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    An 8-year-old boy with Scimitar syndrome: Presentation with gastroesophageal reflux symptoms and concurrent associations, including ectopic herniated liver
    (Wiley, 2024) Alver, Kadir Han; Ayaz, Zozan; Tekinhatun, Muhammed
    [Abstract Not Available]
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    Analysis of factors affecting the diagnostic yield for microbiologic diagnosis from percutaneous abdominal abscess drainage
    (J Infection Developing Countries, 2024) Arslan, Muhammet; Aslan, Halil S.; Tekinhatun, Muhammed; Ozgen, Utku; Sari, Tugba
    Introduction: This study aimed to investigate the factors influencing the diagnostic yield of microbiologic diagnosis obtained through percutaneous abdominal abscess drainage procedures. We analyzed the influence of diverse clinical, radiological, and pre-procedural factors on the success of microbiologic diagnosis in this context. Methodology: A retrospective analysis of patients who underwent percutaneous abdominal abscess drainage was performed to assess the factors affecting the diagnostic yield for microbiologic diagnosis. Results: A total of 174 patients undergoing percutaneous abdominal abscess drainage was included. The use of antibiotics during the procedure and the spread of the abscess to other organs significantly increased the likelihood of obtaining a positive culture. Specifically, antibiotic use during the procedure raised the risk by up to 3.30-fold (OR = 3.30, 95% CI 1.48-7.65, p = 0.004), while abscess spread to another organ increased the risk by approximately 1.87-fold (OR = 1.87, 95% CI 0.98-3.61, p = 0.057). Additionally, abscesses containing air and abscesses with an air-fluid level were more common in patients with positive culture results. Other factors, such as gender, age, malignancy prevalence, and surgical history, did not significantly impact culture results. Conclusions: This study provides valuable insights into the factors affecting the diagnostic yield of microbiologic diagnosis from percutaneous abdominal abscess drainage. The findings underscore the importance of considering patient-specific variables and procedural aspects when planning and executing abscess drainage procedures. Further research can build upon these insights to develop evidence-based guidelines for optimizing the diagnostic yield of percutaneous abdominal abscess drainage procedures.
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    Bilateral pulmonary sequestrations: Distinct types sharing a common celiac artery origin, presented with pneumonia and associated findings in a pediatric case
    (Wiley, 2024) Tekinhatun, Muhammed; Alver, Kadir Han; 0000-0002-3240-6991
    A 14-year-old boy presented with shortness of breath, cough, and mild chest pain, with a history of intermittent milder symptoms. Physical examination and initial tests showed mild iron deficiency anemia, elevated C-reactive protein, and normal vital signs. Chest radiograph revealed abnormalities in the left lower zone, leading to contrast-enhanced chest CT. The CT scan revealed bilateral intrapulmonary sequestrations, both deriving blood supply from a common trunk originating from the celiac artery. The patient's symptoms initially attributed to a pulmonary infection improved with antibiotic therapy. Pulmonary sequestration is a congenital anomaly characterized by aberrant lung tissue lacking connections to bronchial tree or pulmonary arteries. It can lead to recurrent pulmonary infections and postinfectious sequelae. This case presented a unique bilateral sequestration, both originating from the celiac artery. Radiologists should be aware of sequestration types and associated anomalies, even in atypical locations. Blood supply can originate from various arteries, not just the aorta.
