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Akdulum İ, Gürün E, Akyüz M, Tiken R, Oral H, Kaya C, Boyunaga ÖL. Shear wave elastography evaluation in predicting the success of ultrasound-guided saline enema hydrostatic reduction technique in ileocolic intussusception. Acta Radiol 2022; 63:862-866. [PMID: 34018819 DOI: 10.1177/02841851211018799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Intussusception is the invagination of the proximal intestinal segment into the distal portion. Reduction procedures with fluid or air have been used as the primary treatment of choice in clinically stable children. PURPOSE To evaluate the role of intestinal wall elasticity measurements by shear wave elastography (SWE) to predict the success of ultrasound-guided saline enema (USGSE) reduction. METHODS USGSE was performed, if not contraindicated otherwise, after the diagnosis of ileocecal intussusception via the ultrasound (US). The length and diameter of the intussusception and the median stiffness of the intestine were measured before USGSE. RESULTS Seventeen children were diagnosed with ileocolic intussusception via grayscale US assessment. Two children whose SWE images became artifacts due to inadaptability were excluded from the study. Thus, the study involved 15 patients (9 boys, 6 girls; age range = 11-48 months). There was no statistically significant association between age and median stiffness measurement in kilopascal (kPa). (P > 0.05). A moderate positive correlation was observed between the median stiffness measurement (kPa) and the length of intussusception (r = 0.547; P = 0.035). There was no statistically significant relationship between median stiffness measurement (kPa) and short-axis diameter of intussusception (P > 0.05). CONCLUSIONS Stiffness assessment of the intestinal wall in ileocolic intussusception during the US examination, which is the gold standard in the intussusception assessment, can be used as a new criterion for predicting the performance of the USGSE technique and might be useful in making decisions regarding the clinical management of ileocolic intussusception.
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Affiliation(s)
- İsmail Akdulum
- Department of Pediatric Radiology, Gazi University, Ankara, Turkey
| | - Enes Gürün
- Department of Radiology, İskilip Atıf Hoca State Hospital, Çorum, Turkey
| | - Melih Akyüz
- Department of Radiology, Rush University Medical Center, Chicago, IL, USA
| | - Ramazan Tiken
- Department of Pediatric Radiology, Gazi University, Ankara, Turkey
| | - Hayrunnisa Oral
- Department of Pediatric Radiology, Gazi University, Ankara, Turkey
| | - Cem Kaya
- Department of Pediatric Radiology, Gazi University, Ankara, Turkey
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Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic neuroinflammatory disease characterized by inflammation involving the peripheral nerves. Shear wave elastography (SWE) is potentially a method of choice for detecting peripheral nerve involvement. PURPOSE To compare the degree of thickening and nerve elasticity of brachial plexus (BP) nerve roots and evaluate the usefulness of sonoelastography in patients with clinically diagnosed MS without brachial plexopathy. MATERIAL AND METHODS Thirty-two patients with MS and 32 controls were included in the study. Bilateral C5, C6, and C7 mean nerve root diameters, and mean elasticity values in kiloPascal (kPa) were measured in the patient and control groups. The relationship between the age, height, and weight values and nerve diameter-elasticity values of the patient and control groups was compared. RESULTS The elasticity values of the C5 and C6 nerve roots were increased, and the nerve root thickness was decreased in the MS group compared to that in the control (P < 0.05). There was no difference between the C7 mean nerve root elasticity (kPa) and diameter measurements in the patient and control groups (P > 0.05). CONCLUSION Our study showed an increase in the BP nerve root elasticity values (kPa) in patients with MS compared to that of the control group and a decrease in diameter values thought to be related to the possible chronic atrophic process. The results are consistent with the demyelinating process of the peripheral nervous system (PNS) due to MS.
