{"id":10578,"date":"2020-12-24T21:54:25","date_gmt":"2020-12-25T02:54:25","guid":{"rendered":"https:\/\/cornflowerblue-rail-980953.hostingersite.com\/?p=10578"},"modified":"2020-12-24T22:07:23","modified_gmt":"2020-12-25T03:07:23","slug":"whats-new-in-pediatric-imaging-turkish-december-2020-2","status":"publish","type":"post","link":"https:\/\/staging-hub.acoredu.com\/tr\/whats-new-in-pediatric-imaging-turkish-december-2020-2\/","title":{"rendered":"What\u2019s new in Pediatric Imaging (Turkish) \u2013 December 2020"},"content":{"rendered":"

Abdominal G\u00f6r\u00fcnt\u00fcleme<\/strong><\/span><\/h3>\n

 <\/p>\n

Meta-analiz<\/u><\/em><\/strong><\/p>\n

Kontrastl\u0131 Ultrason Karaci\u011fer G\u00f6r\u00fcnt\u00fcleme Raporlama ve Veri Sisteminin Do\u011frulu\u011fu: Sistematik \u0130nceleme Ve Meta-Analiz<\/span>
\n<\/strong><\/h5>\n

Son JH, Choi SH, Kim SY, Lee SJ, Park SH, kim KW, Won HJ, Shin YM, Kim PN.<\/p>\n

Hepatol Int. 2020 Kas\u0131m 10.<\/p>\n

https:\/\/doi.org\/10.1007\/s12072-020-10102-5<\/a><\/p>\n

Arkaplan: <\/strong>\u00a0Hepatosel\u00fcler karsinom (HCC) riski bulunan hastalarda LI-RADS kullan\u0131larak yap\u0131lan kontrastl\u0131 ultrason(CEUS) performans\u0131na ili\u015fkin sonu\u00e7lar literat\u00fcrde \u00f6nemli \u00f6l\u00e7\u00fcde farkl\u0131l\u0131k g\u00f6stermektedir.
\n<\/strong><\/p>\n

Soru: <\/strong>\u00a0HCC riski olan hastalarda CEUS LI-RADS’in tan\u0131sal performans\u0131 nedir?
\n<\/strong><\/p>\n

Dahil Etme Kriterleri: <\/strong>LR-5 bulgusu i\u00e7in duyarl\u0131l\u0131k ve \u00f6zg\u00fcll\u00fck \u00f6zeti i\u00e7eren 8 (105 \u00e7al\u0131\u015fmadan) \u00e7al\u0131\u015fma dahil edildi (toplam 5428 bulgu).<\/p>\n

Tasar\u0131m: <\/strong>\u00c7al\u0131\u015fma kalitesini de\u011ferlendirmek i\u00e7in QUADAS-2 arac\u0131n\u0131 kullanarak yap\u0131lan meta-analiz ve duyarl\u0131l\u0131k ile \u00f6zg\u00fcll\u00fc\u011f\u00fc analiz etmek i\u00e7in kullan\u0131lan iki de\u011fi\u015fkenli bir rastgele etki modeli.
\n<\/strong><\/p>\n

Bulgular: <\/strong>LR-5 lezyonlar\u0131nda CEUS’un toplam duyarl\u0131l\u0131\u011f\u0131 %73, %95 g\u00fcven aral\u0131\u011f\u0131 (CI) %65-79 idi. \u00d6zg\u00fcll\u00fck %95, CI %91-97 idi. HCC vakalar\u0131n\u0131n say\u0131s\u0131 ile ili\u015fkili anlaml\u0131 \u00e7al\u0131\u015fma heterojenli\u011fi vard\u0131 (p\u22640.05).<\/p>\n

Sonu\u00e7lar ve G\u00f6r\u00fc\u015fler: <\/strong>LR-5 lezyonlar\u0131n saptanmas\u0131nda CEUS’un grupland\u0131r\u0131lm\u0131\u015f \u00f6zg\u00fcll\u00fc\u011f\u00fc %95’te g\u00fc\u00e7l\u00fcd\u00fcr.<\/p>\n

 <\/p>\n

Primer Ara\u015ft\u0131rma<\/u><\/em><\/strong><\/p>\n

Erken Postoperatif D\u00f6nemde Greft B\u00f6brek De\u011ferlendirmesi<\/span>
\n<\/strong><\/h5>\n

Goyal A, Hemachandran N, Kumar A, Sharma R, Shamim SA, Bansal VK, Das CJ, Kandasamy D, Agarwal SK, Dinda AK, Seenu V.<\/p>\n

