Browsing by Author "Cebeci, Hakan"
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Item Assesment of perfusion in glial tumors with arterial spin labeling; comparison with dynamic susceptibility contrast method(Elsevier Ireland, 2014-10) Öztürk, Esin Işık; Gümüş, Caner; İnecikli, Mehmet Fatih; Cebeci, Hakan; Aydın, Ömer; Bekar, Ahmet; Kocaeli, Hasan; Hakyemez, Bahattin; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Beyin ve Sinir Cerrahisi Anabilim Dalı.; 0000-0002-3425-0740; AAI-2318-2021; 56033553000; 55933661900; 6603677218; 6603500567; 6602527239Purpose: Arterial spin labeling perfusion imaging (ASL-PI) is a non-invasive perfusion imaging method that can be used for evaluation and quantification of cerebral blood flow (CBF). Aim of our study was to evaluating the efficiency of ASL in histopathological grade estimation of glial tumors and comparing findings with dynamic susceptibility contrast perfusion imaging (DSC-PI) method. Methods: This study involved 33 patients (20 high-grade and 13 low-grade gliomas). Multiphase multislice pulsed ASL MRI sequence and a first-passage gadopentetate dimeglumine T2*-weighted gradient-echo single-shot echo-planar sequence were acquired for all the patients. For each patient, perfusion relative signal intensity (rSI), CBF and relative CBF (rCBF) on ASL-PI and relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) values on DSC-PI were determined. The relative signal intensity of each tumor was determined as the maximal SI within the tumor divided by SI within symetric region in the contralateral hemisphere on ASL-PI. rCBV and rCBF were calculated by deconvolution of an arterial input function. Relative values of the lesions were obtained by dividing the values to the normal appearing symmetric region on the contralateral hemisphere. For statistical analysis, Mann-Whitney ranksum test was carried out. Receiver operating characteristic curve (ROC) analysis was performed to assess the relationship between the rCBF-ASL, rSI-ASL, rCBV and rCBF ratios and grade of gliomas. Their cut-off values permitting best discrimination was calculated. The correlation between rCBV, rCBF, rSI-ASL and rCBF-ASL and glioma grade was assessed using Spearman correlation analysis. Results: There was a statistically significant difference between low and high-grade tumors for all parameters. Correlation analyses revealed significant positive correlations between rCBV and rCBF-ASL (r=0.81, p<0.001). However correlation between rCBF and rCBF-ASL was weaker (r=0.64, p<0.001). Conclusion: Arterial spin labeling is an employable imaging technique for evaluating tumor perfusion non-invasively and may be useful in differentiating high and low grade gliomas.Publication Cardiac hydatid disease and extracardiac organ involvement: A tertiary single-center experience(Istanbul Training & Research Hospital, 2021-05-01) Cam, Isa; Karauzum, Kurtulus; Karauzum, Irem; Ozer, Torehan; Yalniz, Ahmet; Cakir, Ozgur; Cebeci, Hakan; Omay, Oguz; Ciftci, Ercument; Sahin, Tayfun; Anik, Yonca; Gursel, Basak Erdemli; ERDEMLİ GÜRSEL, BAŞAK; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-9551-2364; 0000-0003-3253-1554; 0000-0001-6565-9488; 0000-0002-0851-2946; E-4900-2015; G-3388-2018; AAD-5011-2021; AAH-6568-2021; GXW-0700-2022; G-4427-2018Introduction: Cardiac involvement is rare in hydatid cyst disease, which accounted for 0.5%-2% of all hydatidosis cases. Cardiac cysts usually occur as part of a wider infestation with extracardiac involvement. This study aimed to describe the general characteristics, imaging findings, and range of organ involvement in cases of cardiac hydatid disease.Methods: Retrospective assessment of cardiac hydatid disease records, between 2007 and 2019, was undertaken to identify patients with cardiac hydatidosis. Hydatid cysts were assessed by transthoracic echocardiography, magnetic resonance imaging, and computed tomography. Clinical symptoms, treatment modalities, and follow-up were also evaluated.Results: Over the study period, 