Browsing by Author "Orguc S."
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Item Rhinocerebral mucormycosis: Perineural spread via the trigeminal nerve(2005) Orguc S.; Yücetürk A.V.; Demir M.A.; Goktan C.We report a case of rhinocerebral mucormycosis associated with an abscess in the lateral aspect of the pons associated with perineural spread of disease via the trigeminal nerve. Contrast enhanced MRI was useful in depicting the extent of the disease and suggesting perineural spread. A pathological diagnosis of mucormycosis was established by means of rhino-orbital punch biopsy. © 2005 Elsevier Ltd. All rights reserved.Item Ultra fast resolution of acute post-traumatic subdural haematoma(BMJ Publishing Group, 2005) Mirzai H.; Yaldiz C.; Eminoglu M.; Orguc S.[No abstract available]Item Bilateral breast edema in intestinal lymphangiectasia(2005) Goktan C.; Pekindil G.; Orguc S.; Coskun T.; Serter S.[No abstract available]Item Magnetic resonance imaging findings in a case of remitting seronegative symmetrical synovitis with pitting edema(2005) Unlu Z.; Orguc S.; Ovali G.Y.; Tarhan S.; Dayan I.; Angin A.We describe a case of remitting seronegative symmetrical synovitis with pitting edema (RS3PE syndrome) in a 66-year-old man. This report discusses magnetic resonance imaging findings of RS3PE syndrome and the changes after steroid therapy. © Clinical Rheumatology 2005.Item Transient left paraduodenal hernia(2005) Ovali G.Y.; Orguc S.; Unlu M.; Pabuscu Y.A 52-year-old woman with acute deterioration of recurrent abdominal pain was admitted to the hospital. Spiral computed tomography (CT) of abdomen was performed. A left paraduodenal hernia was identified on CT. There was no clinical sign or imaging finding suggesting intestinal obstruction or mesenteric ischemia. She refused surgical intervention since her pain was intermittant and decreasing. On the fifth day of hospitalization the patient's pain resolved completely and the follow-up CT demonstrated regression of the herniation. © 2005 Elsevier Ltd. All rights reserved.Item A case of endometrial stromal sarcoma with curvilinear calcification(2005) Pekindil G.; Tuncyurek O.; Orguc S.; Inceboz U.; Kandiloglu A.R.; Caglar H.Background. Although many histopathological, clinical, and imaging findings of ESS have been described, intense calcifications have not been reported previously. Case. A 54-year-old female was admitted with vaginal bleeding and abdominal pain. Gynecologic examination revealed a huge, firm pelvic mass extending up to the epigastrium. Transabdominal ultrasonography and computed tomography demonstrated a well-demarcated uterine mass containing heterogeneous solid and cystic areas and a centric curvilinear calcification. Histopathological diagnosis was established as undifferentiated high-grade endometrial stromal sarcoma. Conclusion. Endometrial stromal sarcomas should be considered in the differential diagnosis of uterine masses containing curvilinear calcifications. © 2005 Elsevier Inc. All rights reserved.Item Assessment of mammographic density changes on plain film mammograms in postmenopausal women on hormone replacement therapy(2006) Orguc S.; Goktan C.; Ovali G.Y.; Karaer O.; Oruc S.Background & objectives: Mammographic screening is an effective tool for the early detection of breast cancer. Hormone replacement therapy (HRT) has been shown to increase mammographic density and thus may hinder early detection of small tumours. We undertook this study to determine and compare the frequency and degree of change in mammographic density in postmenopausal women in HRT using two different methods: the classical Wolfe classification and a new semiquentitative method, which we named as the comparison wheel. Methods: This study included 285 women, 206 under hormone treatment, and 79 control subjects. All women underwent baseline mammographic study before the beginning of treatment. Mean interval of the follow up mommograms was 16 months. The methods were compared in evaluating the effects of three types of hormone therapies on mammographic density. Results: The frequency of change was only significant in the combined hormone replacement group when Wolfe classification was used. However, the frequency of increase in density (estrogen group 21%, combined therapy group 42%, tibolone group 28%) was markedly higher when the comparison wheel was used. The inter-rater Kappa value was calculated as 0.977 for the first and 0.957 for the second readings of the two radiologists for the comparison wheel, and 0.973 and 0.968 for the Wolfe classification. The intra-rater Kappa values were determined as 0.972 and 0.957 for the first and and 0.963 and 0.926 for the second radiologist for comparison wheel and Wolfe classification respectively. Interpretation & conclusion: Our findings indicate that the estimated increase of mammographic density depends on the selected hormone regimen, as well as the method of evaluation. The comparison wheel is a semiquantitative method of evaluating changes of mammographic density and is sensitive and reproducible with high inter- and intra-rater Kappa values. This method can be used as an alternative for comparison of digital mammographic applications in the future.Item Musculus sternalis: A normal but rare mammographic finding and magnetic resonance imaging demonstration(2006) Goktan C.; Orguc S.; Serter S.; Ovali G.Y.