OBJECTIVE: Our aim is to measure the stiffness values in different regions of the eye with shear ... more OBJECTIVE: Our aim is to measure the stiffness values in different regions of the eye with shear wave elastography (SWE) in patients with glaucoma and to compare the results with healthy eyes to investigate whether there is a change in the elasticity of the ocular compartments in glaucoma patients.MATERIAL AND METHODS: In this study, we compared 12 patients with open-angle glaucoma and 32 healthy volunteers using an SWE-equipped ultrasonography device. Only the right eye was evaluated in all patients. First, the eye globe was generally examined in B-mode. Then, the stiffness values of the optic nerve head, retro-orbital nerve, sclera-retina complex and retro-orbital adipose tissue in the posterior segment and the stiffness values of the cornea, lens and anterior chamber in the anterior segment of the eye were measured with SWE in kiloPascal and both groups were compared statistically.RESULTS: No statistically significant differences were found between the patient and control groups ...
Background It is important to know the renal vascular variations before renal surgeries and invas... more Background It is important to know the renal vascular variations before renal surgeries and invasive procedures. The aim of this study is to evaluate the prevalence and types of variation of renal arteries and veins. Methods The abdominal CT images of 460 patients, taken between 2019 and 2021, were retrospectively analyzed in axial and coronal planes. The presence and number of accessory renal arteries and early branching in the main renal artery were evaluated. Then, bilateral renal vein variations were investigated. Finally, the compression of the left renal vein by different anatomical structures was evaluated. Results Of the 450 patients included in the study, the mean age was 53 years. No variations were detected in 378 renal arteries on the right side (84%) and 392 renal arteries on the left side (87.1%). The most common variation in renal arteries was an accessory inferior hilar artery in 7.5% and 6% rates on the right and left, respectively. An accessory inferior renal polar...
Objective: We aimed to evaluate the performance of ultrasonography (US) versus computed tomograph... more Objective: We aimed to evaluate the performance of ultrasonography (US) versus computed tomography (CT) scan in detecting intra-abdominal injury among pediatric patients with blunt abdominal trauma. Methods: Pediatric patients aged<18, who were admitted to the emergency department (ED) due to blunt abdominal trauma and underwent both US and CT scan were evaluated retrospectively. Results: A total of 732 pediatric patients were included in this study. Pathology was detected on US of 418 (57.1%) cases, whereas, intra-abdominal pathology was detected in CT scan of 359 (48.7%) cases. The sensitivity of US in detecting pathology (fluid and/or organ injury) was 95.3%, and its specificity was 79.6%. The sensitivity of US in detecting free fluid was 94.9%, and its specificity was 80.5%. In hemodynamically unstable and stable patients, the sensitivities of US in detection of pathology (fluid and/or organ injury) were 97.6% and 91.6%, and its specificities were 74.3% and 80.9%, respectivel...
Objective: We aimed to evaluate the performance of ultrasonography (US) versus computed tomograph... more Objective: We aimed to evaluate the performance of ultrasonography (US) versus computed tomography (CT) scan in detecting intra-abdominal injury among pediatric patients with blunt abdominal trauma. Methods: Pediatric patients aged<18, who were admitted to the emergency department (ED) due to abdominal trauma and underwent both US and CT scan were evaluated retrospectively. Results: A total of 732 pediatric patients were included in this study. Pathology was detected on US of 418 (57.1%) cases, whereas, intra-abdominal pathology was detected in CT scan of 359 (48.7%) cases. The sensitivity of US in detecting pathology (fluid and/or organ injury) was 95.3%, and its specificity was 79.6%. The sensitivity of US in detecting free fluid was 94.9%, and its specificity was 80.5%. In patients with unstable and stable hemodynamic, the sensitivities of US in detection of pathology (fluid and/or organ injury) were 97.6% and 91.6%, and its specificities were 74.3% and 80.9%, respectively. Conclusions: In our study, the sensitivity of US in terms of detecting pathology in pediatrics with blunt abdominal trauma was high, whereas the specificity of US was low.
