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Serdar Akyar

Publications and source records attributed to Serdar Akyar.

14 recordsLinked to original sources
PubMed2006

Hydatid cysts in muscle: a modified percutaneous treatment approach.

INTRODUCTION: Any organ in the human body may be affected by hydatid disease, but the liver and the lungs are most commonly affected. A rare localization of hydatid disease is within muscle tissue. Herein we present three patients with muscular hydatid disease who were successfully treated with a modified percutaneous approach. METHODS: Patients with Gharbi type III cysts were treated on an outpatient basis. All procedures were performed under ultrasound guidance in the ultrasonography unit of our department. After local anesthesia, percutaneous puncture was performed in a one-step procedure. After free drainage stopped, absolute ethanol and polidocanol were injected into the cyst cavity. After the procedure, the patient was observed for at least six hours for any adverse reactions and sent home. Patients were followed-up with ultrasonography. A positive treatment effect was characterized by a reduction of the cyst's pseudo-tumor pattern and size, and by detachment of the germinal membrane. RESULTS: The three patients in this report had a total of five hydatid cysts in muscle tissue and were all successfully treated with a modified percutaneous approach without recurrence. CONCLUSION: Percutaneous drainage without re-aspiration is simple, easy to apply, low cost, repeatable, and does not require hospitalization. There have been no reported deaths associated with the procedure and morbidity is very low. When the technique is applied properly, relapses do not occur. With its low complication rate and its suitability for outpatient treatment, this method can be an alternative to surgery or puncture, aspiration, injection, and re-aspiration (PAIR) in selected patients.

Administration, Cutaneous↗
PubMed2005

An analysis of stereotactic biopsy of brain tumors and nonneoplastic lesions: a prospective clinicopathologic study.

BACKGROUND: Appropriate management of progressive, unverified brain lesions should be guided by conclusive pathological diagnosis. Stereotactic biopsy (SB) is established as a less invasive surgical procedure that provides diagnosis. In this prospective study, we analyzed the diagnostic difficulties and risk of SB in the various brain mass lesions, the rate of conclusive pathological diagnosis, and the rate of and the reasons for discrepancy between the intraoperative smear results and conclusive paraffin diagnosis. METHODS: Using computed tomography (CT) and/or magnetic resonance imaging (MRI), 130 cases underwent SB procedure to assess intra-axial brain mass lesions. A CT-MRI fusion and a multiplanar image processing stereotactic program were used in cases who had lesions adjacent to the neurovascular and critical areas. The intraoperative evaluations were made with the smear preparations (SPs) of 1 or 2 biopsy specimens. The conclusive diagnosis was achieved by paraffin preparations of the remainder of the biopsies. The discrepancy between the smear results and the conclusive diagnosis was analyzed. RESULTS: Conclusive histopathologic diagnosis was achieved in 99.23% of the cases. A discrepancy between smear results and conclusive diagnosis was detected in 6.98% of the conclusively diagnosed cases. The major reasons for the discrepancy were necrosis and improper quality of the preparations. There was no mortality, and hemorrhage-related morbidity was observed in 1 case (0.7%). CONCLUSIONS: Necrosis and the improper quality of the smear preparations (SPs) can cause difficulties in establishing a histopathologic diagnosis in SB. Small tissue samples do not decrease the diagnostic yield with the new stereotactic technologies used by an experienced team consisting of a neurosurgeon, pathologist, and radiologist.

Adolescent↗
PubMed2005

Multislice CT angiography in the evaluation of hepatic vascular anatomy in potential right lobe donors.

PURPOSE: To assess the role of multislice CT angiography in the evaluation of arterial, hepatic and portal venous variations in potential right lobe donors. MATERIALS AND METHODS: Fifty-two potential liver donors (28 females, 24 males), underwent CT angiography in the arterial and portal venous phases with an eight-row CT scanner. Two- and three-dimensional images were obtained from 1.25-mm-thick axial images with multiplanar reformatting, maximum intensity projection and volume rendering techniques. Both axial and two- and threedimensional images were evaluated for possible variants of hepatic vasculature. In twelve operated patients, CT angiography results were compared with the results of surgery. RESULTS: Of 52 patients, 40 had type I, five type III, two type II, three type IX, and two type V hepatic arterial anatomy. In 13 patients (25%), segment IV artery originated from the right hepatic artery. In 26 patients (50%), veins that drained segment V and/or VIII to the middle hepatic vein were larger than 5 mm. Twenty-five patients (48%) had 28 accessory hepatic veins larger than 3 mm; 23 of these drained to the inferior vena cava more than 4 cm caudal to the right hepatic vein-vena cava junction. Three patients (6%) had trifurcation and one patient (2%) had quadrifurcation of the main portal vein. In two patients (4%), the right posterior portal vein arose directly from the main portal vein before its bifurcation. CT angiography findings showed one-to-one correlation with surgery in the 12 operated patients. CONCLUSION: Multislice CT angiography can successfully show the relevant hepatic vascular variations in potential liver donors.

