Objectives: Our aim was to investigate the role of simultaneous apparent diffusion coefficient (ADC) measurement and diffusion-weighted MRI (DWMRI) in the diagnosis and differentiation of bladder masses. Methods: Weexamined 45 patients presenting with hematuria by dynamic and diffusion MRI (at b100, b600, b1000 gradients) and cystoscopy. Thirty healthy volunteers without hematuria were also included in the study. Results from imaging techniques were compared to cystoscopic and histopathologic findings. The ADC values of benign and malignant bladder masses, and bladder tissue in healthy subjects were measured and compared with each other. Results: The mean ADC values of benign (n = 10) and malignant lesions (n = 35) were significantly lower than the mean ADC values of adjacent bladder walls and bladder walls of healthy subjects at all 3 gradients (p < 0.05). However, no significant difference was detected between benign and malignant lesions (p > 0.05). Mean ADC values of invasive tumors were significantly lower than superficial malignancies at b600 and b1000 gradients. The mean ADC values of transitional cell tumors were significantly higher than squamous cell tumors at b100 and b600 gradients. Conclusion: Simultaneous measurement ofADC and DWMRI provided useful information in the diagnosis, staging and histopathological classification of bladder tumors.
Objective: Psoas abscess (PA) is a rare infection disease, which is difficult to diagnose. In the present study, we aimed to evaluate etiological factors and treatment results of patients with PA.Methods: Files of 20 patients who were diagnosed as PA between December 2006 and January 2013, were retrospectively analyzed. Patient's whose data were entirely reached and diagnosed by Ultrasonography and/or Computed Tomography as an exact PA were included to the study. Results:The mean age of the 20 patients was 48.8 (range 17-82) year, and 6 of them were female and remaining were male. Psoas abscess were on the right side in 12 patients (60%), on the left side in seven patients (35%), and bilateral in one (5%). According to data records four patients had Diabetes Mellitus (20%), two had Hypertension (10%), one had cerebrovascular disease (5%), one had tuberculosis (5%), one had hyperthyroidism (5%), one had mental retardation (5%), and one had paraplegia (5%). Six case (30%) were diagnosed as a primary psoas abscess (pPA, sPA) and remaining (n=14, %70) were diagnosed as secondary. Percutaneous drainage was performed to 13 patients (65%) and exploration was performed to three patients (15%) as a treatment modality. Remaining four patients (20%) were followed by medical treatment. Conclusion:Psoas abscess is rare and have variable and non-specific clinical characteristic, which may lead to difficulty in diagnosis. In developed and developing countries, it has been reported that the most common causes of sPA are Pott's disease, and Crohn's disease, also it should be taken into account that open surgery and urinary tract stone disease can receive a significant portion of the etiological factors.
Objective: In this study our aim is to present outcomes of laparoscopic radical nephrectomy (LRN) we have been applying for the management of renal masses. Methods:We retrospectively examined medical files of 54 cases who underwent LRN in the Urology Clinics of Dicle University between October 2010, and April 2014. Archival files of the patients were retrospectively analyzed as for age, gender, obesity, dimensions, and laterality of renal mass, smoking status, history of hypertension, histopathology results, blood transfusion (if any), hospital stays, peri-and post-operative complications, drain removal times, and method of removal of the nephrectomy material.Results: Our study population (n=54) consisted of 21 male, and 33 female patients with a mean age of 58,8 (29-82) years. Some of them were smoker (n=23), hypertensive (n=15), and obese (n=32) patients. Renal masses with a median diameter of 6.2 cm (4,5-16,5) were localized in the right (n=23) or left (n=31) kidneys. In all cases, transperitoneal approach was preferred. In 3 cases we have to switch to an open surgery. In 8 patients, blood transfusions were required. In 18 patients 4th port was used for the retraction of the liver, while in other cases only 3 ports were used. Median operative time was 115.6 min . Median hospital stay was 3,9 days (3-16). In one case abundant bleeding occurred because of splenic artery injury. Conclusion:Transperitoneal LRN is a minimally invasive surgical method which can be performed rapidly, and effectively. We think that in procedures performed in compliance with surgical principles, LRN can be realized safely with lower complication rates even by urologists in their initial experiences. On sekiz hastada, karaciğer ekartasyonu için 4. port kullanılırken, diğer tüm vakalarda 3 port kullanıldı. Ortalama operasyon süresi 115,6 dk (75-192) idi. Ortalama hastanede kalış süresi 3,9 gün (3-16) idi. 1 olguda splenik arter yaralanmasına bağlı abondan kanama gelişti.Sonuç: Transperitoneal LRN, hızlı ve etkin bir şekilde yapılabilen minimal invaziv bir cerrahi yöntemdir. Laparoskopik cerrahi prensiplere bağlı kalarak yapılan cerrahi işlemlerde başlangıç deneyimlerde bile LRN düşük komplikasyon oranları ile güvenle yapılabilecek bir cerrahi olduğunu düşünmekteyiz.
Aim: PSMA expression has been observed in increased levels in patients with high Gleason scores. Current information on Ga-68 PSMA PET/CT shows that primary staging with PET/CT is important in patients with high-risk PC. Ga-68 PSMA PET/CT may also have a place in patients with intermediate risk PC, but only a few data are available at present. In this study, we aimed to elucidate the relationship between PSMA expression value in the prostate gland, total PSA levels and GS in patients diagnosed with prostate cancer. Material and Method: A total of 98 patients who were pathologically diagnosed with prostate cancer that did not receive any treatment and underwent Ga‐68 PSMA PET/CT imaging for staging were included in the study. Findings detected in Ga‐68 PSMA PET/CT imaging were categorized as prostate, lymph node, bone, and visceral organ. The focal increased PSMA expression values observed in the prostate gland were recorded as SUVmax. The patients were divided into two separate groups according to their GS score (GS>7 and GS≤7). Correlations between prostate PSMA SUVmax, GS score and total PSA scores were investigated. Results: PSMA SUVmax levels of the group with a Gleason score of >7 were found to be significantly higher than the group with a Gleason score of ≤7 (p=0.03). The rates of lymph node metastasis, bone metastasis and visceral organ metastases were found to be significantly higher in the group with a Gleason score >7 compared to the group with a Gleason score ≤7. A positive correlation was observed between PSMA SUVmax and Total PSA (r=0.260, p=0.01). A positive correlation was observed between PSMA SUVmax and Gleason score (r=0.260, p=0.01). A positive correlation was observed between total PSA and Gleason score (r=0.320, p=0.001). Conclusion: In conclusion, PSMA SUVmax and Total PSA levels were higher in the group with high Gleason score. There is a positive correlation between PSMA SUVmax and total PSA. Clinicians should be careful in this regard, as the possibility of metastasis will be high in groups with high Gleason scores.
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