22 (13 males: 59.1%; mean age: 43.1 years; range: 12-63 years) patients with 24 cardiac hydatid cysts were identified. The most common symptom was chest pain, which occurred in 13 (59.1%) patients, Cardiac cysts were located in the left ventricle (n=10, 41.7%), right ventricle (n=5, 20.8%), interventricular septum (n=5, 20.8%), and pericardium (n=4, 16.7%). Extracardiac involvement was present in 14 (63.6%) patients, most commonly affecting the liver (n=10, 45.4%), but in 8 (36.3%) patients, there was no extracardiac organ involvement. Cardiac hydatid cysts were surgically removed in 20 (90.9%) patients.Conclusion: Cardiac hydatid disease is very uncommon, with the left ventricle as the most commonly affected structure in this series. Chest pain was the most common presenting symptom. Extracardiac involvement is common, so patients with cardiac hydatid cysts should be investigated for involvement of other organs.Publication Demonstration of cephaloceles in patients with rhinorrhea: Single centre experience of intrathecal gadolinium enhanced MR cisternography(Briefland, 2020-01-01) Cebeci, Hakan; Bilgin, Cem; Candan, Selman; Yılmazlar, Selçuk; Hakyemez, Bahattin; BİLGİN, CEM; CANDAN, SELMAN; YILMAZLAR, SELÇUK; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; HHS-7433-2022; AAH-5070-2021; AAI-2318-2021; GVS-7682-2022Background: MR cisternography has the crucial role for diagnosis of cerebrospinal fluid (CSF) leakage in patients with rhinorrhea and otorrhea. Trauma is the major cause of rhinorrhea. Cephalocele is diagnosed in some rhinorrhea patients.Objectives: To evaluate the CSF leakage in patients with rhinorrhea and assess the frequency of cephalocele in the etiology of rhinorrhea.Patients and Methods: Intrathecal gadolinium enhanced MR cisternography and nonenhanced CT of paranasal sinus images of patients with suspected CSF rhinorrhea between October 2012 and September 2018 were evaluated retrospectively. Twenty-one patients with the diagnosis of contrast leakage causing rhinorrhea were included in the study. All patients had intrathecal gadolinium enhanced MR cisternography. Three dimensional (3D)-T1 weighted and 3D-fluid attenuated inversion recovery (FLAIR) head MRI was obtained after administration of 1 ml intrathecal gadoterate meglumine after half, 3, and 8 hours. Locations of contrast leakage and etiologies were analyzed.Results: Patient group consisted of 21 patients with persistent or intermittent rhinorrhea. CT imaging showed bone defect in all patients. Intrathecal gadolinium enhanced MR cisternography revealed CSF leakage (10 ethmoid, 10 sphenoid, and 1 frontal). Cephalocele was detected in 10 of 21 patients.Conclusion: MR cisternography with intrathecal gadolinium enhancement is an effective and safe imaging modality compared to other techniques used for diagnosis of CSF leakage. Accurate localization of CSF fistula and demonstration of herniating content from cranial bone defect is feasible with this technique.Item Glial tümörlerde perfüzyonun arteriyel spin işaretleme ile değerlendirilmesi ve dinamik suseptibilite kontrast yöntemi ile karşılaştırılması(Uludağ Üniversitesi, 2013) Cebeci, Hakan; Hakyemez, Bahattin; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.Yetişkinlerde en sık rastlanılan primer beyin tümörleri olan gliomlar histolojik olarak heterojen bir spektrum sergilerler. Gliom grade’lemesi, stereotaktik biyopsi ya da cerrahi sonrası yapılan histopatolojik değerlendirmeye dayanarak yapılmaktadır. Perfüzyon manyetik rezonans görüntüleme, beyin tümörlerinin değerlendirilmesinde değerli bir yardımcı ileri görüntüleme tekniği olarak kabul görmüştür. Dinamik suseptibilite kontrast (DSK) ve arteriyel spin işaretleme (ASİ) teknikleri, en sık kullanılan perfüzyon görüntüleme yöntemleridir. ASİ’nin en önemli avantajı, intravenöz kontrast madde uygulaması gerektirmemesidir. Bu çalışmanın amacı, glial tümörlerin grade’lemesinde ASİ’nin rolünü araştırmak ve bulguları DSK perfüzyon yöntemi ile karşılaştırmaktır. Bu çalışmadaki 