Browsing by Subject "Doppler ultrasonography"
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Item Three-dimensional placental volume and mean grey value: Normal ranges in a Turkish population and correlation with maternal serum biochemistry and Doppler parameters(Informa Healthcare, 2015) Pala H.G.; Artunc Ulkumen B.; Uyar Y.; Koyuncu F.M.; Bulbul Baytur Y.The aim of this study is to evaluate the relationship between three-dimensional (3D) ultrasound measurements of placenta at 11136 weeks' gestation and maternal serum levels of pregnancy associated plasma protein-A (PAPP-A), free beta human chorionic gonadotrophin (fβhCG), Doppler parameters in early pregnancy. This prospective study consisted of 334 singleton pregnancies at 11136 weeks' gestation. Placental volume and placental volumetric mean grey values were evaluated. The placental volume (cm3) was analysed using the Virtual Organ Computer-aided AnaLysis (VOCAL) imaging program and 3D histogram was used to calculate the volumetric mean grey value (%). Mean maternal age was 28.35 ± 7.55. Mean gestational age was 12.29 ± 0.68 weeks. Placental volume was 77.04 ± 35.74 cm3. Mean grey value of the placenta was 34.38 ± 8.02%. Correlation analysis revealed that placental volume was significantly correlated with the crown-rump length (r = 0.173, p = 0.002), gestational week (r = 0.116, p = 0.036), ductus venosus pulsatility index (r = 0.101, p = 0.04) and maternal weight (r = 0.099, p = 0.037). There was a significant relation between the mean grey value of the placenta and maternal age (r = 0.131, p = 0.02), nuchal translucency (r = 0.109, p = 0.048), PAPP-A (r = 0.108, p = 0.04) and fβhCG (r = 0.104, p = 0.042). Volumetry of the placenta can be carried out with a high percentage of 1st trimester pregnancies. Volumetry during the 1st trimester could be helpful because of the less advanced state of placentation. This examination is easy to perform and the measurements can be acquired correctly and quickly. © 2015 Informa UK, Ltd.Item Presence of enthesopathy demonstrated with ultrasonography in systemic sclerosis(Taylor and Francis Ltd, 2015) Kilic E.; Kilic G.; Akgul O.; Ozgocmen S.Objective. The aim of this study was to sonographically assess the presence and distribution of enthesopathy in systemic sclerosis (SSc). Methods. Consecutive patients with SSc and age-matched healthy controls were included in this study. All of the patients met the 2013 American College of Rheumatology/European League Against Rheumatism classification criteria for SSc. Six entheses sites were evaluated using gray scale and Doppler ultrasonographies (USs) with a linear transducer and were scored using the Madrid Sonography Enthesitis Index (MASEI). Results. We evaluated 52 patients with SSc (46.10 ± 13.42 years) and 41 healthy controls (49.59 ± 9.35 years). Patients with SSc had significantly higher MASEI scores than the healthy controls. Except for plantar aponeurosis, the tendons and ligaments were thicker in the SSc group. In the SSc group, there were 25 (48.1%) diffuse cutaneous SScs and 22 (42.3%) limited cutaneous SScs. Variables such as age, BMI, disease duration, diagnostic delay and MASEI scores were similar in subgroups of SSc. There was a positive correlation between MASEI score and age, modified Rodnan's skin score and dyspnea grade, and a negative correlation with handgrip strength. Conclusion. To the best of our knowledge, this is the first study showing the presence of enthesopathy in patients with SSc using US. Enthesopathy should be kept in mind in symptomatic patients with SSc; additionally, it can be easily identified with US. © 2015 Japan College of Rheumatology.Item Neonatal Cholestasis as Initial Presentation of Portosystemic Shunt: A Case Report(Elsevier B.V., 2016) Doğan G.; Düzgün F.; Tarhan S.; Appak Y.Ç.; Kasırga E.Congenital intrahepatic portosystemic shunts are rare in children. Portosystemic venous malformations are characterized by extreme clinical variability. We report a full-term 33-day-old male infant presenting with neonatal jaundice. On physical examination, he had generalized icterus and the liver was palpable 3.5 cm below the right costal margin. He had no other symptoms. Laboratory tests showed AST 632 U/L, ALT 198 U/L, total bilirubin 12.1 mg/dL, conjugated bilirubin 10.2 mg/dL, alkaline phosphatase 753 U/L, GGT 47 U/L and glucose 67 U/L. Colour Doppler ultrasonography showed the left portal vein was more dilated than the right portal branch and communication with dilated left hepatic vein. There was no evidence of portal hypertension, heart failure, hepatopulmonary syndrome and encephalopathy during his hospital stay, so he was discharged from the pediatric department