Browsing by Author "Agildere, Ahmet Muhtesem"

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Can Strain Elastography Combined with Ultrasound Breast Imaging Reporting and Data System Be A More Effective Method in The Differentiation of Benign and Malignant Breast Lesions?
(2017) Arslan, Serdar; Uslu, Nihal; Ozturk, Funda Ulu; Akcay, Eda Yilmaz; Tezcaner, Tugan; Agildere, Ahmet Muhtesem; https://orcid.org/0000-0001-7984-4326; https://orcid.org/0000-0002-6733-8669; https://orcid.org/0000-0001-6831-9585; https://orcid.org/0000-0002-3641-8674; https://orcid.org/0000-0003-4223-7017; 28154989; AAH-9796-2019; ABC-5258-2020; AAK-1960-2021; AAD-9865-2021; AAB-5802-2020
To investigate whether a novel method that combines breast imaging reporting and data system (BI-RADS) with strain elastography contributes to diagnostic performance in differentiation of malignant and benign breast lesions. In 81 patients, 81 breast lesions were prospectively investigated. Breast lesions were separately evaluated with ultrasonography and strain elastography. While evaluations with ultrasonography were based on 2003 BI-RADS-US, strain elastography evaluations were based on a 5-point scale and strain ratio. Diagnostic performances of ultrasonography, strain elastography, and the combined method were compared. Among 81 lesions, 43 (53.1%) were benign and 38 (46.9%) were malignant. When a cutoff point of category 3 was used, sensitivity, specificity, positive and negative predictive values, and accuracy for BI-RADS were 100, 11.6, 50, 100, and 53%, respectively. When BI-RADS and strain ratio were combined, sensitivity, specificity, positive and negative predictive values, and accuracy were 89.5, 93, 91.9, 90.9, and 91.3%, respectively. When BI-RADS and elastography scores were combined, sensitivity, specificity, positive and negative predictive values, and accuracy were 86.8, 97.7, 97.1, 89.4, and 92.5%, respectively. The combination of strain elastography and BI-RADS was found to have better diagnostic performances to diagnose breast lesions than BI-RADS alone.
Can unenhanced brain magnetic resonance imaging be used in routine follow up of meningiomas to avoid gadolinium deposition in brain?
(2019) Rahatli, Feride Kural; Donmez, Fuldem Yildirim; Kesim, Cagri; Haberal, kema Murat; Turnaoglu, Hale; Agildere, Ahmet Muhtesem; 0000-0002-8211-4065; 0000-0002-8964-291X; 30343167; R-9398-2019; AAB-5802-2020; AAD-5996-2021; AAE-5528-2021
Purpose: We hypothesized that unenhanced brain MRI can be used in follow up of patients with intracranial meningioma to avoid gadolinium deposition in the brain and allow measurement of meningioma dimensions from pre-contrast T2-weighted images. Methods: Dimensions of meningiomas were measured on pre-contrast T2, post-contrast T1 weighted images. Results: The sizes of meningiomas in post-contrast axial T1-weighted images were similar with that in pre-contrast axial T2-weighted images. Signal intensity increase was detected in dentate nucleus and globus pallidus (P < 0.05). Conclusion: Gadolinium deposition could be avoided in patients with meningioma by using unenhanced brain MRI for follow up scans.
Cervical destructive spondyloarthropathy due to the dialysis-related amyloidosis: imaging findings
(2019) Turnaoglu, Hale; Haberal, Kemal Murat; Unal, Oguzcan; Ozen, Ozlem Isiksacan; Agildere, Ahmet Muhtesem
Dialysis-related amyloidosis that occurs secondary to the deposition of amyloid fibrils containing beta-2-microglobulin, is a type of amyloidosis affecting patients undergoing long-term hemodialysis. It involves the osteoarticular system predominantly. Destructive spondyloarthropathy, is a type of dialysis-related spondyloarthropathy, which frequently involves the cervical spine, have been reported only sporadically. We describe a case of a destructive spondyloarthropathy, in a 43-year-old long-term hemodialysis patient, presenting with myelopathy with particular interest to cervical computed tomography and magnetic resonance imaging findings.
