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Amaç: Bronkopulmoner displazi erken doğumun sık görülen uzun vadeli bir komplikasyonudur. Hastaların erken dönemde en yeni radyolojik teknikler kullanılarak değerlendirilmesi, hastalığın şiddetinin değerlendirilmesi ve takip planının yapılması açısından çok önemlidir. İyonize olmayan bir modalite olan manyetik rezonans görüntüleme, bronkopulmoner displazi ile ilgili akciğer patolojilerin radyolojik değerlendirmesi ve izleminde yol gösterici olabilir.Gereç ve Yöntemler: Ağustos 2017-Ağustos 2019 tarihleri arasında bronkopulmoner displazi tanısı ile takip edilen ve akciğer manyetik rezonans görüntülemesi yapılan hastalar retrospektif olarak değerlendirildi. Koronal ve aksiyel T2 ağırlıklı magnetik rezonans görüntüleri incelendi (TR/TE: 4500-5300/90-106 msn). Manyetik rezonans görüntüleme bulguları bir pediatrik radyolog tarafından değerlendirildi. Akciğerlerin yapısal durumu ve patolojik bulguları değerlendirildi (fibrotik bantlar, distrosiyon). Bulgular, BPD hastalarının şiddeti, klinik ve demografik özellikleri ile karşılaştırıldı. Görüntüleme sedasyon yapılmadan veya kloralhidrat verilmeksizin hastanın uyku süresinde yapıldı.Bulgular: Toplamda yedi hasta araştırmaya dahil edildi. Hastaların dördü erkek, üçü kızdı. Bonkopulmoner displazi sınıflamasına göre 1 hastanın hafif, 3 hastanın orta düzeyde ve 4 hastanın şiddetli bronkopulmoner displazisi vardı. Ortalama gebelik haftası 26.2 haftaydı. Hafif bronkopulmoner displazi hastalarında, Objective: Bronchopulmonary dysplasia is a common long-term complication of preterm birth. The evaluation of patients with advanced radiologic methods at early ages is essential in terms of determining the severity of the disease and follow-up. As a non-ionizing modality, magnetic resonance imaging is particularly appropriate for the repeated radiological assessment of pulmonary pathologies associated with bronchopulmonary dysplasia.Material and Methods: Patients who were followed up with the diagnosis of bronchopulmonary dysplasia and underwent lung magnetic resonance imaging between August 2017 and August 2019 were evaluated retrospectively. Coronal and axial T2-weighted magnetic resonance imaging was performed (TR/TE: 4500-5300/90-106 msec). A pediatric radiologist evaluated magnetic resonance imaging findings. Pulmonary structural findings and their distribution were determined (fibrotic bands, distortion). The findings were compared with bronchopulmonary dysplasia patients’ severity, clinical and demographic characteristics. The imaging was performed during the patient’s sleep time without sedation or by giving chlorhydrate.Results: A total of 7 patients were included in the study. Three patients were female, and 4 were male. According to bronchopulmonary dysplasia classification, 1 patient was mild, 3 patients were moderate, and 3 were severe bronchopulmonary dysplasia. The median gestational week was 26.2. In mild bronchopulmonary dysplasia patients, fibrotic bands were seen in

Objective:This study aims to evaluate outcomes of redo orchiopexy and the effect of redo surgery timing upon testicular volume.Materials and Methods:This prospective study involved children receiving redo orchiopexy for recurrent undescended testis. Patients were recruited to assess testicular position, volume, blood flow and presence of microlithiasis. Testis volume was measured by ultrasound and compared with recently developed normative values for testicular size.Results:A total of 38 patients (40 testes) required redo orchiopexy were reviewed in the study. Thirty three of invited boys could be investigated as long term participation. As a result of long term follow up; 28 of the testes were at scrotum, 2 of them were at inguinal canal and 3 of them were non-palpable, with a 15% failure rate of redo orchiopexy. For all patients evaluated in the control visit mean testis volume was 1.23 mL, at 24 of whom were significantly smaller than the normative values for the same age (p