and his parents advised to attend monthly follow-up. Congenital portosystemic shunts are rarely observed in the childhood period.1 Depending on anatomic characteristics they may be intrahepatic or extrahepatic.2 Intrahepatic portosystemic shunts (PSS) are observed between the portal vein and hepatic vein or vena cava inferior.3,4 Small shunts may close themselves before the age of 2 years.5 With the increase in use of imaging methods, diagnosing PSS has become easier, with an increase in the number of cases reported.6 Neonatal cholestatis is a frequent complication of PSS.1 We present a case presenting with neonatal cholestasis diagnosed with congenital intrahepatic PSS. © 2016Item Scorpion-related cardiomyopathy and acute pulmonary edema in a child who is stung by Leiurus abdullahbayrami(Emergency Medicine Association of Turkey, 2017) Dokur M.; Dogan M.; Yagmur E.A.Venom of Leiurus abdullahbayrami (Scorpiones: Buthidae) is an extremely toxic one and it stimulates voltage-gated sodium and potassium channels. In case of a stung by this scorpion; excessive catecholamine release occur and it impairs left ventricle contractility and consequently a heart failure occurs (scorpion sting-related cardiomyopathy). In addition to this cardiac-induced acute pulmonary, edema may occur in severe cases too. An 11-year-old male child who was stung by a scorpion (species: Leiurus abdullahbayrami) consulted to the Emergency Room. Even after 7 h of scorpion envenomation he was confused and having hallucinations. Besides he was dyspneic, tachycardic, hypotensive and got worse in overall situation due to cardiogenic pulmonary edema. These clinical findings are concordant with the Level III scorpion envenomation (major systemic manifestations). Positive inotropic agents, diuretics and antiagregant agents used on supportive therapy in his treatment. After 2 weeks he get recovered and discharged from the pediatric intensive care unit. This research is conducted by thinking emergency physicians should learn that Leiurus abdullahbayrami envenomation can cause scorpion-related cardiomyopathy and acute pulmonary edema especially in children. © 2017 The Emergency Medicine Association of TurkeyItem Percutaneous embolization of congenital portosystemic venous shunt in an infant with respiratory distress(Turkish Journal of Pediatrics, 2018) Alkan F.; Düzgün F.; Yüksel H.; Tarhan S.; Coşkun Ş.A 5-month-old boy with progressive respiratory distress was admitted to our hospital. Physical examination revealed mild tachypnea and retraction. The left main bronchus was found as severely collapsed between the right pulmonary artery and the descending aorta, on the bronchoscopic evaluation. Further evaluation revealed persistent ductus venosus (PDV). As in the fetal period the ductus venosus arises from the posterior aspect of the left portal vein, a PDV is considered another type of intrahepatic portosystemic shunt. Therefore, he was diagnosed with congenital portosystemic venous shunt, leading to persistent respiratory distress. The PDV was closed with Amplatzer vascular plug II, and then he had immediate clinical improvement. Congenital portosystemic venous shunts (CPSS) are rare vascular malformations associated with severe complications. Here we presented a case with progressive respiratory distress as a result of CPSS and rapid improvement after embolization. © 2018, Turkish Journal of Pediatrics. All rights reserved.Item Sonoelastographic features of major salivary gland tumors and pathology correlation(Kowsar Medical Institute, 2018) Farasat M.; Yilmaz Ovali G.; Duzgun F.; Eskiizmir G.; Tarhan S.; Tan A.Objectives: To investigate the diagnostic efficiency of elastography in differentiation of malignant and benign tumors by evaluating salivary gland masses in means of their elastography scores and strain ratios. Patients and Methods: Twenty five patients with salivary gland mass lesions were detected through B- mode ultrasonography, Doppler ultrasonography, strain elastography and their strain ratios were calculated. The results were compared with histopathologic results. Results: Twenty five patients had 27 lesions consisting of seven malignant and 20 benign lesions. Mann Whitney U test, ROC analysis, Fisher test and Chi square tests were used statistically. Mean strain rates were calculated as 2.26 ± 0.29 in the benign group and 2.02 ± 0.59 in the malignant group. There was no statistically significant difference between the two groups (P = 0.698). Elastography score was calculated as mean 2.4 ± 0.94 in the benign group and mean 2.28 ± 0.38 in the malignant group. There was no statistically significant difference between the two groups (P = 0.708). Accepting the strain rate