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Öğe Accessory liver within the thoracic cavity(Springer France, 2018) Adin, Mehmet Emin; Cetincakmak, Mehmet Guli; Deniz, Muhammed Akif; Goya, CemilEctopic intrathoracic liver tissue is extremely rare. Studies are mainly limited to case reports. In the vast majority of reported cases, a diagnosis of intrathoracic liver tissue was made either after a thoracic surgery or during a postmortem examination. However, once included in differential diagnosis, surgical intervention or biopsy procedures may be avoided with optimal diagnostic approach. In the present study, we conducted a literature review and proposed a new classification method for accessory liver within the thoracic cavity. This approach may provide a better understanding of underlying pathophysiology and aid in determination of optimal diagnostic modality and clinical management of such cases. According to our literature review, type II ectopic liver is the most common subtype followed by types I and III. All types can be definitively diagnosed with imaging modalities. On the other hand, it is important to prevent patients, particularly children, from unnecessary radiation exposure during performance of sophisticated diagnostic imaging modalities. Ultrasound is a safe, low-cost and accessible imaging modality that has not been previously reported in diagnosis of this entity. With addition of Color Doppler Imaging, ultrasound may allow for diagnosis with high precision in types I and II, as demonstrated in the present study. Based on long-term follow-up of a case reported here, this study also illustrates the natural course of this entity via non-operative management. This approach may prevent an unnecessary surgical intervention.Öğe Acoustic radiation force impulse (ARFI) elastography for detection of renal damage in children(Springer, 2015) Goya, Cemil; Hamidi, Cihad; Ece, Aydin; Okur, Mehmet Hanifi; Tasdemir, Bekir; Cetincakmak, Mehmet Guli; Hattapoglu, SalihAcoustic radiation force impulse (ARFI) imaging is a promising method for noninvasive evaluation of the renal parenchyma. To investigate the contribution of ARFI quantitative US elastography for the detection of renal damage in kidneys with and without vesicoureteral reflux (VUR). One hundred seventy-six kidneys of 88 children (46 male, 42 female) who had been referred for voiding cystourethrography and 20 healthy controls were prospectively investigated. Patients were assessed according to severity of renal damage on dimercaptosuccinic acid (DMSA) scintigraphy. Ninety-eight age- and gender-matched healthy children constituted the control group. Quantitative shear wave velocity (SWV) measurements were performed in the upper and lower poles and in the interpolar region of each kidney. DMSA scintigraphy was performed in 62 children (124 kidneys). Comparisons of SWV values of kidneys with and without renal damage and/or VUR were done. Significantly higher SWV values were found in non-damaged kidneys. Severely damaged kidneys had the lowest SWV values (P < 0.001). High-grade (grade V-IV) refluxing kidneys had the lowest SWV values, while non-refluxing kidneys had the highest values (P < 0.05). Significant negative correlations were found between the mean quantitative US elastography values and DMSA scarring score (r = -0.788, P < 0.001) and VUR grade (r = -0.634, P < 0.001). SWV values of the control kidneys were significantly higher than those of damaged kidneys (P < 0.05). Our findings suggest decreasing SWV of renal units with increasing grades of vesicoureteric reflux, increasing DMSA-assessed renal damage and decreasing DMSA-assessed differential function.Öğe Acoustic Radiation Force Impulse Imaging for Evaluation of Renal Parenchyma Elasticity in Diabetic Nephropathy(Amer Roentgen Ray Soc, 2015) Goya, Cemil; Kilinc, Faruk; Hamidi, Cihad; Yavuz, Alpaslan; Yildirim, Yasar; Cetincakmak, Mehmet Guli; Hattapoglu, SalihOBJECTIVE. The goal of this study is to evaluate the changes in the elasticity of the renal parenchyma in diabetic nephropathy using acoustic radiation force impulse imaging. SUBJECTS AND METHODS. The study included 281 healthy volunteers and 114 patients with diabetic nephropathy. In healthy volunteers, the kidney elasticity was assessed quantitatively by measuring the shear-wave velocity using acoustic radiation force impulse imaging based on age, body mass index, and sex. The changes in the renal elasticity were compared between the different stages of diabetic nephropathy and the healthy control group. RESULTS. In healthy volunteers, there was a statistically significant correlation between the