Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item Preferred Music Lowers Anxiety Levels and Pain Perception While Promoting Patient Satisfaction in Women Undergoing Ultrasound-guided Breast Biopsy: Randomized Controlled Study(2023) Ozturk, Funda Ulu; Turnaoglu, Hale; Uslu, Nihal; 0000-0003-2782-2824; 35938620Background Image-guided breast biopsies are well accepted, yet stressful procedures for patients in radiology clinics. Purpose To investigate the effect of music on anxiety, pain, and patient satisfaction related to a breast biopsy session. Material and Methods After approval of institutional review board and giving informed consent, 93 women scheduled for ultrasound-guided breast biopsy or stereotactic wire localization were prospectively enrolled in this randomized controlled study. Patients were referred into two groups either listening to music of their own choice from three options of genre list during the procedure or not. Immediately before and after the biopsy session, participants were asked to complete questionnaires for measuring anxiety (State-Trait Anxiety Inventory, Beck Anxiety Inventory), pain, and patient satisfaction (visual analog scale). Sociodemographic data were described, and the duration was noted at the end. Statistical analysis was made using paired samples t-test, chi-square test, independent samples t-test, and Mann-Whitney U test. Results Except for the duration, demographic characteristics were statistically similar between the two groups. Trait and preprocedural state anxiety scores did not have significant difference between the groups. Both groups showed lowered state anxiety values after the biopsy (P < 0.05) and there was statistically significant reduction in state anxiety levels of music group (10.35 +/- 7.5 music vs. 7 +/- 7.98 control; P = 0.024). Pain perception was fewer (P < 0.05) and patient satisfaction was greater (P < 0.05) through the implementation of music. Conclusion Music intervention reduces anxiety and pain and thereby increases patient satisfaction during ultrasound-guided breast biopsies.Item Left Renal Vein Entrapment In Postural Proteinuria: The Diagnostic Utility Of The Aortomesenteric Angle(2022) Gulleroglu, Nadide Basak; Gulleroglu, Kaan; Uslu, Nihal; Baskin, Esra; https://orcid.org/0000-0002-8533-3781; https://orcid.org/0000-0003-1434-3824; 35789292; AAJ-8833-2021Nutcracker syndrome related to the left kidney vein compression is a cause of orthostatic proteinuria during childhood. Some studies have shown that the ratios between maximum velocities and anterior-posterior diameters of hilar and aortomesenteric segments of the left kidney vein between upright and supine positions must be more than 4 in order to make a Nutcracker syndrome diagnosis. Our aim was to investigate whether the use of a decrease in aortomesenteric angle between upright and supine positions in the presence of isolated orthostatic proteinuria can be a criterion for the diagnosis of Nutcracker syndrome. Relevant patient information, which included demographic data, clinical examination findings, laboratory data, urinary system ultrasound, and kidney color flow Doppler ultrasound results, were prospectively collected. Thirty-nine pediatric patients with orthostatic proteinuria were included in the study. Left kidney vein compression findings were demonstrated in 31 patients. The ratio of maximum velocities of hilar and aortomesenteric segments of the left kidney vein between upright and supine positions was above 4 in only 7 of our patients. Ratio of aortomesenteric angle between upright and supine positions was significantly decreased for patients with left kidney vein compression findings. Conclusion: The use of a decrease in the ratio of aortomesenteric angle between upright and supine positions in the presence of orthostatic proteinuria, instead of the ratios for maximum velocities and anterior-posterior diameters of hilar and aortomesenteric segments, can be more helpful for the diagnosis of Nutcracker syndrome in the differential diagnosis of orthostatic proteinuria.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 Portal Venous Flow Alterations in Hepatic Artery Thrombosis Following Liver Transplant(2022) Tezcan, Sehnaz; Ozturk, Ozturk, Funda Ulu; Soy, Ebru Ayvazoglu; Uslu, Nihal; Haberal, Mehmet; https://orcid.org/0000-0001-7204-3008; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0002-3462-7632; 30702049; AAC-5566-2019; AAJ-8097-2021Objectives: The hepatic vasculature is a unique system due to a dual supply that includes the hepatic artery and portal vein, which interact when the liver vascular supply is decreased. Hepatic artery buffer response, an intrinsic regulatory mechanism that compensates for blood supply, maintains increased hepatic artery flow and caliber in response to portal vein failure. Previous studies revealed that portal vein flow showed no alterations to establish adequate blood supply in response to hepatic artery occlusion. Here, we analyzed portal vein flow changes in patients with hepatic artery thrombosis after liver transplant. Materials and Methods: From December 1988 to October 2017, our center performed 580 liver trans plant procedures. Those diagnosed with hepatic artery thrombosis (19 females, 24 males) by Doppler ultrasonography during postoperative week 1 were analyzed. Patients received either surgery or endovascular treatment for hepatic artery thrombosis, with patency confirmed by Doppler ultrasonography. We compared portal vein flow velocity and caliber before and after treatment using Wilcoxon