Person: YILMAZ, TEMEL FATİH
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Publication Open Access Diagnostic performance of apparent diffusion coefficient values for the differentiation of intrahepatic cholangiocarcinoma from gastrointestinal adenocarcinoma liver metastases(2021-12-22T00:00:00Z) Yilmaz, TEMEL FATİH; Gultekin, Mehmet Ali; Turk, Hacı Mehmet; Cesme, Dilek Hacer; Besiroglu, Mehmet; Simsek, Melih; Toprak, Huseyin; Alkan, ALPAY; YILMAZ, TEMEL FATİH; TÜRK, HACI MEHMET; ÇEŞME, DİLEK HACER; ŞİMŞEK, MELİH; ALKAN, ALPAY; TOPRAK, HÜSEYİNBackground: We aimed to investigate whether there is a difference between intrahepatic cholangiocarcinoma (IHCC) and liver metastases of gastrointestinal system (GIS) adenocarcinoma in terms of apparent diffusion coefficient (ADC) values. Patients and methods: From January 2018 to January 2020, we retrospectively examined 64 consecutive patients with liver metastases due to gastrointestinal system adenocarcinomas and 13 consecutive IHCC in our hospital's medical records. After exclusions, fifty-three patients with 53 liver metastases and 10 IHCC were included in our study. We divided the patients into two groups as IHCC and liver metastases of GIS adenocarcinoma. For mean apparent diffusion coefficient (ADCmean) values, the region of interests (ROI) was placed in solid portions of the lesions. ADCmean values of groups were compared. Results: The mean age of IHCC group was 62.50 ± 13.49 and mean age of metastases group was 61.15 ± 9.18. ADCmean values were significantly higher in the IHCC group compared to the metastatic group (p < 0.001). ROC curves method showed high diagnostic accuracy (AUC = 0.879) with cut-off value of < 1178 x 10-6 mm2/s for ADCmean (Sensitivity = 90.57, Specificity = 70.0, positive predictive value [PPV] = 94.1, negative predictive value [NPV] = 58.3) in differentiating adenocarcinoma metastases from IHCC. Conclusions: The present study results suggest that ADC values have a potential role for differentiation between IHCC and GIS adenocarcinoma liver metastases which may be valuable for patient management.Publication Open Access Diffusion Tensor Imaging Can Discriminate the Primary Cell Type of Intracranial Metastases for Patients with Lung Cancer.(2021-03-04T00:00:00Z) Bilgin, Sabriye Sennur; Gultekin, Mehmet Ali; Yurtsever, Ismail; Yilmaz, Temel Fatih; Cesme, Dilek Hacer; Bilgin, Melike; Topcu, Atakan; Besiroglu, Mehmet; Turk, Haci Mehmet; Alkan, ALPAY; Bilgin, Mehmet; GÜLTEKİN, MEHMET ALİ; YURTSEVER, İSMAİL; YILMAZ, TEMEL FATİH; ÇEŞME, DİLEK HACER; TÜRK, HACI MEHMET; ALKAN, ALPAY; BİLGİN, MEHMETPurpose: Histopathological differentiation of primary lung cancer is clinically important. We aimed to investigate whether diffusion tensor imaging (DTI) parameters of metastatic brain lesions could predict the histopathological types of the primary lung cancer. Methods: In total, 53 patients with 98 solid metastatic brain lesions of lung cancer were included. Lung tumors were subgrouped as non-small cell carcinoma (NSCLC) (n = 34) and small cell carcinoma (SCLC) (n = 19). Apparent diffusion coefficient (ADC) and Fractional anisotropy (FA) values were calculated from solid enhanced part of the brain metastases. The association between FA and ADC values and histopathological subtype of the primary tumor was investigated. Results: The mean ADC and FA values obtained from the solid part of the brain metastases of SCLC were significantly lower than the NSCLC metastases (P < 0.001 and P = 0.003, respectively). ROC curve analysis showed diagnostic performance for mean ADC values (AUC=0.889, P = < 0.001) and FA values (AUC = 0.677, P = 0.002). Cut-off value of > 0.909 × 10-3 mm2/s for mean ADC (Sensitivity = 80.3, Specificity = 83.8, PPV = 89.1, NPV = 72.1) and > 0.139 for FA values (Sensitivity = 80.3, Specificity = 54.1, PPV = 74.2, NPV= 62.5) revealed in differentiating NSCLC from NSCLC. Conclusion: DTI parameters of brain metastasis can discriminate SCLC and NSCLC. ADC and FA values of metastatic brain lesions due to the lung cancer may be an important tool to differentiate histopathological subgroups. DTI may guide clinicians for the management of intracranial metastatic lesions of lung cancer.Publication Open Access Unusual sclerosing orbital pseudotumor infiltrating orbits and maxillofacial regions(2014-05-01) TOPRAK, HÜSEYİN; ARALAŞMAK, AYŞE; YILMAZ, TEMEL