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Kemal Odev

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Armando Marques-Guedes

UNL - New University of Lisbon

Curtin University, Perth

University of British Columbia

Harvard University

Universidade Federal do Paraná

Andrey Sinjushin

Moscow State University

Prof. Dr. Rasime Kalkan

European University of Lefke

Dimuth Siritunga

University of Puerto Rico Rio Piedras

Russian academy of sciences

Rafael B R León-Cachón

Universidad de Monterrey

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Papers by Kemal Odev

Imaging features of isolated unilateral pulmonary artery agenesis presenting in adulthood: a review of four cases

Clinical Radiology, 2007

To highlight the variation in clinical manifestations, imaging and management of four cases of un... more To highlight the variation in clinical manifestations, imaging and management of four cases of unilateral pulmonary artery agenesis presenting in adulthood. METHOD: Four patients with unilateral pulmonary artery agenesis were referred to our institution between 1995 and 2005. They underwent a series of investigations, including chest radiography, echocardiography, ventilation perfusion scintigraphy, angiography, computed tomography (CT) and magnetic resonance imaging (MRI). RESULTS: Two of the four patients had absence of the right main pulmonary artery, whilst the remaining two patients had absence of the left main pulmonary artery. One patient showed a restrictive defect on pulmonary function tests. Two patients who had ventilation perfusion scintigraphy showed absent perfusion and reduced ventilation on the affected side. Angiography (where performed), CT and MRI confirmed the anatomy and the presence of multiple collaterals. Bronchiectasis was demonstrated on CT in two patients, with one also demonstrating a mosaic attenuation pattern. One patient had an incidental lung tumour on the side of the agenesis, which was diagnosed as a chondroid hamartoma on histology. Three of the four patients eventually underwent resection of the affected lung. CONCLUSION: Isolated unilateral pulmonary artery agenesis has a non-specific presentation. Awareness of this condition can lead to earlier diagnosis, with cross-sectional imaging making an important contribution.

Radiologic findings of a male patient followed up due to infertility with a traumatic urethral diverticulum with stones

Diagnostic and Interventional Radiology, 2009

U rethral diverticulum is rarely encountered in male patients, and usually is acquired. Long-term... more U rethral diverticulum is rarely encountered in male patients, and usually is acquired. Long-term urethral catheterization, infection, and trauma are the most common causes of urethral diverticulum in male patients. In 4-10% of cases, stone formation in the diverticulum has been reported. Fluoroscopic imaging and urethroscopy are useful in the diagnosis of diverticulum. In this report, we present ultrasonography (US), retrograde urethrography, and magnetic resonance imaging (MRI) findings of a proximal urethral diverticulum with multiple stones in a male patient. Case report A 40-year-old man, who had been followed for infertility, presented with the complaint of lack of ejaculation during sexual intercourse. Medical history revealed perineal trauma and hematuria as the result of a fall on a metal surface when he was a child. Scrotal Doppler US examination, pelvic MRI, and retrograde urethrography were performed. Doppler US performed in the investigation of infertility revealed a sac 6 cm in diameter, containing multiple stones, and having a posteriorly located acoustic shadow (Fig 1). To determine the relationship of the sac to the urethra, pelvic MRI and retrograde urethrography were performed. Pelvic MRI showed a 7 x 3.5 cm diverticulum in the proximal penile urethra, and multiple millimetric stones within the diverticulum (Fig. 2). Prior to scheduled surgery, retrograde urethrography confirmed MRI findings (Fig. 3). Cystourethroscopy was performed with the patient in the lithotomy position. There was no urethral stricture distal to the diverticulum. The neck of the diverticulum was large, and multiple stones, the largest of which was 10 mm in diameter, were observed within the diverticulum. A 3-cm vertical incision was made on the perineum over the diverticulum. The walls of the diverticulum were dissected, the diverticulum was opened with a longitudinal incision, and stay sutures were placed. The stones were removed. A 20 Fr Foley catheter was inserted into the urethra, and the walls of the diverticulum were trimmed. The urethra was closed with 4.0 vicryl sutures. A Penrose drain was inserted, and skin was closed. The drain was removed on postoperative day 3, and Foley catheter was removed on postoperative day 15. The postoperative period was uneventful. Discussion Urethral diverticulum was first described by Watts in 1906 (1). It is rare in males, and most cases are acquired (90%). Although there is no standard classification, it can be classified as congenital or acquired, or as primary or secondary. However, classification is theoretical, and factors such as localization, size, and presence of accompanying in

