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    Is cerebral spinal fluid flow associated with body mass index and head circumference in healthy children? A phase contrast magnetic resonance imaging study
    (Springer, 2020) Demirtas, Gokhan; Sigirci, Ahmet; Ozturk, Mehmet; Gorkem, Sureyya Burcu; Kilic, Betul; Gungor, Serdal
    Background The aim of this study was to investigate the relationship between age, gender, body mass index (BMI), and head circumference (HC) and cerebral spinal fluid (CSF) flow dynamics in the pediatric population. The prospective study included a total of 137 participants, 75 boys and 62 girls, ranging in age from 2 to 204 months. Quantitative evaluation of CSF flow was made by using phase contrast magnetic resonance imaging (PC-MRI) in the axial plane at the level of the aqueductus cerebri. Flow dynamics were recorded as peak and mean velocity (cm/s); cranial, caudal, and net volume (ml); and aqueductus cerebri area (mm(2)). Correlation between baseline descriptive parameters, including age, gender, BMI, and HC, and the aforementioned CSF flow dynamics were investigated. Results The net volume was significantly lower in girls (p= 0.002). There was no association between age and aqueduct area, mean velocity, and cranial volume. The peak velocity was remarkably higher in children (p= 0.03), whereas cranial and net volume were found to be lower in infants (p= 0.04 andp= 0.03, respectively). Notably, cases with HC below normal values had lower cranial, caudal, and net volume and aqueductus cerebri area (p= 0.01,p= 0.03,p= 0.03, andp= 0.04, respectively). There was no association between BMI and indicators of CSF flow dynamics in PC-MRI. Conclusion BMI and HC may be associated with CSF flow dynamics in children. A smaller HC is accompanied by a lower forward flow volume, reverse flow volume, net volume, and aqueductal diameter. These points should be remembered during the design of further trials on determinants of CSF flow in children.
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    Is Thorax ultrasound efficient in diagnosis and follow-up of childhood pneumonia?
    (2020) Gorkem, Sureyya Burcu; Kose, Mehmet; Ulgen, Emre Can
    Aim: Chest X-ray (CXR) is the first step imaging method for childhood pneumonia. However, radiation exposure is the main concern especially during follow-up due to increased risk for malignancies. Therefore, thorax ultrasound (TUS) has been used recently as a complementary method to assess lung diseases. We aim to show if TUS is a useful diagnostic tool in childhood pneumonia by comparing CXR findings.Material and Methods: One hundred and twenty-four patients who presented with pneumonia (67 girls, 57 boys; mean age: 6.29±3.66 years) were prospectively included in our study. After the chest X-ray was performed for each patient, they underwent a TUS on the same day. Radiologists were blinded to any clinical data. Imaging findings were compared statistically.Results: Of 124 patients (67 girls, 57 boys; mean age: 6.29±3.66 years), 79 patients (63.7%) had bacterial and 39 patients (31.45%) had viral pneumonia. The overall sensitivity of TUS was 86.06% for detecting pneumonia. There was not any statistical difference between TUS and CXR for identifying pneumonia on the bacterial subgroup (p=0.157). TUS was more efficient in recognizing bacterial pneumonia rather than viral pneumonia (Z sensitivity = 5.33>1.96).Conclusion: The use of TUS for initial diagnosis and follow-up of childhood pneumonia should be considered as a complementary imaging method to CXR rather than a substitutive role. TUS is more useful in bacterial pneumonia rather than viral pneumonia by showing findings such as subpleural pneumonitis, consolidation, pleural and pericardial effusion, empyema and the response to the medical therapy.