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Öğe 256 kesitli çift tüplü bilgisayarlı tomografi cihazında prospektif EKG tetiklemeli ve retrospektif EKG kapılamalı teknikle çekilen koroner BT anjiografi ıncelemelerinde radyasyon dozu karşılaştırması(2016) Görmeli, Cemile Ayşe; Kahraman, Aysegul Sagir; Özdemir, Zeynep Maraş; Yağmur, Jülide; Özdemir, Ramazan; Açıkgöz, Nusret; Çolak, CemilGiriş: Koroner arter hastalığı, aterosklerotik plakların meydana getirdiği, önemli mortalite ve morbiditeye sahip sık görülen kardiyovasküler bir hastalıktır. Bilgisayarlı tomografi ile koroner anjiografi tetkiki giderek artan sıklıkta invaziv kateter anjiografi yerine kullanılmaya başlanmıştır. Biz de bu çalışmamız ile koroner arter hastalıklarının değerlendirilmesi için bilgisayarlı tomografi kullanılarak prospektif EKG tetiklemeli ve retrospektif EKG kapılamalıteknikle çekilen koroner anjiografi incelemelerinde efektif radyasyon dozlarını saptamayı amaçladık. Gereç ve Yöntemler: 256 kesitli çift tüplü bilgisayarlı tomografi cihazı ile koroner anjiografi çekilen 326 hasta değerlendirildi. Çalışmamızda, hastaların kalp hızına bağlı olarak 3 farklı çekim tekniği kullanarak teknikler arasındaki efektif radyasyon dozunu karşılaştırdık. Bulgular: Teknik I ile çekilen 195 hastanın kalp hızı ortalama 96,1 atım/dk, teknik II ile yapılan 103 incelemede kalp hızı ortalama 80,7 atım/dk, teknik III ile yapılan 28 görüntülemede ise kalp hızı ortalama 57,1 atım/dk olarak saptandı. Ayrıca, ortalama efektif radyasyon dozları; teknik I ile 1,15 mSv, teknik II ile 3,98 mSv ve teknik III ile 10 mSv olarak hesaplandı. Sonuç: Prospektif EKG tetiklemeli teknikle bilgisayarlı tomografi kullanılarak çekilen koroner anjiografi, retrospektif EKG kapılamalı teknikle karşılaştırıldığında düşük efektif radyasyon dozuna neden olmaktadır. Düşük radyasyon dozunda ve optimal görüntü kalitesinde incelemeler elde etmek için, çekim hastanın kalp hızına bağlı olarak en uygun teknik belirlenerek yapılmalıdır.Öğe Assessment of myocardial changes in athletes with native T1 mapping and cardiac functional evaluation using 3 T MRI(The International Journal of Cardiovascular Imaging, 2016) Görmeli, Cemile Ayşe; Görmeli, Gökhan; Yağmur, Jülide; Özdemir, Zeynep Maraş; Kahraman, Ayşegül Sağır; Çolak, Cemil; Özdemir, RamazanAbstract Intensive physical exercise leads to increases in left ventricular muscle mass and wall thickness. Cardiac magnetic resonance imaging allows the assessment of functional and morphological changes in an athlete’s heart. In addition, a native T1 mapping technique has been suggested as a non-contrast method to detect myocardial fibrosis. The aim of this study was to show the correlation between athletes’ cardiac modifications and myocardial fibrosis with a native T1 mapping technique. A total of 41 healthy non-athletic control subjects and 46 athletes underwent CMR imaging. After the functional and morphological assessments, native T1 mapping was performed in all subjects using 3.0 T magnetic resonance imaging. Most of the CMR findings were significantly higher in athletes who had C5 years of sports activity when compared with non-athletic controls and athletes who had \5 years of sports activity. Significantly higher results were shown in native T1 values in athletes who had \5 years of sports activity, but there were no significant differences in the left ventricular end-diastolic volume, left ventricular end-diastolic mass, or interventricular septal wall thickness between non-athletic controls and athletes who had \5 years of sports activity. The native T1 mapping technique has the potential to discriminate myocardial fibrotic changes in athletes when compared to a normal myocardium. The T1 mapping method might be a feasible technique to evaluate athletes because it does not involve contrast, is non-invasive and allows for easy evaluation of myocardial remodeling.