The purpose of this study was to evaluate the hemodynamic changes occurring in the ophthalmic vas... more The purpose of this study was to evaluate the hemodynamic changes occurring in the ophthalmic vasculature of eyes with Behçet's disease in a controlled clinical trial. Both eyes of patients with retinal involvement due to Behçet's disease were consecutively evaluated and were established as having mild or severe retinal vasculitis according to the ophthalmoscopic and fundus fluorescein angiographic findings. One eye from each patient was randomly selected and 25 eyes with mild to moderate and 25 eyes with severe vasculitis were identified. Color Doppler imaging (CDI) was used to quantitate blood flow velocities and vascular resistance in the ophthalmic artery (OA), central retinal artery (CRA) and central retinal vein (CRV) of these patients and those of 25 healthy volunteers. All three groups were age- and sex-matched. In the OA, peak systolic, end diastolic and average flow velocities were significantly higher in patients with Behçet's disease than in the control group...
Objectives. For the evaluation of skeletal age, the methods of Greulich-Pyle and Tanner-Whitehous... more Objectives. For the evaluation of skeletal age, the methods of Greulich-Pyle and Tanner-Whitehouse are generally used in clinical practice. Our investigation was undertaken to determine whether the ultrasonographic version of the Greulich-Pyle atlas is capable of assessing skeletal age. If so, we aimed to describe the standards for the ultrasonographic version of the Greulich-Pyle atlas for each year during the first 6 years of life. Methods. Ninety-seven subjects underwent left hand and wrist radiography and ultrasonographic examination for bone age assessment during a 1.5-year study. Estimated bone ages derived from the plain radiography and "hand and wrist ultrasonography charts" interpreted by use of the Greulich-Pyle atlas were compared statistically. Results. The estimated bone ages from plain radiography and hand and wrist ultrasonography charts interpreted by use of the Greulich-Pyle atlas were significantly correlated; 71.1% of male patients had the same age in both methods, and in 84.4% of patients, the difference was less than 6 months. In 65.5% of female patients, both methods revealed the same age, and in 88.5% of them, the difference was less then 6 months. Conclusions. The ultrasonographic version of the Greulich-Pyle atlas can be used to estimate bone age even in ultrasonography departments. This method is highly correlated and a valid alternative to plain radiography for bone age estimation. This enables estimation of skeletal age in ultrasonography departments easily without exposing the patient to radiation.
Objective. We aimed to search for differences between observers and automatic and manual measurem... more Objective. We aimed to search for differences between observers and automatic and manual measurements in calculations of Doppler parameters. Methods. The middle cerebral artery (MCA), central retinal artery, ophthalmic artery (OA), common carotid artery (CCA), vertebral artery (VA), popliteal artery (PA), interlobar renal artery (IRA), and arcuate renal artery (ARA) were evaluated in 20 healthy subjects bilaterally. Peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged maximum velocity (TAMAX), resistive index (RI), and pulsatility index (PI) were measured from the same spectrum manually by 3 observers and automatically. Results of 4 measurements were compared by analysis of variance and Pearson tests. Results. The comparison of the 4 measurements revealed significant differences for most parameters except TAMAX of the OA, VA, and ARA and PSV, EDV, and PI of the PA. An automatic calculator yielded lower PSV, RI, and PI values (except the MCA and PA) and higher EDV values compared with manual measurements. The magnitudes of difference were in the range of 1% to 16% for velocities and 4% to 14% for RI and PI. The means of difference were 3.185 cm/s for PSV of the CCA and 0.054 for RI of the IRA. Correlation was high for PSV, EDV, and TAMAX in all arteries (except TAMAX of PA) and relatively low for PI and RI in most of the arteries. Conclusions. Although our study was performed on healthy subjects, our results showed that, in most cases, readers and the automatic approach disagreed on evaluation of Doppler parameters. This may be important in preventing false diagnoses in cases with Doppler values close to upper limits and may necessitate establishment of new limits for each method.
