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Güner A, Atmaca S, Balaban İ, Türkmen İ, Çeneli D, Türkvatan A, Öner E, Sürgit Ö, Güler A, Uzun F, Babür Güler G, Kahraman S, Pala S, Havan N, Yıldız M, Ertürk M. Relationship between myocardial bridging and fatal ventricular arrhythmias in patients with hypertrophic cardiomyopathy: the HCM-MB study. Herz 2023; 48:399-407. [PMID: 37081129 DOI: 10.1007/s00059-023-05171-9] [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: 12/11/2022] [Revised: 01/31/2023] [Accepted: 03/01/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Myocardial bridging (MB) and hypertrophic cardiomyopathy (HCM) are associated with the risk of fatal ventricular arrhythmias (VAs). The goal of the study was to determine the relationship between MB and fatal VAs in HCM patients with implantable cardiac defibrillators (ICD). METHODS A total of 108 HCM patients (mean age: 46.6 ± 13.6 years; male: 73) were enrolled in this retrospective study. All patients underwent transthoracic echocardiography and coronary computed tomography angiography. Fatal VAs including sustained ventricular tachycardia and ventricular fibrillation were documented in ICD records. RESULTS There were documented fatal VAs in 29 (26.8%) patients during a mean follow-up time of 71.3 ± 30.9 months. Compared with the other groups, the fatal VA group had a higher incidence of the following: presence of MB (82.8 vs. 38%, p < 0.001), deep MB (62.1 vs. 6.3%, p < 0.001), very deep MB (24.1 vs. 0%, p < 0.001), long MB (65.5 vs. 11.4%, p < 0.001), presence of > 1 MB (17.2 vs. 0%, p = 0.001), and MB of the left anterior descending artery (79.3 vs. 17.7%, p < 0.001) . Sudden cardiac death (SCD) risk score (hazard ratio: 1.194; 95% CI: 1.071-1.330; p = 0.001) and presence of MB (hazard ratio: 3.815; 95% CI: 1.41-10.284; p = 0.008) were found to be independent predictors of fatal VAs in HCM patients. CONCLUSIONS The current data suggest that the SCD risk score and presence of MB were independent risk factors for fatal VAs in patients with HCM. In addition to conventional risk factors, the coronary anatomical course can provide clinicians with valuable information when assessing the risk of fatal VAs in HCM patients.
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MESH Headings
- Humans
- Male
- Adult
- Middle Aged
- Retrospective Studies
- Myocardial Bridging/complications
- Myocardial Bridging/diagnostic imaging
- Myocardial Bridging/epidemiology
- Arrhythmias, Cardiac
- Cardiomyopathy, Hypertrophic/complications
- Cardiomyopathy, Hypertrophic/diagnostic imaging
- Tachycardia, Ventricular/diagnosis
- Tachycardia, Ventricular/epidemiology
- Tachycardia, Ventricular/etiology
- Risk Factors
- Death, Sudden, Cardiac/epidemiology
- Death, Sudden, Cardiac/etiology
- Defibrillators, Implantable/adverse effects
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Affiliation(s)
- Ahmet Güner
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Istanbul, Turkey.
- Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Turgut Özal Bulvari No. 11, 34303, Kucukcekmece, Istanbul, Turkey.
| | - Sezgin Atmaca
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Istanbul, Turkey
| | - İsmail Balaban
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, University of Health Sciences, Istanbul, Turkey
| | - İrem Türkmen
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Istanbul, Turkey
| | - Doğancan Çeneli
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, University of Health Sciences, Istanbul, Turkey
| | - Aysel Türkvatan
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Radiology, University of Health Sciences, Istanbul, Turkey
| | - Ender Öner
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Istanbul, Turkey
| | - Özgür Sürgit
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Istanbul, Turkey
| | - Arda Güler
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Istanbul, Turkey
| | - Fatih Uzun
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Istanbul, Turkey
| | - Gamze Babür Güler
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Istanbul, Turkey
| | - Serkan Kahraman
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Istanbul, Turkey
| | - Selçuk Pala
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, University of Health Sciences, Istanbul, Turkey
| | - Nuri Havan
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Radiology, University of Health Sciences, Istanbul, Turkey
| | - Mustafa Yıldız
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Istanbul, Turkey
| | - Mehmet Ertürk
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Istanbul, Turkey
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Şengül FS, Ayyıldız P, Türkvatan A, Yıldız O, Güzeltaş A. Total or Partial? Rare Cases of Partial Anomalous Pulmonary Venous Return: Three Pulmonary Veins Connected to the Coronary Sinus. Balkan Med J 2023; 40:226-227. [PMID: 37073373 PMCID: PMC10175882 DOI: 10.4274/balkanmedj.galenos.2023.2023-2-65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Affiliation(s)
- Fatma Sevinç Şengül
- Clinic of Pediatric Cardiology, University of Health Sciences Turkey, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Pelin Ayyıldız
- Clinic of Pediatric Cardiology, University of Health Sciences Turkey, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Aysel Türkvatan
- Clinic of Radiology, University of Health Sciences Turkey, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Okan Yıldız
- Clinic of Pediatric Cardiac Surgery, University of Health Sciences Turkey, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Alper Güzeltaş
- Clinic of Pediatric Cardiology, University of Health Sciences Turkey, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
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3
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Şengül FS, Ayyıldız P, Türkvatan A, Haydın S, Güzeltaş A. The Fifth Chamber of the Heart: Congenital Aneurysm of the Atrial Appendage. Balkan Med J 2023; 40:143-144. [PMID: 36755445 PMCID: PMC9998836 DOI: 10.4274/balkanmedj.galenos.2022.2023-1-3] [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] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Affiliation(s)
- Fatma Sevinç Şengül
- Department of Pediatric Cardiology, University of Health Sciences Turkey, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, İstanbul, Turkey
| | - Pelin Ayyıldız
- Department of Pediatric Cardiology, University of Health Sciences Turkey, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, İstanbul, Turkey
| | - Aysel Türkvatan
- Department of Pediatric Cardiology, University of Health Sciences Turkey, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, İstanbul, Turkey
| | - Sertaç Haydın
- Department of Pediatric Cardiac Surgery, University of Health Sciences Turkey, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, İstanbul, Turkey
| | - Alper Güzeltaş
- Department of Pediatric Cardiology, University of Health Sciences Turkey, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, İstanbul, Turkey
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4
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Şengül FS, Ayyıldız P, Türkvatan A, Haydin S, Güzeltaş A. Fifth Chamber of the Heart: Congenital Aneurysm of the Atrial Appendage. Balkan Med J 2023. [PMID: 36755445 DOI: 10.4274/balkanmedj.galenos.2023.2023-1-3] [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] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Affiliation(s)
- Fatma Sevinç Şengül
- University of Health Sciences Turkey İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Pediatric Cardiology, İstanbul, Turkey
| | - Pelin Ayyıldız
- University of Health Sciences Turkey İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Pediatric Cardiology, İstanbul, Turkey
| | - Aysel Türkvatan
- University of Health Sciences Turkey İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Radiology, İstanbul, Turkey
| | - Sertaç Haydin
- University of Health Sciences Turkey İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Pediatric Cardiac Surgery, İstanbul, Turkey
| | - Alper Güzeltaş
- University of Health Sciences Turkey İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Pediatric Cardiology, İstanbul, Turkey