Purpose: We aimed to correlate the presence or absence of embolic debris in filter-type embolic p... more Purpose: We aimed to correlate the presence or absence of embolic debris in filter-type embolic protection devices (EPD), which are frequently used during carotid artery stenting (CAS), with possible risk factors and ultrasonographic plaque features. Materials and methods: Eighty patients, who underwent CAS using a filter-type EPD in the period between July 2016 and March 2019, were included in our study. The modified Gray-Weale classification (mGWC) subtypes obtained in the pre-procedural ultrasonographic examinations were recorded. In addition, other patient-related risk factors considered to be related to a distal embolism were recorded. After the procedure the filters were evaluated to detect and examine embolic debris in the pathology clinic. The presence and features of embolic debris in the filters were recorded. Results: In the examinations performed after CAS, embolic debris was macroscopically and microscopically detected in 22 (27%) and 34 (42.5%) of the filter-type EPDs, respectively. A significant correlation was found between the change in the mGWC category of stenotic plaques from type 5 to type 1 and the presence of embolic debris in the filter (p < 0.05). Furthermore, a significant relationship was found between stenotic segment length and the presence of embolic debris in the filter (p < 0.05). The presence of embolic debris was not statistically significantly related to predisposing risk factors for atherosclerosis (p > 0.05). Conclusions: During CAS, the likelihood of the presence of embolic debris in the EPDs increases as mGWC categories change from type 5 to type 1 and as the length of the stenotic segment increases.
There are many variations of the iliac vein, and it is aimed to evaluate these variations using m... more There are many variations of the iliac vein, and it is aimed to evaluate these variations using multidetector computed tomography (MDCT). Pelvic MDCT images of 1071 adult patients (576 males; 495 females; age range 18–94 years; mean age 50.3 years) were retrospectively evaluated. Reconstruction images of the pelvic region in sagittal and coronal planes were evaluated. Except for the usual iliac venous anatomy, all types of iliac vein connections were defined as “iliac venous variation”. Of the 1071 patients, 84.2% were considered as type 1 (usual). Different variations were observed in 15.8% of the patients, of whom, 63.9% of were male and 36.1% female, and this gender difference was statistically significant (p < 0.05). The rates of variations detected in the study were type 2 (49.7%), type 3 (29%), type 4 (4.7%), type 5 (6.5%), type 6 (4.8%), type 7 (1.8%) and type 8 (3.6%) respectively. New subtypes that we named as type 3c, type 6f, type 6 × and type 7b were first determined in our study. Knowledge and evaluation of iliac venous variations before pelvic surgery or interventional procedures is of importance in preventing possible complications.
Egyptian Journal of Radiology and Nuclear Medicine, 2022
Background Vascular blow-out syndrome is a life-threatening bleeding condition that usually occur... more Background Vascular blow-out syndrome is a life-threatening bleeding condition that usually occurs in the carotid arteries as a result of invasion of head and neck malignant tumors. There are several case reports in the literature on peripheral vascular blow out. To our knowledge, there is no other case report in the literature on blow-out in the femoral artery secondary to skin malignancy. Case presentation A 66-year-old male patient, who was diagnosed with skin squamous cell carcinoma (SCC) as a result of tissue sampling due to redness and stiffness in the left inguinal region, underwent emergency surgery with severe bleeding. Since edema and deformations on the skin did not render the operation possible, the patient was taken to the interventional radiology unit by applying pressure compression onto the bleeding area for urgent endovascular treatment. The patient was treated with a stent-graft. Conclusion The femoral blow-out is an emergency condition that needs to be managed agg...
