Browsing by Author "Erdoğan, Cüneyt"
Now showing 1 - 20 of 52
- Results Per Page
- Sort Options
Publication Analysis of predictive and preventive factors for access complications associated with vascular closure devices in complicated endovascular procedures(Springer, 2021-06-21) Gönen, Korcan Aysun; Hakyemez, Bahattin; Erdogan, Cuneyt; HAKYEMEZ, BAHATTİN; Erdoğan, Cüneyt; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3425-0740; AAI-2318-2021; COE-1124-2022Purpose The main goal is to evaluate the effectiveness of angioseal and starclose vascular closure devices (VCDs) in high-risk patients under intensive anticoagulation who require therapeutic angiographic procedures and to discuss which factors are important in complications associated with VCDs. Materials and methods Medical records of the patients who underwent therapeutic complex interventional vascular procedures were reviewed retrospectively. One hundred sixty-six patients were divided into two groups regarding VCDs used for access-site closure after the procedure: group 1, (angioseal); group 2, (starclose). Data including patients' demographics and comorbidity information, procedural characteristics, and complications were analyzed. Results The device deployment success rate was 100%. For the procedural characteristics, there was no significant difference between the groups except access site (P = 0.016) and sheath size > 6F (P = 0.0001). No major complications had occurred in none of the patients. Minor complications including hematoma, access-site pain, and access-site infection, except prolonged hemostasis did not differ significantly between groups. The patients' demographic and periprocedural factors were not significantly correlated with the development of complications. Conclusion Contrary to published reports, our study showed that demographic and periprocedural factors may not be responsible for the vascular access-site complications associated with VCDs.Item Apparent diffusion coefficient measurements in the hippocampus and amygdala of patients with temporal lobe seizures and in healthy volunteers(Academic Press Inc Elsevier Science, 2005-03) Yıldız, Harun; Hakyemez, Bahattin; Erdoğan, Cüneyt; Ercan, İlker; Parlak, Müfit; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-3425-0740; 0000-0002-2382-290X; AAI-2318-2021Purpose: The goals of this work were to measure the apparent diffusion coefficients (ADCs) for both hippocampus and amygdala of persons diagnosed with temporal lobe epilepsy (TLE) and unilateral hippocampus pathology on magnetic resonance imaging and to evaluate the sensitivity of diffusion-weighted (DW) images in determination of the lateralization of the epileptogenic focus. Methods: Thirteen cases with a TLE diagnosis and 21 healthy subjects were evaluated. Fluid-attenuated inversion recovery and T2W images of TLE cases revealed hippocampal volume loss and signal intensity changes. DW images were obtained by spin-echo echo-planar sequences vertical to the hippocampal axis. Qualitative and quantitative ADCs for left and right hippocampus and the amygdala of the controls and the patients were determined. Hippocampal ADCs were obtained independently at the head, body, and tail levels of the hippocampus. Statistical evaluation was conducted with Kruskal–Wallis and Mann–Whitney U tests. Predictive cutoff levels of hippocampal ADCs for identifying pathologic areas were established through receiver operating characteristic (ROC) curve analysis. Result On conventional images, 5 of 13 cases had right hippocampal pathology, and 8 of 13 cases had left hippocampal pathology. There were no bilateral hippocampal changes in signal intensity and no cases with bilateral atrophy. The amygdala was normal in all patients except one case of hyperintense signals. No statistical differences were found between the hippocampal and amygdaloid ADCs of the control subjects (P > 0.05). However, there was a significant difference between the ADCs for the side with hippocampal pathology and the ADCs for the contralateral side, and the control group (P < 0.001). No statistical difference was detected for the amygdala (P > 0.05). Hippocampal and amygdaloid ADCs of the contralateral lesion and the values of the control group were not statistically significantly different (P > 0.05). ROC curve analysis indicated 136 as the best cutoff level for hippocampal pathology. Conclusion DW trace images are insensitive in