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Epilepsy is one of the leading chronic diseases of childhood, and an underlying IEM is an etiology that can easily be overlooked. The aim of this study was to determine the frequency of metabolic disease in patients diagnosed with epilepsy in the first two years of life, as well as to determine the clinical, radiological, and electroencephalographic (EEG) characteristics of the metabolic disease subtypes associated with epilepsy and evaluate treatment response in our study.The records of patients diagnosed with epilepsy before the age of 2 years in our pediatric neurology clinic between 2014 and 2021 were reviewed retrospectively. Those diagnosed with an IEM and followed up in the pediatric neurology and pediatric metabolism departments of our hospital were included in the study.A total of 990 patients under the age of 2 years were diagnosed with epilepsy in the pediatric neurology clinic of our hospital and 74 (7.5%) of them had IEM. Thirty-nine (52.7%) of the 74 patients were female. The median age at admission was 144 days (min-max: 0-284). Of the 74 patients diagnosed with metabolic epilepsy, 38 patients were diagnosed with amino acid metabolism disorder, 17 with lysosomal storage disease, 9 with energy metabolism disorder, 5 with vitamin/cofactor/trace element metabolism disorders, 2 with fatty acid metabolism disorder, 2 with peroxisomal disease, and 1 with carbohydrate metabolism disorder. Epilepsy was refractory despite appropriate treatment in 39 patients (52.7%).Inborn errors of metabolism are a rare cause of epilepsy, in regions like our country with high rates of consanguineous marriage, IEM should be considered in patients presenting with seizures that do not respond to conventional antiepileptic treatments.

Introduction: Despite the developments in pharmacologic treatments, traditional and complementary therapies have recently gained popularity in our country, as well as around the world. Aim: To question complementary and alternative medicine practices CAMP during clinical visits of pediatric neurology patients, to raise awareness of families and patients about the use of complementary and alternative medicine, and to prevent possible negative interactions. Methods: This prospective survey study was conducted with the parents of 300 pediatric patients aged between 6 months and 18 years, who were being treated at the Child Neurology Clinic between March 1st and May 30th, 2020. For the study, 360 patients’ parents who came to the Pediatric Neurology clinic for treatment were randomly selected, and a face-to-face survey lasting 2 minutes was conducted with 300 patients’ parents who agreed to participate in the study. This study was approved with the decision number E-20-12-62 at the meeting dated 21.12.2020 of the Clinical Research Ethics Committee of SBU Ankara Dr Sami Ulus Gynecology and Childhood Health and Diseases Training and Research Hospital. Results: Three hundred parents (56% women) participated in the study. Just over half (55.3%) of the patients were followed up with a diagnosis of epilepsy, 56.6% of the parents stated that they had used traditional and complementary therapy methods before, 43.4% stated that they did not use it, 46.54% stated that they used prayer and 23,9% used vitamin methods, respectively. Conclusion: In neurologic diseases, parents use traditional and complementary therapies as treatment methods, creating an alternative to modern medicine. Families and patients should be informed by investigating the reasons and frequency of using traditional and complementary therapies, raising the awareness of parents, and determining the possible harm caused by traditional and complementary therapies.

Aim: We aimed to investigate the quality of life (QL) and sleep habits (SH) of children presenting to the pediatric neurology outpatient clinic with headache. Methods: This prospective, cross-sectional and observational survey study included children aged 2-18 who presented to the pediatric neurology outpatient clinics of Dr. Ali Kemal Belviranlı Maternity and Children's Hospital or Konya City Hospital between April and August 2022. QL was assessed using the Pediatric Quality of Life Inventory (PedsQL) and sleep characteristics were evaluated using the Children’s Sleep Habits Questionnaire. Results: The study included 137 patients (56.2% girls) with a mean age of 153.54±34.5 months at presentation. All patients were diagnosed with primary headache; 51.8% had migraine and 48.2% had tension-type headache. Quality of life scores were 69.07±14.96 according to child self-assessment and 66.39±15.37 according to parental assessment. The mean score on the sleep habits questionnaire was 48.01±7.68, and 9.5% of the patients had good sleep quality. Subscale scores showed that the greatest adverse effects on QL were in the areas of emotional functioning and school functioning. Conclusions: Clinical assessment of patients’ QL and SH is important for individualizing treatment and approach in pediatric primary headache.