shear-wave velocity values and age and sex. The shear-wave velocity values for the kidneys were 2.87, 3.14, 2.95, 2.68, and 2.55 m/s in patients with stage 1, 2, 3, 4, and 5 diabetic nephropathy, respectively, compared with 2.35 m/s for healthy control subjects. Acoustic radiation force impulse imaging was able to distinguish between the different diabetic nephropathy stages (except for stage 5) in the kidneys. The threshold value for predicting diabetic nephropathy was 2.43 m/s (sensitivity, 84.1%; specificity, 67.3%; positive predictive value, 93.1%; negative predictive value 50.8%; accuracy, 72.1%; positive likelihood ratio, 2.5; and negative likelihood ratio, 0.23). CONCLUSION. Acoustic radiation force impulse imaging could be used for the evaluation of the renal elasticity changes that are due to secondary structural and functional changes in diabetic nephropathy.Öğe Adult Diagnosis of Swyer-James-Macleod Syndrome: Retrospective Analysis of Four Cases(Daedalus Enterprises Inc, 2014) Sen, Hadice Selimoglu; Taylan, Mahsuk; Abakay, Ozlem; Sezgi, Cengizhan; Cetincakmak, Mehmet GuliSwyer-James-Macleod syndrome (SJMS) is a rare constrictive bronchiolitis with air-flow obstruction and a decreased number and diameter of ipsilateral peripheral pulmonary vessels. This syndrome is characterized by unilateral hyperlucency on chest radiography. Computed tomography provides useful additional information. The diagnosis is usually made in childhood but sometimes occurs in adulthood. The disease often presents with dyspnea, decreased exercise tolerance, cough, hemoptysis, and recurrent pulmonary infections. SJMS may be confused with asthma or pulmonary embolism due to similar symptoms and may result in inappropriate therapy. This case series examined the clinical and imaging spectrum of four patients who were diagnosed with SJMS in adulthood.Öğe Adult diagnosis of Swyer-James-MacLeod syndrome: Retrospective analysis of four cases(European Respiratory Soc Journals Ltd, 2013) Sen, Hadice Selimoglu; Taylan, Mahsuk; Abakay, Ozlem; Sezgi, Cengizhan; Cetincakmak, Mehmet Guli[Abstract Not Available]Öğe 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, AslanObjective 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.Öğe 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, AslanObjectives: 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.Öğe Combination of Virtual Touch Tissue Imaging and Virtual Touch Tissue Quantification for Differential Diagnosis of Breast Lesions(Amer Inst Ultrasound Medicine, 2015) Teke, Memik; Goya, Cemil; Teke, Fatma; Uslukaya, Omer; Hamidi, Cihad; Cetincakmak, Mehmet Guli; Hattapoglu, SalihObjectives-Breast cancer is the second leading cause of death from cancer in women, and early detection is the key to successful treatment. Unfortunately, even with technological advances, the specificity of imaging modalities is still low. Therefore, we evaluated the value of a newly developed noninvasive technique, acoustic radiation force impulse imaging, for differentiating benign versus malignant breast lesions. Methods We prospectively examined 141 breast lesions in 122 patients. All lesions were classified according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) for mammography, BI-RADS for sonography, and Virtual Touch tissue imaging (VTI; Siemens Medical Solutions, Mountain View, CA) pattern. Internal and marginal shear wave velocity (SWV) values for the lesions were noted. The sensitivity, specificity, accuracy, and positive and negative predictive values for VTI and Virtual Touch tissue quantification (VTQ Siemens Medical Solutions) were calculated. Results The marginal SWV values were statistically higher in malignant lesions (mean +/- SD, 5.41 +/- 1.37 m/s) than benign lesions (2.91 +/- 0.88 m/s; P < .001). When the SWV cutoff level was set at 4.07 m/s, and the higher of the internal and marginal values was adopted, the combination of VTI and VTQ showed 95.1% sensitivity, 99.0% specificity, and 97.8% accuracy. Conclusions Breast Imaging Reporting and Data System category 4 lesions are the main focus of research for early detection of breast cancer. Unfortunately, BI-RADS category 4 assessment covers a-wide range of likelihood of malignancy (2%-95%). This wide range reflects the necessity for a more specific imaging modality. The combination of. VTI and VTQ could increase the diagnostic performance of conventional sonography.