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Biomedical subjects

Musturay Karcaaltincaba

Publications and source records attributed to Musturay Karcaaltincaba.

At least 19 recordsLinked to original sources
PubMed2006

Multidetector CT and MRI findings in periportal space pathologies.

Periportal region is an anatomic space around portal vein comprising hepatic artery, bile duct, nerves, lymphatics and a potential space. Periportal pathologies may involve any of these structures diffusely or focally with characteristic radiologic findings. Radiologic findings can be helpful in differential diagnosis of pathologies of periportal structures including periportal cavernomatous transformation, hepatic artery aneurysm, biliary diseases, neurofibromatosis, lymphoma, langerhans' cell histiocytosis, periportal fatty infiltration and other causes of periportal halo in adult and pediatric patients. Lobar/segmental intrahepatic involvement can be seen in neurofibromatosis, cavernomatous transformation, fatty infiltration and periportal edema. In this review, we discuss CT and MRI findings of periportal pathologies which can be in the form of diffuse or segmental/lobar involvement.

Humans↗
PubMed2006

Imaging of hepatic steatosis and fatty sparing.

Radiology has gained importance in the non-invasive diagnosis of hepatic steatosis. Ultrasonography is usually the first imaging modality for the evaluation of hepatic steatosis. Unenhanced CT with or without dual kVp measurement and MRI with in and out of phase sequence can allow objective evaluation of hepatic steatosis. However, none of the imaging modalities can differentiate non-alcoholic steatohepatitis/fatty liver disease from simple steatosis. Evaluation of hepatic steatosis is important in donor evaluation before orthotopic liver transplantation and hepatic surgery. Recently, one-stop shop evaluation of potential liver donors has become possible by CT and MRI integrating vascular, parenchymal, volume and steatosis evaluation. Moreover hepatic steatosis (diffuse, multinodular, focal, subcortical, perilesional, intralesional, periportal and perivenular), hypersteatosis and sparing (geographic, nodular and perilesional or peritumoral) can cause diagnostic problems as a pseudotumor particularly in the evaluation of oncology patients. Liver MRI is used as a problem-solving tool in these patients. In this review, we discuss the current role of radiology in diagnosing, quantifying hepatic steatosis and solutions for diagnostic problems associated with fatty infiltration and sparing.

Adipose Tissue↗
PubMed2006

CT differentiation of distal pancreas fat replacement and distal pancreas agenesis.

We aimed to describe CT signs useful for differentiation of distal agenesis from distal or dorsal pancreas lipomatosis. Multidetector CT (MDCT) studies of five patients with distal pancreas agenesis (n = 2), distal lipomatosis (n = 1), distal short pancreas (n = 1), and distal pancreatectomy (n = 1) were retrospectively reviewed. Agenesis of dorsal pancreas can be diagnosed by the absence of body and tail of pancreas. In the absence of distal pancreas, distal pancreatic bed can be filled by stomach or intestine (dependent stomach or dependent intestine signs), which abut splenic vein. Same findings can be seen in patients with distal pancreatectomy, however, splenic vein is absent in these patients. In case of distal lipomatosis abundant fat tissue is observed anterior to splenic vein. Dependent stomach and/or dependent intestine signs on MDCT imaging can allow differentiation of distal pancreas agenesis from distal lipomatosis obviating further diagnostic studies.

Adipose Tissue↗
PubMed2006

MRCP diagnosis of Mirizzi syndrome in a paediatric patient: importance of T1-weighted gradient echo images for diagnosis.

We report a 15-year-old boy with Mirizzi syndrome diagnosed by MR cholangiopancreatography (MRCP). Respiratory-triggered 3D MRCP was performed during free breathing. An impacted gallstone was noted in the infundibulum; this was not visible on T2-weighted images, but was hyperintense on T1-weighted gradient-echo images. This case illustrates the utility of 3D MRCP with parallel imaging in paediatric patients and the importance of T1-weighted gradient-echo images for the diagnosis of impacted gallstones.

Adolescent↗
PubMed2006

Does 16-MDCT angiography scanning direction affect image quality of coronary artery bypass grafts and the native coronary arteries?

To assess the impact of scanning direction on the image quality of coronary artery bypass grafts (CABGs), native coronary arteries (NCAs) were examined by electrocardiographically (ECG) gated 16-row multidetector computed tomography (16-MDCT). Eighty-two patients with 209 grafts were studied by 16-MDCT. Forty-one patients with 111 grafts were scanned craniocaudally. Forty-one patients with 98 grafts were scanned caudocranially. CABG, native coronary arteries were examined in four (proximal, middle, distal, distal anastomoses), three (proximal, middle, distal) segments, respectively. Subjective image quality on a four-point scale was calculated for segments. Scores of groups were compared. Results Image quality scores of proximal, distal segments of the right coronary artery (RCA) were better in caudocranially scanned group (P<0.05). When we subgrouped patients according to initial heart rates (IHR) (group 1, <65 beats/min; group 2, > or =65 beats/min), there was no statistical significance between image quality scores of coronary arteries, CABG when IHR was <65 beats/min in groups regardless of scanning direction. Scores of anastomotic segment of CABG to RCA, middle segments of circumflex coronary artery, proximal and distal segments of RCA in caudocranially scanned group were better when the IHR is > or =65 beats/min compared with the craniocaudally scanned group. When the IHR of the patient is > or =65 beats/min, performing ECG-gated 16-MDCT angiography in the caudocranial direction provides better image quality for evaluation of coronary arteries and CABGs.

