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  • Küçük Resim
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    A Comparison of Diagnostic Accuracy of Superior Semicircular Canal Dehiscence in MDCT and MRI, and Coexistence with Tegmen Tympani Dehiscence
    (Thieme Medical Publ Inc, 2021) İnal, Mikail; Muluk, Nuray Bayar; Şahan, Mehmet H.; Asal, Neşe; Şimşek, Gökçe; Arıkan, Osman K.
    Objective Tegmen tympani dehiscence in temporal multidetector computed tomography (MDCT) and superior semicircular canal dehiscence may be seen together. We investigated superior semicircular canal dehiscence in temporal MDCT and temporal magnetic resonance imaging (MRI). Methods In this retrospective study, 127 temporal MRI and MDCT scans of the same patients were reviewed. In all, 48.8% (n = 62) of cases were male, and 51.2% (n = 65) of cases were female. Superior semicircular canal dehiscence and superior semicircular canal-temporal lobe distance were evaluated by both MDCT and MRI. Tegmen tympani dehiscence was evaluated by MDCT. Results Superior semicircular canal dehiscence was detected in 14 cases (5.5%) by temporal MDCT and 15 cases (5.9%) by temporal MRI. In 13 cases (5.1%), it was detected by both MDCT and MRI. In one case (0.4%), it was detected by only temporal MDCT, and in two cases (0.8%), it was detected by only temporal MRI. Median superior semicircular canal-to-temporal distance was 0.66 mm in both males and females in temporal MDCT and temporal MRI. In both temporal MDCT and temporal MRI, as superior semicircular canal-to-temporal lobe distance increased, the presence of superior semicircular canal dehiscence in temporal MDCT and temporal MRI decreased. Tegmen tympani dehiscence was detected in eight cases (6.3%) on the right side and six cases (4.7%) on the left side. The presence of tegmen tympani dehiscence in temporal MDCT and the presence of superior semicircular dehiscence in MDCT and MRI increased. Conclusion Superior semicircular canal dehiscence was detected by both MDCT and MRI. Due to the accuracy of the MRI method to detect superior semicircular dehiscence, we recommend using MRI instead of MDCT to diagnose superior semicircular canal dehiscence. Moreover, there is no radiation exposure from MRI.
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    Asemptomatik Nörosifiliz ile İlişkili Optik Nörit Olgusu
    (2022) Atalay, Enes; Gökçınar, Nesrin; Yumusak, Erhan; Örnek, Nurgül; Asal, Neşe
    Bu yazıda, optik nörit ile başvuran bir hastada, sifiliz tanı ve tedavi yaklaşımını sunmayı amaçlıyoruz. Kırk dört yaşındaki erkek hasta, sol gözde görme kaybı ile başvurdu. Tek taraflı vitrit, optik disk ödemi ve görme alanı skotomu vardı. Zührevi hastalıkları araştırma laboratuvarı ve floresan treponemal antikor absorbsiyon immünglobulin G sifiliz testleri pozitifti. Sifilizin dermatolojik veya başka bir sistemik bulgusu yoktu. Ancak kraniyal manyetik rezonans görüntülemesinde periventriküler ve subkortikal derin beyaz cevherde multipl plaklar mevcuttu. Hasta, sifilitik optik nörit ve nörosifiliz tanısı aldı. Nörosifiliz bu olguda, göz bulguları dışında asemptomatikti. İntravenöz penisilin G, oral doksisiklin ve oral metilprednizolon tedavisi uygulandı. Sifiliz, büyük taklitçi olarak bilinmektedir. Özellikle net tıbbi öykünün elde edilemediği durumlarda, inflamatuar göz hastalıklarının ayırıcı tanısında düşünülmelidir.
  • Küçük Resim
    Öğe
    Biseps Uzun Başı Tendon Subluksasyonunda Biseps-Glenoid Açısı Ve Subskapularis Tendon Patolojileri Arasındaki İlişkinin Mrg İle Değerlendirilmesi
    (2018) Şahan, Mehmet Hamdi; Asal, Neşe
    Amaç: 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.
  • Küçük Resim
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    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 Kürşat
    Objectives: 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.
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    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, Aşkın
    Background/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.
  • Küçük Resim
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    Peripheric smell regions in patients with semicircular canal dehiscence: An MRI evaluation
    (Elsevier Sci Ltd, 2021) İnal, Mikail; Muluk, Nuray Bayar; Asal, Neşe; Çelik, Enes Nusret
    Objectives: We investigated the peripheric smell regions in patients with semicircular canal dehiscence (SCD) by cranial MRI. Methods: In this retrospective study, cranial MRI images of 186 adult patients were included. Group 1 consisted of 83 adult patients with SCD. The control group (Group 2) consisted of 83 healthy subjects without central vertigo. Olfactory bulb (OB) volume and olfactory sulcus (OS) depth were measured in all groups. Results: In group 1, SCD was detected on the right (33.7%), left (26.5%) sides and bilateral (39.8%). Localization of dehiscence was at superior SC (75.9%), posterior SC (21.7%), lateral SC (1.2%), and posterior + superior SCs (1.2%). OB volumes of the SCD group were significantly lower than the control group bilaterally (p < 0.05). There were no significant differences between OS depths of groups 1 and 2 (p > 0.05). In SCD group, there were positive correlations between OB volumes; OS depths; and OB volumes and OS depths (p < 0.05). In older patients, bilateral OS depth values got lower (p < 0.05). In females, left OB volume values were lower than males (p < 0.05). In right SCD (+) patients, left OS depth values got lower (p < 0.05). Conclusion: We concluded that possible changes in CSF dynamics may cause the development of SCD at thin bone segments; and a decrease in the OB volume. CSF leaks into the perineural sheet of the olfactory bulb (OB) maybe responsible for the decrease in the OB volume. In addition, minor trauma, infection, and inflammation may also be responsible for both coexistences of SCD development and OB volume decrease. (C) 2021 Elsevier Ltd. All rights reserved.