Öğe Cerebrospinal fluid dynamics in patients with multiple sclerosis: the role of phase-contrast mrı inthe differential diagnosis of active and chronic disease(Korean radıologıcal soc, 121-8 yangjae-dong, seocho-gu, seoul 137-130, south korea, 2018) Oner, Serkan; Kahraman, Ayşegül Sağır; Özcan, Cemal; Özdemir, Zeynep Maraş; Ünlü, Serkan; Kamisli, Özden; Oner, ZulalObjective: Multiple sclerosis (MS) is an inflammatory disease characterized by demyelinating plaques in the white matter. Chronic cerebrospinal venous insufficiency (CCSVI) has been proposed as a new hypothesis for the etiopathogenesis of MS disease. MS-CCSVI includes a significant decrease of cerebrospinal fluid (CSF) flow through the cerebral aqueduct secondary to an impaired venous outflow from the central nervous system. This study aimed to determine whether CSF flow dynamics are affected in MS patients and the contributions to differential diagnosis in active and chronic disease using phase-contrast magnetic resonance imaging (PC-MRI). Materials and Methods: We studied 16 MS patients with chronic plaques (group 1), 16 MS patients with active plaques-enhanced on MRI (group 2), and 16 healthy controls (group 3). Quantitatively evaluation of the CSF flow was performed from the level of the cerebral aqueduct by PC-MRI. According to heart rates, 14-30 images were obtained in a cardiac cycle. Cardiac triggering was performed prospectively using finger plethysmography. Results: No statistically significant difference was found between the groups regarding average velocity, net forward volume and the average flow (p > 0.05). Compared with the controls, group 1 and group 2, showed a higher peak velocity (5.5 +/- 1.4, 4.9 +/- 1.0, and 4.3 +/- 1.3 cm/sec, respectively; p = 0.040), aqueductal area (5.0 +/- 1.3, 4.1 +/- 1.5, and 3.1 +/- 1.2 mm(2), respectively; p = 0.002), forward volume (0.039 +/- 0.016, 0.031 +/- 0.013, and 0.021 +/- 0.010 mL, respectively; p = 0.002) and reverse volume (0.027 +/- 0.016, 0.018 +/- 0.009, and 0.012 +/- 0.006 mL, respectively; p = 0.000). There were no statistical significance between the MS patients with chronic plaques and active plaques except for reverse volume. The MS patients with chronic plaques showed a significantly higher reverse volume (p = 0.000). Conclusion: This study indicated that CSF flow is affected in MS patients, contrary to the hypothesis that CCSVI-induced CSF flow decreases in MS patients. These findings may be explained by atrophy-dependent ventricular dilatation, which may occur at every stage of MS.Öğe Ekstremitenin Travmatik Olmayan Acilleri(Türk Radyoloji Seminerleri, 2016) Özdemir, Zeynep Maraş; Kerimoğlu, ÜlküEkstremitenin Travmatik Olmayan Acilleri Öz:Öğe Evaluation of intra-articular hip pathology: comparison of ct arthrography and mr arthrography(Turgut Özal Tıp Merkezi Dergisi, 2016) Özdemir, Zeynep Maraş; Çimen, Ayla Özaydoğdu; Cemile Ayşe Görmeli1Abstract Aim: To compare computed tomography arthrography (CTA) and magnetic resonance arthrography (MRA) in the evaluation of intra-artcular hip lesions. Material and Methods: 42 CTA and MRA procedures were performed for 41 patients who have arthrography indications after standard hip MR examinations. All imaging findings were evaluated by a single musculoskeletal radiologist. Data regarding the presence of labral tear, paralabral cyst, cartilage damage, the femoral head-neck morphology and the acetabular retroversion were noted for each examination. Eight patients were operated. The