[No abstract available]Item MRI findings of globe and optic nerves in tilted disk syndrome(Centauro SRL, 2007) Orguc S.; Toprak A.B.; Demiray B.; Tarhan S.; Güler C.We assessed the anatomical variations of the globe and optic nerve in tilted disk (TD) syndrome using magnetic resonance imaging (MRI) findings and compared them with a control group. Eleven patients diagnosed with TD syndrome during eye examination were referred for MRI of the sella and chiasm to exclude intracranial mass lesions. The shape of the globe, the chiasmal angle, the insertion angles of the optic nerve in axial and parasagittal planes determined by lines parallel to the optic nerve and tangent to the globe in TD syndrome were compared with a control group consisting of 53 cases. Gender ratios were 7/4 (F/M) for the TD group and 35/18 for the control group (p>0.05). The insertion angle of the optic disk to the globe was wider in the temporal quadrant (p<0.05) and narrower in the nasal quadrant (p<0.05) in TD syndrome than in the control group. There was no significant difference in the superior and inferior insertion angles between the groups. The anterior-posterior (AP) diameter of the globe was significantly longer in patients with TD (p<0.05). There was no significant difference between the optic chiasm angles. The relationships of the optic disk and the globe were significantly different in patients with TD syndrome in comparison to the control group. TD syndrome is related to the malalignment of optic nerve and globe in the horizontal plane.Item A pediatric case of pyomyositis presenting with septic pulmonary emboli(2007) Yuksel H.; Yilmaz O.; Orguc S.; Yercan H.S.; Aydogan D.Pyomyositis is a suppurative infection of skeletal muscle most commonly caused by Staphylococcus aureus. It is mainly encountered in children and immunocompromised. Eight year old previously healthy girl presented with confusion, fever and swelling of the right knee two days after a trauma. Abdominal ultrasonography and computerized tomography taken upon development of hematemesis revealed no pathology in the abdomen, but potential bleeding sites in lung sections. Thorax CT images were interpreted in favor of septic pulmonary emboli due to the presence of peripheral nodular consolidation areas with central cavitation, mostly pathchy in medial areas. S. aureus was isolated in the blood culture. At the end of third week of hospitalization, gadolinium enhanced contrast MRI of right extremity was taken to evaluate right extremity swelling and revealed abcess formation as expected in the clinical progress of pyomyositis. Pyomyositis and septic pulmonary emboli are a rare association. This case demonstrates that the high index of suspicion in pediatric cases with muscle findings and septic pulmonary findings and early institution of therapy may improve the prognosis. © 2007 Elsevier Masson SAS. All rights reserved.Item Unusual long bone and metacarpo-carpal abnormalities in a case of pseudo-pseudohypoparathyroidism(2007) Unlu Z.; Orguc S.; Yilmaz Ovali G.; Bayindir P.A case of pseudo-pseudohypoparathyroidism (PPH) with shortening of the left femur and tibia and coalition of the base of the fourth metacarpals with capitatum and hamatum in bilateral wrist joints was presented. Involvement of the fourth digits both in hands and feet were more prominent on the left side, with shortening of the left leg. © Clinical Rheumatology 2006.Item Anatomic and hemodynamic evaluation of renal venous flow in varicocele formation using color Doppler sonography with emphasis on renal vein entrapment syndrome(2007) Unlu M.; Orguc S.; Serter S.; Pekindil G.; Pabuscu Y.Objective. To investigate the anatomic and hemodynamic properties of testicular venous drainage and its effects on varicocele formation and reflux using color Doppler ultrasound (US) with emphasis on renal vein entrapment syndrome. Material and methods. Upper abdominal and scrotal US examinations of 35 varicocele patients and 35 healthy male subjects were performed in the supine position during rest, during a Valsalva maneuver and in the erect position. The aortomesenteric angle and distance (AMA and AMD, respectively), peak mean velocities (PVs) and diameters of different segments of renal veins, testicular vein diameters and duration of flow inversion were measured. Results. In the varicocele group, the lateral segment of the left renal vein (LRV) had a larger diameter and slower PV, and the medial segment of the LRV had a smaller diameter and faster PV. The diameter