Radiological characteristics of pulmonary hydatid disease in children

European Journal of Radiology, 2003

To evaluate the chest roentgenogram and CT characteristics of pulmonary hydatid disease (PHD). Fo... more To evaluate the chest roentgenogram and CT characteristics of pulmonary hydatid disease (PHD). Forty-seven (27 male and 20 female, aged between 3 and 11 years) consecutive pediatric patients with surgically proven pulmonary hydatid cysts were enrolled for the study. Posteroanterior and lateral chest roentgenograms, CT of the chest, and laboratory findings (latex agglutination, Casoni skin test, and eosinophil count) were obtained from all of the patients. The radiological features (localization, internal architecture, number, diameter) were determined. On CT examination, a total of 79 cysts were determined. On chest roentgenogram, 57 of 79 cysts were detected in all patients. Single cysts were seen in 33 patients, while multiple cysts were seen in 14. Median CT density of the cysts was 21 Hounsfield units (HU) (0-80). There were six giant cysts (&amp;amp;amp;amp;amp;amp;amp;amp;gt;10 cm of cyst diameter). The crescent sign, water lily sign, and air-fluid level were seen in two, five and eight of the cysts, respectively. Apart from the classically described features of pulmonary hydatid cysts of the lung, a crescent-shaped rim of air at the lower end of the cyst (inverse crescent sign) was detected in three cysts. All of the liquid content of the cyst was expelled to the bronchial system (dry cyst sign) was observed in seven cysts. There were two infected cysts. Heavily calcified curvilinear cyst wall was present in one cyst. Pericystic reaction in the lung tissue was observed in five patients. Other features included pleural effusion (n=2), mediastinal shift (n=6) and atelectasis (n=7). Chest roentgenogram is helpful for diagnosis of intact cysts but, it is impossible to define entire morphology of the complicated cysts. CT imaging recognize certain details of the lesions and discover others that are not visible by conventional radiography. In conclusion, CT examination should be done to elucidate cystic nature of the lung mass and for accurate localization in the preoperative period. In addition, inverse crescent sign should be recognized as feature of pulmonary hydatid cysts on CT.

Subglottik Hemanjiyomda Propranolol Kullanımı

Turkiye Klinikleri Journal of Pediatrics, 2011

Esophageal cyst applied with asthma clinic

Paediatric Respiratory Reviews, 2010

Imaging Findings of Focal and Multiple Cystic and Cavitary Lung Lesions

European Journal of General Medicine, 2012

Cystic and cavitary lung lesions constitute a spectrum of pulmonary diseases diagnosed in both ch... more Cystic and cavitary lung lesions constitute a spectrum of pulmonary diseases diagnosed in both children and adults. Cysts and cavities are commonly encountered abnormalies on chest radiography and chest computed tomography. High-resolution computed tomography (HRCT) of the chest frequently helps define morphologic features that may serve as important clues regarding the nature of cystic and cavitary lesions of the lung. Occasionally, the underlying nature of the lesions can be readily apparent as in bullae associated with emphysema. Cystic and cavitary lung lesions can be diagnostic challange. Although many patients with cystic and cavitary lung lesions have a known underlying disease, in many cases the considerable overlap in morphologic features of these lesions tenders transthoracic needle biopsy necessary to establish the correct diagnosis.

Pictorial Review. Uncommon Locations of Hydatid Cysts

Acta Radiologica, 2003

Human echinococcosis remains a complex problem that may affect several organs, and requires mostl... more Human echinococcosis remains a complex problem that may affect several organs, and requires mostly surgical management. We present two cases with uncommon locations of hydatid cysts that were successfully managed in our hospital during the last two years. The first case was a 62-yearold woman with a multicystic lesion in her right thigh that was radically excised, and histology confirmed the diagnosis of echinococcosis. The second case was a 78-year-old man with multiple large intraabdominal hydatid cysts that required a complex operation, including splenectomy, partial removal of the liver cyst wall and evacuation of the content, and excision of pelvic, mesenteric cysts, and suprahepatic cysts. Both cases have not shown any sign of recurrence to date. Since the disease is still endemic in certain parts of the world and pharmaceutical agents are not radical, specific surgical procedures remain the treatment of choice with good results and acceptable morbidity, mortality and recurrence rates.

Pneumomediastinum and pneumopericardium due to malignant subcarinal lymphadenopathy: CT demonstration

European Radiology, 1997

A 52-year-old man had been treated for oral cancer T3 N0 M0 by radical surgery, neck dissection o... more A 52-year-old man had been treated for oral cancer T3 N0 M0 by radical surgery, neck dissection on the right and cervical irradiation (60 Gy). Two months after therapy he presented with dysphagia and hemoptysis. Admission chest X-ray revealed a pneumopericardium. It was caused by a bronchomediastinal fistula due to necrotic metastatic lymph nodes as shown by CT, which also revealed a concomitant pneumomediastinum. The patient died 10 days later from pneumonia. The CT findings were confirmed at autopsy. We conclude that malignant mediastinal lymphadenopathy is a potential cause of pneumopericardium and pneumomediastinum.

Cystic and Cavitary Lung Lesions in Children: Radiologic Findings with Pathologic Correlation

Journal of Clinical Imaging Science, 2013

A number of diseases produce focal or multiple thin-walled or thick-walled air- or fluid-containi... more A number of diseases produce focal or multiple thin-walled or thick-walled air- or fluid-containing cysts or cavitary lung lesions in both infants and children. In infants and children, there is a spectrum of focal or multifocal cystic and cavitary lung lesions including congenital lobar emphysema, congenital cystic adenomatoid malformation, pleuropulmonary blastoma, bronchogenic cyst, pulmonary sequestration, Langerhans cell histiocytosis, airway diseases, infectious diseases (bacterial infection, fungal infection, etc.), hydatid cysts, destroid lung, and traumatic pseudocyst. For the evaluation of cystic or cavitary lung lesion in infants and children, imaging plays an important role in accurate early diagnosis and optimal patient management. Therefore, a practical imaging approach based on the most sensitive and least invasive imaging modality in an efficient and cost-effective manner is paramount. We reviewed the conventional radiographs and computed tomography findings of the m...

