{"id":7257,"date":"2020-08-06T07:38:50","date_gmt":"2020-08-06T12:38:50","guid":{"rendered":"https:\/\/cornflowerblue-rail-980953.hostingersite.com\/?p=7257"},"modified":"2020-08-07T06:05:00","modified_gmt":"2020-08-07T11:05:00","slug":"whats-new-in-pediatric-imaging-turkish-august-2020","status":"publish","type":"post","link":"https:\/\/staging-hub.acoredu.com\/tr\/whats-new-in-pediatric-imaging-turkish-august-2020\/","title":{"rendered":"What\u2019s new in Pediatric Imaging (Turkish) \u2013 August 2020"},"content":{"rendered":"

ABDOM\u0130NAL G\u00d6R\u00dcNT\u00dcLEME<\/strong><\/span><\/h3>\n

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

Abdominal Radyografilerde G\u00f6r\u00fclen Gaz Yoklu\u011funun Pediyatrik <\/strong>Adheziv \u0130nce Ba\u011f\u0131rsak Obstr\u00fcksyonunda \u00d6nemi<\/strong><\/span><\/h5>\n

Johnson BL, Campagna GA, Hyak JM, et al. The significance of abdominal radiographs with paucity of gas in pediatric adhesive small bowel obstruction. Am J Surg<\/em> 2020; 220: 208\u2013213.<\/p>\n

https:\/\/doi.org\/10.1016\/j.amjsurg.2019.10.035<\/a><\/p>\n

Soru(lar):<\/strong> Ba\u015fvuru \u00a0abdominal direk grafilerde gaz yoklu\u011funun \u00f6nemi nedir?<\/p>\n

\u00c7al\u0131\u015fma dizayn\u0131:<\/strong> 2011\u2019den 2015\u2019e dek retrospektif \u00e7al\u0131\u015fma<\/p>\n

Merkez(ler):<\/strong> Tek merkez, Texas \u00c7ocuk Hastanesi (Texas Children\u2019s Hospital\/Baylor College of Medicine, Houston, Texas)<\/p>\n

Kat\u0131l\u0131mc\u0131lar: <\/strong>Adheziv ince ba\u011f\u0131rsak obstr\u00fcksyonu g\u00f6r\u00fclen 207 hasta<\/p>\n

M\u00fcdahele:<\/strong> Ameliyat<\/p>\n

Elde edilen veriler:<\/strong> Abdominal X-ray bulgular\u0131n\u0131n oranlar\u0131 (dilate olmu\u015f gaz i\u00e7eren anslar, gaz yoklu\u011fu), Abdominal X-ray ve bilgisayarl\u0131 tomografinin obstr\u00fcksiyon t\u00fcr\u00fcne g\u00f6re do\u011fruluk oranlar\u0131 (s\u0131n\u0131fland\u0131r\u0131lmam\u0131\u015f, d\u00fc\u015f\u00fck dereceli, y\u00fcksek dereceli ya da kapal\u0131 loop).<\/p>\n

Ana sonu\u00e7lar: <\/strong>Vakalar\u0131n %41\u2019inde, ba\u015flang\u0131\u00e7 abdominal X-ray\u2019de gaz yoklu\u011fu bulgusu g\u00f6r\u00fcld\u00fc. Cerrahi m\u00fcdahele gaz i\u00e7eren ditand\u00fc ba\u011f\u0131rsak anslar\u0131 olan hastalara oranla gaz yoklu\u011fu olan hastalarda daha yayg\u0131nd\u0131 (%49 vs %32, P=0.01). Ayn\u0131 zamanda, gaz yoklu\u011fu olan hastalarda gaz i\u00e7eren dilate ba\u011f\u0131rsak anslar\u0131 olan hastalara oranla daha \u00e7ok kapal\u0131 loop veya y\u00fcksek dereceli ba\u011f\u0131rsak obstr\u00fcksyonu g\u00f6r\u00fcld\u00fc (%71 vs %29, P<0.0001)<\/p>\n

Yorum:<\/strong> \u0130nce ba\u011f\u0131rsak obstr\u00fcksyonu olan \u00e7ocuklarda, abdominal grafiler s\u0131kl\u0131kla hastan\u0131n ilk y\u00f6netimine rehberlik eder. Gaz yoklu\u011fu, gaz i\u00e7eren dilate ba\u011f\u0131rsak anslar\u0131 ile kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda genellikle daha ciddi obstr\u00fcksyonlarla (y\u00fcksek dereceli ve kapal\u0131-loop) ve cerrahi m\u00fcdahele ile ili\u015fkilidir.<\/p>\n

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

Sedasyon Alt\u0131nda Ultrasonogrofi E\u015fli\u011finde \u0130leokolik \u0130ntussusepsiyonun Salin \u0130le Red\u00fcksiyonu: 20 Y\u0131ll\u0131k Deneyim<\/strong><\/span><\/h5>\n

Sacks RS, Anconina R, Farkas E, et al. Sedated ultrasound guided saline reduction (SUR) of Ileocolic intussusception: 20 year experience. <\/em>Journal Pre-Proof. J Pediatr Surg<\/em> 2020.<\/p>\n

https:\/\/doi.org\/10.1016\/j.jpedsurg.2020.05.049<\/a><\/p>\n

Soru(lar):<\/strong> Ultrasonografi, ileokolik\u00a0 intussusepsiyonun salin ile red\u00fcksyonunda nas\u0131l kullan\u0131l\u0131r?<\/p>\n

\u00c7al\u0131\u015fma dizayn\u0131:<\/strong> 1998\u2019den 2018\u2019e dek retrospektif \u00e7al\u0131\u015fma<\/p>\n

Merkez(ler):<\/strong> Tek kurum, Ben Gurion University of the Negev, Be\u2019er Sheva, Israel<\/p>\n

Kat\u0131l\u0131mc\u0131lar:<\/strong>\u00a0 338\u2019i primer 76\u2019s\u0131 n\u00fcks vaka olmak \u00fczere salin ile red\u00fcksiyon yap\u0131lan toplam 414 intussusepsiyon vakas\u0131<\/p>\n

M\u00fcdahele:<\/strong> Ultrasonogrofi e\u015fli\u011finde salin red\u00fcksiyonu (SUR)<\/p>\n

Elde edilen veriler: <\/strong>Teknik ba\u015far\u0131 oran\u0131, perforasyon oran\u0131, g\u00f6r\u00fcnt\u00fcleme ve klinik ili\u015fkisi (hasta ya\u015f\u0131, serbest s\u0131v\u0131 yoklu\u011fu, sa\u011f \u00fcst kadran lokasyonu dahil)<\/p>\n

Ana sonu\u00e7lar<\/strong> 338 primer vakadan\u00a0 257’si (% 84.3), n\u00fcks 76 ataktan 59’u\u00a0 (% 78) SUR ile ba\u015far\u0131yla red\u00fckte edildi. SUR s\u0131ras\u0131nda perforasyon g\u00f6r\u00fclmedi. Tan\u0131 an\u0131nda ileri ya\u015f (P = 0.016), serbest s\u0131v\u0131 yoklu\u011fu (P = 1.803e-05) ve sa\u011f \u00fcst kadranda lokalizasyon (P = 0.0048), SUR i\u00e7in istatistiksel olarak anlaml\u0131 bulundu.<\/p>\n