33 beyin tümörü hastasının 18’i erkek, 15’i kadındı. Çalışmaya dahil edilen hastaların 20’si, yüksek grade (%60,6), 13’ü düşük grade (%39,4) gliomdu. Lezyonların dağılımı ise 18 glioblastome multiforme (%54,5), 1 grade 3 astrositom (%3), 1 gliosarkom (%3), 11 grade 2 oligodendrogliom (%33,3), 1 disembriyoblastik nöroepitelyal tümör (%3) ve 1 pilositik astrositomdu (%3). DSK perfüzyon görüntülemede, lezyonların rölatif serebral kan hacmi (rCBV) ve rölatif serebral kan akımı (rCBF), ASİ perfüzyon görüntülemede ise CBF, rCBF ve rölatif sinyal intensiteleri (rSİ) ölçüldü. Her iki perfüzyon tekniğiyle elde edilen 5 perfüzyon parametresinin düşük ve yüksek grade gliomlardaki farklılığı karşılaştırıldı. Ayırımın en iyi yapıldığı cut-off değerleri hesaplanarak perfüzyon değerleri aralarındaki korelasyon ölçüldü. Düşük ve yüksek grade grupları arasında perfüzyon parametrelerinin hepsi için anlamlı fark vardı. Yüksek grade gliomlarda tüm parametrelerde değerler daha yüksekti (p<0,001). rCBF ile rCBF-ASİ arasında orta düzeyde (r=0,64, p<0,001), rCBV ile rCBF-ASİ arasında güçlü düzeyde (r=0,81, p<0,001) korelasyon vardı. rCBF-ASİ ile rSİ-ASİ arasında güçlü korelasyon bulunmaktaydı (r=0,90, p<0,001). Sonuçlarımız, ASİ’nin beyin tümörlerinde perfüzyonun değerlendirilmesinde uygun ve invaziv olmayan bir yöntem olduğunu ve yüksek ve düşük grade gliomların ayırımında yararlı olabileceğini göstermektedir.Item The relationship between perimesencephalic subarachnoid hemorrhage and deep venous system drainage pattern and calibrations(Elsevier, 2014) Büyükkaya, Ramazan; Duşak, Abdurrahim; Yıldırım, Nalan; Cebeci, Hakan; Kocaeli, Hasan; Ocakoğlu, Gökhan; Erdoğan, Cüneyt; Hakyemez, Bahattin; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Beyin ve Sinir Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-3425-0740; AAI-2318-2021; AAH-5180-2021; 36867883100; 56033553000; 6603500567; 15832295800; 8293835700; 6602527239Background and purpose: The purpose of this study is to investigate the relationship between Rosenthal basal vein (BVR) type and diameter and perimesencephalic nonaneurysmal subarachnoid hemorrhage (P-SAH). Materials and methods: Aneurysmal subarachnoid hemorrhage (A-SAH), P-SAH, and control groups were evaluated, and BVRs were classified by type. BVR diameters in patients were measured. Results: There was a statistically significant difference of BVR drainage types between groups (P=.002). BVR diameters of patients with normal drainage pattern in P-SAH group were significantly smaller than those in both other groups (P<.001). Conclusion: There is a relationship between P-SAH and BVR primitive drainage type. P-SAH risk increases in parallel with decreasing caliber of BVR in patients with normal drainage pattern.Item Spinal cerebrospinal fluid leakage in spontaneous intracranial hypotension: An intrathecal gadolinium enhanced MR-myelography study(Ubiquity Press, 2019-12-25) Cebeci, Hakan; Bilgin, Cem; Candan, Selman; Demir, Aylin Bican; Hakyemez, Bahattin; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0001-6739-8605; 0000-0002-3425-0740; HHS-7433-2022; GVS-7682-2022; 57200617643; 57209348454; 18036596400; 6602527239Objectives: In the present study, the authors presented the intrathecal gadolinium enhanced MR-myelography findings of patients with spontaneous intracranial hypotension. Materials and Methods: Intrathecal gadolinium enhanced MR-myelography (Gd-MR-myelography) examina-tions between October 2012 and September 2018 in patients having clinical and radiological findings of spontaneous intracranial hypotension were evaluated retrospectively. Sites and types of contrast leakages in 20 patients who met inclusion criteria were reviewed. All patients had undergone T1-fat suppressed sagittal images of cervical, thoracic and lumbar region after the off label intrathecal injection of 1 ml gadolinium-based contrast agent. Results: Patients (18 female, 2 male) are aged between 23 and 62 years-old (mean age: 41.1). Cerebrospi-nal fluid (CSF) leakages were cervical