Researcher:
Özmen, Evrim

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Evrim

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Özmen

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Özmen, Evrim

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20243

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    Occipital emissary vein existence and its impact on the diagnosis of idiopathic intracranial hypertension in pediatric patients
    (Springer, 2024)  ; Özmen, Evrim; Şentürk, Yunus Emre; Peker, Ahmet; Öner, Ali Yusuf;  ; School of Medicine; Koç University Hospital
    Purpose This study aimed to investigate the efficacy of occipital emissary vein (OEV) detection in the diagnosis of idiopathic intracranial hypertension (IHH) in the pediatric age group, and to compare the prevalence and luminal diameter of OEV in patients with IHH and in healthy control subjects. Methods Conventional magnetic resonance imaging findings were assessed in the patients with IHH and in healthy control subjects who were under the age of 18, by two observers. The presence and luminal dimension of OEV and transverse sinus stenosis were also evaluated and compared between these two groups with magnetic resonance venography techniques. Results The rate of OEV existence was 7 times higher in the IIH group compared to the control group based on the second observer outcome (p = 0.010, OR = 7.0), with a very good interobserver agreement (kappa = 0.85). The dimension of OEV ranged between 0.6 and 2.5 mm. There was no correlation found between the opening pressure and the dimension of OEV (p = 0.834). Conclusion In conclusion, OEV existence could be an additional radiological finding for diagnosing IHH among pediatric patients, alongside other conventional findings.
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    Splenic cysts: clues in sonographic differential diagnosis and a new role for twinkling artifact
    (SOC ROMANA ULTRASONOGRAFE MEDICINA BIOLOGIE-SRUMB, 2024) Keven, Ayse; Gunduz, Nesrin; Kabaalioğlu, Adnan; Uzer, Evren; Doğan, Hakan; Özmen, Evrim; School of Medicine; Koç University Hospital
    Aim: Our aim was to investigate the frequency of various splenic cysts, to define the sonographic differential diagnostic clues and to introduce the value of twinkling artefact in the diagnosis of epidermoid splenic cysts. Material and methods: All the splenic cysts imaged by ultrasound in 3 university hospitals during the period of 2005 to 2022 were recorded, followed -up and analyzed. Results: One hundred seventy-one patients with splenic cysts were detected and these were classified and 73% of the cysts were simple. Ten cysts were epidermoid cysts as proven by post -operative final histology. Conclusion : Cystic splenic lesions are rare. Most of them are small simple cysts. Epidermoid cysts are larger in volume, constitute 6% of the total and can be differentiated by the help of twinkling artefact by Doppler ultrasound.
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    Tortuous occipital emissary vein combined with dural venous sinus stenosis in contrast-enhanced MRV for evaluation of idiopathic intracranial hypertension
    (Springer, 2024) Şentürk, Yunus Emre; Peker, Ahmet; Aydın, Kubilay; Özmen, Evrim; Aygün, Murat Serhat; Atalay, Hande Özen; Öner, Ali Yusuf; School of Medicine; Koç University Hospital
    Purpose Venous outflow impediment is increasingly recognized in idiopathic intracranial hypertension (IIH). We aim to search for the value of tortuous occipital emissary vein (OEV) in IIH by integrating measurable transverse sinus (TS) stenosis in contrast-enhanced MR venography (CE-MRV). Methods Twenty-one IIH patients were evaluated with CE-MRV. Each patient had high LP opening pressure (> 25 cm.H2O), and presented papilledema. Age- and sex-matched 21 control subjects who underwent cranial CE-MRV were selected. The OEV and the following features: intraosseous diameter of more than 3 mm, twisted course, and continuous with prominent sub-occipital extracranial veins were named tortuous OEV. TS stenosis was measured by utilizing the coronal T1-VIBE series to calculate quantitative metrics such as TS (max./min.). The tortuous OEV and TS (max./min.) were registered to create a bivariate logistic regression model to assess the performance of tortuous OEV for IIH when accompanied by TS stenosis. Results Six (29%) tortuous OEVs were observed in the IIH group, while no tortuous OEV was identified in the control group (p = 0.021). The mean TSmax./min. was 2.48 +/- 1.19 in patients with IIH and 1.23 +/- 0.33 in the control group (p < 0.001). According to regression analysis, tortuous OEV is not predictive of IIH (p = 0.999), while the higher TSmax./min. (> 1.69) is predictive of IIH (p = 0.022, OR: 8.9; %95 CI; 1.4-59.0) when accompanied together. Conclusion Tortuous occipital emissary vein is more frequently seen in patients with IIH. However, the tortuous appearance alone does not predict idiopathic intracranial hypertension unless associated with measurable transverse sinus narrowing in CE-MRV.