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Öğe Diyabetik retinopatisi olan hastalarda oküler yapıların ultrason elastografi ile değerlendirilmesi(Kırıkkale Üniversitesi, 2018) Kaya, Ahmet; Yılmaz, SevdaAMAÇ: Diyabetik retinopati(DR) tanısı olan hastalarda oküler yapıların strain elastografi (SE) ve shear wave elastografi (SWE) ile değerlendirilerek oküler yapılarda meydana gelen elastikiyet değişikliklerini araştırmak. GEREÇ VE YÖNTEM: Kırıkkale Üniversitesi Tıp Fakültesi Radyoloji Anabilim Dalı'nda yapılan çalışmaya, Kırıkkale Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalı tarafından yönlendirilen nonproliferatif DR(NPDR), proliferatif DR(PDR) tanısı olan ve DR'si olmayan tip 2 diyabetes mellitus(DM) hastaları olacak şekilde 3 hasta grubu çalışmaya dahil edildi. Tip 2 DM hastalığı olmayan sağlıklı gönüllüler kontrol grubu olarak çalışmaya dahil edildi. Her 4 grupta 30 gönüllü olmak üzere, toplam 120 gönüllünün 240 gözü incelendi. Tüm gönüllülerin optik siniri(OS), retina-koroid-skleral kompleksi(RKSK) ve vitröz cismi(VC) SE ve SWE ile değerlendirildi. BULGULAR: Her grupta kadın ve erkek gönüllü sayısı 15'er olup tüm gönüllülerin ortalama yaşı 58,09±6,28'dir. Çalışmaya dahil edilen tip 2 DM hastalarının OS çapı karşılaştırıldığında anlamlı fark bulunmadı. OS'nin SE incelemesinde, DR'si (NPDR ve PDR) olan hastalarda OS'nin sertliğinin kontrol grubuna ve diyabetik olup DR'si olmayan hasta grubuna göre anlamlı daha sert olduğu görüldü. RKSK'nın SE incelemesinde, RKSK/retrobulber yağ dokusu(RYD) strain değerleri oranının, DR hastaları ile diyabetik olup DR'si olmayan hastaların ve kontrol grubunun ayrımında tanısal olduğunu bulduk. OS'nin, RKSK'nın, anterior VC'nin, posterior VC'nin ve global VC'nin SWE ölçümlerinin, DR hastaları ile diyabetik olup DR'si olmayan hastaların ve kontrol grubunun ayrımında tanısal olduğunu bulduk. Benzer şekilde oküler yapıların SWE ölçümlerinin, NPDR hastaları ile PDR hastalarının ayrımında tanısal olduğunu bulduk. Diyabetik olup DR'si olmayan hastalar ile kontrol grubunun oküler yapılarının elastikiyet özelliklerini genel olarak benzer bulduk. SONUÇ: İyonizan radyasyon içermeyen, düşük maliyetli ve noninvazivbir görüntüleme yöntemi olan ultrasonelastografinin(USE), tip 2 DM hastalarında DR tanısında faydalı olabileceğini düşünmekteyiz. ANAHTAR KELİMELER: Diyabetik Retinopati, Oküler Yapılar, Ultrason Elastografi, Strain Elastografi, Shear Wave Elastografi.Öğe Evaluation of posterior clinoid process pneumatization by multidetector computed tomography(Springer, 2017) Burulday, Veysel; Akgul, Mehmet Huseyin; Muluk, Nuray Bayar; Ozveren, Mehmet Faik; Kaya, AhmetIn the present study, we investigated the types and ratio of posterior clinoid process (PCP) pneumatization in paranasal sinus multidetector computed tomography (MDCT). Paranasal MDCT images of 541 subjects (227 males, 314 females), between 15 and 65 years old, were included into the study. Pneumatization of anterior clinoid process and pneumatization types (I, II, or III) were evaluated in the males and females. PCP pneumatization was detected in 20.7 % of the males and 11.5 % of the females. Right, left, and bilateral PCP pneumatizations were detected in 7.9, 5.7, and 7.0 % of the males and 2.9, 3.2, and 4.5 % of the females, respectively. PCP pneumatization of the males is significantly higher than the females. The most detected type of pneumatization was type I (61.2 %) for all groups. In right, left, and bilateral pneumatizations separately, type I pneumatization was the most detected pneumatization type with the ratio of the 70.4, 65.2, and 50.0 %, respectively. In males, type I (61.7 %), and similarly in females, type I (60.6 %) pneumatization were detected more. Type II and type III pneumatizations were detected in decreasing order in both groups. In younger subjects, pneumatization of posterior clinoid process was found as higher, and in older subjects, PCP pneumatization was found as lower. Sclerosis process related to the aging may be responsible for the lower pneumatization ratios in older subjects. Structure of the surrounding regions of PCP is important for surgical procedures related to cavernous sinus, basilar apex aneurysms, and mass lesions. Preoperative radiological examinations are useful for operative planning. Any anomalies to PCP can cause unnecessary injury to the neurovascular complex structure around the cavernous sinus or postclinoidectomy CSF fistulas. Posterior clinoidectomies should be avoided in patients with type III PCP pneumatization to prevent CSF fistulas.