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Öğe 3D Brain Imaging in Vascular Segmentation of Cerebral Venous Sinuses(Springer, 2019) Karakas, Asli Beril; Govsa, Figen; Ozer, Mehmet Asim; Eraslan, CenkThe three-dimensional (3D) visualization of dural venous sinuses (DVS) networks is desired by surgical trainers to create a clear mental picture of the neuroanatomical orientation of the complex cerebral anatomy. Our purpose is to document those identified during routine 3D venography created through 3D models using two-dimensional axial images for teaching and learning neuroanatomy. Anatomical data were segmented and extracted from imaging of the DVS of healthy people. The digital data of the extracted anatomical surfaces was then edited and smoothed, resulting in a set of digital 3D models of the superior sagittal, inferior sagittal, transverse, and sigmoid, rectus sinuses, and internal jugular veins. A combination of 3D printing technology and casting processes led to the creation of realistic neuroanatomical models that include high-fidelity reproductions of the neuroanatomical features of DVS. The life-size DVS training models were provided good detail and representation of the spatial distances. Geometrical details between the neighboring of DVS could be easily manipulated and explored from different angles. A graspable, patient-specific, 3D-printed model of DVS geometry could provide an improved understanding of the complex brain anatomy. These models have various benefits such as the ability to adjust properties, to convert two-dimension images of the patient into three-dimension images, to have different color options, and to be economical. Neuroanatomy experts can model such as the reliability and validity of the designed models, enhance patient satisfaction with improved clinical examination, and demonstrate clinical interventions by simulation; thus, they teach neuroanatomy training with effective teaching styles.Öğe Anti-Myelin Oligodendrocyte Glycoprotein-Associated Disease with Recurrent Tumefactive Demyelinating Lesions(Wolters Kluwer Medknow Publications, 2021) Ozdemir, Huseyin; Eraslan, Cenk; Gokcay, Ahmet; Gokcay, Figen[No Abstract Available]Öğe Application of the life-size patient-specific three-dimensional cervical spine anatomical model for odontoid fracture fixation(Wolters Kluwer Medknow Publications, 2021) Ozgiray, Erkin; Ozer, Mehmet Asim; Sirinturk, Suzan; Govsa, Figen; Dursun, Emre; Eraslan, Cenk; Hepguler, SiminObjective: Cervical fixation is the most common treatment of vertebral fractures, osteosarcoma, osteomyelitis, arthritis, and congenital disorders. Mortal complications, such as internal carotid artery, vertebral artery (VA), and spinal cord damages, may occur during the application. The aim of this study was to create the application of the actual three-dimensional (3D) personalized model which was exercised for screwing insertion in C2 damage patients. Methods: Two patients with Type II of C2 fractures were treated with personalized spine models. These models were investigated to achieve particular information of non- and bony elements such as the highness, thickness, and the field of pedicles and vascular diameters for an intraoperative reference. The model was to determine the probable variations and to observe the success of screw rate in the treatment of C2 fractures. The operation duration, instrumentation time, blood loss volume, and clinical and radiological assessment were done. The 3D model's perception was evaluated. Results: Cervical models were defined to secure intervention areas of the VA pedicles and screws. Neither vascular nor neurologic damages were happened in all cases. Besides, the cases did not include broken nails, screw pullout, fracture of bone structure, or infection. Cervical models demonstrated (1) examination of the VA pattern, (2) valuation of virtual screw trajectory line before screw fixation, (3) the application of prebent rods during procedure to contribute to the safety of the posterior instrumentation, (4) postsurgical confirmation, and (5) examined movements of the neck postoperatively. The perception of 3D model for treating C2 fracture was thereby diminishing surgical time, bleeding amount and operative complications. Survey perception of model was calculated in statistical significance (P < 0.05). Conclusion: Personalized model is active and confident in achieving an accurate and safe screw fixation during surgery, especially in anatomically abnormal cases. Cervical model provides an accurate representation of the fracture location, pedicle size, and VA shapes. It is therefore useful in surgical planning as it maximizes the possibility of ideal screw position, as well as providing individualized information concerning cervical spinal anatomy.