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Aslan S, Türkvatan A, Topel Ç, Güner A, Rıza Demir A, Kahraman S, Çelik Ö, Ertürk M. Structural Changesofthe Right Fibrous Trigone as a Risk Factor for Conduction Disturbance After Transcatheter Aortic Valve Implantation. The Anatolian Journal of Cardiology 2022; 26:532-542. [PMID: 35791709 PMCID: PMC9361055 DOI: 10.5152/anatoljcardiol.2022.987] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: The right fibrous trigone, which the His bundle penetrates, is part of the subaortic area adjacent to the membranous septum. Structural alterations of the right fibrous trigone may cause conduction disturbance as a result of compression in this area after transcatheter aortic valve implantation. This study analyzed the hypothesis of whether imaging parameters of the RFT could predict the risk of conduction disturbance after transcatheter aortic valve implantation. Methods: We retrospectively examined 209 patients who underwent transfemoral transcatheter aortic valve implantationat a tertiary cardiac center. The different valve models were divided into 2 groups: self-expanding valve and balloon-expandable valve. Using pre-procedure computed tomography, we evaluated for the alterations of the right fibrous trigone. Results: New conduction disturbance was seen in 75 of 209 (35.8%) patients. Receiver operating characteristics plots displayed a right fibrous trigone density of −6 Hounsfield unit for SEV and −16 Hounsfield unit for balloon-expandable valve as the optimal cutoff points for prediction conduction disturbance. In multiple regression analyses, the high density of RFT emerged as an independent predictor of conduction disturbance in both the self-expanding valve (odds ratio: 1.01, 95% CI: 1.01 to 1.02, P = 0.035) and balloon-expandable valve (odds ratio: 1.01, 95% CI: 1.01 to 1.03, P = 0.017) groups. A shorter membranous septum length and a greater implantation depth were also found to be significantly associated with a higher incidence of conduction disturbance in both transcatheter aortic valve implantation groups. Conclusion: High density of right fibrous trigone is independently associated with conduction disturbance after transcatheter aortic valve implantation, and its pre-procedure computed tomography evaluation can help predict the new-onset of conduction disturbance.
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Affiliation(s)
- Serkan Aslan
- Department of Cardiology, University of Health Sciences, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
- Corresponding author:Serkan Aslan ✉
| | - Aysel Türkvatan
- Department of Radiology, University of Health Sciences, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Çağdaş Topel
- Department of Radiology, University of Health Sciences, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Ahmet Güner
- Department of Cardiology, University of Health Sciences, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Ali Rıza Demir
- Department of Cardiology, University of Health Sciences, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Serkan Kahraman
- Department of Cardiology, University of Health Sciences, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Ömer Çelik
- Department of Cardiology, University of Health Sciences, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Mehmet Ertürk
- Department of Cardiology, University of Health Sciences, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
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6
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Çilsal E, Çaran B, Türkvatan A, Kamalı H, Haydin S, Güzeltaş A. Multiple aortic aneurysms because of infective endocarditis after repair of aortic coarctation. Anatol J Cardiol 2021; 25:E42-E43. [PMID: 34734822 DOI: 10.5152/anatoljcardiol.2021.350] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Erman Çilsal
- Department of Pediatric Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey
| | - Bahar Çaran
- Department of Pediatric Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey
| | - Aysel Türkvatan
- Department of Radiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey
| | - Hacer Kamalı
- Department of Pediatric Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey
| | - Sertaç Haydin
- Department of Pediatric Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey
| | - Alper Güzeltaş
- Department of Pediatric Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey
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7
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Öztürk E, Tanıdır İC, Kamalı H, Ayyıldız P, Topel C, Selen Onan İ, Türkvatan A, Haydin S, Güzeltaş A. Comparison of echocardiography and 320-row multidetector computed tomography for the diagnosis of congenital heart disease in children. Rev Port Cardiol 2021; 40:583-590. [PMID: 34392902 DOI: 10.1016/j.repce.2020.12.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 08/10/2020] [Accepted: 12/11/2020] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION Echocardiography (echo) is the primary non-invasive imaging modality for the assessment of congenital heart disease (CHD). Computed tomography angiography (CTA) also has potential to examine the anatomy of complex heart anomalies as well as extracardiac involvement. OBJECTIVES The aim of this study is to determine the impact of new CTA technology in the diagnosis of CHD and to compare echo and CTA in terms of diagnostic accuracy. METHODS Forty-five patients who underwent preoperative echo and CTA assessment in the intensive care unit were included in this study. The results were assessed for three main types of CHD (cardiac malformations, cardiac-major vessel connections and major vessels). The main groups were also divided into subgroups according to surgical features in order to assess them more objectively. Imaging methods were compared for diagnostic accuracy, sensitivity and specificity, while surgical findings were accepted as the gold standard. RESULTS Patients' median age and weight were two months (three days-eight years) and 12 kg (2.5-60 kg), respectively. In 45 operated cases, 205 subgroup malformations were assessed. Diagnostic accuracy was significantly greater in echo (echo vs. CTA: 98.4% and 96.2% [chi-square=6.4, p=0.011]). During surgery, 84 cardiac malformations (echo vs. CTA: 97.4% and 95.1% [chi-square=4.9, p=0.03]), 47 cardiac-major vessel connections (echo vs. CTA: 98.3% and 95.4% [chi-square=7.5, p=0.03]), and 74 major vessel malformations (echo vs. CTA: 96% and 98% [chi-square=1.8, p=0.48]) were confirmed. CONCLUSION Echocardiography and CTA are imaging methods with high diagnostic accuracy in children with CHD. The use of echocardiography together with CTA, especially for the visualization of extracardiac anatomy, provides additional information for clinicians.
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Affiliation(s)
- Erkut Öztürk
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey.
| | - İbrahim Cansaran Tanıdır
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Hacer Kamalı
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Pelin Ayyıldız
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Cagdas Topel
- Department of Radyology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - İsmihan Selen Onan
- Department of Cardiovascular Surgery, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Aysel Türkvatan
- Department of Radyology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Sertaç Haydin
- Department of Cardiovascular Surgery, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Alper Güzeltaş
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
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Kasar T, Kafalı HC, Türkvatan A, Ergül Y. A rare case of right corkscrew cervical aortic arch associated with retrotracheal aberrant left brachiocephalic vein. Kardiol Pol 2018; 76:812. [PMID: 29652432 DOI: 10.5603/kp.2018.0086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 11/06/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Taner Kasar
- departmet of pediatric cardiology, saglik bilimleri University, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Research and Training Hospital.
