Publications by authors named "Mecit Kantarci"

348 Publications

Evaluation and Comparison of Left Ventricular Functions by Cardiac MRI and 2D Transthoracic Echocardiography.

Eurasian J Med 2021 Feb;53(1):28-33

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

Objective: It is important to measure left ventricular function (LVF) accurately in the diagnosis and follow-up of cardiovascular diseases. Different imaging algorithms and mathematical calculations have been developed for the evaluation of LVF in cardiac magnetic resonance imaging (MRI), and numerous studies are still being carried on this. In our study, LVF was calculated by two different measurement methods in MRI and were compared with transthoracic echocardiography (TTE) to assess the correlation and the consistency of these with TTE.

Materials And Methods: In this study, 31 patients with left ventricular dysfunction due to different etiologies were evaluated with simultaneous TTE and MRI. In the Cine MR images, LVF parameters of ejection fraction, end-diastolic volume, end-systolic volume, and myocardial mass were measured using short axis images (short axis method) and short axis plus four chamber and two chamber images (combined method). The results were compared with the results from TTE.

Results: We found that the combined and the short axis-based calculations of ejection fraction, end-diastolic volume, end-systolic volume, and myocardial mass in cardiac MRI showed correlation and consistency with those calculated via echocardiography. We also determined that the short axis-based calculations in cardiac MRI showed better correlation with the echocardiography compared with the combined method.

Conclusion: Because our results revealed that the cardiac MRI results obtained from the short axis method better correlate with the TTE, we recommend using short axis-based measurements in the evaluation left ventricular dysfunction.
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http://dx.doi.org/10.5152/eurasianjmed.2021.20038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929590PMC
February 2021

Destructive Effects of Acidic Blood on the Intestines: Experimental Study.

Eurasian J Med 2021 Feb;53(1):22-27

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

Objective: This study aimed to investigate the destructive effects of acidic blood on the intestinal structures, which has been reported as the most hazardous biochemical result of vagosympathetic autonomic imbalances in intensive care unit patients with subarachnoid hemorrhage (SAH).

Materials And Methods: In total, 27 hybrid rabbits were used; 5 rabbits were used as a control group, 7 as the SHAM group into whom 1 cc saline was injected into the cisterna magna, and the remaining 15 were used as the study group. These animals received 1 cc of autologous arterial blood injection into the cisterna magna to create the SAH group. Blood pH values were recorded before, during, and after the experimental procedures. Computed tomography was performed to examine the intestinal morphology. Normal and degenerated epithelial cell densities of the intestine were estimated by stereological methods. The relationship between pH values and intestinal tissue changes was analyzed statistically using the Mann-Whitney U test.

Results: The mean blood pH values were 7.364±0.042 in the control group, 7.326±0.059 in the SHAM group, and 7.23±0.021 in the study group. Intestinal epithelial cell injury, desquamation of villus, and cell loss were observed. It is observed that the number of degenerated epithelial cells, fragmented villi numbers, and vacuoles significantly increased in the study group (p<0.05).

Conclusion: Acidotic intestinal injury secondary to blood pH changes following SAH may be considered as a generalized and dangerous complication with their multiorgan insuficiency effect.
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http://dx.doi.org/10.5152/eurasianjmed.2021.20035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929578PMC
February 2021

Unilateral spontaneous uncal herniation in a patient with chronic headache.

Br J Hosp Med (Lond) 2021 Feb 3;82(2). Epub 2021 Feb 3.

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

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http://dx.doi.org/10.12968/hmed.2020.0455DOI Listing
February 2021

The pneumatization of the sphenoid sinus, its variations and relations with surrounding neurovascular anatomic structures: A computerized tomography study.

Am J Otolaryngol 2021 Feb 13;42(4):102958. Epub 2021 Feb 13.

Department of Radiology, Erzincan University, Erzincan, Turkey; Department of Radiology, Atatürk University, Erzurum, Turkey.

Introduction And Objectives: The wide range of variability of SS pneumatization and relation with surrounding structures can result in serious complications; seeing that, the assessment of regional anatomy is essential for both surgeons and radiologists. We mainly aim to reveal the possible correlation between the SS pneumatization types and protrusion/dehiscence of the adjacent neurovascular structures in a larger population by using computerized tomography (CT) images.

Methods: The type of SS pneumatization (I-IV), pneumatization of anterior clinoid process (ACP), greater wing of sphenoid (GWS), and pterygoid process (PP) was evaluated. Protrusion and dehiscence of ICA, ON, MN, and VN was noted.

Results: 1003 patients were included into the study. ICA, ON, and MN protrusions were not seen in patients with the type I or II SS on both sides. These protrusions were most frequently seen along with the type IV SS on both sides (p < 0.05). ICA, ON, MN, and VN dehiscence was not found in any patients with the type I SS. The rate of ICA protrusion increased with presence of GWS and PP; ICA dehiscence was found to be positively correlated with ACP, GWS, and PP pneumatization.