Amaç: Akut apandisit (AA), çocuklarda tanısı birçok hastalıkla karışabilmektedir. Bu da gecikmiş tedaviye neden olmaktadır. Görüntüleme yöntemleri hekimlere tanıda yardımcı olabilmektedir. Çalışmamızda AA tanısını koymada yaklaşımlar neler olabiliri değerlendiriyoruz. Tanısal yaklaşımları üç gruba ayırdık. Bunlar: birinci basamakta sadece cerrahın muayenesi, ikinci basamak olarak cerrahın muayenesi ile birlikte Ultrason (US), üçüncü basamakta da şüpheli kalınan durumlarda Manyetik rezonans görüntülemenin (MRG) kullanılmasıydı.Yöntem: Klinik olarak apandisit şüphesi olan üç yüz altmış bir hasta, tanısal yaklaşım tipine göre prospektif olarak üç gruba ayrıldı.Bulgular: Toplam 51 hastaya sadece cerrah öngörüsü ile tanı konuldu. Hastaların 254'üne sadece US incelemesi yapıldı ve 56 hastaya hem US hem de MRG yapıldı. Tanı grupları dikkate alındığında hem “sadece cerrahın muayenesi” hem de “Cerrahın muayenesi + US + MRI” gruplarının doğruluğu %100 idi. “Cerrahın muayenesi + US” grubu, %59,8 doğruluk oranı ile %62,4'lük bir duyarlılık değeri ortaya koydu. US'nun duyarlılığı ve özgüllüğü sırasıyla %61,0, %65,5 idi. Bu değerler MRG için %100 idi. Kurumsal algoritmamızın duyarlılığı, özgüllüğü %100,0, %94,4, pozitif-negatif tahmin değerleri %94,7, %100 idi.Sonuç: Çocuklarda apandisit tanısı için cerrahın değerlendirmesi ve klinik değerlendirmesi ilk tanı yöntemi olmalıdır. US, cerrahları doğru tanı koymada desteklemek için yararlı bir yöntemdir ve MRG, doğru tanıyı doğrulamak için ek bir yöntem olarak güvenilir olabilir., Aim: We compare the diagnostic approaches: surgeon prediction, surgeon prediction plus ultrasound imagining (US) as the first-line imaging modality, and magnetic resonance imagining (MRI) as the second-line imaging for suspected pediatric appendicitis. Methods: Three hundred sixty-one patients with a clinically suspected appendicitis were prospectively divided into three groups by the type of diagnostic approach. Results: A total of 51 patients were diagnosed via only the surgeon prediction. Of the patients, 254 only underwent a US examination, and 56 patients underwent both US and MRI. Considering the diagnostic groups, the accuracy of both the “surgeon prediction only” and “surgeon prediction + US + MRI” groups was 100%. The “surgeon prediction + US” group revealed a sensitivity value of 62,4% with an accuracy rate of 59,8%. The sensitivity and specificity of US were 61,0%, 65,5%, respectively. These values were 100% for MRI. The sensitivity, specificity of our institutional algorithm were 100,0%, 94,4%, and the positive-negative predictive values were 94,7%, 100%. Conclusions: To diagnose appendicitis in children, surgeon’s assessment, prudence, and clinical evaluation should be the first method of diagnosis. US is a useful method to support surgeons in ensuring an accurate diagnosis, and MRI can be trusted as an additional method to verify a correct diagnosis.

Background Pneumatosis cystoides intestinalis (PCI) is a disorder in which widespread air sacs are present in mucosa, submucosa, subserosa, and intraabdominal area of the intestinal wall. It has a heterogeneous clinical presentation as a rare complication of intestinal graft-versus-host disease (GVHD). Computed tomography is the preferred imaging method for the diagnosis. Since the air sacs could be ruptured spontaneously, the presence of free air in the peritoneal cavity does not confirm intestinal perforation. The conservative treatment approach is sufficient in cases that do not require urgent surgical intervention, such as perforation or obstruction. Case Here, we present a 2.5-year-old patient diagnosed with primary hemophagocytic lymphohistiocytosis (pHLH), who underwent allogeneic hematopoietic stem cell transplantation from a matched unrelated donor (MUD) and developed PCI secondary to intestinal GVHD 14th months after HSCT. Conclusions Pneumatosis cystoides intestinalis, which is a rare complication, should be kept in mind, especially in patients with intestinal GVHD and receiving intensive immunosuppressive, octreotide, and steroid treatment after HSCT.

The aim of this study is to evaluate the abnormal cortical structures associated with newly diagnosed benign epilepsy with centrotemporal spikes (BECTS) patients and assessed the effects of comorbid attention-deficit/hyperactivity (ADHD) on these abnormalities. Newly diagnosed BECTS patients (n = 33, 23 males) and age-matched healthy controls (n = 48) were evaluated by surface and volumetric MRI. CAT12 toolbox (HYPERLINK “http://www.neuro.uni-jena.de/cat/”\t“_blank” http://www.neuro.uni-jena.de/cat/, version r1109), SPM12(HYPERLINK“http://www.fil.ion.ucl.ac.uk/spm/software/spm12/”\t“_blank”http://www.fil.ion.ucl.ac.uk/spm/software/spm12/, version 6225) and MATLAB (9.5, Mathworks, Natick, MA) were used to gather CT estimates. An additional comparison was performed between BECTS children with (n = 13) and without ADHD (n = 20). BECTS patients had significantly smaller volume in left postcentral gyrus when compared to healthy controls. BECTS patients with ADHD had significantly thinner superior-inferior frontal cortex, superior temporal cortex, left pericalcarine, lingual and fusiform cortex to healthy controls. Also BECTS without ADHD patients had thinner cortical areas when compared to healthy controls, however the significance was more relevant in the BECTS with ADHD. The left fusiform cortex of BECTS patients with ADHD patients was significantly thinner than BECTS patients without ADHD. Our results showed that BECTS affects frontal, temporal, parietal and occipital lobes by cortical thinning. Our study supports the need for better characterization of patients with BECTS so identification of different phenotypes can occur. Further studies are needed to investigate the relationship between BECTS and ADHD.

