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    CLINICAL UTILITY OF RADIOLOGICAL IMAGING IN THE EVALUATION OF GALLSTONE ILEUS
    (2019) Özdemir, Adnan; Yilmazsoy, Yunus; Arslan, Serdar; Pehlivanli, Faruk
    Objective: Gallstone ileus is a rare complication ofcholelithiasis. It occurs as a result of the passage of bile stonesinto intestinal system via bilioenteric fistulae, which are formedby recurrent attacks of cholecystitis, and obstruction of theintestinal lumen. The objective of our study was to discuss theimaging findings of gallstone ileus among patients diagnosed atour center.Material and Methods: Among patients that admitted to ourhospital’s radiology department between December 2016 andJanuary 2019, the medical records of those with a history of gallbladder stone detected on ultrasonography were retrospectivelyevaluated. Among those, cases of gallstone ileus were identified.Admission complaints, age, sex, comorbidities, radiologicalimaging findings, fistula localization, stone size, and obstructionlevel were recorded and analyzed.Results: Among 958 patients with bile stones, 342 (35.7%)were male and 616 (64.3%) were female. Gallstone ileus wasidentified in five patients. Three of them were female (mean age76.67± 13.05 years) and 2 were male (mean age 59±1.41 years).Ileus signs were detected on plain radiograms for all patients.The gallbladders were not clearly visualized by ultrasonographyin any of patients with gallstone ileus. A diameter increasesuggestive of ileus was detected in visualizable intestinalsegments. Computed tomography to identify the cause of ileusrevealed air in the bile ducts, cholecystoduodenal fistula, stonesin intestinal lumen, and an appearance consistent with ileusproximal to that segment. The mean size of the stones was26.20±16.3 mm (16-55 mm).Conclusion: Although gallstone ileus is a rare cause ofintestinal obstruction, it should be definitely remembered in thedifferential diagnosis in patients with advanced age and ahistory of cholelithiasis who present to the emergencydepartment.
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    Evaluation of optic nerve sheath complex by magnetic resonance imaging in patients with idiopathic normal pressure hydrocephalus
    (Asean Neurological Assoc, 2023) Yılmazsoy, Yunus; Özdemir, Adnan; Arslan, Serdar
    Background: We aimed to evaluate the optic nerve and optic nerve sheath diameter of patients with idiopathic normal pressure hydrocephalus with magnetic resonance imaging and to compare with the normal population. Methods: Magnetic resonance images and clinical records of the patients were retrospectively evaluated between 01.01.2015 and 01.01.2020. Twenty one patients in the normal pressure hydrocephalus group and 47 patients in the control group were included. Measurements were performed from the images obtained by creating multiplanar reconstructions from thin-slice Fast Spin Echo T2-weighted images. Measurements were made of optic nerve from the 3 mm posterior to the optic globe, on the plane which is oriented perpendicular to the nerve. Results: There was no difference between the two groups in terms of optic nerve diameters. Optic nerve sheath diameters are significantly higher in the normal pressure hydrocephalus group (p<0.0001). Conclusion: Morphological analysis of the optic nerve sheath complex which contains cerebrospinal fluid will contribute to the diagnosis and understanding chronic effects of normal pressure hydrocephalus, a disease in which changes in brain compliance and cerebrospinal fluid absorption are suspected in its etiology.
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    A new ventricular index based on coronal brain magnetic resonance images in patients with idiopathic normal pressure hydrocephalus
    (Scientific and Technological Research Council Turkey, 2023) Yılmazsoy, Yunus; Arslan, Serdar; Özdemir, Adnan; Korkmazer, Bora; Kızılkılıç, Osman; Kafadar, Ali Metin
    Background/aim: The aim of this study was to assess the effectiveness of a new quantitative index for the diagnosis of idiopathic normal pressure hydrocephalus. Materials and methods: This retrospective study was conducted at Istanbul University Cerrahpasa Medical Faculty between January 2016 and November 2022. A total of 31 patients diagnosed with idiopathic normal pressure hydrocephalus were included in the study group and 48 patients were included in the control group. Measurement via the new Index was performed on a coronal section of magnetic resonance imaging at the level of the anterior commissure. Results: The new Index's mean diagnostic performance was 1.16 +/- 0.08 in the study group, significantly lower (p < 0.0001) than the mean of 1.43 +/- 0.10 in the control group. When a cutoff value of 1.23 was used for the new index, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates were 96.1%, 90.7%, 80.6%, 98%, and 91.3%, respectively. Conclusion: The new Index described here is an effective, feasible, reproducible, highly sensitive, and specific quantitative method that can contribute to the improved diagnosis of patients with idiopathic normal pressure hydrocephalus.