Browsing by Author "Parlak, Mufit"
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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.Publication Crystal storing histiocytosis forming a mass lesion in temporal lobe(Wolters Kluwer Medknow Publications, 2023-07-01) Özsen, Mine; ÖZŞEN, MİNE; TOLUNAY, ŞAHSİNE; Kocaeli, Hasan; KOCAELİ, HASAN; Tolunay, Şahsine; PARLAK, MÜFİT; Parlak, Mufit; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Patoloji Anabilim Dalı.; 0000-0002-5771-7649Crystal storing histiocytosis is a disorder characterized by local or diffuse infiltration of histiocytes containing crystalline inclusions. This entity has been reported in several organs, however the involvement of the central nervous system (CNS) is extremely rare and to date only 7 cases of crystal storing histiocytosis (CSH) of CNS have been reported in the English literature. More than 90% patients with CSH had an underlying lymphoproliferative or plasma cell disorders, especially multiple myeloma, lymphoplasmacytic lymphoma or monoclonal gammopathy. Radiologically and intraoperatively, CSH may mimic an infectious process or neoplasm, hence its histopathological confirmation is important to facilitate appropriate treatment. In this report, we describe an additional case of crystal storing histiocytosis in a 48 year old female who presented with a mass lesion in the right temporal lobe of the cerebrum.Item Evaluation of different cerebral mass lesions by perfusion-weighted MR imaging(Wiley, 2006-06-30) Yıldırım, Nalan; Hakyemez, Bahattin; Cüneyt, Erdoğan; Bolca, Naile; Parlak, Mufit; Gökalp, Gökhan; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3425-0740; AAG-8521-2021; AAI-2336-2021; AAI-2318-2021Purpose: To investigate the contribution of perfusion-weighted MR imaging (PWI) by using the relative cerebral blood volume (rCBV) ratio in the differential diagnosis of various intracranial space-occupying lesions. Materials and Methods: This study involved 105 patients with lesions (high-grade glioma (N = 26), low-grade glioma (N= 11), meningioma (N = 23), metastasis (N 25), hemangioblastoma (N = 6), pyogenic abscess (N 4), schwannoma (N = 5), and lymphoma. (N = 5)). The patients were examined with a T2*-weighted (T2*W) gradient-echo singleshot EPI sequence. The rCBV ratios of the lesions were obtained by dividing the values obtained from the normal white matter. Statistical analysis was performed with the Mann-Whitney U-test. A P-value less than 0.05 was considered statistically significant. Results: The rCBV ratio was 5.76 +/- 3.35 in high-grade gliomas, 1.69 +/- 0.51 in low-grade gliomas, 8.02 +/- 3.89 in meningiomas, 5.27 +/- 3.22 in metastases, 11.36 +/- 4.41 in hemangioblastomas, 0.76 +/- 0.12 in abscesses, 1.10 +/- 0.32 in lymphomas, and 3.23 +/- 0.81 in schwannomas. The rCBV ratios were used to discriminate between 1) high- and low-grade gliomas (P < 0.00 1), 2) hemangioblastomas and metastases (P < 0.05), 3) abscesses from high-grade gliomas and metastases (P < 0.001), 4) schwannomas and meningiomas (P < 0.001), 5) lymphomas from high-grade gliomas and metastases (P < 0.001), and 6) typical meningiomas and atypical meningiomas (P < 0.01). Conclusion: rCBV ratios can help discriminate intracranial space-occupying lesions by demonstrating lesion vascularity. It is possible to discriminate between 1) high- and low-grade gliomas, 2) hemangioblastomas and other intracranial posterior fossa masses, 3) abscesses from highgrade gliomas and metastases, 4) schwannomas and meningiomas, 5) lymphomas and high-grade gliomas and metastases, and 6) typical and atypical meningiomas.Item MR cisternography: Is it useful in the diagnosis of normal-pressure hydrocephalus and the selection of "good shunt responders"?