Conclusions: Variations, either amount or the extent, of the pneumatization of the SS are related with the presence of protrusion/dehiscence of ICA, ON, MN and VN. Knowing and reporting these relations can decrease the rate of complications during skull base surgery.
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http://dx.doi.org/10.1016/j.amjoto.2021.102958DOI Listing
February 2021

Atteinte leptoméningée chez une patiente présentant un lupus érythémateux systémique atteinte de la COVID-19.

Rev Rhum Ed Fr 2021 Mar 15;88(2):149. Epub 2021 Jan 15.

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

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http://dx.doi.org/10.1016/j.rhum.2021.01.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7836368PMC
March 2021

Unexpected lesion of the prepontine cistern: a colloid cyst.

Br J Hosp Med (Lond) 2020 Dec 22;81(12). Epub 2020 Dec 22.

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

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http://dx.doi.org/10.12968/hmed.2020.0456DOI Listing
December 2020

Tissue damage in herniated brain parenchyma into giant arachnoid granulations: demonstration with high resolution MRI.

Acta Radiol 2020 Jul 19:284185120941829. Epub 2020 Jul 19.

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

Background: Brain herniation (BH) into arachnoid granulation has been remarkable in recent years.

Purpose: To evaluate the damage in herniated parenchyma into the giant arachnoid granulation (GAG) and to investigate the clinical-demographic importance of this damage.

Material And Methods: Patients with BH into GAG were retrospectively included in the study. Each of the patients had at least one high-resolution 3D magnetic resonance imaging (MRI) sequence. The arachnoid granulation dimensions, locations, and origin of herniated parenchyma were evaluated by two experienced radiologists. The demographic and symptomatic features of the patients were recorded from the hospital database.

Results: A total of 27 patients (21 females, 6 males; age range 6-71 years; mean age 41.3 years) were found to contain BH into GAG. It was most commonly seen in the transverse sinus (67%); the origin was most common in the cerebellar parenchyma (56%). Abnormal signal and morphology were detected in herniated parenchyma in 11 (47%) patients, atrophy in six, and atrophy and gliosis in five. The most common complaints were headache (47%), while other frequent symptoms were vertigo (15%) and blurred vision (11%). There was a statistically significant positive correlation between frequency of damage in herniated brain parenchyma and the maximal size of GAG (<0.05).

Conclusion: In patients with BH into GAG, parenchymal damage may be associated with various symptoms, such as headache and vertigo, although they have not been statistically proven. It is important to carefully evaluate hernia tissue, as the risk of tissue damage may increase in larger GAGs.
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http://dx.doi.org/10.1177/0284185120941829DOI Listing
July 2020

Leptomeningeal involvement in a patient with systemic lupus erythematosus infected by COVID-19.

Joint Bone Spine 2020 10 10;87(5):495. Epub 2020 Jun 10.

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

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http://dx.doi.org/10.1016/j.jbspin.2020.06.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286267PMC
October 2020

Pseudo-articulation of distal radio-ulnar joint due to radial osteochondroma.

Joint Bone Spine 2020 Oct 11;87(5):493. Epub 2020 May 11.

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

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http://dx.doi.org/10.1016/j.jbspin.2020.04.014DOI Listing
October 2020

Suprapatellar complete plica and lipoma arborescens: an unusual association.

Br J Hosp Med (Lond) 2020 Mar 16;81(3). Epub 2020 Mar 16.

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

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http://dx.doi.org/10.12968/hmed.2019.0397DOI Listing
March 2020

Giant popliteal artery aneurysm presenting as popliteal mass.

Joint Bone Spine 2020 07 25;87(4):359-360. Epub 2020 Mar 25.

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

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http://dx.doi.org/10.1016/j.jbspin.2020.03.005DOI Listing
July 2020

Evaluation of craniocervical pseudomeningoceles with three-dimensional T2-SPACE sequence at 3T.

Acta Radiol 2021 Jan 24;62(1):80-86. Epub 2020 Mar 24.

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

Background: Pseudomingocele is a postoperative fluid collection adjacent to the dural membrane. The distinction of pseudomeningocele from other postoperative collections is very important.

Purpose: To show the efficacy of three-dimensional (3D) T2-weighted sampling perfection with application-optimized contrasts using a different flip-angle evolution (SPACE) magnetic resonance imaging (MRI) sequence in the diagnosis of pseudomeningocele in which conventional MRI sequences may be insufficient.

Material And Methods: A total of 10 patients were included in the study. All of these patients also had 3D T2-SPACE high-resolution volumetric MR image in addition to conventional cervical and cerebral MR sequences. All MR examinations were reviewed by two neuroradiologists.

Results: Pseudomeningocele neck was shown in six patients by both conventional sequences and SPACE sequence. In two patients, the neck was only shown in the SPACE sequence. Four pseudomeningocele necks were shown to have flow void with both conventional sequences and SPACE sequence. Flow void could only be demonstrated by SPACE sequence in two patients.

