, we discuss the MRI, MRS, DWI and MR perfusion findings of our case, which were different from other cases reported in the literature.Öğe Magnetic resonance cholangio pancreatography evaluation of intrahepatic bile duct variations with updated classification(Aves, 2016) Nayman, Alaaddin; Ozbek, Orhan; Erol, Seyit; Karakus, Hayrettin; Kaya, Hasan EminPURPOSE Preoperative detection of intrahepatic bile duct (IHBD) variations is essential to reduce surgical morbidity and mortality rates. Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive and reliable method for demonstrating the normal IHBD anatomy and its variations. This retrospective study aimed to identify and classify novel variations, except those already reported in the literature, using MRCP. METHODS MRCP examinations, which were conducted in two different centers in the last five years, were retrospectively evaluated. IHBD variations were recorded with respect to the Yoshida classification. In addition, newly detected variations that were not included in this classification were identified and classified. RESULTS MRCP examinations of 2624 patients were screened, and 2143 were determined to be eligible for evaluation. Of 2143 patients, 987 were males (average age, 54 +/- 18 years) and 1156 were females (mean age, 57 +/- 17 years). In this study, 10 novel variations that were not included in the Yoshida classification were identified in 14 patients. CONCLUSION MRCP is an effective, reliable, and noninvasive imaging method for evaluating the IHBD anatomy and its variations. Novel variations described in this study may help to better understand the biliary anatomy.Öğe Magnetic resonance cholangiopancreatography evaluation of intrahepatic bile duct variations with updated classification(2016) Nayman, Alaaddin; Özbek, Orhan; Erol, Seyit; Karakuş, Hayrettin; Kaya, Hasan EminPURPOSE Preoperative detection of intrahepatic bile duct (IHBD) variations is essential to reduce surgical mor-bidity and mortality rates. Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive and reliable method for demonstrating the normal IHBD anatomy and its variations. This retrospec-tive study aimed to identify and classify novel variations, except those already reported in the liter-ature, using MRCP.METHODSMRCP examinations, which were conducted in two different centers in the last five years, were ret-rospectively evaluated. IHBD variations were recorded with respect to the Yoshida classification. In addition, newly detected variations that were not included in this classification were identified and classified.RESULTSMRCP examinations of 2624 patients were screened, and 2143 were determined to be eligible for evaluation. Of 2143 patients, 987 were males (average age, 54±18 years) and 1156 were females (mean age, 57±17 years). In this study, 10 novel variations that were not included in the Yoshida classification were identified in 14 patients.CONCLUSIONMRCP is an effective, reliable, and noninvasive imaging method for evaluating the IHBD anatomy and its variations. Novel variations described in this study may help to better understand the biliary anatomÖğe Nörofibromatozis tip 1: Kraniyal MRG Bulguları(2014) Keleşoğlu, Kazım Serhan; Keskin, Suat; Sivri, Mesut; Erdoğan, Hasan; Nayman, Alaaddin; Koplay, MustafaAmaç: Nörofibromatozis tip 1 (NF1, von Recklinghausen hastalığı, periferal nörofibromatozis) öncelikle nöral dokular olmak üzere birçok sistemi tutan nörokutanöz bir hastalıktır. Çocuklarda kanser yatkınlığını artırması sebebiyle bilinmesi ve tanı konması önem kazanan bir sendromdur. Amacımız kliniğimizde incelenen nörofibromatozis tip 1 hastalarının kraniyal MRG bulgularını tartışmak ve mevcut bulgular eşliğinde nörofibromatozis tip 1'in kraniyal tutulum şekillerini değerlendirmektir. Gereç ve yöntemler: Haziran 2011 ve Mart 2013 tarihleri arasında kliniğimizde Nörofibromatozis tip 1 tanısı olan ve en az 1 MRG incelemesi bulunan 21 hastanın 19'u değerlendirilmiştir. 