The management of liver hydatid cysts by percutaneous drainage

Canadian journal of surgery. Journal canadien de chirurgie, 2001

To investigate the effect of percutaneous drainage on liver hydatid cysts. A retrospective case s... more To investigate the effect of percutaneous drainage on liver hydatid cysts. A retrospective case study. Department of Surgery, Selçuk University, Konya, Turkey. Forty-five patients with 83 liver hydatid cysts (types I and II according to the classification of Gharbi and colleagues) followed up for a mean of 30 months (range from 14 to 36 months). The cysts were drained percutaneously with ultrasonographic guidance and then irrigated with 0.05% silver nitrate solution through a fine needle. Albendazole was administered 48 hours before percutaneous drainage and for 2 months after the procedure to prevent the implantation of spilled scolices. Complications of the procedure, decrease in size of the cyst cavity, recurrence and dissemination of the cysts. All the cysts were treated successfully by percutaneous drainage. Anaphylactic shock developed in 1 (2.2 %) patient, and mild allergic reactions were observed in 2 (4.4 %) patients during the interventional procedure. Follow-up ultrasonog...

Chest Imaging Findings in Hospitalized Children with H1N1 Influenza

Eurasian Journal of Pulmonology, 2015

Objective: The aim was to review the radiological findings and to find new prognostic factors tha... more Objective: The aim was to review the radiological findings and to find new prognostic factors that determine the need for pediatric intensive care unit (PICU) in children with swine-origin influenza (H1N1) virus infection. Methods: Chest X-ray (CXR) and computed tomography (CT) findings of 18 children with laboratory-confirmed H1N1 infection (9 boys, 9 girls) with a median age of 34 (1-216) months were retrospectively evaluated. Results: CXRs were performed in 15 (83.3%) and thorax CT in 7 (38.8%) children. Abnormal findings were detected in 60% of the patients who underwent CXR and 85.7% of the patients who underwent thorax CT. Radiological findings were mostly diffuse, bilateral, and asymmetric. Ground-glass opacity (GGO) (66.6%) was the leading abnormality and was followed by reticulation (38.8%), nodules (27.7%), consolidation only (16.6%), tree-in-bud pattern (11.1%), consolidation with GGO (5.5%), and septal lines (5.5%). Lymphadenopathy (22.2%), air trapping (5.5%), and parenchymal band (5.5%) were other recorded findings. CXR was found to be insufficient to detect subpleural nodules, lymphadenopathies, and sometimes GGO. Only existence of nodules (p=0.04) affected the need for PICU admission. Conclusion: The most common radiological findings in children with H1N1 infection were bilateral, asymmetric GGO with or without associated multifocal areas of consolidation. CXR was insufficient to detect subpleural nodules, lymphadenopathies, and sometimes GGO. The existence of nodules is a bad prognostic factor in determining the need for PICU admission.

Intrathoracic Extrapulmonary Hydatid Disease: Radiologic Manifestations

Canadian Association of Radiologists Journal, 2010

Hydatidosis is a parasitic disease caused by the larvae of Echinococcus granulosus and rarely by ... more Hydatidosis is a parasitic disease caused by the larvae of Echinococcus granulosus and rarely by Echinococcus alveolaris. It is endemic to South America, North Africa, Asia, Australia, and the Middle East [1,2]. The definitive hosts are foxes and, less commonly, dogs and cats. Humans are infected by direct contact with an infected animal or by ingestion of contaminated food or fluids. Echinococcal embryos migrate through the intestinal mucosa, and, in 60%e70% of cases, reach the liver via the portal system [1]. They can then enter the systemic circulation via the porta caval anastomoses and be carried by the bloodstream to any organ or tissue in the body. Alternatively, the eggs can be inhaled and cause primary lung disease [2]. Intrathoracic extrapulmonary hydatid disease is very rare but can occur in the pleural space, extrapleural region, pleural fissure, chest wall, mediastinum, pericardium, myocardium, and diaphragm [1]. In this pictorial essay, we present the clinical manifestations and imaging features of patients with hydatid cysts (HC) in the extrapulmonary sites of the thorax. Imaging Findings Generally, HCs are classified into 4 types on the basis of their appearance [2].

Thoracic application of multi-detector CT: A pictorial essay

Electronic Journal of General Medicine

Multi-detector CT (MDCT) has considerable advantage over single-detector helical CT in the form o... more Multi-detector CT (MDCT) has considerable advantage over single-detector helical CT in the form of the shorter acquisition time, greater coverage and superior image resolution. It can be used to systematically evaluate the cardiovascular anatomy, morphologic features of thoracic vessels such as aorta, systemic veins and pulmonary vessels and relationship between the upper lobe bronchi and pulmonary arteries, coronary artery, valves, systemic veins. In diffuse lung diseases, this technique can increase nodule detection and help differentiate between small nodules and vessels. MDCT with three-dimensional (3D) volume rendering provides a unique perspective on thoracic anatomy and disease. MDCT allows shorter acquisition times, greater coverage and superior image resolution. In vascular imaging, this technique provides image quality that equals or surpasses that of conventional angiography. Its use has expanded to aid in diagnosis and surgical planning. In this article we present a pictorial review of the current applications of MDCT in diseases of the thorax.

