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3-T MRI of the biliary tract variations
(Springer France, 2013) Onder, Hakan; Ozdemir, Muhammed Siddik; Tekbas, Guven; Ekici, Faysal; Gumus, Hatice; Bilici, Aslan
The gallbladder and the biliary tract are structures in close connection with the adjacent organs and may show a number of variations and anomalies. It is therefore important for surgical purposes to know their anatomy and variations in detail. Various methods are used in the imaging of the variations of the biliary tract and its pathologies, including ultrasonography, computed tomography; direct cholangiographic methods like endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, intravenous cholangiography and T-tube cholangiography, as well as indirect methods like magnetic resonance cholangiopancreatography (MRCP) or cholescintigraphy. The aim of this study is to investigate the frequency of the anatomic variations of the biliary tract using 3-T MRCP and to compare the findings with the data in the literature. For the purposes of this study, patients who underwent MRCP at our hospital (Dicle University Hospital) between November 2009 and February 2012 were investigated retrospectively. A total of 590 patients (between 6 and 88 years of age; mean age: 51 +/- A 9 years) were included in the study. The MRCP imaging was carried out with an magnetic resonance imaging (MRI) device supplied with 3-T magnetic power and by obtaining T2-weighted images through the single-shot fast spin echo technique using the standard body coil. The axial and coronal source images and the reformatted images were evaluated together in terms of the possible anatomic variations. Among the 590 patients included in the study, of 233 (39.5 %) showed anatomic variations at different levels in the intra- and extrahepatic biliary tracts. Among these variations, a right posterior hepatic duct insertion to the left hepatic duct at the level of the bifurcation has been observed in 71 patients (12.1 %), trifurcation was observed in 30 patients (5.1 %) and insertion into the main hepatic duct at the proximal aspect of the cystic duct was observed in 18 patients (3.1 %). At the level of the cystic duct, medial insertion of the cystic duct was viewed in 58 patients (9.8 %), distal medial insertion was seen in 40 patients (6.8 %), a short cystic duct was detected in 10 patients (1.7 %), pancreatobiliary junction anomaly was viewed in two patients (0.4 %) and duplicate anatomic variations have been observed in 42 patients (7.2 %). MRCP studies conducted using 3-T MRI devices may reveal similar or greater numbers of variations when compared to the existing MRCP studies in the literature. 3-T MRI shows a couple of variations. Pointing out these anatomical variations before the surgical intervention may prevent possible iatrogenic traumas. Donors with unsuitable variations for liver transplant may be spotted out at an early phase through the MRCP and certain operations with a high morbidity rate may thus be avoided.
64-MDCT Pulmonary Angiography and CT Venography in the Diagnosis of Thromboembolic Disease
(Amer Roentgen Ray Soc, 2009) Nazaroglu, Hasan; Oezmen, Cihan Akguel; Akay, Hatice Oeztuerkmen; Kilinc, Ilhan; Bilici, Aslan
OBJECTIVE. The purpose of our study was to investigate whether CT venography (CTV) performed after CT pulmonary angiography (CTPA) using 64-MDCT provides additional findings in the diagnosis of thromboembolic disease. MATERIALS AND METHODS. Three hundred six consecutive patients in whom pulmonary embolism (PE) was clinically suspected were included in the study. The study group was classified according to the diagnostic quality of the CTPA examinations, the presence or absence of PE and deep venous thrombosis (DVT), and the most proximal localization that the embolus could lodge in the pulmonary artery. RESULTS. The diagnostic quality of CTPA was insufficient in 5.9%, acceptable in 8.2%, and excellent in 85.9% of the patients. The diagnostic quality of CTV was insufficient in 11.4%, acceptable in 47.4%, and excellent in 41.2%. The percentages of nondiagnostic examinations for CTPA and CTV were 5.2% and 10.8%, respectively. Acute PE and acute DVT were observed in 25.2% and 18.0%, respectively. The percentage of subsegmental emboli among patients with acute PE was 15.6%. The percentage of patients with thromboembolic disease was 29.1%. Of patients who were diagnosed as having thromboembolic disease, 13.5% (12 of 89 patients) had DVT only. Of all patients, 3.9% (12 of 306) had only isolated DVT. The number of patients with subsegmental PE who had DVT was two (0.7% all patients). CONCLUSION. As in MDCT scanning with a smaller number of slices, the combination of CTV with CTPA in 64-MDCT results in a small but definitive increase in the percentage of patients with a diagnosis of thromboembolic disease.