lateralization of hippocampal pathology; however, lateralization can be achieved through ADC measurements of the hippocampus. An increase in ADC on the affected side should be considered as indicating pathology. On the other hand, amygdaloid ADC values remain inaccurate.Item Arterial lesions in Behcet's disease(Verlag Hans Huber, 2003-05) Saba, Davit; Sarıcaoğlu, Hayriye; Bayram, Ahmet Sami; Erdoğan, Cüneyt; Dilek, Kamil; Gebitekin, Cengiz; Özkan, Hayati; Özer, Z. Gökalp; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Dermatoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Romatoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Kalp Damar Cerrahisi Anabilim Dalı.; ABB-7580-2020; 55987378200; 6603722836; 8347194000; 8293835700; 56005080200; 6602156436; 7103355993; 6701509634Background: Arterial involvement is a rare but serious condition in the course of Behcet's disease. We aimed to assess the results of therapeutic approaches in our patients with arterial lesions caused by Behcet's disease. Patients and methods: The records of 534 patients with Behcet's disease between 1987 and 2002 were retrospectively evaluated for the presence of arterial lesions. All patients were followed up regularly, at 3 to 6 months intervals. Results: Arterial lesions were diagnosed in 21 (3.9%) patients. Eight of these patients had pulmonary artery aneurysms (PAA), and the other 13 patients had non-pulmonary arterial lesions. Urgent surgical intervention was performed in three patients with PAA leading to death in all three. In addition, three other patients died due to massive haemoptysis at home despite to immunosuppressive therapy. Only two out of eight patients with PAA are still alive who were treated with cyclophophamide and corticosteroids. Thirteen operations were performed in 7 out of 13 patients having non-puhnonary arterial lesions. Although ten of the operations were primary operations, three reoperations had to be performed. A stent-graft was applied for the management of an iliac artery aneurysm in one patient. Only one patient died 8 years after the first non-pulmonary arterial involvement following a type IV thoracoabdominal aortic aneurysm repair Five patients with arterial occlusive lesions were successfully treated by corticosteroids. Conclusions: Pulmonary artery aneurysms in Behcet's disease patients have a poor prognosis despite any form of therapy. High dose corticosteroids alone can be successfully used for isolated non-pulmonary arterial occlusive lesions, unless disabling symptoms occur. Surgery or stent-graft insertion is indicated,for non-pulmonary arterial aneurysms because these aneurysms entail high risk of complications.Item Brain abscess and cystic brain tumor - Discrimination with dynamic susceptibility contrast perfusion-weighted MRI(Lippincott Williams & Wilkins, 2005) Erdoğan, Cüneyt; Hakyemez, Bahattin; Yıldırım, Nalan; Parlak, Mufit; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3425-0740; AAI-2318-2021Differentiating between brain abscesses and cystic brain tumors such as high-grade gliomas and metastases is often difficult with conventional MRI. The goal of this study was to evaluate the diagnostic utility of perfusion MRI to differentiate between these pathologies. MRI was performed in 19 patients with rim-enhancing brain lesions (4 pyogenic abscesses, 8 high-grade gliomas, 7 metastases). In addition to standard MR sequences, trace diffusion-weighted MRI with apparent diffusion coefficient (ADC) maps and perfusion-weighted MRI by using a first-pass gadopentetate dimeglumine T2*-weighted gradient echo single-shot echo-planar sequence were performed. Relative cerebral blood volume (rCBV) ratios were obtained via the values of the capsular portions of the lesions and the normal white matter. All the abscesses had markedly hyperintense signals in trace diffusion images, whereas they had significant hypointense signals in ADC images. In perfusion-weighted images, the capsular portions of the abscesses demonstrated low colored areas compared with the normal white matter and the rCBV ratio calculated was 0.76 +/- 0.12 (mean +/- SD). All but two of the cystic tumors showed low signal intensity on trace diffusion-weighted images and high signal intensity on ADC maps. Hyperintense signal was found in two brain tumors mimicking brain abscesses on trace diffusion images. The rCBV values in high-grade gliomas and metastases were 5.51 +/- 2.08 and 4.58 +/- 