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Öğe Association of visceral and subcutaneous adiposity with tumor and histologic grade in breast cancer(2024) Atik, Irfan; Gul, Enes; Başpinar, Nisa; Koç, TülayAims: Obesity is a risk factor for breast cancer. This study aims to evaluate the relationship between abdominal fat tissue and the risk of breast cancer and the histological degree of cancer with the help of computed tomography (CT). Methods: This study is a retrospective, cross-sectional study. It consists of patients diagnosed with breast cancer and a control group. Abdominal fat tissue measurements were taken from the navel or 4th lumbar vertebra level using an abdominal CT workstation. Visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), fat ratio (FR), and waist circumference measurements were made. The relationship between the obtained measurements and breast cancer, histological grade, and hormone status was analyzed. Results: Forty-one breast cancer patients and forty-two individuals without known diseases were examined. VAT and SAT were found to be higher in patients with breast cancer and it was statistically significant (p<0.05). Estrogen and/or progesterone receptor-negative patients tended to have a higher VAT rate. An increase in VAT and FR in breast cancer patients was found to have a more significant effect in patients with negative hormone receptors than in positive ones (estrogen receptor r: 0.585 p<0.05, progesterone receptor r: 0.579, p<0.05). Conclusion: The relationship between breast cancer and abdominal adipose tissue has been demonstrated. In addition, a correlation was found between high VAT and FR and histological grade in patients with hormone receptor-negative.Öğe Canavan Disease as a Rare Cause of Leukodystrophy: MRI and MRS Findings(Turkish Neurological Soc, 2021) Atalar, Mehmet Haydar; Gul, Enes; Atik, Irfan; Yildiz, Ozlem Kayim[Abstract Not Available]Öğe Contribution of Lumbar Vertebral Magnetic Resonance Imaging to Diagnosis in Women with Osteoporosis(Galenos Publ House, 2022) Atik, Irfan; Atik, Seda; Gul, Enes; Bulut, SemaObjective: The aims of this study are to compare bone mineral densitometry and magnetic resonance imaging (MRI) findings in postmenopausal women diagnosed with osteoporosis and the investigation of the effectiveness of MRI in the diagnosis of osteoporosis. Materials and Methods: Forty female patients, 50 years of age or older who underwent lumbar MRI examination and were diagnosed with dual-energy X-ray absorptiometry (DEXA) osteoporosis were included in our study. Forty healthy women aged 20-29 years with lumbar MRI examinations were included in the control group. On sagittal T1-weighted (T1W) images of individuals in the patient and control groups signalto-noise ratio (SNR) was measured from L1-L4 vertebrae. To facilitate the diagnosis of osteoporosis, a quantitative score called the M-score was obtained using SNR values. The relationship between DEXA and the obtained SNR and M-score values were investigated. Results: In the patient group, median SNR values of L1, L2, L3, L4 vertebrae obtained from T1-weighted sequence was 57.49 (25.18-182.48), and they were 24.90 (7.40-41.70) in the control group. Receiver operating characteristics analysis was performed for L1, L2, L3, L4 vertebrae. The area under the curve for the mean value of L1-L4 vertebra was found to be 0.966 (p < 0.001), and the 95% confidence interval was found 0.933-1.000. The mean SNR predictive value of L1-L4 was calculated as 33.45, and sensitivity for this value was found to be 90%, and specificity was found to be 90%. There was a negative correlation between lumbar MRI SNR-DEXA (p > 0.05) and M score-DEXA (p > 0.05). Conclusion: It has been concluded that L1-L4 vertebral SNR measurement in T1-weighted sequence in lumbar MRI can be used to distinguish osteoporosis patients from normal individuals. Thus, osteoporosis can be diagnosed without X-ray exposure.