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Biomedical subjects

S Atilla

Publications and source records attributed to S Atilla.

At least 19 recordsLinked to original sources
PubMed2001

Magnetic resonance imaging and morphometric histologic analysis of prostate tissue composition in predicting the clinical outcome of terazosin therapy in benign prostatic hyperplasia.

PURPOSE: To determine whether magnetic resonance imaging (MRI) or quantitative color-imaged morphometric analysis (MA) of the prostate gland are related to the clinical response to terazosin. METHODS: Thirty-six male patients with symptomatic benign prostatic hyperplasia (BPH) with a serum prostate-specific antigen level of 4-10 ng/mL underwent MRI with body coil, transrectal prostate ultrasonography and biopsy prior to terazosin therapy. For MRI-determined stromal and non-stromal BPH, the ratio of the signal intensity of the inner gland to the obturator internus muscle was evaluated. Histologic sections were stained with hematoxylin and eosin. The MA of the specimens was performed by Samba 2000. Results of the two techniques were interpreted according to the terazosin therapy results. RESULTS: The mean stromal percentage was 60.5 +/- 18.0%. No statistically significant relationship was found between the clinical outcome of terazosin and the MRI findings. The MA results showed a significant relationship between the percentage of stroma and the percent change of the peak urinary flow rate, but not with the percent change of the international prostate symptom score after terazosin therapy (P < 0.05). CONCLUSION: Magnetic resonance imaging alone is not sufficient in predicting the response to terazosin therapy. Morphometric analysis of BPH tissue composition can be used in predicting the clinical outcome of terazosin therapy but it is suitable only in patients for whom prostatic biopsy is necessary in order to rule out prostate cancer.

Adrenergic alpha-Antagonists↗
PubMed1998

MR imaging and MR angiography in popliteal artery entrapment syndrome.

Popliteal artery entrapment (PAE) syndrome is an uncommon congenital anomaly seen in young adults causing ischemic symptoms in the lower extremities. It is the result of various types of anomalous relationships between the popliteal artery and the neighboring muscular structures. The purpose of this study was to define the role of MR imaging combined with MR angiography in the diagnosis of PAE cases. Four cases with segmental occlusion and medial displacement of popliteal artery in digital subtraction angiography (DSA) examinations were diagnosed as PAE syndrome by MR imaging and MR angiography. The DSA and MRA images are compared. All of the cases showed various degrees of abnormal intercondylar insertion of the medial head of the gastrocnemius muscle. The MR images showed detailed anatomy of the region revealing the cause of the arterial entrapment. Subclassification of the cases were done and fat tissue filling the normal localization of the muscle was evaluated. The DSA and MRA images demonstrated the length and localization of the occluded segment and collateral vascular developments equally. It is concluded that angiographic evaluation alone in PAE syndrome might result in overlooking the underlying cause of the arterial occlusion, which in turn leads to unsuccessful therapy procedures such as balloon angioplasty. Magnetic resonance imaging combined with MR angiography demonstrates both the vascular anatomy and the variations in the muscular structures in the popliteal fossa successfully, and this combination seems to be the most effective way of evaluating young adults with ischemic symptoms suggesting PAE syndrome.

Adult↗
PubMed1998

Radiological follow-up in encapsulated intracerebral hematoma mimicking intratumoural bleeding.

Chronic encapsulated intracerebral hematoma, which is usually seen in young, normotensive patients, is rare, but has been reported with increasing frequency in recent years. In this report, we have presented a case of encapsulated intracerebral hematoma mimicking intratumoural bleeding with its whole natural radiological progression. A 55 year-old man developed a progressive neurological deficit one month after hospitalisation due to spontaneous intracerebral hemorrhage. Cranial CT and MR demonstrated a ring-shaped hemorrhagic lesion with mass effect and perifocal edema. After 15 months, there was marked improvement in clinical findings, and imaging techniques showed marked resorption of the mass. Radiological findings of spontaneous resolution of the encapsulated intracerebral hematoma are described for the first time in the reported case. Encapsulated intracerebral hematoma can present much like a brain tumour and should be considered in the differential diagnosis of other hemorrhagic space-occupying lesions.

Brain Neoplasms↗
PubMed1997

MRI in neuro-Behçet's disease.