Percutaneous Treatment of Liver Hydatid Cysts: Comparison of Direct Injection of Albendazole and Hypertonic Saline Solution

American Journal of Roentgenology, 2005

The purpose of this study was to compare the effect of intracystic injection of albendazole and h... more The purpose of this study was to compare the effect of intracystic injection of albendazole and hypertonic saline in patients with liver hydatid disease. Fifty-nine patients with a total of 109 hydatid cysts were treated percutaneously. In all cases, local anesthesia was applied. Twenty percent hypertonic saline was used in 31 patients (40 cysts, group 1) as the scolicidal agent, and albendazole solution was used in 28 patients (69 cysts, group 2). The PAIR (percutaneous puncture, aspiration, injection, reaspiration) method was applied in group 1. In group 2, we used a different procedure that could be called the PAI (percutaneous aspiration and injection) method. After this procedure, routine sonography and CT examinations were conducted. The results of both groups were compared. Follow-up examinations showed that liver hydatids expanded approximately to their original size after a significant reduction during the first month. In the follow-up period, fluid contents totally disappeared; thickening and irregularities were also observed in the cyst walls and a solid, hyperechogenic, heterogeneous pseudotumor appearance representing a degenerated membrane was seen in all patients. Hypertonic saline solution inactivated the scolices from the beginning of the treatment. However, scolices were inactive in the cysts aspirated 1 month after the procedure in group 2. A significant correlation was noted between elapsed time after the treatment and the cyst size using Wilcoxon&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s signed rank test (p = 0.000). No difference was seen between two groups in the amount of cyst size reduction using the Mann-Whitney test (p =0.521). In addition to its oral use, albendazole may be injected intracystically as we did in our study. It sterilizes the cyst cavity and affects scolices as well.

SwyerJames Syndrome: Demonstration By 64-Slice 3d MDCT Angiography And Coronal MPR CT Imaging

European Journal of …, 2008

The 64-slice three dimensional (3D) multidetector computed tomography (MDCT) angiography and high... more

Imaging of Cystic and Cyst-like Lesions of the Mediastinum with Pathologic Correlation

Journal of Clinical Imaging Science, 2012

Cystic masses of the mediastinum are a heterogenous group of asymptomatic or symptomatic, congeni... more Cystic masses of the mediastinum are a heterogenous group of asymptomatic or symptomatic, congenital, infectious, or neoplastic lesions. For early and correct diagnosis, evaluation, and optimal patient management of cystic mediastinal masses in infants, children, or adults imaging plays an important role. A non-invasive and sensitive imaging modality is an efficient and cost-effective tool. Multidetector computed tomography (MDTC) with volumetric acquisition provides fast acquisition of high resolution images and multiplanar reconstruction. Both 2D and 3D imaging in mediastinal imaging help in surgical planning and assessing resectability of mediastinal lesions. MR imaging has many advantages over other modalities for detecting and identifying cystic, or fluid-filled mediastinal masses, because of its intrinsic high soft tissue contrast and direct multiplanar imaging capabilities. However, histological tissue analysis may be required to differentiate a cystic lesion from other cyst-...

Imaging of Cystic and Cyst-like Lesions of the Mediastinum with Pathologic Correlation

Journal of Clinical Imaging Science, 2012

Cystic masses of the mediastinum are a heterogenous group of asymptomatic or symptomatic, congeni... more Cystic masses of the mediastinum are a heterogenous group of asymptomatic or symptomatic, congenital, infectious, or neoplastic lesions. For early and correct diagnosis, evaluation, and optimal patient management of cystic mediastinal masses in infants, children, or adults imaging plays an important role. A non-invasive and sensitive imaging modality is an efficient and cost-effective tool. Multidetector computed tomography (MDTC) with volumetric acquisition provides fast acquisition of high resolution images and multiplanar reconstruction. Both 2D and 3D imaging in mediastinal imaging help in surgical planning and assessing resectability of mediastinal lesions. MR imaging has many advantages over other modalities for detecting and identifying cystic, or fluid-filled mediastinal masses, because of its intrinsic high soft tissue contrast and direct multiplanar imaging capabilities. However, histological tissue analysis may be required to differentiate a cystic lesion from other cyst-...

Value of magnetic resonance imaging in diagnosing breast lesions which need biopsy]

To evaluate MRI in diagnosing breast lesions which need biopsy. One hundred and eight patients we... more To evaluate MRI in diagnosing breast lesions which need biopsy. One hundred and eight patients were admitted to hospital for biopsies due to one hundred and sixteen suspicious lesions detected in their breasts. These lesions were detected by physical examination, mammography or ultrasonography. They were also administrated MRI examination before biopsy. The sensitivity and specificity of each diagnostic method were obtained and the radiologic-pathologic correlation was meanwhile calculated. Seventy (60.3%) breast lesions were diagnosed malignancy. The sensitivity, specificity, accuracy, positive prognostic value and negative prognostic value of ultrasonography were 83.3%, 62.0%, 74.1%, 74.3% and 73.8%. Such data of mammography were 86.8%, 68.1%, 78.0%, 75.4% and 82.1%. And those of MRI were 97.1%, 73.9%, 87.9%, 85.0% and 94.4%. MRI is superior to ultrasonography and mammography in diagnosing breast lesions, especially for the nonpalpable lesions.

Cystic and Cavitary Lung Lesions in Children: Radiologic Findings with Pathologic Correlation

by Tamer Altinok and Kemal Odev

Journal of Clinical Imaging Science, 2013

A number of diseases produce focal or multiple thin-walled or thick-walled air- or fluid-containi... more A number of diseases produce focal or multiple thin-walled or thick-walled air- or fluid-containing cysts or cavitary lung lesions in both infants and children. In infants and children, there is a spectrum of focal or multifocal cystic and cavitary lung lesions including congenital lobar emphysema, congenital cystic adenomatoid malformation, pleuropulmonary blastoma, bronchogenic cyst, pulmonary sequestration, Langerhans cell histiocytosis, airway diseases, infectious diseases (bacterial infection, fungal infection, etc.), hydatid cysts, destroid lung, and traumatic pseudocyst. For the evaluation of cystic or cavitary lung lesion in infants and children, imaging plays an important role in accurate early diagnosis and optimal patient management. Therefore, a practical imaging approach based on the most sensitive and least invasive imaging modality in an efficient and cost-effective manner is paramount. We reviewed the conventional radiographs and computed tomography findings of the most common cystic and cavitary lung lesions in infants and children.