Radiofrequency ablation (RFA) is a minimal invasive approach for treating solid tumors. A compute... more Radiofrequency ablation (RFA) is a minimal invasive approach for treating solid tumors. A computed tomography (CT)-guided needle electrode is inserted percutaneously into the tumor. The electromagnetic current generated by the radiofrequency generator causes coagulation and necrosis in the tumor. In this procedure, the local temperature rises above 90°C, especially in large and close to the chest wall, serious pain occurs during and after the intervention (1). Although RFA procedures can be performed with local anaesthesia–sedation or general anaesthesia, local anaesthesia can lead to simple and fewer postoperative complications and has the advantage of short hospital stay (2).
This study aims to evaluate the morphology of the coccyx in adults with multidetector computed to... more This study aims to evaluate the morphology of the coccyx in adults with multidetector computed tomography and to contribute to the classification of the coccyx using intercoccygeal and sacrococcygeal angle measurements. The pelvic computed tomography images of 224 patients were retrospectively evaluated. The multiplanar reconstruction and 3D volume rendering images of the coccyx were obtained from all patients at sagittal and coronal planes. The morphology of the coccyx, number of bone segments, the presence of scoliosis, and presence of sacrococcygeal and intercoccygeal fusion were evaluated. After the measurement of coccygeal length, width, and thickness, intercoccygeal and sacrococcygeal angles were also calculated in all patients. The morphological classification showed that 136 patients (60.7%) had type 1, 65 patients (29%) had type 2, and 17 patients (7.6%) had type 3 coccyx. The intercoccygeal angle was zero degree in five patients (type 0) and one patient had retroverted coccyx (type 5). The coccyx had four segments in 155 patients (69.2%), three segments in 52 patients (23.2%), five segments in 15 patients (6.7%), two segments in one patient (0.4%), and one segment in one patient (0.4%). We determined patients with an intercoccygeal angle of zero degree, which is not mentioned in the literature before, and we propose to use the term “type 0” for these patients in the classification of coccyx. The coccygeal measurements and classification will be instructive for the radiologists and have a guiding role for the future studies.
OBJECTIVE: Our aim is to measure the stiffness values in different regions of the eye with shear ... more OBJECTIVE: Our aim is to measure the stiffness values in different regions of the eye with shear wave elastography (SWE) in patients with glaucoma and to compare the results with healthy eyes to investigate whether there is a change in the elasticity of the ocular compartments in glaucoma patients.MATERIAL AND METHODS: In this study, we compared 12 patients with open-angle glaucoma and 32 healthy volunteers using an SWE-equipped ultrasonography device. Only the right eye was evaluated in all patients. First, the eye globe was generally examined in B-mode. Then, the stiffness values of the optic nerve head, retro-orbital nerve, sclera-retina complex and retro-orbital adipose tissue in the posterior segment and the stiffness values of the cornea, lens and anterior chamber in the anterior segment of the eye were measured with SWE in kiloPascal and both groups were compared statistically.RESULTS: No statistically significant differences were found between the patient and control groups ...
Background It is important to know the renal vascular variations before renal surgeries and invas... more Background It is important to know the renal vascular variations before renal surgeries and invasive procedures. The aim of this study is to evaluate the prevalence and types of variation of renal arteries and veins. Methods The abdominal CT images of 460 patients, taken between 2019 and 2021, were retrospectively analyzed in axial and coronal planes. The presence and number of accessory renal arteries and early branching in the main renal artery were evaluated. Then, bilateral renal vein variations were investigated. Finally, the compression of the left renal vein by different anatomical structures was evaluated. Results Of the 450 patients included in the study, the mean age was 53 years. No variations were detected in 378 renal arteries on the right side (84%) and 392 renal arteries on the left side (87.1%). The most common variation in renal arteries was an accessory inferior hilar artery in 7.5% and 6% rates on the right and left, respectively. An accessory inferior renal polar...
