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Öğe Analysis of magnetic resonance imaging findings of children with neurologic complications after liver transplantation(Springer-Verlag Italia Srl, 2017) Ozturk, Mehmet; Akdulum, Ismail; Dag, Nurullah; Sigirci, Ahmet; Gungor, Serdal; Yilmaz, SezaiObjective To analyze the magnetic resonance imaging findings in children diagnosed with neurologic complications after liver transplantation (LT). Materials and methods A total of 39 patients diagnosed with neurologic complications following LT between 2010 and 2016. Neuroradiologic imaging was performed using cranial magnetic resonance imaging (MRI). Descriptive statistics regarding age, gender, type of complication, diagnostic and therapeutic modalities were calculated and presented as number and percentage. Results Our series consisted of 18 girls and 21 boys. Cryptogenic hepatitis (n = 13, 32%), metabolic diseases (Wilson's disease, tyrosinemia and glycogen storage disease) (n = 7, 18%) and fulminant toxic hepatitis (n = 4, 11%) constitute the most frequent indications for LT. The indications for neuroradiological imaging were convulsion and alteration of mental status. Conclusion These central nervous system complications may present in a variable spectrum and convulsions and altered mental state were the most frequent clinical pictures. Imaging studies were normal in approximately one-third of cases; the most frequent pathologic findings were diffuse cerebral edema, atrophy, and PRES. Clinical history, careful examination and integrated analysis of radiologic data as well as close collaboration and multidisciplinary approach are of utmost importance for establishing the diagnosis rapidly and accurately.Öğe Analysis of magnetic resonance imaging findings of children with neurologic complications after livertransplantation(Sprınger-verlag ıtalıa srl, vıa decembrıo, 28, mılan, 20137, ıtaly, 2017) Ozturk, Mehmet; Akdulum, Ismail; Dag, Nurullah; Sigirci, Ahmet; Gungor, Serdal; Yilmaz, SezaiObjective To analyze the magnetic resonance imaging findings in children diagnosed with neurologic complications after liver transplantation (LT). Materials and methods A total of 39 patients diagnosed with neurologic complications following LT between 2010 and 2016. Neuroradiologic imaging was performed using cranial magnetic resonance imaging (MRI). Descriptive statistics regarding age, gender, type of complication, diagnostic and therapeutic modalities were calculated and presented as number and percentage. Results Our series consisted of 18 girls and 21 boys. Cryptogenic hepatitis (n = 13, 32%), metabolic diseases (Wilson's disease, tyrosinemia and glycogen storage disease) (n = 7, 18%) and fulminant toxic hepatitis (n = 4, 11%) constitute the most frequent indications for LT. The indications for neuroradiological imaging were convulsion and alteration of mental status. Conclusion These central nervous system complications may present in a variable spectrum and convulsions and altered mental state were the most frequent clinical pictures. Imaging studies were normal in approximately one-third of cases; the most frequent pathologic findings were diffuse cerebral edema, atrophy, and PRES. Clinical history, careful examination and integrated analysis of radiologic data as well as close collaboration and multidisciplinary approach are of utmost importance for establishing the diagnosis rapidly and accurately.Öğe A case with pyopericardium and cardiac tamponade induced by migration of ventriculoperitoneal shunt catheter(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Karakurt, Cemsit; Celik, Serkan Fazli; Ozturk, Mehmet; Disli, Olcay Murat; Yakinci, CengizVentriculoperitoneal (VP) shunt is a method used in the treatment of hydrocephalus. In this article, we report a four-year-old girl who was implanted a VP shunt due to hydrocephalus, and referred to our clinic due to dyspnea and cardiomegalia. Echocardiographic examination revealed cardiac tamponade and pericardial effusion. Thorax computed tomography, which was performed due to suspicion of migration of the VP catheter to the pericardium, showed that the VP catheter tip was inside the pericardium. Pericardiectomy was performed due to pericardial constriction was developed after tube drainage, and the VP shunt catheter was shortened and replaced into the abdominal cavity.