Imaging features of isolated unilateral pulmonary artery agenesis presenting in adulthood: a review of four cases

Clinical Radiology, 2007

To highlight the variation in clinical manifestations, imaging and management of four cases of un... more To highlight the variation in clinical manifestations, imaging and management of four cases of unilateral pulmonary artery agenesis presenting in adulthood. METHOD: Four patients with unilateral pulmonary artery agenesis were referred to our institution between 1995 and 2005. They underwent a series of investigations, including chest radiography, echocardiography, ventilation perfusion scintigraphy, angiography, computed tomography (CT) and magnetic resonance imaging (MRI). RESULTS: Two of the four patients had absence of the right main pulmonary artery, whilst the remaining two patients had absence of the left main pulmonary artery. One patient showed a restrictive defect on pulmonary function tests. Two patients who had ventilation perfusion scintigraphy showed absent perfusion and reduced ventilation on the affected side. Angiography (where performed), CT and MRI confirmed the anatomy and the presence of multiple collaterals. Bronchiectasis was demonstrated on CT in two patients, with one also demonstrating a mosaic attenuation pattern. One patient had an incidental lung tumour on the side of the agenesis, which was diagnosed as a chondroid hamartoma on histology. Three of the four patients eventually underwent resection of the affected lung. CONCLUSION: Isolated unilateral pulmonary artery agenesis has a non-specific presentation. Awareness of this condition can lead to earlier diagnosis, with cross-sectional imaging making an important contribution.

Radiologic findings of a male patient followed up due to infertility with a traumatic urethral diverticulum with stones

Diagnostic and Interventional Radiology, 2009

U rethral diverticulum is rarely encountered in male patients, and usually is acquired. Long-term... more U rethral diverticulum is rarely encountered in male patients, and usually is acquired. Long-term urethral catheterization, infection, and trauma are the most common causes of urethral diverticulum in male patients. In 4-10% of cases, stone formation in the diverticulum has been reported. Fluoroscopic imaging and urethroscopy are useful in the diagnosis of diverticulum. In this report, we present ultrasonography (US), retrograde urethrography, and magnetic resonance imaging (MRI) findings of a proximal urethral diverticulum with multiple stones in a male patient. Case report A 40-year-old man, who had been followed for infertility, presented with the complaint of lack of ejaculation during sexual intercourse. Medical history revealed perineal trauma and hematuria as the result of a fall on a metal surface when he was a child. Scrotal Doppler US examination, pelvic MRI, and retrograde urethrography were performed. Doppler US performed in the investigation of infertility revealed a sac 6 cm in diameter, containing multiple stones, and having a posteriorly located acoustic shadow (Fig 1). To determine the relationship of the sac to the urethra, pelvic MRI and retrograde urethrography were performed. Pelvic MRI showed a 7 x 3.5 cm diverticulum in the proximal penile urethra, and multiple millimetric stones within the diverticulum (Fig. 2). Prior to scheduled surgery, retrograde urethrography confirmed MRI findings (Fig. 3). Cystourethroscopy was performed with the patient in the lithotomy position. There was no urethral stricture distal to the diverticulum. The neck of the diverticulum was large, and multiple stones, the largest of which was 10 mm in diameter, were observed within the diverticulum. A 3-cm vertical incision was made on the perineum over the diverticulum. The walls of the diverticulum were dissected, the diverticulum was opened with a longitudinal incision, and stay sutures were placed. The stones were removed. A 20 Fr Foley catheter was inserted into the urethra, and the walls of the diverticulum were trimmed. The urethra was closed with 4.0 vicryl sutures. A Penrose drain was inserted, and skin was closed. The drain was removed on postoperative day 3, and Foley catheter was removed on postoperative day 15. The postoperative period was uneventful. Discussion Urethral diverticulum was first described by Watts in 1906 (1). It is rare in males, and most cases are acquired (90%). Although there is no standard classification, it can be classified as congenital or acquired, or as primary or secondary. However, classification is theoretical, and factors such as localization, size, and presence of accompanying in

Radiological characteristics of pulmonary hydatid disease in children

European Journal of Radiology, 2003

To evaluate the chest roentgenogram and CT characteristics of pulmonary hydatid disease (PHD). Fo... more To evaluate the chest roentgenogram and CT characteristics of pulmonary hydatid disease (PHD). Forty-seven (27 male and 20 female, aged between 3 and 11 years) consecutive pediatric patients with surgically proven pulmonary hydatid cysts were enrolled for the study. Posteroanterior and lateral chest roentgenograms, CT of the chest, and laboratory findings (latex agglutination, Casoni skin test, and eosinophil count) were obtained from all of the patients. The radiological features (localization, internal architecture, number, diameter) were determined. On CT examination, a total of 79 cysts were determined. On chest roentgenogram, 57 of 79 cysts were detected in all patients. Single cysts were seen in 33 patients, while multiple cysts were seen in 14. Median CT density of the cysts was 21 Hounsfield units (HU) (0-80). There were six giant cysts (&amp;amp;amp;amp;amp;amp;amp;amp;gt;10 cm of cyst diameter). The crescent sign, water lily sign, and air-fluid level were seen in two, five and eight of the cysts, respectively. Apart from the classically described features of pulmonary hydatid cysts of the lung, a crescent-shaped rim of air at the lower end of the cyst (inverse crescent sign) was detected in three cysts. All of the liquid content of the cyst was expelled to the bronchial system (dry cyst sign) was observed in seven cysts. There were two infected cysts. Heavily calcified curvilinear cyst wall was present in one cyst. Pericystic reaction in the lung tissue was observed in five patients. Other features included pleural effusion (n=2), mediastinal shift (n=6) and atelectasis (n=7). Chest roentgenogram is helpful for diagnosis of intact cysts but, it is impossible to define entire morphology of the complicated cysts. CT imaging recognize certain details of the lesions and discover others that are not visible by conventional radiography. In conclusion, CT examination should be done to elucidate cystic nature of the lung mass and for accurate localization in the preoperative period. In addition, inverse crescent sign should be recognized as feature of pulmonary hydatid cysts on CT.

