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Öğe Cytomegalovirus-associated transverse myelitis: A review of nine well-documented cases(Taylor and Francis, 2015) Arslan, Ferhat; Yılmaz, Mesut; Paksoy, Yahya; Karagöz, Ergenekon; Mert, AliCytomegalovirus-associated transverse myelitis is a rare disease. We found 12 cases in the medical literature, 8 of which met our criteria for being well documented. Our aim was to review this clinical entity using information from our own clinical experience as well as published cases.Öğe Diagnostic efficacy of diffusion-weighted MRI for pre-operative assessment of myometrial and cervical invasion and pelvic lymph node metastasis in endometrial carcinoma(Wiley-Blackwell, 2014) Koplay, Mustafa; Doğan, Nasuh Utku; Erdoğan, Hasan; Sivri, Mesut; Erol, Cengiz; Nayman, Alaaddin; Karabağlı, Pınar; Paksoy, Yahya; Çelik, ÇetinIntroduction: To determine the diagnostic accuracy of diffusion-weighted magnetic resonance imaging (DW-MRI) for the pre-operative assessment of patients with endometrial carcinoma and to assess myometrial and cervical invasion as well as pelvic lymph node metastasis. Methods: Fifty-eight women who underwent surgery for histopathologically confirmed endometrial carcinoma were included in the current study. Prior to surgery, patients were evaluated using pelvic DW-MRI and gadolinium-enhanced T1-weighted imaging (Gd-T1WI). Gd-T1WI was evaluated together with T2-weighted images. DW-MR images were obtained in the axial plane using echo-planar spin-echo pulse sequences with different b factors. Endometrial carcinomas were observed as areas of increased intensity on DW-MRI images, and their intensity was compared with the surrounding hypo-intense myometrium. Pre-operative DW-MRI and Gd-T1WI results were compared with post-operative histopathological findings that served as reference standards. Results: The sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and diagnostic accuracy of DW-MRI for differentiation between superficial myometrial invasion and deep myometrial invasion were 85%, 89%, 81%, 92% and 88%, respectively. The sensitivity, specificity and diagnostic accuracy rates were 82%, 91% and 89.6% for cervical invasion and 100%, 96% and 96.5% for pelvic lymph node metastasis, respectively. The sensitivity, specificity, PPV and NPV, and diagnostic accuracy of Gd-T1WI for differentiation between superficial myometrial invasion and deep myometrial invasion were 85%, 81.5%, 71%, 91% and 83%, respectively. The sensitivity, specificity and diagnostic accuracy were 73%, 89% and 86% for cervical invasion, respectively. Conclusions: These findings suggest that DW-MRI may be a good diagnostic tool with high sensitivity and specificity for assessing myometrial invasion and detecting tumour extension. We suggest that DW-MRI should be considered as a routine part of the pre-operative pelvic MRI in all patients with endometrial carcinoma.Öğe Dysembryoplastic neuroepithelial tumor of cerebellum in a child(Kocaeli Derince Education and Research Hospital, 2014) Köse, Doğan; Kalkan, Erdal; Paksoy, Yahya; Toy, Hatice; Üçüncü Ergün, Nurcan; Köksal, YavuzDysembryoplastic neuroepithelial tumors are benign neoplasms with typical supratentorial location. 12 year old patient, who applied to a local hospital with complaints of loss of consciousness and postural tonus, was referred to our hospital with cerebellar mass diagnosis. According to the anamnesis, similar complaints also appeared when the patient was 3 and 10 years old, however no anomaly was found in the examinations done by pediatric cardiologist and pediatric neurologist in that period. Physical examination and routine laboratory examinations of the patient were normal. The mass identified in the cerebellum was totally removed. The patient was diagnosed as dysembryoplastic neuroepithelial tumor by histopathological evaluation of the tissue. The patient has still been under outpatient follow-up and in complete remission without any evidence of recurrence for 5 years. In this report a child patient having dysembryoplastic neuroepithelial tumor with cerebellar location is aimed to be shared with the literature.Öğe Effect of radiation dose reduction on image quality in adult head CT with noise-suppressing reconstruction system with a 256 slice MDCT(Multimed, 2015) Başkan, Özdil; Erol, Cengiz; Özbek, Hanefí; Paksoy, YahyaThe purpose of our study was to investigate the effect of iterative reconstruction (IR) as a dose reduction system on the image quality (IQ) of the adult head computed tomography (CT) at various low-dose levels, and to identify ways of setting the amount of dose reduction. We performed two noncontrast low-dose (LD) adult head CT protocols modified by lowering the tube current with IR which were decided in the light of a group of phantom studies. Two groups of patients, each 100 underwent noncontrast head CT with LD-I and LD-II, respectively. These groups were compared with 100 consecutive standard dose (STD) adult head CT protocol in terms of quantitative and qualitative IQ. The signal-to-noise ratio (SNR) of the white matter (WM) and gray matter (GM) and contrast-to-noise ratio (CNR) values in the LD groups were higher than the STD group. The differences were statistically significant. When the STD and the LD groups were compared qualitatively, no significant differences were found in overall quality. By selecting the appropriate level of IR 34%, radiation dose reduction in adult head CT can be achieved without compromising IQ.