Efficacy of diffusion weighted imaging in sacroiliac joint MRI in children.

OBJECTIVE: Because of the immature bone marrow signal in children, assessment of the sacroiliac joint is more difficult than in adults. Aim of this study is to evaluate the efficacy of diffusion-weighted imaging (DWI) in sacroiliac joint magnetic resonance imaging (MRI). METHODS: Sacroiliac joint MRI, including DWI sequences, were evaluated by two pediatric radiologists in 54 patients with sacroiliitis and 85 completely normal controls. In MRI evaluation, subchondral bone marrow edema and contrast enhancement in the sacroiliac joints were considered as active sacroiliitis. Apparent diffusion coefficient (ADC) measurements were made in six areas from each sacroiliac joint. A total of 1668 fields were evaluated retrospectively without their diagnosis being known. RESULTS: When the postcontrast T1W series were referenced, the sensitivity, specificity, positive predictive value, and negative predictive value of short time inversion recovery (STIR) images in the diagnosis of sacroiliitis were 88%, 92%, 83% and 94% respectively, compared to contrast-enhanced images. False positive results in STIR images were observed secondary to the flaring signal in the immature bone marrow. ADC measurements obtained from diffusion-weighted images were recorded in all patients and healthy groups. The ADC values were 1.35x10-3 mm2/s (SD: 0.21) in the areas of sacroiliitis, 0.44x10-3 mm2/s (SD: 0.71) in the normal bone marrow and 0.72x10-3 mm2/s (SD: 0.76) in the immature bone marrow areas. CONCLUSION: Although STIR studies are an effective sequence in the diagnosis of sacroiliitis, they cause false positive results in immature bone marrow in children in inexperienced hands. DWI is an objective method that prevents errors in the assessment of sacroiliitis by means of ADC measurements in the immature skeleton. In addition, it is a short and effective MRI series that makes important contributions to the diagnosis without the need for contrast-enhanced examinations in children.

Chest computed tomography findings of 1271 patients with COVID-19 pneumonia and classifications with different age groups: a descriptive study from Istanbul, Turkey.

OBJECTIVE: The objectives of this study were to describe lung computed tomography findings of patients with COVID-19 diagnosed by real-time reverse transcription polymerase chain reaction test, investigate whether the findings differ regarding age and gender, and evaluate the diagnostic performance of chest computed tomography based on the duration of symptoms at the time of presentation to the hospital. METHODS: From March 11 to May 11, 2020, 1271 consecutive patients (733 males and 538 females) were included in this retrospective, cross-sectional study. Based on age, patients were divided into five separate subgroups. Then based on the duration of symptoms, patients were divided into five separate phases. The presence of lung lesion(s) and their characteristics, distribution patterns, and the presence of concomitant pleural thickening/effusion and other findings (malignancy, metastasis, chronic obstructive pulmonary disease, interstitial lung disease, bronchiectasis, bronchiectasis, cardiomegaly, pericardial effusion) were evaluated by five radiologists independently. RESULTS: The "normal lung computed tomography finding" was the most common chest CT finding (37%), followed by ground-glass opacity (31%). Regardless of the shape of the lesion, the distribution features were significant (peripheral, subpleural, and lower lobe distribution) (p<0.05). The presence of pleural thickening posteriorly and adjacent to the lesion was statistically different in groups 1-3 (p<0.05). Other concomitant pathologies, except pulmonary congestion, did not suppress the typical findings of COVID-19. CONCLUSION: Chest computed tomography findings were mostly normal in the early phase (P1). Therefore, it may be appropriate to perform the first computed tomography screening of COVID-19 after 6 days to decrease the radiation exposure.

Chest computed tomography findings of 1271 patients with COVID-19 pneumonia and classifications with different age groups: a descriptive study from Istanbul, Turkey

