Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Association Between the Elasticity of Hip Muscles and the Hip Migration Index in Cerebral Palsy(2019) Analan, Pinar Doruk; Aslan, Hulya; https://orcid.org/0000-0002-3528-3712; https://orcid.org/0000-0002-7138-246X; 30779197; AAA-8043-2021; AAK-9104-2021Objectives-Cerebral palsy (CP) increases the risk of hip displacement during childhood. Abnormal hip muscle forces have been proposed as the predisposing factors. In CP, the amount of hip displacement is commonly evaluated by the Reimers hip migration index (MI) on an anteroposterior pelvic radiograph. To the best of our knowledge, the association between the elasticity of hip muscles measured by shear wave elastography and the MI has not been studied yet. Herein, we aimed to analyze the correlation between the elasticity of hip muscles and the MI. Methods-Bilateral hips of 25 children with spastic CP were included prospectively in this study. Anteroposterior pelvic radiographs were used to measure the MI. Shear wave elastography was performed to evaluate the elasticity of muscles. The correlation between the MI and the elasticity of hip flexor and adductor muscle groups was assessed. Also, the association between the elasticity of agonist/antagonist muscles was analyzed. Results-The MI showed fair to good correlations with hip flexors and adductors for both readers (0.71 >= r >= 0.52). The mean MIs of the patients +/- SDs were 22.64% +/- 7.79% for reader 1 and 21.55% +/- 8.83% for reader 2. The elasticity of agonist/antagonist muscle groups showed little/no to a weak correlation for both readers (0.32 >= r >= -0.07). Conclusions-Although, hip flexor and adductor muscle elasticity showed a correlation with MI, it seems very hard to say that increased elasticity of hip flexor and adductor muscles causes hip dislocation.Item 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; 34970437Aim: 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.Item Role of acoustic radiation force-based elasticity imaging in endometrium pathologies(2020) Cenkeri, H. C.; Bidaci, T. B.; Yilmaz, B.; Desteli, G.; 33047689Backround: Ultrasonography is difficult to distinguish between endometrial pathologies and often requires curettage. ARFI (Acoustic Radiation Force-Based Elasticity Imaging) is a new ultrasonography elastography method. Using ARFI, it is possible to obtain information about the likelihood of the tissue benign or malignant. Aim: The aim of this study is to evaluate the contribution of ARFI to differentiate endometrial pathologies in hysterectomy specimens. Subjects and Methods: Our study was prospectively, January-May 2017, performed in randomly 45 cases of 41-91 years of age (mean 58.3 years) who have decided to have hysterectomy. Hysterectomy was performed for uterine prolapse and endometrial hyperplasia in elderly patients and menorrhagia in young patients. Pathology results were compared with ARFI values and endometrial thickness. ANNOVA test was used for the comparison of ARFI values. Results: Pathology revealed 14 cases of endometrial atrophy, 11 cases of proliferative phase, 10 cases of polyp, 6 cases of endometrial hyperplasia, and 4 cases of endometrium cancer. There is a statistically significant difference between mean ARFI values of endometrium, subendometrium, and myometrium of the groups (P < 0.05). There was a statistically significant difference between the mean endometrial thickness of the groups (P < 0.05). Conclusion: Endometrium ARFI contributes to the differential diagnosis of endometrial pathologies. Subendometrial and myometrial ARFI values decrease in polyps and increase in hyperplasia. Our study shows that the addition of subendometrium ARFI to gray-scale sonography before deciding on invasive procedures in endometrial pathologies may improve diagnostic accuracy. We concluded that further in vivo studies will establish the usefulness of this technique for preoperative diagnostic measures.Item Acoustic Radiation Force Impulse (ARFI) elastography quantification of muscle stiffness over a course of gradual isometric contractions: a preliminary study.(2015) Yavuz, Alpaslan; Bora, Aydin; Bulut, Mehmet Deniz; Batur, Abdussamet; Milanlioglu, Aysel; Goya, Cemil; Andic, Cagatay; 25745658Aims: To evaluate the feasibility of quantitative analysis of muscle stiffness by Acoustic Radiation Forced Impulse (ARFI) elastography over a course of graduate isometric voluntary contractions. Material and methods: The stiffness of the bilateral biceps muscle of 13 healthy volunteers was measured in real time by ARFI elastography, while the forearm was in neutral-extended position, 90 degree self-flexed positions and 90 degree self-flexed position, with altered weights ranging from 1 to 8 kg placed on flattened palmar surfaces consecutively. The determined increases in biceps muscle stiffness were measured for both arms and correlated with the loadings weights adopted at progressive trial stages. Results: The mean shear wave velocity (SWV) values of biceps muscles in a neutral position, in 90 degree flex position and 90 degree flex position with 1 to 8 kg weights on palmar surfaces were 2.162 +/- 0.302 m/sec, 3.382 +/- 0.581 m/sec, and 3.897 +/- 0.585 to 5.562 +/- 0.587 m/sec, respectively. Significant correlations between the muscle SWV values and related palmar weights and between the SWV values of right and left sides at different trial stages were identified (r=0.951 and r=0.954, respectively). A mutual propagation path of deep regions to entire areas was described to account for the distribution of increase in stiffness with increases in palmar weights. The confidence of method regarding inter-observer difference was confirmed by the correlation analyses of the results (r=0.998). Conclusions: ARFI elastography is a feasible imaging modality for quantifying the stiffness of isometrically voluntarily contracting muscles.