as 0.89; sensitivity of elastography in differentiating malignant from benign lesions is 71%, and the specificity is 50%. However, the area under the ROC curve is 0.55, which is not statistically significant (P = 0.699). Conclusion: In conclusion, elastography is a supporting method for B-mode ultrasonography in the differentiation of benign and malignant salivary gland masses. However, the overlap of elastographic findings is evident in benign and malignant masses. Care should be taken to have tissues with similar stiffness under the reference tissue and the lesions in elastographic evaluation of the superficial mass. We have not met a study that has pointed out the importance of stiffness of the tissue located beneath the lesion that may affect the elastography results in the literature. In this respect our study is unique. © 2017, Iranian Journal of Radiology.Item Placental elasticity assessment by point shear wave elastography in pregnancies with intrauterine growth restriction(De Gruyter, 2019) Akbas M.; Koyuncu F.M.; Artunç-Ulkumen B.Placental elasticity varies in different diseases. Our objective was to evaluate placental elasticity using point shear wave elastography (pSWE) in pregnancies with intrauterine growth restriction (IUGR). A total of 66 pregnant women with IUGR and 81 healthy pregnant women were enrolled. Placental elasticity was measured using the transabdominal pSWE method. Ten measurements were made, and the mean was accepted as the mean placental elasticity value in each case. The results for IUGR pregnancies and controls were compared. The mean pSWE values were significantly higher in pregnancies with IUGR, which means that women with IUGR have stiffer placentas (P < 0.001). Furthermore, the pSWE values were significantly and positively correlated with Doppler indices and adverse perinatal outcomes. The pregnancies with IUGR had stiffer placentas than the healthy controls. The utilization of pSWE for placental elasticity may be useful in the diagnosis and management of IUGR as a supplement to the existing ultrasonography methods. © 2019 Walter de Gruyter GmbH, Berlin/Boston.Item Evaluation of maternal renal cortical elasticity in pregnancies with early- and late-onset preeclampsia(Taylor and Francis Ltd, 2020) Akbas M.; Koyuncu F.M.Objective: The current study aimed to investigate renal cortical elasticity (RCE) in early- and late-onset preeclampsia patients and compare the results with healthy controls. Materials and methods: The study consisted of 136 pregnant women. Three groups were identified as; the late-onset preeclampsia (LOP) group (n = 40), the early-onset preeclampsia (EOP) group (n = 32) and the control group (n = 64). RCE values were measured by point shear wave elastography (pSWE). Nine measurements were taken for each kidney and the mean of nine measurements was accepted as the mean RCE value for each kidney. The arithmetic mean of left and right RCE values was accepted as the overall RCE value of a subject. Groups were compared in terms of clinical and biochemical parameters, ultrasonography findings and pSWE values. Results: There was a statistically significant difference between groups in terms of overall RCE values (F[2,133] = 17.96, p <.001). Post hoc comparisons indicated that both preeclampsia groups exhibited significantly higher RCE values than the control group. However, overall RCE values were not significantly different between the EOP and LOP groups. Overall RCE values were significantly and positively correlated with systolic blood pressure (r = 0.363, p <.001), diastolic blood pressure (r = 0.347, p <.001), proteinuria (r = 0.343, p <.001), serum creatinine level (r = 0.181, p =.035), serum uric acid level (r = 0.243, p =.004) and blood urea nitrogen (r = 0.27, p =.001). Conclusion: Our study demonstrated that maternal renal cortical stiffness increased in women with preeclampsia. The increased RCE values may be indicative for the severity of preeclampsia due to positive correlations between renal cortical stiffness and systolic–diastolic blood pressure and serum creatinine level. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.Item Xanthogranulomatous pyelonephritis due to calculi in a 5-year-old girl(Turkish National Pediatric Society, 2020) Önder E.N.A.; Özkol M.; Neşe N.; Taneli C.; Özünan İ.Background. Xanthogranulomatous pyelonephritis is characterized by the inflammatory destruction of the renal parenchyma and intensive renal fibrosis. It is named because of its pathological appearance; that of its granulomatous inflammatory process with lipid-laden macrophages, which appear yellow, hence ‘xantho’ which is Greek for yellow. Xanthogranulomatous pyelonephritis is predominantly a disease of adults. In children it is diagnosed sporadically and is extremely rare in infants. The age of onset varies (21 days to 16 years), although 60-75% of cases have been diagnosed before 5 years of age. Recurrent urinary tract infections, obstructive nephropathy caused by renal calculus, malnutrition, abnormal lipid metabolism, altered immunologic response, lymphatic blockage, congenital urinary anomalies have been implicated in the etiology of xanthogranulomatous pyelonephritis in children. Case. We report an unusual case of xanthogranulomatous pyelonephritis in a 5-year-old girl and discuss its clinical features, histopathological findings and treatment. In this article, we also emphasized the importance of diagnostic imaging in urinary tract infections which enabled us not to miss the underlying kidney stone disease. Conclusion. Nephrolithiasis may lead to very serious conditions such as xanthogranulomatous pyelonephritis. This condition can be easily diagnosed by ultrasound, but if not detected, it can lead to complete loss of renal function as in the case. © 2020, Turkish Journal of Pediatrics. All rights reserved.Item Reversible lesion of the corpus callosum associated with COVID-19: A case report(ASEAN Neurological Association, 2021) Gemici Y.I.; Tasci I.Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may affect the central nervous system and peripheral nervous system. Major central nervous system manifestations of SARS-CoV-2 infection include seizures, meningoencephalitis, ischemic stroke, anosmia, and hypogeusia. The reversible splenial lesion syndrome was first described in 2004. Although reversible splenial lesion syndrome was initially recognized as a benign phenomenon, a second type of reversible splenial lesion syndrome was identified in later years, which has a poorer prognosis and potentially serious sequela. Reversible splenial lesion syndrome can be caused by numerous etiologies including viruses. In this report, we present a rare case of COVID-19 with reversible splenial lesion, who presented with ataxia and dizziness. © 2021, ASEAN Neurological Association. All rights reserved.Item Iatrogenic Iliac Arteriovenous Fistula Presenting with Heart Failure Symptoms After Ruptured Ovarian Cyst Surgery; [Over Kist Rüptürü Operasyonu Sonrası Kalp Yetersizliği Semptomları ile Prezente Olan İyatrojenik İliyak Arteriyovenöz Fistül](Ortadog u Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2023) Alkan F.; Düzgün F.Iatrogenic arteriovenous fistulas (AVF), which are increasing in the literature with the increase of surgical closed vascular interventions in diagnosis and treatment, are rare but have fatal complications. AVF may present with congestive heart failure symptoms, cardio-pulmonary symptoms, and leg edema immediately after the operation or over the years, depending on the size of the fistula. Diagnosis can be made by imaging examinations such as Doppler ultrasonography, computed tomography, or magnetic resonance angiography in patients with suspected AVF. The endovascular stent-grafting approach seems to be more popular in eligible patients due to surgical treatment's high morbidity and mortality rates. We aimed to report a rare case of iliac arteriovenous fistula that developed after a laparoscopic intervention due to ovarian cyst rupture and successfully grafted with an endovascular covered stent. 2146-9032 / Copyright © 2023 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Item A child with intravascular fasciitis mimicking deep vein thrombosis: a case report(Turkish National Pediatric Society, 2024) Yiğit Y.; Erdoğan O.; Yıldırım A.T.; Özer E.; Gülen H.Background. Intravascular fasciitis (IF) is a benign, reactive, myofibroblastic proliferation that originates from the superficial or deep fascia of small / medium-sized arteries and veins. Case Report. An 8-year-old male patient was admitted to a health center with the complaint of swelling in the inguinal region. Lower extremity venous Doppler ultrasonography showed deep vein thrombosis (DVT) of the femoral vein and anticoagulation with low-molecular weight heparin (LMWH) was initiated. The patient was referred to our center for follow-up. The D-dimer level was detected within normal limits. Doppler ultrasonography was repeated and showed an intraluminal expanding mass lesion with increasing vascularity, without distinct borders and LMWH was discontinued. This lesion at the sapheno-femoral junction was excised surgically and the histopathological examination revealed intravascular fasciitis. Conclusion. Clinicians should be aware that the clinical findings of IF may mimic sarcoma and thrombosis. © 2024, Turkish National Pediatric Society. All rights reserved.