Does Renal Function Affect Gadolinium Deposition in the Brain?
(2018) Rahatli, Feride Kural; Donmez, Fuldem Yildirim; Kibaroglu, Seda; Kesim, Cagri; Haberal, Kemal Murat; Turnaoglu, Hale; Agildere, Ahmet Muhtesem; 0000-0002-4226-4034; 0000-0003-4502-106X; 0000-0002-3964-268X; 0000-0002-8964-291X; 0000-0002-8211-4065; 0000-0002-0781-0036; 0000-0003-4223-7017; 29857863; AAL-9808-2021; AAE-5528-2021; AAJ-2956-2021; AAD-5996-2021; R-9398-2019; AAK-8242-2021; AAB-5802-2020
Objective: Was to compare T1 signal intensity ratios of dentate nucleus to cerebellar white matter (DN/cerebellum), dentate nucleus to pons (DN/pons) and globus pallidus to thalamus (GP/thalamus) in patients with normal renal function and in patients on chronic hemodialysis. To find out if renal function affects the deposition of gadolinium in brain after administration of linear gadolinium based contrast agents (GBCA). Methods: Seventy eight contrast enhanced brain MRIs (Magnetic Resonance Imaging) with linear GBCA of 13 patients on chronic hemodialysis and 13 patients with normal renal function retrospectively evaluated. The DN/ pons, DN/cerebellum and GP/thalamus signal intensity ratios were measured from each brain MRI on unenhanced axial T1 weighted images. Results: In hemodialysis group statistically significant increase in the signal intensity ratios of DN/pons, DN/ cerebellum and GP/thalamus were found between the first and the last brain MRIs (p = .001). The increase in the signal intensity ratios of DN/pons, DN/cerebellum and GP/thalamus between the first and the last brain MRIs in control group were not significant (p > 0.05). The signal intensity increase in DN and globus pallidus were significantly higher in hemodialysis group than control group (p < 0.05). Conclusions: Patients on hemodialysis had significantly higher DN and GP signal intensity increase compared to the patients with normal renal function. Renal function affects the rate of gadolinium deposition in the brain after administration of linear GBCA.
Evaluation of cortical thickness and brain volume on 3 Tesla magnetic resonance imaging in children with frontal lobe epilepsy
(2020) Rahatli, Feride Kural; Sezer, Taner; Has, Arzu Ceylan; Agildere, Ahmet Muhtesem; 0000-0002-2278-1827; 0000-0003-4223-7017; 0000-0002-4226-4034; 31802343; AAJ-5931-2021; AAB-5802-2020; AAL-9808-2021
Background Frontal lobe epilepsy (FLE) is the most common epilepsy syndrome in the pediatric population; however, brain magnetic resonance imaging (MRI) of the children with FLE is frequently normal. We use both cortical thickness and brain volume measurements to report on cortical changes in children with FLE. Our aim was to determine cortical thickness and brain volume changes on 3 Tesla MRI of children with FLE and normal brain magnetic resonance imaging. Methods Twenty-seven children with FLE and 27 healthy controls received brain magnetic resonance imaging. Cortical thickness and regional brain volumes were assessed using three-dimensional volumetric T1-weighted imaging and patients were compared with controls. Results In children with FLE, statistically significant (p < 0.05) cortical thinning were found in the bilateral middle frontal gyrus, bilateral occipitotemporal and medial lingual gyrus, left subcallosal gyrus, left short insular gyrus, and right long insular gyrus. Statistically significant volume reductions in right and left hemisphere cortical white matter, total cortical white matter, bilateral thalamus, bilateral putamen, bilateral globus pallidus, right caudate nucleus, brain stem, and right cerebellar cortex were found. Conclusion Cortical thinning in frontal and extra-frontal lobes and volume loss in a variety of brain regions were found in children with FLE.
