Person: PARLAK, MÜFİT
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Publication Radiation exposure in the neonatal intensive care unit in newborns and staff(Thieme Medical Publ Inc, 2021-07-28) Çakır, Salih Çağrı; Dorum, Bayram Ali; Köksal, Nilgün; Özkan, Hilal; Yazıcı, Zeynep; Parlak, Müfit; Gülleroğlu, Nadide Başak; ÇAKIR, SALİH ÇAĞRI; Dorum, Bayram Ali; Köksal, Nilgün; ÖZKAN, HİLAL; YAZICI, ZEYNEP; PARLAK, MÜFİT; Gülleroğlu, Nadide Başak; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediat Bölümü; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Bölümü; 0000-0001-5761-4757; 0000-0002-2823-8454; HJZ-4508-2023; AEZ-2469-2022; A-5375-2017; A-5375-2017; CZV-1969-2022; IGT-7005-2023; AAI-2303-2021; AAG-8521-2021; EZQ-1350-2022Objective Portable X-rays remain one of the most frequently used diagnostic procedures in neonatal intensive care units (NICU). Premature infants are more sensitive to radiation-induced harmful effects. Dangers from diagnostic radiation can occur with stochastic effects. We aimed to determine the radiation exposure in premature infants and staff and determine the scattering during X-ray examinations in the NICU. Study Design In this prospective study, dosimeters were placed on premature infants who were <= 1,250 g at birth and <= 30 weeks of gestational age who stayed in the NICU for at least 4 weeks. The doses were measured at each X-ray examination during their stay. The measurements of the nurses and the doctors in the NICU were also performed with dosimeters over the 1-month period. Other dosimeters were placed in certain areas outside the incubator and the results were obtained after 1 month. Results The mean radiation exposure of the 10 premature infants, monitored with dosimeters, was 3.65 +/- 2.44 mGy. The mean skin dose of the six staff was 0.087 +/- 0.0998 mSV. The mean scattered dose was 67.9 +/- 26.5 mu Gy. Conclusion Relatively high exposures were observed in 90% of the patients and two staff. The radiation exposure levels of premature infants and staff may need to be monitored continuously.Publication Neuroimaging of first seizure in the adult emergency patients(Springer Heidelberg, 2020-08-01) Öztürk, Kerem; Soylu, Esra; Bilgin, Cem; Hakyemez, Bahattin; Parlak, Müfit; Öztürk, Kerem; BİLGİN, CEM; HAKYEMEZ, BAHATTİN; PARLAK, MÜFİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-9664-2347; 0000-0002-3425-0740; HHS-7433-2022; E-1228-2018; AAI-2318-2021; AAG-8521-2021The aim is to establish the role of head computed tomography (CT) and magnetic resonance imaging (MRI) in adults presenting to the emergency department (ED) with first-time seizure (FS) and to analyze the potential predictor variables for the adverse imaging outcome. We retrospectively reviewed the medical records of all adults who underwent cranial CT or MRI between January 1, 2011, and December 1, 2016, to an academic ED for FS. Patients were excluded if were under 18 years of age, had known recent intracranial pathology, known brain tumor or having a history of trauma. Important predictive variables to indicate pathology in either CT or MR scan in patients with FS were evaluated with logistic regression analysis. A total of 546 FS (293 men and 253 women; range, 18-81 years; mean, 47 years) were identified in patients receiving either cranial CT or MR scan. Of them, abnormal findings were observed in 22/451 (4.8%) patients on CT and 18/95 (18.9%) patients on MRI. Predictor variables of age greater than 50 years, focal neurologic deficit, hypoglycemia, and history of malignancy were identified on CT, whereas a history of malignancy, age greater than 50 years and focal neurological deficit were determined on MRI. Limiting neuroimaging to this population would potentially reduce head CT scans by 67% and would potentially reduce head MRI scans by 47%. Clinical suspicion should be heightened and the neuroimaging should be considered for advanced age, history of malignancy, hypoglycemia or focal neurological deficits in patients with FS.Publication Castleman's disease: Unilateral cervical involvement and imaging findings a case report(Sage Publications Inc, 2007-06-01) Atahan, S.; Hakyemez, B.; Doğan, Nurullah; HAKYEMEZ, BAHATTİN; Topal, N. B.; BOLCA TOPAL, NAİLE; Parlak, M.; PARLAK, MÜFİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi; 0000-0003-1455-6918; AAI-2327-2021; AAI-2318-2021; AAG-8521-2021Castleman's disease is an idiopathic lymphoproliferative disorder characterized by massive enlargement of lymph nodes. It may have a unifocal or multifocal presentation; the mediastinum is the most common site (70%). Patients with cervical disease usually have unifocal involvement (90%). The main problem posed by cervical Castleman's disease is that it should be considered in the differential diagnosis of cervical tumors. This report describes a patient who had unifocal Castleman's disease on the left side of the neck, and discusses the differential diagnosis with findings on magnetic resonance imaging, computed tomography and ultrasonography.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.