FATİH; ÖZDEMİR, HÜSEYİN; TOPRAK, HÜSEYİN; ARALAŞMAK, AYŞE; YILMAZ, TEMEL FATİH; ÖZDEMİR, HÜSEYINIdiopathic orbital pseudotumor (IOP) is a benign inflammatory condition of the orbit without identifiable local or systemic causes. Bilateral massive orbital involvement and extraorbital extension of the IOP is very rare. We present an unusual case of IOP with bilateral massive orbital infiltration extending into maxillofacial regions and discuss its distinctive magnetic resonance imaging (MRI) features that help to exclude other entities during differential diagnoses.Publication Open Access Pontine bleeding following drainage of subdural hematoma in craniospinal hypotension(2018-02-01) YILMAZ, TEMEL FATİH; ARALAŞMAK, AYŞE; TOPRAK, HÜSEYİN; Kocaman, Gulsen; ALKAN, ALPAY; YILMAZ, TEMEL FATİH; ARALAŞMAK, AYŞE; TOPRAK, HÜSEYİN; ALKAN, ALPAYObjective: Breast cancer (BC) is the most common female malignancy in the world and Turkey. Its prevalence and mortality are surprisingly increasing at a rapid rate. The objective of this study was to determine the effectiveness of training sessions on women's knowledge of relevant risk factors of BC and screening methods, screening behaviors and health beliefs among of healthy women in Turkey. Materials and methods: In this study, in order to establish the efficiency of BC training, a semi-empirical single group pre-test & post-test research model was used. The data were collected by using a self-administered questionnaire and by using the Turkish version of Champion's health belief model scale (CHBMS). The pre-test was performed before the training and after one week of the training, post-test was performed with a questionnaire having the same content. Results: In total, 244 women participated in the study. The average age of the women was 39.44 (SD=1.06) years. The mean total knowledge score increased significantly (p<.001) from 9.05 in the pre-test to 16.53 in the post-test. The results showed that both mean knowledge scores and CHBMS subscales scores of the women were increased significantly (p<.001) from the pre-test to the post-test. In multiple linear regression analysis, BC screening knowledge of women with susceptibility, benefit, self-efficacy and health motivation subscales of CHBMS, breast self-examination (BSE) practice and self-efficacy were also significant in the post-test; in the pre- and post-tests, a significant relationship among the level of education of women, susceptibility and seriousness was found (p<.001). Conclusion: The study showed that the training program had profound effects on BC knowledge, screening behaviors and health beliefs of women.Publication Open Access Traumatic rupture of solid pseudopapillary tumors of the pancreas in children: A case report.(2016-11-01) MIRAPOĞLU, SEMİH LÜTFİ; AYDOGDU, I; Gucin, ZÜHAL; UMUTOGLU, T; KILINCASLAN, H; MİRAPOĞLU, SEMİH LÜTFİ; AYDOĞDU, İBRAHİM; GÜCİN, ZÜHAL; YILMAZ, TEMEL FATİHSolid pseudopapillary tumor (SPT) of the pancreas is a pathological entity rarely encountered in children. Despite its malignant characteristics, SPT has a favorable clinical prognosis. This tumor is more frequently observed in females and is commonly localized in the tail and body of the pancreas. This is the case report of a 9-year-old female patient who presented with severe abdominal pain of sudden onset and vomiting following blunt abdominal trauma. Upon physical examination, abdominal distension, tenderness and abdominal guarding were detected. Abdominal magnetic resonance imaging revealed a mass sized 8×9×12 cm in the pancreas, with hemorrhagic-necrotic areas, and abundant intra-abdominal fluid. Intra-abdominal exploration confirmed the presence of an abundant amount of intraperitoneal hemorrhagic fluid. A mass was identified, originating from the body and the tail of the pancreas, adherent to the mesentery of the colon and the hilum of the spleen, which had ruptured in its inferolateral side. The tumor was extirpated together with the spleen and the involved parts of the pancreas. Histopathological examination demonstrated a solid pseudopapillary tumor of pancreatic origin. The patient's postoperative course was uneventful, clinically as well as metabolically.Publication 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 Open Access Radiological Appearences of Benign Soft-tissue Tumors of the Hand and Wrist with Special Emphasis on