Conclusion: A T2-SPACE sequence can show the presence of pseudomeningocele neck and flow void even in cases where conventional MRI cannot show, thus contributing to the diagnosis of pseudomeningocele. Therefore, especially in postoperative imaging, the T2-SPACE sequence may be included in routine sequences to make the differential diagnosis correctly.
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http://dx.doi.org/10.1177/0284185120912507DOI Listing
January 2021

Analysis of correlation between liver fat fraction and AST and ALT levels in overweight and obese children by using new magnetic resonance imaging technique.

Turk J Gastroenterol 2020 02;31(2):156-162

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

Background/aims: Proton density fat fraction (PDFF) magnetic resonance (MR) imaging can be a useful technique for volumetric measurements of liver fat. The purpose of our study was to evaluate the correlation between liver fat fraction (LFF) and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in children who are overweight and obese.

Materials And Methods: Overall, 25 children, aged 9-17 years, were included. Patients with a body mass index (BMI) z-score between 85-95th percentile (12 of 25 patients) were assigned to the overweight group, and those with BMI z-score above 95th percentile (13 of 25 patients) were assigned to the obese group. The control group comprised 12 healthy children with BMI z-score below 85th percentile. Liver fat fraction measurements were performed on 3D volume measurement workstation by using PDFF magnetic resonance (MR) images. Spearman's correlation coefficients between liver fat fraction and AST and ALT levels were evaluated individually for overweight, obese, and control groups. Receiver operator characteristics (ROC) analysis was also performed.

Results: In the overweight and obese groups, the liver proton density fat fraction and AST levels had a strong correlation (r=0.716, p<0.001). In addition, the LFF and ALT levels demonstrated a strong correlation (r=0.878, p<0.001). ROC analysis ascertained an optimal liver fat fraction threshold of 114 for predicting AST level (sensitivity=75%, specificity=89%). ROC analysis ascertained an optimal LFF threshold of 114 for predicting ALT level (sensitivity=80%, specificity=90%).

Conclusion: Our results indicate a strong correlation between LFF values and AST and ALT levels in children who are overweight and obese.
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http://dx.doi.org/10.5152/tjg.2020.18594DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7062128PMC
February 2020

Sonoarthrographic examination of posterior labrocapsular structures of the shoulder joint.

Br J Radiol 2020 Feb 16;93(1106):20190886. Epub 2020 Jan 16.

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

Objective: To describe the posterior labral lesions and labrocapsular abnormalities of the shoulder on sonoarthrography and to compare these findings with MR arthrography results.

Methods: 82 shoulders were initially evaluated with ultrasonography and MRI and then were examined with sonoarthrography and MR arthrography following intraarticular injection of diluted gadolinium solution. The ultrasonography images were prospectively evaluated for the presence of posterior labral tear, sublabral cleft, and posterior capsular abnormalities by two radiologists. The diagnostic accuracy of sonoarthrography in the detection of posterior labral tears and posterior labrocapsular variants was compared with that of MR arthrography.

Results: In sonoarthrographic examinations of 82 shoulders, 5 and 6 posterior labral tears were identified by Observer 1 and 2, respectively. Moreover, 6 and 7 posterior sublabral clefts, and 2 and 3 posterior synovial folds were identified by Observer 1 and 2, respectively. All the 82 patients were examined with MR arthrography; however, only 14 patients underwent arthroscopic examination. No significant difference was found among the 82 patients with regard to age, gender, and the prevalence of posterior labral tear, posterior labral cleft, and posterior synovial fold ( > 0.05). Interobserver variability showed substantial agreement between the sonoarthrographic and MR arthrographic results of the posterior labrocapsular structures (κ = 0.71, < 0.05).

Conclusion: Posterior labral tears and posterior synovial folds of the shoulder joint can be evaluated non-invasively by sonoarthrography.

Advances In Knowledge: Variations and pathologies of posterior labrocapsular structures of the glenohumeral joint are relatively uncommon.Direct (MR) arthrography is the gold-standard imaging modality to evaluate of posterior labrocapsular abnormalities of the glenohumeral joint.Sonoarthrography of the glenohumeral joint may be utilized in clinical practice in patients with contraindications to (MRI).
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http://dx.doi.org/10.1259/bjr.20190886DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055450PMC
February 2020

New Histopathologic Evidence for the Parasympathetic Innervation of the Kidney and the Mechanism of Hypertension Following Subarachnoid Hemorrhage.

J Craniofac Surg 2020 May/Jun;31(3):865-870

Department of Pathology, Ataturk University Medical Faculty, Erzurum, Turkey.

