PD-L1 and PD-L2 Expression in Different Tumor Stages and Types of Malignant Salivary Gland Neoplasms: A Single-center Experience.

There is a limited amount of data on the role of programmed cell death ligand (PD-L) -1 and PD-L2 in salivary gland carcinomas. We aimed to evaluate the prognostic value of PD-L1 and PD-L2 expressions, which are closely related to immune mechanisms, with respect to salivary gland tumor types and stages. Data from patients with salivary gland masses surgically removed between 2006 and 2021, diagnosed with a malignant salivary gland neoplasm, were retrospectively analyzed. Immunoreactivity for PD-L1 and PD-L2 was performed on resection materials. The mean age of 90 patients was 52.1±18.8 and 46.7% were male. Overall, 55.6% of patients were diagnosed with adenoid cystic carcinoma (ACC), 23.3% with mucoepidermoid carcinoma (MEC), 16.7% with acinic cell carcinoma (AciCC), 3.3% with ductal carcinoma (DC), and 1 patient with pleomorphic adenoma ex carcinoma (PA-ex-CA). In all, 52% of ACC, 12% of AciCC, 24% of MEC, and 12% of DC cases were at stage IV. The tumor diameter, frequencies of lymphovascular invasion, metastasis, positive surgical margin, recurrence, and mortality rates of patients at stages III and IV were significantly larger than those at stages I and II (P<0.05). The percentages of tumor cell score (TCS) and immune cell score (ICS) for PD-L1 were significantly higher among patients with MEC compared with those with other types of tumors (P=0.0011). However, the percentages of combined score (CS) for PD-L1 and tumor cell score for PD-L2 were comparable among tumor types (P>0.05). No significant difference was found in these scores for PD-L1 between tumor stages (P>0.05), but for PD-L2, all patients at stage I had TCS <1% for PD-L2, while all patients at stages II and III, and 92% of patients at stage IV had TCS ≥1% (P<0.0001). High expression of PD-L1 was mostly observed in MEC cases (P=0.0016), while all patients with AciCC had a low PD-L1 expression level (P=0.0206). The mean tumor diameter, rate of lymphovascular invasion, perineural invasion, metastasis, positive surgical margin, recurrence, type of treatment, mortality, and TILs ratio did not differ significantly according to PD-L1 expression level (P>0.05). The percentage of tumor-infiltrating lymphocytes was comparable among negative and positive PD-L1 scores according to both 1% and 5% threshold values (P>0.05). High PD-L1 expression is rare in AciCC, while PD-L1 expression is high in MEC. Our findings underline the importance of future screening for PD-L1 and PD-L2 before patients undergoing immunotherapies in all salivary gland tumors.

Splenic Artery Embolization in a Patient With Intracranial Hemorrhage Due to Refractory Persistent Immune Thrombocytopenia.

BACKGROUND: Managing intracranial bleeding in patients with refractory immune thrombocytopenia is difficult. OBSERVATION: A 16-year-old female refractory to prednisolone, intravenous immunoglobulin, eltrombopag, and cyclosporin exhibited heavy menstrual bleeding requiring packed red blood cell transfusions. Autoimmune antibodies were detected, indicating of lupus, and hydroxychloroquine sulfate was administered. In month 6 following the diagnosis, the patient presented with intracranial hemorrhage. Splenic artery embolization promptly increased platelets, and the patient was discharged without any neurological sequela. In month 5 of embolization, the patient's platelet count continued to exceed 300,000/µL without any medical treatment. CONCLUSIONS: Splenic artery embolization is a life-saving procedure in refractory immune thrombocytopenia.

18 F-FDG PET-Positive Large Pelvic Granuloma Mimicking Malignant Bladder Tumor.

ABSTRACT: An 88-year-old man was admitted to our hospital with a recurrent lower urinary tract infection. He had a history of open prostatectomy for benign prostatic hyperplasia 15 years ago and smoking. A mass arising within a bladder diverticula was suspected on the left lateral wall of the bladder on ultrasonography. Although no mass was observed in the bladder lumen on the cystoscopy, abdominal CT detected a left-sided pelvic soft tissue mass. A hypermetabolic mass was detected on 18 F-FDG PET/CT performed because of suspicion of malignancy, and it was excised. Granuloma secondary to chronic vasitis was diagnosed histopathologically.

Differentiation of pure cystic sellar lesions on magnetic resonance imaging.

