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    Assessment of the optic nerve using strain and shear-wave elastography in patients with pseudotumour cerebri
    (W B SAUNDERS CO LTD, 2020) Asal, N.; Inal, M.; Sahan, M. H.; Say, B.
    AIM: To evaluate the optic nerve using strain elastography (SE) and shear-wave elastography (SWE) in idiopathic intracranial hypertension (IIH) patients in comparison to participants in the control group. MATERIALS AND METHODS: Eighty eyes were evaluated in 40 cases consisting of 20 IIH patients and 20 participants in the control group. This study was conducted using SE and SWE in addition optic nerve sonography measurements of participants in the IIH patient group and the control group. SE patterns were categorised using three main types and two subtypes. Quantitative measurements of optic nerve stiffness with SWE were expressed in kilopascals. RESULTS: In the IIH patient group, type 2 and type 1 elasticity patterns were primarily observed, followed by type 3 patterns. In the control group, type 3 elasticity patterns were most often observed, while type 2 elasticity patterns were seen less frequently. Statistically significance differences in the types of elasticity strain patterns were observed between the groups (p<0.01). Quantitative analysis was also performed, and the SWE moduli were obtained for the control group (10.1 +/- 0.28 kPa) and the IIH patient group (26.97 +/- 1 kPa). A statistically significant difference in the SWE modulus was found between the groups (p<0.01). CONCLUSION: Biomechanical changes may have occurred in the optic nerve secondary to increased intracranial pressure in IIH patients. Strain and shear elastography may have potential as assistive diagnostic techniques for the detection and follow-up of these changes. (C) 2020 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
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    Does ligation of internal iliac artery for postpartum hemorrhage affect clitoral artery blood flow and postpartum sexual functions?
    (Elsevier Science Bv, 2017) Kaya, B.; Usluogullari, B.; Yurttutan, N.; Sahan, M. H.; Gueralp, O.; Malik, E.
    Objective: To investigate whether internal iliac artery ligation (IIAL) for postpartum hemorrhage (PPH) affects the sexual life in the postpartum period or significantly reduces the clitoral artery blood flow. Study design: The women who underwent IIAL due to PPH during cesarean section (CS) were compared with healthy postpartum women delivered by CS between October 2014 and February 2016 in the Gaziantep Women's Health and Maternity Hospital, Gaziantep, Turkey. Clitoral Doppler flow measurements and the Female Sexual Function Index questionnaire (FSFIQ) were performed in all women in the 3rd and 6th postpartum months. This study was registered at ClinicalTrials.gov with the identification number NCT02409602. Results: Mean age, gravidity and parity, body mass index (BMI), first sexual intercourse after childbirth, and education years were similar in both groups. There was no statistically significant difference in the measurements of RI, PI, PSV, EDV, and S/D between the study and control groups in the 3rd month. Lack of statistical significance was also noted between the study and control groups values in the 6th month, as well as between the 3rd and 6th month's values within both the study group and the control group. Additionally, there were no statistically significant differences in the total FSFI scores including sexual desire, sexual arousal, lubrication, orgasm, sexual satisfaction, and pain domain scores between the study and control groups in the 3rd month; between the study and control groups 6th months; whereas all scores were higher in the 6th month compared to the 3rd month within each group. Conclusion: IIAL does not affect the blood flow of the dorsal clitoral artery between the 3rd and 6th months postpartum and between the women who underwent IIAL due to PPH and healthy postpartum women. The sexual function scores were significantly higher in the 6th month compared to the 3rd month in both groups. (C) 2017 Elsevier B.V. All rights reserved.
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    Evaluation of peripheral and central olfactory pathways in HIV-infected patients by MRI
    (W B Saunders Co Ltd, 2024) Mete, A. Ouro.; Muluk, N. Bayar; Sahan, M. H.; Karaoglan, I.
    AIM: To investigate peripheral and central olfactory pathways using cranial magnetic resonance imaging (MRI) in human immunodeficiency virus (HIV)-infected patients. MATERIALS AND METHODS: The cranial MRI images of 37 HIV-infected adult patients and 37 adults without HIV infection having normal cranial MRI results were included in the study. In both groups, olfactory bulb (OB) volume and olfactory sulcus (OS) depth; and insular gyrus and corpus amygdala areas were measured using cranial MRI. In the HIV group, disease duration, HIV RNA, and CD4 lymphocyte count and levels as a percentage were also recorded. RESULTS: The HIV group had significantly lower bilateral OB volumes, insular gyrus and corpus amygdala areas compared to the control group. The HIV group showed positive correlations between OB volumes, OS depths, insular gyrus, and corpus amygdala areas bilaterally. Increases in OB volumes and OS depths were associated with an increase in the insular gyrus area. The corpus amygdala and insular gyrus areas increased similarly. There was no significant correlation between age, gender, disease duration, CD4 lymphocyte count and per cent, HIV RNA values, and the measurement values of the central and peripheral olfactory regions. CONCLUSION: A decrease in olfactory regions of OB, insular gyrus, and corpus amygdala in HIV-infected patients shows that HIV infection may cause olfactory impairment. There is no correlation between disease duration and olfactory impairment. It may be related to neuroinflammation, HIV-related brain atrophy, acquired immunodeficiency syndrome (AIDS) dementia complex, or neurocognitive impairment, which are the other explanations for the olfactory impairment in HIV. The possible toxicity from antiretroviral therapy (ART) may be another cause that should be investigated further. (c) 2023 Published by Elsevier Ltd on behalf of The Royal College of Radiologists.
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    Evaluation of the optic nerve using strain and shear-wave elastography in pre-eclampsia
    (W B Saunders Co Ltd, 2019) Asal, N.; Sayan, C. D.; Gokcinar, N. B.; Sahan, M. H.; Dogan, A.; Inal, M.
    AIM: To investigate the utility of strain elastography and shear-wave elastography for assessing optic nerve involvement in pre-eclampsia. MATERIAL AND METHODS: A total of 120 eyes were evaluated in 60 cases consisting of 30 participants in the pre-eclamptic and 30 participants in the non-pre-eclamptic pregnant patient group. The findings of strain and shear-wave elastography, grey-scale sonography, and optical coherence tomography were compared between the groups. RESULTS: There was a statistically significant difference for the average shear-wave elastography values between groups (17.6 +/- 4.1 and 9.4 +/- 2 kPa, p<0.01). The analysis of the strain elastography types also revealed a statistically significant difference between the groups (p<0.01). A statistically significant difference was found for the average values of the optic nerve sheath diameter between the two groups (p<0.05). A statistically significant difference was found in the average value of the superior quadrant of the retina nerve fibre layer between the groups in optical coherence tomography analysis (p=0.04). The peripapillary choroidal thickness values of pre-eclamptic pregnant women were higher than that of non-preeclamptic pregnant women, but the difference was not significant (p>0.05). CONCLUSION: Stiffness of the optic nerve was greater in patients with pre-eclampsia in the study. Elasticity changes in the optic nerve may be generally attributed to microvascular and biomechanical changes secondary to increased hypertension in pre-eclamptic patients. Elastography could be used as assistive diagnostic techniques to evaluate the optic nerve structure changes in pre-eclampsia. (C) 2019 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.