Objective. To assess whether cigarette smoking had an effect on superior mesenteric artery postpr... more Objective. To assess whether cigarette smoking had an effect on superior mesenteric artery postprandial blood flow. Methods. Forty-six subjects were studied in 3 groups with Doppler sonography. Group A consisted of nonsmokers; groups B and C consisted of smokers. In group B, subjects were allowed to smoke cigarettes postprandially, whereas in group C, postprandial smoking was prohibited. A baseline Doppler evaluation was performed in the fasting state, and consecutive Doppler evaluations were performed postprandially with 30-min intervals for 120 minutes. Doppler sonographic measurements of the superior mesenteric artery, including peak systolic and end-diastolic velocities, resistive index, and diameter, were calculated. Statistical analysis was performed by analysis of variance. Results. All groups showed significant changes with time for all parameters (P < .001 for all). The changes in time were significantly different at 90 and 120 minutes for peak systolic velocity, at 90 minutes for end-diastolic velocity, and at 120 minutes for diameter between groups. Group B had the greatest differences. Compared with group A, changes in peak systolic velocity at 90 to 120 minutes were significantly lower in group B (P = .007 and .006, respectively), and compared with groups A and C, changes in end-diastolic velocity at 90 minutes (P = .006 and .004, respectively) and diameter at 120 minutes (P = .007 and .011, respectively) were significantly lower in group B. Conclusions. Smoking immediately after meals was associated with a superior mesenteric artery blood flow increase that was lower than expected, which may explain the belief that smoking reduces body weight. Postprandial smoking may have undesired results in patients with chronic intestinal ischemia.
ABSTRACT Temporomandibular joint (TMJ) involvement in rheumatoid arthritis (RA) is not uncommon. ... more ABSTRACT Temporomandibular joint (TMJ) involvement in rheumatoid arthritis (RA) is not uncommon. In this study a questionnaire, clinical assessment, and high resolution computerized tomography (HRCT) were used in 15 patients with rheumatoid arthritis to evaluate the diagnostic criteria of TMJ involvement. Symptoms due to TMJ involvement were present in 33.3% of the patients. Frequency of involvement was 40.0% on clinical assessment but 86.6% with HRCT assessment. The most common HRCT findings were decreases in the joint space (33.3%), mandibular subchondral cysts (23.3%), temporal subchondral cysts (23.3%), degeneration (23.3%), shape (13.3%) and height (13.3%) anomalies of the mandibular condyle, condylar head resorption (13.3%), erosion of the mandibular condyle (13.3%), and demineralization (13.3%). All patients with positive clinical findings also had positive HRCT findings. In seven (46.7%) of the patients, there were no symptoms or clinical findings implying TMJ involvement; however, they had positive results on HRCT evaluation. The HRCT findings may be the initial sign of TMJ involvement in patients with rheumatoid arthritis. In conclusion, it is suggested that RA patients with the suspicion of TMJ involvement should undergo HRCT evaluation, because HRCT findings may precede the clinical findings.
Advances in Clinical and Experimental Medicine, 2015
Background. High jugular bulb (HJB) may be detected unilaterally or bilaterally in temporal bone ... more Background. High jugular bulb (HJB) may be detected unilaterally or bilaterally in temporal bone high resolution computerized tomography (HRCT). Objectives. In this retrospective study, we investigated the pitfalls and important surgical distances in patients with unilateral and bilateral HJB via temporal bone HRCT. Material and Methods. In this preliminary report, the study group consisted of 20 adult patients (12 male, 8 female), or 40 ears, all of which underwent temporal bone HRCT. We divided them into groups that consisted of bilateral HJB (14 ears), unilateral HJB (13 ears), and control (No HJB, 13 ears). The anotomical relationships of the sigmoid sinus, jugular bulb, and carotid artery with several landmarks in the temporal bone were studied via temporal bone axial and coronal HRCT. The shortest distances between certain points were measured. These measurements were analyzed in respect to pneumatization. Dehiscence on the jugular bulb (JB) and internal carotid artery (ICA) and the dominance of JB were also evaluated for all of the groups. Results. In the axial sections of the temporal bone HRCTs, the sigmois sinus (SS)-external auditory canal (EAC) distance of the bilateral HJB group (14.00 ± 1.17 mm) was significantly lower than that of the control group (16.46 ± 2.14 mm). The JB-posteromedial points of the umbo on the ear drum (ED) distance of the bilateral HJB (6.28 ± 1.72 mm) and the unilateral HJB groups (7.23 ± 2.00 mm) were significantly lower than that of the control group (11.15 ± 2.30 mm). In the coronal sections of the temporal bone HRCT, the JB-F distance of the bilateral HJB group (5.42 ± 2.10 mm) was significantly lower than that of the control group (8.30 ± 2.28 mm). As the mastoid pneumatisation and mastoid volume increased, the percentage of ICA-dehiscence and the percentage of JB-dehiscence increased. Conclusions. In subjects with well-pneumatised mastoids, the doctors should be aware of the increased risk of ICA-dehiscence and JB-dehiscence. These measurements should be done in greater series to yield more thorough knowledge (Adv Clin Exp Med 2015, 24, 2, 315-324).