Aims: The aim of this study was to assess the neurological aspects of patients who presented to the pediatric neurology outpatient clinic with the complaint of speech retardation. Methods: A retrospective analysis was performed on the data of the patients who underwent treatment for speech retardation between February-October 2022 at the pediatric neurology outpatient clinic of Dr. Ali Kemal Belviranlı Obstetrics and Pediatrics Hospital and Konya City Hospital. Results: The study included 149 patients with a mean age of 41.1+16.2 months, 74.5% of the patients were male. It was revealed that 8.7% of the children had a history of prematurity, 16.1% had a family member with speech retardation. In electroencephalography, epileptic disorders were found in 2.6% of the patients, psychiatric disorders (8.7% autism) in 16.7%, hearing loss in 0.7%, developmental retardation in the isolated language area in 75.8%, and global development retardation in 24.2%. Brain magnetic resonance imaging showed an abnormality of 3.3%. Furthermore, 52.3% of our patients were found to be deficient in stimuli, while 59.7% used intensive media. Conclusions: In terms of early diagnosis and treatment of speech retardation and accompanying pathologies, the diagnostic approach in children brought in due to speech retardation is critical.

Karakus, Volkan/0000-0001-9178-2850; Demirkan, Fatih/0000-0002-1172-8668; Demircioglu, Sinan/0000-0003-1277-5105; Arat, Mutlu/0000-0003-2039-8557; Cagliyan, Gulsum Akgun/0000-0002-2073-1949; Ozturk, Hacer Berna Afacan/0000-0001-9386-7604; WOS: 000473249400014 PubMed: 31036516 Therapeutic plasma exchange (TPE) is used to treat more than 60 diseases worldwide and has drawn growing interest. Little is known about the current situation of TPE activity in Turkey, so we developed a survey to obtain information about this timely topic. We collected data on TPE from 28 apheresis units throughout Turkey. We performed a total of 24,912 TPE procedures with 3203 patients over the past decade. Twenty years ago, the majority of procedures were performed for neurological and hematological disorders, and today, most TPE procedures are done for the same reasons. The only historical change has been an increase in TPE procedures in renal conditions. Currently, renal conditions were more frequently an indication for TPE than rheumatic conditions. Fresh frozen plasma was the most frequently used replacement fluid, followed by 5% albumin, used in 57.9% and 34.6% of procedures, respectively. The most frequently used anticoagulants in TPE were ACD-A and heparin/ACD-A, used with 1671 (52.2%) and 1164 (36.4%) patients, respectively. The frequency of adverse events (AEs) was 12.6%. The most common AEs were hypocalcemia-related symptoms, hypotension, and urticaria. We encountered no severe AEs that led to severe morbidity and mortality. Overall, more than two thirds of the patients showed improvement in the underlying disease. Here, we report on a nationwide survey on TPE activity in Turkey. We conclude that there has been a great increase in apheresis science, and the number of TPE procedures conducted in Turkey has increased steadily over time. Finally, we would like to point out that our past experiences and published international guidelines were the most important tools in gaining expertise regarding TPE.

OBJECTIVE: This study aimed to evaluate the effects of the use of baby walkers on trunk control and motor development in typically developing children. MATERIAL AND METHODS: Demonstrating standard developmental steps, 29 children (14 females, 15 males; mean age 10±1 month) who used a baby walker and 19 children (10 females, 9 males; mean age 10±1 month) who did not use a baby walker were included. Motor skills were assessed using the Alberta Infant Motor Scale and trunk control using Segmental Assessment of Trunk Control. RESULTS: The motor development scores and trunk balance scores were found significantly lower in infants who used a baby walker compared with those not using a baby walker. CONCLUSION: It was concluded that the use of baby walkers might adversely affect the motor development of infants and this may be due to impaired trunk control.

PubMed ID: 33475343 2-s2.0-85100240278 As a result of its unique location, Turkey receives air masses from Europe, Russia, Middle East, and Africa, making it an important place in terms of long-range atmospheric transport (LRT) of contaminants. Atmospheric levels of 22 organochlorine pesticides (OCPs), 45 polychlorinated biphenyls (PCBs), and 14 polybrominated diphenyl ethers (PBDEs) were measured in two metropolitan cities, Istanbul and Izmir, on a weekly basis from May 2014 to May 2015. Dichlorodiphenyltrichloroethane (DDT) and its derivatives were dominant OCP species, followed by isomers of hexachlorocyclohexane (HCH) at both sites. The annual mean concentration of ?DDX (sum of o,p?-DDT, p,p?-DDT, o,p?-DDD, p,p?-DDD, o,p?-DDE, and p,p?-DDE) was 82 pg/m3 for Istanbul and 89 pg/m3 for Izmir, while these levels were about 46 pg/m3 for ?HCHs (sum of ?-, ?-, ?-, and ?-HCH) at both of the sites. At both stations, tri- and tetra-PCBs and tetra- and penta-PBDEs were dominant congeners. The temperature dependence indicates that both LRT and local contaminated areas contribute to the elevated levels. A Lagrangian particle dispersion model (FLEXPART) showed a few potential source regions in northern Africa and Middle East, southern-southwestern and eastern Europe including Russia, as well as from local domestic metropolitan areas. © 2021 American Chemical Society. 112Y315 Consejo Nacional para Investigaciones Científicas y Tecnológicas, CONICIT We acknowledge funding from Turkish Scientific and Technological Research Council (TUBITAK) for the financial support under the grant scheme of The Scientific and Technological Research Projects Funding Program (Grant No. 112Y315).

