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Ayşe Erden

Publications and source records attributed to Ayşe Erden.

16 recordsLinked to original sources
PubMed2006

Budd-Chiari syndrome: a review of imaging findings.

Budd-Chiari syndrome is an uncommon, often fatal disorder resulting from an obstructed hepatic venous outflow tract. The obstructive lesion is situated in the main hepatic veins, in the inferior vena cava or in both. The nature, location and extension of the obstruction can be displayed on diagnostic imaging techniques. In addition to this direct evidence, the indirect findings of venous obstruction such as the presence of intra- and extrahepatic collateral veins, when combined with the altered morphology and enhancement pattern of the liver enables one to arrive at a confident diagnosis. In patients with suspected Budd-Chiari syndrome, gray-scale sonography with complementary support of color and pulsed Doppler examinations is the first step in approaching the diagnosis. It is followed by a contrast-enhanced cross-sectional technique, preferrentially by MR angiography. The patients with a high clinical suspicion of Budd-Chiari syndrome may undergo hepatic venography or venacavography directly so that a potential of recanalization (e.g. percutaneous transluminal angioplasty with or without stent placement or TIPS) of the obstructed segment under the guidance of these techniques would not be delayed.

Budd-Chiari Syndrome↗
PubMed2006

Ectopic hypoplastic and multiseptate gallbladder with coexisting choledochal cyst: evaluation with sonography and magnetic resonance cholangiopancreaticography.

Multiseptate gallbladder, a rare congenital anomaly, may exist as an isolated anomaly or may coexist with other biliary system anomalies. We report a case of a multiseptate, ectopic, hypoplastic gallbladder associated with a choledochal cyst. The diagnosis was made using sonography and magnetic resonance cholangiopancreaticography.

Cholangiopancreatography, Magnetic Resonance↗
PubMed2006

Evaluation of the splenic vein diameter and longitudinal size of the spleen in patients with Gamna-Gandy bodies.

PURPOSE: The aim of this retrospective study was to compare the splenic vein diameter and longitudinal size of the spleen in patients with portal hypertension in whom Gamna-Gandy bodies were present in their spleen with those of cirrhotic patients without Gamna-Gandy bodies and a control group. MATERIALS AND METHODS: Between July 2001 and February 2006, patients in whom Gamna-Gandy bodies were detected in their spleen and the number of patients who had been undergone magnetic resonance (MR) imaging with the diagnosis of chronic liver disease were determined. A total of 43 cases with Gamna-Gandy bodies were noted. Out of these patients, a case of lymphoma was excluded from the study. Additional 3 cases with splenic vein thrombosis were not included in statistical analysis. Accordingly, the splenic vein diameter and longitudinal size of the spleen in 39 patients (group 1: 12 women, 27 men; mean age, 38.5 years) with portal hypertension in whom Gamna-Gandy bodies were detected in their spleen on T1-weighted gradient-echo MR images between July 2001 and February 2006 were measured. The values obtained were compared with those of 29 cirrhotic patients without Gamna-Gandy bodies (group 2: 14 women, 15 men, mean age 48.2 years) and control group (group 3: 13 women, 18 men, mean age 46.8 years). The differences between the groups were analyzed with ANOVA and student-t test. RESULTS: Gamna-Gandy bodies were detected in 6.3% (42/670) of patients with chronic liver disease. The mean longitudinal axis of the spleen (20.2+/-4.2 cm) in group 1 was significantly greater (p<0.001) than in group 2 (14.4+/-3.9 cm). The mean splenic vein diameter was significantly larger in group 1 (14.3+/-4.0 mm) than those in groups 2 and 3 (11.2+/-3.2 mm and 7.8+/-1.4 mm, respectively). CONCLUSION: The splenic vein diameter and longitudinal size of the spleen in portal hypertensive patients with Gamna- Gandy bodies are significantly larger than that of cirrhotic patients without Gamna-Gandy bodies and that of control group.

Adolescent↗
PubMed2005

Primary sclerosing cholangitis: MR cholangiopancreatography and T2-weighted MR imaging findings.

