Publications by authors named "Irmak Durur Subasi"

30 Publications

  • Page 1 of 1

Quantitative perfusion parameters of benign inflammatory breast pathologies: A descriptive study.

Clin Imaging 2020 Dec 27;68:249-256. Epub 2020 Aug 27.

University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Clinic of Radiology, Ankara, Turkey.

Purpose: With this study, we evaluated the perfusion magnetic resonance imaging (MRI) features of benign inflammatory breast lesions for the first time and compared their K K, V values and contrast kinetic curves to benign masses and invasive ductal carcinoma (IDC).

Materials And Methods: Perfusion MRIs of the benign masses (n = 42), inflammatory lesions (n = 25), and IDCs (n = 16) were evaluated retrospectively in terms of K K, V values and contrast kinetic curves and compared by the Kruskal-Wallis, Mann-Whitney U, chi-square tests statistically. Cronbach α test was used to measure intraobserver and interobserver reliability.

Results: Mean K values were 0.052 for benign masses, 0.086 for inflammatory lesions and 0.101 for IDC (p < 0.001). Mean K values were 0.241 for benign masses, 0.435 for inflammatory lesions and 0.530 for IDC (p < 0.001). Mean V values were 0.476 for benign masses, 0.318 for inflammatory lesions and 0.310 for IDC (p = 0.067). For inflammatory and IDC lesions, K and K values were found to be higher and V values were lower than benign masses (p = 0.001 for K, p = 0.001 for K, p = 0.045 for V). There were excellent or good intra-interobserver reliabilities. For the kinetic curve pattern, most of the benign lesions showed progressive (81%), inflammatory lesions progressive (64%) and IDC lesions plateau (75%) patterns (p < 0.001).

Conclusions: On T1 perfusion MRI, similar to IDC lesions, inflammatory lesions demonstrate higher K and K and lower V values than benign masses. Quantitative perfusion parameters are not helpful in differentiating them from IDC lesions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clinimag.2020.08.024DOI Listing
December 2020

Mass and non-mass breast MRI patterns: a radiologic approach to sick lobe theory.

Acta Radiol 2020 Jul 21:284185120941825. Epub 2020 Jul 21.

University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Clinic of Radiology, Ankara, Turkey.

Background: According to sick lobe theory, one or more lobes of the breast are more prone to the development of carcinoma. However, the implications of this theory in breast magnetic resonance imaging (MRI) are unknown.

Purpose: To evaluate the MRI appearance of mass type (multifocal and multicentric diseases) and non-mass type (non-mass enhancements) sick lobe patterns, together with the histopathology results.

Material And Methods: MRI reports of 2015 patients in two tertiary breast imaging centers between June 2012 and June 2018 were retrospectively reviewed for multifocal-multicentric diseases and segmental, linear, and regional enhancements. A total of 113 patients were included. The specimens obtained by thick needle, vacuum, excisional biopsy/lumpectomy or mastectomy after breast MRI scans were pathologically assessed. The pathologic results were categorized as invasive carcinoma, precursor, and benign proliferative lesions according to the 2012 World Health Organization Classification of Tumors.

Results: The percentage of underlying benign and precursor invasive lesions was significantly different in patients with mass and non-mass MRI patterns. While the pathology results of mass type patterns were premalignant and malignant in all cases, nearly half of the underlying histologies were benign proliferative subtypes in patients with non-mass type patterns.

Conclusion: In this study, the mass and non-mass patterns derived from sick lobe theory were related to different risks of malignancy in the pathological examinations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0284185120941825DOI Listing
July 2020

Artifacts in cranial MRI caused by extracranial foreign bodies and analysis of these foreign bodies.

Indian J Radiol Imaging 2019 Jul-Sep;29(3):299-304. Epub 2019 Oct 30.

Department of Biostatistics, Faculty of Medicine, Erzincan University, Erzincan, Turkey.

Purpose: The purpose of our study was to conduct a chemical analysis of extracranial foreign bodies (FBs) causing artifacts in cranial magnetic resonance imaging (MRI) and to investigate the association between chemical composition, magnetic susceptibility, and artifact size.

Materials And Methods: A total of 12 patients were included in the study. The FBs responsible for the artifacts were visualized using cranial computed tomography (CT). Artifact-causing FBs were removed from the scalps of 10 patients and analyzed using scanning electron microscope with energy dispersive spectroscopy (SEM-EDS), X-ray diffraction spectroscopy (X-RD), and Fourier-transform infrared spectroscopy (FT-IR). The magnetic susceptibility of the samples was determined using the reference standard material MnCl.6HO. The volume of the MRI artifacts was measured in cubic centimeters (cm).

Results: EDS results demonstrated that the mean Fe ratio was 5.82% in the stone samples and 0.08% in the glass samples. Although no phase peaks were detected in the X-RD spectra of the glass samples, peaks of FeO, AlCa (SiO) were detected in the X-RD spectra of the stone samples. The FT-IR spectra revealed metal oxide peaks corresponding to Fe, Al, in the stone samples and peaks confirming AlSiO and NaSiO structures in the glass samples. The mean volumes of the MRI artifacts produced by the stone and glass samples were 5.9 cm and 2.5 cm, respectively.