Aims One of the impairments evaluated in children with cerebral palsy (CP), which perhaps has been least investigated, is reduced selective motor control. The aim of the present study was to determine construct validity, discriminative validity, and intra- and interrater reliability of the Selective Control of the Upper Extremity Scale (SCUES). Methods Thirty-three children with unilateral CP, with a mean age of 11.5 +/- 3.3 years, at level I to IV according to the Manual Ability Classification System (MACS), participated. The children were video-recorded and scored using the SCUES. The videos were scored twice to determine the intra- and interrater reliability. Reliability was assessed using the intraclass correlation coefficient, the standard error of the measurement (SEM), and the smallest real difference (SRD). Differences in the SCUES scores were determined between the less- and more-affected arm and across all MACS levels for discriminative validity. Construct validity of the SCUES was established by the MACS, and the Jebsen Taylor Hand Function Test (JTT). Results SCUES scores were significantly different between the less- and more-affected arm (p< .001) and between the arm joints. SCUES scores were also significantly different among MACS levels (p< .001). The SCUES was strongly correlated with the JTT (Spearman's rho = -0.80,p< .001) and MACS (rho = -0.78,p< .001). Intra- and interrater reliability were excellent (intraclass correlation coefficient [ICC] > 0.75) for all joints of the more-affected extremity. The SRDs at the 95% confidence level for intra- and interrater reliability were 2.11 and 1.16, respectively. Conclusions The SCUES is a valid and reliable tool to assess selective motor control of the upper extremity in children with unilateral CP.

PubMedID: 30101368 Henoch–Schönlein purpura (HSP), the most common childhood vasculitis is characterized by non-thrombocytopenic palpable purpura, arthritis/arthralgia, abdominal pain and renal involvement. Functional gastrointestinal disorders (FGIDs) are heterogeneous disease spectrum with unclear etiology and include the most common subtypes: functional dyspepsia, irritable bowel syndrome (IBS), functional abdominal pain and functional constipation. Formerly, FGIDs were known as non-organic disorders; however, recent advances revealed that low-grade inflammation may also play a role. We aimed to clarify whether HSP predisposes to FGIDs in pediatric population. Seventy-four children with HSP, diagnosed at least 6 months before the study and 78 healthy controls were enrolled to the study. Patients with red flag signs for organic GI disorders were excluded. Rome IV criteria were utilized for FGIDs diagnosis. We compared the frequencies of FGIDs between HSP patients and healthy subjects. We also examined the parameters including age, abdominal pain, arthralgia, bloody stool, renal involvement and treatment with corticosteroids and laboratory results at HSP diagnosis such as erythrocyte sedimentation rate, C-reactive protein, hemoglobin, leukocytes and platelet counts among patients with and without FGIDs. Overall FGIDs and IBS frequency were 35.1% (n = 26) and 10.8% (n = 8) in HSP patients, 19.2% (n = 15) and 2.6% (n = 2) in healthy controls, respectively. Disease characteristics and laboratory parameters at disease onset were similar between HSP patients with and without FGIDs. Overall FGIDs rate, particularly IBS were statistically higher in HSP patients. We speculate that children with preceding HSP may be predisposed to FGIDs. Since the FGIDs pathogenesis is still remains unclear, further studies are needed to confirm this hypothesis and clarify the etiology. Physicians also should pay attention to FGIDs in HSP patients with ongoing abdominal pain and thus prevent this comorbidity with dietary and psychologic measures. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

