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Seyrek S, Ayyildiz H, Bulakci M, Salmaslioglu A, Seyrek F, Gultekin B, Cavus B, Berker N, Buyuk M, Yuce S. Comparison of Fibroscan, Shear Wave Elastography, and Shear Wave Dispersion Measurements in Evaluating Fibrosis and Necroinflammation in Patients Who Underwent Liver Biopsy. Ultrasound Q 2024; 40:74-81. [PMID: 38345402 DOI: 10.1097/ruq.0000000000000677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
OBJECTIVE Our aim was to predict these stages of hepatic fibrosis and necroinflammation using measurements from two-dimensional shear wave elastography (2D-SWE), transient elastography (Fibroscan, TE), and shear wave dispersion (SWD). MATERIALS AND METHODS In this prospectively designed study, chronic liver patients with nonspecific etiology whose biopsy was performed for up to 1 week were included. Two-dimensional SWE, SWD, and TE measurements were performed. The METAVIR and F-ISHAK classification was used for histopathological evaluation. RESULTS Two-dimensional SWE and TE were considered significant for detecting hepatic fibrosis. In distinguishing ≥F2, for 2D-SWE, area under the receiver operating characteristics (AUROC) was 0.86 (confidence interval [CI], 0.75-0.96) for the cutoff value of 8.05 kPa ( P = 0.003); for TE, AUROC was 0.79 (CI, 0.65-0.94) for the cutoff value of 10.4 kPa ( P < 0.001). No significance was found for TE in distinguishing ≥F3 ( P = 0.132). However, for 2D-SWE, a cutoff value of 10.45 kPa ( P < 0.001), with AUROC = 0.87 (CI, 0.78-0.97) was determined for ≥F3. Shear wave dispersion was able to determine the presence of necroinflammation ( P = 0.016) and a cutoff value of 15.25 (meter/second)/kiloHertz ([m/s]/kHz) ( P = 0.006) and AUROC of 0.71 (CI, 0.57-0.85) were calculated for distinguishing ≥A2. In addition, a cutoff value of 17.25 (m/s)/kHz ( P = 0.023) and AUROC = 0.72 (CI, 0.51-0.93) were found to detect severe necroinflammation. The cutoff value for SWD was 15.25 (m/s)/kHz ( P = 0.013) for detecting ≥A2 in the reversible stage of fibrosis (F0, F1, and F2), and AUROC = 0.72 (CI, 0.56-0.88). CONCLUSIONS Two-dimensional SWE and TE measurements were significant in detecting the irreversible stage and the stage that should be treated in hepatic fibrosis noninvasively. Shear wave dispersion measurements were significant in detecting necroinflammation noninvasively.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Servet Yuce
- Public Health Department, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
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Bulakci M, Ercan CC, Karapinar E, Aksakal MZT, Aliyev S, Bicen F, Sahin AY, Salmaslioglu A. Quantitative evaluation of hepatic steatosis using attenuation imaging in a pediatric population: a prospective study. Pediatr Radiol 2023; 53:1629-1639. [PMID: 36881143 DOI: 10.1007/s00247-023-05615-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Obesity and fatty-liver disease are increasingly common in children. Hepatic steatosis is becoming the most common cause of chronic liver disease during childhood. There is a need for noninvasive imaging methods that are easily accessible, safe and do not require sedation in the diagnosis and follow-up of the disease. OBJECTIVE In this study, the diagnostic role of ultrasound attenuation imaging (ATI) in the detection and staging of fatty liver in the pediatric age group was investigated using the magnetic resonance imaging (MRI)-proton density fat fraction as the reference. MATERIALS AND METHODS A total of 140 children with both ATI and MRI constituted the study group. Fatty liver was classified as mild (S1, defined as ≥ 5% steatosis), moderate (S2, defined as ≥ 10% steatosis), or severe (S3, defined as ≥ 20% steatosis) according to MRI-proton density fat fraction values. MRI studies were performed on the same 1.5-tesla (T) MR device without sedation and contrast agent. Ultrasound examinations were performed independently by two radiology residents blinded to the MRI data. RESULTS While no steatosis was detected in half of the cases, S1 steatosis was found in 31 patients (22.1%), S2 in 29 patients (20.7%) and S3 in 10 patients (7.1%). A strong correlation was found between attenuation coefficient and MRI-proton density fat fraction values (r = 0.88, 95% CI 0.84-0.92; P < 0.001). The area under the receiver operating characteristic curve values of ATI were calculated as 0.944 for S > 0, 0.976 for S > 1 and 0.970 for S > 2, based on 0.65, 0.74 and 0.91 dB/cm/MHz cut-off values, respectively. The intraclass correlation coefficient values for the inter-observer agreement and test-retest reproducibility were calculated as 0.90 and 0.91, respectively. CONCLUSION Ultrasound attenuation imaging is a promising noninvasive method for the quantitative evaluation of fatty liver disease.