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Affiliation(s)
- Enes Gürün
- Department of Radiology, Gazi University, Ankara, Turkey
- Current affiliation: İskilip Atıf Hoca State Hospital, Çorum, Turkey
| | - İsmail Akdulum
- Department of Radiology, Gazi University, Ankara, Turkey
| | - Melih Akyüz
- Department of Radiology, Gazi University, Ankara, Turkey
- Current affiliation: Rush University Medical Center, Chicago, IL, USA
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Gürün E, Akdulum İ. Shear-wave elastography evaluation of adrenal glands in healthy newborns: a preliminary study. Rev Assoc Med Bras (1992) 2021; 67:1724-1728. [PMID: 34909905 DOI: 10.1590/1806-9282.20210825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 09/07/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Establishing standard shear-wave elastography (SWE) values for healthy newborns can help distinguish normal conditions of the adrenal gland (AG) from pathological conditions. We aimed to establish a reference data set for AG stiffness values using SWE in healthy newborns. METHODS The quantitative stiffness of the AG was measured in the coronal plane in kilopascal (kPa). The quantitative descriptive statistics were presented as mean with standard deviation and median with range. The relationship between the quantitative variables was calculated using "Spearman's rank correlation coefficient test." The intraclass correlation coefficient (ICC) test was used to analyze intraobserver reliability. A p-value <0.05 was considered statistically significant. RESULTS A total of 120 AGs of 60 healthy newborns (30 females and 30 males) was examined. The mean stiffness values of the right AG for the first and second visits were 7.51±2.45 and 7.54±2.49 kPa, respectively, and those of the left AG for the first and second visits were 7.60±2.03 and 7.42±1.97 kPa, respectively. There was no statistically significant difference between the mean values of adrenal stiffness and the length and width of AG and weight, height, and age (p>0.05). The ICC values for mean stiffness values of each AG were >0.80-0.90, indicating good intraobserver agreement. CONCLUSIONS This study is the first SWE study to evaluate the AG in healthy newborns. Our study's data can be used as a reference for future research.
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Affiliation(s)
- Enes Gürün
- Samsun University, Department of Radiology - Samsun, Turkey
| | - İsmail Akdulum
- Gazi University, Department of Radiology - Ankara, Turkey
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Yildirim DG, Akdulum İ, Talim B, Demir E, Buyan N, Bakkaloğlu SA. Milk of calcium: A rare manifestation of juvenile dermatomyositis. Arch Rheumatol 2021; 36:302-304. [PMID: 34527937 PMCID: PMC8418756 DOI: 10.46497/archrheumatol.2021.8197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/25/2020] [Indexed: 12/05/2022] Open
Affiliation(s)
- Deniz Gezgin Yildirim
- Department of Pediatrics, Division of Pediatric Rheumatology, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - İsmail Akdulum
- Department of Radiology, Division of Pediatric Radiology, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Beril Talim
- Department of Pathology Unit, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Ercan Demir
- Department of Pediatrics, Division of Pediatric Neurology, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Necla Buyan
- Department of Pediatrics, Division of Pediatric Rheumatology, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Sevcan A Bakkaloğlu
- Department of Pediatrics, Division of Pediatric Rheumatology, Gazi University, Faculty of Medicine, Ankara, Turkey
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Karamert R, Tutar H, Altinyay Ş, Düzlü M, Yildiz M, Akdulum İ, Uğur MB, Çolak M, Cebeci S, Şahin MM, Orçan E, Bayazit YA. Cochlear Implantation in Inner Ear Malformations: Considerations Related to Surgical Complications and Communication Skills. ORL J Otorhinolaryngol Relat Spec 2021; 84:211-218. [PMID: 34500448 DOI: 10.1159/000517562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 05/30/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION There are particular challenges in the implantation of malformed cochleae, such as in cases of facial nerve anomalies, cerebrospinal fluid (CSF) leaks, erroneous electrode insertion, or facial stimulation, and the outcomes may differ depending on the severity of the malformation. The aim of this study was to assess the impact of inner ear malformations (IEMs) on surgical complications and outcomes of cochlear implantation. METHODS In order to assess the impact of IEMs on cochlear implant (CI) outcomes, 2 groups of patients with similar epidemiological parameters were selected from among 863 patients. Both the study group (patients with an IEM) and control group (patients with a normal inner ear) included 25 patients who received a CI and completed at least 1 year of follow-up. Auditory performance, receptive and expressive language skills, and production and use of speech were evaluated preoperatively and at least 1 year after implantation. Types of surgical complications and rates of revision surgeries were determined in each group. RESULTS In the study group, the most common malformation was an isolated enlarged vestibular aqueduct (EVA) (44.8%). Overall, the patients with IEMs showed significant improvement in auditory-verbal skills. In general, the patients who had normal cochleae scored significantly better compared to patients with IEMs (p < 0.05). The complication rate was significantly lower in the control group compared to the study group (p = 0.001), but the rate of revision surgeries did not differ significantly (p = 0.637). CONCLUSION It is possible to improve communication skills with CIs in patients with IEMs despite the variations in postoperative performances. Patients with EVA, incomplete partition type 2, and cochlear hypoplasia type 2 were the best performers in terms of auditory-verbal skills. Patients with IEMs scored poorly compared to patients with normal cochleae. CSF leak (gusher or oozing) was the most common complication during surgery, which is highly likely in cases of incomplete partition type 3.
