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Erden A, Kuru Öz D, Adıgüzel M, Özalp Ateş FS. Quantitative liver magnetic resonance imaging: correlation between conventional magnetic resonance imaging, laboratory values, and prognostic indices in Budd-Chiari syndrome. Diagn Interv Radiol 2023; 29:428-436. [PMID: 36960638 PMCID: PMC10679617 DOI: 10.4274/dir.2022.221462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 09/29/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE In Budd-Chiari syndrome (BCS), unevenly distributed parenchymal changes and perfusion abnormalities occur due to hepatic venous outflow obstruction. This study aimed to evaluate the changes in the liver parenchyma in BCS using the quantitative magnetic resonance (MR) techniques of MR elastography, T1 and T2 mapping, and diffusion imaging and correlate the quantitative MR parameters through biochemical results and prognostic indices. METHODS Fourteen patients with BCS (seven men and seven women) were examined retrospectively. Liver stiffness (kPa), T1 relaxation times (ms) were achieved using the modified Look-Locker inversion recovery (MOLLI) 3(2)3(2)5 sequence and B1-corrected variable flip angle methods, T2 relaxation times (ms), and apparent diffusion coefficient (ADC) values (mm2/s) were measured using regions of interest placed in the same region in all quantitative methods. Measurements were repeated at the precontrast and postcontrast hepatobiliary phases. The reduction rate (RR; %) and adjusted postcontrast T1 (%) were calculated. The values obtained from different liver parenchyma areas (whole liver, caudate lobe, pathological T2 hyperintense tissue, and relatively preserved normal-appearing tissue) were compared using the Wilcoxon signed-rank test. Spearman's correlation coefficient was used to investigate the correlation between quantitative MR parameters and biochemical parameters/ prognostic scores (Child-Pugh score, Clichy score, and Rotterdam index). RESULTS The parenchymal stiffness and precontrast T1 values of the caudate lobe were significantly lower than those of the remainder of the parenchyma, whereas the adjusted postcontrast T1 percentages (MOLLI) were significantly higher (P ≤ 0.027). The parenchymal stiffness value, T1 and T2 values, percentages of RR (MOLLI), and adjusted postcontrast T1 values for the pathological tissue and relatively normal tissue were significantly different (P < 0.028). No significant difference was found in terms of ADC values between any of the distinct regions of the liver. A strong correlation was detected between the Child-Pugh score, Clichy score, and precontrast T1 values obtained through the MOLLI sequence (r = 0.867, P = 0.012, r = 0.821, P = 0.023, respectively). No correlation was found between the whole liver stiffness values and the laboratory parameters, fibrosis markers, prognostic indices, or MR parameters. A significant correlation was identified between creatinine levels and several T1 parameters and the T2 relaxation time (r ≥ 0.661, P ≤ 0.052). CONCLUSION Tissue stiffness and T1 relaxation values are high in the areas identified as fibrosis compared with those in the relatively preserved parenchyma. The T1 relaxation time can offer quantitative information for assessing segmental functional changes and prognosis in BCS.ion for assessing segmental functional changes and prognosis in BCS.
