Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Use of Generalizability Theory Evaluating Comparative Reliability of the Scapholunate Interval Measurement With X-ray, CT, and US(2023) Kuru, Cigdem Ayhan; Sezer, Rahime; Cetin, Can; Haberal, Bahtiyar; Yakut, Yavuz; Kuru, Ilhami; 0000-0003-3173-1757; 0000-0003-4613-1607; 0000-0002-1668-6997; 36604227; W-9080-2019Rationale and Objectives: There is no universally accepted standard technique for measuring the scapholunate interval and no specific sources of measurement error have been identified. We aimed to establish a set of normal radiological criteria for the scapholunate interval that could be used in comparative studies of wrist pathology to determine interobserver reliability and to identify potential errors that might influence measurements.Materials and Methods: A total of 60 healthy volunteers participated in the study. Scapholunate interval was measured by three independent observers using X-ray, CT, and US in four positions, including neutral, fist, radial and ulnar deviation. Inter-observer reliability was tested using intraclass correlation coefficient. Generalizability theory was applied to evaluate specific sources of measurement error related to participant, observer, imaging modality and measurement position.Results: In neutral position, the scapholunate interval measured by X-ray, CT, and US was 3.1 mm, 3.5 mm and 3.5 mm respectively. The interval remained constant during fist and radial deviation but decreased during ulnar deviation. Correlation coefficients ranged from 0.874 to 0.907 for X-ray, 0.773-0.881 for CT and 0.964-0.979 for US. In the generalizability study, the participant x modality x position interaction accounted for the largest proportion of total variance (29%).Conclusion: X-ray, CT, and US are reliable modalities for measuring the scapholunate interval, with US having the highest reliability. Participant and position factors may independently contribute to measurement error. Therefore, standardized measurement positions are recommended to obtain reliable measurement results.Item A Rare Cause of Duodenal Obstruction: Intramural Hematoma(2014) Coban, Goken; Cifci, Bilal Egemen; Gokturk, Savas; Unler, Ayse Gulhan Kanat; Yildirim, Erkan; 0000-0002-9057-722X; ABI-3856-2020; P-7533-2014Small bowel obstruction due to intramural hematoma secondary to anticoagulant therapy is a rare complication. Other risk factors include hemophilia, idiopathic thrombocytopenic purpura, leukemia, lymphoma, myeloma, chemotherapy, vasculitis, pancreatitis, and pancreatic cancer. The presentation of patients is usually with abdominal pain, nause and vomiting. The patients who were admitted to the emergency clinic with acute abdominal pain and had a history of anticoagulant use with prolonged international normalized ratios should alert to search for intraabdominal hematoma. Herein, we present a patient who was admitted to the emergency clinic with acute abdominal pain, severe nausea and vomiting, and diagnosed by abdominal computed tomography.Item Dynamic Sonography and CT Findings of Unilateral Submandibular Gland Agenesis Associated with Herniated Hypertrophic Sublingual Gland(2014) Yerli, Hasan; https://orcid.org/0000-0003-2463-1758; 23893549; AAK-9572-2021Congenital agenesis of the submandibular gland is uncommon. We report dynamic sonography and CT findings of the unilateral submandibular gland agenesis associated with herniated hypertrophic sublingual gland tissue through the mylohyoid gap. The dynamic sonography examination applied at rest and during the modified Valsalva maneuver demonstrated hypertrophied sublingual gland prolapsing to the anterior part through the mylohyoid gap. This may be the first reported case describing dynamic sonography findings of this entity. CT confirmed the agenesis of the left submandibular gland and compensatory hypertrophy of the ipsilateral sublingual gland. (c) 2013 Wiley Periodicals, Inc. J Clin Ultrasound 42:176-179, 2014Item The Relationship Between Osteoarthritis of the Lumbar Facet Joints and Lumbosacropelvic Morphology(2015) Sahin, Mehmet Sukru; Ergun, Adviye; Aslan, Akin; 0000-0001-7677-8423; 26230538; AAJ-9972-2021Objective. To investigate the relation between lumbosacropelvic morphology and the presence and degree of facet joint degeneration. Summary of Background Data. Osteoarthritis of the facet joints is one of the most common degenerative changes in the spine. It is considered to be formed secondary to repetitive stress or trauma and spinal deformity with secondary overload. The cause(s) of facet joints osteoarthritis, however, have not been clearly identified. Methods. Abdominal computed tomography (CT) images of 723 patients which were taken between the years 2010 and 2014 were evaluated retrospectively. Patients with prior lumbar spinal surgery, serious congenital anomalies on CT, incomplete or complete lumbosacral transition, severe scoliosis, were excluded from the study. To eliminate the age-and sex-related differences in spinopelvic morphology, a study group was formed of the remaining subjects by including patients from a specific age group (30-35 yr) and same sex (females). For each patient the presence and grade of facet joint degeneration was investigated. In addition, pelvic incidence (PI), sacral slope and the angles of L1-L5 lumbar lordosis, sacral table, L5 vertebra posterior, and sacral kyphosis were measured for each patient. Results. Sacral slope, sacral kyphosis, and L1-L5 lumbar lordosis angle were significantly higher in patients with