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Annals of Nuclear Medicine | 2003

Comparison of direct radionuclide cystography and voiding direct cystography in the detection of vesicoureteral reflux

Aysun Sukan; Aysun K. Bayazit; Mustafa Kibar; Aytül Noyan; Süreyya Soyupak; Zeynep Yapar; Ali Anarat

Purpose: The aim of this study is to compare the results of direct radionuclide cystography (DRNC) and voiding cystourethrography (VCUG) in a group of children with a high suspicion of vesicoureteral reflux (VUR).Methods: For this purpose, 25 children were studied with both VCUG and DRNC. Among 50 ureter units able to be compared 39 ureter units did not show any VUR on either study. Eleven ureter units (10 children) had VUR either on one study or on both (VCUG and DRNC). In the children who had VUR on either study, a dimercaptosuccinic acid scintigraphy (DMSA) was performed to determine their cortical function.Results: We identified the following four patterns: 1) Five ureter units (five children) read positive on DRNC who were negative on VCUG and four of these children had positive findings on DMSA; 2) Four ureter units (four children) read positive on VCUG who were negative on DRNC, and two of them had positive findings on DMSA; 3) Two ureters (one child) read positive in both studies and also had abnormal DMSA findings; 4) Thirtynine ureter units read as negative on both studies.Conclusion: Although the results of these two methods did not show a significant difference, DRNC offers a high sensitivity in the younger age group whereas VCUG seems to be more sensitive in the older age group. DRNC also offers continuous recording during the study, ease of assessment and lower radiation dose to the gonads, which makes it a preferable method for the initial diagnosis and follow-up of VUR.


Nuclear Medicine Communications | 2005

The conditions for which the geometric mean method revealed a more accurate calculation of relative renal function in 99mTc-DMSA scintigraphy

A. Fuat Yapar; Mehmet Aydin; Mehmet Reyhan; Zeynep Yapar; Aysun Sukan

Aims(1) To compare the results of calculating relative renal function (RRF) by using only posterior images (POST) with the geometric mean (GM) through both anterior and posterior imaging on dimercaptosuccinic acid (DMSA) scintigraphy. (2) To determine whether there was an age-related difference between them and whether some renal pathologies or asymmetrical renal function cause an error in the RRF calculation by using posterior images only. MethodsEight hundred and ninety-one DMSA scans were studied retrospectively. The patients were divided into five age groups: group I, ≤2 years; group II, >2 to ≤5 years; group III, >5 to ≤10 years; group IV, >10 to ≤18 years; and group V, >18 years. The RRF of the right kidney (RKF) was calculated from the POST and GM counts. The differences between RKFGM and RKFPOST were calculated in all the patients. ResultsAmong the 891 patients, nine had malrotated or malpositioned kidneys, 373 had renal pathologies of pyelonephritis, hydronephrosis, cortical scarring and atrophy, 247 had asymmetrically functioning kidneys and 509 had normal kidneys. When the patients were analysed according to different age groups, significant differences were found between all groups (P<0.05) except groups I–II and IV–V (P>0.05) with the F-test. The clinically meaningful RRF variance (≥5% difference between two methods) rate differed significantly between groups I, II and III, and groups IV and V (chi-squared test, P<0.05). In patients aged ≤10 years, a clinically meaningful RRF variance (≥5%) rate was significantly higher in the groups with pathological or asymmetrically low (≤40% RRF) functioning kidneys than in the groups without pathological or asymmetrically low functioning kidneys, respectively (P<0.05). ConclusionsAccording to our findings, the calculation of RRF using the GM method differs significantly from that using posterior images. Calculation of the GM can effectively correct the RRF measurement not in only adults, but also in the patient population ♯10 years of age. In addition, a significant correction can be made in patients aged ♯10 years who have a renal pathology or an asymmetrically low functioning kidney.


Annals of Nuclear Medicine | 2002

Coincidental visualization of an atypical bronchial carcinoid on Tc-99m-sestamibi scan in Kallmann's syndrome

Zeynep Yapar; Mustafa Kibar; Aysun Sukan; Saime Paydas; Handan Zeren; Mehmet Inal

We report a case of an atypical bronchial carcinoid showing sestamibi uptake. A 27-year-old man with Kallmann’s syndrome and hyperparathyroidism had parathyroid scintigraphy with99mTc-sestamibi. A focal uptake was observed on the right perihilar region, and this right perihilar mass was demonstrated on computed tomography and proved histologically to be an atypical bronchial carcinoid tumor. Factors which may explain the tumoral avidity for sestamibi are increased blood flow, transmembrane potentials of plasma and mitochondrial membranes and the relative number of mitochondria present in the cells of this carcinoid tumor. The importance of this case is the coincidence of an atypical carcinoid in a patient with significant failure of secondary sexual characteristics, right renal agenesis and bilateral anosmia associated with Kallmann’s syndrome.


