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Öğe Anatomical variations of the circle of Willis in children(Springer, 2021) Solak, Serdar; Ustabasioglu, Fethi Emre; Alkan, Aykut; Kula, Osman; Sut, Necdet; Tuncbilek, NerminBackground The morphology of the circle of Willis in adults has been thoroughly discussed in scientific literature. However, the morphology of the circle of Willis in pediatric patients is under-researched. Objectives We aimed to establish reference data for the morphology and variations of the circle of Willis in a population consisting of all pediatric age subgroups and to evaluate the possible temporal evolution of the circle of Willis in pediatric patients along with the variations between pediatric and adult populations. Materials and methods Our patient cohort included 263 pediatric patients ages 1-215 months. A total of 273 magnetic resonance (MR) angiography images were retrospectively analyzed for all circle of Willis vessels to compare the incidence of complete cases and variation frequency based on gender and age group. Result In our study of 273 MR angiograms from all age ranges in the pediatric population, we found a 56.1% circle of Willis completion rate. Overall completion rates were statistically significantly higher in the toddler and preschool age groups. The lowest completion rate was in the newborn-infant group (40%). Conclusion Circle of Willis completion rates and variations in pediatric populations are similar to those in adult populations; completion rates rise in toddler and preschooler age groups and decline as children grow into the school-age and adolescent period.Öğe Cardiac Magnetic Resonance Imaging and Transthoracic Echocardiography: Investigation of Concordance between the Two Methods for Measurement of the Cardiac Chamber(Mdpi, 2019) Gurdogan, Muhammet; Ustabasioglu, Fethi Emre; Kula, Osman; Korkmaz, SelcukBackground and objectives: Cardiac magnetic resonance (CMR) imaging is the gold standard method for the detection of ventricular volumes and myocardial edema/scar. Transthoracic echocardiography (TTE) imaging is primarily used in the evaluation of cardiac functions and chamber dimensions. This study aims to investigate whether the chamber diameter measurements are concordant with each other in the same patient group who underwent TTE and CMR. Materials and Methods: The study included 41 patients who underwent TTE and CMR imaging. Ventricular and atrial diameter measurements from TTE-derived standard parasternal long axis and apical four-chamber views and CMR-derived three- and four-chamber views were recorded. The concordance between the two methods was compared using intra-class correlation coefficients (ICC) and Bland-Altman plots. Results: Of the patients, 25 (61%) were male and the mean age was 48.12 +/- 16.79. The mean ICC for LVDD between CMR observers was 0.957 (95% CI: 0.918-0.978), while the mean ICC between CMR and TTE measurements were 0.849 (95% CI: 0.709-0.922) and 0.836 (95% CI: 0.684-0.915), respectively. The mean ICC for the right ventricle between CMR observers was 0.985 (95% CI: 0.971-0.992), while the mean ICC between CMR and TTE measurements were 0.869 (95% CI: 0.755-0.930) and 0.892 (95% CI: 0.799-0.942), respectively. Passing-Bablok Regression and Bland-Altman plots indicated high concordance between the two methods. Conclusions: TTE and CMR indicated high concordance in chamber diameter measurements for which the CMR should be considered in patients for whom optimal evaluation with TTE could not be performed due to their limitations.Öğe Contrast nephropathy in cancer patients receiving anti-VEGF therapy: a prospective study(Springer Japan Kk, 2020) Gokyer, Ali; Kucukarda, Ahmet; Kostek, Osman; Hacioglu, Muhammet Bekir; Uzunoglu, Sernaz; Kula, Osman; Kurt, NazmiObjectives Contrast nephropathy risk has been increasing in cancer patients. Nephrotoxic side effects of anti-vascular endothelial growth factor/receptor (anti-VEGF/R) drugs used in oncologic treatment are also prominent. The purpose of this study was to identify the possible association among anti-VEGF/R drugs use and development of the contrast-induced nephropathy (CIN) in patients with cancers. Methods A total of 92 patients were included in this prospective cross-sectional study. Patients whose glomerular filtration rate (GFR) of < 50 ml/min, hemoglobin of < 10 g/dl, and eastern cooperative oncology group (ECOG) score of >= 2 and had received nephrotoxic drugs were not included in the study. Blood samples were collected baseline at pre computed tomography (CT) and day 2, day 3 and day 7 later CT imaging. CIN was defined as either an increased serum creatinine value of 0.5 mg/dl or increased 25% to baseline. CIN frequency between groups receivingand not receiving anti-VEGF/R was compared using the chi-squared test. CIN frequency between bevacizumab and other anti-VEGF/R was also analyzed. Results There were 39 patients in the anti-VEGF/R (+) group and 53 patients in the anti-VEGF/R (-) group. Eleven patients (28%) in the anti-VEGF/R (+) group and 3 patients (5.6%) in the anti-VEGF/R (-) group had CIN (p = 0.006). In the anti-VEGF/R (+) group, 23 patients received bevacizumab (combined with FOLFOX/FOLFIRI), while 16 patients received other anti-VEGF/R (sunitinib, axitinib, regorafenib, aflibercept) effective treatments. CIN ratio in patients who received bevacizumab or other anti-VEGFR therapy was similar (p = 0 = 50). Of the patients, one patient had acute kidney injury leading to death. Conclusion CIN was significantly more frequent in cancer patients who receiving anti-VEGF/R drugs than those not receiving anti-VEGF/R drugs.Öğe Evaluation of celiac artery and common hepatic artery variations by CT-angiography and new classification model(Springer France, 2023) Turkyilmaz, Zeliha; Kula, Osman; Celik, Ahmet Onur; Demirel, Tugrul; Gunay, BurakPurposeKnowledge of anatomical variations is important in all interventional procedures. This study aims to evaluate the variations and prevalence of celiac trunk (CeT) and its branches.MethodsThe computerized tomography-angiography (CT-A) findings of 941 adult patients were evaluated retrospectively. Variations of the CeT and common hepatic artery (CHA) were evaluated according to the number of branches and their origin. Findings were compared with classical classification methods. A new classification model has been defined.ResultsNormal (complete) trifurcation was detected in 856 (90.9%) of them, where left gastric artery (LGA), splenic artery (SpA) and CHA branches were derived from the CeT. Among 856 complete trifurcation cases, 773 (90.3%) had non-classical trifurcation patterns. The rate of classic trifurcation was 8.8%, while non-classic trifurcation was 82.1% in all cases. In one case (0.1%), LGA and left hepatic artery together and right hepatic artery and SpA together appeared as a double bifurcation. Complete celiacomesenteric trunk was observed only in 4 (0.42%) cases. In seven cases (0.7%), LGA, SpA and CHA were coming out of abdominal aorta (AAo) independently. CHA normal anatomy (Michels Type I) was detected in 618 (65.5%) patients. We found that 49 (5.2%) of our cases were ambiguous according to the Michels Classification. We have described five different variations of hepatic arteries directly arising from the AAo.ConclusionPreoperative recognition of anatomical variations of CeT, superior mesenteric artery and CHA is of primary importance in both surgical and radiological procedures. With careful evaluation of CT-angiographies, it is possible to detect rare variations.Öğe An extremely rare presentation of hydatid cyst disease: hepatic artery pseudoaneurysm bleeding and synchronous duodenal fistula(Cukurova Univ, Fac Medicine, 2022) Kurt, Idris; Cengiz, Nazlican; Demir, Neslican; Soylu, Ali Riza; Kula, Osman[Abstract Not Available]Öğe A Giant Lipoma Presenting with Colocolonic Invagination(2018) Karabulut, Derya; Kula, Osman; Usta, Ufuk; Sezer, Atakan; Tunçbilek, NerminColonic lipomas are very rare and usually do notcause symptoms until they reach large size. Giantlipomas may mimic malignancy, depending on theirsymptoms, such as obstruction and invagination.Colonic lipomas should always be considered indifferential diagnosis and proper radiological,colonoscopic evaluation is important to avoideunnecessary extensive surgical resection.Öğe A life-threatening haemoptysis case that would have been defined as idiopathic before the COVID-19 era(Turkish Assoc Tuberculosis & Thorax, 2021) Yilmam, Ilker; Karlikaya, Celal; Serez Kaya, Bilkay; Kula, Osman; Emmungil, HakanThe coronavirus disease 2019 (COVID-19) is characterized by respiratory infection which can show very different clinical pictures, somewhat changing medical paradigm. Hemoptysis defined as idiopathic can be seen as much as 15%. Currently, increasing hemoptysis cases are being reported in medical coronavirus literature. We here present a hemoptysis case that would be defined as idiopathic before the COVID-19 era. After the first clinical picture, the case turned into a life-threatening hemoptysis. We studied the case com-prehensively as clinical, pathogenetical, therapeutic and clinical practical aspects. Thus, we hypothesized that especially in the pandemic era, all hemoptysis cases must be evaluated as a possible life threatening infectious disease with unpredictable prognosis.