Öğe Are Multiple Retinal Arterial Macroaneurysms Considered a Sign of Cerebral Aneurysms(Slack Inc, 2017) Nalcaci, Serhad; Oztas, Zafer; Eraslan, Cenk; Akkin, CezmiThe aim of this study is to report the coexistence of retinal arterial macroaneurysms (RAMs) and cerebral aneurysms (CAs) in a 58-year-old woman with hypertension. She was noted as having a 1-week history of vision loss in her left eye, along with a 2-month history of a nonspecific headache. Visual acuity was 20/32 in her left eye and 20/20 in her right eye. A fundus examination revealed multiple areas of retinal hemorrhages that were surrounded by circinate exudation in her left eye, as well as the generalized attenuation of the retinal arteries in both of her eyes. Angiographically, hyperfluorescent round leakage points confirmed the presence of five saccular RAMs. Surprisingly, computed tomography angiography completed based on the recommendation of neurology department identified three saccular CAs. Aging, hypertension, and female preponderance are the common risk factors for both RAMs and CAs. Accordingly, RAMs and CAs may exist simultaneously in hypertensive patients.Öğe BioBERTurk: Exploring Turkish Biomedical Language Model Development Strategies in Low-Resource Setting(Springernature, 2023) Turkmen, Hazal; Dikenelli, Oğuz; Eraslan, Cenk; Çallı, Mehmet Cem; Özbek, Süha SüreyyaPretrained language models augmented with in-domain corpora show impressive results in biomedicine and clinical Natural Language Processing (NLP) tasks in English. However, there has been minimal work in low-resource languages. Although some pioneering works have shown promising results, many scenarios still need to be explored to engineer effective pretrained language models in biomedicine for low-resource settings. This study introduces the BioBERTurk family and four pretrained models in Turkish for biomedicine. To evaluate the models, we also introduced a labeled dataset to classify radiology reports of head CT examinations. Two parts of the reports, impressions and findings, are evaluated separately to observe the performance of models on longer and less informative text. We compared the models with the Turkish BERT (BERTurk) pretrained with general domain text, multilingual BERT (mBERT), and LSTM+attention-based baseline models. The first model initialized from BERTurk and then further pretrained with biomedical corpus performs statistically better than BERTurk, multilingual BERT, and baseline for both datasets. The second model continues to pretrain the BERTurk model by using only radiology Ph.D. theses to test the effect of task-related text. This model slightly outperformed all models on the impression dataset and showed that using only radiology-related data for continual pre-training could be effective. The third model continues to pretrain by adding radiology theses to the biomedical corpus but does not show a statistically meaningful difference for both datasets. The final model combines radiology and biomedicine corpora with the corpus of BERTurk and pretrains a BERT model from scratch. This model is the worst-performing model of the BioBERT family, even worse than BERTurk and multilingual BERT.Öğe Brain Abscess in Children: A Rare but Serious Infection(Sage Publications Inc, 2018) Bal, Zumrut Sahbudak; Eraslan, Cenk; Bolat, Elif; Avcu, Gulhadiye; Kultursay, Nilgun; Özkınay, Ferda; Kurugol, Zafer; Vardar, FadilBrain abscess is a rare disease in childhood requiring prompt medical and/or surgical treatment. The objective was to review presentation, management, and outcome of brain abscess in children. We reviewed the clinical and radiological features and outcomes of 18 children (10 females, 8 males), with a median age of 48 months (range 1-182), that presented with brain abscesses and admitted to a tertiary pediatric infectious department between December 2010 and January 2017. One (5.5%) patient underwent craniotomy and 14 (77.7%) had burr hole aspirations. The most common localization was the frontal lobe (33.3%). The survival rate was 94.4%, and long-term neurological sequelae affected 27.7% of the patients. Empiric treatment choices require knowledge of common pathogens and local resistance. The most predominant infections were still upper respiratory infections. Clinicians may treat the children with appropriate choice and duration of antibiotic treatment for upper respiratory tract infections.