J Ultrason Med. 2020 Kas\u0131m 12.<\/p>\n

https:\/\/doi.org\/10.1002\/jum. 15557<\/a><\/p>\n

Arkaplan:<\/strong> Transplant b\u00f6breklerde red ve akut t\u00fcb\u00fcler nekroz (ATN) gibi parankimal komplikasyonlar nadir de\u011fildir ve erken tan\u0131 kritiktir. Ultrason kontrast maddesi, BT \/ MRI kontrast maddeleri ile ayn\u0131 potansiyel nefrotoksisiteye sahip de\u011fildir.
\n<\/strong><\/p>\n

Soru: <\/strong>Ultrason b\u00f6brek nakli sonras\u0131 erken bozukluklar\u0131n tan\u0131s\u0131nda etkili midir?<\/p>\n

Yer: <\/strong>Yeni Delhi, Hindistan
\n<\/strong><\/p>\n

Hastalar ve Dahil Etme Kriterleri:<\/strong> \u00c7al\u0131\u015fma d\u00f6neminde b\u00f6brek nakilli 105 hasta. 7 tanesi, vask\u00fcler ve \u00fcrolojik komplikasyonlar nedeniyle hari\u00e7 tutuldu.<\/p>\n

Tasar\u0131m: <\/strong>Postop 3-10. g\u00fcnde nakil b\u00f6brekleri de\u011ferlendirmek i\u00e7in renkli Doppler USG, shear-wave elastografi (SWE), CEUS ve b\u00f6brek sintigrafisi kullan\u0131larak prospektif tasar\u0131m. Parametreler bir zaman-intensite e\u011frisi \u00fczerinde analiz edildi.
\n<\/strong><\/p>\n

Bulgular: <\/strong>19\/105 (%18.1) hastada parankimal greft disfonksiyonu geli\u015fti. \u0130nterpolar arter pik sistolik h\u0131z\u0131nda, kontrol grubu ile kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda anlaml\u0131 bir fark vard\u0131 (akut redde daha y\u00fcksek, ATN’de daha d\u00fc\u015f\u00fck) (P<0.001). CEUS kullan\u0131larak \u00f6l\u00e7\u00fclen pik s\u00fcresi oranlar\u0131 da kontrol ve disfonksiyone gruplar aras\u0131nda anlaml\u0131 olarak farkl\u0131yd\u0131 (p<0.05). SWE ve diren\u00e7li indeksler de dahil olmak \u00fczere di\u011fer parametrelerde \u00f6nemli fark saptanmad\u0131.<\/p>\n

Sonu\u00e7 ve G\u00f6r\u00fc\u015fler: <\/strong>\u0130nterpolar renal arterin CEUS ve pik sistolik h\u0131zlar\u0131, greft disfonksiyonunun de\u011ferlendirilmesinde yararl\u0131 olabilir.<\/p>\n

 <\/p>\n

Primer Ara\u015ft\u0131rma<\/u><\/em><\/strong><\/p>\n

Pankreas Graftlerinde Erken Vask\u00fcler Komplikasyonlar\u0131n Saptanmas\u0131nda Doppler USG ve Kontrastl\u0131 USG\u2019nin Kar\u015f\u0131la\u015ft\u0131r\u0131lmas\u0131<\/span> <\/strong><\/h5>\n

Swensson J, Hill D, Tirkes T, Fridell J, Patel A.<\/p>\n

AJR Am J R\u00f6ntgenol. 2020 Kas\u0131m; 215(5): 1093-1097.<\/p>\n

https:\/\/doi.org\/10.2214\/AJR.20. 22858<\/a><\/p>\n

Arkaplan: <\/strong>Vask\u00fcler komplikasyonlar, pankreas transplantasyonu sonras\u0131 (b\u00f6brek transplantasyonuna benzer \u015fekilde) erken d\u00f6nemde ortaya \u00e7\u0131kabilir ve stenoz\/tromboz veya vask\u00fcler anastomozda bozulma olarak ortaya \u00e7\u0131kabilir.
\n<\/strong><\/p>\n

Soru: <\/strong>Transplantasyon sonras\u0131 pankreatik vask\u00fcler komplikasyonlar\u0131n de\u011ferlendirilmesinde CEUS, Doppler US ile kar\u015f\u0131la\u015ft\u0131r\u0131l\u0131nca nas\u0131ld\u0131r?<\/p>\n