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    Case images for 'pediatric DAH: Etiologies and outcomes'
    (Wiley, 2024) Tekinhatun, Muhammed
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    Complications of imaging-assisted port catheters and factors affecting complications
    (Pamukkale University, 2024) Tekinhatun, Muhammed; Arslan, Muhammet; Aslan, Halil Serdar; Yavaş, Hüseyin Gökhan; Demirci, Mahmut; Koluman, Başak Ünver; Alver, Kadirhan
    Purpose: This research investigates complications associated with Imaging-Assisted Port Catheters (IAPCs) to provide insights for healthcare professionals involved in their usage. The study aims to optimize patient safety, implement preventive strategies, and guide evidence-based decision-making in the clinical use of IAPCs. Materials and methods: A retrospective study comprising 1247 patients who underwent IAPC placement in the Interventional Radiology Unit between 01.09.2012-01.09.2020 was conducted. Data, including indications for port placement, complications, duration of port stay, and reasons for explantation, were extracted from electronic medical records. Comparative analysis with surgically implanted ports was performed, and the efficacy and safety of imaging-guided port implantation were assessed. Results: The study predominantly involved right internal jugular vein placement (93.8%). Major complications did not occur during the 7 to 1330 days of port usage. The average usage period was 243 days, totaling 310,503 catheter-days. Infectious complications were the most common (4.8%), significantly higher (13.9%) in hematological malignancies. Multivariate analysis revealed a significantly increased complication rate in hematological malignancy patients (p<0.001). Conclusion: The research reveals an 8.6% overall incidence of complications in IAPC usage, with hematologic malignancy identified as a significant independent risk factor. The low complication rate per 1000 catheter days (0.36) aligns with recent studies, emphasizing the benefits of image guidance and procedural expertise. Notably, infectious complications, especially in hematologic malignancy patients, underscore the need for further research to refine IAPC management for long-term intravenous access. The study contributes essential insights for healthcare professionals involved in the field, emphasizing ongoing efforts in advancing IAPC management for the benefit of patients.
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    Dynamic contrast-enhanced mammography and breast MRI in the diagnosis of breast cancer and detection of tumor size
    (Turkiye Klinikleri, 2024) Tekinhatun, Muhammed; Sabir, Nuran; Erdem, Ergün; Yılmaz, Sevda; Ufuk, Furkan
    Background/aim: The aim of this study is to evaluate the performance of contrast-enhanced mammography (CEM) and dynamic breast MRI techniques for diagnosing breast lesions, assess the diagnostic accuracy of CEM’s using histopathological findings, and compare lesion size measurements obtained from both methods with pathological size. Materials and methods: This prospective study included 120 lesions, of which 70 were malignant, in 104 patients who underwent CEM and MRI within a week. Two radiologists independently evaluated the MR and CEM images in separate sessions, using the BI-RADS classification system. Additionally, the maximum sizes of lesion were measured. Diagnostic accuracy parameters and the receiver operating characteristics (ROC) curves were constructed for the two modalities. The correlation between the maximum diameter of breast lesions observed in MRI, CEM, and pathology was analyzed. Results: The overall diagnostic values for MRI were as follows: sensitivity 97.1%, specificity 60%, positive predictive value (PPV) 77.3%, negative predictive value (NPV) 93.8%, and accuracy 81.7%. Correspondingly, for CEM, the sensitivity, accuracy, specificity, PPV, and NPV were 97.14%, 81.67%, 60%, 77.27%, and 93.75%, respectively. The ROC analysis of CEM revealed an area under the curve (AUC) of 0.907 for observer 1 and 0.857 for observer 2, whereas MRI exhibited an AUC of 0.910 for observer 1 and 0.914 for observer 2. Notably, CEM showed the highest correlation with pathological lesion size (r = 0.660 for observer 1 and r = 0.693 for observer 2, p < 0.001 for both). Conclusion: CEM can be used with high sensitivity and similar diagnostic performance comparable to MRI for diagnosing breast cancer. CEM proves to be a successful diagnostic method for precisely determining tumor size.