Abdomen çok kesitli bilgisayarlı tomografi ile saptanan kolonun anatomik varyasyonları
(Dicle Üniversitesi Tıp Fakültesi, 2012) Gümüş, Hatice; Kuday, Suzan; Hamidi, Cihad; Özdemir, Muhammed Sıddık; Önder, Hakan; Tekbaş, Güven; Bilici, Aslan
Giriş: Bu çalışmanın amacı kolonun anatomik varyasyonlarının sıklığını ve klinik önemini belirlemektir. Gereç ve yöntem: Ocak 2010-Eylül 2011 tarihleri arasında, radyoloji bölümünde, farklı nedenlerden dolayı abdomen çok kesitli bilgisayarlı tomografi (ÇKBT) çekilmiş, 1300 hasta retrospektif olarak, kolonun anatomik varyasyonları açısından incelendi. Bulgular: ÇKBT çekilmiş 1300 hastanın, 640’ı kadın ve 660’ı erkek idi. Ortalama yaş 43,02 yıl (2-92) idi. Kolon varyasyonlarının sayısı: 34 (% 2,6) anterior, 14 (% 0,9) posterior hepatodiyaframatik, 40 (% 3) sağ böbrek-psoas interpozisyonu, 3 (% 0,2) sol böbrek-psoas interpozisyonu, 4 (% 0,3) sağ retrorenal, 16 (% 1,2) sol retrorenal, 2 (%0,2) bilateral, 10 (% 0,8) pankreatikogastrik, 5 (% 0,4) retosplenik kolon ve 64 (% 4,9) yüksek yerleşimli çekum. Sonuç: Kolonun anatomik varyasyonlarının bilinmesi cerrahi ve girişimsel radyolojik işlemlerde önemlidir. ÇKBT bu varyasyonların ayrıntılı bir şekilde gösterilmesine olanak sağlamaktadır.
Abscess formation as a complication of a ruptured urachal cyst
(Springer Heidelberg, 2007) Ilica, A. Turan; Mentes, Oner; Gur, Serkan; Kocaoglu, Murat; Bilici, Aslan; Coban, Hidayet
The urachus is a midline tubular structure that extends upward from the dome of the bladder toward the umbilicus. This tubular structure normally involutes before birth, remaining as a fibrous band with no known function. Persistence of all or any portion of the fetal urachus results in several anomalies, the most common of which is the urachal cyst (Yu JS, Kim KW, Lee HJ, Lee YJ, Yoon CS, Kim MJ, Radiographics, 21: 451-4611, 2001; Ohgaki M, Higuchi A, Chou H, Takashina K, Kawakami S, Fujita Y, Hagiwara A, Yamagishi H, Surg Today, 33: 75-77, 2003). Although most urachal cysts are asymptomatic, there are a few reports about intraperitoneal rupture of infected urachal cysts, all of which caused peritonitis and sepsis (Ohgaki M, Higuchi A, Chou H, Takashina K, Kawakami S, Fujita Y, Hagiwara A, Yamagishi H, Surg Today, 33: 75-77, 2003; Kojima Y, Miyake O, Taniwaki H, Morimoto A, Takahashi S, Fujiwara I, Int J Urol, 10: 174-176, 2003; Agatstein EH, Stabile BE, Arch Surg, 119: 1269-1273, 1984). We report the imaging and operative findings of a patient, presented with a urachal abscess after a spontaneously ruptured urachal cyst.