Öğe Building 3D anatomical model of coiling of the internal carotid artery derived from CT angiographic data(Springer, 2017) Govsa, Figen; Yagdi, Tahir; Ozer, Mehmet Asim; Eraslan, Cenk; Alagoz, Ahmet KemalThe purpose of this study is to recreate live patient arterial anomalies using new recent application of three-dimensional (3D) printed anatomical models. Another purpose of building such models is to evaluate the effectiveness of angiographic data. With the help of the DICOM files from computed tomographic angiography (CT-A), we were able to build a printed model of variant course of the internal carotid artery (ICA). Images of coiling of the ICA taken by CT-A, were then converted into 3D images using Google SketchUp free software, and the images were saved in stereolithography format. Imaging helped us conduct the examination in details with reference to geometrical features of ICA, degree of curve, its extension, location and presence of loop. Challenging vascular anatomy was exposed with models of adverse curve of carotid anatomy, including highly angulated necks, conical necks, short necks, tortuous carotid arteries, and narrowed carotid lumens. It assisted us to comprehend spatial anatomy configuration of life-like models. 3D model can be very effective in cases when anatomical difficulties are detected through the CT-A, and therefore, a tactile approach is demanded preoperatively. 3D life-like models serve as an essential office-based tool in vascular surgery as they assist surgeons in preoperative planning, develop intraoperative guidance, teach both the patients and the surgical trainees, and simulate to show patient-specific procedures in medical field.Öğe A Case of Plurihormonal Pituitary Giant Macroadenoma(Turkiye Klinikleri, 2021) Ozisik, Hatice; Yurekli, Banu Sarer; Ertan, Yesim; Eraslan, Cenk; Ozgiray, Erkin; Saygili, FusunWe would like to draw the attention of the readers to Pit-1 positive giant macroadenomas in this work. A 62-year-old male patient was admitted to the hospital due to his vision loss and blurred vision in the left eye. His pituitary magnetic resonance imaging revealed the presence of a diffuse and homogeneous mass lesion originating from the pituitary gland having grade 4 invasion into the bilateral cavernous sinus and eroding the base of the sella. He consulted our department before his operation in 2016. Laboratory examination revealed that pituitary hormone levels were within normal ranges while the testosterone level [total testosterone 0.27 ng/mL (2.8-8)] was low. Pathological findings revealed a pituitary adenoma that displayed focal immunoreactivity to thyrotrophin, growth hormone, and prolactin. While the main prevalence and the basic mechanism of plurihormonal pituitary adenomas are not clear, one of the hypotheses is based on the role of divergent transcription factors such as Pit-1. According to this condition, we should perform a complete biochemical and histologic evaluation in patients with pituitary adenomas.Öğe A Case of Plurihormonal Pituitary GiantMacroadenoma(2021) Saygılı, Füsun; Özgiray, Erkin; Ertan, Yeşim; Özışık, Hatice; Eraslan, Cenk; Yürekli, Banu SarerWe would like to draw the attention of the readers to Pit-1positive giant macroadenomas in this work. A 62-year-old male patient was admitted to the hospital due to his vision loss and blurred vision in the left eye. His pituitary magne-tic resonance imaging revealed the presence of a diffuse and homogeneous mass lesion originating from the pitui-tary gland having grade 4 invasion into the bilateral caver-nous sinus and eroding the base of the sella. He consulted our department before his operation in 2016. Laboratory examination revealed that pituitary hormone levels were within normal ranges while the testosterone level [total tes-tosterone 0.27 ng/mL (2.8-8)] was low. Pathological fin-dings revealed a pituitary adenoma that displayed focal immunoreactivity