Background: The Cushing response was first described in 1901. One of its components is elevated systemic blood pressure secondary to raised intracranial pressure. However, controversy still exists in its pathophysiologic mechanism. Hypertension is attributed to sympathetic overactivity and vagotomy increased renal-based hypertension. However, the role of the parasympathetic system in hypertension has not been investigated. This subject was investigated following subarachnoid hemorrhage (SAH).

Methods: A total of 24 rabbits were used: control group (n = 5), SHAM group (n = 5), and an SAH group (n = 14; bolus injection of blood into the cisterna magna). Blood pressures were examined before, during, and after the experiment. After 3 weeks, animals were decapitated under general anesthesia. Vagal nodose ganglion, axonal degeneration, and renal artery vasospasm (RAV) indexes of all animals were determined histopathologically.

Results: Significant degenerative changes were detected in the vagal axons and nodose ganglia following SAH in animals with severe hypertension. The mean degenerated neuron density of nodose ganglions, vasospasm index (VSI) values of renal arteries of control, SHAM, and study groups were estimated as 9.0 ± 2.0 mm, 1.87 ± 0.19; 65.0 ± 12.0 mm, 1.91 ± 0.34; and 986.0 ± 112.0 mm, 2.32 ± 0.89, consecutively. Blood pressure was measured as 94.0 ± 10.0 mmHg in control group, 102.0 ± 12.0 mmHg in SHAM; 112.0 ± 14.0 mmHg in middle (n = 9); and >122.0 ± 10.0 mmHg in severe RAV-developed animals (n = 5). Differences VSI values and blood pressure between groups were statistically significant (P < 0.05).

Conclusion: The degeneration of vagal nodose ganglion has an important role in RAV and the development of RAV and hypertension following SAH.
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http://dx.doi.org/10.1097/SCS.0000000000006041DOI Listing
August 2020

The Use of Dynamic Contrast-Enhanced Perfusion MRI in Differentiating Benign and Malignant Thyroid Nodules.

Indian J Otolaryngol Head Neck Surg 2019 Oct 15;71(Suppl 1):706-711. Epub 2018 Oct 15.

2Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

To investigate the efficacy of perfusion magnetic resonance imaging (MRI) in benign-malignant differentiation of thyroid nodules. Images from 24 patients with thyroid masses were obtained using dynamic contrast enhanced MRI (DCE-MRI) at 3-T MR. DCE-MRI images were evaluated by post-processing of selected regions of interest (ROIs) on software, thus eliciting quantitative data for each voxel within the ROI. Ktrans, Ve, Kep, iAUC and chi were calculated automatically. The DCE-MRI values of benign and malignant lesions were then compared. Mean Ktrans and iAUC values in malignant lesions were significantly lower than those in benign lesions ( = 0.028 and 0.049). Ktrans, Kep, and iAUC values in malignant lesions were statistically significantly lower than normal parenchyma values. In contrast to other tissues, the perfusion MRI findings of thyroid masses exhibit a decrease in Ktrans and iAUC values as malignancy increases. Perfusion MRI may be useful in differentiating benign and malignant thyroid nodules once a cut-off value has been determined by other studies.
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http://dx.doi.org/10.1007/s12070-018-1512-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848523PMC
October 2019

Evaluation of giant arachnoid granulations with high-resolution 3D-volumetric MR sequences at 3T.

Eur J Radiol 2019 Dec 25;121:108722. Epub 2019 Oct 25.

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

Purpose: To evaluate the contribution to the diagnosis of the giant arachnoid granulations (AGs) of three-dimensional (3D) high-resolution magnetic resonance (MR) imaging sequences such as T2-weighted sampling perfection with application optimized contrasts using different flip-angle evolution (SPACE) and post-contrast T1-weighted magnetization prepared rapid gradient echo (MPRAGE).

Materials And Methods: Patients with 45 giant AGs were included in this retrospective study. All the patients were performed 3D T2-weighted SPACE and contrast enhanced MR venography sequences, as well as conventional cerebral MR imaging sequences. Post-contrast T1 weighted MPRAGE sequence were performed on 38/45 patients. All cerebral MR examinations were reviewed by the 2 neuroradiologists. Each GA was evaluated carefully to assess location and mean diameter.

Results: The most common location for giant AGs was at both transverse sinuses. Fluid signal feature within the giant AGs was not isointense to CSF on SE T1 and FLAIR MR imaging in 32 of 45 giant AGs. There were cerebral herniation into AG in 10 (22.2 %) of 45 giant AGs. 33 (73.3 %) of 45 giant AGs had central vein finding into AG in contrast enhanced MR venography. Signal void phenomenon into AG in 3D T2-weighted SPACE MR sequence was identified in 28 (62.2 %) of 45 giant AGs.

Conclusions: Fluid within giant AGs had no completely CSF-like signal intensity on conventional and 3D high-resolution MR imaging sequences. Majority of CSF-incongruent fluid within giant AGs on conventional sequences is mostly due to intra-AG CSF flow.
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http://dx.doi.org/10.1016/j.ejrad.2019.108722DOI Listing
December 2019

Unusual Mimicker of Left Ventricular Aneurysm in Contrast Enhanced CT Imaging; Calcified Hydatid Cyst.

