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    Cervical Spinal Meningioma Mimicking Intramedullary Spinal Tumor
    (Lippincott Williams & Wilkins, 2009) Senturk, Senem; Guzel, Aslan; Guzel, Ebru; Bayrak, Aylin Hasanefendioglu; Sav, Aydin
    Study Design. Case report. Objective. To report a very unusual spinal meningioma, mimicking an intramedullary spinal tumor. Summary of Background Data. Spinal meningiomas, usually associated with signs and symptoms of cord or nerve root compression, are generally encountered in women aged over 40. Radiologic diagnosis is often established by their intradural extramedullary location on magnetic resonance images. Methods. A 60-year-old woman had a 6-month history of progressive weakness in her upper extremities, difficulty in walking, and cervical pain radiating through both arms. Neurologic examination revealed motor strength deficiency in all her extremities, with extensor reflexes, clonus, and bilateral hyper-reflexiveness. A sensory deficit was present all over her body. Magnetic resonance images revealed that the spinal cord appeared expanded with an ill-defined, homogeneously contrast-enhanced, lobulated, eccentric mass at the C1-C3 level. The patient was operated with a preliminary diagnosis of an intramedullary tumor. Results. At surgery, the mass was found to be extramedullary, and gross total resection was performed. Histopathological examination revealed a meningioma characterized by the presence of fibrous and meningothelial components. The patient was able to ambulate with a cane, and extremity strength and sensation improved 2 months after surgery. Conclusion. Spinal meningiomas can mimic intramedullary tumors, and should be considered in differential diagnosis of intradural tumors with atypical appearance.
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    Diameters of normal thoracic vascular structures in pediatric patients
    (Springer France, 2009) Akay, Hatice Ozturkmen; Ozmen, Cihan Akgul; Bayrak, Aylin Hasanefendioglu; Senturk, Senem; Katar, Selahattin; Nazaroglu, Hasan; Taskesen, Mustafa
    Purpose To determine the normal range of aortic and pulmonary artery diameters on chest CT, and to search a constant ratio when the diameters of thoracic vascular structures are compared with an internal reference. Methods Contrast-enhanced chest CT scans of 133 pediatric patients were retrospectively evaluated. Diameters of ascending and descending aorta, main pulmonary artery, right and left pulmonary arteries and a constant thoracic vertebra were measured. The mean ratios of thoracic vascular diameters to the diameter of the thoracic vertebra were calculated. Results There was a positive correlation between the age of the patients and vascular diameters. The mean ratios of vascular diameters to the diameter of thoracic vertebra, ranged from 1.1 for the ascending aorta to 0.70 for the right and left pulmonary arteries, were consistent. Conclusions Diameters of thoracic vascular structures increase with age. The consistent vertebral to vessel ratios can be useful in evaluation of chest CT of pediatric patients.
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    Factor X Deficiency Presenting with Bilateral Chronic Subdural Hematoma
    (Karger, 2010) Senturk, Senem; Guzel, Ebru; Bayrak, Aylin Hasanefendioglu; Bukte, Yasar; Guzel, Aslan
    Factor X deficiency is a rare coagulation defect that can result in several hemorrhagic manifestations including central nervous system hematomas in infants and children. In this case report, we present computed tomography (CT) and magnetic resonance (MR) imaging findings of bilateral chronic subdural hematomas due to factor X deficiency. Cranial CT and MR imaging in a hypoactive 7-month-old male infant with right hemiparesis revealed bilateral chronic subdural hematomas at different stages. Laboratory findings showed a severe factor X deficiency, with a level of 0.7%. After fresh frozen plasma replacement, the patient was operated and the large hematoma on the left side evacuated. The patient recovered uneventfully and remained asymptomatic during the 1-year follow-up. Copyright (C) 2010 S. Karger AG, Basel
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    The frequency of intracranial arterial fenestrations: A study with 64-detector CT-angiography
    (Elsevier Ireland Ltd, 2011) Bayrak, Aylin Hasanefendioglu; Senturk, Senem; Akay, Hatice Ozturkmen; Ozmen, Cihan Akgul; Bukte, Yasar; Nazaroglu, Hasan
    Fenestration is a vascular variation that begins with a common origin, then splits into two parallel luminal channels and rejoins distally. Potential association between anomalies of cerebral circulation and increased occurrence of aneurysm makes intracranial arterial fenestrations important. The planning of intracranial arterial interventions may be complicated if a fenestration occurs proximal to the site of intended treatment. This study is planned to determine the frequency of fenestrations on CT angiography and to search whether there is relationship between aneurysms and fenestrations. CT angiographies of 395 consecutive patients, performed by 64-detector CT, were retrospectively reviewed for aneurysms and fenestrations. Overall fenestration frequency, fenestration frequency in patients with and without aneurysm, and aneurysm frequency in patients with and