to thyrotrophin, growth hormone, and prolactin. While the main prevalence and the basic mecha-nism of plurihormonal pituitary adenomas are not clear, one of the hypotheses is based on the role of divergent trans-cription factors such as Pit-1. According to this condition, we should perform a complete biochemical and histologic evaluation in patients with pituitary adenomasÖğe A Case of Polymicrobial Brain Abscess Caused By a Rare Bacterium: Granulicatella elegans(Galenos Yayincilik, 2018) Akyol, Deniz; Yildirim, Cigdem; Tasbakan, Meltem Isikgoz; Yamazhan, Tansu; Tunger, Alper; Eraslan, Cenk; Sipahi, Oguz ResatÖğe Cerebral sinovenous thrombosis in children: A single-center experience(Aves, 2021) Cetin, Ipek Dokurel; Eraslan, Cenk; Simsek, Erdem; Kanmaz, Seda; Serin, Hepsen Mine; Karapinar, Deniz Yilmaz; Yilmaz, Sanem KeskinObjective: The study aimed to evaluate the patients with a diagnosis of cerebral sinovenous thrombosis in terms of clinical findings, etiology and underlying risk factors, imaging findings, treatment, and prognosis in the long term. Materials and Methods: Medical records of 19 patients whose ages ranged between 0 days and 17 years with clinical and radiological cerebral sinovenous thrombosis in Ege University Department of Child Neurology were retrospectively evaluated. Results: Nine of nineteen cases were female (47.3%). The median age was 84 months (0-201 months). The most common complaint at the presentation was headache (n=12) and the most common physical examination finding was papilledema (n=11). In etiology, otitis/mastoiditis in three cases, iron deficiency anemia in three cases, sinusitis in two cases, catheter use in four cases, Behcet's disease in three cases were determined. The most common observed genetic factors causing thrombosis was methylenetetrahydrofolate reductase mutation. The transverse sinus (68.4%) is the sinus where thrombosis is most frequently observed. As a result of an average follow-up of 12 months (2-72 months), hemiparesis (n=3/19, 15.7%) and epilepsy (n=5/19, 26.3%) were recorded as sequelae findings, and no mortality was observed. Conclusion: In cases presenting with headache, evaluation of papilledema on funduscopic examination should not be skipped. Neurological imaging should be performed in the change of consciousness of poor feeding infants and children with infections in the head and neck area or underlying chronic diseases. When cerebral sinovenous thrombosis is detected, anticoagulant therapy should be started immediately.Öğe Clinical and video head impulse test in the diagnosis of posterior circulation stroke presenting as acute vestibular syndrome in the emergency department(Ios Press, 2017) Guler, Ayse; Akarca, Funda Karbek; Eraslan, Cenk; Tarhan, Ceyda; Bilgen, Cem; Kirazli, Tayfun; Celebisoy, NeseINTRODUCTION: Head impulse test (HIT) is the critical bedside examination which differentiates vestibular neuritis (VN) from posterior circulation stroke (PCS) in acute vestibular syndrome (AVS). Video-oculography based HIT (vHIT) may have aadditional strength in making the differentiation. METHODS: Patients admitted to the emergency department of a tertiary-care medical center with AVS were studied. An emergency specialist and a neurologist performed HIT. vHIT was conducted by an neuro-otology research fellow. RESULTS: Forty patients 26 male, 14 female with a mean age of 49 years were included in the analyses. Final diagnoses were VN in 24 and PCS in 16 patients. In the VN group, clinical HIT was assessed as abnormal in 19(80%) cases by the emergency specialist and in 20(83%) by the neurologist. In all PCS patients, HIT was recorded as normal both by the emergency specialist and the neurologist (100%). On vHIT, patients with VN had significantly low gain values for both the ipsilesional and contralesional sides when compared with the healthy controls, with significantly lower figures for the ipsilesional side (p < 0.001). All patients in this group had normal DWI-MRI. PCS patients had bilaterally low gain (p < 0.05) on vHIT. However, gain asymmetry was not significant. Subgroup analyses according to presence of brainstem involvement revealed bilateral low gain (p < 0.05) in patients with brainstem infarction (anterior inferior cerebellar artery-posterior inferior cerebellar artery stroke, AICA-PICA stroke) whereas patients with pure cerebellar