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Affiliation(s)
- Mesut Bulakci
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Topkapi Mahallesi, Turgut Ozal Caddesi, No:118, 34093, Fatih, Istanbul, Turkey.
| | - Celal Caner Ercan
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Topkapi Mahallesi, Turgut Ozal Caddesi, No:118, 34093, Fatih, Istanbul, Turkey
| | - Edanur Karapinar
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Topkapi Mahallesi, Turgut Ozal Caddesi, No:118, 34093, Fatih, Istanbul, Turkey
| | | | - Shamil Aliyev
- Department of Radiology, Faculty of Medicine, Istinye University, Istanbul, Turkey
| | - Fuat Bicen
- Department of Radiology and Neuroradiology, Klinikum Barnim GmbH, Werner Forssmann Hospital, Eberswalde, Germany
| | - Aylin Yetim Sahin
- Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Artur Salmaslioglu
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Topkapi Mahallesi, Turgut Ozal Caddesi, No:118, 34093, Fatih, Istanbul, Turkey
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Bulakci M, Ercan CC, Karapinar E, Aksakal MZT, Aliyev S, Bicen F, Sahin AY, Salmaslioglu A. Correction to: Quantitative evaluation of hepatic steatosis using attenuation imaging in a pediatric population: a prospective study. Pediatr Radiol 2023; 53:1730. [PMID: 36932259 DOI: 10.1007/s00247-023-05643-4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Affiliation(s)
- Mesut Bulakci
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Topkapi Mahallesi, Turgut Ozal Caddesi, No:118, 34093, Istanbul, Fatih, Turkey.
| | - Celal Caner Ercan
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Topkapi Mahallesi, Turgut Ozal Caddesi, No:118, 34093, Istanbul, Fatih, Turkey
| | - Edanur Karapinar
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Topkapi Mahallesi, Turgut Ozal Caddesi, No:118, 34093, Istanbul, Fatih, Turkey
| | | | - Shamil Aliyev
- Department of Radiology, Faculty of Medicine, Istinye University, Istanbul, Turkey
| | - Fuat Bicen
- Department of Radiology and Neuroradiology, Klinikum Barnim GmbH, Werner Forssmann Hospital, Eberswalde, Germany
| | - Aylin Yetim Sahin
- Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Artur Salmaslioglu
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Topkapi Mahallesi, Turgut Ozal Caddesi, No:118, 34093, Istanbul, Fatih, Turkey
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Cakal B, Cavus B, Atasoy A, Altunok D, Poda M, Bulakci M, Gulluoglu M, Demirci M, Sener LT, Arslan AB, Arikan M, Akyuz F. Comparison of S gene mutations in patients with occult and chronic hepatitis B virus infection. Virus Res 2022; 318:198855. [PMID: 35798213 DOI: 10.1016/j.virusres.2022.198855] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM This study aimed to detect mutations in the HBV S gene and evaluate their relationship to occult hepatitis B virus (HBV) infection (OBI). METHODS The study included 32 patients with negative serum HBsAg and HBV DNA who underwent liver biopsy due to different clinical indications defined as the OBI group and 32 patients who underwent liver biopsy due to chronic hepatitis B (CHB) as the comparison group. The HBV S gene region was amplified by Nested PCR, and Sanger sequencing was performed. RESULTS At least one amino acid (aa) mutation was detected in the major hydrophilic region (MHR) of the HBV S gene in 14/32 (43.75%) of the patients with OBI and 8/32 (25.0%) with CHB. The genotype of all patients with OBI and CHB was HBV/D. Although 9 (28.1%) of the cases with OBI had sub-genotype HBV/D3, none of the patients with CHB had sub-genotype HBV/D3. Unlike patients with CHB, L15*, D33N, Q51P, V63F, L91I, P108S, T115I, P120L, T125M, Q129H, T189I, L216F, P217L mutations were detected in the HBV S gene in OBI cases. Also, P127T aa polymorphism was frequently detected. Mutation frequency in the HBV S gene in the major hydrophilic region (MHR) was higher in patients with OBI with sub-genotypes HBV/D3 and D2 than those with HBV/D1 and those with serotype HBV/ayw3 compared to those with HBV/ayw2 (p < 0.05). CONCLUSIONS Sub-genotypic-specific mutation patterns were seen in the "a" determinant region and T helper cell epitopes of HBsAg, especially in the C-terminus domain; this may be associated with OBI.
