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Öğe Comparison of axial and coronal axis MRI kidney volume measurement in pediatric congenital solitary kidney(Springer Science and Business Media, 2023) Bako, Derya; Köksoy, Adem Yasin; Turmak, MehmetBackground Accurate estimation of kidney size and volume in the solitary functioning kidney is crucial because of a higher risk of developing kidney injury. MRI is an accurate method and is suitable for kidney volume measurement. Usually, axial axis images and measurement methods are preferred for kidney volume measurements. However, the anteroposterior diameter of the kidney is smaller than the longitudinal diameter, meaning that imaging in the coronal axis could provide needed information in a shorter time, enabling imaging of younger patients without sedation. Therefore, the purpose of this study was to compare coronal and axial axis kidney volume measurement methods and evaluate intra-observer and inter-observer reliability. Methods Axial axis T2W and coronal axis FIESTA images of kidneys were obtained with 10 mm slice thickness and no slice gap in pediatric patients with congenital solitary kidneys. Free-hand manual tracing was used to calculate volumes in both methods. Images were analyzed by two operators with diferent levels of experience. The expert operator computed solitary kidney volume twice in both methods for the intra-observer reliability, while the beginner operator’s measurements were used for the inter-observer reliability. Results High intra-observer (0.965 for axial and 0.972 for coronal) and inter-observer reliability were revealed (0.964 for axial and 0.963 for the coronal) for both measurement methods. Conclusion The coronal plane volume measurement method, which has a signifcantly shorter examination and post-processing time, is a highly reproducible and reliable method that can enable volume measurement with MRI in younger children, as the imaging time will be shortened.Öğe CT Evaluation of Swallowed Foreign Bodies Located in the Gastrointestinal System(Cureus Inc, 2022) Deniz, Muhammed Akif; Turmak, MehmetBackground and objective CT imaging is important in detecting the location and the structure of swallowed foreign bodies and assessing their complications, due to its features such as the ability to show the detailed anatomical structure and enable multiplanar examination. In this study, we aimed to analyze the CT findings of swallowed foreign bodies located in the gastrointestinal tract and compare them with the data in the existing literature. Materials and methods We conducted a retrospective archive study to achieve our goals. Patients who presented to our radiology department with the preliminary diagnosis of foreign body ingestion, abdominal pain, or acute abdomen and were found to have a foreign body in the gastrointestinal tract on CT between April 2018 and April 2021, especially those in whom the presence of a foreign body was confirmed by endoscopy or surgery, were included in our study. The patients were evaluated in terms of age, gender, foreign body type, foreign body localization, and complications. Results A total of 31 patients (15 males and 16 females) were included in the study. The patients' age ranged from 1 to 67 years, and the mean age was 28.5 +/- 5.4 years. The most common foreign bodies found were metallic toy parts (n=11, 35%), and most of the foreign bodies were located in the ileum (n=9, 29%) of the patients. Complications were observed in nine patients (29%). In patients with complications, the most common finding was perforation (n=3, 38%). Conclusion When a CT exam is performed on patients with abdominal pain, the gastrointestinal tract should be carefully evaluated to determine if a foreign body is involved and to analyze the complications caused by the foreign body.