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Öğe Biseps Uzun Başı Tendon Subluksasyonunda Biseps-Glenoid Açısı Ve Subskapularis Tendon Patolojileri Arasındaki İlişkinin Mrg İle Değerlendirilmesi(2018) Şahan, Mehmet Hamdi; Asal, NeşeAmaç: Manyetik rezonans görüntülemede (MRG) biseps uzun başı tendonunda (BUBT) subluksasyon tespit edilen olgularda biseps-glenoid açısındaki değişkenliklerin tespiti ve subskapularis tendon patolojileri ile ilişkisinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Ocak 2014-Mart 2018 tarihleri arasında Kırıkkale Üniversitesi Tıp Fakültesi Radyoloji Anabilim Dalı’nda çekilen omuz manyetik rezonans görüntüleri incelendi. BUBT’da subluksasyon olan 30 hasta ve subluksasyon olmayan 32 kontrol hastası karşılaştırıldı. T2 ağırlıklı oblik-koronal MRG görüntülerde, BUBT’un supraglenoid tuberküle yapışma düzeyinden geçen kesitte, biseps tendonuna çizilen paralel çizgi ile glenoid kemik çatıya çizilen teğet çizgi arasındaki biseps glenoid açısı ölçüldü. Ayrıca subskapularis tendon patolojileri normal, parsiyel ve tam kat yırtık açısından analiz edildi. Bulgular: BUBT’da subluksasyon olan grupta 12 erkek, 18 kadın olup yaş ortalaması 61.0±13.6 yıl idi. BUBT’da subluksasyon olmayan grupta 14 erkek, 18 kadın olup yaş ortalaması 55.9±14.0 yıl idi. Subluksasyon olan grupta bisepsglenoid açı ortalaması 84.1º±4.9º ve subluksasyon olmayan grupta 92.8º±4.7º idi (p<0.05). BUBT’da subluksasyon olan olguların da %80’inde subskapularis tendon patolojisi mevcuttu. Sonuç: BUBT’da subluksasyon olan hastalarda, bisepsglenoid açı değerleri, subluksasyon olmayanlara göre düşüktür. BUBT subluksasyonu tanısında arada kalınan olgularda biseps-glenoid açı ölçümü yardımcı olabilir. Ayrıca BUBT subluksasyonuna, subskapularis tendon patolojileri sıklıkla eşlik etmektedir.Öğe Changes of the Buccal Fat Pad Volume According to the Different Age Groups, Gender, and Body Mass Index: An Evaluation with Computed Tomography(Lippincott Williams and Wilkins, 2024) Akşamo?lu, Melih; Bayar Muluk, Nuray; Şahan, Mehmet HamdiObjectives We investigated volumetric changes in buccal fat pad (BFP) in age groups and sexes by cranial or neck computed tomography (CT) or cranial CT angiography. Methods One hundred twenty patients underwent cranial or neck CT examinations or cranial CT angiography were retrospectively screened: 18-29 years old (group 1), 30-49 years old (group 2), and 50 years and older (group 3). Left buccal fat tissue measurements were performed in age groups, sexes, and body mass index (BMI) groups. Results Left buccal fat volume in the 30-49 age group and the ?50 age group was significantly higher than that in the 18-29 age group (P < 0.05). Across all groups and specifically within the 18-29 age group, females exhibited significantly lower buccal fat volume than males (P < 0.05). The left buccal fat volume of individuals classified as overweight and obese was significantly higher than that of the underweight and normal weight groups. There was a negative relationship between buccal fat volume and fat density. Moreover, as age increased, within age groups 1 to 3, there was a notable increase in body weight, body length, BMI, and BMI groups (underweight and normal weight to obesity), accompanied by a significant rise in buccal fat volume. Conversely, fat density exhibited a significant decrease with advancing age. Conclusions Buccal fat volume, localized in the middle third of the face, increased with aging and increasing BMI values. Young females had lower buccal fat volume. Buccal fat tissue volume is important in facial rejuvenation procedures such as facial filler applications. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.