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Affiliation(s)
- Ayşe Erden
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Diğdem Kuru Öz
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Adıgüzel
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Funda Seher Özalp Ateş
- Department of Biostatistics and Medical Informatics, Manisa Celal Bayar University, Faculty of Medicine, Manisa, Turkey
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Onur MR, Özbay Y, İdilman İ, Karaosmanoğlu AD, Uysal Ramadan S, Barlık F, Aydın S, Odaman H, Altay C, Başara Akın I, Dicle O, Appak Ö, Gülpınar B, Erden A, Kula S, Gürsöy Çoruh A, Kuru Öz D, Kul M, Uzun Ç, Karavaş E, Levent A, Artaş H, Eryeşil H, Solmaz O, Öztürk Kaygusuz T, Faraşat M, Kale AB, Düzgün F, Pekindil G, Apaydın FD, Nass Duce M, Balcı Y, Esen K, Sağır Kahraman A, Karaca L, Maraş Özdemir Z, Kahraman B, Tosun M, Nural MS, Çamlıdağ İ, Onar MA, Ballı K, Güler E, Harman M, Elmas NZ, Öztürk C, Güngör Ö, Herek D, Yağcı AB, Erol C, Şeker M, İşlek İ, Can Y, Aslan S, Karadeniz Bilgili MY, Göncüoğlu A, Keleş H, Bekin Sarıkaya PZ, Bakır B, Dağoğlu Kartal MG, Durak G, Yücel Oğuzdoğan G, Alper F, Yalçın A, Gürel S, Alan B, Gündoğdu E, Aydın N, Cansu A, Civan Kuş C, Ofluoğlu Tuncer E, Pişkin FC, Çolakoğlu Er H, Değirmenci B, Özmen MN, Kantarcı M, Karçaaltıncaba M. Evaluation of abdominal computed tomography findings in patients with COVID-19: a multicenter study. Diagn Interv Radiol 2023; 29:414-427. [PMID: 36960669 PMCID: PMC10679620 DOI: 10.4274/dir.2022.221575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 07/13/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE To evaluate the frequency of abdominal computed tomography (CT) findings in patients with coronavirus disease-2019 (COVID-19) and interrogate the relationship between abdominal CT findings and patient demographic features, clinical findings, and laboratory test results as well as the CT atherosclerosis score in the abdominal aorta. METHODS This study was designed as a multicenter retrospective study. The abdominal CT findings of 1.181 patients with positive abdominal symptoms from 26 tertiary medical centers with a positive polymerase chain-reaction test for severe acute respiratory syndrome coronavirus 2 were reviewed. The frequency of ischemic and non-ischemic CT findings as well as the association between CT findings, clinical features, and abdominal aortic calcific atherosclerosis score (AA-CAS) were recorded. RESULTS Ischemic and non-ischemic abdominal CT findings were detected in 240 (20.3%) and 328 (27.7%) patients, respectively. In 147 patients (12.4%), intra-abdominal malignancy was present. The most frequent ischemic abdominal CT findings were bowel wall thickening (n = 120; 10.2%) and perivascular infiltration (n = 40; 3.4%). As for non-ischemic findings, colitis (n = 91; 7.7%) and small bowel inflammation (n = 73; 6.2%) constituted the most frequent disease processes. The duration of hospital stay was found to be higher in patients with abdominal CT findings than in patients without any positive findings (13.8 ± 13 vs. 10.4 ± 12.8 days, P < 0.001). The frequency of abdominal CT findings was significantly higher in patients who did not survive the infection than in patients who were discharged after recovery (41.7% vs. 27.4%, P < 0.001). Increased AA-CAS was found to be associated with a higher risk of ischemic conditions in abdominal CT examinations. CONCLUSION Abdominal symptoms in patients with COVID-19 are usually associated with positive CT findings. The presence of ischemic findings on CT correlates with poor COVID-19 outcomes. A high AA-CAS is associated with abdominal ischemic findings in patients with COVID-19.
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Affiliation(s)
- Mehmet Ruhi Onur
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Yakup Özbay
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - İlkay İdilman
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - Selma Uysal Ramadan
- Clinic of Radiology, University of Health Sciences Turkey, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey
| | - Funda Barlık
- Department of Radiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Sonay Aydın
- Department of Radiology, Binali Yıldırım University Faculty of Medicine, Erzincan, Turkey
| | - Hüseyin Odaman
- Department of Radiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Canan Altay
- Department of Radiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Işıl Başara Akın
- Department of Radiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Oğuz Dicle
- Department of Radiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Özgür Appak
- Department of Medical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Başak Gülpınar
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ayşe Erden
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Sezer Kula
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | | | - Diğdem Kuru Öz
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Melahat Kul
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Çağlar Uzun
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Erdal Karavaş
- Department of Radiology, Binali Yıldırım University Faculty of Medicine, Erzincan, Turkey
| | - Akın Levent
- Department of Radiology, Binali Yıldırım University Faculty of Medicine, Erzincan, Turkey
| | - Hakan Artaş
- Department of Radiology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Hasan Eryeşil
- Department of Radiology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Onur Solmaz
