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Öğe Androgen-related hepatocellular tumor of the liver associated with Fanconi's anemia(2003) Aktaş S.; Apa H.; Diniz G.; Erbay A.; Ortaç R.; Vergin C.; Karaca I.; Elmas N.; Yüzer Y.Hepatocellular tumors are quite rare in pediatric age group. Its association with Fanconi's anemia and androgen therapy is well known but the pathogenesis is controversial. Occurrence of significant dysplasia causes great problems to differentiate it as hepatocellular adenoma or hepatocellular carcinoma. In this paper a 13 years old male case of hepatocellular tumor associated with Fanconi's anemia and androgen therapy is presented. He was given androgen and steroid therapy for 5 years and he had had hepatitis C virus infection for 3 years before the multifocal hepatic tumors were observed. Androgen therapy was witheld and surgery was performed twice. Patients taking androgenic-anabolic steroids should be carefully monitored with US and CT and tumor markers should be measured. The worrisome pathology that may occur in hepatic tumor in children particularly with androgen therapy does not necessarily predict malignant behaviour.Öğe Angiomyolipoma with epithelial cyst (AMLEC): A rare variant of fat poor angiomyolipoma mimicking malignant cystic mass on MR imaging(Elsevier Masson SAS, 2015) Acar T.; Harman M.; Sen S.; Kumbaracl B.S.; Elmas N.Angiomyolipoma (AML) of the kidney is the most common benign neoplasm encountered indaily clinical practice. Typical AMLs comprise three elements: mature adipose tissue, bloodvessels, and smooth muscle. Since classic AMLs contain considerable amount of adiposetissue, they are easily recognized on computed tomography (CT) and magnetic resonanceimaging (MRI) [1]. On the other hand, some AMLs comprise too little fat to be detected withunenhanced CT. These lesions are called ''fat poor AMLs'' that may be misdiagnosed asrenal cell carcinoma (RCC) on cross sectional imaging [2,3]. Angiomyolipoma with epithelialcysts (AMLEC) is an extremely rare subtype of fat poor AML, which contains epithelial-linedcysts. According to best of our knowledge imaging findings of AMLEC is very scarce and onlya total of 18 cases have been reported so far [4-8]. Herein, we aimed to report the MRIfeatures of AMLEC that resembles Bosniak category III lesion on MRI and emphasize thepotential role of dual gradient-echo imaging in detecting small amount of fat in AMLEC. © 2015 Published by Elsevier Masson SAS on behalf of the Editions francaises de radiologie.Öğe Contrast agents used in MR imaging of the liver(2006) Karabulut N.; Elmas N.Several categories of contrast agents with different biodistributions are currently available for magnetic resonance imaging of the liver. They improve lesion detection and characterization by increasing lesion-liver contrast. These agents include nonspecific extra-cellular gadolinium chelates, reticuloendothelial system-specific iron oxides, hepatocyte-selective agents, and combined perfusion and hepatocyte-selective agents. This article describes the currently used contrast agents in magnetic resonance imaging of the liver, summarizes their mechanisms of action, biodistributions, and safety profiles. Additionally, it reviews their main clinical indications, administration and imaging techniques, and the appearances of common hepatic lesions in contrast-enhanced studies. © Turkish Society of Radiology 2006.Öğe Correlative CT, MRI and histological findings of hepatic Echinococcus alveolaris: A case report(Elsevier Science Ltd, Exeter, United Kingdom, 1999) Katranci N.; Elmas N.; Yilmaz F.; Mentes A.Diagnosis of liver infestation by Echinococcus alveolaris (EA) is based on serologic, sonographic and CT findings. Literature review yielded only one report discussing the MRI findings of hepatic EA infestation. In this report, we present a case of hepatic EA infestation with its correlative CT, MRI and histological findings. CT showed hypodense mass involving more than half of the liver with rim and central calcifications. MRI revealed hypointense signal of the infiltrative mass on both T1- and T2-weighted images. On MRI, the portal vein branches were seen coursing through the lesion. Neither CT nor MRI demonstrated any contrast enhancement of the mass. On the histological examination, abundant fibrous and hyalinized tissue surrounding multiple small cysts were observed. MRI may provide invaluable information in the diagnosis of EA infestation of the liver, either by disclosing the infiltrative pattern of infestation without significant effect to vascular structures, or by the signal characteristics.Diagnosis of liver infestation by Echinococcus alveolaris (EA) is based on serologic, sonographic and CT findings. Literature review yielded only one report discussing the MRI findings of hepatic EA infestation. In this report, we present a case of hepatic EA infestation with its correlative CT, MRI and histological findings. CT showed hypodense mass involving more than half of the liver with rim and central calcifications. MRI revealed hypointense signal of the infiltrative mass on both T1- and T2-weighted images. On MRI, the portal vein branches were seen coursing through the lesion. Neither CT nor MRI demonstrated any contrast enhancement of the mass. On the histological examination, abundant fibrous and hyalinized tissue surrounding multiple small cysts were observed. MRI may provide invaluable information in the diagnosis of EA infestation of the liver, either by disclosing the infiltrative pattern of infestation without significant effect to vascular structures, or by the signal characteristics.