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    Correlation between breast density in mammography and background enhancement in MR mammography
    (SPRINGER, 2010) Cubuk, R.; Tasali, N.; Narin, B.; Keskiner, F.; Celik, L.; Guney, S.
    Purpose. We aimed to analyse the influence of mammographic breast density on background enhancement (BE) at magnetic resonance (MR) mammography in pre- and postmenopausal women. In addition, we questioned predictability of contrast-enhancement dynamics of normal fibroglandular tissue (NFT) at MR mammography according to mammographic breast density. Materials and methods. Twenty-six patients (mean age 51.54 +/- 11.5 years; range 37-79 years) who underwent both MR mammography and conventional mammography were included in this retrospective study. Fourteen patients were premenopausal and 12 were postmenopausal. The ethics committee of our institution approved the study. The mammograms were retrospectively reviewed for overall breast density according to the four-point scale (I-IV) of the Breast Imaging Reporting and Data System (BI-RADS) classification. Two radiologists, who were unaware of the clinical data, separately assessed the MR mammography images. Images were assessed for enhancement kinetic features (enhancement kinetic curve and the early-phase enhancement rate) and BE. MR mammography and conventional mammography findings were compared according to BI-RADS breast density category and menopausal status. Results. Percentage of increased signal intensity values during the first minute did not change according to mammographic breast density, and the mean early-phase enhancement rate scores were similar among breast density groups (p=0.942). There was no significant difference between pre- and postmenopausal groups. Enhancement kinetic features of the different groups based on BI-RADS breast density category and menopausal status were similar. There was no correlation between breast density and BE in either premenopausal (p=0.211) or in postmenopausal (p=0.735) groups. Conclusions. We determined no correlation between mammographic breast density and so-called BE in MR mammography in either premenopausal or postmenopausal women. NFT at MR mammography cannot be predicted on the basis of mammographic breast density.
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    Effect of an oral anxiolytic medication and heart rate variability on image quality of 64-slice MDCT coronary angiography
    (SPRINGER, 2011) Cubuk, R.; Tasali, N.; Yilmazer, S.; Gokalp, P.; Celik, L.; Dagdeviren, B.; Guney, S.
    The aim of the study was to investigate the relationship between image quality in 64-slice multidetector computed tomography (MDCT) and patients' preimaging anxiety status and heart rate variability (HRV), and to evaluate the efficacy of an orally administered anxiolytic medication on HRV and image quality. Sixty patients [14 women, 46 men; mean age 52.53 +/- 10.55 (SD), range 33-78 years] were studied. Anxiety levels were assessed with the State-Trait Anxiety Inventory 60 min before the procedure. The participating patients were randomly assigned to one of the two study groups: a control group (no medication administered for anxiety reduction) and an anxiolytic medication group, with 30 patients in each group. The presence of motion artefacts and image quality for each coronary artery segment were evaluated using a four-point grading system. To estimate HRV, the duration of each heartbeat during MDCT data acquisition was measured in each patient. A moderate correlation was found between HRV during MDCT scanning and the mean image quality for all coronary segments (r=0.47, p < 0.01). There was an association between HRV and state anxiety scores in all cases (r=0.370, p < 0.01). HRV in the patients who received alprazolam was statistically significantly lower than in controls (p < 0.05). The average image quality in patients who used alprazolam was also statistically significantly higher than in controls (p < 0.05). The most important finding in our study is that oral premedication to reduce anxiety is also effective in decreasing HRV and improves image quality. Therefore, we suggest that using alprazolam in addition to a beta-blocker may improve image quality in patients undergoing MDCT coronary angiography (MDCT-CA). Anxiolytic usage may improve image quality by lowering the HRV in selected cases where administration of a beta-blocker is contraindicated. We also suggest that further studies in larger series are required to validate this finding.