Adolescent↗
PubMed2004

Multidetector CT: contributions in liver imaging.

Multidetector CT has had great impact in the evaluation of the liver. Increased speed combined with thin slice collimation improved the spatial and temporal resolution, which in turn provided a higher sensitivity in the detection of focal lesions, particularly for the hepatocellular cancer (HCC) in patients with cirrhosis. There is no consensus as to whether the so-called "double arterial phase scanning" improves the detection rate of hepatocellular cancers, and the majority of the more recent studies suggest acquiring only the late arterial phase images along with the portal venous phase images. However, if the patient is a surgical candidate, the early arterial phase images must also be obtained, because they provide better pre-surgical mapping of the hepatic arteries. In primary and metastatic liver tumors, arterial and portal venous phase images should be acquired with thin collimation and overlapping reconstruction. Maximum intensity projection and volume rendering methods demonstrate the three-dimensional anatomy of the hepatic arteries, portal and hepatic veins successfully, which provide useful information before hepatic resection or intraarterial chemotherapy. In living donor candidates, early arterial and portal venous phase images obtained with thin collimation and overlapping reconstruction are used to reconstruct three-dimensional images with maximum intensity and volume rendering methods. These have a high sensitivity to detect hepatic artery, portal and hepatic vein variations, which could render the surgery difficult or even impossible. Portal venous phase images can also be used to measure total and lobar liver volumes. A virtual hepatectomy plane can be simulated on the three-dimensional model of the liver and hepatic veins, and when necessary, its location can be modified according to the metabolic needs of the recipient and donor. Thin collimation and better temporal resolution may also have beneficial effects in the characterization of liver lesions.

Carcinoma, Hepatocellular↗
PubMed2004

[Omental infarction: CT findings (case report)].

Omental infarction, the end result of impaired perfusion of the greater omentum, is an uncommon cause of acute abdominal pain. Because its clinical symptoms are nonspecific, it is usually confused with more common conditions such as appendicitis or cholecystitis. Consequently, the diagnosis is generally made intraoperatively. However, computed tomography shows characteristic findings and allows a reliable preoperative diagnosis, preventing unnecessary laparotomy. We report two cases of omental infarction, and describe typical CT findings of this rare entitiy.

Abdomen, Acute↗
PubMed2003

Bilateral maxillary dentigerous cysts: a case report.

Dentigerous cysts are benign odontogenic cysts that are associated with the crowns of permanent teeth. They are usually single in occurrence and located in the mandible. Multiple cysts are reported in patients with conditions such as mucopolysaccharidosis and basal cell nevus syndrome. We present the radiologic findings of bilateral impacted maxillary cuspids with dentigerous cysts displacing the maxillary sinuses in a nonsyndromic patient, a condition that, to our knowledge, has not been previously reported.

Child↗
PubMed2003

[Case report: Cemento-ossifying fibroma of the ethmoidal sinus presenting with exophthalmos].

Cemento-ossifying fibroma is a benign fibro-osseous tumor which contains fibrous tissue and varying amounts of calcified tissue resembling bone, cementum or both. The tumor is frequently seen in the mandibula and maxilla, but it may rarely affect the ethmoidal sinus. In this report, CT findings of cemento-ossifying fibroma located in the ethmoidal sinus are presented.

Adult↗
PubMed2003

[Cross-sectional imaging findings in intradiverticular bladder tumors: Case report].

Neoplasms originating in bladder diverticula are characterized by early transmural invasion and a tendency for higher histopathological grades, which make prompt diagnosis and treatment crucial in these tumors. Filling defects caused by intradiverticular tumors cannot always be visualized in intravenous urography and/or cystography. Cross-sectional imaging methods including ultrasonography, computed tomography and magnetic resonance imaging have been used singly or in combination in neoplasms of the lower urinary tract. We herein present radiological findings in four patients with intradiverticular bladder neoplasms. Although diverticula were readily visualized in all patients, intravenous urography did not detect the neoplasm in two patients. Accurate diagnosis and staging were possible in all patients with both ultrasonography and computed tomography. In one patient magnetic resonance imaging clearly showed the intradiverticular tumor and peridiverticular extension. Cross-sectional imaging methods should be used in the evaluation of bladder diverticula as an adjunct to intravenous urography.