osteoarthritic compared with normal subjects (P = 0.015, P = 0.018, P = 0.016). L5 vertebra posterior and sacral table angle were found to be significantly lower in patients with osteoarthritic than in normal subjects (P = 0.019, P = 0.007). The degree of facet joint degeneration was noticed to increase parallel to the decrease in the sacral table angle and L5 vertebra posterior angle, and to the increase in the L1-L5 lumbar lordosis, PI, and sacral slope. Conclusion. A close relation exists between the presence and degree of degeneration in the facet joint and lumbosacral pelvic morphology. Prevalence and degree of the degeneration in facet joint increases as the angle of sacral slope, L1-L5 lumbar lordosis, and PI increases or the angle of sacral table and L5 vertebra posterior decreases.Item On Visualization and Quantification of Lesion Margin in CT Liver Images(2020) Arica, Sami; Altuntas, Tugce Sena; Erbay, Gurcan; 0000-0002-1706-8680; AAK-5370-2021Cancer is the one of the leading causes of death worldwide, and cancer incidence increases every year. The analysis of lesion margin is quite important to diagnose malignant and benign masses and to detect the presence and the stage of tumor invasion in case of cancer. Accordingly, the aim of the study is to visualize and quantify margin of lesions on radiological images by means of a digital computer. In this study, computed tomography (CT) images of liver have been employed for analysis because the liver has crucial tasks in our body and liver cancerrelated deaths is ranked as the forth among the cancer-related deaths. The proposed method consisted of four main steps: image cropping and smoothing, specification of target lesion, the boundary detection of target lesion, and visualization and quantification of margin. First, the images were converted to gray scale. The blank regions surrounding the liver in the CT images were removed before specification of target lesion, and further were smoothed with a bilateral filter. Next, the target region was specified roughly by drawing it manually. The boundary of lesion was more precisely determined with the active contour method employing the sketched borderline as the initial curve. Next, the properties of the target region: the centroid, major axis length, and the orientation values were computed. The intensities along a line passing through the center of the tumor were obtained for eighteen different rotation angles. A pulse model was fit to each of the intensity signal corresponding to a rotation. Then, the intensity change, margin sharpness and width were acquired from the pulse approximation associated to each rotation angle. The level difference provided the intensity change, the slope of edges gave the margin sharpness, and distance between the start and end points of the pulse edge represented margin width. Besides, the inner (core) and outer diameter with respect to angle were also displayed.Item Thorax CT Dose Reduction Based on Patient Features: Effect of Patient Characteristics on Image Quality and Effective Dose(2019) Koc, Gizem Gul; Koc, Zafer; Kaniyev, Tahir; Kokangul, Ali; https://orcid.org/0000-0003-0987-1980; 30908322; S-8384-2016Computed tomography (CT) radiation dose reduction is vital without compromising image quality. The aim was to determine the effects of patient characteristics on the received radiation dose and image quality in chest CT examinations and to be able to predict dose and image quality prior to scanning. Consecutive 230 patients underwent routine chest CT examinations were included. CT examination and patients input parameters were recorded for each patient. The effect of patients' demographics/anthropometrics on received dose and image quality was investigated by linear regression analysis. All parameters were evaluated using an artificial neural network (ANN). Of all parameters, patient demographics/anthropometrics were found to be 98% effective in calculating dose reduction. Using ANN on 60 new patients was more than 90% accurate for output parameters and 91% for image quality. Patient characteristics have a significant impact on radiation dose and image quality. Dose and image quality can be determined before CT. This will allow setting the most appropriate scanning parameters before the CT scan.Item COPD Phenotypes in A Lung Cancer Screening Population(2016) Balkan, Arzu; Bulut, Yonca; Fuhrman, Carl R.; Fisher, Stephen N.; Wilson, David O.; Weissfeld, Joel L.; Sciurba, Frank C.; 24989058Background and AimsCOPD (chronic obstructive pulmonary disease) is a very heterogeneous disease, and phenotypic categorization of a high-risk population has many potential benefits. The present study uses a symptom questionnaire, low-dose computed tomography (LDCT) and pulmonary function tests (PFT) to phenotypically subgroup a high-risk population. MethodsStudy group consisted of current or former smokers who underwent lung cancer screening with LDCT as a subgroup of Pittsburgh Lung Screening Study. In addition to LDCT, PFT and a symptom query questionnaire were obtained from each patient. ResultsThe study group consisted of 3183 subjects (age 50-79) subdivided into eight groups according to presence of symptoms, obstruction on PFT and presence of emphysema on LDCT. A total of 501 (15.7%) subjects were asymptomatic, with no airflow obstruction or evidence of emphysema. There were 866 (27.2%) subjects with both obstruction on PFT and emphysema on LDCT, but only 660 (20.7%) had symptoms. Five hundred thirty (16.6%) of the subjects had no emphysema on LDCT but