Öğe Neutrophil to Lymphocyte Ratio and Serum Biomarkers : A Potential Tool for Prediction of Clinically Relevant Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage(Korean Neurosurgical Soc, 2023) Kula, Osman; Gunay, Burak; Kayabas, Merve Yaren; Akturk, Yener; Kula, Ezgi; Tutunculer, Banu; Sut, NecdetObjective : Subarachnoid hemorrhage (SAH) is a condition characterized by bleeding in the subarachnoid space, often resulting from the rupture of a cerebral aneurysm. Delayed cerebral ischemia caused by vasospasm is a significant cause of mortality and morbidity in SAH patients, and inflammatory markers such as systemic inflammatory response index (SIRI), systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), and derived NLR (dNLR) have shown potential in predicting clinical vasospasm and outcomes in SAH patients. This article aims to investigate the relationship between inflammatory markers and cerebral vasospasm after aneurysmatic SAH (aSAH) and evaluate the predictive value of various indices, including SIRI, SII, NLR, and dNLR, in predicting clinical vasospasm. Methods : A retrospective analysis was performed on a cohort of 96 patients who met the inclusion criteria out of a total of 139 patients admitted Trakya University Hospital with a confirmed diagnosis of aSAH between January 2013 and December 2021. Diagnostic procedures, neurological examinations, and laboratory tests were performed to assess the patients' condition. The Student's t-test compared age variables, while the chi-square test compared categorical variables between the non-vasospasm (NVS) and vasospasm (VS) groups. Receiver operating characteristic (ROC) curve analyses were used to evaluate the diagnostic accuracy of laboratory parameters, calculating the area under the ROC curve, cut-off values, sensitivity, and specificity. A significance level of p<0.05 was considered statistically significant. Results : The study included 96 patients divided into two groups : NVS and VS. Various laboratory parameters, such as NLR, SII, and dNLR, were measured daily for 15 days, and statistically significant differences were found in NLR on 7 days, with specific cut-off values identified for each day. SII showed a significant difference on day 9, while dNLR had significant differences on days 2, 4, and 9. Graphs depicting the values of these markers for each day are provided. Conclusion : Neuroinflammatory biomarkers, when used alongside radiology and scoring scales, can aid in predicting prognosis, determining severity and treatment decisions for aSAH, and further studies with larger patient groups are needed to gain more insights.Öğe Predictive evaluation of SIRI, SII, PNI, and GPS in cholecystostomy application in patients with acute cholecystitis(Turkish Assoc Trauma Emergency Surgery, 2022) Cakcak, Ibrahim Ethem; Kula, OsmanBACKGROUND: The aims of this study were to investigate the clinical significance of systemic inflammatory response index (SIRI), systemic inflammation index (SII), prognostic nutritional index (PNI), and Glasgow prognostic score (GPS) in deciding whether to perform cholecystostomy when determining if cholecystostomy is the right choice for acute cholecystitis (AC) patients. METHODS: Between January 2018 and December 2020, 126 consecutive patients with AC with and without cholecystostomy were retrospectively recruited from the Trakya University in Edirne, Turkey. Group I included AC patients with cholecystostomy and Group II included AC patients without cholecystostomy. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lymphocyte/monocyte ratio (LMR) were calculated. The PNI and SII were calculated RESULTS: There is significant difference between the two groups by the comparison of SIRI, SII, PNI, and GPS values (p<0.001). In Group I, SIRI, SII, and GPS values are higher than the Group II and PNI value in Group I is lower than the Group II. Furthermore, the NLR and PLR ratios in Group I are significantly higher than Group II, and the LMR ratio in Group I is significantly lower than Group II. CONCLUSION: According to our study, we can say that NLR, PLR, SII, SIRI, and GPS are positive predictors and LMR and PNI are negative predictors for the severity of AC. Therefore, when we decide to treat AC medically, we may prefer the application of chole-cystostomy tube at the beginning of hospitalization by the help of evaluating NLR, PLR, LMR, SIRI, SII, GPS, and PNI values.