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    Acute mesenteric ischemia: The diagnostic value of QT parameters and their relationship with CT findings
    (Bentham Science Publ Ltd, 2024) Alan, Bircan; Alan, Sait; Gürel, Safiye; İnanır, Mehmet; Acar, Emrah; Dönmez, İbrahim; Kalaycıoğlu, Oya
    Background: One of the greatest challenges in the diagnosis of acute mesenteric ischemia (AMI) is the lack of specific laboratory tests that support multidetector computed tomography (CT). Our aim is to investigate the diagnostic value of electrocardiographic QT parameters in AMI and their relationship with CT findings. Materials and Methods: Patients who were admitted to the emergency department with abdominal pain were recruited retrospectively from the hospital information system. Grouping was carried out on the basis of AMI (n=78) and non-AMI (n=78). In both groups, the corrected QT (QTc) and QT dispersion (QTD) were measured on electrocardiographs, and the qualitative and quantitative CT findings were evaluated on CT examinations. Results: The QTc and QTD values were higher in the AMI group. The median QTc values were 456.16 (IQR: 422.88-483.16) for the AMI group and 388.83 (IQR: 359.74-415.83) for the control group (p<0.001), and the median QTD values were 58 (IQR: 50.3-68.25) for the AMI group and 46 (IQR: 42-50) for the control group (p<0.001). In the CT analysis, the QTc values were significantly higher among AMI patients, with images of paper-thin bowel walls and the absence of bowel wall enhancement (p=0.042 and p=0.042, respectively). Meanwhile, the QTD values were significantly higher among patients with venous pneumatosis findings on CT (p=0.005). In the regression analysis, a significant relationship was found between the QT parameters and AMI (p<0.001). For QTc, an AUC of 0.903 (95% CI: 0.857-0.950, p<0.001), a sensitivity of 80.8%, and a specificity of 82.3% were found. For QTD, an AUC of 0.821 (95% CI: 0.753-0.889, p<0.001), a sensitivity of 73.1%, and a specificity of 82.3% were found. Conclusion: We found the QTc and QTD values to be significantly higher among AMI patients. Furthermore, we found a significant relationship between the CT findings and QTc and QTD and a significant relationship between survival and QTc in the AMI group.
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    The diagnostic value of bladder-wall thickness and ARFI elastography of bladder wall amongst patients with BPH
    (Duzce University, Faculty of Medicine, 2022) Alan, Bircan; Göya, Cemil; Utangaç, Mazhar; Dusak, Abdurrahim
    Objective: The present study identified bladder-wall thickness and, through the use of ARFI elastography, bladder-wall elasticity values amongst patients with benign prostate hyperplasia (BPH), then examined their relationship with the disease diagnosis and progression. Methods: The study included 60 patients with BPH (patient group) and 50 healthy volunteers (control group). All members of the patient and control groups were measured for bladder-wall thickness (BWT) and bladder-wall mean shear-wave velocity (BW mean SWV) values, as well as for uroflowmetry parameters. The patient group was divided into the sub-groups of mild-medium and severe BPH, according to the International Prostate Symptom Score (IPSS). The patient and control groups and their sub-groups were compared amongst themselves. Results: Whilst the BPH group indicated a mean wall thickness of 6.3 +/- 2 mm (range: 3-12 mm), the control group yielded a result of 2.8 +/- 0.7 mm (range: 2-5 mm), which led to the conclusion that there was a significant difference between these groups (p<0.01). The BWmeanSWV value was 1.39 +/- 0.5 m/s (range: 0.60-2.65 m/s) for the BPH group and 1.01 +/- 0.2 m/s (range: 0.60-1.50 m/s) for the control group, and this also indicated the presence of a significant difference between the groups (p<0.01). According to the IPSS, BWT was observed to be significantly higher in the severe sub-group when compared to the mild-medium BPH group [(5.07 +/- 1 mm; range: 3-7 mm), (6.8 +/- 2 mm; range: 4-12 mm), p<0.01). Conclusions: When compared to the control group, patients with BPH showed significantly higher BWT and BWmeanSWV values; these two parameters may provide an additional method in the diagnosis of bladder outlet obstruction secondary to BPH. BWT, increasing in parallel with the severity of BPH, may be utilised in the follow-up for BPH progression.
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    Evaluation of carotid artery stiffness in patients with coronary artery disease using acoustic radiation force impulse elastography
    (Sage Publications Ltd, 2023) Alan, Bircan; Alan, Sait
    Objectives We evaluated carotid artery stiffness in patients with coronary artery disease (CAD) using acoustic radiation force impulse (ARFI) elastography and investigated the relationship between stiffness and CAD. Methods This study examined 76 CAD patients (aged 60.7 +/- 11) and 70 healthy individuals (aged 59.6 +/- 9). The left common carotid artery mean shear wave velocity (LCmeanSWV) and the right common carotid artery mean shear wave velocity (RCmeanSWV) of the anterior walls were measured using ARFI elastography, and the results of the patient group and the healthy group were compared. The common carotid intima-media thickness (CIMT) was measured in both groups and compared with mean SWV. Results The RCmeanSWVs in the patient and healthy groups were 3.47 +/- 1 m/s and 2.69 +/- 0.90 m/s, respectively (p < 0.001). The LCmeanSWVs in the patient and healthy groups were 3.60 +/- 0.9 m/s and 2.90 +/- 0.80 m/s, respectively (p < 0.001). A significant correlation was found between the RCmeanSWV and the right CIMT values and between the LCmeanSWV and the left CIMT values (r = 0.231, p = 0.03 and r = 0.331, p = 0.002, respectively). Conclusions The mean SWV values of carotid arteries of CAD patients measured with ARFI elastography were significantly higher than the mean SWV values of the carotid arteries of healthy individuals. Thus, measurement of the carotid artery SWV could be a potential tool in the risk evaluation of cardiovascular disease. Nonetheless, new studies are required to determine whether this method serves as a useful additional tool.