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    Diabetic fibrous mastopathy: Dynamic contrast-enhanced magnetic resonance imaging findings
    (2004) Tuncbilek N.; Karakas H.M.; Okten O.
    Diabetic fibrous mastopathy (DFM) is an uncommon lesion that may clinically mimic breast carcinoma. Routine mammographic and ultrasonographic features of this disease also mimic the those of malignant disease, making an accurate preoperative diagnosis difficult. Dynamic contrast-enhanced magnetic resonance imaging (MRI), however, reveals a homogeneous low-enhancement with a gradual and progressive course without a washout. A corresponding time intensity curve is related to benign lesions of low vascularity, and by being a potential criterion for making a differentiation between DFM and malignant processes, spares patients from excisional biopsy.
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    Evaluation of tumor angiogenesis with contrast-enhanced dynamic magnetic resonance mammography
    (2003) Tuncbilek N.; Unlu E.; Karakas H.M.; Cakir B.; Ozyilmaz F.
    The goal of this research was to correlate dynamic magnetic resonance (MR) mammographic contrast enhancement and microvessel densities in breast masses. Forty-six female patients with breast masses detected by mammography and/or ultrasonography were included in the study. MR contrast enhancements of the lesions were investigated dynamically using axial three-dimensional fast low-angle shot sequences. After excisional biopsy or mastectomy, immunohistochemical staining with factor VIII-RA was performed, followed by microvessel density measurements. Contrast enhancement patterns in dynamic MR mammography were compared with microvessel density measurements using Student's t-test, Pearson's moment correlation coefficients, and one-way analysis of variance (ANOVA). Malignant lesions exhibited three different enhancement patterns: 1) a peak enhancement within 120 seconds (early phase), followed by a decrease in the delayed phase (25 cases); 2) an increase in the early phase, followed by a plateau in the delayed phase (9 cases); and 3) an increase throughout the examination without any peak (5 cases). In benign lesions, signal intensity did not exhibited a peak in five cases, whereas in two cases enhancement was increased in the early phase and made a plateau in the delayed phase. A significant correlation was found between microvessel density and the percentage of maximal signal increase following paramagnetic contrast administration (r= 0.322, p < 0.05). Dynamic enhancement patterns and rates of maximal signal increase predict microvessel density in breast malignancies and may possibly be used as prognostic indicators.
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    Imaging of nail-patella syndrome
    (2005) Tuncbilek N.; Karakas H.M.; Okten O.O.
    Nail-patella syndrome is a rare disorder, which is inherited as an autosomal dominant trait. This condition is also known as hereditary osteo-onychodysplasia or Fong's syndrome. Posterior iliac horns are commonly found in this syndrome and are considered pathognomonic. In this report, we describe the appearance, location, and structure of iliac horns with respect to radiography and magnetic resonance imaging.
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    Use of dynamic contrast-enhanced magnetic resonance imaging for differentiating between aggressive rectal tumours: Two cases with small cell carcinoma and malignant melanoma
    (2006) Tuncbilek N.; Karakas H.M.; Okten O.O.
    Poorly differentiated small cell carcinomas and malignant melanomas are among the rarest of primary colorectal malignancies. Although very aggressive and lethal, small cell carcinomas and the amelanotic variety of malignant melanomas have similar radiological features to adenocarcinomas. We present two different cases with these unusual tumours, with special emphasis on their dynamic contrast-enhanced magnetic resonance imaging features. The dynamic contrast-enhanced magnetic resonance imaging revealed that these tumours have a faster and stronger enhancement pattern than most adenocarcinomas. The technique is thus potentially useful for the preoperative diagnosis of unusual aggressive tumours and for guiding the choice of treatment.