Öğe Quantitative Assessment of Salivary Gland Parenchymal Vascularization Using Power Doppler Ultrasound and Superb Microvascular Imaging: A Potential Tool in the Diagnosis of Sjögren’s Syndrome(2020) Ustabaşıoğlu, Fethi Emre; Korkmaz, Selçuk; İlgen, Ufuk; Solak, Serdar; Kula, Osman; Turan, Sezin; Emmüngil, HakanBackground: Primary Sjögren’s syndrome is a chronic inflammatory autoimmune disease. Minor salivary gland biopsy is the gold standard for the diagnosis of primary Sjögren’s syndrome. Superb microvascular imaging, power Doppler ultrasound, and color Doppler of the salivary glands represent non-invasive, non-irradiating modality for evaluating the vascularity of the salivary glands in the diagnosis and follow-up of primary Sjögren’s syndrome. Aims: To evaluate the efficacy of superb microvascular imaging and vascularity index in salivary glands for the sonographic diagnosis of primary Sjögren’s syndrome. Study Design: Prospective case-control study. Methods: Twenty participants with primary Sjögren’s syndrome and 20 healthy subjects were included in the study. Both parotid glands and submandibular glands were evaluated by superb microvascular imaging, power Doppler ultrasound, and color Doppler. The diagnostic accuracy of superb microvascular imaging was compared using these techniques. Results: In the patient group, the vascularity index values of superb microvascular imaging in parotid glands and submandibular glands were 3.5±1.66, 5.06±1.94, respectively. While the same values were 1.0±0.98 and 2.44±1.34 in the control group (p?0.001). In the patient group, the vascularity index values of power Doppler ultrasound in parotid glands and submandibular glands were 1.3±1.20 and 2.59±1.82, respectively. While the same values were 0.3±0.32 and 0.85±0.68 in the control group (p?0.001). The superb microvascular imaging vascularity index cut-off value for the diagnosis of primary Sjögren’s syndrome in parotid glands that maximizes the accuracy was 1.85 (area under the curve: 0.906; 95% confidence interval: 0.844, 0.968), and its sensitivity and specificity were 87.5% and 72.5%, respectively. While the superb microvascular imaging vascularity index cut-off value for the diagnosis of primary Sjögren’s syndrome in submandibular gland that maximizes the accuracy was 3.35 (area under the curve: 0.873; 95% confidence interval: 0.800, 0.946), its sensitivity and specificity were 82.5% and 70%, respectively. Conclusion: Superb microvascular imaging with high reproducibility of the vascularity index has a higher sensitivity and specificity than the power Doppler ultrasound in the diagnosis of primary Sjögren’s syndrome. It can be a noninvasive technique in the diagnosis of primary Sjögren’s syndrome when used with clinical, laboratory and other imaging methods.Öğe The relationship between computed tomographic obstruction index and pulmonary vein cross-sectional area in acute pulmonary embolism(Springer-Verlag Italia Srl, 2020) Ustabasioglu, Fethi Emre; Solak, Serdar; Kula, Osman; Gunay, Burak; Serez, Bilkay; Tuncbilek, NerminPurpose To investigate whether the increased obstruction of the pulmonary arteries was associated with reduced pulmonary vein areas in acute pulmonary embolism (APE). Method We retrospectively analyzed a consecutive series of computed tomography pulmonary angiography studies of 107 patients with APE and 101 controls without APE between November 2010 and January 2019. The control and patient groups were compared with each other for differences between the mean cross-sectional areas of pulmonary veins. Further analysis was conducted by dividing the patient group into high-risk patients (>= 20%) and low-risk patients (< 20%) according to the pulmonary arterial obstruction index. The mean cross-sectional area of the pulmonary veins in these two groups was compared. Results The mean cross-sectional areas of the 4 pulmonary veins at the ostium level (CSAPV) were significantly lower for the patient group (mean: 102.6 mm(2)) compared with the control group (111.8 mm(2)) (p < 0.001). CSAPV cutoff value for determining the diagnosis of APE that maximized the accuracy was 109.12 mm(2) (AUC = 0.721; 95% CI 0.649-0.794); its sensitivity and specificity were 78.2% and 69.2%, respectively. CSAPV cutoff value for differentiating high-risk APE that maximized the accuracy was 102.6 mm(2) (AUC = 0.634; 95% CI 0.525-0.743); its sensitivity and specificity were 61.9% and 53.8%, respectively. Conclusions There is a negative correlation between the CSAPV and thrombotic material burden in the pulmonary arteries of patients with APE. Hence, the CSAPV can be used as a diagnostic tool in the evaluation of the presence and severity of pulmonary embolism.