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    Evaluation of the relationship between splenic iron overload and liver, heart and muscle features evident on T2?-weighted magnetic resonance imaging
    (Wroclaw University of Medicine, 2020) Çetinçakmak, Mehmet Güli; Hattapoǧlu, Salih; Söker, Murat; Ekici, Faysal; Yılmaz, Kamil; Göya, Cemil; Hamidi, Cihad
    Background. Splenic iron overload is the most common clinical condition in patients with thalassemia. However, few studies of the effects of splenectomy have been published. Objectives. To evaluate the relationship between splenic iron overload and liver, heart and muscle features visible in T2∗-weighted magnetic resonance imaging, and to investigate the effects of splenectomy on these tissues in patients with beta-thalassemia major (TM). Material and methods. We retrospectively included 131 patients (76 male and 55 female) diagnosed with TM. All radiological assessments were performed with the aid of a Philips Achieva 1.5T scanner running a multiecho gradient-echo sequence. Hepatic and splenic T2∗ values were assessed in the same gradient multiecho series. Muscle T2∗ values were assessed in the shoulder girdle muscles adjacent to the heart area. The relationships among splenic T2∗, hepatic T2∗, cardiac T2∗ and muscle T2∗ parameters, serum ferritin levels, age and other parameters were evaluated. Results. The splenic T2∗ value correlated with serum ferritin level and the hepatic T2∗ value (p < 0.001 and p < 0.001, respectively). The splenic T2∗ value did not correlate with age, cardiac or muscle T2∗ values, or with spleen size (p = 0.27, 0.21, 0.99, and 0.39, respectively). The muscle T2∗ value correlated weakly with the serum ferritin level (p = 0.022). The cardiac T2∗ value was lower and the liver size greater in patients who had undergone splenectomy compared with those who had not (p < 0.001 and 0.001, respectively). Conclusions. Splenic iron overload correlated with hepatic overload and the serum ferritin level. Splenectomy increased cardiac iron overload and triggered liver enlargement. However, the muscle iron overload was low and the muscles were therefore unaffected by splenectomy.
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    Predictors of successful treatment after transforaminal epidural steroid injections in patients with lumbar disc herniation
    (IOS Press BV, 2024) Sarıyıldız, Mustafa Akif; Batmaz, İbrahim; Hattapoǧlu, Salih
    BACKGROUND: Epidural steroid injections are common procedures used to treat lumbosacral radicular pain due to lumbar disc herniation (LDH). It is crucial for the clinician to anticipate which patients can benefit from interventional treatment options. OBJECTIVE: This study aimed to examine the effect of radiological and clinical parameters on lumbar transforaminal epidural steroid injections (TFESI)/local anesthetic injection outcomes in patients with LDH. METHODS: This study included 286 patients with LDH (146 males and 140 females). All patients received a fluoroscopically guided TFESI (triamcinolone acetonide 40 mg, lidocaine 2%, and 2.5 ml of physiological saline). Patients were evaluated according to radicular pain, the Oswestry Disability Index (ODI) and the Hospital Anxiety and Depression Scale at baseline and 3 months after the injections. Demographic, clinical and magnetic resonance imaging (MRI) findings were recorded to assess the predictive factors for TFESI outcomes. Pfirrmann Grades 1 and 2 were classified as low-grade nerve root compression and Grade 3 was classified as highgrade nerve root compression. RESULTS: Compared to baseline measurements there were significant improvements in radicular pain, ODI score, Laseque angle, and Schober test scores 3 months after injection. Improvements of at least 50% in radicular pain relief and the ODI functionality index were (n= 214) 82%, (n= 182) 70% respectively at 3 months. Correlation analyses revealed that a shorter duration of symptoms, lowgrade nerve root compression and foraminal/extraforaminal location on MRI findings were associated with a favorable response. CONCLUSIONS: Lowgrade nerve root compression was a predictor of a favorable response to TFESI.