Öğe Esophageal metastasis of hurthle cell thyroid carcinoma eight years after a subtotal thyroidectomy that mimicked esophageal hemangioma [4](Blackwell Publishing, 2005) Akyildiz M.; Ozutemiz O.; Gunsar F.; Akay S.; Aydin A.; Elmas N.; Ertan Y.; Akyildiz M.; Ilter T.[No abstract available]Öğe Evaluation of treatment response of chemoembolization in hepatocellular carcinoma with diffusion-weighted imaging on 3.0-T MR imaging(2012) Sahin H.; Harman M.; Cinar C.; Bozkaya H.; Parildar M.; Elmas N.Purpose: To assess the treatment response of hepatocellular carcinoma (HCC) after transarterial chemoembolization with diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance (MR) imaging with a 3-T system. Materials and Methods: Between February 2010 and November 2010, 74 patients were treated with chemoembolization in our interventional radiology unit. Twenty-two patients (29%) who had liver MR imaging including diffusion and dynamic contrast-enhanced MR imaging on a 3-T system before and after transarterial chemoembolization were evaluated retrospectively. Tumor size, arterial enhancement, venous washout, and apparent diffusion coefficient (ADC) values of lesions, peritumoral parenchyma, normal liver parenchyma, and spleen were recorded before and after treatment. The significance of differences between ADC values of responding and nonresponding lesions was calculated. Results: The study included 77 HCC lesions (mean diameter, 31.4 mm) in 20 patients. There was no significant reduction in mean tumor diameter after treatment. Reduction in tumor enhancement in the arterial phase was statistically significant (P =.01). Tumor ADC value increased from 1.10 × 10 -3 mm 2/s to 1.27 × 10 -3 mm 2/s after treatment (P <.01), whereas the ADC values for liver and spleen remained unchanged. ADC values from cellular parts of the tumor and necrotic areas also increased after treatment. However, pretreatment ADC values were not reliable to identify responding lesions according to the results of receiver operating characteristic analysis. Conclusions: After transarterial chemoembolization, responding HCC lesions exhibited decreases in arterial enhancement and increases in ADC values in cellular and necrotic areas. Pretreatment ADC values were not predictive of response to chemoembolization. © 2012 SIR.Öğe Huge endometriosis presenting like an ovarian tumor: CT appearance(2010) Yerli H.; Askar N.; Zekioglu O.; Baglan Z.; Elmas N.A 32-year-old female with a clinical history of abdominal swelling underwent CT of the abdomen. A huge biloculated cystic mass with a mural nodule in the abdominal and pelvic region was seen. The lesion showed slightly homogeneous enhancement. The imaging findings suggested an ovarian tumor. Histopathological evaluation after surgical resection revealed that the lesion was a bilateral ovarian endometriosis.Öğe Intraoperative fiberoptic choledochoscopy [Intraoperatif fiberoptik koledokoskopi](1997) Mentes A.; Ersin S.; Yuzer Y.; Coker A.; Akyildiz M.; Tekesin O.; Killi R.; Elmas N.The aim of this study is to evaluate the role of choledochoscopy in the differential diagnosis and management of obstructive jaundice. A total of 60 patients (33 female and 27 male) were evaluated for the accuracy of preoperative diagnostic methods, the effectiveness of choledochoscopy in the establishment of the diagnosis, the comparison of intraoperative versus preoperative diagnosis and morbidity and mortality related to the procedure. In 35 patients (58.3 %) choledochoscopy confirmed the preoperative diagnosis. In twelve patients (20 %) the exact diagnosis of obstructive jaundice was established by choledochoscopy and the preoperative diagnosis changed significantly after choledochoscopy in thirtheen patients (21.7 %). Intraoperative flexible choledochoscopy appeared as a very useful diagnostic tool in the diagnosis, surgical decision making and choice of the operation in patients with obstructive jaundice.