signed rank and Mann Whitney U tests. Results: Mean patient age was 18.9 +/- 21.4 years. Portal vein flow velocity pretreatment (median of 70 cm/s) was significantly higher than posttreatment (median of 52 cm/s) in all patients (P < .001). Median flow velocity decreased significantly after treatment when subgroups were compared, including age (adult vs child), transplant type (orthotopic transplant vs living donor), and treatment (surgery vs endovascular). However, portal vein flow velocity showed a significantly higher decrease in the surgery subgroup than in the endovascular treatment subgroup (P = .018). There was no significant relationship between portal vein calibers before and after treatment (P = .36). Conclusions: The significant decrease in portal vein flow velocity after successful treatment of hepatic artery thrombosis may represent a compensatory flow change of the portal vein in response to diminished hepatic artery flow.Item Effect Of Meal Intake For Evaluating Hepatic Artery By Doppler Ultrasonography In Liver Transplants: Does Fasting Matter For Screening Hepatic Artery Due To Hemodynamic Changes In Splanchnic Circulation?(2022) Ozturk, Funda Ulu; Tezcan, Sehnaz; Soy, Ebru Hatice Ayvazoglu; Uslu, Nihal; Haberal, Mehmet; https://orcid.org/0000-0003-2782-2824; https://orcid.org/0000-0001-7204-3008; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0002-3462-7632; 35419884; AAC-5566-2019; AAJ-8097-2021Purpose The aim of this study is to assess the utility of fasting on Doppler ultrasonography findings of hepatic artery in liver transplants. Methods Liver transplant patients without vascular abnormalities were prospectively evaluated between December 2017 and January 2020. Doppler sonography was used to describe hemodynamic changes in response to a standard meal. The diameter, peak systolic velocity, blood flow, resistive index (RI) of the main hepatic artery and portal vein peak velocity were measured. Results The mean hepatic arterial diameter of 44 patients was higher in the fasting group (4.5 mm) than in the postprandial group (3.3 mm) (p < .05). The mean hepatic arterial blood flow decreased (from .276 to .127 L/min) and hepatic arterial RI increased (from .66 to .71) following meal ingestion (p < .05). Hepatic arterial velocity was significantly lower and portal venous velocity was higher after oral intake. Conclusion Meal ingestion has an important effect on hepatic artery Doppler features in liver transplants. Therefore, Doppler ultrasound evaluation should be considered after appropriate fasting due to postprandial responses of liver transplant.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 Acoustic Radiation Force Impulse Elastography Findings of Achilles Tendons in Patients on Chronic Hemodialysis and in Renal Transplant Patients(2021) Rahatli, Feride Kural; Turnaoglu, Hale; Haberal, Kemal Murat; Kirnap, Mahir; Fidan, Cihan; Sayin, Cihat Burak; Uslu, Nihal; Haberal, Mehmet; 0000-0002-8211-4065; 0000-0002-9093-1524; 0000-0002-9093-1524; 30398098; R-9398-2019; F-5830-2019; F-5830-2019Objectives: The Achilles tendon, which is composed of tendinous parts of gastrocnemius and soleus muscles, is the strongest and the largest tendon in the human body. Chronic renal disease can lead to reduced physical activity and exercise capacity. Spontaneous rupture of the Achilles tendon can occur in patients with chronic renal failure, with recurrent microtraumas, hypoxia, and chronic acidosis as predisposing factors. Here, we assessed and compared the elastographic findings in the Achilles tendon using acoustic radiation force impulse elastography in patients on chronic hemodialysis, in renal transplant patients, and in healthy volunteers. Materials and Methods: Our study included 25 patients on chronic hemodialysis, 25 renal transplant patients, and 25 healthy individuals (control group). The thickness and shear wave velocity of the Achilles tendons were measured bilaterally by ultrasonography and acoustic radiation force impulse elastography. Results: The mean shear wave velocity was 3.67 m/s in the right and 3.64 m/s in the left Achilles tendon in the hemodialysis group. In the renal transplant group, the mean shear wave velocity was 4.29 and 4.25 m/s for the right and left Achilles tendon, respectively. In the control group, the mean shear wave velocity was 6.68 and 6.59 m/s, respectively for the right and left Achilles tendon. A statistically significant difference in shear wave velocities was shown among the groups (P<.05). Conclusions: Achilles tendons in patients with chronic renal failure and on hemodialysis were softer than in renal transplant patients and softer than in the control group. Chronic tendinopathy causes softening of the tendon. In the renal transplant group, stiffness of the Achilles tendon was increased versus the hemodialysis group but still softer than the control group, which could be explained as a positive clinical effect of renal transplant. Acoustic radiation force impulse elastography is an objective, easy, and noninvasive method to assess Achilles tendinopathy.Item The Role of Combined Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced MRI for Differentiating Malignant From Benign Breast Lesions Presenting Washout Curve(2021) Tezcan, Sehnaz; Ozturk, Funda Ulu; Uslu, Nihal; Akcay, Eda Yilmaz; 32157892Purpose: The aim of this study is to evaluate the diagnostic performance of combined breast magnetic resonance imaging (MRI) protocol including dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in patients with enhancing lesions that