The aim of this study was to investigate the relationship between tinnitus loudness level (TLL) a... more The aim of this study was to investigate the relationship between tinnitus loudness level (TLL) and internal jugular venous flow rate (IJVFR) in tinnitus patients with a unilateral high jugular bulb detected by temporal bone high-resolution computed tomography (HRCT). The study group consisted of 24 adult patients (13 male, 11 female) with a unilateral high jugular bulb. One ear suffered from tinnitus with a high jugular bulb was included into the study group. The ears without tinnitus and no high jugular bulb on temporal bone HRCT comprised the control group. All patients were evaluated with a history and physical and otolaryngologic examinations, and, using a questionnaire, TLLs were detected. The patency and flow rates in the internal jugular veins were measured by right and left internal jugular venous Doppler ultrasonography. The TLLs were &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;very quiet&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; in 1 (4.1%) patient, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;intermediate loud&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; in 17 (70.9%) patients, and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;very loud&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; in 6 (25.0%) patients. IJVFRs were not different in the study and control groups. In the study group, IJVFRs were not correlated with age. There was no relationship among TLLs and IJVFRs, dominance, dehiscence, and bony septum thickness between the high jugular bulb and the middle ear. TLLs were not affected by IJVFRs, dominance, dehiscence, and bony septum thickness in patients with a high jugular bulb. More detailed studies should be undertaken to determine the reason for the different TLLs in patients with a high jugular bulb.
Bulletin (Hospital for Joint Diseases (New York, N.Y.)), 2005
Computed tomography is used to assess whether ideal femoral component size in knee arthroplasty c... more Computed tomography is used to assess whether ideal femoral component size in knee arthroplasty can be made more accurately. Ideal femoral component size was measured on radiography, computed tomography, and by direct measurement of 20 cadaver femora and analyzed statistically. There was no significance between the tomographically anticipated ideal femoral component size and ideal femoral size values (Wilcoxon W 388.5; p 0.565). There was difference between radiographically anticipated ideal femoral size and ideal femoral size values (Wilcoxon W 324.5; p 0.020). Anticipating the ideal femoral size can be made more precisely with computed tomography than radiographs in cadaver femora. Anticipating the ideal femoral component size by computed tomography may solve the problems in "in-between sizes." Future total knee designs may be manufactured in more anatomic sizes.
Diagnostic and interventional radiology (Ankara, Turkey), 2005
Early-enhancing areas that are perfusion abnormalities rather than tumor deposit are sometimes en... more Early-enhancing areas that are perfusion abnormalities rather than tumor deposit are sometimes encountered on arterial dominant-phase images in multisection dynamic magnetic resonance imaging. Focal sparing in diffusely fatty liver is also a well recognized entity. However, both conditions occasionally create problems in the diagnosis of hepatic mass lesions. Familiarity with these abnormalities on ultrasonography and multisection dynamic magnetic resonance images is important to prevent misinterpretation of these pseudolesions as real masses. In addition, focal sparing can be the only clue for a space occupying lesion in the liver. We present here the ultrasonography and magnetic resonance imaging findings of a case with liver metastasis from pancreas cancer which caused a wedge-shaped fat-spared enhancing area on dynamic magnetic resonance imaging.
Tanısal ve girişimsel radyoloji : Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı, 2004
To test if the apparent diffusion coefficient (ADC) values reflect the ultrastructural changes of... more To test if the apparent diffusion coefficient (ADC) values reflect the ultrastructural changes of normal appearing white and gray matter with advancing age. We selected 45 patients with normal MRI and DW imaging findings. DW and MRI imaging was performed and for each patient the average ADC on trace images of the frontal and occipital white matter and the thalamus were compared with increasing patient age. The average ADC value was 0.753+/-0.054 x 10-3 mm2/sec in frontal white matter, 0.673+/-0.085 x 10-3 mm2/sec in occipital white matter, and 0.763+/-0.063 x 10-3 mm2/sec in the thalamus. For white matter, ADC values increased with advancing age. Although ADC tended to increase with age, comparison of individual thalamic ADC and patient ages did not reach statistical significance. Advancing age is associated with a small but statistically significant increase of water diffusibility in human white matter. This increase may reflect mild structural changes with normal aging.
