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Öğe CLINICAL UTILITY OF RADIOLOGICAL IMAGING IN THE EVALUATION OF GALLSTONE ILEUS(2019) Özdemir, Adnan; Yılmazsoy, Yunus; Arslan, Serdar; Pehlivanlı, FarukObjective: Gallstone ileus is a rare complication ofcholelithiasis. It occurs as a result of the passage of bile stonesinto intestinal system via bilioenteric fistulae, which are formedby recurrent attacks of cholecystitis, and obstruction of theintestinal lumen. The objective of our study was to discuss theimaging findings of gallstone ileus among patients diagnosed atour center.Material and Methods: Among patients that admitted to ourhospital’s radiology department between December 2016 andJanuary 2019, the medical records of those with a history of gallbladder stone detected on ultrasonography were retrospectivelyevaluated. Among those, cases of gallstone ileus were identified.Admission complaints, age, sex, comorbidities, radiologicalimaging findings, fistula localization, stone size, and obstructionlevel were recorded and analyzed.Results: Among 958 patients with bile stones, 342 (35.7%)were male and 616 (64.3%) were female. Gallstone ileus wasidentified in five patients. Three of them were female (mean age76.67± 13.05 years) and 2 were male (mean age 59±1.41 years).Ileus signs were detected on plain radiograms for all patients.The gallbladders were not clearly visualized by ultrasonographyin any of patients with gallstone ileus. A diameter increasesuggestive of ileus was detected in visualizable intestinalsegments. Computed tomography to identify the cause of ileusrevealed air in the bile ducts, cholecystoduodenal fistula, stonesin intestinal lumen, and an appearance consistent with ileusproximal to that segment. The mean size of the stones was26.20±16.3 mm (16-55 mm).Conclusion: Although gallstone ileus is a rare cause ofintestinal obstruction, it should be definitely remembered in thedifferential diagnosis in patients with advanced age and ahistory of cholelithiasis who present to the emergencydepartment.Öğe Effectivity of the Radiological Imaging Methods in the Prediction of the Neurological Loss Risk in Patients with Blunt Chest Trauma(2022) Yuksel, Ulas; Agababaoglu, İsmail; Yildiz, Ozgur Omer; Cinar, Eray; Özdemir, Adnan; Akın, Mustafa Emre; Bakar, BulentObjective: The study was aimed to investigate the diagnostic differences between X-ray\rand thorax computed tomography (CT) scan in patients with blunt chest trauma and to de-\rtermine which radiological method and/or radiological diagnostic criteria are more effective\rand predictive to diagnose the hemothorax, pneumothorax, and neurological deficit.\rMethods: The demographic and radiological imaging results of patients who had blunt chest\rtrauma between April 2011 and December 2018 were analyzed. A total of 869 patients\r(male=548, female=321) were included in the study. Of the patients, 756 (87%) were as-\rsessed by a traffic accident and 113 (13%) by falling from a height. The findings of rib, ster-\rnum, and spine fractures, hemothorax, and pneumothorax detected on X-ray and/or thorax\rCT were evaluated.\rResults: Rib fractures (p<0.001) and vertebra fractures (p<0.001) were detected much\rmore in CT scans than in chest X-rays. ROC curve test revealed that vertebra fracture,\rhemothorax, and pneumothorax could predict the development risk of the neurological\rdeficit. The logistic regression test results revealed that thorax CT imaging could be the\rbest radiological examination method to be used to diagnose hemothorax (p<0.001) and\rpneumothorax (p<0.001) and to predict the development risk of the neurological deficit\r(p<0.001).\rConclusion: In cases with a rib fracture, hemothorax, and/or pneumothorax, advanced\rvertebral radiological imaging should be performed in order not to overlook vertebral frac-\rtures and to predict the development of neurological deficits. Therefore, a thorax CT scan\rmay be the first choice to detect pathological findings in the thoracic vertebrae and other\rthoracic bone structures.