Tasci, Filiz; Kaba, Esat; Ekersular, Mahmut Nedim; Alkan, Ahmet; Er, Huseyin; Hursoy, Nur

Aim: Idiopathic granulomatous mastitis (IGM) is a benign, chronic inflammatory disease of the breast, and its imaging findings may overlap with those of malignant non-mass enhancement (NME). This study aimed to investigate the performance of deep learning and machine learning models in differentiating IGM from malignant NME based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Methods: In this retrospective study conducted between January 2019 and March 2023, DCE-MRI findings of 30 patients with histopathologically confirmed IGM and of 33 patients with breast cancer presenting as NME were analyzed. The second dynamic phase of DCE-MRI (Dataset 1, 475 images) and the corresponding subtracted images (Dataset 2, 402 images) were used in this study. Datasets were sequentially split into 80% training and 20% testing sets to ensure a patient-level split. Image features were extracted using SqueezeNet and classified with a narrow neural network. Results: The mean age was significantly lower in the IGM group than in the NME group (41.3±11.3 vs. 52.2±11.4 years, p<0.001). For Dataset 1, the area under the curve was 0.997 in training and 0.870 in testing; for Dataset 2, the area under the curve was 0.998 in training and 0.807 in testing. Training accuracy was 0.984 (Dataset 1) and 0.978 (Dataset 2), whereas test accuracy was 0.811 (Dataset 1) and 0.704 (Dataset 2). Conclusion: The findings of this study suggest that deep learning shows significant promise for non-invasive differentiation of IGM from malignant NME on DCE-MRI, particularly in cases that are clinically indistinguishable.

Karatas, Beliz

Aim: Acute phase reactants may not always be positive in ankylosing spondylitis (AS). We herein aimed to investigate whether the neutrophil-to-albumin ratio (NAR) is useful in monitoring AS activity. Methods: One hundred nineteen patients who were followed up in the internal medicine rheumatology clinic between August 2024 and September 2024 and diagnosed with AS according to the axial spondyloarthropathy classification criteria of the Association for the Assessment of SpondyloArthritis international Society and the 1984 modified New York criteria were included in our study. The C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), NAR and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) status of the patients were recorded at two visits, before and 6 months following treatment. Results: A significant correlation was found between the initial NLR and the NLR values after 6 months, and between the initial and 6-month BASDAI values in both the CRP positive and CRP negative groups (p=0.000 and p=0.017). It was observed that the changes in individual NAR and NLR values and BASDAI values for each case were parallel (p=0.012). Conclusion: C-reactive protein values in AS are not always consistent with disease activity, but the NLR may be helpful in such cases. As for the NA ratio, we found that each patient should be evaluated individually.

Öztürk, Mustafa; Kalkan, Kamuran; İpek, Emrah; Hamur, Hikmet; Yildirim, Erkan; Cengiz, Mahir

Giriş: Miyokardial bridge (MB) genellikle asemptomatiktir ve iyi huylu olarak bilinir ancak egzersizin indüklediği ventriküler taşikardi, ani ölüm gibi ciddi klinik durumlara neden olabilir. Tp-e intervali elektrokardiyografide T dalgasının tepesi ile sonu arasındaki mesafedir. Tp-e/QT ve Tp-e/QTc oranları ventriküler aritmilerin elektrokardiyografik göstergesi olarak kullanılır. Biz MB'nin koroner anjiyografik özelliklerinin (MB'nin darlık derecesi ve uzunluğu) miyokardiyal repolarizasyon parametreleri üzerindeki etkisini araştırdık. Yöntemler: Bu çalışma izole MB'li 53 ve normal koroner artere sahip 58 hastadan oluşmaktadır.Bulgular:­QT intervali ve QTc gruplar arasında benzerdi, Tp-e intervali (92,72±14,72 ve 79,59±12;12, p <0,001), Tp-e/QT (0,24±0,041 ve 0,21±0,025; p <0,001) ve Tp-e/QTc (0,22±0,037 ve 0,19±0,025; p<0,001) kontrol grubu ile karşılaştırıldığında MB grubunda belirgin olarak artmış bulundu. Kritik ve kritik olmayan darlığı bulunan MB hastaları karşılaştırıldığında, Tp-e intervali (100,69±10,79; 80,57±11,25; p <0,001), Tp-e/QT (0,266±0,033; 0.219±0,037; p <0,001) ve Tp-e/QTc (0,244±0,029; 0,196±0,027; p <0,001) kritik darlığı olan MB hastalarında daha yüksekti.Sonuç: Sonuçlarımız MB hastalarında bu parametrelerin ventriküler aritmilerin pratik elektrokardiyografi belirteçleri olabileceğini göstermiştir.

Yıldırım, Erkan; İpek, Emrah; Kalkan, Kamuran; Öztürk, Mustafa; Cengiz, Mahir; Hamur, Hikmet

Aim: Myocardial bridge (MB) is generally known as an asymptomatic and benign anomaly, however, it can cause serious clinical conditions such as exercise-induced ventricular tachycardia and sudden death. Tp-e interval is the distance between the peak and the end of the T wave in electrocardiography. Tp-e/QT and Tp-e/QTc ratios are used as electrocardiographic indicators of ventricular arrhythmias. We have studied the effect of coronary angiographic features (the degree of stenosis and length of MB) of MB on myocardial repolarization parameters. Methods: The study group consisted of 53 patients with isolated MB and 58 patients with normal coronary arteries. Results: The QT interval and QTc were similar between the groups, however, Tp-e interval (92.72±14.72 and 79.59±12.12, respectively; p<0.001) and Tp-e/QT (0.24±0.041 and 0.21±0.025, respectively; p<0.001) and Tp-e/QTc (0.22±0.037 and 0.19±0.025, respectively; p<0.001) ratios were found to be significantly increased in MB group compared to the control group. In the comparison of the MB patients with critical and those with noncritical stenosis, Tp-e interval (100.69±10.79, 80.57±11.25, respectively; p<0.001) and Tp-e/QT (0.266±0.033, 0.219±0.037, respectively; p<0.001) and Tp-e/QTc (0.244±0.029, 0.196±0.027, respectively; p<0.001) ratios were higher in the MB with critical stenosis group. Conclusion: Our results indicate that these parameters can be practical ECG markers of ventricular arrhythmias in patients with MB.