- Department of Radiology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Türkkan Öztürk Kaygusuz
- Department of Infectious Diseases and Clinical Microbiology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Mustafa Faraşat
- Department of Radiology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Ahmet Burak Kale
- Department of Radiology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Fatih Düzgün
- Department of Radiology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Gökhan Pekindil
- Department of Radiology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - F. Demir Apaydın
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Meltem Nass Duce
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Yüksel Balcı
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Kaan Esen
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | | | - Leyla Karaca
- Department of Radiology, İnönü University Faculty of Medicine, Malatya, Turkey
| | | | - Bayram Kahraman
- Clinic of Radiology, Specialist Doctor Bayram Kahraman Radiology Clinic, Malatya, Turkey
| | - Mesude Tosun
- Department of Radiology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Mehmet Selim Nural
- Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - İlkay Çamlıdağ
- Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Mustafa Arda Onar
- Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Kaan Ballı
- Department of Radiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Ezgi Güler
- Department of Radiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Mustafa Harman
- Department of Radiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Nevra Zehra Elmas
- Department of Radiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Cansu Öztürk
- Clinic of Radiology, University of Health Sciences Turkey, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey
| | - Özlem Güngör
- Clinic of Radiology, University of Health Sciences Turkey, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey
| | - Duygu Herek
- Department of Radiology, Pamukkale University Faculty of Medicine, Denizli, Turkey
| | - Ahmet Baki Yağcı
- Department of Radiology, Pamukkale University Faculty of Medicine, Denizli, Turkey
| | - Cengiz Erol
- Department of Radiology, Medipol University Faculty of Medicine, İstanbul, Turkey
| | - Mehmet Şeker
- Department of Radiology, Medipol University Faculty of Medicine, İstanbul, Turkey
| | - İrem İşlek
- Department of Radiology, Medipol University Faculty of Medicine, İstanbul, Turkey
| | - Yusuf Can
- Department of Radiology, Medipol University Faculty of Medicine, İstanbul, Turkey
| | - Serdar Aslan
- Department of Radiology, Giresun University Faculty of Medicine, Giresun, Turkey
| | | | - Alper Göncüoğlu
- Department of Radiology, Kırıkkale University Faculty of Medicine, Kırıkkale, Turkey
| | - Hatice Keleş
- Department of Internal Medicine, Kırıkkale University Faculty of Medicine, Kırıkkale, Turkey
| | | | - Barış Bakır
- Department of Radiology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
| | | | - Görkem Durak
- Department of Radiology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Gülşen Yücel Oğuzdoğan
- Clinic of Radiology, University of Health Sciences Turkey, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Fatih Alper
- Department of Radiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Ahmet Yalçın
- Department of Radiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Safiye Gürel
- Department of Radiology, Bolu Abant İzzet Baysal University Faculty of Medicine, Bolu, Turkey
| | - Bircan Alan
- Department of Radiology, Bolu Abant İzzet Baysal University Faculty of Medicine, Bolu, Turkey
| | - Elif Gündoğdu
- Department of Radiology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Nevin Aydın
- Department of Radiology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Ayşegül Cansu
- Department of Radiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Ceyda Civan Kuş
- Clinic of Radiology, Marmara University Training and Research Hospital, İstanbul, Turkey
| | - Elif Ofluoğlu Tuncer
- Clinic of Radiology, University of Health Sciences Turkey, Sultan 2. Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Ferhat Can Pişkin
- Department of Radiology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Hale Çolakoğlu Er
- Department of Radiology, Ufuk University Faculty of Medicine, Ankara, Turkey
| | | | - Mustafa Nasuh Özmen
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mecit Kantarcı
- Department of Radiology, Binali Yıldırım University Faculty of Medicine, Erzincan, Turkey
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Çolaklar A, Kuru Öz D, Erden A. Compression of the Distal Common Bile Duct by Enlarged Inferior Pancreaticoduodenal Artery Branches in a Patient with Celiac Trunk Stenosis: A Case Report. Journal of Gastrointestinal and Abdominal Radiology 2022. [DOI: 10.1055/s-0042-1751254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
AbstractVarious benign and malignant pathologies/conditions can cause compression of the extrahepatic biliary system. Anatomical and/or topographic variations of the hepatic artery have long been recognized as a possible cause of the EBS compression. However, anatomical and/or topographic variations, other than the hepatic artery's, should also be considered during the evaluation of the EBS compression. We, herein, report a unique case of the distal common bile duct compression by tortuous and enlarged inferior pancreaticoduodenal artery branches due to severe stenosis of the celiac trunk orifice.