NRI(2022-04-01T00:00:00Z) YILMAZ, TEMEL FATİH; TOPRAK, HÜSEYİN; Atasoy, Bahar; SÖNMEZ, FATMA CAVİDE; ARALAŞMAK, Ayşe; GÜRKAN, Volkan; YILMAZ, TEMEL FATİH; TOPRAK, HÜSEYİN; ATASOY, BAHAR; SÖNMEZ, FATMA CAVİDE; ARALAŞMAK, AYŞE; GÜRKAN, VOLKANTumoral and pseudotumoral lesions of the hand and wrist are commonly encountered in routine clinical practice. Although most of them arc benign, radiological differential diagnosis of these lesions is difficult, because of their nonspecific imaging findings, except ganglia, localized type of tenosynovial giant cell tumors and lipomas. Digital radiography, computed tomography, and ultrasound may be useful in identification of the lesions in the wrist and hand, but magnetic resonance imaging with superior contrast and spatial resolution is the most important imaging modality.Publication Metadata only Advanced cerebrospinal fluid flow MRI findings of aqueductal stenosis caused by web(2023-01-01) YILMAZ T. F.; Sari L.; TOPRAK H.; YILMAZ, TEMEL FATİH; TOPRAK, HÜSEYİNBackground: The aqueductal web (AW) is one of the causes of aqueductus stenosis (AS). Recent advances in Magnetic resonance (MR) imaging have enabled us to better reveal the cerebrospinal fluid (CSF) flow dynamics and aqueductal anatomy. Purpose: The aim of this study is to evaluate the CSF flow dynamics of patients with AW with phase contrast Magnetic resonance imaging (MRI) and compare them with the imaging findings. Materials and Methods: We evaluated 23 patients under 65-year-old age. On constructive interference in steady-state (T2 CISS) images, the width of prepontine cistern (PPC) and the width of Sylvian aqueduct (SA) were measured. Localization and number of webs were evaluated. The existence of flow at the aqueduct and the presence of spontaneous third ventriculostomy (STV) were evaluated on sagittal Sampling Perfection with Application optimized Contrast (SPACE) sequences. Results: Of the 23 patients included in the study, 11 were male and 12 were female. The mean age was 34.02 (0.5–64). A total of 31 AWs were detected in 23 patients. Six of 23 patients (26.1%) had STV and 17 of those not. Four of 23 patients (17.4%) had aqueductal flow on SPACE sequences. The PPC distance was significantly wider in patients with STV (median: 6.7–4.5, interquartile range (IQR): 1.35, p = 0.004). In the cases where artifact secondary to flow is observed in SPACE sequences in aqueduct, the Evan index (EI) was significantly lower (median: 0.2955–0.3900, IQR: 0.03–0.14, p < 0.001). Conclusion: In patients with a low EI, there may be flow in the SA even if there is a web. In patients with a wide PPC distance, it is necessary to consider the presence of STV and evaluate the presence of flow with the SPACE sequences.Publication Metadata only Radiological evaluation of middle meningeal artery by 3D rotational angiography(2023-12-27) Sari L.; YILMAZ T. F.; Oz I. I.; YILMAZ, TEMEL FATİHPurpose: This study aimed to evaluate the topographic features and branches of the middle meningeal artery (MMA) by three-dimensional rotational angiography (3DRA) and describe its variations\" radiological classification based on previous clinical examples of cadaver studies and literature.Methods: We consecutively evaluated 87 cerebral hemispheres, including 32 females and 49 right sides between May 2020 and December 2021 who had undergone unilateral or bilateral cerebral and carotid artery 3D rotational angiography imaging by CCA injection and between 18 and 76-years-old. Maximum intensity projection images with 10-30 mm slice thickness were used for the morphological evaluations and measurements of MMA and its foramen, canal, and branches.Results: The diameters of the common carotid artery, internal carotid artery, and external carotid artery were significantly smaller in females than in men (p = 0.021, 0.021, and <0.001, respectively). According to the branching pattern, the most common pattern of the MMA was Type Ia (49.4%). The ophthalmic artery completely originated from MMA in the 1 (1.1%) cerebral hemisphere. The MMA arises from the ophthalmic artery in 2 cerebral hemispheres (2.3%), and the ophthalmic artery and maxillary artery in 2 cerebral hemispheres (2.3%).Conclusion: It was observed that the branching pattern may show differences when compared to the cadaver studies with a radiologic evaluation with 3D-RA.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.