Baki Hekimoğlu

T.C. Sağlık Bakanlığı Ankara Eğitim ve Araştırma Hastanesi, Engüri, Ankara, Turkey

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Publications (68)74.84 Total impact

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    ABSTRACT: The aim of the study was to investigate the orbital anthropometric variations in the normal population using three-dimensional computed tomography (3D-CT) images and to define the effects of age and gender on orbital anthropometry.
    Folia morphologica 01/2014; 73(2):149-152. · 0.47 Impact Factor
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    Ozgur Bulut, Serdar Sipahioglu, Baki Hekimoglu
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    ABSTRACT: 320 Turkish adults (160 men, 160 women) who had undergone brain CT in the radiology clinic and showed no sign of maxillofacial pathology were analyzed in order to create a facial soft-tissue thickness database of the Turkish adult population. The soft-tissue thicknesses were measured at 31 landmarks, 10 midline and 21 bilateral anatomical landmarks. Average thickness values for each landmark as well as the standard deviation and range classified according to gender and age are reported. The differences of these mean values related to age and sexes were calculated. The values were then statistically compared to the findings of the European and Korean adults. Overall, the soft-tissue thickness measurements obtained in this study can be used as a database for the forensic craniofacial reconstruction of Turkish adult faces.
    Forensic Science International. 01/2014; 242:44–61.
  • Hasan Aydin, Baki Hekimoglu, Volkan Kizilgöz
    American Journal of Roentgenology 02/2013; 200(2):W219. · 2.90 Impact Factor
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    ABSTRACT: Gall bladder (GB) may be found in a variety of abnormal positions. Most of them are due to arrested development of embryonic growth at different stages. A 63-year-old female patient was admitted to our radiology unit for magnetic resonance imaging (MRI) of the liver for the lesions identified in abdominal ultrasonography (US) and computed tomography (CT). MRI showed that there was a lobulated heterogenous mass in the left lobe of the liver and a smaller one in the right lobe of the liver with the same appearance. The inferior pole of the liver was located in the pelvic space, and the GB, which contained sludges and stones, was lying down to the upper pelvic space. Hepatic masses were considered to be hemangiomas, and GB was diagnosed as ptotic GB with luminal sludge and stones. In this case, especially, MR imaging helped the surgeon to plan a proper approach to the GB in abnormal localization.
    Case reports in radiology. 01/2013; 2013:854686.
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    ABSTRACT: PURPOSE: To evaluate the percentages of the left renal vein (LRV) variations and inferior vena cava (IVC) variations as well as the effect of gender on their frequencies. MATERIALS AND METHODS: Contrast-enhanced abdominal helical computed tomography (CT) examinations of 1204 patients were retrospectively evaluated. RESULTS: The correspondent percentages of the total LRV variations, retroaortic left renal vein (RLRV), and circumaortic LRV were 5.2%, 3.1%, and 2.1%, respectively. A statistically significant correlation was found between RLRV variation and gender (P=.036). CONCLUSIONS: Helical CT is an efficient, fast, easily applicable, and reliable imaging modality in demonstration of LRV variations and IVC variations.
    Clinical imaging 10/2012; · 0.73 Impact Factor
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    ABSTRACT: To evaluate the efficacy of apparent diffusion coefficient (ADC) calculation in differentiation between malignant and benign thyroid nodules. A prospective study was conducted in 52 patients. Diffusion-weighted echoplanar imaging was performed and b factors were taken as 0 and 400 s/mm(2). The mean ADC value for malignant thyroid nodules was 0.829±0.179×10(-3) mm(2)/s and that for benign thyroid nodules was 1.984±0.482×10(-3) mm(2)/s. The mean ADC value for malignant nodules was significantly lower than that for benign nodules (P=.0001). ADC value calculation is an effective method in differentiation of malignant thyroid nodules from benign ones.