To identify the relationship between thalamic volume and electrical status epilepticus in sleep (ESES). We analyzed subcortical gray matter volumes in patients with an ESES pattern on their electroencephalographs. All magnetic resonance imaging scans were considered within normal limits. The patients were not receiving antiepileptic drug at the time of the MRI study. High resolution T1-weighted 3-dimensional MPRAGE scans were assessed for segmentation and quantitative volumetric analysis of the brain by using the "volBrain" method. After correcting for total brain volume, volumes were compared with a group of healthy controls (HCs) and patients with benign childhood epilepsy with centrotemporal spikes (BECTS). Fifteen patients with ESES, 15 patients with BECTS, and 30 HCs were included. The median age of the patients with ESES was 8.5 (range, 5.8-13) years, 8 (range, 5-14) years for the HCs, and 7.8 (range, 4-13.5) years for the patients with BECTS. The total relative thalamic volume was significantly lower in patients with ESES than in the healthy controls (0.87 ± 0.07 vs. 0.93 ± 0.03, p = 0.002), and in patients with ESES than in those with BECTS (0.87 ± 0.07 vs. 0.93 ± 0.03, p = 0.006). There was no significant difference the HCs and patients with BECTS (0.93 ± 0.03 vs. 0.93 ± 0.03, p = 0.999). Both right and left relative thalamic volumes were lower in patients with ESES than in HCs (right thalamus: 0.43 ± 0.04 vs. 0.46 ± 0.02, p = 0.003, left thalamus: 0.44 ± 0.03 vs. 0.47 ± 0.02, p = 0.002), in patients with ESES than in patients with BECTS (right thalamus: 0.43 ± 0.04 vs. 0.46 ± 0.01, p = 0.01, left thalamus: 0.43 ± 0.04 vs. 0.47 ± 0.01, p = 0.007); however, there was no significant difference between the HCs and patients with BECTS (right thalamus: 0.46 ± 0.02 vs. 0.46 ± 0.01, p = 0.999, left thalamus: 0.47 ± 0.02 vs. 0.47 ± 0.01, p = 0.999). This study highlights the association between thalamic involvement and ESES, even when not severe enough to cause a detectable lesion on visual interpretation of MRI.

Amac: Medikal tedaviye direncli epilepsi hastalarinda nobet semiyolojisi, skalp-video elektroensefalografi, manyetik rezonans goruntulume (MRG) ve 18-floro-2-deoksi-glukoz pozitron emisyon tomografi (FDG-PET) bulgularinin degerlendirilmesi, epileptojenik odagi lokalize etmede klinik- elektroensefalografi bulgulari ile norogoruntuleme yontemleri arasindaki uyumun degerlendirilmesi amaclandi. Gerec ve Yontemler: Retrospektif olan calismamiz hastane etik kuru onayi alinarak yapildi. Calismaya, Ocak 2011 ile Ocak 2017 tarihleri arasinda, klinik- elektroensefalografi bulgularina gore temporal (30 erkek, 26 kiz, ortalama yas 30,1±8,9 yil) ve ekstra-temporal lob epilepsi (29 erkek, 23 kiz, ortalama yas 22,8±10,9 yil) gruplarina ayrilan ardisik 108 hasta (59 erkek, 49 kiz, ortalama yas 26,6±10,5 yil) dahil edildi. Kategorik-sayisal degiskenler t, Mann-Whitney U, McNemar veya Ki-kare testi ile analiz edildi. Bulgular: Calismaya dahil edilen 108 hastanin 12’si (6 erkek, 6 kiz, ortalama yas 28,7±10,2 yil) epilepsi cerrahisi gecirdi ve bu hastalarin operasyon sonrasi ortalama takip suresi 32 aydi. Klinik- elektroensefalografi bulgulari ile norogoruntuleme yontemleri arasinda en yuksek uyum (%76) hippokampal skleroz disi anormallikler sahip temporal lob epilepsili hastalarda saptandi. MRG’de kortikal gelisimsel anormalliklere sahip hastalardaki, klinik- elektroensefalografi bulgulari ile MRG arasindaki uyum (%84,2), klinik- elektroensefalografi bulgulari ile FDG-PET arasindaki uyumdan (%52,6) yuksekti (p=0,010). T emporal lob epilepsilerindeki k linik- elektroensefalografi bulgulari ile norogoruntuleme yontemleri arasindaki uyum (%48,2), ekstra-temporal lob epilepsilerine (%9,6) gore daha yuksekti (p

