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Öğe 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, AslanOBJECTIVE. 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.Öğe The demonstration of the inferior sternal cleft using three-dimensional reconstruction: a case report(Editura Acad Romane, 2009) Tuncer, M. Cudi; Aluclu, M. Ufuk; Karabulut, Oezlen; Ulku, Refik; Hatipoglu, E. Savas; Nazaroglu, HasanCongenital sternal cleft is a rare disorder in which there is a gap in the midline of the anterior chest wall between the two halves of the sternum. Typically, the contour of the mediastinal structures can be seen beneath the skin. It is rare and the exact incidence is not known. It results from failure of fusion of the two lateral mesodermal sternal bars by 8 weeks of gestation. Most cases are diagnosed shortly after birth and are reported only rarely in adults. We report here one of the congenital major chest wall deformities; inferior sternal cleft is rarely seen, associated with sternal and costal variations in a 22-year young man.Öğe 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, MustafaPurpose 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.Öğe Double outlet right ventricle with giant pulmonary artery aneurysm and severe aortic coarctation: diagnosis with multislice CT(Turkish J Pediatrics, 2009) Hasanefendioglu-Bayrak, Aylin; Ozturkmen-Akay, Hatice; Kervancioglu, Mehmet; Akgul-Ozmen, Cihan; Senturk, Senem; Nazaroglu, HasanComplex cardiovascular pathologies in the pediatric population are usually evaluated with echocardiography and catheter angiography as initial and advanced imaging of choice, respectively. Echocardiography may pose some difficulties in the diagnosis of complex cardiovascular pathologies. Due to short acquisition times, detailed imaging by the use of post-processing techniques, reduced radiation exposure compared to catheter angiography, and additional information obtained on lung parenchyma, multi-slice computed tomography (CT) is the advanced imaging method of choice in selected cases. The present report describes a 14-year-old symptomatic case with complex cardiovascular pathology, whose vascular architecture could be properly demonstrated by multi-slice CT.Öğe 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, BircanThe 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.Öğe Effects of paramagnetic contrast agents on the gallbladder volume(Aves, 2010) Nazaroglu, Hasan; Meric, Kaan; Ozmen, Cihan Akguel; Bukte, Yasar; Akay, Hatice OeztuerkmenPURPOSE Iodinated contrast agents lead to contraction of the gallbladder. The purpose of this prospective study was to investigate whether the paramagnetic contrast agents used for magnetic resonance imaging (MRI) cause volume changes in gallbladder or not. MATERIALS AND METHODS The gallbladder volume changes were evaluated by ultrasound just before and 15 minutes after the imaging procedure in 10 patients without any paramagnetic contrast agent administration and 36 patients in whom paramagnetic contrast agents were administered during MRI. Gallbladder volume measurements before and 15 minutes after MRI were compared with each other. RESULTS The mean pre- and post-procedural gallbladder volumes in patients on paramagnetic contrast agents were 30.2 +/- 19.3 cm(3) and 27.8 +/- 13.5 cm(3), respectively. They were 31.8 +/- 15.0 cm(3) and 29.5 +/- 9.3 cm(3), respectively, in patients who were not administered any paramagnetic contrast agent. There were no statistically significant difference between groups, regarding pre- and post-MRI gallbladder volumes. CONCLUSION MRI, with or without paramagnetic contrast agents, does not lead to gallbladder volume contraction. In that regard, there appears to be no need to avoid ultrasound aimed to evaluate the gallbladder after MRI examinations.Öğe Evaluation of the Singh index and Femur Geometry in Osteoporotic Women(Sciendo, 2010) Karabulut, Ozlen; Tuncer, Mehmet Cudi; Karabulut, Zulfu; Hatipoglu, Eyup Savas; Nazaroglu, Hasan; Akkus, ZekiWe aimed to compare the Singh index with bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA), body mass index (BMI) and femur geometry in the right proximal femur of osteoporotic women, using different statistical tests. Radiographs of each patient were assessed to determine the Singh index by five observers. The observers consisted of a consultant radiologist, physical therapist and anatomists who studied the series of radiographs. They were asked to apply the Singh index by comparing the trabecular bone pattern in the proximal right femur with the reference scale published by Singh et al. [1]. This has a six point scale from grade VI to grade I. We evaluated 47 osteoporotic women in this study. The subjects' mean age, weigth, and height were 63,21 +/- 10,106, 66,72 +/- 12.523, 154,94 +/- 7,026 respectively. We found a significant relationship between the Singh index and BMD. The Singh index correlated significantly with hip axis length, femoral neck diamater and trochanteric width. And, BMD correlated significantly with femoral head and neck diameter, femoral neck cortex width, medial calcar femoral cortex width and femoral shaft cortex width. The evaluation of the Singh index grades in its self, there was a significant relation among them.Öğe 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, HasanFenestration 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.