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Quantified Magnetic Resonance Spectroscopy in the Diagnosis of Burning Mouth Syndrome

Open Journal of Medical Imaging 2019年第3期9卷 33-41页

作者： Duzgun Yildirim deniz alis Ceren alis Filiz Namdar Pekiner Alev Bakir Suha Turkmen Dastan Temirbekov Acibadem University Vocational School of Health Sciences Department of Medical Imaging Istanbul Turkey Cerrahpasa University School of Medicine Department of Radiology Istanbul Turkey Istanbul University Cerrahpasa Faculty of Medicine Department of Neurology Istanbul Turkey Marmara University Department of Maxillofacial Surgery Istanbul Turkey Halic University School of Medicine Department of Biostatistics and Medical Informatics Istanbul Turkey Acibadem University School of Medicine Department of Emergency Medicine Istanbul Turkey Anatomica Hospital Department of HNS Istanbul Turkey

Purpose: To investigate potential pathological differences in major brain metabolites in burning mouth syndrome (BMS). Materials and Methods: We prospectively evaluated eight patients and six healthy controls with single voxel magnetic resonance (MR) spectroscopy throughout 2017 using 3-Tesla MR unit. Metabolite levels measured from the left posterior paracingulate white matter. Raw images were processed with Tarquin version 4.3.10 and area under curve values were automatically calculated for GABA (γ-Aminobutyric acid), Ins (myo-inositole), tNAA (N-Acetylaspartate), tCho (total choline), tCr (total creatine) and GLx (glutamine + Glutamat). Major metabolite levels and all metabolites ratio to tCr calculated and compared between two groups using Mann-Whitney U test. Results: GABA/tCR value of the patients (0.589 ± 0.194, median = 0.515) was significantly higher than control group (0.230 ± 0.067, median = 0.220) (P = 0.002). tNAA/tCR value of the patients (1.106 ± 0.218, median: 1.205), was significantly lower than the control group (1.538 ± 0.401, median: 1.705) (P = 0.028). No significant difference was observed between two groups in terms of all other metabolites (P > 0.05). Conclusion: We demonstrated increased GABA and decreased NAA in the left posterior paracingulate region in BMS patients. We suggest that these metabolite alterations in central nervous system might play a key role in the etiology of the disease by inhibiting the suppression of burning sensation.

关键词： Burning Mouth Syndrome BMS GABA MRI Spectroscopy

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Cranial Magnetic Resonance Spectroscopy: An Update of Metabolites and a Special Emphasis on Practical Points

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Open Journal of Medical Imaging 2014年第4期4卷 163-171页

作者： Duzgun Yildirim Onur Tutar deniz alis Gokhan Kuyumcu Selim Bakan Centermed Advanced Imaging Center Istanbul Turkey Depatment of Radiology Cerrahpasa Medical Faculty Istanbul University Istanbul Turkey

Magnetic resonance spectroscopy (MRS) could be used for dozens of metabolites [1]. In this paper we will focus especially on proton (hydrogen) MRS. Generally published literatures consist of reviews and articles about metabolites are long, complicated and emphasise on physical or on technical data. But with this article, we will try to explain basically how MRS could be used in daily practice of radiologists. First of all we tried to search all current literature only referencing the main ones to make this review and we want all of our colleagues to give feedback about this review. With collection of all these trick points and line up to appropriate order, it is possible to make this review a common guide for radiologists and a useful tool while reporting MRS.

关键词： Magnetic Resonance Spectroscopy Analysis Metabolite Markers Radiology

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Hashimoto Thyroiditis:Simple Diagnosis with 2D-Shear Wave Elastography

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International Journal of Clinical Medicine 2020年第2期11卷 23-31页

作者： Düzgün Yildirim deniz Esin Tekcan Sanli deniz alis Mutlu Sahin Alev Bakir Ahmet Erdem Kilavuz Department of Medical Imaging Vocational School of Health SciencesAcibadem UniversityIstanbulTurkey Department of Radiology Acibadem Kozyatagi HospitalIstanbulTurkey Department of Radiology Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Research and Training HospitalIstanbulTurkey Department of General Surgery Diskapi Yildirim Beyazit Education and Research HospitalAnkaraTurkey Biostatistics and Medical Informatics Department Halic UniversityIstanbulTurkey Department of Otorhinolaryngology Acibadem UniversityIstanbulTurkey

Background: Hashimoto thyroiditis diagnosis is primarily established on clinical and laboratory findings;however, some hashimoto thyroiditis cases are euthyroid and seronegative. Moreover, these patients might also have normal conventional ultrasound findings. Aims: In our study, we aimed to distinguish the typical background characteristics of hashimoto thyroiditis using virtual touch tissue imaging quantification maps obtained with acoustic radiation force impulse imaging. Methods: Our study consisted of 28 hashimoto thyroiditis patients without characteristics of ultrasound findings and 28 healthy subjects. The thyroid parenchymal tissue mechanical properties were analyzed with the virtual touch tissue imaging quantification after ultrasound examination, and then related colored maps were obtained. Shear wave velocities were recorded (m/s) from the homogenous area where hardest and softest points were closest to each other on virtual touch tissue imaging quantification maps. The difference between the minimum and maximum shear wave velocities for each case (Δv) was calculated and recorded. Results: Assessment of virtual touch tissue imaging quantification maps revealed a significant difference between hashimoto thyroiditis and control groups in terms of maximum SWV’s, but no significant difference was observed between the minimum shear wave velocities (p Δv values were taken into account. In summary, the effects of chronic autoimmune thyroiditis can be distinguished by simply using Δv on virtual touch tissue imaging quantification maps. When the cut-off value of Δv was accepted 0.42, the diagnosis of hashimoto thyroiditis could be made with 88% accuracy. Conclusion: We suggest that shear wave velocities measurement on virtual touch tissue imaging quantification maps is a promising method in equivocal hashimoto thyroiditis cases, in which the diagnosis of hashimoto thyroiditis is unachievable with clinical, laboratory and conventional ultra