Conclusions: Artifacts caused by extracranial FBs containing metal/metal oxide components are directly associated with their chemical composition and the artifact size are also related to element composition and magnetic susceptibility.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijri.IJRI_211_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6857268PMC
October 2019

Diagnostic and Interventional Radiology in Idiopathic Granulomatous Mastitis.

Eurasian J Med 2019 Oct 5;51(3):293-297. Epub 2019 Aug 5.

Department of Radiology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.

Idiopathic granulomatous mastitis is a chronic, benign, inflammatory disease of the breast. If the radiological findings are known, patients can be referred for biopsy in the early period. The diagnosis of the disease must be based on a histologic confirmation. After diagnostic and therapeutic management, a radiological follow-up is conducted using an appropriate imaging tool. In this study, we highlight the radiologic evaluations for idiopathic granulomatous mastitis and present specific cases.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/eurasianjmed.2019.19211DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6812909PMC
October 2019

The association of OSAS and uvula: the role of MRI in this egg-chicken problem in OSAS.

Sleep Breath 2020 Jun 26;24(2):465-470. Epub 2019 Jun 26.

Department of Pulmonary Disease, Faculty of Medicine, Ataturk University, Yakutiye, 25240, Erzurum, Turkey.

Purpose: Obstructive sleep apnea syndrome (OSAS) is a condition resulting from repetitive partial or complete upper airway obstruction, and its etiology remains uncertain. Polysomnography is the gold standard diagnostic test for OSAS. However, there are long wait times for this evaluation, so questionnaires or ancillary diagnostic methods are used to select appropriate patients. One of these is magnetic resonance imaging (MRI). The present study aimed to investigate the association between clinical features of OSAS and uvular changes on MRI.

Materials And Methods: A total of 102 participants, 80 with OSAS and 22 controls, were included in the study. All participants underwent full-night polysomnography, MRI, and anthropometric measurements.

Results: In comparisons of MRI measurements of the uvula, statistically significant differences in uvular length, thickness, and angle were observed between the OSAS and control groups. MRI measurement significantly associated with apnea-hypopnea index was uvular thickness. Evaluation of anthropometric and MRI measurements revealed statistically significant associations between waist circumference and uvular thickness, uvular width, and oropharyngeal space among the OSAS patients.

Conclusion: Thickened uvula on MRI is associated with the presence of OSAS, and its thickness is well correlated with the severity of the diseases. Thus, it may be a reliable indicator of OSAS and could be used as a supportive finding to identify patients suitable for referral for diagnostic polysomnography.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11325-019-01879-3DOI Listing
June 2020

DW-MRI of the breast: a pictorial review.

Insights Imaging 2019 Jun 3;10(1):61. Epub 2019 Jun 3.

University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Clinic of Radiology, Ankara, Turkey.

In the current era of breast imaging, magnetic resonance imaging (MRI) has an important role. To get its specificity better, some supporting or cooperative tools might be needed. The search for new methods continues and non-contrast MRI trials are seen. With the shorter and easier acquisition, no need for contrast material, diffusion-weighted (DW)-MRI could be the best collaborator. This pictorial review aims to give an overview of the DW-MRI of the breast by means of a set of specially selected cases.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13244-019-0745-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6546796PMC
June 2019

Diffusion-weighted imaging in ectopic pregnancy: ring of restriction sign.

Br J Radiol 2018 Feb 27;91(1082):20170528. Epub 2017 Oct 27.

2 University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Clinic of Radiology , Ankara, Turkey xs.

Objective: To demonstrate the diffusion-weighted imaging (DWI) findings of ectopic pregnancy (EP) and introduce the "ring of restriction" sign by discussing possible causes.

Methods: Between January 2014 and January 2017, patients with EP and examined by MRI on a 3T scanner were retrospectively evaluated. MRI and DWI findings were recorded.

Results: A total of 40 patients were diagnosed with EP at our university hospital, 8 of whom (20%) were evaluated by MRI and DWI. All of them were haemodynamically and clinically stable and could be imaged adequately. Locations were ovary (n = 3, 37.5%), tuba (n = 2, 25%), Caesarean section scar (n = 2, 25%) and parauterine (n = 1, 12.5%). In all eight EPs, the gestational sac diameter was compatible with 7-9 weeks. With DWI, the gestational sac was seen as a thick-walled cyst-like structure. The thick wall showed diffusion restrictions in all patients (ring of restriction sign).

Conclusions: DWI through its cellular and molecular evidence may contribute diagnosis of EP. Advances in knowledge: Being aware of the EP wall shows diffusion restriction (ring of restriction) avoids interpretation errors especially in appropriate clinical setting with no need for contrast material.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1259/bjr.20170528DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965790PMC
February 2018

Is the necrosis/wall ADC ratio useful for the differentiation of benign and malignant breast lesions?

Br J Radiol 2017 May 24;90(1073):20160803. Epub 2017 Mar 24.

3 Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

Objective: To determine whether the necrosis/wall apparent diffusion coefficient (ADC) ratio is useful for the malignant-benign differentiation of necrotic breast lesions.

Methods: Breast MRI was performed using a 3-T system. In this retrospective study, calculation of the necrosis/wall ADC ratio was based on ADC values measured from the necrosis and from the wall of malignant and benign breast lesions by diffusion-weighted imaging (DWI). By synchronizing post-contrast T weighted images, the separate parts of wall and necrosis were maintained. All the diagnoses were pathologically confirmed. Statistical analyses were conducted using an independent sample t-test and receiver operating characteristic analysis. The intraclass and interclass correlations were evaluated.