Amac: Acil serviste akut atipik inme sikayetleri nedeniyle tetkik edilen hastalarda saptanan patolojileri arastirmak, klinik bulgular ile anormal norogoruntuleme bulgulari arasindaki iliskiyi degerlendirmek. Gerec ve Yontemler: Calismamiz hastane etik kurul onayi alinarak yapildi. Ocak 2016 ile Ocak 2018 tarihleri arasinda, akut atipik inme sikayetleri nedeniyle beyin bilgisayarli tomografisi (BT) ve/veya manyetik rezonans (MR) goruntulemesi yapilmis ardisik 117 hastanin (66 kiz, 51 erkek, ortalama yas 10,9±4,8 yil), klinik ve norogoruntuleme bulgulari geriye donuk tarandi. Kategorik ve sayisal degiskenler Ki-kare, Fisher, t -testi ile analiz edilerek lojistik regresyon analizi yapildi. Bulgular: Hastalarda en sik saptanan sikayetler bas agrisi (%25,6), kusma (%19,6) ve bilinc bulanikligi (%17,9) idi. Hastalarin %20,5’inde klinik ile iliskili vaskulopati, konjenital afibrinojenemi gibi risk faktorleri saptanirken, %39,3’unun norolojik muayenesi ve %35’inin norogoruntulemesi anormaldi. On iki hastada klinik ve norogoruntuleme bulgularina gore acil tedavi gerektiren patolojiler (akut arteriyal iskemi [1 hasta], sinovenoz tromboz [1 hasta], intrakraniyal kitle [3 hasta], menenjit [3 hasta], ensefalit [4 hasta]) saptandi. Risk faktorlerinin varligi, bilinc bulanikligi ve norolojik muayenenin anormal olmasi ile norogoruntulemede anormal bulgu saptanmasi arasinda istatistiksel olarak anlamli iliski bulundu (p=0,045). Lojistik regresyon analizinde anormal norogoruntuleme bulgularini ongormede, bilinc bulanikligi ve norolojik muayenenin anormal olmasi anlamliydi (p=0,006). MR goruntuleme (%45,1) ile saptanabilen anormal bulgular BT’ye gore (%17) anlamli olarak fazlaydi (p

Objective: Accessory renal arteries may be related to the risk of renovascular hypertension. This study aims to evaluate the clinical course of accessory renal arteries in children with hypertension. We also aimed to compare renal function tests, blood pressure loads, frequency of end-organ damage, and prognosis of hypertensive patients who had detected single and accessory renal artery with Magnetic Resonance Angiography.Material and Methods: From 01 January 2015 to 31 December 2017 medical records of hypertensive patients were retrospectively reviewed and patients who had been evaluated with Magnetic Resonance Angiography for differential diagnosis of renovascular hypertension were selected. Hypertensive patients with single renal arteries and those who had accessory arteries were compared in the terms of findings Doppler Ultrasound, blood pressure load, and presence of end-organ damage, laboratory investigations, treatment modalities, and prognosis. Results: Of 49 hypertensive patients who underwent Magnetic Resonance Angiography, 26 (51%) showed accessory renal arteries. Despite the normal Doppler Ultrasound, 13 patients were found to have accessory renal artery with Magnetic Resonance Angiography. There was no significant difference between blood pressure load, and laboratory investigations between the patients with single renal arteries and those who had accessory renal arteries. The frequency of end-organ damage was also similar between both groups at the end of follow-up period as well as the number of medications.Conclusion: Magnetic Resonance Angiography is more successful than Doppler Ultrasound to detect accessory renal artery. It seems that the presence of accessory renal arteries does not affect the prognosis of the disease., Amaç: Aksesuar renal arterler, renovasküler hipertansiyon ile ilişkili olabilir. Bu çalışma, hipertansiyonlu çocuklarda aksesuar renal arterlerin klinik seyrini değerlendirmeyi amaçlamaktadır. Ayrıca, Manyetik Rezonans Anjiyografi ile tek ve aksesuar renal arter tespit edilen hipertansif çocuk hastaların, böbrek fonksiyon testleri, kan basıncı yükleri, hedef organ hasar sıklığı ve prognozunu karşılaştırmayı amaçladık.Gereç ve Yöntemler: Hastanemize 01 Ocak 2015- 31 Aralık 2017 yılları arasında başvuran hipertansif çocuk hastaların tıbbi kayıtları retrospektif olarak incelendi ve renovasküler hipertansiyon şüphesi ile Manyetik Rezonans Anjiyografi ile değerlendirilen hastalar belirlendi. Aksesuar renal arterli ve tek renal arterli hipertansif çocuk hastaların laboratuvar tetkikleri, Doppler Ultrasonografi, kan basıncı yükleri, hedef organ hasarı varlığı, tedavi modaliteleri ve prognozları karşılaştırıldı.Bulgular: Manyetik Rezonans Anjiyografi yapılan 49 hipertansif hastadan 26’sında (%51) aksesuar renal arterler görüldü. Normal Doppler Ultrasonografi’ye rağmen, 13 hastada Manyetik Rezonans Anjiyografi ile aksesuar renal arter olduğu bulundu. Bununla birlikte, aksesuar renal arterleri olan hastalar ile tek renal arterleri olan hastaların laboratuvar incelemeleri ve kan basıncı yükü açısından anlamlı bir fark yoktu. Takip süresi sonunda hedef organ hasarının sıklığı ve kullanılan ilaç sayısı da her iki grup için benzerdi.Sonuç: Manyetik Rezonans Anjiyografi, aksesuar renal arteri saptamada Doppler Ultrasonografi görüntülemesi ile elde edilenden daha başarılıdır. Ancak, aksesuar renal arterlerin varlığının hastalığın prognozunu etkilemediği görülmektedir.