Yer: <\/strong>Indianapolis, Indiana, USA
\n<\/strong><\/p>\n

Hastalar ve Dahil Etme Kriterleri: <\/strong>Pankreas transplantasyonu sonras\u0131 CEUS ve Doppler USG yap\u0131lm\u0131\u015f 34 hasta analize dahil edildi. Kontrol grubu i\u00e7in tekrar cerrahi eksplorasyon yap\u0131lmayan 28 hasta kullan\u0131ld\u0131.<\/p>\n

Tasar\u0131m: <\/strong>CEUS veya Doppler baz\u0131nda \u00e7ift k\u00f6r radyolog taraf\u0131ndan normal veya anormal olarak puanlanan vask\u00fclat\u00fcr ile retrospektif analiz.
\n<\/strong><\/p>\n

Bulgular: <\/strong>G\u00f6zlemciler aras\u0131 uyum anla\u015fmas\u0131 CEUS’ta (k=0.54) Doppler USG’den (k = 0.28) daha y\u00fcksekti.<\/p>\n\n\n\n\n\n\n\n
<\/td>\nKontrastl\u0131 USG(CEUS)<\/td>\nRenkli Doppler USG<\/td>\n<\/tr>\n
<\/td>\nOkuyucu 1<\/td>\nOkuyucu 2<\/td>\nOkuyucu 1<\/td>\nOkuyucu 2<\/td>\n<\/tr>\n
Duyarl\u0131l\u0131k<\/td>\n83%<\/strong><\/td>\n83%<\/strong><\/td>\n68%<\/td>\n50%<\/td>\n<\/tr>\n
\u00d6zg\u00fcll\u00fck<\/td>\n82%<\/td>\n79%<\/td>\n76%<\/td>\n84%<\/td>\n<\/tr>\n
Negatif prediktif de\u011fer<\/td>\n97%<\/strong><\/td>\n97%<\/strong><\/td>\n94%<\/td>\n91%<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Sonu\u00e7 ve G\u00f6r\u00fc\u015fler: <\/strong>CEUS, pankreas transplantasyonu sonras\u0131 erken vask\u00fcler komplikasyonlar\u0131 de\u011ferlendirmek i\u00e7in yararl\u0131 olabilir, vask\u00fcler anormallikleri ekarte etmek i\u00e7in Doppler USG\u2019nin performas\u0131n\u0131 a\u015fabilir.<\/p>\n

 <\/p>\n

Plasenta Akreata Spektrumunun Tan\u0131s\u0131nda\u00a0 Ultrason Ve MRG’nin Kar\u015f\u0131la\u015ft\u0131rmal\u0131 Analizi.<\/span>
\n<\/strong><\/h5>\n

Barzilay e, Brandt B, Gilboa Y, Kassif E, Achiron R, Raviv-Zilka L, Katorza E.<\/p>\n

Matern Fetal Neonatal Med. 12 Kas\u0131m 2020<\/p>\n

https:\/\/doi.org\/10.1080\/14767058.2020.1846699<\/a><\/p>\n

Arkaplan: <\/strong>Ultrason plasenta akreatay\u0131 te\u015fhis etmek i\u00e7in en s\u0131k kullan\u0131lan y\u00f6ntem olmas\u0131na ra\u011fmen, MRG’nin fazladan fayda sa\u011flayabilece\u011fine dair tart\u0131\u015fmal\u0131 kan\u0131tlar vard\u0131r.
\n<\/strong><\/p>\n

Soru: <\/strong>Plasenta akreata spektrumunun tan\u0131s\u0131nda MRG ultrason ile nas\u0131l kar\u015f\u0131la\u015ft\u0131r\u0131l\u0131nca nas\u0131ld\u0131r?<\/p>\n

Yer: <\/strong>\u0130srail
\n<\/strong><\/p>\n

Hastalar ve Dahil Etme Kriterleri: <\/strong>Sezaryen s\u0131ras\u0131nda plasenta akreata spektrumunun te\u015fhis edildi\u011fi 23 olgu. Ayr\u0131ca hastalara, plasenta akreatan\u0131n de\u011ferlendirilmesi i\u00e7in do\u011fum \u00f6ncesi MRG ve US yap\u0131ld\u0131.<\/p>\n