infarction (posterior inferior cerebellar artery-superior cerebellar artery stroke, PICA-SCA stroke) had gain values similar to healthy controls. With a gain cut-off <= 0.75 and gain asymmetry cut-off >= 17%, as determined by ROC analysis, 100% of PCS patients and 80% of VN patients were correctly diagnosed. CONCLUSIONS: Clinical HIT, either performed by an emergency specialist or neurologist is equivalent to vHIT gain and gain asymmetry analysis as conducted by neuro-otologist in the diagnosis of PCS, albeit mislabeling about 20% of VN patients. vHIT does not appear to yield additional diagnostic information. These findings indicate the strength of clinical HIT. Pure gain-based vHIT analysis seems limited and needs to be incorporated with saccade analysis.Öğe Clinical Presentation and Follow Up of Patients with Mucopolysaccharidosis Type IVA (Morquio A Disease): Single Center Experience(2018) Canda, Ebru; Yazıcı, Havva; Er, Esra; Eraslan, Cenk; Uçar, Sema Kalkan; Çoker, MahmutAim: Mucopolysaccharidosis Type IVA (MPS IVA), Morquio A, is caused by the deficiency in lysosomal enzyme N-acetylgalactosamine-6-sulfate sulfatase. Multisystemic involvements include skeletal systems, pulmonary disease, valvular heart disease, hearing loss, mild hepatomegaly, corneal clouding, coarse facial features. Materials and Methods: We retrospectively analyzed clinical and laboratory and follow up findings of our 25 patients with ministry for primary industries independent verification agency. Results: Mean age of the patients was 14.9±7.05 (5.5-36 years). Mean age at diagnosis was 7.3±6.2 years (6 months-31 years). Female: male ratio was 13/12. All patients had skeletal manifestation and X-ray analysis demonstrated “dysostosis multiplex”. Twelve patients (48%) had cardiac valve disease. Twenty three (92%) patients had corneal clouding, 15 (60%) patients had hearing loss and 9 (36%) had hepatomegaly. Six (24%) patients were unable to walk. Mean follow up period is 7.4 years ±3.5 years (3 months-17 years). Four patients have not visit our clinical for last ?3 years. Three patients died during follow up. Conclusion: MPS IVA is a severe disorder and is usually fatal in the second or third decade of life due to the complications of the disease. Early diagnosis of the patient became more important, because specific therapy with elasulphase alpha was approved recent years ago.Öğe Clinical Presentation and Follow Up of Patients with Mucopolysaccharidosis Type IVA (Morquio A Disease): Single Center Experience(Galenos Yayincilik, 2018) Canda, Ebru; Yazici, Havva; Er, Esra; Eraslan, Cenk; Ucar, Sema Kalkan; Coker, MahmutAim: Mucopolysaccharidosis Type IVA(MPS IVA), Morquio A, is caused by the deficiency in lysosomal enzyme N-acetylgalactosamine-6-sulfate sulfatase. Multisystemic involvements include skeletal systems, pulmonary disease, valvular heart disease, hearing loss, mild hepatomegaly, corneal clouding, coarse facial features. Materials and Methods: We retrospectively analyzed clinical and laboratory and follow up findings of our 25 patients with ministry for primary industries independent verification agency. Results: Mean age of the patients was 14.9 +/- 7.05 (5.5-36 years). Mean age at diagnosis was 7.3 +/- 6.2 years (6 months-31 years). Female: male ratio was 13/12. All patients had skeletal manifestation and X-ray analysis demonstrated "dysostosis multiplex". Twelve patients (48%) had cardiac valve disease. Twenty three (92%) patients had corneal clouding, 15(60%) patients had hearing loss and 9(36%) had hepatomegaly. Six (24%) patients were unable to walk Mean follow up period is 7.4 years +/- 3.5 years (3 months-17 years). Four patients have not visit our clinical for last >= 3 years. Three patients died during follow-up. Conclusion: MPS IVA is a severe disorder and is usually fatal in the second or third decade of life due to the complications of the disease. Early diagnosis of the patient became more important, because specific therapy with elasulphase alpha was approved recent years ago.