Subglottik Hemanjiyomda Propranolol Kullanımı

Turkiye Klinikleri Journal of Pediatrics, 2011

Esophageal cyst applied with asthma clinic

Paediatric Respiratory Reviews, 2010

Imaging Findings of Focal and Multiple Cystic and Cavitary Lung Lesions

European Journal of General Medicine, 2012

Cystic and cavitary lung lesions constitute a spectrum of pulmonary diseases diagnosed in both ch... more Cystic and cavitary lung lesions constitute a spectrum of pulmonary diseases diagnosed in both children and adults. Cysts and cavities are commonly encountered abnormalies on chest radiography and chest computed tomography. High-resolution computed tomography (HRCT) of the chest frequently helps define morphologic features that may serve as important clues regarding the nature of cystic and cavitary lesions of the lung. Occasionally, the underlying nature of the lesions can be readily apparent as in bullae associated with emphysema. Cystic and cavitary lung lesions can be diagnostic challange. Although many patients with cystic and cavitary lung lesions have a known underlying disease, in many cases the considerable overlap in morphologic features of these lesions tenders transthoracic needle biopsy necessary to establish the correct diagnosis.

Pictorial Review. Uncommon Locations of Hydatid Cysts

Acta Radiologica, 2003

Human echinococcosis remains a complex problem that may affect several organs, and requires mostl... more Human echinococcosis remains a complex problem that may affect several organs, and requires mostly surgical management. We present two cases with uncommon locations of hydatid cysts that were successfully managed in our hospital during the last two years. The first case was a 62-yearold woman with a multicystic lesion in her right thigh that was radically excised, and histology confirmed the diagnosis of echinococcosis. The second case was a 78-year-old man with multiple large intraabdominal hydatid cysts that required a complex operation, including splenectomy, partial removal of the liver cyst wall and evacuation of the content, and excision of pelvic, mesenteric cysts, and suprahepatic cysts. Both cases have not shown any sign of recurrence to date. Since the disease is still endemic in certain parts of the world and pharmaceutical agents are not radical, specific surgical procedures remain the treatment of choice with good results and acceptable morbidity, mortality and recurrence rates.

Pneumomediastinum and pneumopericardium due to malignant subcarinal lymphadenopathy: CT demonstration

European Radiology, 1997

A 52-year-old man had been treated for oral cancer T3 N0 M0 by radical surgery, neck dissection o... more A 52-year-old man had been treated for oral cancer T3 N0 M0 by radical surgery, neck dissection on the right and cervical irradiation (60 Gy). Two months after therapy he presented with dysphagia and hemoptysis. Admission chest X-ray revealed a pneumopericardium. It was caused by a bronchomediastinal fistula due to necrotic metastatic lymph nodes as shown by CT, which also revealed a concomitant pneumomediastinum. The patient died 10 days later from pneumonia. The CT findings were confirmed at autopsy. We conclude that malignant mediastinal lymphadenopathy is a potential cause of pneumopericardium and pneumomediastinum.

Cystic and Cavitary Lung Lesions in Children: Radiologic Findings with Pathologic Correlation

Journal of Clinical Imaging Science, 2013

A number of diseases produce focal or multiple thin-walled or thick-walled air- or fluid-containi... more A number of diseases produce focal or multiple thin-walled or thick-walled air- or fluid-containing cysts or cavitary lung lesions in both infants and children. In infants and children, there is a spectrum of focal or multifocal cystic and cavitary lung lesions including congenital lobar emphysema, congenital cystic adenomatoid malformation, pleuropulmonary blastoma, bronchogenic cyst, pulmonary sequestration, Langerhans cell histiocytosis, airway diseases, infectious diseases (bacterial infection, fungal infection, etc.), hydatid cysts, destroid lung, and traumatic pseudocyst. For the evaluation of cystic or cavitary lung lesion in infants and children, imaging plays an important role in accurate early diagnosis and optimal patient management. Therefore, a practical imaging approach based on the most sensitive and least invasive imaging modality in an efficient and cost-effective manner is paramount. We reviewed the conventional radiographs and computed tomography findings of the m...

The management of liver hydatid cysts by percutaneous drainage

Canadian journal of surgery. Journal canadien de chirurgie, 2001

To investigate the effect of percutaneous drainage on liver hydatid cysts. A retrospective case s... more To investigate the effect of percutaneous drainage on liver hydatid cysts. A retrospective case study. Department of Surgery, Selçuk University, Konya, Turkey. Forty-five patients with 83 liver hydatid cysts (types I and II according to the classification of Gharbi and colleagues) followed up for a mean of 30 months (range from 14 to 36 months). The cysts were drained percutaneously with ultrasonographic guidance and then irrigated with 0.05% silver nitrate solution through a fine needle. Albendazole was administered 48 hours before percutaneous drainage and for 2 months after the procedure to prevent the implantation of spilled scolices. Complications of the procedure, decrease in size of the cyst cavity, recurrence and dissemination of the cysts. All the cysts were treated successfully by percutaneous drainage. Anaphylactic shock developed in 1 (2.2 %) patient, and mild allergic reactions were observed in 2 (4.4 %) patients during the interventional procedure. Follow-up ultrasonog...