Tanısal ve girişimsel radyoloji : Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı, 2004
The frequency of anatomic variations of the colon detected on abdominal CT scans was examined. 29... more The frequency of anatomic variations of the colon detected on abdominal CT scans was examined. 296 consequtive abdominal tomography were evaluated prospectively for the presence of retrorenal colon, retrogastric (pancreaticogastric interposition or retrosplenic) colon, high positioned colon, interposition of the colon between the psoas muscle and the kidney and hepatodiaphragmatic interposition (anterior or posterior). We observed 2 retrogastric colon [1 pancreaticogastric (0.3%), 1 retrosplenic (0.3%)], 7 retrorenal colon (1.2%) being bilateral in two cases, 2 interposition of colon between the psoas muscle and the kidney (0.7%), 1 posterior (0.3%) and 6 anterolateral hepatodiaphragmatic interposition (2.1%) and 12 high positioned cecum (4.2%) (in 4 of them cecum was totally subhepatic in location). Terminal ileum was lying in Morrison's pouch and anterior to renal hilus in two of the cases with subhepatic cecum. Anatomic variations of the colon probably result due to mild embr...
Penile metastatic tumors are relatively infrequent and very rare compared to extraurogenital tumo... more Penile metastatic tumors are relatively infrequent and very rare compared to extraurogenital tumor metastasis. We present an interesting rare occurrence of a late penile metastasis on an adenocarcinoma of the rectum.
Ossifying fibroma is a rare benign neoplasm that usually affects mandibular and maxillary bones. ... more Ossifying fibroma is a rare benign neoplasm that usually affects mandibular and maxillary bones. In this report, we present a case of sinonasal ossifying fibroma with fluid-fluid levels and posterior extension toward the torus tubarius on MR images.
The cricoarytenoid (CA) joint involvement in rheumatoid arthritis (RA) is not uncommon. In this s... more The cricoarytenoid (CA) joint involvement in rheumatoid arthritis (RA) is not uncommon. In this study, clinical assessment, laryngeal endoscopy, and high-resolution computed tomography (HRCT) were used in 15 patients with RA to evaluate the diagnostic criteria of CA joint involvement. Symptoms owing to CA joint involvement were present in 66.6% of the patients. The frequency of involvement was 13.3% on laryngeal endoscopy but 80.0% with HRCT assessment. The most common HRCT findings were CA prominence (46.6%), density and volume changes (46.6%), and CA subluxation (39.9%). In some of the patients, soft tissue swelling (20%) near the CA joint and narrowing in the piriform sinus (33.3%) were also observed. Radiologic abnormalities related to CA joint involvement generally precede clinical symptomatology. Therefore, HRCT evaluation may be a useful method in the assessment of CA joint involvement in RA patients to exclude possible causes of laryngeal signs and symptoms.
Abscess as a complication of extracorporeal shock wave lithotripsy is a rare condition. We presen... more Abscess as a complication of extracorporeal shock wave lithotripsy is a rare condition. We present the computed tomography findings of an abdominal wall abscess that occurred after extracorporeal shock wave lithotripsy for which prophylactic antibiotics had not been given. The abscess destroyed the posterior abdominal wall muscles and dissected into the thorax. The muscles were thickened and showed enhancement. A parenchymal defect in the right kidney adjacent to a caliceal stone, with strands extending from this defective region to the abscess, was observed, and was thought to be the result of parenchymal destruction caused by the shock waves. Other parts of the kidney and psoas muscle were normal. Microbiologic examination revealed Escherichia coli.
Endosalpingiosis is characterized by the presence of benign glands lined by tubal-type epithelium... more Endosalpingiosis is characterized by the presence of benign glands lined by tubal-type epithelium involving the pelvic and lower abdominal peritoneum and pelvic and para-aortic lymph nodes in women. Rarely, cystification can occur, resulting in a neoplasm-like mass associated with clinical manifestations, an intraoperative abnormality, or a striking finding on gross examination. Here we report the transvaginal ultrasound, magnetic resonance imaging and histopathological appearance of an unusual case of cystic endosalpingiosis involving the right ovary and full thickness of the wall of the uterine fundus in a patient who presented with a 6-month history of menorrhagia and pelvic pain. Clinicians should be aware of this type of uterine benign manifestation so as to refrain from overtreatment. Copyright 2008 ISUOG.