Arch Bronconeumol 2020 10 24;56(10):669. Epub 2019 Oct 24.

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

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http://dx.doi.org/10.1016/j.arbres.2019.08.006DOI Listing
October 2020

MR arthrographic evaluation of posterior paraglenoid labral cysts: a retrospective study.

Acta Radiol 2020 Jun 25;61(6):789-795. Epub 2019 Oct 25.

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

Background: Paraglenoid labral cysts (PLCs) around the shoulder are uncommon. Magnetic resonance imaging (MRI) is the primary imaging modality for the description of PLCs.

Purpose: The purpose of this study was to evaluate PLCs in the posterior part of the glenoid bone via MR arthrography as well as to describe associated labral abnormalities.

Material And Methods: This retrospective study included 14 patients, diagnosed with 15 posterior PLCs at MR arthrography between 2007 and 2012. Conventional MRI and MR arthrography were used for all patients.

Results: A total of 15 PLCs were detected in 14 patients with eight located on the right shoulder and six on the left shoulder. One case had two PLCs. While two cysts were multiloculated, the remaining 13 were seen as unilocated simple cysts. Moreover, 14 of 15 posterior PLCs (60%) were associated with labral tears at MR arthrography. The cysts in proximity to the glenoid labrum were posterosuperior in 33.3% (n = 5), mid-posterior in 36.7% (n = 7), and postero-inferior in 20% (n = 3). The majority of patients with posterosuperior and mid-posterior cysts had an associated superior labral tear from anterior to posterior (SLAP) lesions. Four of six patients with mid-posterior cysts had minimal denervation atrophy in the infraspinatus muscle.

Conclusion: Posterior PLCs are mostly associated with posterior labral defects. The majority of cysts localized in the posterosuperior and mid-posterior were also associated with SLAP lesions. Denervation atrophy in the infraspinatus muscle may frequently accompany mid-posterior PLCs.
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http://dx.doi.org/10.1177/0284185119883389DOI Listing
June 2020

An Unusual Cause of Pulmonary Arterial Hypertension: Hydatid Cyst.

Ann Thorac Surg 2020 04 28;109(4):e267-e269. Epub 2019 Aug 28.

Department of Thoracic Surgery, Ataturk University, Erzurum, Turkey.

Hydatid cyst is an important health problem throughout the world, and it is caused by the larval form of Echinococcus granulosus. Although it is most commonly located in the liver and lungs, hydatid cyst can also affect other organs because the oncospheres spread through the bloodstream. The disease may have many different clinical presentations. Although it is a benign disease, sometimes it can cause serious morbidity and even mortality. Here, the case of a 33-year-old male patient who underwent surgery for a right ventricle and bilateral lung hydatid cyst 9 years ago and had pulmonary hypertension is presented.
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http://dx.doi.org/10.1016/j.athoracsur.2019.07.021DOI Listing
April 2020

The comparison of direct magnetic resonance arthrography with volumetric interpolated breath-hold examination sequence and multidetector computed tomography arthrography techniques in detection of talar osteochondral lesions.

Acta Orthop Traumatol Turc 2019 May 4;53(3):209-214. Epub 2019 Apr 4.

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

Objective: The aim of this study was to compare additive diagnostic values of magnetic resonance (MR) arthrography with volumetric interpolated breath-hold examination (VIBE) sequence and multidetector computed tomography (MDCT) arthrography for diagnosis and grading of talar osteochondral lesions.

Methods: MDCT arthrography and MR arthrography with three dimensional VIBE sequence were performed in 27 patients. Findings of MR arthrography and MDCT arthrography images were compared with arthroscopic findings. Sensitivity, specificity, and accuracy rates were calculated for both MR arthrography and MDCT arthrography imaging findings.

Results: For grade I osteochondral lesions; sensitivity, specificity and accuracy rates of MR arthrography were 95%, 73%, 90%, respectively; For grade I osteochondral lesions; sensitivity, specificity and accuracy rates of MDCT arthrography were 96%, 79%, 81%. For grade IV osteochondral lesions; sensitivity, specificity and accuracy rates of MDCT arthrography and MR arthrography were 100%. For grade II lesions, the sensitivity, specificity and accuracy rates of the MR arthrography were 80%, 76%, 77%, respectively; for grade III lesions, the sensitivity, specificity and accuracy rates of the MR arthrography were 78%, 68%, 75%. For grade II osteochondral lesions; the sensitivity, specificity and accuracy rates of the MDCT arthrography were 91%, 81%, 86%; for grade III osteochondral lesions; the sensitivity, specificity and accuracy rates of the MDCT arthrography were 90%, 83%, 89%; For grade II and III osteochondral lesions, MDCT arthrography had higher sensitivity, specificity and accuracy rates than MR arthrography. MDCT arthrography had higher diagnostic performance than MR arthrography for detection of grade II and III lesions (p = 0.041 and p = 0.038, respectively).

