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- ArticleAçık Erişim2020DTI-MRI findings in synthetic cannabinoid users
Gökharman, Dilek; Aydin, Sonay; Paltun, Salih; Fatihoğlu, Erdem; Şahiner, Şafak; Koşar, Pınar Nercis
Background/aim: Synthetic cannabinoids (SCs) are full agonists of both cannabinoid receptors. Conventional magnetic resonance imaging (MRI) findings of SC users are mainly defined as diffusion restriction and T2/FLAIR hyperintensity. Diffusion tensor imaging (DTI) studies examining SC users have shown contradictory results. The aim of this study was to define white matter (WM) changes of SC users using DTI. Materials and methods: The study included 22 patients with a history of using SC for 5–37 months, and 22 healthy, age and sex-matched control subjects. A total of 41 diffusion gradient directions were used in the acquisition of diffusion imaging data. Fractional anisotropy (FA) and apparent diffusion coefficients (ADC) values were obtained. ROIs were placed on WM areas of normal appearance. Results: In the SC users, significantly lower FA values were determined in the left temporal lobe (216.2 ± 58.9 vs. 263 ± 27.4; P = 0.002) and right hippocampus (224.5 ± 61.5 vs. 255 ± 24.3; P = 0.040). The ADC values of the hippocampus and temporal lobe were significantly higher than those of the control group on both the left and right sides. Conclusion: The SC use causes WM microstructural changes, especially in the hippocampus and temporal lobes. DTI is a useful tool to reveal WM changes in SC addicts and can be used earlier than conventional MRI.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2020Diagnosing Small for Gestational Age during second trimester routine screening: Early sonographic clues
Fatihoglu, Erdem; Aydin, Sonay
Objective: Small for gestational age (SGA) is generally defined as birth weight being at or below the 10th percentile. Children with SGA have a higher risk for complications. There is a need for early predictors, as the accurate diagnosis rate is only 50%. In the current study, we aimed to evaluate diagnostic performance of ultrasound (US)/color Doppler ultrasound (CDUS) parameters (umbilical vein-UV, right portal vein-RPV diameter/flow rate, and portal sinus-PS diameter) examined at 20–22 gestational week as SGA diagnostic factors. Materials and methods: 93 pregnant included (32 SGA, 61 controls). All the US examinations were performed between 20 and 22 weeks of gestation. UV, RPV, and PS measurements were performed by using the same image acquired for abdominal circumference measurement. A fetus with as estimated fetal weight (EFW) below the 10th percentile was diagnosed as SGA and SGA at birth was defined as having a birth weight under the 10th percentile. Results: Pregnant women in the SGA group were significantly older (30 ± 4.8 vs. 26.6 ± 5.4 years, p < 0.01). Median UV diameter was significantly lower in SGA group (2.20 vs. 2.40 mm, p = 0.001). Median RPV diameter was significantly lower in SGA group (2 vs. 2.10 mm, p = 0.018). Median PS diameter was significantly lower in SGA group (2 vs. 20.10 mm, p = 0.008). Conclusion: UV, RPV, and PS diameters can be earlier predictors for SGA diagnosis. Routinely evaluation of these parameters during second trimester screening can increase SGA diagnosis rates and serve for early diagnose.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2020Fetal epicardial fat thickness: Can it serve as a sonographic screening marker for gestational diabetes mellitus?
Aydin, Sonay; Fatihoglu, Erdem
Background: Gestational diabetes mellitus (GDM) is defined as the new onset of impairment in carbohydrate tolerance during pregnancy. The aim of the current study was to define fetal epicardial fat thickness (fEFT) changes that developed before 24 weeks of gestation, to evaluate the diagnostic effectiveness of fEFT in predicting GDM diagnosis, and to correlate fEFT values with hemoglobin A1C (HbA1C) values. Methods: The study included a total of 60 GDM patients and 60 control subjects. A record consisted of fEFT measurements, maternal body mass index, maternal subcutaneous fat thickness, and fetal subcutaneous fat thickness during sonographic screening performed at 18-22 gestational weeks. Fetal abdominal circumference (AC) values, estimated fetal weight (EFW), and fetal gender were also recorded. Results: The median fEFT measurement of the whole study population was 0.9 ± 0.21 mm; 1.05 ± 0.21 mm in the GDM patients, and 0.8 ± 0.15 mm in the control group. The median fEFT values of the GDM patients were significantly higher than those of the control group (P < 0.01). According to the correlation analysis results, a strong positive correlation was determined between the fEFT and HbA1C values (r = 0.71, P < 0.01), gestational week of the fetus (r = 0.76, P = P < 0.01), AC (r = 0.81, P < 0.01), and EFW (r = 0.71, P < 0.01). According to the receiver operating characteristic analysis results, a fEFT value of > 0.95 can predict GDM diagnosis with sensitivity of 65% and specificity of 88% (odds ratio = 13). Conclusion: fEFT values are increased in GDM cases, and the increase can be detected earlier than 24 weeks of gestation. fEFT values are positively correlated with HbA1C values and can serve as an early predictor for GDM diagnosis.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2019Family history in developmental dysplasia of the hip: should we follow-up?