Results: A total of 66 female patients were enrolled, 38 of whom had necrotic breast carcinomas and 28 of whom had breast abscesses. The ADC values were obtained from both the wall and necrosis. The mean necrosis/wall ADC ratio (± standard deviation) was 1.61 ± 0.51 in carcinomas, and it was 0.65 ± 0.33 in abscesses. The area under the curve values for necrosis ADC, wall ADC and the necrosis/wall ADC ratio were 0.680, 0.068 and 0.942, respectively. A wall/necrosis ADC ratio cut-off value of 1.18 demonstrated a sensitivity of 97%, specificity of 93%, a positive-predictive value of 95%, a negative-predictive value of 96% and an accuracy of 95% in determining the malignant nature of necrotic breast lesions. There was a good intra- and interclass reliability for the ADC values of both necrosis and wall.

Conclusion: The necrosis/wall ADC ratio appears to be a reliable and promising tool for discriminating breast carcinomas from abscesses using DWI. Advances in knowledge: ADC values of the necrosis obtained by DWI are valuable for malignant-benign differentiation in necrotic breast lesions. The necrosis/wall ADC ratio appears to be a reliable and promising tool in the breast imaging field.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1259/bjr.20160803DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605106PMC
May 2017

Is it better to include necrosis in apparent diffusion coefficient (ADC) measurements? The necrosis/wall ADC ratio to differentiate malignant and benign necrotic lung lesions: Preliminary results.

J Magn Reson Imaging 2017 10 2;46(4):1001-1006. Epub 2017 Feb 2.

Ataturk University, Faculty of Medicine, Department of Chest Diseases, Erzurum, Turkey.

Purpose: To determine whether the use of necrosis/wall apparent diffusion coefficient (ADC) ratios in the differentiation of necrotic lung lesions is more reliable than measuring the wall alone.

Materials And Methods: In this retrospective study, a total of 76 patients (54 males and 22 females, 71% vs. 29%, with a mean age of 53 ± 18 years, range, 18-84) were enrolled, 33 of whom had lung carcinoma and 43 had a benign necrotic lung lesion. A 3T scanner was used. The calculation of the necrosis/wall ADC ratio was based on ADC values measured from necrosis and the wall of the lesions by diffusion-weighted imaging (DWI). Statistical analyses were performed with the independent samples t-test and receiver operating characteristic analysis. Intraobserver and interobserver reliability were calculated for ADC values of wall and necrosis.

Results: The mean necrosis/wall ADC ratio was 1.67 ± 0.23 for malignant lesions and 0.75 ± 0.19 for benign lung lesions (P < 0.001). To estimate malignancy the area under the curve (AUC) values for necrosis ADC, wall ADC, and the necrosis/wall ADC ratio were 0.720, 0.073, and 0.997, respectively. A wall/necrosis ADC ratio cutoff value of 1.12 demonstrated a 100% sensitivity and 98% specificity in the estimation of malignancy. Positive predictive value was 100%, and negative predictive value 98% and diagnostic accuracy 99%. There was a good intraobserver and interobserver reliability for wall and necrosis.

Conclusion: The necrosis/wall ADC ratio appears to be a reliable and promising tool for discriminating lung carcinoma from benign necrotic lung lesions than measuring the wall alone.

Level Of Evidence: 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1001-1006.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jmri.25649DOI Listing
October 2017

Lenalidomide Induced Late-Onset Acute Respiratory Distress Syndrome.

Eurasian J Med 2016 Oct 18;48(3):228-229. Epub 2016 Aug 18.

Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey.

A 77-year-old man with multiple myeloma (MM) presented with shortness of breath to the emergency department. He also had history of chronic obstructive pulmonary disease, chronic pulmonary embolism and nephrectomy due to malignancy 10 years ago. He had been treated for 9 months with lenalidomide because of MM. He diagnosed with adult respiratory distress syndrome due to lenalidomide. We aimed to demonstrate late onset and destructive effects of lenalidomide on the lungs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/eurasianjmed.2015.0150DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5268609PMC
October 2016

Papillary Lesions of Breast.

Chirurgia (Bucur) 2016 May-Jun;111(3):225-9

Introduction: Papillary breast lesions constitute a pathological heterogeneous group and are characterized by growth in the milk ducts. In this study, we aimed to present in view of literature patients who underwent lumpectomy due to breast mass and with papillary lesion in histopathological examination.

Material Method: The pathology records and informations of 42 patients who were operated between 2006-2014 in our clinic and considered to have papillary lesion in histopathological examination were examined retrospectively. The patients were evaluated for age, gender, complaints, lesion localizations, performed surgery, histopathological type, follow-up period and the lesions occurring during follow-up.

Findings: The excisional biopsy in the form of lumpectomy was made to 34 patients who were reported as benign papillary lesion in coreneedle biopsy performed. The lesion in 11 patients were marked preoperatively by radiology clinic. 33 patients who had benign papillary lesion in excisional biopsy were followed. Modified radical mastectomy was performed to a total of 9 patients including 1 patient with malignant papillary lesion in excisional biopsy and 8 patients with malignant papillary lesion in coreneed lebiopsy.