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Affiliation(s)
- Anıl Çolaklar
- Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
| | - Diğdem Kuru Öz
- Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
| | - Ayşe Erden
- Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
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Erden A, Kuru Öz D, Erden İ. Ectopic opening of common bile duct into the duodenal bulb: magnetic resonance cholangiopancreatography findings. Diagn Interv Radiol 2022; 28:286-293. [PMID: 35950273 PMCID: PMC9634928 DOI: 10.5152/dir.2022.201026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/07/2021] [Indexed: 06/15/2023]
Abstract
PURPOSE We aimed to evaluate the spectrum of magnetic resonance cholangiopancreatography (MRCP) findings in patients with ectopic opening of the common bile duct (CBD) into the duodenal bulb and to determine the effectiveness of the MRCP technique in diagnosis. METHODS Morphologic and morphometric MRCP/MRI features in 16 patients and 36 controls were retrospectively analyzed by 2 radiologists. The frequency of MRCP findings was determined. The significance of the difference between the MRCP observations in patients and controls was evaluated statistically and the diagnostic effectiveness of MRCP was investigated. RESULTS Hook-shaped ending of CBD and bulbar deformity were the most frequent morphologic findings seen on MRCP in the ectopic bulbar opening. Mean pylorus-papilla distance and mean CBD length were significantly shorter and the median diameter of CBD was significantly larger than the control group (patients: 28.6 ± 15.3 mm, 33.7 ± 12.8 mm, 8.6 (2-16) mm; controls: 66.7 ± 11.7 mm, 50.3 ± 14.4 mm, 3.2 (1.5-10) mm, P < .001, respectively). Receiver operating curve analysis showed sensitivity and specificity of MRCP in the diagnosis to be 87.5% and 100%, respectively, if any 3 of the 4 signs (hook-shaped ending of CBD, bulbar deformity, large, and short CBD) were present in a patient whose pylorus-papilla distance was <50 mm. CONCLUSION At MRCP, the presence of short and large CBD with a hook-shaped ending in the deformed duodenal bulb may support the diagnosis of ectopic biliary drainage.
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Affiliation(s)
- Ayşe Erden
- Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
| | - Diğdem Kuru Öz
- Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
| | - İlhan Erden
- Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
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Kul M, Kuru Öz D, Gürsoy Coruh A, Özalp Ateş F, Gülpınar B, Uzun Ç, Atasoy K. Biphasic split-bolus injection protocol for routine contrast-enhanced chest CT: comparison with conventional early-phase single bolus technique. Br J Radiol 2022; 95:20210775. [PMID: 35171718 PMCID: PMC10996411 DOI: 10.1259/bjr.20210775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 02/03/2022] [Accepted: 02/08/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To present a routine contrast-enhanced chest CT protocol with a split-bolus injection technique achieving combined early- and delayed phase images with a single aquisition, and to compare this technique with a conventional early-phase single-bolus chest CT protocol we formerly used at our institution, in terms of attenuation of great thoracic vessels, pleura, included hepatic and portal venous enhancement, contrast-related artifacts, and image quality. METHODS A total of 202 patients, who underwent routine contrast-enhanced chest CT examination aquired with either conventional early-phase single-bolus technique (group A,n = 102) or biphasic split-bolus protocol (group B,n = 100), were retrospectively included. Attenuation measurements were made by two radiologists independently on mediastinal window settings using a circular ROI at the following sites: main pulmonary artery (PA) at its bifurcation level, thoracal aorta (TA) at the level of MPA bifurcation,portal vein (PV) at porta hepatis, left and right hepatic lobe, and if present, thickened pleura (>2 mm) at the level with the most intense enhancement. Respective normalized enhancement values were also calculated. Contrast-related artifacts were graded and qualitative evaluation of mediastinal lymph nodes was performed by both reviewers independently. Background noise was measured and contrast-to-noise ratios (CNRs) of the liver and TA were calculated. RESULTS While enhancement of thoracic vessels and normalised MPA enhancement did not differ significantly between both groups (p > 0.05), enhancement and normalised enhancement of pleura, liver parenchyma and PV was significantly greater in group B (p < 0.001). Perivenous artifacts limiting evaluation were less frequent in group B than in A and mediastinal lymph nodes were judged to be evaluated worse in group A than in group B with an excellent agreement between both observers. No significant difference was detected in CNRTA (p = 0.633), whereas CNR liver was higher in group B (p < 0.001). CONCLUSION Our split-bolus chest CT injection protocol enables simultaneous enhancement for both vascular structures and soft tissues, and thus, might raise diagnostic confidence without the need of multiple acquisitions. ADVANCES IN KNOWLEDGE We think that this CT protocol might also be a promising alternative in lung cancer staging, where combined contrast-enhanced CT of the chest and abdomen is indicated. We therefore suggest to further evaluate its diagnostic utility in this setting, in particular in comparison with a late delayed chest-upper abdominal CT imaging protocol.