Öğe Clinical spectrum, treatment and outcome of myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease in children: a tertiary care experience(Springer Heidelberg, 2021) Serin, Hepsen Mine; Yilmaz, Sanem; Simsek, Erdem; Kanmaz, Seda; Eraslan, Cenk; Aktan, Gul; Gokben, SarenurAnti-myelin oligodendrocyte glycoprotein antibodies have been associated with a wide range of clinical presentations including monophasic and relapsing disease courses. Lack of a definitive marker for predicting further relapses and the final diagnoses complicates the clinical follow-up and treatment decisions for patients with the first episode. This study retrospectively analyzed the clinical spectrum, treatment protocols and outcome of nine children with MOG antibody-associated demyelinating disease. Diagnoses at first presentation were acute disseminated encephalomyelitis (ADEM) in six cases (67%), optic neuritis in two cases (22%), and clinically isolated syndrome in one case (11%). The disease remained monophasic in five (56%) cases. All cases with a monophasic disease course were negative for anti-MOG antibody titers in the third month. The initial diagnosis of all relapsing cases was ADEM. Three of the four cases with a relapsing disease course were available for anti-MOG antibody testing at the third month and all were positive, however, antibody titers at the sixth month were inconsistent. Cases with a relapsing disease course had no further attacks after monthly intravenous immunoglobulin treatment. Relapsing disease course is not rare in childhood MOG-antibody associated demyelinating disease. Monthly IVIG treatment may be a good alternative for the long-term treatment of relapsing cases with a low side effect profile. Anti-MOG antibody serostatus at remission periods should be interpreted cautiously. Further studies are needed to better understand and predict the clinical course of pediatric patients with MOG-antibody associated diseases.Öğe Clinical, Neuroimaging, and Genetic Features of the Patients with L-2-Hydroxyglutaric Aciduria(2018) Canda, Ebru; Köse, Melis; Yazıcı, Havva; Er, Esra; Eraslan, Cenk; Uçar, Sema Kalkan; Karaca, EminAim: L-2-hydroxyglutaric aciduria (L2HGA) is a rare autosomal recessive encephalopathy caused by mutations in the L-2-hydroxyglutarate dehydrogenase gene. Materials and Methods: Here we discuss the clinical and molecular characteristics in patients with L2HGA. Results: There were eight patients with L2HGA. Their median age was 16 (9.5-37) years. Five of them were female and three of them were male. the main symptoms of the patients were psychomotor retardation (8/8), cerebellar ataxia (5/8), extrapyramidal symptoms (7/8) and seizures (4/8). All patients had behavioral problems. Elevated urinary L-2-hydroxy (L-2-OH) glutaric acid was detected and the median level of urine L-2-OH glutaric acid at diagnosis was 146 (60-1460 nmol/mol creat). Characteristic magnetic resonance imaging findings including subcortical cerebral white matter abnormalities with T2 hyperintensities of the dentate nucleus, globus pallidus and putamen were detected. Two patients had homozygous R335X, two patients had homozygous R282Q, two patients had homozygous R302L and one patient had compound heterozygous P302L/A64T mutation in L-2-hydroxyglutarate dehydrogenase (L2HGDH) gene. Conclusion: Because of the slow progression of the disease, the diagnosis of the patients is usually belated. L2HGA must be considered in the differential diagnosis based on clinical findings and specific findings in cranial magnetic resonance imaging. in our study, one of our patients has a novel mutation.Öğe Clinical, Neuroimaging, and Genetic Features of the Patients with L-2-Hydroxyglutaric Aciduria(Galenos Yayincilik, 2018) Canda, Ebru; Kose, Melis; Yazici, Havva; Er, Esra; Eraslan, Cenk; Ucar, Sema Kalkan; Habif, Sara; Karaca, Emin; Onay, Huseyin; Özkınay, Ferda; Coker, MahmutAim: L-2-hydroxyglutaric aciduria (L2HGA) is a rare autosomal recessive encephalopathy caused by mutations in the L-2-hydroxyglutarate dehydrogenase gene. Materials and Methods: Here we discuss the clinical and molecular characteristics in patients with L2HGA. Results: There ware eight patients with L2HGA. Their median age was 16(9.5-37) years. Five of them ware female and three of them were male. The main symptoms of the patients were psychomotor retardation (8/8), cerebellar ataxia (5/8), extrapyramidal symptoms (7/8) and seizures (4/8). All patients had behavioral problems. Elevated urinary L-2-hydroxy (L-2-OH} glutaric acid was detected and the median level of urine L-2-OH glutaric acid at diagnosis was 146(60-1460 nmol/mol creat). Characteristic magnetic resonance imaging findings including subcortical cerebral white matter abnormalities with T2 hyperintensities of the dentate nucleus, globus pallidus and putamen were detected. Two patients had homozygous R335X, two patients had homozygous R2820, two patients had homozygous R302L and one patient had compound heterozygous P302L/A64T mutation in L-2-hydroxyglutarate dehydrogenase (L2HGDH) gene. Conclusion: Because of the slow progression of the disease, the diagnosis of the patients is usually belated L2HGA must be considered in the differential diagnosis based on clinical findings and specific findings in cranial magnetic resonance imaging. In our study, one of our patients has a novel mutation.