Öğe Horseshoe lung associated with rare bilateral variant of scimitar syndrome: demonstration by 64-slice MDCT angiography(Springer, 2008) Akay, Hatice Ozturkmen; Kervancioglu, Mehmet; Nazaroglu, Hasan; Katar, Selahattin; Ozmen, Cihan Akgul; Kilinc, Ilhan; Senturk, SenemScimitar syndrome with bilateral abnormal venous drainage and horseshoe lung is extremely rare. These rare complex anomalies were diagnosed in a 5-year-old boy by 64-slice multidetector CT (MDCT). This technique provides high-quality visualization of vascular, bronchial and parenchymal structures in a single session, such that no further invasive techniques are required. One obvious disadvantage of MDCT is the radiation exposure, especially in paediatric patients. The use of a single phase of contrast material administration reduces radiation exposure. The workstation platforms of MDCT systems allow multiplanar 2-D and 3-D postprocessing. As a result, various complex pathologies, such as that discussed here, can be diagnosed following a single imaging session with a certain precision.Öğe Incidence and management of isolated subsegmental pulmonary embolism(European Respiratory Soc Journals Ltd, 2013) Ates, Gungor; Ozmen, Cihan Akgul; Bogatekin, Gulhan; Nazaroglu, Hasan; Yildiz, Tekin; Topcu, A. Fusun; Bayhan, Seher[Abstract Not Available]Öğe 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, LeventBackground: 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.Öğe Migration of ventriculoperitoneal shunt into the lung by passing through the liver and the diaphragm(Aves, 2009) Nazaroglu, Hasan; Ozkan, Umit; Ozmen, Cihan Akgul; Akay, Hatice Ozturkmen; Senyigit, AbdurrahmanThoracic complications are rare after shunt placement for drainage of cerebrospinal fluid to treat hydrocephalus. We report a case of a ventriculoperitoneal shunt catheter that migrated into the lung by passing through the liver and the diaphragm. To our knowledge, there is no previously published report of a ventriculoperitoneal shunt that has migrated into the lung by a transdiaphragmatic and transhepatic route.Öğe Pulmonary Alveolar Microlithiasis: Radiologic Findings of Eight Cases in Turkey(Ortadogu Ad Pres & Publ Co, 2010) Tanrikulu, A. Cetin; Dagli, Canan Eren; Senyigit, Abdurrahman; Nazaroglu, Hasan; Babayigit, CenkObjective: Pulmonary alveolar microlithiasis (PAM) is a rare idiopathic disease characterized by presence of diffuse innumerable minute calculi called microliths The aim of this report was to describe the radiographic findings of PAM with particular attention to features provided by chest X-ray and high resolution computerized tomography (HRCT). Material and Methods: We diagnosed three index cases of PAM who came from the same village in 1996. In 2005 we performed a study including 279 residents of that village by using microfilm screening to determine undiagnosed cases. Five additional cases of PAM were detected and underwent HRCT. HRCT and chest X-ray images of eight cases were assessed specifically for patterns, distribution, and profusion of pulmonary abnormalities. Results: Of eight cases, four were adults and four were children. Diffuse typical microcalcifications were detected in chest X-ray in three cases while reticulonodular pattern was seen in three cases and reticular pattern in two cases. Fine microcalcification, parenchymal band and fisssural prominence were the most common findings on HRCT. Small subpleural cysts were detected in five cases but only case 1 showed black pleural line in chest X-ray. One case had small subpleural bullae and bronchiectatic changes in both lower lobes predominantly in the left lung in HRCT. Conclusion: Relatives of a patient with PAM having reticular or reticulonodular pattern in chest X-ray must be investigated in detail for PAM because it can be the early stage of the disease. HRCT has a major importance for the detection of the rapid progression.Öğe A Rare Cause of Dysphonia: Laryngeal Lipoma: Differential Diagnosis(Ortadogu Ad Pres & Publ Co, 2009) Ozmen, Cihan Akgul; Nazaroglu, Hasan; Yildirim, Muezeyyen; Akay, Hatice Ozturkmen; Bayrak, Aylin H.Although lipomas are the most common benign tumors of mesenchymal origin, laringeal lipomas are rare. We report a case of laryngeal lipoma with computed tomography (CT) and magnetic resonance imaging (MRI) findings. A mass filling the left pyriform sinus was detected on the examination of a 52-year-old man admitted with dysphonia. The mass was originated from lateral side of left aryepiglottic fold, extending to subglottic area on the neck CT and MRI scans. The radiologic findings were compatible with laryngeal lipoma. Laryngeal lipoma, although rare, should be kept in mind for the differential diagnosis of patients admitted with dysphonia.Öğe Variations and Abnormalities of Major Thoracic Vascular Structures(Bentham Science Publ Ltd, 2014) Oran, Abdurrahman; Goya, Cemil; Nazaroglu, HasanPurpose: To determine the variations and abnormalities of major thoracic vascular structures in patients exposed to thoracic examination via computerized tomography with 64 detectors. Materials and Methods: In this retrospective study, 2,479 patients who underwent thoracic computed tomography between May 2006 and October 2007 in the Radiation Department at Dicle University's School of Medicine were examined. Of these patients, 1,389 were male and 1,090 were female. No variations or abnormalities were detected in 1,588 of the patients. Results: In 1,588 out of 2,479 patients (64.1%), no abnormalities or variations were detected. The most frequently detected variations occurred in the brachiocephalic trunk and the sole root point of the carotid artery from the aorta; these variations were detected in 838 (33.8%) patients. In 74 of the 2,479 patients (3.0%) examined, it was found that the left vertebral artery directly initiated from the arch of the aorta. In addition, in 33 patients, the right brachiocephalic trunk and left major carotid artery initiated from the aorta as a single root. Conclusion: Via multi-slice CT, it is possible to detect variations and abnormalities of major thoracic vascular structures; therefore, there is no need for extra diagnostic invasive digital subtraction angiography.