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9
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Türkvatan A, Tola HT, Kutlutürk N, Güzeltaş A, Ergül Y. Low-Dose Computed Tomographic Imaging of Partial Anomalous Pulmonary Venous Connection in Children. World J Pediatr Congenit Heart Surg 2017; 8:590-596. [DOI: 10.1177/2150135117723903] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: In this study, we aimed to determine lobar distribution, drainage sites, and associated cardiovascular anomalies of partial anomalous pulmonary venous connection in pediatric patients using low-dose multidetector computed tomographic angiography. Methods: Sixty-one cases (27 female, mean age: 4.7 years) with partial anomalous pulmonary venous connection diagnosed by multidetector computed tomographic angiography were included in this study. In all patients, multidetector computed tomographic angiography examinations were performed using dual-source 256-slice scanner without sedation. Results: In 61 patients, 73 anomalous pulmonary veins were detected, 56 (77%) of them were right-sided and 17 (23%) were left-sided. Of 56 right-sided anomalous pulmonary veins in 49 patients, 38 (68%) drained into superior vena cava, eight (14%) into atriocaval junction, six (11%) into inferior vena cava, three (5%) into right atrium, and one (2%) into levoatriocardinal vein. Of 17 left-sided anomalous pulmonary veins in 12 patients, 16 (94%) drained into left innominate vein, and one (6%) into coronary sinus. Only seven (12%) patients had isolated partial anomalous pulmonary venous connection, whereas 54 (88%) patients had additional cardiovascular anomalies. The most common (66%) associated anomaly is atrial septal defect. The overall mean effective radiation dose was 1.12 mSv (range: 0.15-7.41 mSv), and it was 0.58 mSv (range: 0.15-0.73) in the patients younger than one-year old. Conclusions: The presence and course of the anomalous pulmonary veins and associated cardiovascular anomalies can be reliably detected by dual-source 256-slice multidetector computed tomographic angiography with low radiation doses.
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Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Küçükçekmece, Istanbul
| | - Hasan Tahsin Tola
- Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Küçükçekmece, Istanbul
| | - Neşe Kutlutürk
- Department of Radiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Küçükçekmece, Istanbul
| | - Alper Güzeltaş
- Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Küçükçekmece, Istanbul
| | - Yakup Ergül
- Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Küçükçekmece, Istanbul
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10
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Türkvatan A, Güzeltaş A, Tola HT, Ergül Y. Multidetector Computed Tomographic Angiography Imaging of Congenital Pulmonary Venous Anomalies: A Pictorial Review. Can Assoc Radiol J 2017; 68:66-76. [DOI: 10.1016/j.carj.2016.05.003] [Citation(s) in RCA: 6] [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] [Received: 02/25/2015] [Revised: 06/28/2015] [Accepted: 05/06/2016] [Indexed: 11/28/2022] Open
Abstract
Congenital pulmonary venous anomalies are not uncommon that can occur either in isolation or in association with different forms of congenital heart disease. Clinical presentation of these anomalies may vary from the relatively benign single anomalous partial pulmonary venous return to life-threatening critical obstructed total anomalous pulmonary venous return. Accurate delineation of these anomalies and accompanied cardiovascular anomalies are crucial to guide decision making in these patients. Low-dose high-pitch dual-source 256-detector multidetector computed tomographic angiography is a fast and reliable imaging modality allowing comprehensive noninvasive anatomic imaging in neonates and children with congenital pulmonary venous anomalies with lower radiation doses and should be preferred for these patients after transthoracic echocardiography.
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Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Alper Güzeltaş
- Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Hasan Tahsin Tola
- Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Yakup Ergül
- Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
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11
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Çınar C, Türkvatan A. Prevalence of renal vascular variations: Evaluation with MDCT angiography. Diagn Interv Imaging 2016; 97:891-7. [DOI: 10.1016/j.diii.2016.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 03/30/2016] [Accepted: 04/05/2016] [Indexed: 01/01/2023]
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12
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Tosun Ö, Saygı M, Kasar T, Ayyıldız P, Türkvatan A, Ergül Y, Ödemiş E, Güzeltaş A. A rare pathology: Levoatriocardinal vein. Turk Kardiyol Dern Ars 2016; 44:315-9. [PMID: 27372616 DOI: 10.5543/tkda.2015.84404] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Levoatriocardinal vein (LACV) is a rare cardiac pathology that represents a connection between the pulmonary venous and cardinal systems. The aim of the present study was to discuss morphological and clinical characteristics, as well as diagnostic methods, of experience with LACV. METHODS Records of 11 patients (4 male, 7 female; mean age 79±1.83 days; range 1-390 days) diagnosed with LACV between 2010 and 2014 were retrospectively reviewed. Presence of LACV was confirmed with echocardiography. The primary obstructive lesion associated with cardiac defects and the integrity of the interatrial septum was identified in each patient with left-sided obstruction. RESULTS Mean weight was 4.4±0.4 kg (range: 2-8). Age at presentation was under 1 year in 82% of patients. Nine patients had left-sided obstruction, and 2 had normal intracardiac anatomy and pulmonary venous return. In patients with left-sided obstruction, LACV was initially demonstrated with echocardiographic evaluation, performed in apical 4-chamber, high parasternal, and subcostal views. Atrial septum was restrictive or intact in patients with left-sided obstructions. LACV originated directly from the left atrium in all patients. CONCLUSION Levoatriocardinal vein is an extremely rare cardiac pathology, presenting almost exclusively in patients with left-sided obstructive lesions. In patients with left-sided obstructions, LACV must be kept in mind. It may also present in patients with normal intracardiac anatomy and pulmonary venous return.
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Affiliation(s)
- Öykü Tosun
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Training and Research Hospital, İstanbul, Turkey.
| | - Murat Saygı
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Training and Research Hospital, İstanbul, Turkey
| | - Taner Kasar
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Training and Research Hospital, İstanbul, Turkey
| | - Pelin Ayyıldız
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Training and Research Hospital, İstanbul, Turkey
| | - Aysel Türkvatan
- Department of Radiology, Mehmet Akif Ersoy Cardiovascular Training and Research Hospital, İstanbul, Turkey
| | - Yakup Ergül
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Training and Research Hospital, İstanbul, Turkey
| | - Ender Ödemiş
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Training and Research Hospital, İstanbul, Turkey
| | - Alper Güzeltaş
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Training and Research Hospital, İstanbul, Turkey
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Kutlutürk N, Doğan İ, Türkvatan A. Venous aneurysm developed in duplicated inferior vena cava: MDCT features. Diagn Interv Imaging 2016; 97:479-80. [DOI: 10.1016/j.diii.2016.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 01/04/2016] [Accepted: 01/05/2016] [Indexed: 11/27/2022]
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Kasar T, Ayyıldız P, Türkvatan A, Ergül Y, Güzeltaş A. Criss-cross heart with dextrocardia and transposition of the great arteries: a rare pathology. Turk Kardiyol Dern Ars 2016; 44:91. [PMID: 26875142 DOI: 10.5543/tkda.2015.00057] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Taner Kasar
- Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, İstanbul, Turkey
| | - Pelin Ayyıldız
- Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, İstanbul, Turkey
| | - Aysel Türkvatan
- Department of Radiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, İstanbul, Turkey
| | - Yakup Ergül
- Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, İstanbul, Turkey
| | - Alper Güzeltaş
- Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, İstanbul, Turkey
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15
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Türkvatan A, Erden A, Türkoğlu MA, Bostancı EB, Dişibeyaz S, Parlak E. An unusual cause of recurrent pancreatitis: A gastric duplication cyst with an accessory pancreatic lobe. Turk J Gastroenterol 2015; 25 Suppl 1:199-202. [PMID: 25910305 DOI: 10.5152/tjg.2014.4150] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Congenital anomalies of pancreas and its ductal drainage are uncommon but in general surgically correctable causes of recurrent pancreatitis. A gastric duplication cyst communicated with an accessory pancreatic lobe is an extremely rare cause of recurrent pancreatitis, but an early and accurate diagnosis of this anomaly is important because suitable surgical treatment may lead to a satisfactory outcome. Herein, we presented multidetector computed tomography and magnetic resonance imaging findings of a gastric duplication cyst communicating with an accessory pancreatic lobe via an aberrant duct in a 29-year-old woman with recurrent acute pancreatitis and also reviewed other similar cases reported in the literature.