Öğe Incidence of agger nasi and frontal cells and their relation to frontal sinusitis in a Turkish population: a CT study(2018) Özdemir, Adnan; Arslan, SerdarObjectives: The aim of this study was to determine the incidence of agger nasi and frontal cells in a Turkish population andtheir relation to frontal sinusitis.Methods: A total of 412 non-contrast paranasal sinus computed tomography (CT) images taken between March 2017 and June2018 were examined retrospectively. Frontal cells were classified into four types according to Kuhn’s classification. The relationof agger nasi and frontal cells to frontal sinusitis was evaluated.Results: Of the 412 patients, 202 were males (mean age 34.814.9) and 210 were females (mean age 35.113.9). agger nasicell was detected in 214 (51.9%), and frontal cell in 198 patients (48%). Frontal sinusitis was detected in 68 patients (16.5%).According to Kuhn’s classification, Type 1 frontal cell was detected most frequently. A significant relationship was observedbetween the presence of agger nasi and frontal cells and frontal sinusitis (p0.001). When the right and left frontal sinusitis wereevaluated separately, the relationship of frontal cell types of Kuhn’s classification with frontal sinusitis was found to be significant on the right side, but not on the left side.Conclusion: Agger nasi and frontal cells are common paranasal sinus variations that play a role in the development of frontalsinusitis. Although most of the paranasal sinus variationsare considered as predisposing in the development of sinusitis,there are obvious differences in studies. For this reason, a higher number of comprehensive studies are necessary to revealthe relation between the presence of agger nasi and frontal cells and sinusitis.Öğe Palyatif Bakım Ünitesinde Yatan Hastalar İçin Yapılan Harcamalara Genel Bakış: Tek Merkez Deneyimi(2020) Karahan, İrfan; Özdemir, AdnanAMAÇ: Palyatif bakım, yaşamı tehdit eden hastalıkları olan bireylerde yaşam kalitesini artırmayı hedefleyen yaklaşım olarak özetlenebilir. Ülkemizde palyatif bakım ünitelerinin sayısı son zamanlarda artmış olup, harcamalarıyla ilgili ayrıntılı veri bulunmamaktadır. Bu çalışmada hastanemiz palyatif bakım ünitesindeki harcama gruplarının belirlenmesi amaçlanmıştır. GEREÇ VE YÖNTEM: Kırıkkale Üniversitesi, Tıp Fakültesi, İbn-i Sina Palyatif Bakım Ünitesi’nde Mart 2019-Aralık 2019 arasında yatan 333 hastanın arşiv kaydı hasta harcamaları açısından retrospektif olarak incelendi. Harcamalar; ilaçlar ve medikal tedavi, laboratuvar incelemeleri, radyolojik inceleme ve girişimler, tıbbi malzemeler ve diğer harcamalar olarak gruplandı. BULGULAR: Gruplar arasında en pahalı harcama türü ilaç ve medikal tedaviydi. İlaçların içerisinde de en pahalı grubun antibiyotikler olması dikkati çekti. SONUÇ: Giderlerin belirlenmesi; palyatif bakımın doğru kullanımı ve düzgün planlama için önemli olabilir. İlaç ve özellikle antibiyotik giderlerinin ön planda olması akılcı ilaç kullanımının önemini vurgulayabilir.Öğe Pancreas and kidney changes in type 2 diabetes patients: The role of diffusion-weighteimaging(Turkiye Klinikleri, 2021) Şahan, Mehmet Hamdi; Özdemir, Adnan; Asal, Neşe; Karadeniz Bilgili, Yasemin Mirace; Doğan, Adil; Güngüneş, AşkınBackground/aim: The aim of this study was to compare renal and pancreatic apparent diffusion-coefficient (ADC) values of dipatients and control subjects and to examine their potential association with several diabetes-related clinical parameters. Materials and methods: A total of 80 sex-and age-matched patients were included in the study. Of them, 40 were patients with type 2 diabetes and 40 were nondiabetic participants. Abdominal diffusion-weighted MRIs of both groups were retrospectively reviewed. Diabetes-related clinical parameters were recorded. Results: The difference between the mean ADC values of the patient group and the control group was significant (p = 0.012). It was also found that the mean pancreatic ADC values of diabetic patients and the control group significantly differed (p = 0.02). Besides, there were positive correlations between the mean pancreatic ADC values and age, Hb1Ac level, treatment type, and disease duration (p < 0.05). While eGFR values positively correlated with the mean renal ADC values (p < 0.05), there were negative correlations between such values and age, serum creatinine level, and disease duration (p < 0.05). Conclusion: Renal and pancreatic ADC values of diabetic patients could potentially play a role, as markers of renal and pancreatic functions, in clinical decisions in the follow-up of such patients. © TÜBİTAK.