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    Emphysematous hepatitis: A rare fatal case
    (Wiley, 2024) Tekinhatun, Muhammed; Yavas, Hueseyin Gokhan
    Emphysematous hepatitis (EH) is a rare, insidious, rapidly progressing, and often fatal liver infection characterized by diffuse air in the liver parenchyma. While infectious parenchymal diseases can affect many intra-abdominal organs such as the kidney, urinary bladder, gall bladder, stomach, and pancreas, liver involvement is uncommon. Few cases of EH have been reported in the literature, with only four successfully treated. Diagnosis involves patient history, clinical and laboratory findings, and computed tomography. Treatment is challenging and requires close monitoring. This case report aims to enhance the understanding of EH's diagnosis and treatment in medical literature. Emphysematous hepatitis (EH) is a very rare and fatal liver infection with diffuse air in the parenchyma. The diagnosis of EH, can be made by patient history, clinical and laboratory findings, and computed tomography. We aimed to contribute to the literature on the diagnosis and treatment process of EH. image
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    Evaluation of lamina papyracea dehiscence with paranasal computed tomography
    (Springer, 2024) Deniz, Muhammed Akif; Tekinhatun, Muhammed
    IntroductionThe lamina papyracea is the thin line between the ethmoid sinus and the medial orbital wall. Knowledge of the presence of the lamina papyracea dehiscence (LPD) bears critical importance to prevent misdiagnosis of fractures at this level and to define the anatomy before sinonasal surgery, including Functional Endoscopic Sinus Surgery (FESS). The present study is therefore intended to determine the incidence of LPD in paranasal computed tomography, to identify its imaging characteristics in CT, and to compare with the literature.Materials and methodsThe current study included patients who underwent paranasal CT scanning for any reason in our clinic between January 2018 and January 2022. Patients were evaluated in terms of age, gender, and presence of LPD. Patients with dehiscence were evaluated in terms of age, gender, dehiscence localization (right, left), tissue at the level of dehiscence, dehiscence size, and dehiscence grade.Results1000 patients with a mean age of 32. +/- 16.3 (min = 18-max = 79) were included in the study. 20 patients (2%) were found to have LPD. Of those with LPD, 14 (70%) were grade 1, 4 (20%) were grade 2 and 2 (10%) were grade 3. Again of those with LPD, 14 (70%) had LPD localized on the right and 6 (30%) had LPD on the left. In 12 (60%) of the patients with LPD, herniated tissue was detected. Among these patients with herniation, fatty tissue herniation was observed in 10 (83.3%) and medial rectus muscle herniation was observed in 2 (16.7%).Discussion and ConclusionComprehensive evaluation for and identification of LPD are very important before possible sinus surgery.
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    Interventricular septal dissecting aneurysm resulting from congenital coronary fistula: A case report
    (John Wiley and Sons Inc., 2023) Tekinhatun, Muhammed; Cihan, Fatih; Demir, Muhammed
    Dissected interventricular septal aneurysm is a rare complication that occurs in conditions such as acute myocardial infarction, sinus valsalva aneurysm, infective endocarditis, thoracic trauma, pericardiocentesis and balloon angioplasty. Only two cases of dissected interventricular septal aneurysm secondary to coronary fistula have been described in the literature. Here, we present a case of dissected interventricular septal aneurysm secondary to congenital coronary fistula.
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    İntraosseöz migrasyonlu kalsifik tendinitin radyolojik değerlendirmesi: tek merkez deneyimi
    (Pamukkale Üniversitesi, 2025) Tekinhatun, Muhammed; Alver, Kadirhan; Akbudak, İbrahim; Turmak, Mehmet; Deniz, Muhammed Akif
    Amaç: Kalsiyum depositlerin kemik, kaslar ve subakromiyal-subdeltoid bursa gibi komşu dokulara göçü, tanısal zorluklara ve gereksiz prosedürlere yol açabilen nadir bir komplikasyondur. Bu çalışmanın amacı, rotator manşet kalsifik tendinitinin nadir görülen intraosseöz migrasyonunu tanımlamak ve bu vakaları demografik özellikler, ilişkili patolojiler ve radyolojik bulgular açısından değerlendirmektir. Gereç ve yöntem: Bu retrospektif çalışma, Ocak 2021 ile Eylül 2024 tarihleri arasında gerçekleştirilmiş ve 3,755 omuz MRG incelemesi gözden geçirilmiştir. Hariç tutulanlar arasında hareket artefaktı olan hastalar, pediatrik vakalar, travma veya cerrahi öyküsü olanlar ve enfeksiyon vakaları yer almıştır. İki radyolog kalsifik tendinit ve intraosseöz migrasyon vakalarını bağımsız olarak değerlendirmiş, bulgular demografik veriler ve ilişkili patolojilerle analiz edilmiştir. Bulgular: 3,000 tarama sonucunda vakaların %8,17'sinde kalsifik tendinit tespit edilmiştir. İntraosseöz komplikasyonlar toplam popülasyonun %0,5’inde ve kalsifik tendinit vakalarının %6,12'sinde gözlenmiştir. Kalsifik tendinit hastalarının çoğunluğu (%73,77) kadın olup, intraosseöz komplikasyonların %86,67’si kadın hastalarda görülmüştür (p=0.211 (Fisher's Exact Test)). İntraosseöz komplikasyonlar, supraspinatus ve infraspinatus tendonlarının daha yüksek tutulma oranlarıyla ilişkilendirilmiştir (%73'er), komplikasyonu olmayan hastalarda ise bu oranlar sırasıyla %63 ve %36 olarak gözlenmiştir (p<0.001). Sonuç: Kalsifik tendinit, nadir görülen intraosseöz uzanımlar gösterebilir ve doğru tanı için dikkatli görüntüleme gerektirir. MRG ve BT, bu vakaların tanısında kritik bir rol oynar. Tedavi edilmeyen vakalarda komplikasyonlar devam ederken, ultrason rehberliğinde yapılan enjeksiyon tedavisi etkili sonuçlar vermektedir. Kalsifik tendinit, görüntülemede tümörleri taklit edebileceğinden doğru ayırıcı tanı gereklidir. İntraosseöz komplikasyonların erken teşhisi ve uygun tedavisi esastır. Gelecekteki çalışmalar, daha geniş popülasyonlar ve uzun dönem takiplerle prognoz ve tedavi sonuçlarını daha iyi değerlendirmelidir.