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Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey.
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16
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Işcanlı E, Türkvatan A, Bostancı EB, Sakaoğulları Z. Assessment of surgical resectability of pancreatic adenocarcinomas with multidetector computed tomography: what are the possibilities and problems? Turk J Gastroenterol 2015; 25:416-23. [PMID: 25254525 DOI: 10.5152/tjg.2014.4973] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS To investigate the accuracy of multidetector computed tomography (MDCT) in preoperatively determining the surgical resectability of pancreatic adenocarcinomas. MATERIALS AND METHODS Multidetector computed tomography, surgery, and pathological results of 274 patients with pancreatic adenocarcinoma were evaluated retrospectively. MDCT findings were compared with surgical and pathological findings to determine the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MDCT in determining surgical resectability. RESULTS A total of 124 of 274 (56%) patients (83 males, mean age: 60 years) underwent laparoscopy and/or laparotomy. The sensitivity, specificity, PPV, NPV, and accuracy of MDCT in determining the surgical resectability of pancreatic adenocarcinomas were 100%, 72%, 78%, 100%, and 86%, respectively. Liver metastases in 9 cases, peritoneal metastases in 3 cases, and vascular invasion in 5 cases, which were determined during surgery, were not reported by MDCT. On re-review of the MDCT images of these 17 patients, no metastatic lesions could be seen in 9 patients with liver metastases and in 2 of 3 patients with peritoneal metastases. In 1 patient, a peritoneal implant of a diameter of 8 mm was missed on MDCT. There was no vascular invasion according to Lu criteria on the MDCT images in the 5 cases that had vascular invasion in the surgical exploration. CONCLUSION The accuracy of MDCT is high in the preoperative determination of surgical resectability of pancreatic adenocarcinomas, but the detection of small liver and peritoneal metastases and accurate determination of vascular invasion are still major problems. Surgeons should be aware of the limitations of preoperative MDCT.
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Affiliation(s)
- Esra Işcanlı
- Department of Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey.
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17
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Şengül FS, Özyılmaz İ, Ergül Y, Türkvatan A, Güzeltaş A. Case images: D-transposition of the great arteries with bilateral peripheral pulmonary artery stenosis and arcus hypoplasia: A rare association. Turk Kardiyol Dern Ars 2015; 43:411. [PMID: 26142800 DOI: 10.5543/tkda.2015.13794] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Fatma Sevinç Şengül
- Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - İsa Özyılmaz
- Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Yakup Ergül
- Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Aysel Türkvatan
- Department of Radiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Alper Güzeltaş
- Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
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Saygı M, Türkvatan A, Erek E, Ödemiş E, Güzeltaş A. A rare indication for Senning operation: Isolated ventricular inversion and ventricular septal defect. Anatol J Cardiol 2015; 15:E21. [PMID: 26139178 PMCID: PMC5337051 DOI: 10.5152/akd.2015.6432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Murat Saygı
- Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital; İstanbul-Turkey.
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Türkvatan A, Türkoğlu MA, Yüce G. Aneurysm of the dorsal pancreatic artery associated with celiac artery occlusion. Turk J Gastroenterol 2014; 25 Suppl 1:248-249. [PMID: 25910324 DOI: 10.5152/tjg.2014.4023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey.
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20
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Saygı M, Güzeltaş A, Türkvatan A, Odemiş E. Case images: combination of the aortic interruption in a patient with right atrial isomerism: a previously unreported association. Turk Kardiyol Dern Ars 2014; 42:586. [PMID: 25362954 DOI: 10.5543/tkda.2014.32567] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Murat Saygı
- Department of Cardiology, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, İstanbul, Turkey.
| | - Alper Güzeltaş
- Department of Cardiology, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, İstanbul, Turkey
| | - Aysel Türkvatan
- Department of Cardiology, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, İstanbul, Turkey
| | - Ender Odemiş
- Department of Cardiology, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, İstanbul, Turkey
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Yüce G, Türkvatan A, Yener Ö. Can aortic atherosclerosis or epicardial adipose tissue volume be used as a marker for predicting coronary artery disease? J Cardiol 2014; 65:143-9. [PMID: 24954286 DOI: 10.1016/j.jjcc.2014.03.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 01/18/2014] [Accepted: 03/22/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE To investigate whether aortic atherosclerosis or epicardial adipose tissue (EAT) volume on multidetector computed tomography (CT) can predict the presence of significant coronary artery disease (CAD). MATERIALS AND METHODS Coronary CT angiography was performed in 202 cases of CAD that were known or based on suspicion. Based on coronary CT angiography results, the patients with significant stenosis (≥50%) and without significant stenosis (<50%) were compared in terms of demographic characteristics, traditional cardiovascular risk factors, aortic atherosclerosis, and EAT volume. RESULTS Significant coronary artery stenosis was detected in 92 cases (45.5%). Although EAT volume was higher in the patients with significant stenosis, the difference between the two groups was not statistically significant. The presence of calcification in the descending aorta was significantly higher in the patients with significant stenosis than the patients without significant stenosis (50.4% and 15.4%, respectively, p=0.0001). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy rates of the presence of calcification in the descending aorta in predicting the presence of significant coronary artery stenosis were respectively found as 53.8%, 84.4%, 74.6%, 68.1%, and 70.3%. The sensitivity, specificity, PPV, NPV, and accuracy rates of the ≥2.45mm wall thickness of the descending aorta in predicting the presence of significant coronary artery stenosis were respectively found as 75.3%, 74.3%, 71.4%, 77.9%, and 74.8%. CONCLUSION There is a strong relationship between thoracic aortic atherosclerosis and CAD. However, the relationship between EAT volume and CAD is not significant. The presence of aortic atherosclerosis can be used as an additional marker together with traditional cardiovascular risk factors for predicting CAD.
