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Biomedical subjects

Sinan Cakirer

Publications and source records attributed to Sinan Cakirer.

17 recordsLinked to original sources

Infantile Refsum disease: serial evaluation with MRI.

Refsum disease is a rare metabolic disorder, which is characterized by the accumulation of phytanic acid in the blood and tissues, including the brain. A variant of this condition that occurs in young children is called infantile Refsum disease. The MRI findings of symmetrical signal change involving the corticospinal tracts, cerebellar dentate nuclei, and corpus callosum are characteristic. We report the serial MRI findings of a child with this rare metabolic disorder.

Brain↗

[Primary appendagitis epiploica: diagnosis and follow-up with CT (case report)].

Primary appendagitis epiploica is a rare benign self-limiting inflammatory condition of the colonic epiploic appendices. It causes acute localized abdominal pain thought to be the result of torsion or spontaneous vascular thrombosis of epiploic appendices. This is a non-surgical situation that clinically mimics other conditions requiring surgery such as acute diverticulitis or appendicitis. In this report, CT findings of this rare disease are presented at the stage of initial diagnosis and follow-up.

Abdomen, Acute↗

MRI findings in Tolosa-Hunt syndrome before and after systemic corticosteroid therapy.

Tolosa-Hunt syndrome (THS) is characterized by painful ophthalmoplegia due to a granulomatous inflammation in the cavernous sinus. Corticosteroid therapy dramatically resolves both the clinical and radiological findings of THS. We present MRI findings of six patients with a clinical history of at least one episode of unilateral or bilateral orbital-periorbital pain, clinical findings of associated paresis of one or more of 3rd, 4th, 5th or 6th cranial nerves. All of the patients revealed an enlargement of the symptomatic cavernous sinus on magnetic resonance imaging (MRI) scans. Five patients revealed total resolution of the clinical findings within 1-8 weeks, following systemic corticosteroid treatment. One patient revealed only minor regression of clinical findings within 2 weeks after the initiation of the treatment, so the cavernous sinus lesion was reevaluated as meningioma on MRI, and the patient underwent surgical resection of the mass with resultant histopathological finding of cavernous sinus meningioma. A follow-up MRI scan was performed for five patients at the end of 8-weeks of steroid therapy. Three of these five patients showed total resolution of the cavernous sinus lesions whereas two of them revealed a partial regression of the cavernous sinus lesions. MRI findings before and after systemic corticosteroid therapy are important diagnostic criteria to put the definitive diagnosis of THS and to differentiate it from other cavernous sinus lesions that simulate THS both clinically and radiologically.

Adult↗

[Pictorial essay: Evaluation of intracranial lipomatous masses with MRI].

The lipid containing tumors of the intracranial region are rare and usually benign masses. The major lipomatous masses may be listed as lipomas, dermoid cysts, and the tumors with lipoid metaplasia, most common of which is lipomatous meningioma. MRI characteristics of these rare entities have been presented, and the underlying reasons for those appearances on MRI have been discussed in this pictorial review.

Brain Neoplasms↗

[Case report: Isolated pituitary sarcoidosis: MRI findings].

Sarcoidosis is a multisystem granulomatous disease with an unknown etiology. Symptomatic central nervous system involvement occurs in 5% of cases. MRI shows a wide range of central nervous abnormalities including hypothalamic-pituitary infiltrating lesions, cerebral parenchymal masses, leptomeningeal lesions, and focal white-matter lesions. The patients with sarcoidosis may rarely present with sellar masses. A case of isolated pituitary sarcoidosis was presented in this report with pre-treatment and post-treatment MRI pictures.

Adult↗

MRI findings in the patients with the presumptive clinical diagnosis of Tolosa-Hunt syndrome.

The aim of this study was to present our experience in MRI diagnosis of 23 patients with the clinical findings suggesting Tolosa-Hunt syndrome (THS). Cranial MRI studies of the patients with a clinical history of at least one episode of unilateral or bilateral orbital and periorbital pain, and associated paresis of one or more of third to sixth cranial nerves, were performed on a 1.5-T MRI scanner. Whereas 5 patients had the diagnosis of THS, paracavernous meningiomas in 4 patients, pituitary macroadenomas with cavernous sinus infiltration in 3 patients, Meckel's cave neurinoma in 1 patient, and suprasellar epidermoid in 1 patient were surgically proven MRI findings. Other pathological MRI findings were leptomeningeal metastases in 3 patients, granulomatous pachymeningitis sequelae in 2 patients, and aneurysm with compression on cavernous sinus in 1 patient. Three patients had normal MRI findings. The incidence of radiologically proven diagnosis of THS among the patients with the clinical findings suggesting THS seemed to be low in our study. In conclusion, MRI is the most valuable imaging technique to distinguish THS from other THS-like entities, and permits a precise assessment, management, and therapeutic planning of the underlying pathological conditions.

Adolescent↗

Diagnosis of acute appendicitis with unenhanced helical CT: a study of 130 patients.

The aim of this study was to determine the sensitivity, specificity, and diagnostic accuracy of helical computed tomography (CT) without oral, intravenous, or rectal administration of contrast material in confirming the diagnosis of acute appendicitis in patients with suggestive clinical and laboratory findings. One hundred and thirty patients with suspected acute appendicitis underwent an unenhanced helical CT scan. Scans were obtained in a single breath-hold from the level of umbilicus to the pubic symphysis using a 5-mm collimation. Oral, intravenous, or rectal contrast materials were not used. The criteria for diagnosis of acute appendicitis included an enlarged diameter of appendix more than 6 mm with associated periappendiceal inflammation. The results yielded a sensitivity of 94.7%, a specificity of 91.7%, an accuracy of 93.8%, a positive predictive value of 96.7%, and a negative predictive value of 86.8%. Unenhanced helical CT accurately diagnoses acute appendicitis, and it protects the patients from unnecessary further time-consuming diagnostic procedures, the risks associated with contrast material administration, and unnecessary surgical interventions.