Öğe Radiologic features of symptomatic cholelithiasis: a current perspective(2020) Özdemir, Adnan; Şahan, Mehmet HamdiAim: The aim of this study was to investigate the radiological features of symptomatic cholelithiasis with use radiography, ultrasonography (USG), and computed tomography (CT). Material and Method: From January 2014 and September 2019, 543 patients with cholelithiasis were identified. Of these, 174 who also underwent radiography and CT were included in the study. During the 3-year follow-up of the 174 patients, 80 patients had symptomatic cholelithiasis, identified according to USG and/or CT examinations, as well as clinical findings. Findings suggesting cholecystitis, cholangitis, pancreatitis, and choledocholithiasis were accepted as symptomatic. Radio-opaque stones were identified on radiography and stones were visible on CT. The stones were divided into groups according to their calcification types. The Hounsfield unit (HU) values of the stones were measured and the number and size of the stones were determined by CT and USG. Findings and Results: Symptomatic findings included radio-opaque stones, multiple stones, stones with HU values above 100 HU, and cholelithiasis of the uniform calcification type (p<0.05). However, the relationship between symptomatic cholelithiasis and stone size was not significant (p>0.05). Conclusion: The radiological features of symptomatic cholelithiasis are important in terms of follow-up, treatment plan and prevention of complications.Öğe Relation between optic and carotid canals with sphenoid sinus in patients with communicant hydrocephalus: a computed tomography evaluation study(SAGE PUBLICATIONS LTD, 2020) Sencan, Ziya; Muluk, Nuray Bayar; Yilmazsoy, Yunus; Özdemir, Adnan; Mutlucan, Havva MeltemBackground There are neuro-ophthalmologic findings in patients with communicant hydrocephalus (CH). Purpose To investigate the relationships of the optic canal and carotid canal classifications at sphenoid sinus and anterior clinoid process (ACP) pneumatization in patients with CH. Material and Methods In this multicentric retrospective cross-sectional study, the cranial computed tomography (CT) images of 38 patients with CH (20 men, 18 women) and 40 controls (25 men, 15 women) were included. Optic and carotid canal classification at sphenoid sinus, ACP pneumatization, and sphenoid sinus septation were evaluated. Results In the CH group, type 3 optic canal was detected in 21.1% of the patients and type 4 optic canal was detected in 2.6% of the patients on the left side which was significantly different from the control group (P<0.05). In the CH group, type 3 carotid canal was detected in 21.1% of the patients (left) and 18.4% of the patients (right). ACP pneumatization was present in 13.2% of the patients in the CH group bilaterally. There were positive correlations between optic canal classifications and ACP pneumatization (P<0.05). There were also positive correlations between the right and left carotid canal classifications and ACP pneumatization (P<0.05). Conclusion To avoid complications, CT should be evaluated carefully in patients with CH before surgical interventions in sphenoid sinuses and surgeons should work carefully in the sphenoid sinus or adjacent structures. The protrusion possibility of the optic canal or carotid canal to the sphenoid sinus may be higher in pneumatized ACP patients.Öğe Safenofemoral bileşke düzeyi major süperfisiyal ven varyasyonları; ultrasonografi yöntemi ile değerlendirilmesi(2019) Özdemir, Adnan; Yılmazsoy, Yunus; Arslan, SerdarAmaç: Bu çalışmanın amacı varis tedavisinde oldukça önemli bir bölge olan safenofemoral bileşke düzeyinin yüzeyel venöz vasküler anatomik varyasyonlarının ultrasonografi ile ortaya konulmasıdır.Gereç ve Yöntem: Hastanemiz radyoloji bölümüne Şubat 2017 – Temmuz 2018 tarihleri arasında venöz yetmezlik ön tanısıyla yönlendirilen 79 hasta çalışmaya dâhil edildi ve toplam 158 safenofemoral bölge venöz vasküler anatomisi B-mod ve renkli doppler ultrasonografi ile değerlendirdi. Safenofemoral bölge yüzeyel venöz vasküler anatomisi detaylı olarak incelendi, Glasser ve Daseler anatomik sınıflandırmalarına göre sınıflandırıldı ve varyasyon sıklıkları hesaplandı.Bulgular: Çalışmamızda Glasser sınıflandırmasına göre en sık görülen grup 30 (%19) safenofemoral bölgede izlenen tip 2C olurken, bunu tip 2B ve 2C takip etti. Daseler