Öğe Is there a relationship between sphenoid sinus types, septation and symmetry; and septal deviation?(Springer, 2016) Akgul, Mehmet Huseyin; Muluk, Nuray Bayar; Burulday, Veysel; Kaya, AhmetIn the present study, we investigated whether there is a relationship between sphenoid sinus (SS) types, septation (lobulation) and symmetry; and septal deviation (SD) by multidetector computed tomography (MDCT). Paranasal MDCT images of 202 subjects (131 males, 71 females), between 10- and 88-year-old, were included into the study. SS type (conchal, presellar or sellar), SS symmetry, SS septation (lobulation) and SD were evaluated by MDCT images. In the present study, in both males (83.2 %) and females (85.9 %); and in all age groups (80.4-85.7 %), sellar type sphenoid sinus were more detected. Conchal type was detected in two cases of the males (1.5 %) and none of the females. SS was detected mainly as multi-septated (multi-lobulated) (51.9 % in males and 56.3 % in females; in all age groups as 51.0-56.8 %; and both SD (+) and SD (-) groups as 51.2-56.8 %). In subjects with SD, asymmetric SS was detected in 80.2 %. Whereas in SD (-) subjects, asymmetric SS was detected in 50.6 %. Sellar type SS pneumatization is the most detected type in our cases. Presence of SD was related to the higher SS asymmetry values. In SD (-) subjects, SS was detected as symmetric. Nasal septal deformities such as SD may influence the development of the SS pneumatization and asymmetric septation. For well anatomic orientation of the surgeons, good anatomy knowledge and preoperative detailed examination of the CT scans are very important.Öğe Magnetic resonance imaging and computed tomography for diagnosing semicircular canal dehiscence(Churchill Livingstone, 2016) Inal, Mikail; Burulday, Veysel; Muluk, Nuray Bayar; Kaya, Ahmet; Simsek, Gokce; Daphan, Birsen UnalObjectives: We investigated the semicircular canal (SC) dehiscence using temporal computed tomography (CT) and magnetic resonance (MR) imaging. Methods: We retrospectively reviewed 114 (228 ears) consecutive MR images and CT scans of the temporal bones for dehiscence of the SCs. In the 1.5 Tesla (T) MR imaging, T1 and T2-weighted images were obtained. Dehiscence of the SCs was defined by absence of high attenuation bone coverage on the CT scans, and absence of low-signal bone margins on the MR images. Results: Superior SC dehiscence was detected in 4 (1.8%) ears using CT scans and 5 (2.2%) ears using MR imaging. Posterior SC dehiscence was detected in 4 (1.8%) ears using CT scans and 4 (1.8%) ears using MR imaging. In the non-dehiscent cases, there was hypointense bone coverage between the canal and the cerebrospinal fluid (CSF). However, in the cases of semicircular canal dehiscence, hypointense bone tissue did not appear between the canal and the CSF in the MR imaging. Conclusion: If there is clinical doubt about the presence of SC dehiscence, we recommend that MR imaging be conducted first. When dehiscence is not seen in the MR, a CT examination should be performed. MR imaging is preferred primarily, because it does not contain ionizing radiation. (C) 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.Öğe Morphometric Analysis of the Fronto-maxillary Sinuses in Adult Patients with Traumatic Septal Deviations(Bentham Science Publ Ltd, 2019) Inal, Mikail; Simsek, Gokce; Kaya, Ahmet; Kilic, RahmiObjective: The aim of the current study was to investigate a change in the volume of the frontal and maxillary sinuses in patients with nasal septum deviations due to physical trauma. Materials and Methods: Paranasal sinus computed tomography data of 100 patients admitted to Kirikkale University medical faculty hospital between November 2013 and June 2014 were retrospectively analyzed. The side of the nasal septal deviation, the deviation angle, the severity of the deviation, and bilateral frontal and maxillary sinus volumes were calculated using a computer program. The relationship between sinus volumes and deviated septum characteristics was investigated. Results: The maxillary sinus volumes did not differ between the two genders. However, the female patients had significantly decreased frontal sinus volumes when compared with the male patients (p < 0.05). A right-sided septal deviation was found to be associated with a significantly decreased maxillary sinus volume (p < 0.001), and the severity of the deviation was a significant determinant of the maxillary sinus volume (p < 0.001). The age of the patient at the time of the septal trauma was significantly associated with their maxillary sinus volumes. Patients who had experienced this trauma after 12 years of age had significantly increased maxillary sinus volumes when compared with those who experienced the trauma before the age of 12. Conclusion: A distorted septal anatomy was found to be a significant parameter for developing paranasal sinuses. Right-sided and severe traumatic deviations with an onset before the age of 12 were significantly associated with a decreased maxillary sinus volume.Öğe A morphometric evaluation of the humeral component in shoulder arthroplasty(Scientific Publishers India, 2017) Iyem, Cihan; Serbest, Sancar; Inal, Mikail; Burulday, Veysel; Kaya, Ahmet; Kultur, Turgut; Tiftikci, UgurPurpose: Aim of the study is to make a clinical evaluation of parameters used in prosthesis design for the humeral component applied in arthroplasty of the proximal upper extremity. Methods: In our study the plain shoulder radiographs were used of 195 (101 male, 94 female) patients aged 18-65 years (mean age, 38.8 +/- 11.5 years; males 35.4 +/- 11.6 years, females 42.5 +/- 10.2) with soft tissue trauma, but no degenerative or structural disorder in the shoulder joint (fracture, tumour, osteoarthritis etc.). Measurements were made on the radiograph of Head Height (HH), Frontal Base Diameter of the Head (FBD), 3 points at 3 cm intervals from proximal to distal of the medullar canal at surgical neck Endosteal Diameter (ED1, ED2 and ED3 respectively), Neck-Shaft Angle (NSA) and Head-Neck Angle (HNA). Results: According to the results, in the comparison of Groups I and III except the mean values of HH and ED1 in other parameters, no statistically significant difference was determined. In the comparison of Groups II and IV except the mean values of FBD and ED1 in other parameters no statistically significant difference was determined. Conclusions: In conclusion, the success of shoulder arthroplasty is explained well by the anatomic structure and proximal humerus morphometric parameters examined in this study. In prosthesis design, the differences in age and populations should be taken.Öğe Presence and types of anterior clinoid process pneumatization, evaluated by Multidetector Computerized Tomography(Canadian Soc Clinical Investigation, 2016) Burulday, Veysel; Muluk, Nuray Bayar; Akgul, Mehmet H.; Kaya, Ahmet; Ogden, MustafaPurpose: The types and ratio of anterior clinoid process (ACP) pneumatization in paranasal sinus Multidetector Computerized Tomography (MDCT) were investigated the importance of ACP in neurosurgical approaches discussed. Methods: Paranasal MDCT images of 499 subjects (259 male, 240 female), between 17 and 65 years of age, were included in the study. Presence and types of pneumatization of the ACP and pneumatization types (I, II or III) were evaluated. Results: ACP pneumatization was detected in 37.5% of the males and 33.3% of the females. Right, left and bilateral ACP pneumatizations were detected in 12.7%, 9.3% and 15.4% of males and 9.2%, 8.3% and 15.8% of the females, respectively. The most commonly detected types of pneumatization were Type I (49.1%) for right pneumatizations and Type II pneumatization for left (40.9%) and bilateral (37.2%) pneumatizations. In males, Type I (37.1%) and in females, Type II (40.0%) pneumatizations were detected more frequently. Type III pneumatization was detected in 29.9% of the males and 22.5% of the females. ACP pneumatization ratios were higher in younger subjects and lower in older subjects. Conclusion: Sclerosis process related to aging may be responsible for the lower pneumatization ratios in older subjects. When Type III ACP pneumatization is present, clinoidectomy should not be performed: in this type of ACP pneumatization, cerebrospinal fluid fistula develops in all cases.
