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    The Change in the Renal Pelvis Anterior-Posterior Diameter Between Prevoiding and Postvoiding Status, and Its Correlation With Vesicoureteral Reflux
    (Lippincott Williams & Wilkins, 2020) Akdulum, Ismail; Akyuz, Melih; Gurun, Enes; Ozturk, Mehmet; Tabel, Yilmaz; Sigirci, Ahmet
    In this study, our aim was to evaluate the significance of the change in renal pelvis anterior-posterior diameter (RPAPD) before and after micturition between vesicoureteral reflux (VUR)-positive and -negative patients to whom had voiding cystourethrography (VCUG) was performed. In this study, 69 children, age ranging from 0 to 12 years, were included. Before the VCUG imaging, the RPAPD was measured first with a full bladder and then after urination via ultrasound (US). The differences between in RPAPD measurements were noted and values compared made among VUR-positive and -negative children. Data distribution was inhomogeneous, and the Wilcoxon Sign Rank test was utilized instead of Student t test. There was no statistically significant difference in prevoiding and postvoiding RPAPD in VUR (+) and VUR (-) patients (P = 0.672). There was no statistically significant relation between VUR and the presence of hydronephrosis (P = 0.126). Vesicoureteral reflux is more common in patients with urinary tract infections (UTI) (P = 0.001). There was no statistically significant relationship between prevoiding and postvoiding RPAPD change and VUR diagnosis (P = 0,164). Ultrasound is the modality of choice for urinary system evaluation. Diagnosis of hydronephrosis via US is not sufficient in predicting VUR; however, indirect findings may reveal the diagnosis. A decrease in RPAPD in postvoiding US evaluation may not rule out the VUR diagnosis for this reason further imaging modalities, such as VCUG, should be taken into consideration for the patients with clinical suspicion.
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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.