2.19, respectively. The difference between abscesses and cystic tumors was statistically significant (P = 0.003). Perfusion MRI may allow the differentiation of pyogenic brain abscess from cystic brain tumors, making it a strong additional imaging modality in the early diagnosis of these two entities.Item Catheter-directed therapy in acute pulmonary embolism with right ventricular dysfunction: A promising modality to provide early hemodynamic recovery(Int Scientific Information, 2016-04-15) Dilektaşlı, Aslı Görek; Çetinoğlu, Ezgi Demirdoğen; Acet, Nilüfer Aylin; Erdoğan, Cüneyt; Ursavaş, Ahmet; Özkaya, Güven; Coşkun, Funda; Karadağ, Mehmet; Ege, Ercüment; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-9027-1132; 0000-0002-6375-1472; 0000-0003-3604-8826; 0000-0003-0297-846X; AAG-8744-2021; Z-1424-2019; AAD-1271-2019; A-4421-2016; AAI-3169-2021; 36466376600; 57189524206; 56507253300; 8293835700; 8329319900; 16316866500; 21734137500; 6601970351; 6701341320Background: Catheter-directed therapy (CDT) for pulmonary embolism (PE) is considered as an alternative to systemic thrombolysis (ST) in patients with hemodynamically unstable acute PE who are considered at high bleeding risk for ST. We aimed to evaluate the efficacy and safety of CDT in the management of acute PE with right ventricular dysfunction (RVD). The primary outcomes were mortality, clinical success, and complications. Secondary outcomes were change in hemodynamic parameters in the first 24 hours following the procedure. Material/Methods: Medical records of consecutive patients diagnosed as having acute massive or submassive PE with accompanying RVD treated by immediate CDT at our institution from January 2007 to January 2014 were reviewed. Patient characteristics, mortality, achievement of clinical success, and minor and major bleeding complications were analyzed in the overall study group, as well as massive vs. submassive PE subgroups. Change in hemodynamic parameters in the second, eighth, and 24th hours after the CDT procedure were also analyzed. Results: The study included 15 consecutive patients (M/F=10/5) with a mean age of 54.2 +/- 16.6 years who underwent immediate CDT. Nine of the patients had submassive PE, and 6 had massive PE. In-hospital mortality rate was 13.3% (95% CI, 0.04-0.38). One major, but not life-threatening, bleeding episode was evident in the whole group. Hemodynamic parameters were stabilized and clinical success was achieved in 14/15 (93.3%; 95% CI, 70.2-98.8) of the patients in the first 24 hours. Notably, the hemodynamic recovery was significantly evident in the first 8 hours after the procedure. Conclusions: CDT is a promising treatment option for patients with acute PE with RVD with no fatal bleeding complication. In experienced centers, CDT should be considered as a first-line treatment for patients with acute PE and RVD and contraindications for ST, with the advantage of providing early hemodynamic recovery.Item Catheter-directed ultrasound-accelerated thrombolysis may be life-saving in patients with massive pulmonary embolism after failed systemic thrombolysis(Springer, 2016-10) Sağ, Saim; Nas, Ömer Fatih; Kaderli, Aysel Aydın; Özdemir, Bülent; Baran, İbrahim; Erdoğan, Cüneyt; Güllülü, Sümeyye; Hakyemez, Bahattin; Aydınlar, Ali; Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-8404-8252; 0000-0002-3425-0740; 0000-0002-8974-8837; AAW-9185-2020; AAG-8561-2021; AAI-2318-2021; AAI-6632-2021; 12140008100; 51864050100; 7801322152; 7004168959; 35572557400; 8293835700; 57204660708; 6602527239; 6603131517The treatment options for high risk acute pulmonary embolism (PE) patients with failed systemic thrombolytic treatment (STT) is limited. The clinical use of catheter directed thrombolysis with the EkoSonic Endovascular System (EKOS) in this population has not been evaluated before. Catheter directed thrombolysis is an effective treatment modality for high risk PE patients with failed STT. Thirteen consecutive patients with failed STT were included in the study. EKOS catheters were placed and tissue plasminogen activator (t-PA) in combination with unfractionated heparin were given. Clinical and echocardiographic properties of the patients were collected before EKOS, at the end of EKOS and during the follow-up visit 6 months after discharge. The duration of EKOS treatment was 21.8 +/- 3.8 h and the total dose of tPA was 31.2 +/- 15.3 mg. One patient who presented with cardiac arrest