BACKGROUND AND PURPOSE: Cystic pituitary adenomas and cystic craniopharyngiomas may mimic Rathke cleft cysts when there is no solid enhancing component on magnetic resonance imaging (MRI). This study aims to investigate the efficiency of MRI findings in differentiating Rathke cleft cysts from pure cystic pituitary adenoma and pure cystic craniopharyngioma. MATERIALS AND METHODS: 109 patients were included in this study (56 Rathke cleft cysts, 38 pituitary adenomas, and 15 craniopharyngiomas). Preoperative magnetic resonance images were evaluated using 9 imaging findings. These findings include intralesional fluid-fluid level, intralesional septations, midline /off-midline location, suprasellar extension, an intracystic nodule, a hypointense rim on T2-weighted images, ≥ 2 mm thickness of contrast-enhancing wall, T1 hyperintensity and T2 hypointensity. p < 0.01 was considered statistically significant. RESULTS: There was a statistically significant difference among groups for these 9 findings. Intracystic nodule and T2 hypointensity were the most specific MRI findings in differentiating Rathke cleft cyst from the others (98.1% and 100%, respectively). Intralesional septation and thick contrast-enhancing wall were the most sensitive MRI findings ruling out Rathke cleft cysts with 100% sensitivity. CONCLUSION: Rathke cleft cysts can be distinguished from pure cystic adenoma and craniopharyngioma with the presence of an intracystic nodule, T2 hypointensity, the absence of the thick contrast-enhancing wall, and absence of intralesional septations.

Multiple primary intraosseous meningioma mimicking fibrous dysplasia: a case report.

Primary intraosseous meningioma (PIM) is a rare subtype of primary extradural meningiomas. These rare ectopic meningiomas have been usually reported in the frontotemporal regions of the calvarium, orbits, and anterior cranial fossa. We report a case with bilateral tumors located in frontoparietal regions of calvarium. Our initial diagnosis was fibrous dysplasia but the lesions were seen to expand under follow-up. One was resected and the histopathological diagnosis was PIM. This is the second reported case of multiple PIM.

A Case of Subdural Hematoma without Subarachnoid Hemorrhage Secondary to Rupture of Posterior Communicating Artery-infundibular Dilatation.

INTRODUCTION: Subdural hematoma without subarachnoid hemorrhage secondary to intracranial aneurysm rupture is rare and may complicate patient management due to delay in diagnosis and subsequent treatment. Herein, we describe a case presenting with pure SDH secondary to the rupture of a posterior communicating artery infundibular dilatation (PcoA-ID). To the best of our knowledge, this is the first case of rupture of a PcoA-ID with SDH in the convexity and tentorium, which also tracked into the upper cervical spine along the subdural space. Additionally, we briefly discuss the previously published cases of pure SDH secondary to intracranial aneurysm rupture. CASE REPORT: A 44-year-old female presented with headache, dizziness, nausea and left-sided diplopia to an outside institution. Initial diagnostic work-up showed no intracranial hemorrhage, however, magnetic resonance angiography and subsequent digital subtraction angiography revealed left posterior communicating artery infundibular dilatation. Two days later, the patient presented with a loss of consciousness. Computed tomography was positive for bilateral hemispheric subdural hematoma with no evidence of subarachnoid hemorrhage. Digital subtraction angiography showed left posterior communicating artery infundibular dilatation and pseudoaneurysm originating from the inferior area of the infundibular dilatation, concerning recent rupture. Balloon assisted coil embolization was performed and the patient had a good outcome without any neurological deficit. CONCLUSION: Subdural hematoma in a young adult without a history of trauma or coagulopathy warrants additional vascular imaging to search for underlying vascular lesions. It should also be kept in mind that infundibular dilatation may rupture and cause a pure subdural hematoma.

A single-center experience of magnetic resonance imaging findings of fetal sacrococcygeal teratomas.