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Affiliation(s)
- Gökhan Yüce
- Department of Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey
| | - Aysel Türkvatan
- Department of Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey.
| | - Özlem Yener
- Department of Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey
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22
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Türkvatan A, Erden A, Türkoğlu MA, Seçil M, Yüce G. Imaging of acute pancreatitis and its complications. Part 2: complications of acute pancreatitis. Diagn Interv Imaging 2014; 96:161-9. [PMID: 24703377 DOI: 10.1016/j.diii.2013.12.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [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] [Indexed: 12/11/2022]
Abstract
The Atlanta classification of acute pancreatitis was introduced in 1992 and divides patients into mild and severe groups based on clinical and biochemical criteria. Recently, the terminology and classification scheme proposed at the initial Atlanta Symposium have been reviewed and a new consensus statement has been proposed by the Acute Pancreatitis Classification Working Group. Major changes include subdividing acute fluid collections into "acute peripancreatic fluid collection" and "acute post-necrotic pancreatic/peripancreatic fluid collection (acute necrotic collection)" based on the presence of necrotic debris. Delayed fluid collections have been similarly subdivided into "pseudocyst" and "walled of pancreatic necrosis". Appropriate use of the new terms describing the fluid collections is important for management decision-making in patients with acute pancreatitis. The purpose of this review article is to present an overview of complications of the acute pancreatitis with emphasis on their prognostic significance and impact on clinical management and to clarify confusing terminology for pancreatic fluid collections.
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Affiliation(s)
- A Türkvatan
- Department of Radiology, Türkiye Yüksek İhtisas Hospital, Kızılay street, No 4, 06100 Sıhhiye, Ankara, Turkey.
| | - A Erden
- Department of Radiology, Ankara University School of Medicine, Talatpaşa Street, 06100 Sıhhiye, Ankara, Turkey
| | - M A Türkoğlu
- Department of General Surgery, Akdeniz University School of Medicine, Dumlupınar street, Antalya, Turkey
| | - M Seçil
- Department of Radiology, Dokuz Eylul University School of Medicine, Cumhuriyet street, İzmir, Turkey
| | - G Yüce
- Department of Radiology, Türkiye Yüksek İhtisas Hospital, Kızılay street, No 4, 06100 Sıhhiye, Ankara, Turkey
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Türkvatan A, Erden A, Seçil M, Türkoğlu MA. Fluid collections associated with acute pancreatitis: a pictorial essay. Can Assoc Radiol J 2014; 65:260-6. [PMID: 24650871 DOI: 10.1016/j.carj.2013.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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: 04/16/2013] [Revised: 07/05/2013] [Accepted: 08/15/2013] [Indexed: 12/15/2022] Open
Abstract
The terminology and classification scheme of acute pancreatitis proposed at the initial Atlanta Symposium was reviewed, and a new consensus statement was recently proposed. Major changes include subdividing acute fluid collections in the first 4 weeks into "acute peripancreatic fluid collection" and "acute necrotic collection" based on the presence of necrotic debris. Delayed fluid collections have been similarly subdivided into "pseudocyst" and "walled-off necrosis." Correct use of the new terms that describe these collections is important because they lead to different treatment decisions. The purpose of this article is to present an overview of fluid collections associated with acute pancreatitis, with an emphasis on their prognostic significance and impact on clinical management, and to illustrate the new terminology.
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Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.
| | - Ayşe Erden
- Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
| | - Mustafa Seçil
- Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Mehmet A Türkoğlu
- Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey
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Abstract
Acute pancreatitis is an acute inflammatory disease of the pancreas that may also involve surrounding tissues or remote organs. The Atlanta classification of acute pancreatitis was introduced in 1992 and divides patients into mild and severe groups based on clinical and biochemical criteria. Recently, the terminology and classification scheme proposed at the initial Atlanta Symposium have been reviewed and a new consensus statement has been proposed by the Acute Pancreatitis Classification Working Group. Generally, imaging is recommended to confirm the clinical diagnosis, investigate the etiology, and grade the extend and severity of the acute pancreatitis. Ultrasound is the first-line imaging modality in most centers for the confirmation of the diagnosis of acute pancreatitis and the ruling out of other causes of acute abdomen, but it has limitations in the acute clinical setting. Computed tomography not only establishes the diagnosis of acute pancreatitis, but also enables to stage severity of the disease. Magnetic resonance imaging has earned an ever more important role in the diagnosis of acute pancreatitis. It is especially useful for imaging of patients with iodine allergies, characterizing collections and assessment of an abnormal or disconnected pancreatic duct. The purpose of this review article is to present an overview of the acute pancreatitis, clarify confusing terminology, underline the role of ultrasound, computed tomography and magnetic resonance imaging according to the proper clinical context and compare the advantages and limitations of each modality.
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Affiliation(s)
- A Türkvatan
- Department of Radiology, Türkiye Yüksek İhtisas Hospital, Kızılay street, No 4, 06100 Sıhhiye, Ankara, Turkey.
| | - A Erden
- Department of Radiology, Ankara University School of Medicine, Talatpaşa Street, 06100 Sıhhiye, Ankara, Turkey
| | - M A Türkoğlu
- Department of General Surgery, Akdeniz University School of Medicine, Dumlupınar street, Antalya, Turkey
| | - M Seçil
- Department of Radiology, Dokuz Eylul University School of Medicine, Cumhuriyet street, İzmir, Turkey
| | - Ö Yener
- Department of Radiology, Türkiye Yüksek İhtisas Hospital, Kızılay street, No 4, 06100 Sıhhiye, Ankara, Turkey
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25
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Büyükterzi M, Türkvatan A, Büyükterzi Z. Frequency and extent of coronary atherosclerotic plaques in patients with a coronary artery calcium score of zero: assessment with CT angiography. Diagn Interv Radiol 2014; 19:111-8. [PMID: 23271579 DOI: 10.4261/1305-3825.dir.6127-12.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
PURPOSE We aimed to evaluate the frequency and extent of coronary atherosclerotic plaques in patients with a coronary artery calcium (CAC) score of zero and establish the demographic characteristics and the cardiovascular risk factors that affect the formation of atheromatous plaques. MATERIALS AND METHODS Coronary computed tomography (CT) angiography was performed in 288 cases with a CAC score of zero. The plaques that were detected using coronary CT angiography were categorized into two groups: nonsignificant (<50%) and significant (≥50%). Based on the coronary CT angiography results, the patients who had plaque and those who did not have plaque were compared in terms of the demographic characteristics and the presence of cardiovascular risk factors. RESULTS Noncalcified plaques were detected in 50 cases (17.4%) on CT angiography, of which six cases (2.1%) had significant stenosis. The plaques were localized most frequently (38.2%) in the proximal left anterior descending artery. When all the plaques considered 50% of the plaques were localized in the proximal segments, 42.7% were in the mid-segments, and 7.3% were in the distal segments. Hypertension was a significant risk factor for coronary artery disease in both genders, and smoking was a significant risk factor in females. Additionally, diabetes mellitus was a borderline significant risk factor in both genders. CONCLUSION In patients with a CAC score of zero, the frequency of noncalcified plaques is too high to be ignored. The distribution of these plaques in the coronary artery is similar to calcified plaque localizations. Patients who have a CAC score of zero and cardiovascular risk factors need to be evaluated with additional tests for the detection of noncalcified plaques.