without fenestration were searched. Demographic characteristics of patients were also compared. Overall fenestration frequency was 12.9%. Vertebrobasilar system (5.56%) and anterior communicating region (5.32%) were the two most frequent sites of fenestration. The rate of fenestrations was not significantly different between patients who had and did not have aneurysms. Mean age was significantly higher, and females were predominant in patients with aneurysms. However our results did not show significant difference in age and sex of patients with fenestrations. The frequency of fenestrations in this study is higher than in previously published radiological studies, suggesting that fenestrations are relatively common. There is no significant relationship between the frequency of aneurysms and fenestrations. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
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    MDCT Findings of Denim-Sandblasting-Induced Silicosis: a cross-sectional study
    (Bmc, 2010) Ozmen, Cihan Akgul; Nazaroglu, Hasan; Yildiz, Tekin; Bayrak, Aylin Hasanefendioglu; Senturk, Senem; Ates, Gungor; Akyildiz, Levent
    Background: Denim sandblasting is as a novel cause of silicosis in Turkey, with reports of a recent increase in cases and fatal outcomes. We aimed to describe the radiological features of patients exposed to silica during denim sandblasting and define factors related to the development of silicosis. Methods: Sixty consecutive men with a history of exposure to silica during denim sandblasting were recruited. All CT examinations were performed using a 64-row multi-detector CT (MDCT). The nodules were qualitatively and semi-quantitatively analyzed by grading nodular profusion (NP) on CT images. Results: Silicosis was diagnosed radiologically in 73.3% of patients (44 of 60). The latency period (the time between initial exposure and radiological imaging) and duration of silica exposure was longer in patients diagnosed with silicosis than in those without silicosis (p < 0.05). Nodules were present in all cases with centrilobular type as the commonest (63.6%). All cases of silicosis were clinically classified as accelerated and 11.4% had progressive massive fibrosis (PMF). Mild NP lesions were the most prevalent in all six zones of the lung. The NP score was significantly correlated with the duration of silica exposure, the latency period, presence of PMF, and pleural thickening. Enlarged lymphadenopathy was present in 45.5% of patients. Conclusions: The duration of exposure and the latency period are important for development of silicosis in denim sandblasters. MDCT is a useful tool in detecting findings of silicosis in workers who has silica exposure.
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    Occult bleeding of small bowel: endovascular embolization and literature review
    (Wiley, 2009) Bayrak, Aylin Hasanefendioglu; Cantasdemir, Murat; Bas, Ahmet; Numan, Furuzan
    [Abstract Not Available]
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    Percutaneous transluminal angioplasty in pediatric patients with Takayasu arteritis: comparison of initial and long- term results of interventions on aorta and non-aortic vessels
    (Turkish Soc Cardiology, 2010) Numan, Fueruzan; Bayrak, Aylin Hasanefendioglu; Cantasdemir, Murak; Ozer, Harun; Gulsen, Fatih
    [Abstract Not Available]
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    Sonographic assessment of fatty liver: intraobserver and interobserver variability
    (E-Century Publishing Corp, 2014) Cengiz, Mustafa; Senturk, Senem; Cetin, Bulent; Bayrak, Aylin Hasanefendioglu; Bilek, Senem Uysal
    Non-alcoholic fatty liver disease (NAFLD) is a common liver disease worldwide and ultrasonography is widely used in the diagnosis and the follow-up we purposed to assess intraobserver and interobserver variability in the sonographic evaluation of the existence and steatosis grades of NAFLD. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels and AST to ALT (AST/ALT) ratio were compared between the grades of hepatosteatosis. Hepatic ultrasonography (US) examinations consisted of 5-10 static images of 113 successive adult patients, whose records were in the picture archiving and communication system (PACS) of our hospital were retrospectively evaluated by two experienced radiologists. Hepatic images were graded into 4 groups; as normal, mild, moderate or severe hepatic steatosis. Evaluation of hepatic steatosis of the same set of images was repeated after one month under the same conditions. Interobserver and intraobserver agreement was assessed by using kappa (kappa) statistics. In each group, the percentage of individuals with high ALT and/or AST, or AST/ALT ratio over 1 was calculated. The intraobserver agreement was 51%, fair kappa (kappa=0.356) for observer 1; and 68%, moderate (kappa=0.591) for observer 2. The interobserver agreements in the initial and second readings were 39% and 40%, fair (kappa=0.208) and (kappa=0.225), respectively. Elevations of ALT and/or AST levels were similar between groups depending on the degree of hepatosteatosis among the patients. Visual assessment of NAFLD by ultrasonography has substantial interobserver variability, and reproducibility of results is limited. More objective imaging modalities are needed to evaluate the degree of hepatosteatosis.