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Affiliation(s)
- Bulent Cakal
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Fatih, Istanbul 34093, Turkey.
| | - Bilger Cavus
- Department of Internal Medicine, Istanbul Faculty of Medicine, Division of Gastroenterohepatology, Istanbul University, Istanbul, Turkey
| | - Alp Atasoy
- Department of Internal Medicine, Istanbul Faculty of Medicine, Division of Gastroenterohepatology, Istanbul University, Istanbul, Turkey
| | - Damla Altunok
- Department of Internal Medicine, Istanbul Faculty of Medicine, Division of Gastroenterohepatology, Istanbul University, Istanbul, Turkey
| | - Mehves Poda
- Department of Genetics, Aziz Sancar Institute for Experimental Medical Research, Istanbul University, Istanbul, Turkey
| | - Mesut Bulakci
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mine Gulluoglu
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Demirci
- Department of Medical Microbiology, Faculty of Medicine, Kirklareli University, Kirklareli, Turkey
| | - Leyla Turker Sener
- Department of Biophysics Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | | | - Muzaffer Arikan
- Regenerative and Restorative Medicine Research Center (REMER), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University, Istanbul, Turkey
| | - Filiz Akyuz
- Department of Internal Medicine, Istanbul Faculty of Medicine, Division of Gastroenterohepatology, Istanbul University, Istanbul, Turkey
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Cakal B, Atasoy A, Cavus B, Poda M, Bulakci M, Gulluoglu M, Demirci M, Akyuz F. Prevalence of occult hepatitis B infection in liver biopsy sample of patients with nonviral liver disease. Future Virol 2022. [DOI: 10.2217/fvl-2021-0316] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: To determine the prevalence of occult hepatitis B (HBV) infection (OBI) in patients with nonviral liver disease. Materials & methods: This study included 83 HBsAg-negative patients followed up at a gastroenterohepatology clinic. The presence of HBV DNA was investigated by using an in-house nested-PCR method applied to liver parenchymal biopsy samples obtained from patients who underwent due nonviral chronic liver disease. Results: OBI was detected in 19 (22.9%) of the 83 cases, in 11 (44%) of 25 anti-HBc-positive patients, and 15 (31.9%) of 47 anti-HBc and/or anti-HBs antibodies-positive patients. Conclusion: There is a considerable prevalence of OBI among patients with nonviral chronic liver disease. Therefore, it is suggested that closely monitoring HBV can be useful to prevent or more effectively manage possible OBI-related complications among patients with nonviral chronic liver disease, especially those who are HBsAg seronegative or anti-HBV antibody seropositive.
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Affiliation(s)
- Bulent Cakal
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alp Atasoy
- Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Bilger Cavus
- Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehves Poda
- Department of Genetics, Aziz Sancar Institute for Experimental Medical Research, Istanbul University, Istanbul, Turkey
| | - Mesut Bulakci
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mine Gulluoglu
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Demirci
- Department of Medical Microbiology, Faculty of Medicine, Kirklareli University, Kirklareli, Turkey
| | - Filiz Akyuz
- Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Bakkaloglu H, Bayraktar A, Bulakci M, Aydin AE. Intraperitoneal Ultrasound-Guided Safe Laparoscopic Fenestration of Lymphocele After Kidney Transplantation. J Laparoendosc Adv Surg Tech A 2021; 32:299-303. [PMID: 33826425 DOI: 10.1089/lap.2021.0047] [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: 11/13/2022] Open
Abstract
Background: Lymphocele is a common complication after kidney transplantation, which does not require treatment unless it is symptomatic. In this study, we aimed to evaluate the incidence, clinical symptoms, treatment choices, and success of different treatment methods of symptomatic lymphocele. Materials and Methods: We evaluated 168 patients who had kidney transplantation between January 2012 and January 2020. Patients with decreased kidney functions due to lymphocele formation during the clinical follow-up were included in the study. External drainage catheter was placed in all patients, except one. In case of treatment failure with external drainage, laparoscopic fenestration guided by intraperitoneal ultrasonography was performed. Clinical symptoms and success rates of treatments were evaluated. Results: Symptomatic lymphocele requiring interventional treatment was detected in 15 (8.9%) of 168 renal transplant patients. All of the symptomatic lymphocele cases had increased serum creatinine levels, whereas 10 had decreased urine volume, 4 had abdominal discomfort, and 2 had ipsilateral lower extremity edema. External drainage catheter was placed as the first-line treatment in 13 patients. In 6 cases, due to treatment failure with external drainage and in 2 patients as a first-choice treatment, laparoscopic fenestration was performed. No lymphocele recurrence was observed during follow-up. Conclusion: Among various methods defined in the treatment of lymphocele, use of laparoscopic fenestration is increasing because of its high success rate and advantages over other methods. Intraperitoneal ultrasound-guided laparoscopic fenestration is a useful and safe method that can be performed as a first-choice treatment since it eliminates the risk of organ injury or bleeding.