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Affiliation(s)
- Meral Büyükterzi
- Clinic of Radiology, Türkiye Yüksek Ihtisek Ihtisas Hospital, Ankara, Turkey
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26
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Türkvatan A, Türkoğlu MA, Ozoğul Y, Karacan A, Akoğlu M. Multidetector computed tomography diagnosis of adenomyomatosis of the gallbladder. Turk J Gastroenterol 2013; 24:286-9. [PMID: 24226723 DOI: 10.4318/tjg.2013.0534] [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] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The differentiation of gallbladder adenomyomatosis from gallbladder carcinoma is important as both conditions may present with thickening of the gallbladder wall or as a focal mass. Identification of Rokitansky-Aschoff sinuses is the key feature in making an accurate diagnosis of gallbladder adenomyomatosis on imaging studies. The diagnosis of gallbladder adenomyomatosis can be made with accurately by multidetector computed tomography when the presence of Rokitansky-Aschoff sinuses (small cystic spaces within the thickened gallbladder wall) are noted. Herein we present multidetector computed tomography findings of a 27-year-old patient with gallbladder adenomyomatosis.
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Affiliation(s)
- Aysel Türkvatan
- Türkiye Yüksek İhtisas Hospital, Department of Radiology, Ankara, Turkey
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27
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Türkvatan A, Erden A, Türkoğlu MA, Yener Ö. Congenital variants and anomalies of the pancreas and pancreatic duct: imaging by magnetic resonance cholangiopancreaticography and multidetector computed tomography. Korean J Radiol 2013; 14:905-13. [PMID: 24265565 PMCID: PMC3835637 DOI: 10.3348/kjr.2013.14.6.905] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [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: 03/21/2013] [Accepted: 07/16/2013] [Indexed: 12/14/2022] Open
Abstract
Though congenital anomalies of the pancreas and pancreatic duct are relatively uncommon and they are often discovered as an incidental finding in asymptomatic patients, some of these anomalies may lead to various clinical symptoms such as recurrent abdominal pain, nausea and vomiting. Recognition of these anomalies is important because these anomalies may be a surgically correctable cause of recurrent pancreatitis or the cause of gastric outlet obstruction. An awareness of these anomalies may help in surgical planning and prevent inadvertent ductal injury. The purpose of this article is to review normal pancreatic embryology, the appearance of ductal anatomic variants and developmental anomalies of the pancreas, with emphasis on magnetic resonance cholangiopancreaticography and multidetector computed tomography.
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Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, Türkiye Yüksek İhtisas Hospital, Kızılay street, No:4, 06100, Sıhhiye, Ankara, Turkey
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28
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Balcı KG, Türkvatan A, Kırkpantur A, Balcı MM, Arslan U, Er O, Açıkgöz SK. Serum Sclerostin Levels are Associated with Both Arteriovenous Fistula Calcification and Arteriovenous Fistula Survival in Maintenance Hemodialysis Patients. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Balcı MM, Türkvatan A, Kırkpantur A, Arslan U, Er O, Açıkgöz SK, Kocaoğlu İ, Balcı KG. Serum Sclerostin Levels are Associated with Aortic Valve Calcification in Maintenance Hemodialysis Patients. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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30
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Balcı MM, Kırbaş İ, Kırkpantur A, Türkvatan A, Arslan U, Er O, Balcı KG, Kocaoğlu İ, Açıkgöz SK. The Impact of Peripheral Arterial Disease on Outcome After Percutaneous Transluminal Angioplasty for Arteriovenous Fistula: A 1-Year Retrospective Analysis. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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Balcı MM, Mandıroğlu S, Türkvatan A, Kirkpantur A, Arslan U, Kocaoğlu İ, Er O, Açıkgöz SK. The Association among Neuropathy, Echocardiographic Parameters and Carotid Artery Intima Media Thickness in Maintenance Hemodialysis Patients. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Türkvatan A, Türkoğlu MA, Yener O. CT angiography diagnosis of inferior pancreaticoduodenal artery aneurysm in association with celiac artery occlusion. Pancreatology 2013; 13:314-5. [PMID: 23858564 DOI: 10.1016/j.pan.2013.03.001] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, Türkiye Yüksek Ihtisas Hospital, Kızılay Street No. 4, Sıhhiye, Ankara, Turkey.
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Affiliation(s)
- Mehmet Doğan
- Clinic of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey.
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Türkvatan A. Anomalous origin of the three coronary arteries. Intern Med J 2012; 42:845-6. [DOI: 10.1111/j.1445-5994.2012.02822.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Türkvatan A, Paç A, Kiziltepe U, Olçer T, Cumhur T. MDCT angiography of isolated right subclavian artery. Turk J Pediatr 2010; 52:668-672. [PMID: 21428206] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Isolation of a subclavian artery is an uncommon congenital anomaly of the aortic arch in which one subclavian artery loses its connection with the aorta and originates from the homolateral pulmonary artery by way of a ductus arteriosus. Isolation of the left subclavian artery in patients with a right aortic arch is well known. However, isolated right subclavian artery with a left-sided aortic arch is an extremely rare condition. In this report, we present multidetector computed tomographic (MDCT) angiography findings of an isolated right subclavian artery associated with a common carotid trunk and an anomalous origin and proximal interruption of the left pulmonary artery.
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Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey
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Özcan F, Maden O, Türkvatan A, Özlü MF, Özcan HN, Balbay Y. Demonstration of a very rare coronary anomaly with multislice computed tomography: Arising of right coronary artery from left anterior descending artery. Int J Cardiol 2010; 139:e42-3. [DOI: 10.1016/j.ijcard.2008.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2008] [Accepted: 11/01/2008] [Indexed: 10/21/2022]
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Abstract
PURPOSE To evaluate the reliability of 16-slice multidetector computed tomographic (MDCT) angiography for the preoperative morphologic assessment of coarctation of the aorta in adults. MATERIALS AND METHODS Twenty-four adult patients with clinical suspicion of coarctation of the aorta who underwent both Doppler echocardiography and MDCT angiography were included in this study. The sensitivities of diagnosis were assessed comparing MDCT and Doppler echocardiography with surgical results. RESULTS The overall sensitivity of three-dimensional MDCT for diagnosis of the coarctation of the aorta was 100%, which was higher than that of Doppler echocardiography (91%). The overall sensitivity of MDCT for the assessment of cardiac defects was 82%, which was lower than that of Doppler echocardiography (100%). CONCLUSION MDCT angiography with multiplanar and three-dimensional techniques should be the method of choice for preoperative morphologic assessment of coarctation of the aorta in adult patients.
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Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey.