Öğe Hydatid disease of the liver with portal vein invasion mimicking portal vein thrombosis(Elsevier Science Bv, 2019) Ertan, Gülhan; Ulus, Sıla; Kılıçarslan, Rukiye; Yılmaz, Mesut; Paksoy, Yahya; Erol, CengizHydatid cyst disease is a zoonosis caused by the parasite Echinococcus. It may infest any organ of the body, but it most frequently involves the liver, lungs, and nervous system. Portal vein involvement by hydatid cyst disease is extremely rare with only five cases published in the English literature to our knowledge. We present the ultrasonography (US) and computed tomography (CT) findings of a 77-year-old male with hydatid disease of the liver with portal vein invasion mimicking portal vein thrombosis. Colour Doppler US confirmed the lack of blood flow within the portal vein and stigmata of cavernomatosis. CT clearly demonstrated a communication between the multiloculated lesion and the portal vein and the multiple daughter vesicles obstructing the portal vein. The consideration of this complication will make it possible to distinguish this entity from portal vein thrombosis and, thus, the management of the patients with hydatid cyst disease particulary in endemic regions.Öğe Maksiller fibröz displazinin egzofitik varyantı; fibröz displazi protuberans(2014) Erdoğan, Hasan; Paksoy, Yahya; Sivri, Mesut; Erol, Cengiz; Uysal, Emine; Koplay, MustafaFibröz displazi, normal kemik dokunun yerini fibröz doku içeren mineralize bir dokunun aldığı, gelişimsel, neoplastik olmayan bir kemik hastalığıdır. Direkt radyografi, bilgisayarlı tomografi ve manyetik rezonans görüntüleme, fibröz displazi tanısında kullanılan radyolojik görüntüleme yöntemleridir. Bu yazıda maksiller fibröz displazinin oldukça nadir görülen egzofitik varyantının klinik özel- likleri, radyolojik görüntüleme bulguları ve ayırıcı tanısı sunulmuştur.Öğe Neurological complication of non Hodgkin lymphoma in childhood: Experience from a single center in Turkey(Springer, 2014) Köse, Doğan; Paksoy, Yahya; Köksal, Yavuz; Ünal, EkremLymphomas are the third most common childhood malignant disease after leukemia and central nervous system (CNS) tumors. Early diagnosis of these complications will reduce mortality and morbidity. In this study we aimed to review the neurological complications of childhood non Hodgkin Lymphoma (NHL). Forty four children with NHL between 2006 and 2012 were investigated retrospectively and 14 cases with neurological complications were identified. The most common symptom was alteration of the consciousness (10 patients, 71.4 %) followed by convulsion (5 patients, 35.7 %), and hallucination (4 patients, 28.5 %); headache, eye pain, neurogenic bladder, speech disability and facial paralysis, and hemiplegia, were less common and each of them was seen in 1 (7.1 %) of the patients. The neurological complications were mostly seen in children with precursor T lymphoblastic lymphoma followed by anaplastic large cell lymphoma. The complications were secondary to medications (Eight patients) infection (two patients); CNS relapse (two patients); or CNS involvement of the primary disease (two patients). Chemotherapy-related neurologic complications were secondary to intrathecal methotrexate, l-asparaginase, vincristine, and ifosfamide Advanced disease and PTLL subtype can be suggested as predictors of neurological complication. The survival rates of neurological complications are fairly good unless it is secondary to involvement of the primary disease. In patients with drug-induced neurological complications, the treatment can be safely re-administered after controlling the neurological complications. Therefore, clinicians managing children with NHL must be informative about neurological complications.Öğe Quantitative assessment of left ventricular function and myocardial mass: A comparison of coronary CT angiography with cardiac MRI and echocardiography(International Scientific Information, 2016) Kara, Bedia; Nayman, Alaaddin; Güler, İbrahim; Gül, Enes Elvin; Koplay, Mustafa; Paksoy, YahyaThe purpose of this study was to compare the left ventricular parameters obtained from multidetector row computed tomography (MDCT) studies with two-dimensional echocardiography (2DE), and magnetic resonance imaging (MRI), which is accepted as the gold standard in the evaluation of left ventricular functions. The study also aimed to evaluate whether or not there is a relationship between the MR-Argus and CMR tools software programs which are used in post-process calculations of data obtained by MRI. Material/Methods: Forty patients with an average age of 51.4±14.9 years who had been scanned with cardiac MDCT were evaluated with cardiac MRI and 2DE. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), cardiac output (CO), and myocardial mass values calculated by MDCT, MRI, and 2DE were compared with each other. Two different MR software programs were used to compare left ventricular functions. The CMR tools LV tutorials method is accepted as the gold standard because it can be used in three-dimensional functional evaluation. The Pearson Correlation and Bland-Altman analysis were performed to compare the results from the two MR methods (MR-Argus and CMR tools) and the results from both the MDCT and the 2DE with the CMR tools results. Results: Strong positive correlations for EF values were found between the MDCT and CMR tools (r=0.702 p<0.001), and between the MR-Argus and CMR tools (r=0.746 p<0.001). The correlation between the 2DE and CMR tools (r=0.449 p<0.004), however, was only moderate. Similar results were obtained for the other parameters. The strongest correlation for ESV, EDV, and EF was between the two MR software programs. The correlation coefficient between the MDCT and CMR tools is close to the correlation coefficient between the two software programs. While the correlation between 2DE and CMR tools was satisfactory for ESV, EDV, and CO values, it was at a moderate level for the other parameters. Conclusions: Left ventricular functional analysis can be performed easily and reliably with cardiac MDCT used for coronary artery evaluation and it also gives more accurate results than 2DE.Öğe The prevalence and clinical importance of incidentally detected noncoronary cardiovascular findings with coronary multidetector CT angiography(Springer, 2014) Erol, Cengiz; Koplay, Mustafa; Şeker, Mehmet; Paksoy, YahyaThe purpose of this study was to determine the prevalence and clinical importance of incidental findings of noncoronary cardiac structures and mediastinal great vessels in patients who underwent coronary computed tomography angiography (CCTA). The study included 2,096 consecutive patients (1,472 men and 624 women, with a mean age of 55 years). Cardiovascular findings were categorized into three groups according to the clinical importance: group 1 included findings necessitating immediate treatment or intervention; group 2 included findings requiring clinical awareness, follow-up, or further clinical and/or radiological investigations; and group 3 included findings not requiring any follow-up or further tests. We also evaluated whether there was any previous diagnosis of cardiovascular findings. A total of 174 abnormalities (8.3 %) were detected in 170 patients. Of these abnormalities, 21 findings (12 %) were considered as group 1, 121 (69.5 %) as group 2, and 32 (18.5 %) as group 3. The majority of cardiovascular findings (140 of 174, 80.5 %) were unknown by the reporter during the interpretation of CCTA examinations and regarded as incidental findings. Noncoronary incidental cardiovascular findings in patients who underwent CCTA are common. It is important to be aware of these findings necessitating immediate treatment or intervention, and follow-up or further investigations, and careful attention must be paid to all the structures included in the images.Öğe Two- and three-dimensional anatomy of paranasal sinuses in arabian foals(Japanese Society of Veterinary Science, 2014) Bahar, Sadullah; Bolat, Durmuş; Dayan, Mustafa Orhun; Paksoy, YahyaThe 2- and 3-dimensional (3D) anatomy and the morphometric properties of the paranasal sinuses of the foal have received little or no attention in the literature. The aim of this study was to obtain details of the paranasal sinuses using multiplane CT imaging to create 3D models and to determine morphological and morphometric data for the sinuses using the 3D models. The heads of five female foals were used in this study. The heads were scanned using computed tomography (CT) in the rostrocaudal direction. After the heads had been frozen, anatomical sections were obtained in the scan position. The 3D models of sinuses and the skull were prepared using MIMICS (R). These models were used to assess the surface area and volume of the sinuses, the width, height and orientation of the apertures connecting these sinuses and finally the planar relation of the sinuses with the skull. The right and left sides of all anatomical structures, except the sphenoid sinuses, had symmetric organization on CT images and anatomical sections. The total sinus surface area and volume on both sides were 214.4 cm(2) and 72.9 ml, respectively. The largest and the smallest sinuses were the frontal sinus (41.5 ml) and the middle conchal sinus (0.2 ml), respectively. It was found that the planes bounding the sinuses passed through easily palpable points on the head. In conclusion, 3D modeling in combination with conventional sectional imaging of the paranasal sinuses of the foal may help anatomists, radiologists, clinicians and veterinary students.