    Clinical imaging 07/2012; 36(4):316-22. · 0.73 Impact Factor
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    ABSTRACT: INTRODUCTION Dermatofibrosarcoma protuberans (DFSP) is a rare locally aggressive tumor of the dermis and subcutaneous tissue that commonly appears on upper extremities and on the trunk. There is a slight male predominance and the lesion is commonly seen between the second and fifth decades of life. The tumor grows slowly over years and rarely metastasizes; however, local recurrence is frequent. The most common sites for metastasis are lymph nodes and the lungs. The treatment of the tumor is resection with wide margins (1,2). Here we present radiologic findings of DFSP with unusual presentation located in the deep skin over the breast, which was excised successfully and without local recurrence during a 36-month follow-up period. CASE REPORT A 36-year-old female with a palpable right breast mass located in the upper inner quadrant and change in skin color without a significant history was admitted to surgery department. She claimed that the mass had first appeared two years before and was slowly growing. She had no history of recent trauma or surgical operation. On inspection, a well circumscribed, plaque type lesion was observed, along with a violet-purple change in color of the skin over the right breast (Fig. 1). The patient reported neither systemic disease or known illness nor continuous drug usage. Physical examination was unremarkable except for a well-defined non-tender mass on the right breast. The left breast and bilateral axillaries were normal. The patient was referred for radiologic examination to exclude a primary breast tumor. Bilateral breast ultrasound (US) and color Doppler ultrasound (CDUS) was performed with a Toshiba, Powervision 6000 SSA-370A (Tokyo, Japan) with 6-11 MHz high frequency linear transducer.US demonstrated a 3.5x1.5 cm sized solid, hyperechogenic lesion with sharp margins in the subcutaneous fat tissue, without marked vascularity on CDUS (Fig. 2). The left breast and both axillaries were unremarkable. The right mammography (HFXPlus-Fischer Imaging, Denver, USA) on mediolateral oblique (MLO) projection showed a well-defined bilobulated density with irregular margins and no calcifications (Fig. 3). Based on the mammography and sonography findings, the mass was considered suspect of malignancy and breast magnetic resonance imaging (MRI) study was planned for further examination. A contrast-enhanced breast MRI was performed using a 1.5 tesla MR unit (Somatom Vision Plus, Siemens, Erlangen, Germany) at our institution. Unfortunately, the mass could not be demonstrated on either T1, T2 or postcontrast subtracted images (Fig. 4). The patient was referred to surgery department and wide excision of the mass was performed. On pathologic evaluation, spindle cells were seen to be arranged in a storiform pattern, with minimal pleomorphism (Fig. 5). Immunohistochemical stain with CD34 was positive (Fig. 6) and definitive histologic diagnosis was DFSP. On follow-up, 36 months after surgical treatment, the patient continued to be symptom free, with no signs of tumor recurrence. DISCUSSION Dermatofibrosarcoma protuberans is a rare fibrous tumor of the soft tissue, commonly arising from dermis and subcutaneous tissue, which was first described by Darier and Ferran in 1924 (3). It accounts for 0.1% of all malignant tumors and 1% of all soft tissue sarcomas. The tumor is mostly located on the trunk skin (50%-60%) and is more common in men than women. The majority of these tumors are less than 5 cm in diameter. It can be seen at any age but it is much more common between ages 20 and 50, however, there are few cases reported in early childhood. DFSP has an indolent growth pattern and its symptoms are mostly long lasting, spanning over months and years (1,2,4). DFSP poses a diagnostic challenge as the clinical symptoms and the radiologic signs are nonspecific. The tumor usually causes a red-purple change of color on the overlying skin on inspection, and if it presents with a red and irregular bordered lesion, it can mimic a hemangioma. When DFSP is located in the breast, it can be mistaken for primary breast tumor and the accurate diagnosis is difficult to reach. Usually after clinical evaluation, US is the first choice for imaging and CDUS is very helpful for vascular situation but neither of the modalities is specific for diagnosis. Shin et al. report that a diagnosis of DFSP should be considered if US reveals an oval mass in the subcutaneous tissue that is abutting against the skin and has a focal lobulated margin with hypoechogenicity or an irregular margin with mixed echogenicity (5).Although an echogenic macrolobulated oval mass located over the breast lying in the deep dermis and the subcutaneous tissue without marked vascularization was