Objective: We aimed to evaluate the performance of ultrasonography (US) versus computed tomograph... more Objective: We aimed to evaluate the performance of ultrasonography (US) versus computed tomography (CT) scan in detecting intra-abdominal injury among pediatric patients with blunt abdominal trauma. Methods: Pediatric patients aged<18, who were admitted to the emergency department (ED) due to blunt abdominal trauma and underwent both US and CT scan were evaluated retrospectively. Results: A total of 732 pediatric patients were included in this study. Pathology was detected on US of 418 (57.1%) cases, whereas, intra-abdominal pathology was detected in CT scan of 359 (48.7%) cases. The sensitivity of US in detecting pathology (fluid and/or organ injury) was 95.3%, and its specificity was 79.6%. The sensitivity of US in detecting free fluid was 94.9%, and its specificity was 80.5%. In hemodynamically unstable and stable patients, the sensitivities of US in detection of pathology (fluid and/or organ injury) were 97.6% and 91.6%, and its specificities were 74.3% and 80.9%, respectivel...
Objective: We aimed to evaluate the performance of ultrasonography (US) versus computed tomograph... more Objective: We aimed to evaluate the performance of ultrasonography (US) versus computed tomography (CT) scan in detecting intra-abdominal injury among pediatric patients with blunt abdominal trauma. Methods: Pediatric patients aged<18, who were admitted to the emergency department (ED) due to abdominal trauma and underwent both US and CT scan were evaluated retrospectively. Results: A total of 732 pediatric patients were included in this study. Pathology was detected on US of 418 (57.1%) cases, whereas, intra-abdominal pathology was detected in CT scan of 359 (48.7%) cases. The sensitivity of US in detecting pathology (fluid and/or organ injury) was 95.3%, and its specificity was 79.6%. The sensitivity of US in detecting free fluid was 94.9%, and its specificity was 80.5%. In patients with unstable and stable hemodynamic, the sensitivities of US in detection of pathology (fluid and/or organ injury) were 97.6% and 91.6%, and its specificities were 74.3% and 80.9%, respectively. Conclusions: In our study, the sensitivity of US in terms of detecting pathology in pediatrics with blunt abdominal trauma was high, whereas the specificity of US was low.
Purpose: We aimed to correlate the presence or absence of embolic debris in filter-type embolic p... more Purpose: We aimed to correlate the presence or absence of embolic debris in filter-type embolic protection devices (EPD), which are frequently used during carotid artery stenting (CAS), with possible risk factors and ultrasonographic plaque features. Materials and methods: Eighty patients, who underwent CAS using a filter-type EPD in the period between July 2016 and March 2019, were included in our study. The modified Gray-Weale classification (mGWC) subtypes obtained in the pre-procedural ultrasonographic examinations were recorded. In addition, other patient-related risk factors considered to be related to a distal embolism were recorded. After the procedure the filters were evaluated to detect and examine embolic debris in the pathology clinic. The presence and features of embolic debris in the filters were recorded. Results: In the examinations performed after CAS, embolic debris was macroscopically and microscopically detected in 22 (27%) and 34 (42.5%) of the filter-type EPDs, respectively. A significant correlation was found between the change in the mGWC category of stenotic plaques from type 5 to type 1 and the presence of embolic debris in the filter (p < 0.05). Furthermore, a significant relationship was found between stenotic segment length and the presence of embolic debris in the filter (p < 0.05). The presence of embolic debris was not statistically significantly related to predisposing risk factors for atherosclerosis (p > 0.05). Conclusions: During CAS, the likelihood of the presence of embolic debris in the EPDs increases as mGWC categories change from type 5 to type 1 and as the length of the stenotic segment increases.