Öğe Determination of the prevalence of complete type retrotransverse and arcuate foramen of the atlas using three-dimensional computed tomography images(Springer France, 2025) Cimen, Kaan; Gul, EnesPurpose To determine the prevalence of complete type retrotransverse (RTF) and arcuate foramen (AF)'s in a large cohort using three-dimensional (3D) computed images (CT) and explore their correlation with each other. MethodsBetween January 2023 and August 2024, all neck and cervical vertebrae CTs taken in our hospital were scanned retrospectively. It is noted the presence or absence of complete RTF and AF, laterality, gender, and age of those included in the study. Results A total of 2000 patients were included in the study, with an equal distribution of females and males. The prevalence of complete AF was 6.4%, 10%, and 16.3% bilaterally, unilaterally, and in total. The prevalence of complete AF was 12% in females and 20.6% in males. The gender prevalence differences of bilateral AF were statistically significant (p < 0.001). The prevalence of complete RTF was 1.8%, 8.9%, and 10.6% bilaterally, unilaterally, and in total. The prevalence of complete RTF was 9.7% in females, and 11.6% in males. The prevalence differences between genders were insignificant (p = 0.173). The ipsilateral prevalence of complete AF and RTF was 0.2%, 0.2%, and 0.4%, respectively, bilateral, unilateral right, and unilateral left. Conclusions The complete AF and RTF prevalences in the study group were not uncommon. The prevalence of complete AF and RTF together is quite rare. Complete RTF is more common in elderly patients and on the left side, while complete AF does not show any difference in laterality and age, and is more common in males than in females.Öğe Diagnostic value of Achilles tendon shear wave elastography in patients with ankylosing spondylitis: A case-control study(Wiley, 2024) Atik, Irfan; Atik, Seda; Gul, EnesObjectives: Ankylosing spondylitis (AS) can cause peripheral arthritis, tendinitis, enthesitis, and axial skeletal involvement. This study aims to determine early tendon damage by shear wave elastography (SWE) for the Achilles tendon in AS patients. Methods: 48 AS patients and 48 asymptomatic individuals were included in the study. Participants were systematically examined with B-mode, power Doppler, and SWE using a high-resolution linear 6-15 MHz probe. Bilateral Achilles tendon stiffness, thickness, and vascularity were evaluated. Measurements were taken from the middle third of the Achilles tendon in the sagittal plane. Difference between the two groups was evaluated with statistical methods. Receiver operating characteristic analysis was performed to test the diagnostic performance of Achilles tendon stiffness. Additionally, the Spearman correlation test examined the relationship between Achilles tendon stiffness and disease duration. Results: The difference between the two groups regarding Achilles tendon stiffness was statistically significant (p < 0.05). It was observed that Achilles tendon stiffness decreased in the patient group compared with the control group. The diagnostic value of Achilles tendon stiffness measured by SWE was found to be high. A negative correlation was detected between disease duration and tendon stiffness (p < 0.05). Conclusion: In patients diagnosed with AS, deterioration in the Achilles tendon structure was observed, and a significant decrease in tendon stiffness compared with the healthy population. It has been determined that these changes in the Achilles tendon are related to the duration of the disease.Öğe Does ponticulus posticus affect vertebral artery diameter(Springer France, 2024) Gul, Enes; Atik, IrfanPurpose Ponticulus Posticus, atlantooccipital ligament ossification-induced anomaly, surrounds the vertebral artery and the first cervical nerve root. It is believed to wrap around the first cervical nerve root and the vertebral artery, causing compression. We hypothesized that it would also reduce the diameter of the vertebral artery. Methods Between January 1, 2022, and December 31, 2022, cervical spine CT scans taken for any reason were retrospectively reviewed. The images of 1365 patients suitable for evaluation were evaluated by two expert radiologists in 3 dimensions. Among patients with PP, those who underwent cervical angiography were identified for vertebral artery diameter measurement. Results The average age of the 1365 individuals included in the study (732 males, 633 females) was 55.78 (+/- 18.85) with an age range of 1-96. Among this group, PP was detected in 288 individuals, resulting in a total prevalence of 21.1%. Right and left vertebral artery diameters were significantly lower in patients with complete PP compared to the absent group (p < 0,001, p < 0,001, respectively). Additionally, it was observed that width and height diameters and artery diameters were positively correlated in patients with Complete PP. Conclusions Ponticulus posticus can cause vertebrobasilar insufficiency by reducing the diameter of the vertebral artery. Therefore, imaging and detailed evaluation of this region are important in symptomatic patients.