关键词： ARFI Hashimoto Thyroiditis SWE SWV VTIQ

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Current Radiological Approach in Thyroid Nodules

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Journal of Cancer Therapy 2017年第5期8卷 423-442页

作者： Duzgun Yildirim deniz alis Sabri Sirolu Cesur Samanci Fethi Emre Ustabasioglu Bulent Colakoglu Department of Radiology Acibadem Taksim Hospital Istanbul Turkey Department of Radiology Istanbul University Cerrahpasa Medical Faculty Istanbul Turkey Department of Radiology Vehbi Ko&ccedil Foundation American Hospital Istanbul Turkey

The aim of this paper is to review the radiological evaluation of thyroid nodules detected with ultrasonography (US), thoroughly and in harmony with the clinical-endocrinological-surgical management. In this review, we tried to summarize the radiological evaluation of nodules detected in the thyroid in compliance with recently published and accepted guidelines, including the most advanced sonographic protocols, emphasizing the indications of cross-sectional imaging when needed. In this review important aspects were demonstrated with tables, illustrations and take-home points and technical aspects were emphasized with images and diagrams. We believe that this review, which is concluded with an extensive summary with the support of most recent sources, is an up-to-date and comprehensive evaluation of the broad spectrum of thyroid nodule radiology. We think that the management of any kind of nodule that can be encountered during the US examination can be done successfully by going through the paths described in the pictures, tables and texts in this article.

关键词： Elastography Doppler US Thyroid Cancer Thyroid Nodule US

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Diffusion Tensor Imaging without Complex Statistical Analysis Could Be Helpful for Diagnosis

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Open Journal of Medical Imaging 2016年第3期6卷 93-101页

作者： Duzgun Yildirim deniz alis Cesur Samanci Fethi Emre Ustabasioğlu Onur Tutar Atilla Ersen Department of Radiology Acibadem Taksim Hospital Istanbul Turkey Department of Radiology Cerrahpasa Medical Faculty Istanbul University Istanbul Turkey Department of Pediatrics Kas?mpasa Military Hospital Istanbul Turkey

Objective: Thanks to fast developing technology, visualization of fiber tracts at brain is possible. But with the new developments, data processing and interpretation are becoming more difficult. Actually interpretations in these fields are mostly in-group analysis and are generally not useful on the basis of individual patient evaluations. In these regards, we investigated our cases with diffusion tensor imaging (DTI) and tried to show if the data could be interpreted simply by radiologist’s eye or not. Material: Our study consisted of 31 cases that were evaluated in our center with 3 Tesla Magnetic Resonance Imaging (MRI) units. Cranial DTI studies performed for ischemia, posttraumatic axonal injury, congenital malformation, neoplasia, autism, mental retardation and epilepsy. Cranial DTI was performed to demonstrate effected fiber tracts in neoplasia and ischemia cases and was applied to identify any gross anomaly in microstructural anatomy beside normal conventional MRI in other cases. DTI images were evaluated, along with fused conventional T1 weighted 3D high-resolution images and FA maps. DTI were performed at the first administration of the patients. Results: In addition to chronic ischemic focuses in patients with ischemia, DTI-FA images showed us relevant signal changes secondary to Wallerian degeneration in two cases. In traumatic brain injury cases, though being isointense on conventional sequences, FA values showed decreased values at the levels of the axonal discontinuity. Major abnormalities of association and projection fibers in congenital malformation cases were visualized at both 3D-DTI fused images and FA map images. Displacement, infiltration, destruction fibers were clearly visualized in neoplasia cases. However, any objective abnormality wasn’t reported at any cases diagnosed with motor mental retardation, epilepsy or neuropsychiatric diseases. Conclusion: Colored DTI images and FA maps are helpful in the way of diagnosis in most cases with org

关键词： Central Nervous System DTI FA MRI

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Surgical results of the slipped medial rectus muscle after hang back recession surgery

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International Journal of Ophthalmology(English edition) 2014年第6期7卷 1035-1038页

作者： Yasar Duranoglu Hatice deniz Ilhan Meryem Guler alis Department of Ophthalmology Akdeniz University Faculty of Medicine Department of Ophthalmology Bor State Hospital

AIM: To analyze the surgical results of a slipped medial rectus muscle(MRM) after hang back recession surgery for ***: Twenty-one patients who underwent reexploration for diagnosed slipped muscle after hang back recession surgery were included in this retrospective study. Dynamic magnetic resonance imaging was performed to identify the location of the slipped *** motility was evaluated with assessment with prism and cover test in gaze at cardinal positions. The operations were performed by the same *** forced duction test was performed under general anesthesia. The empty sheath of the slipped MRM was resected and the muscle was advanced to the original insertion site in all ***: The average age of 21 patients who had consecutive exotropia with a slipped MRM at the time of presentation was 17.4±5.4y(5-50y). The average duration between the first operation and the diagnosis of the slipped muscle was 25mo(12 to 36mo). The mean follow up after the corrective surgery was 28 mo. The mean preoperative adduction limitation in the field of action of the slipped muscle was-2.26(ranging from-1 to-4). All patients had full adduction ***: The diagnosis of the slipped muscle should be confirmed during the strabismus surgery. The slipped muscle may be caused due to insufficient suture and excessive rubbing of the eye. When divergent strabismus is observed after the recession of the MRM, a slipped muscle should be considered in the differential diagnosis.

关键词： esotropia empty sheath hang back recession re-exploration slipped muscle

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