had obstruction on PFT, although only 370 (11.6%) had symptoms. Four hundred seventy-four (14.9%) of subjects had emphysema on LDCT, but no airflow obstruction, with 312 (9.8%) symptomatic. Finally, 812 (25.5%) of subjects had no evidence of airflow obstruction on PFT or emphysema on LDCT, but had symptoms. ConclusionCombining LDCT with PFT and a comprehensive questionnaire allows subgroup classification of COPD phenotypes in a high-risk population and may lead to earlier intervention and an improved framework for future studies.Item Imaging assessment of the right atrium: anatomy and function(2022) Lang, Roberto M.; Cameli, Matteo; Sade, L. Elif; Faletra, Francesco F.; Fortuni, Federico; Rossi, Alexia; Soulat-Dufour, Laurie; 35079782The right atrium (RA) is the cardiac chamber that has been least well studied. Due to recent advances in interventional cardiology, the need for greater understanding of the RA anatomy and physiology has garnered significant attention. In this article, we review how a comprehensive assessment of RA dimensions and function using either echocardiography, cardiac computed tomography, and magnetic resonance imaging may be used as a first step towards a better understanding of RA pathophysiology. The recently published normative data on RA size and function will likely shed light on RA atrial remodelling in atrial fibrillation (AF), which is a complex phenomenon that occurs in both atria but has only been studied in depth in the left atrium. Changes in RA structure and function have prognostic implications in pulmonary hypertension (PH), where the increased right ventricular (RV) afterload first induces RV remodelling, predominantly characterized by hypertrophy. As PH progresses, RV dysfunction and dilatation may begin and eventually lead to RV failure. Thereafter, RV overload and increased RV stiffness may lead to a proportional increase in RA pressure. This manuscript provides an in-depth review of RA anatomy, function, and haemodynamics with particular emphasis on the changes in structure and function that occur in AF, tricuspid regurgitation, and PH.Item False Positive Computed Tomography Imaging for Coronavirus-2019(2021) Akkucuk, Mehmet Husamettin; Karadas, Mehmet Akif; Seviner, Meltem; Demir, Tayfun Anil; Doganay, Elif Kilicli; 0000-0003-4569-1143; 0000-0002-4719-2535; AAJ-2828-2021; AAJ-1600-2021A 79-year-old female patient presented to the emergency unit with cough and severe shortness of breath. Due to a bilateral multilobular ground glass density result from thoracic tomography, the patient was admitted to intensive care with the preliminary diagnosis of corona virus-2019 (COVID-19), and a continuous positive airway pressure was applied. A polymerase chain reaction (PCR) test was performed, and treatment with hydroxychloroquine and azithromycin was initiated. At the same time, the patient with an arterial blood pressure of 190/100 mm/hg was administered with diuretic treatment to reduce lung congestion. The follow-up computed tomography of the patient showed rapid recovery, and ground glass appearances had completely resolved. The PCR was negative and the patient was diagnosed with acute lung edema. The treatment was prescribed, and the patient was discharged from the hospital. Thoracic tomography findings are useful in early period for COVID-19 diagnosis; however, it may show similar results as other diseases that cause respiratory failure and lead to misleading interpretations.Item Diagnostic importance of maximum intensity projection technique in the identification of small pulmonary nodules with computed tomography(2020) Guleryuz Kizil, Pinar; Hekimoglu, Koray; Coskun, Mehmet; Akcay, Sule; 0000-0001-5630-022X; 0000-0002-0805-0841; 0000-0002-8360-6459; 32718138; AAM-4120-2021; AAD-9097-2021; AAB-5175-2021Introduction: In this retrospective study, the aim is to determine the sensitivity of maximum intensity projection (MIP) technique to 3 mm-thick axial sections in patients with small pulmonary nodules identified via examination using computed tomography (CT), and to identify whether this technique provides significant reduction in duration of nodule evaluation. Materials and Methods: A total of 69 patients (339 nodules) who underwent thoracic tomography due to various complaints and in whom pulmonary nodules were identified as a result of the examination were included in the study. Their axial sections that are 3 mm-thick and MIP sections obtained in the axial plane were evaluated by two different radiologists at different times by keeping time. the dimensions and evaluation times of the nodules were recorded separately for each method. Results: Evaluation compatibility between the radiologists was found to be 86.8% and it was considered to be perfectly compatible. Sensitivity of the 1st radiologist in the detection of nodules with MIP was 81.4%, whereas the sensitivity of the 2nd radiologist was 83.4%. In the evaluation for the reporting periods, when the duration of evaluation of MIP images were compared with the gold standard, a statistically significant reduction was found in the reporting times of both radiologists (p< 0.01). Conclusion: It was found that utilization of MIP images as an alternative method to detect pulmonary modules reduces the duration of evaluation significantly and provides the ability to detect nodules with high sensitivity. According to these data, MIP imaging may be preferred as an adjunct method in the evaluation of lung nodules as it provides fast and reliable information besides classical axial sections.