Anlamlı karotid arter darlığı olmayan olgularda Doppler akım hızları ve rezistans indekslerinin koroner arter hastalığı ile ilişkisi
(2001) Toprak, Nizamettin; Ülgen, Mehmet Sıddık; Sucu, Murat; Bilici, Aslan; Acar, Murat; Önder, Hakan
Amaç: Bu çalışmada anlamlı karotid arter darlığı olmayan olgularda karotid arter akım hızları ve rezistans indeksleri (RI) ile koroner arter hastalığı (KAH) arasındaki olası ilişki araştırılmıştır. Yöntem: Çalışma KAH ön tanısı ile koroner anjiografi yapılan 74'ü erkek olan 114 olgu (yaş ortalaması 53Æ10, yaş aralığı 33-72) üzerinde yapıldı. Anjiografi öncesi sağ, sol ana karotid arterler (sağ-sol CCA) ve sağ, sol internal karotid arterler (sağ-sol ICA) akım hızları ve RI Doppler ultrasonografi (US) ile ölçüldü. Olgular KAH varlığı ve hastalıklı koroner arter sayısına göre gruplandırılarak Doppler parametreleri ve ejeksiyon fraksiyonu (EF) yönünden karşılaştırıldı. Bulgular: Otuz üç olguda koroner arterlerde daralma saptanmazken (normal grup), 81 olguda anlamlı koroner arter darlığı saptandı (22 olguda bir arterde, 27 olguda iki arterde ve 32 olguda üç koroner arterde). Akım hızları Kah olan grupta anlamlı olarak daha düşük, RI ise daha yüksek bulundu. Akım hızları normal grup;ta en yüksek 3 damar hastalığı (DH) olan grupta en düşüt.ü RI ise normal grupta en düşük iken 3 DH olan grupta en yüksekti. Korelasyon analizinde yaş, EF ve hastalıklı damar sayısı ile özellikle minimal akım hızları arasında ters, RI değerleri arasında doğru ve anlamlı korelasyon saptandı. Sonuç: Bu çalışma bu konu ile ilgili ilk çalışma olup elde edilen bulgular; KAH varlığı ve aterosklerozun yaygınlığının Doppler US ile ölçülen CCA, ICA akım hızları ve RI değerlerini değiştirdiğini düşündürmektedir.
Aortofemoral by-pass cerrahisinin nadir bir komplikasyonu: Hidroüretronefroz
(2013) Yavuz, Celal; Tekbaş, Ebru; Önder, Hakan; Tekbaş, Güven; Bilici, Aslan; Ekici, Faysal
Üreterin obstürüksiyonuna sekonder hidronefrozun birçok nedeni bulunmakla birlikte aortofemoral greftoklüzyonuna sekonder hidroüreteronefroz sıralamanın oldukça sonlarındadır. İlk 1960'lı yıllarda raporedilen greft kompresyonuna sekonder hidroüreteronefroz son yıllarda nadiren rapor edilmektedir. Buyazıda aortofemoral bypass cerrahisi geçirmiş, intermittant klaudikasyo ile kliniğe başvuran, 62yaşındaki erkek hastada, insidental saptanan hidroüreteronefroz literatür eşliğinde sunulmuştur.
Aortofemoral by-pass cerrahisinin nadir bir komplikasyonu: hidroüretronefroz Türkçe
(Harran Üniversitesi, 2013) Tekbaş, Güven; Tekbaş, Ebru; Önder, Hakan; Ekici, Faysal; Yavuz, Celal; Bilici, Aslan
Üreterin obstürüksiyonuna sekonder hidronefrozun birçok nedeni bulunmakla birlikte aortofemoral greft oklüzyonuna sekonder hidroüreteronefroz sıralamanın oldukça sonlarındadır. İlk 1960'lı yıllarda rapor edilen greft kompresyonuna sekonder hidroüreteronefroz son yıllarda nadiren rapor edilmektedir. Bu yazıda aortofemoral bypass cerrahisi geçirmiş, intermittant klaudikasyo ile kliniğe başvuran, 62 yaşındaki erkek hastada, insidental saptanan hidroüreteronefroz literatür eşliğinde sunulmuştur
Are Breast Masses in Teenagers Always Benign? Undifferentiated Mesenchymal Sarcoma in a 14-Year-Old Girl
(Karger, 2012) Tekbas, Guven; Ince, Tulay; Kapan, Murat; Ekici, Faysal; Onder, Akin; Kucukonen, Mehmet; Bilici, Aslan
Background: This article is concerned with the evaluation of an adolescent breast mass using imaging methods. Case Report: A 14-year-old girl presented with progressive asymmetric enlargement of the left breast. She had felt a breast lump about 4 months earlier, and over the last 2 months it had been growing progressively. Tumor markers, including AFP, CEA, CA15-3, and CA125, were all normal. Ultrasonography showed a hypoechoic-hyperechoic, solid mass. Magnetic resonance imaging of the breast revealed a well marginated mass with hypointensity on T1-weighted images and mild hyperintensity on T2-weighted images, which showed mild contrast uptake. Biopsy revealed an undifferentiated malignant mesenchymal sarcoma. The patient underwent mastectomy with axillary lymph node sampling. After the operation, she received 3 cycles of chemotherapy and radiotherapy. Conclusion: Due to the rarity of breast sarcoma and inadequate imaging methods to establish an exact diagnosis, radiologists and clinicians may misdiagnose and merely follow these tumors. As in our case, the histology of the patient may be the leading factor in the management of these tumors. Even in very young patients, progressively growing breast masses should alert the clinician to check for malignancy verified by biopsy.
