Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Efficacy of the Sonoelastography Method for Diagnosis of Fibrosis in Renal Transplant Patients(2022) Soudmand, Arash; Ozturk, Funda Ulu; Uslu, Nihal; Haberal, Nihan; Boyvat, Fatih; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-3462-7632; 29993356; AAJ-8097-2021Objectives: Although biopsy is the most important method for diagnosing the cause of renal allograft dysfunction, sonoelastography, a new ultrasonography method, can be used to distinguish between the soft or hard nature of lesions. In this study, our aim was to investigate whether sonoelastography could diagnose fibrosis in renal transplant patients. Materials and Methods: In this prospective study, we included patients over 18 years old who were recommended for clinical biopsy. Sonoelastographic evaluation was made by conducting acoustic radiation force impulse measurements for each patient after they were admitted to the clinic for biopsy. Measurements were performed just before the biopsy procedure. All results were examined by 2 experienced radiologists using the Siemens S3000 Ultrasound Machine (Erlangen, Germany). Comparisons of ultrasonographic values with biopsy results were made with SPSS software (SPSS: An IBM Company, version 20, IBM Corporation, Armonk, NY, USA). Results: Of the 65 patients included in this study, pathology showed acute T-cell-mediated rejection in 37 patients. There was a significant correlation between the pathologic Banff scores and the sonographic acoustic radiation force impulse values (P = .002), where the degree of Banff increased as the mean acoustic radiation force impulse values elevated. A rise in mean impulse values correlated with increased degree of interstitial fibrosis in renal allografts. Renal parenchymal echogenicity of patients significantly differed by sex (P = .009), with an average renal echogenicity of grade 1 in women and grade 0 in men. Also, a statistically significant difference was found between age of the renal transplant recipient and resistive index values. Conclusions: Our study showed a significant correlation between Banff degree and the acoustic radiation force impulse values of renal transplant patients. In addition to biopsy, sonoelastography can be beneficial for the diagnosis of fibrosis in renal transplant patients.Item Liver Stiffness Measurements Using Acoustic Radiation Force Impulse in Recipients of Living-Donor and Deceased-Donor Orthotopic Liver Transplant(2021) Haberal, Kemal Murat; Turnaoglu, Hale; Ozdemir, Adnan; Uslu, Nihal; Reyhan, Asuman Nihan Haberal; Moray, Gokhan; Haberal, Mehmet; 0000-0002-8211-4065; 0000-0002-3462-7632; 28836931; R-9398-2019; AAJ-8097-2021Objectives: The aim of this study was to evaluate the diagnostic efficiency of the acoustic radiation force impulse (Siemens Medical Solutions, Erlangen, Germany) elastography in assessment of fibrosis in orthotopic liver transplant patients. Materials and Methods: We enrolled 28 orthotopic liver transplant patients (5 deceased and 23 living donors), whose biopsy decision had been prospectively given clinically. Ten acoustic radiation force impulse elastographic measurements were applied before the biopsy or within 3 days after the biopsy by 2 radiologists. After the core tissue needle biopsy, specimens of all patients were analyzed according to the modified Ishak scoring system. Measurements of acoustic radiation force impulse elastography and pathology specimen results were compared. Results: From 28 biopsies, fibrosis scores of 4 biopsies were evaluated as F0 (14.3%), 16 as F1 (57.1%), 4 as F2 (14.3%), and 4 as F3 (14.3%). Mean results of acoustic radiation force impulse measurements were calculated as 1.4 +/- 0.07 in F0, 1.74 +/- 0.57 in F1, 2.19 +/- 0.7 in F2, and 2.18 +/- 0.35 in F3. There were no significant correlations of mean acoustic radiation force impulse values between the F0 versus F1 (P =.956) and F0 versus F2 stages (P =.234). A statistically significant correlation of mean acoustic radiation force impulse values was found between the F0 and F3 fibrosis stages (P =.046). Conclusions: Acoustic radiation force impulse imaging is a promising screening test for detecting significant liver fibrosis (>= F3 in modified Ishak) in living- donor or deceased-donor orthotopic liver transplant recipients.Item Karaciğer tümörleri ve cerrahi deneyimlerimiz(Çocuk Cerrahisi Dergisi ,21 ,1 ,34-38, 2007) Arda, İ.Serdar; Ötgün, İbrahim; Coşkun, Mehmet; Boyvat, Fatih; Güney, L.Hakan; Fakıoğlu, Ender; Bilezikçi, Banu; Özen, Özlem; Hiçsönmez, Akgün; Haberal, MehmetKliniğimizde bir yıl içerisinde karaciğer tümörü netanısı ile izlenen hastaların bulguları sunulmaktadır. Gereç ve Yöntem: Kliniğimizde 1 yıl içerisinde 6 olgu (3 hepatoblastom, 1 hepatosellüler karsinom, 1 metastatik karaciğer kitlesi -opere Wilms' tümörü- ve 1 embriyonel rabdomiyosarkom) izlenmiştir. Bu çalışmada hastaların bulguları geriyedönük olarak taranmıştır. Bulgular: 4'ü erkek ikisi kız olan hastaların yaşları 4 ay ile 6 yaş arasındaydı. Hastaların tümü tümör belirteçleri, dopler ultrasonografi ve bilgisayarlı tomografik hepatik anjiyografi ile değerlendirildi. 4 hastada kitle tam olarak çıkarıldı. Hepatoblastoma tanılı bir hastaya canlı vericiden karaciğer nakli yapıldı. Hepatoblastomlu diğer bir hasta ise kemoembolizasyon sonrasında kemoterapi programına alındı. Sonuç: Çocukluk çağı karaciğer tümörleri ameliyat öncesi bilgisayarlı tomografik hepatik anjiyografi ile ayrıntılı olarak değerlendirilmelidir. Bu hastaların cerrahi sağaltımları deneyimli bir cerrahi ekip tarafından uygun ameliyathane donanımı olan merkezlerde yapılmalıdır. Karaciğer nakli, metastazı olmayan ve çıkarılamayan tümörlerde uygulanması gereken cerrahi sağaltım olmalıdır. Here, we present our one year experience in patients with liver tumors. Patients and Method: 6 patients' data (1 hepatoblastoma, 1 hepatocellular carcinoma, 1 metastatic liver mass -previously operated for Wilms' tumor- and 1 embryonal rabdomyosarcoma) were investigated retrospectively. Results: Four of the patients were male and the others were female. Ages were changed between 4 months and 6 years. All patients were investigated with tumor markers, hematological and biochemical analysis, Doppler ultrasonography and computerized tomographic hepatic angiography. Tumor was totally resected in four patients. One patient underwent live-donor partial liver transplantation. One patient with hepatoblastoma is still receiving preoperative chemotherapy. Conclussion: It is quite important to define the tumor borders with computerized tomographic hepatic angiography. We believe that liver tumor surgery should be performed by experienced surgeons in well-equipped centers. Liver transplantation is the treatment of choice in unresectable non-metastatic tumors