The purpose of this study was to evaluate the hemodynamic changes occurring in the ophthalmic vas... more The purpose of this study was to evaluate the hemodynamic changes occurring in the ophthalmic vasculature of eyes with Behçet's disease in a controlled clinical trial. Both eyes of patients with retinal involvement due to Behçet's disease were consecutively evaluated and were established as having mild or severe retinal vasculitis according to the ophthalmoscopic and fundus fluorescein angiographic findings. One eye from each patient was randomly selected and 25 eyes with mild to moderate and 25 eyes with severe vasculitis were identified. Color Doppler imaging (CDI) was used to quantitate blood flow velocities and vascular resistance in the ophthalmic artery (OA), central retinal artery (CRA) and central retinal vein (CRV) of these patients and those of 25 healthy volunteers. All three groups were age- and sex-matched. In the OA, peak systolic, end diastolic and average flow velocities were significantly higher in patients with Behçet's disease than in the control group...
Objectives. For the evaluation of skeletal age, the methods of Greulich-Pyle and Tanner-Whitehous... more Objectives. For the evaluation of skeletal age, the methods of Greulich-Pyle and Tanner-Whitehouse are generally used in clinical practice. Our investigation was undertaken to determine whether the ultrasonographic version of the Greulich-Pyle atlas is capable of assessing skeletal age. If so, we aimed to describe the standards for the ultrasonographic version of the Greulich-Pyle atlas for each year during the first 6 years of life. Methods. Ninety-seven subjects underwent left hand and wrist radiography and ultrasonographic examination for bone age assessment during a 1.5-year study. Estimated bone ages derived from the plain radiography and "hand and wrist ultrasonography charts" interpreted by use of the Greulich-Pyle atlas were compared statistically. Results. The estimated bone ages from plain radiography and hand and wrist ultrasonography charts interpreted by use of the Greulich-Pyle atlas were significantly correlated; 71.1% of male patients had the same age in both methods, and in 84.4% of patients, the difference was less than 6 months. In 65.5% of female patients, both methods revealed the same age, and in 88.5% of them, the difference was less then 6 months. Conclusions. The ultrasonographic version of the Greulich-Pyle atlas can be used to estimate bone age even in ultrasonography departments. This method is highly correlated and a valid alternative to plain radiography for bone age estimation. This enables estimation of skeletal age in ultrasonography departments easily without exposing the patient to radiation.
Objective. We aimed to search for differences between observers and automatic and manual measurem... more Objective. We aimed to search for differences between observers and automatic and manual measurements in calculations of Doppler parameters. Methods. The middle cerebral artery (MCA), central retinal artery, ophthalmic artery (OA), common carotid artery (CCA), vertebral artery (VA), popliteal artery (PA), interlobar renal artery (IRA), and arcuate renal artery (ARA) were evaluated in 20 healthy subjects bilaterally. Peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged maximum velocity (TAMAX), resistive index (RI), and pulsatility index (PI) were measured from the same spectrum manually by 3 observers and automatically. Results of 4 measurements were compared by analysis of variance and Pearson tests. Results. The comparison of the 4 measurements revealed significant differences for most parameters except TAMAX of the OA, VA, and ARA and PSV, EDV, and PI of the PA. An automatic calculator yielded lower PSV, RI, and PI values (except the MCA and PA) and higher EDV values compared with manual measurements. The magnitudes of difference were in the range of 1% to 16% for velocities and 4% to 14% for RI and PI. The means of difference were 3.185 cm/s for PSV of the CCA and 0.054 for RI of the IRA. Correlation was high for PSV, EDV, and TAMAX in all arteries (except TAMAX of PA) and relatively low for PI and RI in most of the arteries. Conclusions. Although our study was performed on healthy subjects, our results showed that, in most cases, readers and the automatic approach disagreed on evaluation of Doppler parameters. This may be important in preventing false diagnoses in cases with Doppler values close to upper limits and may necessitate establishment of new limits for each method.