Öğe A comprehensive study of right and left inferior phrenic artery variations in 1000 patients with multidetector computed tomography angiography: an important study for HCC(Springer France, 2021) Ekingen, Arzu; Cetincakmak, Mehmet GuliPurpose To investigate the anatomic variations in the origins of the right and left inferior phrenic arteries (IPAs) using multidetector computed tomography and to classify their combined variations. Methods This retrospective study included patients undergoing abdominal aorta angiography between January 2015 and October 2019. The RIPA and LIPA origins were evaluated both separately and combined on three-dimensional images. The variant patterns of the IPAs were determined and classified. The numerical evaluation of the data was performed with SPSS 21. Results In total, 1000 patients (478 women, 522 men) were evaluated. The IPAs originated from a common trunk or a common root in 360 (36.00%) patients, while the IPAs originated independently without a common trunk in 609 (60.90%) patients. The most common combined variant detected in the present study was IPAs originating as a common trunk from the coeliac trunk in 197 (19.70%) patients; 14 (1.40%) patients had no inferior phrenic artery (IPA), and 17 (1.70%) patients had only one IPA. Conclusion Fifty-two different types of variations in the combined origin of the inferior phrenic arteries were described in this study for the first time in the literature. Awareness of the anatomic variations in the IPAs, which is critical for hepatocellular carcinoma origins, may benefit various clinical procedures, such as transcatheter arterial chemoembolization, organ transplantations, laparoscopic surgical procedures, and radiological procedures.Öğe Course anomalies of extracranial internal carotid artery and their relationship with pharyngeal wall: an evaluation with multislice CT(Springer France, 2012) Ekici, Faysal; Tekbas, Guven; Onder, Hakan; Gumus, Hatice; Cetincakmak, Mehmet Guli; Palanci, Yilmaz; Bakir, SalihThe goal of our study was to measure the prevalence of anomalies in the extracranial segment of internal carotid artery (ICA), to measure the carotid-pharyngeal distance (CPD). Computed tomography (CT) angiography images of 607 patients were retrospectively examined. The course anomaly and CPD were obtained at different image plane. The patients were divided into four groups according to their age. The incidence of course anomaly in ICA was shown to be 60.3 %. Prevalence of course anomaly showed an increase with age (p < 0.001). Women had more ICAs with a course anomaly than men (p < 0.001). Mean CPD among all ICAs was found to be 11.13 mm. When CPD values were compared between the groups, group 1 and group 2 did not have a significant difference, however, there was a significant difference between other groups (p < 0.05). The CPD significantly decreased with age (p < 0.001). In ICAs that showed a straight course, the mean CPD was 13.0 mm, while in ICAs that showed course anomaly, the mean CPD was determined to be 9.49, showing a significant difference (p < 0.05). In conclusion, the number of ICAs that show a course anomaly increases with age, while the CPD decreases. The CPD is decreased in groups that show anomalies. The detection of a decreased CPD before surgery may lower the chance of a perioperative hemorrhage due to artery damage during pharyngeal procedures. Hence, while reporting neck CT angiographies, it may be valuable to also report the presence of ICA anomalies and CPD.Öğe Detection of-incidental pulmonary embolism with multi-slice computed tomography in cancer patients(Elsevier Science Inc, 2017) Deniz, Muhammed Akif; Deniz, Zelal Tas; Adin, Mehmet Emin; Akil, Ferit; Turmak, Mehmet; Urakci, Zuhat; Cetincakmak, Mehmet GuliThe aim of this study is to show the frequency of incidentally found (pulmonary thromboembolism) PTE in oncological patients and evaluate dispersion of incidents in terms of underlying primary tumor and seek risk factors associated with incidental PTE. Among one thousand oncology patients, 46 (4.6%) individuals found to have incidental PTE. Of positive patients, the highest proportion (24%) was belong to breast cancer group (n = 11). The most common location for pulmonary emboli was the lower lobe branch of right pulmonary artery (n = 33, 71.7%). Evident PTE had not been reported in final radiology reports of 21 cases. (C) 2016 Elsevier Inc. All rights reserved.