of the dominant draining vein correlated with the PV of the medial and lateral segments of the LRV, whereas there was no correlation between the diameter of the dominant draining vein and the diameters of the right renal vein (RRV) and the lateral segment of the LRV or the PV of the RRV. The duration of flow inversion correlated with the diameter and PV of the medial segment of the LRV. No correlation between the diameters and PVs of the RRV and the lateral segment of the LRV was detected. Conclusions. The decreases in the AMA, AMD, diameter of the medial segment of the LRV and PV of the lateral segment of the LRV, and the increases in the PV of the medial segment of the LRV and the diameter of the lateral segment of the LRV in varicocele patients in all positions suggest the entrapment or impingement of the left renal vein between the aorta and the superior mesenteric artery. This has been defined as the "nutcracker phenomenon", which is known to affect varicocele formation. © 2007 Taylor & Francis.Item Doppler sonographic findings in testicular microlithiasis(Brazilian Society of Urology, 2008) Serter S.; Orguc S.; Gumus B.; Ayyildiz V.; Pabucsu Y.Objective: The aim of this prospective study was to compare the resistive index (RI) values, which is a parameter of testicular parenchymal perfusion, in testicular microlithiasis (TM) cases and normal cases. Materials and Methods: 2179 Volunteers, all healthy men (17-42 years of age) from the Annual Army'Reserve Oflicer Training Corps training camp were included in the study. A screening scrotal ultrasound was performed and all men diagnosed, with TM underwent a scrotal Doppler ultrasonography scan (US). US examinations were performed for subjects with TM and without TM as a control group and Rl was determined. Results: 53 men with TM were identified in the 2179 US. Spectral Doppler examination was applied to 50 randomly selected cases (100 testicles) without TM and 92 testicles with TM, 39 cases (78 testicles) with bilateral and 14 cases with unilateral involvement. However, 48 normal testicles (17 bilateral and 14 unilateral) and 47 testicles with TM (15 bilateral and 17 unilateral, 10 of which were cases with bilateral TM) where flow from the centripetal artery could be obtained and analyzed were included in the statistical analysis for resistive indices. There was no significant difference regarding the RI and spectral examinations between subjects with and without TM. An interesting finding was the twinkling artifact observed in three cases. Conclusion: Microliths did not alter the RI values and thus had no influence on testicular perfusion on Doppler US examination.Item Giant breast involvement in acute lymphoblastic leukemia: MRI findings(2012) Basara I.; Orguc S.Breast metastases in cases of leukemia are rare. We aimed to report the conventional-advanced magnetic resonance imaging (MRI) findings of unilateral breast involvement of acute lymphoblastic leukemia (ALL) and review the literature. A 32-year-old woman was first diagnosed with ALL in treated in 2004. She did not continue the follow-up after 2008. She was presented with a giant, progressive right breast palpable mass in 2010. Mass, contralateral breast tissue were evaluated with MRI, diffusion weighted imaging and MR spectroscopy. With MRI findings, lesion was evaluated as malignant, tru-cut biopsy revealed recurrence of ALL. Lymphoma, malignant melanoma, rhabdomyosarcoma are most common tumors metastase to breast. Breast metastases of leukemia are rare and occur primarily in patients with acute myeloid leukemia. Secondary ALL breast involvement is uncommon. In a patient with malignancy, any enlarging breast mass, even with benign radiologic appearance, should be investigated carefully and metastasis should not be forgotten. © 2012 Korean Breast Cancer Society. All rights reserved.Item Diffusion-weighted MR imaging of the breast: Comparison of apparent diffusion coefficient values of normal breast tissue with benign and malignant breast lesions(Singapore Medical Association, 2012) Orguc S.; Basara I.; Coskun T.Introduction The specificity of conventional magnetic resonance (MR) imaging is lower than its high sensitivity. Diffusion-weighted imaging (DWI), based on alterations in the microscopic motion of water molecules, promises improved specificity for breast MR imaging. In this study, we aimed to determine the diagnostic potential of DWI to differentiate between benign and malignant breast lesions and normal breast tissue. Methods Dynamic contrast-enhanced breast MR imaging and DWI were applied to 108 women. Apparent diffusion coefficient (ADC) values were obtained for normal breast tissue (n = 183), benign lesions (n = 66) and malignant lesions (n = 58). The results were compared with the patients' final diagnoses. Resu lts Mean ADC values for benign and malignant breast lesions were 1.04 × 10-3 ± 0.29 × 10-3 mm2/s and 2.00 × 10-3 ± 0.55 × 10-3 mm2/s, respectively (p = 0.001, Student's t-test), while that for normal breast tissue was 1.78 × 10-3 ± 0.33 × 10-3 mm2/s. With a cut-off value of 1.46 × 10-3 mm2/s for ADC in receiver operating characteristic analysis, 95% sensitivity and 85% specificity were achieved for differentiating between benign and malignant lesions. Conclusion DWI of the breast can help differentiate benign and malignant breast lesions from normal breast tissue. DWI, which can be easily introduced into standard breast MR imaging protocols without increasing imaging times, promises to increase the accuracy of breast MR imaging without contrast media. However, its clinical value will depend on the standardisation of b-values and other technical parameters in larger future study series.Item Comparison of OMERACT-RAMRIS scores and computer-aided dynamic magnetic resonance imaging findings of hand and wrist as a measure of activity in rheumatoid arthritis(2013) Orguc S.; Tikiz C.; Aslanalp Z.; Erbay P.D.The purpose of this study was to compare the value of conventional magnetic resonance imaging (MRI) finding of rheumatoid arthritis (RA) and computer-aided dynamic MRI measurements in predicting the activity of disease. The activity of the disease in 40 RA patients was evaluated by the disease activity score in 28 joints (DAS28). The conventional MRI of the wrists of all patients were scored for bone edema, synovitis and erosions, according to the criteria of RA-MRI scoring system (RAMRIS) developed by Outcome measures in rheumatology clinical trials (OMERACT) MR Imaging Group. Synovitis was also quantified by dynamic postcontrast MRI imaging using color coded maximum slope of increase maps and measurements of early enhancement rate (EER) and relative enhancement (RE). Twenty-two (55 %) patients with a score higher than 5.1 constituted the high disease activity group, 18 (45 %) patients with a score of 5.1 or less constituted moderate disease activity group. The dynamic MRI-EER score was the most significant parameter to differentiate between the groups (p = 0.001). Among OMERACT scores, only bone edema [p = 0.020 for wrist and p = 0.037 for metacarpophalangeal joints (MCP)] had a significant difference between the two groups. Dynamic MRI RE score and OMERACT scores for erosions and synovitis for both the wrist and MCP joints did not differ significantly between the two groups. Computer-aided dynamic MRI is a reliable, noninvasive method of evaluating the RA patients, which correlates with the DAS28 scores, at a higher significance than the OMERACT-RAMRIS scores. © 2013 Springer-Verlag Berlin Heidelberg.Item Contribution of advanced magnetic resonance imaging techniques in diagnosis of breast lesions(Kuwait Medical Association, 2014) Basara I.; Orguc S.; Coskun T.Objectives: To determine the diagnostic contribution of diffusion weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) identified either with mammography, ultrasonography or conventional enhanced magnetic resonance imaging (MRI) to cases with palpable breast lesions or for routine control Design: Prospective study Setting: Department of Radiology, Celal Bayar University, Turkey Subjects and Methods: Fifty female patients who applied to the clinic between November 2009 and April 2010 with different indications were included. We applied conventional breast MRI with the routine sequences. We added DWI and BREASE (MRS). After MRI examination postprocessing applications were applied. Intervention: Analysis of contribution of advanced techniques in breast lesions diagnosis Main Outcome Measure: Determining the value of DWI and MRS of breast lesions, which may be useful in improving the specificity Results: Fifty-two breast lesions in 37 cases were evaluated. In DWI when cut off apparent coefficient diffusion (ACD) value was accepted as 1.44 x10.3 mm2/sn, the sensitivity was found to be 91.3% and the specifity was 62.1% in discriminating malignant and benign lesions. When the lesions which have choline peak at 3.2 ppm were accepted as malignant and lesions which do not have choline peak were accepted as benign lesions in spectroscopic examination, the specifity was 80%, the sensitivity was 31.8%, negative predictive value (NPV) was 44.4% and positive predictive value (PPV) was found to be 70%. Conclusions: Our specifity was compatible with that in the literature but sensitivity and negative ppv were lower than reported in the literature. According to ADC values, the findings in our study were compatible with the literature.Item Primary tumors of the spine(Thieme Medical Publishers, Inc., 2014) Orguc S.; Arkun R.Spinal tumors consist of a large spectrum of various histologic entities. Multiple spinal lesions frequently represent known metastatic disease or lymphoproliferative disease. In solitary lesions primary neoplasms of the spine should be considered. Primary spinal tumors may arise from the spinal cord, the surrounding leptomeninges, or the extradural soft