Result: Histopathological diagnosis should be confirmed by performing definitely excisional biopsy in patients who detected benign papillary lesions by coreneedle biopsy and strict clinical follow-up should be made for developing malignancies in patients who detected benign papillary lesions.
View Article and Find Full Text PDF

Download full-text PDF

Source
September 2016

The Use of Breast Magnetic Resonance Imaging Parameters to Identify Possible Signaling Pathways of a Serum Biomarker, HE4.

J Comput Assist Tomogr 2016 May-Jun;40(3):436-41

From the *Department of Radiology, Istanbul Medipol University, School of Medicine, Istanbul; Departments of †Radiology, and ‡General Surgery, Atatürk University, School of Medicine; §Department of Pharmaceutical Toxicology, Atatürk University, School of Pharmacy; ∥Department of Radiation Oncology; and ¶Department of Medical Education, Atatürk University, School of Medicine, Erzurum, Turkey.

Objectives: This study aimed to investigate the relationship between breast magnetic resonance imaging (MRI) parameters; clinical features such as age, tumor diameter, N, T, and TNM stages; and serum human epididymis protein 4 (HE4) levels in patients with breast carcinoma and use this as a means of estimating possible signaling pathways of the biomarker, HE4.

Methods: Thirty-seven patients with breast cancer were evaluated by breast MRI and serum HE4 levels before therapy. Correlations between parameters including age, tumor diameter T and N, dynamic curve type, enhancement ratio (ER), slope washin (S-WI), time to peak (TTP), slope washout (S-WO), and the serum level of HE4 were investigated statistically. Human epididymis protein 4 levels of early and advanced stage of disease were also compared statistically.

Results: Breast MRI parameters showed correlation to serum HE4 levels and correlations were statistically significant. Of these MRI parameters, S-WI had higher correlation coefficient than the others. Human epididymis protein 4 levels were not statistically different in early and advanced stage of disease.

Conclusions: High correlation with MRI parameters related to neoangiogenesis may indicate signaling pathway of HE4.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/RCT.0000000000000390DOI Listing
January 2017

A novel approach to contrast-induced nephrotoxicity: the melatonergic agent agomelatine.

Br J Radiol 2016 17;89(1061):20150716. Epub 2016 Feb 17.

1 Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

Objective: To study the potential nephroprotective role of agomelatine in rat renal tissue in cases of contrast-induced nephrotoxicity (CIN). The drug's action on the antioxidant system and proinflammatory cytokines, superoxide dismutase (SOD) activity, levels of glutathione (GSH) and malondialdehyde (MDA) and the gene expression of interleukin-6 (IL-6), tumour necrosis factor (TNF)-α and nuclear factor kappa B (NF-κB) was measured. Tubular necrosis and hyaline and haemorrhagic casts were also histopathologically evaluated.

Methods: The institutional ethics and local animal care committees approved the study. Eight groups of six rats were put on the following drug regimens: Group 1: healthy controls, Group 2: GLY (glycerol), Group 3: CM (contrast media--iohexol 10 ml kg(-1)), Group 4: GLY+CM, Group 5: CM+AGO20 (agomelatine 20 mg kg(-1)), Group 6: GLY+CM+AGO20, Group 7: CM+AGO40 (agomelatine 40 mg kg(-1)) and Group 8: GLY+CM+AGO40. The groups were evaluated by one-way analysis of variance and Duncan's multiple comparison test.

Results: Agomelatine administration significantly improved the serum levels of blood urea nitrogen (BUN) and creatinine, SOD activity, GSH and MDA. The use of agomelatine had substantial downregulatory consequences on TNF-α, NF-κB and IL-6 messenger RNA levels. Mild-to-severe hyaline and haemorrhagic casts and tubular necrosis were observed in all groups, except in the healthy group. The histopathological scores were better in the agomelatine treatment groups.

Conclusion: Agomelatine has nephroprotective effects against CIN in rats. This effect can be attributed to its properties of reducing oxidative stress and inhibiting the secretion of proinflammatory cytokines (NF-κB, TNF-α and IL-6).

Advances In Knowledge: CIN is one of the most important adverse effects of radiological procedures. Renal failure, diabetes, malignancy, old age and non-steroidal anti-inflammatory drug use pose the risk of CIN in patients. Several clinical studies have investigated ways to avoid CIN. Theophylline/aminophylline, statins, ascorbic acid and iloprost have been suggested for this purpose. Agomelatine is one of the melatonin ligands and is used for affective disorders and has antioxidant features. In this study, we hypothesized that agomelatine could have nephroprotective, antioxidant and anti-inflammatory effects against CIN in rats.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1259/bjr.20150716DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4985449PMC
September 2016

Added value of DCE-MRI in the management of cystic-cavitary lung lesions.

Respirology 2016 May 23;21(4):739-45. Epub 2015 Dec 23.

Department of Pulmonary Diseases, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

Background And Objective: We evaluated the added value of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) to CT in the evaluation of cystic-cavitary lung lesions. We aimed to compare morphological parameters, including wall thickness and inner wall irregularity, and to determine whether DCE-MRI with morphological and dynamic parameters was useful in indeterminate lesions. We also aimed to investigate the added value of DCE-MRI in terms of whether to biopsy, and if so the site of biopsy.

