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Öğe Computed tomography analysis of the infraorbital canal and adjacent anatomical structures(Wiley, 2024) Karatag, Ozan; Guclu, Oguz; Ozer, Sule; Oztoprak, Bilge; Resorlu, Mustafa; Oztoprak, IbrahimThis study aimed to investigate the incidence of infraorbital canal (IOC) protrusion into the maxillary sinus via computed tomography (CT) and classify its variations. Additionally, it sought to identify nearby sinonasal variations that might elevate the risk of iatrogenic injury. Paranasal sinus CT of 500 patients was evaluated retrospectively. The IOC types were categorized. The length of the IOC, septum, the distance between the maxillary ostium and IOC (dOI), the presence of Haller cells, IOC-related intra-sinus opacity, and IOC dehiscence were investigated. The prevalence of type 3 IOC was 12%, of which 9.2% were type 3c. The maximum length of the IOC was positively correlated with type 3 IOC. A significant difference was found between IOC types in terms of dOI only on the left side. On both sides, the incidence of Haller cells was greater in patients with type 2 IOC than in those with type 1 and in patients with type 3 IOC than in those with type 2. IOC-related opacity and IOC dehiscence were more common in types 2 and 3 IOCs. The assessment of preoperative IOC types and neighboring anatomical structures by CT imaging is of great significance in preventing iatrogenic damage. This study aimed to investigate the incidence of infraorbital canal (IOC) types and sinonasal variations via computed tomography. The length of the IOC, septum, the distance between the maxillary ostium and IOC (dOI), presence of Haller cells, IOC-related intra-sinus opacity, and IOC dehiscence were also investigated. The CT assessment of preoperative IOC types and neighboring anatomical structures is of great significance in preventing iatrogenic damage.imageÖğe Evaluation of Thalamus Volumes in Patients with Diabetic Polyneuropathy Using Magnetic Resonance Imaging Method(2022) Öztürk, Ayşegül; Sabanciogullari, Vedat; Taştemur, Yaşar; Oztoprak, IbrahimThe neurological process in diabetes is not limited to peripheral nerves but also affects the central nervous system (CNS). In addition, magnetic resonance images (MRI) showing that this condition can occur early in the neuropathic process are also available. This study was conducted to investigate whether peripheral sensory nerve dysfunction causes changes in thalamus volume in patients with diabetic polyneuropathy (DPNP) who experience sensory loss. Our study is a retrospective study consisting of diabetes mellitus (DM), DPNP and a healthy control group, where brain MRI of 204 individuals aged between 20-90 with no neurological disorder that might affect thalamus. Morphometric measurements for thalamus and cerebrum volumetry were performed in conventional MRI. In order to measure the microstructural changes of thalamus, the apparent diffusion coefficient (ADC) was calculated by the diffusion-weighted imaging method. In conclusion of our measurements, it was found that individuals with DM and DPNP had a decrease in volume of both thalami(p<0.05) and cerebrum(p<0.05). However, no significant difference was found in ADC values(p>0.05). According to the results of research, DM and DPNP affect not only the peripheral nervous system but also the CNS. This effect caused atrophy of thalamus and cerebrum in patients of all age groups.Öğe Pseudosubarachnoid Hemorrhage on MRI: A Potential Pitfall(Emergency Medicine Physicians Assoc Turkey, 2022) Karatag, Ozan; Kilinc, Ali; Gultac, Bilge; Oztoprak, IbrahimFluid attenuated inversion recovery (FLAIR) is one of the most effective magnetic resonance imaging (MRI) sequences in the diagnosis of subarachnoid hemorrhage (SAH). However, sometimes false positive or false negative results can occur. One of the reasons that can lead to erroneous interpretation is artifacts. Especially when metallic artifact occurs, hyperintensity may be observed in the subarachnoid space, similar to SAH. Although FLAIR hyperintensities in the sulci can be detected in many serious diseases, they are not always pathological. Artifact related hyperintensities, especially in cases with severe headache, may be mistakenly evaluated as SAH by a clinician or radiologist who is not well-experienced in MRI. However, it is extremely important to recognise these artifact related hyperintensities, to make a correct diagnosis and to prevent unnecessary interventions. In order to achieve this, the evaluation of all radiological images, especially SWI and GRE, is critical. Both radiologists and clinicians evaluating neuroradiological examinations should be knowledgeable about this subject and show maximum attention. In this report, we present the radiological images of 4 cases of pseudosubarachnoid hemorrhage, one of which was caused by conductive EEG gel and the other three due to braces artifacts, who were admitted to the hospital with headache.Öğe The Quantitative Evaluation of the Density of the Segmental Branches of the MCA in Acute Ischemic Stroke Patients(Rambam Health Care Campus, 2020) Demirtas, Erdal; Oztoprak, IbrahimAim: The aim of this study was to assess the density of the segmental branches of the middle cerebral artery (MCA) quantitatively as a predictor of acute ischemic stroke in patients without definitive infarct findings at cerebral parenchyma by non-contrast computed tomography (CT). Clinical rationale for the study: The clinical rationale for the study is to evaluate if the measurement of Sylvian fissure dot sign (SDS) would help early management of patients with stroke at the emergency department. Methods: Computed tomography scans of 101 patients admitted to the emergency department with stroke symptoms and/or signs were included in the study, retrospectively. In the patient group, the quantitative density of the segmental branches of the MCA in the Sylvian fissure was measured on the affected side and the contralateral side. Results: Quantitative density of SDS was significantly higher on the ischemic side of the brain. Receiver operating characteristic (ROC) analysis showed a cut-off value of 38.5 Hounsfield units (HU) as a predictor for acute ischemic stroke, with a sensitivity and specificity of 79% and 92%, respectively. Conclusion: Quantitative density of SDS on the affected side in patients without definitive cerebral infarct findings of parenchyma can be used in the emergency room as an objective predictor sign for the diagnosis of acute ischemic stroke. Considering this finding in the differential diagnosis of acute stroke patients in the emergency room has the potential to improve their clinical management, particularly for the patients without early parenchymal and vascular signs of stroke.
