Person: GÖKALP, GÖKHAN
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GÖKALP
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GÖKHAN
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Publication The association between the CT severity index and the pulmonary artery area in COVID-19 pneumonia(Sage Publications Ltd, 2022-01-24) Ongen, Gökhan; Gökalp, Gökhan; Nas, Ömer Fatih; Özpar, Rıfat; Candan, Selman; ÖNGEN, GÖKHAN; GÖKALP, GÖKHAN; NAS, ÖMER FATİH; ÖZPAR, RİFAT; Tıp Fakültesi; Radyoloji Ana Bilim Dalı; 0000-0001-6649-9287; FQR-8472-2022; GMO-0473-2022; AAG-8561-2021; AAH-5062-2021Background The pulmonary artery area (PAA) is a valuable non-invasive method for the diagnosis of pulmonary hypertension. Purpose To compare the change in PAA in patients with COVID-19 with the computed tomography (CT) severity index using follow-up imaging. Material and Methods A total of 81 patients who were followed up and underwent CT assessment more than once at our hospital's pandemic department were evaluated retrospectively. Patients with progression were separated into three groups: progression ranging from mild-to-mild infiltration (Group A, CT severity index of 0-2); progression from mild to severe infiltration (Group B, CT severity index of 0-2 to 3-5); and progression from severe-to-severe infiltration (Group C, CT severity index of 3-5). The PAAs were calculated separately. Results The mean age was 56 +/- 12 years. In terms of those patients showing progression in the CT images, the number of patients in Groups A, B, and C was 29, 40, and 12 in the right lung; 32, 45, and 4 in the left lung; 23, 45, and 13 on both lungs, respectively. There was no significant difference between the main, right, and left PAAs in Group A (P > 0.05). In Group B, there were significant increases in the areas of the main, right, and left PAAs (P < 0.05). There were also significant increases in the areas of the right and main pulmonary arteries in Group C (P < 0.05). Conclusion PAAs increase as disease involvement advances in cases with COVID-19 pneumonia, which is thought to be correlated with progression.Publication An assessment of slap type 5 lesions using proton density oblique sagittal imaging in magnetic resonance arthrography(Sage Publications, 2021-12-10) Öngen, Gökhan; Gökalp, Gökhan; Nas, Ömer Fatih; ÖNGEN, GÖKHAN; GÖKALP, GÖKHAN; NAS, ÖMER FATİH; Tıp Fakültesi; Radyoloji Ana Bilim Dalı; 0000-0002-3682-2474; FQR-8472-2022; GMO-0473-2022; AAG-8561-2021Background Bankart lesions accompany superior labrum anteroposterior (SLAP) lesions; these are called SLAP type 5. Purpose To compare SLAP type 5 lesions using routine magnetic resonance arthrography (MRA) and thin-slice oblique sagittal proton density (PDW) sequences and correlation operation results. Material and Methods In total, 181 patients were admitted with shoulder instability. The study was completed with 44 patients. The presence or absence of isolated Bankart and SLAP type 5 lesions in routine MRA and PDW oblique sagittal images were evaluated separately. Absence of rupture scored 0 points, suspected ruptures scored 1 point, and apparent ruptures scored 2 points. The two scores were compared with the shoulder arthroscopy findings. Results According to the findings in the shoulder arthroscopy, 40 patients had Bankart lesions and 17 patients had accompanying SLAP type 5 lesions. To detect a Bankart lesion, there was no significant difference between routine MRA sequences and PDW oblique sagittal images (P = 0.061). Routine MRA sensitivity was 95%, specificity 25%, positive predictive value (PPV) 92%, negative predictive value (NPV) 33%, while for PDW oblique sagittal images, sensitivity was 75%, specificity 100%, PPV 100%, and NPV 28.5%. In 8/17 type 5 SLAP lesions, routine MRA detected sensitivity 47%, specificity 92.6%, PPV 80%, and NPV 73.5%; in 14/17 SLAP type 5 lesions, PDW oblique sagittal images detected sensitivity 82%, specificity 100%, PPV 100%, and NPV 90% (P = 0.015). Conclusion The PDW oblique sagittal images may play a significant role in assessing the anterior and superior extent of the tears.Publication An association between femoral trochlear morphology and non-contact anterior cruciate ligament total rupture: A retrospective MRI study(Springer, 2021-01-06) Işıklar, Sefa; Özdemir, Senem Turan; Gökalp, Gökhan; IŞIKLAR, SEFA; Özdemir, Senem Turan; GÖKALP, GÖKHAN; Tıp Fakültesi; Anatomi Ana Bilim Dalı; 0000-0002-2070-5193; AAI-2336-2021; AAK-3779-2021; FPU-9468-2022Introduction The present study aims to investigate the association of the femoral trochlear morphology with the risk of ACL injury and whether this can be considered