WOS: 000435622600021 PubMed: 29772401 Objectives: In the study, the effect of valproic acid on serum free/acylcarnitine levels and left ventricular systolic function in pediatric patients with idiopathic epilepsy receiving valproic acid was investigated. Patients and Methods: Patients receiving valproic acid treatment for six months between January 2012 and December 2012 were evaluated. Blood samples were obtained from the participants twice (pretreatment and the sixth month of treatment) and serum-free and acylcarnitine levels (from C2 to C18:1 OH) were measured using tandem mass spectrometry. Cardiac functions (ejection fraction, shortening fraction, cardiac output, left ventricular systolic and diastolic diameters, left atrial diameter, aortic diameter, cardiac output, and myocardial performance index) were evaluated by echocardiography simultaneously. Results: A total of fourty patients, 23 female (57.5%) and 17 male (42.5%), with the diagnosis of idiopathic epilepsy and receiving valproic acid monotherapy were studied. Comparison of serum-free and acylcarnitine levels measured pretreatment and sixth month of treatment revealed a decrease in average CO and C5:1 (respectively p < 0.001, p = 0.013) and an increase in C2, C3, C5-OH, C8:1 and C4 DC levels (respectively p < 0.001, p < 0.001, p = 0.019, p = 0.013, p < 0.001). Other serum acylcarnitine levels did not change significantly (p > 0.05). No difference was observed in concurrent echocardiographic measurements of left ventricular systolic function (p > 0.05). Conclusion: The study demonstrated that valproic acid treatment results in low levels of free carnitine and changes in some acylcarnitine subgroups but has no influence on left ventricular systolic function.

Polyurethane foam (PUF) passive samplers were employed to assess air concentrations of polychlorinated biphenyls (PCBs) in background, agricultural, semi-urban, urban and industrial sites in Bursa, Turkey. Samplers were deployed for approximately 2-month periods from February to December 2014 in five sampling campaign. Results showed a clear rural-agricultural-semi-urban-urban-industrial PCBs concentration gradient. Considering all sampling periods, ambient air concentrations of Σ43PCBs ranged from 9.6 to 1240 pg/m3at all sites with an average of 24.1 ± 8.2, 43.8 ± 24.4, 140 ± 190, 42.8 ± 24.6, 160 ± 280, 84.1 ± 105, 170 ± 150 and 280 ± 540 pg/m3for Mount Uludag, Uludag University Campus, Camlica, Bursa Technical University Osmangazi Campus, Hamitler, Agakoy, Kestel Organised Industrial District and Demirtas Organised Industrial District sampling sites, respectively. The ambient air PCB concentrations increased along a gradient from background to industrial areas by a factor of 1.7–11.4. 4-Cl PCBs (31.50–81.60%) was the most dominant homologue group at all sampling sites followed by 3-Cl, 7-Cl, 6-Cl and 5-Cl homologue groups. Sampling locations and potential sources grouped in principal component analysis. Results of PCA plots highlighted a large variability of the PCB mixture in air, hence possible related sources, in Bursa area. Calculated inhalation risk levels in this study indicated no serious adverse health effects. This study is one of few efforts to characterize PCB composition in ambient air seasonally and spatially for urban and industrial areas of Turkey by using passive samplers as an alternative sampling method for concurrent monitoring at multiple sites., Scientific and Technological Research Council of Turkey (21514107-221.01-8290); TUBITAK (112Y315)

Amaç: Preterm bebekler, santral sinir sistemi immatürasyonu ve yeni doğan yoğun bakım ünitelerinin aşırı duyusal uyarıları nedeniyle duyusal işlemleme problemlerine (DİP) sahip olabilirler. Bu çalışmanın amacı, preterm ve term bebeklerde duyusal işlemleme becerisini karşılaştırmak ve preterm bebeklerin DİP’lerini incelemekti. Yöntem: Çalışmaya düzeltilmiş yaşları 10-12 ay arasında olan 30 preterm ve yaşları 10-12 ay arasında olan 30 term bebek dahil edildi. Bebeklerin sosyodemografik özellikleri ve doğum bilgileri kaydedildikten sonra, duyusal işlemleme değerlendirmesi için Bebeklerde Duyusal Fonksiyonlar Testi (BDFT) kullanıldı. Sonuçlar: Gruplar karşılaştırıldığında, term bebeklerin BDFT total puanının daha yüksek olduğu görüldü (p