Methods: This prospective study included 39 consecutive patients with cystic and/or cavitary lung lesions detected by CT who then underwent additional DCE-MRI. After initial evaluation, the lesions were classified as benign, indeterminate or malignant and the findings of CT and DCE-MRI compared with each other by considering the final diagnosis that was determined by histopathological findings and clinical evaluation and follow up.

Results: The mean values for wall thickness obtained by DCE-MRI were lower and the range of wall thickness for indeterminate lesions was narrower than those obtained by CT (5.50-11.50 mm and 5.75-13.50 mm for DCE-MRI and CT), and inner wall irregularity on DCE-MRI was more sensitive in malignant lesions. Also, DCE-MRI obviated biopsy in three benign patients and changed the biopsy site in two patients.

Conclusion: Our study suggests that DCE-MRI is helpful in indeterminate cystic-cavitary lung lesions, with morphological and dynamic features. It narrowed the range of wall thickness used for indeterminate lesions, was more sensitive than CT in determining malignant inner wall irregularity, and was also useful in determining the need for and appropriate site of biopsy. See article, page 576.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/resp.12717DOI Listing
May 2016

Granulomatous Mastitis: A Ten-Year Experience at a University Hospital.

Eurasian J Med 2015 Oct;47(3):165-73

Department of Pathology, Atatürk University Faculty of Medicine, Erzurum, Turkey.

Objective: In this study we aimed to define clinical, radiologic and pathological specialties of patients who applied to General Surgery Department of Atatürk University Medical Faculty with granulomatous mastitis and show medical and surgical treatment results. With the help of this study we will be able to make our own clinical algorithm for diagnosis and treatment.

Materials And Methods: We searched retrospectively addresses, phone numbers and clinical files of 93 patients whom diagnosed granulomatous mastitis between a decade of January 2001 - December 2010. We noted demographic specialties, ages, gender, medical family history, main complaints, physical findings, radiological and laboratory findings, medical treatments, postoperative complications and surgical procedures if they were operated; morbidity, recurrence and success ratios, complications after treatment for patients discussed above.

Results: In this study we evaluated 93 patients, 91 females and 2 males, with granulomatous mastitis retrospectively who applied to General Surgery Department of Atatürk University Medical Faculty between January 2001 and December 2010. Mean age was 34.4 years. The diagnosis was confirmed by histopathologic examination of the lesions. Seventy three patients had idiopathic granulomatous lobular mastitis and 20 patients had specific granulomatous mastitis IGM (18 tuberculosis mastitis, 1 alveolar echinococcosis and 1 silk reaction). All the patients had surgical debridement or antibiotic, and anti-inflammatory treatment with results bad clinical response before applied our clinic.

Conclusion: Empiric antibiotic therapy and drainage of the breast lesions are not enough for complete remission of idiopathic granulomatous mastitis. The lesion must be excised completely. In selected patients, corticosteroid therapy can be useful. In the patients with tuberculous mastitis, abscess drainage and antituberculous therapy can be useful, but wide excision must be chosen for the patients with recurrent disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/eurasianjmed.2015.118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4659517PMC
October 2015

Correlation of diffusion MRI with the Ki-67 index in non-small cell lung cancer.

Radiol Oncol 2015 Sep 21;49(3):250-5. Epub 2015 Aug 21.

Department of Radiology, Pamukkale University, Medical Faculty, Denizli, Turkey.

Background: The primary objective of the study was to evaluate the association between the minimum apparent diffusion coefficient (ADCmin) and Ki-67, an index for cellular proliferation, in non-small cell lung cancers. Also, we aimed to assess whether ADCmin values differ between tumour subtypes and tissue sampling method.

Methods: The patients who had diffusion weighted magnetic resonance imaging (DW-MRI) were enrolled retrospectively. The correlation between ADCmin and the Ki-67 index was evaluated.

Results: Ninety three patients, with a mean age 65 ± 11 years, with histopathologically proven adenocarcinoma and squamous cell carcinoma of the lungs and had technically successful DW-MRI were included in the study. The numbers of tumour subtypes were 47 for adenocarcinoma and 46 for squamous cell carcinoma. There was a good negative correlation between ADCmin values and the Ki-67 proliferation index (r = -0.837, p < 0.001). The mean ADCmin value was higher and the mean Ki-67 index was lower in adenocarcinomas compared to squamous cell carcinoma (p < 0.0001). There was no statistical difference between tissue sampling methods.

Conclusions: Because ADCmin shows a good but negative correlation with Ki-67 index, it provides an opportunity to evaluate tumours and their aggressiveness and may be helpful in the differentiation of subtypes non-invasively.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1515/raon-2015-0032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4577221PMC
September 2015

Osteochondral Lesions of Major Joints.

Eurasian J Med 2015 Jun;47(2):138-44

Department of Orthopedics and Traumatology, Ataturk University Faculty of Medicine, Erzurum, Turkey.

This paper provides information about osteochondral lesions (OCL) and example cases of OCL occurring in major joints, some of which are rarely seen. This simple tutorial is presented in question and answer format.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/eurasianjmed.2015.50DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4494550PMC
June 2015

[Hydatid Cyst Cases with Different Localization: Region of Erzurum].

Turkiye Parazitol Derg 2015 Jun;39(2):103-7

Atatürk Üniversitesi Tıp Fakültesi, Patoloji Anabilim Dalı, Erzurum, Türkiye.

