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Macit Ariyürek

Publications and source records attributed to Macit Ariyürek.

8 recordsLinked to original sources

Low dose CT: practices and strategies of radiologists in university hospitals.

PURPOSE: We surveyed the practices and policies of the radiology departments of academic institutions in Turkey regarding the use of low dose CT in daily practice. MATERIALS AND METHODS: Surveys were mailed electronically to radiology departments of 40 university hospitals. Information gathered included modifications of standard protocols for dose reduction according to body parts being examined or depending on specific patient groups such as children, pregnant, or slim patients. RESULTS: Thirty-three radiology departments (82%) responded. Twenty-eight (85%) reported that they modify CT scanning parameters in order to reduce the patient dose. Of these, 5 (18%) reported that they always modulate the scan parameters, 10 (36%) often, 11 (39%) sometimes, and 2 (7%) seldom. Reduced dose CT is applied mostly in pediatric and pregnant patients, reported by 93% and 57% of respondents, respectively. The most common body part for the application of low dose CT was chest examination followed by imaging of paranasal sinuses, abdomen, and CT-guided interventions. The most common modification for dose reduction is using low mA, followed by increasing the pitch value. CONCLUSION: Most respondents are aware of low dose CT, but the frequency of application varies considerably in routine practice. Reduced mA and increased pitch are the most commonly used modifications.

Dose-Response Relationship, Radiation↗

Evaluation of breast microcalcifications according to Breast Imaging Reporting and Data System criteria and Le Gal's classification.

INTRODUCTION/OBJECTIVE: Our aim was to evaluate the positive predictive value (PPV) of the analysis of breast microcalcifications according to Breast Imaging Reporting and Data System (BI-RADS) and Le Gal's classification in identification of malignancy, and to assess the interobserver agreement using these criteria. METHODS AND MATERIAL: Eighty-two patients with breast microcalcifications on their screening mammograms underwent surgical excision after a needle localization at our institution between July 1993 and June 2000. The mammograms were examined by two experienced mammographers retrospectively and independently. Each observer noted the morphology, distribution, associated findings, final assessment categories of microcalcifications according to BI-RADS criteria and the morphologic type of microcalcifications according to Le Gal's classification. The PPVs for each radiologist and the interobserver agreement were determined by using these data and histologic findings. RESULTS: Histopathologic results yielded malignancy in 25 (30%) cases. The evaluation of microcalcifications according to BI-RADS criteria revealed PPVs of 17% and 25% for category 4 lesions, and 68% and 44% for category 5 lesions. In the assessment of microcalcifications according to Le Gal's classification, the PPV of type 4 lesions was 45% (for both observers), whereas the PPVs of type 5 lesions were 70% and 50%. The interobserver agreement was fair in evaluation of morphology of microcalcifications (kappa:0.31), distribution of microcalcifications (kappa:0.29), final assessment categories (kappa:0.27), and moderate in evaluation of associated findings (kappa:0.48) by using BI-RADS lexicon. It was higher for the assessment of milk of calcium and round microcalcifications than other typically benign microcalcifications, and for fine linear or fine linear branching microcalifications than other probably malignant calcifications. There was a fair interobserver agreement (kappa:0.30) in the description of the morphologic type of microcalcifications according to Le Gal's classification. DISCUSSIONS AND CONCLUSION: In our study, both BI-RADS lexicon and Le Gal's classification did not succeed expectedly in reducing the ambiguity in assessment of breast microcalcifications. Further studies and perhaps development of new methods are required to improve accuracy and standardization in mammographic interpretation.

Breast Neoplasms↗

Lumbar pedicle morphology in the immature spine: a three-dimensional study using spiral computed tomography.