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 Diagnostic contribution of focal cortical dysplasia MRI imaging findings and ADC values(Springer, 2019) Aslan, Aydin; Deniz, Muhammed Akif; Deniz, Zelal Tas; Turmak, Mehmet; Ekici, FaysalBackgroundFocal cortical dysplasia (FCD) is a condition that often interferes with the cranial mass. Knowledge of focal cortical dysplasia magnetic resonance imaging (MRI) characteristics is of utmost importance for diagnosis. This study aimed to determine the diagnostic contribution of cranial MRI and the apparent diffusion coefficient (ADC) in FCD.ResultsCranial MRI revealed subcortical hyperintensity (SCH) in 52 patients (82.5%), blurring of the gray-white matter (GWM) interface (blurring) in 52 patients (82.5%), cortical thickening (CT) in 48 patients (76%), cortical signal increase (CSI) in 41 patients (65%), and transmantle sign (TMS) in 29 patients (46%). All of the FCDs had a diffusion increase in diffusion-weighted images (DWIs). The mean ADC value at the lesion level was 1.087 x 10(-3) mm(2)/s (0.82/1.316 x 10(-3) mm(2)/s), which was significantly higher than the mean ADC value measured from the contralateral symmetric region (0.758 x 10(-3) mm(2)/s, 0.678/0.872 x 10(-3) mm(2)/s, p = 0.001).ConclusionResults of this study revealed that the most common MRI findings in FCD patients are SCH, blurring, and CT. These findings aid in an easier diagnosis in patients with suspected FCD. All of the lesions studied here in had a diffusion increase in DWI. The quantitative mean ADC values detected in the differential diagnosis of other lesions with a diffusion increase can be used as a reference. Therefore, in addition to the ADC values and electroencephalography (EEG) findings, the conventional MRI findings of FCD, which is resistant to medical treatment, can help to facilitate the diagnosis of FCD, which can be treated with surgery.Öğe Evaluation of the multi-slice computed tomography outcomes in diaphragmatic injuries related to penetrating and blunt trauma(Elsevier Science Inc, 2018) Turmak, Mehmet; Deniz, Muhammed Akif; Ozmen, Cihan Akgul; Aslan, AydinPurpose: Traumatic diaphragmatic rupture is a diagnostic challenge for both surgeons and radiologists and generally occurs secondary to blunt and penetrating trauma of thoracoabdominal region. Material and methods: 56 patients who underwent surgical. procedure due to blunt or penetrating trauma were included to the study. Results: There were 37 diaphragmatic ruptures in the left side and 19 patients in the right side. The most common radiological finding was the direct monitoring of defect (54,3%). Conclusion: Findings suggestive of diaphragmatic rupture must be carefully evaluated in patients with blunt or penetrating thoracoabdominal trauma.Öğe Evaluation of thyroid Zuckerkandl tubercle by computed tomography(Springer France, 2022) Deniz, Muhammed Akif; Turmak, Mehmet; Hattapoglu, Salih; Akbudak, Ibrahim; Tay, MuhyettinPurpose This study investigated the incidence of thyroid Zuckerkandl Tubercle (ZT) using a computed tomography (CT) scan of the neck with contrast to identify the typologies in ZT-positive CT scans, investigate the presence of nodules located in that area, and compare the results with the relevant literature. Methods We selected and retrospectively examined the CT scan images of patients who presented to our clinic with CT scans of the neck with contrast that clearly showed thyroid tissue and boundaries. Patients were evaluated based on age, gender, and presence of thyroid ZT. Patients with thyroid ZT were further investigated for localization and type of tubercles as well as for presence of nodules at the tubercle level. Results A total of 1000 patients (mean age: 48.4 +/- 19.1) were included in the study. Out of the total 222 (22.2%) patients who had thyroid ZT, 134 (60.4%) patients had unilateral thyroid ZT on the right side and 29 (13.1%) patients had unilateral thyroid ZT on the left side; 59 (26.6%) patients had bilateral thyroid ZT. In addition, nodules at the ZT level were observed in 13 (1.3%) of the patients. A review of all cases with ZTs indicated that 63% were Type 1, 31% were Type 2, and 5% were Type 3. Conclusion During the thyroid operations, ZT is essential for locating the recurrent laryngeal nerve. Reporting the presence of ZTs based on CT scans is crucial because it can prevent unnecessary interventional procedures, misdiagnoses, and likely complications in patients with planned thyroid operations.