BACKGROUND: Sacrococcygeal teratomas (SCT) are known as rare tumors, but they are the most common tumor in fetuses and newborns. This study aims to present fetal magnetic resonance imaging (MRI) findings of SCT diagnosed prenatally and compare them with that of the prenatal Ultrasound (US) findings. METHODS: Eleven patients diagnosed as SCT prenatally by US and further assessed by MRI are included. MRI was performed via a 1.5-T magnet with a body coil. The presence, size, content extension, and compressive effects of each mass were determined and correlated with US findings and with postnatal examinations, including surgery and pathology. As complications, the presence of ascites and skin edema or pleural or pericardial effusion was diagnosed as hydrops. The amniotic fluid index was calculated for the assessment of oligo- or polyhydramnios. RESULTS: US findings are found strongly correlated with MRI findings. An agreement on the extent of each mass was observed in eight patients, disagreement in one fetus was an extension of the tumor within the spinal canal recognized only at MR and assessment of intrapelvic-abdominal extension was superior in MRI. There were n = 6 type I, n = 2 type II, n = 1 type III and, n = 2 type IV tumors. MRI was superior to US for detecting displacement of the colon (n = 3), intrapelvic-intraabdominal extension (n = 1), urinary tract complication (n = 2), and intraspinal extension (n = 1). DISCUSSION: MRI is found to be superior to US especially in the assessment of intrapelvic and intraspinal extension of the tumor, colonic displacement, and complications.

Effects of Modified Osteoplastic Pterional Craniotomy on Temporal Muscle Volume and Frontal Muscle Nerve Function.

Introduction Pterional craniotomy is a surgical approach frequently used in aneurysm and skull base surgery. Pterional craniotomy may lead to cosmetic and functional problems, such as eyebrow drop due to facial nerve frontal branch damage, temporal muscle atrophy, and temporomandibular joint pain. The aim was to compare the postoperative effects of our modified osteoplastic craniotomy with classical pterional craniotomy in terms of any change in volume of temporal muscle and in the degree of frontal muscle nerve damage. Materials and Methods Aneurysm cases were operated with either modified osteoplastic pterional craniotomy or free bone flap pterional craniotomy according to the surgeon's preference. Outcomes were compared in terms of temporal muscle volume and frontal muscle nerve function 6 months postoperatively. Results Preoperative temporal muscle volume in the modified osteoplastic pterional and free bone flap pterional craniotomy groups were not different ( p > 0.05). However, significantly less atrophy was observed in the postoperative temporal muscle volume of the osteoplastic group compared with the classical craniotomy group ( p < 0.001). In addition, when comparing frontal muscle nerve function there was less nerve damage in the modified osteoplastic pterional craniotomy group compared with the classical craniotomy group, although this did not reach significance ( p > 0.05). Conclusion Modified osteoplastic pterional craniotomy significantly reduced atrophy of temporal muscle and caused proportionally less frontal muscle nerve damage compared with pterional craniotomy, although this latter outcome was not significant. These findings suggest that osteoplastic craniotomy may be a more advantageous intervention in cosmetic and functional terms compared with classical pterional craniotomy.

Selective Arterial Embolisation of Uterine Arteriovenous Malformation in an Infertile Patient, subsequent Term Pregnancy and Postpartum Recurrence.

Uterine arteriovenous malformation (AVM) is a rare entity. This report describes selective catheterisation and embolisation of a uterine AVM in an infertile woman, subsequent spontaneous pregnancy and postpartum recurrence of the AVM treated with a second embolisation procedure. A 22-year woman presented with menometrorrhagia and failure to conceive. Pelvic magnetic resonance imaging showed a large uterine AVM. Selective catheterisation and embolisation of the AVM was performed. The patient conceived spontaneously two months later and delivered vaginally. A second embolisation was performed due to recurrence of uterine AVM at six months postpartum. This is the first case reporting postpartum recurrence of a pre-conceptionally treated uterine AVM. Selective catheterisation and embolisation is a minimally-invasive, fertility-preserving procedure that successfully treats uterine AVM and should be the treatment of choice when the patient desires pregnancy. Successful pregnancy and vaginal delivery following embolisation is possible; however, an increased awareness of postpartum AVM recurrence is required. Key Words: Fertility, Pregnancy, Therapeutic embolisation, Uterus, Arteriovenous malformation.

Does second generation n-butyl cyanoacrylate embolization really smooth in greater saphenous vein closure?

BACKGROUND: Cyanoacrylate (CA) has been used as an embolizing agent in the treatment of greater saphenous vein (GSV) insufficiency in recent years and the results regarding the use of this method have started to be published. To the best of our knowledge, the publications in literature do not mention about a significant negative effect of endovenous CA (EVCA) embolization. We aimed to evaluate the effects and undesirable events of this relatively new treatment method and compare them with literature, using the follow-up data of our patients. METHODS: Patients who had GSV insufficiency for at least 3 months and were treated with EVCA embolization because of this disease were included in the study. Patients were excluded if they had deep vein thrombosis (DVT), excessive tortuous GSV, and peripheral neuropathy. Hospital archive records were reviewed and undesirable events like DVT, thrombophlebitis, and pain related to this treatment procedure were recorded. RESULTS: EVCA embolization procedure was performed in a total of 54 patients with an average age of 49.36 ± 13.06 years for the purpose of treating GSV insufficiency. One patient was observed to develop n-butyl CA (NBCA) extension of approximately 5 mm from saphenofemoral junction (SFJ) to the main femoral vein and painful thrombophlebitic reaction was observed in 6 extremities at the first control examination. CONCLUSION: In our opinion, while EVCA embolization is a treatment option with similar success rates to endovenous thermal ablation (EVTA), it should be kept in mind that there may be a possibility of developing thrombophlebitis and NBCA extension or thrombus extension to the deep veins.