Öğe The Change in the Renal Pelvis Anterior-Posterior Diameter Between Prevoiding and Postvoiding Status, and Its Correlation With Vesicoureteral Reflux(Lippincott Williams & Wilkins, 2020) Akdulum, Ismail; Akyuz, Melih; Gurun, Enes; Ozturk, Mehmet; Tabel, Yilmaz; Sigirci, AhmetIn this study, our aim was to evaluate the significance of the change in renal pelvis anterior-posterior diameter (RPAPD) before and after micturition between vesicoureteral reflux (VUR)-positive and -negative patients to whom had voiding cystourethrography (VCUG) was performed. In this study, 69 children, age ranging from 0 to 12 years, were included. Before the VCUG imaging, the RPAPD was measured first with a full bladder and then after urination via ultrasound (US). The differences between in RPAPD measurements were noted and values compared made among VUR-positive and -negative children. Data distribution was inhomogeneous, and the Wilcoxon Sign Rank test was utilized instead of Student t test. There was no statistically significant difference in prevoiding and postvoiding RPAPD in VUR (+) and VUR (-) patients (P = 0.672). There was no statistically significant relation between VUR and the presence of hydronephrosis (P = 0.126). Vesicoureteral reflux is more common in patients with urinary tract infections (UTI) (P = 0.001). There was no statistically significant relationship between prevoiding and postvoiding RPAPD change and VUR diagnosis (P = 0,164). Ultrasound is the modality of choice for urinary system evaluation. Diagnosis of hydronephrosis via US is not sufficient in predicting VUR; however, indirect findings may reveal the diagnosis. A decrease in RPAPD in postvoiding US evaluation may not rule out the VUR diagnosis for this reason further imaging modalities, such as VCUG, should be taken into consideration for the patients with clinical suspicion.Öğe Diaphragmatic Mesothelial Cyst: Radiological Appearance and Follow-Up Results During Childhood(Lippincott Williams & Wilkins, 2021) Akdulum, Ismail; Ozturk, Mehmet; Karatoprak, Sinan; Akyuz, Melih; Sigirci, Ahmet; Boyunaga, Oznur LemanTo identify radiological findings of diaphragmatic mesothelial cysts (DMC) in the pediatric age group and to assess follow-up outcomes. In this study, 27 pediatric age group patients were evaluated with ultrasonography (US), computed tomography (CT), or magnetic resonance imaging due to various clinical indications and diagnosed with DMC from May 2014 to September 2018. Age, sex, imaging indications and DMC localization, volumes in the first diagnosis, and follow-ups were retrospectively evaluated. Descriptive statistics were used for age, sex, imaging indications, and volume are presented as numbers and percentages. Ages range from 5 months to 13 years. Nine girls and 18 boys included in this study. The most common imaging indications were abdominal pain, diarrhea, and obesity. The mean volume of DMC was at first 2.62 and 2.45 mL during the follow-ups. There was volume reduction in 24 cases, and no change in 3 cases. Mean follow-up duration was 22.4 months. The US imaging findings were similar for all cases, bilobular cystic lesion with fat indentation between the cyst and liver parenchyma. The typical localization and lateral fat sign are useful in differential diagnosis of DMC from cystic lesions of liver. The US is a very effective and beneficial radiological method for diagnosis and follow-up. Routine clinical and sonographic follow-ups may be sufficient for asymptomatic patients with stable cyst volume.Öğe Evaluation of aqueductal cerebrospinal fluid flow dynamics with phase-contrast cine magnetic resonance imaging in normal pediatric cases(Elsevier Science Inc, 2016) Ozturk, Mehmet; Sigirci, Ahmet; Unlu, SerkanPurpose: This study aimed to determine differences according to age groups and gender in the parameters of aqueductal cerebrospinal fluid (CSF) flow in childhood using phase-contrast cine magnetic resonance imaging (MRI) method. Materials and methods: This prospective study included 47 boys and 36 girls for a total of 83 healthy children. The cases were divided into three groups depending on age as infants (1-12 months), children (12-120 months), and adolescents (120-204 months). To quantitatively evaluate CSF flow, images in the transverse plane were taken at the cerebral aqueduct level using the phase-contrast MR angiography technique in a 1.5-T MR unit. Peak and average velocity (cm/s), cranial direction, caudal direction and net volume (ml), and aqueduct area (mm2) were calculated. To assess differences between the groups, a one-way