Öğe Comparison of diffusion-weighed MRI findings of the testis in patients with the advanced stage unilateral testicular varicocele(2017) Burulday, Veysel; Şahan, Mehmet Hamdi; Erdem, Gülnur; Yuvanç, ErcanThe aim of this study was to compare the testicular apparent diffusion coefficient (ADC) values of the patients with unilateral advanced stage varicocele and healthy volunteers. Twenty-seven patients with unilateral advanced stage varicocele and twenty-seven healthy volunteers were included in the study. Those with a diagnosis of clinical varicocele and the healthy volunteers were examined clinical and color Doppler ultrasonography. Patients with a unilateral (left) varicocele clinically grade III, color Doppler ultrasound grade IV-V were included in the study. All the patients and healthy volunteers were obtained ADC values. Mean values were calculated and statistical comparison was performed. ADC values were analysed by using an independent t test for each participant. Pearson's correlation test was used for the comparison of left pampiniform venous diameter and both testicular parenchymal ADC values. Left testicular ADC values were observed to be significantly lower when a comparison of the testicular parenchymal with left advanced stage varicocele and healthy volunteers revealed significantly low left testicular ADC values in patients (p0.05) Furthermore, a negative correlation was detected between the increase in the left testicular venous diameter and parenchymal ADC values of the bilateral testis in patients with left advanced stage varicocele (left p -624, right p -0.382). Diffusion weighted magnetic resonance imaging may be beneficial in defining the testicular damage in patients with varicoceleÖğe COMPARISON OF ULTRASONOGRAPHY AND MAGNETIC RESONANCE IMAGING IN EVALUATING ROTATOR CUFF PATHOLOGIES(2018) Şahan, Mehmet Hamdi; Babuna, ÇiçekObjective: This study was conducted to determine the effectiveness of magnetic resonance imaging in comparison to ultrasonography in the diagnosis of rotator cuff tears. Material and Methods: Magnetic resonance imaging and ultrasonographic findings of 28 cases who admitted to our clinic with shoulder pain and dysfunction were analyzed retrospectively. Magnetic resonance imaging findings were accepted as gold standard. Results: From among 15 cases where complete tear was determined by magnetic resonance imaging, 11 cases were confirmed by ultrasonography and in the remaining 4 of them, thinning in the tendons which is a non-specific finding was seen. In 9 cases where there was thinning in the tendons, the classifications in magnetic resonance imaging was made as follows: 5 of them were classified as stage 2 (partial tear) and 4 of them were classified as stage 3 (complete tear). In 4 cases, tear and retraction were determined in supraspinatus tendon in magnetic resonance imaging; however, supraspinatus tendon could not be visualized by ultrasonography. In our study, in rotator cuff tears, the sensitivity and specificity of the shoulder ultrasonography were found as 73% and 93%, respectively. Conclusion: In the evaluation of rotator cuff, it was found that ultrasonography should be the first imaging method considering its low cost and easy accessiblity. Moreover ultrasonography could display a similar performance with magnetic resonance imaging if it is performed by experienced radiologist.Öğe Humerus başındaki kistler ile rotator manşet ve biseps uzun başı tendonu patolojileri arasında bir ilişki var mı?(2019) Şahan, Mehmet HamdiAmaç: Humerus başı tüberkül kistlerin lokalizasyonu ile rotator manşet ve biseps uzun başı tendonu patolojileri arasındaki ilişkinin araştırılması amaçlandı.Gereç ve Yöntemler: Şubat 2014-Mart 2018 tarihleri arasında kliniğimizde çekilen omuz manyetik rezonans görüntüleri retrospektif olarak incelendi. Humerus başı tuberkül kisti olan 123 hasta çalışmaya dahil edildi. Büyük tüberkül, sagital görüntülerde humerus şaftına çizilen paralel çizgi ile ön ve arka olarak ayrıldı. Ön büyük tüberkül, arka büyük tüberkül ve küçük tüberkül olarak kistler üç gruba ayrıldı. Ayrıca kist boyutlarına göre 5 mm küçük ve 5 mm büyük olmak üzere ayrıldı. Rotator manşet tendonlarındaki patolojiler tam kat ve parsiyel yırtık olarak incelendi. Biseps uzun başı tendonundaki patolojiler tam kat/parsiyel yırtık ve tendinit-tendinozis olarak incelendi.Bulgular: Toplam 123 hastanın 57’si erkek (yaş ortalaması 50,49±11,8), 66’sı kadındı (yaş ortalaması 56,2±11,9). Ön büyük tüberkülde 50 (%40) hastada kist tespit edildi ve bu hastaların 41 (%82)’inde supraspinatus tendonunda yırtık mevcuttu. Ön büyük tüberküldeki kist boyutu 5 mm’den büyük olanların hepsinde supraspinatus tendonunda yırtık izlendi. Arka büyük tüberkülde 64 (%52) hastada kist mevcut olup infraspinatus tendonu ile anlamlı bir birliktelik saptanmadı. Küçük tüberkülde 22 (%18) hastada kist mevcuttu, bunlardan 10 (%45) hastada subskapularis tendonunda yırtık, 19 (%86) hastada biseps uzun başı tendonu patolojisi izlendi. 