Journal of Ultrasound in Medicine | 2005

Sonographic Diagnosis of a Tracheal Extramedullary Plasmacytoma

Mehmet Reyhan; Fahri Tercan; Melek Ergin; Aysun Sukan; Mehmet Aydin; A. Fuat Yapar

Solitary extramedullary plasmacytoma (EMP) is a rare tumor constituting 4% of all plasma cell neoplasms. It may occur in any reticuloendothelial system containing organs but is found most frequently in the head and neck regions, which are rich in lymphoid tissue. The most common sites of origin are the subepithelial tissues of mucous membranes of the oronasopharynx and paranasal sinuses.1-5 Sonography has no role in the evaluation of tracheal lesions. We report a case of tracheal plasmacytoma that was discovered during a sonographic examination of the neck for goiter. The interesting aspect of this case is the presentation of a rare tracheal tumor diagnosed by a sonographic examination.


Clinical Nuclear Medicine | 2007

Gated SPECT findings revealing diastolic dysfunction in acute hypothyroidism.

Mehmet Aydin; Mehmet Reyhan; Aysun Sukan; Ali Fuat Yapar; Aktas A

Purpose: The purpose of this study was to assess left ventricular (LV) function by gated SPECT in acute hypothyroidism. Methods: Thirty-eight acute hypothyroid patients without any cardiac disease and 40 healthy controls underwent gated SPECT at rest. Fourteen patients had a second examination during thyroxine replacement therapy. Gated SPECT was performed using Tc-99m sestamibi with 16 frames per cardiac cycle. The LV end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), peak ejection rate (PER), peak filling rate (PFR), and time to peak filling (TTPF) were measured by quantitative gated SPECT (QGS). Systolic wall thickening/motion was determined in 5 myocardial segments. Results: Hypothyroid patients exhibited a decrease in PFR (222 ± 52 EDV/s) and prolongation of TTPF (194 ± 32 msec) as compared with controls (247 ± 41 EDV/s and 179 ± 17 msec, respectively; P < 0.05). During thyroxine therapy, the mean values for EDV (74 ± 21 mL) and PFR (265 ± 64 EDV/s) increased significantly in 14 follow-up patients (pretreatment values 67 ± 18 mL and 219 ± 50 EDV/s, respectively; P < 0.05). A significant difference was detected in the mean TTPF between the thyroxine group and the controls (195 ± 35 msec vs 179 ± 17 msec; P < 0.05). No significant differences were found in wall thickening and motion values (P > 0.05). Conclusion: Gated SPECT findings revealed diastolic dysfunction as indicated by a decrease in PFR and a prolongation in TTPF in patients with acute hypothyroidism.


Clinical Nuclear Medicine | 2002

Vesicoureteral reflux causing misinterpretation of a Tc-99m DTPA scan.

Zeynep Yapar; Aysun Sukan; Mustafa Kibar

The authors examined a 10-year-old girl to determine the functional status of an atrophic kidney resulting from chronic pyelonephritis. A Tc-99m DTPA scan revealed an atrophic right kidney with an 11.8% split renal function. On DMSA images, severe cortical loss was visualized in the right kidney, and the right relative function was 2%. Vesicoureteric reflux was thought to be a possible cause, leading to misinterpretation of the DTPA study. Direct radionuclide ureterocystography showed severe vesicoureteric reflux on the right side. This case indicates that DTPA and DMSA studies are complementary in measurements of the differential function of an atrophic kidney. If any uncertainty exists, additional studies should be performed to identify the underlying cause.


Clinical Nuclear Medicine | 2005

Lymphoscintigraphic appearance of scrotal lymphatic reflux in a patient with idiopathic genital lymphedema.

Aysun Sukan; Ozgur Yaycioglu; Mehmet Aydin; A. Fuat Yapar; Osman Kizilkilic; Mehmet Reyhan


Clinical Nuclear Medicine | 2005

Ventilation-perfusion mismatch resulting from an aberrant systemic arterial supply to Basal segments of the right lung.

A. Fuat Yapar; Mehmet Aydin; Dalokay Kilic; Mehmet Reyhan; Fahri Tercan; Aysun Sukan


Nuclear Medicine Communications | 2007

99mTc(V)-DMSA SPECT for the assessment of disease activity in Graves' ophthalmopathy.

Mehmet Reyhan; Okan Toygar; Aysun Sukan; Gulsah Seydaoglu; Okan S. Bakiner; Mehmet Aydin; A. Fuat Yapar; Ayse Aktas


Clinical Nuclear Medicine | 2007

Ventilation-perfusion mismatch secondary to arterial bullet embolism.

Mehmet Reyhan; Mehmet Aydin; Aysun Sukan; Dalokay Kilic; Ali Fuat Yapar; Fahri Tercan

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