Objective. To assess whether cigarette smoking had an effect on superior mesenteric artery postpr... more Objective. To assess whether cigarette smoking had an effect on superior mesenteric artery postprandial blood flow. Methods. Forty-six subjects were studied in 3 groups with Doppler sonography. Group A consisted of nonsmokers; groups B and C consisted of smokers. In group B, subjects were allowed to smoke cigarettes postprandially, whereas in group C, postprandial smoking was prohibited. A baseline Doppler evaluation was performed in the fasting state, and consecutive Doppler evaluations were performed postprandially with 30-min intervals for 120 minutes. Doppler sonographic measurements of the superior mesenteric artery, including peak systolic and end-diastolic velocities, resistive index, and diameter, were calculated. Statistical analysis was performed by analysis of variance. Results. All groups showed significant changes with time for all parameters (P < .001 for all). The changes in time were significantly different at 90 and 120 minutes for peak systolic velocity, at 90 minutes for end-diastolic velocity, and at 120 minutes for diameter between groups. Group B had the greatest differences. Compared with group A, changes in peak systolic velocity at 90 to 120 minutes were significantly lower in group B (P = .007 and .006, respectively), and compared with groups A and C, changes in end-diastolic velocity at 90 minutes (P = .006 and .004, respectively) and diameter at 120 minutes (P = .007 and .011, respectively) were significantly lower in group B. Conclusions. Smoking immediately after meals was associated with a superior mesenteric artery blood flow increase that was lower than expected, which may explain the belief that smoking reduces body weight. Postprandial smoking may have undesired results in patients with chronic intestinal ischemia.
ABSTRACT Temporomandibular joint (TMJ) involvement in rheumatoid arthritis (RA) is not uncommon. ... more ABSTRACT Temporomandibular joint (TMJ) involvement in rheumatoid arthritis (RA) is not uncommon. In this study a questionnaire, clinical assessment, and high resolution computerized tomography (HRCT) were used in 15 patients with rheumatoid arthritis to evaluate the diagnostic criteria of TMJ involvement. Symptoms due to TMJ involvement were present in 33.3% of the patients. Frequency of involvement was 40.0% on clinical assessment but 86.6% with HRCT assessment. The most common HRCT findings were decreases in the joint space (33.3%), mandibular subchondral cysts (23.3%), temporal subchondral cysts (23.3%), degeneration (23.3%), shape (13.3%) and height (13.3%) anomalies of the mandibular condyle, condylar head resorption (13.3%), erosion of the mandibular condyle (13.3%), and demineralization (13.3%). All patients with positive clinical findings also had positive HRCT findings. In seven (46.7%) of the patients, there were no symptoms or clinical findings implying TMJ involvement; however, they had positive results on HRCT evaluation. The HRCT findings may be the initial sign of TMJ involvement in patients with rheumatoid arthritis. In conclusion, it is suggested that RA patients with the suspicion of TMJ involvement should undergo HRCT evaluation, because HRCT findings may precede the clinical findings.
Advances in Clinical and Experimental Medicine, 2015
Background. High jugular bulb (HJB) may be detected unilaterally or bilaterally in temporal bone ... more Background. High jugular bulb (HJB) may be detected unilaterally or bilaterally in temporal bone high resolution computerized tomography (HRCT). Objectives. In this retrospective study, we investigated the pitfalls and important surgical distances in patients with unilateral and bilateral HJB via temporal bone HRCT. Material and Methods. In this preliminary report, the study group consisted of 20 adult patients (12 male, 8 female), or 40 ears, all of which underwent temporal bone HRCT. We divided them into groups that consisted of bilateral HJB (14 ears), unilateral HJB (13 ears), and control (No HJB, 13 ears). The anotomical relationships of the sigmoid sinus, jugular bulb, and carotid artery with several landmarks in the temporal bone were studied via temporal bone axial and coronal HRCT. The shortest distances between certain points were measured. These measurements were analyzed in respect to pneumatization. Dehiscence on the jugular bulb (JB) and internal carotid artery (ICA) and the dominance of JB were also evaluated for all of the groups. Results. In the axial sections of the temporal bone HRCTs, the sigmois sinus (SS)-external auditory canal (EAC) distance of the bilateral HJB group (14.00 ± 1.17 mm) was significantly lower than that of the control group (16.46 ± 2.14 mm). The JB-posteromedial points of the umbo on the ear drum (ED) distance of the bilateral HJB (6.28 ± 1.72 mm) and the unilateral HJB groups (7.23 ± 2.00 mm) were significantly lower than that of the control group (11.15 ± 2.30 mm). In the coronal sections of the temporal bone HRCT, the JB-F distance of the bilateral HJB group (5.42 ± 2.10 mm) was significantly lower than that of the control group (8.30 ± 2.28 mm). As the mastoid pneumatisation and mastoid volume increased, the percentage of ICA-dehiscence and the percentage of JB-dehiscence increased. Conclusions. In subjects with well-pneumatised mastoids, the doctors should be aware of the increased risk of ICA-dehiscence and JB-dehiscence. These measurements should be done in greater series to yield more thorough knowledge (Adv Clin Exp Med 2015, 24, 2, 315-324).