The hepatosplenic (HS) form of cat scratch disease (CSD) is rarely seen; however, management of the treatment is challenging for clinicians. Monotherapy or combination regimens may be preferred based on severity of cases. Along with that, there are uncertainties as to the combination and duration of antibiotics effective against the microorganisms. In this report, a 12-year-old girl diagnosed with HS-CSD and unresponsive to primary treatment with macrolide group antibiotic was presented. The patient had liver findings compatible with CSD, confirmed radiologically and pathologically, and Bartonella henselae indirect immunofluorescence assay IgG was positive at 1/2048 titre. A combination therapy for six months with doxycycline and rifampicin was initiated, and the patient was successfully treated. The preference for monotherapy or combination regimen in HS-CSD is predominantly determined by the clinician according to the severity of the patient’s clinical findings. The effectivity of antimicrobial regimen in HS-CSD requires further investigation.

Background: Our aim in this study was to evaluate the efficacy of magnetic resonance imaging (MRI) studies in the detection of brain regions effected by Sydenham chorea and to determine whether they provided data regarding the pathogenesis of Sydenham chorea. To this end, we assessed basal ganglia structures in Sydenham chorea patients and control group by quantitative MRI volumetric analysis. Methods: Patients with a recent onset of chorea and control subjects matched for age and gender were included in the study. Medical history, laboratory tests, and physical and neurologic examinations were reviewed. All MRIs were considered within normal limits. High-resolution T1-weighted 3D magnetization-prepared rapid acquisition of gradient echo scans were used for quantitative volumetric assessment of the brain via the “volBrain” method. Results: Twenty-four subjects with Sydenham chorea (16 girls and 8 boys, aged between 7 and 16 years) and 35 control subjects were evaluated. Mean age was 11.25 ± 2.89 years for Sydenham chorea patients and 10.58 ± 2.53 years for the controls. No significant difference was found relative to globus pallidus, caudate, and thalamic volumes between patients with Sydenham chorea and controls. The relative mean total, left, and right putamen volumes were significantly larger in patients with Sydenham chorea compared to controls ( P = .003, P = .018, P = .001, respectively). Conclusion: Selective neuroanatomic differences in putamen among other basal ganglia structures and significant increases in size are consistent with a hypothesis of a cross-reactive antibody-mediated inflammation of the putamen as being the pathophysiologic mechanism for this disorder.

Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive disease. There is no definitive treatment available. Case; A 13-year-old male with no remarkable medical history presented with a sore throat. Chest X-ray performed because of prolonged symptoms. He referred to pediatric pulmonology department because of the reticulonodular opacities in X-ray. Physical examination was normal and no clinical complaints. X-ray revealed reticulonodular opacities that had a greater distribution in the middle and lower lung zones. PFT showed a mild restrictive pattern. CT images were consistent with interstitial lung disease. The patient underwent open lung biopsy, and histopathologic analysis results confirmed a diagnosis of pulmonary alveolar microlithiasis. The patient started disodium etidronate treatment. Sandstorm-like appearance on chest x-ray decrease and restrictive pattern in PFT improved after three months of treatment. There was no significant change in parenchymal findings on CT. In follow up concomitant thoracic CT and MRG performed. However, the micronodular pattern observed in CT was not present in MRG. Conclusion: There is no known effective treatment for PAM. Number of the report describes the beneficial effects of long-term treatment with disodium etidronate but in a certain case, it seems ineffective. Our patient’s chest X-ray and PFT improved after three months of disodium etidronate treatment. However, there was no major change in CT. It is possible to observe parenchymal improvement in long term treatment. CT is a major tool for the detection and follows up the patients. We performed thoracic MRG in follow up however the parenchymal patterns of PAM could not be detected in MRG.