tissues and bony structures. A wide variety of benign neoplasms can involve the spine including enostosis, osteoid osteoma, osteoblastoma, aneurysmal bone cyst, giant cell tumor, and osteochondroma. Common malignant primary neoplasms are chordoma, chondrosarcoma, Ewing sarcoma or primitive neuroectodermal tumor, and osteosarcoma. Although plain radiographs may be useful to characterize some spinal lesions, magnetic resonance imaging is indispensable to determine the extension and the relationship with the spinal canal and nerve roots, and thus determine the plan of management. In this article we review the characteristic imaging features of extradural spinal lesions. Copyright © 2014 by Thieme Medical Publishers, Inc.Item Benign versus malignant vertebral compression, chemical shift MR imaging, is it useful?(Kowsar Medical Institute, 2017) Yilmaz Ovali G.; Düzgün F.; Farasat M.; Orguc S.Objectives: The aim of this study was to evaluate the diagnostic accuracy of chemical shift imaging in vertebral compression. Patients and Methods: Forty-nine patients with vertebral compression with suspected malignancy or history of trauma were included in this study. MR imaging of the spine with standard conventional MR sequences and additional chemical shift imaging was done with 1.5 Tesla MR Unit. Regions of interest (ROI) were placed on the abnormal marrow of compressed vertebrae both on the opposed phase and on the matching in phase images and signal intensity (SI) ratio values (SI out-phase/SI-in phase) were calculated. Results: Forty-nine patients had 68 spine lesions, consisting of 49 benign and 19 malignant fractures. Student t test, receiver operating characteristic (ROC) analysis and interclass correlation test were used statistically. Mean SI ratio of benign vertebral compression (0. 68 ± 0.29, range 0.13 - 1.53) was significantly lower than malignant SI ratio values (1.06 ± 0.10, range 0.96 - 1.35). With student t-test, there was significant difference between benign compressions compared to malignant compressions (P < 0.001). Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut off value in malignant and benign lesion definition. The optimal SI ratio cut off value was found to be 0.96 for separating benign and malignant vertebral compression. The area under the curve (AUC) value was observed as 0.92 (95% confidence interval [CI] = 0.86 - 0.99). According to that cutoff value, sensitivity was 100% (95% CI = 82.35% - 100%) and the specificity was 86% (95% CI = 72.76% - 94.06%). Interobserver reliability was studied with intraclass correlation and results were statistically significant with intraclass correlation coefficient (ICC) as 0.85 (P < 0.05). Conclusions: There is significant difference in signal values between benign and malignant compression fractures in chemical shift MR imaging. Chemical shift MR imaging has much additive data to conventional MRI in vertebral compression. © 2016, Tehran University of Medical Sciences and Iranian Society of Radiology.Item Magnetic Resonance Imaging and Clinical Outcomes of Laser Therapy, Ultrasound Therapy, and Extracorporeal Shock Wave Therapy for Treatment of Plantar Fasciitis: A Randomized Controlled Trial(Academic Press Inc., 2017) Ulusoy A.; Cerrahoglu L.; Orguc S.We determined and compared the effectiveness of low-level laser therapy (LLLT), therapeutic ultrasound (US) therapy, and extracorporeal shock wave therapy (ESWT) using magnetic resonance imaging (MRI). We performed a randomized, prospective, comparative clinical study. A total of 60 patients with a diagnosis of chronic plantar fasciitis were divided randomly into 3 treatment groups: group 1 underwent 15 sessions of LLLT (8 J/cm2; 830 nm); group 2 underwent 15 sessions of continuous US (1 mHz; 2 W/cm2); and group 3 underwent 3 sessions of ESWT (2000 shocks). All patients were assessed using the visual analog scale (VAS), heel tenderness index (HTI), American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, Roles–Maudsley score, and MRI before and 1 month after treatment. The primary efficacy success criterion was the percentage of decrease in heel pain of >60% from baseline at 1 month after treatment for ≥2 of the 3 heel pain (VAS) measurements. Significant improvement was measured using the mean VAS, AOFAS scale, and HTI scores for all 3 groups. The thickness of the plantar fascia had decreased significantly on MRI in all 3 groups. The treatment success rate was 70.6% in the LLLT group, 65% in the ESWT group, and 23.5% in the US group. LLLT and ESWT proved significantly superior to US therapy using the primary efficacy criterion (p =.006 and p =.012, respectively), with no significant difference between the LLLT and ESWT groups (p >.05). The treatment of chronic plantar fasciitis with LLLT and ESWT resulted in similar outcomes and both were more successful than US therapy in pain improvement and functional outcomes. © 2017 American College of Foot and Ankle Surgeons