in 6 patients, thoracic in 5 patients, lumbar in 5 patients. One patient had leakage in multiple levels on both cervical and thoracic region and another patient on both cervical-thoracic and lumbar regions. No patients had adverse effects related to intrathecal injection of gadolinium. Conclusions: Gd-MR-myelography is effective imaging modality to reveal spinal CSF leakages in patients with spontaneous intracranial hypotension.Item Treatment of complex intracranial aneurysms using flow-diverting silk stents: An analysis of 32 consecutive patients(Sage Publications, 2014) Büyükkaya, Ramazan; Kocaeli, Hasan; Yıldırım, Nalan; Cebeci, Hakan; Erdoğan, Cüneyt; Hakyemez, Bahattin; Uludağ Üniversitesi/Tıp Fakültesi/Beyin ve Sinir Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3425-0740; AAI-2318-2021; 6603500567; 36867883100; 56033553000; 8293835700; 6602527239This study describes the pen-procedural and late complications and angiographic follow-up results of 32 patients with 34 complex aneurysms treated with flow diverter Silk stents in a single centre. In this retrospective study, 40 Silk stents (SS) were implanted in 34 complex intracranial aneurysms in 32 patients. In our series, 20 (58.8%) carotid-ophthalmic internal carotid artery (ICA), six (17.6%) cavernous ICA, two (5.9%) supraclinoid ICA, two (5.9%) petrosal ICA (the same patient-bilateral) and four (11.8%) posterior circulation aneurysms were treated. One of the posterior circulation lesions was a fenestrated-type aneurysm. Twenty wide-necked, saccular; eight neck remnant; four fusiform and two blister-like aneurysms were included in our series. SS were successfully implanted in all patients (100%). Mis-deployment occurred in 17.6% of patients. In two of these patients adequate stent openness was achieved via Hyperglide balloon dilatation. Coil embolization in addition to SS placement was utilized in four aneurysms. One patient (3%) experienced transient morbidity due to a thromboembolic event and there was one mortality (3%) due to remote intraparenchymal haemorrhage. Complete occlusion of 27/33 (81.8 %) and 29/33 (87.9 %) aneurysms was achieved six and 12 months after the procedure, respectively. In-stent intimal hyperplasia was detected in 6.1 % patients. Flow-diverter Silk stent implantation is an effective method of treating complex aneurysms with acceptable mortality and morbidity rates. Complete occlusion is achieved in most of the complex aneurysms.Item Vertebral kemik iliği t2 relaksasyon zamanının osteoporozda tanı değeri(Uludağ Üniversitesi, 2010-03-26) Gökalp, Gökhan; Mutlu, Fatma Şentürk; Cebeci, Hakan; Uçar, Ayşe Kalyoncu; Yazıcı, Zeynep; Sığırlı, Deniz; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.Çalışmanın amacı osteoporozda, lomber vertebra kemik iliği T2 relaksasyon zamanının tanı değerini araştırmaktır. Aydınlatılmış onam formu ve etik kurul onayı tüm katılımcılardan alındı. “Dual x-ray absorptiometry” (DEXA)’ya göre değişken kemik mineral dansitesi (KMD) olan 56 hasta (50-65 yaşlar arası) prospektif olarak çalışmaya alındı. DEXA sonuçlarına göre hastalar normal, osteopeni ve osteoporoz olarak gruplandı. T2 relaksasyon zamanı (MR relaksometri), sagittal planda multi spin eko sekans ile yapıldı. Kantitatif değerler, DEXA sonuçlarına göre istatistiksel olarak karşılaştırıldı. Gruplar arası karşılaştırmada “Kruskal-Wallis” ve “Mann-Whitney-U” testleri kullanıldı. DEXA’ya göre 18 olgu normal kemik dansitesi (ortalama T skoru, 0,39 ±1,13 [standart sapma]), 20 olgu osteopeni (ortalama T skoru, -1,79±0,38) ve 18 olgu osteoporoz (ortalama T skoru, -3±0,5) olarak değerlendirildi. Vertebral kemik iliği T2 relaksasyon zamanı değerleri normal olgularda 113.6 (min:max=104:124), osteopenide 114.2 (min:max=107:135), osteoprozda 112.8 (min:max=102:121.4) idi. T2 relaksasyon zamanı bakımından gruplar arasında anlamlı farklılık bulunmadı (p>0.05). 50-65 yaş grubundaki kadın hastalarda, vertebral kemik iliği T2 relaksasyon zamanı, KMD’nin öngörülmesinde güvenilir bir parametre değildir.