6-32 yaş aralığında (ortalama yaş 15,3), 7 kız ve 12 erkek hastadan elde edilen kraniyal MRG incelemeleri retrospektif olarak taranmıştır. Çalışmaya dahil edilen olgulardaki lezyonların tipi ve lokalizasyonları farklı bir radyolog tarafından yeniden değerlendirilmiştir. Bulgular: Nörofibromatozis tip 1 tanısıyla takip edilen ve kraniyal MR görüntülemeleri değerlendirilen 19 hastanın 16'sında santral sinir sisteminde hamartomatöz lezyonlar, 5 hastada optik gliom ya da optik sinir kalınlaşması, 5 hastada pleksiform nörofibromlar ve 2 hastada nörofibrom odakları izlenmiştir. Sonuç: Birçok farklı tümör ve bulgu içermesi ve en sık kalıtılan santral sinir sistemi hastalığı olması Nörofibromatozis tip 1'in tanı kriterlerinin ve lezyonlarının bilinmesini ve akılda tutulmasını gerektirmektedir. Klinik bulguları Nörofibromatozis tip 1 kriterlerini karşılamayan, tanı kriterlerindeki lezyonlar gelişmeyen veya tanı konurken şüphede kalınan hastaların tanısı ve hastalığın tümöral oluşumların gelişmesine olan yatkınlığı sebebiyle Nörofibromatozis tip 1 hastalarında MR görüntüleme bulguları erken ve doğru tanı açısından önemlidir.Öğe A novel modified PAIR technique using a trocar catheter for percutaneous treatment of liver hydatid cysts: a six-year experience(Aves, 2016) Nayman, Alaaddin; Guler, Ibrahim; Keskin, Suat; Erdem, Tuba Berra; Borazan, Hale; Kucukapan, Ahmet; Ozbiner, HuseyinPURPOSE We aimed to demonstrate the success and reliability of a novel puncture, aspiration, injection, and reaspiration (PAIR) technique in liver hydatid cysts. METHODS Percutaneous treatment with ultrasonographic guidance was performed in 493 hepatic hydatid cysts in 374 patients. Patients were treated with a new PAIR technique by single puncture method using a 6F trocar catheter. The results of this novel technique were evaluated with regards to efficacy and safety of the procedure and complication rates. RESULTS Out of 493 cysts, 317 were Gharbi type I (WHO CE 1) and 176 were Gharbi type II (WHO CE 3A). Of all cysts, 13 were referred to surgery because of cystobiliary fistulization. Recurrence was observed in 11 cysts one month later. Therefore, the success rate of the PAIR technique was 97.7% (469/480). Minor complications (fever, urticaria-like reactions, biliary fistula) were seen in 44 treated patients (12%, 44/374); the only major complication was reversible anaphylactic shock which was observed in two patients (0.5%, 2/374). CONCLUSION This novel modified PAIR technique may be superior to catheterization by Seldinger technique due to its efficiency, easier application, lower severe complication rate, and lower cost. Further comparative studies are required to confirm our observations.Öğe Radiofrequency ablation of a rare pathology: vertebral intraosseous lipoma(Elsevier Science Inc, 2016) Ozbek, Orhan; Keskin, Fatih; Kaya, Hasan Emin; Guler, Ibrahim; Nayman, Alaaddin; Koc, Osman[Abstract Not Availabe]Öğe Radiological anatomy of the C7 vertebra: Clinical implications in spine surgery(Wolters Kluwer Medknow Publications, 2015) Keskin, Fatih; Erdi, Fatih; Nayman, Alaaddin; Babaoglu, Ozan; Erdal, Kalkan; Ozer, Ali FahirContext: This study was designed to understand and define the special radio-anatomic morphometry of C7 vertebra by using multidetector computed tomography (MDCT). Aims: The major aim of the study was to detect the gender- and side-related morphometric differences of C7 vertebra among subjects. Setting and design: Our radiology unit database scanned for MDCT sections of the C7 vertebra. Materials and Methods: A total of 214 patients (134 men, 80 women) were selected. A detailed morphometric evaluation of C7 was done. Statistical analysis used: T test, ANOVA. Lamina length (P < 0.001), pedicle length (P < 0.001), outer cortical (P = 0.01) and inner cancellous pedicle (P < 0.001) width, pedicle angle to sagittal plane (P < 0.001) values were statistically significantly different on the right versus left side. When the results were stratified by gender, lamina length, inner cancellous lamina height, pedicle length, inner cancellous pedicle height, outer cortical pedicle width, lateral mass anteroposterior length, anteroposterior length of C7 corpus, height of C7 corpus (P < 0.001), C6-7 (P = 0.013) and C7-T1disc height (P = 0.04), transverse foramina perpendicular width at C7 (P = 0.046) values were found to be statistically significantly different. Vertebral artery most commonly enters into the transverse foramina at C6 level. Conclusions: Gender and side differences are important factors for preoperative planning and showed significant differences among subjects. MDCT is a practical option for investigating the exact anatomical features of osseous structures.