Öğe The distribution of stylohyoid chain anatomic variations by age groups and gender: an analysis using MDCT(Springer, 2013) Ekici, Faysal; Tekbas, Guven; Hamidi, Cihad; Onder, Hakan; Goya, Cemil; Cetincakmak, Mehmet Guli; Gumus, HaticeThe aim of this study is to investigate the frequency of the SHC variations, and the distribution of the SP lengths in different age and sex groups using MDCT. MDCT scans were performed in 805 patients (401 males, 404 females). The patients were divided into six groups according to their ages. The length of the styloid process (SP) and its angulation on the transverse (TA) and sagittal (SA) planes were measured. Structural variations of the SHC were observed by means of three-dimensional (3D) and multiplanar reconstruction (MPR) images. Absence of the styloid process (n = 10), double proximal origin (n = 13), segmentation (n = 223), complete ossification (n = 24), and an SP with three proximal parts in one patient were among the anomalies detected. The mean length of the SP was greater in males than in females (33.2 +/- A 13.2 vs. 29.6 +/- A 10.5 mm, P < 0.001). Elongated SP (ESP) was observed in 56 % of the patients in the study group, and this ratio was the highest in Group 3 with 65.4 % (P < 0.05). TA and SA were 70.2A degrees A A +/- A 4.1A degrees, 69.9A degrees A A +/- A 4.2A degrees and 86.6A degrees A A +/- A 6.5A degrees, 88.3A degrees A A +/- A 6.6A degrees for the right and left sides, respectively. Besides, 3D and MPR images also present detailed and reliable data to radiologists and surgeons for the evaluation of the SHC. ESP has been detected in more than half of the patients, being more frequent in males and in individuals in the fifth decade of life. For an accurate diagnosis, clinicians should consider the ESP while evaluating the patients in this age group.Öğe Double Filtration Plasmapheresis in the Treatment of a Case with Acute Disseminated Encephalomyelitis(Turkish Neurological Soc, 2013) Cevik, Mehmet Ugur; Cetincakmak, Mehmet Guli; Varol, Sefer; Akil, EsrefAcute disseminated encephalomyelitis (ADEM), is a monophasic autoimmune demyelinating disease of the central nervous system. Although high-dose steroid management has been considered the mainstay of treatment for ADEM, some patients are unresponsive to steroid therapy. We report the case of a 44-year-old woman with ADEM who did not respond to steroid therapy, but who showed a noticeable improvement with double filtration plasmapheresis (DFPP). To the best of our knowledge, this is the first case report of ADEM in literature treated with DFPP.Öğe Evaluation of Dural Venous Sinus Variations through Three-dimensional Phase-Contrast Magnetic Resonance Venography(Wolters Kluwer Medknow Publications, 2024) Ozkoc, Songul Erdem; Cetincakmak, Mehmet Guli; Hattapoglu, SalihObjective:The aim of this study was to evaluate the anatomy of dural venous sinus variations through three-dimensional phase-contrast (3D-PC) magnetic resonance venography (MRV). Awareness of the normal anatomical variations of venous sinuses and apparent MRV flow gaps prevent misdiagnosis of dural venous sinus diseases.Materials and Methods:The dural venous sinuses were assessed using nonenhanced 3D PC-MRV. Of these 968 patients, 154 were excluded due to venous thrombosis and mass invasion. A total of 814 patients (186 male and 628 female) were included in the study.Results:The most common variation of superior sagittal sinus (SSS) was atresia of anterior one-third SSS 19 (2.3%). Other variations were hypoplasia of the anterior half of SSS 2 (0.2%), atresia of posterior one-third of SSS (7, 0.9%), and combined variation of SSS (13, 1.6%). The left transverse sinus was hypoplastic in 224 (27.5%) and aplastic/atretic in 259 (31.8%) cases. The right transverse sinus was hypoplastic in 76 (9.3%) and aplastic/atretic in 57 (7.0%) patients. The combined variation of bilateral transverse sinuses had 42 (5.2%) cases. The left sigmoid sinus was hypoplastic in 22.2% (181) of cases. The right sigmoid sinus was hypoplastic in 60 (7.4%). Two patients had hypoplastic bilateral sigmoid sinuses (0.2%). The right occipital sinus was identified in 20 (2.5%) patients. Left occipital sinus was noted in 2 (0.2%) patients. Duplication or triplication of the occipital sinus is noted in 5 (0.6%) study populations. Straight sinus continued in 13 (1.6%) cases with the right transverse sinus and in 29 (3.6%) patients with left transverse sinus.Conclusion:These anatomical variants can be a potential pitfall in the MRV diagnosis of dural sinus variations, especially when there are no supportive imaging features such as brain infarcts or appropriate clinical background. 3D PC-MRV is a great option for patients with gadolinium allergy/renal insufficiency/pregnant patients. We hope this article can add information and assist in preoperative venous analysis for neurosurgeons and neuroradiologists.