PURPOSE: To present MR cholangiopancreatography (MRCP) findings and to determine the hepatic morphological changes of primary sclerosing cholangitis (PSC) seen on T2-weighted fast spin echo (FSE) images. MATERIALS AND METHODS: Twenty-three patients (15 women, 8 men) with ages ranging from 17 to 80 years (median, 45.1 years) were included in the study. MR imaging was performed on a 1 Tesla MR unit using a phased-array coil. Heavily T2-weighted images were obtained with single-shot fast spin echo technique for MRCP. Morphological changes encountered in livers were evaluated with coronal and axial T2-weighted fast spin echo images. RESULTS: Irregularities, multifocal strictures, and dilatations in different levels of the biliary channels were seen in all patients. T2-weighted images showed lobulated hepatic contours in 21.73%, atrophy in both anterior and posterior segments of the right lobe in 21.73%, atrophy in the anterior segment in 13.04%, atrophy in both medial and lateral segments of the left lobe in 17.39%, atrophy in the medial segment in 8.69%, atrophy in the lateral segment in 4.34%, hypertrophy in the posterior segment of the right lobe in 4.34%, global hypertrophy in the left lobe in 4.34%, hypertrophy in the lateral segment of the left lobe in 4.34%, and caudate lobe hypertrophy in 21.73% of the patients. In addition, periportal edema was noted in 39.13%, increased parenchymal signal on T2-weighted images in 26.08%, periportal and/or portocaval lymphadenopathy in 34.78%, and portal hypertension in 34.78% of our patients. In one patient (4.34%), the liver had a round shape characteristic of PSC. CONCLUSION: MR imaging is a useful method for establishing the changes in biliary ducts specific to PSC, and for identifying long-standing cases complicated with cirrhosis.

Adolescent↗
PubMed2004

Contrast-enhanced MR angiography of benign regenerative nodules following TIPS shunt procedure in Budd-Chiari syndrome.

In this report we describe the magnetic resonance (MR) angiographic features of benign hepatic nodules that developed in a patient with Budd-Chiari syndrome, and present the distinguishing features of benign regenerative nodules from hepatocellular cancer. In a 27-year-old woman with chronic Budd-Chiari syndrome, previously non-existing benign nodules developed in the liver parenchyma during the 10-month period following transjugular intrahepatic portosystemic (TIPS) shunt placement. The liver had been examined with gray-scale and Doppler sonography in addition to the MR imaging and MR angiography. On MR angiography, more hepatic nodules became visible in the portal venous phase compared to that of the arterial phase. Delayed washout of contrast medium in nodules was considered to be due to stasis in hepatic sinusoids. Hypervascularization, appearance after portosystemic shunt creation, multiplicity, small size ( <=2 cm in diameter in our patient), presence of peripheral rim, and high signal intensity on T1-weighted images are important imaging features of benign hepatic nodules that develop in patients with Budd-Chiari syndrome.

Adult↗
PubMed2004

[Anatomic variations of the bile ducts: MRCP findings].

PURPOSE: Anatomic variations of intra or extrahepatic bile ducts may be problematic during surgical procedures. Besides iatrogenic trauma of the bile ducts during cholecystectomy, formation of bile duct stones, recurrent pancreatitis, cholangitis and biliary malignancies can be seen. The aim of this study was to evaluate the frequency of anatomic variations of the biliary tree and to present the magnetic resonance cholangiopancreatography (MRCP) findings. MATERIALS AND METHODS: Between July 2000 and April 2004, 581 patients suspected to have pancreatobiliary disease, were referred to our MR unit. Four hundred and seventy-five patients with ages ranging from 22 to 88 (median: 56) were included in the study retrospectively. MRCP was performed on a 1 Tesla MR unit, using phased-array coil for signal detection. Heavily T2 weighted images were obtained with SSFSE technique. Axial and coronal source images and reformatted images were all evaluated together for the possibility of any anatomic variation. RESULTS: Anatomic variations at different levels of biliary tree were found in 115 patients (24.2%). MRCP showed an aberrant right hepatic duct in 23 patients (4.8%), a right posterior hepatic duct in 27 patients (5.7%), trifurcation in 4 patients (0.8%), a long cystic duct in 8 patients (1.7%), a medial cystic duct insertion in 3 patients (0.63%), a low medial cystic duct insertion in 18 patients (3.8%), a short cystic duct in 1 patient (0.2%), a high localized gallbladder in 5 patients (1%), a vascular compression of common hepatic duct in 12 patients (2.5%), a pancreatobiliary junction anomaly in 3 patients (0.63%). Eleven patients had more than one anatomic variation (2.3%). CONCLUSION: MRCP is a useful, rapid, and non-invasive method for demonstrating the anatomy and the variations of the biliary tree. Diagnosis of these anatomic variations prior to surgical procedures may prevent iatrogenic injury to bile ducts.