demonstrated, an exact diagnosis could not be made in the present study. Unfortunately, mammography was also found to be nonspecific, with macrolobulated density on MLO projection. Considering mammography and sonography findings, a primary breast tumor could not be excluded and the present case was classified as BI-RADS category 4. Computed tomography is not indicated unless bony invasion or pulmonary metastasis is suspected in some occasional cases. Although MRI is also nonspecific for the exact diagnosis of DFSP, it is useful for identifying the extent and location of the mass, especially in large recurrent tumors. In addition, the areas of hemorrhage within the tumor may be demonstrated by use of MRI and can suggest the diagnosis (6,7). Another current imaging modality, multivoxel proton [1H]) MR spectroscopy (MRS), is accepted as an adjunctive method to breast MRI on differential diagnosis of benign versus malignant tumors. A recent case study of DSFP located on the breast, reported by Ivanovic et al., did not show significant cholin peak on [1H] MRS (8). In the present case, the mass could not be demonstrated on either T1 or T2 weighted images, and there was no significant enhancement on post-contrast subtracted images on breast MRI examination. It is considered that the discrimination failed both on pre- and post-contrast images as the mass was probably carrying similar signal characteristics of the adjacent subcutaneous fat tissue in which the lesion developed. Complete surgical resection is accepted as the optimal treatment for primary or recurrent DFSP. Studies have shown that resection with wide margins is essential and recurrence rates after local resection are reduced while the excision margins are widened. The combination of adjuvant radiotherapy before or after the surgery is a treatment option, particularly in those who cannot undergo wide surgical excision for several reasons. In addition, there are some successful clinical reports on imatinib, a tyrosine kinase inhibitor, which can induce regression in patients with unresectable or metastatic DFSP (1,2,4). Proper follow-up seems critical since the most significant characteristic of the tumor is recurrence, and local recurrence generally occurs in the first 3 years after surgery. Sonographic evaluation and re-biopsy is advisable if suspicion occurs. In addition, mammography might be helpful in the diagnostic work-up in breast located tumors for periodic control of recurrence. In conclusion, DFSP is a rare soft tissue tumor of cutaneous origin that mostly occurs on the trunk and might be rarely seen on the breast skin and can be confused with primary breast tumors. We believe that the importance of the present case is to upgrade the awareness of this soft tissue tumor while keeping in mind the differential diagnosis of other breast tumors.
    Acta dermatovenerologica Croatica : ADC. 04/2012; 20(1):50-4.
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    ABSTRACT: BACKGROUND: Epilepsy, a well-known mostly idiopathic neurologic disorder, has to be correctly diagnosed and properly treated. Up to now, several diagnostic approaches have been processed to determine the epileptic focus. OBJECTIVES: The aim of this study was to discover whether proton-MR-spectroscopic imaging (MRSI) aids in the diagnosis of temporal lobe epilepsy in conjunction with classical electroencephalography (EEG) findings. PATIENTS AND METHODS: Totally, 70 mesial temporal zones consisting of 39 right hippocampi and 31 left hippocampi of 46 patients (25 male, 21 female) were analyzed by proton MRSI. All patients underwent a clinical neurologic examination, scalp EEG recording and prolonged video EEG monitoring. Partial seizures on the right, left or both sides were recorded in all patients. All patients were under medical treatment and none of the patients underwent amygdalohippocampectomy and similar surgical procedures. RESULTS: The normal average lactate (Lac), phosphocreatine, N-acetyl aspartate (NAA), creatine (Cr), choline (Cho), myo-inositol, glutamate and glutamine (Glx) peaks and Nacetyl aspartate/Cr, NAA/ Cho + Cr, Cho/Cr ratios were measured from the healthy opposite hippocampi or from the control subjects. The Lac, glutamate and glutamine (Glx), myo-inositol, phosphocreatine and NAA metabolites plus Cho/Cr ratio showed statistical difference between the normal and the epileptic hippocampi. Cho, Cr metabolites plus NAA/Cr, NAA/ Cho + Cr ratios were almost the same between the groups. The sensitivity of Proton-MR-Spectroscopy for lateralization of the epileptic foci in all patients was 96% and the specificity was 50%. CONCLUSIONS: Proton-MRSI can easily be considered as an alternative modality of choice in the diagnosis of temporal lobe epilepsy and in the future; Proton-MR-Spectroscopy may become the most important technique used in epilepsy centers.