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Affiliation(s)
- Huseyin Bakkaloglu
- Department of General Surgery and Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Adem Bayraktar
- Department of General Surgery and Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mesut Bulakci
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ali Emin Aydin
- Department of General Surgery and Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Aksakal N, Ozturk A, Tutal F, Dogan S, Agcaoglu O, Bulakci M, Barbaros U, Erbil Y. Magnetic Probe–Guided Excision of Nonpalpable Neck Lesions. Surg Innov 2016; 24:42-48. [DOI: 10.1177/1553350616676444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Reoperative neck surgery is technically more demanding because of the presence of scar tissue and distorted anatomy. We aimed to investigate the magnetic probe–guided excision of nonpalpable neck lesions in patients with previously operated neck compartments. Methods: This study included 9 patients with recurrent/persistent thyroid carcinoma, recurrent/persistent hyperparathyroidism with previously operated neck compartments. The pathologic lesions were localized by ultrasonography, and magnetic tracer (0.2 mL, iron oxide) was injected directly into the pathologic lesions. Careful dissection was carried out following the area of maximum magnetic activity until the nonpalpable lesions were identified and excised. Result: All neck lesions were removed in 9 patients. The median count from lesion was significantly higher than values from lesion bed (background activity; (9900/5 seconds vs 250/5 seconds, P < .001). During follow-up, all patients had negative ultrasonography. Conclusion: Magnetic probe–guided technique could provide access to nonpalpable lesion localization in centers without readily available access to nuclear medicine facilities.
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Bulakci M, Ilhan M, Bademler S, Yilmaz E, Gulluoglu M, Bayraktar A, Asik M, Guloglu R. Efficacy of ultrasound-guided core-needle biopsy in the diagnosis of hepatic alveolar echinococcosis: a retrospective analysis. ACTA ACUST UNITED AC 2016; 23:19. [PMID: 27101838 PMCID: PMC4840258 DOI: 10.1051/parasite/2016019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Accepted: 03/21/2016] [Indexed: 12/19/2022]
Abstract
Background: This study retrospectively analyzed the clinical data, laboratory results, imaging findings, and histopathological features of 28 patients who underwent ultrasound-guided core-needle biopsy from a hepatic lesion and were diagnosed with alveolar echinococcosis. Results: Among 28 patients included in the study, 16 were females and 12 were males. The mean age of the studied population was 53 ± 16 years, and the age range was 18–79 years. The most common presenting symptom was abdominal pain, which was observed in 14 patients. A total of 36 lesions were detected in the patients’ livers, out of which 7 had a cystic appearance. Hepatic vascular involvement, bile duct involvement, and other organ involvement were depicted in 14, 5, and 7 patients, respectively. The average number of cores taken from the lesions was 2.7, ranging between 2 and 5. In histopathological evaluation, PAS+ parasitic membrane structures were visualized on a necrotic background in all cases. Regarding seven patients, who were operated, the pathological findings of preoperative percutaneous biopsies were in perfect agreement with the pathological examinations after surgical resections. None of the patients developed major complications after biopsy. Conclusion: Ultrasound-guided core-needle biopsy is a minimally invasive, reliable, and effective diagnostic tool for the definitive diagnosis of hepatic alveolar echinococcosis.