Yorumlar<\/strong>\u00a0 Bildirilen floroskopik hava \/ hidrostatik intussussepsiyon red\u00fcksiyonlar\u0131nda ba\u015far\u0131 oranlar\u0131 % 68-90 aras\u0131nda de\u011fi\u015fmektedir. Bu prosed\u00fcrler radyasyona maruziyet ve d\u00fc\u015f\u00fck olas\u0131l\u0131kla pn\u00f6matik perforasyon risklerini i\u00e7erir. Bu \u00e7al\u0131\u015fma, herhangi bir perforasyon vakas\u0131 ve radyasyon maruziyeti ger\u00e7ekle\u015fmeden, floroskopik red\u00fcksiyon ile benzer oranlarda SUR ba\u015far\u0131 oran\u0131n\u0131 g\u00f6stermektedir. Verilen havan\u0131n sonografik olarak g\u00f6r\u00fcnt\u00fclemeyi engellemesi nedeniyle \u00e7ekum ve ileumun ger\u00e7ek zamanl\u0131 olarak vizualize edilememesi SUR\u2019un \u00f6nemli limitasyonlardan biridir. Ek olarak, bu teknik, potansiyel riskler olu\u015fturan ve \u00e7o\u011fu hastanede standart olarak uygulanmayan anestezi i\u015flemi gerektirir. SUR, ileokolik intususepsiyon red\u00fcksiyonunda yararl\u0131 ve ba\u015far\u0131l\u0131 bir teknik olsa da, uygun sonografik altyap\u0131 ve teknik e\u011fitimin mevcut olmad\u0131\u011f\u0131 uzman olmayan hastanelerde uygulanmas\u0131 m\u00fcmk\u00fcn olmayabilir.<\/p>\n

 <\/p>\n

G\u00d6\u011e\u00dcS G\u00d6R\u00dcNT\u00dcLEME<\/span><\/strong><\/h3>\n

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

Kistik Fibrozlu \u00c7ocuklarda Akci\u011fer Hastal\u0131\u011f\u0131n\u0131n De\u011ferlendirilmesinde T1 Haritalamas\u0131 Manyetik Rezonans G\u00f6r\u00fcnt\u00fcleme: Pilot \u00c7al\u0131\u015fma<\/strong><\/span><\/h5>\n

Neemuchwala F, Mahani MG, Pang Y, et al. Lung T1 mapping magnetic resonance imaging in the assessment of pulmonary disease in children with cystic fibrosis: a pilot study. Pediatr <\/em>Radiol 2020; 50: 923\u2013934.<\/p>\n

https:\/\/doi.org\/10.1007\/s00247-020-04638-9<\/a><\/p>\n

Soru(lar): <\/strong>Kistik fibrozlu (KF) \u00e7ocuklarda T1 akci\u011fer haritalamas\u0131 erken akci\u011fer hastal\u0131\u011f\u0131n\u0131 tespit edebilir veya pulmoner alevlenmeleri izlemde rol oynayabilir mi?<\/p>\n

\u00c7al\u0131\u015fma dizayn\u0131: <\/strong>\u00a0Eyl\u00fcl 2017’den Ocak 2018’e kadar prospektif \u00e7al\u0131\u015fma. Faz 1 kesitsel bir de\u011ferlendirme ve Faz 2 2 haftal\u0131k longutidunal bir de\u011ferlendirmedir.<\/p>\n

Merkez(ler):<\/strong> \u00a0Muhtemelen tek Merkez<\/p>\n

Kat\u0131l\u0131mc\u0131lar: <\/strong>16 \u00e7ocuk: Faz 1’deki 5 sa\u011fl\u0131kl\u0131 g\u00f6n\u00fcll\u00fcye k\u0131yasla KF’li 5 hasta ve Faz 2’de 6 KF hastas\u0131<\/p>\n

M\u00fcdahele<\/strong> Kontrasts\u0131z T1 haritalama, ultra short eko time (UTE) MRI, spirometri testi<\/p>\n

Elde edilen veriler: <\/strong>Ortalama T1 de\u011feri, T1 de\u011feri olmayan akci\u011fer hacminin y\u00fczdesi ve MRI KF skoru<\/p>\n

Ana sonu\u00e7lar <\/strong>\u00a0Faz 1\u2019de, KF hastalar\u0131nda sa\u011f alt lob (P = 0.29) d\u0131\u015f\u0131nda akci\u011ferin normalle\u015ftirilmi\u015f T1 de\u011ferleri anlaml\u0131 olarak d\u00fc\u015f\u00fck \u00e7\u0131kt\u0131 (P = 0.02). KF’li hastalar ayr\u0131ca T1 sinyali olmadan anlaml\u0131 olarak daha y\u00fcksek akci\u011fer hacmine sahipti (P \u200b\u200b= 0.006). Faz 2’de, biri hari\u00e7 t\u00fcm olgularda tedavi s\u00fcresince t\u00fcm akci\u011fer alanlar\u0131nda T1 de\u011fer art\u0131\u015f\u0131 (P = 0.001) ve perf\u00fczyon skor art\u0131\u015f\u0131 (P = 0.02) saptand\u0131.<\/p>\n

Yorumlar:<\/strong> KF’de mukus t\u0131kanmas\u0131 ve hava hapsi, hipoksinin neden oldu\u011fu vazokonstriksiyon ve perf\u00fczyon anormalliklerine neden oldu\u011fu i\u00e7in KF olan yeti\u015fkinlerin MR g\u00f6r\u00fcnt\u00fclemesinde T1 haritalamas\u0131 kullan\u0131lmaktad\u0131r. Kan akci\u011fer parankiminden daha y\u00fcksek bir T1 sinyaline sahip oldu\u011fundan, iyi perf\u00fcze olmu\u015f akci\u011ferde hipoksik akci\u011fere k\u0131yasla y\u00fcksek T1 sinyali izlenir. Bu \u00e7al\u0131\u015fmada, yeti\u015fkinlerde oldu\u011fu gibi, KF’li \u00e7ocuklarda, spirometri normal olsa bile, normalle\u015ftirilmi\u015f T1 sinyalinin d\u00fc\u015f\u00fck oldu\u011fu saptanm\u0131\u015ft\u0131r. Yazarlar, T1 haritalamas\u0131n\u0131n KF’li \u00e7ocuklarda radyasyon maruziyetini en aza indirerek\u00a0 erken d\u00f6nem akci\u011fer hastal\u0131\u011f\u0131n\u0131 tespit etmede ve tedavi planlamada kullan\u0131labilece\u011fini belirtmektedir. Akut alevlenmesi olan KF hastalar\u0131nda, T1 haritalamas\u0131 antibiyotik tedavisi ve s\u00fcresini belirlemede rehberlik yapabilir. \u00c7al\u0131\u015fman\u0131n temel limitasyonlar\u0131 \u00f6rneklemin k\u00fc\u00e7\u00fck olmas\u0131 ve T1 de\u011ferleri \u00fczerindeki artefaktif etkilerdir.<\/p>\n