The objective of the study was to identify the relationship between subcortical gray matter (GM) volumes and juvenile myoclonic epilepsy (JME).We analyzed the brain magnetic resonance imaging (MRI) scans that were performed during the time of the diagnosis of epilepsy by using voxel-based morphometry (VBM) method. The volumetric three-dimensional sequence was used for structural investigation. The volumes of the thalamus, caudate nucleus, pallidum, and putamen were measured in both hemispheres of patients with JME, patients with generalized tonic-clonic seizures alone (GTCS) (as a disease control group) and healthy controls (HCs). All patients were drug-naïve, and treatment had been started after evaluating MRI results.Fifteen patients with JME (9 females, mean age = 16.1 ± 3.2), 18 patients with GTCS (10 females, mean age = 15.5 ± 2.9), and 43 HCs (24 females, mean age = 15.9 ± 2.8) were included in the analysis. No significant difference was found for relative globus pallidus, caudate, and putamen volumes among the groups with JME, GTCS, and the HC group. The relative left and right thalamic volumes were significantly different between groups (Kruskal-Wallis rank test, p = 0.007, p = 0.001). In pairwise comparisons, both right and left relative thalamic volumes were lower in patients with JME than in HCs (right thalamus: means: 0.521 ± 0.066 vs. 0.597 ± 0.058, p 0.001; left thalamus: means: 0.526 ± 0.088 vs. 0.605 ± 0.057, p 0.001, Bonferroni post hoc corrections) and in patients with JME than in patients with GTCS (right thalamus: means: 0.521 ± 0.066 vs. 0.578 ± 0.066, p = 0.03; left thalamus: means: 0.526 ± 0.088 vs. 0.592 ± 0.068, p = 0.01, Bonferroni post hoc corrections), whereas there was no significant difference between the HCs and patients with GTCS (right thalamus: means: 0.597 ± 0.058 vs. 0.578 ± 0.066, p = 0.8; left thalamus: means: 0.605 ± 0.057 vs. 0.592 ± 0.068, p = 0.999, Bonferroni post hoc corrections).This study allowed us to know that microstructural abnormalities exist from the disease onset, and the thalamus might play a critical role in the pathogenesis of JME.

Summary Background Snapping scapula syndrome, also known as scapulothoracic crepitus or bursitis, is a manifestation of a mechanical abnormality of the scapulothoracic joint. In addition to characteristic findings on physical examination, magnetic resonance imaging (MRI) exquisitely reveals soft tissue changes such as muscle edema and scapulothoracic bursitis. Case Report We present a case of a 10-year-old boy who had snapping scapula syndrome of the right scapula that was associated with edema of the serratus anterior muscle at the scapulothoracic interface and with scapulothoracic, specifically supraserratus, bursitis on MRI. Conclusions MRI in snapping scapula syndrome, which is a clinical diagnosis, exquisitely reveals soft tissue changes such as muscle edema and scapulothoracic bursitis. Such soft tissue findings of snapping scapula syndrome need to be kept in mind while evaluating routine shoulder and/or scapular region MRI, especially in the absence of relevant clinical information at the time of the imaging study.

Amac: Cocuklarda akciger kist hidatigi eriskinlerden daha sik gorulur. Akciger kist hidatigi bronsiyal ruptur ve/veya sekonder enfeksiyon ile komplike olabilir. Komplike lezyonlar ozgun olmayan goruntuleme bulgulari gosterebilir. Arastirmada komplike ve komplike olmayan akciger kist hidatiklerinin tanisal radyolojik bulgularinin karsilastirilmasi amaclanmistir. Gerec ve Yontemler: Calismaya akciger kist hidatigi olan 23 cocuk hastada toplam 28 akciger kist hidatik lezyonu dahil edildi. Hastalarin demografik bilgileri, basvuru semptomlari, akciger grafileri, bilgisayarli tomografi (BT), manyetik rezonans goruntuleme ve abdominal ultrasonografi bulgulari retrospektif olarak degerlendirildi. Radyolojik goruntulemelerde lezyon sayisi, lobar yerlesim, bronsiyal ruptur, enfeksiyon varligi, en genis boyut, duvar kalinligi, BT incelemesi olan sivi icerikli lezyonlarin sivi dansitesi degerlendirildi. Bulgular: Calismaya dahil olan 23 cocugun (kiz: 7, erkek: 16) yas ortalamasi 10.1 (yas araligi, 4-17)’di. Lezyonlarin 17’si sag, 11’i sol akcigerde izlendi. Soliter lezyon sayisi 19’du (%82.6). Lezyonlar iki hastada cift tarafli (%9.5) goruldu. Lezyonlar en sik sag akciger alt lobda yerlesim gostermekteydi (%42.9). Hastalarin 19’u (%82.6) tani aninda semptomatikti. Yirmisekiz lezyonun 19’u (%67.9) bronsiyal ruptur ve/veya sekonder enfeksiyon ile komplike olmustu. Akciger grafilerinde bronsiyal ruptur sonucu 12 lezyonda (%42.9); nilufer (n=5), meniskus (n=5) ve cift kubbe (n=2) isaretleri saptandi. BT incelemesi olan 16 hastada toplam 21 lezyon degerlendirildi. Bronsiyal ruptur ve/veya enfeksiyon bulgusu olan 16 lezyonda (%76.2) hava kabarcigi (n=6), nilufer (n=4), meniskus (n=4), cift kubbe (n=3) ve sarmal (n=1) isaretleri saptandi. Kist hidatik icin tanisal bulgunun gosterildigi lezyon sayisi BT incelemede istatistiksel anlamli olarak daha fazlaydi (p=0.031). Sekonder enfeksiyon ile komplike olan kist hidatik lezyonlarinin duvar kalinligi komplike olmayanlara gore daha kalin olculdu (p=0.028). Sonuc: Komplike akciger kist hidatigi lezyonlarinda direkt grafiler ile tanisal zorluk yasanabilir. BT goruntuleme lezyonun kistik yapisini ortaya koymada, kist hidatige ait ozel isaretlerin ve sakli alanlarda yerlesim gosteren kistlerin gosterilmesinde, komplike lezyonlarin degerlendirmesinde, cerrahi oncesi planlamada direkt grafilere ustundur. Bu nedenle akciger kist hidatiklerinin goruntulemesinde ilk tercih edilen yontem akciger grafileri olmakla birlikte komplike kistlerin BT ile degerlendirilmesi tanisal dogrulugu artirir.