Ultrasound guided percutaneous cephalic venipuncture for implantation of cardiac implantable electronic devices.

BACKGROUND: Preoperative ultrasound (US) for cephalic cut-down is related to shorter procedure time and higher success rate. This study aimed to assess efficiency of US-guided percutaneous cephalic vein (CV) puncture for placement of cardiac implantable electronic devices (CIEDs). METHODS: Patients undergoing a procedure including both US-guided pectoral nerve block (PECS) and percutaneous CV puncture were retrospectively investigated. Patient medical history and demographic data was collected. Clinical features of the procedures and intra- and post-operative complications occurring were collected from patient records. Clinical data included target vessel features, and the time taken for the following: CV puncture; CV and PECS puncture; total procedure. RESULTS: In total 34 patients had CV puncture with US-guided PECS block was attempted in all patients and the procedure was successful in 27 of 34 (79.4%) patients. The total number of CV puncture attempts was 62 for 34 leads (mean attempts per lead = 1.82). The mean ± standard deviation time for CV puncture was 137.5 ± 27.4 s. There were no venous access-related complications. CONCLUSION: US-guided CV puncture appears feasible and safe with an acceptable success rate. In case of failure of the US-guided axillary or subclavian vein approach, it may be preferred as an alternative to the cephalic cut-down procedure, where the success rate is relatively lower and the risk of bleeding is higher.

Inflammatory Scores: Comparison and Utility in HCC Patients Undergoing Transarterial Chemoembolization in a North American Cohort.

BACKGROUND: The purpose of this study is to determine and compare the ability of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), aspartate-aminotransferase-to-lymphocyte ratio (ALRI), systemic-inflammation index (SII) and lymphocyte count to predict oncologic outcomes in hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE). MATERIALS AND METHODS: A single-center retrospective review of 296 patients who were treated for 457 HCCs was performed. Pre- and post-treatment laboratory and treatment outcome variables were collected. Objective radiologic response (ORR), progression-free survival (PFS), and overall survival (OS) were evaluated. Patients were categorized into above and below median scores and compared. RESULTS: The median pretreatment NLR, PLR, ALRI, SII, and lymphocyte count were 2.7 (range: 0.4-55), 88.3 (range: 0.1-840), 71.8 (range: 0.1-910), 238.1 (range: 0.1-5150.8), and 1 (range: 0.1-5.2) 103/µL, respectively. Patients with above median ALRI scores were less likely to achieve an ORR as compared to those with below median ALRI values (132 (132/163, 81%) vs 150 (150/163, 92%), p = 0.004). On univariate analysis, patients with above median pretreatment NLR (HR 1.41, 95% CI: 1.09-1.83, p = 0.01) and below median lymphocyte count (HR 0.69, 95% CI: 0.53-0.92, p = 0.01) had significantly worse PFS. The relationship between PFS and NLR (p = 0.08) as well as lymphocytes (p = 0.20) no longer remained on multivariate analysis. On univariate analysis, below median pretreatment NLR (HR 1.72, 95% CI: 1.2-2.45, p = 0.003) and ALRI (HR 1.52, 95% CI: 1.05-2.2); p = 0.03) as well as above median lymphocyte count (HR 0.48, 95% CI: 0.34-0.7, p < 0.0001) were associated with improved OS. The significant relationship between lymphocytes and OS remained on multivariate analysis (HR 0.50, 95% CI: 0.28-0.9, p = 0.02), but the relationship with NLR (p = 0.94) did not persist. CONCLUSION: NLR is predictive of PFS and OS in patients with HCC undergoing TACE and may be superior to other inflammatory scores (PLR, ALRI, and SII) in this setting. However, lymphocyte count may be most predictive of OS.

Clinicopathological evaluation of idiopathic granulomatous mastitis patients: A retrospective analysis from a tertiary care hospital in Turkey.