Arterial distensibility in patients with ruptured and unruptured intracranial aneurysms: Is it a predisposing factor for rupture risk?
(Int Scientific Information, Inc, 2013) Dusak, Abdurrahim; Kamasak, Kaan; Goya, Cemil; Adin, Mehmet E.; Elbey, Mehmet A.; Bilici, Aslan
Background: A risk factor assessment that reliably predicts whether patients are predisposed to intracranial aneurysm (IA) rupture has yet to be formulated. As such, the clinical management of unruptured IA remains unclear. Our aim was to determine whether impaired arterial distensibility and hypertrophic remodeling might be indicators of risk for IA rupture. Material/Methods: The study population (n=49) was selected from consecutive admissions for either unruptured IA (n=23) or ruptured IA (n=26) from January to December 2010. Hemodynamic measures were taken from every patient, including systolic and diastolic blood pressure using a sphygmomanometer. Unruptured IA and ruptured IA characteristics, including aneurysmal shape, size, angle, aspect ratio, and bottleneck factor, were measured and calculated from transverse brain CT angiography images. With ultrasound, the right common carotid artery intima-media thickness was measured, as well as the lumen diameter during systole and diastole. Arterial wall strain, distensibility, stiffness index, and elastic modulus were calculated and compared between patients with unruptured IAs and ruptured IAs. A p-value less than 0.05 was considered statistically significant. Results: General demographic data did not differ between patients with unruptured IAs and ruptured IAs. Greater mean intima-media thickness (p=0.013), mean stiffness index (p=0.044), and mean elastic modulus (p=0.026) were observed for patients with ruptured IAs. Moreover, mean strain (p=0.013) and mean distensibility (p=0.024) were decreased in patients with ruptured IAs. Conclusions: Patients with ruptured IAs demonstrated decreased arterial distensibility and increased intima-media thickness at the level of the carotid arteries. By measuring these parameters via ultrasound, it may be possible to predict whether patients with existing IAs might rupture and hemorrhage into the subarachnoid space.
The association between varicocele and ankylosing spondylitis via color duplex sonography
(Springer, 2014) Hamidi, Cihad; Batmaz, Ibrahim; Gumus, Hatice; Penbegül, Necmettin; Cetincakmak, Mehmet Guli; Tahtasiz, Mehmet; Bilici, Aslan
Objective To evaluate the relationship between varicocele and ankylosing spondylitis (AS) via color duplex sonography (CDS). Methods Thirty male patients (age range 18-40 years, mean age 30.27 years) with AS and 30 male healthy controls (age range 20-36 years, mean age 27.23 years) were evaluated for varicocele using CDS. Results Vein diameter in right and left pampiniform plexus (PP) in the AS group was significantly higher than in the control group (p < 0.001 and p = 0.003, respectively). The incidence of varicocele was observed as 33.3 % in the AS group and 10 % in the control group. However, the difference was statistically significant (p = 0.028). The rate of right, left, and bilateral varicocele was 3.3 % (1 patient), 23.3 % (7 patients), and 6.6 % (2 patients), respectively, in the AS group, versus 0, 10, and 0 % in the control group (p = 1.000, p = 0.166, and p = 0.492, respectively). Conclusions The incidence of varicocele in AS patients is higher than in control subjects, and the difference is statistically significant. Therefore, varicocele must be taken into consideration and investigated in patients with AS.