Evaluation of Neuroimaging Findings of Central Nervous System Complications in Heart Transplant Recipients
(2020) Turnaoglu, Hale; Agildere, Ahmet Muhtesem; Rahatli, Feride Kural; Donmez, FuldemYildirim; Ocal, Ruhsen; Sezer, Taner; Can, Ufuk; Sezgin, Atilla; Aslamaci, Sait; 0000-0002-2278-1827; 0000-0001-8689-417X; 0000-0003-4223-7017; 29790456; AAJ-5931-2021; AAJ-2999-2021; AAB-5802-2020
Objectives: In this study, we presented neuroradiologic findings and diagnoses of neurologic complications in a series of heart transplant recipients. Materials and Methods: A retrospective review was conducted at Baskent University Hospital. We searched the hospital and radiology databases and identified 109 heart transplant recipients. Thirty-one of these recipients had neuroradiologic evaluations secondary to presentation of neurologic symptoms after heart transplant, with 18 patients evaluated with computed tomography and 22 patients evaluated with magnetic resonance imaging (overlap of imaging-defined groups occurred in 9 recipients). Computed tomography and magnetic resonance imaging studies were retrieved from the Picture Archiving and Communication System, with each type of imaging retrospectively evaluated on consensus by 2 radiologists. Results: Radiopathologic findings related to symptoms were detected in 12 of the 31 study patients. The most common abnormality was posterior reversible leuko-encephalopathy syndrome (5 patients, 4.6%). The other abnormalities were ischemic stroke (3 patients, 2.8%), hemorrhagic stroke (1 patient, 0.9%), intracranial abscess (2 patients, 1.8%), and intracranial dissemination of sinusoidal fungal infection and related hemorrhagic infarct (1 patient, 0.9%). The other 19 heart transplant recipients who underwent computed tomography and/or magnetic resonance imaging for neurologic complaints showed no neuroradiologic findings related to neurologic symptoms. Conclusions: Posterior reversible leukoencephalopathy syndrome and ischemic stroke were the most common neurologic complications in our heart transplant recipients. The other complications were hemorrhagic stroke, intracranial abscess, and intracranial dissemination of sinusoidal fungal infection. Neurologic complications are common in heart transplant recipients and should be identified promptly for early treatment. For the recognition of these complications, computed tomography should be performed for initial evaluation to rule out edema or hemorrhage. However, in the presence of serious neurologic symptoms that cannot be explained by computed tomography, magnetic resonance imaging should be indicated.
Late onset hirayama disease: Characteristic magnetic resonance imaging features hirayana disease
(2020) Haberal, Kemal Murat; Avci, Aynur Yilmaz; Bayramoglu, Mert; Agildere, Ahmet Muhtesem; 0000-0002-8211-4065; 0000-0003-4223-7017; 0000-0001-9004-9382; R-9398-2019; AAB-5802-2020; F-6770-2019
Hirayama Disease is a rare benign lower motor neuron disorder which is primarily affecting young males. It is characterized by the progressive weakness of the distal upper extremities followed by spontaneous stabilization of the symptoms. In this paper, we describe a 58 year- old female patient with a complaint of weakness in the right hand and forearm. Magnetic resonance imaging of the cervical spine established the final diagnosis of Hirayama disease. Hirayama disease when detected and intervened at an early stage of the disease process, can have a good prognosis. Clinicians and radiologists should be aware of the clinical features, as well as suspicious findings on neutral-position MR imaging and an additional neck-flexion MR imaging study should be arranged to confirm the diagnosis.