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Affiliation(s)
- Melahat Kul
- Department of Radiology, School of Medicine, Ankara
University, Ankara,
Turkey
| | - Diğdem Kuru Öz
- Department of Radiology, School of Medicine, Ankara
University, Ankara,
Turkey
| | | | - Funda Özalp Ateş
- Department of Biostatistics, School of Medicine, Manisa Celal
Bayar University, Manisa,
Turkey
| | - Başak Gülpınar
- Department of Radiology, School of Medicine, Ankara
University, Ankara,
Turkey
| | - Çağlar Uzun
- Department of Radiology, School of Medicine, Ankara
University, Ankara,
Turkey
| | - K.Çetin Atasoy
- Department of Radiology, School of Medicine, Koç
University, İstanbul,
Turkey
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Erden A, Kuru Öz D, Peker E, Kul M, Ateş FSÖ, Erden İ, İdilman R. MRI quantification techniques in fatty liver: the diagnostic performance of hepatic T1, T2, and stiffness measurements in relation to the proton density fat fraction. Diagn Interv Radiol 2021; 27:7-14. [PMID: 33290237 PMCID: PMC7837725 DOI: 10.5152/dir.2020.19654] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/22/2020] [Accepted: 04/05/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Nonalcoholic fatty liver disease (NAFLD) can progress to liver cirrhosis and is predicted to become the most frequent indication for liver transplantation in the near future. Noninvasive assessment of NAFLD is important for diagnosis and patient management. This study aims to prospectively determine the liver stiffness and T1 and T2 values in patients with NAFLD and to compare the diagnostic performance of magnetic resonance elastography (MRE) and mapping techniques in relation to the proton density fat fraction (PDFF). METHODS Eighty-three patients with NAFLD and 26 participants with normal livers were imaged with a 1.5 T scanner. PDFF measurements obtained from the multiecho Dixon technique were used to quantify the liver fat. MRE, native T1 mapping (modified Look-Locker inversion recovery [MOLLI] schemes 5(3)3, 3(3)3(3)5, and 3(2)3(2)5 and the B1-corrected variable flip angle [VFA] method), and T2 mapping values were correlated with PDFF. The diagnostic performance of MRE and the mapping techniques were analyzed and compared. RESULTS T1 values measured with the MOLLI schemes and the B1-corrected VFA (P < 0.001), and the stiffness values from MRE (P = 0.047) were significantly higher in the NAFLD group. No significant difference was found between the groups in terms of T2 values (P = 0.127). In differentiation of the NAFLD and control groups, the B1-corrected VFA technique had slightly higher accuracy and area under the curve (AUC) than the MOLLI schemes. In the NAFLD group, there was a good correlation between the PDFF, MOLLI 3(3)3(3)5 and 3(2)3(2)5, and VFA T1 measurements (r=0.732; r=0.735; r=0.716, P < 0.001, respectively). CONCLUSION Liver T1 mapping techniques have the potential to distinguish steatotic from nonsteatotic livers, and T1 values seem to have a strong correlation with the liver fat content.