Blue rubber bleb nevus syndrome
(2003) Dursun, Mehmet; Canoruç, Fikri; Tuzcu, Alpaslan; Yılmaz, Şerif; Bilici, Aslan
Amaç: Blue rubber bleb nevus sendromu (BRBNS) gastrointestinal sistem ve deride hemanjiomlarla karakterize nadir bir durumdur. Bu hemanjiomlar gastrointestinal kanama ve anemiye neden olabilirler. Olgu: On dokuz yaşında bir erkek hasta kliniğimize anemiyle başvurdu. Fizik muayenede konjonktival solukluk, auri-kulada insizyon skarı ve sağ el sırtı, sağ ayak baş parmağı ve gluteal bölgede hemanjiomlar mevcuttu. Laboratuvarda demir eksikliği anemisi saptandı. Kolonoskopik bakıda kolon ve rektumun tüm alanlarında histolojik olarak ispatlanan hemanjiomlar mevcuttu. BRBNS'u demir eksikliği anemisinde nadir sebep olarak göz önünde bulundurulmalıdır.
Blue rubber bleb nevus syndrome: imaging of small bowel lesions with peroral CT enterography
(Springer, 2011) Senturk, Senem; Bilici, Aslan; Miroglu, Tugba Cezlan; Bilek, Senem Uysal
Blue rubber bleb nevus syndrome (BRBNS) is a rare entity that consists of multiple venous malformations involving several organ systems, particularly the skin and the gastrointestinal tract. The diagnosis is based on clinical findings; however, imaging is required to investigate the extent of involvement and complications. A 17-year-old patient, with multiple blue skin nevus, was admitted to the emergency room of our hospital with severe gastrointestinal bleeding and melena. Upper endoscopy showed two wine-color vascular lesions in the duodenum, and colonoscopy revealed multiple lesions in the colon. Peroral CT enterography demonstrated multiple (more than 30) contrast-enhanced polypoid small bowel lesions, ranging in size from 5 to 16 mm. Some lesions contained millimetric calcifications representing phleboliths. The patient also had three pancreatic lesions which showed homogenous enhancement on the delayed images. Our findings show that peroral CT enterography is useful to demonstrate the extent of small bowel lesions of BRBNS. This is the first report of pancreatic involvement of BRBNS.
Clinical and multidetector computed tomography findings of patients with median arcuate ligament syndrome
(Elsevier Science Inc, 2012) Gumus, Hatice; Gumus, Metehan; Tekbas, Guven; Onder, Hakan; Ekici, Faysal; Cetincakmak, Mehmet Guli; Bilici, Aslan
Objectives: The present study aimed to present the clinical and multidetector computed tomography (MDCT) findings of patients who were diagnosed with the median arcuate ligament (MAL) syndrome on MDCT retrospectively. Methods: Seven hundred forty-four patients in whom MDCT angiography was performed were retrospectively analyzed for investigating incidental MAL syndrome. Results: Twenty-one patients were shown to have MAL syndrome. Of 21 patients, 18 with MAL syndrome were asymptomatic. Three patients had some symptoms. On MDCT angiography, proximal narrowing of the arteries was observed in 21 patients. Conclusions: MDCT is a minimally invasive and useful tool for the diagnosis of MAL syndrome. (c) 2012 Elsevier Inc. All rights reserved.
Comparison of 3.0-T MRI findings in drug resistant and non-resistant adult epileptic patients
(2013) Ekici, Faysal; Tekbaş, Güven; Önder, Hakan; Gümüş, Hatice; Çetinçakmak, Mehmet Güli; Balık, Suzan K.; Acar, Abdullah; Hamidi, Cihat; Bilici, Aslan; 0000-0002-4293-1335
Epilepsy is a common chronic disease characterized by spontaneous and recurrent seizures. Along with the increases in life expectancy, the prevalence of epilepsy in adults increased in parallel. 3.0-T MRI provides high signal/noise ratio and is an important tool in the determination of epileptic lesion in epilepsy patients. Our aim in this study was to research and compare 3.0-T MRI findings of Turkish epileptic patients that are resistant and non-resistant to medical treatment. 3.0-T MRI images from 264 consecutive patients, of which 150 were males and 114 were females (age range 18-82 years; mean age 31.3 years) were examined, retrospectively. Among those patients, 94 were resistant to medical treatment (DRE+) and 170 were non-resistant (DRE-). Epileptic lesion was determined in 119 of the patients. Epileptic lesion was determined in sixty-three patients who were resistant to medical treatment and in fifty-six patients who were non-resistant. Epileptic lesion was determined in approximately half of the adult epilepsy patients by using 3.0-T MRI. This study demonstrates a high prevalence of brain abnormalities in Turkish epileptic patients with DRE+. The lesion was determined in 67% of patients with medical treatment resistance, while the percentage for the other group was only 32.9%. The ratio of epileptic lesion determination by using 3.0-T MRI was quite higher in the medical treatment resistant group than the non-resistant group.