Öğe Relationship between the Size and Location of the Mass and Hilar and Mediastinal Lymph Node Metastasis in Early and Locally Advanced Non-small Cell Lung Cancer(Coll Physicians & Surgeons Pakistan, 2020) Kuzucuoglu, Mustafa; Gokyer, Ali; Kula, Osman; Yekdes, Ali Cem; Sunal, Baran Serdar; Karamustafaoglu, Yekta Altemur; Yoruk, YenerObjective: To determine whether there is a relationship between the size and location of the mass and lymph node metastasis in non-small cell lung cancer. Study Design: Observational study. Place and Duration of Study: Department of Medical Oncology of Trakya University, from November 2013 to November 2018. Methodology: Records of 112 patients, who were followed up for non-small cell lung cancer, were retrospectively reviewed. Patients with distant organ metastasis (M1) and distant lymph node metastasis (N3), a previous history of malignancy, synchronous or metachronous tumors, and those for whom required data could not be obtained were excluded. Lymph nodes were evaluated according to pathology reports in patients undergoing invasive procedures. In patients without invasive procedures, lymph node larger than 1 cm in thorax CT, SUV above 2.5 in PET, and acceptance of metastasis at the Oncology Council was considered decisive. Diameter of the tumor, the shortest distance between the tumor and the mediastinum, the shortest distance between the tumor and the hilum, and the diameters of the largest mediastinal or hilar lymph nodes were measured from the thoracic computed tomography (CT) taken at the time of the diagnosis. The relationship between these values and lymph node metastasis was statistically evaluated. Results: Upon consideration of thoracic CT measurements, lymph node metastasis was found to have a statistically significant relationship with tumors with a large diameter (>55 mm) (p<0.001), tumors close to the mediastinum (<7 mm) (p=0.003), and tumors close to the hilum (<60 mm) (p=0.045). The evaluation of the distinctiveness of markers in diagnosis through ROC analysis showed AUC of 0.70 (p<0.001) for the largest tumor diameter, and the risk of lymph node metastasis was higher for lesions above 55 mm. Conclusion: In thorax CT, Large tumor size, tumor close to mediastinum, tumor close to hilum, large lymph node, and high SUV value of lymph node in PET-CT are associated with increased chances of metastasis.Öğe Relationship of breast arterial calcification and radiotherapy(2024) Karataş, Gökhan; Kula, Osman; Tunçbilek, NerminObjective: The purpose of this research is to compare the pre and post-radiotherapy mammograms of patients who had breast-conserving surgery (BCS) and radiotherapy to see how radiotherapy affects breast arterial calcifications (BAC). Methods: The study retrospectively compared the mammography examinations at least 24 months after radiotherapy and pre-radiotherapy mammography examinations of 123 female patients diagnosed with breast cancer and treated with BCS and radiotherapy between December 2001 and July 2011. Results: Breast arterial calcifications (BAC) increased statistically significantly in 25 patients who underwent radiotherapy after BCS. Conclusion: Our results indicate that BAC increases significantly after RT, especially in breasts treated with radiotherapy, with age being also a risk factor for BAC development.Öğe Retrieval of a missed intraperitoneal gallstone with early second look laparoscopy Missed gallstones after laparoscopic cholecystectomy(Bayrakol Medical Publisher, 2021) Turkyilmaz, Zeliha; Sunar, Orhan; Demirel, Tugrul; Kula, OsmanThe perforation of the gall bladder is the most common complication in laparoscopic cholecystectomy (LC). Retrieval of spilled gallstones is routine when possible. However, it Is not infrequent to leave some. Although significantly rare, abandoned gallstones may cause late and subtle symptoms and even severe intra-abdominal complications. In this study, we present a 60-year-old male patient who had an attack of acute cholecystitis and underwent laparoscopic cholecystectomy 6 weeks later. A second emergency laparoscopy was performed to remove the unremoved gallstone presenting with mild complaints. Postoperative CT might locate missed gallstones in the peritoneal cavity, and early laparoscopy may prevent severe late complications.