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BİLGİN, CEM

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BİLGİN

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CEM

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2018 - 201942020 - 20215
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    Diagnostic utility of superb microvascular imaging in depiction of corkscrew collaterals in Buerger's disease
    (Wiley, 2020-05-27) Nas, Ömer Fatih; Kandemirli, Sedat Giray; Erdemli Gürsel, Başak; Bilgin, Cem; Korkmaz, Barış; Yolgösteren, Atıf; İnecikli, Mehmet Fatih; NAS, ÖMER FATİH; Kandemirli, Sedat Giray; ERDEMLİ GÜRSEL, BAŞAK; BİLGİN, CEM; KORKMAZ, BARIŞ; YOLGÖSTEREN, ATIF; İNECİKLİ, MEHMET FATİH; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kalp ve Damar Cerrahisi Anabilim Dalı.; 0000-0002-4467-3915; AAG-2372-2021; HHS-7433-2022; AAK-5124-2020; AAG-8561-2021; AAH-6568-2021; A-1409-2017; FHT-9776-2022
    Purpose To evaluate the corkscrew collaterals in Buerger's disease by superb microvascular imaging (SMI) and power Doppler ultrasonography (PDU). Methods We evaluated with SMI and PDU 14 patients with Buerger's disease in whom corkscrew collaterals had been identified on digital subtraction angiography (DSA). Corkscrew collaterals were classified on DSA and PDU based on their size and morphology. Results A total of 17 vascular regions of collateral vessel formation were assessed. Based on DSA classification, there were three cases of type I collaterals (arterial diameter of >2 mm with large helical pattern), seven cases of type III collaterals (arterial diameter of 1-1.5 mm with small helical pattern), and seven cases of type IV collaterals (arterial diameter of <1 mm with tiny helical pattern). On PDU, all type I collaterals on DSA appeared as "large snake" images, all type III collaterals on DSA appeared as "small snake" images, and all type IV collaterals on DSA appeared as dots. SMI imaging, both in color and monochrome mode, provided superior demonstration of the continuity of the vessel of large or small "snake" images. In cases appearing as dot pattern on PDU, color SMI was able to show continuity of the flow signal as a helical pattern. Discussion SMI is a promising new Doppler imaging technique that is superior to conventional power Doppler imaging in depiction and identification of corkscrew collaterals in Buerger's disease.
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    Understanding the effect of effective metal surface area of flow diverter stent's on the patient-specific intracranial aneurysm numerical model using lagrangian coherent structures
    (Elsevier, 2020-10-01) Mutlu, Onur; Olcay, Ali Bahadır; Bilgin, Cem; Hakyemez, Bahattin; BİLGİN, CEM; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı; 0000-0002-3425-0740; AAI-2318-2021; HHS-7433-2022
    The effective metal surface area (EMSA) of flow diversions plays an essential role in the occlusion mechanism inside the aneurysm since the value of EMSA determines the amount of blood flow into the aneurysm sac. In the present study, three different models of a flow diverter stent, namely FRED 4017, FRED 4038, and FRED 4539, were virtually placed at the aneurysm neck of a 52-years-old female patient to identify the effect of EMSA on stagnation region formation inside the aneurysm sac. Lagrangian coherent structures (LCSs), hyperbolic time, and particle tracking analysis were employed to the velocity vectors obtained from computational fluid dynamics (CFD). It is noticed that use of FRED 4017 stent with 0.42 EMSA value caused nearly 40% of the weightless blood flow particles (more than FRED 4038 and FRED 4539) to stay inside the aneurysm while only 0.35% of the blood flow was remaining inside the aneurysm sac when no stent was placed into the aneurysm site. Furthermore, hyperbolic time computations illustrated the formation of stagnation fluid flow zones that can be associated with the residence time of the blood flow particles. Lastly, the results of hyperbolic time analysis are in good agreement with digital subtraction angiography (DSA) images taken in the clinic a few minutes after a FRED 4017 implantation. (C) 2020 Elsevier Ltd. All rights reserved.
