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    Adrenolökodistrofinin Manyetik Rezonans Görüntüleme Bulguları: Spektroskopi ve Difüzyon Ağırlıklı Görüntülemenin Tanıya Katkısı
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2008) Mutlu, Deniz Yakar; Fırat, Ahmet Kemal; Karakaş, Hakkı Muammer; Erdem, Gülnur; Fırat, Yezdan; Güngör, Serdal
    Adrenolökodistrofi (ALD), adrenal korteks, santral sinir sistemi ve testisin etkilendiği uzun zincirli yağ asitlerinin birikimine bağlı olarak ortaya çıkan X’e bağlı geçiş gösteren metabolik bir hastalıktır. İnsidansı: 1/25 000-1/100 000 arasındadır. Beyin beyaz cevherini tutan peroksizomal bir hastalıktır. ALD tanısı plazmada ve cilt-fibroblast kültüründe çok uzun zincirli yağ asitlerinin artışı ve kromozomal çalışma ile konur. Adrenal yetmezlik ve demyelinizasyona bağlı nörolojik bulgularla seyreder. Lökodistrofi hastalarında altta yatan beyaz cevher anormalilerinin karakterizasyonu, lokalizasyonu ve ayırıcı tanısında MRG öncelikli görüntüleme yöntemidir. Biz bu olgu sunumu aracılığıyla adrenolökodistrofinin manyetik rezonans görüntüleme, manyetik rezonans spektroskopi ve difüzyon ağırlıklı görüntüleme bulgularının kliniğe katkısını sunmayı amaçladık.
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    Diffusion-Weighted Images Differentiate Benign From Malignant Thyroid Nodules
    (Wiley, 2010) Erdem, Gulnur; Erdem, Tamer; Karakas, Hakki Muammer; Mutlu, Deniz Yakar; Firat, Ahmet Kemal; Sahin, Ibrahim; Alkan, Alpay
    Purpose: To reveal the possible role of diffusion-weighted images (DWI) in the differential diagnosis of benign and malignant thyroid nodules by comparing the results of fine-needle aspiration cytology (FNAC). Materials and Methods: In an 18-month period (December 2005 to May 2007), 27 cases with benign thyroid nodules with a total of 52 benign nodules, nine cases with thyroid gland malignancy and 24 healthy control cases were included in the study. Cases that were indicated to undergo to FNAC examination and sent by a clinician for biopsy to the radiology unit were included in the study to assess the cytopathologic confirmation of the clime, ultrasonographic, and magnetic resonance imaging (MRI) findings. Results: The mean apparent diffusion coefficient (ADC) values of thyroid nodules were 2745.3 +/- 601.1 x 10(-6) mm(2)/s (1605-3899 x 10(-6)mm(2)/s) in the benign group and 695.2 +/- 312.5 x 10(-6)mm(2)/s (165-1330 x 10(-6)mm(2)/s) in the malignant group. Normal thyroid tissues had mean ADC values of 1344.1 +/- 276.4 x 10(-6) mm(2)/s (1015-1764 x 10(-6)mm(2)/s). The ADC values of three subgroups were significantly different (P = 0.0001). A reduced ADC was observed in most. types of malignant tumors due to the consequent decrease of the extracellular extravascular space. Conclusion: Our preliminary results showed that ADC values of nodules may provide useful data about the nature of a thyroid nodule.
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    Diffusion-weighted magnetic resonance imaging in differentiation of postobstructive consolidation from central lung carcinoma
    (Elsevier Science Inc, 2009) Baysal, Tamer; Mutlu, Deniz Yakar; Yologlu, Saim
    Purpose: To prospectively evaluate diffusion-weighted (DW) magnetic resonance (MR) imaging for differentiation of postobstructive consolidation from centrally located lung carcinomas by using apparent diffusion coefficients (ADCs). Materials and Methods: An institutional review board approved this study; informed consent was obtained from patients. Forty-nine consecutive patients (3 women, 46 men; mean age, 63.6 years; age range, 42-85 years) with lung carcinoma underwent DW MR imaging. Forty patients had central and nine patients had peripheral lung carcinomas. ADC of each lung carcinoma was calculated from DW MR images obtained with two different h Values (0, 1000 s/mm(2)). In the final Study group including 27 patients with central lung carcinoma accompanying distal lung consolidation (mean age, 67.2 years, 3 women, 24 men), ADCs Of lung carcinomas were statistically compared among cytologic/histologic types and accompanying postobstructive consolidations. Unpaired t test was used for measurable variables with normal distribution, and Kruskal-Wallis variance analysis and Mann-Whitney U tests were used for the Measurable variables without normal distribution. Results: There was no significant difference between mean ADC values of all types of carcinomas (P=.302) and also between mean ADC values of central (1.91 +/- 0.7 x 10(-3) mm(2)/s) and peripheral carcinomas (1.58 +/- 0.6 x 10(-3) mm(2)/s) (P=.224). The mean ADC value for the masses Of Central lung carcinoma with postobstructive consolidations was 1.83 +/- 0.75 x 10(-3) mm(2)/s, and for consolidation was 2.50 +/- 0.76 x 10(-3) mm(2)/s. ADC of central carcinoma masses was significantly lower than that of postobstructive consolidations (P=.003). Conclusions: A DC values of central lung I I Ling carcinoma masses appear to be lower than accompanying postobstructive consolidations. A DC values Could be considered useful as a differentiating parameter among central lung carcinomas and accompanying postobstructive consolidations. (C) 2009 Elsevier Inc. All rights reserved.