Aydin, Sonay; Fatihoglu, Erdem
Objectives: Developmental dysplasia of the hip (DDH) is an important problem. Ultrasonography (US) is aproper method before 6 months of age. For older children, plain radiographs can be useful. Six risk factors areemphasized: breech presentation, female sex, a positive family history, being first-born, left hip affected, andmode of delivery. In some centers, clinicians prefer to perform a control US examination or pelvic radiographsafter 6 months of age for the children having a positive family history. We aimed to evaluate the necessity ofcontrol US/direct radiography examinations.Methods: A total of 205 children with a positive family history for DDH are included. US examinations areperformed according to Graf’s method. We have evaluated direct radiographs by using Hilgenreiner, Perkin,and Shenton lines, acetabular angle.Results: Initial US examinations are performed at a median age of 8.3 weeks. Seventy-four patients (36%)had a repeat ultrasound scan at a median age of 7 months; none of them demonstrated abnormal findings. Onehundred and thirty-one patients (63.9%) had control radiographs at a median age of 8.2 months. Shenton lineis considered as normal, and the upper femoral epiphysis is located in inferomedial quadrant according toHilgenreiner and Perkin lines.Conclusions: A positive family history for DDH may be a less important reason for performing control US orradiographic examination. Patients with a normal screening US result and having risk factors can be dischargedfrom follow up safely, so that unnecessary examinations and family anxiety will be reduced.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2019Intrathyroidal ectopic thymus tissue: a diagnostic challenge
Aydin, Sonay; Fatihoglu, Erdem; Kacar, Mahmut
Objectives: The prevalence of thyroid nodules in pediatric population is 0.2–2%, which is lower than adults. However, the probability of the nodule to be malignant is higher than adults (20–73%). Differential diagnosis of thyroid lesions in children includes intrathyroidal ectopic thymus tissue (ITT). ITT can present as a thyroid nodule, and be confused with malignancy with its hyperechoic pattern; this might cause unnecessary fine-needle aspiration biopsies and/or surgical interventions. In the current study, we mainly aim to define both US and color Doppler ultrasonography (CDUS) characteristics of ITT. We also aim to describe the most sensitive and most specific diagnostic parameters of ITT. Methods: We have evaluated US examination reports of 56 children for whom differential diagnosis included ITT between February 2015 and August 2018. We have recorded sonographic characteristics of the lesions, CDUS data, and thyroid hormone levels. Results: Study population consists of 56 patients (22 ITT, 34 other diagnoses). Median age of the population is 10 years. Age, sex, laboratory results, and follow-up change in lesion diameters do not show any significant difference between ITT and other diagnosis groups. Typical US appearance, fusiform lesion shape, and isovascular CDUS characteristics are higher in ITT group. The median value of the lesion’s highest diameter is smaller in ITT group. The most valuable criteria to predict ITT presence were the fusiform shape and the longest diameter of the lesion. Conclusions: Fusiform shape and a maximum diameter of ≤ 9 mm are the most selective criteria to predict ITT diagnosis.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2018Perfore apandisit: ultrasonografik bir tanısal zorluk
Aydin, Sonay; Fatihoglu, Erdem
AMAÇ: Perfore apandisit (PA) vakaları pediyatrik popülasyonda, özellikle 5 yaş altı çocuklarda daha sık görülmektedir. Perfore apandisit vakalarında klinik pek çok başka patoloji ile örtüşebildiğinden görüntüleme yöntemleri tanıda önem kazanmaktadır. Ne yazık ki, perforasyon sonucu apendiks dekomprese olduğundan, ultrason incelemesi ile perfore apandisiti tanımlamak güç olabilmektedir. Güncel çalışmada, perfore apandisit tanısı için en yararlı sonografik parametrelerin belirlenmesi hedeflenmiştir. GEREÇ VE YÖNTEM: Radyoloji bölümüne akut apandisit ön tanısı ile yönlendirilen çocukların medikal kayıtları geriye dönük olarak taranmıştır. Eritrosit sedimentasyon hızı (ESH), C reaktif protein (CRP) düzeyleri, lökosit sayımları kaydedilmiştir. Ayrıca sonografik paramatreler olarak; apendiks çevresinde lokule sıvı varlığı, apendikolit tespiti, kompleks serbest sıvı bulunması, periapendisyel yağ dokuda ekojenite artışı olması, abdominal reseslerde asit tespit edilmesi ve periportal ekojenite artışı olması belirlenmiştir. BULGULAR: Araştırma popülasyonu 132 hastadan oluşmaktadır. Apendiks çevresinde lokule koleksiyon tespit edilmesi, apendikolit varlığı, 3-4 abdominal reseste sıvı bulunması, tüm abdominal reseslerde sıvı bulunması, ESH, CRP değerlerinde artış olması parametreleri PA varlığını başarı ile öngörmektedir. Ayrıca, apendiks çevresinde lokule koleksiyon tespit edilmesi, tüm abdominal reseslerde sıvı bulunması ve CRP değerlerinde artış olması paramaterelerinin kombinasyonu (%98.2 spesifik, %48.3 sensitf), PA tanısında oldukça yararlı bulunmuştur. SONUÇ: Apendiks çevresinde lokule koleksiyon tespit edilmesi ve tüm abdominal reseslerde sıvı bulunması en değerli sonografik parametrelerdir. Bu parametrelere CRP değerinin de eklenmesi tanısal başarıyı arttırabilir. Anahtar kelimeler: Ultrason, perfore apandisit, tanı
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