Conclusion: MDCT arthrography appears to be more reliable than MR arthrography with three dimensional VIBE sequence for accurate detection and grading of osteochondral lesions.

Level Of Evidence: Level III, Diagnostic Study.
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http://dx.doi.org/10.1016/j.aott.2019.03.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599417PMC
May 2019

An Ancillary Sign in the Diagnosis of Bankart and Bankart Variants in Patients With Glenohumeral Instability on Nonarthrographic Magnetic Resonance Imaging: Preglenoid Fat Thickness.

J Comput Assist Tomogr 2019 May/Jun;43(3):367-371

Department of Orthopedic, Medical Faculty, Ataturk University, Erzurum, Turkey.

Objective: We investigated whether preglenoid fat thickness can be used as an ancillary sign for preliminary diagnosis of Bankart and its variants on nonarthrographic magnetic resonance imaging.

Materials And Methods: Sixty-eight anterior dislocation patients were included in this retrospective study. Forty-eight patients with Bankart and its variants, as detected by arthroscopy and magnetic resonance arthrography, were included in the study group. The study group was divided into osseous Bankart, labral Bankart, Perthes, and anterior labroligamentous periosteal sleeve avulsion subgroups. Twenty patients with no detected labral pathologies by arthroscopy and magnetic resonance arthrography were included in the control group. In these patients, preglenoid fat tissue thickness at the anteroinferior portion was measured at the level of the glenoid tubercle. Thickness of preglenoid fat tissue was compared between groups with different labral pathologies and those with normal labrum.

Results: The preglenoid fat tissue thickness was 2.65 ± 1.05 mm in the control group and 0.90 ± 0.59 mm in the study group (P < 0.0001). Patients with preglenoid fat tissue thinner than 1.6 mm showed a significantly increased likelihood of having Bankart and its variants in receiver operating characteristic analysis (sensitivity of 95.8% and specificity of 85%). There was no significant difference in preglenoid fat tissue thickness between the subgroups of the study group (osseous Bankart, labral Bankart, Perthes, and anterior labroligamentous periosteal sleeve avulsion).

Conclusion: Preglenoid fat tissue measurement can be used as an ancillary sign in the diagnosis of Bankart and Bankart variants in glenohumeral instability patients.
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http://dx.doi.org/10.1097/RCT.0000000000000856DOI Listing
June 2019

MR arthrographic evaluation of the association between anterolateral soft tissue impingement and osteochondral lesion of the tibiotalar joint.

Radiol Med 2019 Jul 14;124(7):653-661. Epub 2019 Mar 14.

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

Purpose: To retrospectively evaluate on magnetic resonance (MR) arthrography the relationship between joint capsule thickness and the stage of osteochondral lesions of the tibiotalar joint, as well as to evaluate the ankle joint capacity in patients with osteochondritis dissecans (OCD). Also, we demonstrate the unusual locations of osteochondral lesions of the ankle joint.

Methods: MR arthrography images were analyzed by two staff radiologists in consensus. The normality of the data was analyzed by the Kolmogorov-Smirnov test. The Mann-Whitney U test was used to compare the relationship between joint capsule thickness and patient groups with OCD.

Results: The anterolateral joint capsule thickness was significantly higher than the anteromedial and posterior joint capsule thickness in the OCD with loose bodies group (p = 0.049). Osteochondral defects were most commonly detected at the medial talar dome: in 29 of 37 patients (78.3%) in the OCD without loose bodies group and in 16 of 29 (55.2%) patients in the OCD with loose bodies group. The second most common localization of the osteochondral defect in the OCD with loose bodies group was the medial plafond of distal tibia [in 9 of 29 (31.1%) patients].

Conclusions: Clinical and radiological evidence of anterolateral impingement syndrome often accompanies stage 4 OCDs. OCDs of the distal tibial plafond are not rare in the ankle joint and are often associated with loose bodies.
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http://dx.doi.org/10.1007/s11547-019-01022-yDOI Listing
July 2019

Brachial Artery Vasospasm Caused by Cervical Dorsal Root Ganglion Degeneration After Subarachnoid Hemorrhage: An Experimental Study.

World Neurosurg 2019 Jun 11;126:e895-e900. Epub 2019 Mar 11.

Department of Pathology, Medical Faculty of Ataturk University, Erzurum, Turkey.

Purpose: Subarachnoid hemorrhage (SAH) may lead to vasospasm in various vessels. The cervical nerves have a vasodilatory effect on the upper extremity arteries. The aim of this study was to investigate if there is a relationship between C6 dorsal root ganglion (DRG) degeneration and brachial artery (BA) vasospasm after spinal SAH.