Tasar\u0131m: <\/strong>Plasenta akreata tan\u0131s\u0131 i\u00e7in US ve MRG’nin duyarl\u0131l\u0131\u011f\u0131n\u0131 ve \u00f6zg\u00fcll\u00fc\u011f\u00fcn\u00fc kar\u015f\u0131la\u015ft\u0131ran retrospektif prospektif \u00e7al\u0131\u015fma. Prospektif US te\u015fhisi, daha \u00f6nce yay\u0131nlanm\u0131\u015f yap\u0131land\u0131r\u0131lm\u0131\u015f raporlamaya dayan\u0131yordu. MRG’yi de\u011ferlendirmek i\u00e7in analiz sonras\u0131 al\u0131c\u0131 operat\u00f6r e\u011frileri kullan\u0131ld\u0131.
\n<\/strong><\/p>\n

Bulgular: <\/strong>Plasenta akreata spektrumunun tan\u0131s\u0131nda duyarl\u0131l\u0131k ve \u00f6zg\u00fcll\u00fck ultrason i\u00e7in s\u0131ras\u0131yla 0.96 ve 0.6, MRG i\u00e7in ise s\u0131ras\u0131yla 0.83 ve 0.4 idi. Yap\u0131land\u0131r\u0131lm\u0131\u015f bir raporlama senaryosunu sim\u00fcle eden bir MRG sonras\u0131 analiz kullan\u0131ld\u0131\u011f\u0131nda, duyarl\u0131l\u0131k 0.96’ya y\u00fckselirken \u00f6zg\u00fcll\u00fck 0.6 idi.<\/p>\n

Sonu\u00e7lar ve G\u00f6r\u00fc\u015fler: <\/strong>US, plasenta akreata spektrumu i\u00e7in \u00fcst\u00fcn tan\u0131sal performansa sahip olsa da, yap\u0131land\u0131r\u0131lm\u0131\u015f bir raporlama sistemi MRG’nin kullan\u0131m\u0131n\u0131-faydas\u0131n\u0131 art\u0131rabilir.<\/p>\n

 <\/p>\n

Primer Ara\u015ft\u0131rma<\/u><\/em><\/strong><\/p>\n

Mesane Endometriozis Nod\u00fcllerinin Tan\u0131s\u0131nda Transvajinal Ultrasonografinin Sistoskopiye G\u00f6re \u0130sabeti<\/strong><\/span><\/h5>\n

Ros C, de Guirior C, Rius M, Escura S, Mart\u00ednez \u2010 Zamora M\u00c1, Gracia M, Peri L, Franco A, Carmona F.<\/p>\n

J Ultrasound Med. 2020 Ekim 21.<\/p>\n

https:\/\/doi.org\/10.1002\/jum.15537<\/a><\/p>\n

Arkaplan<\/strong>: Mesane, derin infiltratif endometriozisin tuttu\u011fu en s\u0131k \u00fcriner sistem b\u00f6lgesidir. Sistoskopi tan\u0131 i\u00e7in alt\u0131n standartt\u0131r, ancak invazivdir.<\/p>\n

Soru<\/strong>: Ultrason, mesane endometriozisi tan\u0131s\u0131nda sistoskopik sonu\u00e7lar\u0131 tahmin edebilir mi?<\/p>\n

Yer<\/strong>: Barselona, \u200b\u200b\u0130spanya<\/p>\n

Hastalar ve Dahil Etme Kriterleri:<\/strong> Sistoskopi yap\u0131lm\u0131\u015f, transvajinal ultrason (TVUS) ile mesane endometriozisi g\u00f6r\u00fclen \u00a022 hasta.<\/p>\n

Tasar\u0131m<\/strong>: \u0130lk ultrason incelemesini sistoskopi s\u0131ras\u0131ndaki bulgularla kar\u015f\u0131la\u015ft\u0131ran retrospektif \u00e7al\u0131\u015fma.<\/p>\n

Bulgular<\/strong>: 22 hastan\u0131n 9’unda k\u0131smi detr\u00fcs\u00f6r tutulumu ve normal sistoskopi vard\u0131. 13 hastada tam transmural detrusor kas infiltrasyonu vard\u0131 ve t\u00fcm vakalar sistoskopi ile g\u00f6r\u00fclebildi. Bu gruplar\u0131n her ikisinde de ultrason %100 pozitif prediktif de\u011ferine sahipti. 20\/22 hasta, ultrasonda adenomiyozis ve \/ veya endometrioz i\u00e7in di\u011fer kriterleri de kar\u015f\u0131lad\u0131.<\/p>\n

Sonu\u00e7lar ve G\u00f6r\u00fc\u015fler<\/strong>: Mesane endometriozisinde TVUS, detr\u00fcs\u00f6r kas tutulumu i\u00e7in %100 pozitif prediktif de\u011ferle sistoskopik bulgular\u0131 tahmin ediyor g\u00f6r\u00fcnmektedir.<\/p>\n