 <\/p>\n

KARD\u0130YAK G\u00d6R\u00dcNT\u00dcLEME<\/strong><\/span><\/h3>\n

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

Okul \u00c7a\u011f\u0131ndaki \u00c7ocuklarda V\u00fccut Ya\u011f Da\u011f\u0131l\u0131m\u0131, A\u015f\u0131r\u0131 Kilo ve Kardiyak Yap\u0131lar: Pop\u00fclasyon Bazl\u0131 Kardiyak Manyetik Rezonans G\u00f6r\u00fcnt\u00fcleme \u00c7al\u0131\u015fmas\u0131<\/strong><\/span><\/h5>\n

Toemen L, Santos S, Roest AA, et al. Body fat distribution, overweight, and cardiac structures in school-age children: a population-based cardiac magnetic resonance imaging study. JAHA<\/em> 2020; 9: e014933. https:\/\/doi.org\/10.1161\/JAHA.119.014933<\/a><\/p>\n

Soru(lar): <\/strong>A\u015f\u0131r\u0131 kilolu \u00e7ocuklarda genel ve abdominal v\u00fccut ya\u011f\u0131n\u0131n sa\u011f ve sol ventrik\u00fcl yap\u0131s\u0131 ve fonksiyonu ile ili\u015fkisi nedir?<\/p>\n

\u00c7al\u0131\u015fma dizayn\u0131: <\/strong>Populasyon bazl\u0131, prospektif kohort \u00e7al\u0131\u015fmas\u0131<\/p>\n

Merkez(ler): <\/strong>Generation R \u00e7al\u0131\u015fmas\u0131 Rotterdam, Hollanda<\/p>\n

Kat\u0131l\u0131mc\u0131lar: <\/strong>\u00a0Birden \u00e7ok etnik k\u00f6kene (Hollanda ve Avrupa, T\u00fcrkiye, Fas, Surinam, Cape Verdian dahil Hollanda d\u0131\u015f\u0131 k\u00f6kenler) sahip 10 ya\u015f\u0131nda 2836 \u00e7ocuk<\/p>\n

Elde edilen veriler:<\/strong>\u00a0 \u00c7ocukluk \u00e7a\u011f\u0131 v\u00fccut kitle indeksi (VK\u0130), v\u00fccut kompozisyonu (ya\u011fs\u0131z kitle indeksi, ya\u011f kitle indeksi ve viseral ya\u011f dokusu indeksi), kan bas\u0131nc\u0131 ve kardiyak \u00f6l\u00e7\u00fcmler: sa\u011f ventrik\u00fcl diyastol sonu hacmi (RVEDV), sa\u011f ventrik\u00fcl ejeksiyon fraksiyonu (RVEF), sol ventrik\u00fcl diyastol sonu hacmi (LVEDV), sol ventrik\u00fcl ejeksiyon fraksiyonu (LVEF), sol ventrik\u00fcl kitlesi (LVM), konsantrik remodeling at\u0131m hacmi ve kardiyak output i\u00e7in bir belirte\u00e7 olarak sol ventrik\u00fcl kitle \/ hacim oran\u0131 (LMVR).<\/p>\n

Ana Sonu\u00e7lar <\/strong>A\u015f\u0131r\u0131 kilolu ve obez \u00e7ocuklarda normal kilolu \u00e7ocuklara g\u00f6re daha y\u00fcksek ya\u011fs\u0131z kitle indeksi, ya\u011f kitle indeksi, viseral ya\u011f dokusu indeksi ve kan bas\u0131nc\u0131 saptand\u0131. VKI, RVEDV (0.39), LVEDV (0.41), LVM (0.39) ve LMVR (0.07) ile pozitif ili\u015fkiliydi. Ya\u011fs\u0131z kitle indeksi ile, LVEDV ile en g\u00fc\u00e7l\u00fc olmak \u00fczere, t\u00fcm kardiyak \u00f6l\u00e7\u00fcmler aras\u0131ndaki ili\u015fkiler, VKI\u2019ye oranla daha g\u00fc\u00e7l\u00fcyd\u00fc (0.51). Ya\u011f kitle indeksi ve viseral adipoz doku indeksi; RVEDV (s\u0131ras\u0131yla 0.15 ve 0.09), LVEDV (0.17 ve 0.09), LVM (0.19 ve 0.12) ve LMVR (0.07 ve 0.09) ile pozitif korele bulundu. VKI ve v\u00fccut kompozisyonu (ya\u011fs\u0131z kitle indeksi, ya\u011f kitle indeksi ve viseral ya\u011f dokusu indeksi) sistemik vask\u00fcler diren\u00e7 ile ters korelasyon g\u00f6sterdi. Obez \u00e7ocuklar en y\u00fcksek kardiyak hacim, kitle, kitle \/ hacim oran\u0131, at\u0131m hacmine sahipken, RVEF bu grupta daha d\u00fc\u015f\u00fck bulundu. LVEF i\u00e7in ise fark g\u00f6r\u00fclmedi.<\/p>\n

Yorumlar <\/strong>Ya\u011fs\u0131z kitle, kardiyak b\u00fcy\u00fcmenin g\u00fc\u00e7l\u00fc bir belirleyicisi olabilir. Ya\u011f kitlesi daha sonraki ya\u015flarda kalp yap\u0131s\u0131n\u0131 da etkileyebilir. Bu \u00e7al\u0131\u015fma sol kalp fonksiyonu ile VK\u0130 aras\u0131nda bir ili\u015fki g\u00f6stermemekle birlikte, at\u0131fta bulunulan di\u011fer \u00e7al\u0131\u015fmalarda d\u00fc\u015f\u00fck LVEF ve artm\u0131\u015f viseral ya\u011f dokusu indeksi tespit edilmi\u015ftir. Obezite, daha d\u00fc\u015f\u00fck sa\u011f kalp fonksiyonu ile ili\u015fkili bulunmu\u015ftur.<\/p>\n

 <\/p>\n

MUSKULOSKELETAL RADYOLOJ\u0130<\/strong><\/span><\/h3>\n

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

Alt\u0131n Standart Olarak Direk Grafilerin Kullan\u0131ld\u0131\u011f\u0131 Klasik Metafiz Lezyonlar\u0131n Tan\u0131s\u0131nda Ultrasonografinin Do\u011fruluk Oran\u0131<\/strong><\/span><\/h5>\n

Karmazyn B, Marine MB, Wanner MR et al. Accuracy of ultrasound in the diagnosis of classic metaphyseal lesions using radiographs as the gold standard. Pediatr Radiol<\/em> 2020; 50: 1123\u20131130.<\/p>\n

https:\/\/doi.org\/10.1007\/s00247-020-04671-8<\/a><\/p>\n

Soru(lar): <\/strong>\u00c7ocuk istismar\u0131 \u015f\u00fcphesi olan vakalarda, klasik metafiz lezyonlar\u0131n\u0131n (KML) tan\u0131s\u0131nda ultrasonografi do\u011fru bir y\u00f6ntem midir?<\/p>\n