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    Neuroimaging of first seizure in the adult emergency patients
    (Springer Heidelberg, 2020-08-01) Öztürk, Kerem; Soylu, Esra; Bilgin, Cem; Hakyemez, Bahattin; Parlak, Müfit; Öztürk, Kerem; BİLGİN, CEM; HAKYEMEZ, BAHATTİN; PARLAK, MÜFİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-9664-2347; 0000-0002-3425-0740; HHS-7433-2022; E-1228-2018; AAI-2318-2021; AAG-8521-2021
    The aim is to establish the role of head computed tomography (CT) and magnetic resonance imaging (MRI) in adults presenting to the emergency department (ED) with first-time seizure (FS) and to analyze the potential predictor variables for the adverse imaging outcome. We retrospectively reviewed the medical records of all adults who underwent cranial CT or MRI between January 1, 2011, and December 1, 2016, to an academic ED for FS. Patients were excluded if were under 18 years of age, had known recent intracranial pathology, known brain tumor or having a history of trauma. Important predictive variables to indicate pathology in either CT or MR scan in patients with FS were evaluated with logistic regression analysis. A total of 546 FS (293 men and 253 women; range, 18-81 years; mean, 47 years) were identified in patients receiving either cranial CT or MR scan. Of them, abnormal findings were observed in 22/451 (4.8%) patients on CT and 18/95 (18.9%) patients on MRI. Predictor variables of age greater than 50 years, focal neurologic deficit, hypoglycemia, and history of malignancy were identified on CT, whereas a history of malignancy, age greater than 50 years and focal neurological deficit were determined on MRI. Limiting neuroimaging to this population would potentially reduce head CT scans by 67% and would potentially reduce head MRI scans by 47%. Clinical suspicion should be heightened and the neuroimaging should be considered for advanced age, history of malignancy, hypoglycemia or focal neurological deficits in patients with FS.
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    Post-traumatic occipital intradiploic encephalocele
    (Elsevier Science, 2019-05-22) Kandemirli, Sedat Giray; Candan, Selman; Bilgin, Cem; Kandemirli, Sedat Giray; CANDAN, SELMAN; BİLGİN, CEM; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3976-4062; HHS-7433-2022; GVS-7682-2022; A-1409-2017
    BACKGROUND: Brain parenchyma herniation through a disrupted inner table into an enlarged diploic cavity with an intact outer table is described as intradiploic encephalocele. Intradiploic encephaloceles share common morphologic characteristics with expanding skull fractures and intradiploic arachnoid cysts. Herein, we describe a case of traumatic occipital intradiploic encephalocele.CASE DESCRIPTION: Cranial computed tomography of an 11-year-old boy revealed erosion of the inner table of the left side of occipital bone and expansion of the cranial diploe by a soft-tissue density with a gyral pattern. His medical history was positive for head trauma at the age of 3 years to the same region. Magnetic resonance imaging showed herniation of left occipital parenchyma with cystic encephalomalacic changes into the diploe.CONCLUSIONS: Intradiploic encephaloceles have different features compared with the classic encephalocele and can be considered as a variant of expanding skull fracture and intradiploic arachnoid cyst.