Objective: In this study it is aimed to contribute in determination of geographic distribution of Hydatid Cysts in Turkey and to emphasize the clinic chaos of Hydatid Cysts cases found in various localizations, by indicating the prevalence of Hydatid Cysts in our region.

Methods: It is evaluated that the cases diagnosed as Hydatid Cysts in Atatürk University Medical Faculty Pathology Depatment/Erzurum laboratories between 2003-2013; in terms of their age, gender, organ involvement and histopathologic detail.

Results: In our study, 459 Hydatid Cysts cases are defined. The most common localizations of cases are determined as liver (n:280, 61%) and lung (n:86, 18,7%). Those are followed by the kidney (n:12, 2,6%), brain (n:12, 2,6%) and spleen (n:9, 2.3%). Multi-organ involvement is observed in 31 cases (6.7%), in 10 (2.2%) cases co-occurence of liver and lung is determined. Unusual organ involvement is observed in 64 cases (13.9%) while the liver and lung is not involved.

Conclusion: Hydatid Cysts is an important health issue which is endemically seen in our region. It can be observed in various localizations of human body, other than the liver and lung. Those various localizations lie behind the serious diagnostic problems in endemic regions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/tpd.2015.3590DOI Listing
June 2015

Sonoelastography findings for idiopathic granulomatous mastitis.

Jpn J Radiol 2015 Jan 3;33(1):33-8. Epub 2014 Dec 3.

Department of Radiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.

Objectives: In this paper we describe sonoelastography findings for idiopathic granulomatous mastitis (IGM), the clinical and radiological features of which often mimic those of breast carcinoma.

Materials And Methods: In this retrospective study, sonoelastography findings for patients with pathologically proved IGM were studied. Twenty-seven patients with pathologically proved IGM were enrolled in the study. All were female, and the mean age was 37.81 years (standard deviation 7.10 years; range 24 to 56 years). Elasticity scores (ES), strain ratios (SR), and elastic diameters (ED) were evaluated for the lesions.

Results: Ten lesions (37.0 %) were diffuse, six (22.2 %) were tubular, six (22.2 %) were a mass, and five (18.5 %) were cystic in appearance on ultrasonography. On sonoelastography, mean ES ± standard deviation was 1.66 ± 0.55 (between 1.00 and 3.00); mean SR ± standard deviation was 1.10 ± 0.79 (between 0.29 and 4.00). ED was no different between grey-scale and sonoelastogram images.

Conclusions: The features of idiopathic granulomatous mastitis suggest it is benign in nature.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11604-014-0378-xDOI Listing
January 2015

Value of MRI sequences for prediction of invasive breast carcinoma size.

J Med Imaging Radiat Oncol 2014 Oct 4;58(5):565-8. Epub 2014 Jul 4.

Department of Radiology, Ataturk University, School of Medicine, Erzurum, Turkey.

Introduction: In this retrospective study, we compared transverse short tau inversion recovery (STIR), transverse diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) map and first post-contrast fat-saturated fast low-angle shot (FLASH) 3D T1 with pathology results in terms of their accuracy in estimating breast carcinoma size.

Methods: Magnetic resonance imaging data for 47 patients with invasive breast carcinoma, who were treated surgically, were reviewed. The longest dimension (LD) of the index lesion was measured using STIR, DWI, ADC map and first post-contrast FLASH 3D T1, and this was compared with the LD measured on the pathology specimen.

Results: All four MRI sequences overestimated the LD by an average of about 1 mm with 95% limits of agreement approximately 0 to 2 mm. This is not considered to be clinically significant in tumours of 10 mm or larger.

Conclusion: Magnetic resonance imaging serves as an accurate tool in sizing breast carcinomas. ADC may be a useful evaluation tool for sizing carcinomas without requiring contrast material.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/1754-9485.12205DOI Listing
October 2014

Roles of Ki-67, p53, transforming growth factor-β and lysyl oxidase in the metastasis of lung cancer.

Respirology 2014 Oct 3;19(7):1034-9. Epub 2014 Jul 3.

Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey.

Background And Objective: Most lung cancer (LC) patients have metastatic disease at time of diagnosis, which influence the treatment regimen and is the most important prognostic factor. The main purpose of our study was to evaluate the relationship between cell proliferation (Ki-67 label index), p53, transforming growth factor-β (TGF-β) and lysyl oxidase (LOX), and the metastatic stages of different lung cancers. The secondary aim was to correlate these parameters with the standardized uptake value (SUVmax) of the primary lesion during positron emission tomography-computed tomography (PET-CT).

Methods: Eighty-five treatment-naive patients with LC were enrolled. All patients were examined with PET-CT. Ki-67, p53, TGF-β and LOX were evaluated histopathologically.

Results: Small cell lung cancer (SCLC) showed the most intense staining in all parameters. A well-differentiated adenocarcinoma (AC) demonstrated a more diffuse and intense staining than squamous cell carcinoma (SCC). There was no statistically significant relationship between the four parameters and metastases of SCLC and SCC. However, a significant relationship between TGF-β, LOX and metastatic AC was demonstrated with regards to diffusivity and intensity. p53 and Ki-67 did not show a significant relationship. No correlation between SCLC and SCC and SUVmax was found. However, in AC, the diffusivity and intensity of the LOX and p53 staining showed a statistically significant relationship to the SUVmax.