analysis of variance and least significant difference tests were used. Results: A statistically significant difference was determined between children and adolescents in peak velocity and caudal direction volume (P=.012 and P=.039, respectively) and between infants and children in cranial direction volume (P=.036). Peak velocity, cranial direction, and net volume were higher in boys (P=.050, P=.016, and P=.029, respectively). There were no differences by age and gender in the aqueduct area. Conclusion: In conclusion, this study determined the normal values for the CSF flow parameters of velocity, volume, and aqueduct area using phase-contrast MRI in healthy children. Velocity and volume parameters varied according to age and sex and were not affected in the aqueductal area. Published by Elsevier Inc.Öğe Evaluation of Early and Late Complications of Pediatric Liver Transplantation with Multi-slice Computed Tomography: A High-Volume Transplant Single-Center Study(Aves, 2021) Ozturk, Mehmet; Dag, Nurullah; Sigirci, Ahmet; Yilmaz, SezaiBackground: To present abdominal multi-slice computed tomography (MSCT) results following transplantation in pediatric patients with a liver transplantation (LT), and to create awareness of early (<3 months) and late (>3 months) complications that may occur. Methods: This retrospective study included 119 children with an LT performed in our hospital from 2014 to 2017. The descriptive statistics relating to patients' age, gender, transplantation indications, transplantation technique, and MSCT findings were calculated, and are presented as numbers and percentages. The complications were divided into 4 groups: vascular, biliary, parenchymal, and extraparenchymal. Results: The LT procedures were performed with organs from living donors for 83 patients, and from deceased donors for 36 patients. Hepatic artery and portal vein complications were mostly seen in the early period (n = 18), and hepatic vein complications were also observed in the late period (n = 6). The most commonly encountered biliary complications were stenosis/stricture (n = 13) and bile leak/ bilioma (n = 9). Stenosis/stricture frequently occurred in the late period. The most common parenchymal complications were ischemic infarct (n = 8) in the early period, and abscess (n = 4) and recurrent hepatoblastoma (n = 2) in the late period. Hematoma (n = 7), intestinal perforation (n = 3), and focal spleen infarct (n = 3) were among the most commonly observed extraparenchymal abdominal complications. Conclusion: The complications occurring after pediatric LT varied according to the time after surgery and the transplantation technique used. Using MSCT, different abdominal complications can be assessed simultaneously, greatly contributing to diagnosis and treatment.Öğe Evaluation of physiologic pineal gland calcification via computed tomography in the pediatric population(2019) Ozturk, Mehmet; Caliskan, EmineAim: To determine the area, density and morphology of physiologic pineal gland calcification in the preadolescents and adolescents using computed tomography and to evaluate correlations with age and sex.Material and Methods: This retrospective study evaluated 220 cases (110 males, 110 females) with ages ranging from 7-17 years (mean age: 12±3.17). Cases were divided into two groups according to age of 7-12 years (n=120, preadolescent) and 13-17 years (n=100, adolescent). Morphology (homogeneous-heterogeneous), area (mm2) and density (Hounsfield Units [HU]) of pineal calcifications were investigated on computed tomography. Comparisons were made between age groups and sex in terms of these variables.Results: This study found pineal calcification frequency was 50%, 35% and 67% in all cases, preadolescents, and adolescents, respectively. According to morphology, 60.9% of calcifications were homogeneous and 39.1% were heterogeneous. Median calcification area and density values were 8.50 (6-15) mm2 and 67 (50-109.75) HU, and 7 (4.75-14.25) mm2, and 67 (53.25-87.75) HU, for males and females, respectively, with no significant difference identified between the sexes (p=0.353 and p=0.463, respectively). Median calcification area in the preadolescent and adolescent age groups was 7 (6-12) and 10 (5-18) mm2, with no significant difference identified between the groups (p=0.175). Median density values were 70 (56-109) HU for adolescents and this was high compared to preadolescents (59 [47-78] HU) (p=0.005). Conclusion: Physiologic pineal calcification frequency, area, density and morphology were revealed for preadolescent and adolescents. These values may be used as qualitative and quantitative reference data for differentiation of normal/abnormal pineal calcification in routine practice.