\u00c7al\u0131\u015fma dizayn\u0131:<\/strong> 2014\u2019ten 2017\u2019ye kadar prospektif \u00e7al\u0131\u015fma. \u00c7ift k\u00f6r bi\u00e7imde iki radyolog (Rad1 ve Rad2), her bir kat\u0131l\u0131mc\u0131ya ait bilateral distal femur ve sa\u011f ya da sol proksimal ve distal tibialar\u0131n ultrason g\u00f6r\u00fcnt\u00fclerini incelemi\u015ftir. Vakalar, direk grafide KML varsa pozitif, net bir \u015fekilde KML g\u00f6zlemlenemiyorsa negatif kabul edilmi\u015ftir. Direk grafi raporunda \u201cmuhtemel\u201d, \u201cku\u015fkulu\u201d ya da \u201cd\u00fc\u015f\u00fcnd\u00fcr\u00fcc\u00fc\u201d kelimelerinin kullan\u0131ld\u0131\u011f\u0131 vakalar, karars\u0131z kal\u0131nan vakalard\u0131r.<\/p>\n

Merkez(ler):<\/strong> Tek kurum, Riley \u00c7ocuk Hastanesi, Indianapolis (Single institution, Riley Hospital for Children, Indianapolis)<\/p>\n

Kat\u0131l\u0131mc\u0131lar: <\/strong>Bir ya\u015f alt\u0131nda 63 \u00e7ocu\u011fun\u00a0 241 metafiz b\u00f6lgesi incelendi. <\/strong>Dahil edilen \u00e7ocuklar \u00fc\u00e7 gruba ayr\u0131lm\u0131\u015ft\u0131r: kontrol grubu, muhtemel \u00e7ocuk istismar\u0131 nedeniyle direk grafi incelemeleri planlanm\u0131\u015f \u00e7ocuklar ve KML \u015f\u00fcphesiyle tetkiklerini tamamlam\u0131\u015f \u00e7ocuklar.<\/p>\n

Elde edilen veriler: <\/strong>US ile saptamada 2 radyolog aras\u0131ndaki duyarl\u0131l\u0131k, \u00f6zg\u00fcll\u00fck ve hassasiyet de\u011feri; kappa (<\/strong>g\u00f6zlemciler aras\u0131 uyum)<\/p>\n

Ana Sonu\u00e7lar:<\/strong> Ultrason g\u00f6r\u00fcnt\u00fcs\u00fcndeki KML varl\u0131\u011f\u0131n\u0131n kappa de\u011feri g\u00f6zlemciler aras\u0131 %96 uyumla 0.7 saptand\u0131. Ultrasonun sensitivitesi d\u00fc\u015f\u00fck (Rad1 ve Rad2 i\u00e7in s\u0131ras\u0131yla, %55 ve %63) spesifisitesi (Rad1 ve Rad2 i\u00e7in s\u0131ras\u0131yla, %98 ve %97) ve do\u011fruluk oran\u0131 y\u00fcksek \u00f6l\u00e7\u00fcld\u00fc (Her iki radyolog i\u00e7in %94)<\/p>\n

Yorumlar:<\/strong> ABD\u2019de iki ya\u015f alt\u0131 \u00e7ocuklarda, her \u015f\u00fcpheli \u00e7ocuk istismar\u0131 vakas\u0131nda direk grafi incelemeleri mecburidir ve ilgili k\u0131r\u0131klar\u0131n tan\u0131s\u0131nda referans kabul edilir. K\u0131r\u0131klar ultrasonografide tespit edilebilir; bu \u00e7al\u0131\u015fmada KML vakalar\u0131n\u0131n de\u011ferlendirilmesi i\u00e7in ultrasonografinin sensitivite, spesifisite ve do\u011fruluk oranlar\u0131 incelenmi\u015ftir. G\u00f6zlemciler aras\u0131 uyum, iki d\u00fczlemde elde edilen direk grafilere g\u00f6re daha y\u00fcksektir. KML tan\u0131s\u0131nda ultrasonun spesifisite ve do\u011fruluk de\u011ferleri y\u00fcksek fakat sensitivitesi d\u00fc\u015f\u00fckt\u00fcr. Bu y\u00fczden, direk grafilerde karars\u0131z kal\u0131nan KML de\u011ferlendirmelerinde ultrasonografi kullan\u0131\u015fl\u0131 bir ek y\u00f6ntemdir.<\/p>\n

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

\u00dcst Ekstremite K\u0131r\u0131\u011f\u0131 Olan \u00c7ocuklarda Ultrasonun Tan\u0131<\/strong><\/span>sal Do\u011frulu\u011fu: Sistematik \u0130nceleme ve Meta-analiz<\/span> <\/strong><\/h5>\n

Tsou PY, Ma YK, Wang YH, et al. Diagnostic accuracy of ultrasound for upper extremity fractures in children: a systematic review and meta-analysis. Article in Press. Am J of Emerg Med,<\/em> 2020.<\/p>\n

https:\/\/doi.org\/10.1016\/j.ajem.2020.04.071<\/a><\/p>\n

Soru(lar): <\/strong>\u00dcst ekstremite k\u0131r\u0131\u011f\u0131 olan \u00e7ocuklarda ultrasonun tan\u0131sal do\u011frulu\u011fu nedir?<\/p>\n

\u00c7al\u0131\u015fma dizayn\u0131:<\/strong> Veri tabanlar\u0131nDA (PubMed, EMBASE, Web of Science) Kas\u0131m 2019\u2019dan bu yana tan\u0131mlanan terimler kullan\u0131larak yap\u0131lan sistematik inceleme. Meta-analiz i\u00e7in iki de\u011fi\u015fkenli rastgele etki modeli (random-effects bivariate model) kullan\u0131lm\u0131\u015ft\u0131r. Ayr\u0131ca, k\u0131r\u0131k b\u00f6lgesinin alt grup analizi de yap\u0131lm\u0131\u015ft\u0131r (dirsek ve dirsek-olmayan).<\/p>\n

\u00c7al\u0131\u015fma Say\u0131s\u0131: <\/strong>\u00c7e\u015fitli k\u0131talardan dahil olan 32 \u00e7al\u0131\u015fma<\/p>\n

Uygulama: <\/strong>\u00dcst ekstremite k\u0131r\u0131klar\u0131 i\u00e7in ultrasonografi uygulamas\u0131<\/p>\n

Elde edilen veriler:<\/strong> \u00dcst ekstremite k\u0131r\u0131klar\u0131nda sonografik de\u011ferlendirmenin ve dirsek k\u0131r\u0131klar\u0131nda alt grup analizinin duyarl\u0131l\u0131k, \u00f6zg\u00fcll\u00fck, pozitif olabilirlik oran\u0131 (LR +), negatif olabilirlik oran\u0131 (LR-) ve ROC alt\u0131nda kalan alan (AUROC) de\u011ferleri analiz edilmi\u015ftir. K\u0131r\u0131k b\u00f6lgesinin tan\u0131sal hassasiyeti etkileyip etkilemedi\u011fini belirleme ama\u00e7l\u0131 meta-regresyon yap\u0131lm\u0131\u015ft\u0131r.<\/p>\n