Idiopathic granulomatous mastitis (IGM) is a chronic inflammatory disease of the breast with unknown etiology that is characterized by granuloma formation. We analyzed the clinical, radiological, and therapeutic approaches; the recurrence rate of the disease; and the pathological findings diagnosed with mastitis in a retrospective study. We evaluated a total of 77 patients subjected to core needle or excisional biopsy with preliminary diagnosis of mastitis between January 2017-December 2019 who diagnosed with IGM, nonspecific mastitis/abscess, or periductal mastitis/plasma cell mastitis as a result of their pathological assessment. The mean age was 39.24 ± 10.6. Though 65 patients were diagnosed with IGM (84.4%), other diagnoses were reported as nonspecific mastitis/abscess (n = 9), periductal mastitis (n = 2) and plasma cell mastitis (n = 1). Recurrence occurred in 30 (39%) patients during follow-up. In patients without IGM, the number of 5-year postpartum mastitis diagnoses was significantly higher (p = 0.0008) while number of 2-year postpartum mastitis diagnoses was lower (p = 0.255) compared to those in IGM patients. The rates of axillary lymphadenopathy, bacterial culture, parity, and menopausal status were not different in patients without IGM. Linear correlation analysis did not reveal a significant relationship between radiological preliminary diagnosis and pathological diagnosis with BI-RADS classification. A detailed assessment, accompanied with clinical, radiological, and pathological findings, should be performed to achieve an accurate diagnosis and effective patient management in IGM. Furthermore, IGM should always be considered in the differential diagnosis of mastitis among breast masses.

Risk factors related to the size and volume of femoral artery pseudoaneurysm after catheter angiography: a single-center study

Background/aim: Evaluate the risk factors associated with pseudoaneurysms' development after the percutaneous interventional procedures performed by cardiology, interventional radiology (IR), and the other clinics. Materials and methods: We retrospectively analyzed the ultrasound scans in the hospital database and picture archiving system (PACS) and enrolled a total of 132 patients during the period from October 2015 and December 2019. We evaluated the maximum diameter and volume of the pseudoaneurysm with the patient and procedure-related factors with univariate analysis. Results: We found that the patients with hypertension and without peripheric artery disease (PAD) had greater sac diameter (p = 0.010 and p = 0.016) and increased sac volume (p = 0.029 and p = 0.007). However, the sac volume increased in patients with diabetes than those without (p = 0.003). Both the increased maximum diameter and the volume of the pseudoaneurysm sac were in the patients in whom the procedure was applied in the common femoral artery (CFA) and with the venous intervention (p < 0.010 and p < 0.016; p = 0.004 and p = 0.001, respectively). We found that platelet count correlated negatively with the sac's maximum diameter and the volume (r = ­0.383, p < 0.001 and r = ­0.486, p < 0.001, respectively) duration of intervention correlated positively with the sac's maximum diameter and the volume (r = 0.205, p = 0.019 and r = 0.320, p < 0.001). Conclusion: Our study reveals that prolonged procedure duration, simultaneous arterial and venous accesses, peripheral artery disease, thrombocytopenia, and puncture site are the aggressive risk factors of pseudoaneurysms size after angiographic procedures.

Alcohol Recidivism Following Transjugular Intrahepatic Portosystemic Shunt Placement: Frequency and Predictive Factors.

PURPOSE: To determine the frequency and predictive factors for alcohol recidivism following transjugular intrahepatic portosystemic shunts (TIPS) placed in patients with alcoholic cirrhosis. METHODS: One hundred ninety-nine patients who had a TIPS placed at a single institution for different indications in the setting of alcoholic cirrhosis were reviewed. Length of sobriety prior to TIPS placement and maintained sobriety at 1, 3 and 6-12 months after TIPS placement were recorded. Smoking history, substance abuse and psychiatric comorbidities were also recorded as was ascitic response to TIPS at 1, 3 and 6-12 months. RESULTS: At 1 month 11/199 (5.5%) patients had experienced a relapse while, 20/199 (10.1%) had at 3 months, and 44/199 (22.1%) had at 12 months. There was no difference in ascitic response in those who did and did not relapse at 1 month (p = 0.57), 3 months (p = 1.00) or 1 year (p = 0.44). The mean time of sobriety at the time of TIPS placement for those who relapsed by 12 months was significantly less than those who did not relapse (5.11 (1.10-7.90) months vs 18.32 (8.63-48.12) months, p < 0.001). Concurrent psychiatric comorbidity (p < 0.001), substance abuse (p < 0.001), age less than 40 (p = 0.004) and smoking history at the time of procedure (p < 0.001) were also associated with alcohol relapse. CONCLUSION: Recidivism is a frequent issue for patients following TIPS placement; those who have concurrent psychiatric comorbidity, substance abuse, smoking history are younger than 40 and shorter sobriety duration prior to TIPS may be at increased risk.