Our purpose was to characterise specific MRI findings and to determine their value in neuro-Behçet's disease. We examined 17 patients (14 men, 3 women) with neuro-Behçet's disease using T1- and T2-weighted spin-echo images and contrast-enhanced images at 0.5 T. There were 13 patients (76.5%) who had single or multiple lesions. Most of these were in the basal ganglia, brain stem or deep white matter region, giving high signal on T2-weighted images and isointense or low signal on T1-weighted images. In 3 cases (17.6%) there was linear high signal along the posterior limb of the internal capsule on T2-weighted images. This was considered as a potential differentiating feature of neuro-Behçet's disease. Contrast-enhancement was seen in 17 lesions in 7 patients.

Adult↗
PubMed1997

SPECT and MRI findings in a case of extensive neuronal migration disorder.

We report a 20-year-old male with epilepsy, mild mental retardation, growth asymmetry, and MRI and SPECT features of unilateral subcortical ectopic cortex. The neurological examination showed mild growth asymmetry, hemiparesis and hemihypoesthesia and pyramidal signs on the left side. EEG showed focal abnormality in the right frontotemporal region. MRI revealed pachygyria and severe heterotopia associated with some abnormalities of ventricles and cerebellum on the right. Cortical responses were absent on stimulation of the left median and tibial nerves. Central motor conduction time from cortex to left upper extremity was prolonged in magnetic stimulation test. SPECT using 99 mTc-HMPAO revealed increased perfusion of the right subcortical region as compared with those of overlying cortical mantle and opposite hemisphere. To our knowledge, there has been no report documenting such a large and extensive subcortical ectopic cortex which appears as a mass distorting and shifting the middle structure in an adult, such as in our case.

Adult↗
PubMed1997

Characterization of focal hepatic masses by dynamic contrast-enhanced MR imaging: findings in 311 lesions.

This study aimed to determine the overall accuracy of known enhancement patterns for the characterization of a large series of focal hepatic masses on dynamic contrast-enhanced magnetic resonance (MR) images. Breath-hold T1-weighted images of the liver acquired before intravenous gadolinium administration and serially over 6-10 min after contrast injection were acquired in < 25 a using FLASH or rapid spin-echo pulse sequences. A total of 311 proven focal hepatic masses in 128 patients were analyzed, including 192 malignant lesions (166 metastases and 26 hepatomas) and 119 benign lesions (48 cavernous hemangiomas, 45 hepatic cysts, and 26 other abnormalities). The lesions were evaluated for a variety of characteristics independently by two reviewers who were blinded to results. Cavernous hemangiomas showed early peripheral nodular enhancement (80% sensitivity and 99% specificity) and hepatic cysts showed no enhancement (100% sensitivity and 95% specificity). Hepatic metastases showed variable, moderate enhancement (47% by one reviewer and 74% by the other). Metastatic lesions from hypervascular primary neoplasms displayed peak enhancement during the hepatic artery dominant (bolus) phase, while other malignant neoplasms showed later peak enhancement (72% sensitivity and 77% specificity). Five metastatic foci with early homogeneous enhancement showed a delayed peripheral washout of contrast (rim sign), while no nonmetastatic foci displayed this finding (3% sensitivity and 100% specificity). Characteristic enhancement patterns of focal hepatic lesions were described in a large series of patients. This study confirms results of previous investigators who have shown that early nodular peripheral enhancement was highly specific for hemangiomas and lack of enhancement was highly specific for hepatic cysts. Hypervascular metastatic foci show earlier peak enhancement than other malignant lesions. Some (2-3%) metastatic lesions display a peripheral washout of contrast on serial images, with 100% specificity.

Adolescent↗
PubMed1997

The value of MRI in a case of Tolosa-Hunt syndrome.

We report a case of Tolosa-Hunt syndrome (THS) in which the lesion has been demonstrated by magnetic resonance imaging (MRI), computed tomography (CT), and angiography. A healthy 23-year-old man developed an acute painful ophthalmoplegia on the right side. CT and MRI scans revealed asymmetric enlargement of the right cavernous sinus with contrast enhancement extending down to the region of trigeminal ganglion. MRI further delineated the detailed anatomical structures of the region and excluded any infiltration of the surrounding tissues by a mass lesion. Cerebral angiography showed a significant decrease in the calibration of petrous segment and a mild decrease in the calibration of cavernous segment of the ipsilateral internal carotid artery. The patient was treated with oral prednisone, 100 mg daily. Neurological findings totally subsided after 2 weeks on corticosteroid and MRI showed resolution of the lesion in the cavernous sinus. The patient was symptom-free for 6 months after discharge. Our findings have suggested that MRI is the most valuable imaging technique for demonstration and follow-up of lesions in the cavernous sinus that are directly responsible for the symptoms of THS and the lesions can be more extensive than was currently believed.