an additional risk factor in this clinical table.Materials and methods This is a retrospective case-control study with 93 patients, 41 patients with ACL total rupture (ACL-TR), and 52 patients without ACL injury who underwent knee magnetic resonance imaging (MRI) between January 2013 and January 2016. The femoral trochlear morphology was evaluated at the proximal and distal levels from the axial knee MRI. The morphological features of the trochlea using sulcus angle, sulcus depth, condylar heights, trochlear sulcus height, percentage of condyles and trochlear sulcus height to transepicondylar width, and lateral and medial trochlear inclination were evaluated. The notch width index was measured on the coronal MR images for notch stenos.Results ACL-TR group had a significantly higher sulcus angle (p = 0.00-0.001) and lower sulcus depth (p = 0.00-0.002) than the control group at both levels. Femoral trochlea had morphometric differences between genders. NWI was lower in the ACL-TR group than the control group (control 0.273; ACL-TR 0.247), and there was a statistically significant difference (p = 0.00).Conclusion This study was shown that the difference in morphology between the trochlear sulcus of patients with normal and ACL injuries should be taken into account in order to increase awareness of ACL injuries. We observed that mild trochlear dysplasia may cause intercondylar notch stenosis rather than changing the localization of the patella. Studies are needed regarding the effect of trochlear dysplasia on ACL.Publication Right- versus left-sided approach for transhepatic tunneled catheter placement: Is there a difference?(Springer, 2021-04-08) Nas, Ömer F.; Candan, Selman; Öztepe, Muhammed F.; Kandemirli, Sedat G.; Bilgin, Cem; İnecikli, Mehmet F.; Özkaya, Güven; Gökalp, Gökhan; Öngen, Gökhan; Erdoğan, Cüneyt; NAS, ÖMER FATİH; CANDAN, SELMAN; Öztepe, Muhammed F.; İNECİKLİ, MEHMET FATİH; ÖZKAYA, GÜVEN; GÖKALP, GÖKHAN; ÖNGEN, GÖKHAN; Tıp Fakültesi; Biyoistatistik Bilim Dalı; 0000-0003-0297-846X; 0000-0002-3682-2474; AAK-5124-2020; HHS-7433-2022; GVS-7682-2022; AAG-8561-2021; DLB-1623-2022; IVU-2672-2023; GMO-0473-2022; FQR-8472-2022Objective We aimed to compare the technical difficulties, complications, long-term efficacy, and risks between right- and left-sided approach transhepatic tunneled catheterization. Methods We retrospectively evaluated transhepatic tunneled catheter placement cases in our institution between May 2012 and November 2019. Demographic and procedural parameters were recorded. Statistical tests were used to compare the complication rates of right- and left-sided approach. Furthermore, Cox regression analyses were used to investigate the relationship between functional catheter days and included parameters. Results A total of 83 procedures were performed in 46 patients, with a female to male ratio of 1.88 and a mean age of 55.5 +/- 18.2 years. Indication for catheter placement was chronic renal insufficiency and loss of central venous access through traditional routes in all cases. Median functional catheter durations were 28 days (1-382) and 55.5 days (1-780) for right-sided and left-sided access, respectively. Complication rates were similar for both sides. There was no difference between primary and revision procedures in terms of safety and efficacy outcomes. In univariate Cox regression analysis, gender was the only variable which was found to be statistically significant (HR = 2.014 (1.004-4.038)) for functional catheter days. In multivariate Cox regression model, gender and access side were included which failed to reach statistical significance. Conclusions In our study, both right- and left-sided approaches provided similar safety and efficacy outcomes, suggesting that both techniques can be employed based on physician's preference.Publication Effect of needle-tract bleeding on pneumothorax and chest tube placement following CT guided core needle lung biopsy(Ubiquity Press, 2019-01-01) Soylu, Esra; Öztürk, Kerem; Gökalp, Gökhan; Topal, Uğur; Öztürk, Kerem; GÖKALP, GÖKHAN; Topal, Uğur; Tıp Fakültesi; Radyoloji Ana Bilim Dalı; 0000-0001-9664-2347; AAI-2336-2021; E-1228-2018; F-6421-2019Background: Bleeding in the biopsy tract has been studied for its ability to decrease the risk of pneumothorax with indefinite results in the previous studies.Purpose: To investigate the risk factors for needle-tract bleeding (NTB) and the possible effect of NTB on the pneumothorax and resultant chest tube placement after CT-guided cutting needle biopsy (CT-CNB) of pulmonary lesions.Methods: Predictive variables for NTB and the effect of NTB on the development of pneumothorax and