Person: SARI, LÜTFULLAH
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Publication Metadata only Papillary Lesions of the Breast: Addition of DWI and TIRM Sequences to Routine Breast MRI Could Help in Differentiation Benign from Malignant(2022-01-01T00:00:00Z) GÜLTEKİN, MEHMET ALİ; ÇELİK YABUL, FATMA; OTÇU TEMUR, HAFİZE; SARI, LÜTFULLAH; YILMAZ, TEMEL FATİH; TOPRAK, HÜSEYİN; YILDIZ, ŞEYMA; GÜLTEKİN, MEHMET ALİ; ÇELİK YABUL, FATMA; OTÇU TEMUR, HAFİZE; SARI, LÜTFULLAH; YILMAZ, TEMEL FATİH; TOPRAK, HÜSEYİN; YILDIZ, ŞEYMAAim: We aimed to investigate the magnetic resonance imaging (MRI) features of benign, atypical, or malignant papillary breast lesions and to assess the additional value of diffusion-weighted imaging (DWI) and turbo inversion recovery magnitude (TIRM) sequences to routine breast MRI. Background: Differentiation between benign and malignant papillary breast lesions is essential for patient management. However, morphologic features and enhancement patterns of malignant papillary lesions may overlap with those of benign papilloma. Methods: Seventy-two papillary breast lesions (50 benign, 22 atypical or malignant) were included in the current study, retrospectively. We divided the patients into two groups: benign papillary breast lesions and atypical or malignant papillary breast lesions. Morphologic, dynamic, turbo inversion recovery magnitude (TIRM) values and diffusion features of the papillary lesions were compared between two groups. Results: Benign papillary lesions were smaller in size (p=0.006 and p=0.005, for radiologists 1 and 2 respectively), closer to the areola (p=0.045 and 0.049 for radiologist 1 and 2 respectively), and had higher ADC values (p=0.001 for two radiologists) than the atypical or malignant group. ROC curves showed diagnostic accuracy for ADC (AUC=0.770 and 0.762, p & lt; 0.0001 for two radiologists), and showed a cut-off value of <= 957 x 10-6 mm(2/s) (radiologist 1) and <= 910 x 10-6 mm(2/s) (radiologist 2). Conclusion: MRI is a useful method for differentiation between benign and malignant papillary breast lesions. Centrally located, lesser in size, and higher ADC values should be considered benign, whereas peripherally located, larger in size, and lower ADC values should be considered malignant.Publication Open Access Comparison of MRI Features of Invasive Pleomorphic and Classical Lobular Carcinoma: Differentiation Is Possible?(2022-01-01T00:00:00Z) YILMAZ, TEMEL FATİH; OTÇU TEMUR, HAFİZE; SARI, LÜTFULLAH; GÜCİN, ZÜHAL; GÜLTEKİN, MEHMET ALİ; ÇELİK YABUL, FATMA; TOPRAK, HÜSEYİN; YILDIZ, ŞEYMA; YILMAZ, TEMEL FATİH; OTÇU TEMUR, HAFİZE; SARI, LÜTFULLAH; GÜCİN, ZÜHAL; GÜLTEKİN, MEHMET ALİ; ÇELİK YABUL, FATMA; TOPRAK, HÜSEYİN; YILDIZ, ŞEYMATo evaluate breast MRI and DWI and demographic features of pleomorphic invasive lobular carcinoma (pILC) and classic invasive lobular carcinoma (cILC). Invasive lobular (ILC) is the second most common breast malignancy after invasive ductal carcinoma (IDC) and constitutes the 8-14% of all invasive breast cancers. ILC morphologically can be classified into the classic, alveolar, solid, tubulolobular, and pleomorphic subtypes according to WHO. This study was performed retrospectively. The MRI and demographic features of 18 patients with 23 pILC were compared with those 22 consecutive patients with 27 cILC. There was no significant difference in demographic features of patients, MR appearance, kinetics, and ADC values between two groups. pILC, an aggressive subtype of ILC, cannot be differentiated from cILC with breast MRI.Publication Metadata only MR Enterography Features of Jejunal Lipoma Causing Intussusception: A Unique Case Report(2020-05-13T04:00:00Z) KILINÇ, YAĞMUR BAŞAK; SARI, LÜTFULLAH; KARABULUT, ÜMMÜHAN EBRU; AYKAN, MAHMUT ESAT; TOPRAK, HÜSEYİN; KILINÇ, YAĞMUR BAŞAK; SARI, LÜTFULLAH; KARABULUT, ÜMMÜHAN EBRU; AYKAN, MAHMUT ESAT; TOPRAK, HÜSEYİNIntussusception