Adult↗
PubMed1995

Parasternal sonography of the internal mammary lymphatics in breast cancer: CT correlation.

The purpose of this study was to evaluate the efficacy of parasternal ultrasonography (US) in diagnosing internal mammary lymph node metastases in breast cancer, an important site of occult metastases, adversely affecting the disease-free interval and long-term survival. Thirty-five patients who were diagnosed with breast cancer were examined for internal mammary lymph node (IMLN) involvement with parasternal US, and results were correlated with computed tomography (CT). Longitudinal and transverse images of the first through sixth parasternal rib interspaces were evaluated with a 7.5-MHz linear-array transducer. The enlarged nodes were demonstrated as discrete, spherical or ovoid hypoechoic lesions in six cases with parasternal US, and corresponding CT scans confirmed the presence of lymphadenopathy. Our results suggest that parasternal US may be helpful in the evaluation of IMLN metastases in breast cancer as a part of staging the disease.

Adult↗
PubMed1995

Computed tomographic evaluation of surgically significant vascular variations related with the temporal bone.

Variations of the vascular structures related with the temporal bone may cause important problems in diagnosis, treatment planning and surgery. High resolution computed tomography (CT) scans of 700 temporal bones of 350 patients were retrospectively examined for the incidence of dehiscent jugular bulb, high jugular bulb, diverticulum of jugular bulb, anteriorly located sigmoid sinus and dehiscent internal carotid artery. Dehiscent jugular bulb was seen in 27 (3.9%), high jugular bulb was seen in 142 (20.3%), jugular bulb diverticulum was seen in 55 cases (7.9%). The average distance between external acoustic canal and sigmoid sinus was found to be 13.3 mm and in 12.4% of the cases this distance was < 10 mm. Of 700 temporal bones, 10 (1.4%) showed dehiscent carotid canal. To aid diagnosis, treatment planning and surgery, CT scanning is currently a very reliable tool in determining these conditions. Special attention should be paid to the position of the vascular structures in the preoperative temporal bone CT scans.

Carotid Artery, Internal↗
PubMed1995

Dynamic contrast-enhanced MR imaging of the liver: parenchymal enhancement patterns.

A retrospective study of 164 patients undergoing dynamic contrast-enhanced magnetic resonance (MR) imaging was performed to assess hepatic parenchymal enhancement patterns and to correlate these patterns with hepatic function and disease. Rapid T1-weighted images were acquired before and after gadolinium administration. Hepatic enhancement patterns were analyzed blindly by two observers. Medical records were reviewed to document known liver pathology and liver function test results. A total of 72% of patients had homogeneous enhancement of the liver parenchyma; 28% had heterogeneous enhancement. Of the latter group, 61% of patients had enhancement conforming to segmental or lobar boundaries. Patients with heterogeneous enhancement patterns were more likely to have abnormal liver function test results and hepatic morphological abnormalities on their MR examinations than patients with homogeneous enhancement patterns. Heterogeneous hepatic enhancement on dynamic MR images is associated with a higher likelihood of liver disease and biochemical evidence of hepatic dysfunction than homogeneous enhancement.

Adult↗
PubMed1995

Hibernoma: MRI appearance of a rare tumor.

We report the features of a hibernoma on magnetic resonance (MR) imaging. The MR characteristics of this lesion were consistent with a complex lipid-containing mass. The mass did not suppress on short tau inversion recovery (STIR) imaging and was clearly not a simple lipoma. Hibernoma should be considered in the differential diagnosis of complex fatty masses.

Adipose Tissue, Brown↗
PubMed1995

Cost-effectiveness of computed tomography in the evaluation of patients with headache.

We report a retrospective study to determine the cost-effectiveness of cranial computed tomography in patients with headache without neurological finding. Five hundred ninety-two neurologically normal patients were examined between 1990 and 1993 for the complaint of headache. Examination results were reevaluated from written report and image archive systems. Results were divided into three groups. In group P0, we included patients with normal cranial computed tomography findings. In group P1, patients showed some minor pathologies like ischemic or atrophic changes. These findings neither explained the reason for headache nor changed the clinical or therapeutic approach. The third group (P2) was to include patients with gross intracranial pathology like space-occupying lesions or bleeding. Five hundred forty-six of 592 patients were in the P0 group (92%), and the remaining 46 patients were in the P1 group (8%). No patient was found to have serious intracranial pathology detected by computed tomography. Cost of detection of a case with significant pathology was calculated. It is our opinion that computed tomography is an unrewarding technique in the evaluation of patients with chronic headache whose neurological examinations are normal.