Öğe Investigation of the prognostic value of psoas muscle area measurement in pediatric patients before liver transplantation: A single-center retrospective study(Wiley, 2021) Dag, Nurullah; Karatoprak, Sinan; Ozturk, Mehmet; Karatoprak, Nur Betul; Sigirci, Ahmet; Yilmaz, SezaiBackground: In this study, our aim is to investigate the prognostic value of psoas muscle area (PMA) evaluation before liver transplantation (LT) in pediatric patients. Methods: Two hundred seventy-six patients under 18 years of age who underwent LT between January 2012 and December 2019 were included in the study. The patients' demographic, laboratory, clinical, and imaging data were scanned retrospectively. PMA was measured at the L4/5 level using computed tomography images. To determine reproducibility, a different radiologist evaluated 30 randomly selected patients. Results: In patients with end-stage liver disease (ESLD), PMA was significantly lower than in patients with acute liver failure (P < .001). In patients with ESLD, a weakly significant correlation was found between PMA and 1-year survival after LT (r: .251, P = .030), hospitalization period (r: -.275, P = .039), and pediatric ESLD score (r: -.338, P < .001). Interobserver correlation was excellent (ICC: .941, 95% CI: .925, .971). Conclusion: In children with ESLD, PMA evaluated before LT can be used as a negative prognostic factor.Öğe Is cerebral spinal fluid flow associated with body mass index and head circumference in healthy children? A phase contrast magnetic resonance imaging study(Springer, 2020) Demirtas, Gokhan; Sigirci, Ahmet; Ozturk, Mehmet; Gorkem, Sureyya Burcu; Kilic, Betul; Gungor, SerdalBackground The aim of this study was to investigate the relationship between age, gender, body mass index (BMI), and head circumference (HC) and cerebral spinal fluid (CSF) flow dynamics in the pediatric population. The prospective study included a total of 137 participants, 75 boys and 62 girls, ranging in age from 2 to 204 months. Quantitative evaluation of CSF flow was made by using phase contrast magnetic resonance imaging (PC-MRI) in the axial plane at the level of the aqueductus cerebri. Flow dynamics were recorded as peak and mean velocity (cm/s); cranial, caudal, and net volume (ml); and aqueductus cerebri area (mm(2)). Correlation between baseline descriptive parameters, including age, gender, BMI, and HC, and the aforementioned CSF flow dynamics were investigated. Results The net volume was significantly lower in girls (p= 0.002). There was no association between age and aqueduct area, mean velocity, and cranial volume. The peak velocity was remarkably higher in children (p= 0.03), whereas cranial and net volume were found to be lower in infants (p= 0.04 andp= 0.03, respectively). Notably, cases with HC below normal values had lower cranial, caudal, and net volume and aqueductus cerebri area (p= 0.01,p= 0.03,p= 0.03, andp= 0.04, respectively). There was no association between BMI and indicators of CSF flow dynamics in PC-MRI. Conclusion BMI and HC may be associated with CSF flow dynamics in children. A smaller HC is accompanied by a lower forward flow volume, reverse flow volume, net volume, and aqueductal diameter. These points should be remembered during the design of further trials on determinants of CSF flow in children.Öğe Normative data for trachea and main bronchi dimensions on computed tomography in children and adolescents(2020) Caliskan, Emine; Gul, Ozan Berk; Ozturk, MehmetAim: To determine the reference values for trachea and main bronchi dimensions in children and adolescents using CT and to evaluate correlations with age and sex.Material and Methods: This retrospective study evaluated 150 cases (75 males, 75 females) with the median age of 9 (6-14) years. Cases were divided into three groups according to age of 4-7 years (n=50, preschool), 8-12 years (n=50, school), and 13-17 years (n=50, adolescent). The dimensions of trachea segments (proximal, middle, distal parts), and right and left bronchi were measured on coronal CT images. Comparisons were made between age groups and sex in terms of these variables.Results: The proximal, middle and distal sections of the trachea had median dimensions of 0.91 (0.79-1.08)cm, 1.08 (0.96-1.22)cm and 1.17 (1.06-1.32)cm, respectively. The order from statistically largest to smallest was distal, middle and proximal levels (p0.001). The dimension of the right main bronchus was significantly larger than the left one (p0.001) (median dimension for right 1.11 [0.96-1.30]cm, for left 1.04 [0.91-1.22]cm). There were no significant differences between the genders for main bronchi and trachea proximal and middle sections in terms of size. The trachea distal dimension was significantly larger in males compared to females (p=0.036). There were significant differences for all airways dimensions between the age groups (p0.001) (from largest to smallest; adolescents, children, preschoolers).Conclusion: Quantitative normative data were determined for the central airways of children and adolescents using coronal CT. These values may be used for diagnosis and management of medical procedures in routine practice.Öğe A rare cause of embolism in the popliteal artery of an adolescent: ruptured cardiac hydatid cyst(Turkish Soc Cardiology, 2015) Ozturk, Mehmet; Sigirci, Ahmet; Dagli, Adile Ferda[Abstract Not Available]Öğe A rare cause of infant facial paralysis: atypical teratoid rhabdoid tumour located in the cerebellopontine angle(Springer International Publishing Ag, 2015) Ozturk, Mehmet; Sigirci, Ahmet; Karadag, NeseAtypical teratoid rhabdoid tumour (ATRT) is a rare malignant tumour of the central nervous system with embryonal roots. The majority are seen in early childhood and location is often in the posterior fossa. Surgery, radiotherapy and chemotherapy are used in treatment. Knowledge of the localisation of the mass preoperatively is necessary for direction of the chemoradiotherapy and sufficient resection in surgery. Differentiation from other brain tumours is important because of poor prognosis and differences in treatment. In this paper it was aimed to present the clinical and radiological findings of an ATRT located in the cerebellopontine angle, which occurred with facial paralysis.Öğe A Rare Variant of Type I Truncus Arteriosus: Truncus Arteriosus with Anterior Origin of a Main Pulmonary Artery(Wiley-Blackwell, 2015) Celik, Serkan F.; Karakurt, Cemsit; Elkiran, Ozlem; Ozturk, Mehmet; Gormeli, Ayse C.Mini-Abstract Truncus arteriosus with anterior origin of a main pulmonary artery is a very rare condition. In this report we present a newborn who has a truncus arteriosus with anterior origin of a main pulmonary artery.Öğe Scoliosis After Liver Transplantation in Pediatric Patients(Aves, 2022) Dag, Nurullah; Ozturk, Mehmet; Sigirci, Ahmet; Yilmaz, SezaiObjective: Little is known about the development of scoliosis after pediatric liver transplantation. In this study, we aimed to evaluate the frequency of scoliosis and its relationship with potential risk factors in children after liver transplantation. Methods: Pediatric liver transplantations (under of age 18) performed between January 2009 and December 2017 at Malatya Inonu University Institute of Liver Transplantation were scanned retrospectively. In the spinal axis, >10 degrees lateral deviations were accepted as scoliosis. The curve patterns were classified according to the Lenke classification. Results: Among 287 pediatric liver transplantationss, 17 of them were scoliosis (6%). Nine patients were females and eight were males. The median Cobb angle was 12 degrees at the time of diagnosis and then 17 degrees at the last follow-up. According to the Lenke classification, 11 patients had type 5 curve pattern. During the follow-up period (ranging from 1 to 11 years), scoliosis progression was slow and no patient requiring surgical treatment was detected. Conclusion: We found that the prevalence of scoliosis increased after pediatric liver transplantation, but we do not have any definite information about the cause. Comparable new studies with more patients are needed to make a definitive conclusion in this regard.