Öğe Evaluation of iron overload in visceral organs in thalassemia patients by point shear-wave elastography(Springer London Ltd, 2024) Hattapoglu, Salih; Cetincakmak, Mehmet GuliIntroduction The aim of this study was to investigate the value of point shear-wave elastography (pSWE) in the measurement of iron overload in the liver and other visceral organs in patients with beta thalassemia major (BTM). Materials and methods The study included 103 patients diagnosed with BTM who were referred to our clinic for cardiac and liver T2* measurement and a control group of 120 age- and gender-matched healthy volunteers. Cardiac and hepatic T2* measurements were performed in the patient group. Hepatic, pancreatic, splenic, and renal pSWE values were measured in both groups. The pSWE values were compared between the two groups. In the patient group, correlations between pSWE values, cardiac-hepatic T2* values and hepatic size, patient age, and serum ferritin levels were analyzed. Results Hepatic, pancreatic, splenic, and renal pSWE values were significantly higher in the patient group compared to the control group (p <= 0.001, < 0.001, 0.014, 0.026, respectively). In the patient group, hepatic pSWE values established a significant correlation with cardiac T2* values, liver size-T2*, pancreatic pSWE values, serum ferritin levels, and age (p = 0.006, < 0.001, 0.001, 0.042, 0.001, 0.032, respectively). In the ROC analysis, the area under the ROC curve was 0.807 for hepatic pSWE in the discrimination of thalassemia patients and healthy controls, and the cut-off value was 1.42, which gave a sensitivity and specificity of 75.7% and 75%, respectively. Conclus & imath;on Point shear-wave elastography can be a useful technique in the clinical measurement of iron overload in the liver, pancreas, spleen, and kidney.Öğe Evaluation of the Glucocorticoid, Mineralocorticoid, and Adrenal Androgen Secretion Dynamics in A Large Cohort of Patients Aged 6-18 Years with Transfusion-dependent ?-Thalassemia Major, with an Emphasis on the Impact of Cardiac Iron Load(Karger, 2016) Ucar, Ahmet; Oner, Nergiz; Ozek, Gulcihan; Cetincakmak, Mehmet Guli; Abuhandan, Mahmut; Yildirim, Ali; Kaya, Cemil[Abstract Not Available]Öğe Evaluation of the glucocorticoid, mineralocorticoid, and adrenal androgen secretion dynamics in a large cohort of patients aged 6-18 years with transfusion-dependent ?-thalassemia major, with an emphasis on the impact of cardiac iron load(Springer, 2016) Ucar, Ahmet; Oner, Nergiz; Ozek, Gulcihan; Cetincakmak, Mehmet Guli; Abuhandan, Mahmut; Yildirim, Ali; Kaya, CemilThe variable presence of adrenal insufficiency (AI) due to hypocortisolemia (HC) in patients with thalassemia is well established; however, the prevalence of adrenocortical hypofunction (ACH) in the zona glomerulosa and zona reticularis of the adrenal cortex is unknown. To establish the prevalence of ACH, we examined the cortisol response to 1-A mu g and 250-A mu g ACTH tests, plasma aldosterone (A)/plasma renin activity (PRA) ratio, and serum dehydroepiandrosterone sulfate (DHEAS) levels in a large cohort of patients with thalassemia, and to investigate the impact of total body iron load (TBIL) on adrenocortical function. The setting used was University hospital and government-based tertiary care center. One hundred twenty-one (52 females) patients with beta-thalassemia major (beta-TM) and 72 healthy peers (38 females) were enrolled. The patients underwent a 250-A mu g cosyntropin test if their peak cortisol was < 500 nmol/L in a 1-A mu g cosyntropin test. Magnetic resonance imaging (MRI) was performed to assess the MRI-based liver iron content and cardiac MRI T2* iron. The associations between ACH and TBIL were investigated. The patients with thalassemia had lower ACTH, cortisol, DHEAS, and A/PRA values compared with the controls (p < 0.001). Thirty-nine patients (32.2 %) had HC [primary (n = 1), central (n = 36), combined (n = 2)], and 47 (38.8 %) patients had reduced DHEAS levels; 29 (24.0 %) patients had reduced A/PRA ratios. Forty-six (38.0 %) patients had hypofunction in one of the adrenal zones, 26 (21.5 %) had hypofunction in two adrenal zones, and 9 (7.4 %) had hypofunction in all three zones. Patient age and TBIL surrogates were significant independent parameters associated with ACH. Cardiac MRI T2* iron was the only significant parameter that predicted the severity of ACH at a cut-off of 20.6 ms, with 81 % sensitivity and 78 % specificity. Patients with thalassemia have a high prevalence of AI due to HC and zona glomerulosa and zona reticularis hypofunction. TBIL surrogates can predict ACH, but cardiac iron was the only surrogate that was adequately sensitive to predict the severity of ACH.