Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item A Rare Triplet Found in a Patient With Drug-Resistant Hypertension: Adnexal-Adrenal Sex Cord-Stromal Tumors and Castleman?s Disease(2022) Erbay, Gurcan; Pehlivan, Umur Anil; Karadeli, Elif; 36158343Adrenal and ovarian sex cord-stromal tumors which originate from the ovarian stroma and adrenal cortex, have an extremely low incidence even alone. Castleman's disease is also one of the rare causes of non-neoplastic lymphadenopathy. The aim of this case report was to contribute to the literature by identifying the coexistence of these three pathologies, which are encountered with a low incidence even alone.A 46-year-old female patient had experienced drug-resistant hypertension. In the laboratory test, electrolyte imbalance was detected. Imaging modalities revealed left adrenal and adnexal mass lesions as well as a right paraspinal intramuscular nodular lesion. When hypertension and electrolyte imbalance were evaluated together with their etiology, it was thought that the left adrenal lesion, which also has a chemical shift, may be compatible with functional adenoma. Left adrenalectomy was planned. The ovarian lesion and right paraspinal intramuscular lesion were also excised during the same session with the suspicion that the ovarian lesion may be hormone-active neoplasia and the intramuscular lesion may be a metastasis. The diagnosis of adnexal-adrenal sex cord-stromal tumors and unicentric Castleman's disease were made histopathologically.Radiologically, it should be kept in mind that the radiological manifestations of adrenal sex cord-stromal tumors can be confused with adrenal adenomas. Even when these extremely rare tumors are encountered, avoiding the "satisfaction of search" plays a crucial role in the identification of additional pathologies that can explain the etiology.Item A Case of Mediastinal Mesenchymal Tumor Resembling Hemopericardium(2021) Acibuca, Aynur; Yilmaz, Mustafa; Karadeli, Elif; Canpolat, Emine Tuba; Erol, Tansel; 34404995Mediastinal neoplasms are rare in the elderly, and clinical suspicion is the first and most important step of differential diagnosis. Mediastinal tumors can be misdiagnosed because their symptoms or signs can overlap with cardiovascular diseases, which have a higher prevalence among the older population. The diagnostic process should be managed with multimodality imaging and clinical judgement. Here, the case of a 74-year-old male patient, who presented with shortness of breath, is examined. A chest X-ray revealed an increased cardiothoracic ratio, and he was diagnosed with hemopericardium following an emergent chest computed tomography. In the echocardiography, it was suspected that a hyperechogenic area adjacent to the heart might be due to a mass, and further examinations confirmed a mediastinal neoplasm. A surgical biopsy was performed, and it was determined to be a mesenchymal tumor. To conclude, clinicians should keep in mind the possibility of paracardiac neoplasm in the elderly, as well as in other age groups, when encountering mediastinal widening so that the patient can be protected from unnecessary interventions such as pericardiocentesis.Item Use of Histogram Analysis in Diffusion-Weighted Magnetic Resonance Imaging for Differentiation of Renal Tumor Subgroups(2021) Erbay, Gurcan; Goren, Mehmet Resit; Karadeli, Elif; Koc, Zafer; 0000-0002-0352-8818; 0000-0002-2001-1386; AAK-5399-2021; Y-6143-2019Background: The histopathological differentiation of renal neoplasms can be challenging via imaging. Objectives: To evaluate differences in histogram parameters on apparent diffusion coefficient (ADC) maps and to investigate the efficacy of histogram analysis in differentiation of oncocytomas from malignant renal neoplasm (MRN) subgroups. Patients and Methods: In this cross-sectional, retrospective study, the texture parameters of diffusion-weighted magnetic resonance images (DW-MRI) were evaluated in 65 patients with renal tumors (nine cases of oncocytoma and 59 cases of MRN) for a Results: A total of 68 lesions from 50 male and 15 female patients, with a median age of 55.4 years, were examined in this study. There were significant differences in the mean, median, and peak ADC values, as well as ADC percentiles, between the oncocytoma and MRN subgroups. Regarding the histopathological features of the lesions, 9 (11.5%) cases of oncocytomas, 23 (29.5%) cases of clear cell renal carcinoma (ccRCC), 14 (17.9%) cases of papillary renal cell carcinoma (pRCC), 12 (15.4%) cases of chromophobe renal cell carcinoma (chRCC), and 10 (12.8%) other tumors (including four cases of transitional cell carcinoma, four cases of non-Hodgkin's lymphoma, and two cases of primitive neuroectodermal tumor) were identified. Significant differences were found in the mean and median ADC values between the oncocytoma, pRCC, chRCC, and other MRN subgroups. Moreover, significant differences were found in the mean and median ADC values between the ccRCC, pRCC, and chRCC subgroups. There were also significant differences in the percentiles of mean and median ADCs between oncocytomas and pRCC, chRCC, and other MRN subgroups. However, there