Öğe Role of Contrast Enhancement and Corrected Attenuation Values of Renal Tumors in Predicting Renal Cell Carcinoma (RCC) Subtypes: Protocol for a Triphasic Multi-Slice Computed Tomography (CT) Procedure(Int Scientific Information Inc, 2017) Ertekin, Ersen; Amasyali, Akin Soner; Erol, Bulent; Acikgozoglu, Saim; Kucukdurmaz, Faruk; Nayman, Alaaddin; Erol, HalukBackground: To distinguish RCC subtypes based on contrast enhancement features of CT images. Material/Methods: In total, 59 lesions from 57 patients were included. All patients underwent multi-slice CT imaging with a triphasic protocol, which included non-contrast, corticomedullary, nephrographic and urographic phases. Contrast enhancement features of renal masses were evaluated in terms of CT attenuation values (AV) and differences in contrast density; the aorta or renal parenchyma were evaluated based on corrected or relative values. Results: Clear cell RCC (ccRCC) showed more intense contrast enhancement than other RCC subtypes. When differentiating ccRCC from other RCC subtypes, a cut-off AV of 86-89 HU, aorta-based corrected AV of 89-95 HU and renal parenchyma-based corrected AV of 87-95 HU showed a diagnostic accuracy of 81-86%, 86-88% and 74-78%, respectively, in the corticomedullary phase. Furthermore, a cutoff of 2.42-2.72 for the relative contrast enhancement ratio, a cutoff of 2.59-2.74 for the aorta-based corrected relative contrast enhancement ratio and a cutoff of 2.63-2.76 for the renal parenchyma based attenuation ratio showed a diagnostic accuracy of 83-88%, 88-90% and 81%, respectively. Conclusions: The most reliable parameters for differentiating ccRCC from other RCC subtypes are aorta-based corrected AV and aorta-based corrected relative contrast enhancement values in the corticomedullary phase.Öğe Role of Contrast Enhancement and Corrected Attenuation Values of Renal Tumors in Predicting Renal Cell Carcinoma (RCC) Subtypes: Protocol for a Triphasic Multi-Slice Computed Tomography (CT) Procedure(Int Scientific Information Inc, 2017) Ertekin, Ersen; Amasyali, Akin Soner; Erol, Bulent; Acikgozoglu, Saim; Kucukdurmaz, Faruk; Nayman, Alaaddin; Erol, HalukBackground: To distinguish RCC subtypes based on contrast enhancement features of CT images. Material/Methods: In total, 59 lesions from 57 patients were included. All patients underwent multi-slice CT imaging with a triphasic protocol, which included non-contrast, corticomedullary, nephrographic and urographic phases. Contrast enhancement features of renal masses were evaluated in terms of CT attenuation values (AV) and differences in contrast density; the aorta or renal parenchyma were evaluated based on corrected or relative values. Results: Clear cell RCC (ccRCC) showed more intense contrast enhancement than other RCC subtypes. When differentiating ccRCC from other RCC subtypes, a cut-off AV of 86-89 HU, aorta-based corrected AV of 89-95 HU and renal parenchyma-based corrected AV of 87-95 HU showed a diagnostic accuracy of 81-86%, 86-88% and 74-78%, respectively, in the corticomedullary phase. Furthermore, a cutoff of 2.42-2.72 for the relative contrast enhancement ratio, a cutoff of 2.59-2.74 for the aorta-based corrected relative contrast enhancement ratio and a cutoff of 2.63-2.76 for the renal parenchyma based attenuation ratio showed a diagnostic accuracy of 83-88%, 88-90% and 81%, respectively. Conclusions: The most reliable parameters for differentiating ccRCC from other RCC subtypes are aorta-based corrected AV and aorta-based corrected relative contrast enhancement values in the corticomedullary phase.