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    A Practical MRI Technique for Detecting Abdominal Aorta Aneurysm and Peripheral Arterial Disease
    (Derman Medical Publ, 2016) Aktas, Aykut Recep; Unal, Birsen; Kara, Simay; Kemal, Gokhan; Yilmaz, Omer; Kayan, Mustafa; Cetin, Meltem
    Aim: Peripheral Arterial Disease(PAD) and abdominal aorta aneurysm(AAA) are frequent problems in geriatric population. In DSA, CTA or MRA techniques contrast agents has to be used for diagnosis that can be nephrotoxic for elderly patients. Magnetic resonans imaging (MRI) is the most powerful, non-ionising radiological diagnostic tool that has the highest soft tissue contrast resolution. The aim of our study was to investigate the effectivity of MRI by the means of detecting the AAA and PAD in comparison with DSA. Material and Method: After getting ethical commitee approvel and informed consent, we have performed Balanced turbo field echo(B-TFE) MRI technique without contrast agent in 1.5 Tesla MRI device before DSA examination. The luminal diameters of renal arteries, infrarenal abdominal aorta, iliac and femoral arteries was measured by using Philips DICOM Viewer R2.2 application. The intraclass corelation coefficient and reliability used to check if the techniques could be used for each other and the t-test was used to measure the differences between them. Results: There has been a high relationship between B-TFE and DSA in detecting the pathologies of larger arteries like aorta. In the case of small arterial pathologies, there is relatively lower relationship between BTFE and DSA. Discussion: For the diagnosis of AAA and PAD, DSA is the gold standart technique but it is invasive and patients have radiation exposure. In the follow up of geriatric patients with larger arterial pathologies B-TFE can be used instead of contrast enhanced MRA and invasive DSA.
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    Pulmonary Embolism: Cardiovascular And Parenchymal Changes
    (Derman Medical Publ, 2017) Aktas, Aykut Recep; Senocak, Eda; Cetin, Meltem; Yilmaz, Sevda; Celik, Ahmet Orhan; Demirtas, Hakan; Callioglu, Mehmet
    Aim: To investigate the effects and the severity of pulmonary embolism on the cardiovascular system and lung parenchyma. Material and Method: Pulmonary artery (PA) obstruction index ratios were calculated, and cardiovascular and pleuroparenchymal changes were retrospectively assessed in 180 patients with a prediagnosis of PE using computerized tomography pulmonary angiography (CTPA). Results: Main PA, right PA, and mean superior vena cava (VCS) diameters, right (RV) and left ventricle (LV) short diameters, and RV/LV ratios in patients with PE were increased (p<0.001, p=0.004, p=0.007, p=0.01, p=0.001, respectively) and correlated with the obstruction index ratio (OIR). Also, the convexity of the interventricular septum, VCI, and vena azygos reflux frequency were increased with PE (p<0.001, p=0.001, p=0.001) and with massive PE (p<0.001, p=0.003, p<0.001). It was determined that the frequency of the presence of wedge-shaped opacities and vein mark findings was increased in patients with PE (p<0.001, p<0.001); however, it was found less frequently in patients with massive PE when compared to the submassive patients (p=0.002, p=0.014). The presence of atelectasis was not different between patients with and without PE; consolidation, ground glass appearance, oligemia frequency, and the average scores were increased in the patients with PE (p=0.02, p<0.001, p=0.001), and there was a positive correlation between the oligemia score and OIR (r=0.202, p=0.027). Pleural effusion was infrequent with PE. Discussion: CTPA is a rapid and reliable method for the determination of the severity of PE, affected vascular structures and lung regions, and for the assessment of right heart function.