Atmospheric levels of 43 PCBs, 22 OCPs, and 14 PBDEs were determined in 16 cities at urban and rural sites by passive sampling to generate the first large-scale nationwide dataset of POP residues in Turkey's atmosphere. Sampling campaign was performed from May 2014 to April 2015 with three-month sampling periods at locations on east-west and north-south transects through the country to investigate seasonal and spatial variations, including long range atmospheric transport (LRAT). Factor analysis was conducted to infer on the potential sources. Overall average Σ43PCBs concentration was 108 ± 132 pg/m3. PCB-118 (26.3 ± 44.6 pg/m3) was the top congener, and penta-CBs had the highest contribution with 54.3%. ΣDDTs had the highest annual mean concentration with 134 ± 296 pg/m3 among the OCP groups among which the highest concentration compound was p'p-DDE (97.6 ± 236 pg/m3). Overall average concentration of Σ14PBDEs was 191 ± 329 pg/m3 with the highest contribution from BDE-190 (42%). Comparison of OCPs and PCBs concentrations detected at temperatures which were above and below annual average temperature indicated higher concentrations in the warmer periods, hence significance of secondary emissions for several OCPs and Σ43PCBs, as well as inference as LRAT from secondary emissions. The first nationwide POPs database constructed in this study, point to current use, local secondary emissions, and LRAT for different individual compounds, and indicate the need for regular monitoring. The first country-wide passive sampling of selected POPs showed no unequivocal trends reflecting transitional location of Turkey., TUBITAK (112Y314)

In this study, some experiments were performed for the dimensional control, pre-treatment, getting salt, metallic aluminum and aluminum oxide into the solution of 15 kg aluminum black dross obtained from a private company which recycles aluminium drosses. Water leaching experiments are done for removing salts and aluminum nitride. Temperature stirring speed, solid-liquid rate are investigated while water leaching experiments. Removing of AlN is provided at 25 °C at a rate of 42.48%, at 80 °C at a rate of 86.4%. Leaching experiments performed with NaOH. NaOH concentration and time was analyzed. Efficiency of including metallic aluminum into the solution is determined to be 98% approximately. Melting (fusion) experiments were performed with NaOH at high temperatures to include aluminum oxide in the structure of the remaining after dissolving process into the solution and after dissolving the resulting structures in water, efficiency of including aluminum into the solution is determined to be 85%.

OBJECTIVE. The aim of this study was to analyze the correlation between sensory processing and motor development in preterm infants.METHOD. We included 30 preterm and 30 term infants with corrected and chronological ages between 10 and 12 mo. We used the Test of Sensory Functions in Infants to evaluate sensory processing and the Alberta Infant Motor Scale to evaluate motor development.RESULTS. The Spearman correlation test indicated a strong positive relationship between sensory processing and motor development in preterm infants (r = .63, p < .001).CONCLUSION. Given the relationship between sensory processing and motor development in the preterm group, the evaluation of sensory processing and motor development in preterm infants was considered necessary for the effective implementation of physiotherapy assessment and interventions.

Background: Thin-section diffusion-weighted imaging (DWI) is known to improve lesion detectability, with long imaging time as a drawback. Parallel imaging (PI) is a technique that takes advantage of spatial sensitivity information inherent in an array of multiple-receiver surface coils to partially replace time-consuming spatial encoding and reduce imaging time. Purpose: To prospectively evaluate a 3-mm-thin-section DWI technique combined with PI by means of qualitative and quantitative measurements. Material and Methods: 30 patients underwent conventional echo-planar (EPI) DWI (5-mm section thickness, 1-mm intersection gap) without parallel imaging, and thin-section EPI-DWI with PI (3-mm section thickness, 0-mm intersection gap) for a b value of 1000 s/mm2, with an imaging time of 40 and 80 s, respectively. Signal-to-noise ratio (SNR), relative signal intensity (rSI), and apparent diffusion coefficient (ADC) values were measured over a lesion-free cerebral region on both series by two radiologists. A quality score was assigned for each set of images to assess the image quality. When a brain lesion was present, contrast-to-noise ratio (CNR) and corresponding ADC were also measured. Student t-tests were used for statistical analysis. Results: Mean SNR values of the normal brain were 33.61±4.35 and 32.98±7.19 for conventional and thin-slice DWI ( P>0.05), respectively. Relative signal intensities were significantly higher on thin-section DWI ( P0.05). Quality scores and overall lesion CNR were found to be higher in thin-section DWI with parallel imaging. Conclusion: A thin-section technique combined with PI improves rSI, CNR, and image quality without compromising SNR and ADC measurements in an acceptable imaging time.