were no significant differences in the mean and median ADCs (including the percentile histogram analysis) or the peak ADC between the oncocytoma and ccRCC groups. The mean, median, and percentile of ADC for renal masses were superior to kurtosis, skewness, and entropy. Conclusion: Although differentiation between ccRCC and oncocytoma was not possible by only measuring the mean, median, and peak ADC values, the histogram analysis of ADCs may improve differentiation between the MRN subgroups. Clearly, ADC cannot be used to differentiate between oncocytomas and MRNs.Item Generalist versus Abdominal Subspecialist Radiologist Interpretations of Abdominopelvic Computed Tomography Performed on Patients with Abdominal Pain and its Impact on the Therapeutic Approach(2020) Yesilagac, Hasan; Arer, Ilker Murat; Gulalp, Betul; Yabanoglu, Hakan; Karagun, Ozlem; Karadeli, Elif; 0000-0003-0681-8375; 0000-0002-2045-2771; 0000-0002-0352-8818; 0000-0002-1365-9256; 0000-0002-1161-3369; 32322789; U-4084-2017; P-6931-2016; AAK-5399-2021; AAJ-6068-2021; AAJ-7865-2021Introduction: Abdominal pain is one of the most common patient complaints in the emergency department (ED) and abdominopelvic computed tomography (ACT) scan plays an important role in evaluation of these patients. Objective: The aim of this study was to determine the differences between interpretations by generalist radiologists and abdominal subspecialist radiologists regarding the abdominopelvic computed tomography (ACT) of patients who were admitted to the Emergency Department (ED) and to investigate its effect on the patients' therapeutic approach. Methods: The records of 16452 patients who were admitted to the emergency department with complaint of abdominal pain between January 2015 and April 2017 were reviewed, retrospectively. Out of these patients, 245 (1.5%) underwent ACT for differential diagnosis and among them, 137 (0.8%) patients had their ACT reports evaluated by generalist radiologists in 45 minutes and by abdominal subspecialist radiologist 8-12 hours later and were included in the study. Patients were divided into three groups according to the effect of ACT reports on the performed treatment. Group 1: no effect on planned treatment, group 2: minor effect on planned treatment, which did not result in a change in the treatment process and group 3: major effect on planned treatment approach, which resulted in a change in the treatment process. These changes included at least one of the two criteria: changing the indication of surgery from emergency surgery to elective surgery and/or discharge of the patient from the ED, when actually hospitalization was required. Results: Out of the 137 patients, 87 (63.5%) were male, 50 (36.5%) were female and the patients' mean age was 56 (27-93) years. There were 117 (85.4%) patients in group 1, 15 (10.9%) patients in group 2, and 5 (3.7%) patients in group 3. We determined minor inconsistency between the reports in group 2 and major inconsistency in group 3. Patients in group 3 suffered from delayed surgical intervention due to inconsistency of the CT reports resulting in prolonged hospital stay and increased morbidity. In 17 patients (four patients in Group 1 and 13 patients in Group 2) treatment plan was changed due to CT results; and while surgical treatment was planned for them prior to CT scan, they were discharged with medical treatment after that and overtreatment was prevented. Conclusion: Contribution of abdominal radiologists to evaluation of ACT images in the ED would reduce the inconsistency in ACT reports and prevent the patients from receiving insufficient treatment or overtreatment.Item Prognostic values of ADC(mean) and SUVmax of the primary tumour in cervical cancer patients treated with definitive chemoradiotherapy(2019) Yildirim, Berna Akkus; Onal, Cem; Erbay, Gurcan; Guler, Ozan Cem; Karadeli, Elif; Reyhan, Mehmet; Koc, Zafer; 0000-0002-2742-9021; 0000-0003-0987-1980; 30354907; D-5195-2014; S-8384-2016We analysed the correlation of F-18-fluorodeoxyglucose uptake into primary tumours using the maximum standardised uptake value (SUVmax) and the mean apparent diffusion coefficient (ADC(mean)) values in magnetic resonance imaging (MRI) with the clinical and pathological factors in patients with cervical cancer who were treated with concurrent chemoradiotherapy. The patients were stratified according to the primary tumour pre-treatment ADC(mean) and SUVmax cut-off values. There were significant correlations between the SUVmax of the primary tumour and tumour size, and the treatment response. The correlation between the ADC(mean) and FIGO stage, tumour size, and the lymph node metastasis was significant. The SUVmax was significantly and inversely correlated with the ADC(mean) for cervical cancer (r = -0.44, p <.001). In the multivariate analysis, the primary tumour ADC(mean), treatment response and the lymph node metastasis emerged as significant independent predictors of both OS and DFS, and of the primary tumour SUVmax for DFS. Tumour size has a borderline significance for OS. High SUVmax and low ADC(mean) of the primary tumour are important predictive factors for identifying