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    Chest CT in COVID-19 pneumonia: correlations of imaging findings in clinically suspected but repeatedly RT-PCR test-negative patients
    (Springer, 2021) Korkmaz, Inan; Dikmen, Nursel; Keles, Fatma Ozturk; Bal, Tayibe
    Background: To emphasize the importance of CT in the diagnosis of COVID-19 disease by comparing the thoracic CT findings of COVID-19 patients with positive RT-PCR results and patients with clinical suspicion of COVID-19 but with negative RT-PCR results. Results: In our study, COVID-19 patients with positive RT-PCR results (RT-PCR (+) group) and patients with clinical suspicion of COVID-19 but negative RT-PCR results (RT-PCR (-) group) were compared in terms of CT findings. In CT images, ground-glass opacity and ground-glass opacity + patchy consolidation were the most common lesion patterns in both groups. No statistically significant differences in the rates and types of lesion patterns were observed between the two groups. In both groups, lesion distributions and distribution patterns were similarly frequent in the bilateral, peripheral, and lower lobe distributions. Among the 39 patients who underwent follow-up CT imaging in the first or second month, a regression in lesion number and density was detected in 18 patients from both groups. Consolidations were completely resorbed in 16 of these patients, and five patients had newly developed fibrotic changes. The follow-up CT examination of 16 patients was normal. Conclusions: Due to the false-negative rate of RT-PCR tests caused by various reasons, clinically suspected COVID-19 patients with a contact history should be examined with CT scans, even if RT-PCR tests are negative. If the CT findings are positive, these patients should not be removed from isolation.
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    Efficacy of ultrasound-guided percutaneous drainage in the treatment of psoas abscess
    (Bayrakol Medical Publisher, 2022) Kayali, Alperen; Beyazit, Selen; Keles, Fatma Ozturk; Bal, Tayibe; Seyfettin, Ayca; Ugur, Mustafa
    Aim: In this study, we aimed to evaluate the efficacy of ultrasound-guided percutaneous drainage applied to cases determined with psoas abscess, and to investigate predisposing factors and micro-organisms causing the disease.Material and Methods: Twenty-eight patients were examined, including 15 males and 13 females, aged 22-87 years, who underwent ultrasound-guided percutaneous drainage. Predisposing factors for the development of psoas abscess, the need for an additional surgical procedure after percutaneous abscess drainage, length of stay in hospital after the procedure, complications, and agent micro-organisms were evaluated. The efficacy of percutaneous drainage in the treatment was investigated.Results: The most common agents were determined to be Staphylococcus aereus, Escherichia coli, and Mycobacterium tuberculosis. Primary psoas abscess was determined in 6 (21.4%) patients and secondary psoas abscess in 22 patients. In cases with secondary psoas abscess, skeletal origin predisposing factors (spondylodiscitis, history of abdominal or vertebral surgery) were seen to most often play a role in the etiology. In 20 of the 22 (78.5%) patients with secondary psoas abscess, effective treatment was applied with antibiotherapy and percutaneous drainage. The mortality rate was 10.7%.Discussion: Low morbidity and mortality rates are the greatest advantages of percutaneous drainage. Although CT has emerged as a better diagnostic method for psoas abscess, ultrasound-guided percutaneous drainage has the advantages of easy availability, low cost, and it does not contain radiation. Ultrasound -guided percutaneous drainage is an effective and reliable method in the treatment of psoas abscess.
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    Evaluation of the structure, autoimmunity, and functions of the thyroid gland in familial Mediterranean fever patients
    (Sbem-Soc Brasil Endocrinologia & Metabologia, 2020) Yilmaz, Muge Ozsan; Celik, Muhammet Murat; Keles, Fatma Ozturk; Ozcan, Oguzhan
    Objective: Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disorder that is frequently seen in the eastern Mediterranean region. The thyroid gland can be affected in FMF patients through autoimmunity or amyloidosis. Here, we aimed to evaluate the structure and functions of the thyroid gland in addition to possible autoimmunity in FMF patients. Subjects and methods: The study was conducted by the Endocrinology and Metabolism and Internal Medicine Departments.Thirty FMF patients and 30 age and gender-matched healthy controls were enrolled in the study. Free thyroxin (fT4), free triiodothyronine (fT3), thyroid-stimulating hormone (TSH), and anti-thyroid peroxidase (anti-TPO) autoantibodies were investigated. Detailed thyroid grayscale and Doppler Ultrasonography examinations and shear-wave elastosonography (SWE) were performed in the patient and control groups. Results: Anti-TPO was detected in 24% (n = 7) of the patients. On the grayscale US, mean thyroid volumes were similar between the FMF and the control groups (p > 0.05). By Doppler US, thyroid vascularity observed was detected in 10.3% (n = 3) of the patients. SWE revealed that the mean velocity value of right vs. left lobe in the patient group was 1.77 +/- 0.45 m/s and 1.95 +/- 0.51 m/s, respectively. Compared to the control group, the mean velocity values were significantly higher in the right (p = 0.004) and left (p = 0.01) lobes of the patient group. The mean stiffness value in the patient group was also significantly higher in the right and left lobes [10.13 +/- 5.65 kPa (p = 0.005) and 12.24 +/- 6.17 kPa (p = 0.02), respectively]. Conclusion: Recognizing the complications of FMF early in the course of the disease is as important as the early diagnosis of the disorder. Based on this, thyroid functions and changes in its structure should be evaluated carefully for early diagnosis of a possible coexisting thyroid disorder.