died and the clinical status of the remaining subjects improved significantly. Any hemorrhagic complication was not observed. EKOS resulted in significant improvement of right ventricular functions and decrease of systolic pulmonary artery pressure. During a follow-up period of 6 months none of the patients died or suffered recurrent PE. In addition, echocardiographic parameters or right ventricular function significantly got better compared to in-hospital measurements. EKOS is an effective treatment modality for high risk PE patients with failed STT and can be applied with very low hemorrhagic complications.Item Closure of the axillary artery puncture site with starclose system after endovascular interventions(Elsevier, 2014-04) Gönen, Korcan Aysun; Erdoğan, Cüneyt; Hakyemez, Bahattin; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3425-0740; AAI-2318-2021; 8293835700; 6602527239The use of the StarClose vascular closure device for puncture site hemostasis after therapeutic endovascular interventions performed through the axillary artery under anticoagulant therapy in six patients is reported. Three minor complications, including hematoma, prolonged hemostasis, and pain, occurred in three patients. Based on this limited experience, this method can be used safely for axillary artery puncture site hemostasis after endovascular procedures without significant complications.Item The contribution of diffusion-weighted MR imaging to distinguishing typical from atypical meningiomas(Springer, 2006) Hakyemez, Bahattin; Yıldırım, Nalan; Gökalp, Gökhan; Erdoğan, Cüneyt; Parlak, Müfit; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3425-0740; AAG-8521-2021; AAI-2318-2021; AAI-2336-2021Introduction: Atypical/malignant meningiomas recur more frequently then typical meningiomas. In this study, the contribution of diffusion-weighted MR imaging to the differentiation of atypical/malignant and typical meningiomas and to the determination of histological subtypes of typical meningiomas was investigated. Methods: The study was performed prospectively on 39 patients. The signal intensity of the lesions was evaluated on trace and apparent diffusion coefficient (ADC) images. ADC values were measured in the lesions and peritumoral edema. Student's t-test was used for statistical analysis. P < 0.05 was considered statistically significant. Results: Mean ADC values in atypical/malignant and typical meningiomas were 0.75 +/- 0.21 and 1.17 +/- 0.21, respectively. Mean ADC values for subtypes of typical meningiomas were as follows: meningothelial, 1.09 +/- 0.20; transitional, 1.19 +/- 0.07; fibroblastic, 1.29 +/- 0.28; and angiomatous, 1.48 +/- 0.10. Normal white matter was 0.91 +/- 0.10. ADC values of typical meningiomas and atypical/malignant meningiomas significantly differed (P < 0.001). However, the difference between peritumoral edema ADC values was not significant (P > 0.05). Furthermore, the difference between the subtypes of typical meningiomas and atypical/malignant meningiomas was significant (P < 0.001). Conclusion: Diffusion-weighted MR imaging findings of atypical/malignant meningiomas and typical meningiomas differ. Atypical/malignant meningiomas have lower intratumoral ADC values than typical meningiomas. Mean ADC values for peritumoral edema do not differ between typical and atypical meningiomas.Item Diagnosis and endovascular treatment of acute thromboembolic renal artery occlusion presenting with abdominal pain(Springer, 2012-10) Dusak, Abdurrahim; Eryılmaz, Nalan Y.; Gönen, Aysun; Hakyemez, Bahattin; Dilek, Kamil; Erdoğan, Cüneyt; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0002-3425-0740; A-7826-2019; AAI-2318-2021; 6507393726; 55191388500; 26655524000; 6602527239; 56005080200; 8293835700Acute renal artery thromboembolic occlusion is seldomly encountered with respect to other central and peripheral ones. Patients may present with non-specific abdominal pain and renal colic. Organ functions can be preserved by means of endovascular treatment when early diagnosis is possible. Acute occlusion of renal arteries must be considered in the differential diagnosis of acute flank pain. This paper presents successful endovascular treatment of thromboembolic renal artery occlusion in two cases.Item Dirençli malign asiti olan olgularda tünelli peritoneal kateter takılmasının etkinliğinin ve kateter fonksiyonlarının retrospektif olarak değerlendirilmesi(Uludağ Üniversitesi, 