Adult↗
PubMed2003

Hepatic outflow obstruction: enhancement patterns of the liver on MR angiography.

Our purpose was to present the enhancement patterns of the liver on MR angiography in patients with hepatic outflow obstruction. Twenty-three patients with Budd-Chiari syndrome (4 in acute stage and 19 in chronic stage of the disease) were examined with 3D contrast-enhanced MR angiography. During early and late portal venous phase of MR angiography the pattern of parenchymal enhancement was assessed on source images. The enhancement patterns were evaluated under 4 groups as following: (a) central (b) peripheral (c) patchy and (d) homogeneous enhancement. The morphologic changes in the liver (lobar hypertrophy or atrophy, hepatic surface irregularities) were also recorded. In the acute stage global liver enlargement (75%) with caudate hypertrophy (100%) and central enhancement of the liver (75%) were suggestive findings of the hepatic outflow obstruction. The left lobe hypertrophy (53%) associated with the caudate lobe hypertrophy (72%) and irregular surface (26%) were predominant in the chronic stage of the disease. The enhancement patterns seen in chronic disease were variable and reflected the persistent stasis of the portal blood flow (patchy enhancement in 32% of the patients) or the altered hemodynamics of the liver due to the development of subcapsular collaterals (peripheral enhancement in 21% of the patients). Homogeneous enhancement of the liver in Budd-Chiari syndrome may indicate the chronicity of the outflow obstruction (37%) and shows a more stable hepatic perfusion that occurs after the formation of intra and extrahepatic collateral veins. The morphological and perfusional features on multiphase contrast-enhanced MR angiography are valuable in understanding the effects of the hepatic outflow obstruction on the liver parenchyma.

Acute Disease↗
PubMed2003

Perianal infections: reader agreement and diagnostic performance of fat-suppressed contrast-enhanced MRI.

We aimed to determine the diagnostic performance of the contrast-enhanced fat-suppression technique in the detectability of perianal infections and to compare this technique with different MR sequences used for this purpose. Thirty consecutive patients with clinically suspected anorectal infections were examined with fast spin-echo (FSE) T2-weighted, short-inversion-time inversion recovery (STIR), and fat-suppressed and non-fat-suppressed T1-weighted spoiled gradient-echo (SGE) (in-phase) dynamic contrast-enhanced sequences. The results of MRI were correlated with the findings of surgery, which was considered as the standard of reference. Receiver-operating-characteristic curves were reconstructed to describe and compare the diagnostic value of each MR technique. The values of kappa were used as a measure of observer reliability. Diagnostic performances of STIR, FSE T2-weighted and fat-suppressed and non-fat-suppressed, contrast-enhanced SGE T1-weighted techniques showed statistically insignificant differences in detection of perianal infections. There was almost perfect interobserver agreement regarding the presence of lesions on each MR technique. Fat-suppressed, contrast-enhanced SGE T1-weighted MRI showed adequate diagnostic performance in the detection of perianal infections. However, its significance is not different from the other MR sequences used for the present study.

Adult↗
PubMed2003

[Pancreas divisum: Diagnostic importance of MR cholangiopancreatography].

PURPOSE: Pancreas divisum, non-fusion of the ventral and dorsal pancreatic ductal system, affects up to almost 10% of the population. Approximately 20% of the patients with pancreas divilsum will develop complications such as recurrent pancreatitis. In this study, we aimed to present the magnetic resonance cholangiopancreatography (MRCP) findings of pancreas divisum, evaluate its frequency in our study group and illustrate the importance of MRCP in the diagnosis of this anatomic variation. MATERIALS AND METHODS: Between August 2000 and October 2002, 248 patients suspected of having pancreatobiliary disease underwent MRCP with a 1.0 Tesla scanner. A phased-array coil was used for signal detection. Thirty-five to 70 millimeter thick slabs and thin (3 mm) collimation heavily T2 weighted images were obtained with the SSFSE (single shot fast spin echo) technique. Diagnosis of pancreas divisum was made by evaluation of the thick slabs, source and three dimensional reformatted images. RESULTS: Eleven of the patients with ages ranging from 23 to 71 years (mean: 55.8 +/- 4.2) were diagnosed as having the variation "pancreas divisum" (4.4%). Ten had symptoms of hepatobiliary disease and one showed signs of recurrent pancreatitis. All but three of the patients were correlated well with ERCP; in one patient ERCP could not be performed due to a cannulation problem secondary to Billroth II procedure and, in two patients ERCP was found to be unnecessary as MRCP was efficient. The patient having signs of pancreatitis was diagnosed as recurrent pancreatitis during the clinical diagnostic work-up. A dominant dorsal duct draining into minor papilla was detected in all patients, only five of them showed a short segment ventral duct in the pancreatic head region, while it was absent in the others. CONCLUSION: MRCP is a rapid and non-invasive method of evaluating the pancreatic ductal system. It helps in identifying pancreas divisum, which may be the cause of recurrent pancreatitis, and so obviates the need of ERCP.

