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Yayın Accidental injection of autologous fat into the breast implant: a case report highlighting radiological findings(SPRINGER, 2017) Celik, Levent; Cubuk, Rahmi; Arslan, Gozde; Atasoy, Mehmet Mahir; Celik, LeventAutologous fat grafting is a popular technique for breast augmentation and improving breast contour depressions. It is a technique that involves using the patient's own adipose tissue to be applied on a subcutaneous area to increase total fat volume. Intraimplant fat is an unexpected finding after autologous fat grafting. A 51-year-old asymptomatic female who underwent breast augmentation with silicone implants and secondary breast augmentation with autologous fat grafting presented with unidentified cluster of radiolucencies superimposed to left implant on screening mammogram. Corresponding MRI revealed intraimplant fat intensities. This case represents a previously unreported intraimplant injection of fat with resultant intracapsular rupture and highlights the radiological findings of intracapsular implant rupture.Yayın Automated Aortic Supravalvular Sinus Detection in Conventional Computed Tomography Image(IEEE, 2013) Unay, Devrim; Harmankaya, Ibrahim; Oksuz, Ilkay; Kadipasaoglu, Kamuran; Cubuk, Rahmi; Celik, LeventValvular diseases are those where one or more of the cardiac valves are affected. Treatment of valvular diseases often involves replacement or restoration of the affected valve(s). In such a surgical procedure, the medical expert performing the procedure can largely benefit from a patient-specific and dynamic valvular model containing information complementary to the 2D/3D static images. To this end, in this study a novel automated supravalvular sinus detection method (to be used as a first step in aortic valve segmentation) on conventional contrast-enhanced ECG-gated multislice CT data and its evaluation on expert annotated 31 real cases are presented. Results demonstrate a highly accurate detection performance with average error rate inferior to 1.12 mm.Yayın Background parenchymal enhancement: is it just an innocent effect of estrogen on the breast?(AVES, 2017) Arslan, Gozde; Celik, Levent; Cubuk, Rahmi; Celik, Levent; Atasoy, Mehmet MahirPURPOSE We aimed to retrospectively analyze whether background parenchymal enhancement (BPE) on breast magnetic resonance imaging (MRI) correlates with menarche, menopause, reproductive period, menstrual cycle, gravidity-parity, family history of breast cancer, and the Breast Imaging-Reporting and Data System (BI-RADS) category of the patient. METHODS The study included 126 pre- and 78 postmenopausal women who underwent breast MRI in our institute between 2011 and 2016. Patients had filled a questionnaire form before the MRI. Two radiologists blinded to patient history graded the BPEs and the results were compared and analyzed. RESULTS The BPE was correlated with patient age and the day of menstrual cycle (P < 0.01 for both). No correlation was found with menarche age, menopause age, total number of reproductive years, and family history of breast cancer. In the moderate BPE group, only 1 out of 35 patients and in the marked BPE group only 1 out of 13 patients were postmenopausal and had BI-RADS scores of 4 and 5, respectively. CONCLUSION Increased symmetrical BPE is mainly due to current hormonal status in the premenopausal women. High-grade BPE, whether symmetrical or not, is rarely seen in postmenopausal women; hence, these patients should be further investigated or closely followed up.Yayın Bronchial hyperreactivity and airway wall thickening in obstructive sleep apnea patients(SPRINGER HEIDELBERG, 2011) Sariman, Nesrin; Levent, Ender; Cubuk, Rahmi; Yurtlu, Sirin; Aksungar, Fehime BenliHypoxia/reoxygenation episodes in obstructive sleep apnea (OSA) results in the alteration of the oxidative balance, leading to the development of inflammation. Airway wall thickening and inflammatory changes are suggested as a primary cause of the airway hyperresponsiveness in asthmatics. Bronchial hyperreactivity (BH) may also occur in patients with OSA. We investigated the presence of BH and airway wall thickness in OSA and correlations with inflammatory markers. Sixteen OSA patients and ten controls without allergic diseases were