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Biyikoğlu SF, Cağirci G, Boyaci A, Duru E, Türkvatan A. An uncommonly seen congenital heart defect: aortopulmonary window with pulmonary hypertension in a 19-year old male patient. Anadolu Kardiyol Derg 2009; 9:E13. [PMID: 19666424] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Demirkan B, Güray Y, Türkvatan A, Tüfekçioğlu O. [A rare cause of aortic insufficiency: quadricuspid aortic valve]. Turk Kardiyol Dern Ars 2009; 37:260-262. [PMID: 19717960] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Quadricuspid aortic valve can be documented incidentally as a rare cause of aortic regurgitation. An asymptomatic 24-year-old male patient underwent cardiac evaluation after detection of a cardiac murmur on routine examination. There was a grade 1/6 early diastolic murmur on the right upper side of the sternum. The electrocardiogram was in sinus rhythm and normal. Transthoracic echocardiography showed normal left ventricular dimensions and functions, but it did not provide an adequate visualization of valve structure. Color Doppler examination showed mild aortic insufficiency. Transesophageal echocardiography revealed a qaudricuspid aortic valve composed of two equal large cusps and two equal small cusps. Color Doppler scans demonstrated aortic regurgitant flow at the coaptation sites of small and large cusps. Further studies by aortic computed tomographic (CT) angiography and cardiac CT did not show aortic coarctation or any other coronary abnormality, but the latter confirmed quadricuspid aortic valve.
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Affiliation(s)
- Burcu Demirkan
- Department of Cardiology, Türkiye Yüksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey.
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Türkvatan A, Olçer T, Cumhur T. Multidetector CT urography of renal fusion anomalies. Diagn Interv Radiol 2009; 15:127-134. [PMID: 19517383] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Renal fusion anomalies, in which both kidneys are fused togeher in early embyronic life, are rarely encountered. Once a fused kidney is diagnosed or suspected, further laboratory and imaging evaluation should be performed to assess the status of the kidneys and to look for treatable causes of renal pathology. The early dignosis of potential complications that can accompany this anomaly must be made in order to prevent permanent renal damage. The advantage of multidetector computed tomographic (MDCT) urography is its ability to depict the normal urinary tract anatomy, including both the renal parenchyma, and collecting structures and ureters. MDCT urography is helpful to screen for the presence of stones, hydronephrosis or masses. Additionally, it provides information about the vascular supply of the fused kidneys. Therefore, MDCT urography enables a comprehensive evaluation of patients with renal fusion anomalies in a single examination. Especially three-dimensional reformatted images can provide good delineation of congenital fusion anomalies of the kidney. In this study we report our experience with MDCT urography for the anatomic demonstration of renal fusion anomalies.
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Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey.
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Türkvatan A, Altınsoy D, Küçüker Ş, Cumhur T. Multidetector CT angiography in spontaneous popliteal artery dissection. J Cardiovasc Comput Tomogr 2009; 3:180-1. [DOI: 10.1016/j.jcct.2009.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2008] [Revised: 02/05/2009] [Accepted: 03/05/2009] [Indexed: 10/21/2022]
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Türkvatan A, Büyükbayraktar FG, Olçer T, Cumhur T. Congenital anomalies of the aortic arch: evaluation with the use of multidetector computed tomography. Korean J Radiol 2009; 10:176-84. [PMID: 19270864 PMCID: PMC2651449 DOI: 10.3348/kjr.2009.10.2.176] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [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: 04/11/2008] [Accepted: 08/11/2008] [Indexed: 11/27/2022] Open
Abstract
Congenital anomalies of the aortic arch have clinical importance, as the anomalies may be associated with vascular rings or other congenital cardiovascular diseases. Multidetector computed tomography (MDCT) angiography enables one to display the detailed anatomy of vascular structures and the spatial relationships with adjacent organs; this ability is the greatest advantage of the use of MDCT angiography in comparison to other imaging modalities in the evaluation of the congenital anomalies of the aortic arch. In this review article, we illustrate 16-slice MDCT angiography appearances of congenital anomalies of the aortic arch.
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Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, TürkIye Yüksek Ihtisas Hospital, Ankara, Turkey.
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Türkvatan A, Akdur PO, Altinel M, Olçer T, Turhan N, Cumhur T, Akinci S, Ozkul F. Preoperative staging of renal cell carcinoma with multidetector CT. Diagn Interv Radiol 2009; 15:22-30. [PMID: 19263370] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE To evaluate the diagnostic accuracy of multidetector computed tomography (MDCT) for preoperative staging of renal cell carcinoma (RCC) using the 1997 TNM (tumor, node, metastasis) classification. MATERIALS AND METHODS We conducted a retrospective review of MDCT in 57 consecutive patients with RCC performed for tumor staging before radical (n = 51) or partial nephrectomy (n = 6). The scanning protocol of MDCT consisted of unenhanced and biphasic contrast-enhanced scans during corticomedullary and nephrographic phases. MDCT and surgical-histopathologic staging were performed using the 1997 TNM staging system. The results of MDCT were compared with the histopathological results. Agreement between the two staging methods was evaluated using the kappa (kappa) statistic. RESULTS Consistency between MDCT and histopathologic staging was excellent for T staging (kappa= 0.87), fair for N staging (kappa= 0.40), and excellent for M staging (kappa= 1.00). Fifty-one of 57 tumors were correctly staged, five overstaged and one understaged by MDCT, with an overall accuracy of 89%. MDCT was able to correctly identify and localize the extension of the tumor thrombus in all 10 patients. In the evaluation of nodal involvement, 42 of 57 patients (74%) were correctly staged, 11 (19%) overstaged, and four (7%) understaged. CONCLUSION MDCT with a dynamic contrast enhancement protocol is an accurate method for preoperative staging of RCC. MDCT with multiplanar reconstruction capability enables a reliable detection and characterization of the tumor, but the involvement of lymph nodes by tumor is still difficult to predict because it is based on node size criterion only.
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Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey.
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Türkvatan A, Biyikoğlu SF, Büyükbayraktar FG, Cumhur T, Duru E, Olçer T, Ulaş MM. Noninvasive evaluation of coronary artery bypass grafts and native coronary arteries: is 16-slice multidetector CT useful? Diagn Interv Radiol 2009; 15:43-50. [PMID: 19263374] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE To investigate the diagnostic accuracy and limitations of 16-slice multidetector computed tomography (MDCT) in the detection of significant ( > 50%) stenosis of coronary artery bypass grafts (CABG) and native coronary arteries. MATERIALS AND METHODS One hundred two patients with 236 grafts were investigated by 16-slice MDCT. Native coronary arteries were also investigated. The image quality was assessed in terms of artifact, and the evaluable segments were screened for the presence of occlusion and significant ( > 50%) stenosis. MDCT results were compared with conventional coronary angiography. RESULTS The evaluability of MDCT was 90.4% for CABG and 71.2% for native coronary arteries. The most frequent causes of nonevaluable segments were motion artifact in venous grafts, metallic clip artifact in arterial grafts, and severe calcification in native coronary arteries. MDCT correctly diagnosed all of the 46 occluded grafts. The sensitivity, specificity, and the positive and negative predictive value of MDCT for the detection of significant CABG stenoses were 91.4%, 98.5%, 84.2%, and 99.2%, respectively. Including nonevaluable segments in the analysis, overall sensitivity was 84.2%. For the evaluation of native coronary arteries, MDCT had a sensitivity of 82.1% and a specificity of 75.3%, but evaluability was only 71.2%, resulting in overall sensitivity of 62.1%. CONCLUSION Use of 16-slice MDCT angiography allows very accurate evaluation of CABG patency and has high diagnostic accuracy in detecting graft stenoses. But evaluation of native coronary artery stenosis is limited, particularly in patients with advanced coronary artery disease with severe calcification.