Ana Sonu\u00e7lar<\/strong> Ultrasonografi tan\u0131s\u0131 i\u00e7in duyarl\u0131l\u0131k, \u00f6zg\u00fcll\u00fck pozitif olabilirlik oran\u0131 (LR +), negatif olabilirlik oran\u0131 (LR-) ve ROC alt\u0131nda kalan alan (AUROC) s\u0131ras\u0131yla 0.95, 0.95, 21.1, 0.05 ve 0.98 bulundu. Dirsek k\u0131r\u0131klar\u0131n\u0131n alt grup analizinde ise\u00a0 duyarl\u0131l\u0131k, \u00f6zg\u00fcll\u00fck, pozitif olabilirlik oran\u0131 (LR +), negatif olabilirlik oran\u0131 (LR-) ve ROC alt\u0131nda kalan alan (AUROC) s\u0131ras\u0131yla 0.95, 0.87, 7.3, 0.06 ve 0.96 saptand\u0131. Meta-regresyon, k\u0131r\u0131k b\u00f6lgesinin ultrasonografinin tan\u0131sal hassasiyetini etkiledi\u011fini g\u00f6stermi\u015ftir (Dirsek k\u0131r\u0131klar\u0131 vs dirsek d\u0131\u015f\u0131 k\u0131r\u0131klar i\u00e7in P<0.01).<\/p>\n

Yorumlar: <\/strong>Mevcut veriler, ultrasonografinin \u00e7ocuklarda \u00fcst ekstremite k\u0131r\u0131klar\u0131 i\u00e7in \u00fcst\u00fcn tan\u0131sal performans \u00f6zelliklerine sahip oldu\u011funu ve direk radyografilere alternatif olabilece\u011fini g\u00f6stermektedir. Ayr\u0131ca yazarlar, ek bir alt grup analizi olarak radyoloji taraf\u0131ndan ger\u00e7ekle\u015ftirilen ultrasonografiyi (Radiology-Performed US, RADUS), hasta ba\u015f\u0131 ultrasonografi (Point-of-Care US, POCUS) ile kar\u015f\u0131la\u015ft\u0131rmal\u0131 olarak de\u011ferlendirdiklerinde duyarl\u0131l\u0131k, \u00f6zg\u00fcll\u00fck, pozitif olabilirlik oran\u0131 (LR +), negatif olabilirlik oran\u0131 (LR-) ve ROC alt\u0131nda kalan alan\u0131 (AUROC) s\u0131ras\u0131yla 0.95, 0.96, 22.7, 0.06 ve 0.97 olarak saptad\u0131lar. Bu, POCUS’un potansiyel olarak RADUS’a benzer \u015fekilde performans g\u00f6sterebilece\u011fini \u00f6nerebilir; ancak d\u00fc\u015f\u00fck istatistiksel g\u00fc\u00e7 (POCUS i\u00e7in yap\u0131lan 17 \u00e7al\u0131\u015fma) ve kas-iskelet e\u011fitimi d\u00fczeyindeki geni\u015f yelpaze nedeniyle (klinisyenler taraf\u0131ndan 30 dakikal\u0131k aktif kat\u0131l\u0131ml\u0131 e\u011fitimlere k\u0131yasla radyologlar\u0131n seneler verdikleri deneyimleri) sonu\u00e7lar yorumlan\u0131rken, ultrasonografi kullan\u0131c\u0131ya ba\u011fl\u0131 bir y\u00f6ntem oldu\u011fundan, dikkatli olunmal\u0131d\u0131r.<\/p>\n

 <\/p>\n

G\u0130R\u0130\u015e\u0130MSEL RADYOLOJ\u0130<\/strong><\/span><\/h3>\n

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

Pediatrik Perk\u00fctan Gastrostomi\/Gastrojejunostomi T\u00fcp\u00fc Yerle\u015ftirme S\u0131ras\u0131nda Teknik Ba\u015far\u0131y\u0131 Artt\u0131rma Ama\u00e7l\u0131 Postpilorik Balon Okl\u00fczyonu<\/strong><\/span><\/h5>\n

Durand R, Cahill AM, Shellikeri S, et al. Postpyloric balloon occlusion to increase technical success during pediatric percutaneous gastrostomy\/gastrojejunostomy tube placement. J Vasc Interv Radiol <\/em>2020; 31:1139\u20131142.<\/p>\n

https:\/\/doi.org\/10.1016\/j.jvir.2020.03.004<\/a><\/p>\n

Soru(lar): <\/strong>Pediatrik perk\u00fctan gastrostomi\/gastrojejunostomi t\u00fcp\u00fc yerle\u015ftirme s\u0131ras\u0131nda konvansiyonel metotlar\u0131n ba\u015far\u0131s\u0131zl\u0131\u011f\u0131 durumunda postpilorik balon okl\u00fczyonu, gastrik ins\u00fcflasyonu maksimize eder mi?<\/p>\n

Tasar\u0131m: <\/strong>2016\u2019dan 2019\u2019a kadar retrospektif \u00e7al\u0131\u015fma.<\/p>\n

Merkez(ler): <\/strong>Tek kurum, Philadelphia \u00c7ocuk Hastanesi (Children\u2019s Hospital of Philadelphia)<\/p>\n

Kat\u0131l\u0131mc\u0131lar <\/strong>Postpilorik balon okl\u00fczyonunun kullan\u0131ld\u0131\u011f\u0131 vakalar se\u00e7ilmi\u015ftir. 155 besleme t\u00fcp\u00fc tak\u0131lan vakalar\u0131n 29\u2019u balon okl\u00fczyonuna ihtiya\u00e7 duymu\u015ftur. Hastalar\u0131n medyan ya\u015f\u0131 36 ayd\u0131r.<\/p>\n

Uygulama<\/strong>:Postpilorik balon okl\u00fczyonu; e\u011fer operat\u00f6r mide marjininin yeteri kadar subkostal olmad\u0131\u011f\u0131na karar vermi\u015fse, karaci\u011fer marjinini a\u00e7\u0131k h\u00e2le getirmediyse ya da ins\u00fcflasyon yap\u0131lan havada erken bir kay\u0131p varsa kullan\u0131lm\u0131\u015ft\u0131r.<\/p>\n

Elde edilen veriler: <\/strong>Teknik ba\u015far\u0131 oran\u0131.<\/p>\n

Ana Sonu\u00e7lar: <\/strong>Balon okl\u00fczyonu 29 hastan\u0131n 23\u2019\u00fcnde (%79.3) ba\u015far\u0131yla sonu\u00e7lanm\u0131\u015ft\u0131r. Bu da perk\u00fctan besleme t\u00fcp\u00fc yerle\u015ftirilmesindeki toplam ba\u015far\u0131 oran\u0131n\u0131 %80.1\u2019den %95.2\u2019ye \u00e7\u0131kartm\u0131\u015ft\u0131r.<\/p>\n

