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Öğe Computerized Tomography Patterns of Mediastinal Lymphadenopathy(Galenos Yayincilik, 2010) Altunrende, S. Sevil; Demir, M. Kemal; Anik, Yonca Akgoz; Ozdemir, HuseyinAim: The aim of our study is to demonstrate the efficiency of computerized tomography (CT) in determining the etiology of mediastinal lymphadenopathy detected on thoracic CT by evaluating its dimension, location, number, enhancing pattern and structure of the parenchyma. Methods: Ninety-six subjects, 73 men and 23 women, who were referred to our clinic with various initial diagnoses and whose thorax CT examination revealed mediastinal lymphadenopathy, were included in the study. Results: Among the patients divided into 5 groups according to the etiology of the mediastinal LAP, statistically significant difference was found when comparing the third group with the first and the second groups in terms of the presence or absence of lymph node calcification. Significant difference was observed between the first group and the second group regarding the lymph node dimensions. No statistically significant difference was found between the groups in terms of the presence of lymph nodes packet. Conclusion: CT is an effective imaging method for evaluating the dimension, location, number, enhancing pattern and the structure of parenchyma of mediastinal lymphadenopathy, for staging, and for following after operation or medication.Öğe Contrast-enhanced MR 3D angiography in the assessment of brain AVMs(Elsevier Ireland Ltd, 2006) Unlu, Ercument; Temizoz, Osman; Albayram, Sait; Genchellac, Hakan; Hamamcioglu, M. Kemal; Kurt, Imran; Demir, M. KemalBackground and purpose: Digital subtraction angiography (DSA) is the current reference standard for the diagnosis, assessment, and management of brain arteriovenous malformations (AVMs). The purpose of this study was to compare the diagnostic utility of three-dimensional (3D) time-off-light (TOF) magnetic resonance angiography (MRA) and contrast-enhanced 3D MRA in patients with intracranial arteriovenous malformations (AVMs) in different sizes and locations. The AVM diagnosis was proved via DSA and almost half of the patients had also hematoma. Materials and methods: Two radiologists, experienced on neurovascular imaging and independent from each other, retrospectively reviewed two MRA techniques and DSA with regard to the assessment of feeding arteries, AVM nidus, and venous drainage patterns on 20 patients with 23 examinations by scoring system. Disagreements were resolved by consensus. Results: An excellent agreement between contrast-enhanced MRA and DSA was found in order to assess the numbers of arterial feeders and draining veins (Spearman r=0.913, P<0.001). The average scores in contrast-enhanced MRA for feeders, nidi, and drainers were respectively 2.26, 2.69, and 2.48, while in TOF-MRA they are 1.96, 1.35, and 0.89, respectively. Conclusion: Compared to TOF-MRA, 3D contrast-enhanced MRA is useful for visualization by subtraction technique of malformation components presented by hematoma or by haem product. On the other hand, for the cases presented by slow or complex flow that is especially in around or nidi or around the venous portion is also advantageous because of the independence from flow-related enhancement. Therapeutic effects were clearly demonstrated in three follow-up patients. A major limitation of this technique is the low spatial resolution. Since there is such a limitation, arterial feeder of a case with micro-AVM is not detected by contrast-enhanced MRA and nidus for the same case was observed retrospectively. In this respect, we believe that 3D contrast-enhanced MRA is a less invasive and inexpensive angiographic tool, but not a safe substitute for DSA. Yet, it can be a beneficial supplement to DSA in patients with cerebral AVMs at both initial diagnosis and at follow-up processes after therapy. (C) 2006 Elsevier Ireland Ltd. All rights reserved.Öğe Digital subtraction angiography of a persistent trigeminal artery variant(Aves, 2010) Temizoz, Osman; Genchellac, Hakan; Unlu, Ercuement; Cagli, Bekir; Ozdemir, Hueseyin; Demir, M. KemalPersistent trigeminal artery variants are described as cerebellar arteries that directly originate from the precavernous segment of the internal carotid artery. This has been observed in 0.18% of cerebral catheter angiograms. On the other hand, a persistent trigeminal artery variant feeding both the anterior inferior cerebellar artery and the posterior inferior cerebellar artery territory is very rare. We present this uncommon anomalous artery along with digital subtraction angiography findings and discuss its clinical significance in light of the literature.