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    Demonstration of cephaloceles in patients with rhinorrhea: Single centre experience of intrathecal gadolinium enhanced MR cisternography
    (Briefland, 2020-01-01) Cebeci, Hakan; Bilgin, Cem; Candan, Selman; Yılmazlar, Selçuk; Hakyemez, Bahattin; BİLGİN, CEM; CANDAN, SELMAN; YILMAZLAR, SELÇUK; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; HHS-7433-2022; AAH-5070-2021; AAI-2318-2021; GVS-7682-2022
    Background: MR cisternography has the crucial role for diagnosis of cerebrospinal fluid (CSF) leakage in patients with rhinorrhea and otorrhea. Trauma is the major cause of rhinorrhea. Cephalocele is diagnosed in some rhinorrhea patients.Objectives: To evaluate the CSF leakage in patients with rhinorrhea and assess the frequency of cephalocele in the etiology of rhinorrhea.Patients and Methods: Intrathecal gadolinium enhanced MR cisternography and nonenhanced CT of paranasal sinus images of patients with suspected CSF rhinorrhea between October 2012 and September 2018 were evaluated retrospectively. Twenty-one patients with the diagnosis of contrast leakage causing rhinorrhea were included in the study. All patients had intrathecal gadolinium enhanced MR cisternography. Three dimensional (3D)-T1 weighted and 3D-fluid attenuated inversion recovery (FLAIR) head MRI was obtained after administration of 1 ml intrathecal gadoterate meglumine after half, 3, and 8 hours. Locations of contrast leakage and etiologies were analyzed.Results: Patient group consisted of 21 patients with persistent or intermittent rhinorrhea. CT imaging showed bone defect in all patients. Intrathecal gadolinium enhanced MR cisternography revealed CSF leakage (10 ethmoid, 10 sphenoid, and 1 frontal). Cephalocele was detected in 10 of 21 patients.Conclusion: MR cisternography with intrathecal gadolinium enhancement is an effective and safe imaging modality compared to other techniques used for diagnosis of CSF leakage. Accurate localization of CSF fistula and demonstration of herniating content from cranial bone defect is feasible with this technique.
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    Superb microvascular imaging in assessment of synovitis and tenosynovitis in juvenile idiopathic arthritis
    (Lippincott Williams & Wilkins, 2021-03-01) Kandemirli, Sedat Giray; Çicek, Fatih; Erdemli Gürsel, Başak; Bilgin, Cem; Kiliç, Sara Sebnem; Yazıcı, Zeynep; Çicek, Fatih; ÇİÇEK, FATİH; Erdemli Gürsel, Başak; ERDEMLİ GÜRSEL, BAŞAK; Bilgin, Cem; BİLGİN, CEM; Kiliç, Sara Sebnem; KILIÇ GÜLTEKİN, SARA ŞEBNEM; Yazıcı, Zeynep; YAZICI, ZEYNEP; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-7348-7081; 0000-0001-8571-2581; AAH-1658-2021; HHS-7433-2022; JKI-5906-2023; AAH-6568-2021
    The aim of this study is to evaluate the diagnostic utility of superb microvascular imaging (SMI) in assessment of synovitis/tenosynovitis in juvenile idiopathic arthritis in comparison to power Doppler ultrasound. Thirty juvenile idiopathic arthritis cases with active clinical findings and ultrasound features of effusion and/or tenosynovitis were further imaged with power Doppler and SMI. For classification of synovial inflammation, a semiquantitative scale (4 points) adopted by Outcome Measures in Rheumatology was used.A total of 35 knee, 2 hip, 2 ankle, 2 wrist, 2 elbow joints, and 6 flexor hallucis longus/tibialis posterior tenosynovitis were assessed. In knee joint, power Doppler and SMI scales were the same for 23 (65.7%) joints, SMI upgraded scale from 0 to 2 in single joint (2.9%); 1 to 2 (14.3%) in 5 joints; and 2 to 3 (17.1%) in 6 joints. For other joints, power Doppler and SMI scales were the same for 5 (62.5%) joints. Superb microvascular imaging upgraded scale from 1 to 2 (25%) in 2 joints and 1 to 3 (12.5%) in a single joint. For flexor hallucis longus/tibialis posterior tenosynovitis, power Doppler and SMI scales were the same for two cases (33.3%). Superb microvascular imaging upgraded scale from 0 to 2 in two cases (33.3%); and 2 to 3 (33.3%) in 2 cases. There was no case of SMI scale downgraded compared with power Doppler scale.Superb microvascular imaging is a feasible technique in the assessment of synovial inflammation and tenosynovitis in juvenile idiopathic arthritis. Superb microvascular imaging has higher sensitivity compared with power Doppler ultrasound in depiction of increased vascularity.