  • Küçük Resim
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    Peripheric smell regions in patients with temporal and frontal lobe epilepsies: An MRI evaluation
    (Elsevier Sci Ltd, 2021) İnal, Mikail; Muluk, Nuray Bayar; Asal, Neşe; Alpua, Murat
    Objectives: We investigated peripheric smell regions of olfactory bulb (OB) volume and olfactory sulcus (OS) depth in temporal and frontal lobe epilepsy patients by cranial magnetic resonance imaging (MRI). Methods: In this retrospective study, cranial MRI images of 150 adult patients were included. Group 1 was consisted of 50 adult patients with temporal lobe epilepsy (TLE). Group 2 was consisted of 50 adult patients with frontal lobe epilepsy (FLE). The control group (Group 3) was consisted of 50 healthy subjects without epilepsy. OB volume and OS depth were measured in all groups. Results: OB volumes of the temporal and frontal epilepsy groups were significantly lower than those of the control group (p(adjusted) < 0.0175). However, OS depths were not different between groups 1-3 (p > 0.05). In the temporal and frontal epilepsy groups, there were positive correlations between OB volumes; OS depths; left OB volume and bilateral OS depths p < 0.05). There were no significant correlations between OB volume and OS depth; and age and gender of the epilepsy group (p > 0.05). Conclusion: We concluded that temporal and frontal epilepsy maybe related to decrease in OB volume and may cause olfactory impairment. Olfactory deficit maybe related to central epileptic focus. Therefore, early diagnosis and appropriate treatment of epilepsy are important to prevent olfactory impairment. (C) 2021 Elsevier Ltd. All rights reserved.
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    ROTATOR MANŞET YIRTIKLARINDA MRG İLE KORAKOİD İNKLİNASYON AÇISI VE KORAKOAKROMİAL ARK AÇISININ DEĞERLENDİRİLMESİ
    (2019) Asal, Neşe
    Amaç: Bu çalışmada, rotator manşet yırtıklarının etyolojisindekorakoid inklinasyon açısı ve korakoakromial ark açısınınrolünün manyetik rezonans görüntüleme ile araştırılmasıamaçlandı.Gereç ve Yöntemler: Çalışmada Ocak 2014-Ocak 2019tarihleri arası kliniğimizde çekilmiş total 102 omuz manyetikrezonans görüntüleme retrospektif olarak değerlendirildi.Supraspinatus tendonu, parsiyel yırtık ve tam kat yırtıkaçısından değerlendirildi. Tüm olgularda korakoid inklinasyonaçısı ve korakoakromial ark açısı ölçümü yapıldı. Gruplararasındaki karşılaştırmalar için independent t testi kullanıldı.Ayrıca korakoid inklinasyon açı ve korakoakromial ark açısıarasında Pearson korelasyon analizi yapıldı.Bulgular: Rotator manşet yırtık olan grupta 29 kadın, 24 erkekolup yaş ortalaması 49.5±11.3 yıl; kontrol grubunda 21 kadın,28 erkek olup yaş ortalaması 45.08±11.7 yıldı. Rotator manşetyırtık olan grupta; korakoid inklinasyon açı ortalaması92.8±8º, korakoakromial ark açı ortalaması 127.4±7.3º idi.Kontrol grubunda; korakoid inklinasyon açı ortalaması106.5±9.5º, korakoakromial ark açı ortalaması 122.4±5º idi.Gruplar arasında her iki açı değeri için istatistiksel anlamlıfarklılık tespit edildi (p <0.05).Sonuç: Rotator manşet yırtık olgularında, korakoidinklinasyon açısı daha dar ve korako-akromial ark açısı dahagenişti. Korakoid proçes morfolojisi ve buna bağlı değişkenkorakoid inklinasyon açısı, korakoakromial ark açısı rotatormanşet yırtıkları için predispozan faktörler olabilir, rotatormanşet patolojilerinin etyolojisini belirlemede yardımcı olarakkullanılabilir.
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    Sigmoid Colon Perforation Mimics a Tuboovarian Absces
    (2018) Sayan, Cemile Dayangan; Yeral, Mahmut İlkin; Özkan, Zehra Sema; Karaca, Gökhan; Asal, Neşe; Aydın, Oktay; Sagsöz, Nevin
    Introduction: An adnexal mass may be diagnosed after a routine pelvic ultrasonographic examination or an emergent hospital admission due to rupture of ectopic pregnancy, adnexal torsion or rupture of tuboovarian abscess. It is necessary to evaluate the origin of the mass initially and to classify patients who need further evaluation and treatment for an urgent condition.Case presentation: We report a case of sigmoid colon rupture due to sigmoid colon adenocarcinoma presenting as acute abdomen with left adnexal mass in a 28 years old woman. Abdominopelvic computed tomography revealed a left adnexal mass with suspicion of tuboovarian abscess. In laparatomy, rupture of sigmoid colon was observed and resection of sigmoid colon was performed. Histological examination of resection part revealed diagnosis of sigmoid colon adenocarcinoma due to familial adenomatous polyposis.Conclusion: This case may be interesting for clinicians because pelvic pain, fever, increased infection markers in the laboratory and mass at ultrasonography or other screening methods could cause a misdiagnosis of tubaovarian abscess especially in reproductive age women. Before the operation of the pelvic mass of all age women with the diagnosis of tuboovarian abscess other causes of the pelvic abscess should come into mine and necessary preparation for operation must be done.