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Affiliation(s)
- Mesut Bulakci
- Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Ilhan
- Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Suleyman Bademler
- Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Erdem Yilmaz
- Department of Radiology, Trakya University, Faculty of Medicine, Edirne, Turkey
| | - Mine Gulluoglu
- Department of Pathology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Adem Bayraktar
- Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Murat Asik
- Department of Radiology, Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| | - Recep Guloglu
- Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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Bulakci M, Cengel F. The role of radiology in diagnosis and management of drug mules: an update with new challenges and new diagnostic tools. Br J Radiol 2016; 89:20150888. [PMID: 26867003 DOI: 10.1259/bjr.20150888] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Emergency physicians and radiologists have been increasingly encountering internal concealment of illegal drugs. The packages commonly contain powdered solid drugs such as cocaine, heroin, methamphetamine and hashish, but they may also contain cocaine in the liquid form. The second type of package has recently been more commonly encountered, and poses a greater diagnostic challenge. As clinical evaluation and laboratory tests frequently fail to make the correct diagnosis, imaging examination is typically required. Imaging methods assume a vital role in the diagnosis, follow-up and management. Abdominal X-ray, ultrasonography, CT and MRI are used for the imaging purposes. Among the aforementioned methods, low-dose CT is state-of-the-art in these cases. It is of paramount importance that radiologists have a full knowledge of the imaging characteristics of these packages and accurately guide physicians and security officials.
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Affiliation(s)
- Mesut Bulakci
- 1 Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ferhat Cengel
- 2 Department of Radiology, Haseki Training and Research Hospital, Istanbul, Turkey
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Bulakci M, Tefik T, Kartal MG, Celenk E, Erol OB, Sanli O, Salmaslioglu A. Imaging Appearances of Paratesticular Fibrous Pseudotumor. Pol J Radiol 2016; 81:10-4. [PMID: 26834864 PMCID: PMC4720173 DOI: 10.12659/pjr.895405] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 07/21/2015] [Accepted: 08/17/2015] [Indexed: 12/01/2022] Open
Abstract
Background In this paper the clinical and radiological features of three cases with paratesticular fibrous pseudotumor were presented after a retrospective analysis of medical archives of our hospital. Case Report Each of the three cases had unilateral, multiple nodular lesions with smooth borders accompanied by a hydrocele. On sonographic examination, the lesions showed echogenicity similar to, or slightly lower than, the testis, and the two large lesions had posterior acoustic shadowing. Color Doppler ultrasound examination of two cases showed intralesional vascularity of mild-to-moderate degree. All lesions appeared hypointense compared to testicular tissue on T1W and T2W magnetic resonance images. Moderate-to-high enhancement was observed in the diffuse pattern after intravenous injection of contrast material. An intraoperative pathological examination was performed and local excision carried out in all three cases. Conclusions Fibrous pseudotumor is a rare benign paratesticular lesion, which can be confused with malignant masses. Imaging procedures play an important role in correct diagnosis. Unfamiliarity with imaging findings of paratesticular fibrous pseudotumor may eventuate in an unnecessary orchiectomy.
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Affiliation(s)
- Mesut Bulakci
- Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Tzevat Tefik
- Department of Urology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Merve Gulbiz Kartal
- Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Erhan Celenk
- Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Oguz Bulent Erol
- Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Oner Sanli
- Department of Urology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Artur Salmaslioglu
- Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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Bulakci M, Gocmez A, Demir AA, Salmaslioglu A, Tukenmez M, Yavuz E, Acunas G. Fibroadenomatosis involving bilateral breasts and axillary accessory breast tissues in a renal transplant recipient given cyclosporin A. J Clin Ultrasound 2014; 42:495-497. [PMID: 25131521 DOI: 10.1002/jcu.22220] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 07/04/2014] [Accepted: 07/21/2014] [Indexed: 06/03/2023]
Abstract
We present the mammographic and sonographic findings in a case of fibroadenomatosis involving both breasts and axillae in a renal transplant patient after 16 years of treatment with cyclosporin A. Awareness of the fact that cyclosporin A may induce the formation of fibroadenomas, including in accessory breast tissue, is important for correct diagnosis and preventing unnecessary intervention.