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Affiliation(s)
- Ayşe Erden
- From the Departments of Radiology (A.E., D.K.Ö. , E.P., M.K., İ.E.), Biostatistics (F.S.Ö.A.), and Gastroenterology (R.İ.), Ankara University School of Medicine, Ankara, Turkey
| | - Diğdem Kuru Öz
- From the Departments of Radiology (A.E., D.K.Ö. , E.P., M.K., İ.E.), Biostatistics (F.S.Ö.A.), and Gastroenterology (R.İ.), Ankara University School of Medicine, Ankara, Turkey
| | - Elif Peker
- From the Departments of Radiology (A.E., D.K.Ö. , E.P., M.K., İ.E.), Biostatistics (F.S.Ö.A.), and Gastroenterology (R.İ.), Ankara University School of Medicine, Ankara, Turkey
| | - Melahat Kul
- From the Departments of Radiology (A.E., D.K.Ö. , E.P., M.K., İ.E.), Biostatistics (F.S.Ö.A.), and Gastroenterology (R.İ.), Ankara University School of Medicine, Ankara, Turkey
| | - Funda Seher Özalp Ateş
- From the Departments of Radiology (A.E., D.K.Ö. , E.P., M.K., İ.E.), Biostatistics (F.S.Ö.A.), and Gastroenterology (R.İ.), Ankara University School of Medicine, Ankara, Turkey
| | - İlhan Erden
- From the Departments of Radiology (A.E., D.K.Ö. , E.P., M.K., İ.E.), Biostatistics (F.S.Ö.A.), and Gastroenterology (R.İ.), Ankara University School of Medicine, Ankara, Turkey
| | - Ramazan İdilman
- From the Departments of Radiology (A.E., D.K.Ö. , E.P., M.K., İ.E.), Biostatistics (F.S.Ö.A.), and Gastroenterology (R.İ.), Ankara University School of Medicine, Ankara, Turkey
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Coruh AG, Kul M, Kuru Öz D, Yenigün B, Cansız Ersöz C, Özalp Ateş F, Atasoy Ç. Is it possible to discriminate pulmonary carcinoids from hamartomas based on CT features? Clin Imaging 2020; 62:49-56. [PMID: 32066033 DOI: 10.1016/j.clinimag.2020.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/22/2020] [Accepted: 02/06/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE The purpose of this study was to determine whether the computed tomography (CT) features might be used in distinguishing pulmonary carcinoids from hamartomas. MATERIALS AND METHODS Ninety solid pulmonary nodules (43 carcinoids and 47 hamartomas) in 90 patients were evaluated. The following CT scan features were evaluated: size, location (peripheral/central), contour (lobulated/nodular), number of lobulation, attenuation, calcification, endobronchial status, bronchial extension and involvement, parenchymal abnormalities distal to the lesion e.g. hyperlucency, atelectasis, and nodularity. The final pathologic diagnosis of the lesions and bronchial extension were confirmed by review of histopathological specimens. RESULTS Out of 43 carcinoids, 37 (86%) were typical. Twenty-three carcinoids and four hamartomas were central (p < 0.001). Ten carcinoids and one hamartoma were endobronchial. The majority of tumors had lobulated contours (65% of carcinoids, 44% of hamartomas) and carcinoids tended to have more lobulations (p = 0.052). Distal nodularity (p = 0.001), distal hyperlucency (p < 0.001), and atelectasis (p = 0.005) were significantly more common in carcinoids. Carcinoids had significantly more bronchial extension and involvement (p < 0.001; respectively). In addition, a new sign that we call "bronchial triangle sign" differentiated carcinoids with a sensitivity and specificity of 84.9% (95% CI: 69,1%-93.4%) and 91% (95% CI: 79.7%-96.6%). CONCLUSION To the best of our knowledge this is the first study on discrimination of carcinoids and hamartomas. A new CT sign called "bronchial triangle sign" might be used to differentiate carcinoids from hamartomas. Distal parenchymal abnormalities are more common in carcinoids than in hamartomas.