usually occurs in children due to benign causes, whereas in adults, it is mostly caused by malign causes in the colon. On the other hand, the causes of small bowel intussusceptions in adulthood are usually benign, such as polyps, lipomas, adenomas, and Meckel-s diverticulum. Intestinal lipomas are an uncommon entity among benign tumors. Here, we present MR enterography features of jejunojejunal intussusception caused by an intramural lipoma.Publication Metadata only A Case of Neurosarcoidosis Mimicking Brain Tumor(2021-01-01T00:00:00Z) SARI, LÜTFULLAH; PEKER, ABDUSSELİM ADİL; ÇEŞME, DİLEK HACER; ALKAN, ALPAY; SARI, LÜTFULLAH; PEKER, ABDUSSELİM ADİL; ÇEŞME, DİLEK HACER; ALKAN, ALPAYBackground: Neurosarcoidosis manifests symptomatically in 5% of patients with sarcoidosis and diagnosis can be challenging if not clinically suspected. Cerebral mass-like presentation of neurosarcoidosis rarely reported in the literature. We presented a woman with neurosarcoidosis who had a cerebral mass-like lesion which completely disappeared after medical treatment.Publication Open Access Diffusion Tensor Imaging Features of the Auditory Pathways in Patients With Vestibular Schwannoma After Gamma Knife Radiosurgery(2021-03-01T00:00:00Z) ÇEŞME, DİLEK HACER; ALKAN, ALPAY; GÜLTEKİN, MEHMET ALİ; SARI, LÜTFULLAH; Alkan, Gokberk; KAYA, AHMET; MAYADAĞLI, Alpaslan; Akdur, Kerime; UYSAL, ÖMER; HATİBOĞLU, MUSTAFA AZİZ; ÇEŞME, DİLEK HACER; ALKAN, ALPAY; GÜLTEKİN, MEHMET ALİ; SARI, LÜTFULLAH; KAYA, AHMET; MAYADAĞLI, ALPASLAN; UYSAL, ÖMER; HATİBOĞLU, MUSTAFA AZİZObjective In this study, we aimed to investigate whether there is any change in diffusion tensor imaging (DTI) parameters in ipsilateral and contralateral auditory pathways after Gamma Knife radiosurgery (GKR) in patients with vestibular schwannoma (VS) and the relationship between radiosurgery variables. Methods Sixty-six patients were evaluated with MRI and DTI before and after GKR. The apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were measured from the bilateral lateral lemniscus (LL), inferior colliculus (IC), medial geniculate body (MGB), and Heschl's gyrus (HG). Results There was no significant difference in ADC and FA values obtained from bilateral LL, IC, and MGB before and after radiosurgery. However, there was a significant difference between pretreatment and post-radiosurgery contralateral HG ADC values. The ADC values obtained from the contralateral HG and IC positively correlated with the duration after radiosurgery. As the duration after radiosurgery increases, the difference between the ADC values obtained from ipsilateral and contralateral HG also increases. Conclusion The high ADC values in the contralateral HG after radiosurgery may indicate microstructural alterations such as demyelination and axonal loss. Radiation exposure doses to the brainstem and cochlea are the most important factors that can cause microstructural damage to the auditory pathways. When planning radiosurgery, extreme care should be taken to prevent the harmful effects of radiation on the auditory pathways.Publication Metadata only A Case of Intratumoral and Hepatic Portal Venous Gas in Patient with Gastric Cancer Liver Metastases(2022-01-01T00:00:00Z) KARABULUT, ÜMMÜHAN EBRU; GÜLTEKİN, MEHMET ALİ; SARI, LÜTFULLAH; KILINÇ, YAĞMUR BAŞAK; KARABULUT, ÜMMÜHAN EBRU; GÜLTEKİN, MEHMET ALİ; SARI, LÜTFULLAH; KILINÇ, YAĞMUR BAŞAKBackground: Hepatic portal venous gas [HPVG] is not a common finding in daily practice. It is usually associated with mesenteric ischemia and bowel necrosis in adults. Combination of intratumoral gas in metastatic liver lesions with HPVG is quite rare and thought to be associated with chemotherapy-induced necrosis and infection of the necrotized metastasis. Objective: Here we present a case of gastric adenocarcinoma with portal venous and intratumoral gas in metastatic liver