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    Numerical study of a simplified cerebral aneurysm using a two different flow diverter stent modeling
    (Ieee, 2019-01-01) Tercanlı, Muhammed Furkan; Mutlu, Onur; Olcay, Ali Bahadır; Bilgin, Cem; Hakyemez, Bahattin; BİLGİN, CEM; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3425-0740 ; HHS-7433-2022; AAI-2318-2021
    The effectiveness of clinical treatments in-stent modeling have been recently started to be analyzed using Computational Fluid Dynamics (CFD) technique. Particularly, variation of pressure loss with flow velocity is used to evaluate permeability and internal resistance coefficients of the flow diverter stents to describe the stent properties to CFD model. The velocity profile is described as pulsatile parabolic at the inlet, the pressure is described at the outlet to be 93 mmHg as a mean arterial pressure (MAP) in the present study. The results implied that there was no significant difference found between porous media and stent implantation of a flow diverter stent modelings based on the studied cases. However, fluid flow simulations indicated that use of 48 wires stent allows more blood flow passing into the aneurysm sac compared to the 72 and 96 wires stents for the studied geometry. Effect of pressure change in the vessel and shape factor of the artery was neglected.
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    Diffuse large B-cell lymphoma presenting with masses in the pineal and adrenal glands
    (Wiley, 2019-03-01) Bilgin, Cem; Korkmaz, Barış; Soylu, Esra; Öztürk, Hulya; Öztürk, Kerem; BİLGİN, CEM; KORKMAZ, BARIŞ; Soylu, Esra; ÖZTÜRK NAZLIOĞLU, HÜLYA; Öztürk, Kerem; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0001-9664-2347; HHS-7433-2022; E-1228-2018; FHT-9776-2022; DSW-1175-2022; IXQ-3375-2023
    Key Clinical Message Magnetic resonance imaging (MRI) may offer several potential advantages in the evaluation of lymphoma with the additive value of H-1-MRS for differential diagnosis. Even though lymphoma has unique imaging findings on CT and multiparametric MRI, definite diagnosis must be thoroughly established by histopathological examination.
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    Predictor variables of abnormal imaging findings of syncope in the emergency department
    (Springer London Ltd, 2018-03-12) Soylu, Esra; Öztürk, Kerem; Bilgin, Cem; BİLGİN, CEM; Hakyemez, Bahattin; HAKYEMEZ, BAHATTİN; Parlak, Mufit; PARLAK, MÜFİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-9664-2347; AAI-2318-2021; AAG-8521-2021; E-1228-2018; HHS-7433-2022
    Background: This study aimed to describe the pathological findings and to analyze clinical predictors of abnormal imaging findings in patients presenting to the emergency department (ED) with syncope.Methods: The database was retrospectively reviewed for all patients who underwent cranial computed tomography (CT) or magnetic resonance imaging (MRI), having the symptom of syncope. Patients were included only if they were from the emergency department and excluded if were under 18 years of age, had known recent intracranial pathology, known brain tumor, or having a history of trauma. The primary outcome was assumed as abnormal head CT or MRI including intracranial hemorrhage, acute or subacute stroke, and newly diagnosed brain mass. Univariate and multivariate logistic regression analysis was utilized to determine the association between clinical variables and any significant pathology in either CT or MR scan.Results: Total of 1230 syncope (717 men and 513 women; range, 18-92 years; mean, 54.5 years) as presenting symptoms were identified in patients receiving either cranial CT or MR scan in the ED. Abnormal findings related to the syncope were observed in 47 (3.8%) patients. The following predictor variables were found to be significantly correlated with acutely abnormal head CT and MRI: a focal neurologic deficit, history of malignancy, hypertension, and age greater than 60 years.Conclusions: Our data offer that the identification of predictor variables has a potential to decrease the routine use of head CT and MRI in patients admitting to the ED with syncope.