Methods: This experimental study was conducted on 23 rabbits. The animals were divided into 3 groups: control (n = 5), SHAM (n = 5), and study group (n = 13). One cubic centimeter (cc) of serum saline was injected into the cisterna magna of animals of the SHAM group; the same procedure was performed by 1 cc of homologous blood in the study group. Degenerated neuron densities (DNDs) of DRGs (n/mm) at C6 levels and BA vasospasm indexes (VSI; wall surface/lumen surface) of all animals were determined and results were analyzed statistically.

Results: Mean VSI values of BAs and DNDs of CDRGs of the control, SHAM, and study groups were estimated as 10 ± 3/1.12 ± 0.11 n/mm, 34 ± 9/1.27 ± 0.24 n/mm, and 1031 ± 145/2.93 ± 0.78 n/mm, respectively. Mean DNDs and VSI values were statistically significantly different between the control and study groups (P < 0.0001).

Conclusions: CDRG degeneration may be considered as an important factor in the etiopathogenesis of severe BA vasospasm after SAH.
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http://dx.doi.org/10.1016/j.wneu.2019.03.007DOI Listing
June 2019

The clinical and radiological features of cisternal and pericallosal lipomas.

Acta Neurol Belg 2020 Feb 13;120(1):65-70. Epub 2019 Mar 13.

Department of Radiology, Medical Faculty, Ataturk University, Kazım Karabekir Mah. Terminal Cad, Yakutiye, Erzurum, Turkey.

Purpose: To demonstrate the clinical and radiological features of pericallosal and cisternal lipomas and to compare these two groups in terms of radiological and clinical features.

Methods: This retrospective study included 23 patients diagnosed with pericallosal and cisternal lipoma between 2010 and 2017. The patients comprised 12 females and 11 males with a mean age of 38.8 years (range 12-69 years). Magnetic resonance imaging was applied to all the patients. Computed tomography (CT) was also performed in 10 patients.

Results: 9 lesions were pericallosal and 14 were cisternal (7 were right quadrigeminal cistern, 3 were left quadrigeminal cistern, 1 was interpeduncular cistern, 1 was left cerebellopontine cistern, 1 was right cerebellopontine cistern, and 1 was supracerebellar cistern). The mean size of the lesions was 18.7 ± 10 mm. The shape of the lesions was curvilinear in 10 patients (43.5%) and tubulonodular in 13 patients (56.5%). The mean CT density of the lesions was - 87.7 ± 25.6 HU. The size of pericallosal lipomas (mean 27.5 mm) was statistically significantly larger than that of cisternal lipomas (mean 13.1 mm) (p = 0.001). No statistically significant difference was determined between the two groups in terms of lesion shape (p = 0.478), gender (p = 0.707), age (p = 0.639), and symptoms (p = 0.084).

Conclusions: In this study, the incidence of pericallosal lipomas was 0.011% and the incidence of cisternal lipomas was 0.017%. Although rare, the knowledge of the clinical and radiological features of pericallosal and cisternal lipomas will play an important role in the accurate diagnosis and follow-up of the patient.
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http://dx.doi.org/10.1007/s13760-019-01119-1DOI Listing
February 2020

Circulatory Stasis or Thrombus in Left Atrial Appendage, An Easy Diagnostic Solution.

J Comput Assist Tomogr 2019 May/Jun;43(3):406-409

Cardiology, and.

Objective: The purpose of this study was to assess the diagnostic performance of prone position cardiac multidetector computed tomography (MDCT) in the detection of left atrial appendage (LAA) thrombi and to make differentiate between thrombus and circulatory stasis using transesophageal echocardiography (TEE) as the criterion-standard imaging modality.

Methods: From December 2014 to April 2016, 53 consecutive patients were admitted to the hospital because of circulatory stasis or/and thrombus. All patients underwent prone-position MDCT and TEE. Prone-position MDCT and TEE sensitivity, specificity, positive predictive value, and negative predictive value were calculated.

Results: For the MDCT scan in the prone position, the sensitivity, specificity, positive predictive value, and negative predictive value results were 100%, 100%, 100%, and 100%, respectively.

Conclusions: Multidetector computed tomography scanning in the prone position differentiates circulatory stasis and LAA thrombus, is clinically useful for detecting and ruling out LAA thrombus, and may be an alternative to TEE as a diagnostic tool.
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http://dx.doi.org/10.1097/RCT.0000000000000853DOI Listing
June 2019

Vascular imaging findings with high-pitch low-dose dual-source CT in atypical Kawasaki disease.

Diagn Interv Radiol 2019 Jan;25(1):50-54

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

Purpose: Determining the presence of aneurysms, thrombosis, and stenosis is very important for the diagnosis of atypical Kawasaki disease (AKD) and in the follow-up of AKD patients with aneurysms. We aimed to demonstrate high-pitch low-dose dual-source computed tomography (CT) angiography findings in pediatric patients with AKD.