    Iranian Journal of Radiology 03/2012; 9(1):1-11. · 0.04 Impact Factor
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    ABSTRACT: Biliary microhamartomas, also known as bile duct hamartomas and von Meyenburg complexes, are benign neoplasms containing cystic dilated bile ducts embedded in fibrous stroma. They develop in hepatobiliary system, do not generally give clinical outcomes, and are detected incidentally. However, they can rarely show malignant transformation. Our aim was to report the contribution of computed tomography, routine magnetic resonance imaging, and magnetic resonance cholangiopancreatography in the diagnosis of biliary microhamartomas in a 61-year-old woman.
    Case Reports in Medicine 01/2012; 2012:976078.
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    ABSTRACT: A 58-year-old female patient presented to the hospital with hearing loss. In the chest radiography obtained before her ear surgery, volume decrease in the right hemithorax, elevation of the right diaphragm, and increase of ventilation in the right lung were detected. At the thorax CT-CT angiography, hypoplasia of the main pulmonary artery and its branches and arteriovenous malformation localized in the middle lobe of the right lung were detected. Thus, diagnosis of Swyer-James-Macleod syndrome associated with right lung middle lobe hypoplasia and arteriovenous malformation was made. This kind of association has not been reported earlier, so we are presenting it in the light of the literature knowledge.
    Case Reports in Medicine 01/2012; 2012:959153.
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    ABSTRACT: Heterotaxy syndrome is a rare, complex, and confusing type of the situs anomalies. It is not possible to estimate the degree of lateralization, isomerism, and rotational variation in these types of cases. Heart and abdominal organ anatomy is specific to the individual, and it should be defined specifically on the basis of each case due to possible cardiac and extracardiac surgical interventions in patients with heterotaxy syndrome. Here, we present our findings obtained from a 58-year-old female patient with heterotaxy syndrome. The main components of this rare variation consist of right-hand-sided aorta, aortic arc, cardiac apex, gall bladder and left-hand-sided inferior vena cava, stomach, and spleen (polysplenia, 3 foci) according to the midline. Besides, the components include left-dominant liver, right-hand-sided large intestines, and left-hand-sided small intestines.
    Case Reports in Medicine 01/2012; 2012:840453.
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    A Dilli, I Gunes Tatar, B Keyik, B Hekimoglu
    JBR-BTR: organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR) 01/2012; 95(3):138-9.
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    ABSTRACT: A prospective study was designed to figure out the percentages of the left renal vein variations using routine lumbar spinal magnetic resonance imaging (MRI) in patients with neurological problems. Between March 2010 and October 2010, the study population was recruited from a total of 2,644 consecutive patients who would undergo a routine lumbar spinal MRI examination. In addition to the routine MRI sequences, axial, balanced turbo field echo sequence (BTFE-BH SENSE) was applied after detection of a left renal vein variation. As the left renal vein variations, retroaortic left renal vein (RLRV) and circumaortic left renal vein were detected. The number of cases with the correspondent percentages of the total left renal vein variations, RLRV and circumaortic left renal vein were 71/2,644 (2.68%), 44/2,644 (1.66%) and 27/2,644 (1.02%), respectively. In cases with RLRV, the numbers of males and females with their correspondent percentages were 19/44 (43.2%) and 25/44 (56.8%), respectively. In cases with circumaortic left renal vein, the numbers of males and females with their correspondent percentages were 13/27 (48.1%) and 14/27 (51.9%), respectively. With Chi-square test, no statistically significant gender difference was found between the percentages of left renal vein variations (P = 0.83). MRI is useful in detecting RLRV and circumaortic left renal vein. If a left renal vein variation is detected, an additional BTFE-BH SENSE sequence is suggested to confirm whether it is retroaortic or circumaortic.