A variety of conditions may affect the trigeminal nerve. Magnetic resonance imaging is the modality of choice when trigeminal nerve pathology is suspected, and this modality plays an essential role in detecting causes. This review illustrates some of the pathological conditions relevant to the trigeminal nerve in magnetic resonance imaging.

Large nonresolving neonatal ovarian cysts may be a risk factor for complications such as torsion, mass effect, rupture, intracystic hemorrhage, and autoamputation. Torsed cysts and autoamputated cysts can cause a diagnostic dilemma. The objective of our study was to correlate the imaging findings of intrauterine ovarian torsion and autoamputated ovaries with their pathologic findings.We retrospectively analyzed the pre- and postnatal medical records, sonographic findings, operation notes, and pathologic reports of 15 patients with ovarian torsion. All patients had complex cysts noted on postnatal sonographic examination. A complex heterogeneous ovarian cyst was defined by the presence of a fluid-debris level indicating hemorrhage within the cyst, a retracting clot, septations with or without internal echoes, calcification, and a solid component.On ultrasound examination, four cysts had solid components, and 11 were heterogeneous and had a fluid-debris level. Calcifications were seen in two patients. The mean patient age at the time of surgery was 3.9 months. Exploratory laparotomy was performed on all patients. Torsed ovaries were identified in five patients. Ten patients had ovaries that were floating free in the peritoneal cavity at the time of surgery. Histopathologic evaluation revealed that 11 of the cysts consisted of extensive hemorrhagic, necrotic autolytic tissue with dystrophic calcification. None of the cysts contained any ovarian tissue.A complex heterogeneous ovarian cyst with a fluid-debris level indicating hemorrhage is a significant sonographic hallmark for the diagnosis of ovarian torsion. A calcified abdominal mass, with or without wandering, can be an autoamputated ovary.

Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive lung disease. It is characterized by the accumulation of calculi called microliths. There is no definitive treatment. Disodium etidronate has been administered due to its alleged calcium phosphate precipitation-reducing effect; however, its effectiveness is controversial. Case; A 13-year-old male referred because of the reticulonodular opacities in chest X-ray detected during evaluation for upper respiratory tract infection. Pulmonary function test results showed a mild restrictive pattern. Findings on computed tomographic (CT) images were consistent with interstitial lung disease. Open lung biopsy confirmed a diagnosis of PAM. The patient started disodium etidronate treatment. Sandstorm-like appearance on chest x-ray decrease and restrictive pattern in pulmonary function test improved after six months of treatment. There was no significant change in CT. After cessation of treatment, the patient remains stable clinically. His asymptomatic sister also screened and similar mutation in SLC34A2 detected. However, because of his sister asymptomatic and younger, she is followed without treatment and remained stable clinically. Conclusion: Currently, there is no consensus on the treatment of PAM. The number of the report describes the beneficial effects of long-term treatment with disodium etidronate, but in a certain case, it seems ineffective. Our patient9s chest X-ray and pulmonary function improved after six months of disodium etidronate treatment. However, there was no major change in CT. He remains asymptomatic after discontinuation of treatment. Therefore, the effectiveness of disodium etidronate still remains controversial.