prospectively studied. Plasma pro-B-type natriuretic peptide (pro-BNP), fibrinogen, D-dimer, alpha 1-antitrypsin, and high-sensitive C-reactive protein levels were measured. Airway wall thickness was evaluated with high-resolution CT, and BH was assessed by giving each subject a methacholine challenge test. In OSA patients, bronchial wall thickness, fibrinogen, D-dimer, alpha 1-antitrypsin, high sensitive C-reactive protein, and pro-BNP levels were significantly greater than those in control subjects. Among the 16 patients, three had BH on methacholine challenge. Bronchial wall thickness(mm) was positively correlated with apnea-hypopnea index (AHI: number of apneas + hypopneas/hour of sleep), BMI, respiratory arousal index, nocturnal oxygen desaturation (NOD) duration (time in minutes with a nocturnal arterial oxygen saturation of < 90% during sleep), and alpha 1-antitrypsin levels. NOD duration also correlated with pro-BNP and fibrinogen levels. In OSA patients, walls of central airways were thicker than normal subjects. BH may have occurred in OSA patients. NOD duration correlated with inflammatory parameters and oxygen desaturation index 3% had an effect on the thickness of bronchial walls. But overall, AHI was found to be the only independent predictor of bronchial wall thickness.Yayın Cauda Equina Paraganglioma with Ependymoma-Like Histology: A Case Report(TURKISH NEUROSURGICAL SOC, 2012) Midi, Ahmet; Yener, Arzu Nese; Sav, Aydin; Cubuk, RahmiParaganglioma affecting the cauda equina region is very rare and can be misinterpreted as an ependymoma which is more common at this site. A 38-year-old woman with a paraganglioma in the cauda equina is presented. MRI revealed a well-circumscribed, intradural, extramedullary tumor nodule with the dimensions of 2.5x1x1 cm. The patient underwent L3 laminectomy and total excision of the tumor. The tumor was diagnosed as ependymoma and the patient was decided to undergo adjuvant radiotherapy. The patient applied to our medical center for a second opinion. Histopathologically, her tumor was found to be a paraganglioma with ependymal features. Therefore no adjuvant therapy was applied. There is no evidence of recurrence or metastases for 15 months after her operation. Paraganglioma in the cauda equina/ filum terminale is very rare and can be misdiagnosed as ependymoma especially when it exhibits ependymoma-like histology. This rare form of paraganglioma behaves like a WHO grade I tumor of CNS like classic paraganglioma. No recurrence or metastasis is expected when it is totally resected. Morphology can be misleading hence immunohistochemistry and/or ultrastructural study is necessary for correct diagnosis.Yayın Clinical experiences of ultrasound-guided lumbar erector spinae plane block for hip joint and proximal femur surgeries(ELSEVIER SCIENCE INC, 2018) Tulgar, Serkan; Selvi, Onur; Senturk, Ozgur; Ermis, Mehmet Nurullah; Cubuk, Rahmi; Ozer, Zeliha…Yayın COMPARISON OF HOUNSFIELD UNITS OF THE RENAL PAPILLAE IN KIDNEY STONE FORMERS AND NON STONE FORMERS(NOBEL ILAC, 2014) Sinanoglu, Orhun; Ekici, Sinan; Cakiroglu, Basri; Cubuk, Rahmi; Aksoy, Suleyman HilmiObjective: To investigate whether renal papillae of patients with nephrolithiasis are more radiodense than that of control patients and to evaluate the predictibility of urolithiasis events using papillary density differences between stone and non stone formers. Material and Method: Hounsfield unit (HU) values of the papillae of 212 patients with unilateral nephrolithiasis and 108 patients in the control group at the level of the upper pole, middle region and lower pole of both kidneys were evaluated. Results: Mean HU density of all papillae of kidneys with stones was higher than that of stone free kidneys in nephrolithiasis patients (27.21 +/- 2.83 vs 25.66 +/- 2, p=0.000). Mean HU density of renal papillae of stone patients in calyces with stones was significantly higher than that of all papillae in control patients (25,82 +/- 1.97 vs 30,25 +/- 4,03, p<0,001). Mean HU density of all papillae in stone-free kidneys of nephrolithiasis patients was not significantly different from that of control patients (25.82 +/- 1.97 vs 25.66 +/- 2.57, p=0.642). When the values for control and patient groups according to stone laterality was evaluated, the