2016) Kaya, Ahmet; Erdoğan, Cüneyt; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.Malign asit; çeşitli maliginitelerde periton zarının tutulumu, vasküler permeabilite değişiklikleri, lenfatik drenaj obstruksiyonu, yaygın hepatik metastazlara bağlı hepatik konjesyon ve tümör dokusundan eksudatif sıvı salınımı gibi mekanizmalara bağlı peritoneal kavitede anormal miktarda sıvı birikmesidir. Malign asit sıklıkla sistemik medikal tedaviye dirençlidir. Parasentez işlemi ile hastalarda semptomatik rahatlama sağlanmaktadır. Ancak hızlı sıvı birikimine bağlı sık parasentez ihtiyacı gerekir ve bu durum kanama, enfeksiyon, organ perforasyonu ve fazla sıvı drenajı ile ilişkili hipotansiyon gibi riskleri beraberinde getirmektedir. Ayrıca sık drenaj önemli ölçüde sıvı, elektrolit, protein kaybı ve dehidratasyona neden olabilmektedir. Girişimsel radyoloji departmanınımızda, Ekim 2013-Haziran 2016 tarihleri arasında tünelli periton kateteri yerleştirilen 30 olguya ait veriler retrospektif olarak tarandığında kateterlerin %96'sında fonksiyonunu korunduğu görülmüştür. İki (%6,6) olguda bakteriyel peritonit, bir (%3,3) olguda trakt enfeksiyonu, bir (%3,3) olguda sellülit, bir (%3,3) olguda ise drenaj bozukluğu gelişmiştir. Dirençli malign asit olgularında bu uygulamanın güvenilir ve asit drenajında etkin bir yöntem olduğu ortaya konmuştur.Item Dislodgement of the indwelling hemodialysis catheter into the peritoneum in hemodialysis patients using a trans-hepatic approach(SAGE, 2016) Nas, Ömer Fatih; Toklu, Emrah; Erdoğan, Cüneyt; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; AAG-8561-2021; GEQ-7865-2022; COE-1124-2022; 51864050100; 57163562100; 8293835700Publication Effectiveness of percutaneous vertebroplasty in cases of vertebral metastases(Elsevier Masson, 2015-11-01) Nas, O. F.; İnecikli, M. F.; Kaçar, E.; Büyükkaya, R.; Özkaya, G.; Aydın, O.; Erdoğan, C.; Hakyemez, B.; NAS, ÖMER FATİH; ÖZKAYA, GÜVEN; Erdoğan, Cüneyt; HAKYEMEZ, BAHATTİN; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; 0000-0002-3425-0740; AAG-8561-2021; COE-1124-2022; A-4421-2016; AAI-2318-2021Purpose and objectives: To assess the effectiveness of percutaneous vertebroplasty (PV) in patients with vertebral collapse due to metastases.Materials and methods: PV procedures performed on 95 vertebras in 52 patients with primary malignancy were retrospectively evaluated. Vertebral metastases, primary malignancies of the patients, pain before and after PV on a visual analogue scale (VAS), amount of polymethylmethacrylate (PMMA) cement applied to the vertebral body during PV, PMMA cement leakage and vertebral approaches were evaluated.Results: VAS scores of 43 patients (in total 79 vertebras) were evaluated. Median VAS scores of patients declined from 8 (4-10) before PV to 3 (0-7) within one day after the procedure, to 2 (0-9) one week after the procedure and eventually to 2 (0-9) 3 months after the procedure (p < 0.001). PMMA amount applied to the vertebral body during PV varied between 1.5-9 mL (average +/- SD 4.91 +/- 1.61). There was no significant statistical correlation between PMMA amounts and VAS scores within one day after, 1 week after and 3 months after the PV procedure (p > 0.05).Conclusion: PV is a simple, effective, reliable, easy to perform and minimally invasive procedure in patients with painful vertebral metastases.Item Effectiveness of percutaneous vertebroplasty in patients with multiple myeloma having vertebral pain(Türk Radyoloji Derneği, 2015-09-07) İnecikli, Mehmet Fatih; Büyükkaya, Ramazan; Nas, Ömer Fatih; Hacıkurt, Kadir; Özkaya, Güven; Özkalemkaş, Fahir; Ali, RIdvan; Erdoğan, Cüneyt; Hakyemez, Bahattin; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; 0000-0002-3425-0740; 0000-0003-0297-846X; AAI-2318-2021; A-4421-2016; AAG-8561-2021; AAG-8495-2021; 51864050100; 56732936100; 16316866500; 6601912387; 7201813027; 8293835700; 6602527239PURPOSE: We aimed to assess the effectiveness, benefits, and reliability of percutaneous vertebroplasty (PV) in patients with vertebral involvement of multiple myeloma. METHODS: PV procedures performed on 166 vertebrae of 41 patients with multiple myeloma were retrospectively evaluated. Most of our patients were using level 3 (moderate to severe pain) analgesics. Magnetic resonance imaging was performed before the procedure to assess vertebral involvement of multiple myeloma. The following variables were evaluated: affected vertebral levels, loss of