lesions due to the infected necrosis. Case Presentation: The patient was presented to the emergency room with severe abdominal pain and septic condition after the second round of chemotherapy. Hepatic portal venous and intratumoral gas in metastatic liver lesions due to the infected necrosis of liver metastasis was detected in computed tomography images. There were no findings of mesenteric ischemia both clinically and radiologically. Massive intratumoral infected necrosis in metastatic liver lesions and fistulization to the right portal vein branches were detected on abdominopelvic CT. Secondary infection of the necrotic metastases and fistulization to portal vein branches was believed to cause the air in metastatic liver masses and portal venous gas. Conclusion: Infected necrosis of metastatic liver lesions and fistulizations to the portal venous structures is extremely rare. Clinicians and radiologists should be aware of such a rare complication because early detection is crucial for patient management.Publication Metadata only A Rare Complication of Umbilical Vein Catheterization: TPNoma: US, X-ray, and MRI Findings(2023-01-01) Sari L.; ORAN Z.; Ali Gültekin M.; Sharifov R.; TOPRAK H.; SARI, LÜTFULLAH; ORAN, ZEYNEP; SHARIFOV, RASUL; TOPRAK, HÜSEYİNBACKGROUND: Umbilical vein catheterization (UVC) is an early venous access route in newborns and is frequently used for delivering total parenteral nutrition (TPN) and medications. Vascular, hepatic parenchymal, and infectious complications of UVC can be seen rarely. OBJECTIVE: We present preterm neonates\" X-ray, US, and MRI findings with parenchymal TPN extravasation and portal vein thrombosis. Our case was the first case about MRI findings of TPNoma. CASE PRESENTATION: A 30 week female with a birth weight of 1340 g was born via Cesarean section. Due to the diagnosis of transient tachypnea of the newborn and prematurity, the infant was hospitalized in the neonatal intensive care unit. On the first day of hospitalization, UVC was inserted and TPN with 20% lipid content was started. After 10 days, UVC was removed and TPN treatment was continued with a piccline catheter. Abdominal US and portal venous Doppler examination was applied to the patient whose general condition deteriorated on the 12th day. US and Doppler revealed a lesion of 17x17x18mm in size with lobulated contour, hyperechoic heterogeneous internal structure, and no central or peripheral blood supply was observed in the left lobe of the liver. Moreover, a filling defect compatible with a thrombus was observed in the proximal part of the left portal vein. An abdominal MRI was performed to characterize this liver lesion. Axial T1 weighted and T2- weighted images showed a heterogeneous hyperintense lesion without contrast enhancement. Axial fat saturation T1-weighted and out of phase T1-weighted images showed a reduction in signal intensity. US and MRI examinations showed that the thrombosed umbilical vein ended superior to the lesion. In the differential diagnoses, fat-containing lesions such as lipoma-teratoma and fat-containing collection secondary to extravasation of TPN treatment via UVC were thought. CONCLUSION: In the differential diagnosis of liver localized lesions in newborns, UVC-related liver injury should be considered and the localization of the catheter tip should be checked. In case of the doubt based on US and X-ray findings, presence of fat on MRI could be diagnosed. Serious complications should be avoided with catheter revision or removal.Publication Metadata only A Case Series of Malign Hyperechoic Breast Lesions(2020-06-01T00:00:00Z) Toprak, Hüseyin; YILMAZ, TEMEL FATİH; SARI, LÜTFULLAH; TOPRAK, HÜSEYİN; YILDIZ, ŞEYMAPublication Metadata only Association of trochlear dysplasia with knee meniscal–cartilage damage and anterior cruciate ligament mucoid degeneration(2023-01-01) Atay M.; YILMAZ T. F.; Sarı