Öğe Imaging Features of Unusual Intracranial Cystic Meningiomas(Elsevier Science Bv, 2007) Demir, M. Kemal; Musluman, Murat; Kilicoglu, Gamze; Hakan, Tayfun; Aker, Fugen V.Objective: To describe the imaging features of unusual intracranial cystic meningiomas in infants and adults. Methods: We retrospectively reviewed the magnetic resonance and computed tomography findings for 2 female patients and 3 male patients, ranging in age from 1 to 73 years (median 41 years), with histopathologically proven cystic meningioma. Result: Although cystic meningiomas usually appear as solid and cystic masses, they may present as a mainly multicystic lesion. The wall of a cystic part of the meningioma may include both enhancing and unenhancing areas at imaging. The cystic portion of a meningioma is hypointense on diffusion-weighted images and markedly hyperintense on corresponding apparent diffusion coefficient maps. Conclusion: Cystic meningiomas may vary in appearance at imaging. They can be very challenging when present in infants. Knowledge of imaging findings and awareness of variability in the differential diagnosis can help to avoid preoperative diagnostic pitfalls.Öğe Mediastinal lenfadenopatilerin bilgisayarlı tomografi paternleri(2010) Altunrende, Ş. Sevil; Demir, M. Kemal; Akgök, Yonca Anık; Özdemir, HüseyinAmaç: Bu çalışmada, bilgisayarlı tomografi (BT) ile saptanan mediastinal lenf nodlarının boyut, lokalizasyon, sayı, boyanma pater-ni ve parankim yapısını değerlendirerek, BT'nin etiyolojiyi açığa çıkarmadaki etkinliğini araştırdık.Yöntemler: Bu çalışmaya çeşitli ön tanılarla kliniğimize başvuran, toraks BT incelemesi yapılan ve mediastinal LAP saptanan 73'ü erkek 23'ü kadın toplam 96 olgu alındı. Bulgular: Mediastinal LAP etiyolojilerine göre 5 gruba ayrılan hastalarda lenf nodu kalsifikasyonu içerip içermemesi yönüyle 3. grup ile 1. ve 2. gruplar arasında istatistiksel olarak anlamlı farklılık bulundu. Lenf nodu boyutlarına göre 1. grup ile 2. grup arasında anlamlı farklılık saptandı. Lenf nodlarında paket oluşumu varlığı açısından gruplar arasında istatistiksel olarak anlamlılık saptanmadı.Sonuç: BT, lenfadenopatilerin varlığı, lokalizasyonu, boyut, sayı, boyanma paterni ve parankim yapısının değerlendirilmesinde, evreleme ve operasyon veya tedavi sonrası ise kontrol ve takip aşamasında doğruluğu yüksek bir görüntüleme yöntemidir.Öğe Prevalence and MDCT characteristics of asymptomatic Bochdalek hernia in adult population(Turkish Soc Radiology, 2010) Temizoz, Osman; Genchellac, Hakan; Yekeler, Ensar; Umit, Hasan; Unlu, Ercument; Ozdemir, Huseyin; Demir, M. KemalPURPOSE To determine the frequency of asymptomatic incidental Bochdalek hernias in adults, using multidetector computed tomography (MDCT), and to ascertain any possible relationship between Bochdalek hernia and age, gender, or body mass index (BMI). MATERIALS AND METHODS Seven hundred and forty-eight abdominal, and 602 chest MDCT scans, which had been performed for a variety of reasons on 1350 adults, were investigated retrospectively. Location and size of Bochdalek hernias seen on these scans were correlated with age, gender, and BMI. On the basis of BMI, patients with Bochdalek hernia were classified as group A (BMI <25) and group B (BMI >= 25). RESULTS A total of 171 Bochdalek hernias were identified in 142 of 1350 patients, ranging in age from 25 to 90 years (median age, 57.2), representing a prevalence of 10.5%. Sixty left-sided unilateral Bochdalek hernias (42.2%), 53 (37.4%) right-sided unilateral Bochdalek hernias, and 29 (20.4%) bilateral Bochdalek hernias were detected. Forty-five (31.6%) were categorized as small, 82 (57.8%) were medium-sized, and 1 5 (10.5%) were large. BMI was <25 in 62 patients (43.7%), and >= 25 in 80 patients (56.3%). Fourteen patients (9.9%) were young adults, while 86 (60.6%) were middle aged, and 42 (29.6%) were elderly. No statistically significant relationship was found between dimensions or hernia locations and age, gender, or BMI of patients with Bochdalek hernia. CONCLUSION In view of the high prevalence of Bochdalek hernia in our study (10.5%), the multiplanar and reconstruction features of MDCT seem to facilitate the diagnosis of asymptomatic incidental Bochdalek hernia. No relationship was found between asymptomatic incidental Bochdalek hernia and age, gender, or BMI in adults.