Objective. The purpose of this study was to investigate the efficacy of late-phase pulse inversion harmonic imaging (PIHI) in detecting occult metastases and to compare the results with helical computed tomography (CT) in a group of patients whose fundamental liver sonographic results were normal. Methods. Thirty-two patients (21 women and 11 men; age range, 20-87 years) with a known primary malignancy were enrolled in the study. The patients were evaluated with conventional sonography, unenhanced PIHI, and PIHI 3 minutes after the injection of Levovist (SH U 508A; Schering AG, Berlin, Germany). All patients also underwent triphasic helical CT within 1 week after sonography. In 1 patient, mangafodipir-enhanced magnetic resonance imaging was performed as part of the clinical workup. Results. After Levovist injection, in 4 (12.5%) of 32 patients, at least 1 hypoechoic lesion was detected by PIHI; multiple lesions were shown in 1 patient. The mean diameter of newly detected lesions was 12 mm. Triphasic helical CT also showed all of the lesions that were detected by PIHI. The diagnoses were confirmed by biopsy and CT findings in 2 patients and by the typical CT and magnetic resonance imaging findings in 1 patient. For the fourth patient, the diagnosis was confirmed by fol-low-up and CT Conclusions. Late-phase PIHI is comparable to helical CT for detecting occult hepatic metastases, but it protects patients from the potentially hazardous effects of radiation and iodinated contrast agents. Further series involving a larger number of patients are needed to determine its place in the evaluation of cancer staging and treatment planning.

Magnetic resonance imaging is the most important diagnostic method in the investigation of the pituitary lesions. Our aim is to determine whether T2-weighted coronal images may be helpful in the evaluation of the pituitary gland with suspected pituitary adenomas. One hundred and sixty-seven patients were examined prospectively with T2-weighted coronal and T1-weighted coronal images enhanced with intravenous contrast material. The images were evaluated for the presence, the size, the location, and the ancillary signs including sellar floor erosion or ballooning, infindibulary deviation, convexity of the superior border of the gland, diffuse enlargement of the gland, and the invasion of the cavenous sinuses on both images. In forty-six (28%) patients lesions were revealed on both sequences. In twenty-one (12%) patients the lesions that were revealed on the T1-weighted images were not detected on the T2-weighted images. Positive predictive value, negative predictive value, sensitivity, specificity, and diagnostic accuracy rates of T2-weighted coronal images on the detection of the presence of lesions were 100%, 17.4%, 68.7%, 100%, and 87.4%, respectively. Both T2-weighted coronal and T1-weighted coronal images enhanced with intravenous gadolinium-based contrast material are important in the diagnosis of pituitary adenomas. T2-weighted coronal images could be used as a screening tool for the primary evaluation of the pituitary gland.

BACKGROUND AND PURPOSE: Tinnitus is a common disorder, and the etiology remains mostly unclear. The purpose of this study was to investigate the causative effect of the vascular loop and compression of the vestibulocochlear nerve at the cerebellopontine angle in patients with unexplained tinnitus. MATERIALS AND METHODS: This study was approved by our institutional review board. Written informed consent was obtained from all participants. Fifty-eight patients with unexplained tinnitus and 44 age- and sex-matched asymptomatic controls were examined with temporal MR imaging. Besides the tinnitus and control groups, a third group was formed by asymptomatic sides of patients with unilateral tinnitus. A 3D fast imaging employing steady-state acquisition (3D-FIESTA) sequence was performed in addition to the regular pre- and postcontrast axial and coronal sequences. The anatomic type of vascular loop, the vascular contact, and the angulation of the vestibulocochlear nerve at the cerebellopontine angle (CPA) were evaluated by 2 experienced neuroradiologists. The χ 2 test was used for statistical analysis. RESULTS: No statistically significant differences were found between the patient and control groups for the anatomic type of vascular loop, the vascular contact, and the angulation of the vestibulocochlear nerve at the CPA ( P > .05). CONCLUSION: Although 3D-FIESTA MR imaging correctly shows the anatomic relationships of the vestibulocochlear nerve, its vascular compression cannot be attributed as an etiological factor for tinnitus.