difference was significant only between right upper and right lower calyces for the right nephrolithiasis and the left middle region for the left nephrolithiasis. (26.32 +/- 3.30 vs. 27.90 +/- 3.92 and 25.10 +/- 3.34 vs. 26.95 +/- 4.73, p=0.003 and p=0.009 and 25.70 +/- 3.67 vs 27.15 +/- 3.77 p=0.001, respectively). Conclusion: Only the kidneys with stones and especially the patients with papillae facing the stones in nephrolithiasis have higher renal papillary HU. This fact implies the impossibility of HU per se in predicting future urolithiasis events and/or patients; opposing to the findings of a few previous studies.Yayın Comparison of Internal Mammary Artery and Lateral Thoracic Artery Width in Patients with Benign and Malignant Breast Tumors(AVES, 2017) Arslan, Gozde; Celik, Levent; Cubuk, Rahmi; Celik, Levent; Atasoy, Mehmet MahirObjective: The main objective of this study was to analyze the differences in ipsilateral and contralateral internal mammary artery (IMA) and lateral thoracic artery (LTA) width in patients with malignant and benign breast tumor. Materials and Methods: A total of 104 female patients, of which 41 had benign and 63 had malignant tumors, were included in the study. The diameters of the IMA and LTA were measured from the widest point in T1-weighted post-contrast images. Breast magnetic resonance images were evaluated by a breast radiologist. Results: The ipsilateral IMA diameter of cases in the malignant group was found to be statistically significantly higher when compared with the benign group. In the benign group, the ipsilateral IMA diameter being an average of 0.43 +/- 0.87 mm larger than the contralateral IMA diameter was found to be statistically significant, whereas in the malignant cases, the ipsilateral IMA diameter being an average of 0.78 +/- 1.08 mm larger than the contralateral IMA diameter was found to be statistically significant. Also, in benign cases, the ipsilateral LTA diameter being an average of 0.31 +/- 0.70 mm larger than the contralateral LTA diameter was found to be statistically significant, whereas in malignant cases, the ipsilateral LTA diameter being an average of 0.29 +/- 0.68 mm larger than the contralateral LTA diameter was found to be statistically significant. Conclusion: The IMA and LTA diameters in benign and malignant cases were found to be higher in comparison with contralateral breast, independent of the size of the lesion.Yayın Complication of non-US guided procedure of aquafilling breast gel(SOC ROMANA ULTRASONOGRAFE MEDICINA BIOLOGIE-SRUMB, 2017) Arslan, Gozde; Celik, Levent; Atasoy, Mehmet Mahir; Celik, Levent; Cubuk, Rahmi…Yayın Degeneration of the lumbar spine and dual-energy X-ray absorptiometry measurements in patients without osteoporosis(ELSEVIER SCIENCE INC, 2009) Atalay, Ayce; Kozakcioglu, Meral; Cubuk, Rahmi; Tasali, Nuri; Guney, SefikAim: The aim of this study was to evaluate the effects of degenerative findings on the accuracy of readings obtained by dual-energy X-ray absorptiometry (DXA) in patients without osteoporosis. Methods: Twenty-four female patients who had undergone both DXA and lumbar magnetic resonance imaging were included in the study. Conclusion: This study has demonstrated that degenerative radiologic changes, especially in the osteophyte area, affect bone mineral density measurements, so degeneration should be considered in the evaluation of this measurement. (C) 2009 Elsevier Inc. All rights reserved.Yayın Distinguishing Depressive Pseudodementia from Alzheimer Disease: A Comparative Study of Hippocampal Volumetry and Cognitive Tests(KARGER, 2017) Sahin, Sevki; Onal, Tugba Okluoglu; Cinar, Nilgun; Bozdemir, Meral; Cubuk, Rahmi; Karsidag, SibelBackground and Aim: Depressive pseudodementia (DPD) is a condition which may develop secondary to depression. The aim of this study was to contribute to the differential diagnosis between Alzheimer disease (AD) and DPD by comparing the neurocognitive tests and hippocampal volume. Materials and Methods: Patients who met criteria of AD/DPD were enrolled in the study. All patients were assessed using the Wechsler Memory Scale (WMS), clock-drawing test, Stroop test, Benton Facial Recognition Test (BFRT), Boston Naming Test, Mini-Mental State Examination (MMSE), and Geriatric Depression Scale (GDS). Hippocampal