Browsing by Author "Yilmaz, Birnur"

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Achilles Tendon Elasticity Decreases with Intermittent Claudication in Patients by Acoustic Radiation Force Impulse Imaging (ARFI)
(2018) Yilmaz, Birnur; 29371711
Objective: To investigate the value of Acoustic Radiation Force Impulse elastography and its application in Achilles tendon elasticity of intermittent claudication due to lower extremity arterial ischaemia. Methods: This prospective case-control study was conducted at the Department of Radiology, Faculty of Medicine, Baskent University, Istanbul, Turkey, from October 2015 to January 2016, and comprised bilateral Achilles tendons of patients with intermittent claudication and healthy individuals. Shear-Wave Velocity (SWV) of each tendon was measured using Acoustic Radiation Force Impulse elastography. Arterial Doppler ultrasonography at tibialis posterior artery was performed to establish the diagnosis of occlusive arterial disease, and the degree of obstruction was recorded. SPSS 16 was used for data analysis. Results: Of the 84 subjects, 42(50%) were patients and 42(50%) were controls. The number of bilateral Achilles tendons was 168, i.e. 84(50%) of patients and 84(50%) of controls. SWV of the Achilles tendon were different between the two groups (p<0.05). The mean SWV was 5.24 +/- 0.45 m/s in the relaxed state in the patients and 2.83 +/- 0.56 m/s in the controls. No monophasic flow pattern was observed in 23(54.8%) posterior tibial artery and SWV was 4.94 +/- 0.40 m/s in the relaxed state Achilles tendon in patients. Monophasic flow pattern was observed in 61(72.6%) posterior tibial artery and SWV was 5.35 +/- 0.42 m/s in the relaxed state Achilles tendon in patients. SWV values were higher in monophasic flow patterns in the posterior tibial artery than in those without monophasic flow patterns in patients group (p<0.01). Conclusion: The elasticity of healthy tendon decreased with intermittent claudication in patients.
Diagnostic value of shear wave velocity in polycystic ovarian syndrome
(2021) Gursu, Turkan; Cevik, Halime; Desteli, Guldeniz Aksan; Yilmaz, Birnur; Bildacı, Tevfik Berk; Eraslan, Alper; 34970437
Aim: In polycystic ovarian syndrome, the ovaries become stiffer due to chronic anovulation. We aimed to compare tissue elasticity in terms of shear wave velocities measured using acoustic radiation force impulse imaging technique between the ovaries of polycystic ovarian syndrome women and non-polycystic ovarian syndrome women. Material and methods: The study was designed as a retrospective data analysis of women who underwent transvaginal ultrasound and acoustic radiation force impulse imaging in a university hospital between July 2014 and March 2015, for various reasons. There were 32 polycystic ovarian syndrome patients and 32 patients without a diagnosis of polycystic ovarian syndrome. Age, body mass index, fasting glucose levels, cycle day 3 follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, prolactin, antimullerian hormone levels, and menstrual patterns with clinical hyperandrogenism were evaluated. On the menstrual cycle days 2-4, by performing a transvaginal ultrasound scan, the ovarian volumes and antral follicle counts in both ovaries were recorded for each woman. The ultrasound system was converted into the elastography mode, and acoustic radiation force impulse imaging was performed. Shear wave velocity (m/sec) was measured at least 5 times for each ovary, and the mean value was calculated for each polycystic ovarian syndrome and non-polycystic ovarian syndrome woman. Results: Age, body mass index, fasting glucose levels, cycle day 3 follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, and prolactin levels were similar between the groups (p 0,05). Antimullerian hormone levels, antral follicle counts, and mean ovarian volumes were statistically different between the groups (p <0,05). Mean shear wave velocity values for both ovaries were 2.12 +/- 0.82 (0.78-4.9) m/sec in the polycystic ovarian syndrome group, and 1.18 +/- 0.41 (0.77-2.0) m/sec in the non-polycystic ovarian syndrome group, which was statistically significantly different (p = 0.016). Conclusion: In our study, we found significantly higher shear wave velocity levels in polycystic ovarian syndrome women than non-polycystic ovarian syndrome women, which indicates an impact of the condition on shear wave velocity. The increased acoustic frequencies cause a decreased response in time to transition, and motion becomes out of phase; in other words, scattered waves are faster in stiffer ovaries. Our results are thus compatible with the pathophysiology of the disease. Shear wave velocity is a beneficial tool for evaluating ovarian elasticity in polycystic ovarian syndrome patients in whom the levels are found to be significantly higher than non-polycystic ovarian syndrome women. In light of these findings, shear wave velocity is expected to be slower than polycystic ovarian syndrome levels in ovulatory women.
Renal Stiffness on Patients with Gestational Diabetes
(2017) Yilmaz, Birnur; Cevik, Halime; Bildaci, Tevfik Berk; Ozdogan, Serdinc
Introduction: Gestational diabetes is defined as glucose intolerance first recognized in pregnancy. Oral glucose tolerance testing is the cornerstone in diagnosing gestational diabetes. In this study, we aimed to find a new method of diagnosis in addition to conventional diagnosed by 75 gr oral glucose tolerance testing. Material and methods: 121 pregnant woman were included part in this study, forming two groups as gestational diabetic patients (51 patients) and control group (70 pregnant woman). Both kidneys are evaluated with B Mode Ultrasound and Colour Doppler Ultrasound mode by measuring resistive index for depiction of other renal pathologies. Stiffness of renal tissue determined by Acoustic Radiation Force Impulse (ARFI) technology utilized by two blinded radiology specialists. Results: We were not able to find any correlation between gestational diabetes mellitus and resistivity index measurements (p > 0.05). But a correlation between second hour glucose levels in oral glucose tolerance test and bilateral renal stiffness was found (p < 0,05). Conclusion: ARFI ultrasound may be a non-invasive technique in determining the course of the disease.
Value of in Vitro Acoustic Radiation Force Impulse Application on Uterine Adenomyosis
(2018) Bildaci, Tevfik Berk; Cevik, Halime; Yilmaz, Birnur; Desteli, Guldeniz Aksan; 10.1007/s10396-017-0845-y
Adenomyosis is the presence of endometrial glandular and stromal tissue in the myometrium. This phenomenon can be the cause of excessive bleeding and menstrual pain in premenopausal women. Diagnosis of adenomyosis may present difficulty with conventional methods such as ultrasound and magnetic resonance imaging. Frequently, diagnosis is accomplished retrospectively based on the hysterectomy specimen. This is a prospective case control study done in vitro on 90 patients' hysterectomy specimens. Acoustic radiation force impulse (ARFI) and color elastography were used to determine the elasticity of hysterectomy specimens of patients undergoing indicated surgeries. Based on histopathological examinations, two groups were formed: a study group (n = 28-with adenomyosis) and a control group (n = 62-without adenomyosis). Elasticity measurements of tissue with adenomyosis were observed to be significantly higher than measurements of normal myometrial tissue (p < 0.01). Uterine fibroids were found to have higher values on ARFI study compared to normal myometrial tissues (p < 0.01). The findings lead to the conclusion that adenomyosis tissue is significantly softer than the normal myometrium. ARFI was found to be beneficial in differentiating myometrial tissue with adenomyosis from normal myometrial tissue. It was found to be feasible and beneficial to implement ARFI in daily gynecology practice for diagnosis of adenomyosis.