consequent chest tube placement were retrospectively determined in 416 patients who had undergone an 18-gauge non-coaxial CT-CNB (338 men and 78 women; average age, 59.3 years). Patient-related parameters were age, gender, patient position, and severity of pulmonary emphysema. Lesion-related variables were size, localization, and contour characteristics of the lesion. Procedure-related variables were the presence of atelectasis, pleural tag, and fissure in the needle-tract, length of the aerated lung parenchyma crossed by needle, needle entry angle, number of pleural punctures, the experience of the operator, and procedure duration. All variables were analyzed by x(2) test and logistic regression analysis.Results: NTB was demonstrated in 142 of 421 (33.7%) procedures. The predictive variables of NTB were smaller lesion size (p = 0.011) and greater lesion depth (p = 0.002). In patients without emphysema around the lesion, the pneumothorax developed in 44/190 cases (23.1%) without NTB and in 12/95 procedures (12.6%) with NTB (p < 0.001).Conclusion: NTB may have a preventive effect on pneumothorax development, particularly in the absence of emphysema around the lesion.Publication Spontaneous occlusion of cerebral arteriovenous malformation following partial embolization with onyx(Sage Publications Inc, 2017-02-01) Nas, Ömer Fatih; Öztürk, Kerem; Gokalp, Gökhan; Hakyemez, Bahattin; NAS, ÖMER FATİH; Öztürk, Kerem; GÖKALP, GÖKHAN; HAKYEMEZ, BAHATTİN; Tıp Fakültesi; Radyoloji Ana Bilim Dalı; 0000-0001-9664-2347; AAI-2336-2021; E-1228-2018; AAI-2318-2021; AAG-8561-2021Management options for brain arteriovenous malformations (AVMs) are surgery, radiosurgery, and endovascular embolization. The aim of partial embolization in endovascular treatment is to make total resection possible. However, increased risk of bleeding in partial embolization creates some controversies about treatment options. Spontaneous total occlusion of cerebral AVMs following partial obliteration with embolization agents is a rarely seen condition. We present a case with an AVM vanishing from right posterior cerebral artery which spontaneously occluded following partial embolization with Onyx liquid agent.Publication Bronchial carcinoid tumors with massive osseous metaplasia: A case report and review of the literature(Türk Patoloji Derneği, 2020-05-01) Özşen, Mine; Yalçınkaya, Ulviye; Akyıldız, Elif Ülker; Bayram, Ahmet Sami; Gökalp, Gökhan; YALÇINKAYA, ÜLVİYE; AKYILDIZ, ELİF ÜLKER; BAYRAM, AHMET SAMİ; GÖKALP, GÖKHAN; Tıp Fakültesi; Cerrahi Patoloji Ana Bilim Dalı; 0000-0002-5771-7649; 0000-0003-0684-0900; JHY-9777-2023 ; AAI-2336-2021; ABB-7580-2020; AAH-8924-2021Bronchial carcinoid tumors are primary lung neoplasms thought to originate from neuroendocrine cells, i.e. Kulchitsky cells, in the bronchial mucosa, although the type of cellular origin has not been clearly understood. A 61-year-old male patient underwent surgery and microscopic examination of the specimen revealed an anastomosing trabecular bony structure among the nests of tumor cells with round nucleus, granular chromatin, and large eosinophilic cytoplasm. Our case has been deemed worthy of being presented as bronchial carcinoid tumor with exaggerated osseous metaplasia.Publication Robinow syndrome(Galenos Yayıncılık, 2010-04-01) Gökalp, Gökhan; Eren, Erdal; Yazıcı, Zeynep; Sağlam, Halil; GÖKALP, GÖKHAN; EREN, ERDAL; YAZICI, ZEYNEP; SAĞLAM, HALİL; Tıp Fakültesi; Radyoloji Ana Bilim Dalı; 0000-0002-1684-1053; 0000-0002-6598-8262; C-7392-2019; AAI-2303-2021; AAI-2336-2021; JPK-3909-2023Introduction: Robinow syndrome is characterized by dwarfism demonstrating short-limbed extremities, vertebral malsegmentation/malformation (hemivertebra), costal dysplasia, genital hypoplasia, and fetal facial appearance (wide and prominent forehead, hypertelorism, small and wide nose, molar hypoplasia, and retrognathia). It is a rare genetic disease which may present with either mild autosomal dominant form or severe recessive form. Vertebral and costal abnormalities are common diagnostic signs that may be severe. The disease presents with kyphoscoliosis and chest abnormalities along with thoracic vertebral fusion and hemivertebral appearance. Ribs may demonstrate fusion. Based on those involvements, the disease can be categorized as spondylothoracic, spondylocostal, ischiovertebral dysplasia, and cervicofaciothoracic syndrome. Diagnosis is established by the help of clinical characteristics. Radiography might contribute to the diagnosis by revealing changes in the skeletal system. Case Report: A three-year-old male patient presented with operated left undescendent testis and buried