volume was measured by importing the coronal T1-weighted magnetic resonance images to the Vitrea 2 workstation. Results: A significant difference was found between the AD and DPD groups on the WMS test, clock-drawing test, Stroop test, Boston Naming Test, MMSE, GDS, and left hippocampal volume. A significant correlation between BFRT and bilateral hippocampal volumes was found in the AD group. No correlation was found among parameters in DPD patients. Conclusions: Our results suggest that evaluation of facial recognition and left hippocampal volume may provide more reliable evidence for distinguishing DPD from AD. Further investigations combined with functional imaging techniques including more patients are needed. (C) 2017 The Author(s) Published by S. Karger AG, BaselYayın Ectopic Ureterocele: An Infrequent Cause of Retrograde Ejaculation and Its Diagnosis: Case Report(ORTADOGU AD PRES & PUBL CO, 2011) Ekici, Sinan; Sinanoglu, Orhun; Cubuk, RahmiRetrograde ejaculation is an uncommon cause of infertility. It may be congenital, acquired or idiopathic. It can be very rarely a consequence of an ectopic ureterocele. Herein, we present an infertile patient with retrograde ejaculation due to ectopic ureterocele and emphasize the role of magnetic resonance imaging in diagnosis. Only three similar cases have been reported in the literature. The pathogenesis of retrograde ejaculation due to ureterocele remains unclear. It is postulated that dilated ectopic ureter in some way affected the development of the innervation of the bladder neck. Ectopic ureterocele should be kept in mind in the differential diagnosis of patients with retrograde ejaculation.Yayın Effects of Smoking and Hemoglobin Values on Femoral Bone Marrow Resonance Signal Intensity(YERKURE TANITIM & YAYINCILIK HIZMETLERI A S, 2017) Arslan, Gozde; Sanel, Selim; Cubuk, Rahmi; Gemici, Aysegul Akogan; Inci, ErcanObjective: The aim of our study is to evaluate the correlation of residual-reconverted red bone marrow areas of distal femoral metaphysis with the age, gender, weight and hemoglobin (hgb) values and smoking. Material and Methods: 150 non smoking and 62 smoking patients were included in the study. The residual red bone marrow areas in the distal femoral metaphysis in MRI (Magnetic Resonance Imaging) images were examined by two radiologists. The size of the residual red bone marrow area and the age, gender, weight and hemoglobin values of the patients were compared by using the Oneway Anova Test, Tukey HSD Test, Fisher's Exact Test and Pearson Chi-Square Test. Results: In our study, residual red marrow areas were detected higher in smoking male and female patients when compared to non-smoking patients (p=0.004; p<0.01), (p=0.026; p<0.05). Residual red marrow areas were more common in female patients when compared to male patients (p=0.004; p<0.01). We haven't seen significant effect of weight, hemoglobin values and age on these areas (p>0.05). Conclusion: We have determined correlation between reconverted-residual red marrow areas, female sex and smoking behavior. In the correlation existing group; we are not in favor of mentioning these areas on MRI reports of the knee. But they should be phrased in reports considering the probability of malignancy if they are hypointense compared to adjacent muscle groups on T1-weighted sequences; if they are extensive involved in bone tissue; if they show epiphyseal extension or if there is accompanying soft tissue mass.Yayın AN EFFICIENT ALGORITHM FOR AUTOMATIC TUMOR DETECTION IN CONTRAST ENHANCED BREAST MRI BY USING ARTIFICIAL NEURAL NETWORK (NEUBREA)(ACAD SCIENCES CZECH REPUBLIC, INST COMPUTER SCIENCE, 2013) Bayram, Bulent; Koca, Hilmi K.; Narin, Burcu; Cavdaroglu, G. Cigdem; Celik, Levent; Acar, Ugur; Cubuk, RahmiThe advances in image processing technology contribute to the interpretation of medical images and early diagnosis. Moreover various studies can be found in medical journals dedicated to Artificial Neural Networks (ANN). In the presented study, a method was developed to learn and detect benign and malignant tumor types in contrast-enhanced breast magnetic resonance images (MRI). The backpropagation algorithm was taken as the ANN learning algorithm. The algorithm (NEUBREA) was developed in C# programming language by