Öğe The Role of Superb Microvascular Imaging and Shear Wave Elastography in the Prediction of Hemorrhage Complications After Renal Parenchyma Biopsy(Lippincott Williams & Wilkins, 2023) Gunay, Burak; Uslu, Burak; Celik, Ahmet Onur; Korkmaz, Selcuk; Ustabasioglu, Fethi Emre; Solak, Serdar; Kula, OsmanObjectives: The aim of study was to evaluate the diagnostic utility of the renal parenchyma elasticity with the shear wave elastography (SWE) and microvascularization with the superb microvascular imaging (SMI) technique before kidney biopsy and to predict the complication of hemorrhage before kidney biopsy.Methods: A total of 75 patients were included in the prospective study. Before the biopsy, vascularity features of the kidney parenchyma in the area to be biopsied were assessed by SMI and parenchymal stiffness by SWE and were examined by 2 independent radiologists.Results: A statistically significant difference was found in the SMI and SWE values between the groups with and without hematoma and hematuria when compared with the Student t test and Mann-Whitney U test (P < 0.05). The SWE hardness cutoff value, which maximizes the prediction of the development of hematuria, was found to be 18.40 kPa, and the sensitivity and specificity values were 84.4% and 62.8%, respectively. In SMI vascularity index values, the cutoff value was found to be 0.247410800 kPa, and sensitivity and specificity values were 81.3% and 83.7%, respectively. The cutoff value of the SMI vascularity index values that maximized the prediction of hematoma development was 0.297009650, and the sensitivity and specificity values were 87% and 87%, respectively.Conclusions: We believe that evaluating and standardizing the microvascularization and elasticity of the kidney parenchyma before a percutaneous kidney biopsy will be potentially useful as a guiding method in the prediction of postbiopsy hemorrhage development.Öğe A Stent Misplaced in the Septal Perforating Artery: Right Ventricular Fistula, Interventricular Septal Hematoma, and Right Ventricular Outflow Tract Obstruction(Arquivos Brasileiros Cardiologia, 2023) Demir, Melik; Goek, Murat; Guerdogan, Muhammet; Kula, Osman; Ustabasioglu, Fethi Emre; Yalta, KenanCoronary-cameral fistulas, though mostly regarded as congenital entities, have also been encountered as complications of major traumas and percutaneous coronary interventions (PCIs).(1) On the other hand, interventricular septal (IVS) hematoma might potentially arise mostly during retrograde chronic total occlusion (CTO) interventions and has a benign course in this context.(2) Herein, we describe a challenging PCI complication (and its management strategy) presenting with IVS hematoma, right ventricular fistula, and right ventricular outflow tract (RVOT) obstruction due to a misimplanted coronary stent in the septal perforating artery (SPA).Öğe Ultrasound evaluation of stiffness and vascularity of renal parenchymal damage secondary to hydronephrosis in pediatric patients using shear wave elastography and superb microvascular imaging(Wiley, 2024) Gunay, Burak; Solak, Serdar; Ustabasioglu, Fethi Emre; Kula, Osman; Karabulut, Derya; Tuncbilek, NerminAims: The purpose of this study is to assess the diagnostic value of SWE (shear wave elastography) and renal parenchymal elasticity and microvascularization with the SMI (super microvascular imaging) technique in diagnosing and predicting the progression of renal parenchymal damage in pediatric patients with hydronephrosis. Patients and Methods: A total of 45 patients were included in the prospective study. To evaluate parenchymal changes, SWE and SMI-Vacularity Index (VI) measurements were performed in various sections of the affected and normal kidneys. The affected and control renal pelvises' anteroposterior (AP) diameters were also measured. Results: The average SWE values were measured as 16.62 kPa for the affected kidneys, whereas the control kidneys showed an average SWE value of 12.70 kPa, indicating a statistically significant difference (p < .01). Furthermore, in the affected kidneys, the average SMI-VI value was measured as 5.92, whereas the control kidneys exhibited a higher average SMI-VI value of 6.64, showing a statistically significant difference (p < .01). A reverse correlation was found between renal pelvis AP diameter and SMI-VI values, while a positive correlation existed between renal pelvis AP diameter and SWE values. Conclusions: We believe that SWE and SMI may be useful for diagnosing and predicting the progression of renal parenchymal damage in pediatric hydronephrotic patients.