To evaluate prospectively the improvement in the signal:noise ratio (SNR), with the use of parallel technique in single breath-hold diffusion-weighted imaging (DWI) of the liver and its affect on apparent diffusion coefficient (ADC) measurements.This study was approved by our institutional review board. Written informed consent was obtained from all participants. Fifteen patients underwent single breath-hold DWI of the liver with and without parallel imaging technique. SNR and ADC values were measured over a lesion-free right hepatic lobe by two radiologists in both series. When a focal hepatic lesion was present the contrast:noise ratio (CNR) and ADC were also measured. Paired Student's t-tests were used for statistical analysis.Mean SNR values of the liver were 20.82+/-7.54 and 15.83+/-5.95 for DWI with and without parallel imaging, respectively. SNR values measured in DWI using parallel imaging were found to be significantly higher (p0.01). Mean ADC of the liver were 1.61+/-0.45 x 10(-3)mm(2)/s and 1.56+/-0.28 x 10(-3)mm(2)/s for DWI with and without parallel imaging, respectively. No significant difference was found between the two sequences for hepatic ADC measurement (p0.05). Overall lesion CNR was found to be higher in DWI with parallel imaging.Parallel imaging is useful in improving SNR of single breath-hold DWI of the liver without compromising ADC measurements.

Aspergillus infection is invasive in nature in the immunosuppressed population and disseminates throughout the body, with the brain being a common site. Conventional magnetic resonance imaging (MRI) combined with diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) play a life-saving role in the early diagnosis and treatment monitoring of this potentially fatal infection. We present MRI, DWI, and MRS findings of a case of central nervous system aspergillosis with treatment follow-up.

To evaluate the frequency of visualization, thickness and location of the normal appendix at non-enhanced spiral computed tomography (CT).Low-dose spiral CT scans obtained for renal colic assessment in 243 patients were retrospectively reviewed. The frequency of visualization, thickness and location of normal appendices were recorded without knowledge of the patients' history for the appendectomy.Forty of 234 patients had a past history of appendectomy (17%). Sensitivity, specificity, positive and negative predictive values, and accuracy of visualization of the normal appendix were 71%, 85%, 96%, 37% and 73%, respectively. When no intraluminal content was visualized, this area was excluded from the measurement and the mean thickness was 3.4 mm+/-0.66.The normal appendix is frequently seen at nonenhanced spiral CT. Knowing the normal thickness of the appendix can help reduce false positive and false negative diagnoses of acute appendicitis when reviewing non-enhanced spiral CT.

Objective. The aim of this study was to evaluate hyperechoic focal liver lesions with pulse inversion harmonic imaging in the late phase of SH U 508A (Levovist, Schering AG, Berlin, Germany) and to determine whether quantitative evaluation improves the characterization of the lesions. Methods. Twenty-six patients with hyperechoic liver lesions were enrolled in this study. Pulse inversion harmonic imaging was performed before and after administration of Levovist. Scan data were digitally stored, and each lesion was analyzed with a personal computer-based quantification package. All lesions were confirmed by histologic or triphasic spiral computed tomographic examinations. The intensity was measured in decibels in regions of interest drawn within the lesion and surrounding liver parenchyma. The lesion-liver ratios were than calculated. After contrast agent administration, a ratio equal to or greater than I was presumed benign, whereas a ratio of less than I was considered malignant. Results. Nine malignant (7 metastases, 1 hepatocellular carcinoma, and 1 cholangiocarcinoma) and 17 benign (14 hemangioma, 1 focal nodular hyperplasia, 1 focal fatty change, and 1 inflammatory pseudotumor) hyperechoic lesions were quantitatively evaluated. All malignant (n = 9) and 2 benign lesions (I hemangioma and I inflammatory pseudotumor) had ratios of less than 1. In 15 of 17 benign lesions, the ratios were equal to or greater than 1. The intensity ratios calculated for benign and malignant lesions showed a statistically significant difference (P < .05). Conclusions. Pulse inversion harmonic imaging with quantitative evaluation facilitates the differential diagnosis of hyperechoic focal liver lesions. A lesion-liver ratio equal to or greater than I predicts a benign nature, assuming that malignant lesions show a ratio of less than 1.

A pseudoaneurysm is a pulsating hematoma that results from disruption of a portion of the arterial wall. Clotting occurs in the peripheral limits of the hematoma, whereas the center remains fluid and communicates with thearterial lumen, causing a pulsatile mass. Femoral artery pseudoaneurysms are potentially serious complications of arterial catheterization. Various studies have shown that the pseudoaneurysm rate after cardiac catheterization is 1.6%, and it is 0.7% to 6.3% after percutaneous transluminal coronary angioplasty. 1 A pseudoaneurysm arising from the superior thyroid artery (STA) is extremely rare. Two cases of STA pseudoaneurysms have been reported after ultrasonographically guided chemical parathyroidectomy and after radiotherapy for hypopharyngeal cancer. 2 , 3 To the best of our knowledge, any case of an STA pseudoaneurysm due to fine-needle aspiration biopsy has not been reported. We report a case of an STA pseudoaneurysm during fine-needle aspiration biopsy, which showed spontaneous thrombosis.