Adult↗
PubMed2002

Segmental hyperattenuation in the liver as a result of right hepatic vein thrombosis: an unusual complication of central venous catheterization.

Liver perfusion disorder secondary to hepatic vein occlusion is not often reported. This abnormality might be caused by invasion of the hepatic veins by tumour or compression by a large right adrenal mass. We present an unusual cause of hepatic perfusion disturbance due to right hepatic vein thrombosis resulting from inadvertent hepatic venous catheterization. On contrast-enhanced CT, the tip of a central venous catheter extended into the right hepatic vein, which was thrombosed. A sharply marginated wedge-shaped hyperdense region was demonstrated in the right lobe of the liver, thought to represent a compensatory increase in arterial flow to the affected territory.

Adolescent↗
PubMedDate not supplied

CT and MRI in tuberculous sternal osteomyelitis: a case report.

We report a 58-year-old male patient presenting with a 1-year history of presternal swelling and pain. Plain radiography revealed increased soft tissue density anterior to the body of the sternum, which showed cortical sclerosis. Computed tomography (CT) demonstrated ring-enhancing hypodense soft tissue masses surrounding the sternum, whose anterior and posterior cortices were markedly thickened. On three-phase technetium bone scintigraphy, the left side of the sternum showed increased radiotracer uptake and the central part of the bone was photopenic. The bone marrow of the sternum and peristernal soft tissue lesions were hypo- and hyperintense on T1- and T2-weighted magnetic resonance (MR) images, respectively, and showed marked enhancement postgadolinium. Treatment included both surgical intervention and medical therapy.

Humans↗
PubMedDate not supplied

Granulocytic sarcoma. Cranial and breast involvement.

The term granulocytic sarcoma designates an infrequent solid tumor composed of aggregates of immature granulocytic precursors in extramedullary sites. The lesion generally occurs either during the natural course of acute myelogenous leukemia or after a remission has been achieved; however, it may rarely represent the initial manifestation of the disease. We present radiologic features of cranial and breast involvement of granulocytic sarcoma in a 13-year-old female with acute myelogenous leukemia. The cranial lesion appeared nearly isointense with cortical gray matter on T1- and T2-weighted magnetic resonance (MR) images, and enhanced homogeneously after the injection of gadolinium. MRI showed a well-delineated lobulated mass in the left breast, which had a heterogeneous hyperintense signal and remarkable contrast enhancement.

Adolescent↗
PubMedDate not supplied

Hippocampal malrotation with normal corpus callosum in a child with Opitz syndrome.

We present cranial magnetic resonance imaging (MRI) findings in a 6-year-old boy with Opitz syndrome. The electroencephalogram revealed epileptiform abnormalities in both frontal regions. MRI showed normal callosal development, but a rounded shape of the left hippocampus due to malrotation. The temporal horn was slightly dilated on the left side. These features were consistent with isolated hippocampal malrotation.

Child↗
PubMedDate not supplied

Virtual cystoscopy in the evaluation of bladder tumors.

OBJECTIVE: The objective of this study was to investigate the value of contrast material-filled virtual cystoscopy in the detection of bladder tumors. MATERIALS AND METHODS: Thirty-nine patients who had recent diagnosis or were followed up due to priory history of bladder tumor underwent virtual cystoscopy. After the intravenous injection of contrast medium, the bladder was examined with helical computed tomography (CT) scan. The data were transferred to a workstation for interactive navigation using surface rendering. Two radiologists independently interpreted the axial and virtual images, and discrepancies were resolved by consensus. The results of virtual cystoscopy were compared with the findings of conventional cystoscopy. RESULTS: Forty-nine of 54 bladder lesions detected with conventional cystoscopy in 33 patients were also shown on virtual images. On virtual cystoscopy, three of the seven lesions 5 mm or smaller in diameter could be identified. There were no false-positive findings. The sensitivity of the technique was 96.2% for polypoid tumors and 88.9% for sessile lesions. When axial and virtual images were evaluated together, the sensitivity rate increased to 94.4%. CONCLUSION: Bladder tumors can be diagnosed noninvasively using contrast medium-filled virtual cystoscopy. Evaluation of both the axial and virtual images increases the sensitivity of the technique.

Carcinoma, Transitional Cell↗