Yorumlar <\/strong>Postpilorik balon okl\u00fczyonu, \u00f6zellikle ba\u011f\u0131rsak ve karaci\u011fer interpozisyonu olan \u00e7ocuklarda perk\u00fctan besleme t\u00fcp\u00fc yerle\u015ftirme ba\u015far\u0131s\u0131n\u0131 art\u0131rabilir. Basit bir tekniktir ve 3 kg a\u011f\u0131rl\u0131\u011fa kadar k\u00fc\u00e7\u00fck \u00e7ocuklarda kullan\u0131labilir. Yazarlar bu tekni\u011fin uygun durumlarda glukagon yerine kullan\u0131labilece\u011fini belirtmektedir. Bu \u00e7al\u0131\u015fmada ba\u015far\u0131s\u0131z olan 6 vaka, kal\u0131c\u0131 kolonik interpozisyon, ince ba\u011f\u0131rsak distansiyonu ve hepatomegali dahil olmak \u00fczere etki edilemeyen fakt\u00f6rlere ba\u011flanm\u0131\u015ft\u0131r. Bu nedenle, bu teknik cerrahi besleme t\u00fcp\u00fc yerle\u015ftirme ihtiyac\u0131n\u0131 tamamen ortadan kald\u0131rmaz. Bu \u00e7al\u0131\u015fman\u0131n ve tekni\u011fin limitasyonlar\u0131, \u00f6rneklemin k\u00fc\u00e7\u00fck olmas\u0131 ve ek floroskopi s\u00fcresine ba\u011fl\u0131 olarak radyasyon maruziyeti art\u0131rmas\u0131d\u0131r.<\/p>\n

 <\/p>\n

N\u00d6RORADYOLOJ\u0130<\/strong><\/span><\/h3>\n

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

Bakteriyel Menenjitli \u0130nfantlarda Sens\u00f6rin\u00f6<\/strong>ral \u0130\u015fitme Kayb\u0131 <\/strong>Geli\u015fimini Tespit Etmede MRG<\/strong>\u2019nin Tan\u0131<\/strong><\/span>sal Do\u011frulu\u011fu<\/span> <\/strong><\/h5>\n

Orman G, Kukreja MM, Vallejo JG, et al. Accuracy of MR imaging for detection of sensorineural hearing loss in infants with bacterial meningitis. AJNR<\/em> 2020; 41: 1081\u20131086.<\/p>\n

http:\/\/dx.doi.org\/10.3174\/ajnr.A6539<\/a><\/p>\n

Soru(lar):<\/strong> Bakteriyel menenjiti olan infantlarda sens\u00f6rin\u00f6ral i\u015fitme kayb\u0131 geli\u015fimini saptamada MRG\u2019nin tan\u0131sal do\u011frulu\u011fu nedir?<\/p>\n

Tasar\u0131m:<\/strong> 2011\u2019den 2019\u2019a kadar retrospektif \u00e7al\u0131\u015fma.<\/p>\n

Merkez(ler): <\/strong>Tek kurum, Texas \u00c7ocuk Hastanesi\/ Baylor T\u0131p Fak\u00fcltesi, Houston, Texas (Texas Children\u2019s Hospital\/Baylor College of Medicine, Houston, Texas)<\/p>\n

Kat\u0131l\u0131mc\u0131lar:<\/strong> 115 infant<\/p>\n

Uygulama:<\/strong> Restrospektif bi\u00e7imde, 7-9 y\u0131l deneyimli ve sertifikal\u0131 iki pediyatrik n\u00f6roradyolog taraf\u0131ndan ba\u011f\u0131ms\u0131z ve k\u00f6r olarak beyin MRG incelemesi. Odyometrik test, t\u00fcm hastalarda sens\u00f6rin\u00f6ral i\u015fitme kayb\u0131 tan\u0131s\u0131 i\u00e7in referans kabul edilmi\u015ftir.<\/p>\n

\u00c7\u0131kt\u0131lar: <\/strong>Kontrastl\u0131 T1-a\u011f\u0131rl\u0131kl\u0131 g\u00f6r\u00fcnt\u00fclemenin (T1WI+C), FLAIR g\u00f6r\u00fcnt\u00fclemenin ve odyometrik test sonu\u00e7lar\u0131yla kombine de\u011ferlendirmenin; duyarl\u0131l\u0131k, \u00f6zg\u00fcll\u00fck, pozitif prediktif de\u011fer (PPD), negatif prediktif de\u011fer (NPD) ve tan\u0131sal do\u011fruluk de\u011ferleri. BOS k\u00fclt\u00fcr\u00fc, BOS glikozu, BOS proteini, BOS l\u00f6kosit say\u0131s\u0131 ve kan k\u00fclt\u00fcr\u00fcn\u00fc i\u00e7eren laboratuvar \u00f6l\u00e7\u00fcmleri de analiz edilmi\u015ftir.<\/p>\n

Ana Sonu\u00e7lar: <\/strong>T1WI+C i\u00e7in konsens\u00fcs sa\u011flanarak var\u0131lan duyarl\u0131l\u0131k, \u00f6zg\u00fcll\u00fck, PPD, NPD ve tan\u0131sal do\u011fruluk oranlar\u0131 s\u0131ras\u0131yla %61.4, %95.5, %83.3, %87.1 ve %86.3 olarak saptand\u0131. FLAIR g\u00f6r\u00fcnt\u00fcleme i\u00e7in konsens\u00fcs sa\u011flanarak var\u0131lan duyarl\u0131l\u0131k, \u00f6zg\u00fcll\u00fck, PPD, NPD ve do\u011fruluk oranlar\u0131 s\u0131ras\u0131yla %50, %93.6, %75, %83.1 ve %81.6 bulundu. T1WI+C, FLAIR g\u00f6r\u00fcnt\u00fclemeler ve kombine de\u011ferlendirme i\u00e7in g\u00f6zlemciler aras\u0131 uyum m\u00fckemmeldir (kappa > 0.9). Sens\u00f6rin\u00f6ral i\u015fitme kayb\u0131 ile ilgili istatistiksel olarak anlaml\u0131 fakt\u00f6rler, d\u00fc\u015f\u00fck BOS glukozu, y\u00fcksek BOS proteini ve pozitif BOS k\u00fclt\u00fcr\u00fcd\u00fcr.<\/p>\n

Yorumlar: <\/strong>\u0130\u00e7 kulak MRG\u2019sinde anormal kontrast tutulumu ve artm\u0131\u015f FLAIR sinyali, bakteriyel menenjiti olan infantlarda sens\u00f6rin\u00f6ral i\u015fitme kayb\u0131 tahmininde y\u00fcksek oranda spesifiktir; bu bulgular; enflamasyonla, kan-beyin bariyeri y\u0131k\u0131m\u0131yla ve bakteriyel menenjitte biriken anormal protein i\u00e7erikli s\u0131v\u0131yla ili\u015fkili olabilir. Bulgular, bakteriyel menenjitli hastalarda rutin beyin MRG s\u0131ras\u0131nda, i\u00e7 kulak yap\u0131lar\u0131n\u0131n daha dikkatli incelenmesi a\u00e7\u0131s\u0131ndan fark\u0131ndal\u0131k olu\u015fturmal\u0131d\u0131r.<\/p>\n