McNemar chi-square test was used to compare radiological examinations. Results: Labral tears and cartilage damages were the most common findings. Labral tears were visualized at 23 of 42 (%55) hips on MRA and most common site of location was anterosuperior quadrant (21/23, %91.3), on the other hand they were visualized at 17 of 42 (%40) hips on CTA with the most common site as anterosuperior quadrant (15/17, %88.2). Cartilage lesions were visualized 10 of 42 (%24.80) hips on MRA while 11 (%26.19) cartilage lesions were shown on CTA. %9.5 (4/42) patients have acetabular cartilage lesions and %14.3 (6/42) patients have both acetabular and femoral cartilage lesions on MRA. Meanwhile %11.9 (5/42) patients have acetabular cartilage lesions, %2.4 (1/42) patients has femoral cartilage lesions alone, and also %11.9 (5/42) patients have both acetabular and femoral cartilage lesions on CTA. Statistical analysis shows that CTA and MRA are compatible with each other for the evaluation of intraarticular hip lesions (p>0.05). Conclusion: CTA can be used as an alternative imaging method to MRA for the detection of intra-articular pathologies in appropriate patients especially who have imaging challenges due to surgical hardwares and contraindications of the MRI procedure. Keywords: Hip; CT arthrography; MR arthrography.Öğe Incidence and clinical presentation of portal vein thrombosis in cirrhotic patients(La radiologia medica, 2016) Görmeli, Cemile Ayşe; Özdemir, Zeynep Maraş; Kahraman, Ayşegül Sağır; Yağmur, Jülide; Özdemir, Ramazan; Çolak, CemilPurpose The aim of this study was to examine the correlation between ventricular function and the extracellular volume fraction (ECV) in patients with non-ischemic dilated cardiomyopathy (NIDCM) using 3.0 T magnetic resonance imaging (MRI). We also hypothesized that native T1 and ECV values would be increased in patients with NIDCM, independent of the left ventricular ejection fraction (LVEF). The findings of our study could lead to further studies of the follow-up protocols.Öğe Proksimal tibyofibular eklemden kaynaklanan peroneal sinir yerleşimli intranöral ganglion kisti: preoperatif tanıda manyetik rezonans görüntülemesinin katkıları(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2014) Özdemir, Zeynep Maraş; Kahraman, Ayşegül Sağır; Karakaplan, Mustafa; Topgül, Haldun; Görmeli, Cemile Ayşe; Hamurcu, Meryem MervePeroneal intranöral ganglion kisti, genelde erişkin yaşta erkeklerde ortaya çıkar ve nörolojik bulgulara yol açabilir. Hastaların çoğunda peroneal sinirin geçtiği fibula boynu laterali komşuluğunda ele gelen şişlik ve ağrı şikayeti ile karşılaşılmaktadır. Tanıda elektromiyografi ve radyolojik görüntüleme yöntemleri kullanılmaktadır. Biz burada dizinin dış yan tarafında ağrılı şişlik ve düşük ayak klinik tablosu ile başvuran 14 yaşında kız hastada alt ekstremite paralizisinin nadir nedenlerinden biri olan peroneal sinir yerleşimli intranöral ganglion kisti olgusunu sunduk. Sinir fonksiyonlarının geri kazanılabilmesi için mümkün olan en kısa zamanda cerrahi müdahale yapılmalıdır. Manyetik rezonans görüntülemesi (MRG) bu lezyonun hızlı ve doğru tanısına katkı sağlamakta ve tedavi yaklaşımlarına ışık tutmaktadır.