vertebral body height, polymethylmethacrylate (PMMA) cement amount applied to the vertebral body during PV, PMMA cement leakages, and pain before and after PV as assessed by a visual analogue scale (VAS). RESULTS: Median VAS scores of patients decreased from 9 one day before PV, to 6 one day after the procedure, to 3 one week after the procedure, and eventually to 1 three months after the procedure (P < 0.001). During the PV procedure, cement leakage was observed at 68 vertebral levels (41%). The median value of PMMA applied to the vertebral body was 6 mL. CONCLUSION: Being a minimally invasive and easily performed procedure with low complication rates, PV should be preferred for serious back pain of multiple myeloma patients.Item Endovascular treatment of ruptured aneurysm associated with vertebrobasilar junction fenestration: Case report(Ortadoğu Yayınları, 2010-04) Hakyemez, Bahattin; Erdoğan, Cüneyt; Gökalp, Gökhan; Korfali, Ender; Parlak, Müfit; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Beyin ve Sinir Cerrahisi Anabilim Dalı.; 0000-0002-3425-0740; AAI-2336-2021; AAI-2318-2021; 6602527239; 8293835700; 8312505100; 7004641343; 7003589220Vertebrobasilar junction fenestration is a rare congenital anomaly which is commonly seen with an aneurysm formation. Because of the complex anatomical structure of this area complicates the surgical intervention, endovascular coil treatment of aneurysm is an alternative method. Several fenestration-related aneurysms may not be detected by 2D conventional angiography imaging due to their considerably thin and short structure or small size. By 3D rotational digital subtraction angiography, small-sized fenestrations can be examined at the intended plane from various angles. This method enables us to plan the endovascular intervention in detail by revealing orientation, neck, origin of perforator arteries, and the relation between aneurysm and fenestration. In the present case, we present the angiographic results of the case with vertebrobasilar junction fenestration, along with endovascular treatment of the ruptured aneurysm.Item Evaluation of communication between intracranial arachnoid cysts and cisterns with phase-contrast cine MR imaging(Amer Soc Neuroradiology, 2005-01) Yıldız, Harun; Erdoğan, Cüneyt; Yalçın, Ramazan; Yazıcı, Zeynep; Hakyemez, Bahattin; Parlak, Müfit; Tuncel, Ebru Kaynar; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3425-0740; 0000-0003-0848-2561; AAI-2318-2021; AAG-8521-2021; AAI-2303-2021; ABD-1329-2020BACKGROUND AND PURPOSE: The demonstration of communication between arachnoid cysts (ACs) and the adjacent subarachnoid space is a prerequisite for their proper management. CT cisternography (CTC) is the conventional method for functional evaluation of ACs. The sensitivity of MR imaging to CSF flow has been demonstrated, but reports of the clinical usefulness of MR CSF flow techniques in this application are limited. The purpose of our study was to prospectively evaluate the accuracy of MR CSF flow study as an alternative to CTC in this setting. METHODS: MR CSF flow study with retrospective ECG-gated 2D, fast low-angle shot, phase-contrast (PC), cine gradient-echo sequence was performed in 39 patients with an intracranial AC. Results were compared with intraoperative and CTC findings. RESULTS: PC cine MR imaging results were compatible with operative or CTC findings in 36 (92.3%) of 39 patients. Twenty-four cysts were noncommunicating, and 15 were communicating. Three cysts were evaluated as being noncommunicating on PC cine MR imaging (false-negative) but demonstrated contrast enhancement on CTC. No false-positive diagnoses occurred. All cysts regarded as being communicating on PC cine MR imaging were also found to be communicating on both confirmation methods. CONCLUSION: MR CSF flow imaging with a PC cine sequence can be incorporated in the imaging work-up of ACs. This is a reliable alternative to invasive CTC for the functional evaluation of ACs.Item Evaluation of CSF flow patterns of posterior fossa cystic malformations using CSF flow MR imaging(Springer, 2006) Yıldız, Harun; Yazıcı, Zeynep; Hakyemez, Bahattin; Erdoğan, Cüneyt; Müfit, Parlak; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3425-0740; 0000-0003-0848-2561; AAI-2318-2021; AAI-2303-2021; AAG-8521-2021; ABD-1329-2020Introduction: Differential radiologic diagnosis of cystic malformations of the posterior fossa is often difficult with