Ozyoruk D, Kocayozgat A, Yaman-Bajin I, Cetindag F, Oguz- Erdogan AS, Gunes A. A synchronous occurrence of bifocal intracranial germinoma and bilateral testicular epidermoid cyst in an adolescent patient with Klinefelter`s syndrome. Turk J Pediatr 2019; 61: 456-459. Klinefelter syndrome (KS) is characterized by an additional X chromosome in males leading to a karyotype of 47,XXY. It is associated with an increased risk of certain malignancies, including leukemia, breast cancer and extragonadal germ cell tumor such as mediastinal germ cell tumors and rarely intracranial germ cell tumors. It is possible that the increased risk of developing certain cancers can be attributed to a direct effect of the chromosomal abnormality or the combined action of the abnormal chromosomes and hormonal imbalances. Here we describe a synchronous occurrence of bifocal intracranial germinoma and bilateral testicular epidermoid cyst in an adolescent patient with Klinefelter`s syndrome. The synchronous occurrence of the dual tumors in this patient with Klinefelter`s syndrome might be resulted from the migration defect during embriyogenesis due to underlying genetic disease or it is a coincidental condition, yet there has been no case reported in the literature, so far.

Although generally more common in adults, lower extremity impingement and friction syndromes are also observed in the pediatric age group. Encompassing femoroacetabular impingement, iliopsoas impingement, subspine impingement, and ischiofemoral impingement around the hip; patellar tendon-lateral femoral condyle friction syndrome; iliotibial band friction syndrome; and medial synovial plica syndrome in the knee as well as talocalcaneal impingement on the hindfoot, these syndromes frequently cause pain and may mimic other, and occasionally more ominous, conditions in children. Magnetic resonance imaging (MRI) plays a key role in the diagnosis of musculoskeletal impingement and friction syndromes. Iliopsoas, subspine, and ischiofemoral impingements have been recently described, while some features of femoroacetabular and talocalcaneal impingements have recently gained increased relevance in the pediatric population. Fellowship-trained pediatric radiologists and radiologists with imaging workloads of exclusively or overwhelmingly pediatric patients (particularly those without a structured musculoskeletal imaging program as part of their imaging training) specifically need to be aware of these rare syndromes that mostly have quite characteristic imaging findings. This review highlights MRI features of lower extremity impingement and friction syndromes in children and provides updated pertinent pathophysiologic and clinical data.

Introduction: Structural changes in the lung visualized with CT may correlate with histologic findings in a number of chronic airway diseases and bronchiectasis.Chest CT is an important tool in detection and management of bronchiectasis, but there is little information about CT findings in primary ciliary dyskinesia(PCD).The aim of this study was to analyze the chest CT findings of patients with PCD and make clinical correlation with radiological findings. Method: We analyzed the radiological findings of 95 patients diagnosed with PCD folllowing at Hacettepe University Pediatric Pulmonology Department. CT findings were correlated with phenotypic findings, including situs type, spirometry and microbiologic findings in the airways. Results: The mean age of the patients were 10.8(1-20 years)years and 49(%52) of the patients were female. Situs inversus totalis(%13.7) or heterotaxy(%5.3) was identified in %19 of the patients. Chest CT revealed out %7.4 pectus excavatum, %3.2 sternal tilt, %4.2 pectus carinatum. The most common lung lobes involved were %60 right-middle lobe, %58.7 left-lower lobe, %53 left lingula, %41.6 right lower lobe, %22.8 right upper lobe, %7.5 left upper lobe and central bronchiectasis was the most common finding. It was found that bronchiectasis score increased with age and lung function tests decreased with bronchiectasis severity. Conclusion: Chest CT shows that pulmonary disease related to PCD predominantly involves the middle and lower lobes of the lungs. This finding contrasts to the more diffuse disease of cystic fibrosis, which has an upper-lobe predilection. Bronchiectasis severity correlated with worse pulmonary function as reflected by FEV1 and older age at CT.

Introduction Many studies have been performed on adult patients to reveal the relationship between Hounsfield unit (HU) value and composition of stone, but none have focused on childhood. Objective We aimed to predict stone composition by HU properties in pre-intervention non-contrast computed tomography (NCCT) in children. This could help to orient patients towards more successful interventions. Materials and methods Data of 94 children, whose pre-intervention NCCT and post-interventional stone analysis were available were included. Stones were grouped into three groups: calcium oxalate (CaOx), cystine, and struvite. Besides spot urine PH value, core HU, periphery HU, and Hounsfield density (HUD) values were measured and groups were compared statistically. Results The mean age of patients was 7 ± 4 (2–17) years and the female/male ratio was 51/43. The mean stone size was 11.7 ± 5 (4–24) mm. There were 50, 38, and 6 patients in the CaOx, cystine, and struvite groups, respectively. The median values for core HU, periphery HU, and mean HU in the CaOx group were significantly higher than the corresponding median values in the cystine and struvite groups. Significant median HUD difference was seen only between the CaOx and cystine groups. No difference was seen between the cystine and struvite groups in terms of HU parameters. To distinguish these groups, mean spot urine PH values were compared and were found to be higher in the struvite group than the cystine group (Table). Table. Comparison of stone types according to HU parameters, spot urine PH, and p values. Parameters Core HU Periphery HU Mean HU Spot urine PH CaOx vs Cyst