STUDY DESIGN: A cross-sectional study was conducted. OBJECTIVE: To investigate the pediatric pedicle morphology with the help of modern computed tomography technology. SUMMARY OF BACKGROUND DATA: The use of pedicular screws recently has gained popularity because of their ability to provide three-dimensional correction of spinal deformity. Extensive work has been published on the pedicle morphology of the adult and adolescent thoracolumbar spine. Less is known about the pedicle morphology of children. METHODS: A total of 21 patients ages 5 to 10 years underwent standard spiral computed tomography of the abdomen. The patients were grouped according to age: Group 1 (5 to 8 years of age) and Group 2 (9 to 10 years of age). Images were reformatted, and multiplanar reconstructions were used to attain images of lumbar pedicles on sagittal, coronal, and transverse planes. The measurements included the inner and outer pedicle diameters on the transverse plane, the pedicle angle on both the transverse and sagittal planes, and pedicle length. RESULTS: The smallest pedicle lengths were 24 mm for Group 1 and 25 mm for Group 2. When the average values were considered, the smallest lengths were at L5 and the longest at L3. The smallest diameter was at L1 (2.3 mm for Group 1 and 3 mm for Group 2), whereas L5 had the largest diameter (6.17 mm for Group 1 and 8.72 mm for Group 2). In the transverse plane, the pedicle angle increased from L1 to L5 in both groups. In the sagittal plane, the angulations followed an opposite trend. CONCLUSIONS: The inner transverse diameter of the lumbar pedicle, particularly in young children, is smaller than previously reported. Insertion of screws currently available commercially screws seems to be safe in the L4-L5 pedicles of children ages 5 to 8 years, and in the L3-L5 pedicles of older children. Custom-made screws might be considered for upper levels for safe application.

Bone Screws↗

Treatment and follow-up of pulmonary alveolar microlithiasis with disodium editronate: radiological demonstration.

A 9-year-old girl with pulmonary alveolar microlithiasis is presented. She was asymptomatic except for failure to thrive. Plain chest radiographs on admission showed sand-like opacities with calcific densities throughout both lung fields, predominantly in the lower zones. A black pleural line was also seen between the ribs and lung parenchyma. High-resolution CT (HRCT) revealed diffuse ground-glass opacities throughout both lungs, micronodular densities, interlobular septal thickening, linear calcifications along the pleura and a few scattered subpleural cysts. Disodium editronate, which is known to inhibit the microcrystal growth of hydroxyapatite, was started at 10 mg/kg per day orally. After 1 year of therapy, considerable regression of the calcific densities was detected on chest radiographs and HRCT scans.

Child↗

Changes in alveolar bone thickness due to retraction of anterior teeth.

In cases of bimaxillary protrusion, extraction of 4 premolars and orthodontic treatment with retraction of the anterior teeth is a widely used approach. However, there is controversy over whether the changes that occur in the anterior alveolar bone always follow the direction and quantity of tooth movement. Nineteen patients with dentoalveolar bimaxillary protrusion treated by extracting the 4 first premolars were evaluated with lateral cephalograms and computed tomography (CT). Cephalograms and CT scans were made before treatment and 3 months after retraction of the incisors. The measurements of the cephalograms showed that maxillary and mandibular incisors were retracted primarily by controlled tipping of the teeth. For all maxillary and mandibular incisors, we assessed the labial and the lingual alveolar plates at crest level (S1), midroot level (S2), and apical level (S3) for bone-thickness changes during retraction of the maxillary and mandibular anterior segments. In the mandibular arch, the labial bone maintained its original thickness, except the S1 measurements, which showed a significant decrease in bone thickness (P <.001). In the maxillary arch, the labial bone thickness remained unchanged. There were statistically significant decreases in lingual bone width in both arches after retracting the incisors. Some of the patients demonstrated bone dehiscence that was not visible macroscopically or cephalometrically. When tooth movement is limited, forcing the tooth against the cortical bone may cause adverse sequelae. This type of approach must be carefully monitored to avoid negative iatrogenic effects.

Alveolar Bone Loss↗

Breast abscess mimicking malignant mass due to retained penrose drain: diagnosis by mammography and MRI.

We report a breast mass associated with a foreign body mimicking malignancy on mammography. Although retained penrose drains have been reported in other parts of the body, our case is the first report of a retained penrose drain in breast diagnosed by mammography. Mammography can be used if there is suspicion of a retained penrose drain during the course of breast abscess treatment.

Abscess↗

Metastatic endodermal sinus tumor: CT appearances.

A one-week-old boy had undergone resection of a sacrococcygeal benign cystic teratoma. At the age of 12 months, he had a serum alpha-fetoprotein level of 139,000 IU/ml and a recurrent pelvic mass which was removed, and the microscopic examination revealed endodermal sinus tumor. Postoperatively, massively enlarged inguinal lymph nodes and abdominal distention developed. Computerized tomography displayed enlarged inguinal lymph nodes, metastatic lesions in the liver, and a pelvic recurrent mass. He received BEP (bleomycin, etoposide, cisplatin) chemotherapy regimen, and a complete remission was achieved with a normal serum alpha-fetoprotein. Close follow-up and serum alpha-fetoprotein monitoring are mandatory after the resection of a sacrococcygeal teratoma.

Antineoplastic Combined Chemotherapy Protocols↗