Methods: Over a 5-year period, high-pitch low-dose CT angiography was performed to determine vascular aneurysms or occlusions in 17 patients who had suspected AKD. The patients ranged from 2 months of age to 11.3 years, with a mean age of 3 years. The American Heart Association's criteria were used to diagnose AKD.

Results: We did not detect any vascular problems in 6 of the patients, and they were not included in our study. Arterial aneurysms were present in 11 patients (aged 2 months to 11.3 years; mean age, 4.2 years; 7 males). In one patient, there was also a thrombus at an arterial aneurysm. Coronary artery aneurysms were detected in 7 patients and systemic artery aneurysms were detected in 7 patients. Three patients had both systemic and coronary aneurysms.

Conclusion: Our results suggest that high-pitch low-dose dual-source CT can detect all types of aneurysms, stenosis and occlusions of vessels in patients with AKD who were not previously diagnosed. This useful, easy, robust and fast technique may be preferred to diagnose AKD.
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http://dx.doi.org/10.5152/dir.2018.18092DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339624PMC
January 2019

The Value of Superb Microvascular Imaging in Detecting Hepatic Artery Occlusion in Liver Transplantation: A Preliminary Study.

Ultrasound Q 2019 Dec;35(4):325-329

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

Superb microvascular imaging (SMI) is an innovative color Doppler technique that is used to evaluate low-velocity blood flow in particular. Our purpose in this study was to examine the sensitivity and specificity of SMI for assessing occlusion of the hepatic artery after liver transplantation. Ninety-five prospective patients who underwent liver transplantation were included in our study between April 2014 and February 2018. The patients were assessed with color power Doppler sonography and SMI method examinations in this study. Those who were suspected of having hepatic artery occlusion were assessed with computed tomography angiography. Computed tomography angiography was used in all the patients who were suspected of having occlusion of the hepatic artery on power Doppler and SMI method. The hepatic artery was considered to be patent and have normal flow on color Doppler examination in 72 (75.7%) of the total 95 patients. The hepatic artery was not observed in 23 (24.2%) of the patients with color Doppler sonography. In 3 of those 23 patients, arterial flow was detected with power Doppler sonography (31%). The sensitivity of SMI for the detection of hepatic artery occlusion was 100%, the specificity was 97.87%, the positive predictive value was 33.33%, and the negative predictive value was 100%. Thus, SMI is a noninvasive technique that is easy to use and has high sensitivity in patients who have undergone liver transplantation. In patients who are suspected of having hepatic artery occlusion with Doppler ultrasound, SMI can detect hepatic artery occlusion without the need for invasive techniques.
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http://dx.doi.org/10.1097/RUQ.0000000000000416DOI Listing
December 2019

MR arthrographic characterization of posterior capsular folds in shoulder joints.

Br J Radiol 2019 Feb 28;92(1094):20180527. Epub 2018 Nov 28.

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

Methods:: This was a retrospective study of 604 consecutive shoulder MR images and MR arthrograms obtained from April 2010 to January 2018. Extension in the vertical-oblique plan of the posterior synovial fold on MR arthrography was identified according to the posterosuperior, posteroinferior, superoposterior, and inferoposterior portions. The morphologies of the posterior synovial folds on MR arthrography were divided three subtypes. Morphologic appearances of the posterior labrocapsular complex on conventional MR images were described with four subtypes.

Results:: A posterior synovial fold in the shoulder joint was identified in 35 of 604 (5.8%) MR arthrography patients. 8 of 35 posterior synovial fold identified on MR arthrography were confirmed at arthroscopy. The most common MR arthrographic type of the posterior synovial fold was triangular-this was detected in 17 of 35 (48.6%) patients. The most common MRI morphology of the posterior labrocapsular complex was doubled posterior labrum. This was detected in 15 of 35 (42.9%) patients. 17 % of patients with posterior synovial folds who were diagnosed with MR arthrography had normal MRI features. The most common localization of the posterior synovial fold was posterosuperior and posteroinferior portions of the posterior labrocapsular structures. The mean of the shortest distance between the posterior synovial fold and the posterior labrum was significantly higher in the positive arthroscopic synovial fold group than in the negative arthroscopic synovial fold group (p = 0.047).

Conclusion:: Posterior synovial folds, normal capsular anatomic variants, are seen rarely on MR arthrography, and tend to be in the posterosuperior and posteroinferior portions of the posterior capsule. Some types of the posterior synovial fold can mimic a posterior labral tear in conventional MRI.

Advances In Knowledge:: On a direct MR arthrographic image, a posterior capsular synovial fold may be a normal anatomic variant. A fold is more commonly occur in the posterosuperior and posteroinferior capsular portions. The results of our study may allow differentiation of normal variations from abnormalities in patients with symptomatic shoulder joint.
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http://dx.doi.org/10.1259/bjr.20180527DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404847PMC
February 2019