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    Diaphragmatic Mesothelial Cyst: Radiological Appearance and Follow-Up Results During Childhood
    (Lippincott Williams & Wilkins, 2021) Akdulum, Ismail; Ozturk, Mehmet; Karatoprak, Sinan; Akyuz, Melih; Sigirci, Ahmet; Boyunaga, Oznur Leman
    To identify radiological findings of diaphragmatic mesothelial cysts (DMC) in the pediatric age group and to assess follow-up outcomes. In this study, 27 pediatric age group patients were evaluated with ultrasonography (US), computed tomography (CT), or magnetic resonance imaging due to various clinical indications and diagnosed with DMC from May 2014 to September 2018. Age, sex, imaging indications and DMC localization, volumes in the first diagnosis, and follow-ups were retrospectively evaluated. Descriptive statistics were used for age, sex, imaging indications, and volume are presented as numbers and percentages. Ages range from 5 months to 13 years. Nine girls and 18 boys included in this study. The most common imaging indications were abdominal pain, diarrhea, and obesity. The mean volume of DMC was at first 2.62 and 2.45 mL during the follow-ups. There was volume reduction in 24 cases, and no change in 3 cases. Mean follow-up duration was 22.4 months. The US imaging findings were similar for all cases, bilobular cystic lesion with fat indentation between the cyst and liver parenchyma. The typical localization and lateral fat sign are useful in differential diagnosis of DMC from cystic lesions of liver. The US is a very effective and beneficial radiological method for diagnosis and follow-up. Routine clinical and sonographic follow-ups may be sufficient for asymptomatic patients with stable cyst volume.
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    Radiation dose reports and determinants of image quality during ECG-triggered Cardiac Computed Tomography Angiography in children
    (2021) Akdulum, Ismail; Gurun, Enes; Durukan, Gulcin; Beyoglu, Rana; Boyunaga, Oznur Leman
    Aim: This study aimed to evaluate the radiation doses and determinants of image quality during prospective and retrospective ECG-triggered cardiac computed tomography angiography.Materials and Methods: Patients included study who underwent ECG-triggered and low radiation dose dual-source cardiac computed tomography angiography scans. Dose length product values were obtained from the computed tomography scanning protocol. Effective dose (mSv) was estimated using the dose length product method with a conversion factor (mSv/mGy × cm). All images were evaluated and scored by two pediatric radiologists. Results: 37 patients have ECG-triggered cardiac computed tomography. The ages of the patients were between 3 days to 17 years (mean 73.78 ±79.95 months). The average heart rate of the patients was 101.11±27.12 bpm. The mean DLP was 93.05 ±64.4 mGy/cm. The mean effective dose was calculated as 1.74 ±1.03 mSv. We found good agreement between observers while analyzing determinants of image quality (kappa values 0.71-0.80).Conclusion: High-quality images with a low dose can be obtained with an ECG-triggered cardiac computed tomography angiography method. Because of the high sensitivity of radiation in children, dose reduction techniques should be used effectively. Cardiac computed tomography examinations can be performed at diagnostic quality limits with prospective ECG-triggered technique in patients with high pitch, low kV, and dual source techniques.