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  • Küçük Resim
    Öğe
    Amfizemin yüksek rezolüsyonlu bilgisayarlı tomografi incelemesinde görsel skorlama: gözlemci içi ve gözlemciler arasında korelasyon
    (2012) Asil, Kıyasettin; Beşir, Fahri Halit; Mahmutyazıcıoğlu, Kamran; Kart, Levent; Gündoğdu, Sadi
    Amaç: Amfizem değerlendirmesinde genellikle hard-copy film veya BT ekranı üzerinde subjektif görsel değerlendirme kullanılmaktadır. Bu yöntemde gözlemciler arası ve gözlemci içi uyumsuzluk kantitatif analizlere oranla yüksektir. Bu çalışmanın amacı density mask yöntemi kullanılarak segmentasyon analizi ile elde edilen amfizematöz parankim görüntüleri ile konvansiyonel görüntülerin gözlemciler arası ve gözlemci içi subjektif skorlamaya etkisini araştırmaktır. Gereç ve Yöntem: Çalışmada 10’u amfizemli 7’si sağlıklı birey incelendi. YRBT kesitleri iki gözlemci tarafından standart hard-copy filmden ve amfizematöz parankim pencerelerinde amfizemin yaygınlığı ve şiddeti olmak üzere skorlandı. Her hastada total amfizem skorları hesaplandı ve gözlemciler arası ve gözlemci içi korelasyona bakıldı. Bulgular: Gözlemcilerin yaptıkları skorlamada; yaygınlık skorlarında 19 skorda, şiddet skorlarında 30 skorda artış izlendi. Gözlemciler arasında hem konvansiyonel hem de segmentasyon penceresinde korelasyon vardı. Ayrıca gözlemciler arası korelayona benzer şekilde gözlemci içi korelasyon da izlendi. Sonuç: Amfizemli hastalarda YRBT incelemesinin amfizematöz parankim penceresinde görsel skorlanması kolay uygulanabilir bir metodolojidir. Bu metod ile gözlemciler arasındaki uyum artmakta ve gözlemcilerin tekrar eden değerlendirmelerindeki uyumsuzluk azaltmaktadır.
  • Küçük Resim
    Öğe
    Enoxaparin-associated giant retroperitoneal hematoma in pulmonary embolism treatment
    (2011) Beşir, Fahri Halit; Gül, Mesut; Örnek, Tacettin; Özer, Tülay; Uçan, Bülent; Kart, Levent
    Context: Retroperitoneal hematoma may usually occur as a result of trauma. A life threatening retroperitoneal hematoma is not expected complication of anticoagulation treatment and rarely reported. Low molecular weight heparins (Enoxaparin) which are used as effective and safe medicine in the venous thromboemboly treatment have some major complications such as hematomas of different organs. We aim to present a giant spontaneous retroperitoneal hematoma after anticoagulant treatment of pulmonary embolism with enoxaparin. Case Report: A 73-year-old male patient with the diagnosis of pulmonary embolism underwent anticoagulant treatment (enoxaparin). In the second day of admission, the patient had an episode of abdominal and back pain. Abdominal ultrasonography and computerized tomographic scan revealed a giant retroperitoneal hematoma. Enoxaparin treatment was then stopped and the supportive treatment was started. In the following days, hemoglobin levels returned to normal and a control CT revealed regression of hematoma size. Conclusion: The anticoagulant treatment with enoxaparin may lead to severe hematomas. Therefore, the clinical suspicion is required especially in elderly patients and patients with impaired renal function for retroperitoneal hematoma, when they suffer from acute abdominal pain.
  • Küçük Resim
    Öğe
    The results of computed tomography guided tru-cut transthoracic biopsy: complications and related risk factors
    (Springer Wien, 2011) Beşir, Fahri Halit; Altın, Remzi; Kart, Levent; Akkoyunlu, Muhammed; Özdemir, Hüseyin; Örnek, Tacettin; Gündoğdu, Sadi
    Introduction: Transthoracic biopsy (TTB) is a well-defined and effective method used for pathologic sampling in the diagnosis of the pulmonary lesions. It is less invasive in comparison to surgical procedures. In addition, diagnostic rate of tru-cut biopsy is higher than that of fine needle aspiration biopsy (FNAB) especially for benign lesions. In this study, we presented tru-cut transthoracic biopsy (TTB) procedure results and the frequency of TTB complications with related risk factors. Material and methods:A total of 102 patients were evaluated by CT scan guided tru-cut TTB in the diagnosis of lung lesions between January 2003 and December 2007. The complications due to tru-cut TTB were recorded. The factors such as the lesion depth, the lesion size, and the emphysematous changes that accompany the lesion were evaluated through chi(2) test. Results: Among the samples, 51% malignancy and 49% benign pathology were observed. Pneumothorax developed in 15.7% of the 102 procedures. It was found that the lesion's distance from the pleura, the size of the lesion, and emphysematous changes around the lesion significantly increased the risk of pneumothorax. Discussion: The tru-cut biopsy complications are similar to those of FNAB. In the centers where cytologic examination is insufficient in the diagnosis of lung lesions, tru-cut biopsy should be routinely performed as it is a reliable biopsy technique compared to FNAB.
  • Küçük Resim
    Öğe
    The Visual Scoring of Emphysema With High-resolution Computed Tomography Examination: Intraobserver and Interobserver Correlations
    (Düzce Üniversitesi, 2012) Beşir, Fahri Halit; Mahmutyazıcıoğlu, Kamran; Kart, Levent; Gündoğdu, Sadi; Asil, Kıyasettin
    Purpose: The subjective visual assessment is usually used on the hard-copy film or CT monitorfor assessment of emphysema. This method has a higher interobserver and intraobserverdiscrepancy than quantitative analyzes. In this study, the effect of interobserver and intraobserverdiscrepancy was investigated on subjective visual scoring of conventional images andemphysematous parenchyma images which is gained with the density mask method.Material and Methods: In this study, ten emphysematous patient and seven healthy subjectswere examined. HRCT images were scored on the standard hard-copy film and emphysematousparenchymal window settings as the distribution and severity of emphysema by two observers.Total emphysema score was calculated for each patient and the interobserver and intraobservercorrelations were evaluated.Results: An increase was observed in 19 scores of distribution and 30 scores of severity. Theinterobserver correlation was observed in both conventional images and emphysematousparenchyma images. In addition, an intraobserver correlation was also observed similar tointerobserver correlation.Conclusion: The visual scoring methodology of patients with emphysema can be easilyapplicable in HRCT examination of emphysematous parenchymal window. Intraobservercorrelation was increased, and the concordance was reduced in repeated assessments ofphysicians with this method