Ultrasound-Guided Portal Vein Access and Percutaneous Wire Placement in the Portal Vein Are Associated With Shorter Procedure Times and Lower Radiation Doses During TIPS Placement.

BACKGROUND. TIPS placement is an effective method for treating a number of complications of portal hypertension. Although this complex procedure has been firmly established in treatment algorithms, more data are needed to determine the most efficient and safest ways to perform the procedure. OBJECTIVE. The purpose of this study was to determine the effect of three different techniques of portal vein (PV) cannulation during TIPS placement on procedure efficiency. METHODS. The medical records of patients who underwent TIPS creation between 2005 and 2019 were reviewed. On the basis of the PV access technique used, patients were grouped as follows: group 1 (G1) included patients who underwent a transabdominal ultrasound (US)-guided technique to obtain PV access, group 2 (G2) consisted of those who underwent fluoroscopically guided wedged hepatic portography, and group 3 (G3) included those who underwent percutaneous US-guided PV guidewire placement for fluoroscopic targeting. RESULTS. Of the 264 patients who underwent TIPS creation, 54 (20.5%) were in G1, 172 (65.1%) were in G2, and 38 (14.4%) were in G3. The mean (± SD) fluoroscopic time in G1 (34.8 ± 16.6 minutes) did not differ from that in either G2 (38.9 ± 20.8 minutes; p = .09) or G3 (29.5 ± 14.6 minutes; p = .06). However, G2 patients had significantly longer fluoroscopic times than G3 patients (p = .005). The mean total anesthesia time in G1 (190.2 ± 45.6 minutes) did not differ from that in G2 (199.7 ± 59.5 minutes; p = .15). However, G3 had a mean anesthesia time (162.6 ± 39.7 minutes) that was significantly shorter than that in both G1 (p = .003) and G2 (p < .001). The mean contrast volume was significantly lower in G1 than in G2 (67.9 ± 36.8 mL vs 87.1 ± 42.9 mL; p = .005). More intrahepatic needle passes were required in G2 (median, 4 passes; interquartile range [IQR], 1-7 passes) than in G1 (median, 2 passes; IQR, 1-4 passes; p = .004) and G3 (median, 2 passes; IQR, 1-7.25 passes; p = .04). When complications in G1 and G3 were pooled, this cohort had significantly fewer complications than G2 (p = .01). CONCLUSION. Ultrasound-guided PV access and percutaneous PV guidewire placement for fluoroscopic targeting during TIPS creation are associated with shorter procedure and fluoroscopic times and potentially decreased complications. CLINICAL IMPACT. The present study helps interventional radiologists understand the safest and most efficient way to access the PV, which is a key step during TIPS placement.

Role of Susceptibility-Weighted Imaging in Detecting Retinal Hemorrhages in Children with Head Trauma.

PURPOSE: This study was carried out to evaluate the utility of susceptibility-weighted imaging (SWI) in demonstrating retinal hemorrhages (RH) in pediatric head trauma. METHODS: Over a period of 7 years 67 children (age 0-4 years) with head trauma and MRI were included as either abusive head trauma (AHT) (n = 23), non-abusive head trauma (NAHT) (n = 38), or indeterminate (n = 6). Two pediatric neuroradiologists jointly reviewed the MR images for the presence of RH and sensitivity and specificity of SWI and T2WI were calculated. RESULTS: The dilated fundoscopic examination (DFE) was positive for RH in 18/23 (78.3%) of the AHT group, 5/38 (13.2%) in the NAHT group, and 4/6 (66.7%) in the indeterminate group. Regarding the SWI MRI findings, SWI was positive for RH in 13/23 (%56.5), while T2WI was positive in 6/23 (%26.1) of the AHT group. Based on utilizing DFE as a standard, the sensitivity and specificity of SWI in the detection of RH was 63% and 100%, respectively and 30% and 100%, respectively on T2WI. CONCLUSION: Our results suggest that SWI is a useful diagnostic tool for detection of RH in pediatric head trauma in whom DFE is difficult to perform.