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  • Küçük Resim Yok
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    Computed tomography guided percutaneous nephrostomy
    (2003) Baysal T.; Soylu A.; Saraç K.; Alkan A.; Dusak A.; Sarier M.
    Objectives: We investigated the value of computed tomography guided nephrostomies'in patients with absent or minimal pelvicaliceal dilatation and with different kidney anatomy and localization without using ultrasound and fluoroscopy. Material and Methods: We attempted 48 computed tomography guided nephrostomy placements in 40 patients. Both puncture of collecting system and placement of the catheters were made under computed tomography guidance. The Seldinger method was used in all procedures. Results: Percutaneous nephrostomies were successfully achieved in all patients without major complications. There were minimal dilatation of the pelvicaliceal systems in 28 (58.3%) of 48 nephrostomies. Four patients had obesity, and another 4 had rotation anomaly. One patient had both ectopic located and malrotated kidney. One patient had subcapsular haematoma and another one had retrorenal colon variation. Eighteen of the percutaneous nephrostomies were made intercostally. Single puncture was used in 35 (73%) and twice puncture were used in 13 (27%) procedures. The time necessary for the procedure ranged from 17-36 min (mean 28 min). Conclusion: Computed tomography guided percutaneous nephrostomy is a safe method with low rate of complications especially in patients with obesity, without pelvicaliceal dilatation or with minimal dilatation and patients with ectopic, malrotated kidneys and retrorenal colon variations.
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    MR spectroscopy in the differential diagnosis of focal brain lesions in neurofibromatosis type 1 patients
    (2003) Alkan A.; Kutlu R.; Sigirci A.; Baysal T.; Altinok T.; Dusak A.; Saraç K.
    PURPOSE: To determine the role of MR spectroscopy in the differential diagnosis of focal brain lesions in neurofibromatosis type 1. MATERIALS AND METHODS: Fifteen patients with neurofibromatosis type 1 were evaluated by routine MRI and single voxel MR spectroscopy (TE: 31). The posterior parietal white matter of 20 age-matched healthy volunteers constituted the control group. NAA/Cr, Cho/Cr and MI/Cr ratios were calculated and compared with the control group. RESULTS: A total of 58 focal brain lesions were detected by MR imaging. When patients with hamartomas and gliomas were compared with the control group, a decrease in the NAA/Cr ratio, and a significant increase in Cho/Cr and MI/Cr ratios were found. The decrease in the NAA/Cr ratio and the increase in Cho/Cr and MI/Cr ratios of gliomas were significant when compared with hamartomas. With MRI and MR spectroscopy findings, 52 hamartomas and 6 gliomas were detected. CONCLUSION: Since MR spectroscopy has the ability to detect cellular metabolic changes, it could provide additional information to MR imaging about the differential diagnosis and treatment planning of focal parenchymal lesions in neurofibromatosis type 1.