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    Pericardial rupture of mediastinal mature cystic teratoma: An unusual cause of pediatric acute chest pain
    (John Wiley and Sons Inc., 2023) Tekinhatun, Muhammed; Ufuk, Furkan; Yılmaz, Münevver; Gürses, Dolunay; Kış, Argün; Öztürk, Gökhan
    Apreviouslyhealthy12‐year‐old girl presented to the emergency departmentwith severe chest pain and dyspnea that woke her from sleep. She had short‐termsyncope just before the emergency admission. On physical examination,respiratory rate was 26 breaths per minute while resting, and blood pressurewas 92/56 mmHg. Other physical examination findings were insignificant. Shehad no past medical history, and her family history was unremarkable. Laboratorytest results showed elevated C‐reactive protein (27 mg/L; reference range:<5 mg/L) and white blood cell count (13.7 K/μL; reference range: 4–12 K/μL).Other laboratory test results were within normal limits, including troponinT value(3 ng/L; reference range: 3–14 ng/L). An electrocardiogram showed 1 mmST‐segment elevation in bipolar (D1 and D2) limb leads, and augmented vectorfoot leads, and echocardiography revealed a complicated pericardial effusion anda suspicious mass adjacent to the left ventricle.
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    Persistent trigeminal artery detected on computed tomography angiography
    (Springer France, 2022) Deniz, Muhammed Akif; Turmak, Mehmet; Hattapoğlu, Salih; Tekinhatun, Muhammed
    Purpose This study aimed to investigate the prevalence of persistent trigeminal arteries (PTAs) using computed tomography (CT) angiography, emphasize its major characteristics, and compare the findings with those reported in the relevant literature. Methods Patients who underwent cerebral CT angiography in our radiology clinic for any preliminary diagnosis between December 2013 and December 2020 were included in this retrospective study. The patients were reviewed in terms of their age, sex, and the presence of PTAs. The localization of the PTA, vascular connection, PTA type (according to Saltzman and Salas classification), and vascular pathology at the level of anastomoses were examined in the patients with PTAs. Results A total of 1150 patients, (632 [55%] males and 518 [45%] females) were included in this study. A total of seven (0.6%) patients had PTAs. PTAs were located on the right and left sides in three (43%) and four (57%) patients, respectively. A total of three (43%), two (28%), and two (28%) cases were classified as types I, II, and III PTA based on the Saltzman classification, respectively. Moreover, four (57%) and three (43%) cases were lateral and medial types based on the Salas classification, respectively. Conclusion In conclusion, understanding the diagnosis and classification of PTAs is crucial for the diagnosis of possible vascular pathologies by neuroradiologists and physicians performing neurovascular interventional procedures or operations. If these vascular pathologies remain undetected, they may cause fatal bleeding or embolism during surgeries and endovascular procedures.