Chest Imaging Findings in Hospitalized Children with H1N1 Influenza

Eurasian Journal of Pulmonology, 2015

Objective: The aim was to review the radiological findings and to find new prognostic factors tha... more Objective: The aim was to review the radiological findings and to find new prognostic factors that determine the need for pediatric intensive care unit (PICU) in children with swine-origin influenza (H1N1) virus infection. Methods: Chest X-ray (CXR) and computed tomography (CT) findings of 18 children with laboratory-confirmed H1N1 infection (9 boys, 9 girls) with a median age of 34 (1-216) months were retrospectively evaluated. Results: CXRs were performed in 15 (83.3%) and thorax CT in 7 (38.8%) children. Abnormal findings were detected in 60% of the patients who underwent CXR and 85.7% of the patients who underwent thorax CT. Radiological findings were mostly diffuse, bilateral, and asymmetric. Ground-glass opacity (GGO) (66.6%) was the leading abnormality and was followed by reticulation (38.8%), nodules (27.7%), consolidation only (16.6%), tree-in-bud pattern (11.1%), consolidation with GGO (5.5%), and septal lines (5.5%). Lymphadenopathy (22.2%), air trapping (5.5%), and parenchymal band (5.5%) were other recorded findings. CXR was found to be insufficient to detect subpleural nodules, lymphadenopathies, and sometimes GGO. Only existence of nodules (p=0.04) affected the need for PICU admission. Conclusion: The most common radiological findings in children with H1N1 infection were bilateral, asymmetric GGO with or without associated multifocal areas of consolidation. CXR was insufficient to detect subpleural nodules, lymphadenopathies, and sometimes GGO. The existence of nodules is a bad prognostic factor in determining the need for PICU admission.

Intrathoracic Extrapulmonary Hydatid Disease: Radiologic Manifestations

Canadian Association of Radiologists Journal, 2010

Hydatidosis is a parasitic disease caused by the larvae of Echinococcus granulosus and rarely by ... more Hydatidosis is a parasitic disease caused by the larvae of Echinococcus granulosus and rarely by Echinococcus alveolaris. It is endemic to South America, North Africa, Asia, Australia, and the Middle East [1,2]. The definitive hosts are foxes and, less commonly, dogs and cats. Humans are infected by direct contact with an infected animal or by ingestion of contaminated food or fluids. Echinococcal embryos migrate through the intestinal mucosa, and, in 60%e70% of cases, reach the liver via the portal system [1]. They can then enter the systemic circulation via the porta caval anastomoses and be carried by the bloodstream to any organ or tissue in the body. Alternatively, the eggs can be inhaled and cause primary lung disease [2]. Intrathoracic extrapulmonary hydatid disease is very rare but can occur in the pleural space, extrapleural region, pleural fissure, chest wall, mediastinum, pericardium, myocardium, and diaphragm [1]. In this pictorial essay, we present the clinical manifestations and imaging features of patients with hydatid cysts (HC) in the extrapulmonary sites of the thorax. Imaging Findings Generally, HCs are classified into 4 types on the basis of their appearance [2].

Thoracic application of multi-detector CT: A pictorial essay

Electronic Journal of General Medicine

Multi-detector CT (MDCT) has considerable advantage over single-detector helical CT in the form o... more Multi-detector CT (MDCT) has considerable advantage over single-detector helical CT in the form of the shorter acquisition time, greater coverage and superior image resolution. It can be used to systematically evaluate the cardiovascular anatomy, morphologic features of thoracic vessels such as aorta, systemic veins and pulmonary vessels and relationship between the upper lobe bronchi and pulmonary arteries, coronary artery, valves, systemic veins. In diffuse lung diseases, this technique can increase nodule detection and help differentiate between small nodules and vessels. MDCT with three-dimensional (3D) volume rendering provides a unique perspective on thoracic anatomy and disease. MDCT allows shorter acquisition times, greater coverage and superior image resolution. In vascular imaging, this technique provides image quality that equals or surpasses that of conventional angiography. Its use has expanded to aid in diagnosis and surgical planning. In this article we present a pictorial review of the current applications of MDCT in diseases of the thorax.

Percutaneous Treatment of Liver Hydatid Cysts: Comparison of Direct Injection of Albendazole and Hypertonic Saline Solution

American Journal of Roentgenology, 2005

The purpose of this study was to compare the effect of intracystic injection of albendazole and h... more The purpose of this study was to compare the effect of intracystic injection of albendazole and hypertonic saline in patients with liver hydatid disease. Fifty-nine patients with a total of 109 hydatid cysts were treated percutaneously. In all cases, local anesthesia was applied. Twenty percent hypertonic saline was used in 31 patients (40 cysts, group 1) as the scolicidal agent, and albendazole solution was used in 28 patients (69 cysts, group 2). The PAIR (percutaneous puncture, aspiration, injection, reaspiration) method was applied in group 1. In group 2, we used a different procedure that could be called the PAI (percutaneous aspiration and injection) method. After this procedure, routine sonography and CT examinations were conducted. The results of both groups were compared. Follow-up examinations showed that liver hydatids expanded approximately to their original size after a significant reduction during the first month. In the follow-up period, fluid contents totally disappeared; thickening and irregularities were also observed in the cyst walls and a solid, hyperechogenic, heterogeneous pseudotumor appearance representing a degenerated membrane was seen in all patients. Hypertonic saline solution inactivated the scolices from the beginning of the treatment. However, scolices were inactive in the cysts aspirated 1 month after the procedure in group 2. A significant correlation was noted between elapsed time after the treatment and the cyst size using Wilcoxon&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s signed rank test (p = 0.000). No difference was seen between two groups in the amount of cyst size reduction using the Mann-Whitney test (p =0.521). In addition to its oral use, albendazole may be injected intracystically as we did in our study. It sterilizes the cyst cavity and affects scolices as well.