There are many variations of the iliac vein, and it is aimed to evaluate these variations using m... more There are many variations of the iliac vein, and it is aimed to evaluate these variations using multidetector computed tomography (MDCT). Pelvic MDCT images of 1071 adult patients (576 males; 495 females; age range 18–94 years; mean age 50.3 years) were retrospectively evaluated. Reconstruction images of the pelvic region in sagittal and coronal planes were evaluated. Except for the usual iliac venous anatomy, all types of iliac vein connections were defined as “iliac venous variation”. Of the 1071 patients, 84.2% were considered as type 1 (usual). Different variations were observed in 15.8% of the patients, of whom, 63.9% of were male and 36.1% female, and this gender difference was statistically significant (p < 0.05). The rates of variations detected in the study were type 2 (49.7%), type 3 (29%), type 4 (4.7%), type 5 (6.5%), type 6 (4.8%), type 7 (1.8%) and type 8 (3.6%) respectively. New subtypes that we named as type 3c, type 6f, type 6 × and type 7b were first determined in our study. Knowledge and evaluation of iliac venous variations before pelvic surgery or interventional procedures is of importance in preventing possible complications.
Egyptian Journal of Radiology and Nuclear Medicine, 2022
Background Vascular blow-out syndrome is a life-threatening bleeding condition that usually occur... more Background Vascular blow-out syndrome is a life-threatening bleeding condition that usually occurs in the carotid arteries as a result of invasion of head and neck malignant tumors. There are several case reports in the literature on peripheral vascular blow out. To our knowledge, there is no other case report in the literature on blow-out in the femoral artery secondary to skin malignancy. Case presentation A 66-year-old male patient, who was diagnosed with skin squamous cell carcinoma (SCC) as a result of tissue sampling due to redness and stiffness in the left inguinal region, underwent emergency surgery with severe bleeding. Since edema and deformations on the skin did not render the operation possible, the patient was taken to the interventional radiology unit by applying pressure compression onto the bleeding area for urgent endovascular treatment. The patient was treated with a stent-graft. Conclusion The femoral blow-out is an emergency condition that needs to be managed agg...
Radiofrequency ablation (RFA) is a minimal invasive approach for treating solid tumors. A compute... more Radiofrequency ablation (RFA) is a minimal invasive approach for treating solid tumors. A computed tomography (CT)-guided needle electrode is inserted percutaneously into the tumor. The electromagnetic current generated by the radiofrequency generator causes coagulation and necrosis in the tumor. In this procedure, the local temperature rises above 90°C, especially in large and close to the chest wall, serious pain occurs during and after the intervention (1). Although RFA procedures can be performed with local anaesthesia–sedation or general anaesthesia, local anaesthesia can lead to simple and fewer postoperative complications and has the advantage of short hospital stay (2).
This study aims to evaluate the morphology of the coccyx in adults with multidetector computed to... more This study aims to evaluate the morphology of the coccyx in adults with multidetector computed tomography and to contribute to the classification of the coccyx using intercoccygeal and sacrococcygeal angle measurements. The pelvic computed tomography images of 224 patients were retrospectively evaluated. The multiplanar reconstruction and 3D volume rendering images of the coccyx were obtained from all patients at sagittal and coronal planes. The morphology of the coccyx, number of bone segments, the presence of scoliosis, and presence of sacrococcygeal and intercoccygeal fusion were evaluated. After the measurement of coccygeal length, width, and thickness, intercoccygeal and sacrococcygeal angles were also calculated in all patients. The morphological classification showed that 136 patients (60.7%) had type 1, 65 patients (29%) had type 2, and 17 patients (7.6%) had type 3 coccyx. The intercoccygeal angle was zero degree in five patients (type 0) and one patient had retroverted coccyx (type 5). The coccyx had four segments in 155 patients (69.2%), three segments in 52 patients (23.2%), five segments in 15 patients (6.7%), two segments in one patient (0.4%), and one segment in one patient (0.4%). We determined patients with an intercoccygeal angle of zero degree, which is not mentioned in the literature before, and we propose to use the term “type 0” for these patients in the classification of coccyx. The coccygeal measurements and classification will be instructive for the radiologists and have a guiding role for the future studies.
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Papers by Azad Hekimoglu