Öğe Radiological evaluation in living donor liver transplantation (LDLT): the effets of variations in segment 4 artery on the ratio of left lobe volume to total liver volume(Turgut Özal Tıp Merkezi Dergisi, 2016) Kahraman, Ayşegül Sağır; Özdemir, Zeynep Maraş; Kahraman, Bayram; Görmeli, Ayşe Cemile; Yılmaz, SezaiAbstract Aim: The aim of this study was to evaluate whether the variations in the origin of the segment 4 artery effects the left liver lobe volume ratio to the total liver volume in living donor liver transplantation (LDLT). Material and Methods: Multiphasic CT images were obtained in 136 potential donors (70 men, 66 women). The mean age was 32.6±9 years (ranging from 19 to 53). Volume-rendering techniques were used to evaluate hepatic arteries. The origins of the segment 4 arteries were noted. The volumes of the right lobe, the left lobe and the total liver were measured in each case. The ratios of the left lobe volume to the total liver volume were calculated and subjects were divided into two groups based on this ratio. There were 78 cases with this ratio of ≥ 30 % and 58 cases with this ratio of < 30% in Group1 and Group 2, respectively. Results: The origins of the segment 4 artery were left hepatic artery in 85 cases and variational in 51 cases. The significant difference was shown in right (p=0,003) and left lobe (p=0,000) volumes between two groups whereas not shown in total liver volumes (p=0,775). No significant difference was observed in origins of segment 4 arteries between two groups (p=0,82). Women significantly have greater ratios of left lobe volume than men (p=0,013). Conclusion: Our results indicate that the variations in the origin of the segment 4 arteries have no effects on the ratio of left lobe volume to total volume, and merits further study. Keywords: Living Donor Liver Transplantation; Volumetric Analysis; Hepatic Arterian Anatomy.Öğe Radiological findings of the primary female urethral malignant melanoma: a rare case report(European journal of therapeutıcs, 2018) Oner, Serkan; Erdem, Gulnur; Özdemir, Zeynep Maraş; Gunes, Ali; Unlu, SerkanPrimary malignant melanomas of the female urethra are rare tumors with poor prognosis. Biopsy of the detected urethral mass was performed in a 71-year-old woman who presented with hematuria and voiding dysfunction. No other localized lesions were detected. The patient was diagnosed with primary malignant melanoma of the urethra according to the histopathologic and immunohistochemical findings. Immunohistochemical staining revealed that the tumor cells were immunoreactive for vimentin, HMB-45, S-100, and Melan-A. The present study aimed to present radiological findings of very rare primary urethral malign melanoma with histopathologic correlation and to review the relevant literature.Öğe Wandering intraperitoneal daughter vesicle following spontaneous rupture of a hydatid cyst: a case report(2016) Kahraman, Aysegul Sagir; Kahraman, Bayram; Cimen, Ayla; Özdemir, Zeynep Maraş; Görmeli, Cemile AyşeAmacımız spontan rüptüre karaciğer kist hidatik sonrası gezici intraabdominal kız vezikül olgusunun Bilgisayarlı Tomografi (BT) bulgularını sunmaktadır. Karın ağrısı şikayeti ile başvuran 39 yaşındaki kadın olguda ultrasonografide (USG) karaciğer sol lobda, egzofitik uzanımlı, kistik lezyon tespit edildi. Yapılan BT tetkikinde karaciğer segment III'den kaynaklanan ve inferiora doğru egzofitik uzanım gösteren, yaklaşık 8 cm boyutta, ince duvar yapısına sahip, belirgin kontrast tutulumu göstermeyen hipodens kistik lezyon saptandı. Kist hidatik tanısı alan olguya takip önerildi. Iki hafta sonra karın ağrısı şikayeti ile başvuran hastaya BT incelemesi yapıldı. Önceki BT görüntüsünde saptanan kistik lezyon kaybolmuştu ve kemik pelvis içerisinde önceki karaciğer kisti ile benzer boyutlarda, diğer bir kistik lezyon ile birlikte barsak ansları arasında serbest mayi mevcuttu. Bu bulgularla olguda rüptüre kist hidatik sonrası gezici intraperitoneal kız vezikül düşünüldü. Cerrahi müdahale yapılan olguda intraoperatif bulgular radyolojik değerlendirmeyi destekliyordu. Bu nadir durum akut batına neden olan potansiyel kist hidatik olgularında radyolojik takibin önemini vurgulamaktadır