Öğe Effectiveness of shear wave elastography for assessing major salivary gland involvement in ankylosing spondylitis(Colegio Brasileiro de Radiologia, 2025) Atik, Irfan; Atik, Seda; Gul, EnesObjective: To use shear wave elastography (SWE) in the evaluation of salivary glands in patients with ankylosing spondylitis (AS) who present with sicca symptoms. Materials and Methods: This was a prospective controlled study of patients diagnosed with AS and exhibiting sicca symptoms (study group) and of healthy volunteers (control group). The levels of antinuclear, anti-Ro, and anti-La antibodies were determined in blood samples. In both groups, parotid and submandibular glands were evaluated by ultrasound and tissue stiffness was determined by SWE. Intraclass correlation coefficients were used in order to assess reliability. The differences between the two groups were assessed by statistical methods, and a ROC curve analysis was performed to determine the predictive values. Results: A total of 66 patients with AS and 71 healthy volunteers were included in the study. There were no significant differences between the groups in terms of age or sex (p > 0.05). The intra-and inter-rater reliability of SWE were good for the parotid gland (0.81–0.85 and 0.80, respectively) and for the submandibular gland (0.85–0.88 and 0.80, respectively). Statistically significant differences were found. Tissue stiffness in the parotid and submandibular glands, as determined by SWE, was significantly greater in the study group than in the control group (p < 0.05). Conclusion: Although there was no histopathological correlation in the parotid and submandibular salivary glands of patients with AS and sicca symptoms compared with the healthy volunteers, quantitative measurements showed greater tissue stiffness in the former group. In patients with AS, SWE guides salivary gland biopsy, which is the gold standard for diagnosing Sjögren’s syndrome. © Colégio Brasileiro de Radiologia e Diagnóstico por Imagem.Öğe Evaluation of Sarcopenia by Psoas Muscle Measurements in Osteoporotic Patients with Vertebral Compression Fracture(Coll Physicians & Surgeons Pakistan, 2024) Atik, Irfan; Gul, EnesObjective: To examine the effect of sarcopenia on osteoporotic vertebral compression fracture with psoas muscle measurements. Study Design: Cross-sectional study. Place and Duration of the Study: Department of Radiology, Sivas Cumhuriyet University, Sivas, Turkiye, from January 2020 to March 2023. Methodology: Measurements evaluating psoas muscle area (PMA), psoas muscle index (PMI), and psoas muscle density (PMD) were made at L2 vertebral corpus level for the diagnosis of sarcopenia from muscle mass with computed tomography (CT). The association between sarcopenia and osteoporotic compression fracture was examined with significance at p <0.05. Results: Osteoporotic patients with 37 compression fractures and 37 without compression fractures were examined. PMA and PMI were statistically significantly lower in the study group (p <0.01). PMD was also found to be statistically significantly lower in the study group (p <0.05). Diagnostic performance (DP) was good for the discrimination of patients and control groups for psoas area (AUC = 0.88; 95% confidence interval (CI) 0.807 - 0.956 and PMI (AUC = 0.83; 95% CI 0.734 - 0.917. It was poor for psoas density (AUC = 0.66, 95% CI 0.531 - 0.782). Conclusion: Sarcopenia is an important risk factor for osteoporotic compression fracture. Psoas measurements show a significant association with osteoporosis and vertebral fracture and can be easily determined on CT scan.