conventional imaging techniques because of overlapping features of these entities. Posterior fossa cystic malformations occupy the cerebrospinal fluid (CSF) spaces. They may create secondary dynamic effects on the movements of CSF. The aim of this study was to investigate CSF flow alterations in posterior fossa cystic malformations with CSF flow MR imaging. Methods: The study included 40 patients with cystic malformations of the posterior fossa. The patients underwent cardiac-gated phase-contrast cine MR imaging. CSF flow was qualitatively evaluated using an in-plane phase-contrast sequence in the midsagittal plane. The MR images were displayed in a closed-loop cine format. Results: Twelve of the patients had communicating arachnoid cyst, seven had non-communicating arachnoid cyst, ten had mega cisterna magna, six had Dandy-Walker malformation, two had Dandy-Walker variant, and three had Blake's pouch cyst. CSF flow MR imaging indicated the regions of no, slow or higher flow, direction of flow, and abnormal cystic fluid motion. Each malformation displayed a distinct CSF flow pattern. Conclusion: Phase-contrast cine MR imaging for CSF flow evaluation may be a useful adjunct to routine MR imaging in the evaluation of the cystic malformations of the posterior fossa because it can improve the specificity in differentiating such malformations.Item High-grade and low-grade gliomas: Differentiation by using perfusion MR imaging(W B Saunders Co Ltd, 2005) Hakyemez, Bahattin; Ergin, Nida; Uysal, Sibel; Atahan, Safak; Erdoğan, Cüneyt; Ercan, Ilker; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-2382-290XAIM: Relative cerebral blood volume (rCBV) is a commonly used perfusion magnetic resonance imaging (MRI) technique for the evaluation of tumour grade. Relative cerebral blood flow (rCBF) has been less studied. The goal of our study was to determine the usefulness of these parameters in evaluating the histopathotogical grade of the cerebral gliomas. METHODS: This study involved 33 patients (22 high-grade and 11 low-grade glioma cases). MRI was performed for all tumours by using a first-passage gadopentetate dimeglumine T2*-weighted gradient-echo single-shot echo-ptanar sequence followed by conventional MRI. The rCBV and rCBF were calculated by deconvolution of an arterial, input function. The rCBV and rCBF ratios of the lesions were obtained by dividing the values obtained from the normal white matter of the contralateral, hemisphere. For statistical analysis Mann-Whitney testing was carried out. A p value of less than 0.05 indicated a statistically significant difference. Receiver operating characteristic curve (ROC) analysis was performed to assess the relationship between the rCBV and rCBF ratios and grade of gliomas. Their cut-off value permitting discrimination was calculated. The correlation between rCBV and CBF ratios and glioma grade was assessed using Pearson correlation analysis. RESULTS: In high-grade gliomas, rCBV and rCBF ratios were measured as 6.50 +/- 4.29 and 3.32 +/- 11.87 (mean +/- SD), respectively. In low-grade gliomas, rCBV and rCBF ratios were 1.69 +/- 0.51 and 1.16 +/- 0.38, respectively. The rCBV and rCBF ratios for high-grade gliomas were statistically different from those of tow-grade gliomas (p < 0.001). The rCBV and CBF ratios were significantly matched with respect to grade, but difference between the two areas was not significant (ROC analysis, p > 0.05). The cut-off value was taken as 1.98 in the rCBV ratio and 1.25 in the rCBF ratio. There was a strong correlation between the rCBV and CBF ratios (Pearson correlation = 0.830, p < 0.05). CONCLUSION: Perfusion MRI is useful in the preoperative assessment of the histopathologicalal grade of gliomas; the rCBF ratio in addition to the rCBV ratio can be incorporated in MR perfusion analysis for the evaluation. (c) 2005 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.Item Internal jugular vein cannulation: An ultrasound-guided technique versus a landmark-guided technique(Hospital Clinicas, 2009) Türker, Gürkan; Kaya, Fatma Nur; Gurbet, Alp; Aksu, Hale; Erdoğan, Cüneyt; Atlas, Ahmet; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-6503-8232; 0000-0001-5999-0510; 0000-0002-3019-581X; AAI-8213-2021; AAI-6642-2021; A-7994-2018; S-2847-2016; A-7725-2019; 7003400116; 7003619647; 35618853300; 16432662600; 8293835700; 35108766800OBJECTIVES: To compare the landmark-guided technique versus the ultrasound-guided