CT and MR imaging of chronic subdural haematomas: a comparative study
(E M H Swiss Medical Publishers Ltd, 2010) Senturk, Senem; Guzel, Aslan; Bilici, Aslan; Takmaz, Ilker; Guzel, Ebru; Aluclu, M. Ufuk; Ceviz, Adnan
Questions under study/principles: This study was designed to compare CT and MR appearances of chronic subdural haematomas as well as CT- and MR-guided measurements of haematoma thicknesses. Methods: CT and MR images of 48 chronic subdural haematomas of 34 patients were reviewed retrospectively. The thickness measurements and imaging characteristics of haematomas were compared. Results: Levelling was observed in 25% of haematomas, and most of them (60%) had intra-haematomal membranes. All membranes could be delineated by MR imaging, whereas only 27% were defined by CT. Mixed density (52%) and T1 hyperintensity (59%) were commonly observed in membraned haematomas, but the difference was not statistically significant. Haematomas were measured significantly thicker on MR images. All patients had been treated with burr-hole craniotomy and irrigation. Conclusions: MR imaging is more sensitive than CT in determining the size and internal structures of chronic subdural haematomas.
Diagnosis of pre-eclampsia and assessment of severity through examination of the placenta with acoustic radiation force impulse elastography
(Wiley, 2016) Alan, Bircan; Tunc, Senem; Agacayak, Elif; Bilici, Aslan
Objective: To assess the value of placental shear wave velocity (SWV) measurement by acoustic radiation force impulse (ARFI) imaging for the diagnosis of pre-eclampsia and to determine the relationship between the SWV and the severity of pre-eclampsia. Methods: A prospective study was performed at a center in Turkey between August 2014 and March 2015. The study included consecutive pregnant women in the second or third trimester diagnosed with pre-eclampsia and healthy pregnant women without pre-eclampsia of similar ages. Patients with pre-eclampsia were divided into two groups (severe or mild disease) on the basis of revised American College of Obstetricians and Gynecologists criteria. All patients underwent ARFI, and the SWV was measured at several placental locations. Results: Overall, 86 women were enrolled (42 with pre-eclampsia, 44 controls). Minimum, maximum, and mean SWV values were significantly higher in the pre-eclampsia group than in the control group (P < 0.001 for all). These values were also significantly higher among patients with severe pre-eclampsia than among patients with mild pre-eclampsia (P < 0.001 for all). Conclusion: Measurement of the placental SWV with ARFI imaging is a useful additional method for the diagnosis of pre-eclampsia and for determination of the disease severity. (C) 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Diameters of the common bile duct in adults and postcholecystectomy patients: A study with 64-slice CT
(Elsevier Ireland Ltd, 2012) Senturk, Senem; Miroglu, Tugba Cezlan; Bilici, Aslan; Gumus, Hatice; Tekin, Rojbin Ceylan; Ekici, Faysal; Tekbas, Guven
This study aims to collect data by multidetector computed tomography (MDCT) on the diameter of the normal common bile duct (CBD) and the diameter of CBD after cholecystectomy. In this retrospective study, CBD measurements were performed on axial oblique images, perpendicular to the long axis of the distal CBD. The mean diameter of the normal CBD was measured in 604 patients without cholecystectomy. The patients were divided into 6 groups according to their age. Analysis of variance (ANOVA) was used to compare data obtained from the six age groups. The mean diameter of the CBD of 46 patients who had cholecystectomy was calculated. The results were compared with age matched control group by Student's t test. The largest diameter of CBD ranged from 1.8 to 11.8 mm. The mean of the largest diameter of 604 subjects was 4.77 +/- 1.81. The diameter of the CBD significantly increased with age. Mean largest CBD diameters of postcholecystectomy subjects (7.28 +/- 2.37) were significantly greater than age matched control group. In conclusion the diameter of CBD shows a considerable increase with age. The largest diameter of the CBD is up to 6 mm in most of the subjects. An upper limit of 8 mm appears reasonable after the age of 50; and an upper limit of 10 mm seems appropriate for cholescystectomized subjects. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