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.; 0000-0002-5771-7649Publication Morphological evaluation of the normal and hydrocephalic third ventricle on cranial magnetic resonance imaging in children: A retrospective study(Springer, 2022-08-22) Işıklar, Sefa; IŞIKLAR, SEFA; ÖZPAR, RİFAT; Özdemir, Senem Turan; ÖZKAYA, GÜVEN; Özpar, Rıfat; PARLAK, MÜFİT; Parlak, Müfit; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anatomi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Bursa Uludağ Üniversitesi/Ziraat Fakültesi.; 0000-0002-2070-5193; 0000-0003-0297-846X; 0000-0001-6649-9287; A-4421-2016; AAK-3779-2021Background Third ventricle morphological changes reflect changes in the ventricular system in pediatric hydrocephalus, so visual inspection of the third ventricle shape is standard practice. However, normal pediatric reference data are not available. Objective To investigate both the normal development of the third ventricle in the 0-18-year age group and changes in its biometry due to hydrocephalus. Materials and methods For this retrospective study, we selected individuals ages 0-18 years who had magnetic resonance imaging (MRI) from 2012 to 2020. We included 700 children (331 girls) who had three-dimensional (3-D) T1-weighted sequences without and 25 with hydrocephalus (11 girls). We measured the distances between the anatomical structures limiting the third ventricle by dividing the third ventricle into anterior and posterior regions. We made seven linear measurements and three index calculations using 3DSlicer and MRICloud pipeline, and we analyzed the results of 23 age groups in normal and hydrocephalic patients using SPSS (v. 23). Results Salient findings are: (1) The posterior part of the third ventricle is more affected by both developmental and hydrocephalus-related changes. (2) For third ventricle measurements, gender was insignificant while age was significant. (3) Normal third ventricular volumetric development showed a segmental increase in the 0-18 age range. The hydrocephalic third ventricle volume cut-off value in this age group was 3 cm(3). Conclusion This study describes third ventricle morphometry using a linear measurement method. The ratios defined in the midsagittal plane were clinically useful for diagnosing the hydrocephalic third ventricle. The linear and volumetric reference data and ratios are expected to help increase diagnostic accuracy in distinguishing normal and hydrocephalic third ventricles.Publication Arterial transit artifacts observed on arterial spin labeling perfusion imaging of carotid artery stenosis patients: What are counterparts on symptomatology, dynamic susceptibility contrast perfusion, and digital subtraction angiography?(Masson Editeur, 2023-05-23) Özpar, Rıfat; ÖZPAR, RİFAT; Dinç, Yasemin; DİNÇ, YASEMİN; Nas, Ömer Fatih; NAS, ÖMER FATİH; İnecikli, Mehmet Fatih; İNECİKLİ, MEHMET FATİH; Parlak, Müfit; PARLAK, MÜFİT; Hakyemez, Bahattin; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0001-6649-9287; AAK-5124-2020; IUQ-6999-2023Purpose: To investigate possible relationships between the presence and location of arterial transit artifacts (ATA) and clinical symptoms, digital subtraction angiography (DSA), and dynamic susceptibility contrast (DSC) perfusion imaging abnormalities in patients with carotid artery stenosis (CAS).Methods: Forty-seven patients who underwent arterial spin labeling (ASL) and DSC perfusion imaging in the same period diagnosed with > 50% unilateral internal carotid artery (ICA) stenosis by DSA performed 24 h after perfusion imaging were included. The presence of ATA, localization and hypoperfusion were evaluated using ASL interpretation. Maps derived from DSC perfusion, symptomatology, stenosis rates, and collateralization findings observed in DSA were investigated. Probable relationships were evaluated.Results: ATA on ASL were detected in 68.1% (32/47); 40.6% (13/32) of ATAs were observed in the distal middle cerebral artery (MCA) trace, 50% (16/32) in the intracranial ICA and MCA traces, and 9.4% (3/32) in the intracranial ICA trace. When classifications based on the ATA presence and localization was made, qualitative and quantitative CBF, MTT, and TTP abnormalities, symptomatology, stenosis rates, and collateralization findings significantly differed between groups (p < 0.05).Conclusion: The presence and localization of ATA in patients with CAS may provide essential insights into cerebral hemodynamics and the CAS severity. ATAs observed only in the distal MCA trace may represent early-stage perfusion abnormalities and a moderate level of stenosis. ATA in the ICA trace may related to a more advanced level of perfusion abnormalities, critical stenosis rates, symptom or collateralization presence.Publication Dural venous sinus thrombosis: The combination of noncontrast CT, MRI and PC-MR venography to enhance accuracy(Sage Publications Inc, 2018-10-01) Öztürk, Kerem; Soylu, Esra; Parlak, Müfit; Öztürk, Kerem; PARLAK, MÜFİT; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı; 0000-0001-9664-2347; E-1228-2018; AAG-8521-2021Aim: The aim of this article is to determine whether a combination of noncontrast CT (NCCT), three-dimensional-phase contrast magnetic resonance venography (3D PC-MRV), T1- and T2-weighted MRI sequences can help to identify acute and subacute dural venous sinus thrombosis (DVST) with greater accuracy.Methods: A total of 147 patients with DVST (n = 30) and a control group (n = 117) underwent NCCT, T1- and T2-weighted MRI sequences, and 3D PC-MRV from 2012 to 2016. Two experienced observers interpreted the images retrospectively for the presence of DVST. Nonvisualization of the dural venous sinuses on 3D PC-MRV and signal changes supporting acute or subacute thrombus on T2- and T1-weighted images were considered a direct sign of DVST. Also, using circle region of interest (ROI) techniques, attenuation measurement from each sinus was obtained on NCCT. Sensitivity and specificity were computed for these modalities separately and in combination for diagnosis of DVST using digital subtraction angiography as the reference standard.Results: Nonvisualization of venous sinuses on 3D PC-MRV (sensitivity 100%, specificity 71%) in combination with both applying Hounsfield unit (HU) threshold values of greater than 60 on NCCT (sensitivity 70%, specificity 94%) and acquiring signal changes supporting DVST on T2- and T1- weighted images (sensitivity 83%, specificity 96%), were found to have 100% sensitivity and 100% specificity in the identification of acute or subacute DVST.Conclusion: The combination of NCCT, T1- and T2-weighted MRI and 3D PC-MRV may allow the diagnosis of acute or subacute DVST and may obviate the need for contrast usage in patients with renal impairment or contrast allergies.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.