13 (%10,5) hastada farklı tuberküllerde kistler mevcuttu.Sonuç: Çalışmamızda, arka büyük tüberkül kistleri en sık görülen kistler olup yaş ve tendon patolojisi ile anlamlı bir ilişki bulunmadı. Ön büyük tüberkül kistleri olanlarda supraspinatus tendonunda yaygın olarak yırtık izlendi. Küçük tüberkül kistleri daha az sıklıkta görülmekte olup subskapularis tendon ve biseps uzun başı tendonu patolojileri ile birliktelik göstermektedir.Öğe Olfactory Fossa and New Angle Measurements: Lateral Lamella-Cribriform Plate Angle(Lippincott Williams & Wilkins, 2019) Asal, Neşe; Muluk, Nuray Bayar; İnal, Mikail; Şahan, Mehmet Hamdi; Doğan, Adil; Arıkan, Osman KürşatObjectives: The authors investigated the olfactory fossa (OF) in patients with unilateral nasal septal deviation (NSD) and presented the lateral lamella-cribriform plate angle (LLCPA). Methods: Paranasal sinus computed tomography images of 300 adult subjects with unilateral NSD (111 males, 189 females) were evaluated retrospectively. Septal deviation angle (SDA), Keros Classification, OF depth and width, LLCPA; and orbital plate and cribriform plate (OPCP) distance were measured. Results: The OF depth values (ipsilateral, contralateral) were found as Keros III >Keros II >Keros I (P-adjusted<0.0175). The OF width values (ipsilateral) were detected as Keros I >Keros II and Keros I >Keros III (P-adjusted<0.0175). In patients with higher SDA values, ipsilateral OF depth values decreased (P<0.05). The LLCPA and OPCP values were higher in Keros I and lower in Keros III (P<0.05). Conclusion: In patients with lower LLCPA and OPCP, endoscopic sinus surgery will be more dangerous for trauma to lateral lamella and intracranial penetration.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 Reliability of magnetic resonance imaging in rotator cuff and biceps tendon pathologies(Derman Medical Publ, 2017) Şahan, Mehmet Hamdi; Serbest, Sancar; Tiftikci, Uğur; İnal, Mikalil; Burulday, VeyselAim: In the study, we aimed to evaluate the diagnostic performance of magnetic resonance imaging in comparison with arthroscopy in rotator cuff lesions and pathologies of the long head of the biceps tendon, which are one of the most important causes of shoulder pain and dysfunction. Material and Method: 180 patients treated with arthroscopic surgery were identified. Sixty-four patients (17 males, 47 females) who had undergone diagnostic magnetic resonance imaging and met the study criteria were enrolled in the study. The magnetic resonance imaging within the last 6 weeks preoperatively and arthroscopic shoulder joint examination findings during the operation were reviewed retrospectively. Results: Sensitivity was found to be 89.1% and specificity was found to be 94.4% in the full thickness tears, and sensitivity was found to be 93.8% and specificity was found to be 87.5% in the partial tears of the supraspinatus tendon; sensitivity was found to be 33.3% and specificity was found to be 98.4% in the full-thickness tears, and sensitivity was found to be 58.3% and specificity was found to be 80.8% in We partial tears of the long head of the biceps tendon. 24 (37.5%) patients in arthroscopy and 32 (50%) patients in magnetic resonance imaging had more than one tear in the tendon. Furthermore, the combination of the tears of the long head of the biceps tendon was found in the rotator cuff tears' arthroscopy of 15 patients (23.4%) and magnetic resonance imaging of 19 (29.6%) patients. Discussion: In comparison with arthroscopy, magnetic resonance imaging in rotator cuff tendon pathologies, especially in the supraspinatus tendon tears, demonstrated high accuracy, the kappa value (kappa value: 0.78), high sensitivity and specificity in the strong consistency range. However, sensitivity was low in pathologies of the long head of the biceps tendon. Magnetic resonance imaging remains to be a reliable diagnostic method in shoulder tendon pathologies, especially in rotator cuff tendon pathologies.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.