Conclusions: LOX and TGF-β may play roles in metastatic AC. LOX and TGF-β may become markers of metastatic disease and inhibition could be explored for treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/resp.12345DOI Listing
October 2014

Brachiocephalic artery anomaly at the neck: importance during minimally invasive video-assisted parathyroidectomy.

J Craniofac Surg 2013 Nov;24(6):e750-73

From the *Departments of Radiology, †Otolaryngology, Head and Neck Surgery, and ‡Pathology, Ataturk University Faculty of Medicine, Erzurum; and §Department of Radiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.

A 76-year-old woman was referred to our hospital for evaluation of a parathyroid adenoma, detected on sonography. It had been located posteroinferiorly to the right thyroid lobe. Parathyroid scintigraphy confirmed the right inferior parathyroid adenoma. During physical examination of the neck, a pulsatile mass in the anterior inferior right was determined, and because of suspicion for a vascular anomaly, a computed tomography angiography was performed. The computed tomography showed that the right brachiocephalic artery ascended vertically to the level of the inferior border of right thyroid lobe and dividing into the right common carotid artery and subclavian artery at this level. Right subclavian artery after its origin brought about a curve by means of turning first posteromedially and then anterolaterally. Parathyroid adenoma remained between the right thyroid lobe, right common carotid artery, and right brachiocephalic artery. Minimally invasive video-assisted parathyroidectomy was performed and no complication appeared.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0b013e31829ad242DOI Listing
November 2013

Vesicoureteral reflux in a nonfunctioning kidney detected by 99mTc-DTPA study.

Jpn J Radiol 2013 Dec 1;31(12):823-5. Epub 2013 Nov 1.

Department of Nuclear Medicine, Medical Faculty, Ataturk University, Erzurum, Turkey,

Vesicoureteral reflux (VUR) is a well-recognized condition in the pediatric population, but is less well described in the adult population, and its prevalence decreases with increasing age. We describe the case of a 53-year-old male with nonfunctional kidney in which accumulation of radioactivity was observed in the ureter and renal pelvis owing to VUR, which was detected by technetium-99m diethylenetriamine pentaacetic acid dynamic renal scintigraphy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11604-013-0259-8DOI Listing
December 2013

DCE-MRI findings of invasive aspergillosis in patient with acute myeloid leukemia.

Clin Respir J 2014 Apr 26;8(2):248-50. Epub 2013 Nov 26.

Department of Pulmonary Disease, Ataturk University, Erzurum, Turkey.

Thoracic radiography and high resolution computerized tomography is used to diagnose pulmonary infections in immunosuppressed patients, although in some cases these do not provide enough information about the lesion. Dynamic contrast-enhanced magnetic resonance imaging may be useful in these cases, especially for the characterization of cavitary lesions and assessment of their contrast diffusion.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/crj.12061DOI Listing
April 2014

Breast lesions with high signal intensity on T1-weighted MR images.

Jpn J Radiol 2013 Oct 30;31(10):653-61. Epub 2013 Aug 30.

Department of Radiology, School of Medicine, Ataturk University, Terminal M. Somunoglu C., Kardelen sitesi B/12, 25000, Erzurum, Turkey,

Magnetic resonance imaging of the breast supplies much information concerning the signal characteristics of a lesion. Among these, high signal intensity on non-fat saturated T1-weighted imaging (WI) is a special finding. Such a finding may result from different causes, such as a paramagnetic substance or fatty, bloody or proteinaceous content. In this article, we present hyperintense breast lesions on T1-WI.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11604-013-0239-zDOI Listing
October 2013

Magnetic resonance imaging findings of breast juvenile papillomatosis.

Jpn J Radiol 2013 Jun 9;31(6):419-23. Epub 2013 Mar 9.

Department of Radiology, Faculty of Medicine, Ataturk University, 25240 Erzurum, Turkey.

Juvenile papillomatosis is a rare disease affecting young women. Here we present magnetic resonance imaging features of two cases with histopathologically proven juvenile papillomatosis of the breast and review some of the relevant literature. Case 1 exhibited bilateral, well-bordered breast masses, with complex cystic and solid components. The kinetic evaluation showed continuous and plateau patterns. Case 2 featured a giant mass with a few cystic and many solid nodular components and filled the entire right breast. The kinetic evaluation showed a continuous curve.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11604-013-0197-5DOI Listing
June 2013

Comparison of 16-slice computed tomography with conventional angiography to evaluate coronary artery stent patency.

Eurasian J Med 2009 Apr;41(1):4-9

Ataturk University, Faculty of Medicine, Department of Radiology, Erzurum, Turkey.

Objective: In this study, we evaluated the utility of 16-slice MDCT (multidetector computed tomography) to assess stent patency after coronary artery stenting.

Materials And Methods: Retrospective ECG-gated CT-angiography using 16-slice MDCT was performed in 52 consecutive patients with coronary artery stents. Qualitative assessment of 61 coronary stent lumens by MDCT is reported, and the reasons preventing assessment were investigated.

Results: All non-assessable stents were non-assessable due to partial volume effects and metal artifacts. To evaluate instent restenosis, conventional coronary angiography was performed on the 54 assessable stents in 48 patients, and the results were compared with the MDCT results. Based on the results of the conventional coronary angiography, MDCT correctly detected four in-stent restenosis.