Adult↗
PubMed2005

Meigs' syndrome with highly elevated ca. 125 levels in a patient with Takayasu arteritis: a case report.

A 56-year-old post-menopausal woman presented with abdominal swelling and shortness of breath. An evaluation of abdomen and pelvis showed ascites and a solid mass. Serum CA-125 level was elevated (509 IU/ml). A computerized tomography-angiography was performed since the pulses of upper extremities could not be palpated. The patient was diagnosed to be suffering from Takayasu arteritis. The exploratory laparotomy revealed a fibroma of the ovary.

Angiography↗
PubMed2005

Efficacy of transvaginal contrast-enhanced MRI in the early staging of cervical carcinoma.

The objective of this study was to evaluate the efficacy of transvaginal contrast for local staging of cervical carcinoma. Fifty patients diagnosed with cervical carcinoma prospectively underwent magnetic resonance (MR) imaging before and after vaginal opacification (VO) with a mixture of 25 ml saline and 25 ml barium. T2-weighted (T2W) TSE images in axial and sagittal planes were compared before and after vaginal opacification. Dynamic T1W images in sagittal and fat-suppressed T1W images in transverse planes were also evaluated after intravenous contrast administration. Involvement of vaginal wall, lumen, and fornices; parametrium; rectum; and bladder were noted. Changes in local tumor staging and in treatment planning were also assessed after vaginal opacification. MR results were later compared with surgical pathological findings. Twenty-eight patients who went through surgical staging were included in the study. VO did not change any of the MR interpretations in 14 patients (50%). Correct staging was achieved with T2W TSE images with and without VO (in sagittal and transverse planes) in 78.5% and 50% of the patients, respectively. VO correctly lowered staging in seven and increased it in three patients compared with sagittal standard T2W images. Treatment planning was also changed in four (14%) of these patients. When overall accuracy of MR staging to indicate the appropriate treatment was evaluated, patients would have received the proper treatment in 90% and 79% of the cases when only T2W sagittal images with and without VO were evaluated, respectively. Dynamic gradient-echo images in sagittal planes and postcontrast T1W images in transverse planes evaluated with T2W series after VO, accomplished correct staging in 23 (82%) of the patients. MRI staging in early cervical cancer may be difficult and overestimated, especially if the tumor is slightly extended into the proximal vagina. Use of vaginal contrast medium is an easy, well-tolerated, and effective method to better delineate the borders of the tumor. It increases the specificity and accuracy of MR staging by showing the exact relation of the tumor with the vaginal wall and beyond.

Adult↗
PubMed2005

Long-term results of single-session percutaneous drainage and ethanol sclerotherapy in simple renal cysts.

PURPOSE: To demonstrate the efficacy and long-term results of the single-session ethanol sclerotherapy in simple renal cysts. MATERIALS AND METHODS: Ninety-eight cysts in 97 patients (range: 18-76 years; mean age, 54 years) were included in the study. Indications were determined as flank pain in 74, hydronephrosis in 12, hypertension in 8, patient reassurance due to increasing cyst size in three patients. Mean follow-up period was 24.4 months. Procedures were performed with the guidance of fluoroscopy and ultrasonography at all times using 5-7 Fr pigtail catheters. After the cystogram that was obtained in all cases, 95% ethanol with a volume of 30-40% of the cyst volume was used as a sclerosing agent on an outpatient basis. Maximum volume of the injected ethanol was 200 ml. Follow-up examinations were performed 1, 3, 6 and 12 months after the procedure and once every year thereafter. RESULTS: Average cyst volume reduction was 93% at the end of the first year. The cysts disappeared completely in 17 (17.5%) patients. After the procedure, in 67 (90%) patients improvement in flank pain was noted. Sixty-one (82%) patients were free of pain and in 6 (8%) of them the pain decreased. Normotension was obtained in 7 (87.5%) of the 8 hypertensive patients and no hydronephrosis was detected in 10 (83.3%) of the 12 patients after the procedure. Second intervention was required in 2 (2%) patients due to recurrence of cysts and related symptoms. One (1%) patient had small retroperitoneal hematoma that resolved spontaneously and in another (1%) patient spontaneous hemorrhage was detected into the cyst 1 year after the procedure. No other complication was detected during the procedure and follow-up. CONCLUSION: Percutaneous treatment of simple renal cysts with single-session sclerotherapy is a safe, effective and minimally invasive procedure and can be used as an alternative to multiple-session sclerotherapy with comparable results. High volume, up to 200 ml ethanol can be used without adverse effects for large renal cysts.