Öğe Mammography quality in Turkey: Auditors’ report on a nationwide survey(Kowsar Medical Publishing Company, 2017) Ozsoy A.; Aribal E.; Araz L.; Erdogdu M.B.; Sari A.; Sencan I.; Elmas N.Objectives: To evaluate the mammography image and reporting quality in Turkey. Materials and Methods: One hundred sixty five units which provide mammography examination services were included in the audit. Samples of mammographic examinations conducted between July 1st and December 31st, 2012 were evaluated. Auditors completed web-based evaluation forms, including quality parameters and descriptive statistics on the patients and institutions. Results: Nine hundred eighty eight mammography examinations were evaluated; 47.34% of them used mammography machines less than 5 years old. Most of the older machines (10 years old or more) were grouped in private hospitals (22.1%) and university hospitals (21%). Mammographic image quality evaluation showed 56.1% non-compliance with the standard parameters. Private institutions showed the highest failure rates (P < 0.001), and low-quality images mostly (42.2%) resulted from mistakes in positioning. In 32% of the mammography reports, some mandatory information was incomplete. The reports were deemed inadequate in 59.2% of the cases. Conclusion: The audit showed significant deficiencies in terms of quality. We suggest investing more time and effort to train both radiologists and radiologic technicians to implement image and report quality standards in their units. Moreover, our study emphasized the importance of the accreditation of the units. © 2016, Tehran University of Medical Sciences and Iranian Society of Radiology.Öğe Peutz-Jeghers syndrome: CT and US demonstration of small bowel polyps(Springer-Verlag, 1991) Sener R.N.; Kumcuoglu Z.; Elmas N.; Oyar O.; Tugran C.A family affected with Peutz-Jeghers syndrome is reported with an emphasis on radiological findings. A patient showed extensive pigmentation around the lips, buccal mucosa, and nose. Another showed prolonged transient intussusception of a jejunal loop on barium meal examination, and massive rectal bleeding. In this patient, small bowel polyps could also be seen on ultrasonography (US) and computed tomography (CT). On CT several polyps, up to 3 cm in size, were detected along with a "carpeting" pattern of several loops presumably caused by multiple small polyps. © 1991 Springer-Verlag New York Inc.Öğe Primary hepatic actinomycosis: a case of inflammatory pseudotumor (case report) [Primer hepatik aktinomikoz: inflamatuar psödotümör olgusu.](2004) Tamsel S.; Demirpolat G.; Killi R.; Elmas N.Actinomycosis is an uncommon chronic infection in which primary liver involvement accounts for 5% of all actinomycotic infections. Abdominal actinomycosis is a severe and progressive peritoneal infection due to an anaerobic gram-positive bacterium, Actinomyces israelii. The presence of a long-standing intrauterine device (IUD) is a well-known risk factor in young women. Although hepatic lesions are present in 15% of cases of abdominal actinomycotic infection, liver involvement in the majority of these cases is attributable to metastatic spread from other evident intraabdominal sites. Hepatic actinomycosis presents most commonly as a single abscess. However, hepatic actinomycosis can closely mimic a malignant tumor on clinical and radiological examination. Such lesions have been termed inflammatory pseudotumors. Tissue specimens for microscopic examination are necessary for diagnosis. We report a rare case of inflammatory pseudotumor of the liver caused by actinomycotic infection.Öğe Primary lymphoma of rectum with a fistula to ileum(2001) Karasu Z.; Elmas N.; Musoglu A.Primary lymphoma of the rectum is uncommon and if the criteria described by Dawson et al. are used for diagnosis, it is a rare tumor. Barium enema, rectosigmoidoscopy, ultrasonography, computed tomography and magnetic resonance imaging have been used in the diagnosis and staging of rectal lymphomas. Since the introduction of per rectal paramagnetic contrast agents, magnetic resonance imaging appears to have superiority over other diagnostic tools. We report a case of primary rectal lymphoma with a fistula to the ileum, which was diagnosed by magnetic resonance imaging using a per rectal paramagnetic contrast agent.Öğe Primary mesenchymal liver tumors: radiological spectrum, differential diagnosis, and pathologic correlation(Springer New York LLC, 2015) Harman M.; Nart D.; Acar T.; Elmas N.With the exception of hemangioma, benign or malignant primary mesenchymal tumors of the liver are seldom encountered. The aim of this review was to discuss the clinical, histopathological, and imaging features of liver hemangiomas (cavernous, capillary, and sclerosed types), liver lipoma, angiomyolipoma, mesenchymal hamartoma, neurofibroma, infantile hemangioendothelioma, epithelioid hemangioendothelioma, myofibroblastoma, angiosarcoma, malignant fibrous histiocytoma, undifferentiated embryonal sarcoma, and nested stromal tumor. In most of these rare liver tumors, radiological findings obtained by cross-sectional imaging may reflect the characteristic pathologic features required for differential diagnosis; however, definitive diagnosis should be confirmed using histopathological examination. © 2014, Springer Science+Business Media New York.Öğe Stromal predominant type mesenchymal hamartoma of liver: CT and MR features(2002) Çetin M.; Demirpolat G.; Elmas N.; Yüce G.; Çetingül N.; Balik E.Mesenchymal hamartoma is a rare pediatric liver tumor. The tumor is mainly cystic but occasionally a solid component is seen. Therefore the tumor can be divided into two forms: (a) cystic predominant, and (b) stromal predominant. In this report, CT and MR features of stromal predominant type mesenchymal hamartoma are presented. © 2002 Elsevier Science Ltd. All rights reserved.