Öğe Sonographic measurement of subarachnoid space and ventricular width in premature and mature newborns(2017) Ozturk, MehmetAim: We aimed to measure the subarachnoid space and ventricular width with transfontanel sonography in premature and mature newborns and to identify the subarachnoid space/ventricular width ratio. Material and method: This prospective study included 123 premature and 121 mature newborns, totally 244 cases. All cases had sonographic investigation from the anterior fontanel with 4.8-11.0 MHz linear transducer. The subarachnoid space/ventricular width ratio was calculated. Analysis of variables was completed with SPSS 22.0 program; and independent samples T test was used for the comparisons between the groups. Results: The birth week, head circumference, weight and height values of mature newborns were higher compared to the premature newborns (p<0.001, for each). The subarachnoid space and ventricular width values for mature and premature newborns were 3.13±0.39 mm, 1.79±0.45 mm, and 3.45±0.47 mm and 2.02±0.54 mm, respectively (p<0.001, for each). The subarachnoid space/ventricular width ratios were 0.90±0.02 and 0.89±0.05 in mature and premature newborns with no difference identified between the groups (p=0.432). The result of Receiver Operating Curve analysis was that the threshold values for premature-mature distinction were 2.29 mm for subarachnoid space and 2.49 mm for ventricular width; and the sensitivity and specificity for both values were found to be 100% (p<0.001, for each). Conclusion: Subarachnoid space and ventricular width values vary according to the birth week of newborns, though the subarachnoid space/ventricular width ratio is not different. Transfontanel sonography is a useful imaging method for measurement of cerebrospinal fluid spaces in newbornsÖğe Torsion of a wandering spleen in an adolescent with Gaucher disease(Aves, 2017) Gungor, Sukru; Ozturk, Mehmet; Varol, Fatma Ilknur; Sigirci, Ahmet; Selimoglu, Mukadder AyseA wandering spleen is a rare condition characterized by the malposition of the spleen due to laxity or absence of its supporting ligaments. Although Gaucher disease generally presents with massive splenomegaly, which one of the predisposing causes of a wandering spleen, literature shows only one report of a wandering spleen in a child with Gaucher disease. In this case presentation, a 13-year-oldadolescent with Gaucher disease on enzyme replacement treatment was presented, who was detected having an abdominal mass on a routine visit and diagnosed with partial torsion of a wandering spleen associated with left lobe hypoplasia of the liver.Öğe Tuberculous Arthritis in the Elbow Joint in an Adolescent(Aves Press Ltd, 2018) Ozturk, Mehmet; Akatli, Aysenur; Sigirci, Ahmet; Akpolat, NusretMusculoskeletal system tuberculosis (TB) accounts for approximately 10% of all TB cases, excluding those involving pulmonary TB. Elbow TB is extremely rare and is seen in 2%-5% of musculoskeletal system cases. The diagnosis of TB arthritis is very difficult because its onset is insidious and progress is slow and there are nonspecific local and systemic symptoms. A delay in treatment can result in irreversible osteoarticular destruction. This paper presents the clinical and radiological findings of a 12-year-old adolescent patient with elbow TB arthritis.Öğe Ultrasonographic Measurement of Palatine Tonsil Size and Its Correlation with Body-Mass Index and Hepatosteatosis in Adolescents(2017) Ozturk, MehmetAim: To research the correlation between body-mass index (BMI) and hepatosteatosis with palatine tonsil size measured using transcervical ultrasonography (TCU) in adolescents.Öğe The utility of diffusion-weighted imaging to assess acute renal parenchymal changes due to unilateral ureteral stone obstruction(Springer, 2017) Duzenli, Kursat; Ozturk, Mehmet; Yildirim, Ismail Okan; Erdem, GulnurOur aim in this study was to evaluate the use of diffusion-weighted imaging (DWI) for acute renal parenchymal changes occurring as a result of unilateral ureteral obstruction due to stones. Twenty four patients with obstructed and opposite unobstructed kidney were enrolled in this prospective study. DWI was used at two different b values (b = 0 s/mm(2) and b = 1000 s/mm(2)). Apparent diffusion coefficient (ADC) measurements were completed on the upper pole, central section and lower pole parenchyma of both kidneys. ADC values were calculated. The unpaired t test was used to assess differences between the groups. The results of measurements identified a reduction in ADC values in obstructed renal parenchyma compared to unobstructed opposite renal parenchyma. The reduction in ADC values was greater in the upper and lower pole parenchyma and was statistically significant (p < 0.001, for both). Diffusion changes in renal parenchyma due to acute unilateral ureteral obstruction linked to stone may be quantitatively shown with DWI. The reduction in ADC values was more pronounced in the upper and lower pole parenchyma.