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    An evaluation with shear wave elastography of kidney elasticity in patients with familial Mediterranean fever
    (Wiley, 2023) Kayali, Alperen; Keles, Fatma Ozturk; Seyfettin, Ayca; Dirican, Emre; Celik, Muhammed Murat
    Purpose To investigate the changes in kidney elasticity in patients with familial Mediterranean fever using the non-invasive diagnostic method of shear wave elastography (SWE). Methods The kidney elasticity of 35 FMF patients and 23 healthy control subjects was evaluated with SWE. The relationships were evaluated of the SWE values with eGFR, microproteinuria, FMF severity score, number of attacks per month, and colchicine doses of the FMF patients. Results The kidney stiffness and velocity values of the FMF patients were found to be higher than those of the control group (p < 0.001). A negative correlation was found between the renal stiffness and velocity values and the colchicine dose (r = -0.48, p = 0.004, and r = -0.50, p = 0.003, respectively). Conclusion The results of the current study demonstrated that the SWE values of the FMF patients were significantly higher than those of the control group. SWE can be used as an alternative method in the follow up of FMF patients. In addition, a negative correlation was determined between the colchicine dose and renal stiffness. This suggests that SWE values could be used in the adjustments of colchicine doses. However, there is a need for further studies with greater numbers of patients to support this hypothesis.
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    Our clinical experience in pelvic magnetic resonance imaging with vaginal contrast
    (Via Medica, 2023) Keles, Fatma Ozturk; Korkmaz, Inan; Dogan, Esin; Hakverdi, Sibel; Dolapcioglu, Kenan; Karazincir, Sinem
    Objectives: Magnetic resonance imaging (MRI) is an important modality for pelvic imaging. Vaginal distension is provided by the use of vaginal contrast in pelvic MRI, and it plays an important role in staging especially cervical and vaginal cancer. The aim of this study is to show whether the use of vaginal contrast material contributes to the diagnosis in pelvic examination. Material and methods: Between October 1, 2016 and December 30, 2020, a total of 57 patients who underwent pelvic magnetic resonance imaging with vaginal contrast in the radiology clinic were included in the study and evaluated retrospectively. Results: Cervical cancer was detected in 38 of the 57 patients included in the study, and when the vaginal pre-and post-contrast staging of the patients was performed, the pre-contrast stage was found to be high in six patients (15%). Eight of 38 patients diagnosed with cervical cancer underwent surgery. When the pathological and radiological staging of the patients who underwent surgery were compared, they were 100% compatible. Conclusions: The use of vaginal contrast material increases the diagnostic value of MRI in various pelvic pathologies, especially in cervical cancer staging.
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    Retrospective evaluation of Chest CTs and [18 F]-FDG PET/CTs in Oncological Patients with Unsuspected Asymptomatic Infection with COVID 19
    (2021) Ozturk, Tulin; Azar, Cebrail; Keles, Fatma Ozturk; Narin, Yavuz
    Objectives: The aim of this study is to investigate the incidence of asymptomatic COVID 19 patients who underwent CT and PET/CT for oncological indications and to detect lung changes in CT and PET/CT in these patients. Methods: Between March 2020 and September 2021, 3135 patients admitted to the nuclear medicine department were retrospectively analyzed. Our study involved the oncology patients with a history of contact, clinical and labora- tory findings and possible COVID-19 disease, whose radiological findings at PET/CT and CT were compatible with viral pneumonia and confirmed by PCR testing. Results: Lung imaging findings suspicious of SARS-Co V-2 infection were found in 78 of 3135 patients (2,48%) included. The most frequent finding was multiple ground glass opacities (GGOs). In our study, we found characteristic peripheral ground-glass opacities with high FDG activitiy with increased nodal FDG uptake in favor of reactive lymphadenitis in FDG-PET/CT. Conclusion: Chest CT is used in the initial diagnosis and monitoring of COVID-19 progression as well as in the evalu- ation of complications. Although PET imaging is not typically considered among the primary research methods for the diagnosis of lower respiratory tract infections, it has made a significant contribution to the incidental diagnosis of especially asymptomatic COVID-19 oncological cases