Öğe Examination of radiological findings and clinical parameters in paediatric patients with Covid-19(Dicle Üniversitesi Tıp Fakültesi, 2023) Polat, Zeynep Ece Taştekin; Yılmaz, Kamil; Turmak, MehmetObjective: It was aimed to evaluate the relationship between imaging techniques and clinical and laboratory parameters in paediatric COVID-19 patients. Methods: Our study included 187 patients under the age of 18 whose diagnosis of COVID-19 was confirmed by PCR test. Demographic, clinical, laboratory and radiological imaging findings of the patients were reviewed retrospectively from their file records. Results: 57.2% of the patients were male and the mean age was 110.1±67.4 months. A pulmonary finding associated with COVID-19 was detected in 21 (12%) of 175 patients who underwent Posterior-anterior (PA) chest X-ray. The most common findings were consolidation (n=16; 9.1%), bilateral ground-glass appearance (n=11; 6.3%), and atelectasis (n=5; 2.9%), respectively. Computed lung tomography was performed in 67 of the patients. The presence of a pulmonary finding associated with COVID-19 was detected in 28 (41.8%) of these patients. The three most common findings were consolidation (n=16; 23.9%), bilateral ground glass appearance (n=16; 23.9%), and atelectasis (n=15; 22.4%), respectively. It was determined that for patients with imaging findings on PA X-ray needed more paediatric intensive care, the length of their hospital stay was longer, comorbid diseases were present, their cough and tachypnea complaints were more pronounced (p<0.05). As the disease severity increased, especially in patients <1 year of age, the frequency of significant findings increased in both imaging methods (p<0.05). Conclusion: We think that imaging methods can be performed when necessary in children with suspected COVID-19 and can provide preliminary information about the course and severity of the disease.Öğe Image-Guided Subcutaneous Port Implantation in Patients with Malignant Diseases(Modestum Ltd, 2014) Onder, Hakan; Tekbas, Guven; Turmak, Mehmet; Inal, Ali; Ekici, Faysal; Gumus, Hatice; Onder, AkinTo present the results of our retrospective study on 49 totally implantable subcutaneous venous ports inserted in angiography unit under ultrasound and fluoroscopic guidance. 49 subcutaneous venous chest ports were placed in 48 patients (mean age, 49.3 +/- 16.7 years). One patient underwent port implantation twice. All the ports had single lumen catheters. The procedures were performed under ultrasound and fluoroscopic guidance in angiography unit. All ports were placed on the anterior chest wall. The technical success rate was 100%. There was no procedure-related minor or major complication. There was no early complication (in the first month). Late complications occurred at a rate of 8.3% (n:4). In patients with malignant diseases, radiological implantation of subcutaneous venous ports can be performed with similar or lower complication rates, as compared to the surgical literature, due to the obvious advantage of imaging guidance. Hence, port implantation with imaging guidance may become a more preferred implantation method in the future.Öğe İntraosseöz migrasyonlu kalsifik tendinitin radyolojik değerlendirmesi: tek merkez deneyimi(Pamukkale Üniversitesi, 2025) Tekinhatun, Muhammed; Alver, Kadirhan; Akbudak, İbrahim; Turmak, Mehmet; Deniz, Muhammed AkifAmaç: 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.