demonstrated washout curve and to determine whether applying apparent diffusion coefficient (ADC) cutoff value could improve the diagnostic value of breast MRI. Methods: The retrospective study included 116 patients with 116 suspicious breast lesions, which showed washout curve on DCE-MRI, who underwent subsequent biopsy. Morphologic characteristics on DCE-MRI and ADC values on DWI were evaluated. Apparent diffusion coefficient values and morphologic features of benign and malignant lesions were compared. Diagnostic values of DCE-MRI and combined MRI, including DCE-MRI and DWI (applying an ADC cutoff value) for distinguishing malignancy from benign lesions, were calculated. Results: Of the 116 breast lesions, 79 were malignant and 37 were benign. The ADC value of malignant tumors (median ADC, 0.72 x 10(-3) mm(2)/s) was significantly lower than that of benign lesions (median ADC, 1.03 x 10(-3) mm(2)/s; P < .000). The sensitivity and specificity of an ADC cutoff value of 0.89 x 10(-3) mm(2)/s were 92% and 95%, respectively. Dynamic contrast-enhanced MRI alone presented 100% sensitivity and 59.4% specificity. Adding an ADC cutoff value of 0.89 x 10(-3) mm(2)/s provided 100% sensitivity and 81% specificity, which would have prevented biopsy for 21.6% of benign lesions without missing any malignancies. Conclusion: Applying an ADC cutoff value to DCE-MRI provides an improvement in the diagnostic value of breast MRI for differentiating among lesions presenting washout curve.Item Carpal Tunnel Syndrome: Evaluation of the Effects of Low-Level Laser Therapy With Ultrasound Strain Imaging(2019) Tezcan, Sehnaz; Ozturk, Funda Ulu; Uslu, Nihal; Nalbant, Merve; Yemisci, Oya Umit; 0000-0001-7204-3008; 29892976; ABC-5258-2020Objectives To evaluate the efficacy of low-level laser therapy on median nerve stiffness by using strain elastography in carpal tunnel syndrome (CTS). Methods This study included 37 wrists of 34 patients with mild or moderate CTS between January 2016 and August 2016. The control group comprised 17 patients (18 wrists) with CTS who were treated with wrist splinting for 3 weeks. The low-level laser therapy group included 17 patients (19 wrists) with CTS who were treated with a combination of splinting and low-level laser therapy, which was applied 5 times per week for 3 weeks. Clinical assessment scales, including the Symptom Severity Scale (SSS) and Functional Status Score (FSS), were obtained from our database. The cross-sectional area by ultrasound and strain ratio by elastography were studied. The differences in the strain ratio, cross-sectional area, SSS, and FSS between pretreatment and posttreatment periods in the groups were compared by the paired-sample t test. The correlations between changes in the strain ratio and the cross-sectional area, SSS, and FSS were analyzed by Pearson correlation coefficients. Results The control group included 13 women and 4 men, and the therapy group included 14 women and 3 men. In the therapy group, the mean values of the strain ratio, cross-sectional area, SSS, and FSS decreased significantly after laser therapy (P < .001) in contrast to the control group. No significant correlation was observed between the decreasing degree of the strain ratio and the cross-sectional area, SSS, and FSS after laser therapy. Conclusions The strain ratio and cross-sectional area of the median nerve decrease after low-level laser therapy. These changes may be related to the therapeutic effects of low-level laser therapy, such as nerve regeneration and improvement of the vascular supply.Item Assessment of Parotid and Submandibular Glands With Shear Wave Elastography Following Radioactive Iodine Therapy for Papillary Thyroid Carcinoma(2019) Rahatli, Feride Kural; Turnaoglu, Hale; Iyidir, Ozlem Turhan; Kirnap, Nazli Gursoy; Haberal, Kemal Murat; Aydin, Erdinc; Uslu, Nihal; 0000-0001-5305-6807; 0000-0002-8211-4065; 30027680; K-7904-2019; R-9398-2019; ABC-5258-2020Objectives Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. Radioactive iodine (RAI) therapy is used for remnant ablation following thyroidectomy. Side effects such as dysphagia, xerostomia, and sialoadenitis may occur. We aimed to determine the differences in the parotid and submandibulary glands between healthy patients and patients with PTC who had undergone RAI therapy and have dry mouth symptoms using both shear wave elastography and ultrasonography. Methods We enrolled 30 patients with PTC who had undergone RAI therapy following surgery and 30 healthy controls. Ultrasonography and shear wave elastography of submandibular and parotid glands were performed. The volume of the submandibular glands and the thickness of parotid glands were determined. Ten independent measurements were obtained from each gland, with the region of interest placed at different points on the glands. The mean shear wave velocities (SWVs) were calculated and compared between the patients and controls. Results In the PTC group, there was a significant reduction in the volume of the submandibular glands (P < .05) and in the thickness of the parotid glands (P < .05) compared with the control group. The mean SWVs of the parotid glands and submandibular glands were significantly higher in the PTC group compared with the control group (P < .0001). The SWVs of the parotid glands were higher than the SWVs of the submandibular glands (P < .0001). Conclusions Shear wave elastography could be a noninvasive and easy assessment method of parotid and submandibular glands in patients who had undergone RAI therapy and experience dry mouth.