using Fast Artificial Neural Network Library (FANN). Having been diagnosed by radiologists, 7 cases of malignant tumor, 8 cases of benign tumor, and 3 normal cases were used as a training set. The results were tested on 34 cases that had been diagnosed by radiologists. After the comparison of the results, the overall accuracy of algorithm was defined as 92%.Yayın Extrinsic allergic alveolitis as an uncommon diagnostic pitfall in lung cytology(WILEY-BLACKWELL, 2012) Midi, Ahmet; Yener, Nese Arzu; Orki, Alpay; Cubuk, Rahmi; Ersev, AyseHouse paints, the industrial products of toxic chemicals are known to be linked with severe respiratory disturbances especially in inadequately ventilated places. In this study, we aimed to report a biopsy-proven case of extrinsic allergic alveolitis (EAA) who presented with nonspecific respiratory symptoms 1 month after having her whole house interior painted. At CT scanning, we observed the ground glass opacities and the micronodular pattern typical for EAA and also a solid, consolidative lung area, highly suggestive of malignancy. The case initially was misinterpreted as a malignant tumor both radiologically and cytologically at CT-guided transthoracic fine needle aspiration biopsy. The final pathologic diagnosis was given as EAA on frozen section performed during thoracotomy operation. The patient received short-term steroid treatment and has been doing well for the last 7 months after her operation. As a conclusion, when assessing a cytologic material from a patient who has got a solid lung mass and also a history of chemical dye exposure, consolidative mass formation which is a rare form of EAA should always be kept in mind. Another final point is that the appropriate ventilation should be achieved if the exposure with the house paint chemicals is inevitable. Diagn. Cytopathol. 2012. (c) 2011 Wiley Periodicals, Inc.Yayın Finding the underlying cause of thoracic outlet syndrome(Maltepe Tıp Dergisi, 2016) Arslan, Gözde; Cubuk, RahmiCervical rib is an extra rib arising from the 7th vertebra. It is estimated to occur in 0.6% (1 in 150 people) to 0.8% of the population. It may compress the nerves and vessels and cause thorasic outlet syndrome. Cervical rib is diagnosed by Computer Tomography (CT). 3D CT images are very helpful for the correct diagnosis. Treatment is surgical most of the time. Symptoms usually diminish dramatically after surgery.Yayın Internal Mammary Artery Anastomoses in Patients without Breast Lesions (BIRADS 1) and in Patients with Malignant Breast Lesions (BIRADS 6) on Magnetic Resonance Imaging (MRI)(INT SCIENTIFIC INFORMATION INC, 2017) Arslan, Gozde; Celik, Levent; Cubuk, Rahmi; Celik, Levent; Atasoy, Mehmet MahirBackground: We aimed to compare the frequency of IMA (internal mammarian artery) anastomoses in right and left breasts in patients without breast lesions and in patients with malignant breast lesions. Material/Methods: A total of 100 patients with no breast lesions and a total of 100 patients with malignant breast lesions were included in the study. The anastomoses of IMA of right and left breasts were evaluated on MIP and post-contrast T1-weighted magnetic resonance imaging (MRI) sequences. Breast MRI scans were read by a radiologist. Results: In patients with no breast lesions, IMA anastomoses were found in 45% of cases, and in patients with malignant breast lesions, IMA anastomoses were found in 58% cases. In four patients with malignant lesions, ipsilateral IMA was rudimentary, and the lesion was feeding from the contralateral IMA. Conclusions: No statistically significant difference was found between patients without any breast lesions and patients with malignant breast lesions with respect to the frequency of IMA anastomoses in right and left breasts. The frequencies were higher than expected in both groups.Yayın Knowledge and experience of radiologists working in Istanbul on radiographic contrast medium anaphylaxis(AMER INST MATHEMATICAL SCIENCES-AIMS, 2017) Arslan, Gozde; Balci, Ayla; Cubuk, Rahmi; Cetinkaya, FeyzullahRadiologists are among the physicians with the highest probability of encountering cases with anaphylaxis. Therefore, they should be familiar with the recent developments in the diagnosis and treatment of anaphylaxis. In this study, we aimed to investigate