Öğe Is a two-hour monitoring period sufficient and safe for patients undergoing ultrasound-guided percutaneous liver mass biopsy?: A prospective and multicenter experience(Wiley, 2024) Aslan, Halil Serdar; Arslan, Muhammet; Alver, Kadir Han; Demirci, Mahmut; Korkmaz, Mehmet; Esen, Kaan; Turmak, MehmetPurposeTo investigate whether patients undergoing percutaneous liver mass biopsy (PLMB) can be safely discharged following a two-hour monitoring period.MethodsA multi-center prospective analysis was conducted for 375 patients (196 males and 179 females), mean age 63 +/- 12.45 years (range 37-89) who underwent PLMB between August 2023 and March 2024. Patients were monitored for 24 h, and complications were classified as minor or major. The timing of complications was categorized into three groups: within the first two hours, between the 2nd and 24th hours, and within 1 week after 24 hours.ResultsMinor complications occurred in 18.93% (71/375) and major complications in 2.13% (8/375). Most minor complications (80.2%, 57/71) appeared within the first two hours, 12.7% (9/71) between 2 and 24 h, and 7.1% (5/71) after 24 h. All major complications (62.5%, 5/8) except late-onset cases, occurred within the first two hours. No major complications occurred between 2 and 24 h. Late-onset major complications occurred in 37.5% (3/8) after 24 h.ConclusionThe two-hour monitoring period did not adversely impact patient management regarding minor complications and is safe for identifying all major complications except for late-onset ones. Extending the post-biopsy recovery period does not significantly improve patient care. A two-hour observation period after PLMB, including hemogram monitoring and ultrasound, does not adversely affect patient management regarding minor complications and is safe and efficient for detecting significant complications except delayed ones. Extending recovery time does not significantly improve patient care, as delayed complications appear later. imageÖğe “Meme İçinde Meme” mi Var? Meme Hamartomlarının Radyolojik Özellikleri(2020) Denız, Muhammed Akif; Cakır, Caglayan; Denız, Zelal Taş; Aslan, Aydın; Turmak, MehmetAmaç: Bu çalışmada benign lezyonlar olan meme hamartomlarının (MH) radyolojik görüntüleme özelliklerini ele almak ve hamartom lezyonlarının tanınabilirliğini vurgulayarak gereksiz tetkik ve biyopsilerin azaltılmasına katkıda bulunmak amaçlanmıştır. Gereç ve Yöntemler: Ocak 2014—Temmuz 2019 döneminde Dicle Üniversitesi Tıp Fakültesi radyoloji kliniğimizde MH tanısı almış olan toplam 33 (32 kadın, 1 erkek) hastanın mamografi (MG), ultrason (US) ve manyetik rezonans görüntüleme (MRG) görüntüleri retrospektif olarak incelendi. Altı hastanın MG, US ve MRG, 21 hastanın MG ve US, 6 hastanın ise sadece MRG görüntüleri mevcuttu. Erkek hasta için MG ve US görüntüleri mevcuttu. Bulgular: Ortalama hasta yaşı 48,5 (28–74) yıldı. Ortalama kitle boyutu 3,4 (1,5–12) cm idi. En büyük kitle jinekomasti ön tanısı ile başvuran erkek hastada olup sağ memeyi tamamen kaplamıştı. Lezyonlar 20 hastada sağ, diğer 13 hastada sol meme yerleşimliydi. MRG görüntüleri incelendiğinde postkontrast görüntülerde lezyonların tamamında periferal ağırlıklı heterojen kontrastlanma mevcutken kontrastlı serilerde 10 hastada tip 1, 2 hastada tip 2 kinetik eğri mevcuttu. Hiçbir hastada tip 3 kinetik eğri saptanmadı. Difüzyon MRG’de normal meme dokusu görünür difüzyon katsayısı (GDK) değeri ile hamartom GDK değeri arasında istatistiksel olarak anlamlı fark bulunmadı (p>0,5). Tartışma ve Sonuç: Benign lezyonlar olan MH’ler radyolojik incelemelerde memeye benzer özellikte küçük nodüler lezyonlar şeklinde izlenirler ve bu özellikleriyle “meme içinde meme” görünümü verdiklerinden kolaylıkla tanınabilirler.Öğe Orbital MRI in thyroid-associated orbitopathy(MediHealth Academy Yayıncılık, 2022) Deniz, Muhammed Akif; Turmak, Mehmet; Pekkolay, Zafer; Hattapoğlu, SalihAim: Thyroid-associated orbitopathy (TAO) is the most common cause of proptosis in adults and the clinical picture is mostly associated with thyroid dysfunction. MRI is frequently used because of its advantages, such as high soft tissue resolution, multiple plane evaluation, and no risk of ionizing radiation exposure to the lens. The research aim was to present cases of thyroid orbitopathy with MRI findings and to compare the findings with existing literature. Material and Method: Patients who visited our radiology clinic with a preliminary diagnosis of TAO between April 2015 and February 2021 and underwent orbital MRIs were included in the study. We evaluated parameters such as age, sex, presence of proptosis, orbital muscle involvement, increase in orbital fatty tissue, and lacrimal gland involvement. Results:A total