Adolescent↗
PubMed2005

Radiologic imaging and percutaneous treatment of pelvic lymphocele.

Pelvic lymphocele, also known as lymphocyst, is a cystic structure caused by lymphatic injury usually secondary to pelvic lymphadenectomy and renal transplantation. Lymphoceles can cause morbidity and rarely mortality by compression of adjacent structures and infectious complications. This review discusses etiology and treatment options for pelvic lymphoceles including surgical and percutaneous methods with emphasis on percutaneous techniques particularly in conjunction with sclerotherapy. Percutaneous catheter drainage with sclerotherapy procedure with various sclerosing agents is described in detail. Ethanol, povidone-iodine, tetracycline, doxycycline, bleomycin, talc and fibrin glue can be used as sclerosing agents. Combination of sclerosing agents to percutaneous catheter drainage significantly improves success rate in the treatment of pelvic lymphoceles. Infected lymphoceles are usually treated solely with percutaneous catheter drainage. Percutaneous treatment can be tailored according to volume of lymphoceles. We generally prefer single session sclerotherapy and 1 day catheter drainage in lymphoceles less than 150 mL, and larger ones are treated by multi-session sclerotherapy until daily drainage decreases below 10 mL. Percutaneous treatment preferably with sclerotherapy should be considered as the first-line treatment modality for pelvic lymphoceles due to its effectiveness, widespread applicability on an outpatient basis, ease of procedure and low complication rate.

Drainage↗
PubMed2005

Percutaneous hepaticogastrostomy in a patient with complete common duct obstruction after right hepatectomy.

Complete bile duct obstruction that cannot be traversed by a guide wire can be challenging for the interventional radiologist. Although hepaticogastrostomy, which can be an alternative for such cases, has been performed under fluoroscopic and endoscopic guidance previously, this technique can be simplified by using only fluoroscopy. This technique was used in a patient who had complete common bile duct obstruction after hepatic resection. The patient initially had a good clinical outcome and stayed symptom-free for 5 months but eventually developed biliary epithelial hyperplasia and required placement of another metallic stent.

Adenocarcinoma↗
PubMed2005

Assessment of the radial artery and hand circulation by computed tomography angiography: a pilot study.

OBJECTIVES: The radial artery (RA) is increasingly being used as a coronary bypass graft. Results of a previous study using Doppler ultrasound and histopathologic examinations indicated that the RA has a higher incidence of preexisting intimal hyperplasia, medial calcification, and atherosclerosis than the internal thoracic artery. The aims of this study were to evaluate the use of computed tomographic angiography (CTA) to display hand collateral circulation, to define the criteria for an abnormal CTA test result, and to demonstrate usefulness of CTA as an alternative to conventional angiography for evaluation of the radial artery. MATERIALS AND METHODS: Sixteen patients scheduled for coronary artery bypass grafting entered this study. We performed 32 examinations of forearm and hand arterial anatomy in these patients. CTA was performed in patients with a normal Allen test result, except 1 patient who had a persistent median artery. Soft tissue density forehand roentgenography was performed in all patients before the CTA evaluation. There was no selection of patients in relation to patient characteristics. As a risk factor for radial artery calcification, 6 of the patients had diabetes mellitus, 6 had aortofemoral occlusive disease, and 4 had a history of smoking. RESULTS: Bilateral forearm arteries were visualized in all patients. Severe RA calcification was found in 1 patient, and distal occlusion was found in another patient. Focal RA calcification was noted in 2 patients. In the remaining patients no radial artery calcification or occlusion was noted. Anatomic variation of the upper limb arteries was shown in 2 patients; these variations were persistent median artery with absence of the radial and ulnar arteries and high bifurcation of the radial artery from the brachial artery. CONCLUSION: CTA is useful and safe for detection of radial artery calcific disease and assessment of the forehand circulation and its anatomic variations. Preoperative imaging of the RA is a means to avoid unnecessary forearm exploration or inadvertent use of a diseased conduit in coronary artery bypass candidates with multiple risk factors such as diabetes mellitus.

Age Factors↗
PubMed2005

Diaphragmatic mesothelial cysts in children: radiologic findings and percutaneous ethanol sclerotherapy.

OBJECTIVE: We describe CT, MR, and sonography findings of diaphragmatic mesothelial cysts and the results of percutaneous treatment with ethanol. All cysts were bilobulate and showed extrahepatic location between the right liver lobe and diaphragm. CONCLUSION: Radiologic findings are helpful in diagnosing diaphragmatic mesothelial cysts, which should be managed conservatively. Percutaneous ethanol sclerotherapy should be the first choice of treatment if necessary.

Child↗