    Anatomia Clinica 05/2011; 34(3):267-70. · 0.93 Impact Factor
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    ABSTRACT: To assess the most effective magnetic resonance imaging (MRI) sequence for the visualization of the 9th, 10th, and 11th cranial nerves (glossopharyngeal, vagus, and accessory nerves, respectively) in their intraforaminal/canalicular courses. Balanced fast-field echo (b-FFE), 3D-T2W DRIVE, T2W 2D TSE and post-contrast T1W MRI sequences were all applied and we tried to get the best sequence for the exact assessment of the 9th, 10th, and 11th cranial nerves. Six hundred nerves of 100 patients without symptoms of neurovascular compression were examined using the above sequences. Imaging analysis was graded as: a) nerves analyzed by certainty (score of 2), b) nerves analyzed partially (score of 1), and c) nerves not identified (score of 0). In all three nerves, the best sequence for the visualization of the cisternal and intraforaminal course was b-FFE, with 58%, 73%, 62%, and all together 64.3% success in showing the fascicles of the 9th-11th nerves. This sequence with a very short time of repetition, symmetrical and balanced gradient around the echo time allowed very fast imaging and a high signal to noise ratio. T2W TSE sequence was superior to the DRIVE T2W sequence in assessing the cisternal and intraforaminal part of all three nerves. Post-contrast T1W sequence was probably the worst sequence in showing all three nerves. b-FFE gradient echo MRI sequence with high spatial resolution is the optimal sequence for determining the courses of 9th-11th cranial nerves.
    Diagnostic and interventional radiology (Ankara, Turkey) 03/2011; 17(1):3-9. · 1.03 Impact Factor
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    ABSTRACT: Our objective was to assess the accuracy of computed tomographic virtual cystoscopy (CTVC) in the detection of urinary bladder lesions. Twenty-five patients were examined using CTVC. Bladder scanned using multislice CT at a slice thickness of 1 mm. The data were transferred to a workstation for interactive navigation using surface rendering. Findings obtained from CTVC were compared with results from conventional cystoscopy and with pathological findings. Thirty-eight lesions were identified. The smallest was 0.2 × 0.3 cm; the largest was 7 × 4.5 cm. Both CTVC and conventional cystoscopy were used. Conventional cystoscopy detected the same number of lesions that were detected by CTVC. On morphological examination, 26 of the lesions were polypoid, 7 were sessile and 5 were bladder wall-thickening. While one of the polypoid lesions was reported as an inverted papilloma, 2 of the 5 lesions that were identified as wall-thickening were malignant and 3 were benign. The sensitivity of using CTVC to identify neoplasias was 100%; the accuracy was 89%. Although the definitive diagnosis of some suspected urinary bladder tumours is only possible with conventional cystoscopy and biopsy, CTVC is a minimally invasive technique which provides beneficial information about urinary bladder lesions.
    Canadian Urological Association journal = Journal de l'Association des urologues du Canada 02/2011; 5(1):34-7. · 1.66 Impact Factor
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    Hasan Aydin, Volkan Kizilgöz, Baki Hekimoğlu
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    ABSTRACT: Our aim was to evaluate the efficacy of Diffusion-Weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) mapping with different b-factors in visualisation of meniscal tears. Seventy-four patients; 30 males and 44 females, 37 left and 37 right knees with meniscal tears were involved in this study. Eleven of them were lateral meniscal tears and 63 - medial meniscal tears. DWI was obtained by 3D-SE Echo-planar Imaging (EPI) in coronal and sagittal planes. ADC mapping was carried out in coronal planes with b-factors of 50, 400, and 800 sec/mm(2). The statistical analysis of DWI and ADC mapping results was performed with the use of the Fisher's test and the chi-square test. 1. For both menisci and 74 tears: DWI revealed 86% sensitivity and 100% specificity (p=0.149) with a positive predictive value (PPV) of 1 and a negative predictive value (NPV) of 0.09. ADC mapping with b-value of 400 sec/mm(2) had 78% sensitivity, and 100% specificity, with PPV of 1 and NPV of 0.06 (p=0.230). 2. For the lateral meniscal tears: DWI and ADC mapping with b-value of 800, for the medial meniscal tears: DWI and ADC mapping with b-factor of 400 s/mm(2) revealed higher sensitivity and specificity than other methods. Quantitative DWI and ADC mapping, especially with b-factor of 400 sec/mm(2), may be an alternative to routine MR imaging sequences for the visualisation of meniscal tears in the knee.