 <\/p>\n

T\u00fcm Temel Sekanslar \u0130le Bir-Dakikal\u0131<\/strong>k Ultra-H\u0131zl\u0131 Beyin MRG: Pediyatrik N\u00f6ro-G\u00f6r\u00fcnt\u00fclemede Gelecek Vadeden Bir Yol Olabilir Mi?<\/strong><\/span><\/h5>\n

Ha JY, Baek HJ, Ryu KH, et al. One-minute ultrafast brain MRI with full basic sequences: can it be a promising way forward for pediatric neuroimaging? AJR<\/em> 2020; 215: 198\u2013205.<\/p>\n

https:\/\/www.ajronline.org\/doi\/10.2214\/AJR.19.22378<\/a><\/p>\n

Soru(lar): <\/strong>Bir-dakikal\u0131k ultra-h\u0131zl\u0131 beyin MRG protokol\u00fc pediyatrik hastalarda klinik olarak uygulanabilir midir?<\/p>\n

\u00c7al\u0131\u015fma dizayn\u0131:<\/strong> Retrospektif \u00e7al\u0131\u015fma<\/p>\n

Merkez: <\/strong>Tek kurum , Gyeongsang Mill\u00ee \u00dcniversitesi T\u0131p Fak\u00fcltesi ve Gyeongsang Mill\u00ee \u00dcniversitesi Changwon Hastanesi, Kore Cumhuriyeti (Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Republic of Korea).<\/p>\n

Kat\u0131l\u0131mc\u0131lar:<\/strong> Normal ve anormal bulgular\u0131 olan 23 hasta.<\/p>\n

Uygulama<\/strong>:<\/strong> Rutin beyin MRG\u2019ye (total tarama zaman\u0131 9 dakika, 51 saniye) k\u0131yasla bir-dakikal\u0131k ultra-h\u0131zl\u0131 MRG (total tarama zaman\u0131 1 dakika, 11 saniye) protokol\u00fc.<\/p>\n

Elde edilen veriler:<\/strong> G\u00f6r\u00fcnt\u00fc kalitesini derecelendirmek i\u00e7in 4\u2019l\u00fc Likert \u00f6l\u00e7e\u011fi, okuyucular\u0131n derecelerini k\u0131yaslama ama\u00e7l\u0131 Wilcoxon testi ve\u00a0 iki ba\u011f\u0131ms\u0131z okuyucu aras\u0131ndaki g\u00f6zlemciler aras\u0131 uyum de\u011ferlendirildi.<\/p>\n

Ana Sonu\u00e7lar:<\/strong> Ultra-h\u0131zl\u0131 beyin MRG\u2019deki genel g\u00f6r\u00fcnt\u00fc kalitelerinin ve anatomik \u00f6l\u00e7\u00fctlerin ortalama de\u011ferleri rutin beyin MRG\u2019ye k\u0131yasla istatistiksel olarak anlaml\u0131 \u00f6l\u00e7\u00fcde d\u00fc\u015f\u00fck saptand\u0131. Ancak, ultra-h\u0131zl\u0131 beyin MRG g\u00f6r\u00fcnt\u00fcleri 4\u2019l\u00fc Likert \u00f6l\u00e7e\u011finde >2 puan alarak genel olarak yeterli g\u00f6r\u00fcnt\u00fc kalitesi ve anatomik detay\u0131 g\u00f6stermi\u015ftir. Her iki protokoldeki g\u00f6zlemciler aras\u0131 uyum %60-100 aras\u0131nda de\u011fi\u015fiklik g\u00f6stermi\u015ftir.<\/p>\n

Yorumlar<\/strong> Yazarlar, bir-dakikal\u0131k ultra-h\u0131zl\u0131 beyin MRG protokol\u00fcn\u00fcn rutin beyin MRG protokol\u00fcne k\u0131yasla tan\u0131 ama\u00e7l\u0131 yeterli g\u00f6r\u00fcnt\u00fc kalitesine sahip oldu\u011fu sonucuna varm\u0131\u015flard\u0131r. K\u0131sa tarama zaman\u0131 ile; tarama hatas\u0131, sedasyon ihtiyac\u0131 ve MRG ile ili\u015fkili anksiyetenin azalmas\u0131 sa\u011flanabilir. K\u00fc\u00e7\u00fck \u00f6rneklem grubu, d\u00fc\u015f\u00fck g\u00f6zlemciler aras\u0131 uyum ve g\u00f6r\u00fcnt\u00fc kalitesi analizindeki s\u00fcbjektiflik \u00e7al\u0131\u015fmadaki limitasyonlard\u0131r.<\/p>\n

 <\/p>\n

KAL\u0130TE VE G\u00dcVENL\u0130K<\/strong><\/span><\/h3>\n

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

Genel Pediyatrik Bilgisayarl\u0131 Tomografi Muayeneleri S\u0131ras\u0131nda Refakat\u00e7inin Radyasyon Dozu<\/span> <\/strong><\/h5>\n

Overhoff D, Weis M, Riffel P, et al. Radiation dose of chaperones during common pediatric computed tomography examinations. Pediatr Radiol<\/em> 2020; 50: 1078\u20131082.<\/p>\n

https:\/\/doi.org\/10.1007\/s00247-020-04681-6<\/a><\/p>\n

Soru(lar): <\/strong>\u00c7ocuklara BT taramas\u0131 esnas\u0131nda e\u015flik eden eri\u015fkin refakat\u00e7ilerin maruz kald\u0131\u011f\u0131 radyasyon dozu nedir?<\/p>\n

\u00c7al\u0131\u015fma dizayn\u0131: <\/strong>Prospektif \u00e7al\u0131\u015fma. \u0130ki protokol kullan\u0131lm\u0131\u015ft\u0131r: 1) g\u00f6\u011f\u00fcs modeli, 2) rutin g\u00f6\u011f\u00fcs taramalar\u0131ndaki pediyatrik hastalar<\/p>\n

Merkez(ler): <\/strong>Tek kurum, Mannheim \u00dcniversite Medikal Merkezi, Heidelberg \u00dcniversitesi (Single institution, University Medical Center Mannheim, Heidelberg University)<\/p>\n

Kat\u0131l\u0131mc\u0131lar: <\/strong>Model kullan\u0131larak yap\u0131lm\u0131\u015f 10 tarama ve rutin pediyatride yap\u0131lm\u0131\u015f 12 taramadan 3 total dozimetre \u00f6l\u00e7\u00fcm\u00fc<\/p>\n

Giri\u015fim:<\/strong> BT taray\u0131c\u0131s\u0131 etraf\u0131na birbirinden farkl\u0131 yerlere (gantri a\u00e7\u0131kl\u0131\u011f\u0131nda, gantriden 1 m uzakl\u0131kta ve gantri yan\u0131nda) 3 dozimetre yerle\u015ftirilmi\u015ftir. Radyasyon dozlar\u0131 kaydedilmi\u015ftir.<\/p>\n