of 35 patients were included in our study. The mean age was 40.6 (18-60) years, 19 (54%) patients were female, and 16 (46%) were male. All patients were diagnosed with Graves’ disease, whereas no patient was diagnosed with Hashimoto’s thyroiditis. The most common findings were proptosis in 33 (94%) patients, inferior rectus involvement in 27 (77%) patients, and medial rectus muscle involvement in 25 (71%) patients. No significant correlation was found between the presence of uni/bilateral involvement and TSH values (p = 0.008). Conclusion: In conclusion, since the presence of orbital involvement is crucial for treating thyroid diseases, all orbital structures involved should be reported by imaging. Orbital MRI is an effective imaging modality in the detection and differential diagnosis of TAO.Öğe Penetran ve künt travmalara bağlı diyafragma yaralanmalarında multidedektör bilgisayarlı tomografi bulgularının değerlendirilmesi(2015) Turmak, MehmetAmaç: Travmatik diafragma rüptürü, hem radyologların hemde cerrahların tanı koymada zorlandığı bir durumdur ve genellikle torakoabdominal bölgenin künt ve penetran travmaları sonucu oluşmaktadır. Erken tanınması ve cerrahi olarak onarılması hayati öneme sahiptir. Günümüzde artan trafik kazaları, kesici delici alet yaralanmaları ve ateşli silah yaralanmaları diyafragma rüptürü insidansında artışa yol açmaktadır. Biz bu çalışmada diyafragma rüptürü gelişen travma hastalarında travma çeşitlerini, diyafragma rüptürüne sekonder gelişen organ herniasyonlarını ve radyolojik olarak saptanan tanısal işaretleri, çok kesitli bilgisayarlı tomografi ile ortaya koymayı amaçladık. Gereç ve Yöntem: Dicle Üniversitesi Tıp Fakültesi Hastanesinde 2006-2012 yılları arasında, künt veya penetran torakoabdominal travma sonucu radyoloji kliniğinde 16 veya 64 dedektörlü bilgisayarlı tomografi cihazları ile çekimleri yapılmış ve diyafragma rüptürü nedeni ile cerrahi prosedür uygulanmış 56 hasta çalışmamıza dahil edildi. Hastaların görüntüleri iki deneyimli radyolog tarafından retrospektif değerlendirildi. Hastalar, yaş ve cinsiyet, yaralanma nedeni (penetran veya künt), yaralanan taraf, eşlik eden diğer organ yaralanmaları, diyafragma yaralanmasına sekonder gelişen organların intratorasik herniasyonu açısından değerlendirildi. Ayrıca diyafragma rüptürüne sekonder gelişen radyolojik işaretlerin sıklığı araştırıldı. Bulgular: Çalışmaya 45 erkek (% 80,3) ve 11 kadın (% 19,7) dahil edildi. Hastaların yaş ortalaması 33,9 ± 17,1 (4-84) yıl bulundu. Olgularımızın 37’si (% 66,1) penetran, 19’si (% 33,9) künt travmaya maruz kalmıştı. Travma sonucu 37 hastada (% 66,1) sol, 19 hastada (% 33,9) sağ hemidiyafragma yaralanmıştı. Hastaların tümünde eşlik eden organ yaralaması vardı ve en sık akciğer (% 51,7), daha sonra dalak (% 37,5) yaralanması mevcuttu. 25 (% 44,6) hastada eşlik eden organ herniyasyonu olup en sık kolon (% 60) sonra mide (% 48) herniye olmuştu. En sık radyolojik bulgu “defektin doğrudan izlenmesi’’ (% 53,6) olup takiben “Abdominal organ herniasyonu” (% 44,6), “diyafragmada kalınlaşma’’ (% 39,3) saptandı. Künt travmalarda (penetran travmalara oranla) diyafragma rüptüründe radyolojik bulguların sıklığı istatistiksel olarak anlamlı şekilde daha fazla bulundu. Sağ ve sol hemidiyafragma yaralanmaları karşılaştırıldığında künt ve penetran travmalarda diyafragma rüptürünü düşündüren radyolojik işaretler sol tarafta daha fazla saptandı. Sonuç: Radyolog, diyafragma rüptüründe radyolojik özel işaretlere aşina olmalıdır. Künt veya penetran torakoabdominal travmalarda, diyafragma rüptürünü düşündüren bulgular dikkatle değerlendirilmeli ve cerrah bu durum ile ilgili bilgilendirilmelidir. Anahtar kelimeler: Çok kesitli bilgisayarlı tomografi, Travma, Diyafragma rüptürü, Radyolojik işaretler,Öğe Persistent trigeminal artery detected on computed tomography angiography(Springer France, 2022) Deniz, Muhammed Akif; Turmak, Mehmet; Hattapoğlu, Salih; Tekinhatun, MuhammedPurpose 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.Öğe 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, MuhammedPurpose 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.
