Browsing by Author "Kahraman, Gokhan"

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Diagnostic Impact of Quantitative Dual-Energy Computed Tomography Perfusion Imaging for the Assessment of Subsegmental Pulmonary Embolism
(2021) Celtikci, Pinar; Hekimoglu, Koray; Kahraman, Gokhan; Bozbas, Serife; Gultekin, Bahadir; Akay, Hakki Tankut; 0000-0002-1655-6957; 0000-0002-0805-0841; 33186173; AAD-9097-2021; ABA-7388-2021
Objective The aim of this study was to investigate the quantitative differences of dual-energy computed tomography perfusion imaging measurements in subsegmental pulmonary embolism (SSPE), between normal lung parenchyma (NLP) and hypoperfused segments (HPS) with and without thrombus on computed tomography angiography (CTA). Methods Lung attenuation, iodine density, and normalized uptake values were measured from HPS and NLP on iodine maps of 43 patients with SSPE. Presence of pulmonary embolism (PE) on CTA was recorded. One-way repeated-measures analysis of variance and Kruskal-Wallis analyses with post hoc comparisons were conducted. Results The numbers of HPS with and without SSPE on CTA were 45 (55.6%) and 36 (44.4%), respectively. Lung attenuation of NLP was significantly different from HPS (P < 0.001). Iodine density and normalized uptake values of HPS with PE were significantly lower than those of HPS without PE, which is significantly lower than NLP (P < 0.001). Conclusions Subsegmental pulmonary embolism causes HPS on dual-energy computed tomography perfusion imaging, which demonstrates different iodine density and normalized uptake values depending on the presence of thrombus.
Dual-Energy Computed Tomography Pulmonary Angiography With Ultra-Low Dose Contrast Administration: Comparison Of Image Quality With Standard Computed Tomography Pulmonary Angiography
(2022) Celtikci, Pinar; Hekimoglu, Koray; Kahraman, Gokhan; Haberal, Kemal Murat; Kilic, Dalokay
Background: This study aims to compare quantitative and qualitative image quality between standard computed tomography pulmonary angiography and dual-energy computed tomography pulmonary angiography protocols. Methods: Between September 2017 and August 2018, a total of 91 consecutive patients (34 males, 57 females; mean age: 65.9 +/- 15 years; range, 37 to 91 years) who were referred for computed tomography pulmonary angiography were randomly imaged with either a standard or dual-energy protocol. Standard protocol (n=49) was acquired with a 64-slice multidetector computed tomography scanner using 60 mL contrast media (18 g iodine). A third-generation dual-energy computed tomography scanner was utilized to acquire dual-energy computed tomography pulmonary angiography and simultaneous lung perfusion imaging (n=42), which required 40 mL contrast media (12 g iodine). Two radiologists reviewed images separately to determine interobserver variability. Attenuation and noise in three central and two segmental pulmonary arteries were measured; signal-to-noise ratio and contrast-to-noise ratio were calculated. A five-point scale was utilized to evaluate image quality and image noise qualitatively. Results: The standard protocol required a significantly higher amount of iodine. Comparison of two groups employing quantitative measurements (attenuation value in five pulmonary arteries, mean attenuation value, mean background noise, signal-to-noise ratio, and contrast-to-noise ratio) and employing qualitative measurements (five-point scale scores of image quality and image noise) revealed no significant difference between dual-energy and standard groups (p>0.05). Qualitative and quantitative evaluations demonstrated low interobserver variability. Conclusion: Dual-energy computed tomography pulmonary angiography protocol delivers image quality equal to standard protocol, while requiring less amount of iodinated contrast medium and providing simultaneous lung perfusion imaging to contribute the diagnosis of pulmonary embolism.
Interventional Treatment Methods for Ureteral Complications After Kidney Transplant: A Single-Center Experience
(2023) Ozen, Ozgur; Karakaya, Emre; Zeydanli, Tolga; Kahraman, Gokhan; Yildirim, Sedat; Boyvat, Fatih; Haberal, Mehmet; 0000-0002-4879-7974; 0000-0001-7122-4130; 37698400; AAD-5466-2021; F-4230-2011; AAN-1681-2021
Objectives: Ureteral complications are one of the most common complications after kidney transplant. Although these complications have been treated surgically in the past, almost all can be successfully treated with interventional methods today. In this study, we assessed the interventional treatment of ureteral complications after kidney transplants performed in our center and the long-term results of these treatments. Materials and Methods: We performed a retrospective analysis of 2223 kidney transplant recipients seen between January 1, 2000, and May 1, 2020. Among these, 70 kidney transplant recipients who experienced ureteral leakage or ureteral obstruction in the early or late posttransplant period were included in the study. Complications within the first 2 months posttransplant were classified as early complications, whereas those occurring after 2 months were considered late complications. We treated all patients with interventional methods.Results: In review of patients, 44 patients were diagnosed with ureteral obstruction (22 patients were early obstruction, 22 were late obstruction) and 26 patients with ureteral anastomosis leakage. All patients with early and late ureteral obstruction were successfully treated with percutaneous methods. In the group of patients with ureteral leakage, all patients except 2 patients were treated with interventional methods. For 2 patients with ureteral leakage, surgical treatment was necessary because of persistent leakage despite percutaneous treatment methods. Conclusions: Ureteral complications after kidney transplant can be successfully treated with interventional methods in experienced centers without the need for surgery.
Oxalosis Crystals' Redeposition in Cardiac Tissue Leading to New-Onset Fatal Cardiac Complication After Liver Transplant in Primary Oxalosis Patient: Case Report
(2020) AlShalabi, Omar; Soy, Ebru H. Ayvazoglu; Akdur, Aydincan; Karakaya, Emre; Kahraman, Gokhan; Moray, Gokhan; Haberal, Mehmet; 0000-0002-4879-7974; 0000-0002-3462-7632; 0000-0002-0993-9917; 0000-0002-8726-3369; 0000-0003-2498-7287; 33187466; AAD-5466-2021; AAJ-8097-2021; AAC-5566-2019; AAA-3068-2021; AAE-1041-2021
Primary oxalosis is a rare hereditary disorder of metabolism resulting in accumulation of calcium oxalate in almost all tissues of the body. All published data point out the improvement of cardiac function after transplant. Here, we report the first case in the literature of an 8-year-old patient with primary oxalosis in which oxalosis implantations increased in cardiac tissue after liver transplant and manifested as new-onset ventricular tachycardia and cardiomyopathy, leading to death.
Partial Splenic Torsion in situ: Revealed by Ultrasound and Computed Tomography
(2018) Haberal, K. Murat; Bayramoglu, Mert; Kahraman, Gokhan; Avci, Tevfik; 0000-0001-5225-959X; 0000-0002-8211-4065; 30065530; AAF-1698-2021; R-9398-2019
We present a case of acute abdominal pain due to partial torsion of spleen located in its own normal anatomical position in a 20-year-old woman, diagnosed by ultrasound and confirmed on computed tomography and treated laparoscopically.