Magnetic Resonance Imaging Evaluation of Head and Neck Involvement in Igg4-Related Disease
(2023) Pehlivan, Umur Anil; Karaali, Kamil; Ilhan, Hatice Deniz; Soy, Mehmet; Arslan, Didem; Kaya, Omer; Kisla-Ekinci, Rabia Miray; Cakir-Pekoz, Burcak; Cay, Ummuhan; Acikalin, Arbil; Agildere, Ahmet Muhtesem; 0000-0003-4223-7017; 0000-0001-5871-0695; AAB-5802-2020
Objective: To evaluate the radiological features of IgG4-related disease (IgG4-RD) in the head and neck region. Methods: In this radiology-based study, radiological features, clinical, laboratory, pathological findings, and prognosis of nine patients with head and neck involvement diagnosed with IgG4-RD were investigated retrospectively. Results: The median age of the patients was 38 years (range: 2.5-79 years), and there were six males and three females. The most common symptoms and clinical findings of the patients were eyelid and lacrimal gland swelling, painless exophthalmos, and ophthalmoplegia. The most common site of involvement on MRI was the orbit. Orbital involvement was followed by branches of the trigeminal nerve, sinonasal cavity, cervical lymph nodes, and dural involvement. The most common and remarkable imaging features were T2 hypointensity and diffuse homogeneous contrast enhancement. Conclusions: Head and neck involvement of the IgG4-RD, has specific imaging features that can help with diagnosis. Thus, early diagnosis and better outcomes can be achieved with increasing awareness of these features of this relatively new pathology.
Predisposing Factors in Posterior Circulation Infarcts: A Vascular Morphological Assessment
(2015) Coban, Gokcen; Cifci, Egemen; Yildirim, Erkan; Agildere, Ahmet Muhtesem; 0000-0002-4010-2883; 0000-0002-9057-722X; 0000-0003-4223-7017; 25666230; P-7533-2014; ABI-3856-2020; AAB-5802-2020
The aim of the study is to assess the effect of shape, diameter, elongation and deviation criteria of basilar artery (BA), convergence angle and diameter variations of vertebral arteries, and concurrent chronic diseases on posterior circulation infarcts. Between January 2010 and May 2013, 186 patients who underwent brain and diffusion magnetic resonance imaging (MRI) with suspected cerebrovascular accident and were diagnosed with posterior circulation infarct and 120 infarct negative control subjects were included in this case-control retrospective study. Vertebral artery (VA) and BA diameter, right (R) and left (L) VA angles at the level of bifurcation, and BA elongation-deviation, and shape of BA were assessed in a total of 306 subjects. Ischemic lesions in the posterior circulation were classified according to their anatomical location and vascular perfusion areas. No significant difference was noted between the control and patient groups with respect to BA diameter (p = 0.676). The most effective risk factors for posterior circulation infarcts were as follows: BA elongation of 2 or 3, BA transverse location of 2 or 3, increase in left VA angle, and history of hypertension, hypercholesterolemia, and diabetes mellitus. Our results suggest that prominent elongation and deviation, C and J shape of BA, and increased L VA angle may be the predictors of at-risk patients in posterior circulation infarcts. Reporting marked morphological BA and VA variations detected at routine brain MRI will aid in selection of patients. Timely detection and treatment of at-risk patients may be life-saving.