Elde edilen veriler:<\/strong> 1., 2. ve 3. dozimetrenin \u201cTotal Radyasyon Dozu (\u03bcSv)\u201d<\/p>\n

Ana Sonu\u00e7lar<\/strong> 1. protokolde; Dozimetre 1\u2019de 3 \u03bcSv, Dozimetre 2\u2019de 1 \u03bcSv total radyasyon dozu \u00f6l\u00e7\u00fclm\u00fc\u015f olup Dozimetre 3\u2019te hi\u00e7 radyasyon saptanamam\u0131\u015ft\u0131r. 2. protokolde; Dozimetre 1\u2019de 2 \u03bcSv, Dozimetre 2\u2019de 1 \u03bcSv total radyasyon dozu \u00f6l\u00e7\u00fcl\u00fcrken Dozimetre 3\u2019te hi\u00e7 radyasyon saptanamam\u0131\u015ft\u0131r.<\/p>\n

Yorumlar <\/strong>Her iki protokolde de, gantri yan\u0131ndaki dozimetrede hi\u00e7 saptanmamakla beraber, b\u00fct\u00fcn dozimetrelerde d\u00fc\u015f\u00fck radyasyon dozlar\u0131 \u00f6l\u00e7\u00fclm\u00fc\u015ft\u00fcr. Model \u00fczerindeki ve ger\u00e7ek klinik taramalardaki doz \u00f6l\u00e7\u00fcm farkl\u0131l\u0131klar\u0131 sa\u00e7\u0131l\u0131ma ba\u011flanm\u0131\u015ft\u0131r. \u00c7al\u0131\u015fman\u0131n limitasyonlar\u0131 aras\u0131nda, doz \u00f6l\u00e7\u00fcmlerinin tek bir y\u00fckseklikten yap\u0131lmas\u0131 ve refakat\u00e7iler taraf\u0131ndan giyilen kur\u015fun \u00f6nl\u00fck varl\u0131\u011f\u0131n\u0131n hesaba kat\u0131lmamas\u0131 bulunmaktad\u0131r. Bu sonu\u00e7lar, v\u00fccudun di\u011fer k\u0131s\u0131mlar\u0131na yap\u0131lan taramalarda ya da floroskopi gibi farkl\u0131 tip y\u00f6ntemlerde kullan\u0131lamayabilir. Ancak bununla birlikte \u00f6l\u00e7\u00fclen dozlar\u0131n d\u00fc\u015f\u00fckl\u00fc\u011f\u00fc, refakat\u00e7ilerin BT taramalar\u0131nda emniyetli bir \u015fekilde \u00e7ocuklara e\u015flik etmesine g\u00fcvence vermektedir.<\/p>\n","protected":false},"excerpt":{"rendered":"ABDOM\u0130NAL G\u00d6R\u00dcNT\u00dcLEME \u00a0 Abdominal Radyografilerde G\u00f6r\u00fclen Gaz Yoklu\u011funun Pediyatrik Adheziv \u0130nce Ba\u011f\u0131rsak Obstr\u00fcksyonunda \u00d6nemi Johnson […]","protected":false},"author":3,"featured_media":3056,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[209],"tags":[],"class_list":["post-7257","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-tr"],"yoast_head":"\nWhat\u2019s new in Pediatric Imaging (Turkish) \u2013 August 2020 - ACORE<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/staging-hub.acoredu.com\/whats-new-in-pediatric-imaging-august-2020\/\" \/>\n<meta property=\"og:locale\" content=\"tr_TR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What\u2019s new in Pediatric Imaging (Turkish) \u2013 August 2020 - ACORE\" \/>\n<meta property=\"og:description\" content=\"ABDOM\u0130NAL G\u00d6R\u00dcNT\u00dcLEME \u00a0 Abdominal Radyografilerde G\u00f6r\u00fclen Gaz Yoklu\u011funun Pediyatrik Adheziv \u0130nce Ba\u011f\u0131rsak Obstr\u00fcksyonunda \u00d6nemi Johnson […]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/staging-hub.acoredu.com\/whats-new-in-pediatric-imaging-august-2020\/\" \/>\n<meta property=\"og:site_name\" content=\"ACORE\" \/>\n<meta property=\"article:published_time\" content=\"2020-08-06T12:38:50+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2020-08-07T11:05:00+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/staging-hub.acoredu.com\/wp-content\/uploads\/2020\/07\/broken-leg-x-ray-scanning-PWB9QTL-1-scaled.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"2560\" \/>\n\t<meta property=\"og:image:height\" content=\"1678\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Abdelrahman\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Yazan:\" \/>\n\t<meta name=\"twitter:data1\" content=\"Abdelrahman\" \/>\n\t<meta name=\"twitter:label2\" content=\"Tahmini okuma s\u00fcresi\" \/>\n\t<meta name=\"twitter:data2\" content=\"19 dakika\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/staging-hub.acoredu.com\/whats-new-in-pediatric-imaging-august-2020\/\",\"url\":\"https:\/\/staging-hub.acoredu.com\/whats-new-in-pediatric-imaging-august-2020\/\",\"name\":\"What\u2019s new in Pediatric Imaging (Turkish) \u2013 August 2020 - ACORE\",\"isPartOf\":{\"@id\":\"https:\/\/staging-hub.acoredu.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/staging-hub.acoredu.com\/whats-new-in-pediatric-imaging-august-2020\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/staging-hub.acoredu.com\/whats-new-in-pediatric-imaging-august-2020\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/staging-hub.acoredu.com\/wp-content\/uploads\/2020\/07\/broken-leg-x-ray-scanning-PWB9QTL-1-scaled.jpg\",\"datePublished\":\"2020-08-06T12:38:50+00:00\",\"dateModified\":\"2020-08-07T11:05:00+00:00\",\"author\":{\"@id\":\"https:\/\/staging-hub.acoredu.com\/#\/schema\/person\/75293c6e4870f3aa293e1394c53df6b7\"},\"breadcrumb\":{\"@id\":\"https:\/\/staging-hub.acoredu.com\/whats-new-in-pediatric-imaging-august-2020\/#breadcrumb\"},\"inLanguage\":\"tr\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/staging-hub.acoredu.com\/whats-new-in-pediatric-imaging-august-2020\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"tr\",\"@id\":\"https:\/\/staging-hub.acoredu.com\/whats-new-in-pediatric-imaging-august-2020\/#primaryimage\",\"url\":\"https:\/\/staging-hub.acoredu.com\/wp-content\/uploads\/2020\/07\/broken-leg-x-ray-scanning-PWB9QTL-1-scaled.jpg\",\"contentUrl\":\"https:\/\/staging-hub.acoredu.com\/wp-content\/uploads\/2020\/07\/broken-leg-x-ray-scanning-PWB9QTL-1-scaled.jpg\",\"width\":2560,\"height\":1678,\"caption\":\"Broken Leg of Little Children X Ray Scanning. 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