The objective is to evaluate the appearance of phleboliths and distal ureteral stones by determining their roundness and presence of central lucency on thin-slice CT. Seventy-seven patients with pelvic radioopacities at unenhanced CT were selected. Those patients consequently underwent thin-slice CT with 1-mm collimation, a FOV of 10 cm, a pitch of 1: 1 and a bone reconstruction algorithm. Three radiologists reviewed all images for roundness and the presence of central radiolucency. No calculi showed central lucency on either imaging technique used. Thin-slice CT revealed central lucency in 60% of phleboliths with 100% specificity. Three of 40 ureteral stones showed round contour. Thin-slice CT revealed a round contour in 97% of phleboliths with 93% specificity. Central lucency is a characteristic finding of pelvic phleboliths on thin-slice CT. This finding can therefore be used in combination with roundness as a problem-solving tool in differentiating phleboliths from distal ureteral stones.

Sublingual artery and its branches run in the floor of the mouth and prone to substantial bleeding when injured during an implantation procedure. These branches enter the mandible from the lingual side and run through bony canals in the mandible. The purpose of this investigation is to evaluate the frequency, diameter, direction and position of lingual canals by dental CT.26 patients who underwent dental CT of the mandible before implantation were included in this study. Tomographic examination was performed in a transverse plane parallel to the mandibular base by bone algorithm. Multiplanar reconstructions were obtained in the sagittal and coronal oblique planes.All patients demonstrated at least one canal, and 8 patients had two or more canals. Two of the patients presented with four canals. The typical lingual canal locations were the middle of the mandible and the premolar regions. The mean diameter of the lingual canals was 0.8 mm +/- 0.2 mm in the middle, 0.6 mm +/- 0.1 mm in the premolar regions. The direction of median canal was anterior and slightly caudal. Lateral canals were directed in a medial manner.Before the dental implantation procedure, beside the relationships of implant with the important anatomic structures, lingual vascular canals should also be evaluated. Dental CT examination easily demonstrates the presence, position, direction and size of the lingual canals. By ensuring that radiologists and dentists are aware of these canals and their importance, bleeding complications during the placement of implants could be avoided.

To evaluate multiple-segment reconstruction to reduce cardiac-motion artifacts on thin-section computed tomographic (CT) images in the lung.Fifty patients were enrolled in the study. All images were obtained with a scanner capable of 1-second revolution time. Routine lung thin-section CT examination was performed with images reconstructed with bone algorithm. Multiple-segment images reconstructed with lung algorithm were obtained for three levels in the left paracardiac region. Segment images were reconstructed retrospectively with data for 225 degrees rotation rather than the 360 degrees rotation used for a complete scan. To minimize differences resulting from reconstruction algorithms, additional nonsegmented reconstruction was performed with lung algorithm. Three radiologists reviewed each set of images and assigned a quality score. Multiway analysis of variance was performed to compare motion artifact reduction with 225 degrees and 360 degrees reconstructions.Differences were not significant (P.05) between scores for images reconstructed with bone or lung algorithms. Differences were significant between scores for reconstructed images obtained with the combination of 360 degrees bone and 225 degrees segment algorithms (P.001) and for those obtained with the combination of 360 degrees lung and 225 degrees segment algorithms (P.001).Multiple-segment reconstruction of lung thin-section CT images is an effective technique for reducing cardiac-motion artifacts without increasing patient dose.

The objective of this study was to determine the normal range of dimensions for the liver, spleen, and kidney in healthy neonates, infants, and children.This prospective study involved 307 pediatric subjects (169 girls and 138 boys) with normal physical or sonographic findings who were examined because of problems unrelated to the measured organs. The subjects were 5 days to 16 years old. All measured organs were sonographically normal. At least two dimensions were obtained for each liver, spleen, and kidney. Relationships of the dimensions of these organs with sex, age, body weight, height, and body surface area were investigated. Suggested limits of normal dimensions were defined.Dimensions of the measured organs were not statistically different in boys and girls. Longitudinal dimensions of all three organs showed the best correlation with age, body weight, height, and body surface area. Height showed the strongest correlation of all. This correlation was a polynomial correlation.Determination of pathologic changes in size of the liver, spleen, and kidney necessitates knowing the normal range of dimensions for these organs in healthy neonates, infants, and children. Presented data are applicable in daily routine sonography. Body height should be considered the best criteria to correlate with longitudinal dimensions of these organs.