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Affiliation(s)
- Mesut Bulakci
- Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, 34390, Capa, Istanbul, Turkey
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Yahyayev A, Bulakci M, Yilmaz E, Ucar A, Sayin OA, Yekeler E. Absence of the right iliac vein and an unusual connection between both common femoral veins. Phlebology 2014; 28:162-4. [PMID: 22431769 DOI: 10.1258/phleb.2011.011080] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of the study is to report a case of a rare congenital anomaly of the venous system and to emphasize its clinical importance. We describe a case of aplasia of the right common and external iliac veins in a healthy seven-year-old boy who was referred for Doppler ultrasound examination for further evaluation of an abnormal varicosity in the suprapubic region. Colour Doppler ultrasound revealed a dilated, arch-shaped vein. Contrast-enhanced magnetic resonance angiography showed the absence of the right common iliac vein and external iliac vein. It also clearly demonstrated the aberrant venous structure, originating from the right common femoral vein and draining to the left common femoral vein. In conclusion, in our case, the patient’s life was threatened because the aberrant venous connection crossing within subcutaneous fatty tissue was not protected from external trauma and possible abdominal surgical interventions. Additional attention should be given to avoid such injuries, which can cause significant haemorrhage.
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Affiliation(s)
- A Yahyayev
- Radiology Department, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Abstract
PURPOSE In this study, we aimed to describe non-contrast abdominal MRI findings in body packers and emphasize the role of this imaging technique in diagnosis of body packing. MATERIALS AND METHODS Non-contrast abdominopelvic MRI was performed at the radiology department in 16 suspected body packers that were brought to our hospital, and 13 of them were diagnosed with body packing. We evaluated the presence, location, and shapes of packets as well as signal characteristics on T1- and T2-weighted images. RESULTS We came across two types of packets: those containing solid substances (10 cases) and those filled with liquid cocaine (3 cases). Both types were accurately diagnosed with the help of MRI. Only 1 suspected body packer received a false positive diagnosis. CONCLUSION Abdominopelvic MRI is a reliable and valuable method of diagnosing body packing.
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Affiliation(s)
- Mesut Bulakci
- Department of Radiology, Haseki Training and Research Hospital, Aksaray, Istanbul, Turkey.
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Bulakci M, Kalelioglu T, Bulakci BB, Kiris A. Comparison of diagnostic value of multidetector computed tomography and X-ray in the detection of body packing. Eur J Radiol 2013; 82:1248-54. [PMID: 23357250 DOI: 10.1016/j.ejrad.2012.12.022] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 11/24/2012] [Accepted: 12/09/2012] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Radiologists and other clinicians are facing an increasing number of illegal drug-related medical conditions. We aimed to draw attention to this growing global problem and to highlight some of the important points related to diagnosis and follow-up of body packing. We compare the diagnostic performance of unenhanced multidetector CT (MDCT) and abdomen X-ray for the detection of drug-filled packets. MATERIALS AND METHODS Sixty-seven suspects, who underwent both CT and X-ray examinations, have been included in the study. All MDCT and X-ray images were independently and retrospectively reviewed by two observers with different degrees of experience in abdomen imaging. Fifty-two of them were identified as body packers finally. Interobserver agreement, sensitivity, specificity, positive and negative predictive value were calculated. RESULTS Two types of packets with different characteristics were identified in all body packers. Type 1 packets (solid-state drug) were found in 41 patients and type 2 packets (liquid cocaine) in 11 patients. All statistical analyses concern the detection of any packets. That is, the whole evaluation has been performed per patient. Sensitivity/specificity values of type 1 and type 2 packets for MDCT were 100-98%/100-100% and 100-100%/100-100%, respectively. Besides, sensitivity/specificity values of type 1 and type 2 packets for X-ray were 93-90%/100-91% and 64-45%/73-71%, respectively. In addition, interobserver agreements for detection of any packets were excellent (κ=0.96) and good (κ=0.75) for interpretation of MDCT and X-ray, respectively. CONCLUSION Unenhanced MDCT is a fast, accurate and easily used diagnostic tool with high sensitivity and specificity for the exact diagnosis of body packing.
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Affiliation(s)
- Mesut Bulakci
- Department of Radiology, Haseki Training and Research Hospital, 34096 Aksaray, Istanbul, Turkey.