\u00a0<\/strong><\/p>\n

Derleme<\/u><\/em><\/strong><\/p>\n

Ultrason Tabanl\u0131 Karaci\u011fer Elastografisi: G\u00fcncel Sonu\u00e7lar ve Gelecekteki Perspektifler<\/strong><\/span><\/h5>\n

Fang C, Sidhu PS.<\/p>\n

Abdom Radyol (NY). 2020 kas\u0131m.<\/p>\n

https:\/\/doi.org\/10.1007\/s00261-020-02717-x<\/a><\/p>\n

Genel Bak\u0131\u015f:<\/strong><\/p>\n

\u00d6zellikle karaci\u011fer fibrozisi analizinde, karaci\u011fer elastografisinin mevcut uygulamas\u0131n\u0131 kapsayan a\u00e7\u0131k eri\u015fimli bir inceleme makalesi. Hem strain elastografi hem de shear-wave elastografi, klinik kullan\u0131mlar\u0131 ile birlikte tart\u0131\u015f\u0131lm\u0131\u015ft\u0131r. Teknikler ve yorumlar\u0131n t\u00fcm\u00fc, alkolik olmayan ya\u011fl\u0131 karaci\u011fer hastal\u0131\u011f\u0131 dahil olmak \u00fczere \u00e7e\u015fitli hastal\u0131klara referansla tart\u0131\u015f\u0131lm\u0131\u015ft\u0131r. Son olarak, yapay-zeka analizine vurgu yap\u0131larak gelece\u011fe y\u00f6nelik y\u00f6nlere k\u0131saca de\u011finilmektedir.<\/p>\n

\u00a0<\/strong><\/p>\n

Kas-\u0130skelet G\u00f6r\u00fcnt\u00fcleme<\/strong><\/span><\/h3>\n

 <\/p>\n

Metanaliz<\/u><\/em><\/strong><\/p>\n

DirsektUlnar N\u00f6ropatisinin Tan\u0131s\u0131nda Ultrasona Dayal\u0131 \u00d6l\u00e7\u00fcmlerin Optimal Se\u00e7imi: 1961 \u0130ncelemenin Meta-analizi<\/strong><\/span><\/h5>\n

Haj-Mirzaian A, Hafezi-Nejad N, Grande FD, Endo Y, Nwawka OK, Miller TT, Carrino JA.<\/p>\n

AJR Am J Roentgenol. 2020 Kas\u0131m.<\/p>\n

https:\/\/doi.org\/10.2214\/AJR.19.22457 <\/a><\/p>\n

Arkaplan<\/strong>: Ulnar n\u00f6ropati, dirsekte k\u00fcbital t\u00fcnelde sinirin s\u0131k\u0131\u015fmas\u0131 veya gerilmesinden kaynaklanabilir. Ultrason, \u00f6dem veya sinir kal\u0131nla\u015fmas\u0131 g\u00f6sterilerek tan\u0131da kullan\u0131labilir.<\/p>\n

Soru<\/strong>: Ulnar n\u00f6ropatinin de\u011ferlendirilmesinde ulnar siniri ultrason ile \u00f6l\u00e7mek i\u00e7in en uygun teknik nedir?<\/p>\n

Hastalar ve Dahil Etme Kriterleri:<\/strong> 1961 inceleme olan 19 \u00e7al\u0131\u015fmada, ultrasonda ulnar sinir i\u00e7in yeterli \u00f6l\u00e7\u00fcmler vard\u0131 ve bu nedenle dahil edildi.<\/p>\n

Tasar\u0131m<\/strong>: Medial epikondilde ger\u00e7ekle\u015ftirilen \u00f6l\u00e7\u00fcmlerin sensitivitesi, spesifikli\u011fi ve tan\u0131sal olas\u0131l\u0131k oran\u0131n\u0131 hesaplayan metanaliz. Sinir oranlar\u0131, farkl\u0131 d\u00fczeylerdeki sinir \u00f6l\u00e7\u00fcmlerini kar\u015f\u0131la\u015ft\u0131r\u0131yor ancak \u00e7al\u0131\u015fmalar aras\u0131nda farkl\u0131l\u0131k g\u00f6steriyor.<\/p>\n

Sonu\u00e7lar<\/strong>: Ulnar n\u00f6ropati i\u00e7in \u00f6l\u00e7\u00fcmler:<\/p>\n