The aim of this study was to investigate the relationship between tinnitus loudness level (TLL) a... more The aim of this study was to investigate the relationship between tinnitus loudness level (TLL) and internal jugular venous flow rate (IJVFR) in tinnitus patients with a unilateral high jugular bulb detected by temporal bone high-resolution computed tomography (HRCT). The study group consisted of 24 adult patients (13 male, 11 female) with a unilateral high jugular bulb. One ear suffered from tinnitus with a high jugular bulb was included into the study group. The ears without tinnitus and no high jugular bulb on temporal bone HRCT comprised the control group. All patients were evaluated with a history and physical and otolaryngologic examinations, and, using a questionnaire, TLLs were detected. The patency and flow rates in the internal jugular veins were measured by right and left internal jugular venous Doppler ultrasonography. The TLLs were &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;very quiet&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; in 1 (4.1%) patient, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;intermediate loud&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; in 17 (70.9%) patients, and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;very loud&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; in 6 (25.0%) patients. IJVFRs were not different in the study and control groups. In the study group, IJVFRs were not correlated with age. There was no relationship among TLLs and IJVFRs, dominance, dehiscence, and bony septum thickness between the high jugular bulb and the middle ear. TLLs were not affected by IJVFRs, dominance, dehiscence, and bony septum thickness in patients with a high jugular bulb. More detailed studies should be undertaken to determine the reason for the different TLLs in patients with a high jugular bulb.
Bulletin (Hospital for Joint Diseases (New York, N.Y.)), 2005
Computed tomography is used to assess whether ideal femoral component size in knee arthroplasty c... more Computed tomography is used to assess whether ideal femoral component size in knee arthroplasty can be made more accurately. Ideal femoral component size was measured on radiography, computed tomography, and by direct measurement of 20 cadaver femora and analyzed statistically. There was no significance between the tomographically anticipated ideal femoral component size and ideal femoral size values (Wilcoxon W 388.5; p 0.565). There was difference between radiographically anticipated ideal femoral size and ideal femoral size values (Wilcoxon W 324.5; p 0.020). Anticipating the ideal femoral size can be made more precisely with computed tomography than radiographs in cadaver femora. Anticipating the ideal femoral component size by computed tomography may solve the problems in "in-between sizes." Future total knee designs may be manufactured in more anatomic sizes.
Diagnostic and interventional radiology (Ankara, Turkey), 2005
Early-enhancing areas that are perfusion abnormalities rather than tumor deposit are sometimes en... more Early-enhancing areas that are perfusion abnormalities rather than tumor deposit are sometimes encountered on arterial dominant-phase images in multisection dynamic magnetic resonance imaging. Focal sparing in diffusely fatty liver is also a well recognized entity. However, both conditions occasionally create problems in the diagnosis of hepatic mass lesions. Familiarity with these abnormalities on ultrasonography and multisection dynamic magnetic resonance images is important to prevent misinterpretation of these pseudolesions as real masses. In addition, focal sparing can be the only clue for a space occupying lesion in the liver. We present here the ultrasonography and magnetic resonance imaging findings of a case with liver metastasis from pancreas cancer which caused a wedge-shaped fat-spared enhancing area on dynamic magnetic resonance imaging.
Tanısal ve girişimsel radyoloji : Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı, 2004
To test if the apparent diffusion coefficient (ADC) values reflect the ultrastructural changes of... more To test if the apparent diffusion coefficient (ADC) values reflect the ultrastructural changes of normal appearing white and gray matter with advancing age. We selected 45 patients with normal MRI and DW imaging findings. DW and MRI imaging was performed and for each patient the average ADC on trace images of the frontal and occipital white matter and the thalamus were compared with increasing patient age. The average ADC value was 0.753+/-0.054 x 10-3 mm2/sec in frontal white matter, 0.673+/-0.085 x 10-3 mm2/sec in occipital white matter, and 0.763+/-0.063 x 10-3 mm2/sec in the thalamus. For white matter, ADC values increased with advancing age. Although ADC tended to increase with age, comparison of individual thalamic ADC and patient ages did not reach statistical significance. Advancing age is associated with a small but statistically significant increase of water diffusibility in human white matter. This increase may reflect mild structural changes with normal aging.