technique for internal jugular vein cannulation in spontaneously breathing patients. METHODS: A total of 380 patients who required internal jugular vein cannulation were randomly assigned to receive internal jugular vein cannulation using either the landmark- or ultrasound-guided technique in Bursa, Uludag University Faculty of Medicine, between April and November, 2008. Failed catheter placement, risk of complications from placement, risk of failure on first attempt at placement, number of attempts until successful catheterization, time to successful catheterization and the demographics of each patient were recorded. RESULTS: The overall complication rate was higher in the landmark group than in the ultrasound-guided group (p<0.01). Carotid puncture rate and hematoma were more frequent in the landmark group than in the ultrasound-guided group (p<0.05). The number of attempts for successful placement was significantly higher in the landmark group than in the ultrasound-guided group, which was accompanied by a significantly increased access time observed in the landmark group (p<0.05 and p<0.01, respectively). Although there were a higher number of attempts, longer access time, and a more frequent complication rate in the landmark group, the success rate was found to be comparable between the two groups. CONCLUSION: The findings of this study indicate that internal jugular vein catheterization guided by real-time ultrasound results in a lower access time and a lower rate of immediate complications.Item İnternal juguler venöz kateterizasyonda ultrasonografi kılavuzluğunun etkinliği(Uludağ Üniversitesi, 2008-03-21) Doğan, Nurullah; Algın, Oktay; Erdoğan, Cüneyt; Uludağ Üniversitesi/Tıp Fakültesi.Bu çalışmanın amacı, ultrasonografi kılavuzluğunda gerçekleştirilen internal juguler venöz girişlerin etkinliğini değerlendirmektir. Bu çalışmada ünitemizde 23.02.2007 ile 19.02.2008 tarihleri arasında ultrasonografi kılavuzluğunda gerçekleştirilen internal juguler venöz giriş işlemi uygulanan 190 olgunun retrospektif olarak veri tabanı ve dosya bilgileri incelenmiştir. Teknik başarı oranı %99.5 düzeyinde bulundu. 1 olguda girişim başarısız oldu. İlk seferde vene başarılı giriş oranı % 93.2 (177 hasta) idi. Erken dönem komplikasyon oranı % 2 (arteriyel yaralanma %0.5, sızıntı şeklinde kanama %1, enfeksiyon %0.5) olup, ek girişim veya cerrahi gerektirecek major komplikasyon saptanmadı. Bu çalışmada radyolojik yöntemle takılan santral venöz kateterlerle ilgili başarı ve komplikasyon oranlarımızı sunmaktayız. Santral venöz kateterizasyon amacıyla vitra sonografi kılavuzluğunda internal juguler venöz girişin, landmark yönteme göre etkili ve güvenli bir alternatif olduğunu düşünüyoruz.Item Intraorbital arteriovenous fistula secondary to penetrating injury(Lippincott Williams & Wilkins, 2016-12-13) Rootman, Jack; Yazıcı, Bülent; Yazıcı, Zeynep; Erdoğan, Cüneyt; Uludağ Üniversitesi/Tıp Fakültesi/Oftalmoloji Bölümü.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji anabilim Dalı.; 7005398015; 6701668723; 8293835700Purpose: To describe the clinical and radiologic features and management of an intraorbital arteriovenous fistula secondary to penetrating injury. Method. Interventional case report and literature review. Results: We describe a 13-year-old girl with a history of penetrating orbital injury who presented with proptosis, eyelid hyperemia, and orbital venous congestion. Computed tomography showed a large foreign body in the superiormedial orbit and an enlarged superior ophthalmic vein (SOV). Doppler ultrasonography revealed arterialized flow in the SOV. Removal of the foreign body did not alter the orbital symptoms. Carotid angiography disclosed a fistula between the ophthalmic artery and the SOV. The patient underwent an attempted coil embolization of the fistula through the femoral vein, which was unsuccessful, but she developed profound thrombosis of the SOV, which propagated through the orbital venous system. Although orbital venous congestive symptoms were acutely exacerbated, they regressed spontaneously within I month. The patient was followed for 23 months without recurrence. Conclusions: Penetrating injury of the orbital apex may lead to the formation of an arteriovenous fistula, transvenous embolization of which may be complicated by thrombosis of the SOV. In our case, this unintentional result facilitated the resolution of the fistula.
- «
- 1 (current)
- 2
- 3
- »