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Affiliation(s)
- Aysegul Gursoy Coruh
- Department of Radiology, School of Medicine, Ankara University, Talatpaşa Bulvarı, Sıhhiye, 06100 Ankara, Turkey.
| | - Melahat Kul
- Department of Radiology, School of Medicine, Ankara University, Talatpaşa Bulvarı, Sıhhiye, 06100 Ankara, Turkey
| | - Diğdem Kuru Öz
- Department of Radiology, School of Medicine, Ankara University, Talatpaşa Bulvarı, Sıhhiye, 06100 Ankara, Turkey
| | - Bülent Yenigün
- Department of Thoracic Surgery, School of Medicine, Ankara University, Ankara, Turkey
| | | | - Funda Özalp Ateş
- Department of Biostatistics, School of Medicine, Ankara University, Ankara, Turkey
| | - Çetin Atasoy
- Department of Radiology, School of Medicine, Koç University, İstanbul, Turkey
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Peker E, Kuru Öz D, Kul M, Erdoğan M, Öztuna D, Erden Mİ. Neuro-Ophthalmologic MRI Findings in the Detection of Rhinorrhoea Aetiology. Neuroophthalmology 2019; 43:244-249. [PMID: 31528189 DOI: 10.1080/01658107.2018.1540643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/19/2018] [Accepted: 10/23/2018] [Indexed: 10/28/2022] Open
Abstract
The purpose of this study is to evaluate the importance of neuro-ophthalmological magnetic resonance imaging (MRI) findings in the identification of the aetiology of rhinorrhoea, and the differentiation of spontaneous rhinorrhoea from non-spontaneous rhinorrhoea. MR images of 25 patients with spontaneous and 21 patients with non-spontaneous rhinorrhoea were evaluated for the presence of neuro-ophthalmological findings of intracranial hypertension (IHT). These include optic nerve vertical tortuosity, optic nerve sheath enlargement, flattening of the posterior sclera and optic nerve protrusion, as well as other MRI findings of ICH, such as partial empty sella, dilatation of Meckel's cave and the presence of arachnoid pits. IHT findings were more common in the spontaneous group. Six criteria (optic nerve distention, optic nerve vertical tortuosity, posterior flattening of the sclera, partial empty sella, Meckel's cave dilatation and presence of arachnoid pits) differentiate between patient and control groups. Patients with spontaneous cerebrospinal fluid (CSF) leaks should be evaluated for signs of IHT on MRI, as they are present in the majority of spontaneous CSF leaks and are representative of increased intracranial pressure.
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Affiliation(s)
- Elif Peker
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Diğdem Kuru Öz
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Melahat Kul
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Erdoğan
- Department of Biostatistics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Derya Öztuna
- Department of Biostatistics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Memet İlhan Erden
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
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Akkaya HE, Erden A, Kuru Öz D, Ünal S, Erden İ. Magnetic resonance elastography: basic principles, technique, and clinical applications in the liver. ACTA ACUST UNITED AC 2019; 24:328-335. [PMID: 30272563 DOI: 10.5152/dir.2018.18186] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Magnetic resonance elastography (MRE) is a constantly advancing technique for assessment of stiffness of tissues with newer technology and sequences. It is being increasingly used for the assessment of liver fibrosis. In this article, we discuss the advantages of MRE over biopsy and noninvasive methods such as US elastography in the assessment of liver fibrosis. Image acquisition and interpretation of liver MRE is also discussed.
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Affiliation(s)
| | - Ayşe Erden
- Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
| | - Diğdem Kuru Öz
- Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
| | - Sena Ünal
- Department of Radiology, Erzurum Local Training and Research Hospital, Erzurum, Turkey
| | - İlhan Erden
- Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
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Kul M, Kuru Öz D, Erden A. Spherical liver in primary sclerosing cholangitis. Abdom Radiol (NY) 2018; 43:2876-2877. [PMID: 29500643 DOI: 10.1007/s00261-018-1522-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Melahat Kul
- Departement of Radiology, Ibni Sina Hospital, Ankara University Medical Faculty, Ankara, Turkey.
| | - Diğdem Kuru Öz
- Departement of Radiology, Ibni Sina Hospital, Ankara University Medical Faculty, Ankara, Turkey
| | - Ayşe Erden
- Departement of Radiology, Ibni Sina Hospital, Ankara University Medical Faculty, Ankara, Turkey
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