(Aves, 2011-06) Algin, Oktay; Hakyemez, Bahattin; Parlak, Mufit; Ocakoğlu, Gökhan; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3425-0740; AAI-2318-2021; AAG-8521-2021; AAH-5180-2021; 6602527239; 15832295800; 7003589220PURPOSE The aim of this study was to evaluate the efficiency of MR cisternography (MRC) in the diagnosis of idiopathic normal-pressure hydrocephalus (INPH) and in the prediction of the response to shunt treatment. MATERIALS AND METHODS Thirty-six patients with the diagnosis of "probable INPH" were included in the study group and 15 asymptomatic age-matched individuals were included in the control group. Pre-contrast T1-weighted (T1W) imaging was followed by intrathecal administration of 1 ml gadopentetate dimeglumine. Post-contrast T1W images were taken at the 12(th), 24(th) and 48(th) hours. The presence of contrast material in the lateral ventricles for more than 24 hours was accepted as a positive diagnosis of INPH. Data from both groups were compared statistically. Statistical significance was accepted for P < 0.05. RESULTS All of the INPH patients had remaining contrast material in their lateral ventricles at the 12(th) and 24(th) hours, while only 28 (78%) patients had contrast material remaining at the 48(th) hour after MRC. Only 3 (20%) of the control cases had remaining contrast material in their lateral ventricles at the 24(th) hour. No contrast material was present in the control cases at the 48(th) hour. The contrast material was found to be significantly more prevalent in the INPH patients at the 24(th) and the 48(th) hours compared with the control cases (P < 0.001). Shunt placement was performed in 14 INPH patients, and eight improved after shunt placement. All patients (100%) who improved after shunt placement had remaining contrast material in their lateral ventricles at the 24(th) and at the 48(th) hours. The sensitivity and specificity of MRC in the prediction of the response to shunt treatment were 100% and 17%, respectively. CONCLUSION MRC does not use ionizing radiation and is generally a useful procedure to diagnose NPH and to predict a positive response to shunt treatment; thus, we recommend MRC after routine MRI in patients with the presumed diagnosis of NPH.Publication Predictor variables of abnormal imaging findings of syncope in the emergency department(Springer London Ltd, 2018-03-12) Soylu, Esra; Öztürk, Kerem; Bilgin, Cem; BİLGİN, CEM; Hakyemez, Bahattin; HAKYEMEZ, BAHATTİN; Parlak, Mufit; PARLAK, MÜFİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-9664-2347; AAI-2318-2021; AAG-8521-2021; E-1228-2018; HHS-7433-2022Background: This study aimed to describe the pathological findings and to analyze clinical predictors of abnormal imaging findings in patients presenting to the emergency department (ED) with syncope.Methods: The database was retrospectively reviewed for all patients who underwent cranial computed tomography (CT) or magnetic resonance imaging (MRI), having the symptom of syncope. Patients were included only if they were from the emergency department and excluded if were under 18 years of age, had known recent intracranial pathology, known brain tumor, or having a history of trauma. The primary outcome was assumed as abnormal head CT or MRI including intracranial hemorrhage, acute or subacute stroke, and newly diagnosed brain mass. Univariate and multivariate logistic regression analysis was utilized to determine the association between clinical variables and any significant pathology in either CT or MR scan.Results: Total of 1230 syncope (717 men and 513 women; range, 18-92 years; mean, 54.5 years) as presenting symptoms were identified in patients receiving either cranial CT or MR scan in the ED. Abnormal findings related to the syncope were observed in 47 (3.8%) patients. The following predictor variables were found to be significantly correlated with acutely abnormal head CT and MRI: a focal neurologic deficit, history of malignancy, hypertension, and age greater than 60 years.Conclusions: Our data offer that the identification of predictor variables has a potential to decrease the routine use of head CT and MRI in patients admitting to the ED with syncope.Publication Tumor-to-tumor metastasis-metastasis of pulmonary adenocarcinoma to intracranial meningioma: A case report(Wolters Kluwer Medknow Publications, 2022-10-01) YILMAZLAR, SELÇUK; TOLUNAY, ŞAHSİNE; Özsen, Mine; Tolunay, Sahsine; Yılmazlar, Selcuk; Karadağ, Göksen; Parlak, Mufit; PARLAK, MÜFİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroşurji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-5771-7649