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Affiliation(s)
- Recep Karamert
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Hakan Tutar
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Şenay Altinyay
- Department of Audiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Mehmet Düzlü
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Merve Yildiz
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - İsmail Akdulum
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Mehmet Birol Uğur
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Mustafa Çolak
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Süleyman Cebeci
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Muammer Melih Şahin
- Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Elçin Orçan
- Department of Audiology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Abstract
PURPOSE To determine the normal range of optic canal diameters in the Turkish pediatric population. METHODS Brain, orbital, and maxillofacial computed tomography examinations were evaluated retrospectively. Children with cranial bone disorders affecting the bone structure of the optic canal were excluded from the study. Oblique axial and oblique sagittal multiplanar reformatted images were created in accordance with the axis of the optic canal on both sides, and measurements were taken from the shortest transverse and craniocaudal diameters of the optic canal in these images. RESULTS Two hundred computed tomography examinations were evaluated. One hundred two of the patients were female and the rest were male. Patient ages ranged from 1 to 211 months (mean ± standard deviation: 86.42 ± 65.39 months). There was no significant difference between the transverse and craniocaudal optic canal diameters between sexes (P > .05). Therefore, the analyses were reevaluated in the entire patient series, regardless of sex. No significant correlation was found in the correlation test performed between optic canal diameters according to the age of the patients. No statistically significant difference was observed between the right and left optic canal diameters. CONCLUSIONS The determination of normal values of tissues, structures, and organs that differs with age has an important role in pediatric radiology. The authors believe that the determination of normal optic canal diameters according to certain age groups will meet the needs of daily practice. [J Pediatr Ophthalmol Strabismus. 2021;58(5):319-323.].
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Gürün E, Akdulum İ, Kılıç P, Tokgöz N, Uçar M. Evaluation of schwannoma using the 3D-SPACE sequence: comparison with the 3D-CISS sequence in 3T-MRI. Turk J Med Sci 2021; 51:1123-1135. [PMID: 33387986 PMCID: PMC8283456 DOI: 10.3906/sag-2010-30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 01/01/2021] [Indexed: 12/03/2022] Open
Abstract
Background/aim The purpose of this study is to compare the diagnostic accuracy and interobserver reliability of the T2-weighted 3D-SPACE (three-dimensional sampling perfection with application-optimized contrasts by using different flip angle evolutions) sequence in comparison with T2-weighted 3D-CISS (three-dimensional constructive interference in steady state) sequences for diagnosis of schwannomas. Materials and methods Forty patients with cerebellopontine angle (CPA), internal acoustic canal (IAC), and cochlear schwannoma who had undergone magnetic resonance imaging (MRI) using the 3D-CISS and 3D-SPACE sequences were identified. The sequences were retrospectively evaluated by two radiologists for the qualitative analyses, which were subsequently compared using the Mann–Whitney U test. Following this, kappa values were used for interobserver agreement. P < 0.05 was considered to be of statistical significance. Results The interobserver agreement was found to be excellent between the two observers for the interpretation of all qualitative analyses for both sequences (kappa value > 0.8). The 3D-SPACE sequences demonstrated significantly better qualitative scores and fewer artifacts compared with the 3D-CISS sequences (p < 0.05). Conclusion Our results demonstrate that 3D-SPACE is superior to 3D-CISS in the imaging process of the schwannoma in terms of image quality, description of the relationship between the lesion and cranial nerve, signal differentiation between lesion and cistern, and signal differentiation between the lesion and adjacent brain.