Öğe Evaluation of Subclinical Atherosclerosis in Patients with Psoriatic Arthritis(2024) Atik, Irfan; Atik, Seda; Gul, EnesBackground/Aims: Psoriatic arthritis with peripheral and axial involvement; It is a heterogeneous disease that can cause enthesitis, dactylitis, and nail and skin involvement. The persistence of inflammation in psoriasis leads to comorbidities such as psoriatic arthritis, cardiovascular disease, and metabolic syndrome. Our study aimed to identify subclinical atherosclerosis in psoriatic arthritis patients without a known risk factor and to prevent possible morbidity and mortality in patients. Methods: Thirty-three patients with psoriatic arthritis and twenty-five healthy control groups were included in our study. Diabetes mellitus, hypertension, coronary artery disease, diagnosis of hyperlipidemia, body mass index above 30, and smoking were determined as exclusion criteria. The age, gender, duration of the disease, medical treatment used for the disease, high-density lipoprotein, low-density lipoprotein, triglyceride, and total cholesterol values, monocyte-lymphocyte ratio, carotid intima-media thickness measurement results obtained by carotid doppler ultrasonography imaging were recorded. Results: A comparison was made between the study and control groups in terms of age, triglyceride, high-density lipoprotein, low-density lipoprotein, and monocyte-lymphocyte ratio, and no statistically significant difference was observed. Monocyte and lymphocyte levels were significantly higher in the study group (p<0.05). Carotid intima-media thickness was statistically higher in the study group and this difference was statistically significant (p<0.05). Conclusions: Patients with psoriatic arthritis have an increased risk of atherosclerosis compared to the healthy population without any risk factors. This awareness will be useful in the follow-up of patients and in taking precautions against morbidities that may develop.Öğe Evaluation of the contralateral hemisphere with DWI in pediatric patients with Dyke-Davidoff-Masson syndrome(Springer Heidelberg, 2024) Gul, Enes; Atalar, Mehmet Haydar; Atik, IrfanIntroductionDyke-Davidoff-Masson Syndrome (DDMS) is a clinical syndrome that causes different clinical symptoms and is defined by volume decrement in one cerebral hemisphere. In this study, we aimed to evaluate the involvement of the normal-appearing contralateral hemisphere in 16 pediatric patients with DDMS using diffusion-weighted imaging (DWI).Materials and methodsBrain MRIs were retrospectively reviewed between January 2014 and January 2023. Sixteen pediatric patients radiologically compatible with DDMS were included in the study. Sixteen children who had undergone brain MRI, most commonly for headaches and whose MRI findings had been completely normal, were included as the control group. Apparent diffusion coefficient (ADC) values of the deep gray and white matter of the normal-appearing hemisphere in the patient group were calculated and compared with that of the control group.ResultsThe ADC values of the gray and white matters of the patient and control groups were not statistically different. However, in the patient group, the ADC values of the gray and white matters in males were remarkably lower than in females (p = 0.038, p = 0.037, respectively).ConclusionThe difference in the ADC values of the contralateral hemisphere between females and males in the patient group suggests that the normal-appearing hemisphere may have been affected by DDMS. Although, the exact mechanism of this effect is not known. Therefore, in patients with DDMS, contralateral hemisphere involvement in cerebral hemiatrophy and hemispherectomy should be evaluated clinically and radiologically.Öğe Evaluation of the relationship between Knee Osteoarthritis and Meniscus Pathologies(Malawi Medical Journal, 2024) Atik, Irfan; Gul, Enes; Atik, SedaBackground Knee osteoarthritis is a common, degenerative joint disease that causes chronic pain that affects daily life. Our study aims to evaluate geriatric patients aged 65 and over with knee pain in terms of osteoarthritis with radiography and magnetic resonance imaging and to investigate its relationship with meniscal pathologies. Methods Radiography and magnetic resonance imaging of patients aged 65-88 years with knee pain were evaluated in terms of knee osteoarthritis and staging was performed. Meniscal pathologies were evaluated in magnetic resonance imaging, and the prevalence of different meniscal lesion types was calculated. In addition, the relationship between knee osteoarthritis and meniscal pathologies was analyzed. Results Radiographic evidence of knee osteoarthritis was found in 182 (84.2%) of the 216 cases in our study group. A strong correlation was found between the degrees of knee osteoarthritis on magnetic resonance imaging and radiography. At