L.; TOPRAK H.; YILMAZ, TEMEL FATİH; SARI, LÜTFULLAH; TOPRAK, HÜSEYİN© 2022 The Royal College of RadiologistsAIM: The purpose of this study was to evaluate meniscal and tibiofemoral cartilage injury in patients with trochlear dysplasia (TD) and investigate whether there were correlations between TD grade and meniscal and cartilage injury. In addition, the relationship between TD and mucoid degeneration of the anterior cruciate ligament (ACL-MD) was investigated. MATERİALS AND METHODS: Magnetic resonance imaging (MRI) examinations of 133 patients with TD were included in the study. TD was graded (types A, B, C, D). The tibial tuberosity (TT)–TG distance was also measured. The ACL was assessed for ACL-MD. Both menisci were evaluated for the degeneration and tears. Medial–lateral tibial plateau (MTP–LTP), medial–lateral femoral condyles (MFC–LFC), and trochlear cartilage were examined for focal cartilage defect (FCD). RESULTS: ACL-MD was present in 42 of the patients with TD (31.6%). There was a significant positive relationship between ACL-MD and TT–TG distance. Meniscal tear was detected in 40 (30.1%) of all patients. FCD were detected in the tibiofemoral compartments in 41 (30.8%) of 133 patients. There was a significant positive relationship between the presence of FCD in the LFC and the type of TD (p<0.01). FCD was present in the LFC of all cases in the type D. A significant positive relationship was found between the TT–TG distance and the presence of FCD, especially in the anterior part of LFC (p<0.01). There was a significant relationship between the lateral trochlear cartilage defect and the type of dysplasia (p=0.037). CONCLUSİON: TD is a significant risk factor for ACL-MD, meniscal, and tibiofemoral cartilage injury.Publication Metadata only Patellar height: an important parameter in knee MRI associated with tendinopathy, quadriceps fat pad edema (QFPE), anterior cruciate ligament mucoid degeneration (ACL-MD), and lateral cartilage damage(2024-01-01) Atay M.; TOPRAK H.; YILMAZ T. F.; Sari L.; Balsak S.; UÇAN V.; Mehdi E.; TOPRAK, HÜSEYİN; YILMAZ, TEMEL FATİH; SARI, LÜTFULLAH; BALSAK, SERDAR; UÇAN, VAHDETBackground: Some pathologies associated with abnormal patellar height have been reported in the literature. However, its relationship with some pathologies, such as anterior cruciate ligament mucoid degeneration (ACL-MD) and focal cartilage defect, has not been investigated. Purpose: To investigate the relationship between patellar height with patellar-quadriceps tendinopathy, quadriceps fat pad edema, ACL-MD, and focal cartilage defect. Material and Methods: Magnetic resonance imaging of the knees of 261 patients were classified into three groups as normal, patella alta, and patella baja, and evaluated in terms of patellar-quadriceps tendinopathy, quadriceps fat pad edema, ACL-MD, and focal cartilage defect. Results: There were 261 patients (140 men, 121 women; age range = 18–60 years; mean age = 30 ± 4.7 years). Of the 261 patients, 181 (69.3%) were normal, 56 (21.4%) were patella alta, and 24 were patella baja (9.1%). Patellar-quadriceps tendinopathy, quadriceps fat pad edema, and ACL-MD rates were significantly higher compared to the normal group (P <0.05). While a moderate positive correlation was found between patellar height shift and patellar-quadriceps tendinopathy and ACL-MD, there was a small correlation between patellar height shift and quadriceps fat pad edema. The rate of focal cartilage defect was significantly higher in the middle part of the lateral femoral condyle and lateral knee joint only in patella alta. Conclusion: The risk of patellar-quadriceps tendinopathy, quadriceps fat pad edema, ACL-MD, and lateral focal cartilage defect is higher in patients with alta-baja. The radiologist should evaluate these pathologies more carefully, especially subtle ones, in patients with abnormal patellar height.