    Polish journal of radiology / Polish Medical Society of Radiology. 01/2011; 76(1):30-40.
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    ABSTRACT: It is important to diagnose retroaortic left renal vein (RLRV) before a probable retroperitoneal surgery in a case of a suspicious adrenal mass. Our purpose is to present the ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) findings in a case of left adrenal adenoma with a coincidental RLRV and to discuss the clinical importance of their imaging. Abdominal and scrotal US, abdominal CT and MRI were performed for a 50-year-old male patient who was referred with continuous abdominal pain, intractable hypertension, high levels of blood cortisol and proteinuria. On US, a hypoechoic solid mass measuring 4 × 3 cm in the left adrenal location and coincidental RLRV, besides multiple renal cysts, hepatomegaly, left-sided varicocele, and small-sized left testis were detected. CT and MRI also revealed the mass in the left adrenal gland which was consistent with adenoma. With CT and MRI, presence of RLRV was also verified.
    Case Reports in Medicine 01/2011; 2011:867895.
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    JBR-BTR: organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR) 01/2011; 94(2):81-2.
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    ABSTRACT: Hydatid disease (HD) continues to be a significant health problem in areas where animal husbandry is common but no proper veterinary control exists. The involvement of the spleen in HD is rare, and isolated splenic involvement is even less common. In this case report, we present isolated splenic HD in a 26-year-old female with complaint of abdominal pain, and we discuss some of the clinical aspects of HD. Evaluation of the patient with ultrasonography, computed tomography, and magnetic resonance imaging revealed the presence of an isolated splenic HD as a multivesicular cystic mass located near splenic hilus, measuring 12 × 11 cm. No other organ or system involvement could be demonstrated.
    Case Reports in Medicine 01/2011; 2011:763895.
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    ABSTRACT: The characteristics of Sprengel deformity, which is also called congenital high scapula, are malposition and dysplasia of the affected scapula, with possible omovertebral connection. The aim of the present study was mainly to present the magnetic resonance imaging (MRI) findings of two pediatric cases of Sprengel deformity. A 7-year-old girl and a 9-year-old boy with deformities in their right shoulder were studied. Plain radiographs were obtained. MRI was performed for both children. The fibrous omovertebral connection is depicted in its longest form in one plane. Omovertebral band is best screened in coronal and axial cross sections. We are introducing a new MRI sign which we named as "Ra's eye" to define the appearance of omovertebral band within the surrounding fat tissue.
    Journal of clinical imaging science. 01/2011; 1:13.

Publication Stats

370 Citations
74.84 Total Impact Points

Institutions

  • 2012
    • T.C. Sağlık Bakanlığı Ankara Eğitim ve Araştırma Hastanesi
      Engüri, Ankara, Turkey
  • 2010–2012
    • Dışkapı Yıldırım Beyazıt Training and Research Hospital
      Engüri, Ankara, Turkey
  • 2011
    • Elazığ Eğitim ve Araştırma Hastanesi
      Mezreh, Elazığ, Turkey
  • 2007
    • Erciyes Üniversitesi
      • Department of Radiology
      Caesarea, Kayseri, Turkey
  • 2006
    • Dokuz Eylul University
      • Department of Radiology
      İzmir, Izmir, Turkey
    • Ankara Atatürk Training and Research Hospital
      Engüri, Ankara, Turkey
  • 1996–2002
    • Social Security Administration
      Baltimore, Maryland, United States
  • 2001
    • Istanbul Occupational Diseases Hospital
      İstanbul, Istanbul, Turkey