Adult↗
PubMed2002

Nasolacrimal system: evaluation with gadolinium-enhanced MR dacryocystography with a three-dimensional fast spoiled gradient-recalled technique.

The aim of this study was to determine the diagnostic accuracy of gadolinium-enhanced three-dimensional (3D) fast spoiled gradient-recalled (FSPGR) MR dacryocystography in patients with epiphora. Bilateral nasolacrimal systems of 19 patients suspected of having nasolacrimal canal obstruction were evaluated with MR dacryocystography. A sterile 0.9% NaCl solution containing 1:100 diluted gadolinium chelate was instilled into the bilateral conjunctival sacs of the patients. The 3D FSPGR sequence was used with 1.0-T scanner with the following parameters: TR 9.3 ms; TE 2 ms; flip angle 20; 256x224 matrix; 13- or 26-cm field of view; and 1-mm slice thickness. Seventeen patients had digital dacryocystography for comparison which we considered standard of reference. Thirty-four nasolacrimal systems were evaluated with MR and digital dacryocystography. Discrepancies between the findings of both methods were detected in 2 patients. The overall sensitivity of MR in detecting the obstruction was 100%. Magnetic resonance helped to determine the canalicular and ductal obstruction in 100% of the patients and the saccular obstruction in 80% of the patients. We conclude that 3D FSGR technique for MR dacryocystography is a reliable and noninvasive method in the evaluation of the obstruction level in the lacrimal system in patients with epiphora.

Adult↗
PubMed2002

Trigeminal nerve involvement in T-cell acute lymphoblastic leukemia: value of MR imaging.

A 30-year-old male with T-cell acute lymphoblastic leukemia presented with facial numbness. Neurological examination revealed paresthesia of the left trigeminal nerve. Cerebrospinal fluid (CSF) cytology showed no atypical cells. Gadolinium-enhanced magnetic resonance (MR) imaging demonstrated enlargement and enhancement of intracranial portions of the left trigeminal nerve. The abnormal MR imaging findings almost completely resolved after the chemotherapy. Gadolinium-enhanced MR imaging is not only a useful procedure for the early diagnosis of cranial nerve invasion by leukemia but it might be helpful to follow the changes after the treatment.

Adult↗
PubMed2002

MR imaging of a ruptured intraspinal dermoid tumour with fat droplets in the central spinal canal.

We report a patient with intramedullary ruptured spinal dermoid tumour. The MR imaging revealed an intra-medullary lumbar mass heterogenous in intensity in all sequences. Fat droplets were observed in the subarachnoid space as well as in the dilated central spinal canal. Fat droplets in the subarachnoid space are frequently seen in the rupture of intraspinal dermoid tumours; however, fat droplets within the central canal is quite rare and was unexpected. Magnetic resonance imaging is a useful tool in the determination of spinal pathologies before they become large enough to cause severe symptoms and/or morbidity.

Dermoid Cyst↗
PubMedDate not supplied

Portal venous system: evaluation with contrast-enhanced 3D MR portography.

The purpose of this study is to compare contrast-enhanced three-dimensional (3D) magnetic resonance (MR) portograms to Doppler sonography in detection of portal venous abnormalities. Thirty-five consecutive patients, who were suspected of having portal venous system abnormalities, were examined with MR portography and Doppler sonography. Vascular abnormalities were identified in 27 of 35 patients. There was statistically significant agreement between the results of MR portography and Doppler sonography. The major limitation of contrast-enhanced 3D MR portography was its inability to provide objective hemodynamic data regarding flow direction and flow pattern.

Adolescent↗