SUMMARY OBJECTIVE: The objectives of this study were to describe lung computed tomography findings of patients with COVID-19 diagnosed by real-time reverse transcription polymerase chain reaction test, investigate whether the findings differ regarding age and gender, and evaluate the diagnostic performance of chest computed tomography based on the duration of symptoms at the time of presentation to the hospital. METHODS: From March 11 to May 11, 2020, 1271 consecutive patients (733 males and 538 females) were included in this retrospective, cross-sectional study. Based on age, patients were divided into five separate subgroups. Then based on the duration of symptoms, patients were divided into five separate phases. The presence of lung lesion(s) and their characteristics, distribution patterns, and the presence of concomitant pleural thickening/effusion and other findings (malignancy, metastasis, chronic obstructive pulmonary disease, interstitial lung disease, bronchiectasis, bronchiectasis, cardiomegaly, pericardial effusion) were evaluated by five radiologists independently. RESULTS: The "normal lung computed tomography finding" was the most common chest CT finding (37%), followed by ground-glass opacity (31%). Regardless of the shape of the lesion, the distribution features were significant (peripheral, subpleural, and lower lobe distribution) (p<0.05). The presence of pleural thickening posteriorly and adjacent to the lesion was statistically different in groups 1-3 (p<0.05). Other concomitant pathologies, except pulmonary congestion, did not suppress the typical findings of COVID-19. CONCLUSION: Chest computed tomography findings were mostly normal in the early phase (P1). Therefore, it may be appropriate to perform the first computed tomography screening of COVID-19 after 6 days to decrease the radiation exposure.

Evaluation of radiological findings in pediatric patients with COVID-19 in Turkey.

OBJECTIVE: The objective of the study was to describe the findings of pediatric patients diagnosed with COVID-19 in computed tomography (CT) and chest X-ray (CXR) images. Therefore, the aim of this study is to show protecting the children from radiation as much as possible while guiding the diagnosis. METHODS: Between March and June 2020, 148 pediatric patients examined who underwent CT due to suspicion of COVID-19. Fifty patients of 148 with normal thorax CT and negative reverse transcription polymerase chain reaction (RT-PCR) were excluded from the study. Of the remaining 98 patients were evaluated retrospectively by two pediatric radiologists with 15 years of experience. RESULTS: The demographic, clinical, and laboratory data were evaluated for 52 RT-PCR-positive patients. CT finding of 23 RT-PCR positive and 12 negative patients was classified. According to our study, unilateral (61-67%), multifocal (50-52%), and peripheral (83-91%) involvement were higher in all groups. Lower lobe involvement was frequently detected (58-65%). The most frequently detected parenchymal lesion was ground-glass opacity followed by consolidated areas accompanying ground-grass opacities. Halo sign and vascular enlargement signs were the common signs of lung lesions (35%). In addition, some rare findings not previously described in this disease in children were mentioned in this study. The clinical course of all our patients was mild and control radiological imaging checked by CXR. CONCLUSION: Most pediatric patients have a mild course. Hence, a balance between the risk of radiation and necessity for chest CT is very important. Low-dose CT scan is more suitable for pediatric patients but still it should be used cautiously.

Bone Deformities as a Complication of Giant Thoracic Aortic Aneurysm.

The contained rupture of thoracic aortic aneurysm and related bone deformities is a rare condition. The diagnosis is critical due to potential and fatal complications. Radiologic evaluation is required to show the location, extension, and complications. Herein we present the X-ray radiography, ultrasonography, computed tomography, and magnetic resonance images of a giant dissected and contained rupture of the thoracic aortic aneurysm. The aneurysm destructed the adjacent vertebrae and rib, resulting in compression of dural sac and spinal cord, and obliteration of the neural foramina. Our case demonstrates a gigantic expansion of an aneurysm (14 cm) with chronic skeletal complications.

Thyroid functions after contrast agent administration for coronary angiography: a prospective observational study in euthyroid patients.

OBJECTIVE: This study aims to investigate long-term effects of iodinated radiographic contrast media used for coronary angiography (CAG) on the thyroid function in euthyroid patients. METHODS: In a prospective observational cohort study, nonionic iodinated contrast material was electively used in 101 patients for coronary angiography. The patients were recruited without age restrictions and, at baseline, all had normal levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyrotropin (TSH). The morphology of the thyroid was evaluated by thyroid ultrasonography (USG). Four and eight weeks after CAG, serum TSH, FT3 and FT4 levels were assessed. RESULTS: Compared to a mean baseline level of 1.49 (25%-75%, range 13-2.21), follow-up TSH levels decreased significantly to 1.45 (25%-75%, range 1.98-0.92, p=0.017) and 1.40 (25%-75%, range 1.89-0.87, p=0.003) at 4 weeks and 8 weeks, respectively (p=0.008). No significant diffe-rence was observed in TSH levels between the 4th and 8th weeks (p=0.833). CONCLUSION: Iodinated radiographic contrast agents may cause subclinical hyperthyroidism in euthyroid patients undergoing CAG.