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Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey.
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Türkvatan A, Ozdemir Akdur P, Akdoğan M, Cumhur T, Olçer T, Parlak E. Inferior mesenteric arteriovenous fistula with ischemic colitis: multidetector computed tomographic angiography for diagnosis. Turk J Gastroenterol 2009; 20:67-70. [PMID: 19330739] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Inferior mesenteric arteriovenous fistula is rare and may be congenital or acquired. Two serious manifestations may occur in the course of the disease: portal hypertension and bowel ischemia. The diagnosis is generally established by conventional angiography. In this report, we present a case with multiple inferior mesenteric arteriovenous fistulas, considered idiopathic due to no known cause related to the etiology, and associated ischemic colitis, which were clearly demonstrated by multidetector computed tomographic angiography. We also review the available literature.
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Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey.
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Abstract
Abstract The purpose of this study was to evaluate the utility of 16-slice multidetector computed tomographic (MDCT) angiography for identifying anatomic features of aberrant subclavian arteries. Seventeen patients with aberrant subclavian arteries were assessed by MDCT angiography. The aortic arch position, the presence of a Kommerell’s diverticulum, aneurysm, vascular compression of trachea and oesophagus and associated cardiovascular abnormalities were evaluated. MDCT findings were confirmed by surgery in eight patients but in the other nine patients no further evaluation or management was warranted as the aberrant subclavian artery had no significant clinical consequence. Eleven patients had an aberrant right subclavian artery arising from the left aortic arch and six patients had an aberrant left subclavian artery arising from the right aortic arch. Kommerell’s diverticulum was identified in three patients with an aberrant right subclavian artery and in five patients with an aberrant left subclavian artery. In two patients it was aneurysmal. Oesophageal compression was detected in eight patients, and tracheal compression was identified in only one paediatric patient. An aberrant subclavian artery was associated with complex congenital heart disease in one patient, intracardiac defects in two patients, aortic coarctation in two patients, patent ductus arteriosus in two patients and an aberrant vertebral artery in one patient. In conclusion, MDCT angiography is superior to digital subtraction angiography for the assessment of aberrant subclavian arteries since digital subtraction angiography has only a poor ability to visualize adjacent structures completely and is invasive in nature. MDCT angiography or magnetic resonance angiography are the current standard in the initial evaluation of thoracic vascular anomalies.
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Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, Türkiye Yüksek İhtisas Hospital, Sıhhiye, Ankara, Turkey
| | | | - Tülay Ölçer
- Department of Radiology, Türkiye Yüksek İhtisas Hospital, Sıhhiye, Ankara, Turkey
| | - Turhan Cumhur
- Department of Radiology, Türkiye Yüksek İhtisas Hospital, Sıhhiye, Ankara, Turkey
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Türkvatan A, Akıncı S, Yıldız Ş, Ölçer T, Cumhur T. Multidetector computed tomography for preoperative evaluation of vascular anatomy in living renal donors. Surg Radiol Anat 2008; 31:227-35. [DOI: 10.1007/s00276-008-0428-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2008] [Accepted: 10/02/2008] [Indexed: 10/21/2022]
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Biyikoğlu SF, Boyaci A, Duru E, Türkvatan A, Saşmaz A. Diagnostic techniques in a case of patent ductus arteriosus: is the computerized tomography angiography gold-standard method for the diagnosis of patent ductus arteriosus? Anadolu Kardiyol Derg 2008; 8:227-229. [PMID: 18524732] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Türkvatan A, Biyikoğlu ŞF, Büyükbayraktar F, Ölçer T, Cumhur T, Duru E. Clinical value of 16-slice multidetector computed tomography in symptomatic patients with suspected coronary artery disease. Acta Radiol 2008; 49:400-8. [PMID: 18415783 DOI: 10.1080/02841850701870922] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Multidetector computed tomography angiography has emerged as a rapidly developing method for the noninvasive detection of coronary artery disease. PURPOSE To investigate the diagnostic accuracy and limitations of multidetector computed tomography (MDCT) in the detection of significantly (> 50%) obstructive coronary artery disease (CAD) using a scanner equipped with 16 x 0.625-mm collimation. MATERIAL AND METHODS MDCT angiography was performed in 153 patients (99 male, 54 female; mean age 55 +/- 10 years) with suspected CAD and scheduled for conventional coronary angiography (CCA). Image quality was assessed in terms of artifacts and segment visibility, and the assessable segments were screened for the presence of significant stenoses (> 50% lumen diameter reduction). The diagnostic performance of MDCT for the detection of significant stenosis was compared with the results of CCA. RESULTS In all 153 patients, MDCT was carried out without complications. A total of 1989 coronary artery segments were evaluated. After exclusion of 394 non-evaluable segments (19.8%), 1595 segments (80.2%) were included in the analysis. The most frequent causes of poorly assessable segments were motion artifact (36%) and severe calcification (23%). Considering only the segments judged to be evaluable, the sensitivity, specificity, and positive and negative predictive values of 16-slice MDCT were 85%, 97%, 79%, and 98%, respectively. Including all segments in the analysis (evaluable and non-evaluable), the sensitivity was 74%, specificity 96%, positive predictive value 73%, and negative predictive value 97%. CONCLUSION When all coronary artery segments are included, 16-slice MDCT has moderate sensitivity and very high specificity and negative predictive value in assessing coronary artery stenoses. High specificity and negative predictive value indicate that 16-slice MDCT may be a useful tool in reliably ruling out significant lesions in patients with a low pretest probability.
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Affiliation(s)
- A. Türkvatan
- Department of Radiology and Cardiology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey
| | - Ş. F. Biyikoğlu
- Department of Radiology and Cardiology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey
| | - F. Büyükbayraktar
- Department of Radiology and Cardiology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey
| | - T. Ölçer
- Department of Radiology and Cardiology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey
| | - T. Cumhur
- Department of Radiology and Cardiology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey
| | - E. Duru
- Department of Radiology and Cardiology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey
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Abstract
Cake (fused pelvic) kidney is an uncommon congenital anomaly. Early diagnosis and recognition of potential complications that may accompany this anomaly are important to prevent permanent renal impairment. To the best of our knowledge, this is the first report on a case of cake kidney that was diagnosed by multidetector row computed tomographic urography.
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Affiliation(s)
- Aysel Türkvatan
- Department of Radiology, Türkiye Yüksek Ihtisas Hospital, 06100 Sihhiye, Ankara, Turkey.
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