penis. On physical examination, he also had a dysmorphic face characterized by macrocephaly, hypertelorism, prominent eyes, a flattened nasal bridge, triangular-fish mouth, gingival hypertrophy and left hand clinodactyly. Radiographic examination documented mesomelic shortening of the radius-ulna, malsegmentation of the thoracal spine and the ribs fusion. Conclusion: Robinow syndrome is a rare syndrome which can be diagnosed by typical facial appearance and radiologic findings.Publication Redesign of missing mandible by determining age group and gender from morphometric features of skull for facial reconstruction (approximation)(Springer Heidelberg, 2021-05-01) Babacan, Serdar; Işıklar, Sefa; Kafa, İlker Mustafa; Gökalp, Gökhan; GÖKALP, GÖKHAN; KAFA, İLKER MUSTAFA; IŞIKLAR, SEFA; Sağlık Hizmetleri MYO; 0000-0002-7410-7738; 0000-0002-2070-5193; 0000-0001-8309-0934; AAK-3779-2021; AAG-7125-2021; GMO-0473-2022The identification of an unknown person by facial reconstruction, gender, and age determination is one of the duties of the forensic sciences. In some cases, the skull and mandible cannot be obtained together. In this case, facial reconstruction of the skull without a mandible becomes a serious problem. The aim of our study was to design the mandible suitable for the anatomic structure of the skull by first determining the age group and gender of the skull for skulls without mandible. Our study was carried out on 3D-CT images provided in Bursa Uludag University Radiology Department. Individuals were divided into five age groups considering tooth and bone development. Our study was conducted on 282 3D-BT images. Twenty-three variables on the mandible and 54 variables on the skull were examined. SPSS 20.0 was performed for the developing the regression formulas, discriminant function analysis, and descriptive and comparative statistics. Comparative and descriptive statistical findings between sexes and age groups are presented in tables. Discriminant function analyzes were performed for age group and gender determination. Regression formulas were developed for the redesign of the missing mandible suitable for the skull anatomy. We believe that our thesis will be useful for forensic scientists and anthropologists with the regression formulas that will design the mandible suitable for the anatomy of the skulls without the mandible and age group determination by discriminant analysis method with morphometric data.Publication Can the greater trochanter/femoral neck signal intensity ratio on coronal t1 weighted images of the hip differentiate normal-abnormal bone mineral density?(Springer London Ltd, 2023-07-19) KAYA, HASAN EMİN; AKAY, TAYFUN; Akay, Tayfun; Gökalp, Gökhan; GÖKALP, GÖKHAN; Tıp Fakültesi; Radyoloji Ana Bilim Dalı; 0000-0002-7411-4102; ABE-7366-2020A simple index calculated by dividing the greater trochanter signal intensity by that of the femoral neck on coronal T1-weighted magnetic resonance images of the hip may be useful as an opportunistic screening tool to differentiate normal vs. abnormal bone mineral density.PurposeThe aim of this study is to evaluate the efficacy of the greater trochanter/femoral neck (T/N) signal intensity (SI) ratio on T1 weighted images of the hip in differentiating patients with normal vs. abnormal bone mineral density (BMD) using hip dual-energy x-ray absorptiometry (DXA) as the reference.MethodsThree BMD groups according to the T score of the femoral neck (i.e., normal, osteopenia, and osteoporosis) were created, and 20 patients were included for each group. The T/N ratio was calculated by dividing the greater trochanter SI by that of the femoral neck on coronal T1-weighted images. Receiver-operator characteristic (ROC) analysis was performed to determine diagnostic efficacy.ResultsThe mean age was 59.2 & PLUSMN;9.4; there were 57 women and 3 men. The mean BMD was 0.67 & PLUSMN;0.14 g/cm(2). The mean T/N ratio for the normal, osteopenia, and osteoporosis groups were 1.37 (& PLUSMN;0.12), 1.19 (& PLUSMN;0.10), and 1.18 (& PLUSMN;0.13), respectively. When the osteopenia and osteoporosis groups were combined into one group, i.e., low BMD group, the mean T/N ratio was 1.18 (& PLUSMN;0.11), and it was significantly different from that of the normal BMD group (p<0.00001). In ROC analysis, the area under curve (AUC) for the T/N ratio in the diagnosis of low BMD was 0.870. An optimal cutoff value of 1.28 was found for the differentiation of normal vs. abnormal BMD with 80% sensitivity and 80% specificity.ConclusionsThe T/N ratio seems to be effective at differentiating patients with normal vs. abnormal BMD and may help triage patients for additional evaluation.