Conclusion: Despite some limitations, 16-slice MDCT provides sufficient evaluations of some coronary stents, and can detect in-stent restenosis with high accuracy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261646PMC
April 2009

Pott's puffy tumor: multidetector computed tomography findings.

J Craniofac Surg 2008 Nov;19(6):1697-9

Departments of Radiology, Atatürk University School of Medicine, Erzurum, Turkey.

A subperiostal abscess of the frontal bone as a complication of osteomyelitis, appearing as a puffy, indolent tumor of the forehead, was first described by Pott. This less-common complication of is known as Pott's Puffy tumor. The complications of Pott's Puffy tumor are preseptal and orbital cellulites by downward spread to the orbit and intracranial infection by posterior extension. We present a case of Pott's Puffy tumor complicated by intracranial infection imaged by means of multidetector computed tomography.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0b013e31818eed33DOI Listing
November 2008

How image quality can be improved: our experience with multidetector computed tomography coronary angiography.

Clin Imaging 2007 Jan-Feb;31(1):11-7

Department of Radiology, GATA Haydarpasa Teaching Hospital, Istanbul, Turkey.

Purpose: The objective of this study was to investigate the factors that may influence image quality on multidetector computed tomography (MDCT) coronary angiography (CA).

Materials And Methods: Two hundred twenty-four consecutive patients (161 men and 63 women; mean age, 52 years; age range, 34-76 years) evaluated with MDCT CA were included in the study. The evaluation of the quality of the patients' images was mainly based on the contrast material phase (early phase, optimal phase, or late phase) and the level of stepladder artifact (none, acceptable, or unacceptable). In addition, factors such as patient selection, patient preparation, scanning, processing, and steps of analysis, which may be affecting the quality of a final image, were examined independently.

Results: Patients who could not achieve sufficient breath-holding despite multiple breath exercises, those with a calcium score of 500 or higher, those with a heart rate greater than 90 bpm after metoprolol administration (because of shortening of the diastolic phase in the most still period), and those whose scanning was not completed were excluded from the study. The results for the remaining 224 patients were evaluated. Based on the contrast phase, there were 66 (29.5%) patients in the first group (early), 93 (41.5%) in the second group (optimal), and 65 (29%) in the third group (late). Among the 224 patients, the images of 152 (67.9%) had no stepladder artifact, those of 67 (29.9%) were of acceptable image quality, and those of 5 (2.2%) were of unacceptable image quality.

Conclusion: It is important to obtain high-quality images to achieve correct interpretation with coronary artery CT angiography. This study aimed to describe a technique performed on 224 patients based on an array of factors ranging from patient selection to postprocessing. The results show that patient selection, cooperation with the patient, and breath-holding exercises play a very important role in obtaining the best images. In addition, a proper scanning technique (e.g., placement of electrocardiographic electrodes and contrast material phase) and postprocessing (e.g., reconstruction interval) may also contribute to obtaining high-quality images.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clinimag.2006.10.003DOI Listing
March 2007

Remarkable anatomic anomalies of coronary arteries and their clinical importance: a multidetector computed tomography angiographic study.

J Comput Assist Tomogr 2006 Nov-Dec;30(6):939-48

Department of Radiology, Florence Nightingale Hospital, Istanbul, Turkey.

Objective: An anomalous origin and course of the coronary arteries can be benign or life threatening. Recently, because of new advances in computed tomography technology, radiologists have begun to interpret the diseases of coronary arteries. We aimed to demonstrate some remarkable anomalies of coronary arteries, some of which were not shown by multidetector computed tomography (MDCT) coronary angiography previously, and to discuss the clinical importance of these anomalies.

Materials And Methods: Seven hundred twenty-five consequent patients referred to Florence Nightingale Hospital and Atatürk University Hospital for MDCT coronary angiography were included in this study. The patients were between the ages of 33 and 78 years (mean +/- SD, 59 +/- 13.86 years). Four hundred ninety-seven patients (68.6%) were men, and 228 (31.4%) were women. All the examinations were evaluated by both a radiologist and a cardiologist.

Results: The incidence of anomalous anatomical origin and course of the coronaries found in our study group was 5.79% (n = 42). The anomalies found in our study are absence of the right coronary artery (RCA; n = 1, 0.13%), ectopic origin of RCA from the left anterior descending (LAD) artery (n = 1, 0.13%), absence of the left main coronary artery (n = 4, 0.52%), ectopic origin of the left main coronary artery from the right sinus of Valsalva (n = 1, 0.13%), double LAD and ectopic origin of LAD from RCA (n = 1, 0.13%), ectopic origin of the left circumflex artery from the right sinus of Valsalva (n = 3, 0.39%), ectopic origin of the left circumflex artery from RCA (n = 2, 0.26%), and myocardial bridging (n = 29, 4%).

Conclusions: An anomalous origin of the coronary anatomy must be present in the interpretations because of its importance for patients, cardiologists, and surgeons. As a conclusion, our study showed that MDCT, especially volume rendering and maximum intensity projection techniques, may be useful for assessment of complex variations, when the conventional angiography may not be sufficient.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/01.rct.0000230004.38521.8eDOI Listing
January 2007