the level of knowledge of the radiologists about the current diagnostic criteria and management of anaphylaxis in addition to their personal experiences on radiographic contrast medium (RCM) induced systemic reactions. Radiologists working in Istanbul were randomly selected and asked to fill out a 16-item questionnaire related to their experience on radiographic contrast medium anaphylaxis and knowledge about current anaphylaxis diagnosis and management guidelines. The study group consisted of 106 physicians 11 (10.4%) of whom have reported that they had encountered anaphylaxis due to radiographic contrast medium during their own practice. They have also reported two cases of mortality due to RCM. Most of the physicians were familiar with the signs and symptoms of anaphylaxis and about two thirds of them chose epinephrine as the first-line medication for treatment of anaphylaxis. Radiologists may encounter patients with RCM-induced anaphylaxis. Therefore they should be aware of the diagnosis and management of anaphylaxis.Yayın Lumbar Disc and Facet Degeneration: Correlation with Age and Facet Orientation(AVES YAYINCILIK, IBRAHIM KARA, 2009) Cubuk, Rahmi; Kozakcioglu, Meral; Tasali, Nuri; Atalay, Ayce; Celik, LeventObjectives: The influence of age on orientation of the facet joint remains controversial. We aimed to examine facet joint degeneration, orientation and their relationships with disc degeneration in a group of patients in different age groups. Patients and Methods: The study included 106 patients with low back pain and/or leg symptoms who had undergone magnetic resonance imaging of L1-S1 lumbar segments. For evaluation of osteoarthritis of the facet joints grading described by Weishaupt et al. and for evaluation of disc degenerations grading by Pfirmann et al. were used. Results: Orientation of the facet joints were similar among age groups. Age was not correlated with facet joint orientation. Facet joint orientation was not correlated with facet or disc degeneration in neither female nor male patients. Age was positively correlated with facet degeneration at all spinal levels. At all levels except L3-4 level, facet joint degeneration was more prominent in male subjects. Conclusion: This study have demonstrated that facet joint orientation is similar among different age groups. The finding of greater prevalence and degree of facet arthrosis in men at all lumbar levels is in accordance with some recent studies. Our study supported the notion that disc degeneration precedes facet arthrosis.Yayın The morphologic and functional features of LAD myocardial bridging at multi detector computed tomography coronary angiography: correlation with coronary artery disease(TURKISH SOC CARDIOLOGY, 2015) Aydin, Alper; Cubuk, Rahmi; Atasoy, Mehmet Mahir; Gurol, Tayfun; Soylu, Ozer; Dagdeviren, BahadirObjectives: The aim of this study was to retrospectively evaluate the morphologic and functional features of myocardial bridging (MB) and to investigate the impact of morphologic features on presence of atherosclerosis with multi-detector computed tomography (MDCT) coronary angiography. Study design: The study population consisted of 191 consecutive patients. Besides coronary lesions, morphologic features of the MB (depth, length and the distance of the tunneled artery from the left coronary ostium) were analyzed. Results: MDCT detected MB on left anterior descending artery in 41 patients (21.5%). The prevalence of atherosclerotic plaques proximal to the MB of LAD was 49% (20/41). There was a statistically significant correlation between percentage of systolic compression and depth of the tunneled segment (r=0.538, p<0.01). There was no relation between distance of the tunneled segment from the ostium and degree of systolic compression. No significant correlation was found between percentage of systolic compression and length of the tunneled segment (r=0.058, p=0.721). Morphologic features of MB were not related to the presence of CAD in proximal segments. Conclusion: MDCT coronary angiography depicts the morphologic and functional features of the MB in detail. The depth of MB segment was correlated with systolic compression of MB. There was no relationship between distance of the tunneled segment from the ostium and systolic compression.