sınıflandırmasına göre en sık izlenen safenofemoral bölge varyasyonu tip H (VIII) olurken bunu tip F (VI) ve tip E (V) takip etti. Safenofemoral bileşke düzeyinde safena magnaya açılan süperfisiyal venöz dal sayıları değerlendirildiğinde, 1 ile 5 arasında süperfisiyal venöz dalın açıldığı izlendi. Bunlardan en sık 78 (%49) olguda izlenen üç venöz dalın açıldığı tespit edildi. Bunu sırasıyla iki venöz dalın açıldığı 50 (%32) olgu, dört venöz dalın açıldığı 25 (%16) olgu, bir venöz dalın açıldığı 3 (%2) olgu ve beş venöz dalın açıldığı 1 (%1) olgu takip etti.Sonuç: Safenofemoral bileşke düzeyinde major süperfisiyal venöz yapıların ayrıntılı anatomisinin ultrasonografi ile ortaya konulması, variköz venlerin etiyopatogenezinin ayrıntılı bir şekilde ortaya konmasına yardımcı olmasının yanı sıra selektif tedavi planlanmasına ve dolayısıyla tedavi sonuçlarına katkı sağlayacağı kanaatindeyiz.Öğe The Evaluation of CT Images for COVID-19 Prior to Reporting of the First Case(2021) Özdemir, Adnan; Kömürcü, Selmin Perihan; Sarıkaya, Pelin Zeynep Bekin; Karahan, İrfanPurpose: It is possible to evaluate the accuracy of the onset date of the disease with CT images with high diagnostic rates. The aim ofour study is to evaluate the possibility of the presence of the disease in the dates before the diagnosis of COVID-19 in our country withimaging findings.Materials and Methods: The first Covid-19 diagnosis in our country was made on March 11, 2020, and in our city on March 26,2020. A total of patients whose thorax bt was taken in a period of 45 days from 26 March 2020 backwards and in the same period ofthe previous year were included in the study. The images were evaluated by two radiologists according to The Radiological Society ofNorth America consensus statement. In order to evaluate the pre-existing disease with higher accuracy, the images were divided intotwo groups: 1) Typical and indeterminate, 2) Atypical and negative for pneumonia,Results: Before the beginning of pandemic, there were a total of 502 patients who had chest CT scans, including 365 patients from2019 and 137 patients from 2020. There was a statistically significant difference between negative for pneumonia subgroups of 2019and 2020.Conclusion: In our study, the number of patients with typical COVID-19 findings according to CT scans in the pre-pandemic periodwas determined similar to the previous year. This may be an indication that the disease has not started before the specified date in ourcountry.Öğe ULTRASONOGRAFİ REHBERLİĞİNDE PERKÜTAN KESİCİ KARACİĞER BİYOPSİSİ (PARANKİM VE LEZYON): KLİNİK DENEYİMİMİZ(2019) Özdemir, Adnan; Şahan, Mehmet HamdiAmaç: Ultrasonografi rehberliğinde yapılan perkütan kesicikaraciğer parankim/lezyon biyopsilerinin nedenleri, tanı almaoranları, komplikasyonları ve histopatolojik tanılarında kliniktecrübemizin paylaşılması amaçlandı.Gereç ve Yöntemler: 1 Ocak 2017-1 Mart 2019 tarihleriarasında, ultrasonografi rehberliğinde 18 gauge kesici otomatikbiyopsi iğnesi ile girilerek perkütan karaciğer parankim/lezyonbiyopsisi yaptığımız hastalar tespit edildi. Lezyon ve parankimbiyopsisi olarak iki gruba ayrıldı. Her iki grupta; komplikasyon,tanı alma oranı, biyopsi nedenleri ve hepatit varlığıdeğerlendirildi. Lezyon biyopsilerinde; lezyonun sayısı,lokalizasyonu, büyüklüğü, ekojenitesi, kistik-solid komponentvarlığı, histopatoloji sonuçları, parankim biyopsilerinde fibrozisskorları değerlendirildi.Bulgular: Karaciğer biyopsisi yapılan 70 hastanın 47’si erkek(yaş ortalaması 43.1±19.8 /yıl), 23’ü kadın (yaş ortalaması48.3±15.8 /yıl) idi. Hastalardan 21’inde lezyon biyopsisiyapılırken, 49’unda parankim biyopsisi yapıldı.Parankim/lezyon biyopsi yapılan hastalarımızın 66 (%94.3)’sınatanı konuldu. Biyopsi sonrası 66 hastada komplikasyongörülmedi, ancak 3 (%4.3) hastada ağrı ve 1 (%1.4) hastadakanama komplikasyonları gözlendi. Lezyon dışında, biyopsiyapılma nedenleri viral ve viral olmayan karaciğer fonksiyontestleri yüksekliği idi. Parankim biyopsilerimizin %81.6’sındakronik hepatit saptandı. Parankim biyopsisi ile lezyon biyopsisikomplikasyon ve tanı alma oranları karşılaştırıldığındaistatistiksel olarak anlamlı bir farklılık saptanmadı (p > 0.05).Sonuç: Ultrasonografi rehberliğinde yapılan perkütan kesicikaraciğer parankim/lezyon biyopsileri yüksek tanı oranı vedüşük komplikasyon oranları ile güvenilir bir tanı yöntemdir.