Adolescent↗
PubMed1995

Diagnosis of ocular involvement in Behçet's disease: value of spectral and color Doppler sonography.

OBJECTIVE: The purpose of this study was to determine the value of duplex and color Doppler sonography in the detection of ocular involvement in Behçet's disease. SUBJECTS AND METHODS: Duplex and color Doppler sonography was done in 21 patients with Behçet's disease and ocular involvement and in 22 patients with Behçet's disease but without ocular involvement. Twenty health volunteers also were examined as a control group. Flow velocities in the central retinal artery, posterior ciliary arteries, and ophthalmic artery were measured in the patients with Behçet's disease. RESULTS: In patients with Behçet's disease and ocular involvement, peak systolic velocities in the central retinal, posterior ciliary, and ophthalmic arteries were 7.3 +/- 2.3, 12.8 +/- 3.1, and 35.8 +/- 7.2 cm/sec, respectively. In patients with Behçet's disease but without ocular involvement, these values were 10.0 +/- 1.9, 17.3 +/- 3.4, and 33.5 +/- 4.0 cm/sec, respectively. In control subjects, the respective calculated values were 12.3 +/- 1.0, 16.5 +/- 1.6, and 35.8 +/- 4.4 cm/sec. For the central retinal and posterior ciliary arteries, peak systolic and diastolic velocities were significantly lower in patients with Behçet's disease and ocular involvement than in control subjects and patients with Behçet's disease but without ocular involvement (p < .001). Peak systolic and diastolic velocities in the central retinal artery were significantly lower in patients with Behçet's disease but without ocular involvement than in the control group (p < .001); however, no difference was observed for the posterior ciliary artery. Flow velocities in the ophthalmic artery were not significantly different among groups. CONCLUSION: These findings suggest that duplex and color Doppler sonography may be helpful in the diagnosis of ocular involvement in patients with Behçet's disease.

Adolescent↗
PubMed1995

An important anatomic variation in head and neck region: anomaly of the anterior belly of the digastric muscle.

Anomalies of the anterior belly of the digastric muscle are not very rare. An anomaly in this region may have clinical significances. In this study, bilateral anomalies of the anterior bellies of both digastric muscles are presented. When an asymmetry in the floor of the mouth is detected during diagnostic procedures like radiologic studies, anomalies of the anterior belly of the digastric muscle should also be considered besides other reasons of asymmetry. Additionally, possible occurrence of this kind of anomalies should be remembered during surgical procedure involving this region.

Head↗
PubMed1994

Treatment of autonomous thyroid nodules: safety and efficacy of sonographically guided percutaneous injection of ethanol.

OBJECTIVE: We evaluated the efficacy of sonographically guided percutaneous injection of ethanol as an alternative to surgery and administration of radioiodine, which have a higher risk of complications, for treatment of autonomously functioning thyroid nodules that may develop hyperthyroidism. SUBJECTS AND METHODS: Sixteen patients between 23 and 67 years of age who had solitary autonomous thyroid nodules were included in the study. The nodules were detected and evaluated using physical examination, measurements of hormonal levels, sonography, and scintigraphy. Sonographically guided percutaneous injection of ethanol was repeated one to two times each week for a total of four to eight treatments. The amount of ethanol used was 0.5-9.0 ml per treatment, depending on the volume of the nodule. RESULTS: Patients were followed up for at least 18 months. Clinical evaluation, including laboratory tests, showed that the patients' signs and symptoms subsided and hormones returned to normal levels in all cases. Scintigrams showed that the normal thyroid tissue that was suppressed before treatment regained normal function. Sonograms showed that the volume of the nodules decreased in 13 of 16 cases. No early or late permanent complications associated with treatment were noted. CONCLUSION: Our results show that sonographically guided percutaneous injection of ethanol can be used as an alternative treatment of autonomous thyroid nodules with the aim of eliminating the possible risk factors of surgery and radioiodine. This method of treatment may be particularly desirable in patients who are poor candidates for surgery and who refuse standard treatment.

Ethanol↗