Tanısal ve girişimsel radyoloji : Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı, 2004
The frequency of anatomic variations of the colon detected on abdominal CT scans was examined. 29... more The frequency of anatomic variations of the colon detected on abdominal CT scans was examined. 296 consequtive abdominal tomography were evaluated prospectively for the presence of retrorenal colon, retrogastric (pancreaticogastric interposition or retrosplenic) colon, high positioned colon, interposition of the colon between the psoas muscle and the kidney and hepatodiaphragmatic interposition (anterior or posterior). We observed 2 retrogastric colon [1 pancreaticogastric (0.3%), 1 retrosplenic (0.3%)], 7 retrorenal colon (1.2%) being bilateral in two cases, 2 interposition of colon between the psoas muscle and the kidney (0.7%), 1 posterior (0.3%) and 6 anterolateral hepatodiaphragmatic interposition (2.1%) and 12 high positioned cecum (4.2%) (in 4 of them cecum was totally subhepatic in location). Terminal ileum was lying in Morrison's pouch and anterior to renal hilus in two of the cases with subhepatic cecum. Anatomic variations of the colon probably result due to mild embr...
Penile metastatic tumors are relatively infrequent and very rare compared to extraurogenital tumo... more Penile metastatic tumors are relatively infrequent and very rare compared to extraurogenital tumor metastasis. We present an interesting rare occurrence of a late penile metastasis on an adenocarcinoma of the rectum.
Ossifying fibroma is a rare benign neoplasm that usually affects mandibular and maxillary bones. ... more Ossifying fibroma is a rare benign neoplasm that usually affects mandibular and maxillary bones. In this report, we present a case of sinonasal ossifying fibroma with fluid-fluid levels and posterior extension toward the torus tubarius on MR images.
The cricoarytenoid (CA) joint involvement in rheumatoid arthritis (RA) is not uncommon. In this s... more The cricoarytenoid (CA) joint involvement in rheumatoid arthritis (RA) is not uncommon. In this study, clinical assessment, laryngeal endoscopy, and high-resolution computed tomography (HRCT) were used in 15 patients with RA to evaluate the diagnostic criteria of CA joint involvement. Symptoms owing to CA joint involvement were present in 66.6% of the patients. The frequency of involvement was 13.3% on laryngeal endoscopy but 80.0% with HRCT assessment. The most common HRCT findings were CA prominence (46.6%), density and volume changes (46.6%), and CA subluxation (39.9%). In some of the patients, soft tissue swelling (20%) near the CA joint and narrowing in the piriform sinus (33.3%) were also observed. Radiologic abnormalities related to CA joint involvement generally precede clinical symptomatology. Therefore, HRCT evaluation may be a useful method in the assessment of CA joint involvement in RA patients to exclude possible causes of laryngeal signs and symptoms.
Abscess as a complication of extracorporeal shock wave lithotripsy is a rare condition. We presen... more Abscess as a complication of extracorporeal shock wave lithotripsy is a rare condition. We present the computed tomography findings of an abdominal wall abscess that occurred after extracorporeal shock wave lithotripsy for which prophylactic antibiotics had not been given. The abscess destroyed the posterior abdominal wall muscles and dissected into the thorax. The muscles were thickened and showed enhancement. A parenchymal defect in the right kidney adjacent to a caliceal stone, with strands extending from this defective region to the abscess, was observed, and was thought to be the result of parenchymal destruction caused by the shock waves. Other parts of the kidney and psoas muscle were normal. Microbiologic examination revealed Escherichia coli.
Endosalpingiosis is characterized by the presence of benign glands lined by tubal-type epithelium... more Endosalpingiosis is characterized by the presence of benign glands lined by tubal-type epithelium involving the pelvic and lower abdominal peritoneum and pelvic and para-aortic lymph nodes in women. Rarely, cystification can occur, resulting in a neoplasm-like mass associated with clinical manifestations, an intraoperative abnormality, or a striking finding on gross examination. Here we report the transvaginal ultrasound, magnetic resonance imaging and histopathological appearance of an unusual case of cystic endosalpingiosis involving the right ovary and full thickness of the wall of the uterine fundus in a patient who presented with a 6-month history of menorrhagia and pelvic pain. Clinicians should be aware of this type of uterine benign manifestation so as to refrain from overtreatment. Copyright 2008 ISUOG.
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