high-risk patients with cervical cancer who are treated with definitive chemoradiotherapy. These results point to a future role for the diffusion-weighted MRI and for F-18-fluorodeoxyglucose positron emission tomography, not only in the staging of cervical cancer but as an aid in the selection of an adjuvant treatment regimen after chemoradiotherapy for individual patients.Item MRI Findings of Borderline Retroperitoneal Serous Cystadenocarcinoma(2019) Erbay, Gurcan; Karadeli, Elif; Parlakgumus, Alper; 30823957Retroperitoneal serous cystadenocarcinoma is an extremely uncommon lesion. Here, we present MR imaging findings of a 40-year woman who was admitted to the hospital due to abdominal pain. The patient was evaluated with abdominal Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). Abdominal CT revealed a 13x18 cm large retroperitoneal and cystic mass with polypoid projections. MRI was superior than CT in showing polypoid projections. Contrast enhanced MRI detected enhancement of thin septations and cyst appearance inner the cyst. Diffusion-weighted MRI showed restricted diffusion in the polypoid component with contrast enhancement. Therefore, we thought malignant lesion. The findings of contrast-enhanced CT and MRI were helpful in the diagnosis of those lesions. In addition, diffusion weighted MRI with multi parametric modalities played unlimited role in the assesment of the differential diagnosis.Item Correlation of Clinical Risk Factors with Diffusion-Weighted Magnetic Resonance Images in Prostate Cancer Patients Treated with Definitive Radiotherapy(2015) Erbay, Gurcan; Onal, Cem; Guler, Ozan C.; Karadeli, Elif; Koc, ZaferThis study is aimed to correlate apparent diffusion coefficient (ADC) values and clinical T-stage, serum PSA, pathology Gleason scores. We also further analyzed whether ADC values could be used to appropriately define the risk groups. 135 biopsy-proven, radiotherapy-(RT)-treated, prostate cancer patients who underwent pre-RT DW-MRI and standard T2W pelvic MRI were included. ADC and normalized ADC (nADC) values were calculated from DW-MRI delivered a median 8.1 weeks after prostate biopsy. ADC values were correlated with clinical risk factor values by using Pearson correlation test. ADCs in low-, intermediate-, and high-risk patients were 0.873 +/- 0.122X10(-3) mm(2)/s, 0.763 +/- 0.124X10(-3) mm(2)/s, and 0.701 +/- 0.132X10(-3) mm(2)/s (p = 0.001), respectively. Patients with preRT PSA <10 ng/mL had significantly higher ADCs than patients with preRT PSA 10-20 ng/mL (p = 0.02) or >20 ng/mL (p < 0.001). Mean ADC for patients with Gleason score <7 was significantly higher than patients scoring 7 (p = 0.001) or >7 (p < 0.001). Clinical stageItem Ruptured Ovarian Dermoid Cyst Mimicking Peritoneal Carcinomatosis: CT and MRI(2015) Erbay, Gurcan; Ozen, Merve; Karadeli, ElifSpontaneous rupture of ovarian dermoid cyst and chronic abdominal spillage of its content is a very uncommon condition, which causes granulomatous peritonitis and can be confused with peritoneal carcinomatosis. Here is presented such a case of ruptured dermoid cyst causing chronic granulomatous peritonitis with radiologic findings mimicking peritoneal carcinomatosis.Item CT findings of Intramural Small Bowel Hematoma Secondary to use of Oral Anticoagulant Therapy(2016) Karadeli, Elif; Tok, Sermin; Erbay, GurcanItem Polycystic Ovary Syndrome: The Correlation Between Renal Doppler Ultrasound and Laboratory Parameters(2016) Karadeli, Elif; Uckuyu, Ayla; Ciftci, Faika Ceylan; Toprak, Erzat; Turhan, Erdem; Ozcimen, Emel; Niron, Emin AlpAim: To investigate whether there is alteration both right and left kidney lenght, parenchymal thickness, renal arterial, venous blood flow measurements in normotensive reproductive age women with polycystic ovary syndrome (PCOS). Material and Method: Forty women with PCOS according to Rotterdam criteria and thirty-six healthy volunteers women were included in our study. Hormonal, biochemical analysis, renal Doppler ultrasonography were performed and were investigated in terms of both left and right renal lenght, parenchymal thickness, peak systolic velocity (PSV), resistive index (RI), venous impedance index (VI), metabolic characteristics having insulin resistance, impaired glucose tolerance, serum lipid concentration. The student t test and pearson corelation test were used for statistical analysis. Results: The measurements for kidneys were not different between women with PCOS and healthy women. The peak systolic velocity of mean renal artery was lower in PCOS group. The mean renal venous impedance also was higher in PCOS group than control group. The mean renal resistive index was slightly higher in PCOS but not statistical significant. In bivariate corelation analyse including all patients, it was seen that BMI, WHR, level of serum fasting glucose, insulin, LDL, trigliserides were positively related with mean renal length and mean parenchymal thickness measurements. Discussion: We found that there was alterations kidney blood flow in normotensive reproductive age women with PCOS. This findings may indicate results of long term renal and cardiovascular complications of PCOS.