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    Relation between anterior ethmoidal artery course on computed tomography and supraorbital ethmoid cell and Keros classification
    (Springer, 2024) Saglam, Tarik; Deniz, Muhammed Akif; Turmak, Mehmet; Hattapoglu, Salih; Akbudak, Ibrahim; Tekinhatun, Muhammed
    Purpose The anterior ethmoidal artery (AEA) is an important risk area in endoscopic sinus surgery. This study aimed to evaluate the course of AEA according to the Keros classification and the presence of supraorbital ethmoid cell (SOEC) and to prevent possible complications by emphasizing the importance of preoperative paranasal computed tomography (CT) imaging. This approach will increase the effectiveness of endoscopic sinus surgery and improve patient safety.Methods The paranasal CT scan images of patients aged > 18 years between October 2020 and November 2021 from our center were retrospectively analyzed. The images were primarily evaluated in the coronal plane, and the sagittal and axial planes were utilized to evaluate variations in AEA regarding the skull base. Furthermore, the relation of AEA course with Keros classification and SOEC was evaluated. The study included 1000 patients aged 18-80 years (right and left, a total of 2000 samples).Results Grade 3 AEA was the most common regarding the skull base. Keros Type 2 was the most common classification. Overall, 48.7% patients had SOEC. The incidence of Grade 3 AEA was higher among patients with SOEC and a higher Keros classification compared with those without SOEC and a lower Keros classification. Furthermore, Keros Type 3 was the most associated with SOEC presence.Conclusion Consistent with the literature, the probability of Grade 3 AEA in patients with high Keros classification and SOEC was significantly higher in our study. Therefore, we consider that preoperative imaging according to Keros classification and SOEC presence can predict AEA course and guide surgery.
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    Role of Superb Microvascular Imaging (SMI) vascularity index values and vascularity patterns in the differential diagnosis of malignant liver lesions
    (Springer, 2024) Aslan, Halil Serdar; Arslan, Muhammet; Alver, Kadir Han; Vurgun, Sercan; Demirci, Mahmut; Tekinhatun, Muhammed
    PurposeTo evaluate the Superb Microvascular Imaging (SMI) vascular patterns and vascularity index (VI) values of malignant focal liver lesions (FLLs), assess their role in differential diagnosis, and examine interobserver agreement.Materials and methodsA total of 107 patients (52 males, 55 females; mean age 62 +/- 12.8 years, range 25-87) referred to the interventional radiology clinic for FLL biopsy between April 2022 and April 2023 were analyzed. Two radiologists independently assessed the SMI vascular patterns and calculated VI values. Differences among three lesion groups - hepatocellular carcinoma (HCC, n = 16), non-HCC primary liver malignancies (n = 16), and metastases (n = 75) - were evaluated, and interobserver agreement was assessed.ResultsMost metastases (88%) demonstrated hypovascular patterns, while HCCs predominantly exhibited hypervascular patterns (68.7-81.3%). Non-HCC primary malignancies showed no dominant vascular pattern. Significant differences in SMI patterns were observed among lesion types (p = 0.001-0.035). VI values for HCCs (7.53-7.73) were significantly higher than those for non-HCC malignancies (2.73-2.93) and metastases (1.35-1.36) (p = 0.0001). ROC analysis based on VI values yielded AUCs of 0.886-0.887, with a cutoff of 2.92 providing 81.3% sensitivity and 79.1-80.2% specificity for HCC diagnosis. The inter-reader agreement for SMI patterns had a kappa score of 0.634, while the intraclass correlation coefficient (ICC) for VI values was 0.959.ConclusionHCCs displayed more hypervascular SMI patterns and significantly higher VI values compared to other malignant FLLs, emphasizing the diagnostic potential of VI in distinguishing HCC from non-HCC tumors. Although metastases primarily exhibited hypovascular patterns and low VI values, no dominant vascular pattern was identified in non-HCC primary liver malignancies. Assessing VI values provided higher interobserver agreement compared to SMI patterns, enhancing objectivity and reproducibility.
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    Supra-Aortic Branch Occlusion From Takayasu Arteritis
    (Wiley, 2024) Tekinhatun, Muhammed; Ertas, Faruk
    This illustration depicts the complete occlusion of all supra-aortic branches due to Takayasu arteritis, as shown in invasive coronary angiography and CT angiography (a) Catheter angiography showing the occluded branches of the aortic arch (*). (b) Sagittal CT angiography showing calcification in the occluded supra-aortic branches (arrows) and thickened aortic wall (dashed arrow). image