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Santral Sinir Sistemi Lenfomaları: Klinik ve Manyetik Rezonans Görüntüleme Bulguları
2017
Journal:  
Osmangazi Tıp Dergisi
Author:  
Abstract:

Öz: Santral sinir sistemi (SSS) lenfomaları primer ve sistemik tutulumun eşlik ettiği sekonder lenfomalar olarak ikiye ayrılır. Bu çalışmada SSS lenfomalarının klinik ve manyetik rezonans görüntüleme (MRG) bulgularını literatür bilgileri eşliğinde sunmayı amaçladık. Aralık 2011 ile Haziran 2017 arasında farklı histolojik subtiplere sahip SSS lenfoma tanısı olan hastaların klinik ve kontrastlı serebral MRG incelemeleri retrospektif değerlendirildi. Hastaların demografik özellikleri, lenfoma subtipleri, immünitesi, serum laktat dehidrogenaz değerleri, klinik ve MRG bulguları kaydedildi. MRG görüntülerde lezyon sayısı, lokalizasyonu, sinyal özellikleri, difüzyon özellikleri, kontrastlanma paterni, hemoraji ve kelebek görünümü varlığı değerlendirildi. Çalışmaya SSS lenfoma tutulumu olan 23 hasta dahil edildi. (erkek/kadın:9/14, yaş ortalaması 53.6±18.8 dağılımı 15-81) ve primer (n=3,%13) ve sekonder (n=20, %87) olarak iki gruba ayrıldı. Hastaların tümünde non-Hodgkin lenfoma ve subtip olaraksık diffüz büyük B hücreli lenfoma (%65.2) saptandı. En sık semptom baş ağrısı ve halsizlikti. SSS lenfomalarında sıklıkla parankimal (%56.5) ve leptomeningeal (%47.8) tutulum izlendi. Primer SSS lenfomalarında parankimal tutulum bütün hastalarda izlenirken, leptomeningeal tutulum sekonder SSS lenfomalarında daha sık saptandı (%55). SSS lenfomalı 13 hastada 33 parankimal lezyon saptandı. Parankimal lezyonlar çoğunlukla supratentoryal (%87.9) ve lokalizasyon olarak dasık beyaz cevher (%57.6) yerleşimliydi. Primer SSS lenfoma grubunda tüm lezyonlar T1 ağırlıklı görüntülerde (AG) hipointens, T2AG’de heterojen hipo-hiperintens ve difüzyon kısıtlaması izlenirken çoğunlukla homojen nodüler kontrastlanma mevcuttu(%83). Sekonder SSS lenfoma grubunda ise lezyonların çoğunda T1AG’de hipointens (%74.1), T2AG’de hiperintens (%51.9), difüzyon kısıtlaması (%96.3) ve çoğunlukla homojen nodüler (%55.6) kontrastlanma izlendi. SSS lefomalarında klinik ve radyolojik görüntüleme özelliklerinin bilinmesi; tanıda, prognozda, tedavi cevabını değerlendirmede ve sağkalımı belirlemede oldukça önemlidir.

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Central nervous system lymphomas: clinical and magnetic resonance imaging findings
2017
Author:  
Abstract:

The central nervous system (SSS) lymphomas are divided into two, secondary lymphomas accompanied by primary and systemic attitude. In this study, we aimed to present the findings of SSS lymphomas in clinical and magnetic resonance imaging (MRG) accompanied by literary information. Clinical and contrasted brain MRG studies of patients diagnosed with SSS lymphoma with different histological subtypes between December 2011 and June 2017 were evaluated retrospective. The demographic characteristics of patients, subtypes of lymphoma, immunity, serum lactate dehydrogenase values, clinical and MRG findings were recorded. The MRG images assessed the number of injury, localization, signal characteristics, diffusion characteristics, contrast paternity, hemorrhage and the presence of bird appearance. In the study, 23 patients with SSS lymphoma have been included. (Man/woman:9/14, age average 53.6±18.8 distribution 15-81) and primary (n=3,13) and secondary (n=20,87) were divided into two groups. In all patients, non-Hodgkin lymphoma and subtype diffuse large B cell lymphoma (65.2%) were detected. The most common symptoms were headaches and discomfort. In SSS lymphomas, parankimal (56.5) and leptomeningeal (47.8) adhesions were frequently observed. Primary SSS lymphoma parankimal attitude was observed in all patients, while leptomeningeal attitude was more frequently detected in secondary SSS lymphoma (55%). In 13 patients with SSS lymphoma, 33 parankimal injuries were detected. Paranchimal lesions were mostly supratentoryal (87.9%) and localized by the dusted white cider (57.6%) inhabited. All injuries in the Primary SSS lymphoma group were observed in T1 gravity images (AG) hypointensity, heterogene hypo-hyperintensity and diffusion limitation in T2AG while mostly homogene nodular contrastation was present (83%). In the secondary SSS lymphoma group, the majority of lesions were followed by hypointensity (%74.1) in T1AG, hyperintensity (%51.9) in T2AG, diffusion limitation (%96.3) and mostly homogeneous nodular (%55.6) contrast. The knowledge of the clinical and radiological imaging characteristics in the SSS lefomas is very important in diagnosis, prognosis, evaluation of the treatment response and determination of survival.

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Osmangazi Tıp Dergisi

Field :   Sağlık Bilimleri

Journal Type :   Uluslararası

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Osmangazi Tıp Dergisi