Journal Article↗

Separate origins of the left internal and external carotid arteries from the aortic arch: MR angiographic findings.

Agenesis of the left common carotid artery with independent origins of the internal and external carotid arteries arising directly from the aortic arch is an extremely rare congenital anomaly. We present MR angiographic findings in a case with agenesis of left common carotid artery that, to our knowledge, is unique by virtue of its detection and description with MR angiography.

Aged↗

Aneurysmal bone cyst of the temporal bone.

Aneurysmal bone cysts are benign fibrosseous lesions of the bone that are rarely detected in the temporal bone. Seventeen cases of aneurysmal bone cysts with histological confirmation involving the temporal bone were reported in the literature. We report a case of left temporal aneurysmal bone cyst in a 52-year-old male with the clinical findings of periauricular painful swelling, decreased hearing, and facial paralysis. A magnetic resonance image of the patient showed a well-circumscribed multi-loculated expansile lesion of the left temporal bone during the first admission to the hospital. The lesion recurred 1 year after the subtotal resection with a more solid appearance. In addition, we review the literature for these rare lesions.

Bone Cysts, Aneurysmal↗

Spontaneously T1-hyperintense lesions of the brain on MRI: a pictorial review.

In this work, the brain lesions that cause spontaneously hyperintense T1 signal on MRI were studied under seven categories. The first category includes lesions with hemorrhagic components, such as infarct, encephalitis, intraparenchymal hematoma, cortical contusion, diffuse axonal injury, subarachnoid hemorrhage, subdural and epidural hematoma, intraventricular hemorrhage, vascular malformation and aneurysm, and hemorrhagic neoplasm. The second category includes protein-containing lesions, such as colloid cyst, craniopharyngioma, Rathke's cleft cyst, and atypical epidermoid. The third category includes lesions with fatty components, such as lipoma, dermoid, and lipomatous meningioma. Lesions with calcification or ossification, such as endocrine-metabolic disorder, calcified neoplasm, infection, and dural osteoma, constitute the fourth category, whereas the fifth category includes lesions with other mineral accumulation, such as acquired hepatocerebral degeneration and Wilson disease. The sixth category includes melanin-containing lesions, such as metastasis from melanoma and leptomeningeal melanosis. The last category is the miscellaneous group, which includes ectopic neurohypophysis, chronic stages of multiple sclerosis, and neurofibromatosis type I. The above-mentioned lesions are presented with their typical T1-hyperintense images, and the underlying reasons for those appearances in magnetic resonance imaging are discussed.

Brain Diseases↗

Aneurysmal bone cyst of the orbit: a case of rare location and review of the literature.

Aneurysmal bone cysts (ABCs) are benign fibrosseous lesions, very rarely occurring in the orbit. Seventeen cases of ABCs involving the orbit were reported in the literature. MRI pictures of a 7-year-old female patient with ABC involving the orbit are presented here. The clinical findings were left-sided painless proptosis, diplopia, papilledema and partial loss of the vision. MRI study showed a well-circumscribed mutliloculated expansile lesion of the orbital roof. We additionally make a review of the literature for these rare lesions.

Bone Cysts, Aneurysmal↗

Evaluation of extraocular muscles in the edematous phase of Graves ophthalmopathy on contrast-enhanced fat-suppressed magnetic resonance imaging.

OBJECTIVE: Extraocular muscles (EOMs) reveal characteristic contrast-enhancement patterns on magnetic resonance (MR) imaging due to their rich vascular supply. The objective of this study was to evaluate contrast-enhancement patterns of EOMs in patients with edematous phase of Graves ophthalmopathy (GO) using contrast-enhanced fat-suppressed MR imaging in comparison with normal volunteers. METHODS: EOMs of 15 patients with edematous phase of GO and those of 15 normal volunteers were evaluated using coronal T1-weighted MR images with fat suppression before and after intravenous administration of gadolinium. The image sequence was a fast spin-echo with chemical shift selective fat saturation. The degree of contrast enhancement for EOMs and temporal muscles (TMs) was assessed via a 4-step grading system and by 2 reviewers. RESULTS: There were statistically significant differences for the degrees of contrast enhancement in all EOMs between the patients with GO and normal volunteers. The degrees of contrast enhancement for all EOMs were significantly decreased in patients with edematous phase of GO. CONCLUSIONS: The microcirculation within the EOMs tends to be impaired during the progress of disease, and the MR imaging pattern gives a semiquantitative measurement of the microcirculatory impairment of the EOMs during the edematous phase of the disease.

Acute Disease↗

Infantile refsum disease: case report.

Infantile Refsum disease is a rare inborn error of phytanic acid metabolism. It is inherited in an autosomal recessive manner and frequently causes signs and symptoms in the neonate period. The only source of phytanic acid in humans is exogenous, from diet. We report the MR imaging findings in two cases of infantile Refsum disease and note the MR imaging changes that occurred over time because of further progression of the disease. The initial diagnosis in both patients was made on basis of history, clinical findings, and biochemical studies.

Brain↗