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Affiliation(s)
- Enes Gürün
- Department of Radiology, İskilip Atıf Hoca State Hospital, Çorum, Turkey
| | - İsmail Akdulum
- Department of Radiology, Gazi University Hospital, Ankara, Turkey
| | - Pınar Kılıç
- Department of Radiology, Pursaklar State Hospital, Ankara, Turkey
| | - Nil Tokgöz
- Department of Radiology, Gazi University Hospital, Ankara, Turkey
| | - Murat Uçar
- Department of Radiology, Gazi University Hospital, Ankara, Turkey
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Gürün E, Aksakal M, Akdulum İ. Measuring stiffness of normal medial collateral ligament in healthy volunteers via shear wave elastography. Surg Radiol Anat 2021; 43:1673-1679. [PMID: 33871710 DOI: 10.1007/s00276-021-02749-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/10/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE We aim to determine a reference data set for normal medial collateral ligament (MCL) stiffness values using shear wave elastography (SWE). METHODS Quantitative stiffness of the MCL was measured at three levels: the proximal (MCL area from the level of the medial meniscus to the level of the femoral attachment), the middle (MCL area at the level of the medial meniscus), and the distal (MCL area from the level of the medial meniscus to the level of the tibial attachment) segments of the MCL at a knee position of 0°. RESULTS A total of 60 MCL of 30 healthy volunteers (15 female, 15 male) were examined. The mean stiffness values of the proximal, middle, and distal MCL for observer 1 were 32.25 ± 6.44, 34.25 ± 6.84, and 35.47 ± 6.98, respectively. The mean stiffness values of the proximal, middle, and distal MCL for observer 2 were 33.56 ± 6.76, 35.44 ± 6.91, and 36.32 ± 7.04, respectively. CONCLUSION SWE has a strong potential to be a method of choice for evaluating MCL stiffness. Our study participants were healthy volunteers and the data can be used as reference data for future studies.
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Affiliation(s)
- Enes Gürün
- İskilip Atıf Hoca State Hospital, 19400, Çorum, Turkey.
| | - Mehmet Aksakal
- Department of Radiology, Gazi University, 06560, Ankara, Turkey
| | - İsmail Akdulum
- Department of Radiology, Gazi University, 06560, Ankara, Turkey
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Bozbulut NE, Akdulum İ, Sarı S, Özen İO, Çavuşoğlu YH, Boyunağa Ö, Dalgıç A, Dalgıç B. Obstructive jaundice and severe pancreatitis due to the foramen of Winslow hernia with multiple anomalies. Turk J Pediatr 2020; 62:152-155. [PMID: 32253883 DOI: 10.24953/turkjped.2020.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Internal hernia through the foramen of Winslow is a very rare condition, especially in children. Here we report a 16-month-old girl who presented with obstructive jaundice and elevation of pancreatic enzymes and was ultimately diagnosed with internal hernia and malrotation by radiologic investigation and open approach surgery. To the best of our knowledge, obstructive jaundice with pancreatitis and other congenital abnormalities in children with the foramen of Winslow hernia have not been reported previously in the literature.
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Affiliation(s)
- Neslihan Ekşi Bozbulut
- Departments of Pediatric Gastroenterology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - İsmail Akdulum
- Departments of Pediatric Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Sinan Sarı
- Departments of Pediatric Gastroenterology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - İbrahim Onur Özen
- Departments of Pediatric Surgery, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Yusuf Hakan Çavuşoğlu
- Departments of Pediatric Surgery, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Öznur Boyunağa
- Departments of Pediatric Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Aydın Dalgıç
- Departments of General Surgery, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Buket Dalgıç
- Departments of Pediatric Gastroenterology, Gazi University Faculty of Medicine, Ankara, Turkey
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Gezgin Yildirim D, Bedir Demirağ T, Akdulum İ, Yılmaz G, Bakkaloğlu S. Chronic non-bacterial osteomyelitis coexistent with familial Mediterranean fever. Clin Exp Rheumatol 2018; 36:150. [PMID: 30582506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 09/28/2018] [Indexed: 06/09/2023]
Affiliation(s)
- Deniz Gezgin Yildirim
- Department of Paediatric Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Tuğba Bedir Demirağ
- Department of Paediatric Infectious Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - İsmail Akdulum
- Department of Paediatric Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Güldal Yılmaz
- Department of Paediatric Pathology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Sevcan Bakkaloğlu
- Department of Paediatric Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
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