Dynamic multidetector computed tomography findings of hepatocellular carcinoma of hepatitis B virus-positive and -negative patients
(E-Med, 2014) Senturk, Senem; Cetin, Bulent; Cengiz, Mustafa; Bilici, Aslan; Ozekinci, Selver
Background: The objective of this study was to retrospectively investigate and compare multidetector computed tomography findings of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV)-positive and -negative patients. Methods: Triphasic (arterial, portal venous, and delayed phases) dynamic multidetector computed tomography (CT) was performed in 83 patients with HCC, 48 of whom were HBV-positive. The diagnosis of HCC was established with typical CT imaging findings (68 patients) or histopathological evaluation (15 patients). Distribution of solitary, multiple, and diffuse HCC, portal/hepatic vein thrombosis, metastasis, and patients with high alpha-fetoprotein levels in the HBV-positive and -negative groups were compared using the Kolmogorov-Smirnov test. Lesion size, alpha-fetoprotein levels, arterial, portal, delayed enhancement, and washout of lesions were compared using the Student's t-test. Results: Hypervascular tumors were observed in 72 (87%) patients, and hypovascular tumors were found in 11 (13%) patients. The mean alpha-fetoprotein value of HBV-positive patients with HCC was significantly higher than the mean alpha-fetoprotein value of HBV-negative patients (P < 0.05). Portal/hepatic vein thrombosis and metastasis were more frequently observed in HBV-positive patients (P < 0.05). The frequencies of solitary, multiple, and diffuse lesions in HBV-positive and -negative patients were not significantly different (P > 0.05). The mean diameters, arterial, portal, and delayed phase attenuations, and washout of HCC were not significantly different (P > 0.05). Conclusions: Multidetector CT imaging findings of HCC in HBV-positive and -negative patients are alike. Portal/hepatic vein thrombosis and metastasis are more frequently observed in HBV-positive patients. Alpha-fetoprotein levels are higher in HBV-positive patients.
The effect of ACE gene polymorphisms on Doppler blood flow parameters of carotid and brachial arteries in patients with myocardial infarction
(Sage Publications Inc, 2006) Bilici, Aslan; Ulgen, Mehmet Siddik; Nazaroglu, Hasan; Ozturk, Onder; Ekici, Faysal; Akgul, Cihan; Alan, Bircan
The authors investigated the relationship between the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and the blood flow characteristics of common carotid (CCA) and brachial arteries (BA) by color Doppler ultrasound (CDUS) in patients with acute anterior myocardial infarction (AAMI). Sixty four patients (11 women and 53 men), aged 25 to 77 years, with AAMI were studied. The ACE genotypes were established. Peak-systolic (PSV) and end-diastolic velocity (EDV) of right and left CCA, PSV of right BA, and intimal-medial thickness (IMT) of both CCAs were measured by CDUS. All results were evaluated statistically. The ACE genotypes were distributed as follows: 43.8% DD, 43.8% ID, and 12.5% II. PSVs of BA and both CCAs were lower in patients with DD and ID than with 11 (p < 0.05). EDVs of both CCAs were also lower in the same groups, but statistically not significant (p > 0.05). IMTs of both CCAs did not differ among patients with various ACE genotypes (p > 0.05). These results suggest that ACE I/D polymorphism influences Doppler blood flow parameters of both BA and CCA, but does not affect IMT of CCA.
The effect of alternate-day low dose prednisolone on bone age in children with steroid dependent nephrotic syndrome
(Kluwer Academic Publishers, 1997) Bircan, Zelâl; Soran, Mustafa; Yıldırım, İdris; Doğan, Sait Murat; Şahin, A.; Bilici, Aslan; Danacı, M.; 0000-0001-8840-4365
Radius, ulna, short bones (RUS), carpal (CARP) bone age (BA), tibial corticodiaphyseal (C/D) ratio and trabecular aspect were assessed in 19 children with steroid dependent nephrotic syndrome and 15 age matched healthy children. Both RUS and CARP BA were significantly lower than in the controls. Trabecular aspect and tibial C/D ratio did not show any statistical significance. There was a positive correlation between HSDS and RUS BA delay (r =0.476, p<0.05); CARP BA delay and RUS BA delay (r=0.563, p<0.01) and RUSBA and CARP BA (r=0.891, p<0.001). In conclusion, RUS and CARP BA are both retarded and positively correlated in steroid dependent nephrotic children.

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