Quantitative elastography in differentiating benign and malignant breast lesions
(2016) Purbager, Aysin; Pekoz, Burcak Cakir; Aslan, Hulya; Agildere, Ahmet Muhtesem; 0000-0003-4223-7017; 0000-0002-7138-246X; AAB-5802-2020; AAK-9104-2021
Purpose: The purpose of this study was to evaluate the effectiveness of quantitative elastography in differentiating benign and malignant breast lesions that were detected by B-mode ultrasonography, to compare shear wave velocities of benign and malignant lesions, and to determine cut-off values differentiating malignant lesions from benign ones Material and Methods: In this prospective study we enrolled 254 breast lesions of 240 patients detected by B-mode ultrasonography, and underwent biopsy in our department. Shear wave elastography was performed to all lesions before biopsies. The patients who had radiotherapy or chemotherapy previously were not included. Elastography examinations were performed by one of the two radiologists specialising in breast radiology. The mean and median shear wave velocities, and standard deviation values were measured in meters/second. Both mean and median shear wave velocities were compared with histopathology results. Sensitivity, specificity, and the area under the curve were obtained by using a receiver operating characteristic curve analysis Results: The mean age of the patients, lesion size, mean and median shear wave velocities were significantly different between benign and malignant groups. The mean shear wave velocity of benign and malignant lesions were 3.59 +/- 1.2m/s and 5.59 +/- 1.9m/s, respectively. The cut-off value for the mean shear wave velocity was 4.08 m/s (71.6% sensitivity and 69.6% specificity) to differentiate malignant lesions from benign ones Conclusion: Quantitative elastography is an effective and complementary method making a significant contribution in differentiating benign and malignant lesions. In this respect, we believe that clinical usage of shear wave elastography should be generalized
Recurrent Childhood PRES
(2015) Donmez, Fuldem Yildirim; Agildere, Ahmet Muhtesem; 0000-0003-4502-106X; 0000-0003-4223-7017; 25894844; AAE-5528-2021; AAB-5802-2020
The purpose of the study was to review the recurrent posterior reversible encephalopathy syndrome (PRES) and emphasize the possibility of repeated attacks on the basis of particular clinical situations. 32 children, diagnosed with PRES were included in our study. The recurrent cases were determined; their radiological features such as involved localizations and clinical information such as presenting symptoms, underlying diseases and clinical prognosis are retrospectively assessed. Of the 32 children (8 months to 18 years old; mean age 11), four of the patients had recurrent episodes of PRES. They had different underlying diseases. One had Chediak-Higashi syndrome, one had ALL, one had chronic renal disease on hemodialysis and one was a renal transplant recipient. Three of the children recovered with no residual neurological deficits, one of them passed away due to multiorgan failure. Three of them had high blood pressures at the time of either one or both PRES, and the renal transplant recipient had also high blood levels of Tacrolimus. Recurrent PRES is encountered most commonly because of repeated increasing blood pressures due to various underlying diseases, immune system disorders or side effects of the treatments.
Utility of Diffusion-Weighted MRI to Detect Changes in Liver Diffusion in Benign and Malignant Distal Bile Duct Obstruction: The Influence of Choice of b-Values
(2016) Karan, Belgin; Erbay, Gurcan; Koc, Zafer; Pourbagher, Aysin; Yildirim, Sedat; Agildere, Ahmet Muhtesem; 0000-0003-0987-1980; 0000-0002-5735-4315; 0000-0002-1706-8680; 0000-0003-4223-7017; 27592163; S-8384-2016; AAF-4610-2019; AAK-5370-2021; AAB-5802-2020
Purpose: The study sought to evaluate the potential of diffusion-weighted magnetic resonance imaging to detect changes in liver diffusion in benign and malignant distal bile duct obstruction and to investigate the effect of the choice of b-values on apparent diffusion coefficient (ADC). Methods: Diffusion-weighted imaging was acquired with b-values of 200, 600, 800, and 1000 s/mm(2). ADC values were obtained in 4 segments of the liver. The mean ADC values of 16 patients with malignant distal bile duct obstruction, 14 patients with benign distal bile duct obstruction, and a control group of 16 healthy patients were compared. Results: Mean ADC values for 4 liver segments were lower in the malignant obstruction group than in the benign obstruction and control groups using b = 200 s/mm(2) (P < .05). Mean ADC values of the left lobe medial and lateral segments were lower in the malignant obstruction group than in the benign obstructive and control groups using b = 600 s/mm2 (P < .05). Mean ADC values of the right lobe posterior segment were lower in the malignant and benign obstruction groups than in the control group using b = 1000 s/mm(2) (P < .05). Using b = 800 s/mm(2), ADC values of all 4 liver segments in each group were not significantly different (P > .05). There were no correlations between the ADC values of liver segments and liver function tests. Conclusion: Measurement of ADC shows good potential for detecting changes in liver diffusion in patients with distal bile duct obstruction. Calculated ADC values were affected by the choice of b-values.