Öğe Imaging features of cerebral and spinal cystic echinococcosis(Springer-Verlag Italia Srl, 2015) Teke, Memik; Gocmez, Cuneyt; Hamidi, Cihad; Gunduz, Ercan; Goya, Cemil; Cetincakmak, Mehmet Guli; Hattapoglu, SalihThe main objective of this study was to describe the characteristic imaging features of cerebral and spinal hydatid disease (HD) in magnetic resonance imaging (MRI) and computed tomography (CT) in order to provide more effective differential diagnoses in endemic regions. We also aimed to use MRI and CT to evaluate whether the World Health Organization's (WHO) new classification of hepatic cystic echinococcosis (CE) could be used in the classification of cerebral HD. We retrospectively reviewed the CT and MR images of 30 patients who were diagnosed with cerebral and spinal HD between 1990 and 2014. The imaging findings were noted. All hydatid cysts were classified according to the WHO classification of hepatic CE, consisting of six types. The study group consisted of 49 CEs in 27 patients with cerebral HD and 12 CEs in three patients with spinal HD. Of the cysts, 14 were type CL (cystic lesion), 29 were type CE1, 11 were type CE2 and seven were type CE3. In other words, 54 cysts were in the active group and seven were in the transition group. Most of the cysts were type CL and CE1. Even though characteristic imaging features could be used in the differential diagnosis of HD, sometimes the differentiation of HD from other cystic lesions may be difficult. The use of WHO classification will provide standardisation of uniform treatment modality, as the treatment of HD, according to the stage of the disease, may be surgical or medical.Öğe Level of Variations of the Aortic Bifurcation and Distance Measurements between the Aortic Bifurcation and the Common Iliac Bifurcations(Wolters Kluwer Medknow Publications, 2022) Ekingen, Arzu; Cetincakmak, Mehmet GuliIntroduction: The purpose of the present study was to investigate the vertebral levels of the aortic bifurcation (AB) in patients with and without the abdominal aorta (AA) deviation and to measure the distances between the AB and the right-left common iliac bifurcations (CIBs) which are crucial anatomical information, especially for anterior lumbar interbody fusion surgery. Additionally, we made comparisons levels of the AB according to sex and examined whether the results were statistically significant, which we could not find other studies comparing gender in literature. Material and Methods: The images of 721 patients, undergoing angiography with multidetector computed tomography between January 2016 and October 2019, were reviewed retrospectively. The AB levels of the patients with and without the AA deviation were classified and evaluated separately. It was measured the distances between the level of the AB and the right and left CIBs with the 3-dimensional ruler technique in only 207 of 721 patients. Results: It was detected seven different vertebral levels of the AB among patients (116 patients) with the AA deviation, in which is the highest L4-upper (27.59%), and 11 different vertebral levels of the AB among patients (605 patients) without the AA deviation, in which is the highest L4-upper (22.48%). When comparing cases with and without AA deviation, a statistically significant difference was found between the sexes (P < 0.05). Discussion and Conclusion: The presented study demonstrates that there is a significant relationship between the genders at some levels. The preoperative information of the morphological variations of the AB may be very useful for laparoscopic, invasive procedures, and spinal surgery procedures. At the same time, these variation information reveals new information for anatomy.Öğe Migration of two swallowed foreign bodies to different locations in the same case(Aves, 2014) Gul, Mesut; Aliosmanoglu, Ibrahim; Hakseven, Musluh; Cetincakmak, Mehmet GuliForeign body ingestion can be seen at all ages, especially in childhood. Most swallowed foreign objects are disposed from the body without any health problems through defecation. It is rare that a foreign object perforates the intestine and migrates into the liver or peritoneum. In our case two unintentionally swallowed needles pierced the intestine and were located in the left lobe of the liver and small intestine mesentery. Foreign objects were detected in the abdomen of a 20-year-old female patient during examination performed for abdominal pain that lasted for three months. After a follow up period of three weeks the patient's complaints continued. She underwent laparotomy and both needles were removed in one session. It should be kept in mind that swallowed foreign objects can sometimes perforate the gastrointestinal system and may be located in different organs in the abdomen.