SwyerJames Syndrome: Demonstration By 64-Slice 3d MDCT Angiography And Coronal MPR CT Imaging

European Journal of …, 2008

The 64-slice three dimensional (3D) multidetector computed tomography (MDCT) angiography and high... more

Imaging of Cystic and Cyst-like Lesions of the Mediastinum with Pathologic Correlation

Journal of Clinical Imaging Science, 2012

Cystic masses of the mediastinum are a heterogenous group of asymptomatic or symptomatic, congeni... more Cystic masses of the mediastinum are a heterogenous group of asymptomatic or symptomatic, congenital, infectious, or neoplastic lesions. For early and correct diagnosis, evaluation, and optimal patient management of cystic mediastinal masses in infants, children, or adults imaging plays an important role. A non-invasive and sensitive imaging modality is an efficient and cost-effective tool. Multidetector computed tomography (MDTC) with volumetric acquisition provides fast acquisition of high resolution images and multiplanar reconstruction. Both 2D and 3D imaging in mediastinal imaging help in surgical planning and assessing resectability of mediastinal lesions. MR imaging has many advantages over other modalities for detecting and identifying cystic, or fluid-filled mediastinal masses, because of its intrinsic high soft tissue contrast and direct multiplanar imaging capabilities. However, histological tissue analysis may be required to differentiate a cystic lesion from other cyst-...

Imaging of Cystic and Cyst-like Lesions of the Mediastinum with Pathologic Correlation

Journal of Clinical Imaging Science, 2012

Cystic masses of the mediastinum are a heterogenous group of asymptomatic or symptomatic, congeni... more Cystic masses of the mediastinum are a heterogenous group of asymptomatic or symptomatic, congenital, infectious, or neoplastic lesions. For early and correct diagnosis, evaluation, and optimal patient management of cystic mediastinal masses in infants, children, or adults imaging plays an important role. A non-invasive and sensitive imaging modality is an efficient and cost-effective tool. Multidetector computed tomography (MDTC) with volumetric acquisition provides fast acquisition of high resolution images and multiplanar reconstruction. Both 2D and 3D imaging in mediastinal imaging help in surgical planning and assessing resectability of mediastinal lesions. MR imaging has many advantages over other modalities for detecting and identifying cystic, or fluid-filled mediastinal masses, because of its intrinsic high soft tissue contrast and direct multiplanar imaging capabilities. However, histological tissue analysis may be required to differentiate a cystic lesion from other cyst-...

Value of magnetic resonance imaging in diagnosing breast lesions which need biopsy]

To evaluate MRI in diagnosing breast lesions which need biopsy. One hundred and eight patients we... more To evaluate MRI in diagnosing breast lesions which need biopsy. One hundred and eight patients were admitted to hospital for biopsies due to one hundred and sixteen suspicious lesions detected in their breasts. These lesions were detected by physical examination, mammography or ultrasonography. They were also administrated MRI examination before biopsy. The sensitivity and specificity of each diagnostic method were obtained and the radiologic-pathologic correlation was meanwhile calculated. Seventy (60.3%) breast lesions were diagnosed malignancy. The sensitivity, specificity, accuracy, positive prognostic value and negative prognostic value of ultrasonography were 83.3%, 62.0%, 74.1%, 74.3% and 73.8%. Such data of mammography were 86.8%, 68.1%, 78.0%, 75.4% and 82.1%. And those of MRI were 97.1%, 73.9%, 87.9%, 85.0% and 94.4%. MRI is superior to ultrasonography and mammography in diagnosing breast lesions, especially for the nonpalpable lesions.

Cystic and Cavitary Lung Lesions in Children: Radiologic Findings with Pathologic Correlation

by Tamer Altinok and Kemal Odev

Journal of Clinical Imaging Science, 2013

A number of diseases produce focal or multiple thin-walled or thick-walled air- or fluid-containi... more A number of diseases produce focal or multiple thin-walled or thick-walled air- or fluid-containing cysts or cavitary lung lesions in both infants and children. In infants and children, there is a spectrum of focal or multifocal cystic and cavitary lung lesions including congenital lobar emphysema, congenital cystic adenomatoid malformation, pleuropulmonary blastoma, bronchogenic cyst, pulmonary sequestration, Langerhans cell histiocytosis, airway diseases, infectious diseases (bacterial infection, fungal infection, etc.), hydatid cysts, destroid lung, and traumatic pseudocyst. For the evaluation of cystic or cavitary lung lesion in infants and children, imaging plays an important role in accurate early diagnosis and optimal patient management. Therefore, a practical imaging approach based on the most sensitive and least invasive imaging modality in an efficient and cost-effective manner is paramount. We reviewed the conventional radiographs and computed tomography findings of the most common cystic and cavitary lung lesions in infants and children.