Öğe Clivus Osteomyelitis as a Complication of Retropharyngeal Abscess in an Immunocompetent Adolescent(Lippincott Williams & Wilkins, 2024) Ekemen, Coskun; Avcu, Gulhadiye; Arslan, Asli; Ozer, Emine Cigdem; Eraslan, Cenk; Tanriverdi, O. Hasan; Bal, Zumrut Sahbudak[Abstarct Not Available]Öğe Comparison between dynamic susceptibility contrast magnetic resonance imaging and arterial spin labeling techniques in distinguishing malignant from benign brain tumors(Elsevier Ireland Ltd, 2016) Ata, Emine Sevcan; Turgut, Mehmet; Eraslan, Cenk; Dayanir, Yelda OzsunarObjectives: The purpose of this study was to preliminarily compare unenhanced arterial spin-labeled (ASL) imaging, dynamic susceptibility contrast-enhanced cerebral blood volume (DSCE-CBV) magnetic resonance imaging (MRI) for evaluation of tumor perfusion in patients with brain tumors. Materials and methods: A total of 27 patients with brain tumors were examined in 1,5 T MRI. Single phase and multiphase ASL, DSCE-CBV examinations were assessed by both qualitative and quantitative analysis for the detection of malignancy. Imaging results were correlated with a histopathology or follow-up. Results: Based on 31 studies in 27 patients with brain tumors, the visual inspection sensitivities for ASL and dynamic DSC perfusion imaging were 88% and 94%, respectively, with 100% specificity for both. On qualitative evaluation, sensitivities for ASL and DSC perfusion imaging perfusions were 88% and 94%, respectively, with 100% specificity for both. The highest sensitivity values for quantitative ASL imaging were obtained using a normalized cut-off ratio of 1.65, resulting in sensitivity of 94% for ASL imaging and cut-off ratio of 1.95 and sensitivity 94% for DSCE-CBV imaging. Conclusion: The present study revealed similar sensitivity and specificity for both multhiphase ASL and DSC MRI. Thus, we suggest that ASL perfusion can be used in daily clinical practice. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Öğe Comparison of the results of ultrasonography-guided percutaneous liver mass biopsy performed with 18 and 20 gauge needles(2019) Eraslan, Cenk; Köseoğlu, Ömer Faruk Kutsi; Meydan, Nezih; Çulhacı, Nil; Oral, AylinAim: To evaluate the role of using 18 Gauge (G) and 20G sharp needles in ultrasonography (US)-guided percutaneous liver mass biopsy regarding diagnostic success and efficacy is aimed. Materials and Methods: Sixty patients who underwent US-guided liver mass biopsy using 18G and 20G cutting needles were included in the study. Definite diagnosis was established based on results of histopathological examinations of the biopsied lesions, follow-up clinical and imaging findings and for performed patients the results of repeated biopsy. In addition, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated for 18G and 20G needles. Results: Among 60 liver masses, definite diagnosis was malignant in 54 (90%) masses and benign in 6 (10%) masses. Sensitivity, specificity, PPV, NPV, and diagnostic accuracy were 90.7%, 100.0%, 100.0%, 75.0%, and 91.6%, respectively, for the liver mass biopsies performed with 18G needles. These values were 87.0%, 100.0%, 100.0%, 66.7%, and 88.3%, respectively, for the liver mass biopsies performed with 20G needles. No significant difference was determined between the results found for the use of 18G needle and 20G needle in US-guided cutting needle biopsy performed in hepatic masses (p=0.540) Conclusion: The present study demonstrated that 18G and 20G sharp needles had similar diagnostic success and efficacy in US-guided percutaneous biopsy of liver mass lesions. Owing to its fine calibration, 20G sharp needle can be preferred in high-risk patient groups, particularly in those with bleeding disorder.