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Bulakci M, Yilmaz E, Yahyayev A, Bulakci BB, Yekeler E. Superparamagnetic iron oxide-enhanced magnetic resonance imaging in a case of spleen hamartoma. Med Princ Pract 2013; 22:301-3. [PMID: 23107785 PMCID: PMC5586731 DOI: 10.1159/000343577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 09/10/2012] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To emphasize the contribution of superparamagnetic iron oxide (SPIO) contrast agent in the diagnosis of the splenic hamartoma. CLINICAL PRESENTATION AND INTERVENTION A 63-year-old female was admitted to our hospital with diffuse abdominal pain. An ultrasound examination revealed a 5 × 4 cm solid lesion in the spleen. Dynamic gadolinium-enhanced magnetic resonance imaging (MRI) of the abdominal findings was consistent with a splenic hamartoma. SPIO-enhanced MRI was then performed and it confirmed the diagnosis. The lesion showed a decrease of signal intensity on T2-weighted images. CONCLUSION This case showed that SPIO-enhanced MRI was useful for establishing a noninvasive diagnosis of the splenic hamartomas.
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Affiliation(s)
- Mesut Bulakci
- Department of Radiology, Haseki Education and Research Hospital, Istanbul, Turkey
| | - Erdem Yilmaz
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul, Turkey
- *Erdem YIlmaz, Department of Radiology, Istanbul Faculty of Medicine, TR-34093 Capa, Istanbul, Turkey, E-Mail
| | | | | | - Ensar Yekeler
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul, Turkey
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Bulakci M, Kalelioglu T, Kiris A. The importance of susceptibility-weighted imaging in familial cerebral cavernous malformation. ACTA ACUST UNITED AC 2012; 69:1376-7. [PMID: 22825481 DOI: 10.1001/archneurol.2012.96] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Mesut Bulakci
- Department of Radiology, Haseki Education and Research Hospital, Aksaray, Istanbul, Turkey.
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Ucar A, Sahin D, Bulakci M, Bakan S, Yilmaz R, Yahyayev A, Yekeler E. Prevalence of hepatic pseudolesions around the falciform ligament in a paediatric population. J Int Med Res 2011; 39:1490-6. [PMID: 21986152 DOI: 10.1177/147323001103900438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study investigated the prevalence and features of hepatic pseudolesions around the falciform ligament in 320 children undergoing contrast-enhanced abdominal multidetector computed tomography. Aberrant venous drainage was investigated using thin-section computed tomography images. Pseudolesions around the falciform ligament were detected in 63 patients (20%). The longest diameter was in the craniocaudal direction in 41 (65%) patients (lesions). An inferior vein of Sappey supplying the pseudolesions was seen in 11 patients (17%). Thirteen patients of the 63 patients (21%) with pseudolesions who had a history of extrahepatic malignancy were also examined by ultrasound; in two of the 13 patients the lesions were isoechoic and, in the remainding 11 patients, they were hyperechoic. It was concluded that hepatic pseudolesions around the falciform ligament occur frequently in the paediatric population on CT images. Detection of the longest diameter in the craniocaudal direction and the presence of an inferior vein of Sappey and fatty infiltration should be sufficient to exclude true lesions and make further evaluations unnecessary.
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Affiliation(s)
- A Ucar
- Department of Radiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Yahyayev A, Guven K, Bulakci M, Ucar A, Aghayev A, Yekeler E. Spontaneous thrombosis of uterine artery pseudoaneurysm: follow-up with Doppler ultrasonography and interventional management. J Clin Ultrasound 2011; 39:408-409. [PMID: 21626515 DOI: 10.1002/jcu.20842] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Ozkok A, Tufan F, Namli S, Bulakci M, Pinarbasi B, Dogan O, Karan MA, Tascioglu C. Mucosa-associated lymphoid tissue lymphoma of the duodenum together with multiple intra-abdominal thromboses and hepatitis C virus infection: a case report. Cases J 2009; 2:9354. [PMID: 20062604 PMCID: PMC2804004 DOI: 10.1186/1757-1626-2-9354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Accepted: 12/18/2009] [Indexed: 11/10/2022]
Abstract
Mucosa associated lymphoid tissue MALT lymphoma is a low grade malignancy that arises most commonly from the gastric mucosa. Small intestinal involvement is very rare. The causative relationship between Helicobacter pylori and the gastric MALT lymphoma is a well known issue, but recently there are several data suggesting the role of hepatitis C virus (HCV) infection in the pathogenesis of lymphoma including MALT lymphoma. Herein we present a rare case of duodenal MALT lymphoma with multiple intra-abdominal thromboses together with HCV infection that was confirmed by real-time polymerase chain reaction detecting HCV-RNA within the peripheral blood mononuclear cells.
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Affiliation(s)
- Abdullah Ozkok
- Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul (34390), Turkey
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