least one meniscus pathology was observed in all 182 radiography cases with knee osteoarthritis findings. At least one meniscus pathology was observed in 29 (85.3%) of those without osteoarthritis signs. It was determined that meniscus degeneration, tear, and extrusion were observed more frequently in patients with knee osteoarthritis than in patients without osteoarthritis. Meniscal extrusion and complex and horizontal-type tears were the most common lesions. Conclusions Osteoarthritis was found to be common in geriatric patients with knee pain. A correlation was found between radiography and magnetic resonance imaging regarding knee osteoarthritis. It was observed that meniscal pathologies were detected more frequently in patients with knee osteoarthritis. © 2024 Kamuzu University of Health Sciences.Öğe Sonographic and magnetic resonance imaging findings in post-traumatic median nerve neuroma: A case report(Wiley, 2024) Atik, Irfan; Apalan, Deniz; Atik, Seda; Gul, EnesNerves are frequently damaged in cases of blunt or penetrating injuries to the limbs. Post-traumatic neuromas arising from peripheral nerves are formations that emerge after nerve injury, potentially leading to swollen and agonizing nerve terminations upon severance. Post-traumatic neuromas commonly appear as irregular, non-cancerous nodules formed due to injury-induced damage. The most common clinical symptom is neuralgic pain significantly the patient's quality of life. The main peripheral nerve abnormalities that lead to a referral for imaging are benign peripheral nerve tumors such as schwannoma, neurofibroma, and traumatic pathologies. This case report discusses a 35-year-old woman who presented with a neuroma in her wrist months after a laceration and trauma, with typical imaging findings on sonographic and magnetic resonance imaging.Öğe Subclinical atherosclerosis in fibromyalgia syndrome(Wiley, 2024) Gul, Enes; Yildiz, Bulent; Atik, Irfan; Sahin, OzlemIntroduction: Fibromyalgia syndrome (FMS) is a chronic disease of unknown pathophysiology in which inflammatory markers are not increased. The risk of cardiovascular disease is known to be raised in FMS. Determination of carotid intima-media thickness (CIMT) is essential for the early detection of cardiovascular disease risk. In this study, we aimed to investigate how FMS affects CIMT and its relationship with disease duration.Methods: This study was planned prospectively and included 20 female FMS patients and 20 healthy female controls. Detailed medical histories were obtained. Persons with a known chronic disease (diabetes mellitus, hypertension, thyroid function disorder, rheumatic disease, etc.), known atherosclerotic condition, body mass index >30 and smokers were excluded. Laboratory values of FMS patients and the control group in the last 3 months were recorded. The patients' and control groups' right and left common carotid arteries were imaged with ultrasonography.Results: There was no significant difference in laboratory values (although creatinine was different, it was within the normal range in both groups). The mean right common carotid artery intima-media thickness was 0.5 (+/- 0.07) mm in the patient group and 0.43 (+/- 0.05) mm in the control group (p = .005). The mean left common carotid artery intima-media thickness was 0.5 (+/- 0.06) mm in the patient group and 0.43 (+/- 0.05) mm in the control group (p = .001). Carotid intima-media thickness values were significantly higher in the patient group than in the control group.Conclusions: Although FMS is not an inflammatory disease, it causes endothelial dysfunction and atherosclerosis.Öğe Thorax CT Findings in Novel Coronavirus Disease 2019 (COVID-19)(Erciyes Univ Sch Medicine, 2021) Atalar, Mehmet; Caylak, Halil; Atasoy, Dilara; Cetinkaya, Nazim; Dogan, Omer Tamer; Gul, EnesNovel coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has high mortality rates. It has become a severe pandemic worldwide. Real-time PCR testing is still the gold standard test method for the definitive diagnosis of COVID-19 despite the possibility of false negatives. Radiological imaging methods, especially computed tomography (CT), are important assistant methods in the diagnosis and management of the disease. This review presents the role of CT in COVID-19 pneumonia, its diagnostic accuracy, thorax CT findings of the disease and differential diagnosis.
